Evaluation of the addiction history of a dead woman after exhumation and sectional hair testing.

In Greece, sectional hair analysis, in addition to clinical examination, has been used as a valuable tool for the confirmation of a person's history of drug use. The present report concerns the toxicologic analysis of the exhumed remains and hair samples of an 18-year-old woman. Postmortem toxicologic analysis of blood and urine confirmed recent opiate and cannabis use and indicated that death was associated with heroin abuse. Several months later, the woman's family asked for exhumation and reexamination of the body, insisting that the cause of death was homicide. The investigating judge ordered exhumation and new medicolegal examination of the body. The investigation of the drug profile along the hair shaft was undertaken by analyzing hair sections 1 cm from the hair root for morphine, 6-monoacetylmorphine, heroin, and cannabinoids. The total lengths of the hair samples ranged from 8 to 11 cm. The total morphine levels in the hair sections corresponding to the 3-month period before death were significantly lower (1.5-2.85 ng/mg) than those of the 4- to 10-month period before death (7.4-14.8 ng/mg). An interpretation of these results may be occasional drug use (with considerable attenuation of use during the last 3 months before death). Decrease of tolerance to heroin caused by abstinence and relapse in use could have been the cause of death.     

Craniometric analysis of the modern Cretan population

Despite the fact that sex assessment using craniofacial characteristics is commonly made worldwide, a lack of such investigation is noted in the Balkan area and in Greece in particular. The aim of this study is to develop a sex determination technique using osteometric data from skeletal remains of a contemporary Cretan cemetery population.A total of 90 males and 88 females are measured according to standard osteometric techniques. Age differences are not significant (mean age for men = 68.94 ± 13.41, N = 66; for women = 73.21 ± 16.77, N = 66). A total of 16 dimensions taken from the craniofacial skeleton are used and data are analyzed using SPSS subroutines. A comparison is made with other contemporary populations, including Americans (Terry collection) and South Africans (Dart and Pretoria collections), as well as an archaeological sample (Middle and Late Helladic) from Crete.Results indicate that males are statistically significantly greater than females in all dimensions. Bizygomatic breadth is the most discriminatory single dimension and can provide an accuracy rate of 82% on average. Using a stepwise method involving five dimensions (bizygomatic breadth, cranial length, nasion–prosthion and mastoid height and nasal breadth), accuracy is raised to 88.2%. Interestingly, cranial length is selected as the first discriminating variable by the stepwise analysis when only the neurocranium is available for measurement.     

Sexual dimorphism in permanent teeth of modern Greeks

Sex determination is considered an important step in reconstructing the biological profile of unknown individuals from a forensic context. Forensic anthropologists have long used teeth as an additional tool for sex determination as they resist postmortem destruction. In this case the use of population-specific data is necessary since sexual dimorphism varies between different populations. Currently there are no odontometric standards for determining sex in Greek populations. The purpose of this study is to examine the degree of sexual dimorphism in permanent teeth of modern Greeks. A total of 839 permanent teeth in 133 individuals (70 males and 63 females) from the Athens Collection were examined. Mesiodistal and buccolingual crown and cervical diameters of both maxillary and mandibular teeth were measured. It was found that males have bigger teeth than females and in 65 out of 88 dimensions measured, male teeth exceeded female teeth significantly (P<0.05). Canines were the most dimorphic teeth followed by first premolars, maxillary second premolar and mandibular second molar. Although other teeth were also sexually dimorphic they did not have a statistically significant difference in all dimensions. The most dimorphic dimension was buccolingual cervical diameter followed by buccolingual crown diameter. A comparison of sexual dimorphism in teeth between different populations showed that it differs among different groups. European population groups presented the highest degree of sexual dimorphism in teeth whereas Native South Americans the lowest.     

Forensic pathology on the threshold of the 21st century and the need for harmonization of current practice and training: the Greek concept

Our era is characterized by the globalization of crime. This poses to all democratic countries the urgent need to reform their systems to fight crime more effectively. Forensic sciences remain an integral part of the system against crime. This scientific field can also offer valuable knowledge regarding the causes of death. From an epidemiologic point of view, this can result in better organization of prevention measures for the best interests of the community. Harmonization and collaboration in the operation of the various forensic systems that presently exist around the world is of paramount importance if effective prevention of crime and other causes of death in contemporary reality is to be achieved. In addition, revision of training in forensic pathology and forensic sciences is essential if harmonizing the forensic systems is to succeed. This report provides an overview of the wide variation in the operation of forensic systems and training. Emphasis is given to the importance of their harmonization, and an attempt is made to explore principles that may contribute along these lines. Finally, the authors provide proposals for revision of the training system in forensic pathology in Greece.     

An Unusual Suicide Inside a Grave with Two Gunshot Wounds to the Head—The Psychological Approach

Abstract: In this report, the authors present a case of suicide committed by a 66-year-old man, inside a grave at the local cemetery, with two gunshot wounds to the head. A multiple-paged, handwritten suicide note was found in an army type bag inside the victim’s car, while a second one was found in his house. Medicolegal examination of the body revealed two typical contact gunshot entrance wounds and one exit wound to the head. Toxicological analysis of the femoral blood was negative for alcohol and drugs. The history, scene and autopsy findings, along with further police investigation, indicated an obvious case of suicide. The literature is reviewed and discussed. We report this case as the place of suicide is extremely uncommon and as there is no mention of a gunshot suicide inside a grave in the current literature.     

Sexual Dimorphism of the Humerus in Contemporary Cretans—A Population‐Specific Study and a Review of the Literature*

Abstract: Sex determination is the first essential step for positive identification when a decomposed body is recovered. Taking into consideration the population aspect of sexual dimorphism of the skeleton, the present study aimed to create a sex identification technique using osteometric standards, derived from a contemporary Cretan population. A total of 168 left humeri were measured according to standard osteometric techniques. The differences between the means in males and females were significant (p < 0.0005). About 92.3% of cases were correctly classified when all measurements were applied jointly. Stepwise procedure produced an accuracy rate of 92.9%. The most effective single dimension was vertical head diameter (89.9%). The current study provides standards for a population that has not been represented so far in the existing databases. It demonstrates that the humerus is an effective bone for the estimation of sex because even in a fragmentary state it can give high classification accuracy.     

Death related to midazolam overdose during endoscopic retrograde cholangiopancreatography

We report a midazolam-related death that occurred during endoscopic retrograde cholangiopancreatography (ERCP). The acute intoxication due to midazolam overdose was confirmed by high-pressure liquid chromatography (HPLC) analysis of the blood samples taken from the patient in the intensive care unit (2.8 microg/ml) and postmortem (2.4 microg/ml). The case strongly emphasizes the necessity of the precautions that should be taken when midazolam is intravenously administered.     

The application of histochemical methods to the age evaluation of skin wounds: experimental study in rabbits.

Enzyme histochemical methods allow determination of wound age, especially in the range of a few hours, and are used to distinguish between postmortem and antemortem skin wounds. The methods are based on the determination of the presence and changes of the enzyme reaction in the wound area. Increased activity of nonspecific esterases was observed approximately 1 hour after wounding and was followed by an increase in adenosine triphosphatase at approximately 2 hours and alkaline phosphatase at approximately 3.5 hours. Maximum enzyme activity was reached for nonspecific esterases at 24 hours, for adenosine triphosphatase at 20 hours, and for alkaline phosphatase at 32 hours after wounding.