Immediate fatal outcome vs. fatal outcome within the first 48 hours following a severe traffic trauma--analysis of the possible effect of alcohol intoxication on the outcome.

UNLABELLED: This paper is a retrospective analysis of data on 278 persons with fatal outcomes in traffic accidents in Osjecko--baranjska County, Croatia, during a five-year period. The observed sample of casualties was divided according to the time of fatal outcome into three groups: immediately deceased (139 or 50.0%), deceased within the first 48 hours (84 or 30.2%) and deceased after 48 hours (55 or 19.8%). A comparison of data was made for the first two groups of casualties, based on the level of alcohol intoxication, and an analysis of the possible influence of alcohol intoxication on an early outcome of severe trauma, which was defined as immediate fatal outcome and fatal outcome within the first 48 hours following the trauma. Casualties from the group of immediately deceased had a significantly higher average blood alcohol level than casualties from the group of persons deceased within the first 48 hours (shown through arithmetic mean of 0.81 g/kg vs. 0.33 g/kg, p =0.000). A binary logistic regression analysis showed that every increase in blood alcohol level by 1 g/kg also increased the odds of an immediate fatal outcome by 1.92 times (p=0.004). CONCLUSION: Beside increased risks of traffic accidents, the collected data showed that alcohol intoxication of accident participants also increases their chances of an immediate fatal outcome.

Double suicide.

Most suicides are solitary and private; but few result from a pact between 2 people to die together. Two young men made a pact to commit suicide by hanging from a tree. It was the first case among 1320 single suicides in more than 2 decades in eastern Croatia. Double suicide between people of the same gander is an unusual event. It is predominantly made by male-female partners and by less violent methods. One of the 2 members experienced depression. He may have been the initiator and the other partner may have been the dependent. The initiator usually plans the act and stimulates the other party. Whether the decision was evenly shared by both partners and initiative came from one of the two or it was result of 2 independent decisions remains open for analysis. Double suicide is also very interesting from the perspective of medical examiners. They need to make comprehensive postmortem examination to finally conclude the proper cause and the manner of death.

Evaluation of the reliability of DNA typing in the process of identification of war victims in Croatia.

Aiming to estimate the frequency of various types of errors that can occur in the large-scale process of identification, we identified and compared genotypes of 911 parent-child pairs in the database of 3498 relatives of people that disappeared during the 1991/1992 war in Croatia. Genotypes of 891 pairs (97.8%) were matching, while 20 pairs did not match in one or more loci. Reanalysis of these samples revealed that out of 1822 analyzed genotypes, one genotype was completely wrong, and two genotypes had one wrong allele because of human errors. Five genotypes had a single wrong allele due to either polymerase chain reaction or electrophoresis errors. In five genotypes mutations were the cause of mismatch. Genetic inconsistencies with parentage were found in four "fathers" (4.2%) and three "mothers" (0.36%). As the majority of observed single-locus errors were caused by nonhuman errors, all databases produced with similar technology would probably have comparable level of errors.

Infanticide in Eastern Croatia.

For the layperson no crime is more difficult to comprehend than the killing of a child by his or her own parents. This is a retrospective study of neonaticide and infanticide in Eastern Croatia from 1980 to 2004. Judicial records of infanticide cases stored in Regional and County Courts were analyzed for the circumstances surrounding the offense. Twenty-four babies were discovered in various places during investigating period of time. The victims were almost equally divided between boys (12) and girls (11). The gender of one baby was unknown. The mean weight of babies was 2.7 SD = 0.66 kg. The perpetrators preferred rubbish-heaps (33.4%), burying in soil (16.7%), various premises in or around the house (16.7%) and garbage cans (12.5%) as places for hiding the dead babies. The most dominant cause of death in sixteen cases of live birth was asphyxia (37%) with equal distribution of smothering, stuffing the mouth with rags and strangulation. Other frequent causes of death were placing the child in a plastic bag and abandonment (25%), brain injury (25%) and wounding using a sharp weapon (12.5%). The cause of death for six babies remained unknown due to advanced decomposition. Two babies were stillborn. The age of accused mothers varied from 16 to 33, mean 24 SD=5.2 years. Most of them were unmarried (60%) and had limited formal education. They usually kept the pregnancy a secret (73%) and gave birth (93%) without public welfare assistance. The mother lived in the terror of shame and with the guilt that accompany conception without marriage. Fear seemed to be a pronounced motivating factor for committing infanticide. The data on court proceedings were available in fifteen cases. The mothers were officially indicted in all cases for infanticide under the Croatian Criminal Code. The perpetrator remained unidentified in nine suspicious crimes. The court convicted ten mothers of the crime of infanticide. Often juries were unwilling to punish the mother, citing the mother's lifelong guilt of having killed her child as enough punishment.

Morphological classification and sexual dimorphism of hyoid bone: new approach.

Hyoid bone is a part of viscerocranium placed between the tongue root and thyroid cartilage to which it is connected by thyrohyoid membrane. Widely accepted morphological classification does not exist. Sexual dimorphism was analysed in this study and new guidelines for anatomical classification of hyoid bones based on anthropometric parameters were given. Total number of analysed bones was 70. The bones were classified into three groups: symmetrical U-type, symmetrical V-type and asymmetrical type according to the angle between greater horns and the proportion of greater horns length. In the females incidence of asymmetrical type is considerably higher than in the males, while the incidence of symmetrical V-type is lower The angle value that is on average higher in males may be the parameter indicating that in puberty hyoid bone, still not completely ossified, to some extent follows development of thyroid cartilage because of their close anatomical relation.

Epidemiological features of suicides in Osijek County, Croatia, from 1986 to 2000.

Suicide is a devastating tragedy associated with social, cultural and psychological factors. It takes approximately 1,060 lives in the Republic of Croatia each year. We retrospectively reviewed all cases referred to in the Registrar office and Police Department at Osijek County from 1986 to 2000. The cases of suicide totaled 1,017. All of the cases were analyzed as to age, gender, marital status, occupation, place and time of suicide and method of suicide. The suicide rate for the entire population of the County averaged 20.5/100,000 inhabitants per annum. The age of the suicides ranged from 15 to 92. The male to female ratio was 2.1:1. The highest suicide incidence was among the age groups from 55 to 64 (19.27%), followed by age group from 45 to 54 (16.12%). The lowest suicide incidence was among the age group < 19 (3.4%). The incidence in the group 85 > years was also low (2.06%). The suicide was frequent among people who live alone: single, widowed, divorced (47.29%). Eighty percent of victims were found in surroundings familiar to them. These included various premises of their residences. The retired, the laborers and the unemployed (67.36%) were predominant among suicide victims. The most common methods of suicide were hanging (43%), followed by firearms (24%). No correlation was found with the day of the week or the month of the year. The study showed a slightly increased rate of suicide, from 21 cases at the beginning of the investigation (in 1986) to 22.3/100,000 population fifteen years later (in 2000).

How high should paternity index be for reliable identification of war victims by DNA typing?

AIM: To analyze statistically and logically the significance of genetic matches between skeletal remains and relatives of missing persons in the process of identification of war victims by DNA typing. METHODS: DNA was isolated from bone and blood samples and short tandem repeat (STR) loci were typed by using AmpFLSTR Profiler, Profiler Plus, and Identifiler kits. Novel mini-haplotype analysis that compares matches in all three-locus combinations of alleles was developed and used in the analysis of inbreeding in the group of 295 unrelated individuals. RESULTS: While comparing 98 skeletal remains exhumed in the process of identification of war victims in Croatia with over 3,000 genotypes of relatives of missing persons, we revealed 20 cases of 14-locus matches and 4 cases of 15-locus matches between unrelated people. We hypothesized that this unexpectedly high number of false matches might be a consequence of local inbreeding and supported this hypothesis with very low correlation between the probability of a genotype and the number of matching genotypes in the database (R(2) = 0.36). Further support for the hypothesis was obtained by the analysis of mini-haplotypes, which revealed up to 90% overrepresentation of some mini-haplotypes. CONCLUSIONS: STR DNA typing is the "golden standard" of human identification, but evidential value of a genetic match can be easily misinterpreted. Therefore, careful use of statistical methods is essential for the proper evaluation of laboratory results. Whenever possible, multiple relatives should be analyzed and other evidence based on the information about time, place, and other conditions of disappearance, as well as anthropological and other "classical" forensic data should always be put together and compared before any final decision about the identity is made.

The identification of war victims by reverse paternity is associated with significant risks of false inclusion.

Since February 2001 the process of DNA identification of war victims in Croatia relies on the database of over 3,000 9-locus (D3S1358, vWA, FGA, TH01, TPOX, CSF1PO, D5S818, D13S317 and D7S820) STR genotypes of relatives of missing persons. Instead of a targeted approach to DNA typing, the genotype of each skeletal remains analysed is compared to all genotypes in the database to identify potential parents and children. Although this approach has significantly increased the pace of identification by DNA typing, non-targeted matching in a database containing several thousand genotypes considerably decreases the significance of inclusion, especially when identification is based on reverse paternity analysis. To support this statistical prediction we present 3 cases of 10 STR loci matches and 1 case of 11 STR loci matches between a child, child's mother and skeletal remains that did not originate from a father of that child.