A casework study: The effect of the porcine digestive process on animal carcasses and human teeth.

What happens if a human body is fed to pigs? Although a popular notion in the entertainment industry, no scientific published literature exists that documents this porcine feeding behaviour, nor, more importantly, what elements of the cadaver may survive such a process. A study conducted in 2020, born out of a casework enquiry, aimed to investigate the following two questions; Would pigs feed on a human body? And, if so, what could be recovered post feeding event? Kangaroo carcasses, porcine carcasses (as human analogues) and 90 human teeth were prepared, and fed, to two domestic pigs, in a variety of feed scenarios. Biological traces including bones, bone fragments, teeth and tooth fragments were recovered both post-digestion from the faeces of the pigs, as well as uneaten from the porcine enclosure. 29% of all human teeth were recovered from the study; 35% of which were recovered post-digestion from the faeces and 65% were recovered uneaten from the porcine enclosure, Of the recovered human teeth, 81% were deemed suitable for identification by a forensic odontologist. From the 447 bones recovered from the enclosure, 94% could be identified to a bone type and species. From all 3338 bone fragments recovered from the faeces of the pigs, none retained any morphological traits that would allow further intelligence to be generated. Overall, it was found that pigs will feed on human analogues and will consume soft tissue, bones, and human teeth. Biological traces in the form of bones, bone fragments, teeth and tooth fragments may be recovered both post-digestion from the faeces, or from the porcine enclosure. The biological traces can be used for identification of an individual via forensic odontology, identification of a species via forensic anthropology and may be suitable for DNA analysis. The outcomes of this study generated new avenues for investigation in the case and may be used to inform future operational resources.

Establishing and developing a paediatric psychodermatology service and our experience of a new paediatric psychodermatology clinic during the Covid 19 pandemic.

Children and young people (CYP) with skin and hair conditions are at an increased risk of mental health problems and vice versa. Current child and adolescent mental health services are already stretched and in our experience, this unique combination of symptoms and signs requires a multi-disciplinary approach. We report our experience of establishing a paediatric psychodermatology clinic where, at each appointment, CYP are seen by a consultant dermatologist and a clinical psychologist initially jointly and then individually to ensure all viewpoints are heard and a collaborative treatment plan can be agreed. The clinic was established one month prior to the national lockdown during the COVID-19 pandemic and the face-to-face model was converted to a virtual format. CYP are now seen either face to face or virtually according to CYP/parent/carer preference and this hybrid model increases accessibility and has reduced DNA rates. Referrals were received from primary, secondary and tertiary care settings. Thirty -six new patients were seen and followed-up over a 2 year period, age range 3-17 years old. The majority of patients presented with compulsive hair pulling (trichotillomania) and medically unexplained signs (dermatitis artefacta); other problems seen were eczema, skin picking and acne. Half of the patients required additional psychology sessions. Seventy-six percent of patients have been discharged, almost half back to the care of their general practitioner. We use pre- and post-clinic questionnaires and share these and feedback from CYP/families who have found this clinic model helpful and effective.

Operationalising forensic genetic genealogy in an Australian context.

Forensic genetic genealogy, a technique leveraging new DNA capabilities and public genetic databases to identify suspects, raises specific considerations in a law enforcement context. Use of this technique requires consideration of its scientific and technical limitations, including the composition of current online datasets, and consideration of its scientific validity. Additionally, forensic genetic genealogy needs to be considered in the relevant legal context to determine the best way in which to make use of its potential to generate investigative leads while minimising its impact on individual privacy. This article presents these issues from an Australian perspective, with the observations and conclusions likely to be applicable to other jurisdictions.

From Identification to Intelligence: An Assessment of the Suitability of Forensic DNA Phenotyping Service Providers for Use in Australian Law Enforcement Casework.

Forensic DNA Phenotyping (FDP) is an established but evolving field of DNA testing. It provides intelligence regarding the appearance (externally visible characteristics), biogeographical ancestry and age of an unknown donor and, although not necessarily a requirement for its casework application, has been previously used as a method of last resort in New South Wales (NSW) Police Force investigations. FDP can further assist law enforcement agencies by re-prioritising an existing pool of suspects or generating a new pool of suspects. In recent years, this capability has become ubiquitous with a wide range of service providers offering their expertise to law enforcement and the public. With the increase in the number of providers offering FDP and its potential to direct and target law enforcement resources, a thorough assessment of the applicability of these services was undertaken. Six service providers of FDP were assessed for suitability for NSW Police Force casework based on prediction accuracy, clarity of reporting, limitations of testing, cost and turnaround times. From these assessment criteria, a service provider for the prediction of biogeographical ancestry, hair and eye colour was deemed suitable for use in NSW Police Force casework. Importantly, the study highlighted the need for standardisation of terminology and reporting in this evolving field, and the requirement for interpretation by biologists with specialist expertise to translate the scientific data to intelligence for police investigators.

Systemic hypersensitivity reaction to Omnipaque radiocontrast medium: a case of mini-DRESS.

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a delayed drug reaction defined by physical signs and laboratory parameters. Mini-DRESS is a new entity, in cases that display some but not all features of DRESS. Cases of mini-DRESS have a less protracted course, and respond well to systemic corticosteroid treatment.

Glucocorticoid treatment and impaired mood, memory and metabolism in people with diabetes: the Edinburgh Type 2 Diabetes Study.

OBJECTIVE: Both type 2 diabetes and glucocorticoid therapy are highly prevalent. Although people with type 2 diabetes may be more susceptible to adverse effects of glucocorticoids, and it is recommended that glucocorticoid therapy is avoided for fear of worsening glycaemic control, the extent to which this advice is followed and the consequences when glucocorticoids are prescribed are poorly documented. The aim was to assess the characteristics of people with type 2 diabetes prescribed glucocorticoids in a real-world setting and to quantify resulting adverse effects. DESIGN: Cross-sectional cohort study. METHODS: Cardiometabolic variables, body fat distribution, cognitive function and mood were studied in the 1066 participants of the Edinburgh Type 2 Diabetes Study, of whom 162 (15%) were taking systemic, topical or inhaled glucocorticoids. RESULTS: Glucocorticoid therapy was more common in women and in smokers but was not avoided in patients with diabetic complications or cardiovascular risk factors. People taking glucocorticoids were more centrally obese with slightly higher HbA1c and total serum cholesterol but were no more likely to have hepatic steatosis or hypertension. Glucocorticoid treatment was associated with substantially lower mood and greater anxiety. Women taking glucocorticoid therapy were twice as likely to report depressive symptoms compared with those not taking treatment. Glucocorticoid therapy was also associated with poorer cognitive function among those with subclinical atherosclerosis, as indicated by low ankle-brachial pressure index. CONCLUSIONS: Glucocorticoids are prescribed commonly for people with type 2 diabetes despite being associated with adverse indices of glycaemic control, cardiovascular risk factors, mood and cognitive function.