ABSTRACT
This report on a male head revealed biologic rhythms, as gleaned from hydrogen isotope ratios in hair, consistent with a South-American origin and Atomic Mass Spectrometry radiocarbon dating (AMS) compatible with the last pre-Hispanic period (1418-1491 AD, 95.4% probability). Biopsies showed exceptionally well-preserved tissues. The hair contained high levels of toxic elements (lead, arsenic and mercury) incompatible with life. There was no evidence for lead deposition in bone consistent with post-mortem accumulation of this toxic element in the hair. We propose that the high content of metals in hair was the result of metabolic activity of bacteria leading to metal complexation in extra cellular polymeric substances (EPS). This is a recognized protective mechanism for bacteria that thrive in toxic environments. This mechanism may account for the tissues preservation and gives a hint at soil composition where the head was presumably buried. Our results have implications for forensic toxicology which has, hitherto, relied on hair analyses as one means to reconstruct pre-mortem metabolism and for detecting toxic elements accumulated during life. Our finding also has implications for other archaeological specimens where similar circumstances may distort the results of toxicological studies.
Subject(s)
Hair/chemistry , Hair/metabolism , Head , Hispanic or Latino , Adult , Blood Vessels/metabolism , Epithelium/metabolism , Fossils , Hair/microbiology , Hair/ultrastructure , History, 15th Century , Humans , Hydrogen , Immunohistochemistry , Male , Mass Spectrometry , Muscles/metabolism , Poisoning/diagnosis , Skin/cytology , Skin/ultrastructure , Skull/ultrastructure , South AmericaABSTRACT
Brugada syndrome is a congenital arrhythmogenic disease, characterized by alterations in sodium channels in the absence of structural myocardial changes. It leads to ventricular electrical instability, causing arrhythmias with high risk of sudden cardiac death. Patients affected by Brugada syndrome show electrocardiographic alterations either at baseline or after stimulation. Symptomatology and electrocardiographic alterations are the most important prognostic elements. The only effective treatment is the implantation of an automatic implantable cardioverter-defibrillator, which dramatically reduces arrhythmic mortality. This device is used only in symptomatic patients for abortive sudden cardiac death or syncope with electrocardiographic alterations, whereas in most patients just a careful follow-up is required. In this article we evaluate the medical-legal aspects of patients with Brugada syndrome, in forensic pathology, social insurance, private insurance, medical professional liability and ability to work. First of all, we analyze the question of medical professional liability, mostly in case of a wrong identification of prognostic factors. Then we consider the medical-legal evaluation of Brugada syndrome in the field of social insurance, in relation to the clinical picture and particularly to the frequency of arrhythmic events. As far as private insurance is concerned, we dwell upon patients' insurability in the various types of policies, refundable medical expenses and evaluation of pathology in health insurance. Finally, we discuss the question of ability to work, with special regard to armed forces and police, whose committees do not provide a specific evaluation for Brugada syndrome by making identical use of automatic implantable cardioverter-defibrillators and pacemakers, thus ignoring the great clinical differences between these two devices.
