Giancarlo Di Vella

Factors affecting decomposition and Diptera colonization

Understanding the process of corpse decomposition is basic to establishing the postmortem interval (PMI) in any death investigation even using insect evidence. The sequence of postmortem changes in soft tissues usually gives an idea of how long an individual has been dead. However, modification of the decomposition process can considerably alter the estimate of the time of death. A body after death is sometimes subject to depredation by various types of animals among which insects can have a predominant role in the breakdown of the corpse thus, accelerating the decomposition rate. The interference of the insect community in the decomposition process has been investigated by several experimental studies using animal models and very few contributions directly on cadavers. Several of the most frequent factors affecting PMI estimates such as temperature, burial depth and access of the body to insects are fully reviewed. On account of their activity and world wide distribution, Diptera are the insects of greatest forensic interest. The knowledge of factors inhibiting or favouring colonization and Diptera development is a necessary pre-requisite for estimating the PMI using entomological data.

Sex determination by discriminant analysis of patella measurements

The authors have analyzed 80 skeletons (40 males and 40 females) from the collection at the Institute of Legal Medicine of the University of Bari belonging to a known contemporary Southern Italian population; time of death was around 1970 and ages ranged from 25 to 80 years. Seven measurements taken on 80 intact, undeformed right patellae (max height, max width, thickness, height and width of the external facies articularis, height and width of the internal facies articularis) were used to determine sex by multivariate discriminant analysis. One function associating two parameters (max width and thickness) obtained the highest value of correct sex determination with a rate of 83.3%; other functions showed a higher percentage of misclassification (up to 17.5%). This study tests the success rate of correct sex prediction based exclusively on patellar dimensions. The discriminant factors carried out by statistical analysis may aid the forensic anthropologist when no other human skeletal remains suitable for sex determination are available.

Sex determination by discriminant analysis of calcanei measurements

Eight measurements taken on the right calcaneus (maximum length, load arm width, minimum width, height of calcaneus, body height, breadth of the facies articularis talaris posterior, breadth and height of the facies articularis cuboidea) of a known contemporary Southern Italian skeletal population (40 males and 40 females) were used to determine sex by multivariate discriminant analysis. Three functions revealed a correct sex-determination of 85%. These functions were obtained by the association of the following parameters: maximum length, load arm width and breadth of the facies art. talaris post. (function no. 1); maximum length and breadth of the facies art. talaris post. (function no. 2); maximum length and height of the facies art. cuboidea and breadth of the facies art. cuboidea (function no. 3). These results may aid the forensic anthropologist when no other remains, useful for skeletal sex determination, are available.

Pink Teeth in a Series of Bodies Recovered From a Single Shipwreck

Pink teeth have most often been observed in victims of drowning but have also been reported in subjects who died suddenly and unnaturally. There is general agreement that there is no obvious connection between the occurrence of pink teeth and the cause of death, but the condition of the surroundings (especially humidity) must certainly play an important role in the development of the pink-tooth phenomenon. The frequency and distribution of postmortem pink coloration of the teeth have been studied among a representative sample of 52 cadavers. All the bodies were victims of a single shipwreck that occurred on March 13, 1997, in the middle of the Otranto Canal (Mediterranean Sea). The bodies were recovered from the seawater after approximately 7 months. A distinct pink coloration of the teeth was found in only 18 cadavers (13 females and 5 males) of ages ranging between 13 and 60 years. The phenomenon was more pronounced in younger individuals due to age-related changes of the root canal, less penetrable by the pigment responsible for the postmortem pink staining. By histochemical methods and autofluorescence, hemoglobin and its derivatives have been identified as the most likely pigments responsible for this postmortem process that can be considered analogous to postmortem lividity. These data are consistent with previous reports on pink teeth, indicating that the diffusion of the blood in the pulp into the dentinal tubules causes the red discoloration of the teeth. Based on the results, the pigmentation is more prominent on the teeth with single roots rather than in the posterior teeth with multiple roots.

Metric characterization of the human coxal bone on a recent Italian sample and multivariate discriminant analysis to determine sex

The ability of human pelvic bones to sexually differentiate has been of great interest in forensic anthropology for quite some time as it allows for the determination of skeletal sex by combining metric and morphological data. However, the criteria for determining the sex of a skeleton must be calibrated according to the variability of the population to which it belongs. The aim of this work is the metric characterization of the human coxal bone on a recent sample (of known sex) from the region of Apulia, in southern Italy, in order to establish its efficacy in sex determination by way of multivariate discriminant analysis. Seventeen standard anthropological measurements used in sex determination were taken from 168 coxal bones (78 males and 90 females) all belonging to 86 adult skeletons (40 males and 46 females). The bones used were taken from subjects who had died in the 1960s and 1970s in Apulia. The results obtained define the variability in size and proportion of the sample analyzed with respect to the variations of other skeletal populations. Nine discriminant functions, utilizing between 4 and 11 variables, have been shown to be useful in determining the sex of coxal bones, whether they be complete, partial, or fragmented. All of the functions selected resulted in an attribution error equal to zero, and differ only in the number of variables utilized and by the degree of separation between the groups. The results of this study confirm the validity and utility of diagnostic techniques based on discriminant functions as reported in the literature for other population groups. The combination of metric characteristics from various regions of the coxal bone is, therefore, a valid aid in the correct attribution of skeletal sex even when the combination of variables is numerically limited, but sufficient in sex determination from partial coxal bones.

Vestibular evoked myogenic potentials (VEMPs) in whiplash injury: a prospective study

Conclusions. Patients affected by whiplash-associated disorder presented alterations of vestibular evoked myogenic potentials (VEMPs). VEMP testing may be an important ‘forensic’ diagnostic tool in the assessment of cervical spine injury. Objectives. The purpose of this prospective study was to evaluate changes in VEMPs in the assessment of whiplash injuries. Patients and methods. Fourteen patients complaining of whiplash injury were examined and compared with 15 controls. All patients underwent VEMP testing within 7 days from the injury and 90 days after whiplash injury. Beside VEMPs, standard investigation consisted of pure-tone and speech audiometry, impedance audiometry and evaluation of the vestibular system. Results. All subjects presented normal hearing, normal impedence audiometry findings, and normal vestibular function. VEMPs were present both in patients affected by whiplash injury and in the control group at time 0. At 90 days VEMPs were absent in two cases (14.3%). Statistical analysis showed that at time 0 and at time 90 days p1 latency was significantly higher in whiplash patients compared with healthy subjects on both sides (p<0.002). The amplitude of p1–n1 was significantly lower in whiplash patients at time 0 (p = 0.003 on the right and p = 0.018 on the left), but not at 90 days.

Nasal ciliary motility: a new tool in estimating the time of death

Determination of time since death is one of the most difficult and crucial issue in forensic medicine. Apart from body cooling, which is commonly used in the early postmortem interval (PMI), supravital reactions are the most interesting postmortem changes for time of death estimation. Nasal ciliary motility has been occasionally observed in postmortem period although no studies have focused on this phenomenon for forensic purposes. We aimed to evaluate the diagnostic usefulness of ciliary motility as a potential tool in estimating the time of death. Specimens of ciliated epithelium from 100 consecutive cadavers were obtained by scraping the nasal mucosa at three different postmortem intervals. The samples were then smeared on a slide, and an in vitro evaluation of ciliary movement was analyzed by phase-contrast microscopy. A postmortem nasal ciliary motility was observed, and a statistically significant relationship between decreasing ciliary movements and increasing postmortem interval was detected even in presence of putrefactive changes of nasal ultrastructure integrity. Some peculiar causes of death seem to influence ciliary motility in the early PMI, while no significant correlations with sex or age were observed. According to the results of this study, postmortem evaluation of nasal ciliary motility may be a bona fide and a feasible option for estimating the time of death.

Complete Cardiac Rupture Associated with Closed Chest Cardiac Massage: Case Report and Review of the Literature†

Chest skeletal injuries are the most frequent complications of external chest massage (ECM) during cardiopulmonary resuscitation, but heart and great vessels lacerations that are indeed very rare. We report the case of a 35‐year‐old workman who collapsed and underwent ECM by his co‐workers for almost 30 min. At autopsy, no external injuries, fractures or bruises of the ribs or sternum, were observed. A hemopericardium with a rupture of the heart was found, with no signs of pre‐existent cardiac disease. Bruises of thoracic aortic wall, lung petechiae, a contusion of the liver, and bruises of lumbar muscles were found. The cause of death was due to sudden cardiac death with an extensive cardiac rupture. This is an unusual report of massive heart damage without any skeletal or muscle chest injuries, secondary to cardiopulmonary resuscitation. This kind of cardiac lesions may be considered when thoracic–abdominal trauma, or medical history, is unclear.

Faith, folie à famille, and mummification: a brief review of the literature and a rare case report.

Folie à deux is a rare clinical syndrome characterized by the transference of delusional ideas from one person to one or more other people in close association with the primary affected patient. Mummification indicates the preservation of the corpse of a person for a variable period of time. A brief review of the literature in this field is presented, and an exceptional case is described, characterized by the association of both these rare phenomena. The case is an example of folie à fammille which developed out of a condition of extreme religiousness and seclusion of an entire family. The shared psychosis led to the horrible death of some of the family members, while the last surviving member of the family lived for more than a year and a half with their mummified remains. The Judge commissioned a forensic psychiatry assessment to verify the survivors ability to bear witness. The development of the psychiatric syndrome and its consequences are extensively discussed.

Multiple stab wounds: understanding the manner of death through the psychological autopsy

A 48-year-old physical therapist with no history of psychiatric disorders or suicidal tendencies was found dead by his relatives inside his apartment. Multiple stab wounds were present on the chest and the abdomen. Several more superficial cuts were also seen on the neck and the left wrist. At the death scene, there was a large pool of blood in the room, with secondary droplets and stains; a kitchen knife was found beside the body, and a suicide note on a table. Especially the number of wounds raised strong suspicion of a homicide in the first instance but some circumstances (the farewell letter, the absence of clothing injuries, no signs of third-party involvement) and autopsy findings (absence of defense or blunt injuries, the localization of the wounds, the presence of hesitation marks) pointed toward a suicide etiology. Because of the many stab injuries and the lack of a psychiatric history, further forensic investigations were required including a so-called psychological autopsy. This case report highlights that only a comprehensive interpretation of all the elements (circumstances, the scene of death, autopsy findings, and psychological autopsy) can lead to the correct solution of atypical cases of suicide.