Journal of forensic and legal medicine
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The whole population is susceptible to infection but elderly people with previous diseases are at greater risk. All these epidemiological data show that older age represents an important risk factor for infection and especially for mortality. In recent weeks an increase in mortality among the elderly has been observed in many Italian residential care homes. ⋯ According to the ISS report, 7.4% of the total deaths in care homes for elderly involved patients with SARS-CoV-2 infection and 33.8% involved patients with flu-like symptoms. Herein, we discuss the dangerous spread of COVID-19 in residential care homes for elderly. In addition, we present a case of an elderly person admitted to a residential care home, whose COVID-19 diagnosis was performed only after death.
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All Covid-19 deaths and all nursing home and residential home deaths in Ireland must by law be reported to the Coroner, the independent Judicial Officer of the State, in the District in which they occur. This enables accurate and early collation of these death reports. Between January 1, 2015 and June 30, 2020 3342 deaths were reported to the Coroner's District for Kildare. ⋯ Underlying medical conditions were recorded in 99% of those dying from Covid-19 and the average age of the deceased was 82.5 years with median of 78 years and 55% of those dying were female and 45% male. The clinical epidemiology and documented excess mortality of the reported deaths are chronicled and analysed to learn also about the future challenges with the continuing Covid-19 infection. A centralized national mortality database providing near real-time death certification enhances infectious disease surveillance and prompt clinical epidemiology and mortality excess studies and reduces under-reporting of Covid-19 deaths.
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The body packing represents an illegal drug trafficking practice across the borders of certain countries. It has experienced enormous growth in recent years. ⋯ However, reported cases of cannabis body packing appear to be rare, sometimes underestimated, despite the notoriety of cannabis in the illegal drug market and its wide consumption around the world. We report in this work a forensic case of a cannabis body packer deceased due toa stercoral peritonitis secondary to a double perforation of thesigmoid and rectal colon.
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Case Reports
A verified period of normal neurologic status in a young victim of abusive head trauma.
Abusive head trauma (AHT) is the leading cause of child physical abuse fatalities, and survivors frequently face life-long consequences. Victims of AHT are typically infants, and many are subjected to repeat AHT if not accurately identified and protected. Identifying the timing of AHT is often a medical-forensic process, and investigative personnel use the determination of timing of AHT to guide safety decisions for the child victim. ⋯ This case involves a 2-month-old infant victim of AHT who presented to medical care with mild neurologic symptoms that resolved without intervention from medical personnel. While hospitalized, the infant had an asymptomatic period of approximately 38 hours prior to more severe neurologic decompensation, then later returned to neurologic baseline. This case highlights the challenges in accurately timing AHT in very young victims who return to neurologic baseline by characterizing a verifiable prolonged period of normal neurologic appearance and function after AHT.
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Review
Precautions in postmortem examinations in Covid-19 - Related deaths: Recommendations from Germany.
The Covid-19 pandemic is also a considerable risk for forensic workers, among other healthcare providers. The risk of contamination is serious in post-mortem procedures. SARS-CoV2 is a microorganism classified as Hazard Group 3. ⋯ This article highlights preventive measures to be taken into consideration in post-mortem processes when a Covid-19 infection is suspected or confirmed. It should be noted that there is no standard guide yet in this regard. A guide should be created according to international standards and revised according to changing conditions.