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Anabolic-androgenic steroids (AASs) are a large group of molecules including endogenously produced androgens, such as testosterone, as well as synthetically manufactured derivatives. AAS use is widespread due to their ability to improve muscle growth for aesthetic purposes and athletes’ performance, minimizing androgenic effects. AAS use is very popular and 1–3% of US inhabitants have been estimated to be AAS users. However, AASs have side effects, involving all organs, tissues and body functions, especially long-term toxicity involving the cardiovascular system and the reproductive system, thereby, their abuse is considered a public health issue. The aim of the proposed review is to highlight the most recent evidence regarding the mechanisms of action of AASs and their unwanted effects on organs and lifestyle, as well as suggesting that AAS misuse and abuse lead to adverse effects in all body tissues and organs. Oxidative stress, apoptosis, and protein synthesis alteration are common mechanisms involved in AAS-related damage in the whole body. The cardiovascular system and the reproductive system are the most frequently involved apparatuses. Epidemiology as well as the molecular and pathological mechanisms involved in the neuropsychiatric side-effects of AAS abuse are still unclear, further research is needed in this field. In addition, diagnostically reliable tests for AAS abuse should be standardized. In this regard, to prevent the use of AASs, public health measures in all settings are crucial. These measures consist of improved knowledge among healthcare workers, proper doping screening tests, educational interventions, and updated legislation.

Health risks within prisons are well known and have worsened with the 2019 coronavirus pandemic (COVID-19), becoming a public health emergency. To date, there are more than 10 million inmates in the world; in most cases, conditions are bad and health care is scarce. A SARS-CoV-2 outbreak inside a prison is extremely rapid. The aim of this systematic review was to analyze all possible prevention techniques to reduce the risk of COVID-19 related infection within prisons. A systematic review of the literature was performed according to the PRISMA guidelines. Scopus, Web of Science, PubMed, and Google Scholar were used as search engines from 1 January 2020 to 1 November 2021 to evaluate the prevention of COVID-19 in prisoners. A total of 1757 articles were collected. Of them, 486 duplicates were removed. A total of 1250 articles did not meet the inclusion criteria. In conclusion, 21 articles were included in the present systematic review. From this analysis, it emerged that the most common COVID-19 prevention methods were the screening of the entire population (prisoners and workers) inside the prison through swab analysis and the reduction in overcrowding in prisons. Few studies concerned the prevention of COVID-19 infection through vaccination and the implementation of quarantine. To our knowledge, this is the first systematic review that evaluates the prevention of COVID-19 within jails and the real effectiveness of all possible methods used and published in the literature. Finally, a very useful strategic protocol is provided to reduce the incidence of infection and to control and manage COVID-19 in prisons.

During the COVID-19 pandemic, forensic sciences, on the one hand, contributed to gaining knowledge about different aspects of the pandemic, while on the other hand, forensic professionals were called on to quickly adapt their activities to respond adequately to the changes imposed by the pandemic. This review aims to clarify the state of the art in forensic medicine at the time of COVID-19, discussing the following: the influence of external factors on forensic activities, the impact of autopsy practice on COVID-19 and vice-versa, the persistence of SARS-CoV-2 RNA in post-mortem samples, forensic personnel activities during the SARS-CoV-2 pandemic, the global vaccination program and forensic sciences, forensic undergraduate education during and after the imposed COVID-19 lockdown, and the medico-legal implications in medical malpractice claims during the COVID-19 pandemic. The COVID-19 pandemic has greatly influenced different aspects of human life, and, accordingly, the practical activities of forensic sciences that are defined as multidisciplinary, involving different expertise. Indeed, the activities are very different, including crime scene investigation (CSI), external examination, autopsy, and genetic and toxicological examinations of tissues and/or biological fluids. At the same time, forensic professionals may have direct contact with subjects in life, such as in the case of abuse victims (in some cases involving children), collecting biological samples from suspects, or visiting subjects in the case of physical examinations. In this scenario, forensic professionals are called on to implement methods to prevent the SARS-CoV-2 infection risk, wearing adequate PPE, and working in environments with a reduced risk of infection. Consequently, in the pandemic era, the costs involved for forensic sciences were substantially increased.

The medico-legal term “sudden death (SD)” refers to those deaths that are not preceded by significant symptoms. SD in apparently healthy individuals (newborn through to adults) represents a challenge for medical examiners, law enforcement officers, and society as a whole. This review aims to introduce a useful flowchart that should be applied in all cases of SD. Particularly, this flowchart mixes the data obtained through an up-to-date literature review and a revision of the latest version of guidelines for autopsy investigation of sudden cardiac death (SCD) in order to support medico-legal investigation. In light of this review, following the suggested flowchart step-by-step, the forensic pathologist will be able to apply all the indications of the scientific community to real cases. Moreover, it will be possible to answer all questions relative to SD, such as: death may be attributable to cardiac disease or to other causes, the nature of the cardiac disease (defining whether the mechanism was arrhythmic or mechanical), whether the condition causing SD may be inherited (with subsequent genetic counseling), the assumption of toxic or illicit drugs, traumas, and other unnatural causes.

In Italy, a person suffering from a mental disorder who commits a crime will be given a custodial security order and serve the period of admission at a Residenza per la esecuzione delle misure di sicurezza (REMS) (Residence for the Execution of Security Measures, hereinafter “REMS”). These institutions have been established recently and though equipped with the necessary safety measures, the focus is on psychiatric therapy. Despite being present on a national scale, access is very limited in terms of capacity. Immediate remedial measures are needed, so much so that the European Court of Human Rights recently condemned Italy for this very reason. This article, through a review of the constitutive principles of these institutions, shows how they have very positive aspects such as the attention to necessary psychotherapy in order to protect the right to health and the real taking charge of the fragility of the subjects; however, it is seen how there are many negative aspects linked above all to the scarce availability of places in these structures. The article provides suggestions on a more comprehensive strategy for facilities for detainees with mental disorders.

Introduction: Smart drugs are among the most common drugs used by students. It is estimated that they are second in incidence after cannabis. Although they are usually used for diseases such as attention deficit hyperactivity disorder (ADHD) and dementia, in most cases the use of smart drugs is illegal and without a prescription. Methodological issues: A systematic review was conducted according to PRISMA guidelines. SCOPUS, Medline (using PubMed as a search engine), Embase, Web of Sciences, and Google Scholar were used as search engines from January 1, 1980 to June 1, 2021 to evaluate the association between smart drugs and neuro-enhancement. A total of 4715 articles were collected. Of these, 295 duplicates were removed. A total of 4380 articles did not meet the inclusion criteria. In conclusion, 48 articles were included in the present systematic review. Results: Most of the studies were survey studies, 1 was a prospective longitudinal study, 1 was a cross-over study, and 1 was an experimental study in an animal model (rats). The largest group of consumers was school or university students. The most frequent reasons for using smart drugs were: better concentration, neuro enhancement, stress reduction, time optimization, increased wake time, increased free time, and curiosity. There are conflicting opinions, in fact, regarding their actual functioning and benefit, it is not known whether the benefits reported by consumers are due to the drugs, the placebo effect or a combination of these. The real prevalence is underestimated: it is important that the scientific community focus on this issue with further studies on animal models to validate their efficacy.

Adipose tissue is a multifunctional organ involved in many physiological and metabolic processes through the production of adipokines and, in particular, adiponectin. Caloric restriction is one of the most important strategies against obesity today. The very low-calorie ketogenic diet (VLCKD) represents a type of caloric restriction with very or extremely low daily food energy consumption. This study aimed to investigate the physiological effects of a VLCKD on anthropometric and biochemical parameters such as adiponectin levels, as well as analyzing oligomeric profiles and cytokine serum levels in obese subjects before and after a VLCKD. Twenty obese subjects were enrolled. At baseline and after eight weeks of intervention, anthropometric and biochemical parameters, such as adiponectin levels, were recorded. Our findings showed a significant change in the anthropometric and biochemical parameters of these obese subjects before and after a VLCKD. We found a negative correlation between adiponectin and lipid profile, visceral adipose tissue (VAT), C-reactive protein (CRP), and pro-inflammatory cytokines such as tumor necrosis factor-a (TNF-a), which confirmed the important involvement of adiponectin in metabolic and inflammatory diseases. We demonstrated the beneficial short-term effects of a VLCKD not only in the treatment of obesity but also in the establishment of obesity-correlated diseases.

Cranial trepanation is among the oldest head surgical procedures, creating a hole through the skull. This procedure is the surgical removal of a portion of the skull as a medical treatment to cure a specific disease or as a religious or magical ritual. Cranial trepanation has been reported from very early times and widespread all over the world. This work is based on data from six trepanned skulls from the Hellenistic Age (IV century BC) to the Late Antiquity (VI century). The samples come from Puglia (Southern Italy), from the northern (the peninsula of Gargano) to the central area: three cases come from Vieste (Foggia), Ischitella (Foggia) and Alberona (Foggia), the others three from Gravina in Puglia (Bari) and Canosa (Barletta, Andria, Trani). All skulls have been evaluated via an anthropological, radiological and odontological approach. This study indicates the value of a methodology, which encompasses anthropology, radiology and imaging, and archeo-forensic investigations, highlighting the need for multidisciplinary teamwork in any assessment of human remains. The study supports the hypothesis of the presence of a long tradition of medical centres in the Mediterranean basin area.

Prenatal alcohol exposure is considered one of the main causes of preventable birth disorders; however, it represents the main form of developmental delay in the world. Among the so-called secondary disabilities related to fetal alcohol spectrum disorder (FASD), there is a close connection with criminal behavior. This systematic review aims to provide up-to-date information about the relationship between FASD subjects and criminal justice analyzing different aspects. In light of the results of this review, a further goal is to provide several suggestions in order to reduce the public cost impact of FASD. A systematic review of the literature was conducted according to the PRISMA guidelines, producing 20 articles that met the inclusion criteria. Based on the results published in the selected studies, fetal alcohol syndrome (FAS) is a leading cause of preventable birth disorders and developmental disabilities in newborns. Moreover, these subjects seem to be more inclined to criminal acts compared to others. In conclusion, it should be pointed out that FASD entails high public health costs, both regarding the support measures provided to the affected individual and to their family, as well as the cost and social impact of any criminal offenses committed.

Background: Caloric restriction is a valid strategy to reduce the visceral adipose tissue (VAT) content in obese persons. Hypocretin-1 (orexin-A) is a neuropeptide synthesized in the lateral hypothalamus that strongly modulates food intake, thus influencing adipose tissue accumulation. Therapeutic diets in obesity treatment may combine the advantages of caloric restriction and dietary ketosis. The current study aimed to evaluate the effect of a very low calorie ketogenic diet (VLCKD) in a population of obese patients. Methods: Adiposity parameters and orexin-A serum profiling were quantified over an 8 week period. The effect of the VLCKD on reactive oxygen species (ROS) production and cell viability was evaluated, in vitro, by culturing Hep-G2 cells in the presence of VLCKD sera. Results: Dietary intervention induced significant effects on body weight, adiposity, and blood chemistry parameters. Moreover, a selective reduction in VAT was measured by dual-energy X-ray absorptiometry. Orexin-A levels significantly increased after dietary treatment. Hep-G2 cell viability was not affected after 24, 48, and 72 h incubation with patients&rsquo, sera, before and after the VLCKD. In the same model system, ROS production was not significantly influenced by dietary treatment. Conclusion: The VLCKD exerts a positive effect on VAT decrease, ameliorating adiposity and blood chemistry parameters. Furthermore, short-term mild dietary ketosis does not appear to have a cytotoxic effect, nor does it represent a factor capable of increasing oxidative stress. Finally, to the best of our knowledge, this is the first study that shows an effect of the VLCKD upon the orexinergic system, supporting the usefulness of such a therapeutic intervention in promoting obesity reduction in the individual burden of this disease.

Phorate is a systemic organophosphorus pesticide (OP) that acts by inhibiting cholinesterases. Recent studies have reported that long-term low/moderate exposure to OP could be correlated with impaired cardiovascular and pulmonary function and other neurological effects. A 70-year-old farmer died after an intention ingestion of a granular powder mixed with water. He was employed on a farm for over 50 years producing fruit and vegetables, and for about 20 years, he had also applied pesticides. In the last 15 years, he used phorate predominantly. The Phorate concentration detected in gastric contents was 3.29 µg/mL. Chronic exposure to phorate is experimentally studied by histopathological changes observed in the kidney. In the light of current literature, our case confirms that there is an association between renal damage and chronic exposure to phorate in a subject exposed for years to the pesticide. Autopsies and toxicological analyses play a key role in the reconstruction of the dynamics, including the cause of the death.

Il fenomeno della violenza di genere, intesa come la violenza maschile agita sulle donne in quanto tali, è divenuto, da almeno vent’anni a questa parte, uno dei temi di dibattito più salienti in una pluralità di ambiti, da quello sociologico a quello giuridico e politico, da quello criminologico a quello psicologico, medico e sanitario. La violenza di genere è infatti un fenomeno globale, senza confini territoriali, culturali, sociali o di classe, che riguarda milioni di donne in tutto il mondo. Per un’analisi dettagliata delle relative evidenze statistiche, a livello globale e nazionale, rinviamo ai successivi contributi contenuti in questo volume (e in particolare a quelli della Prof.ssa Merzagora e a quello del Prof. Di Nunno), ma basta citare un solo dato per comprendere appieno le dimensioni del fenomeno in tutta la sua gravità: l’Organizzazione Mondiale della Sanità ha stimato che a livello mondiale il 35% delle donne ha subito almeno un episodio di violenza fisica e/o sessuale nel corso della sua vita. Né si deve pensare che la situazione sia migliore o differente in Italia, dove un’altra ricerca, condotta dall’Istat nel 2006, ha permesso di delineare un quadro altrettanto emergenziale, con un totale del 31,9% delle donne intervistate che si è dichiarato vittima di almeno un episodio di violenza fisica e/o sessuale nel corso della propria esistenza. Ad allarmare, poi, non è solo l’incidenza del fenomeno, ma anche la gravità delle sue conseguenze. Anche quando gli episodi di violenza non sfociano nel femminicidio (o femicidio che dir si voglia), infatti, comportano una serie di effetti diretti e indiretti che riguardano non solo la donna stessa, ma anche la sua famiglia, in particolare i figli, soprattutto se minori, e la comunità nel suo complesso. Un corpus sempre più nutrito di studi ha dimostrato come la violenza contro le donne, sia essa di tipo fisico, sessuale, psicologico o economico, ha pesanti ricadute a lungo termine sulla salute delle vittime; le donne che hanno subito abusi, infatti, patiscono non solo un’ampia gamma di conseguenze fisiche dirette (lesioni, fratture, disabilità di varia natura, disturbi ginecologici, malattie a trasmissione sessuale), ma sono altresì soggette a complicazioni concernenti la loro salute psicologica e mentale (depressione, tendenze suicidarie, disturbo post-traumatico da stress, abuso di alcoolici e sostanze stupefacenti, solo per citarne alcune). Altrettanto problematiche si rivelano le ripercussioni di tipo intergenerazionale, legate agli effetti della violenza assistita, che sono spesso destinate a incidere in maniera decisiva sullo sviluppo emotivo e lo stile di relazione dei minori appartenenti ai nuclei familiari in cui si verificano episodi di abuso. Il che ci porta infine a discutere del nucleo familiare quale teatro privilegiato delle violenze contro la donna. Tutte le ricerche dedicate all’argomento hanno infatti messo in luce come la violenza domestica, agita nel contesto familiare, e ancora più specificamente l’Intimate Partner Violence (IPV), ossia la violenza perpetrata da un uomo nei confronti della moglie o della compagna nell’ambito di una relazione di coppia, risultino di gran lunga le più comuni tra le forme di abuso che rientrano nella più generale categoria di violenza di genere. Un dato, questo, che contravviene alla comune nozione di famiglia quale nido degli affetti e delle cure, ma che pure, come detto, è ampiamente attestato e comprovato nella letteratura scientifica. Alla radice di questa problematica appare allora necessario individuare e indagare un’altra nozione: quella di conflitto. Il conflitto è un elemento caratterizzante di tutte le forme di relazione, a livello culturale o sociale quanto a livello inter-personale; in quanto tale è una componente ineliminabile di ogni forma di incontro e convivenza e proprio dalla capacità di risoluzione del conflitto dipende la stabilità del sistema di relazione. Una degenerazione del conflitto determinata dalla mancata, incompleta o disfunzionale risoluzione dello stesso è invariabilmente la causa della dissoluzione della relazione o dell’instaurarsi di dinamiche disfunzionali, tali da determinare tensioni e aggressività che nei peggiori dei casi finiscono poi con lo sfociare nell’esercizio della violenza. Comprendere le ragioni della violenza allo scopo di prevenirla, evitarne il ripetersi o mitigarne gli effetti negativi una volta che questa si sia manifestata (quelle che tecnicamente si definiscono prevenzione primaria, secondaria e terziaria), implica allora anche la necessità di comprendere le ragioni del conflitto e quella di addivenire a efficaci strategie di gestione, negoziazione e risoluzione dello stesso. Il contenuto di questo volume fa riferimento ad una serie di riflessioni e studi prodotti nell’ambito dell’attività di ricerca e didattica della cattedra di Criminologia dell’Università del Salento, che hanno trovato espressione nell’elaborazione di un cospicuo numero di tesi di laurea nonché nella promozione e partecipazione a numerosi convegni e iniziative culturali tra le quali, in particolare, il seminario di studi dall’omonimo titolo “La violenza nelle relazioni affettive”, presieduto dal Prof. Francesco Carrieri e tenutosi in Lecce nel giugno del 2013. Si è ritenuto opportuno rendere conto dell’evoluzione della giurisprudenza sull’argomento nelle more della pubblicazione.

Canosa (Bari) is one of the most important archeological centers in Apulia, and in southern Italy. The importance of this town, which had already emerged in the pre-Roman age when Canosa was one of the wealthiest and most powerful settlements in the Daunia region, was further strengthened during Roman times. It reached a peak in the 6th–8th century A.D., when the town became the seat of the governors and the regional capital of the provincia Apulia et Calabria. The town very soon became a leading religious center, too, thanks to the presence of a large Christian community led by powerful bishops, who were frequently called to attend important religious councils and were involved in diplomatic missions. The greatest splendor of the Canosa church was in the middle of the 6th century, at the time of the famous bishop Sabino, who was held traditionally to have presided over the diocese for over 50 years (514–566), and who commissioned an intensive program of construction of holy buildings. The Paleo-Christian settlement attributed great importance to the cemetery, which features tombs of various types in which one or more bodies were buried, generally without funerary accoutrements. Nevertheless, they were clearly people of rank, including an anonymous defensor (civitatis or ecclesiae) and a certain Georgius parbulus; the inscription in his name found in the hall confirms that the cemetery was fully in use already in the 7th century. Finally, the southern area of the quarter was occupied by craftsmen, as demonstrated by at least two furnaces for the production of building materials and of ceramics. The building compounds identified up to now were devoted to many different functions of a liturgical, pastoral, funerary, administrative and residential type, typical of an important Paleo-Christian settlement like the town of Canosa.

Questo lavoro si rivolge a studenti che, pur afferendo a Facoltà non mediche, manifestano interesse per la Medicina Sociale. Tale Materia è per sua natura multidisciplinare. Lo scopo è quello di offrire in maniera sintetica quelle informazioni necessarie per l’approfondimento di temi essenziali per operatori di professioni di aiuto. Tra gli autori vi sono medici legali, psichiatri, psicologi, giuristi e pedagogisti. In tale modo, l’approccio interdisciplinare consente di trattare i vari argomenti in modo polispecialistico. Il lavoro è stato svolto prediligendo un approccio inclusivo.

The time of death can be established by determining the length of the postmortem interval. Many methods have been proposed to achieve this goal. Flow cytometric evaluation of DNA degradation seems to be reliable for the first 72 hours after death. Our study evaluated the correspondence of the corruption process between in vitro and corpse tissues. We chose spleen tissue to perform our investigation because it is rich in nucleated cells. Results showed a precise correspondence between the two kinds of samples in the time period between 24 and 36 hours. The period from 36 to 72 hours is characterized by a much looser correspondence than that found in the first period. After the first 72 hours, DNA denaturation is massive and does not allow useful cytofluorimetric readings. The spleen does not seem to be the most suitable organ for this type of investigation because it tends to colliquate very rapidly. We therefore are evaluating other organs to identify a more suitable tissue source for the investigation of longer postmortem period using flow cytometry.

The problem of the possibility of modifying blank cartridge dummy firearms to make them fire a real bullet has long been known, but the phenomenon has been constantly on the increase in the recent years. In Italy, there are no restrictions on the purchase of an inoffensive weapon. However, few modifications are frequently enough to transform the inoffensive weapon into a harmful one: a procedure is often undertaken to avoid the mandatory control and registration of firearms. We describe a case of suicide of a man in Trieste, Italy, in 2002, with a blank cartridge dummy pistol that had been modified to fire homemade bullets. Today the achievement of a proper control of the spread of firearms is a serious problem worldwide. In particular, this is true in the case of weapons the lethal nature of which can be masked to pass a superficial examination, with the aim of evading the security laws in all nations. For various reasons, individuals may become illicit holders of firearms of various types and natures, often made out of common objects produced for other purposes. These can be bought on the market or found at home, but after assembly and proper modifications, they can be transformed into true weapons, homemade guns that work perfectly and are potentially lethal. The situation is slightly different in the case of home-modified guns, in which the transformed object was already a weapon, but originally produced to fire blank cartridges, as a replica or a toy (such as air guns or gas guns, or other instruments like tear-gas pen guns and pellet guns), that are available on the market and can be easily modified to convert them into harmful weapons. These are peculiar events that demonstrate a particular manual skill and ingenuity of their inventors, and make extremely difficult to identify the weapon used, in case of its absence on the scene-of-crime, or the dynamics of the event.

The authors describe a singular case of fatal impalement due to penetration of a metal tube at the level of the neck in a victim of a road traffic accident. The man was traveling in the passenger seat ("death seat") of a car that hit the parapet of a bridge head on; death was attributed to hemorrhagic shock, which was brought on virtually instantly at the moment of impact.

The authors present 3 cases of asphyxia caused by atypical compression of the neck by the metal bed bars fitted at the sides of the bed to prevent falling out. These occurred in 3 elderly women living in nursing homes, confined to bed by severe neuropsychiatric disturbances. In all 3 cases, the minor nature of the skin lesions and absence of blood infiltrations in the anatomic structures of the neck had made it difficult to diagnose the cause of death. Inspection of the rest homes, together with the autopsy findings (acute pulmonary emphysema, conjunctival petechiae, and dark, fluid blood), enabled identification of asphyxia as the cause of death and its causal agent as the bed bars.

In cases of rape, obtaining enough biologic material for DNA identification of the attacker is often difficult because the methods for distinguishing and separating sperm cells from vaginal cells are not sufficiently efficacious. This article describes a new, innovative method for spermatic DNA extraction from the vaginal washing fluid by means of flow cytometry. The high specificity and sensitivity of the flow-cytometric sorting method provides enough sperm cells for DNA typing. The ease of execution of this method, involving vaginal washing with physiologic solution and flow-cytometric reading of the fresh sample, substantially increases its cost-benefit ratio.

Blood samples were obtained from selected and unrelated individuals. DNA was extracted with the standard Chelex® 100 (Bio-Rad, CA) extraction procedure (1); DNA samples were amplified in a DNA Thermal Cycler 480 (Perkin Elmer Cetus, NJ) using 10 ng of template DNA.

Blood samples were obtained from selected and unrelated individuals. DNA was extracted with the standard Chelex® 100 (Bio-Rad, CA) extraction procedure (1); DNA samples were amplified in a DNA Thermal Cycler 480 (Perkin Elmer Cetus, NJ) using 10 ng of template DNA.

The level of degradation of DNA as a means for determining the time of death has been proposed as a valid adjunct to the classic thanatochronologic methods. The twofold aim of this work was to determine which organ might reveal both a correlation between the percentage of degradation of the DNA and the time lapse since death, and would be easiest to sample and yield the most reproducible results even in technically unfavorable situations such as on-the-spot investigations at the scene of death. A comparison of the spleen, blood, and liver showed that hepatic tissue best meets these specific needs because it shows a virtually linear correlation between the time elapsed since death and the level of degradation of the DNA, and it can easily be sampled at the scene of death by use of a common biopsy needle.

This paper proposes the use of radiographic magnification to detect the effects of neck traumas. This technique, both fast and economical, has proved to be particularly useful in all those cases where post mortem examinations failed to detect valid evidence of lesions of the hyoid-larynx complex. This is the case with corpses in an advanced stage of putrefaction where death occurred as a result of pressure or when a soft object is placed between the victim's neck and the assailant's hands. The radiological study was performed "on site" on four cases of medicolegal interest and its potential was confirmed.

THE AMERICAN JOURNAL OF SURGICAL PATHOLOGY (NEW YORK)

The authors anlayze the case of an Albanian refugee who was killed by the propellers of the outboard engine of a rubber dinghy while illegally attempting to reach Italy. The finding of multiple parallel, deep clear-cut injuries is uncommon, but highly characteristic of the object producing the lesions. These are typical and cannot be mistaken with those produced by sharp objects or shark bites. The description of the injuries is vital for establishing the position of the victim with regard to the propellet that struck him.

We present a case of death caused by voluntary ingestion of non-organic foreign bodies observed at the Institute of Legal Medicine of the University of Trieste. The victim was a young schizophrenic patient whose death, at first giving rise to suspicions of murder by another psychiatric patient, was found to be caused by an uncommon chronic permanence of foreign bodies at different locations of the digestive tract which suddenly evolved into a series of simultaneous lethal complications as yet never described. The case also raised the issue of possible responsibilities of the subject's healthcare providers.

Distribution of HumvWA31, HumFESFPS, HumTH01, HumTPOX, HumCD4, HumCSF1PO Alleles in a Southern Italian Population Sample