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Impact of changing from autopsy to post-mortem CT in an entire HM Coroner region due to a shortage of available pathologists

A significant problem facing routine medicolegal coroner-referred autopsies is a shortfall of pathologists prepared to perform them. This was particularly acute in Lancashire, where the coroner decided to initiate a service that relied on post-mortem computed tomography (PMCT). This involved training anatomical pathology technologists (APTs) to perform external examinations, radiographers to perform scans, and radiologists to interpret them. The service started in 2018 and now examines over 1,500 cases per year. This study outlines the PMCT process using NHS staff, with CT equipment and logistics managed by the commercial sector. It compares the demographics and outcomes of PM investigations for two 6-month periods: the autopsy service prior to 2018, and then the PMCT service. These data were then compared with previous UK PMCT data. Referrals for adult non-suspicious deaths were made in 913 cases of which 793 (87%) had PMCT between 01/10/2018 and 31/03/2019. Fifty-six cases had autopsy after PMCT, so 81% of cases potentially avoided autopsy. The PMCT service did not delay release of bodies to the next-of-kin. Comparing the cause of death given shows no difference in the proportions of natural and unnatural deaths. There was an increase in diagnosis of coronary artery disease for PMCT, with less respiratory diagnoses, a feature not previously demonstrated. These data suggest PMCT is a practical solution for potentially failing autopsy services. By necessity, this involves changes in diagnoses, as PMCT and autopsy have different strengths and weakness, but the ability to pick up unnatural death appears unaffected.

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Anogenital injury following sexual assault and consensual sexual intercourse: a systematic review and meta-analysis

Sexual violence is a grave human rights violation and a serious global public health challenge. Rates of reporting of sexual violence and subsequent passage of cases through the criminal justice system are poor all over the world. The presence or absence of anogenital injury following sexual assault may influence survivors in their willingness to report a crime, and law enforcement officers and jurors in their decision making regarding the laying of charges and/or conviction of offenders. The aim of this systematic review was to compare rates of identification of anogenital injury (AGI) in women following sexual assault and consensual sexual intercourse using the same examination techniques.

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Defining cat mitogenome variation and accounting for numts via multiplex amplification and Nanopore sequencing

Reprinted from University of Leicester website.

Cat hair could be the purr-fect way to catch criminals, according to researchers from the University of Leicester.

They have shown that a single cat hair contains DNA which could link a suspect and a crime-scene, or a victim.

Around 26 percent of UK householders own a cat and with the average feline shedding thousands of hairs annually, it’s inevitable that once you leave, you’ll bear evidence of the furry resident. This is potentially useful in the forensic investigation of criminal activity.

While a human perpetrator may take pains not to leave their own DNA behind, transferred cat hair contains its own DNA that could provide a link between a suspect and a crime-scene, or a victim.

In a paper published in the journal Forensic Science International: Genetics earlier this month, researchers at the University of Leicester describe a sensitive method that can extract maximum DNA information from just one cat hair.

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Impact of changing from autopsy to post-mortem CT in an entire HM Coroner region due to a shortage of available pathologists

A significant problem facing routine medicolegal coroner-referred autopsies is a shortfall of pathologists prepared to perform them. This was particularly acute in Lancashire, where the coroner decided to initiate a service that relied on post-mortem computed tomography (PMCT). This involved training anatomical pathology technologists (APTs) to perform external examinations, radiographers to perform scans, and radiologists to interpret them. The service started in 2018 and now examines over 1,500 cases per year. This study outlines the PMCT process using NHS staff, with CT equipment and logistics managed by the commercial sector. It compares the demographics and outcomes of PM investigations for two 6-month periods: the autopsy service prior to 2018, and then the PMCT service. These data were then compared with previous UK PMCT data. Referrals for adult non-suspicious deaths were made in 913 cases of which 793 (87%) had PMCT between 01/10/2018 and 31/03/2019. Fifty-six cases had autopsy after PMCT, so 81% of cases potentially avoided autopsy. The PMCT service did not delay release of bodies to the next-of-kin. Comparing the cause of death given shows no difference in the proportions of natural and unnatural deaths. There was an increase in diagnosis of coronary artery disease for PMCT, with less respiratory diagnoses, a feature not previously demonstrated. These data suggest PMCT is a practical solution for potentially failing autopsy services. By necessity, this involves changes in diagnoses, as PMCT and autopsy have different strengths and weakness, but the ability to pick up unnatural death appears unaffected.

Direct link to the article.

 

The Dark Side of Energy Drinks: A Comprehensive Review ofTheir Impact on the Human Body

In recent years, the consumption of energy drinks by young adults and athletes has risensignificantly, but concerns have been raised about the potential health risks associated with excessiveconsumption. These concerns include cardiovascular problems, nervous system disorders, andthe potential for addiction. This review aims to examine the reported effects of acute or chronicabuse of energy drinks on human health. The analysis shows a significant prevalence of adverseeffects, particularly on the cardiovascular and neurovegetative systems. In particular, the analysisidentified nine cases of cardiac arrest, three of which were fatal. The aetiology of these adverse effectsis attributed to the inherent neurostimulant properties of these beverages, of which caffeine is thepredominant component. A comparison of documented effects in humans with experimental studiesin animal models showed an overlap in results. This review highlights the need for greater rigour inthe assessment of sudden cardiac death, particularly in young people, as legal substances such asenergy drinks may be involved. We propose stricter limits on the consumption of these beveragesthan for caffeine, based on the evidence found and the data in the literature. This review also callsfor the establishment of regulations governing the consumption of these products in view of theirpotential impact on human health.

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Application of 3D printing in assessment and demonstration of stab injuries

In stabbing related fatalities, the forensic pathologist has to assess the direction of wound track (thus, the direction of the stabbing) and the weapon's possible characteristics by examining the stab wound. The determination of these characteristics can be made only with a high level of uncertainty, and the precise direction of the stabbing is often difficult to assess if only soft tissues are injured. Previously reported techniques used for the assessment of these wound characteristics have substantial limitations. This manuscript presents a method using today's easily accessible three-dimensional (3D) printing technology for blade-wound comparison and wound track determination. Scanning and 3D printing of knives is a useful method to identify weapons and determine the precise stabbing direction in a stabbing incident without compromising the trace evidence or the autopsy results. Identfication of the exact knife is not possible with complete certainty but excluding certain knives will decrease the number of necessary DNA examinations, hence it can lower the burden on forensic genetic laboratories. The method addresses many of the shortcomings of previously used methods of probe insertion or post-mortem CT. Insertion of the printed knife into the wound gives a good visual demonstration of the stabbing direction, thus easing the forensic reconstruction of the stabbing incident. After combining the 3D printing with photogrammetry, the achieved 3D visualization is useful for courtroom demonstration and educational purposes.

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