Tumoral and normal brain tissue extraction protocol for wide-scope screening of organic pollutants.

Little is known about the presence of organic pollutants in human brain (and even less in brain tumors). In this regard, it is necessary to develop new analytical protocols capable of identifying a wide range of exogenous chemicals in this type of samples (by combining target, suspect and non-target strategies). These methodologies should be robust and simple. This is particularly challenging for solid samples, as reliable extraction and clean-up techniques should be combined to obtain an optimal result. Hence, the present study focuses on the development of an analytical methodology that allows the screening of a wide range of organic chemicals in brain and brain tumor samples. This protocol was based on a solid-liquid extraction based on bead beating, solid-phase extraction clean-up with multi-layer mixed-mode cartridges, reconstitution and LC-HRMS analysis. To evaluate the performance of the extraction methodology, a set of 66 chemicals (e.g., pharmaceuticals, biocides, or plasticizers, among others) with a wide range of physicochemical properties was employed. Quality control parameters (i.e., linear range, sensitivity, matrix effect (ME%), and recoveries (R%)) were calculated and satisfactory results were obtained for them (e.g., R% within 60-120% for 32 chemicals, or ME% higher than 50% (signal suppression) for 79% of the chemicals).

[Descriptive study of a series of deaths due to accidental falls in the elderly.] / Estudio descriptivo de una serie de muertes por caída accidental en personas mayores.

OBJECTIVE: Accidental falls are a growing public health problem. The objective was to describe the characteristics of deaths due to accidental falls in people over 65 from the forensic source. METHODS: Descriptive observational study of deceased at over 65 undergoing judicial autopsy in Tarragona between the years 2013-2017 whose basic cause of death was coded as accidental fall (W00-W19 of the International Classification of Diseases - 10th edition). RESULTS: 89 cases were identified (42.7% women). The mean age of the deceased females (82.9 years) was significantly higher than that of the males (77.6 years). The cause of death was a head injury in 77.5% of cases. 78.7% had previously been assisted in a hospital center. Falls from one level to another were significantly more lethal (60% vs 40%), and were associated with those corpses not coming from hospital. 82% had prescribed at least one drug (57.5% more than 5). 85.4% had a pathological history. Comorbidity was significantly higher in females and in corpses from hospital and lower in falls from one level to another. CONCLUSIONS: The data, based on forensic sources, show the presence of risk factors associated with the fatality of accidental falls in ≥65 years of age. More studies are needed to understand its role in these injuries.

OBJETIVO: Las caídas accidentales son un problema creciente de salud pública. El objetivo fue describir las características de las defunciones por caídas accidentales en personas ≥65 años a partir de la fuente forense. METODOS: Estudio descriptivo observacional de fallecidos de edad ≥65 años sometidos a autopsia judicial en Tarragona entre los años 2013-2017 cuya causa de básica de defunción se codificó como caída accidental (W00-W19 de la Clasificación Internacional de Enfermedades-10ª edición). RESULTADOS: Se identificaron 89 casos (42,7% mujeres). La edad media de las mujeres fallecidas (82,9 años) fue significativamente superior a la de los hombres (77,6 años). La causa de muerte fue un traumatismo craneoencefálico en el 77,5% de los casos. El 78,7% procedían de un centro hospitalario. Las caídas a distinto nivel resultaron significativamente más letales (60% vs 40%) y se asociaron a aquellos cadáveres no procedentes de hospital. El 82% tenía prescrito al menos un fármaco (el 57,5% más de 5). El 85,4% presentaba antecedentes patológicos. La comorbilidad fue significativamente mayor en el sexo femenino y en los cadáveres procedentes de centro hospitalario, y menor en caídas a distinto nivel. CONCLUSIONES: Los datos, basados en fuentes forenses muestran la presencia de factores de riesgo asociados a la letalidad de las caídas accidentales en ≥65 años. Se necesitan más estudios para conocer su papel en estos traumatismos.

Muerte súbita por hernia diafragmática congénita no diagnosticada / Sudden death due to undiagnosed congenital diaphragmatic hernia

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Mejora de la estadística de mortalidad por suicidio en Tarragona (Cataluña, España) entre 2004 y 2012 / Improving suicide mortality statistics in Tarragona (Catalonia, Spain) between 2004-2012

Introducción: La vigilancia y prevención de la conducta suicida requiere, entre otros datos, conocer con precisión las muertes por suicidio (MPS). Frecuentemente existe una infradeclaración o mala clasificación de las MPS en las estadísticas oficiales de mortalidad. El objetivo del estudio es analizar la infradeclaración de la estadística de mortalidad por suicidio en Tarragona (Cataluña, España). Material y métodos: Análisis de las MPS ocurridas en la División de Tarragona del Institut de Medicina Legal i Ciències Forenses de Catalunya (DT-IMLCFC) entre los años 2004 y 2012. Las fuentes de información fueron el fichero de defunciones del Registre de Mortalitat de Catalunya (RMC) y el archivo de autopsias del DT-IMLCFC. Se compararon estadísticamente las tasas y las características demográficas de las MPS declaradas en el RMC y las recuperadas. Resultados: La media de casos no declarados en el período fue del 16,2%, con el mínimo en el año 2005 (2,2%) y el máximo en el año 2009 (26,8%). La tasa bruta de mortalidad por suicidio pasó de 6,6 por 100.000 habitantes a 7,9 por 100.000 habitantes tras la incorporación de los datos forenses. Se detectaron diferencias poco importantes en el perfil sociodemográfico de los suicidios declarados inicialmente y los definitivos, excepto en el método de suicidio, con un aumento significativo de los envenenamientos y los arrollamientos en vía férrea. Conclusiones: La recuperación de datos en las MPS a partir de las fuentes forenses mejora la información estadística, corrigiendo su infradeclaración y ampliando el conocimiento sobre el método de suicidio y las características personales

Introduction: Monitoring and preventing suicidal behaviour requires, among other data, knowing suicide deaths precisely. They often appear under-reported or misclassified in the official mortality statistics. The aim of this study is to analyse the under-reporting found in the suicide mortality statistics of Tarragona (a province of Catalonia, Spain). Method and materials: The analysis takes into account all suicide deaths that occurred in the Tarragona Area of the Catalan Institute of Legal Medicine and Forensic Sciences (TA-CILMFS) between 2004 and 2012. The sources of information were the death data files of the Catalan Mortality Register, as well as the Autopsies Files of the TA-CILMFS. Suicide rates and socio-demographic profiles were statistically compared between the suicide initially reported and the final one. Results: The mean percentage of non-reported cases in the period was 16.2%, with a minimum percentage of 2.2% in 2005 and a maximum of 26.8% in 2009. The crude mortality rate by suicide rose from 6.6 to 7.9 per 100,000 inhabitants once forensic data were incorporated. Small differences were detected between the socio-demographic profile of the suicide initially reported and the final one. Supplementary information was obtained on the suicide method, which revealed a significant increase in poisoning and suicides involving trains. Conclusions: An exhaustive review of suicide deaths data from forensic sources has led to an improvement in the under-reported statistical information. It also improves the knowledge of the method of suicide and personal characteristics

Improving suicide mortality statistics in Tarragona (Catalonia, Spain) between 2004-2012. / Mejora de la estadística de mortalidad por suicidio en Tarragona (Cataluña, España) entre 2004 y 2012.

INTRODUCTION: Monitoring and preventing suicidal behaviour requires, among other data, knowing suicide deaths precisely. They often appear under-reported or misclassified in the official mortality statistics. The aim of this study is to analyse the under-reporting found in the suicide mortality statistics of Tarragona (a province of Catalonia, Spain). METHOD AND MATERIALS: The analysis takes into account all suicide deaths that occurred in the Tarragona Area of the Catalan Institute of Legal Medicine and Forensic Sciences (TA-CILMFS) between 2004 and 2012. The sources of information were the death data files of the Catalan Mortality Register, as well as the Autopsies Files of the TA-CILMFS. Suicide rates and socio-demographic profiles were statistically compared between the suicide initially reported and the final one. RESULTS: The mean percentage of non-reported cases in the period was 16.2%, with a minimum percentage of 2.2% in 2005 and a maximum of 26.8% in 2009. The crude mortality rate by suicide rose from 6.6 to 7.9 per 100,000 inhabitants once forensic data were incorporated. Small differences were detected between the socio-demographic profile of the suicide initially reported and the final one. Supplementary information was obtained on the suicide method, which revealed a significant increase in poisoning and suicides involving trains. CONCLUSIONS: An exhaustive review of suicide deaths data from forensic sources has led to an improvement in the under-reported statistical information. It also improves the knowledge of the method of suicide and personal characteristics.

Valoración médico-legal de las drogas de abuso / Medical-legal evaluation of abuse drugs

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Importancia de la documentación clínica para la Administración de Justicia / Importance of clinic documentation for the justice administration

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