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AbstractFor the medicolegal evaluation of victims of survived strangulation, a neck-magnetic resonance imaging (MRI) can be performed for assessing lesions in the inner soft tissues (fat, muscles or lymph nodes, for example). In our institute, such MRI examinations have been performed for a test period of 4 years with the aim of evaluating the use of this tool by forensic pathologists and identifying medicolegal indicators for the performance of neck-MRI in surviving victims of strangulation. We retrospectively reviewed medicolegal reports from all victims examined during the test period. We extracted objective lesions (e.g. petechiae, bruising and abrasions) and reported clinical symptoms (e.g. vision disorder, dysphasia) from the reports. These findings were compared to those reported from the neck-MRI. In total, 112 victims were clinically examined after suspected strangulation. Eleven of these victims underwent an MRI examination of the neck. Eighty-four of the victims presented objective lesions during the clinical examination, with eight showing signs of both petechiae and bruising. Neck-MRI was performed in four of these eight victims and three of them showed lesions visible in MRI. Of 76 victims with bruising as the only objective finding, 66 victims described clinical symptoms. Of those 66 victims, seven were examined by MRI and two demonstrated lesions in MRI. When MRI was performed, relevant findings were detected in 45% of the cases. This leads to the suspicion that many more findings could have been detected in the other victims, if an MRI had been performed in those cases. Our results lead us to the conclusion that an MRI examination of victims of suspected strangulation is useful, and strict indications for its application should be established.

Obesity is an international public health concern and it is related to various metabolic disorders such as type 2 diabetes mellitus and cardiovascular diseases [WHO, Obesity and overweight, 2021, online]. Some trace elements (i.e. Zn, Cd, Hg and Pb) have showed obesogen-like abilities [W. Shao, Environ Sci Pollut Res, 2017, 24, 11573–11581] but studies on chronic organs accumulation are limited. White adipose tissue (WAT), recognized as an endocrine and paracrine organ, stores energy and fat but its expansion causes obesity. Two main classes of WAT have been identified according to their location: subcutaneous adipose tissue (SAT) – including abdominal and gluteofemoral adipose tissues, which are highly sensitive to insulin- and visceral adipose tissue (VAT), sensitive to lipolysis and inflammation. A specific depot of VAT is the epicardial one, which exerts a direct vasocrine and paracrine influence on the heart. Although each of these adipose tissue depots shows functional specificities, very few epidemiological studies investigated the concentrations of trace elements in adipose tissues. Here we monitored trace element levels in four different adipose tissue deposits and explored their relation with different phenotypic data.

Background Sports-related sudden cardiac deaths (SrSCDs) occur most frequently in highly dynamic and/or static sports. We aimed to assess the incidence and characteristics of SrSCDs in Switzerland and to compare SrSCD occurrence according to sports categories with the sports participation behaviour in the general population.Methods Between 1999 and 2010, forensic reports of SrSCDs in young individuals (10–39 years of age) were retrospectively reviewed and categorised based on peak static (increasing from I to III) and dynamic sports components (increasing from A to C). Data were compared to the sports participation behaviour of the Swiss population.Results Sixty-nine SrSCDs were identified. Forty-eight (69.6%) occurred during recreational sports (REC) and 21 (30.4%) during competitive sports (COMP). Incidences (per 100,000 athlete person-years) for COMP and REC were 0.90 and 0.52, respectively (p= 0.001). Most SrSCDs occurred in IC (23 cases, 33.3%), followed by IIC (13, 18.9%), IIIA and IIIC (11 each, 15.9%), IIIB (6, 8.7%), IIA (4, 5.8%) and IB sports categories (1, 1.5%). No SrSCDs were found in IA and IIB sports categories. Incidences between sports categories (IIIA 0.25, IB 0.25, IC 0.18, IIC 0.33 and IIIC 0.25) were not significantly different except to IIA (0.94, p< 0.001), due to the fact that few people were involved in this sports category. Coronary artery disease (CAD) was the most common underlying pathology of SrSCD.Conclusions In this Swiss cohort, incidence of SrSCD was very low and similar in all sports categories classified by their static and dynamic components. However, the incidence was higher in COMP compared to REC, and CAD proved to be the most common underlying cause of SrSCD.

La population est exposée quotidiennement à un nombre considérable de xénobiotiques circulants dans l’environnement et ayant des effets néfastes sur la santé. Parmi ces xénobiotiques, plusieurs classes de polluants et médicaments ont été identifiés comme étant obésogènes. En effet, en plus d’une diminution de l’activité physique, d’une augmentation de l’apport en nourriture hautement calorique et de certaines prédispositions génétiques, l’exposition à certains xénobiotiques pourrait participer au développement de l’obésité. Notamment, certains métaux lourds comme le cadmium, le mercure, le plomb, l’arsenic et le zinc sont fortement associés avec un risque d’obésité et de complications métaboliques comme le diabète de type II et certaines maladies cardiovasculaires. Au niveau cellulaire, les métallothionéines, une classe de protéines riches en cystéines, ont un rôle clé dans le métabolisme et la protection des cellules contre l’exposition aux métaux lourds. Le but de cette étude est d’évaluer l’effet du cadmium sur le tissu adipeux humain grâce à un modèle cellulaire, les cellules souches mésenchymateuses humaines (human Mesenchymal Stem cells, hMSCs), capables de se différencier in vitro en adipocytes.

Ambiguous loss is a condition of uncertainty experienced following the disappearance of a person or following the psychological absence of a loved one. It generally has psychological and psychosocial repercussions, in addition to economic and administrative consequences. In the current Mediterranean migration crisis, this condition affects families and persons who have remained in the country of origin or are waiting for the arrival of the person in the host country. In the literature few studies have analysed the psychological state of these persons and who they are, especially those who managed to reach the European coasts, and in particular no one has highlighted the desire to know which accompanies the families of the missing. The present study begins to fill this gap by analysing data collected from the families and friends of the missing who disappeared during the crossing of the Mediterranean; it aims to begin to discuss a little known issue, well visible to forensic scientists and psychiatrists and very likely relevant for clinical purposes. To this end, 340 ante mortem forms containing the information collected during interviews of the living to identify the victims were analysed, focusing especially on the data useful to trace a profile of relatives who seek their missing loved ones. Since, for these relatives, the information needed to investigate the emotional and behavioural trends of ambiguous loss was lacking, a different sample of ten patients from the Ethnopsychiatry Department of the Grande Ospedale Metropolitano Niguarda (Milan, Italy) who had recently lost a loved one was also included in the study. The results suggested that the living do not forget those who left and continue to seek their loved ones, even six years after the last contact, some investing economically in their travels. The number of persons looking for the missing supported this, underlining the great number of potential victims of ambiguous loss caused by the migration disasters and lack of identification of the dead. From a psychological point of view, comparisons were identified with post-war victims, highlighting that similar clinical consequences occur regardless of different cultural contexts and modalities of loss. Differences were also identified, especially concerning the tensions that the journey could have caused to the identity of the patients and the loneliness experienced where these persons live, making the cause of the malaise ascribable to the emotional and psychological repercussions of ambiguous loss. In such a situation the identification of a body may represent the way to find one's own roots, to facilitate the end of ambiguity, and to mark the point where they can start rebuilding a life. In conclusion, migrants should not only be included in the group of victims of ambiguous loss, but they should be ensured an integrated health path that takes into account their psychological and social conditions, remembering that the recovery and identification of a body or of an emotional bond may ameliorate mental health concerns.

La présence d’éthanol après un décès est souvent observée lors des analyses toxicologiques, et sa recherche revêt une certaine importance pour évaluer le degré d’intoxication du défunt peu avant le décès et sa capacité d’agir. En outre, le rapport des concentrations entre les différentes matrices biologiques permet généralement de pouvoir déterminer si l’éthanol a été consommé avant le décès ou s’il provient d’une formation post mortem. Pour une consommation d’éthanol avant le décès, cela permet également de déterminer dans quelle phase toxicocinétique le décès est survenu. Nous rapportons le cas d’un décès survenu par pendaison complète présentant une distribution atypique de l’éthanol dans les échantillons post mortem.