Forensic Science, Medicine and Pathology最新文献

{"title":"Dog bites or knife wounds? A case report of atypical neck injuries.","authors":"Eulalie Pefferkorn, Fabrice Dedouit, Frédéric Savall, Pauline Saint-Martin","doi":"10.1007/s12024-024-00924-2","DOIUrl":"10.1007/s12024-024-00924-2","url":null,"abstract":"<p><p>A 24-year-old woman was brought to the emergency department after suffering dog bites, as reported by a witness. Autopsy revealed 21 deep wounds of the neck, along with unclear injuries to both carotid arteries, extensive damage to neck muscles, a wound to the larynx, and the right lobe of the thyroid gland had been avulsed. The forensic pathologist initially concluded that the cause of death was asphyxia and haemorrhagic syndrome. Furthermore, due to the nature of some wounds resembling stab wounds, as well as facial injuries and marks consistent with gripping, the death was initially considered a possible homicide rather than attributing it to dog bites. Following these findings, the investigation took a drastic turn, resulting in the arrest of the witness. Three years later, our team was consulted for a second opinion. Reviewing the medical records confirmed dissection of both carotid and vertebral arteries without complete section, and fractures of cervical transverse processes, with the left and right vertebral arteries occluded by a bone fragment as seen on a CT scan from the emergency department. The second forensic expert supported the conclusion that the cervical injuries were consistent with dog bites, particularly due to the torn appearance of the muscle masses and soft tissue avulsion. Additionally, the vascular dissections and cervical fractures were attributed to hyperextension and/or compression of the neck, consistent with the dynamics of a dog attack involving shaking or grabbing the neck. Similar types of injuries have been documented in the scientific literature in cases of dog attacks. Furthermore, instances of wounds resembling stab wounds following dog bites have also been reported. The experts conclude that death was secondary to cerebral anoxia resulting from multiple dissections of neck vessels, aggravated by blood spoliation and asphyxia related to the laryngeal wound. All of the wounds were consistent with dog bites, leading to the release of the defendant.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1273-1280"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750161","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":"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":"1138-1144"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","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":"Advances in postmortem interval estimation: A systematic review of machine learning and metabolomics across various tissue types.","authors":"Abdulkreem Abdullah AlJuhani, Rodan Mahmoud Desoky, Abdulaziz A Binshalhoub, Mohammed Jamaan Alzahrani, Mofareh Shubban Alraythi, Farouq Faisal Alzahrani","doi":"10.1007/s12024-025-01026-3","DOIUrl":"10.1007/s12024-025-01026-3","url":null,"abstract":"<p><strong>Background: </strong>Traditional postmortem interval (PMI) estimation methods rely on observable changes such as rigor mortis, livor mortis, and algor mortis but are often affected by environmental factors. Metabolomics, combined with techniques like nuclear magnetic resonance (NMR) and mass spectrometry, improves accuracy by identifying biochemical changes postmortem. Machine learning methods such as Principal Component Analysis (PCA), Partial Least Squares (PLS), and Support Vector Machines (SVMs), enhance PMI predictions by analyzing metabolite data. This review aims to summarize advances in using machine learning for PMI estimation and identify the optimal combination of tissue samples and algorithms for accurate predictions.</p><p><strong>Methods: </strong>We retrieved relevant articles up to September 2024 from PubMed, Scopus, Web of Science, IEEE, and Cochrane Library. Data were extracted from eligible studies by two independent reviewers. This included the number and species of subjects, tissue sample used, PMI range in the study, metabolic profiling technique, machine learning algorithms, potential PMI markers, and model performance.</p><p><strong>Results: </strong>We compared machine learning models for PMI estimation across various tissues. Zhang et al. (2022) had the best performance with a random forest (RF) model using cardiac blood, achieving a mean absolute error (MAE) of 1.067 h by selecting key metabolites. Wu et al. (2017) followed with an orthogonal signal-corrected PLS model (R² > 0.99, MAE 1.18-2.37 h). Lu et al. (2022) achieved 93% accuracy with a multi-organ stacking model. Other promising models include Zhang et al.'s (2017) nu-SVM on pericardial fluid (RMSE = 2.38 h) and Sato et al.'s (2015) PLS model on cardiac blood (MAE = 5.73 h).</p><p><strong>Conclusion: </strong>Cardiac blood is best for short PMIs with random forest models, while skeletal muscle and stacking models excel for longer PMIs. Future studies should refine and validate these findings as well as extend the findings to human subjects.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1428-1446"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698039","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":"Novel insights into estimating the postmortem interval: red cell distribution width - standard deviation.","authors":"Hiroki Kondou, Kaori Shintani-Ishida, Hiroshi Ikegaya","doi":"10.1007/s12024-025-00957-1","DOIUrl":"10.1007/s12024-025-00957-1","url":null,"abstract":"<p><p>Estimation of the postmortem interval (PMI) is highly significant, and many estimation methods have been developed. However, as no estimation method is determinate, several methods must be combined to achieve an accurate estimation. Therefore, the more methods available, the more accurate the estimation. To facilitate this, we examined whether red cell distribution width standard deviation (RDW-SD) was associated with PMI. We compared the RDW-SDs of blood samples from hospitals and autopsies in the same cadavers using a paired test. Additionally, we performed an unpaired test with multiple regression analysis to confirm the relationship between PMI and RDW-SD. Eighteen cases were included in the paired analysis, and a significant difference between hospital and autopsy RDW-SDs was confirmed. The 95% confidence interval for the difference was between 11.7 and 17.4. In the multiple regression analysis of the 756 cadavers, the 95% confidence interval of the regression coefficient of PMI for RDW-SD was 1.63-3.43. Our results suggest that RDW-SD may have a positive relationship with PMI. However, further research is required to determine the accuracy of this estimation method.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1191-1195"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064772","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":"Forensic identification of fatal mushroom poisoning: a case report.","authors":"Zhonghao Yu, Yuhao Yuan, Jiaxin Zhang, Qing Shi, Hang Gao, Yiwu Zhou","doi":"10.1007/s12024-025-00956-2","DOIUrl":"10.1007/s12024-025-00956-2","url":null,"abstract":"<p><p>Mushroom poisoning incidents happen infrequently, yet owing to the non-lethal nature of most toxins and the efficacy of timely treatment, fatalities from mushroom poisoning are uncommon, leading to a scarcity of pertinent clinical and pathological data. Here, we reported a case of death caused by the consumption of raw mushrooms, alongside detailed clinical data and multi-organs pathological alterations, which underscored its potential significant reference value in forensic practice. Futhermore, ibotenic acid, a type of mushroom toxin, was detected both in the patient's blood and gastric lavage fluid about 19 h after the consumption of mushrooms, and was successfully quantified at concentrations of 0.381 µg/mL and 0.202 µg/mL, respectively, indicating a relatively significant finding.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1313-1320"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064770","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":"Post-cardiopulmonary resuscitation trauma: retrospective analysis of skeletal and visceral injuries in autopsy findings.","authors":"Cemyigit Deveci, Batuhan Turgut, Mehmet Atilgan","doi":"10.1007/s12024-025-01028-1","DOIUrl":"10.1007/s12024-025-01028-1","url":null,"abstract":"<p><p>This study evaluates skeletal and visceral injuries associated with CPR, providing insights for clinicians and forensic experts. A retrospective analysis of 520 autopsy cases, selected from 2,508 conducted between 2021 and 2022 in Türkiye, was performed. Inclusion criteria focused on cases receiving CPR post-cardiac arrest, excluding pre-existing thoracic or abdominal trauma. Data were analyzed for demographic variables, injury types, and correlations with age, gender, and body mass index (BMI). Rib fractures were identified in 56.7% of cases, with a median of 9 fractures. Sternum fractures occurred in 42.9%, more frequently in females (55.4% vs. 38.7%; OR = 2.36, 95% CI = 1.50-3.74) and older individuals. Rib fractures were associated with age and BMI, whereas sternum fractures correlated with age and female gender. Lung (13.5%) and cardiac (5.4%) contusions were the most common. Younger individuals (0-17 years) showed fewer skeletal injuries but higher rates of isolated visceral trauma. Skeletal injuries were prevalent in individuals > 50 years, whereas visceral injuries were more common in younger cases. CPR-related injuries exhibit significant variation across demographics. Awareness of these patterns is vital for improving resuscitation protocols and post-CPR evaluations, potentially minimizing trauma.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1222-1229"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198708","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 rare complication of a thoracic wound: the pneumopericardium?","authors":"C Poulain, T Prigent, B Guibourg, G Le Flahec, E Martin, D Ben Salem","doi":"10.1007/s12024-025-00952-6","DOIUrl":"10.1007/s12024-025-00952-6","url":null,"abstract":"<p><p>Pneumopericardium (PPC) is defined by the presence of gas in the pericardial cavity, often leading to cardiac tamponade and a high mortality rate. This report describes a case involving a 33-year-old man found deceased a few meters from a knife, his clothes intact, with no resuscitation attempt made. A knotted scarf was tightly fastened around his neck, without ligature mark. Post-mortem CT revealed 271 ml of gas in the pericardial cavity, with \"flattened heart\". The forensic examination revealed two thoracic stab wounds, one penetrated the pericardium without penetrating the heart chamber, while the second remained superficial. In the absence of resuscitation or exsanguination, and in the presence of some non-specific signs observed in the context of asphyxia, the hypothesis of death by compressive PPC was supported. This first French case report of PPC highlights the rarity of this entity in forensic settings, and comparison with other cases described in the literature which did not present the same characteristics points out the diagnostic difficulties it presents and the importance of post-mortem CT in diagnosis.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1551-1555"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yellow meconium.","authors":"Johanna Preuß-Wössner, Jan-Peter Sperhake, Burkhard Madea","doi":"10.1007/s12024-024-00932-2","DOIUrl":"10.1007/s12024-024-00932-2","url":null,"abstract":"<p><p>The intestinal content of newborns is known as meconium, usually described as a black-greenish slimy substance. However, in rare cases, meconium might be yellow. This is of great relevance with regard to the forensic assessment of life birth, i.e. (longer) survival time and possible (breast-)feeding before death. While in older German forensic literature, yellow meconium has been occasionally mentioned from the 19th century on - without any conclusions being drawn from this finding whether the newborn was alive or had been fed -, current forensic literature does not provide information about this phenomenon. No reports of yellow meconium were found in (older) English forensic literature as well. We report two cases of newborn autopsies with yellow meconium and provide a short overview of the respective literature.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1561-1565"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of postmortem computed tomography when neonatal death occurred after fetoscopic endotracheal occlusion- case report.","authors":"Rafał Skowronek, Jacek Zamłyński, Aleksandra Borowska-Solonynko","doi":"10.1007/s12024-025-01036-1","DOIUrl":"10.1007/s12024-025-01036-1","url":null,"abstract":"<p><p>Congenital diaphragmatic hernia is associated with high risk of neonatal death. It is observed in about 1 in 3,000 live births. Fetoscopic tracheal occlusion procedure is a therapeutic option with survival rate 46.4%. Our aim was analysis of the suitability of postmortem computed tomography in the case of neonatal death occurred after fetoscopic endotracheal occlusion performed due to the severe isolated left-sided congenital diaphragmatic hernia. Postmortem computed tomography can be helpful in such cases because it allows for an objective assessment of whether the procedures used after the birth of the newborn enabled effective lung ventilation. Our case was the first use of postmortem computed tomography in neonatal death after fetoscopic endotracheal occlusion worldwide.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1566-1569"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diatoms pass through the gastrointestinal barrier and lead to false-positive: an animal experiment.","authors":"Burkhard Madea, Elke Doberentz","doi":"10.1007/s12024-024-00882-9","DOIUrl":"10.1007/s12024-024-00882-9","url":null,"abstract":"","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1575-1576"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055339","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}