Frontal sinus as an identity and sex indicator.

The present study explores the variability of frontal sinuses volume in modern Greeks and their potential use in the forensic identification process. METHODS: The sample consisted of 102 CT scan images from a modern Greek population. 50 (49%) were male and 52 (51%) were female. Ages ranged from 19 to 101 (mean age 70.6 for males and 69.6 for females). 3D models of the skull were constructed, and volume calculations of the frontal sinus were done with the software Amira 5.4. 10 CT scans were used to extract 2D frontal and lateral images that were used as proxies of antemortem X-rays which were matched to the CT scans using manual craniofacial superimposition. RESULTS: The average of frontal sinus volume of male was 9,220 mm3 (±SD) and female was 5,880 mm3 (±SD). Mann-Witney test confirmed that mean values were significantly different (P<0.05) between them. Pearson's correlation coefficient showed no evident correlation between the volumes and ages of the skulls in both groups. Using the lateral and anterior oriented radiographs for matching the sinuses, the method produced 60% sensitivity / 99.32% specificity and 80% sensitivity / 99.97% specificity, respectively. CONCLUSIONS: Even though there are statistically significant differences in the shape and volume between sexes, these are not sufficient to be used as an indicator of sex in worldwide populations. The results indicate that using the anterior view of the frontal sinuses is more consistent in human identification, and that the method proves to be reliable, as long as the sinus is adequately observed on the radiograph.

Genome sequences of chikungunya virus isolates circulating in midwestern Brazil.

Chikungunya virus (CHIKV) is a reemerging arbovirus of the family Togaviridae that causes CHIKV fever, a disease that can extend from weeks to years depending on whether clinical signs of arthralgia persist. CHIKV is mainly transmitted by Aedes aegypti mosquitoes and possibly reached the Americas in 2013, causing an outbreak in Brazil in 2015. So far, two evolutionary lineages of CHIKV have been reported in Brazil: the Asian and the East-Central-South African (ECSA) lineages. In this study, six CHIKV isolates circulating in midwestern Brazil (Mato Grosso state) were isolated from patient sera, and their complete genomes were sequenced using a high-throughput sequencing platform. All of these isolates shared high nucleotide sequence similarity with CHIKV isolates from northeastern Brazil and were found to belong to the ECSA lineage. These CHIKV isolates did not contain the A226V or L210Q mutations that are associated with increased transmissibility by A. albopictus, suggesting that the CHIKV isolates circulating in midwestern Brazil are predominantly transmitted by A. aegypti.

Sexual dimorphism of the tibia in contemporary Greek-Cypriots and Cretans: Forensic applications.

Sex estimation is an essential step in the identification process of unknown heavily decomposed human remains as it eliminates all possible matches of the opposite sex from the missing person's database. Osteometric methods constitute a reliable approach for sex estimation and considering the variation of sexual dimorphism between and within populations; standards for specific populations are required to ensure accurate results. The current study aspires to contribute osteometric data on the tibia from contemporary Greek-Cypriots to assist the identification process. A secondary goal involves osteometric comparison with data from Crete, a Greek island with similar cultural and dietary customs and environmental conditions. Left tibiae from one hundred and thirty-two skeletons (70 males and 62 females) of Greek-Cypriots and one hundred and fifty-seven skeletons (85 males, 72 females) of Cretans were measured. Seven standard metric variables including Maximum length (ML), Upper epiphyseal breadth (UB), Nutrient foramen anteroposterior diameter (NFap), Nutrient Foramen transverse diameter (NFtrsv), Nutrient foramen circumference (NFCirc), Minimum circumference (MinCirc) and Lower epiphyseal breadth (LB) were compared between sexes and populations. Univariate and multivariate discriminant functions were developed and posterior probabilities were calculated for each sample. Results confirmed the existence of sexual dimorphism of the tibia in both samples as well as the pooled sample. Classification accuracy for univariate functions ranged from 78% to 85% for Greek-Cypriots and from 69% to 83% for Cretans. The best multivariate equations after cross-validation resulted in 87% for Greek-Cypriots and 90% accuracy for Cretans. When the samples were pooled accuracy reached 87% with over 95% confidence for about one third of the population. Estimates with over 95% of posterior probability can be considered reliable while any less than 80% should be treated with caution. This work constitutes the initial step towards the creation of an osteometric database for Greek-Cypriots and we hope it can contribute to the biological profiling and identification of the missing and to potential forensic cases of unknown skeletal remains both in Cyprus and Crete.

Os parietale partitum: Exploring the prevalence of this trait in four contemporary populations.

Os parietale partitum is a variable segmentation of the parietal bone. This manifests as a parietal division in the anteroposterior or superoinferior planes that is separated by an unusual suture and can be complete or incomplete. The existence of parietal divisions was observed and documented more than 260 years ago. The main objectives of this paper are to record the incidence of this rare trait in four modern populations with no previous records of it and provide a review of the literature. Four contemporary skeletal collections from Crete (Greece), Limassol (Cyprus), Coimbra (Portugal) and Salvador (Brazil) were assessed by the authors of this paper for non-metric cranial traits. Out of 711 skulls, only three cases of parietal division were found and all three originated from the Cypriot collection. These three cases were anatomically analyzed, showing that all three cases were adult females and showed unilateral expression of the trait. Two skulls showed superoinferior division, and the third case showed anteroposterior division. Numerous other cranial non-metric traits were found in these three skulls. Based on the cemetery archives, there seems to be no genetic link between the individuals bearing this trait. Further genetic analysis is suggested in order to verify this conclusion.

[Infectious endocarditis in a drug addict]. / Endocardite infecciosa em toxicômanos.

PURPOSE: To compare two groups of patients with infective endocarditis, the drug addicts and non-drug addicts. We attempted to set particularities among the various aspects that involve the patient with endocarditis, due to the concurrent chronic use of cocaine intravenously. METHODS: Twenty nine patients, group B, whose clinical diagnose was compatible with infective endocarditis, with risk factor of parenteral toxicomania by cocaine were treated at Institute "Dante Pazzanese de Cardiologia" and Hospital "Emilio Ribas" in São Paulo, from 1984 to 1990. The data obtained for etiological agents, previous cardiac pathology, affected heart structures, affected heart side and clinical-surgical evolutions of group B were compared to group A (193 patients), which was also composed of patients with endocarditis, without chronic endovenous use of cocaine antecedent. The data obtained were analysed comparatively according to the chi square with Yates correction. RESULTS: Male gender (89.7%) was predominate in group B towards group A (57.0%); (p < 0.01). Previous cardiopathy, either congenital or acquired, as antecedent proning to endocarditis, was found in 89.1% of patients in group A, significantly higher than 17.2% of patients group B (p < 0.001). Staphylococcus aureus was the most frequent agent, which accounted for endocarditis of group B in 86.4% of the cases, significantly higher when compared to 23.9% of cases of group A (p < 0.01). Streptococcus viridans was the most frequent etiological agent for endocarditis of group A (44.8%), significantly higher than group B (4.5%), (p < 0.01). In concern to the affected structures, the tricuspid valve was most affected in group B (65.5%), significantly higher than group A (4.7%) p < 0.001. The mitral valve was significantly more affected in group A (45.1%) in comparison to group B (6.9%), (p < 0.05). In group A 82 patients (42.5%) required surgical treatment and this occurred in 3 patients of group b (10.3%), (p < 0.05). No significant statistical difference was found as for the general mortality (clinical and surgical) in both groups. CONCLUSION: a) presence of previous cardiac disease was lower suggesting permanent contamination blood flow by pathologic agents, mainly of those found in the skin as S. aureus; b) right side of the heart is most frequently affected, specially the tricuspid valve even without previous damage.

Obstructive jaundice caused by blastomycosis of the lymph nodes around the common bile duct.

A case of obstructive jaundice due to granulomatous blastomycosis is presented. The patient had complained of abdominal pain in the right hypochondrium and jaundice. During hospitalization, the laboratory tests showed evidence of obstructive jaundice and complementary tests a distended gallbladder, dilatation of the intra and extrahepatic bile ducts with enlarged lymph nodes of the hepatic hilus. During the operation a cholestatic liver, distended gallbladder and enlarged lymph nodes around the common bile duct were found. Histopathology of the lymph nodes revealed South American blastomycosis. The medical management consisted of amphotericin B. At present the patient is alive and well.