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When analyzing human adult skeletal remains, it is often difficult to decide whether a single aging method will give a more reliable age estimation than a combination of methods. This study evaluates four macroscopic indicators for age estimation on 218 American White and Black individuals, ranging in age from 25 to 90 years of age, from the Terry collection. Individuals in the sample were selected to have a balanced race, sex, and age distribution. The following aging methods were applied to each skeleton by one experienced observer: the Suchey-Brooks (SB) pubic symphysis method, the Lovejoy auricular surface method, the monoradicular teeth Lamendin (LM) method, and the Işcan (IC) method for fourth ribs. The statistical study involved the evaluation of inaccuracy and bias (based on median age) for each age indicator and the combination of methods using Principal component analysis (PCA). Analysis was performed on the entire sample, then by race, then sex, and then age group (25-40 years, 41-60 years, and >60 years). PCA was the most accurate method for both racial groups when all age groups are analyzed together. When the sample was divided into age groups, SB was the most accurate for young adults (25-40 years) and LM was the most accurate for middle adults (41-60 years). After the age of 60, all methods are highly inaccurate, although IC gives the lowest inaccuracy. As regards bias, the study highlights the tendency of all methods to overestimate the age of young individuals and to underestimate in the older age group. No single skeletal indicator of age at death is ever likely to reflect accurately the many factors that accumulate with chronological age. In fact, one must use as many dental and skeletal indicators as possible. However, in order to maximize the potential of each method, in the final evaluation one should consider mainly the method or methods that have a higher accuracy for a particular age range.

Wound age evaluation is one of the most challenging issues in forensic pathology. In the first minutes or hours, standard histological examination may not determine whether the wound was inflicted in the pre- or post-mortem period. While red blood cell infiltration is classically considered as a sign of vital reaction, several studies have shown that extravasation of blood cells may also occur after death and cannot be used as a reliable marker in the diagnosis of wound vitality. Numerous studies about wound vitality are available in the literature. They have evaluated markers involved in coagulation or inflammation, using various methods such as enzymology, molecular biology or immunohistochemistry. In this update, we first introduce some methodological principles. Then, we review the main studies available in the literature. Immunohistochemistry seems to be the most valuable method, given its easy application and the possibility to analyse the localization of the molecules of interest. Some markers are promising, such as CD15, TNFα, IL-6, IL-1β, TGFα or TGFβ1. Prior to their application in daily practice, these early results need to be confirmed with other studies, conducted by independent teams and integrating multiple controls. Most notably, the antibodies have to be tested in numerous post-mortem wounds. Indeed, a critical risk of overexpression in post-mortem wounds is present. Some promising markers have been later invalidated because of post-mortem false positivity. Finally, optimal sensitivity and specificity values could probably be reached by combining several markers, validated by large groups of pre- and post-mortem wounds.

Virtual volumetry may provide significant information concerning the macroscopic features of the main organs and help pathologists in sampling organs that are more likely to yield histological findings.

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BackgroundFew studies have prospectively examined risk factors for posttraumatic stress disorder (PTSD) in the aftermath of a traumatic exposure. The aim of this study is to identify the concurrent influence of psychological and biological diatheses on PTSD onset and maintenance, taking into account socio-demographic factors and psychiatric antecedents.MethodsA total of 123 civilians (61.8% of women) recruited in emergency units, were assessed using validated instruments during the first week and then at 1, 4, and 12 months post-trauma. Baseline assessment included evaluation of the psychological diathesis (i.e. psychiatric history and peritraumatic distress and dissociation), and the biological diathesis [i.e. cortisol, norepinephrine, epinephrine, c-reactive protein, total cholesterol, HDL cholesterol, glycosylated haemoglobin, waist-to-hip ratio (WHR), body mass index, diastolic and systolic blood pressure (SBP), and heart rate].ResultsMultivariate logistic regression analyses demonstrated both psychological and biological diatheses to be independent risk factors for PTSD. Peritraumatic distress and dissociation predicted onset (1-month) and mid-term PTSD (4-months), respectively. PTSD risk was associated positively with SBP and negatively with WHR, throughout the follow-up. In addition, a higher level of 12 h-overnight urinary norepinephrine independently predicted mid-term PTSD (4-months).ConclusionsThis prospective study shows that peritraumatic psychological and biological markers are independent predictors of PTSD onset with specificities according to the stage of PTSD development; the psychological diathesis, i.e. peritraumatic distress and dissociation, being a better predictor of short-term dysfunction whereas biological diathesis was also predictive of development and maintenance of PTSD.

The timing of skin wounds is one of the most challenging problems in forensic pathology. In the first minutes or hours after infliction, histological examination fails to determine whether a wound was sustained before or after death. The aim of this study was to evaluate the use of three immunohistochemical markers (FVIIIra, CD15, and tryptase) for the interpretation of the timing of cutaneous stab wounds. We evaluated these markers in intravital wounds from autopsy cases (n = 12) and surgical specimens (n = 58). As controls, we used normal skin samples from autopsies (n = 8) and an original ex vivo surgical human model of recent postmortem wounds (n = 24). We found overexpression of FVIIIra in 100 % of vital wounds, but also in 53 % of the controls. The number of CD15-positive cells was higher in wound margins than in internal controls (p < 0.0001) and was significantly correlated with the time interval between incision and devascularization (p = 0.0005; minimal time for positivity, 9 min). Using the anti-tryptase antibody, we found that the mast cell degranulation rate was higher in wound margins (p < 0.0001) and correlated with the time interval (minimal time, 1 min). The sensitivity and specificity for the diagnosis of vitality were respectively 100 and 47 % for FVIIIra, 47 and 100 % for CD15, and 60 and 100 % for tryptase. The inter-observer agreement coefficients were 0.68 for FVIIIra, 0.90 for CD15, and 0.46 for tryptase. Finally, we demonstrated that these markers were not reliable in putrefied or desiccated specimens. In conclusion, CD15 and tryptase, but not FVIIIra, may be useful markers for differentiating recent antemortem from postmortem injuries.

Lamendin and colleagues (1992) proposed to assess age-at-death from root translucency and periodontosis. Several teeth from the same individual were included in their study. In our work, we evaluate the reliability of their formulas without introducing this bias. Our sample was constituted of 214 individuals (114 males and 100 women) selected from the Terry collection (U.S.A.). The R(2) between age and both indicators is equal to 0.33 and 0.08 (p < 0.001). Based on linear regression, the mean of standard error for individual age prediction was equal to 13.67 years, and the mean interval length is equal to 53.89 years. Multinomial logistic regression and Bayesian approach failed to give satisfactory results when classifying the individuals in age categories. Therefore, the use of root translucency and periodontosis may lead to incorrect age-at-death assessment, and it is thus necessary to complement this approach with other techniques to assess age-at-death.