Forensic Science, Medicine and Pathology最新文献

{"title":"Enhancing postmortem diagnostics: over a decade of ISO 17020 accreditation and guidelines implementation in forensic pathology.","authors":"Wouter Van Den Bogaert, Joke Wuestenbergs, Bram Bekaert, Elisabeth Dequeker, Wim Van de Voorde","doi":"10.1007/s12024-024-00918-0","DOIUrl":"https://doi.org/10.1007/s12024-024-00918-0","url":null,"abstract":"<p><p>Forensic autopsies remain indispensable for accurately determining the cause and manner of death. However, pathologists face significant challenges inherent to the complex process of postmortem diagnostics (PMD), including the potential for diagnostic errors. The implementation of quality assurance (QA) mechanisms is crucial for minimizing these errors. Nonetheless, the lack of QA programs, specifically tailored for forensic pathology, continues to pose a significant obstacle. This article explores the enhancement of PMD after the adoption of ISO 17020 accreditation at a Belgian forensic institute in 2010. Drawing on over a decade of experience, it details on the development and implementation of label-specific standard operating procedures (SOPs) designed to address the various types of deaths in forensic practice. Additionally, it underscores the necessity of adapting international directives from leading organizations into effective local protocols, aiming to standardize practices and improve efficacy. Through a comparative review of existing international guidelines, this study provides forensic pathologists and institutions worldwide with practical strategies for qualitative standardization and improving their PMD.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738848","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":"Suicidal behavior among forensic psychiatric patients in Japan: Risk factors and implications for treatment.","authors":"Shota Matsunaga, Kumiko Ando","doi":"10.1007/s12024-024-00912-6","DOIUrl":"https://doi.org/10.1007/s12024-024-00912-6","url":null,"abstract":"<p><p>In Japan, the Medical Treatment and Supervision Act (MTSA) was enacted in 2005 to provide intensive interventions aimed at reintegrating forensic psychiatric patients into society. However, these individuals face challenges with social reintegration and have an elevated risk of suicide. Therefore, identifying the risk factors for suicide among forensic psychiatric patients is essential. We compiled an extensive database spanning 12 years of data on Japanese forensic outpatients. Using a generalized linear model (GLM), we explored the relationship between suicidal behaviors-both attempted and completed suicides-and several variables, including outpatient pathways defined by law, histories of psychiatric outpatient/inpatient treatment, diagnoses of schizophrenia or mood disorders, types of crimes committed, and the types of victims involved. Our analysis included data from 2,263 Japanese forensic outpatients. Suicidal behaviors were observed in 6.9% of patients, with 1.5% completing suicide. Risk factors for suicidal behavior included being a direct outpatient (odds ratio [OR] = 1.63, 95% confidence interval [CI]: 1.14-2.34), having a history of outpatient treatment (OR = 1.92, 95% CI: 1.07-3.48), and being arrested for arson (OR = 2.24, 95% CI: 1.33-3.76). Conversely, a diagnosis of schizophrenia was associated with a reduced risk of suicidal behavior (OR = 0.61, 95% CI: 0.39-0.95). Forensic psychiatric patients are at a higher risk of suicide compared to the general population. It is essential to account for both risk and protective factors when planning interventions for these individuals.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675408","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":"Blue toe syndrome - systemic cholesterol crystal embolism secondary to cardiovascular procedures: a forensic autopsy report of two cases.","authors":"Atsushi Yamada, Kyoka Kiryu, Satoshi Takashino, Masaki Yoshida, Toshiaki Takeichi, Osamu Kitamura","doi":"10.1007/s12024-024-00917-1","DOIUrl":"https://doi.org/10.1007/s12024-024-00917-1","url":null,"abstract":"<p><p>Blue toe syndrome, also referred to as cholesterol crystal embolism is characterized by the distal embolization of cholesterol crystals originating from ruptured atherosclerotic plaques. This condition commonly arises in the context of cardiovascular procedures. Emboli from the thoracoabdominal aorta primarily affect the downstream extremities and intra-abdominal viscera, often resulting in fatal atheroembolic renal failure. Owing to its insidious and delayed onset, antemortem diagnosis of cholesterol crystal embolism is often underrecognized. Two cases of blue toe syndrome secondary to cardiovascular procedures are presented. In Case 1, the patient died 35 days after coronary angioplasty, whereas in Case 2, the patient developed toe necrosis 95 days after endovascular aortic repair, leading to progressive renal failure over the following five years. A comprehensive forensic autopsy included external examination, skin biopsy, histopathological examination of major organs, and serum biochemical evaluation of renal function parameters. Two cases of blue toe syndrome secondary to cardiovascular procedures are presented. In Case 1, the patient died 35 days after coronary angioplasty, whereas in Case 2, the patient developed toe necrosis 95 days after endovascular aortic repair, leading to progressive renal failure over the following five years. A comprehensive forensic autopsy included external examination, skin biopsy, histopathological examination of major organs, and serum biochemical evaluation of renal function parameters. This report underscores the importance of including systemic cholesterol crystal embolism in the differential diagnosis of blue toe syndrome, particularly in patients with a history of cardiovascular procedures. Fingertips serve as reliable indicators of impaired blood perfusion. To assess blue toe syndrome accurately, we highlight the value of focusing on the toe tips where cholesterol crystal embolism can be consistently detected.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638584","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":"Opportunistic post mortem scavenging by the terrestrial flatworm Platydemus manokwari.","authors":"Marianne Tiemensma, Roger W Byard, Richard C Willan, Leigh Winsor","doi":"10.1007/s12024-024-00916-2","DOIUrl":"https://doi.org/10.1007/s12024-024-00916-2","url":null,"abstract":"<p><p>Post mortem damage by predators varies with geography, climate, and location of cadavers. Frequently encountered facultatively parasitic terrestrial organisms include fly larvae (maggots), ants and beetles. This report describes for the first time opportunistic post mortem damage caused by the terrestrial flatworm Platydemus manokwari de Beauchamp,1963 (New Guinea Flatworm) (phylum Platyhelminthes: order Tricladida: suborder Continenticola: family Geoplanidae) to exposed skin of a body located in a tropical urban location. Several flatworms were attached to the body associated with areas of skin loss. Microscopy showed epidermal damage with no vital reaction and the presence of PAS-positive granules consistent with flatworm secretions. No human DNA profile was recovered with genetic testing of two of the flatworms. This case extends the range of potential post mortem predators to include flatworms, albeit opportunistically.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617908","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":"Identifying latent subgroups of primary head injury: an explorative latent class analysis on neuropathologically examined medico-legal autopsy cases.","authors":"Essi Laakko, Petteri Oura","doi":"10.1007/s12024-024-00913-5","DOIUrl":"https://doi.org/10.1007/s12024-024-00913-5","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is a significant global health concern and frequently encountered in medico-legal autopsies. Previous studies suggest that certain TBI subtypes are more likely to co-occur than others. Therefore, we aimed to explore the potential of latent class analysis (LCA) to identify and characterize primary head injury combinations in neuropathologically examined medico-legal autopsy cases. The dataset comprised 78 cases from the Forensic Medicine Unit of the Finnish Institute for Health and Welfare over the period of 2016-2022. Data on background and circumstantial characteristics as well as primary and secondary head and brain injuries were collected from police documents, medical records, general autopsy reports and neuropathology reports. Latent class solutions with two to five classes were explored to identify clustering of primary head injuries among the sample. The dataset comprised 69.2% males and the median age was 49 years. In LCA, the solutions appeared reasonable, and each class appeared to represent a distinct TBI profile. The two-class solution was found to fit the present dataset best. Class 1 was characterized by older age, presence of an underlying CNS disease, and less diverse primary head injuries; these were interpreted as suggestive of lower traumatic forces. Class 2 was characterized by male sex and assaults as a prominent injury circumstance; subarachnoid and intracerebral/ventricular haemorrhages and contusions were classified exclusively into this class. In conclusion, this study identified two distinct subgroups of primary head injuries. Understanding typical injury combinations related to distinct circumstances could assist not only forensic pathologists but also clinicians treating TBI patients. However, the present latent class solution should not be interpreted as \"ground truth\", but instead further research is needed.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617839","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 relics of Jesus and Eucharistic miracles: scientific analysis of shared AB blood type.","authors":"Kelly P Kearse","doi":"10.1007/s12024-024-00915-3","DOIUrl":"https://doi.org/10.1007/s12024-024-00915-3","url":null,"abstract":"<p><p>Various relics ascribed to have been in physical contact with the historical Jesus of Nazareth have been evaluated for the presence of blood, including the Tunic of Argenteuil, the Sudarium of Oviedo, and most famously, the Shroud of Turin. Interestingly, the blood type on all three textiles was found to be AB by serological testing; a similar result was observed for various modern Eucharistic miracles, in which consecrated hosts are reported to change into human cardiac tissue and blood. As AB is a relatively rare blood type, these collective observations have been used in numerous contemporary media outlets to support the idea that all such objects share a common origin. Here, the scientific validity of mutual blood type expression is evaluated. As discussed, AB antigens are not unique to human red blood cells but are also expressed in bacteria, providing a practical connection between such varied objects. Moreover, this article clarifies that the communal presence of specific and unique polymorphic markers would be required to validate that bloodstains associated with such items truly originate from a single source.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617917","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":"Altitudinal variations in forensically relevant dipterans in Trentino Region (Italy): implications for PMI estimation and forensic ecology.","authors":"Simone Corotti, Francesca Dattrino, Fouzi Boulkenafet, Simonetta Lambiase","doi":"10.1007/s12024-024-00909-1","DOIUrl":"https://doi.org/10.1007/s12024-024-00909-1","url":null,"abstract":"<p><p>This study investigates the populations of dipterans in the southeastern Prealps of Trentino, Italy, along an altitudinal gradient that exceeds 1000 m. The study is important because dipterans play a significant role in crime scene analysis by helping to determine the post-mortem interval (PMI) and understand corpse relocation dynamics. Nine aerial traps were used across three sites from May to November 2023, and a total of 17,876 individuals from diverse species were captured. Statistical analyses revealed significant differences in dipteran populations across sites and exposure levels. The study identified relationships between species and environmental factors such as altitude, temperature, and sunlight exposure using Canonical Correspondence Analysis (CCA). Results demonstrated that species composition varied with environmental conditions, offering insights into potential shifts due to climate change. The presence of specific species was notably affected by temperature fluctuations, which could impact their usefulness in PMI estimation. Continuous monitoring is crucial to track dipteran population dynamics amidst changing environmental conditions. Such knowledge is important for improving accuracy in PMI estimations and enhancing forensic investigations. In conclusion, ongoing research is pivotal in adapting forensic entomological analyses to evolving ecological contexts, ensuring their reliability in forensic science applications. This study highlights the dynamic nature of dipteran ecology within forensic contexts and emphasises the need for further investigation to observe shifting population dynamics under climate change impacts.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617836","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":"Impact of population size on population genetic analysis of Short Tandem Repeat (STR) allelic data, forensic and paternity parameters and its effect on forensic DNA analysis.","authors":"Hirak Ranjan Dash, Rhea Shetkar, Nora Rashid Al-Snan","doi":"10.1007/s12024-024-00907-3","DOIUrl":"https://doi.org/10.1007/s12024-024-00907-3","url":null,"abstract":"<p><p>The selection of an appropriate STR allelic frequency database is the prerequisite for assessing the evidentiary value of DNA evidence. Four data sets comprising 50, 100, 200, and 500 samples were evaluated in 21 autosomal STR markers in the Indian and the Bahrain population. Allelic richness showed an increasing trend with the increase in sample size i.e., 193 and 201 (50 samples), 217 and 221 (100 samples), 255 and 238 (200 samples), and 292 and 285 (500 samples) in both the populations. TPOX and D13S317 markers did not show any increase in allele number, whereas SE33 markers showed the highest increase in both populations. With the increase in sample size, 70 (Bahrain population) and 100 (Indian population) alleles having < MAF were detected. Similarly, 37 and 47 previously undetected alleles could be detected when the sample size was increased from 50 to 500 in the Indian and Bahrain populations respectively. In the Indian population, Match probability, decreased with a 500-sample size, whereas, the PIC, PE, Heterozygosity, and PI increased with the increase in sample size. Further, database size did not show any statistical difference in the outcome of the Paternity Index value in the 50 paternity trio cases studied.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602911","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 forensic overview of deaths in mountainous terrain.","authors":"Roger W Byard","doi":"10.1007/s12024-024-00914-4","DOIUrl":"https://doi.org/10.1007/s12024-024-00914-4","url":null,"abstract":"<p><p>Deaths at high altitudes may arise from a range of quite disparate entities including trauma (e.g. falls), environmental factors (e.g. hypothermia and hypoxia), and pre-existing medical conditions (e.g. coronary artery disease). Unique conditions include high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE) which may contribute to lethal mechanisms or precipitate a traumatic event. Forensic issues that may arise in these cases are logistical problems due to remote locations, sometimes with failure to find a body, delay in discovery and/or repatriation, prior local autopsies being performed with embalming, and the non-specificity of pathology markers. Traumatic deaths involve blunt force impacts, falls, suffocation, crush asphyxia and hypothermia. The assessment of cases requires careful integration of the autopsy findings with the medical history of the decedent and an accurate description of their behaviour in the hours leading up to death.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582502","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":"Fifty shades of green and blue: autopsy findings after administration of xenobiotics.","authors":"J Baumgarten, I Greb, F Holz, C Nieß, S Petzel-Witt, Christoph G Birngruber","doi":"10.1007/s12024-024-00903-7","DOIUrl":"https://doi.org/10.1007/s12024-024-00903-7","url":null,"abstract":"<p><p>Unusual findings during an autopsy may come from peculiarities in the position, shape, size, weight, consistency, smell or color of organs. The following study was triggered by an autopsy case in which an unusual blue-green discoloration of organs, which changed during the autopsy, was noticed. A review of the local autopsy database, selected cases including the antemortem clinical documentation and the literature has been performed to clarify the etiology of these conspicuous discolorations and to evaluate their diagnostic value. The study showed that certain xenobiotics may lead to such discoloration. After systemic administration of methylene blue, darkening blue-green discoloration of organs, especially the brain and heart, can be observed. In addition, the systemic administration of toluidine blue also appears to be capable of causing such discoloration. Beyond that, drugs (like Rohypnol^®) or other foreign substances (like detergents) containing warning colors, i.e. indigocarmin (E132) or Brilliant Blue FCF (E133) may cause discolorations of the upper gastrointestinal tract or the urinary bladder respectively. A blue-green, possibly darkening discoloration of organs during autopsy may point towards an antemortem administration of certain xenobiotics. The affected organs give an indication of the possible route of application and the type of substance. A differentiated interpretation of the etiology of such conspicuous discolorations at autopsy should only be made considering the (medical) history and, if necessary, complementary (toxicological) examinations.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544726","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}