Criminological and Medico-legal Aspects in Homicidal and Suicidal Sharp Force Fatalities.

The interpretation of sharp force fatality dynamics may be difficult in some cases, but a contribution to analysis of the phenomenon may be provided by case studies. Therefore, the purpose of our study is focused on identifying, in observed sharp force fatalities, reliable parameters that can differentiate a homicidal and suicidal manner of death, with particular reference to criminological parameters. Data derived from sharp force fatality cases in Padua and Venice from 1997 to 2019, anonymized and collected in Excel, included personal, circumstantial, clinical, and psychopathological-criminological data, as well as crime scene investigation, necroscopic, and toxicological data. Statistical analyses were performed using chi-square and Wilcoxon rank-sum tests. Possible predictors of homicide were analyzed by logistic regression. Six parameters (bloodstains distant from the body, clothing lacerations, hesitation/defense wounds, number of injuries, and potential motives) were significantly different in the two groups (p < 0.05). An independent statistical association between potential motives explaining the crime (p < 0.001; OR 27.533) and homicide on multiple logistic regression analysis was highlighted. The absence of clothing lacerations was inversely related to homicide (p = 0.002, OR 0.092). To the best of our knowledge, this is one of very few Italian studies concerning the differential diagnosis between homicidal and suicidal sharp force fatalities. The dynamics of the event is established in most cases by the integrated evaluation of data from crime scene investigation and the autopsy. Nevertheless, in an atypical scenario, a psychopathological-criminological analysis may provide essential elements, and particular attention should be given to the identification of potential explanatory motives.

Post-mortal lesions in freshwater environment.

Postmortem animal feeding activity may cause considerable damage to bodies resulting in the modification of wounds, loss of identifying features and injury. Certain postmortem lesions may appear inflicted or non-inflicted antemortem injuries. At present, apart from cases in sea water, no data are available about post mortal lesions performed by aquatic organisms. This note that represents the first report concerning colonisation of a dead body by crustaceans a few hours after death, describes injuries caused by the amphipod Niphargus elegans on the face, and in particular on the eye region, of a young man dead by drowning. The lesions recorded in this case are comparable with the lesions caused by ants. The high plasticity in the food choice can allow Amphipoda to colonise drowning bodies in every moment after dead, however the benthonic behaviour of these animals suggests a more important role in the colonisation during post-mortem submersion periods.

Machinery-related deaths: relevance of workplace investigation and antemortem radiological data in reconstructing the fatality.

Machinery-related fatalities are one of the leading causes of traumatic occupational deaths. In our report, we present the case of a 40-year-old male who suffered a severe head trauma while working in a cut-foam industry and died despite an early craniectomy. The radiological reconstruction of the skull based on preoperative computed tomography scans disclosed a large depressed conical fracture of the left parietal bone. The 3D-reconstruction of the work area, combined with a fit-matching analysis between the machinery and the depressed skull fracture allowed us to conclude that the head was crushed between the sliding bar of the cutting device and the metallic protuberance on the opposite side. The case underlines the importance of a detailed workplace investigation and of a thorough evaluation of all circumstantial, clinical, radiological, and autopsy data in the reconstruction of machinery-related fatalities to identify any possible legal responsibilities of the worker and/or the employer.

Onset and progression of fatal coronary dissection during angiography.

Coronary angiography was performed in a 43-year-old man admitted to hospital for chest pain. The first frames after the injection of contrast medium showed plaque in the left main coronary artery and subtotal stenosis of the mid-left anterior descending coronary artery. Dissection of the left main coronary artery appeared, with intimal flaps at the proximal segment of the main trunk and the origin of the left anterior descending artery. Dissection rapidly progressed into the circumflex artery and left anterior descending coronary artery. Although two stents were deployed in the left main coronary artery, the patient died of ventricular fibrillation.

[The early semiautomatic defibrillation: legislative Italian framing and medical-legal aspects]. / La defibrillazione semiautomatica precoce: inquadramento legislativo italiano e risvolti medico-legali.

Following Anglosaxon experience, automatic external defibrillators (AEDs), devices capable of automatically identifying a defibrillating rhythm and triggering a life-saving discharge, are now becoming widespread in Italy too. Their extremely simple functioning, and diagnostic sensitivity combined with diagnostic specificity all mean that AEDs can even be used by non-medical personnel (nurses) and, more extensively and after proper training, also by "first responders" who are not necessarily healthcare-related (red cross volunteers, members of the police force, firemen, etc.). In this sense Italian law no. 120/2001, enacted in the interests of the collectivity, and its later provisions approved at the conference of the Italian state and regional authorities in 2003, admits this type of application. AED safety assurance means that these devices can also be used by ordinary people who are not trained and have no specific obligations, but who suddenly find themselves in an emergency situation. However, medical personnel, paramedics and non-healthcare-related "first responders" trained in the use of AEDs, are required to apply them in suitable circumstances and, if they do not, may be accused of refusal to act in an official capacity, omission of first aid, and manslaughter.