Browsing by Author "Damjanjuk, Irina (37064314500)"

In Europe, the first case of coronavirus disease (COVID-19) and the first COVID-19-related death were reported in France on January 24th and February 15th, 2020, respectively. Officially, the first case of COVID-19 infection in the Republic of Serbia was registered on March 6th. Herein, we presented the first case of retrospective detection of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the post-mortem-obtained vitreous humor (VH), which took place on February 5th, 2020. This is the first death in Europe proven to be caused by COVID-19 by means of post-mortem histopathological and molecular analyses. Based on this finding, it appears that SARS-CoV-2 has been spreading faster and started spreading much earlier than it had been considered and that COVID-19 was probably the cause of the much-reported pneumonia of unknown origin in January and February 2020. © Copyright © 2021 Bogdanović, Skadrić, Atanasijević, Stojković, Popović, Savić, Mihailović, Radnić, Aćimović, Damjanjuk, Despotović and Barać.

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Two cases of intestinal obstruction in the mentally disabled are reported. The first case concerns 61-year-old oligophrenic woman who resided in a nursing home, where she was found hypotensive and unresponsive. Upon opening the peritoneal cavity at autopsy, extremely dilated (measuring on average 12 cm in diameter) loops of the colon emerged– they compressed the small intestine and other intraperitoneal organs, lifting both hemidiaphragms deep into the pleural cavity. Lodged firmly into the rectum, a partly disintegrated sanitary pad was found. In the second case, young man with Down syndrome was found dead in his room in a nursing facility. At autopsy, a massively dilated stomach and intestinal loops emerged, interposing one of the loops between the liver and right hemidiaphragm (pushing it to the 3rd intercostal space). This was caused by a volvulus – the cecum, the entire ascending colon and hepatic flexure were gangrenous, dilated (the maximum diameter was 15 cm) and twisted in a full circle around the mesenteric attachment. There were no signs of colon perforation. In both cases, intellectual disability was at the core of poor communication and delayed medical treatment, which led to a fatal outcome. Caregivers must be trained to recognize distress in the mentally disabled, especially since the symptoms and signs of gastrointestinal diseases may be subtle, or at least less recognizable. By performing careful physical examination medical staff should search more cautiously for these signs. Any suspicion of mistreatment or neglect of the mentally impaired requires a medico-legal investigation and autopsy. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

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Background/Aim. Serotonin [5-hydroxytriptanine (5-HT)], as a neurotransmitter in the central nervous system, is included in the regulation of autonomic and cognitive functions, sensory processing, motor activity, emotions, mood, and almost every kind of behavior. In forensic investigations of death, 5-HT has been studied in different body fluids, regarding the cause of death, particularly in suicides and drug abuse or as a marker of an acute stress response. The aim of this study was to establish 5-HT levels in cerebrospinal fluid (CSF) as a marker of its central activity during fatal event in deaths different in manner, particularly in cases where the victims were aware of the stressful event. Methods. Study sample consisted of 81 postmortem CSF obtained during autopsy. Concentrations of the 5-HT were established regarding natural versus violent (accidents, homicides and suicides) deaths. After preparation, samples were analyzed through the liquid chromatography-tandem mass spectrometry method. Results. Violent deaths had significantly higher 5-HT levels (U = 519.000; p < 0.05). Differences were found in mean values among different causes of death (higher in blunt injury, stabbing and intoxication, while lower in cardiac deaths and hypothermia) but without statistical significance. 5-HT levels significantly differed among age groups (χ2 = 13.354; p = 0.001), with the tendency to decrease with age. No differences in 5-HT levels were observed regarding gender, length of agony period, and awareness of impending lethal outcome. The values tended to increase with postmortem interval albeit without significant differences. Conclusion. Serotonin could be a useful postmortem biochemical marker to distinguish natural and violent death, regardless of individual variability in concentrations. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

A 63-year-old mechanic, diagnosed with schizophrenia, was found next to a hydraulic press used for removing car wheel bearings. He was in a sitting position, bent towards the machine, with his head placed between the piston and the pressing plate. His flexed left arm was resting on the lever beneath the machine pedestal, and on the right side there was a power switch that was still in the “on” position. His right arm was beside his body, but away from the machine. On the pressing plate, beneath the decedents head, was a piece of bloody cloth. Blood spatters were present on the left hand and left trouser leg. At autopsy there was a gaping laceration in the right temporal area extending to the right ear lobe, where a piece of helix was missing. This missing tissue was found on the inner surface of the left temporal bone. The temporal lobes and brain-stem were destroyed along the wound trajectory but there were no brain contusions present. There was blood aspiration in both lungs, but all other findings were unremarkable. Death was attributed to the fatal head injury that resulted from the low-velocity penetration of the hydraulic press piston. While the cause of death was self-evident and undoubted, the manner of death required medico-legal investigation. The protective cloth that had been placed on the pressing plate, a medical history of schizophrenia, and the absence of any defensive injuries, all led to the conclusion that this was a case of a rather unusual suicide, which could be regarded as related to the decedents occupation. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

Introduction The risk of suicide among war veterans is a controversial issue, where findings so far have been contradictory. Objective This study focusses on suicide in Serbian veterans from the wars in former Yugoslavia in the 1990s in order to create appropriate preventive measures and reduce the number of these fatal cases. Methods The autopsy protocols of all 44 suicides committed by war veterans in the Belgrade District population over a period between 1992 and 2000 were investigated. Data were obtained from autopsy records, results of toxicological investigations and psychological autopsy protocols. Results Symptoms of posttraumatic stress disorder were present in 27.3%, major depression in 9.1% and schizophrenia in 6.8% of veterans. The majority of suicides (84.1%) were committed by recruits in the Yugoslav National Army, spending between three and eight months in the zone of war operations. Six committed suicide during the first 30 days after their war activities, while the majority of suicides occurred between five and six years after combat. The most frequent manner of suicide was the use of handguns (56.8%) and bombs (18.2%). Conclusion The results of this research may give useful information about the individuals with the highest suicidal risk in order to alleviate the consequences of war psychotraumas in veterans and prevent their growth into a permanent handicap or suicide. © 2015 Serbia Medical Society. All rightsreserved.

A 40-year-old drug addict, who was being treated with methadone and occupational therapy, committed suicide by striking a wooden pencil into his right eye socket. While still conscious, he hit his head hard against a table, jamming the pencil even deeper into his head. The autopsy showed that the pencil missed the globe and lodged in the inner part of the right eye socket. It pierced the orbital part of the right ethmoid bone, the right ethmoid cells, and the right superior nasal concha, then passed through the body of the sphenoid bone and the clivus of the occipital bone before stopping in the brain tissue. The basilar artery was transected at the pontomedullary junction, where the tip of the pencil had lodged. Also, at the pontomedullary junction, an approximately 3 mm deep laceration of the brainstem was evident together with flecks of green paint. Histological examination revealed that laceration at the pontomedullary junction was even deeper than the macroscopic appearance had suggested, with several small lateral cracks, focal deep hemorrhage, and disruption of both gray and white matter of the brainstem. Fragments of cellulose originating from the wooden pencil could also be clearly distinguished. Toxicological analysis was performed using liquid chromatography with mass spectrometry, and it showed traces of methadone in the blood and humor vitreous samples. The cause of death was damage to the vital structures in the brainstem, resulting from a penetrating injury to the head by a pencil. Herein, we present a self-inflicted trans-orbital penetrating injury by a non-missile, low-velocity object – a pencil, with a rather unusual, immediately incapacitating outcome. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

�External bevelling of an entrance gunshot wound to the skull is a known, but rare entity. We present two cases of a combined external and internal bevelling of cranial entries. In the first case, a 35-year-old woman had two entrance wounds in the right half of the forehead, made by a 10.2 mm calibre bullet. Second case presents a 48-year-old man with an entry wound in the middle of the occiput, made by a 7.62 mm calibre bullet. All the entry wounds on the skin had stellate appearance. The corresponding wounds to the skull were of roughly round shape. Both the inner and the outer plates of the bone were bevelled for 2-4 mm. Bony edges of all entrance wounds were covered in soot, as a definite sign of an entry. In this case study, we underline the importance of recognizing this phenomenon in order to avoid misinterpretation of entry vs. exit wounds. © 2018 Romanian Society of Legal Medicine.