Browsing by Author "Savic, Slobodan (7005859439)"

Objective: This study examines the incidence and other epidemiological and medico-legal characteristics of child homicide in the territory of Belgrade, Republic of Serbia. Methods: We performed a retrospective analysis of all autopsies carried out at the Institute of Forensic Medicine in Belgrade during a 15 year period between 1991 and 2005, focusing on homicide cases of victims aged 0-14 years. These were then analyzed in terms of number of deaths, mortality rates, age, and sex of the victim, relation to the perpetrator, and cause of death and injury. Results: Forty-six homicides were identified where the victims were aged 0-14 years. These included 24 girls and 22 boys. In 32 cases (69.6%) the perpetrator was one of the child's birth parents, more frequently the mother. Blunt head trauma was the most frequent cause of death, followed by exsanguination. In 9 cases (19.5%) there was evidence of physical abuse; 16 children died in the setting of multiple homicide and/or murder/suicide. In 4 cases (8.7%) there was evidence of neglect which contributed to the fatal outcome. There were 10 cases of neonaticide within the 46 homicides. There were, however, 49 further cases where bodies of newborn infants were discovered after having been disposed of in suspicious circumstances. Conclusions: Proportionally, the largest number of victims fell within the 1-4 years age group, with a slight preponderance of females, most of them killed at home by a close family member, usually the mother. Blunt head trauma was the single most frequent cause of death. Injury patterns consistent with child abuse were identified among 20% of the study group. © 2010 Elsevier Ltd.

Objective: This study examines the incidence and other epidemiological and medico-legal characteristics of child homicide in the territory of Belgrade, Republic of Serbia. Methods: We performed a retrospective analysis of all autopsies carried out at the Institute of Forensic Medicine in Belgrade during a 15 year period between 1991 and 2005, focusing on homicide cases of victims aged 0-14 years. These were then analyzed in terms of number of deaths, mortality rates, age, and sex of the victim, relation to the perpetrator, and cause of death and injury. Results: Forty-six homicides were identified where the victims were aged 0-14 years. These included 24 girls and 22 boys. In 32 cases (69.6%) the perpetrator was one of the child's birth parents, more frequently the mother. Blunt head trauma was the most frequent cause of death, followed by exsanguination. In 9 cases (19.5%) there was evidence of physical abuse; 16 children died in the setting of multiple homicide and/or murder/suicide. In 4 cases (8.7%) there was evidence of neglect which contributed to the fatal outcome. There were 10 cases of neonaticide within the 46 homicides. There were, however, 49 further cases where bodies of newborn infants were discovered after having been disposed of in suspicious circumstances. Conclusions: Proportionally, the largest number of victims fell within the 1-4 years age group, with a slight preponderance of females, most of them killed at home by a close family member, usually the mother. Blunt head trauma was the single most frequent cause of death. Injury patterns consistent with child abuse were identified among 20% of the study group. © 2010 Elsevier Ltd.

Research into crainiocerebral injury (CCI) characteristics of traffic accidents with fatal outcomes, as well as certain types of CCIs and defined categories of traffic participants, has been conducted. The research data were obtained from autopsy protocols at the Institute of Forensic Medicine in Serbia. Out of the 202 cases of individuals who had been fatally injured in traffic accidents, CCIs were diagnosed in 82.7% of them. The highest percentage of CCIs was established for front-seat passengers (95%), while for drivers it was 86.2%, pedestrians 78%, and 76% for rear-seat passengers. The domination of males among the deceased was also found, mostly as drivers (92%). The majority of individuals who experienced a CCI were in the age group of 21 to 30 years old, while pedestrians were commonly older than 60. In these cases, a high frequency of skull fractures was usually localized in different cranial regions (67.7%). In the majority of cases with CCIs (81.4%), these injuries contributed to an ultimate fatal outcome, mainly in pedestrians (93%). Fatal and non-fatal CCIs resulting from traffic accidents can result in significant socio-economic consequences for the individual and society as a whole that include specifically the ongoing costs and outcomes in cases from non-fatal injuries. © 2013 Australian Academy of Forensic Sciences.

Aim. The purpose of this study was to find the incidence of death caused by undiagnosed intracranial tumors. Methods. Autopsy material of the Institute of Forensic Medicine in Belgrade, from 1990 to 2004, was analyzed. The cases in which the cause of death is undiagnosed brain tumor have been extracted. Results. Brain tumors have caused death in 10 cases, of that 7 persons had benign tumors and three malignant and that was 3.9% of 259 indistinct natural deaths caused by pathological disorders of the brain. Of those three cases of malignant neoplasmas of the brain, one has been proven by pathohistological analysis to be an astrocytome of third grade malignity while the second case was a glioblastome. The histological type of tumor in the third case could not be determined because of big necrotic changes in the histological preparation. In the group of benignant tumors leading to death, five cases were menigothel tumors (meningiomas), and two cases were indistinct histogenesis (hemangioglioblastomas). Conclusion. The incidence of sudden death caused by undiagnosed primary intracranial tumors is extremely low. In every case with a susception to intracranial pathology a multidisciplinary approach that includes a total autopsy with thorough documentation and neuropathological tests is necessary. © 2011 Romanian Society of Legal Medicine.

Four human Ankrd2 transcripts, reported in the Ensembl database, code for distinct protein isoforms (360, 333, 327 and 300 aa), and so far, their existence, specific expression and localization patterns have not been studied in detail. Ankrd2 is preferentially expressed in the slow fibers of skeletal muscle. It is found in both the nuclei and the cytoplasm of skeletal muscle cells, and its localization is prone to change during differentiation and upon stress. Ankrd2 has also been detected in the heart, in ventricular cardiomyocytes and in the intercalated disks (ICDs). The main objective of this study was to distinguish between the Ankrd2 isoforms and to determine the contribution of each one to the general profile of Ankrd2 expression in striated muscles. We demonstrated that the known expression and localization pattern of Ankrd2 in striated muscle can be attributed to the isoform of 333 aa which is dominant in both tissues, while the designated cardiac and canonical isoform of 360 aa was less expressed in both tissues. The 360 aa isoform has a distinct nuclear localization in human skeletal muscle, as well as in primary myoblasts and myotubes. In contrast to the isoform of 333 aa, it was not preferentially expressed in slow fibers and not localized to the ICDs of human cardiomyocytes. Regulation of the expression of both isoforms is achieved at the transcriptional level. Our results set the stage for investigation of the specific functions and interactions of the Ankrd2 isoforms in healthy and diseased human striated muscles. © 2016, Springer-Verlag Berlin Heidelberg.

Four human Ankrd2 transcripts, reported in the Ensembl database, code for distinct protein isoforms (360, 333, 327 and 300 aa), and so far, their existence, specific expression and localization patterns have not been studied in detail. Ankrd2 is preferentially expressed in the slow fibers of skeletal muscle. It is found in both the nuclei and the cytoplasm of skeletal muscle cells, and its localization is prone to change during differentiation and upon stress. Ankrd2 has also been detected in the heart, in ventricular cardiomyocytes and in the intercalated disks (ICDs). The main objective of this study was to distinguish between the Ankrd2 isoforms and to determine the contribution of each one to the general profile of Ankrd2 expression in striated muscles. We demonstrated that the known expression and localization pattern of Ankrd2 in striated muscle can be attributed to the isoform of 333 aa which is dominant in both tissues, while the designated cardiac and canonical isoform of 360 aa was less expressed in both tissues. The 360 aa isoform has a distinct nuclear localization in human skeletal muscle, as well as in primary myoblasts and myotubes. In contrast to the isoform of 333 aa, it was not preferentially expressed in slow fibers and not localized to the ICDs of human cardiomyocytes. Regulation of the expression of both isoforms is achieved at the transcriptional level. Our results set the stage for investigation of the specific functions and interactions of the Ankrd2 isoforms in healthy and diseased human striated muscles. © 2016, Springer-Verlag Berlin Heidelberg.

An interesting case of firearm suicide carried out using an unusual type of handmade weapon and a peculiar combination of tandem missiles is presented. A nail and a screw were placed in the rifle barrel ahead of a bullet, and all 3 were simultaneously discharged. The inflicted injury began with 1 common channel, which later split in 2 separate channels, both directed backwards and upwards; one was caused by the screw, ending in the epistropheal body, and the other, caused by the bullet and the nail, penetrated into the cranial cavity, where it bifurcated in 2 branches, one from the bullet, ending in the cerebellar tissue, and the other from the nail, penetrated through the brain stem. The established site of the entrance suicidal wound, the appearance of the weapon, and the unusual missiles are discussed with regard to the available references dealing with different types of nail injuries to the head. Copyright © 2007 by Lippincott Williams & Wilkins.

Water intoxication (WI) is a rare condition that originates from over-consumption of water, with a potentially fatal outcome. Increased water intake (polydipsia) is followed by urination of high amount of diluted urine (polyuria) which are the main initial symptoms of WI. We present four case reports of WI. Two of them are unusual pediatric clinical cases using medical documentation and police case files, one of which is related to child abuse, and the other to a psychiatric disorder. The other two cases are fatal adult cases submitted to autopsy from a psychiatric hospital. Also, we present a diagnostic algorithm for polydipsia and polyuria before death. WI is usually seen in patients with psychiatric disorders, victims of child abuse or torture, drug abusers or it can be iatrogenically induced. © 2012 Elsevier Ireland Ltd.

Objective To examine antioxidative system in hippocampi of patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (mTLE-HS). Methods Activity and levels of antioxidative enzymes - catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), manganese superoxide dismutase (MnSOD), and copper-zinc superoxide dismutase (CuZnSOD) - were assessed in hippocampi of nine pharmacoresistant mTLE-HS patients (mean age 37.7 ± [standard deviation] 6.6 years) who underwent amygdalohippocampectomy, and in 10 hippocampi obtained via autopsy from five neurologically intact controls (mean age 34.4 ± 9.0 years). Subfield and cellular (neuron/astrocyte) distribution of CAT, GPx, and MnSOD was analyzed in detail using immunohistochemical staining. Results Sclerotic hippocampi showed drastically increased activity of hydrogen peroxide-removing enzymes, CAT (p < 0.001), GPx (p < 0.001), and GR (p < 0.001), and significantly higher protein levels of CAT (p = 0.006), GPx (p = 0.040), GR (p = 0.024), and MnSOD (p = 0.004), compared to controls. CAT immunofluorescence was located mainly in neurons in both controls and HS. Control hippocampi showed GPx staining in blood vessels and CA neurons. In HS, GPx-rich loci, representing bundles of astrocytes, emerged in different hippocampal regions, whereas the number of GPx-positive vessels was drastically decreased. Neurons with abnormal morphology and strong MnSOD immunofluorescence were present in all neuronal layers in HS. Small autofluorescent deposits, most likely lipofuscin, were observed, along with astrogliosis, in CA1 in HS. Significance Antioxidative system is upregulated in HS. This documents, for the first time, that epileptogenic hippocampi are exposed to oxidative stress. Our findings provide a basis for understanding the potential involvement of redox alterations in the pathology of epilepsy, and may open new pharmacologic perspectives for mTLE-HS treatment. © Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

Objective To examine antioxidative system in hippocampi of patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (mTLE-HS). Methods Activity and levels of antioxidative enzymes - catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), manganese superoxide dismutase (MnSOD), and copper-zinc superoxide dismutase (CuZnSOD) - were assessed in hippocampi of nine pharmacoresistant mTLE-HS patients (mean age 37.7 ± [standard deviation] 6.6 years) who underwent amygdalohippocampectomy, and in 10 hippocampi obtained via autopsy from five neurologically intact controls (mean age 34.4 ± 9.0 years). Subfield and cellular (neuron/astrocyte) distribution of CAT, GPx, and MnSOD was analyzed in detail using immunohistochemical staining. Results Sclerotic hippocampi showed drastically increased activity of hydrogen peroxide-removing enzymes, CAT (p < 0.001), GPx (p < 0.001), and GR (p < 0.001), and significantly higher protein levels of CAT (p = 0.006), GPx (p = 0.040), GR (p = 0.024), and MnSOD (p = 0.004), compared to controls. CAT immunofluorescence was located mainly in neurons in both controls and HS. Control hippocampi showed GPx staining in blood vessels and CA neurons. In HS, GPx-rich loci, representing bundles of astrocytes, emerged in different hippocampal regions, whereas the number of GPx-positive vessels was drastically decreased. Neurons with abnormal morphology and strong MnSOD immunofluorescence were present in all neuronal layers in HS. Small autofluorescent deposits, most likely lipofuscin, were observed, along with astrogliosis, in CA1 in HS. Significance Antioxidative system is upregulated in HS. This documents, for the first time, that epileptogenic hippocampi are exposed to oxidative stress. Our findings provide a basis for understanding the potential involvement of redox alterations in the pathology of epilepsy, and may open new pharmacologic perspectives for mTLE-HS treatment. © Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

Current autopsy principles for evaluating the existence of brain edema are based on a macroscopic subjective assessment performed by pathologists. The gold standard is a time-consuming histological verification of the presence of the edema. By measuring the diameters of the cranial cavity, as individually determined morphometric parameters, a mathematical model for rapid evaluation of brain edema was created, based on the brain weight measured during the autopsy. A cohort study was performed on 110 subjects, divided into two groups according to the histological presence or absence of (the – deleted from the text) brain edema. In all subjects, the following measures were determined: the volume and the diameters of the cranial cavity (longitudinal and transverse distance and height), the brain volume, and the brain weight. The complex mathematical algorithm revealed a formula for the coefficient ε, which is useful to conclude whether a brain edema is present or not. The average density of non-edematous brain is 0.967 g/ml, while the average density of edematous brain is 1.148 g/ml. The resulting formula for the coefficient ε is (5.79 x longitudinal distance x transverse distance)/brain weight. Coefficient ε can be calculated using measurements of the diameters of the cranial cavity and the brain weight, performed during the autopsy. If the resulting ε is less than 0.9484, it could be stated that there is cerebral edema with a reliability of 98.5%. The method discussed in this paper aims to eliminate the burden of relying on subjective assessments when determining the presence of a brain edema. © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine

Current autopsy principles for evaluating the existence of brain edema are based on a macroscopic subjective assessment performed by pathologists. The gold standard is a time-consuming histological verification of the presence of the edema. By measuring the diameters of the cranial cavity, as individually determined morphometric parameters, a mathematical model for rapid evaluation of brain edema was created, based on the brain weight measured during the autopsy. A cohort study was performed on 110 subjects, divided into two groups according to the histological presence or absence of (the – deleted from the text) brain edema. In all subjects, the following measures were determined: the volume and the diameters of the cranial cavity (longitudinal and transverse distance and height), the brain volume, and the brain weight. The complex mathematical algorithm revealed a formula for the coefficient ε, which is useful to conclude whether a brain edema is present or not. The average density of non-edematous brain is 0.967 g/ml, while the average density of edematous brain is 1.148 g/ml. The resulting formula for the coefficient ε is (5.79 x longitudinal distance x transverse distance)/brain weight. Coefficient ε can be calculated using measurements of the diameters of the cranial cavity and the brain weight, performed during the autopsy. If the resulting ε is less than 0.9484, it could be stated that there is cerebral edema with a reliability of 98.5%. The method discussed in this paper aims to eliminate the burden of relying on subjective assessments when determining the presence of a brain edema. © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine

Retrospective examination of 5-year autopsy material showed the presence of posttraumatic gastroduodenal ulcers (PGDU) in 17.7% of decedents deemed to be at risk. They were more common in males (77%) and in patients aged over 50. In the majority of cases (76%) the survival period was <12 days; in 16.5% it was < 48 h. PGDU developed most commonly in victims of polytrauma and isolated craniocerebral injury, with ISS values ≥16; patients with spinal cord injuries were at greatest risk. Most frequently affected was the stomach, exhibiting numerous, usually superficial lesions, while solitary acute and exacerbated chronic peptic ulcers were more common in the duodenum. Complications of PGDU developed in 40% of cases, mostly in the form of hemorrhage; in 20% of cases PGDU have contributed to death. Medicolegal aspects of PGDU are, most frequently, concerned with the causal relationship between trauma, PGDU, and fatal outcome, as well as the potential for allegations of medical negligence. © 2009 American Academy of Forensic Sciences.

Retrospective examination of 5-year autopsy material showed the presence of posttraumatic gastroduodenal ulcers (PGDU) in 17.7% of decedents deemed to be at risk. They were more common in males (77%) and in patients aged over 50. In the majority of cases (76%) the survival period was <12 days; in 16.5% it was < 48 h. PGDU developed most commonly in victims of polytrauma and isolated craniocerebral injury, with ISS values ≥16; patients with spinal cord injuries were at greatest risk. Most frequently affected was the stomach, exhibiting numerous, usually superficial lesions, while solitary acute and exacerbated chronic peptic ulcers were more common in the duodenum. Complications of PGDU developed in 40% of cases, mostly in the form of hemorrhage; in 20% of cases PGDU have contributed to death. Medicolegal aspects of PGDU are, most frequently, concerned with the causal relationship between trauma, PGDU, and fatal outcome, as well as the potential for allegations of medical negligence. © 2009 American Academy of Forensic Sciences.

A comparative analysis of firearm homicides committed in Belgrade was performed including four representative years: 1987 (before the civil war in the Former Yugoslavia), 1991 (beginning of the war), 1997 (end of the war), and 2007 (period of social stabilization). The increase in the number of homicides was established in 1991 and 1997 compared with 1987, with the decrease in 2007, but with the continuous increase in the percentage of firearm homicides in the total number of homicides, from 12% in 1987 up to 56% in 2007. The significant increase in firearm homicides during the last decade of the 20th century can be explained by the social disturbances and the high availability of firearms, while their reduction in 2007 could be linked to the gradual stabilization of social circumstances. The results showed that the actual social, political, and economical changes strongly influenced medicolegal characteristics of homicides and particularly firearm homicides. © 2013 American Academy of Forensic Sciences.

A comparative analysis of firearm homicides committed in Belgrade was performed including four representative years: 1987 (before the civil war in the Former Yugoslavia), 1991 (beginning of the war), 1997 (end of the war), and 2007 (period of social stabilization). The increase in the number of homicides was established in 1991 and 1997 compared with 1987, with the decrease in 2007, but with the continuous increase in the percentage of firearm homicides in the total number of homicides, from 12% in 1987 up to 56% in 2007. The significant increase in firearm homicides during the last decade of the 20th century can be explained by the social disturbances and the high availability of firearms, while their reduction in 2007 could be linked to the gradual stabilization of social circumstances. The results showed that the actual social, political, and economical changes strongly influenced medicolegal characteristics of homicides and particularly firearm homicides. © 2013 American Academy of Forensic Sciences.

Objective. Homicide is a destruction of human life, and it essentially conditioned by socio-economic situation in the society. The aim of this study is to analyze the frequency and other significant epidemiological and medicolegal characteristics of homicides in the population of Belgrade. Methods. An analysis was performed of all homicide cases in which autopsies were performed at the Institute of Forensic Medicine in Belgrade from 2003. to 2005. Data were obtained by using the autopsy records, the investigation reports, the heteroanamnesis obtained from family members of the fatally injured persons and the results of chemical toxicological analysis. Results. There were a total of 143 cases of autopsies of homicide victims. The majority of victims were males (103 or 72.03%) aged from 21 to 30 (25.17%). Homicides were mostly performed by using mechanical weapons only (127 or 88.8%). In most of the cases five or more injuries were registered per victim (48 victims or 33.57%) or only one injury (52 or 36.36%). Most of entrance wounds were located on the anterior side of the body. Conclusion. We demonstrated a gradual decrease in the number of murders in our population, and therefore we can expect a decrease in the absolute number of homicides in the future.

Muscle-specific mechanosensors Ankrd2/Arpp (ankyrin repeat protein 2) and Ankrd1/CARP (cardiac ankyrin repeat protein) have an important role in transcriptional regulation, myofibrillar assembly, cardiogenesis and myogenesis. In skeletal muscle myofibrils, Ankrd2 has a structural role as a component of a titin associated stretch-sensing complex, while in the nucleus it exerts regulatory function as transcriptional co-factor. It is also involved in myogenic differentiation and coordination of myoblast proliferation. Although expressed in the heart, the role of Ankrd2 in the cardiac muscle is completely unknown. Recently, we have shown that hypertrophic and dilated cardiomyopathy pathways are altered upon Ankrd2 silencing suggesting the importance of this protein in cardiac tissue. Here we provide the underlying basis for the functional investigation of Ankrd2 in the heart. We confirmed reduced Ankrd2 expression levels in human heart in comparison with Ankrd1 using RNAseq and Western blot. For the first time we demonstrated that, apart from the sarcomere and nucleus, both proteins are localized to the intercalated disks of human cardiomyocytes. We further tested the expression and localization of endogenous Ankrd2 in rat neonatal cardiomyocytes, a well-established model for studying cardiac-specific proteins. Ankrd2 was found to be expressed in both the cytoplasm and nucleus, independently from maturation status of cardiomyocytes. In contrast to Ankrd1, it is not responsive to the cardiotoxic drug Doxorubicin, suggesting that different mechanisms govern their expression in cardiac cells. © 2015, Springer-Verlag Berlin Heidelberg.

Muscle-specific mechanosensors Ankrd2/Arpp (ankyrin repeat protein 2) and Ankrd1/CARP (cardiac ankyrin repeat protein) have an important role in transcriptional regulation, myofibrillar assembly, cardiogenesis and myogenesis. In skeletal muscle myofibrils, Ankrd2 has a structural role as a component of a titin associated stretch-sensing complex, while in the nucleus it exerts regulatory function as transcriptional co-factor. It is also involved in myogenic differentiation and coordination of myoblast proliferation. Although expressed in the heart, the role of Ankrd2 in the cardiac muscle is completely unknown. Recently, we have shown that hypertrophic and dilated cardiomyopathy pathways are altered upon Ankrd2 silencing suggesting the importance of this protein in cardiac tissue. Here we provide the underlying basis for the functional investigation of Ankrd2 in the heart. We confirmed reduced Ankrd2 expression levels in human heart in comparison with Ankrd1 using RNAseq and Western blot. For the first time we demonstrated that, apart from the sarcomere and nucleus, both proteins are localized to the intercalated disks of human cardiomyocytes. We further tested the expression and localization of endogenous Ankrd2 in rat neonatal cardiomyocytes, a well-established model for studying cardiac-specific proteins. Ankrd2 was found to be expressed in both the cytoplasm and nucleus, independently from maturation status of cardiomyocytes. In contrast to Ankrd1, it is not responsive to the cardiotoxic drug Doxorubicin, suggesting that different mechanisms govern their expression in cardiac cells. © 2015, Springer-Verlag Berlin Heidelberg.

It is generally accepted that victims of sexual assault sustain bodily injury. This study's objective was to determine specific characteristics and severity of injuries among victims of sexual violence in Belgrade. Retrospectively, we analyzed a subgroup of victims of sexual violence that was legally processed over a five-year period. We evaluated 113 cases of sexual crimes selected from the District Court of Belgrade in order to analyze the medical records. All victims were female, at average 24.1 years old (range 5-80 years). In more than half of the cases (52%) evaluated, a medical examination was completed on the day of assault, while 84% took place within 72 hours post-assault. Due to delayed referral, body examination was not conducted on 12 victims (10.6%). We noted one or more extra-genital injuries in 64 victims (63.4%), no injuries in 36 victims (35.6%), whereas for one victim the medical records were inconclusive. Injuries, predominantly bruises, were located on limbs (32%), face (23%), and torso (7%). Abrasions and contusions were less frequently present, while two victims sustained lacerations. The Clinical Injury Extent Score was used to rate the physical severity of the assault. The majority of victims (44%) sustained light injuries, 18% were moderate, while one victim had severe injuries. © 2006 Elsevier Ltd and AFP.