Measurement of ß-tryptase in postmortem serum, pericardial fluid, urine and vitreous humor in forensic setting

L'activation des mastocytes se produit dans plusieurs conditions pathologiques et est principalement observée chez des patients développant une réaction anaphylactique. Dans la pratique clinique, la mesure de l'histamine et de ses métabolites dans le plasma et dans l'urine du patient peut être effectuée et montre parfois des résultats aussi précis que la mesure de la beta-tryptase dans le sang lorsqu'il est nécessaire de confirmer une activation mastocytaire. En revanche, la mesure de la beta tryptase dans l'urine dans un but diagnostic n'a que rarement été effectuée sur des personnes vivantes et a montré des résultats contradictoires. Dans le domaine de la médecine légale, la mesure de la beta-tryptase dans un but diagnostic est effectuée dans le sérum postmortem obtenu à partir de sang prélevé au niveau fémoral. Cependant, le sang peut être partiellement ou complètement indisponible dans certains cas spécifiques, dans les autopsies de nourrissons ou de corps sévèrement mutilés par exemple. Un des buts de notre étude est d'évaluer la pertinence de la mesure de la beta-tryptase dans des échantillons biologiques alternatifs, à savoir dans l'urine, l'humeur vitrée et le liquide péricardique. Pour cela nous avons sélectionné 94 cas d'autopsies comprenant 6 cas de réaction anaphylactique suite à l'administration de produits de contraste radiologique, 10 cas d'hypothermie, 10 cas d'acidocétose diabétique, 10 cas de suicide par arme à feu, 18 cas de décès consécutif à une injection d'héroïne, 10 cas de décès traumatiques, 10 cas de mort subite avec peu ou pas d'athérosclérose coronarienne, 10 cas de décès avec une athérosclérose coronarienne sévère mais sans signe d'infarctus du myocarde et 10 cas de décès consécutif à un infarctus du myocarde avec une athérosclérose coronarienne sévère. Dans tous les cas de réaction anaphylactique suite à l'administration de produit de contraste radiologique, les concentrations de beta-tryptase, mesurées dans le sérum postmortem et dans le liquide péricardique, ont montré des valeurs plus élevées que le seuil clinique de référence (11 ng/l) et le seuil postmortem de référence (45 ng/l). La concentration de beta-tryptase mesurée dans l'urine et l'humeur vitrée a montré des valeurs inférieures au seuil clinique dans tous les cas de notre étude. La mesure de la concentration de beta tryptase dans le liquide péricardique semble donc une alternative valable à la mesure dans le sérum postmortem, lorsque le sang fémoral n'est pas disponible durant l'autopsie, afin de poser un diagnostic de réaction anaphylactique.

European Council of Legal Medicine (ECLM) accreditation of forensic pathology services in Europe.

Forensic experts play a major role in the legal process as they offer professional expert opinion and evidence within the criminal justice system adjudicating on the innocence or alleged guilt of an accused person. In this respect, medico-legal examination is an essential part of the investigation process, determining in a scientific way the cause(s) and manner of unexpected and/or unnatural death or bringing clinical evidence in case of physical, psychological, or sexual abuse in living people. From a legal perspective, these types of investigation must meet international standards, i.e., it should be independent, effective, and prompt. Ideally, the investigations should be conducted by board-certified experts in forensic medicine, endowed with a solid experience in this field, without any hierarchical relationship with the prosecuting authorities and having access to appropriate facilities in order to provide forensic reports of high quality. In this respect, there is a need for any private or public national or international authority including non-governmental organizations seeking experts qualified in forensic medicine to have at disposal a list of specialists working in accordance with high standards of professional performance within forensic pathology services that have been successfully submitted to an official accreditation/certification process using valid and acceptable criteria. To reach this goal, the National Association of Medical Examiners (NAME) has elaborated an accreditation/certification checklist which should be served as decision-making support to assist inspectors appointed to evaluate applicants. In the same spirit than NAME Accreditation Standards, European Council of Legal Medicine (ECLM) board decided to set up an ad hoc working group with the mission to elaborate an accreditation/certification procedure similar to the NAME's one but taking into account the realities of forensic medicine practices in Europe and restricted to post-mortem investigations. This accreditation process applies to services and not to individual practitioners by emphasizing policies and procedures rather than professional performance. In addition, the standards to be complied with should be considered as the minimum standards needed to get the recognition of performing and reliable forensic pathology service.

The forensic radiographer: a new member in the medicolegal team.

Multidetector computed tomography is becoming more widespread in forensic medicine. In most services, autopsy assistants perform the radiological examination. We introduced professional radiographers into the legal medicine service and hypothesized they would also be able to take over duties currently reserved for other specialists. The aims of this study were to evaluate if radiographers could be trained as "forensic radiographers" by (1) integrating graduated medical radiographers into the legal medicine service, (2) investigating the advantages of this collaboration, and (3) defining the duties of the forensic radiographers.The study was performed prospectively on a group of 8 recruited radiographers who underwent a testing period with special training. They learned the basics of medicolegal case treatment, the autonomous execution of postmortem computed tomography angiography, and postprocessing of data. Seven of 8 radiographers finished the training and were integrated into our service. Although all radiographers were able to fulfill the duties demanded after the training period, some radiographers could not enter or complete the program because they were unable to work with dead bodies.Our study presents the advantages of integrating radiographers into the medicolegal team and proposes how to train the forensic radiographers. In addition, the duties and responsibilities of these new specialists are defined.

Vulgariser les sciences sans l'appui des savants. Jean Lanteires et le Journal de Lausanne (1786-1792)

Popularizing science without the support of scholars. Jean Lanteires and the Journal de Lausanne (1786-1792). - Founded in 1786 by Jean Lanteires, the Journal de Lausanne is a widespread, weekly journal with the express aim of disseminating scientific knowledge among the lower and middle classes. Its articles are easily comprehensible and cover a wide range of topics from literature to agriculture, from natural sciences to charity. Considerable space is given to reader's questions and comments. The journal can be situated somewhere between an almanac and a scientific journal. Lanteires' attempt to solicit contributions from scholars of medicine and natural sciences received a dismissive response. Of the few articles written by specialists, the majority deal with agriculture and charity. Lanteires' difficult relationship with the scholarly community is reflected in the journal's content. This makes the Journal de Lausanne a privileged observatory for studying the social context of the vulgarization process in late-eighteenth-century Switzerland and Europe.

Simultaneous identification of multiple mammalian species from mixed forensic samples based on mtDNA control region length polymorphism

Molecular species identification in mixed or contaminated biological material has always been problematic. We developed a simple and accurate method for mammal DNA identification in mixtures, based on interspecific mitochondrial DNA control region length polymorphism. Contrary to other published methods dealing with species mixtures, our protocol requires a single universal primer pair and amplification step, and is not based on a pre-defined panel of species. This protocol has been routinely employed by our laboratory for species identification in dozens of human and animal forensic caseworks. Six representative forensic caseworks involving the specific identification of mixed animal samples are reported in this paper, in order to demonstrate the applicability and usefulness of the method.