Decapitation of an agricultural worker by a combine harvester: a case report.

Background: Each year, there are billions of agricultural work accidents involving the operation of tractors, grain augers, harvest combines, power take-off devices, or balers and thrashers. Field accidents of this nature seem more common on afternoons, just as road accidents tend to skew toward nighttime. The lesions can vary widely and depends strictly on the operation of the machinery analyzed. Aims: This paper aims to present a peculiar case of decapitation by a combine harvester, showing how, in cases of injury due to agricultural machinery, it is fundamental a correct execution of a scene investigation, autoptic examination, and cooperation with a specialist in engineering. Case Report: A 54-year-old man was found decapitated on the header of a combine harvester; his extremities were also dismembered. At autopsy, a clean oblique cut across the first cervical vertebra had severed the head at the neck. Although the right arm remained intact, both lower extremities were mutilated, showing numerous exposed and open fractures. A bleeding, penetrating wound to the back was additionally noted. In the days that followed, missing parts (head and left leg) were discovered in other machine components (grain tank and straw walker, respectively). All observed injuries were compatible with the mechanics of the cochlea, its rotating movement inflicting the damages above. Collaboration between pathologists and engineers was fundamental to recreating the dynamics of this rare decapitation accident by a combine harvester.

Death by artery injury: two peculiar cases of sharp force fatality.

Background: As sharp force injury accounts for 10-20% of clinical forensic examinations, forensic pathologists are often asked to investigate deceased victims of stab wounds. Moreover, homicide by sharp force (stabbing) is one of the most common in European countries, involving generally domestic or interpersonal conflict. Stabbing as a suicide method constitutes a low percentage of all suicides, 2% to 3%. Accidental death due to sharp force is even rarer (0-3%) and usu-ally caused by an impact or a fall into different type of glass surface. Death due to stabbing is usually caused by exsanguinating incisions to organs or large blood vessels (such as arteries), leading to haemor-rhagic shock. Penetrating artery injuries are well known in clinical settings, and extremities are the most common sites of such injuries. Indeed, 50% to 60% of injuries occur in femoral or popliteal arteries, 30% in brachial artery. Aims: The aim of this paper is to present two rare cases of sharp force fatality, showing how a thorough forensic pathology methodology, including death scene investigation, autopsy examination, and toxicological analyses, are pivotal to detect the manner of death. Case Reports: This paper presents two peculiar cases of sharp force fatalities: the first, a single and accidental stab injury on the right armpit which caused a complete transection of the axillary artery; the second, a single homicidal stab wound on the lower leg causing a full-thickness lesion of the anterior tibial artery.

Abuse and misuse of prescription opioids: is it only an Ameri- can problem? An observational study on an Italian casuistry.

ABSTRACT: Medical use of prescription opioids has steadily increased since the 1990s, particularly in the U.S.A. and Canada, along with abuse of these substances and significant increases in rates of addiction and death related to prescription opioids. The American authorities speak of an "addiction epidemic" and are launching a series of countermeasures to better address the problem. In Europe, there is an increasing use of prescription opioids and related problems, but the European context is much less dramatic than the American and Canadian ones. Never-theless, based on the data, it cannot be ruled out that a similar crisis will occur on the Old Continent. The aim of this study is to analyze the Italian context to better understand whether there is a possibility of an addiction epidemic. Twenty-four cases of death of people under treatment with pre-scription opioids have been retrospectively analyzed. Toxicological samples were collected with routine methods during the autopsy, followed by systematic screening for substances by diverse methods. Volatile compounds were identified using gas chromatography-flame ionization detection (GC-FID). Medical drugs and drugs of abuse were identified via the use of gas chromatography-mass spectrome-try (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS-MS). Of a total of 24 subjects, 14 died due to an overdose of Tramadol, while 7 died due to an overdose of Buprenorphine and 3 dues to a Fentanyl overdose. The most used drug was Tramadol. Histological examination was performed with hematoxylin/eosin staining, though no significant findings emerged apart from widespread edema and focal sclerosis of the myocardium, and interstitial and alveolar edema of the lungs. Our data show that attention must be paid to prescription opioids. European institutions, as soon as possible, must implement preventive measures that avoid the recurrence of the North American situation.

Comparative study between conventional and new methods in defining the cause of death from anaphylactic shock.

ABSTRACT: Anaphylaxis is defined as a rapid systemic reaction that develops in individuals previously exposed to specific allergens. The new exposure causes systemic cellular degranulation, which in turn leads to cardiovascular and respiratory changes that are fatal if not treated immediately. One of the main problems of this scenario in the forensic field is the determination of a correct post-mortem diagnosis. Traditional methods, such as histopathological examination of the respiratory tract and the use of specific antibodies used in immunohistochemistry, are sensitive but not always specific and therefore do not guarantee a high degree of probability in the diagnosis of anaphylaxis. For this reason, a new and promising research frontier in this field of forensic pathology could be represented by the application of miRNAs as biomarkers, as has been done in other areas of medicine.

[Human allogeneic cultured epidermis: medico-legal considerations]. / Epidermide umana coltivata allogenica: considerazioni medico-legali.

The possibility of cultivating in vitro human kerathinocytes has opened new prospectives in the surgical treatment of major burns and, generally, in patients with extensive skin loss (degloving, etc.). Epidermidal sheets, obtained in vitro, have been used initially, successfully, as autografts. Later, their peculiar immunological characteristic (absence of Langerhans cells expressing class II MHC antigens and inability of evocating omograft rejection) has allowed it's use as allograft without the need of resorting to treatment with immunosuppressive drugs. Medico-legal problems raised by the use of human epidermys cultivated as allograft are described hereafter.

Refining method for the design of multilayer stacks.

An analytical procedure is presented for the calculation of the maximum of transmittance in a limited spectral region and of the efficiency of a given multilayer configuration when the thickness is altered of certain films in the stack. This refining process method is employed in examples where the spectral transmittance is improved when only a few matching layers are used for refining.

Aplanatic double reflection system for thermophotovoltaic applications: design.

The design of a solar concentrator is presented; it consists of a spherical mirror and a field of Fresnel mirror facets deployed on a spherical surface so that sine condition is satisfied, eliminating both spherical aberration and coma. This particular easy to construct optical system yields high concentration ratios and has the distinct advantage of having a narrow beam aperture near the receiver. These design features make the concentrator particularly suitable for thermophotovoltaic applications.

Design method for multilayer interference filters.

In this paper expressions for the transmittance and the reflectance of a system consisting of a spacer surrounded by two multilayer stacks are presented. These expressions provide a general approach for the design of multilayer coatings. High- and low-transmittance bands and a narrowband in the transmittance spectrum of multilayer stacks with unequal designed wavelengths are reported.