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The determination of vitality of skin injuries is one of the most central research areas in forensic pathology for it is often necessary to discern antemortem from postmortem damage. Typical is the case of a hanging, which should be distinguished from the postmortem suspension of a body. In this study, 15 human skin samples from ligature marks (study group) of victims of suicidal hanging and 15 uninjured skin samples (negative control group) were analyzed. In addition, 15 skin samples from ecchymoses in homicide victims with short survival intervals were investigated as a positive control group. Sections were processed for immunohistochemistry in order to detect the expression of Fibronectin, P-Selectin, FVIII, HSP-70, and MRP8. Immunohistochemical reactions were classified semiquantitatively (mild - score 1, moderate - score 2, and intense - score 3). In the ligature marks, Fibronectin was significantly less expressed compared to ecchymoses. The expression was similar to hanging marks and uninjured skin. In both ligature marks and ecchymoses, the expression of P-Selectin was significantly increased compared to uninjured skin. In both ligature marks and ecchymoses, expression of HSP-70 was significantly decreased in the epidermis compared to uninjured skin. In both ligature marks and ecchymoses, the expression of FVIII and MRP8 was significantly increased in the dermis and hypodermis compared to uninjured skin. The results of this study show that the immunohistochemical study of early inflammatory and coagulation factors could help determine the vitality of ligature marks. The combined analysis of P-Selectin, FVIII, HSP-70, and MRP-8 can be considered for this purpose. • Determination of vitality of ligature marks is important. • Immunohistochemical study of early inflammatory factors could be valuable. • P-Selectine, FVIII, HSP-70 and MRP-8 could indicate vitality of ligature marks. • Fibronectin seems not to be useful for the purpose. [ABSTRACT FROM AUTHOR]

In a forensic pathologist's mind, a suspicious death scene involving inflicted injuries and a weapon always raises three possible hypotheses regarding the manner of death-homicide, suicide, or accident; the latter is slightly less common. We present a case of a 43-year-old homeless man with a history of chronic alcohol abuse who was found dead in a skate park in Geneva. He was inflicted with a stab wound to his abdomen, with a knife found in situ. With the suspicion of homicide, a crime scene investigation team, including a forensic pathologist, was summoned to the scene. However, further examination of the body revealed a deep cut with hesitation marks on the left forearm. This discovery raised the hypothesis of a suicide. Here, we have described the investigations made by the police and forensic department, along with the circumstances and autopsy findings that determined the cause of death as an effect of a natural disease. [ABSTRACT FROM AUTHOR]

To provide an objective quantification of the demographic characteristics and clinical findings related to female child and adolescent sexual abuse cases reported at the Geneva University Hospitals. Retrospective study. Obstetrics and gynecology emergency unit. Female children (0-12 years old) and adolescents (13-20 years old) seeking primary care after sexual assault. None, observational study. Delay from assault to time of presentation to primary care presentation, type of perpetrators, and the presence gynecological and bodily lesions. Compared with children, a significantly higher proportion of adolescents presented to the hospital within 24 hours (134/289 (46.4%) vs 7/33 (21.2%); P =.006). Perpetrators were family members in 15/36 (41.7%) of children and in only 14/304 (4.6%) of adolescent patients (P <.00001); perpetrators were unfamiliar/nonrelated people in 8/36 (22.2%) of children and in 166/304 (54.6%) of adolescent patients (P <.0003). We did not find a significant difference between the 2 age groups with regard to the presence of gynecological lesions (15/35 (42.9%) of children and 91/298 (30.5%) of adolescent patients). However, we found a significant difference in the proportion of patients with bodily lesions such that 11/36 (30.6%) of children and 175/300 (58.3%) of adolescents (P =.002) were afflicted with bodily lesions. To our knowledge this is the first study to evaluate child and adolescent sexual abuse cases on the basis of real-life data collected in Switzerland. Our results highlight important differences in child and adolescent sexual assault in terms of delay in presentation to primary care, perpetrator's relation to the victim, and presence of bodily lesions. This study confirms that gynecological findings alone are not consistently present in the patients who seek primary care after sexual assault. [ABSTRACT FROM AUTHOR]

Abstract: Testimonies disclosed that a 44-year-old pedestrian was struck head-on by a truck while she was roaming on the motorway; at the time of collision, the truck was travelling at a speed of about 90km/h. In the second phase of the collision, the pedestrian was projected about 100m before her body was run over by the truck and then by a car. The autopsy revealed extensive mutilations, making it impossible to verify the testimonies of witnesses to the collision as regards the pedestrian''s position at the moment of the first impact. However, the reports produced by the technical expert and the forensic pathologist were able to confirm the testimonies, based on an impact zone on the front panel of the cab of the truck, where part of the pedestrian''s face was reproduced like a “modern holy shroud”. [Copyright &y& Elsevier]