Serum biochemical markers in drowning: diagnostic efficacy of Strontium and other trace elements.

The aim of our study was to analyse several serum biochemical markers in order to evaluate the discriminant capacity of trace elements individually and jointly in drowning (seawater drowning and freshwater drowning) and their correlation with age, sex, postmortem interval, time in water and concentrations of the trace elements in the drowning medium. Sixty-seven cases of drowning (53 seawater drownings (SWD); 14 freshwater drownings (FWD) and 73 control cases (other asphyxias, n=44, and other causes of death, n=29) were selected according to the scene, cause and circumstances of death, together with autopsy findings. Serum strontium (Sr), magnesium (Mg), sodium (Na), chloride (Cl), calcium (Ca), iron (Fe), urea, creatinine (Cr) and cardiac Troponine T (cTn-T) were measured in the left ventricle (Lv), right ventricle (Rv) and peripheral blood. Lv-Rv differences for each marker and Sr, Mg, Na, Cl, Ca and Fe concentrations in the drowning medium were determinated. Mean concentrations of Sr, Cl and Mg in both ventricles and peripheral serum and Lv-Rv differences and Ca Lv and Na Rv were significantly higher in cases of drowning than for other causes of death. In SWD, Sr, Mg, Ca, Na and Cl were significantly higher in Lv than in Rv as a result of aspirating water. In contrast, haemodilution is evident from the significantly higher levels of Fe and urea in Rv than in Lv in cases of SWD, and from the higher Mg and Cr levels in Rv in FWD. In the case of SWD, serum levels of Sr are confirmed as the best parameter for diagnosis, although other trace elements may also be useful, such as the serum concentrations of Mg and Cl. In the case of FWD, the joint determination of Sr and other biochemical markers, especially Fe, may increase correct diagnosis.

Strontium levels in different causes of death: diagnostic efficacy in drowning.

Trace element determination can be applied in forensic medicine to diagnose the cause of death. Drowning is the second leading cause of death from unintentional injury. Despite the many diagnostic methods used, the post-mortem diagnosis of drowning continues to be one of the most difficult in forensic pathology. Strontium is a highly sensitive marker of water aspiration in a liquid medium rich in this metal. The aims of this study were to confirm the diagnostic value of strontium in cases of drowning compared with other causes of death, to analyse factors that could affect its concentration and to ascertain the sensitivity and specificity of strontium in right and left ventricles and peripheral serum for the post-mortem diagnosis of drowning. We studied 120 cadavers selected from medico-legal autopsies with different causes of death. Strontium (Sr) levels were measured in the serum (left and right ventricles and peripheral vein) of all cadavers and, in the case of drowning, in the water medium itself, by using Zeeman AAS. Our results confirm the usefulness of blood Sr levels for diagnosing seawater and freshwater drowning, although great care should be exercised in the latter case.

Histological findings and immunohistochemical surfactant protein A (SP-A) expression in asphyxia: its application in the diagnosis of drowning.

The histopathological alterations that permit the diagnosis of death by asphyxia are very unspecific, although pulmonary alterations are of great importance in this respect. The postmortem diagnosis of drowning, particularly, continues to be one of the most difficult in forensic pathology. The aim of this study is to jointly evaluate microscopic findings and immunohistochemical surfactant protein A (SP-A) expression in the upper and lower lobes of lungs in different causes of death, and their possible application to the diagnosis of drowning. We studied 120 cadavers from subjects with a mean age of 48.73 years (SD 19.45; range 2-86 years), and with a mean post-mortem interval of 30 hours (SD 39.59; range 3-216 hours). According to the scene, cause and circumstances of death, and autopsy findings, cases were classified into groups as follows: (a) drowning (n=47); (b) other asphyxia (n=44) and (c) other causes (n=29). In the upper and lower lobes of lungs, histological studies of H&E staining and immunohistochemical surfactant protein A expression were made. The presence and severity of congestion, haemorrhage and oedema, together with immunohistochemical SP-A expression, may have a diagnostic value in differentiating asphyxia and drowning from other causes of death, and drowning from other types of asphyxia. Our findings suggest that both lobes should be investigated to establish the diagnosis, although the findings in the upper lobe might be the most important for differentiating the exact cause of death.

A study among the population of Sevilla of death due to submersion.

Death due to submersion is of great interest from the medical-legal point of view, given the increase in nautical activity among children and adults alike over the past number of years. However, the lack of reliable statistical data concerning the impact of this specific form of death in our country must be emphasized. These are the circumstances that have led us to study the incidence of this form of death in a specific area. The population analyzed lived in the city of Sevilla during the period 1967-1993.

Precision of estimating time of death by vitreous potassium--comparison of various equations.

This paper is a study of the precision of estimating the time since death comparing the equations developed by different authors. Our aim is to determine with the maximum degree of accuracy the exact time of death of the individual. We consider that the study has been fully justified by the observed differences in the results obtained from the different equations under study when the concentration of potassium in the vitreous humour was identical.

Group-specific component (GC) polymorphism in Cádiz (southern Spain).

The genetic polymorphism of group-specific component (GC) was analysed in a sample of 443 healthy unrelated subjects of both sexes resident in the province of Cádiz (Southern Spain). Isoelectric focusing was carried out in polyacrylamide gels followed by staining with coomassie blue R 250. The estimated gene frequencies were as follows: GC*1S = 0.6185; GC*1F = 0.1162; GC*2 = 0.2652.

Polymorphisms of the enzyme systems galactose-1-phosphate uridyltransferase (GALT) and esterase D (EsD) in the province of Cádiz, southern Spain.

Galactose-phosphate uridyltransferase (GALT) and esterase D (EsD) phenotypes were determined by isoelectric focusing in ultrathin-layer polyacrylamide gel (PAGIF) for 406 healthy subjects randomly chosen and residing in the province of Cádiz, in Southern Spain. The following gene frequencies were observed: for GALT, GALT1 = 0.952 970 3 and GALT2 = 0.047 029 71; for EsD, EsD1 = 0.895 320 2, EsD2 = 0.094 827 59, and EsD5 = 0.009 852 21.

Polymorphism of the plasminogen (PLG) system in Cádiz Province, southern Spain.

In this work, the authors report a plasminogen (PLG) system genetic-population study in a sample of 378 healthy subjects, of both sexes and unrelated, all resident in the province of Cádiz in Southern Spain. In this study, the PLG types were determined by isoelectric focusing in polyacrylamide gels (PAGIF), followed by staining with Coomassie blue. The genic frequencies obtained were the following: PLG A = 0.833 333 3; PLG B = 0.166 666 7.

Transferrin gene frequencies in Cádiz (southern Spain).

The genetic polymorphism of transferrin (Tf) was studied in a sample of 385 healthy unrelated subjects of both sexes resident in the province of Cádiz (southern Spain). Isoelectric focusing was carried out in polyacrylamide gels, followed by staining with Coomassie Blue R250. The gene frequencies obtained were as follows: Tf C1, 0.7922; Tf C2, 0.1883; Tf C3, 0.0195.