Background and Objectives: The post-mortem diagnosis of hypothermia is challenging in forensics. The aim of our study was to detect the kidney and heart histopathological changes that occurred in a group of hypothermia-related fatalities. Materials and Methods: The cohort included 107 cases identified in the database of our department between 2007 and 2021, which have been associated with extreme cold stress. Demographic and clinicopathological data were collected from the medico-legal reports. Archived tissue samples were evaluated to identify the histopathological features, in routine haematoxylin-eosin (H&E), Periodic acid-Schiff (PAS), and Masson’s trichrome stainings, while cardiac sirtuin1 (SIRT1) and renal ubiquitin (Ub) immunostaining have been performed. Results: The majority of cases exposed to low temperatures were males (76%) from rural regions (68.2%) during the cold season. Paradoxical undressing was documented in 9.3% of cases. The common comorbidities included alcoholism (50.5%), neuropsychiatric diseases (10.3%), diabetes mellitus (3.7%), and lung tuberculosis (4.7%). The microscopic heart exam revealed areas of myocardial degeneration (100%), contraction bands (95.3%), fatty change (13.1%) and focal wavy contractile myocardial cells. Basal vacuolisation of renal tubular epithelial cells (Armanni-Ebstein lesions) (21.5%), focal tubular necrosis (7.5%), tubular renal cysts (7.5%), interstitial haemorrhages (5.6%), diabetic kidney disease (3.7%), background benign nephroangiosclerosis (42.1%), variable thickening of tubules and corpuscles basement membranes, capsular space amorphous material, and intratubular casts were identified in kidney tissue samples. Myocardial cells displayed SIRT1 weak expression, with a loss of immunopositivity correlated with areas with contraction bands, while a variable Ub expression was observed in renal corpuscles capsules, proximal, distal, and collecting renal tubules, Henle’s loops, urothelium, and intratubular casts. Conclusions: In the context of the current concept that death associated with hypothermia is still a diagnosis of exclusion, our findings suggest that the microscopic exam provides relevant data that support the diagnosis of hypothermia-related fatalities in appropriate circumstances of death. A deeper insight into the histopathologic findings in hypothermic patients may lead to new therapeutic approaches in these cases.

Background and Objectives: Although classical gross features are known in hypothermia victims, they lack specific diagnosis features. The aim of our study was to reveal specific brain and lung pathological features in a group of hypothermia-related fatalities. Materials and Methods: The study group comprised 107 cases from our files associated with hypothermia. Routine hematoxylin–eosin (H&E) staining and postmortem immunohistochemistry were performed. Results: The microscopic cerebral exam revealed diffuse perineuronal and perivascular edema, gliosis, mononuclear cell infiltration, acute brain injuries, focal neuronal ischemia, lacunar infarction, and variable hemorrhages. Variable alveolar edema, pulmonary emphysema, intra-alveolar and/or pleural hemorrhage, and bronchopneumonia, as well as other pre-existing lesions, were identified in lung tissue samples. Glial cells displayed S100β expression, while neurons showed moderate Hsp70 immunopositivity. Alveolar basal membranes exhibited diffuse ICAM-1 positive expression, while ICAM-1 and AQP-1 positivity was observed in the alveolar septum vascular endothelium. Statistical analysis revealed a significant correlation between S100β and Hps70 immunoexpression and cerebral pathological features, between ICAM-1 immunoexpression and alveolar edema and pulmonary emphysema, and between AQP-1 immunoexpression and pulmonary emphysema. Conclusions: Our results add supplementary data to brain and lung pathological findings in hypothermia-related fatalities, with potential therapeutic value in hypothermia patients.

Traditional medical education can be disrupted during periods of epidemic or pandemic, due primarily to the closure of universities and the restriction of social human contact in order to limit the pathogen transmission. COVID-19 pandemic thus determined universities and teachers to go towards alternative education methods, based on the use of the Internet, by teaching online courses and practical activities stipulated in the university curriculum. The alternative methods are based on the simulation as close as possible to the reality of the practical laboratories through the use of different software platforms that allow the attachment of study materials, live video conferences, the sharing of the screen with the transmission of power-point presentations, video materials, photos but also the evaluation of students by applying questionnaires with the possibility of real-time response. In this article, the authors analyze the advantages and disadvantages of teaching forensic autopsy through traditional methods versus teaching through alternative methods. The authors particularize the problems approached by analyzing the new online method of teaching the forensic autopsy to the students of the Grigore T. Popa University of Medicine and Pharmacy of Iasi, which allows the continuity of the teaching activity, avoiding the direct human contact in order to encourage the students to maintain isolation according to the plan of the current state of emergency and, at the same time, without creating important dysfunctions in the structure of the academic year and of the university curriculum.

Spinal cord injuries represent a special category of injuries in traumatic pathology, with high morbidity and mortality, which justify their analysis with the aim to identify useful aspects in order to prevent and treat them. We therefore performed a retrospective study on 426 cases in order to analyze epidemiology and medico-legal issues related to spinal cord injuries. The studied items regarded socio-demographic aspects (gender, age, home region), type of lesions (vertebral, spinal cord, association with other trauma), circumstances leading to trauma (cause of the injury, season), data regarding hospitalization (medical condition at the hospital admission, number of days of hospitalization, clinical diagnosis, imaging exploration level) and data resulting from autopsy (diagnosis, toxicological examination). Most of our results are consistent with literature data, except for some epidemiological items, which might be explained with cultural differences, life style and inhomogeneous population. Based on our results, the general conclusion is the need for prevention campaigns, focusing on road traffic accidents and falls (especially in elderly) as the main causes of spinal cord injuries.

Ingestion of cheap para-pharmaceuticals (such as disinfectants, deodorizing solutions, etc.) which are designed only for external use is an unfortunate habit encountered in the recent decades in the economically disadvantaged areas of Romania inhabited by poor, uninformed, and sanitary uneducated population. These para-pharmaceutical products are based on different concentrations of ethanol. Occasionally, the manufacturer modifies the product formula, or worse omits on the label that the ethanol was replaced with methanol, resulting in mass poisoning with a large number of casualties. The authors present a case of mass poisoning by methanol that occurred during one month and resulted in 40 cases of methanol intoxication. Only 5 out of the 40 victims survived the intoxication. All the dead victims underwent medico-legal autopsy which revealed only general features, liable to poisoning. The toxicological examination result was positive for methanol in all the cases. All the intoxicated victims were homeless; they were heavy ethanol consumers, especially of the product rubbing alcohol. The male: female ratio was 31:4 and the age range was between 25 and 70 years old, with an average of 50 years. All the victims were hospitalized in deep coma, showing obvious pathological changes specific to chronic ethanol consumption. Conclusions: some alcoholic para-pharmaceutical products manufactured for external use are ingested by chronic ethanol drinkers. When these products contain methanol, they can cause severe intoxication followed by an impressively large number of deaths.