Clotilde Rougé-Maillart

The Determination of Male Adult Age at Death by Central and Posterior Coxal Analysis—A Preliminary Study

In forensic anthropological analysis, the pelvis is of particular interest as it is often a comparatively well-preserved part of the skeleton. This study in age determination uses the acetabulum, the central element of the pelvis, as a complement to the examination of the auricular surface. The test sample consisted of 30 individuals. First, the authors studied the auricular surface using the Lovejoy criteria. Second, they isolated four criteria based on chronological changes in the acetabulum. Third, they conducted an evaluation of each of these variables. The study examines the correlation between these criteria and the age of the individuals. A significant correlation was found between the acetabular criteria and age, and between the acetabular criteria and the Lovejoy criteria of the auricular surface. For forensic purposes, the acetabulum is an effective predictor in the determination of age. This newly proposed method explores the same criteria of ageing as the Lovejoy method. The combination of the two methods produces relatively consistent results in the estimation of age.

Women who kill their children

The killing of a newborn on the day of its birth is known as neonaticide. A child aged 1 through 16 has a different role in the family, and their murder is perceived differently. We would expect mothers charged with filicide to be drawn from a slightly different population than other child-killing mothers. Method:Our study was carried out at the Institute of Forensic Medicine in Angers over a 10-year period. All the victims were autopsied at the Institute of Forensic Medicine in Angers. Information concerning the mothers was collected from forensic medical files, police reports, and legal files. Interviews and forensic psychiatric examinations were available for consultation. Results:Our study concerns 17 observations of child-killing mothers and 19 child autopsies. In 2 cases, the issue was in fact a double murder, with the mother killing all the siblings. The mean age was 3.5 years for victims and 29.5 years for the women. The majority of the mothers were married or lived with their partners. They often had an occupation. Generally the economic status was average. Head trauma, strangulation, suffocation, and drowning were the most frequent means of filicide. However, some mothers used more active methods such as striking and shooting. Disturbed or disturbing behavior was documented in 15 perpetrators. Seven women tried to commit suicide. It was often possible to identify apparent motivation for the offense. Discussion:In our study, we can distinguish 2 types of killer mothers. We distinguished a first group made up of 5 mothers. These 5 women killed their children in a general context of abused children and present similarities with the neonaticide mothers (young, immature). The other group of filicide mothers is different. They are generally older, married, and employed. The crime is usually premeditated, committed with the direct use of hands and sometimes very violent. To understand the motives or the source of the impulse to kill, we can use a classification such as Resnicks classification: mothers from the first group fall within the framework of accidental filicides: the risk and prevention factors are those of infanticide and ill treatment. For the other mothers, we can distinguish altruistic filicides (8 cases) and spouse revenge filicides (2 cases). Few of the mothers suffered from real psychiatric problems; however, most of them presented troubles which could have been taken into account. A lot of women showed signs of suicidal tendencies prior to the event, displaying aggressive and angry behavior. In general, suicide attempts tend to prevail. These offenders act out of an acute sensitivity to social regulation. A variety of psychosocial stresses appears to have been a major factor. These stresses include lack of social or marital support, economic difficulties, family stress, and unrealistic expectations of motherhood. The precipitating stress may have been a dispute. Prevention begins with the identification of potential perpetrators. Therefore, medical doctors have a significant role in relation to the prevention of child murder.

Development of a method to estimate skeletal age at death in adults using the acetabulum and the auricular surface on a Portuguese population

Aging techniques that use the posterior or middle part of the pelvis are of interest because this part of the body is very resistant to decay. In a preliminary study, acetabular criteria correlated with age were isolated. In a second study, three acetabular criteria and four auricular surface criteria were described and it was demonstrated that it is of interest to associate these criteria. The goal of the present study was to test these criteria in a larger sample and to elaborate a standardized procedure for the use of these criteria. The study concerned 462 os coxae (hip bones) of known age and sex. All of the criteria are correlated with age. Establishing a score allows a better correlation with age with lower intra-/inter-observer variability. Seven categories of overall score corresponding to eight age groups were defined and the probabilities of belonging to an age group depending on the overall score were calculated. The first main advantage of this procedure is that it is still applicable when only some parts of the body remain. The other benefit is its ability to discriminate older people.

Age at death estimation of adult males using coxal bone and CT scan: a preliminary study.

INTRODUCTION Age at death estimation is of major importance for the forensic scientist. Currently, various methods have used macroscopic osseous criteria for articular surfaces. Particularly in the pelvis, articular surfaces are used to classify bone evolution and age. The objective was to assess coxal bone computed tomography (CT) scan procedure to initially estimate adult male age at death and model this age using quantitative measurements. MATERIALS AND METHODS The material used included 33 coxal bones obtained from adult males of known age. Samples were obtained from 27 males during forensic autopsies and the 6 remaining samples were collected by the Normandy Whole Body Donation Center. Criteria of all bone samples were measured by CT scan. The criteria were inspired by previous osseous anthropological methods for age estimation using coxal symphyseal, auricular and acetabular surfaces. Inter- and intra-reproducibility of each criterion was calculated. Then, correlation to age at death of the reproducible variables was calculated. RESULTS Correlation factors were used. These link CT scan criteria data to age at death. Reproducible criteria included in the analysis as reproducible and correlated to age were: auricular surface apex activity, symphyseal ventral rampart and acetabular fossa porosity. CONCLUSION The results suggest that research using CT scan criteria data could be a useful forensic tool to determine age at death.

Suicide by Skull Stab Wounds: A Case of Drug-induced Psychosis

Suicide by stabbing to the head and/or driving sharp objects into the skull is of extreme rarity. This article reports the case of a 27-year-old man, who committed suicide by multiple knife stabs and cuts to the head, the torso, one shoulder and the forearms. Autopsy showed a perforating wound of the skull and the 10-cm long broken blade of the knife being still embedded in the right temporal lobe of the brain. The deceased had no history of psychiatric illness but was currently treated by mefloquine, a quinine derivative associated with a high rate of psychiatric adverse effects. Toxicological examination confirmed a recent intake of mefloquine together with chloroquine, another antimalarial drug. To our knowledge, this is the first report of a completed suicide with very strong evidence of mefloquine implication. Discussion focuses upon mefloquine-induced psychiatric disorders and highlights the importance of performing toxicological investigations in cases of unusual suicides.

Abdominal stab wounds: self-inflicted wounds versus assault wounds.

Intentional penetrating wounds, self inflicted or inflicted by others, are increasingly common. As a result, it can be difficult for the forensic examiner to determine whether the cause is self-inflicted or not. This type of trauma has been studied from a psychological perspective and from a surgical perspective but the literature concerning the forensic perspective is poorer. The objective of this study was to compare the epidemiology of abdominal stab wounds so as to distinguish specific features of each type. This could help the forensic scientist to determine the manner of infliction of the wound. We proposed a retrospective monocentric study that included all patients with an abdominal wound who were managed by the visceral surgery department at Angers University Hospital. Demographic criteria, patient history, circumstances and location of the wound were noted and compared. A comparison was drawn between group 1 (self inflicted wound) and group 2 (assault). This study showed that the only significant differences are represented by the patients prior history and the circumstances surrounding the wound, i.e. the scene and time of day. In our study, neither the site, nor the injuries sustained reveal significant clues as to the origin of the wound. According to our findings, in order to determine the cause, the forensic examiner should thus carefully study the circumstances and any associated injuries.

Suicide spectaculaire lié à une prise de méfloquine

Resume Introduction Nous rapportons un cas de suicide spectaculaire survenu au decours d’une complication neuropsychiatrique liee a la prise de mefloquine. Les medecins doivent connaitre ces effets secondaires graves de la mefloquine et les evoquer devant la survenue de troubles psychiatriques soudains et atypiques ou devant des tableaux de suicide suspects. Observation Le corps d’un homme de 27 ans, ayant de multiples plaies par arme blanche, a ete decouvert a son domicile. Le rapport d’autopsie a permis d’etablir que le deces etait en rapport avec une plaie crânio-cerebrale grave provoquee par un coup de couteau intracrânien porte avec violence. Un homicide etait initialement suspecte. Un suicide lors d’un delire survenu a la suite de la prise de mefloquine ayant ete evoque, une analyse toxicologique a ete realisee et l’hypothese a ete confirmee. Discussion Depuis l’introduction de la mefloquine (Lariam®) en 1985, la survenue de complications psychiatriques graves a ete decrite. Une prophylaxie par mefloquine est recommandee lors de sejour dans les zones resistantes a la chloroquine. L’efficacite prouvee de cette prevention justifie le maintien de la prescription malgre le risque d’effets secondaires. Cependant, les medecins doivent connaitre ces graves effets secondaires neuropsychiatriques. En effet, devant un comportement inexplique, le diagnostic doit etre evoque afin de prevenir la survenue de complications plus graves. De meme, devant des tableaux de suicide atypique, une prise de mefloquine dans les mois precedents doit etre recherchee pres de la famille ou des amis. Des prelevements sanguins et urinaires doivent etre realises pour analyse toxicologique. Enfin, il est necessaire de respecter les recommandations de l’OMS concernant les contre-indications.

Organ donation in France: legislation, epidemiology and ethical comments.

The Bioethics Laws revised in 2004 have defined rules concerning organ donation and transplantation. They have also permitted the creation of the French Biomedicine Agency which guarantees the right of enforcement. In France there are three situations in which organs may be harvested: from cadaveric donors, from living donors and, since 2005, from non heart beating donors. Organ harvesting from cadaveric donors is permissible if the deceased did not make known his refusal during his lifetime (this may be recorded in the national registry set up for this purpose). The rule of presumed consent also applies in the case of organs taken after cardiac arrest. With regard to organ harvesting from living persons, a panel of experts is required to give approval. The recipients spouse, brothers or sisters, sons or daughters, grandparents, uncles or aunts and first cousins may be authorised to donate organs, as well as the spouse of the recipients father or mother. The donor may be any person who provides proof of having lived with the recipient for at least two years. Some ethical questions will need to be resolved; for example the relevance of maintaining the EEG for brain death diagnosis, enforcement of the law on presumed consent, the real nature of the will of living donors and the definition of death.

Left Diaphragm Laceration Due to Cardiopulmonary Resuscitation

External cardiac massage is the essential life‐saving gesture for the management of any cardiac arrest. Since the 1960s, many recommendations have been published to improve the effectiveness of chest compressions alongside the development of automated systems intended to maximize the chances of survival. The use of these manual and/or instrumental techniques can cause secondary injuries, of which rib fractures are the most commonly observed by forensic pathologists. However, a comprehensive review of the literature seldom highlights reports of injuries to the abdomen, even less so to the diaphragm. In this observation, an iatrogenic left diaphragmatic laceration for the first time is described, as a result of manual and instrumental cardiopulmonary resuscitation, in a victim from an intrathoracic wound caused by a bladed weapon.

Anal lesions presenting in a cohort of child gastroenterological examinations. Implications for sexual traumatic injuries

The purpose of this study was to describe the anal lesions found in children during a pediatric gastroenterology consultation when the reason for the complaint was related to a digestive disease. This prospective descriptive study included 100 children under 15 years of age over a 13-month period, consulting due to digestive symptoms. The children were under 8 years old (90%) and 25% were under 3.1 years old. Constipation was the most frequent reason for consultation (69%). Fifty-one anal lesions were observed, of which 58.8% were anal fissures, 15.7% were skin tags and 5.8% were venous congestions related to straining. Anal fissures and skin tags were located at the median line, according to the clock-face method in supine position. No child had more than two anal lesions. No anal dilatation, sphincter hypotonia, anal scars, anal lacerations or bruises were found. The two most common anal lesions were anal fissures and skin tags. These anal lesions were mainly observed at the median line and were due to constipation. No cases of multiple anal lesions were found in terms of common digestive diseases.