Forensic Science International Supplement Series最新文献

Introduction

In the years 1997–2007 in the Forensic Medicine Department, Silesian University of Medicine, Katowice a total of 785 blood samples collected from drivers being the perpetrators of road accidents was tested for the presence of psychoactive drugs.

Methods

The studies took advantage of FPIA (Abbott), ELISA (Neogen), LC–MS and GC FID.

Results

21% of tested samples were positive. In the blood of the driver cannabinoids, amphetamine and its derivatives were most frequently found. Moreover, individual opium alkaloids, their combinations with barbiturates, benzodiazepines or amphetamine, benzodiazepine derivatives (isolated cases), drugs of benzodiazepine group in combination with barbiturates, tramadol or tricyclic anti-depressants (isolated cases), carbamazepine, phenotiazine, cocaine, dibenzepine, benzene, toluene and acetone were determined.

Conclusion

The obtained results showed cannabinoids and amphetamine derivatives to be the most frequent whereas opium alkaloids, barbiturates and benzodiazepines rather rare psychoactive drugs found in the tested blood samples of the drivers involved in the road accidents. The authors suggest screening psychoactive drugs not only in drivers involved in road accidents but also those put through the routine road check procedures. While giving opinions on the influence of the above mentioned drugs on the psychophysical efficiency of road traffic users, drugs and compounds which are not subject to legal control but have an effect on the human psychomotor efficiency and thus, enhance the risk of the road accident should be also taken into account.

An expert examination is a medical examination performed by a doctor on the order of a police officer or investigating judge. It includes a clinical examination of the subject, collection of samples for toxicological analysis, and the doctor's assessment of whether the subject is under the influence of psychoactive substances. The doctor requires expert knowledge, skill, experience and sufficient time to successfully perform the examination. Since the accurate assessment of the effects of psychoactive substances present depends on a comprehensive evaluation of toxicological test results, the calculation of results at the time of the event and the results of the medical examination, an unprofessionally performed examination can have far-reaching consequences, primarily legal in nature.

In the following case, the authors are discussing a connection between treating Hodgkin's disease in childhood and later sudden cardiac death of the patient at the age of 37. Examined expert literature describes injuries of the myocardium because of therapeutic irradiation in the childhood.

Due to the rapid development of motorisation in the past few decades, the epidemic of traffic injuries has become a serious problem. Numerous studies indicate that the human factor, often in connection with alcohol consumption, plays a major role in traffic accidents. Studies also show that people addicted to alcohol often drive under the influence and are not deterred by the possibility of punishment, e.g. a revocation of their driving licence.

Our study examined people who caused traffic accidents under the influence of alcohol in Slovenia, the consequences of their actions, police and judicial measures and medical selection.

In the last decade, the share of people causing traffic accidents under the influence of alcohol in Slovenia has been on the rise. Higher blood alcohol levels are found in people causing fatal traffic accidents, most of them are cyclists, pedestrians and tractor drivers, aged between 25 and 34; the accidents are most common on village roads, on weekends. The discrepancy between numbers of intoxicated drivers with suspended driving licences (approximately 8500/year) and between numbers of successfully terminated judicial procedures is particularly worrisome. When these drivers get their licences back, the medical selection process is inadequate.

Our results emphasise the problem of medical selection for reinstatement of penalized drivers. The inadequate approach currently in force allows too many dangerous drivers, most still addicted to alcohol, to return to traffic without medical selection. The only solution to this problem is an immediate change in legislation that would require rigorous medical selection for all reinstatements of drivers who drove under the influence of alcohol. This would decrease the numbers of intoxicated drivers in traffic and at least partly decrease the numbers of alcohol addicts in society.

Shrinking heads as trophies are well known all over the world. Several forms of mummified human trophy heads were produced by different tribes, in addition not true or not traditional shrunken heads were put out. A well preserved shrunken head of unknown origin was examined by our group. Besides anatomy histological and DNA analysis of the mummified material was performed. Furthermore larvae connected to the hair were examined microscopically. Histology of the skin from the neck region showed cellular structures with cytoplasm and nucleus. The larvae were identified as from Pediculus humanis capitis, the human hair lice. Finally DNA analysis of the mummified head revealed a human female STR profile.

Criminal offences are simulated for manifold reasons and are often associated with the intentional self-infliction of injuries and unrealistic, typically dramatic descriptions of the alleged incident. In the two cases presented here, the injuries were caused accidentally and the motive of the subsequent simulation of a road accident was to divert from previous misconduct.

Case 1

A 33-year-old man was taken to a hospital by his girlfriend with fractures of the pelvis, the left distal lower leg and the metatarsus. According to the friend, the man had been struck and injured by a car as a pedestrian. The driver did not stop after the accident. The physical examination revealed an extensive soft tissue lesion distal to the left inner ankle and on the back of the left foot as well as scratch-like skin lesions on the legs, but no injuries typical of the impact of a car. The external and internal findings were not consistent with the reported collision. Later, the girlfriend admitted that her statements regarding the incident were wrong. According to the police investigations, he sustained the injuries while fleeing after a burglary.

Case 2

An injured 29-year-old woman was found lying on the pavement in front of her house. In the hospital, she stated that she had almost been struck by a van as a pedestrian and had fallen to the ground. She was diagnosed with an open pilon fracture of the right tibia and a fracture of the end plate of the first lumbar vertebra. In view of the findings, the forensic expert expressed doubts as to the alleged fall from a standing position. In an additional interrogation, she admitted that she had jumped from a window of her boyfriend's room on the first floor as she did not want that the fellow occupants got to know about her love affair. In order to cover up the real origin of the injuries, she invented the story of the near-accident and alleged hit-and-run offence.

Conclusion

In both cases the medical findings were not in line with the findings to be expected from the described course of events. In the first case, the traffic accident was simulated to divert from an attempted burglary, in the second case the motive was to prevent the disclosure of an embarrassing love affair.

Pedestrians belong to the group of road users with the highest mortality rate. The frequency of road accidents involving pedestrians is 2% but pedestrians represent as many as 13% of all road accident deaths. Because of the mechanism and dynamics of injury and the effects of alcohol on physical and mental performance, pedestrians under the influence of alcohol are classed among the road users most at risk.

Our retrospective study included 125 pedestrian fatalities treated at the Institute of Forensic Medicine, Faculty of Medicine, University of Ljubljana between 1999 and 2006. We classified the victims into two groups by blood alcohol level Group I (alcohol positive) and Group II (alcohol negative), defined differences in gender, age, incidence of injuries and established causes of death and period of survival following the road accident. In Group I (n = 53) 96% were male and 4% female; the average age was 45.6 years. In Group II (n = 72) 40% were male and 60% female; the average age was 63.1 years. The percentage of injuries to individual parts of the body was higher in Group I than among the deceased pedestrians in Group II. The most common cause of death in both groups was craniocerebral trauma. Death occurred in the first 6 h following the accident in 92% of cases in Group I and in 69% of cases in Group II.

Alcohol-positive pedestrians are predominantly younger men, who have a higher level of risk of a road accident, greater incidence of injuries and a shorter period of survival following a road accident.

Research on alcohol, drugs and driving can be broadly separated into experimental and epidemiological studies. Every approach has its inherent advantages and disadvantages. Experimental studies can result in an interpretation by single cause, but can only identify potential risks, and the results can sometimes be of limited value because of the use of non-realistic doses or because of the drug use history or inter-individual differences of the volunteers. Recent studies have used higher, more realistic doses and paid more attention to the combination of alcohol and drugs and have shown that the chronic use of illicit drugs can be associated with some cognitive and/or psychomotor impairment, and can lead to a decrease in driving performance even when the subject is no longer intoxicated.

Epidemiological studies include roadside surveys, studies in a subset of drivers, accident risk studies, responsibility analyses, surveys and pharmaco-epidemiological studies. Between studies, results may be incomparable due to testing different populations, different kinds of samples, etc. More large-scale roadside studies are conducted now.

Advances in analytical toxicology have also contributed to a better understanding of the risks associated with driving under the influence. While older studies measured the inactive metabolite THC-COOH and did not show an increased risk in cannabis-positive drivers, more recent studies measured the active THC in blood and did show a concentration dependent increase in crash risk. The use of LC–MS/MS has allowed more broad-range screening as this technique can measure many different drugs in a small sample volume. While some older studies used saliva but had many analytical problems (including an insufficient sample volume in up to a third of the cases), newer methods of saliva sampling and analysis give better results. The use of saliva for roadside surveys allows non-invasive sampling, but the lack of correlation with the concentrations in blood makes interpretation of results difficult.

The results of both epidemiological and experimental studies should be combined to obtain a good estimate of the impact of certain drugs on driving performance and accident risk. In 2006–07 a committee of international experts drafted guidelines for future research into drugs and driving. These have been taken on board by the DRUID project, a large-scale EU funded project on driving under the influence of drugs, alcohol and medicines.

Introduction

The process of recovering and identifying human remains from individual and mass graves has proven to be the most effective method of resolving the fate of missing individuals in the former Yugoslavia. These efforts have two primary objectives: medicolegal—to identify the cause of death, and humanitarian—to bring closure to living family members, thus supporting the human rights of both the living and the deceased. From 1996 to the present, the remains of 388 individuals killed during the 1991 War in Croatia were recovered from the Glina and Petrinja areas (Sisačko–Moslovačka County). The purpose of this paper is to report on the demographic and taphonomic characteristics of the recovered remains, and identify factors responsible for the discrepancy in the identification ratios.

Methods

To identify factors potentially responsible for the noted discrepancy, data were collected on the taphonomic characteristics of the recovered remains, the types of burials, as well as the factors responsible for positive identification. These factors included: forensic DNA testing, dental criteria, special signs (healed fractures, etc.), clothing and personal artifacts.

Results

The age distributions between males and females in the sample are significantly different. The mean age-at-death for males is 51.6 years, for females 67.0 years. In both sexes the majority of identifications (62.9% in females and 45.9% in males) were established through a combination of biological and non-biological features. In terms of the types of graves from which the bodies were recovered, positive identification in both sexes was lowest in mass graves (61.2% for males, and 84.2% for females). Females from mass graves were, however, better preserved than males—36.6% of males recovered from mass graves were completely skeletonized, while the same was true for only 19.3% of females (χ² = 7.06, P < 0.029). Completely skeletonized remains were identified in only 65.1% of cases, while partially skeletonized and saponified bodies were identified in 80.1% of cases.

Conclusion

Since positive identification in both sexes is strongly correlated with preservation of the bodies, the reason why female identification frequencies in the Glina and Petrinja regions are higher than male frequencies lies in the fact that females recovered from mass graves were better preserved than males recovered from mass graves. Identification of the factors responsible for this is a challenge that needs to be resolved in future studies.