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The Covid 19 pandemic we are currently facing all over the world is undoubtly an emergency condition which exposes all workers to the risks of a serious infection. The personnel working in the autoptic room is at high risk for the possible contact with infected material from corpses, splashes and aerosols diffusion, and must be always prepared to stay safe and healthy. We offer to the forensic odontologists’ community a short summary of some old and new hints on the treatment of dead bodies in the autopsy room during this pandemic emergency time.

Pathogenic CD4+ T cells are capable of initiating neuroinflammation in experimental autoimmune encephalomyelitis (EAE). However, the precise effector mechanism of these autoaggressive CD4+ T cells is not entirely elucidated. Here, we demonstrated that pathogenic CD4+ T cells, upon autoantigen stimulation, developed a cytotoxic phenotype at the onset of EAE. The cytotoxic activity of pathogenic CD4+ T cells was sufficient to explain the initial myelin lesion. Consistently, CD4+ T cells of peripheral blood (PBMCs) and cerebrospinal fluid (CSF) from relapse-remitting multiple sclerosis (RRMS) patients present an enhancement of the cytotoxic profile in comparison with healthy control (HC). Moreover, cytotoxic CD4+ T cells (CD4-CTLs) are restrained in the PBMCs of Natalizumab-treated RRMS patients. Mechanistically, autoaggressive CD4-CTLs matched the majority of the molecular pathways of effector CD8+ T cells. Altogether, our findings point to potential new targets for monitoring MS diagnosis, treatment, and the development of novel therapeutic avenues.

The migrants arrived to the Italian coasts in 2016 were 181.436, 18% more than the previous year and 6% more than the highest number ever since. An "unaccompanied minor" (UAM) is a third-country national or a stateless person under eighteen years of age, who arrives on the territory of the Member State unaccompanied by an adult responsible for him/her whether by law or by the practice of the Member State concerned, and for as long as he or she is not effectively taken into the care of such a person; it includes a minor who is left unaccompanied after he/she entered the territory of the Member States. As many as 95.985 UAMs applied for international protection in an EU member country just in 2015, almost four times the number registered in the previous year. The UAMs arrived in Italy were 28.283 in 2016; 94% of them were males, 92% unaccompanied, 8% of them under 15; the 53,6% is 17; the individuals between 16 and 17 are instead the 82%. Many of them (50%), 6561 in 2016, escaped from the sanctuaries, thus avoiding to be formally identified and registered in Italy in the attempt to reach more easily northern Europe countries, since The Dublin Regulations (2003) state that the asylum application should be held in the EU country of entrance or where parents reside. The age assessment procedures can therefore be considered as a relevant task that weighs in on the shoulders of the forensic experts with all the related issues and the coming of age is the important threshold. In the EU laws on asylum, the minors are considered as one of the groups of vulnerable persons towards whom Member States have specific obligations. A proper EU common formal regulation in the matter of age estimation procedures still lacks. According to the Italian legal framework in the matter, a medical examination should have been always performed but a new law completely changed the approach to the procedures of age estimation of the migrant (excluding the criminal cases) with a better adherence to the notions and concepts of vulnerability and psychological and social maturity.

Background: Research on in-utero exposure to Ramadan found long-term negative health effects among the offspring including higher risks for symptoms indicative of chronic diseases such as type 2 diabetes and coronary heart disease [ref:2] and higher rates of learning disabilities [ref:1].[for full text, please go to the a.m. URL], 62. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS)

Delayed graft function, defined as the need of dialysis in the first week after transplantation, neither due to immunological nor technical causes, determines a poor outcome of renal grafts. Delayed graft function is related to the cold ischemia time, which is shorter in local allocation programs. These, however, do not assure an optimal HLA-A,B,DR matching that can be provided by national allocation organizations. We reviewed 160 cadaveric kidney grafts performed in our local transplant network. Owing to the long waiting list caused by organ shortage, we were able to ensure both a high-grade histocompatibility and short cold ischemia times. The mean HLA-B,DR mismatch was 1.17. Cold ischemia time was24 h in 85% of cases. The incidence of DGF was 23.1%. In our experience a regional sharing program in the case of organ shortage provides good graft outcome (86.9% graft survival at 1 yr) with low incidence of delayed graft function.

The migratory flows to Europe from the African countries, Asia and Middle East, have hugely intensified in the recent years. In 2016, more than 98,000 out of a total of 260,000 migrants across the Mediterranean Sea arrived in Italy and in May 2017, the trend of arrivals is: Italy +576%; Greece -39% compared to previous years. Some migrants die before touching the sole of the European continent, during the crossing, often afforded with ships, made available by unscrupulous smugglers or criminal organizations, which are unsuitable for this type of transportation. The tremendous occurrence of migrant casualties during the Mediterranean Sea crossing remains underestimated and nobody, country officers or databank, can provide a reliable number of dead bodies in such a large and now, endemic phenomenon. Forensic officers, who intervened to examine migrants’ corpses, are ideally required to perform the usual activity and to answer the routine questions about the causes of death by detecting signs of possible crimes and body identification. In practice, several specific issues and limits challenge the activity of the forensic professionals addressed to ascertain both circumstances of death and possible related crimes and the identity of the corpses. Generally speaking, in case of examining up to a few dead bodies in Italy, a complete autopsy is performed, whilst, when several tens or hundreds of corpses are recovered, the lack of resources on one hand and clearer clues on incident, connected crimes, and cause of deaths on the other, push the public prosecutor to limit the request of complete autopsies. In some cases, the dead migrants were identified through visual recognition by relatives, friends, or travel companions. The DVI Interpol protocol is never completely applied to dead migrants for several reasons, mainly for the huge difficulties in retrieving AM data of the missing persons and for some limitations affecting both the primary and the secondary identifiers. The few chances of identification by dental data are further reduced by the systematic lack of an odontologist among the forensic teams charged of the PM; valuable dental data for body identification or for constructing the biological profile of the missing person (age, ancestry, country of provenance/residence, etc.) are likely to be overlooked. This approach implies a clear disparity with the approach applied when corpses of citizens of the EU or other developed countries are involved and undergo identification. The dead migrants’ identification activity should be reconsidered for an improvement in the common international effort in accordance to an approach more respectful toward the legal rights and dignity of the dead migrants and their families.

When the age of an individual is unknown, age assessment refers to the procedures through which authorities try to establish the chronological age of an individual. Dental evidence demonstrated to be very effective in estimating age and dental mineralization is largely deemed a process scarcely influenced by major diseases and nutritional or environmental factors which can affect child growth. This research aims to understand the possible influence of genetic syndromes on dental maturation of affected individuals. The sample is composed of a test sample of 159 chromosomal affected children, 69 males and 90 females, and a control sample of 157 healthy children, 77 males and 80 females aged between 4,49 and 19,8years. London Atlas was applied to estimate dental age on OPGs (orthopantompographies). No statistical significant difference has been found in dental estimates between syndromic and healthy individuals. Moreover no statistical significant difference emerged between sexes and age cohorts. Children affected by Down or Williams syndromes nor mean error neither the mean accuracy per cohort of age show differences compared to non-affected subjects. The London Atlas can be validly applied to age estimation of individuals with multiple agenesis as in Down and Williams syndromes, even if it a slight overestimation of age occurs systematically in syndromic as well as in healthy samples. The current findings suggest that dental maturation is a very stable biological process scarcely affected by even serious illnesses as genetic syndromes.

Burned bodies raise relevant issues for forensic patologist and odontologist both for the identification and the cause of death and possible vital burning.. The tongue protrusion is regularly investigated for the death caused by strangulation or hanging, whilst seems to be overlooked in case of charred remains as the significance of this sign is still discussed. Different mechanims are hypothized in literature to explain the toungue protrusion both for vital and non-vital burning. This paper retrospectively evaluates some cases of carbonized corpses examined at the Forensic Pathology service of the University of Florence. The tongue protrusion shows a high occurrence both in vital (100%) and non-vital fires (66%). The involvement of a forensic odontologist in the cadaver examination result to be limited to one third of the cases. In two non-vital cases the tongue was described as protruded and clenched between the dental arches. The rigor of the genioglossus induced by the heat could explain the phenomenon. Further research on fire fatalities is required to analyze the tongue bleeding as a possible parameter to discriminate the vital by the non-vital tongue protrusion. Moreover, the mechanism at the origin of vital and non-vital tongue protrusion, the different position of the tongue (protruded from an open mouth, protruded and clenched between the dental arches, etc.) in different death circumstances, should be furtherly investigated with a meaningful collaboration between forensic pathologists and odontologists for a complete registration and interpretation of all the mouth originated evidence.