Forensic Science, Medicine and Pathology最新文献

Two cases of fatal insulin homicide resolved using combined immunohistochemistry and immunofluorescence techniques.

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2024-12-26 DOI: 10.1007/s12024-024-00921-5

Yiling Li, Zhonghao Yu, Yuhao Yuan, Jiaxin Zhang, Shuquan Zhao, Yijie Duan, Yiwu Zhou

{"title":"Two cases of fatal insulin homicide resolved using combined immunohistochemistry and immunofluorescence techniques.","authors":"Yiling Li, Zhonghao Yu, Yuhao Yuan, Jiaxin Zhang, Shuquan Zhao, Yijie Duan, Yiwu Zhou","doi":"10.1007/s12024-024-00921-5","DOIUrl":"https://doi.org/10.1007/s12024-024-00921-5","url":null,"abstract":"Diabetes is a prevalent disease in modern society. Since the development and widespread use of synthetic insulin, its therapeutic application has become globally recognized for managing diabetes. However, excessive administration of insulin may lead to fatal outcomes. The rapid pharmacokinetics of insulin in the human body, combined with the lack of distinct pathological changes, makes the forensic identification of fatal insulin overdose challenging. In this study, we present two cases of fatal insulin overdose, one with a postmortem interval of up to 28 days. Postmortem specimens were collected and analyzed. Immunohistochemical and immunofluorescence assays revealed the consistent distribution of insulin and protamine at the injection sites in both cases. Insulin and protamine particles were observed in the epidermis, epidermal cells, adipocyte membranes, inter-adipocyte spaces, inflammatory cells, and glandular structures. Toxicological analyses confirmed the presence of insulin in the injected skin, subcutaneous fat, blood, urine, vitreous humor, and bile. This study provides valuable insights and guidelines for the forensic identification of insulin overdose cases.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Yellow meconium.

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2024-12-21 DOI: 10.1007/s12024-024-00932-2

Johanna Preuß-Wössner, Jan-Peter Sperhake, Burkhard Madea

引用次数: 0

Lack of gastric emptying at autopsy eleven days after heat trauma in the sauna- a forensic autopsy case report. 桑拿热创伤十一天后尸检胃排空缺乏--法医尸检案例报告。

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2024-12-17 DOI: 10.1007/s12024-024-00931-3

Susanne R Kerscher, Natascha Kern, Nadezhda Chistiakova, Doreen Verhoff, Marcel A Verhoff

{"title":"Lack of gastric emptying at autopsy eleven days after heat trauma in the sauna- a forensic autopsy case report.","authors":"Susanne R Kerscher, Natascha Kern, Nadezhda Chistiakova, Doreen Verhoff, Marcel A Verhoff","doi":"10.1007/s12024-024-00931-3","DOIUrl":"https://doi.org/10.1007/s12024-024-00931-3","url":null,"abstract":"A man in his mid-70s passed out in a public 90-degree sauna and remained unconscious for at least half an hour. He suffered third-degree burns to approximately 50% of his body surface area. Despite immediate transport to a burn center and intensive care therapy, he did not regain consciousness and died eleven days later.When the body was opened, the lungs, liver, kidneys, and spleen showed changes consistent with the burns, intensive care therapy, and clinically suspected septic shock. The stomach contained approximately 200 ml of thickened chyme with coarse vegetable components. Such food components were not seen in the duodenum or in the following intestinal segments.Considering the overall circumstances, the stomach contents must have been the last meal the man had eaten before the sauna session. The problem of reduced gastrointestinal motility in burn patients is clinically recognized. Nevertheless, a complete failure of gastric emptying for eleven days after intensive care therapy has not been described before and shows that the use of gastric contents in forensic practice is inappropriate for drawing conclusions about the time interval between last food intake and death and thus for estimating the time of death.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Branch in the heart: unusual fatal self-inflicted injury.

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2024-12-12 DOI: 10.1007/s12024-024-00930-4

Michał Kaliszan

{"title":"Branch in the heart: unusual fatal self-inflicted injury.","authors":"Michał Kaliszan","doi":"10.1007/s12024-024-00930-4","DOIUrl":"https://doi.org/10.1007/s12024-024-00930-4","url":null,"abstract":"The case presents a suicide committed by a 21-year-old man who thrusted a broken tree branch into his chest which penetrated to his heart and caused death. Despite the unusual tool, a tree branch, suicide was confirmed on the basis of similar attempted self-injury, which was committed several weeks earlier, and a history of mental disorders. The man committed suicide 3 days after leaving the psychiatric ward, where he had been hospitalized after being admitted immediately after his previous suicide attempt by self-stabbing with knife. He was discharged from the psychiatric hospital after 1.5 months therapy with diagnosis of improvement and denials of suicide thoughts. The presented case reflects the tragedy of a young man with mental disorders, who effectively committed suicide by using an unusual tool after several previous attempts made with the use of more frequently observed suicide methods. Such cases may cause problems to investigators as to whether the death was a result of suicide, homicide or accident. Therefore it is very important to complete the result of autopsy with analysis of medical history of the deceased, particularly regarding previous suicide attempts and psychiatric treatment. This is a first report of using such peculiar tool as tree branch to pierce the chest in effective suicide attempt.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Investigation of authors' self-citation in contemporary forensic odontology literature.

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2024-12-11 DOI: 10.1007/s12024-024-00928-y

N Angelakopoulos, N Polukhin, S B Balla

{"title":"Investigation of authors' self-citation in contemporary forensic odontology literature.","authors":"N Angelakopoulos, N Polukhin, S B Balla","doi":"10.1007/s12024-024-00928-y","DOIUrl":"https://doi.org/10.1007/s12024-024-00928-y","url":null,"abstract":"This bibliometric investigation aimed to analyze trends in author self-citation within prominent forensic odontology literature and explore potential correlations between self-citation rates and publication attributes. We reviewed seven leading forensic sciences journals from 2003 to 2023. For this analysis, we focused on two specific timeframes: 2003-2007 and 2018-2023. Our review encompassed original research articles, reviews, and case reports. Eligible articles underwent detailed examination for article and author attributes and citation metrics. Utilizing univariable and multivariable negative binomial regression analyses, we explored potential associations between the number of self-citations and various publication characteristics. This study analyzed 415 articles related to forensic odontology, of which 237 (57.1%) included at least one self-citation. Key findings highlight prevalent topics such as dental age estimation and human dental identification. A significant portion of the studies involved prospective, retrospective, and cross-sectional designs, and there has been a notable increase in the number of reviews and meta-analyses in recent years compared to an equivalent past period. Self-citation was observed in over half of the analyzed articles, with a median total citation count of 31 and a median self-citation rate of 7.5%. Further bibliometric investigation is required to establish definitive conclusions regarding author self-citation patterns in forensic odontology literature, particularly by exploring longer time spans.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Post-mortem diagnosis of malaria in decomposed and embalmed body.

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2024-12-09 DOI: 10.1007/s12024-024-00925-1

Magdalena Kusior, Danuta Piniewska-Róg, Marta Wojtas, Marek Sanak, Martyna Maciów-Głąb, Artur Moskała

{"title":"Post-mortem diagnosis of malaria in decomposed and embalmed body.","authors":"Magdalena Kusior, Danuta Piniewska-Róg, Marta Wojtas, Marek Sanak, Martyna Maciów-Głąb, Artur Moskała","doi":"10.1007/s12024-024-00925-1","DOIUrl":"https://doi.org/10.1007/s12024-024-00925-1","url":null,"abstract":"The diagnosis of malaria during the autopsy of a decomposed corpse may prove challenging. Macroscopic changes are non-specific and may include, among others, cerebral oedema, pulmonary oedema, hepatosplenomegaly and, on occasion, the presence of petechiae. The most effective diagnostic tools for malaria are the examination of blood smears and the use of rapid immunochromatographic tests. As a result of the progressive putrefaction of the corpse and blood hemolysis, classical tests are no longer viable. Consequently, the sole remaining option is the utilisation of real-time reaction (RT-PCR) to ascertain the presence of plasmodium DNA in specific organs. This study concerns the diagnosis of a fatal form of cerebral malaria in a 23-year-old Caucasian male who had travelled to Africa. The autopsy was conducted at a local hospital, after which the body was embalmed and stored in cold storage for a period of 8.5 months. Subsequently, the corpse was transported to Poland, where a further forensic autopsy was conducted. A significant challenge was to confirm the presence of malaria in a corpse that had been embalmed several months prior to the investigation. Samples were obtained from internal organs for genetic analysis to determine the presence of parasite DNA. An RT-PCR test was conducted on genetic material obtained from the brain, heart, lungs, kidney, liver, and spleen. The presence of Plasmodium falciparum genetic material was identified in samples obtained from the brain, lungs, kidney, liver, and spleen. These findings substantiated the post-mortem diagnosis of a severe form of cerebral malaria, which was the underlying cause of death.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A forensic autopsy case of suicide using baking soda and citric acid in a bathtub.

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2024-12-06 DOI: 10.1007/s12024-024-00927-z

Masahiko Yatsushiro, Takuma Nakamae, Midori Katsuyama, Machiko Miyamoto, Takahito Hayashi

{"title":"A forensic autopsy case of suicide using baking soda and citric acid in a bathtub.","authors":"Masahiko Yatsushiro, Takuma Nakamae, Midori Katsuyama, Machiko Miyamoto, Takahito Hayashi","doi":"10.1007/s12024-024-00927-z","DOIUrl":"https://doi.org/10.1007/s12024-024-00927-z","url":null,"abstract":"A mixture of baking soda (sodium hydrogen carbonate) and citric acid is used for cleaning purposes, but, in recent years, this mixture has been introduced on the internet as a method for suicide. Here, we report a case in which the two agents were mixed in a bathtub to generate carbon dioxide (CO2). A man in his early 60s was found dead in his clothes in a bathtub with a lid. Postmortem changes were somewhat progressed, but only pulmonary edema was observed, with no injuries or lesions that could have led to cause of death, and no drug toxicants detected. Empty containers of baking soda (789 g) and citric acid (850 g) were found at the scene. We conducted a reproduction experiment showing that CO2 reached a lethal concentration (~ 60%) within 12 s, but the O2 concentration was about 10%, which is not a lethal concentration. Therefore, it is highly likely that the man died of CO2 intoxication within a short period of time and before he would have suffered asphyxiation due to oxygen deficiency. Normally, this result can only be obtained with the cooperation of an investigative agency and a large-scale reproduction experiment, but we were able to diagnose the cause of his death, including a differential diagnosis of asphyxia due to oxygen deficiency, by means of a reproduction model at 1/35 scale that could easily be performed in the laboratory.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Penetrating skull stab.

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2024-12-05 DOI: 10.1007/s12024-024-00926-0

Claas Buschmann, Johanna Preuß-Wössner, Christoph Meißner

引用次数: 0

Defining, exploring the sources and expressing post-mortem diagnostic uncertainty.

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2024-12-04 DOI: 10.1007/s12024-024-00919-z

Wouter Van Den Bogaert, Lotte Alders, Joke Wuestenbergs, Elisabeth Dequeker, Wim Van de Voorde

{"title":"Defining, exploring the sources and expressing post-mortem diagnostic uncertainty.","authors":"Wouter Van Den Bogaert, Lotte Alders, Joke Wuestenbergs, Elisabeth Dequeker, Wim Van de Voorde","doi":"10.1007/s12024-024-00919-z","DOIUrl":"https://doi.org/10.1007/s12024-024-00919-z","url":null,"abstract":"Background: Diagnostic uncertainty is a well-recognized concept in clinical practice, encompassing both technical perspectives and the subjective perceptions of physicians. Post-mortem diagnostics (PMD), which involves all post-mortem investigations to assess diseases and injuries and determine the cause of death, shares this inherent uncertainty due to the complexity and multidisciplinary nature of autopsies.Methods: A comprehensive literature review was conducted to uncover relevant publications focusing on diagnostic uncertainty in PMD. An expert panel evaluated expressions and sources of diagnostic uncertainty to identify factors influencing PMD uncertainty.Results: Literature specifically addressing PMD uncertainty is sparse, though implicit and explicit references exist. This article illustrates the presence of uncertainty in PMD by drawing upon both literature and pathology practice. We introduce the definition of PMD uncertainty as \"the inability to determine the exact cause of death and/or the precise significance of certain autopsy findings\". PMD uncertainty can stem from a pathologist's subjective perception, but often results from several objective factors. Six factors inherent to the PMD setting were identified as contributing to this uncertainty. To systematically express the certainty of cause-of-death determinations, we developed a new Post-Mortem Diagnostic Certainty Scale (PMDCS) featuring eight categories, distinguishing between assignable and non-assignable causes of death.Conclusion: Understanding and applying the concept of PMD uncertainty will enhance comprehension of the importance of certain post-mortem findings and improve the accuracy of autopsy result interpretation. While eliminating PMD uncertainty entirely is not feasible, standardizing investigations can reduce uncertainty, and using the PMDCS can improve the clarity of autopsy reports.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Autopsy characteristics of deaths due to pulmonary thromboembolism in northern and western denmark: a 10-year retrospective study.

IF 1.5 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2024-12-02 DOI: 10.1007/s12024-024-00922-4

Martin Roest Christensen, Annesofie Bjerrum Larsen, Lene Warner Thorup Boel

{"title":"Autopsy characteristics of deaths due to pulmonary thromboembolism in northern and western denmark: a 10-year retrospective study.","authors":"Martin Roest Christensen, Annesofie Bjerrum Larsen, Lene Warner Thorup Boel","doi":"10.1007/s12024-024-00922-4","DOIUrl":"https://doi.org/10.1007/s12024-024-00922-4","url":null,"abstract":"Because pulmonary thromboembolism (PTE) has an inherent high risk of sudden and unexpected death, this condition is a classic entity in forensic casework. The purpose of this study was to elucidate the characteristics surrounding deaths from PTE. We conducted a retrospective study from 2010 to 2019 at the Department of Forensic Medicine in Aarhus, Denmark. We recorded demographic characteristics, risk factors, comorbidities, and autopsy findings, including BMI. Furthermore, we contextualized the role of forensic autopsy in terms of determining the correct cause of death (COD).Among the 3,572 autopsies, 58 had PTE as the main COD (1.6%), whereas only 0.3% of the deaths in the Danish COD registry were attributed to PTE in the same period. The decedents had a mean age of 52 years (range 19-87), and although the majority had preexisting comorbidities, approximately one-third died suddenly and unexpectedly. Additionally, more than half (35/58) of the decedents died in an out-of-hospital setting, and only a few of these (6/35) reported symptoms prior to death, underscoring the insidiousness of the condition. We identified a mean BMI of 32.7 among the decedents, with more than half of them (30/58) having a BMI ≥ 30.In conclusion, obesity is a major risk factor for fatal PTE. The blurred clinical presentation of PTE underscores the importance of an autopsy to determine the correct COD, and with an increased autopsy rate, the true prevalence may well be higher.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0