The role of paranasal sinus fluid in determining drowning as the cause of death: A systematic review and meta-analysis.

Drowning is a significant global cause of unintentional injury fatalities, and accurate forensic diagnosis of drowning remains a challenge due to the nonspecific nature of post-mortem findings obtained through classical autopsy methods. Our manuscript addresses this issue by focusing on the emerging use of paranasal sinus fluid as a valuable tool in determining the cause of death, specifically in distinguishing drowning from non-drowning cases. The study provided a comprehensive summary of available evidence from observational studies that compared findings in the paranasal sinuses between drowning and non-drowning victims, analyzing parameters such as the presence of fluid, fluid volume, and density. The study encompassed a total of 14 selected studies involving 1044 subjects and utilized rigorous risk of bias assessment and data synthesis techniques. The meta-analysis demonstrated a strong association between the presence of fluid in the paranasal sinuses and drowning (OR = 17.1; 95% CI 7.2 to 40.5; p < 0.001). In addition, drowning victims had a significantly greater volume of fluid (SMD = 0.8; 95% CI 0.5 to 1.2; p < 0.001) and lower fluid density (SMD = -1.4; 95% -2.5 to -0.4; p = 0.008) compared to non-drowning cases. The results support the utility of paranasal sinus fluid analysis as a valuable diagnostic method in cases where drowning is suspected but cannot be definitively confirmed through traditional approaches.

Recommendations for procedures related to the evidence chain of custody in forensic anthropology in Brazil.

Forensic anthropologists perform specialised analysis, mainly involving skeletonised human remains, cadavers in advanced stages of decomposition, disassociated elements from the human body, and human remains in extreme carbonisation. The main objectives of the forensic anthropology expertise are human identification and assisting in determining the cause and manner of death. Estimating the time since death is also a priority for some cases, especially ones involving missing persons. This science works on individual cases, violent deaths, missing persons, mass disasters, suspected violations of human rights, and crimes against humanity. Forensic anthropological evidence is, in general, very sensitive. Thus, it is important to detail aspects relevant to the maintenance of the chain of custody at all phases of the investigation, as well as standardise the actions of the individuals involved. This aims to preserve the evidence integrity and sameness (Sameness: free translation of the Portuguese word "mesmidade", derived from a Spanish word that does not possess a translation to Portuguese. Sameness of evidence is understood as the guarantee that the evidence under valuation (or under analysis of its probative value) is exactly and integrally the same one which was collected, corresponding, therefore, to "the same" (and not "part of", "derived from"), safeguarding its value. Brazil Law No. 13.964 of 14 December 2019 establishes and lists 10 phases related to the evidence chain of custody that must be followed. These newly introduced requirements resulted in the need for adaptation of the forensic, investigative, and legal actors involved in an investigation, and in the detailed description of the procedures for the different areas related to criminalistics, including forensic anthropology. The information provided in this article should be interpreted as recommendations, even though their non-compliance may weaken the investigative and forensic analysis processes in whole or in part.