Death on New Year's Eve caused by illegal fireworks-a firework shell.

During the turn of the year, injuries caused by fireworks occur in Germany every year. According to the professional associations, the Unfallkrankenhaus Berlin, for example, treats an average of 50 injuries caused by fireworks on New Year's Eve. Patients come with burns, soft tissue injuries, or fractures; eyes and hands are particularly frequently affected. Again and again, there are also very serious or even fatal injuries. The background is usually the improper or illegal use of larger fireworks. Smaller fireworks such as sparklers, bangers, or smaller rockets are available in Germany in most supermarkets, and their use is permitted from the age of 12 or 18. However, the use of larger fireworks in Germany requires proof of an official permit to handle pyrotechnic objects, which is why they are often acquired abroad. The following report describes such a case. Shortly after the turn of the year 2022, a young man died as a result of an explosive effect on the facial skull after using an illegal firework shell. The case is discussed with regard to the autopsy findings, the possible cause of the accident, and the type of firework used.

Histological examination of carotid artery tissue in cases of ligature strangulation and hanging.

Violence against the neck can result in a range of macromorphological and micromorphological findings. However, the forensic relevance of the carotid sinus in cases of violence against the neck remains controversial. In this follow-up study of 22 cases of suicidal and accidental strangulations, carotid bifurcations were examined histologically for morphological changes implying direct trauma, including haemorrhage and immunohistochemical expression of heat-shock proteins 27, 60, and 70 and aquaporin-3. These cases were compared with a control group (82 cases) without neck compression or head trauma and with variable causes of death. No relevant histopathological findings implying direct trauma of the carotid bifurcation were found. No cases showed positive aquaporin-3 staining and only five cases showed positive heat-shock protein-27 staining, all of which were hangings. Without massive trauma of the carotid bifurcation, histological alterations cannot be expected. Without signs of rapid death, findings of acute circulatory failure, macromorphological and micromorphological findings of neck compression, and reliable markers indicating relevant impact on the carotid bifurcation the diagnosis of a lethal reflex cannot be verified.Key pointsAmong 22 cases of strangulation causing death, there were 16 cases of hanging and 6 cases of ligature strangulationFew cases showed small haemorrhages located predominantly in the surrounding fat and connective tissues; however, the haemorrhages did not have any effects on the tissuesNeck compression had minimal effects on heat shock protein 27 expression in carotid artery tissueAquaporin-3 staining suggested it is not a useful marker for relevant neck pressure, or that there had not been any relevant neck impactOur findings suggested no direct evidence for reflex cardiac death resulting from a brief force against the neck.

Case report: fatal bleeding from a duodenal ulcer-Dieulafoy's lesion?

A 46-year-old man was admitted to the hospital by ambulance due to syncope. A standard blood screening showed a normal Hb value. The man had known hemorrhoids and a single fresh rectal bleeding earlier at home. On the following morning, the patient suddenly required resuscitation within a few minutes and subsequently died. Autopsy revealed a fatal hemorrhage with blood loss in the stomach and small and large intestines and a mucosal defect of the duodenum. After autopsy, the question arose whether the cause of death might have been a rare Dieulafoy's lesion-aim of this case report was to clarify the diagnosis.