Forensic Science, Medicine and Pathology最新文献

{"title":"Sudden unexpected death due to B-cell acute lymphocytic leukaemia (B-ALL) in a 3-year-old child.","authors":"Elke Doberentz, Glen Kristiansen, Marit Bernhardt, Frank Musshoff, Burkhard Madea","doi":"10.1007/s12024-025-00998-6","DOIUrl":"https://doi.org/10.1007/s12024-025-00998-6","url":null,"abstract":"<p><p>Sudden unexpected death due to haematologic disease in children is unusual. A 3-year-old girl had been ill for several weeks, but her parents did not consult a doctor. Her complaints included a cough, fever, vomiting and fatigue. On the day of her death, the girl fell from the toilet and was unresponsive. In hospital, severe dyspnoea and a haemoglobin value of only 1.7 mg/dl were diagnosed, as well as hypothermia and haemorrhaging from mouth and nose. Despite intensive medical care and cardiopulmonary resuscitation, the girl died. Main autopsy findings were severe anaemia and the underlying disease, B-cell acute lymphocytic leukaemia (B-ALL). In particular, liver, spleen, lymph nodes, kidneys and bone marrow showed marked infiltration of atypical mononuclear cells replacing haematopoiesis. Intra-alveolar exudation, consistent with the early phase of acute pneumonia, was identified as cause of death. Toxicological investigations revealed positive findings of morphine (53.3 ng/ml), as well as amphetamine and THC in femoral blood, respectively, in hair samples. This paper discusses the medicolegal implications of the case (omitted duty of care by the parents).</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751842","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}

{"title":"New molecular markers to differentiate carbon dioxide intoxication from asphyxia due to oxygen deficiency.","authors":"Masahiko Yatsushiro, Midori Katsuyama, Takuma Nakamae, Kotomi Imahara, Machiko Miyamoto, Takahito Hayashi","doi":"10.1007/s12024-025-00981-1","DOIUrl":"https://doi.org/10.1007/s12024-025-00981-1","url":null,"abstract":"<p><strong>Purpose: </strong>The lack of specific autopsy findings for carbon dioxide (CO₂) intoxication hinders the determination of cause of death based on autopsy findings alone. In addition, when death occurs in a space is filled with CO₂ or other gases, the cause of death must be distinguished between intoxication and asphyxia due to oxygen deficiency, which also has no specific autopsy findings. In this study, we aimed to identify diagnostic markers of mRNA expression in the brainstem that indicate cause of death in cases of suspected CO₂ intoxication.</p><p><strong>Methods: </strong>Mouse models of CO₂ intoxication (composition of ambient gases at 70% CO₂, 20% O₂, and 10% N₂) and asphyxia due to oxygen deficiency (5% O₂, 95% N₂) were used to identify mRNA markers specific to intoxication or asphyxia.</p><p><strong>Results: </strong>Using RNA-Sequence analysis, we identified 7 candidate genes for qRT-PCR analysis: Acid-sensing ion channel 4 (Asic4), Early growth response protein 1 (Egr1), Neurogranin (Nrgn), Opioid receptor delta 1 (Oprd1), Semaphorin 3f (Sema3f), Transthyretin (Ttr), and Tryptophan hydroxylase 2 (Tph2). We observed a significant increase of Nrgn mRNA expression in the brainstem of CO₂ intoxication and a significant increase of Ttr mRNA expression in the brainstem of asphyxia due to oxygen deficiency.</p><p><strong>Conclusion: </strong>Assays for the expression of Nrgn and Ttr in the human brainstem may assist in the diagnosis/differential diagnosis of CO₂ intoxication and asphyxia due to oxygen deficiency, respectively.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751839","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}

{"title":"Optimizing the postmortem diagnosis of alcoholic ketoacidosis.","authors":"John A Daniels, Michael Caplan","doi":"10.1007/s12024-025-00978-w","DOIUrl":"https://doi.org/10.1007/s12024-025-00978-w","url":null,"abstract":"<p><p>Alcoholic ketoacidosis (AKA) is an underreported and underrecognized complication of chronic alcohol use disorder, which may present as a sudden death with few diagnostic clues. The most frequent history is that the affected individual stops eating and uses alcohol as one's primary source of nutritional intake, with the subsequent development of nausea, vomiting, and general malaise. Chronic alcoholics may also stop drinking days or weeks before death, precipitating a terminal ketoacidotic state, of which beta-hydroxybutyrate (BHB) is the principal ketoacid. The postmortem toxicology and chemistry findings may be low to absent (undetectable) blood and vitreous ethanol concentrations, elevated blood and vitreous acetone, and elevated BHB levels. We present a case series of 19 deaths of AKA at the Franklin County, Ohio Forensic Science Center that is characterized by an essentially bimodal distribution due to the introduction of an algorithm designed to facilitate the detection of ketoacids, and specifically, BHB, by two principal measures: (1) substantially lowering the detection threshold of acetone; and (2) prompting reflex testing for BHB when that threshold has been achieved. The result of this change in laboratory protocol has been a noticeably enhanced ability to make the diagnosis of AKA and to offer a feasible mechanism by which chronic alcoholics die suddenly, over the purely morphologic but mechanistically vacuous designation of \"fatty liver\".</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742755","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}

{"title":"A review of micro-computed tomography and artificial intelligence in talus-based forensic anthropology for sex and age estimation.","authors":"Intasin Kitpatanasombat, Pittayarat Intasuwan, Pasuk Mahakkanukrauh","doi":"10.1007/s12024-025-00987-9","DOIUrl":"https://doi.org/10.1007/s12024-025-00987-9","url":null,"abstract":"<p><p>Biological profiling is a crucial tool in forensic science, allowing for evaluating biological information from bones found at crime scenes. This method includes assessments of sex, age, stature, and ancestry. Sex assessment is the first step in biological profiling, as it influences other assessments. Age estimation is a particularly challenging aspect. Combining sex and age assessment may improve accuracy in age estimation. Researchers often use the pelvis and skull bones for these assessments due to their prevalence at crime scenes and their higher accuracy in evaluation. However, the talus, a foot bone with robust density, resilience, and resistance to damage, is another bone frequently encountered at crime scenes and may be a valuable subject for study. Medical imaging technology, particularly micro-CT imaging, supports sex and age assessment. Micro-CT images can significantly enhance the accuracy of assessments. The high resolution of these images presents an exciting opportunity for exploration in conjunction with artificial intelligence (AI), which has revolutionized forensic science workflows. AI can potentially improve the efficiency and accuracy of sex and age assessment from bones. This article compiles research on past sex and age assessments and evaluations of the talus, including the application of micro-CT images to support these assessments. The aim is to provide a comprehensive knowledge base for studying sex and age assessment from the talus using micro-CT images in conjunction with AI.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742753","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}

{"title":"Praising a glorious page of forensic pathology: a reply to Kelly Kearse.","authors":"Franco Serafini","doi":"10.1007/s12024-025-00996-8","DOIUrl":"https://doi.org/10.1007/s12024-025-00996-8","url":null,"abstract":"<p><p>This commentary reconsiders the debate on the reliability of the serological tests used to determine the ABO blood group found in ancient human biological tissues and Christian relics, particularly in response to the recent critique by Kelly Kearse. It is known that the results of investigations on the Passion relics and some Eucharistic miracles converge on the rarest AB group. The issue of the suboptimal specificity of these tests, due to possible bacterial and fungal contamination, is also acknowledged. However, despite these limitations, the great value demonstrated by these techniques in the reconstruction of the history of the origin of mankind and human migrations should not be ignored, especially given that DNA testing was not yet available in the 1970s and 80s. This article cautions against rejecting an important wealth of knowledge obtained by authoritative researchers, who applied rigorous scientific standards to their studies. Control group tissue samples were also extensively used in the analyses of Christian relics, and despite the limitations of serological tests, the identification of the same blood group in these studies was so widespread that it cannot be underestimated. The inclusion of Eucharistic miracles in peer-reviewed literature marks a significant step in bridging faith and science, encouraging a more open and multidisciplinary inquiry into these fascinating relics.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691441","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}

{"title":"Exploring the capabilities of Micro-XRF to study the dispersion of GSR in firearms cases.","authors":"Niha Ansari, Hemang Parmar","doi":"10.1007/s12024-025-00989-7","DOIUrl":"https://doi.org/10.1007/s12024-025-00989-7","url":null,"abstract":"<p><p>The forensic scientific establishment requires an evaluation of GSR obtained at the scene of the incident because it provides answers to challenges like differentiating between different types of ammunition, estimating the firing range, and linking an individual to the discharge of a firearm. There is inadequate information on the classification of ammunition types utilizing GSR analysis. This paper delves into the capabilities of Micro-XRF in characterizing GSR particles, assessing their distribution, and elucidating their significance in forensic investigations. A cloth substrate as a target sample for assemblage of firearm discharge that is GSR particles was selected as an analog of sample obtained from the crime scene from victim or suspect. Micro-XRF proved to very advantageous non-destructive technique for the aimed study herein. The results of Micro-XRF are were able to characterize the heterogeneity of GSR particles originating from different distance & firearm-ammunition respectively. The technique provided non-destructive, highly sensitive, qualitative, quantity analysis with Fast deconvolution of the samples signals proving to be beneficial in GSR discrimination with respect ammunition and shooting distance. By exploring the benefits and limitations of this technique, we aim to contribute to the advancement of forensic science methodologies, ultimately aiding law enforcement in firearm-related cases.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691528","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}

{"title":"The mastoid triangle (Ma-Ast-Po) as a sexually dimorphic feature - a systematic review of 1604 human skulls and meta-analysis.","authors":"Maria Eduarda Ramos Stefanel, Lígia Melissa de Souza, Fernanda Thomaz de Aquino Macedo, Débora Duarte Moreira, Rhonan Ferreira Silva, Nikolaos Angelakopoulos, Walbert Andrade Vieira, Luiz Renato Paranhos, Ademir Franco","doi":"10.1007/s12024-024-00906-4","DOIUrl":"https://doi.org/10.1007/s12024-024-00906-4","url":null,"abstract":"<p><p>The mastoid triangle is the area between the craniometric landmarks Mastoidale (Ma), Asterion (Ast) and Porion (Po), which has been studied in the field of physical anthropology as an alleged tool for sexual dimorphism. The evidence in the current scientific literature, however, is disputable. This systematic review aimed to find out how safe is the mastoid triangle for sexual dimorphism. A research protocol submitted to PROSPERO (CRD42023488216) was designed based on PRISMA-P. Pubmed, SciELO, LiLACS, LIVIVO, Open Gray and Open Access Theses and Dissertations were searched with structured strategies. The Joanna Briggs Institute manual was followed and the critical appraisal checklist for cross-sectional studies was used. The search found 14 eligible studies out of 2148 initially screened. The combined sample consisted of 1604 human skulls. Eight studies (57,14%) clearly encouraged the use of the mastoid triangle for sexual dimorphism, while three (21,42%) advised against it. All the studies had a low risk of bias (75-100%). The standardized mean difference between male and females was between 1.00 and 1.42 without statistically significant differences between geographic regions (p > 0.05). Expressive heterogeneity and large confidence intervals were detected, showing great variability across studies. A country-specific subgroup meta-analysis revealed lack of statistically significant differences based on geographic regions. This systematic review showed low level of evidence to support the use of the mastoid triangle as a tool for sexual dimorphism.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691442","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}

{"title":"An alternative method to differentiate pleural effusion after leakage of artificial enteral nutrition formula.","authors":"Fabian Picht, Karen Blümke-Anbau, Carolin Richter, Marco Weber","doi":"10.1007/s12024-025-00982-0","DOIUrl":"https://doi.org/10.1007/s12024-025-00982-0","url":null,"abstract":"<p><strong>Purpose: </strong>This case report highlights a rare but fatal complication of artificial enteral nutrition due to feeding tube misplacement, leading to pleural effusion and respiratory failure. The primary objective was to determine whether enteral nutrition formula leakage contributed to the patient's death and to differentiate the pleural effusion from other possible etiologies, such as chylothorax.</p><p><strong>Methods: </strong>A 59-year-old male patient with severe lung disease underwent left-sided partial lung resection and subsequently received enteral nutrition via a nasogastric feeding tube. After suspected feeding tube misplacement and formula leakage into the pleural cavity, autopsy and histological examination were performed. Cytological and chemical analyses, including gas chromatography-mass spectrometry, were employed to identify nutritional components in pleural effusion and to confirm the presence of enteral nutrition formula.</p><p><strong>Results: </strong>The autopsy revealed milky, turbid pleural effusion, aspiration pneumonia, and a rupture of the right visceral pleura. Cytological analysis confirmed granulocytic pleural empyema with rod-shaped Congo red-positive material resembling the enteral nutrition formula. Gas chromatography-mass spectrometry identified tricaprylin, a unique marker for enteral nutrition formula, confirming nutritional leakage into the pleural cavity.</p><p><strong>Conclusions: </strong>This case study emphasizes the necessity for radiological confirmation of feeding tube placement and the implementation of comprehensive diagnostic protocols for suspected cases of nutritional fluid leakage. Gas chromatography-mass spectrometry proved invaluable in distinguishing nutritional effusions from other potential etiologies by enabling the specific identification of enteral formula components. The high specificity and adaptability of gas chromatography-mass spectrometry render it an essential tool for forensic investigations and clinical diagnostics involving complex fluid analyses, facilitating evidence-based conclusions in critical care and postmortem contexts.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673713","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}

{"title":"Sudden cardiac death due to isolated right ventricle thromboembolism in a young male.","authors":"Hunter Koster, Lorenzo Gitto","doi":"10.1007/s12024-025-00988-8","DOIUrl":"https://doi.org/10.1007/s12024-025-00988-8","url":null,"abstract":"<p><p>Sudden cardiac death due to an isolated right ventricular thromboembolism is an uncommon cause of death. In the reported case, a healthy, asymptomatic young male with no past medical history outside of obesity and his age was found unresponsive by a family member who suspected him to be sleeping. Examination of the heart at autopsy revealed a large serpiginous, organized and obstructive blood clot compromising most of the right ventricle with no other cardiac abnormalities and without any evidence of a pulmonary embolism. The patient was found to not have any history of substance abuse, genetic predispositions, kidney disease, or COVID-19 infection which has all been linked to ventricular thrombi.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668742","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}

{"title":"The application of neutrophil extracellular traps to thrombus age Estimation in rat deep vein thrombosis model.","authors":"Xing Pan, Kai-Qiao Zhang, Quan Liu, Liang Ren","doi":"10.1007/s12024-025-00986-w","DOIUrl":"https://doi.org/10.1007/s12024-025-00986-w","url":null,"abstract":"<p><p>In experimental models of deep vein thrombosis (DVT), neutrophil extracellular traps (NETs) have been established as pivotal mediators in the initial phases of thrombus formation. Through the establishment of a chromatin-based scaffold, NETs provide a structural foundation that enhances platelet adhesion. Furthermore, they significantly contribute to the perpetuation of a self-amplifying cycle of venous endothelial cell injury, thereby exacerbating thrombogenesis. While extant research has predominantly concentrated on the role of NETs in the initiation of DVT, there remains a paucity of investigation into the temporal dynamics of NETs content across the sequential stages of thrombus development, including formation, elongation, organization, and recanalization. The present study elucidates the forensic application of NETs for temporal assessment of thrombus age in cases of sudden death resulting from pulmonary embolism secondary to deep vein thrombosis. This was accomplished through the establishment of a time-gradient DVT model in a rat model system. Utilizing myeloperoxidase (MPO) antibody, a well-established marker of neutrophil activation, in conjunction with CitH3 histone antibody, a specific marker for neutrophil extracellular traps, we performed dual immunofluorescence co-localization studies. These investigations confirmed the integral involvement of NETs in the thrombotic process. Complementary Western blot analyses demonstrated temporal variations in NETs content within the thrombotic mass. The CitH3 levels exhibited no significant elevation during the initial 3-6 h post-ligation period, followed by a gradual increase after 24 h, reaching maximal expression on day 3. Subsequently, a progressive decline was observed, culminating in complete resolution by day 21. Quantitative analysis of positive cell counts (×1000, across five representative fields) at sequential time points revealed distinct temporal patterns. During the initial 3-hour to 1-day post-ligation period, MPO-positive cells demonstrated a significantly more rapid increase compared to CitH3-positive cells. By day 3, MPO levels commenced a decline, ultimately falling below CitH3 levels. Subsequent analysis of the CitH3/MPO ratio yielded significant forensic implications. Our findings demonstrate that a CitH3/MPO ratio approximating 1.0 corresponds to a thrombus formation time within 5 days. The degree of ratio variation among multiple samples serves as a temporal indicator: minimal variation (approaching 1.0) suggests a shorter thrombus formation interval, while ratios exceeding 2.0 or demonstrating substantial variation are indicative of thrombus formation times surpassing 7 days.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668875","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}