Forensic Science, Medicine and Pathology最新文献

{"title":"Fatal tracheostomy-site hemorrhage in blue rubber bleb nevus syndrome: case report and literature review.","authors":"Irene Pradelle, Marta Helenowski, Lauren M Woertz, Lorenzo Gitto","doi":"10.1007/s12024-026-01172-2","DOIUrl":"10.1007/s12024-026-01172-2","url":null,"abstract":"<p><p>Blue Rubber Bleb Nevus Syndrome (BRBNS) is a rare congenital disorder characterized by multiple venous malformations, most frequently affecting the skin and gastrointestinal tract, but occasionally involving the central nervous system and other visceral organs. Fatal outcomes are exceedingly rare and usually result from acute hemorrhage or airway compromise. This report describes a fatal case of BRBNS in a 31-year-old woman who developed uncontrollable bleeding from vascular malformations following an emergent tracheostomy performed for anaphylaxis secondary to lidocaine administration during dental treatment. Despite aggressive resuscitative measures, the patient succumbed to hemorrhagic shock. External examination revealed bluish subcutaneous lesions in the perioral region, periorbital ecchymosis, and multiple bluish, compressible subcutaneous vascular \"blebs\" on the right upper extremity, extending to the right hemithorax. Internally, multiple submucosal, hemorrhagic-appearing lesions were identified on the base of the tongue, hypopharynx, larynx, and aryepiglottic folds, with additional vascular malformations in the posterior mediastinum and right temporalis muscle. Histologic examination confirmed cavernous hemangiomas at the tracheostomy site. A review of the English-language literature revealed only a small number of fatal cases associated with BRBNS. This case highlights the potential for fatal airway hemorrhage in BRBNS, particularly during emergent procedures involving the upper airway. Awareness of possible laryngeal and tracheal involvement is crucial to avoid iatrogenic complications. Comprehensive autopsy remains essential to determine the cause of death, document lesion distribution, and distinguish disease-related hemorrhage from procedural injury.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1064-1069"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009415","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":"Fatal neuroleptic malignant syndrome: a forensic case series on postmortem diagnostic challenges.","authors":"Yusuf Atan, Mehmet Doğan, İbrahim Üzün","doi":"10.1007/s12024-026-01340-4","DOIUrl":"10.1007/s12024-026-01340-4","url":null,"abstract":"<p><p>Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal adverse reaction to antipsychotic and other dopamine-modulating medications and remains one of the most challenging diagnoses in forensic pathology. Postmortem findings are typically nonspecific and toxicological analyses often demonstrate therapeutic drug concentrations; therefore, accurate cause-of-death determination requires integrated medico-legal evaluation. A retrospective forensic case series was evaluated using the national forensic death investigation system of the Council of Forensic Medicine of Türkiye. First Forensic Medicine Board (FFMB) reports between 2013 and 2024 (n = 53,677) obtained via the National Judiciary Informatics System (UYAP) were screened. Cases in which NMS or malignant hyperthermia was considered underwent detailed manual review, and only those in which the FFMB established NMS or malignant hyperthermia as the final cause of death were included. Demographic characteristics, medication exposure, clinical course, laboratory investigations, autopsy findings, histopathology, toxicological analyses, and final forensic determinations were systematically evaluated. Seventeen deaths met the inclusion criteria, of which fourteen deaths were attributed to NMS associated with antipsychotic therapy and three deaths were attributed to anesthesia-related malignant hyperthermia. Most NMS decedents had underlying psychotic disorders and were receiving antipsychotic treatment, frequently in the setting of psychotropic polypharmacy or depot formulations. A recurring clinical pattern of hyperthermia, neuromuscular abnormalities, altered mental status, autonomic instability, and marked creatine kinase elevation was observed. Autopsy findings were predominantly nonspecific, most commonly demonstrating visceral congestion and pulmonary edema. Toxicological analyses identified prescribed psychotropic medications at therapeutic or near-therapeutic concentrations without evidence of lethal intoxication. Final cause-of-death determination relied on integrated forensic evaluation and systematic exclusion of competing hyperthermic syndromes. Fatal NMS represents a diagnostically challenging functional drug-related cause of death for which neither autopsy nor toxicological analysis alone is sufficient. Accurate forensic diagnosis requires comprehensive integration of clinical history, medication exposure, laboratory investigations, autopsy findings, toxicological results, and exclusion of competing hyperthermic syndromes. Recognition of these recurring clinical and forensic patterns may facilitate more accurate medico-legal cause-of-death determination in suspected NMS-related deaths.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1191-1199"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863991","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":"Real-world application of non-clinical smile photographs for forensic human identification - a systematic review of case reports.","authors":"Jeyaseelan Augustine, Sourendra Nath Basu, Kuldeep Singh, Nitendra Singh, Ruchi Sehrawat, Anil Kumar Saini, Aadithya B Urs, Priya Kumar, Amit Prakash Singh, Mahesh Verma","doi":"10.1007/s12024-026-01211-y","DOIUrl":"10.1007/s12024-026-01211-y","url":null,"abstract":"","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1179-1188"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147485146","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":"DNA Profiling in forensic genetics and anthropogenetics: Techniques, databases, and ethical considerations.","authors":"Abderrazak El Khair","doi":"10.1007/s12024-026-01206-9","DOIUrl":"10.1007/s12024-026-01206-9","url":null,"abstract":"","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1016-1028"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147485117","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":"Comment on \"Reanalyzing DNA mixture: a evaluation of EuroForMix for deconvolution and weight‑of‑evidence computing\".","authors":"Pawan Mandal, Ritu Gupta","doi":"10.1007/s12024-025-01119-z","DOIUrl":"10.1007/s12024-025-01119-z","url":null,"abstract":"","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1051-1052"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145408564","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 Seaport criteria for myocarditis.","authors":"Barbara Sampson, Joseph J Maleszewski, Katarzyna Michaud","doi":"10.1007/s12024-025-01103-7","DOIUrl":"10.1007/s12024-025-01103-7","url":null,"abstract":"","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"984-985"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291685","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":"Bibliometric analysis of shaken baby syndrome and abusive head trauma research.","authors":"Bayram Deleş, Neriman Aral","doi":"10.1007/s12024-026-01296-5","DOIUrl":"10.1007/s12024-026-01296-5","url":null,"abstract":"<p><p>Shaken Baby Syndrome and Abusive Head Trauma are significant traumatic brain injuries observed in infants and represent a critical public health issue. Although there is a vast literature on this subject, conducting a descriptive bibliometric analysis is essential to map the topic's quantitative development over time and to reveal its current geographical and conceptual distribution objectively. This study systematically analyzes 3,571 articles published between 1977 and 2025 in the Web of Science Core Collection database, examining the distribution of publications by year and country, leading journals, citation rates, and keyword networks. Our findings indicate a linear increase in the volume of SBS/AHT research publications since the 2000s. The analysis highlights two significant strengths and shifts in the literature. First, the emergence of countries from diverse regions-such as Romania, the United Arab Emirates, Malaysia, and Russia-in the literature network, alongside traditional research hubs, objectively confirms the subject's expanding global scope. Second, the fact that the highest citation rates and publication density are not limited to clinical medicine journals (e.g., Pediatrics) but are simultaneously concentrated in pioneering journals with social and legal content (e.g., Child Abuse & Neglect) highlights the field's multidimensional and interdisciplinary nature. In conclusion, this study provides an objective resource for all stakeholders-including physicians, forensic scientists, and legal professionals-by visualizing the current geographic diversity of scientific output, key terms, and journal dynamics.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"957-967"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301431","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 Agkistrodon halys bite by the combination of ELISA and immunohistochemistry: a case report and literature review.","authors":"Yubei Wang, Zhaoxuan Wang, Xiangting Gao, Qing Shi, Yuhao Yuan, Chen Chen, Zhonghao Yu, Yiwu Zhou","doi":"10.1007/s12024-026-01178-w","DOIUrl":"10.1007/s12024-026-01178-w","url":null,"abstract":"","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1106-1112"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118429","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":"Cannabis in road traffic - a retrospective analysis to identify possible cut-off-values.","authors":"A Ludwig, U Küpper, M Lau, A Holzer, T Wulff, B Hartung","doi":"10.1007/s12024-025-01133-1","DOIUrl":"10.1007/s12024-025-01133-1","url":null,"abstract":"<p><p>In light of the recent partial legalization of cannabis in Germany and the associated adjustment of the legal threshold for THC serum concentration from 1 ng/ml to 3.5 ng/ml, we investigated whether a specific THC serum concentration or cannabis influence factor (CIF) value could be identified, above which behavioural and driving impairments significantly increase. We retrospectively analysed cases from 2020 to 2021, in which blood samples had been submitted for toxicological analysis from drivers suspected of operating a vehicle under the influence of cannabis alone (DUIC) or in combination with alcohol (DUIAC). 740 cases were evaluated with respect to behavioural and driving impairments, serum concentration of THC and its metabolites, CIF values, and-in cases involving co-consumption-blood alcohol concentration (BAC). Our findings indicate that cannabis impairs psychomotor and cognitive functions and that THC serum concentrations are roughly correlated with driving impairment. However, we were unable to define a clear cut-off-value above which a significant increase in impairment could be detected. Slightly (but statistically significant) higher THC serum concentrations and CIF values were observed in cases where there was concrete evidence of criminal offenses pursuant to § 316 of the German Penal Code. However, absolute differences were small and there was too much overlap between the two groups to define a useful cut-off-value for THC. There is a measurable relationship between THC serum concentration and impairment. This relationship is too weak to scientifically define a cut-off value. Regarding the revised legal threshold for THC serum concentration, we found that approximately one-third of the evaluated cases would no longer be subject to legal penalties if the new threshold of 3.5 ng/ml were applied.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"997-1007"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145539810","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":"The importance of medical imaging history for medicolegal evaluation.","authors":"Ufuk Akın, Gökmen Karabağ","doi":"10.1007/s12024-025-01165-7","DOIUrl":"10.1007/s12024-025-01165-7","url":null,"abstract":"<p><p>As with all traumatic pathologies, determining when a fracture occurred and during which event it occurred is necessary for an accurate medicolegal evaluation. Among the 4,224 cases for which forensic reports were prepared, the report outcome changed in 105 cases (2.5%) when prior medical imaging was included in the medicolegal evaluation. In the initial assessment of the cases (based on emergency department medical records and radiology reports), a bone fracture was recorded in 59.0% of the cases, no bone fracture in 10.5%, and a suspected bone fracture in 30.5%. In the final evaluation-conducted by the forensic medicine outpatient clinic-where current medical images were compared with prior medical images, it was determined that a bone fracture had occurred in the most recent trauma in 17.1% of the cases, that no new fracture attributable to the most recent trauma was present in 79.1%, and that new fractures in addition to old bone fractures were present in 3.8%. We believe that, when analysing current medical images, the search for prior medical imaging and the comparative analysis of obtained prior images with current images should be a routine component of medicolegal evaluation for all forensic cases, regardless of case type.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"989-994"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917408","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}