Soudni Lekarstvi最新文献

The article presents the first Polish case of fatal single-substance poisoning with cyclopropylfentanyl, a representative of fentanyl derivatives, whose victim was a 37-year-old man. This opioid was detected in biological material collected during medicolegal autopsy and in the syringe found near the deceased. Blood and urine samples were analyzed using liquid chromatography with mass spectrometry. The concentration of cyclopropylfentanyl was 24 ng/mL in blood and 73 ng/mL in urine.

In the case report, the authors describe the death of a 48-year-old man with several chronic diseases, like an arterial hypertension, chronic ischemic heart disease and diabetes, 2nd type, in the field of asymptomatic covid pneumonia due to massive pulmonary thromboembolism. Atypical findings at autopsy were the unusual appearance, structure and location of blood clots, which were found in several arteries and veins in almost all areas of the body. At the autopsy it was really difficult to decide, if the found blood cloths are “vital” thrombes, or typical postmortal coagulation of blood, mostly due to their glossy appearance (typical for postmortal coagulation of blood) and strange resistance. An assumtion for thrombosis was proven by microscopical examination of some tissue samples. Based on several performed autopsies and expert articles, the authors want to point out the connection between COVID-19 disease and atypical thromboembolic complications. Demonstration of similar deaths may be helpful in the future in diagnosis and especially in preventive treatment, or in its research in patients with Covid-19.

We present here a fatal case of heatstroke, involving olanzapine and levomepromazine medications. A male in his sixties was found dead in his storage room in the middle of August, with a high rectal temperature. Autopsy revealed congestion of the lungs without any specific findings. Quantitative toxicological analysis demonstrated concentrations of olanzapine, levomepromazine, 7-aminonitrazepam, and 7-aminoflunitrazepam in a femoral blood sample of 0.433 µg/mL, 0.177 µg/mL, 0.604 µg/mL, and 0.041 µg/mL, respectively. The concentration of olanzapine exceeded toxic levels; however, levomepromazine level was within the therapeutic range. Due to the blocking mechanism of both olanzapine and levomepromazine against muscarinic receptors, they might depress sweating and impair heat dissipation. Based on autopsy findings, results of toxicological examination, and investigation by the authorities, we concluded that the cause of death was heatstroke under the influence of olanzapine and levomepromazine.

Autoerotic death is a rare but recurring phenomenon in forensic medicine. This article presents two cases of unusual autoerotic death with signs of autoerotic asphyxia. Although the first case appeared to be asphyxia, the autopsy confirmed natural cause of death during solitary sexual activity of 69-year-old man found with exposed and bandaged genitals. The other case was asphyxiation utilizing a plastic bag and multiple panties wrapped around the head of 18-year-old man disguised in women´s dress.

From the National Registry of autopsies and toxicology examinations, we selected the deceased for 2015, 2016, 2017 and January 2018 active road accident participants, i.e. pedestrians, cyclists and motor vehicle drivers. From these, we further selected those who were tested for THC presence. Of the 836 deceased active road accident participants, only 251 (i.e. 30%) were tested for cannabinoids, most often passenger car drivers, 46 percent. Of the 251 people tested, THC was demonstrated in 12 (4.8%), most commonly motorcycle drivers (7.8%) and passenger car drivers (3.4%). Of the 12 positive people, 7 were found to have a possible effect of THC ingestion on the road accident, but only one participant was found to have overdosed on THC, and 2 were reported by the dissecting physician to have had no effect on the accident. In the Czech Republic, when driving under the influence of addictive substances, there is no uniform procedure for qualification, whether it is an offence or an offence, and thus in the award of punishment. While somewhere there is an effort to divide this wrongdoing into offences and crimes, elsewhere it practically always only constitutes an offense. This situation seeks to resolve the instruction of the Attorney-at-chief 1 SL 732/2018 of 29 December 4.2019, which, however, arose without any discussion with the professional public, which is heavily criticized especially for the absurly high limits, which in particular in morphine and cocaine are practically unachievable. At the time of this writing, the impact of this guideline on practice is not clear.

Traumatic injury due to crossbows is a rare occurrence these days. The aim of this study is to present a case of perforating chest injury caused by a bolt shot from a crossbow in suicidal intent which occurred “live“ during a telephone conversation. The autopsy revealed perforation of the heart and left lungs with massive bleeding to the left pleural cavity which caused haemorrhagic shock. The motive of the mans suicide was the breakup with his girlfriend.

Předkládaná studie zkoumala aktuální stav a příčiny smrtelných pracovních úrazů ze zdravotně-sociálního hlediska. Retrospektivně jsme hodnotili případy smrtelných pracovních úrazů mezi lety 2007 a 2016 v Ósace, která je druhým nejlidnatějším městem v Japonsku, z forenzních posmrtných dat 1689 zemřelých. Z těchto případů jsme analyzovali celkem 57 smrtelných průmyslových nehod. Oběťmi byli typicky muži v relativně pokročilém věku pracující generace, téměř polovina případů (přesněji 28) byli muži mezi 50 a 70 lety života. Nejčastějším typem nehody byl pád z výše (24 případů) a nejčastějším místem, kde k nehodám docházelo, bylo staveniště (28 případů). Většina nehod (29 případů) se odehrála na pracovišti s malým pracovním týmem. V 60 % případů oběť na sobě neměla ochranou helmu a ve 34 případech (60 %) byla nehoda připisována vlastní nedbalosti. Nehody se nejčastěji stávaly v úterý. Nejběžnější doba, kdy k nehodám docházelo, byla kolem 10. a 11. hodiny dopolední a kolem 1. a 2. hodiny odpolední. V přibližně 60 % případů žaludeční obsah zahrnoval i zbytky potravy, což naznačuje, že k nehodám typicky docházelo po jídle. V předkládané studii jsme zjistili, že pracovní nehody, z nichž nejčastější byl pád z výše, vykazují tendenci se vyskytovat na pracovišti s malým pracovním týmem. Pouze pár obětí mělo na sobě ochranou helmu. Tato zjištění naznačují, že na pracovištích by měly být důkladně zaváděny systémy monitorování a řízení bezpečnosti a že pracovníci by měli před i po jídle dbát zvýšené opatrnosti.

Tonsillitis is a relatively well treatable disease. Complications of untreated tonsillitis can even today result in life-threatening complications. The aim of this study is to present a case of a 47-year-old man without previous history of health problems, who suffocated after a brief episode of breathing difficulties. At the forensic autopsy, left-side necrotising tonsillitis with adjacent soft tissue, uvula, and epiglottis swelling and inflammation and significant airway narrowing were found.

A literature review of cases of acute poisoning by petroleum and its distillates was conducted, while a new fatal case of suicide by gasoline intake is reported. Specifically, a number of studies were reviewed in order to update and summarize the relevant literature on the incidence, sociodemographic variables, method of poisoning, diagnostic - toxicological procedures, variables associated with survival and fatality on acute petroleum/gasoline intoxication. Results show that acute poisoning by petroleum and its distillates is relatively rare. Male prevalence was observed among patients, while most incidents were classified as suicide attempts. Oral ingestion was the most frequent method of intake, while a case of intravenous injection was also reported. The survival rates were low, as among all literature cases, two thirds of them managed to reach the hospital alive, and only the one fourth of them had a medically successful outcome.

Sudden cardiac death is defined as sudden death due to a confirmed cardiovascular disease or when there is no explanation after medico-legal autopsy and arrhythmogenic, possibly hereditary etiology is presumed. Molecular autopsy should be indicated in all cases of sudden cardiac death due to suspected cardiomyopathy and hereditary arrhythmic syndrome. It should also be considered in thoracic aortic dissection. These hereditary cardiovascular diseases account for the majority of sudden cardiac death cases in the young up to 40 years of age. They are mostly inherited in an autosomal dominant manner carrying a 50% risk of passing the diasease-causing mutation to the offspring. In fact, all first-degree relatives have a high risk of developing the disease associated with sudden cardiac death. Hence, knowledge of the exact cause of death derived from molecular autopsy combined with a cardiologic and targeted genetic examination of first-degree relatives may help us detect other at risk family members and provides us with an opportunity to prevent further sudden deaths in the family by means of timely preventive measures. Forensic pathologists play a key role in this process of primary prevention of sudden death. They should retain tissue samples for DNA analysis whenever a hereditary cardiovascular disease is suspected. They should also recommend to the relatives a thorough cardiogenetic examination at one of the specialized centres. A multipdisciplinary team including cardiologists, geneticists, psychologists, forensic pathologists and coroners should be involved in the investigation of sudden cardiac death in the young.