59 results on '"Guido Pelletti"'
Search Results
2. The Evaluation of CYP2D6, CYP2C9, CYP2C19, and CYP2B6 Phenoconversion in Post-Mortem Casework: The Challenge of Forensic Toxicogenetics
- Author
-
Arianna Giorgetti, Sara Amurri, Giulia Fazio, Carla Bini, Laura Anniballi, Filippo Pirani, Guido Pelletti, and Susi Pelotti
- Subjects
drug metabolism ,drug–gene interaction ,cytochrome P450 genes ,genotype ,phenotype ,phenoconversion ,Microbiology ,QR1-502 - Abstract
In toxicogenetics, an integrative approach including the prediction of phenotype based on post-mortem genotyping of drug-metabolising enzymes might help explain the cause of death (CoD) and manner of death (MoD). The use of concomitant drugs, however, might lead to phenoconversion, a mismatch between the phenotype based on the genotype and the metabolic profile actually observed after phenoconversion. The aim of our study was to evaluate the phenoconversion of CYP2D6, CYP2C9, CYP2C19, and CYP2B6 drug-metabolising enzymes in a series of autopsy cases tested positive for drugs that are substrates, inducers, or inhibitors of these enzymes. Our results showed a high rate of phenoconversion for all enzymes and a statistically significant higher frequency of poor and intermediate metabolisers for CYP2D6, CYP2C9, and CYP2C19 after phenoconversion. No association was found between phenotypes and CoD or MoD, suggesting that, although phenoconversion might be useful for a forensic toxicogenetics approach, more research is needed to overcome the challenges arising from the post-mortem setting.
- Published
- 2023
- Full Text
- View/download PDF
3. Infection Induced Fetal Inflammatory Response Syndrome (FIRS): State-of- the-Art and Medico-Legal Implications—A Narrative Review
- Author
-
Elena Giovannini, Maria Paola Bonasoni, Jennifer Paola Pascali, Arianna Giorgetti, Guido Pelletti, Giancarlo Gargano, Susi Pelotti, and Paolo Fais
- Subjects
fetal inflammatory response syndrome ,placental pathology ,causal link ,medical liability ,medico-legal compensation ,Biology (General) ,QH301-705.5 - Abstract
Fetal inflammatory response syndrome (FIRS) represents the fetal inflammatory reaction to intrauterine infection or injury, potentially leading to multiorgan impairment, neonatal mortality, and morbidity. Infections induce FIRS after chorioamnionitis (CA), defined as acute maternal inflammatory response to amniotic fluid infection, acute funisitis and chorionic vasculitis. FIRS involves many molecules, i.e., cytokines and/or chemokines, able to directly or indirectly damage fetal organs. Therefore, due to FIRS being a condition with a complex etiopathogenesis and multiple organ dysfunction, especially brain injury, medical liability is frequently claimed. In medical malpractice, reconstruction of the pathological pathways is paramount. However, in cases of FIRS, ideal medical conduct is hard to delineate, due to uncertainty in diagnosis, treatment, and prognosis of this highly complex condition. This narrative review revises the current knowledge of FIRS caused by infections, maternal and neonatal diagnosis and treatments, the main consequences of the disease and their prognoses, and discusses the medico-legal implications.
- Published
- 2023
- Full Text
- View/download PDF
4. Validation of a HS–GC–FID Method for the Quantification of Sevoflurane in the Blood, Urine, Brain and Lungs for Forensic Purposes
- Author
-
Guido Pelletti, Rossella Barone, Susan Mohamed, Francesca Rossi, Marco Garagnani, Arianna Giorgetti, Paolo Fais, and Susi Pelotti
- Subjects
sevoflurane ,gas chromatography ,flame ionization detector ,biological matrices ,forensic toxicology ,Biochemistry ,QD415-436 - Abstract
Background: Sevoflurane is a polyfluorinated compound extensively used as an inhalation anesthetic in patients undergoing surgery. If administered outside the operating room, sevoflurane is dangerous and potentially lethal, and toxicologists may be asked to investigate its presence in biological matrices for forensic purposes. The aim of the present study is to develop and validate a method for the detection and the quantification of sevoflurane in biological fluids and organs through gas chromatography coupled to flame ionization detection (GC–FID). Methods: The method was optimized based on the maximization of the signal-to-noise ratio. The GC–FID instrument was equipped with a Zebron capillary column ZB-624 (30 m, 0.32 mm ID, 1.80 µm film thickness). Results: The method was validated over a concentration range of 1.0–304.0 µg/mL (blood and urine) and µg/g (brain, lungs). The lower limit of quantitation was 1.0 µg/mL or µg/g. Both the intra- and interassay imprecision and inaccuracy were ≤15% at all quality control concentrations in all the matrices. The method was successfully applied to measure the sevoflurane concentrations for 20 negative controls and for a real forensic case. Conclusions: The present method is suitable for the identification and quantification of sevoflurane in fluids and organs and can be a reliable tool in forensic casework.
- Published
- 2023
- Full Text
- View/download PDF
5. Molecular Mechanisms of Action of Novel Psychoactive Substances (NPS). A New Threat for Young Drug Users with Forensic-Toxicological Implications
- Author
-
Arianna Giorgetti, Jennifer P. Pascali, Paolo Fais, Guido Pelletti, Andrea Gabbin, Giorgia Franchetti, Giovanni Cecchetto, and Guido Viel
- Subjects
forensic toxicology ,new psychoactive substances (NPS) ,mass spectrometry ,toxicodynamic ,mechanism of action ,Science - Abstract
Novel psychoactive substances (NPS) represent a severe health risk for drug users. Even though the phenomenon has been growing since the early 2000s, the mechanisms of action of NPS at the receptors and beyond them are still scarcely understood. The aim of the present study was to provide a systematic review of the updated knowledge regarding the molecular mechanisms underlying the toxicity of synthetic opioids, cannabinoids, cathinones, and stimulants. The study was conducted on the PubMed database. Study eligibility criteria included relevance to the topic, English language, and time of publication (2010–2020). A combined Mesh and free-text protocols search was performed. Study selection was performed on the title/abstract and, in doubtful cases, on the full texts of papers. Of the 580 records identified through PubMed searching and reference checking, 307 were excluded by title/abstract and 78 additional papers were excluded after full-text reading, leaving a total of 155 included papers. Molecular mechanisms of synthetic opioids, synthetic cannabinoids, stimulants, psychedelics, and hallucinogens were reviewed and mostly involved both a receptor-mediated and non-receptor mediated cellular modulation with multiple neurotransmitters interactions. The molecular mechanisms underlying the action of NPS are more complex than expected, with a wide range of overlap among activated receptors and neurotransmitter systems. The peculiar action profile of single compounds does not necessarily reflect that of the structural class to which they belong, accounting for possible unexpected toxic reactions.
- Published
- 2021
- Full Text
- View/download PDF
6. Routine Photography of Injuries
- Author
-
Arianna Giorgetti, Jennifer Paola Pascali, Guido Pelletti, Annamaria Silvestri, Elena Giovannini, Susi Pelotti, and Paolo Fais
- Subjects
Pathology and Forensic Medicine - Published
- 2023
7. Impact on touch DNA of an alcohol-based hand sanitizer used in COVID-19 prevention
- Author
-
Carla Bini, Arianna Giorgetti, Giulia Fazio, Sara Amurri, Guido Pelletti, and Susi Pelotti
- Subjects
Pathology and Forensic Medicine - Abstract
In the last years, forensic research has been focused on touch DNA in order to improve its evidential value in criminal activity investigations as well as to understand the variables impacting touch DNA. One of the emerging variables is represented by the use of alcohol-based sanitizers, which was suggested for hand hygiene during the COVID-19 pandemic. The aims of the present study were to assess the effect of a hand sanitizer on touch DNA deposition, transfer, and recovery and also to evaluate STR typing success, quality of DNA profiles, and personal identification. Before and after the use of an alcohol-based hand sanitizer, 20 volunteers deposited on glass surfaces 120 fingerprints, containing skin-derived or salivary DNA. Samples were quantified by real-time quantitative PCR (q-PCR), and 76 samples yielding > 15 pg/μl were typed for 21 autosomal STRs by GlobalFiler® PCR Amplification Kit. DNA profiles were classified into single source, mixed, and inconclusive profiles, and a LR assessment was performed by comparison to the reference samples using LRmix Studio software. After the use of hand sanitizer, samples yielded lower quantities of recovered transferred DNA, especially considering samples containing salivary DNA (p 6. Results showed that, although the hand sanitizer reduces the DNA recovering, touch DNA samples might still be useful for forensic personal identification even when hand sanitizers are used.
- Published
- 2023
8. Deliberate Self-Poisoning: Real-Time Characterization of Suicidal Habits and Toxidromes in the Food and Drug Administration Adverse Event Reporting System
- Author
-
Michele Fusaroli, Guido Pelletti, Valentina Giunchi, Chiara Pugliese, Mattia Bartolucci, Elena Narmine Necibi, Emanuel Raschi, Fabrizio De Ponti, Susi Pelotti, Elisabetta Poluzzi, Fusaroli M., Pelletti G., Giunchi V., Pugliese C., Bartolucci M., Necibi E.N., Raschi E., De Ponti F., Pelotti S., and Poluzzi E.
- Subjects
Pharmacology ,drugs safety ,FAERS ,Deliberate self poisoning ,Pharmacology (medical) ,Toxicology ,suicide - Abstract
IntroductionDeliberate self-poisoning (DSP) using drugs is the preferred method of suicide at a global level. Its investigation is hampered by limited sample sizes and data reliability. We investigate the role of the US FDA Adverse Event Reporting System (FAERS), a consolidated pharmacovigilance database, in outlining DSP habits and toxidromes.MethodsWe retrieved cases of 'intentional overdose' and 'poisoning deliberate' from the FAERS (January 2004-December 2021). Using descriptive and disproportionality analyses, we estimated temporal trends, potential risk factors, toxidromes, case-fatality rates and lethal doses (LDs) for the most frequently reported drugs.ResultsWe retrieved 42,103 DSP cases (17% fatal). Most cases were submitted in winter. Reports of DSP involved younger people, psychiatric conditions, and alcohol use, compared with non-DSP, and fatality was higher in men and older patients. Suspected drugs were mainly antidepressants, analgesics, and antipsychotics. Multiple drug intake was recorded in more than 50% of the reports, especially analgesics, psychotropics, and cardiovascular agents. The most frequently reported drugs were paracetamol, promethazine, amlodipine, quetiapine, and metformin. We estimated LD25 for paracetamol (150 g).ConclusionWorldwide coverage of the FAERS complements existing knowledge about DSP and may drive tailored prevention measures to timely address the DSP phenomenon and prevent intentional suicides.
- Published
- 2023
9. A Genome-Wide Analysis of a Sudden Cardiac Death Cohort: Identifying Novel Target Variants in the Era of Molecular Autopsy
- Author
-
Pelotti, Livia Beccacece, Paolo Abondio, Arianna Giorgetti, Carla Bini, Guido Pelletti, Donata Luiselli, and Susi
- Subjects
forensic genomics ,autopsy ,unexpected death ,sudden death ,sudden cardiac death ,coronary artery disease - Abstract
Sudden cardiac death (SCD) is an unexpected natural death due to cardiac causes, usually happening within one hour of symptom manifestation or in individuals in good health up to 24 h before the event. Genomic screening has been increasingly applied as a useful approach to detecting the genetic variants that potentially contribute to SCD and helping the evaluation of SCD cases in the post-mortem setting. Our aim was to identify the genetic markers associated with SCD, which might enable its target screening and prevention. In this scope, a case–control analysis through the post-mortem genome-wide screening of 30 autopsy cases was performed. We identified a high number of novel genetic variants associated with SCD, of which 25 polymorphisms were consistent with a previous link to cardiovascular diseases. We ascertained that many genes have been already linked to cardiovascular system functioning and diseases and that the metabolisms most implicated in SCD are the lipid, cholesterol, arachidonic acid, and drug metabolisms, suggesting their roles as potential risk factors. Overall, the genetic variants pinpointed herein might be useful markers of SCD, but the novelty of these results requires further investigations.
- Published
- 2023
- Full Text
- View/download PDF
10. Human DNA contamination of postmortem examination facilities: Impact of COVID‐19 cleaning procedure
- Author
-
Carla Bini, Arianna Giorgetti, Elena Giovannini, Guido Pelletti, Paolo Fais, and Susi Pelotti
- Subjects
Genetics ,COVID-19 ,Equipment Contamination ,Humans ,Autopsy ,DNA ,DNA Contamination ,Pandemics ,Pathology and Forensic Medicine - Abstract
The DNA contamination of evidentiary trace samples, included those collected in the autopsy room, has significant detrimental consequences for forensic genetics investigation. After the COVID-19 pandemic, methods to prevent environmental contamination in the autopsy room have been developed and intensified. This study aimed to evaluate the level of human DNA contamination of a postmortem examination facility before and after the introduction of COVID-19-related disinfection and cleaning procedures. Ninety-one swabs were collected from the surfaces and the dissecting instruments, analyzed by real-time quantitative PCR (q-PCR) and typed for 21 autosomal STRs. Sixty-seven out of 91 samples resulted in quantifiable human DNA, ranging from 1 pg/μl to 12.4 ng/μl, including all the samples collected before the implementation of COVID-19 cleaning procedures (n = 38) and 29 out of 53 (54.7%) samples taken afterward. All samples containing human DNA were amplified, resulting in mixed (83.6%), single (13.4%), and incomplete (3%) profiles. A statistically significant decrease in DNA contamination was found for dissecting instruments after treatment with chlorhexidine and autoclave (p 0.05). Environmental decontamination strategies adopted during COVID-19 pandemic only partially solved the long-standing issue of DNA contamination of postmortem examination facilities. The pandemic represents an opportunity to further stress the need for standardized evidence-based protocols targeted to overcome the problem of DNA contamination in the autopsy room.
- Published
- 2022
11. Cognitive biases in the medical-legal assessment of medical malpractice
- Author
-
Michele D’ALEO, Marco IRMICI, Guido PELLETTI, and Francesca INGRAVALLO
- Published
- 2023
12. Multiple sharp force injuries: an unplanned complex suicide or a brutal homicide?
- Author
-
Marco IRMICI, Michele D’ALEO, Guido PELLETTI, Arianna GIORGETTI, and Susi PELOTTI
- Published
- 2023
13. Insights in opiates toxicity: impairment of human vascular mesenchymal stromal cells
- Author
-
Maria Carla Mazzotti, Gabriella Teti, Arianna Giorgetti, Francesco Carano, Guido Pelletti, Jennifer Paola Pascali, Mirella Falconi, Susi Pelotti, Paolo Fais, Mazzotti, Maria Carla, Teti, Gabriella, Giorgetti, Arianna, Carano, Francesco, Pelletti, Guido, Pascali, Jennifer Paola, Falconi, Mirella, Pelotti, Susi, and Fais, Paolo
- Subjects
Morphine sulphate ,In vitro ,Human vascular mesenchymal stromal cell ,Opiate-related fatalities ,Pathology and Forensic Medicine ,Forensic toxicology - Abstract
The most common pulmonary findings in opiate-related fatalities are congestion and oedema, as well as acute and/or chronic alveolar haemorrhage, the cause of which is thought to be a damage to the capillary endothelium related to ischemia. Human vascular mesenchymal stromal cells (vMSCs) play a fundamental role in tissue regeneration and repair after endothelial cell injury, and they express opioid receptors. The aim of this study was to assess the effect of in vitro morphine exposure on the physiological activity and maintenance of human vMSCs. vMSCs were obtained from abdominal aorta fragments collected during surgery repair and were exposed to incremental doses (0.1 mM, 0.4 mM, 0.8 mM and 1 mM) of morphine sulphate for 7 days. The effect was investigated through cell viability assessment, proliferation assay, reactive oxygen species (ROS) detection assay, senescence-associated β-galactosidase assay, senescent-related markers (p21WAF1/CIP1 and p16INK4) and the apoptosis-related marker caspase 3. Moreover, an ultrastructural analysis by transmission electron microscopy and in vitro vascular differentiation were evaluated. Results showed a decrease of the cellular metabolic activity, a pro-oxidant and pro-senescence effect, an increase in intracellular ROS and the activation of the apoptosis signalling, as well as ultrastructural modifications and impairment of vascular differentiation after morphine treatment of vMSC. Although confirmation studies are required on real fatal opiate intoxications, the approach based on morphological and immunofluorescence methodologies may have a high potential also as a useful tool or as a complementary method in forensic pathology. The application of these techniques in the future may lead to the identification of new markers and morphological parameters useful as complementary investigations for drug-related deaths.
- Published
- 2023
14. Intravascular large <scp>B‐cell</scp> lymphoma affecting multiple cranial nerves: A histopathological study
- Author
-
Andrea Porzionato, Martina Contran, Veronica Macchi, Luisa Barzon, Aron Emmi, Guido Pelletti, Angelo Arminio, Raffaele De Caro, Porzionato A., Pelletti G., Barzon L., Contran M., Emmi A., Arminio A., Macchi V., and De Caro R.
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Cerebellum ,nerve palsy ,Hypoglossal nucleus ,cranial nerves ,Motor Neuron ,Solitary tract nucleus ,Pathology and Forensic Medicine ,medicine ,cranial nerve ,Diplopia ,neurolymphomatosi ,Intravascular large B-cell lymphoma ,business.industry ,intravascular large B-cell lymphoma ,Cranial nerves ,General Medicine ,Middle Aged ,medicine.disease ,neurolymphomatosis ,medicine.anatomical_structure ,Medulla oblongata ,Autopsy ,Lymphoma, Large B-Cell, Diffuse ,Neurology (clinical) ,medicine.symptom ,Cuneate nucleus ,business ,Human - Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a rare form of lymphomas with poor prognosis, characterized by atypical lymphocytes selectively growing within the lumen of small or medium-sized vessels. Here, we report a case of intracerebral IVLBCL in a 54-year-old man who died three months after symptom onset. The diagnosis was made by postmortem pathological examination, based on the identification of multiple ischemic lesions, with small or medium-sized vessels filled with malignant B-cells, in the cerebral hemispheres, cerebellum, midbrain, and medulla oblongata, including the external cuneate nucleus and trigeminal spinal tract nucleus. Apart from necrotic lesions, specific histopathological search for occluded vessels in the other brain stem structures permitted identification of significant involvement of the cuneate nucleus, solitary tract nucleus, hypoglossal nucleus, and inferior olivary complex. Small vessels affected by IVLBCL were also found in the trunks of the oculomotor, trigeminal, glossopharyngeal, vagal, and hypoglossal nerves. These histopathological findings were consistent with some cranial nerve symptoms/signs ascertained during hospitalization, such as diplopia, dysphonia, and asymmetry/hypomotility of the palatal veil. The case study presented here reports novel insights on radiological, anatomical, and clinical correlations of the IVLBCL, including the possible involvement of nuclei and trunks of multiple cranial nerves. The reported findings may help clinicians in the early identification of this rapidly progressive disease that can be easily misdiagnosed, through integrated neuroradiological, neurological and neuropathological approaches.
- Published
- 2021
15. [Sudden cardiac death in young people and in adults: primary and contributing causes. The experience of the multidisciplinary network in Emilia-Romagna]
- Author
-
Ornella, Leone, Valentina, Agostini, Maddalena, Graziosi, Cesare, Rossi, Guido, Pelletti, Alberto, Foà, Gianni, Guadagnini, Mattia, Riefolo, Matteo, Ziacchi, Paolo, Fais, Susi, Pelotti, Claudio, Rapezzi, and Marco, Seri
- Subjects
Adult ,Male ,Adolescent ,Heart Diseases ,Infant ,Middle Aged ,Young Adult ,Death, Sudden, Cardiac ,Child, Preschool ,Humans ,Female ,Autopsy ,Genetic Testing ,Child ,Brugada Syndrome - Abstract
The multidisciplinary network of Emilia-Romagna for the study of juvenile sudden cardiac death (SCD) was started in Bologna in June 2018 in order to: (1) define the spectrum of etiologies and mechanisms of SCD in young people; (ii) standardize diagnostic terminology and categories; (iii) identify potentially hereditary genetic heart diseases and define the contribution of post-mortem genetic analysis (so-called molecular autopsy) to the overall diagnostic process; (iv) identify preclinical forms of the pathologies in the first-degree relatives of the deceased subject using both phenotypic and genotypic evaluation and, where possible, undertake therapeutic/prophylactic measures (primary prevention).In the first 2 years of activity (01/06/2018-27/08/2020) 50 cases of SCD came to the attention of the Cardiovascular Pathology Unit of the S. Orsola-Malpighi Polyclinic in Bologna, from Centres of Forensic Medicine and Pathological Anatomy in most of the region.Sixty-two percent of cases were sent by forensic pathologists, 36% by clinical pathologists and 2% by the family of the deceased. Medico-legal cases were prompted by autopsies requested by the Judicial Authority in 70% of cases; 55.5% of patients referred by pathologists came from the Cardiovascular Tissue Bank, as part of the regional program for the quality and safety control of organs and tissues from multiorgan-multitissue donors. The average age of the subjects was 35 ± 13.6 years (70% male, range: 1-55 years; median: 38 years). The spectrum of the final diagnoses includes: structurally normal hearts 14%, cardiomyopathies 40%, coronary heart disease 23%, Brugada syndrome 6%, aortic dissection 4%, substance abuse 6%, valvular heart disease 2%, mixed causes 2%.The network is necessarily centered on post-mortem pathological activities, but it does not end with these. If in 60% of cases the pathological autopsy examination was decisive in identifying the cause of death, in the other cases a detailed final diagnosis was reached only with more complex pathways involving molecular genetics, clinical genetics, and toxicology.
- Published
- 2022
16. Medico-Legal issues in a neurosurgical case series of Rathke Cleft Cysts. Informed consent, complications and medical liability
- Author
-
Guido Pelletti, Francesca Galuppini, Marina Paola Gardiman, Carla Scaroni, Tommaso Prayer Galetti, Salvatore Scrivano, R. Snenghi, and Luca Denaro
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,Compensation (psychology) ,Medical jurisprudence ,Liability ,Retrospective cohort study ,Asymptomatic ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Informed consent ,Intervention (counseling) ,Medicine ,030216 legal & forensic medicine ,Rathke Cleft Cysts ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Rathke cleft cysts (RCCs) are asymptomatic benign sellar cysts. Their surgical treatment may lead to a series of well known complications, many of which can be interpreted as failed surgical interventions. We present a retrospective study on patients with treated RCCs that filed a claim for compensation for medical professional liability, with the aim of reporting the medico-legal issues related to the surgical resection of RCC. A retrospective analysis was performed between 1999 and 2016 on patients diagnosed with RCCs and who underwent surgical resection. The clinical experience of the patients alleging medical liability was analysed by an interdisciplinary group following the European Guidelines proposed by the European Academy of Legal Medicine. Eight patients developed late complications and made a claim for compensation. Only in one case a prognostic error was detected. The pre- and postoperative conditions, as well as the onset of early and late complications are reported and discussed in the paper, as well as the differentiation between “error-free” vs “error-related” complications. Understanding the underlying causes of the increase in compensation claims, as in the specific case, can help not only in the reduction of errors, but also in the prevention of compensation claims, which result in an increase in public and private spending. One of the main causes of the disproportion between the request for compensation and actual compensation is the expectation regarding surgery and the onset of complications, which could be solved through the appropriateness of consent submitted before the intervention.
- Published
- 2020
17. Valproic acid determination by liquid chromatography coupled to mass spectrometry (LC-MS/MS) in whole blood for forensic purposes
- Author
-
Jennifer P. Pascali, Arianna Giorgetti, Rossella Barone, Guido Pelletti, and Paolo Fais
- Subjects
Pharmaceutical Science ,Environmental Chemistry ,Spectroscopy ,Analytical Chemistry - Abstract
Valproic acid (VPA) is a well-known drug prescribed as anti-epileptic. It has a narrow therapeutic range and shows great individual differences in pharmacodynamics and pharmacokinetics. Consequently, the therapeutical drug monitoring (TDM) in patient's plasma is of crucial importance. Liquid chromatography coupled to mass spectrometry (LC-MS/MS) has gained importance in TDM applications for its features of sensitivity, selectivity and rapidity. However, in case of VPA, the LC-MS/MS selectivity could be hampered by the lack of a sufficient number of multiple reaction monitoring (MRM) transitions describing the molecule. In fact, the product ion scan of deprotonated molecules of VPA does not produce any ion and thus most LC-MS/MS methods are based on the detection of the unique MRM transition m/z 143➔143. In this way, the advantages of selectivity in LC-MS cannot be effectively exploited. In the present method, stable analyte adducts were exploited for the determination of VPA in blood. An Acquity HSS C18 column and mobile phases consisting of 5-mM ammonium formate and acetonitrile both added 0.1% formic acid were used. Source worked in negative acquisition mode and parameters were optimized to increase the adduct (m/z 189) and dimer (m/z 287) stability, and their fragmentation were used to increase the selectivity of MRM detection. The method has been validated according to the toxicological forensic guidelines and successfully applied to 10 real blood samples. Finally, the present method showed suitable for the rapid LC-MS/MS detection of VPA in whole blood, demonstrating the possibility to increase specificity by exploiting stable in-source adducts. This should be considered of utmost importance in the case of forensic applications.
- Published
- 2022
18. Toluene Abuse: A Medicolegal Perspective
- Author
-
Guido Pelletti
- Published
- 2022
19. Gender differences in driving under the influence of psychoactive drugs: Evidence mapping of real case studies and meta-analysis
- Author
-
Guido Pelletti, Rafael Boscolo-Berto, Rossella Barone, Arianna Giorgetti, Clara Fiorentini, Jennifer P. Pascali, Paolo Fais, and Susi Pelotti
- Subjects
Male ,Automobile Driving ,Psychotropic Drugs ,GenderDrugs of abuseMedicationForensic ToxicologyDriving Under the Influence ,Substance-Related Disorders ,Cannabinoids ,Amphetamines ,Pathology and Forensic Medicine ,Substance Abuse Detection ,Analgesics, Opioid ,Sex Factors ,Cocaine ,Humans ,Female ,Driving Under the Influence ,Law - Abstract
Very few studies have examined predictors of Driving Under the Influence (DUI) as a function of gender. This oversight is relevant, because analyzing gender differences prevents generalization of results observed in men, who still currently account for the majority of drivers worldwide, to women. The aim of this study is to analyze the prevalence of DUI of drugs in men and women reported in real case studies published in the last two decades, and to assess gender differences in risky DUI behaviour.PubMed, Scopus, Web of Science were searched for eligible studies in May 2021; a follow-up literature search was conducted in August 2021. Real-case studies of drivers convicted for DUI of psychoactive drugs with positive toxicological confirmatory analysis were included. The extracted outcome was the prevalence of positive findings of men and women for cocaine, cannabinoids, amphetamine-like drugs, opioids, and psychoactive prescription drugs. A meta-analysis of random effects estimates was performed to investigate the change in the size of the overall effect (by Cohen d standardized mean difference test). A Mann Whitney U test was performed to test for differences between genders.Of the 2877 studies screened, 439 were retrieved in full-text and 26 were included. The meta-analysis showed a significant higher prevalence among men for cocaine (1.8% vs 0.9%; p 0.001), cannabinoids (3.5% vs 1.6%; p = 0.01) and amphetamine-like drugs (1.2% vs 0.6%; p 0.01). Surprisingly, no differences were observed in the use of opioids (2.3% vs 2.2%; p = 0.45) and benzodiazepines/Z-drugs (2.9% vs 3.7%; p = 0.52).Contrary to the extraordinary number of real-case studies reported in literature, only a few papers differentiate the prevalence of DUI between men and women. This can lead to an underestimation of the influence of gender in DUI phenomenon or complicate the evaluation of the results for some classes of substances, as observed for medications and opioids. The primary goal in the future will be to collect the data concerning DUI drivers following shared and homogeneous methodologies, in order to allow the analysis of data disaggregated by gender, which can be used for monitoring evolving trends and developing gender-specific targeted prevention and enforcement efforts.
- Published
- 2022
20. Morphological characterization using scanning electron microscopy of fly artifacts deposited by Calliphora vomitoria (Diptera: Calliphoridae) on household materials
- Author
-
Desiree Martini, Laura Ingrà, Paolo Fais, Arianna Giorgetti, Maria Carla Mazzotti, Mirella Falconi, Guido Pelletti, Pelletti G., Martini D., Ingra L., Mazzotti M.C., Giorgetti A., Falconi M., and Fais P.
- Subjects
Morphology (linguistics) ,Scanning electron microscope ,Analytical chemistry ,01 natural sciences ,Calliphora ,Pathology and Forensic Medicine ,Forensic pathology ,03 medical and health sciences ,0302 clinical medicine ,Calliphoridae ,Animals ,Humans ,030216 legal & forensic medicine ,Texture (crystalline) ,biology ,Chemistry ,Diptera ,010401 analytical chemistry ,Bloodstain pattern analysi ,biology.organism_classification ,0104 chemical sciences ,Amorphous solid ,Fly artifact ,Polyester ,Blood Stains ,Ultrastructure ,Microscopy, Electron, Scanning ,Artifacts ,Bloodstain pattern analysis ,Scanning electron microscopy ,Crime scene - Abstract
Insects found at a crime scene can produce traces referred to as fly artifacts (FA) due to their movement over the corpse and the manner in which they feed upon it. These can be detrimental for carrying out criminal investigations. Confusing a FA with a genuine bloodspot can lead to misinterpretations, also taking into consideration that FA may contain a human DNA profile. The aim of the present study was to employ scanning electron microscopy (SEM) for the analysis of FA produced by Calliphora vomitoria on hard surfaces and fabrics that are commonly present at crime scenes. FA and control bloodstains were produced under experimental conditions on metal, glass, plaster, cotton, and polyester. After macroscopic analysis, FA were examined at standard low (20–40 ×), medium low (300–600 ×), and high ultrastructural (1200 ×) magnification through a SEM Stereoscan 360, Leica, Cambridge. SEM analysis enabled the identification of distinctive features of FA on hard surfaces, namely, amorphous crystals, micro-crystals with a morphology similar to those of uric or micro-crystals with a comparable morphology to cholesterol, absent in controls. Moreover, red blood cells (RBC) were absent in FA but were always present in controls. On cotton, for both FA and controls, the drop was almost completely absorbed and thus indistinguishable from the underlying fabric texture. On polyester, FA showed amorphous/crystal-like deposits and no RBC, as observed on hard surfaces, except for those showing a completely flat surface. SEM analysis appeared to be suitable for differential diagnosis between FA and genuine bloodstains on hard surfaces, although the results may be inconclusive on tested fabrics.
- Published
- 2022
21. Development and validation of a rapid LC-MS/MS method for the detection of 182 novel psychoactive substances in whole blood
- Author
-
Belal Haschimi, Guido Pelletti, Volker Auwärter, Marco Garagnani, Rossella Barone, Jennifer P. Pascali, Arianna Giorgetti, Giorgetti, Arianna, Barone, Rossella, Pelletti, Guido, Garagnani, Marco, Pascali, Jennifer, Haschimi, Belal, and Auwärter, Volker
- Subjects
Pharmaceutical Science ,Context (language use) ,Mass spectrometry ,Analytical Chemistry ,Forensic Toxicology ,Liquid chromatography–mass spectrometry ,Limit of Detection ,Tandem Mass Spectrometry ,Synthetic cannabinoids ,Lc ms ms ,novel psychoactive substance ,medicine ,Environmental Chemistry ,Spectroscopy ,Whole blood ,mass spectrometry ,Detection limit ,screening method ,validation ,Psychotropic Drugs ,Chromatography ,Chemistry ,Psychotropic Drug ,Forensic toxicology ,Substance Abuse Detection ,forensic toxicology ,novel psychoactive substances ,medicine.drug ,Chromatography, Liquid - Abstract
INTRODUCTION The analysis of novel psychoactive substances (NPS) represents a challenge in forensic toxicology, due to the high number of compounds characterized by different structures and physicochemical properties both among different subclasses and within a single subclass of NPS. The aim of the present work is the development and validation of a targeted liquid chromatography tandem mass spectrometry (LC-MS/MS) method for the detection of NPS in whole blood. MATERIALS AND METHODS A protein-precipitation based LC-MS/MS method for the detection of more than 180 NPS was developed and validated by assessing the following parameters: selectivity, linearity, accuracy, precision, limit of detection (LOD) and of quantification (LOQ) recovery, and matrix effect. Then, the method was applied to real forensic samples. RESULTS The method allowed the identification of 132 synthetic cannabinoids, 22 synthetic opioids, and 28 substances among synthetic cathinones, stimulants, and other drugs. Validation was successfully achieved for most of the compounds. Linearity was in the range of 0.25-10 ng/ml for synthetic cannabinoids and 0.25-25 ng/ml for other drugs. Accuracy and precision were acceptable according to international guidelines. Three cases tested positive for fentanyl and ketamine, in the setting of emergency room administration. CONCLUSIONS The present methodology represents a fast, not expensive, wide-panel method for the analysis of more than 180 NPS by LC-MS/MS, which can be profitably applied both in a clinical context and in postmortem toxicology.
- Published
- 2021
22. PANDEMIA DA COVID-19 E ABUSO DI SOSTANZE STUPEFACENTI. LE NUOVE FRONTIERE DELLA RIDUZIONE DEL DANNO
- Author
-
Leonardo Brevi, Guido Pelletti, Susi Pelotti, and Leonardo Brevi, Guido Pelletti, Susi Pelotti
- Subjects
COVID-19, droghe d’abuso, disturbo da uso di sostanze, riduzione del danno, EMCDDA, prevenzione - Abstract
Il modello di riduzione del danno (RdD), una misura sanitaria già diffusa in Europa dall’inizio degli anni ’80, ha come principale obiettivo quello di tutelare la salute dell’individuo che fa uso di sostanze stupefacenti. La diffusione del COVID-19 ha creato nuove aree di vulnerabilità ed esacerbato quelle preesistenti, ponendo sfide senza precedenti in ambito sanitario, tra cui la tutela delle persone che consumano droghe. Per le persone che utilizzano sostanze stupefacenti sono state diffuse buone pratiche, che si aggiungono alle raccomandazioni standard. Non di meno, le attuali politiche di RdD dovranno essere potenziate alla luce della nuova pandemia COVID-19, come previsto in questi mesi dalle principali società scientifiche ed associazioni nazionali ed internazionali. I messaggi sulla RdD incentrati sui rischi associati all’iniezione dovranno essere rimodulati alla luce del contagio attraverso droplets, tipico di pratiche considerate fino ad oggi “meno a rischio”, come la condivisione di sigarette, strumenti per la vaporizzazione e l’inalazione. L’assistenza territoriale dovrà essere potenziata con l’ausilio su larga scala della telemedicina, percorso già avviato nei primi due mesi della pandemia, nonché per mezzo di screening tossicologici ed infettivologici a domicilio, sulla base del modello applicato nella provincia di Hubei (Cina). L’attività dei laboratori di tossicologia forense e clinica e l’attivazione di ulteriori sistemi di allerta rapida saranno indirizzati alla prevenzione e alla tempestiva segnalazione delle possibili variazioni del mercato in termini di modifica della domanda, sostituzione e contraffazione delle sostanze
- Published
- 2020
23. A DNA-based method for distinction of fly artifacts from human bloodstains
- Author
-
Alessandra Iuvaro, Arianna Giorgetti, Guido Pelletti, Elena Giovannini, Denise Gianfreda, Susi Pelotti, Carla Bini, Bini C., Giorgetti A., Iuvaro A., Giovannini E., Gianfreda D., Pelletti G., and Pelotti S.
- Subjects
Mitochondrial DNA ,genetic structures ,Human dna ,Forensic genetics ,Biology ,Pathology and Forensic Medicine ,Crime scene ,Animals ,Humans ,A-DNA ,Bloodstain pattern analysis ,Species identification ,Artifact (error) ,Fly artifacts ,Human blood ,mtDNA ,Diptera ,fungi ,Bloodstain pattern analysi ,Reproducibility of Results ,Forensic genetic ,DNA ,Feeding Behavior ,Fly artifact ,Blood Stains ,Evolutionary biology ,Mitochondrial cytochrome ,Original Article ,Artifacts ,COI sequence - Abstract
Fly artifacts resulting from insect activity could act as confounding factors on a crime scene and interfere with bloodstain pattern analysis interpretation. Several techniques have been proposed to distinguish fly artifacts from human bloodstains based on morphological approach and immunological assay, but a DNA-based method has not been developed so far. Even if in forensic genetic investigations the detection of human DNA is generally the primary goal, fly artifacts can provide useful information on the dynamics of crime events. The present study provides a molecular method to detect fly DNA from artifacts deposited by Calliphora vomitoria after feeding on human blood through the analysis of the mitochondrial cytochrome oxidase gene subunit I (COI). Fly artifacts originated from digestive process and of different morphology spanning from red and brownish/light brown, circular and elliptical stains to artifacts with sperm-like tail or a tear-shaped body were collected. The COI amplification was successfully obtained in 94% of fly artifact samples. The method showed high sensitivity and reproducibility, and no human DNA contamination was observed, offering specificity for use in confirmatory test. This molecular approach permits the distinction of fly artifacts from genuine bloodstains and the identification of fly’s species through the COI region sequencing by protocols usually applied in forensic genetic laboratories. Supplementary Information The online version contains supplementary material available at 10.1007/s00414-021-02643-7.
- Published
- 2021
24. Sudden Unexpected Death after a mild trauma: The complex forensic interpretation of cardiac and genetic findings
- Author
-
Susi Pelotti, Simone Gavelli, Guido Pelletti, Alberto Foà, Cesare Rossi, Valentina Agostini, Ornella Leone, Pelletti G., Leone O., Gavelli S., Rossi C., Foa A., Agostini V., and Pelotti S.
- Subjects
medicine.medical_specialty ,Heart disease ,business.industry ,RYR2 variation ,Cardiomyopathy ,Dilated cardiomyopathy ,Autopsy ,medicine.disease ,Catecholaminergic polymorphic ventricular tachycardia ,Ryanodine receptor 2 ,Pathology and Forensic Medicine ,Sudden cardiac death ,Dilated cardiopathy, Molecular autopsy ,Internal medicine ,medicine ,Cardiology ,Next-generation sequencing ,Medical genetics ,business ,Law - Abstract
A 55-year-old man affected by a psychotic disorder suddenly died during a quarrel with his father. The autopsy excluded traumatic causes of death, and the cardiac examination identified a severe cardiomegaly with biventricular dilatation of very likely multifactorial origin. Toxicological and pharmacogenetic analyses excluded a fatal intoxication and identified the presence of the antipsychotic drug fluphenazine in the therapeutic range in a normal metabolizer. The screening for genetic variations highlighted a novel heterozygous single-nucleotide variant in the exon 36: c 0.4750C>A (p.Pro1584Thr) of the Ryanodine Receptor Type 2 (RYR2) gene. The mutation detected can be classified as Likely Pathogenic according to the American College of Medical Genetics and Genomics (ACMG) criteria. RYR2 variation has been associated to catecholaminergic polymorphic ventricular tachycardia (CPVT), a disease currently recognized as one of the most malignant cardiac channelopathies, expressed mostly in young patients, normally in the absence of structural heart disease. The victim late middle age, compared to juvenile onset of CPVT reported in literature, his clinical history, his structurally altered heart, circumstances at death and the absence of phenotype-related variations of dilated cardiomyopathy genes, suggested that the fatal arrhythmia could have been caused by an acquired form of dilated cardiopathy/cardiomyopathy. However, the contribution of the genetic variant to death cannot be completely ruled out, since the significance of a VUS or of a novel variant depends on the data available at the time of investigation, and should be periodically evaluated. We discuss the contribution of the structural alteration and of the variant detected, as well as the role of the molecular autopsy in forensic examination, which can make a significant contribution for inferring both cause and manner of death.
- Published
- 2021
25. The use of fly artifacts in a crime scene: Is there any application for forensic toxicology?
- Author
-
Elena Giovannini, Arianna Giorgetti, Paolo Fais, Guido Pelletti, Rossella Barone, Susi Pelotti, Jennifer P. Pascali, Giorgetti A., Pelletti G., Fais P., Giovannini E., Barone R., Pelotti S., and Pascali J.P.
- Subjects
6-MAM ,human bloodstains ,Pathology and Forensic Medicine ,Heroin ,chemistry.chemical_compound ,Trace evidence ,Tandem Mass Spectrometry ,Genetics ,Crime scene ,Medicine ,Heroin users ,forensic toxicology ,Putrefaction ,liquid chromatography-mass spectrometry ,codeine ,Morphine Derivatives ,fly artifacts ,business.industry ,Codeine ,human bloodstain ,Forensic toxicology ,Pattern recognition ,chemistry ,benzoylecgonine ,fly artifact ,Benzoylecgonine ,crime scene investigation ,Crime ,Artificial intelligence ,Artifacts ,business ,Chromatography, Liquid ,medicine.drug - Abstract
Fly artifacts (FA) are bloodstains resulting from insect activity at a crime scene, usually by feeding on human blood. Whether these artifactual stains might be useful for forensic toxicological investigations in cases of absence of conventional and unconventional matrices, for example, in cases concealment of the body or of extensive putrefaction, has not yet been investigated. The purpose of this study is to understand if FA trace evidence permits toxicological analysis when traditional matrices are not available. To this aim, FA experimentally produced by Calliphora vomitoria feeding on human blood of a cocaine and heroin user were collected from absorptive and non-absorptive material. FA material was analyzed by a new simple and fast LC-MS/MS method. Results were evaluated in terms of presence of the drug and relative amount of the detected molecules. From a qualitative point of view, the analysis of FA revealed all the substances originally detected in post-mortem blood in both cases. The ratios of cocaine/benzoylecgonine, codeine/morphine, and 6-monoacetylmorphine/morphine recovered in FA from cotton-textile materials and from non-absorptive surfaces were consistent with data resulted from original post-mortem blood. The preliminary study herein reported demonstrated that FA are extremely informative in case of cocaine and heroin users and merit further research in order to be applied in real caseworks.
- Published
- 2021
26. Importance of dashboard camera (Dash Cam) analysis in fatal vehicle–pedestrian crash reconstruction
- Author
-
Arianna Giorgetti, Alessio Giusti, Marco Garagnani, Elena Giovannini, Guido Pelletti, Paolo Fais, Susi Pelotti, Jennifer P. Pascali, Giovannini E., Giorgetti A., Pelletti G., Giusti A., Garagnani M., Pascali J.P., Pelotti S., and Fais P.
- Subjects
Computer science ,Vehicle pedestrian crash ,Video Recording ,Case Report ,Dash Cam ,Pedestrian ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Aeronautics ,Traffic crash ,0502 economics and business ,Dash ,Humans ,030216 legal & forensic medicine ,Articulated vehicle ,Forensic Pathology ,Pedestrians ,050210 logistics & transportation ,Privacy right ,05 social sciences ,Digital video ,Accidents, Traffic ,General Medicine ,Manner of death ,Motor Vehicles ,Dashboard ,Motor Vehicle ,Forensic pathology ,Human - Abstract
The reconstruction of dynamic of traffic injuries remains a challenge in forensic pathology and is often based on circumstantial data. Dash Cams are digital video recorders which can be located inside a vehicle and continuously record the view through the windscreen, thus providing objective evidence. Here we present the case of a traffic crash in which a pedestrian was hit by an articulated lorry. The analysis of a video recorded from a Dash Cam retrieved inside the vehicle during the death scene investigation (DSI) was crucial in the reconstruction of the manner of death. Indeed, the death, which was initially assumed to be accidental, was finally deemed as a suicide on the basis of the video recording, which showed an intentional and sudden rush of the victim to the middle of the roadway. Advantages and disadvantages of the use of Dash Cams will be discussed, focusing on the profound differences in the related national and international regulations. Based on the present case, in traffic crashes, the search for Dash Cams during the DSI may be recommended and the video recordings should be analyzed in the setting of a multidisciplinary and multimodal evaluation of the case, for a proper reconstruction of the facts. Supplementary Information The online version contains supplementary material available at 10.1007/s12024-021-00382-0.
- Published
- 2021
27. Molecular mechanisms of action of novel psychoactive substances (Nps). A new threat for young drug users with forensic-toxicological implications
- Author
-
Giorgia Franchetti, Giovanni Cecchetto, Guido Pelletti, Paolo Fais, Andrea Gabbin, Arianna Giorgetti, Jennifer P. Pascali, Guido Viel, Giorgetti A., Pascali J.P., Fais P., Pelletti G., Gabbin A., Franchetti G., Cecchetto G., and Viel G.
- Subjects
0301 basic medicine ,Hallucinogen ,Drug ,media_common.quotation_subject ,Science ,Neurotransmitter systems ,toxicodynamic ,Review ,Mechanism of action ,Bioinformatics ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Study Eligibility Criteria ,Synthetic cannabinoids ,Medicine ,Health risk ,Ecology, Evolution, Behavior and Systematics ,media_common ,Mass spectrometry ,business.industry ,Toxicody-namic ,Forensic toxicology ,Paleontology ,030104 developmental biology ,Action (philosophy) ,Space and Planetary Science ,New psychoactive substances (NPS) ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Novel psychoactive substances (NPS) represent a severe health risk for drug users. Even though the phenomenon has been growing since the early 2000s, the mechanisms of action of NPS at the receptors and beyond them are still scarcely understood. The aim of the present study was to provide a systematic review of the updated knowledge regarding the molecular mechanisms underlying the toxicity of synthetic opioids, cannabinoids, cathinones, and stimulants. The study was conducted on the PubMed database. Study eligibility criteria included relevance to the topic, English language, and time of publication (2010–2020). A combined Mesh and free-text protocols search was performed. Study selection was performed on the title/abstract and, in doubtful cases, on the full texts of papers. Of the 580 records identified through PubMed searching and reference checking, 307 were excluded by title/abstract and 78 additional papers were excluded after full-text reading, leaving a total of 155 included papers. Molecular mechanisms of synthetic opioids, synthetic cannabinoids, stimulants, psychedelics, and hallucinogens were reviewed and mostly involved both a receptor-mediated and non-receptor mediated cellular modulation with multiple neurotransmitters interactions. The molecular mechanisms underlying the action of NPS are more complex than expected, with a wide range of overlap among activated receptors and neurotransmitter systems. The peculiar action profile of single compounds does not necessarily reflect that of the structural class to which they belong, accounting for possible unexpected toxic reactions.
- Published
- 2021
28. A 70-year study of femicides at the Forensic Medicine department, University of Bologna (Italy)
- Author
-
Arianna Giorgetti, Paolo Fais, Elena Giovannini, Chiara Palazzo, Ilenia Filipuzzi, Guido Pelletti, and Susi Pelotti
- Subjects
Humans ,Female ,Autopsy ,Violence ,Homicide ,Forensic Pathology ,Law ,Crime Victims ,Pathology and Forensic Medicine - Abstract
Femicide is defined as the gender-related killings of women and girls or as an any intentional murder of women and it represents a worldwide health issue. Although it has gained a growing attention across the public and the media, true data on its prevalence and a characterization of the phenomenon are still scarce. The aim of the present study was to evaluate the characteristics of female homicides and femicides, which are necessary to design and monitor effective preventive efforts. Post-mortem examination reports of female homicides occurred in the judicial district of Bologna over a period of 70 years were revised. Characteristics of victims and perpetrators, circumstantial and post-mortem data were extracted. Overall, 172 female homicides were observed, including 103 femicides, with no significant changes over time. The mean age of victims increased over time and showed a statistically significant association with the victim-perpetrator relationship. Homicides committed by non-intimate partner family members increased. Our study unveiled that, in the past decades, femicide was a hidden but constant social phenomenon, despite the social, cultural and juridical changes. The research in forensic pathology could help bring to light trends, characteristics and risk factors to be considered for strategies to counteract violence against women.
- Published
- 2022
29. Integrated multidisciplinary approach in a case of occupation related planned complex suicide-peticide
- Author
-
Chiara Palazzo, Paolo Fais, Guido Pelletti, Susi Pelotti, Jennifer P. Pascali, Federica Fersini, Maria Carla Mazzotti, Palazzo C., Pascali J.P., Pelletti G., Mazzotti M.C., Fersini F., Pelotti S., and Fais P.
- Subjects
Forensic pathology ,medicine.medical_specialty ,01 natural sciences ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Dogs ,Multidisciplinary approach ,Dog ,Medicine ,Animals ,Humans ,Psychiatric drugs ,030216 legal & forensic medicine ,Occupations ,Psychiatry ,business.industry ,Illicit Drugs ,Mentally ill ,Mental Disorders ,010401 analytical chemistry ,Forensic toxicology ,Pets ,Middle Aged ,0104 chemical sciences ,Pet ,Suicide ,Issues, ethics and legal aspects ,Licit drug ,Female ,business ,Homicide - Abstract
The combined event of a suicide and the killing of a pet has been hardly explored in forensic literature, but it is not rare at all. In the reported case the dead corpse of a 60-year old mentally ill woman and the carcass of a dog were found on the bed of a private apartment. In light of death scene investigation, necroscopic examination and toxicological analyses death was attributed to licit drug intoxication and self-strangulation after lethal poisoning of the dog. Due to the presence of two lethal means (cervical noose and drugs), acting in chronological order, the event was classified as a secondary complex suicide. Moreover, the woman, although mentally ill, was a psychiatrist. Thus, her professional background, namely the easy access to psychiatric drugs together with her knowledge of drug composition and properties lead to suppose an occupation related suicide. The comprehensive analysis of all the available information, including death scene investigation, occupational, necroscopic and toxicological data, resulted of the utmost importance for a proper reconstruction of the events and are recommended in complex cases such as occupation related planned complex suicides combined to the killing of pets.
- Published
- 2020
30. 'Light cannabis' consumption in a sample of young adults: Preliminary pharmacokinetic data and psychomotor impairment evaluation
- Author
-
Rossella Barone, Arianna Giorgetti, Francesca Rossi, Susi Pelotti, Marco Garagnani, Guido Pelletti, Paolo Fais, Pelletti G., Barone R., Giorgetti A., Garagnani M., Rossi F., Fais P., and Pelotti S.
- Subjects
media_common.quotation_subject ,Pharmacokinetic ,Cannabidiol (CBD) ,01 natural sciences ,Pathology and Forensic Medicine ,03 medical and health sciences ,Psychomotor Performances ,0302 clinical medicine ,Human use ,Pharmacokinetics ,Δ9-tetrahydrocannabinol (Δ9-THC) ,Medicine ,030216 legal & forensic medicine ,Young adult ,media_common ,Psychomotor learning ,biology ,Light cannabi ,business.industry ,010401 analytical chemistry ,Psychomotor impairment ,biology.organism_classification ,0104 chemical sciences ,Blood ,Cannabis ,business ,Law ,Cannabidiol ,Vigilance (psychology) ,Demography ,medicine.drug - Abstract
Introduction: In 2019, the Italian Supreme Court established that hemp cannot be commercialized for human use, when the “psychotropic effect” of the product or its “offensiveness” can be demonstrated. The aim of the present study is to assess Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) blood concentrations after smoking cannabis with a low percentage of Δ9-THC, also referred as “light cannabis”, and its effects on young adults’ vigilance, cognitive and motor skills. Materials and methods: Eighteen young adults consumed three light cannabis cigarettes containing 400 mg of inflorescences each, with a percentage of 0.41% of Δ9-THC and of 12.41% of CBD. Blood samples were collected before the experiment (t0), after each light cannabis cigarette (t1→t3), 60 (t4) and 120 (t5) minutes after the beginning of the experiment. Five performance tasks and a subjective scale were employed for measuring cognitive and psychomotor performances the day before the experiment (TT0) and after the third cigarette (TT1). Results: Mean (SD) concentrations (ng/ml) were 1.0 (0.8) in t1, 1.2 (0.9) in t2, 1.0 (0.8) in t3, 0.6 (0.4) in t4 and 0.3 (0.3) in t5 for Δ9-THC; 10.5 (10.3) in t1, 10.3 (13.2) in t2, 15.1 (14.8) in t3, 9.9 (9.2) in t4 and 5.7 (5.7) in t5 for CBD. No significant differences were observed between TT0 and TT1 for all performed psychomotor performance task. None of the subjects declared to feel “high” after the experiment. Discussion: All study participants reported that a higher number of cigarettes, corresponding in this study to 1200 mg of herbal product, could hardly be consumed by smoking in a recreational setting. Δ9-THC and CBD concentrations showed a high inter-subject variability, and the average concentrations were lower than those previously reported. Toxicological results showed a decrease of Δ9-THC and CBD after the third light cannabis cigarette, and a Δ9-THC /CBD ratio always
- Published
- 2021
31. Micro-computed tomography of false starts produced on bone by different hand-saws
- Author
-
Diego Miotto, Alessia Viero, Guido Viel, Giovanni Cecchetto, Sindi Visentin, Massimo Montisci, Chiara Giraudo, Paolo Fais, Guido Pelletti, Pelletti, Guido, Viel, Guido, Fais, Paolo, Viero, Alessia, Visentin, Sindi, Miotto, Diego, Montisci, Massimo, Cecchetto, Giovanni, and Giraudo, Chiara
- Subjects
Micro-CT ,Engineering ,Saw marks ,False start ,Human bone ,High resolution ,01 natural sciences ,Bone and Bones ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Tool marks ,Humans ,Orthopedic Procedures ,030216 legal & forensic medicine ,Micro ct ,Micro-computed tomography ,business.industry ,False starts ,Micro computed tomography ,010401 analytical chemistry ,nutritional and metabolic diseases ,Pattern recognition ,X-Ray Microtomography ,Surgical Instruments ,0104 chemical sciences ,Issues, ethics and legal aspects ,Saw mark ,Forensic Anthropology ,Artificial intelligence ,Tomography ,business ,Biomedical engineering - Abstract
The analysis of macro- and microscopic characteristics of saw marks on bones can provide useful information about the class of the tool utilized to produce the injury. The aim of the present study was to test micro-computed tomography (micro-CT) for the analysis of false starts experimentally produced on 32 human bone sections using 4 different hand-saws in order to verify the potential utility of micro-CT for distinguishing false starts produced by different saws and to correlate the morphology of the tool with that of the bone mark. Each sample was analysed through stereomicroscopy and micro-CT. Stereomicroscopic analysis allowed the identification of the false starts and the detection of the number of tool marks left by each saw. Micro-CT scans, through the integration of 3D renders and multiplanar reconstructions (MPR), allowed the identification of the shape of each false start correlating it to the injuring tool. Our results suggest that micro-CT could be a useful technique for assessing false starts produced by different classes of saws, providing accurate morphological profiles of the bone marks with all the advantages of high resolution 3D imaging (e.g., high accuracy, non-destructive analysis, preservation and documentation of evidence). However, further studies are necessary to integrate qualitative data with quantitative metrical analysis in order to further characterize the false start and the related injuring tool.
- Published
- 2017
32. Prevalence of therapeutic drugs in blood of drivers involved in traffic crashes in the area of Bologna, Italy
- Author
-
Guido Pelletti, Tim Reyns, Francesca Rossi, Marco Garagnani, Rossella Barone, Alain Verstraete, Susi Pelotti, and Pelletti G, Verstraete AG, Reyns T, Barone R, Rossi F, Garagnani M, Pelotti S.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Population ,Poison control ,01 natural sciences ,Suicide prevention ,Occupational safety and health ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Age Distribution ,Environmental health ,Injury prevention ,Epidemiology ,Prevalence ,Medicine ,Humans ,030216 legal & forensic medicine ,Sex Distribution ,education ,Driving Under the Influence ,Driving under the influence ,education.field_of_study ,Psychotropic Drugs ,business.industry ,Illicit Drugs ,010401 analytical chemistry ,celebrities ,Psychoactive medicinal drugsEpidemiologyDriversRoad traffic crashesDriving under the influence ,Accidents, Traffic ,Human factors and ergonomics ,Middle Aged ,0104 chemical sciences ,celebrities.reason_for_arrest ,Analgesics, Opioid ,Substance Abuse Detection ,Italy ,Blood Alcohol Content ,Female ,business ,human activities ,Law - Abstract
Introduction Psychoactive medicines, such as benzodiazepines and Z-drugs (BdZ), antidepressants and antipsychotics (AA) and medical opioids (MO), have an impairing effect on driving ability. In previous epidemiological studies performed on impaired and/or injured drivers, not all relevant psychoactive substances were included in the toxicological assessment, and their prevalence may be underestimated. This study aims to assess the prevalence of a large set of psychoactive substances (n = 53) in Italian drivers involved in a road traffic crash and in predefined population subgroups. Materials and methods The toxicological analyses were performed on the whole blood of 1026 drivers involved in a road traffic crash in the area of Bologna, Italy, from January 2017 to March 2018. Analyses were performed using GC-FID (alcohol), GC MS (illicit drugs) and LC/HRMS (psychoactive drugs). The population was divided into subgroups according to gender, age and crash time. Descriptive statistics were used in order to assess differences among sub-groups. Results The highest prevalence was found for alcohol (17.3%), followed by medicinal drugs (13.6%) and illicit drugs (5.5%). The prevalence of BdZ, AA and MO were 7.3%, 7.2% and 3.1%, respectively. The frequency of BDZ and AA was significantly higher in female drivers and showed higher prevalence at increasing age. The presence of medicinal drugs was significantly higher during the week and in crashes occurring during the day. Conclusion Results for alcohol and illicit drugs partially overlap with those reported in previous European and Italian studies, but the prevalence of BdZ was much higher. We also found a high prevalence of AA, which are rarely investigated in epidemiological studies performed on drivers, but may cause impairment of the ability to drive, especially when taken in combination with alcohol or other drugs. The pattern of medication use differs from that involving drugs of abuse, since it is mainly observed in female subjects and older drivers and does not follow the same weekly trend observed for alcohol and other illicit drugs.
- Published
- 2019
33. Crime scene and body alterations caused by arthropods: implications in death investigation
- Author
-
Stefano Vanin, Massimo Montisci, Guido Pelletti, and Alessia Viero
- Subjects
Movement activity ,Experimental laboratory ,01 natural sciences ,Pathology and Forensic Medicine ,Forensic pathology ,03 medical and health sciences ,0302 clinical medicine ,Body artefacts ,Crime scene alteration ,Forensic entomology ,Cadaver ,Animals ,Humans ,Crime scene ,030216 legal & forensic medicine ,Arthropods ,Forensic Sciences ,fungi ,010401 analytical chemistry ,food and beverages ,Forensic Medicine ,0104 chemical sciences ,Larva ,Postmortem Changes ,Forensic pathologist ,Original Article ,Autopsy ,Psychology ,Coroners and Medical Examiners ,Cognitive psychology - Abstract
The activity of arthropods on corpses has been largely investigated, since they can produce information to reconstruct the peri-mortem events. However, the feeding/movement activity of insects around the crime scene, among the clothes and on the body, can also cause some alterations that can lead to wrong reconstruction and misinterpretations. This article summarises all the post-mortem arthropods artefacts related to the scene (i.e. fly artefacts and floor stripes) and the body (i.e. skin and other soft tissue alterations, bone alterations and hair alterations) that can mislead the forensic pathologist, discussing macroscopic and microscopic findings derived from forensic casework and from experimental laboratory studies, in order to provide a useful instrument to avoid misinterpretations and evaluation errors. Finally, some procedural notes for the documentation and the interpretation of findings are proposed.
- Published
- 2019
34. Scanning electron microscopy in the identification of fly artifacts
- Author
-
Desiree Martini, Alberto Amadasi, Laura Ingrà, Mirella Falconi, Susi Pelotti, Maria Carla Mazzotti, Guido Pelletti, Paolo Fais, Chiara Palazzo, Pelletti G., Mazzotti M.C., Fais P., Martini D., Ingra L., Amadasi A., Palazzo C., Falconi M., and Pelotti S.
- Subjects
Scanning electron microscope ,Sarcophagidae ,Sarcophaga carnaria ,01 natural sciences ,Pathology and Forensic Medicine ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Animals ,Humans ,030216 legal & forensic medicine ,biology ,Chemistry ,010401 analytical chemistry ,Bloodstain pattern analysi ,Sem analysis ,biology.organism_classification ,Blood Physiological Phenomena ,0104 chemical sciences ,Fly artifact ,Blood Stains ,Microscopy, Electron, Scanning ,Artifacts ,Bloodstain pattern analysis ,Scanning electron microscopy ,Biomedical engineering ,Crime scene - Abstract
Bloodstain pattern analysis has a key role in crime scene reconstruction; however, it can be hampered by diverse confounding factors, such as insect activity which may lead to the production of small artifactual bloodstains, commonly referred to as fly artifacts (FA). Although several techniques aimed at distinguishing human bloodstains and FA have been developed, actually, no standardized and reproducible methodology is available. The aim of our study was to test the use of scanning electron microscopy (SEM) to distinguish human bloodstains from FA produced by Sarcophaga carnaria. FA and bloodstains have been produced on five different deposition surfaces under experimental conditions. After visual analysis, bloodstains and FA were analyzed at standard low (× 40–× 300) and high (× 600–× 1200) magnification through a Philips SEM 515. Although differential diagnosis between bloodstains and FA resulted often inconclusive at visual analysis, SEM analysis allowed the identification of additional key distinctive morphological features. In particular, on the surface of FA, small crystal-like and/or amorphous material deposits were observed. Such deposits were absent on bloodstains which, on the other hand, displayed red blood cells stacked in “rouleaux.” Basing on these results and under our experimental conditions, SEM analysis resulted suitable to perform a differential diagnosis between bloodstains and FA produced from the insect activity of Sarcophaga carnaria.
- Published
- 2018
35. Validation and preliminary application of a GC-MS method for the determination of putrescine and cadaverine in the human brain: a promising technique for PMI estimation
- Author
-
Susi Pelotti, Paolo Fais, Rafael Boscolo-Berto, Marco Garagnani, Annalisa Morotti, Francesca Rossi, Guido Pelletti, Rossella Barone, Raffaella Roffi, and Pelletti G, Garagnani M, Barone R, Boscolo-Berto R, Rossi F, Morotti A, Roffi R, Fais P, Pelotti S.
- Subjects
Accuracy and precision ,Correlation coefficient ,Gas chromatography mass spectrometry ,Liquid-Liquid Extraction ,CAD ,Post mortem interval ,01 natural sciences ,Gas Chromatography-Mass Spectrometry ,Pathology and Forensic Medicine ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Limit of Detection ,Cadaverine ,medicine ,Putrescine ,Humans ,030216 legal & forensic medicine ,Forensic Pathology ,Mathematics ,Post-mortem interval ,Biogenic polyamine ,Forensic biochemistry and toxicology ,business.industry ,010401 analytical chemistry ,Forensic toxicology ,Brain ,Reproducibility of Results ,Pattern recognition ,Human brain ,Biogenic polyamines ,2734 ,0104 chemical sciences ,medicine.anatomical_structure ,chemistry ,Postmortem Changes ,Artificial intelligence ,Gas chromatography–mass spectrometry ,business ,Law ,Biomarkers - Abstract
Introduction Among the several techniques proposed for the estimation of the Post Mortem Interval (PMI), the analysis of odorous amines has been applied in the past, with conflicting results. The aims of this study are: (i) to develop and validate a GC–MS method for the determination of putrescine (PUT) and cadaverine (CAD) in the human brain (validation study) and (ii) to study the relation of PUT and CAD concentration in the human brain and the PMI (decomposition study). Materials and methods Validation study. Analysis has been performed through GC–MS after a liquid-liquid extraction and a single step-derivatization for the identification and quantification of odorous amines in brain cortex samples. The standard protocol used in forensic toxicology, slightly modified for endogenous compounds according to recent guidelines, was used for validation. Decomposition study. Three uninjured human brains were sampled during the autopsy of three fatal traumatic cases. Along a 120-hour period of decomposition under experimental conditions, each brain was sampled along predetermined time intervals. Results Validation study. Both PUT and CAD validation parameters were within the acceptable values defined by the Scientific Working Group for Forensic Toxicology (SWGTOX), with better selectivity, linearity, accuracy and precision values for PUT. Decomposition study. A significant relationship between PUT and CAD levels and PMI has been demonstrated through statistical analysis with a correlation coefficient of 0.98 for PUT and 0.93 for CAD (p Conclusion Although further experimental studies on a wider number of samples are necessary, the results of this study suggest a possible role of polyamine levels in brain cortex for the estimation of PMI.
- Published
- 2018
36. Application of aquatic decomposition scores for the determination of the Post Mortem Submersion Interval on human bodies recovered from the Northern Adriatic Sea
- Author
-
Chiara Palazzo, Arianna Giorgetti, Guido Pelletti, Rafael Boscolo-Berto, Susi Pelotti, Paolo Fais, Filippo Pirani, Rosa Maria Gaudio, Adriano Tagliabracci, Palazzo C., Pelletti G., Fais P., Giorgetti A., Boscolo-Berto R., Gaudio R.M., Pirani F., Tagliabracci A., and Pelotti S.
- Subjects
Adult ,Male ,Mediterranean climate ,Adolescent ,Oceans and Seas ,Submersion (coastal management) ,Warm season ,Pathology and Forensic Medicine ,Aquatic decomposition score ,Young Adult ,Northern Adriatic Sea ,Prediction model ,Immersion ,Linear regression ,Cadaver ,medicine ,Humans ,Forensic Pathology ,Marine environment ,Aged ,Retrospective Studies ,Cold season ,Post Mortem Submersion Interval ,Temperature ,Middle Aged ,Seasonality ,medicine.disease ,Fresh water ,Water temperature ,Postmortem Changes ,Female ,Regression Analysis ,Environmental science ,Physical geography ,Law - Abstract
Purpose The decomposition process of human bodies in marine environment is not well understood, and it is influenced by external variables related to the geographical area where the body is submerged. We report the application of two decomposition scores, the Heaton’s score and the van Daalen’s score, on a casuistry of human bodies recovered from the Northern Adriatic Sea. The aims of this study are to verify whether the marine environment of a Mediterranean climate area may affect the applicability of both scores and to develop a prediction model that can be applied on bodies recovered in salt water. Methods A retrospective study was performed on 61 human bodies recovered between 2005 and 2019 from coastal water of the Northern Adriatic Sea nearby the Italian regions Emilia-Romagna and Marche. For each of the 61 cases included, the Total Aquatic Decomposition Score (TADS) was calculated with the Heaton’s score and the Van Daalen’s score. The prediction model was assessed through multiple regression analyses, and the determination coefficients (r2) between TADS and PMSI (expressed in days) and between TADS and Accumulate Degrees Days (ADD) were studied. The prediction model was applied to the entire case sample, to bodies recovered during the warm season and to bodies recovered during the cold season. Results All bodies were recovered floating, and a very poor scavenging activity was observed. The regression analyses showed a strong correlation between the TADS and the total case sample using both scores and both independent variables (PMSI and ADD). The determination coefficients were greater than 0.95 also when considering the total case sample. Discussion The proposed prediction models are not significantly influenced by seasonality, contrarily to what observed on bodies recovered in fresh water in the same climate area. However, the ADD model, which also consider the water temperature, should be preferred for higher decomposition stages. This study helps increase the accuracy of PMSI estimation in bodies recovered from a marine environment of the Northern Adriatic Sea.
- Published
- 2021
37. Deaths related to nitrogen inhalation: Analytical challenges
- Author
-
Gianni Guadagnini, Guido Pelletti, Rossella Barone, Marco Garagnani, Paolo Fais, Francesca Rossi, Arianna Giorgetti, Susi Pelotti, Giorgetti A., Pelletti G., Barone R., Garagnani M., Rossi F., Guadagnini G., Fais P., and Pelotti S.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Nitrogen ,Autopsy ,01 natural sciences ,Vial ,Gas Chromatography-Mass Spectrometry ,Pathology and Forensic Medicine ,Asphyxia ,03 medical and health sciences ,0302 clinical medicine ,Administration, Inhalation ,Suicide, Completed ,medicine ,Biological fluids ,Humans ,GC–MS ,030216 legal & forensic medicine ,Nitrogen inhalation ,Cause of death ,Peak area ,Inhalation ,business.industry ,010401 analytical chemistry ,Forensic toxicology ,Carbon Dioxide ,0104 chemical sciences ,Oxygen ,Case-Control Studies ,Emergency medicine ,Asphyxiant ga ,medicine.symptom ,business ,Law - Abstract
Dinitrogen (N2) has been increasingly connected to suicidal deaths. The analysis of N2 in post-mortem cases still represents a major challenge in forensic toxicology and circumstantial data has so far played a major role for the determination of the cause of death. In this paper, after presenting a review of cases of N2 intoxication described in forensic literature, we report the application of two approaches in order to quantify an excess of N2 in post-mortem whole blood collected from a case of suicide by nitrogen inhalation. N2 analyses were performed by GC–MS on the suicidal case and on controls taken from 10 autopsy cases with similar PMI (5 traumatic deaths and 5 deaths by asphyxia). The percentage of N2 was estimated by building a five-point N2 peak area calibration curve (0, 15.6 %, 62.4 % 78.1 %, 100 %) and through an external QC, assessing linearity, accuracy and precision, LLOQ, specificity and stability of N2 in the sample vial. Percentage of N2 of the case was significantly higher than the post-mortem controls (p < 0.05). The N2/O2 ratio of the case and controls was also calculated as an additional indicator, and was significantly higher in the case (p < 0.05). The strengths and the limitation of both methods are reported in the paper. Toxicological confirmation for N2 are rarely performed when the cause of death is evident, probably due to the lack of validated methods and the complexity of the interpretation of N2 concentration in biological fluids. The presented methods can be rapidly and profitably applied with instrumentation normally available in forensic laboratories.
- Published
- 2020
38. Optimization of cloned enzyme donor immunoassay cut-offs for drugs of abuse in post-mortem whole blood
- Author
-
Rossella Barone, Marco Garagnani, Francesca Rossi, Susi Pelotti, Paolo Fais, Raffaella Roffi, Guido Pelletti, Pelletti G., Rossi F., Garagnani M., Barone R., Roffi R., Fais P., and Pelotti S.
- Subjects
Drugs of abuse ,Post-mortem ,Sensitivity and Specificity ,Gas Chromatography-Mass Spectrometry ,Pathology and Forensic Medicine ,Immunoenzyme Techniques ,Forensic Toxicology ,chemistry.chemical_compound ,Cocaine ,False positive paradox ,Humans ,Medicine ,Amphetamine ,Whole blood ,Immunoassay ,Chromatography ,Receiver operating characteristic ,medicine.diagnostic_test ,Cannabinoids ,Illicit Drugs ,business.industry ,Opiate Alkaloids ,Amphetamines ,Cut-off ,CEDIA ,Substance Abuse Detection ,chemistry ,Benzoylecgonine ,business ,Law ,Methadone ,medicine.drug - Abstract
Introduction Immunoassay (IA) tests are not widely applied in post-mortem samples, since they are based on technologies requiring relatively non-viscous specimens, and compounds originating from the degradation of proteins and lipids during the post-mortem interval can alter the efficiency of the test. However, since the extraction techniques for IA tests are normally rapid and low-cost, IA could be used as near-body drug-screening for the classes of drugs most commonly found in Italy and Europe. In this study, semi-quantitative results on post-mortem whole blood samples obtained through CEDIA analysis (cannabinoids, cocaine, amphetamine compounds, opiates and methadone), were compared with results of confirmatory analysis obtained using GC–MS. Screening cut-offs for all drugs were retrospectively optimized. Methods Post-mortem whole blood samples from autopsy cases of suspected fatal intoxication were collected over 3 years. Samples were initially analyzed through CEDIA (CEDIA, ILab 650, Werfen). Confirmatory analyses were then performed by GC–MS (QP 2010 Plus, Shimadzu). Screening cut-offs were retrospectively optimized using Receiver Operating Characteristic (ROC) analysis. Results CEDIA results were available for 125 samples. Two-hundred-eighty-nine (289) positive screening results were found. Among these, 162 positive confirmation results were obtained. Optimized screening cut-offs were as follows: 6.5 ng/ml for THC; 4.2 ng/ml for THC-COOH; 12.0 ng/ml for cocaine; 6.6 ng/ml for benzoylecgonine; 6.4 ng/ml for opiates; 2.0 ng/ml for methadone. Analysis of ROC-curves showed a satisfying degree of separation in all tests except for amphetamine compounds, with areas under the curve (AUC) between 0.915 (THC) and 0.999 (for benzoylecgonine and methadone). Discussion The results of the study showed that CEDIA screening at the optimized cut-offs exhibits a very high sensitivity and good specificity and positive predictive value (PPV) for cannabinoids, cocaine and metabolites, opiates and methadone. A high number of false positives (n = 19) for amphetamine compounds was observed at the optimized cut-off, resulting in a very low PPV, which is also influenced by the very low number of TP (n = 4). Conclusion The results of the study show that the CEDIA is a valuable screening test on post-mortem whole blood for cannabinoids, cocaine and metabolites, opiates and methadone, but it is not recommended for amphetamine compounds, due to the high number of false positives. The strengths of the study are the large sample size, the inclusion of post-mortem cases only and the high level of sensitivity and specificity obtained at the optimized cut-offs.
- Published
- 2020
39. Postmortem submersion interval in human bodies recovered from fresh water in an area of Mediterranean climate. Application and comparison of preexisting models
- Author
-
Federica Fersini, Paolo Fais, Chiara Palazzo, Rafael Boscolo-Berto, Guido Pelletti, Rosa Maria Gaudio, Susi Pelotti, Palazzo C., Pelletti G., Fais P., Boscolo-Berto R., Fersini F., Gaudio R.M., and Pelotti S.
- Subjects
Adult ,Male ,Mediterranean climate ,Italian river ,Correlation coefficient ,Climate ,Fresh Water ,Context (language use) ,Biology ,Mediterranean area ,01 natural sciences ,NO ,Pathology and Forensic Medicine ,Submersion (mathematics) ,Aquatic decomposition score ,03 medical and health sciences ,0302 clinical medicine ,Retrospective Studie ,Models ,Immersion ,Linear regression ,Statistics ,Cadaver ,Temperate climate ,Humans ,030216 legal & forensic medicine ,Retrospective Studies ,Models, Statistical ,Italian rivers ,Postmortem submersion interval ,Female ,Italy ,Temperature ,Postmortem Changes ,010401 analytical chemistry ,Regression analysis ,Statistical ,0104 chemical sciences ,Fresh water ,Law ,Human - Abstract
Purpose The methods developed in recent years for the assessment of the Postmortem Submersion Interval (PMSI) have proven to be promising, but are strictly related to specific geographical areas or climates. The aim of this study is to assess the suitability of two of the most recent total aquatic decomposition scores (TADS) for the determination of the PMSI in bodies recovered from fresh water in an area of Mediterranean climate in the last 15 years. To do this, the correlation coefficient (r2) between PMSI and Accumulate Degrees Days (ADD) or PMSI and days was studied. Methods The correlation between PMSI (expressed in days or in ADD) and the TADS was evaluated considering: (a) bodies recovered during the entire period; (b) bodies recovered during the cold season; (c) bodies recovered during the warm season. A linear regression analysis was set comparing the statistical significance of a model plotting TADS versus ADD, and another model plotting TADS versus PMSI (expressed in days) for both scores. Results Scores were scarcely applicable when considering the entire casuistry, as regression models showed low r2 values, but both scores showed high correlations after dividing the cases into 2 groups. In fact, after performing the seasonal partition, we observed a strong correlation between PMSI and TADS, using either of the scores. Conclusion This study helps increase the accuracy, reliability, and validity of PMI estimation in bodies recovered from freshwater in an area of temperate climate, such as Northern Italy, supporting the need to establish regionally-specific equations for estimating PMI in a forensic context.
- Published
- 2020
40. Alcohol and illicit drugs in drivers involved in road traffic crashes in Italy. An 8-year retrospective study
- Author
-
Susi Pelotti, Alessio Giusti, Guido Pelletti, Marco Garagnani, Francesca Rossi, Rossella Barone, Paolo Fais, Raffaella Roffi, Mattia Marzi, and Barone R, Pelletti G, Garagnani M, Giusti A, Marzi M, Rossi F, Roffi R, Fais P, Pelotti S
- Subjects
Adult ,Male ,medicine.medical_specialty ,Substance-Related Disorders ,Blood concentration ,01 natural sciences ,Pathology and Forensic Medicine ,03 medical and health sciences ,Age Distribution ,0302 clinical medicine ,Epidemiology ,medicine ,Humans ,030216 legal & forensic medicine ,Sex Distribution ,Tetrahydrocannabinol ,Amphetamine ,Driving Under the Influence ,Driving under the influence ,Retrospective Studies ,Road crash ,Illicit Drugs ,business.industry ,Incidence (epidemiology) ,010401 analytical chemistry ,celebrities ,Accidents, Traffic ,MDMA ,Middle Aged ,Methamphetamine ,medicine.disease ,0104 chemical sciences ,Substance Abuse Detection ,celebrities.reason_for_arrest ,Substance abuse ,Italy ,Blood Alcohol Content ,Female ,Drug ,Alcohol ,business ,human activities ,Law ,Demography ,medicine.drug - Abstract
his study aims to investigate the prevalence of alcohol and drugs of abuse in Italian drivers involved in road traffic crashes between 2011 and 2018. Toxicological analyses were performed on the whole blood of 7593 injured drivers. Alcohol and illicit drugs, namely tetrahydrocannabinol (THC; cut-off 2ng/ml), cocaine (cut-off 10ng/ml), illicit opiates (cut-off 10ng/ml) and amphetamines (amphetamine, methamphetamine, MDMA, MDA; cut-off 20ng/ml) were investigated. The age and gender of the driver, the time of the crash (weekend/weekday and day/night), the road crash year and Blood Alcohol Concentration (BAC) were also considered. The 16.2% of samples tested positive for alcohol, 2.5% for cocaine, followed by opiates (2.0%), cannabinoids (1.5%), and amphetamines (0.5%). The overall prevalence of alcohol and drugs was lower than those reported in previous epidemiological studies of the DRUID project. The year 2011 showed the highest prevalence of drug-positive cases (24.1%), while the lowest prevalence was found in 2016 (16.8%), after the update of the Road Traffic Law (RTL) that increased punishments for driving under the influence. A progressive increase in the number of alcohol-positive female drivers was observed from 2011 to 2018, and the highest prevalence was found in the 26-35-year-old age range. Illicit drugs showed the highest overall prevalence in drivers
- Published
- 2019
41. Safe drugs in drug facilitated crimes and acute intoxications in Northern Italy
- Author
-
Guido Pelletti, Antonio Banchini, Susi Pelotti, Raffaella Roffi, Francesca Rossi, Marco Garagnani, Pelletti, Guido, Garagnani, Marco, Rossi, Francesca, Roffi, Raffaella, Banchini, Antonio, and Pelotti, Susi
- Subjects
Drug ,Adult ,Male ,medicine.medical_specialty ,Drug facilitated crime ,media_common.quotation_subject ,Disease ,01 natural sciences ,Pathology and Forensic Medicine ,03 medical and health sciences ,Forensic Toxicology ,0302 clinical medicine ,Homicide ,medicine ,Humans ,Northern Italy ,030216 legal & forensic medicine ,Medical prescription ,Psychiatry ,Crime Victims ,Cause of death ,media_common ,Retrospective Studies ,Aged, 80 and over ,Psychotropic Drugs ,business.industry ,Poisoning ,010401 analytical chemistry ,Forensic toxicology ,Prescription drug ,General Medicine ,Elder abuse ,Middle Aged ,0104 chemical sciences ,Safe drugs ,Suicide ,Acute intoxication ,Italy ,Pharmaceutical Preparations ,Accidental ,Accidents ,Female ,business - Abstract
Toxicological analyses are often performed in drug-facilitated sexual assaults (DFSA), when the victim shows or reports impaired consciousness and reduced ability. However, in other crimes or fatalities, especially in cases of concurrent natural disease or when another likely cause of death has been established, the involvement of drugs can be overlooked. The aim of this study is to report a series of cases of (i) victims of drug-facilitated crimes (DFC) other than DFSA and (ii) victims of acute intoxications, in which "licit" psychoactive drugs were found in blood samples, with the aim of understanding in which circumstances and to what extent prescription drugs have been used for non-medical purposes in recent Italian casuistry. Circumstantial, autopsy, and toxicological data were collected through a retrospective analysis performed between 2013 and 2017 in the Forensic Toxicology Unit of the University of Bologna. Cases of "DFC other than DFSA" and "Acute Intoxication" in which "psychoactive drugs" or "prescription drugs" or "licit drugs" were found in the blood samples of the victims were included in the study. Nine cases of DFC other than DFSA, and 11 cases of acute intoxication, were identified. Different categories of "licit" psychoactive drugs (e.g. hypnotics, antipsychotics, antidepressants, anticonvulsants) had been used to facilitate diverse types of crime (homicide, robberies, elder abuse, fatal poisoning) or acute intoxication (suicide, attempted suicide, accidental death). The circumstances of these cases, as well as toxicological findings in blood samples and other relevant forensic elements, are reported, summarized and discussed in this paper. The non-medical use of pharmaceuticals has been identified by recent forensic literature and the present study as a significant and growing phenomenon, and its implication in fatalities should be taken into consideration and accurately investigated through appropriate toxicological analysis. Our study presents an overview of the circumstances of non-medical use of prescription drugs, usually considered "safe drugs", and their involvement in cases of DFC, suicides and accidental intoxication. In order to estimate the real incidence of these medications in DFC and acute intoxication, and thus collect more analytical and contextual data, further studies are needed, along with effective cooperation among police officers, clinicians, forensic pathologists, and toxicologists.
- Published
- 2018
42. Optimization of cloned enzyme donor immunoassay cut-offs for drugs of abuse in whole blood of drivers involved in road accidents
- Author
-
Marco Garagnani, Raffaella Roffi, Francesca Rossi, Rossella Barone, Guido Pelletti, Susi Pelotti, Pelletti, Guido, Garagnani, Marco, Rossi, Francesca, Roffi, Raffaella, Barone, Rossella, and Pelotti, Susi
- Subjects
Drugs of abuse ,Optimization ,Drug ,medicine.medical_specialty ,media_common.quotation_subject ,Urine ,01 natural sciences ,Sensitivity and Specificity ,Gas Chromatography-Mass Spectrometry ,Pathology and Forensic Medicine ,Immunoenzyme Techniques ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Positive predicative value ,medicine ,Humans ,030216 legal & forensic medicine ,Driving Under the Influence ,Driving under the influence ,Whole blood ,media_common ,Immunoassay ,Cutoff value ,medicine.diagnostic_test ,business.industry ,Illicit Drugs ,010401 analytical chemistry ,celebrities ,Accidents, Traffic ,CEDIA ,0104 chemical sciences ,celebrities.reason_for_arrest ,Substance Abuse Detection ,chemistry ,Benzoylecgonine ,business ,Law ,Methadone ,medicine.drug - Abstract
Introduction Immunoassay (IA) tests should be able to detect low concentrations of illegal drugs when used for the screening of drugs in drivers. False negatives should be avoided, and false positives should be reduced as far as possible. In this study, semi-quantitative results for blood samples containing illicit drugs (cannabinoids, cocaine, amphetamines/methamphetamines, opiates and methadone) obtained with cloned enzyme donor immunoassay (CEDIA), were compared with results of confirmatory analysis performed through gas chromatography-mass spectrometry (GC–MS). Screening cut-off points for each class of drugs were retrospectively optimized. Methods Whole blood samples from drivers involved in road accidents in the period from January 2013-December 2017 were analyzed with CEDIA (4200 samples). Confirmatory analyses were performed through (GC–MS) on: (i) all samples with screening concentrations above 1 ng/ml for at least one drug (positive screening results); (ii) 800 samples with screening concentration lower than 1 ng/ml (negative screening results). Recommended per se limits in relation to driving under the influence of drugs were set as fixed values. Sensitivity, specificity, positive and negative predictive values were evaluated by contingency tables and compared to ROC-analysis in order to obtain ideal screening cut-offs. Results CEDIA results were available for 4200 blood samples and 1172 positive screening results were found. Among these, 1008 confirmation analysis were obtained through GC–MS. Optimized screening cut-offs obtained through ROC analysis were as follows: 8.0 ng/ml for THC; 5.5 ng/ml for THC-COOH; 21.1 ng/ml for cocaine; 6.9 ng/ml for benzoylecgonine; 33.1 ng/ml for opiates; 61.6 ng/ml for amphetamines; 5.0 ng/ml for methadone. Using these cut-offs, sensitivity was above 97% for THC-COOH, cocaine, benzoylecgonine, amphetamines, opiates and methadone, and 92% for THC; specificity was above 90% for cocaine, benzoylecgonine, amphetamines, opiates and methadone, 80% for THC and 89% for THC-COOH; negative predictive value was above 99% for all drugs and metabolites. Conclusion Previous studies have shown that CEDIA tests are useful for preliminary screening of serum and urine. Its implementation in whole blood is of primary importance for the assessment of impaired driving, since the per se limits of many European countries refer to whole blood, and preparation of the serum and/or the collection of urine is not always possible in the hospital emergency department, where blood samples are withdrawn. Our study shows that CEDIA tests on whole blood permit the definition of cut-off values with optimal sensitivity and negative predictive values for all analytes (near to 100%), including very good specificity.
- Published
- 2018
43. The Dangerous Pattern of Concurrent Use of Alcohol and Cocaine Among Drunk-Drivers of Northeast Italy
- Author
-
Giovanni Forza, Rossella Snenghi, Guido Pelletti, Alessandro Nalesso, Massimo Montisci, Anna Chiara Frigo, and Donata Favretto
- Subjects
Drug ,Adult ,Male ,medicine.medical_specialty ,Automobile Driving ,Alcohol Drinking ,media_common.quotation_subject ,01 natural sciences ,Drunk drivers ,03 medical and health sciences ,Cocaine-Related Disorders ,0302 clinical medicine ,Alcohol intoxication ,Cocaethylene ,Cocaine ,Environmental health ,mental disorders ,Traffic ,Medicine ,Humans ,030216 legal & forensic medicine ,Driving Under the Influence ,Driving under the influence ,media_common ,Ethanol ,business.industry ,010401 analytical chemistry ,celebrities ,Medical jurisprudence ,Accidents, Traffic ,General Medicine ,Middle Aged ,medicine.disease ,0104 chemical sciences ,celebrities.reason_for_arrest ,Substance abuse ,Substance Abuse Detection ,Exact test ,Italy ,Accidents ,Female ,business ,medicine.drug - Abstract
Aim To estimate the prevalence of drug and polydrug use among drunk-drivers during the driving license regranting program, in order to assess the inclusion of toxicological tests on hair and urine samples in the systematic methodology in this category of subjects. Short summary A total of 2160 drunk-drivers were tested for alcohol and drugs during driving license regranting. Thirty-one subjects showed alcohol use, 212 illicit drug use and, among these, 131 were polydrug users. Nineteen different patterns of drug and polydrug use were found. Cocaine was detected in 165 subjects. Methods The study was performed on 2160 drunk-drivers examined at Legal Medicine and Toxicology Unit of the University of Padova, in a 3-year-period (2014-2017). The positivity for one or more illicit drugs in hair or urine samples was confirmed by LC/MS and GC/MS methods. Chi-square test, Fischer's exact test and Cochran-Armitage Trend test were used to study the correlation between general characteristics of the examined sample and the presence of drug/polydrug use. Results Thirty-one subjects showed alcohol use, 212 illicit drug use and, among these, 131 were polydrug users. Nineteen different patterns of drug and polydrug use were found. Cocaine was detected in 165 subjects in whom 122 showed a concurrent use of alcohol and cocaine, identified through the detection of cocaethylene in hair samples. No significant association and/or trends between drug/polydrug use and the general characteristics of the sample were detected. Conclusions The results show that drug and polydrug use among drunk-drivers should be subjected to toxicological as well as alcohological monitoring, especially in the regranting procedure. The implementation of this procedure could improve the knowledge of dimensions of the issue, providing a powerful means for the reduction of phenomenon of driving under the influence of alcohol and drugs.
- Published
- 2018
44. A homemade furnace. Influence of occupational skills in a fire-related planned complex suicide
- Author
-
Maria Carla Mazzotti, Paolo Fais, Chiara Palazzo, Guido Pelletti, Susi Pelotti, Rosa Maria Gaudio, Palazzo, Chiara, Fais, Paolo, Mazzotti, Maria Carla, Gaudio, Rosa Maria, Pelletti, Guido, and Pelotti, Susi
- Subjects
Adult ,Male ,Engineering ,Firearms ,Fatal outcome ,Applied psychology ,Homemade furnace ,Plan (drawing) ,Firearms, Suicide, Complex suicide ,01 natural sciences ,Fires ,Pathology and Forensic Medicine ,NO ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Crime scene ,Humans ,030216 legal & forensic medicine ,3D reconstruction ,Death scene investigation ,Flammable liquid ,business.industry ,010401 analytical chemistry ,General Medicine ,0104 chemical sciences ,Manner of death ,Suicide ,chemistry ,Carboxyhemoglobin ,Complex suicide ,Factory (object-oriented programming) ,Blood Alcohol Content ,business ,Burns ,Alcoholic Intoxication ,Professional skills ,Occupational skill - Abstract
The term "planned complex suicideâ" means the combination of more than one method of suicide, planned to prevent failure of the first method to ensure a fatal outcome. Professional skills and tools are sometimes used to plan and perpetrate the suicide. A case of planned complex suicide of a mechanical engineer working with furnaces in a tube factory is herein reported. The suicide was committed in a rudimental furnace set up in the victimâs apartment using his professional skills, by assembling furniture, mattresses, books and flammable liquid present in the house. Three-dimensional models of the crime scene before and after the realization of the âhomemade furnaceâ are proposed. The discussion will focus on the importance of a comprehensive analysis of the professional background of the victim to infer the manner of death for the identification of complex and occupation-related suicides.
- Published
- 2018
45. Medico-legal implications of toluene abuse and toxicity. Review of cases along with blood concentrations
- Author
-
Guido Pelletti, Rossella Barone, Marco Garagnani, Susi Pelotti, Raffaella Roffi, Francesca Rossi, Pelletti, Guido, Rossi, Francesca, Garagnani, Marco, Barone, Rossella, Roffi, Raffaella, and Pelotti, Susi
- Subjects
Adult ,Male ,Medico legal ,Forensic pathology ,Adolescent ,Substance-Related Disorders ,01 natural sciences ,Pathology and Forensic Medicine ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Environmental health ,Humans ,Medicine ,030216 legal & forensic medicine ,business.industry ,010401 analytical chemistry ,Medical examiner ,Forensic toxicology ,Toluene exposure ,Driving impairment ,Forensic Medicine ,Middle Aged ,Toluene ,Toluene related deaths ,0104 chemical sciences ,Substance Abuse Detection ,Manner of death ,Issues, ethics and legal aspects ,chemistry ,TOLUENE EXPOSURE ,Solvents ,Female ,business ,Biomarkers - Abstract
Toluene, a liquid aromatic hydrocarbon, is one of the most widely used industrial solvents, and is present in numerous paints, paint thinners, glues and other industrial and household products. It has become the most abused solvent in the world due to its rapid effects following inhalation. However, the numerous cases of fatal and non-fatal toluene-related intoxication reported in the literature have not yet been collected and discussed in the forensic setting. In this paper we aim to provide a review of the cases of toluene abuse and intoxication and the state of the art of the forensic toxicological analysis of toluene intoxications in the living and in the dead subject, from the early identification to the medico-legal interpretation of the toxicological result. We have identified a total of 45 papers regarding different aspects of toluene abuse, and divided them into three sections, namely sampling, storage and techniques of analysis, assessment in living subjects and post-mortem assessment. This article reports toluene concentrations in blood from 202 living subjects, 23 fatal toluene intoxications and 85 toluene related deaths. Toxicological results are discussed in relation to the clinical presentation (living subjects, including impaired drivers), and the manner of death according to the medical examiner reports (post-mortem examinations). Finally, we discuss the strengths and limitations of the review.
- Published
- 2018
46. Hair analysis for the detection and quantification of letrozole after single and repeated use
- Author
-
Susanna Vogliardi, R El Mazloum, Guido Pelletti, Marianna Tucci, S. Visentin, R. Snenghi, Roberto Pertile, and Donata Favretto
- Subjects
Aromatase inhibitor ,integumentary system ,business.industry ,medicine.drug_class ,Health, Toxicology and Mutagenesis ,Letrozole ,Hair analysis ,Physiology ,Toxicology ,SWEAT ,Therapeutic index ,medicine.anatomical_structure ,Scalp ,medicine ,Ingestion ,Adverse effect ,business ,medicine.drug - Abstract
Objective Letrozole is an aromatase inhibitor, used to treat post-menopausal women with hormone receptor-positive or advanced breast cancer. It is prohibited in sport because it is used together with androgen anabolizing steroids to avoid their adverse effects. In case of adverse analytical finding, it may be important to distinguish between repetitive use due to voluntary administration and occasional use, possibly due to involuntary intake. With the objective to identify the dose capable of producing a positive hair testing, this study aims at investigating the incorporation into hair of single or repeated doses of letrozole. Methods Four subjects were recruited to investigate the incorporation in hair after ingestion of letrozole. Hair samples were obtained from: (i) 2 subjects (A and B) in chronic therapy with 2.5 mg of letrozole/day and (ii) 2 subjects (C and D) who ingested one dosage of 2.5 mg and 0.62 mg of letrozole, respectively. From subject A and B a whole length hair sample was collected, and segmental analysis was performed on 1 cm long segments. From subjects C and D, beard hair was sampled by shaving before administration (t = 0), 3 days after administration, and 6 days after administration. Head hairs were cut close to the scalp 10 and 90 days after administration. Analysis were performed through HPLC–HRMS. Results Letrozole was present in concentration higher than 160 pg/mg in all segments from subjects A and B. In subject C a detectable amount of the analyte in beard of the first 3 days (160 pg/mg in 0–3 days), up to the 6th day (130 pg/mg in 3–6 days) after ingestion and in head hair collected 10 days after ingestion (60 pg/mg) were found. In subject D, a lower amount of letrozole both in beard (100 and 85 pg/mg) and in head hair (30 pg/mg) was determined. Letrozole was detected also in head hair collected 90 days after the drug administration (30 pg/mg in C and 17 pg/mg in subject D). Conclusion This preliminary study shows that a single administration of a therapeutic dose (2.5 mg) or less than a dose (0.62 mg) of the drug produces a positive hair sample. Moreover, the results highlight large differences between concentrations in hair of subjects who consumed a single dose and hair of subjects in chronic therapy and suggest a positive correlation between frequency and/or dose ingested and hair concentration. The relatively higher amount identified in beard when compared to head hair suggests a mixed mode of incorporation in beard through sweat and blood.
- Published
- 2019
47. Micro-Computed Tomography (CT) Analysis of Deadly Gunshot Wounds
- Author
-
Paolo Fais, Chiara Giraudo, Guido Pelletti, Alessia Viero, Diego Miotto, Massimo Montisci, Giovanni Cecchetto, and Paolo Fais, MD, Chiara Giraudo, Guido Pelletti, Alessia Viero, Diego Miotto, Massimo Montisci,Giovanni Cecchetto
- Subjects
Forensic Radiology, Micro-CT, Gunshot wounds - Published
- 2016
48. Post-autopsy computed tomography. Pros and cons in a firearm death
- Author
-
Caterina Dengo, Sindi Visentin, Massimo Montisci, Maria De Matteis, Guido Pelletti, Visentin, Sindi, Pelletti, Guido, Dengo, Caterina, De Matteis, Maria, and Montisci, Massimo
- Subjects
PMCT ,medicine.medical_specialty ,Forensic imaging ,Rib Fractures ,Computed tomography ,Autopsy ,030218 nuclear medicine & medical imaging ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Imaging, Three-Dimensional ,Homicide ,medicine ,Humans ,Foreign country ,Whole Body Imaging ,030216 legal & forensic medicine ,PACT ,Foreign Bodies ,Fractures, Comminuted ,medicine.diagnostic_test ,business.industry ,General surgery ,Gunshot ,Surgery ,Firearm ,External Examination ,Autopsy report ,Wounds, Gunshot ,business ,Artifacts ,Tomography, X-Ray Computed ,Law - Abstract
Many studies have focused on the importance of post-mortem computed tomography (PMCT) prior to or in substitution of standard forensic autopsies in case of firearm death. However, due to the fact that PMCT is not routinely performed in all countries, in cases of death abroad it can happen that a CT scan is performed only after a first autopsy. A case of post-mortem re-examination, including the external examination and a post-autopsy computed tomography (PACT), of a gunshot victim of homicide in a foreign country is presented, and the pros and cons of imaging in post-autopsy setting are discussed. PACT could be a tool for carrying out more complete investigations and for obtaining information on bone injuries and foreign bodies trapped within peripheral soft tissues that can be re-analyzed after the arrival of the first autopsy report. Given that the value of information derived may be strongly influenced by the previously performed autopsy, in order to process the definitive considerations it is necessary to compare and interpret the data obtained through PACT with the results of the first autopsy, and to continue the international cooperation effort and the application of international guidelines in order to share information at the repatriation of the corpse.
- Published
- 2017
49. Traumatic fatal aortic rupture in motorcycle drivers
- Author
-
Guido Viel, Alessia Viero, Giovanni Cecchetto, Maria De Matteis, Massimo Montisci, Guido Pelletti, Pelletti, Guido, Cecchetto, Giovanni, Viero, Alessia, De Matteis, Maria, Viel, Guido, and Montisci, Massimo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Forensic pathology ,Motorcycle accident ,Aortic Rupture ,Population ,Autopsy ,Fatal aortic rupture ,Shock, Hemorrhagic ,Blunt trauma ,Countermeasures ,Injury pattern ,Motorcycle accidents ,Preventative forensic pathology ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Countermeasure ,Retrospective analysis ,medicine ,Humans ,030216 legal & forensic medicine ,education ,Aortic rupture ,Retrospective Studies ,education.field_of_study ,Multiple Trauma ,business.industry ,Medical jurisprudence ,Accidents, Traffic ,030208 emergency & critical care medicine ,Middle Aged ,Surgery ,Motorcycles ,Emergency medicine ,Etiology ,business ,Law - Abstract
Traumatic fatal aortic rupture (FAR) is a common finding in victims of motor vehicle crashes (MVC), but its aetiology and mechanisms of production remain an issue of major concern, above all in motorcyclists. This study reports a series of cases obtained from a retrospective analysis of traumatic FARs occurring in motorcycle drivers, with the aim of defining the injury patterns and correlating them with the mechanisms of FAR production. Circumstantial, autopsy and histology data were collected through a retrospective analysis of post mortem examinations performed at the Institute of Legal Medicine of the University of Padova between 2014 and 2016. Among 151 traffic related victims, 8 were motorcycle drivers and displayed traumatic FAR and were thus included in the study. In 7 cases, the presence of abdominal/thoracic injuries suggested that the external compression due to the accident was at least a concurrent cause of FAR, being the predominant mechanism of aortic injury in 4 cases, through the âosseous pinchâ or the âwaterhammer effectâ mechanisms. Our study highlights the well-known role of âpreventative forensic pathologyâ, which has become routinary in traffic medicine since many years, also for defining the points of impact and the injury patterns of motorcyclists sustaining traumatic FAR, thereby facilitating the development of new prevention strategies and devices. Further studies, however, are needed in order to widen the investigated population and to estimate the real number of victims for which traumatic FAR might hypothetically be prevented with specific countermeasures.
- Published
- 2017
50. Methodology for the identification of vulnerable asylum seekers
- Author
-
Sindi Visentin, Thomas Bajanowski, Guido Pelletti, Santo Davide Ferrara, Visentin, Sindi, Pelletti, Guido, Bajanowski, Thoma, and Ferrara, Santo Davide
- Subjects
medicine.medical_specialty ,Refugee ,Torture ,Vulnerability ,Medizin ,Guidelines as Topic ,Legislation ,Documentation ,Medical law ,Criminology ,Pathology and Forensic Medicine ,Interviews as Topic ,03 medical and health sciences ,0302 clinical medicine ,Istanbul Protocol ,medicine ,Humans ,Genetic Testing ,030216 legal & forensic medicine ,030212 general & internal medicine ,Medical History Taking ,Psychiatry ,Physical Examination ,Vulnerable person ,Psychological Tests ,Refugees ,business.industry ,Methods of ascertainment ,Forensic Medicine ,Personal injury ,Asylum seeker ,Mental Health ,Harm ,business - Abstract
Asylum seekers often experience situations of vulnerability, being frequently exposed to a heightened risk of harm, and thus require special care, support and protection. The categories of âvulnerable personsâ, identified by International Legislation, and an individualâs classification as a âvulnerable asylum seekerâ, have important implications in the reception procedures, in the decision-making phase and in the definition of therapeutic needs and rehabilitation. The Istanbul Protocol, the first international guideline approved by the United Nations and applied in different contexts, is not applicable for the assessment of the totality of the conditions (medical and otherwise), and therefore, the identification and assessment of conditions of vulnerability is largely delegated to questionnaires administered by non-medical personnel. The proposed methodology, based on the modificatory reworking of the Guidelines of the International Academy of Legal Medicine concerning the âmedicolegal ascertainment of personal injury and damage on the living personâ, takes into consideration all the medical issues relevant for the decision concerning the applicant, both in the reception procedures and in the outcome of the asylum application.
- Published
- 2017
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.