Forensic Science, Medicine and Pathology最新文献_第9页

Tattoo-associated toxic shock syndrome: potential role of hematological biomarkers in risk stratification. 纹身相关中毒性休克综合征：血液学生物标志物在危险分层中的潜在作用。

IF 1.6 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2026-09-01 Epub Date: 2025-09-20 DOI: 10.1007/s12024-025-01092-7

Daniel Matovu

引用次数: 0

Recognizing pellagra with Casal's necklace: a fatal case of anorexia nervosa. 用卡萨尔的项链识别糙皮病：神经性厌食症的致命案例。

IF 1.6 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2026-09-01 Epub Date: 2026-06-23 DOI: 10.1007/s12024-026-01218-5

Atsushi Yamada, Kana Unuma, Nobutaka Arai, Ryohei Kuroda, Naoka Umemoto, Takanao Matsumoto, Osamu Kitamura

{"title":"Recognizing pellagra with Casal's necklace: a fatal case of anorexia nervosa.","authors":"Atsushi Yamada, Kana Unuma, Nobutaka Arai, Ryohei Kuroda, Naoka Umemoto, Takanao Matsumoto, Osamu Kitamura","doi":"10.1007/s12024-026-01218-5","DOIUrl":"10.1007/s12024-026-01218-5","url":null,"abstract":"Pellagra is a nutritional deficiency caused by the inadequate intake or metabolism of niacin (vitamin B3) and its precursor tryptophan. While pellagra is now rare in developed countries, individuals with eating disorders such as anorexia nervosa or chronic alcoholism remain at risk of developing this condition. We report a fatal case of pellagra in a woman with anorexia nervosa. Autopsy revealed severe emaciation, Casal's necklace, and additional cutaneous findings, including Russell's sign. Histopathological examination of the neck lesion revealed characteristic psoriasiform changes. Postmortem serum analysis revealed a markedly reduced tryptophan concentration (16.1 nmol/mL; reference range: 40.9-68 nmol/mL), consistent with the diagnosis of pellagra. This case highlights the diagnostic importance of integrated histopathology, cutaneous findings, and postmortem serum amino acid profiling in identifying fatal nutritional deficiencies. Furthermore, it emphasizes the need to consider pellagra in at-risk populations, even in modern forensic settings.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1113-1118"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301510","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}

引用次数: 0

Suicide by flecainide: a case report and review of the literature. 服毒自杀：一例报告及文献回顾。

IF 1.6 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2026-09-01 Epub Date: 2026-03-07 DOI: 10.1007/s12024-026-01188-8

Angelo Montana, Fabrizio Lo Faro, Chiara Turchi, Federica Alessandrini, Arianna Giorgetti

{"title":"Suicide by flecainide: a case report and review of the literature.","authors":"Angelo Montana, Fabrizio Lo Faro, Chiara Turchi, Federica Alessandrini, Arianna Giorgetti","doi":"10.1007/s12024-026-01188-8","DOIUrl":"10.1007/s12024-026-01188-8","url":null,"abstract":"Purpose: Flecainide is a prescription drug used to treat or prevent various types of arrhythmias by decreasing conduction velocity. Despite its therapeutic utility, flecainide has a narrow safety margin and potential for fatal toxicity. This study presents a forensic case of fatal flecainide intoxication and investigates the role of pharmacogenetics in drug metabolism and toxicity.Methods: A 27-year-old medical doctor, prescribed flecainide, was found deceased. Postmortem examination included histological and toxicological analyses of blood and urine samples, with flecainide quantification by a validated method. CYP2D6 and CYP3A5 were genotyped to check for variants of the respective drug-metabolizing enzymes. A literature review of fatal and non-fatal flecainide intoxication is also presented.Results: Flecainide concentrations measured 3.411 mg/l and 2.962 mg/l in central and peripheral blood, respectively. Pharmacogenetic analysis identified a CYP3A5 *3/*3 poor metabolizer genotype, likely contributing to reduced drug clearance and increased toxicity. Histology revealed mild coronary stenosis and signs consistent with cardiogenic shock. The death was deemed a suicide, possibly facilitated by abnormal metabolic phenotype in a mildly compromised cardiac substrate.Conclusions: This case highlights the complexities in diagnosing lethal flecainide intoxication, particularly considering postmortem concentration variability and individual metabolic differences. Integrating pharmacogenetic data enhances interpretation of toxicological findings and may guide personalized therapeutic strategies to mitigate risk. Further research is warranted to clarify genetic influences on flecainide toxicity.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"944-956"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372865","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}

引用次数: 0

Non-occlusive mesenteric ischemia induced by methamphetamine: an autopsy case report. 甲基苯丙胺致非闭塞性肠系膜缺血一例尸检报告。

IF 1.6 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2026-09-01 Epub Date: 2026-01-14 DOI: 10.1007/s12024-025-01145-x

Ayumi Nitta, Takahiro Umehara, Toshiko Tanaka, Satoshi Kimura, Sang-Eun Kim, Hiroaki Sato

{"title":"Non-occlusive mesenteric ischemia induced by methamphetamine: an autopsy case report.","authors":"Ayumi Nitta, Takahiro Umehara, Toshiko Tanaka, Satoshi Kimura, Sang-Eun Kim, Hiroaki Sato","doi":"10.1007/s12024-025-01145-x","DOIUrl":"10.1007/s12024-025-01145-x","url":null,"abstract":"Non-occlusive mesenteric ischemia (NOMI) is an acute form of intestinal ischemia that occurs in the absence of organic stenosis of the mesenteric arteries. Vasoconstrictive agents have been recognized as potential etiological factors. This report describes the first documented Japanese autopsy case of NOMI induced by methamphetamine (MA), a potent sympathomimetic agent. A forensic autopsy was performed on a man in his 60s who died suddenly. Gross and histopathological findings of the small intestine and mesenteric arteries were examined, and post-mortem toxicological analysis was performed to quantify the blood MA concentration. Autopsy revealed a dilated small intestine without mechanical obstruction, accompanied by non-contiguous ischemic necrosis and no signs of organic stenosis in the mesenteric arteries. Histopathological examination of the small intestine showed hemorrhage and necrosis, consistent with a diagnosis of NOMI. The blood concentration of MA was within the toxic range but below the fatal threshold, suggesting a causal relationship between MA use and the onset of NOMI. Given the fatal outcome despite an MA concentration below the reported fatal range, prolonged mucosal exposure from oral ingestion may have locally intensified vasoconstrictive effects, contributing to intestinal ischemia. This case highlights the importance of considering MA-induced NOMI in the differential diagnosis of sudden death among MA users and highlights the risk of fatal ischemic complications even at non-fatal MA concentrations.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"879-885"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965745","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}

引用次数: 0

Fatal diabetic ketoacidosis associated with excessive soft drink consumption: a case report. 致死性糖尿病酮症酸中毒与过量饮用软饮料：1例报告。

IF 1.6 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2026-08-26 DOI: 10.1007/s12024-026-01344-0

Wei Zhang, Akiko Ishigami, Satoshi Hata, Miyu Osako, Philipp Nett, Yuko Ishida, Mizuho Nosaka, Hiroki Yamamoto, Yumi Kuninaka, Reiko Matsuki, Toshikazu Kondo

{"title":"Fatal diabetic ketoacidosis associated with excessive soft drink consumption: a case report.","authors":"Wei Zhang, Akiko Ishigami, Satoshi Hata, Miyu Osako, Philipp Nett, Yuko Ishida, Mizuho Nosaka, Hiroki Yamamoto, Yumi Kuninaka, Reiko Matsuki, Toshikazu Kondo","doi":"10.1007/s12024-026-01344-0","DOIUrl":"https://doi.org/10.1007/s12024-026-01344-0","url":null,"abstract":"We report a case of sudden and unexpected death due to diabetic ketoacidosis in a severely obese young woman (height, 146 cm; weight, 98 kg) with no prior diagnosis of diabetes mellitus but a history of prolonged excessive consumption of sugary beverages. Autopsy and histopathological findings revealed no fatal organic pathology except for severe fatty liver, and the toxicological examination was negative. Postmortem biochemical analysis showed markedly elevated serum glucose (1890 mg/dL), vitreous glucose (1900 mg/dL), glycated hemoglobin (13.7%), and acetone levels in the cardiac blood (65 µg/mL), peripheral blood (68 µg/mL), and urine (119 µg/mL). Tests for glutamic acid decarboxylase antibodies were negative. Based on these findings and the scene investigation, the cause of her death was determined to be diabetic ketoacidosis in the context of chronic excessive sugar intake, consistent with the phenomenon of \"soft drink ketosis.\" This report highlights the essential role of postmortem biochemical analyses in elucidating the metabolic causes of sudden death.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826723","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

Survivor experiences of forensic and legal processes after sexual assault: an exploratory mixed-methods study of participants recruited through Middle Eastern support networks. 性侵犯后法医和法律程序的幸存者经历：通过中东支持网络招募的参与者的探索性混合方法研究。

IF 1.6 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2026-08-25 DOI: 10.1007/s12024-026-01342-2

Salma R Abdelrahman, Salem K Alketbi

{"title":"Survivor experiences of forensic and legal processes after sexual assault: an exploratory mixed-methods study of participants recruited through Middle Eastern support networks.","authors":"Salma R Abdelrahman, Salem K Alketbi","doi":"10.1007/s12024-026-01342-2","DOIUrl":"https://doi.org/10.1007/s12024-026-01342-2","url":null,"abstract":"Effective forensic and legal responses to sexual assault require reliable evidence collection and respectful, fair procedures. This exploratory mixed-methods study examined psychological distress, cooperation with forensic procedures, legal-process satisfaction, and contextual experiences among survivors recruited through advocacy and legal-aid networks across multiple Middle Eastern jurisdictions. Fifty adult survivors (34 women and 16 men) completed study-specific single-item ratings of psychological distress and cooperation on 10-point scales and satisfaction on a five-point scale, followed by semi-structured interviews. Quantitative data were summarized. Gender differences were examined using Mann-Whitney U tests, and the distress-satisfaction association was assessed using Spearman's rank correlation. Interviews underwent thematic analysis and integration during interpretation. Mean scores were 7.72 (SD = 1.20) for distress, 6.68 (SD = 1.71) for cooperation, and 3.26 (SD = 1.17) for satisfaction. Satisfaction ratings of 4-5 were reported by 44% of participants, 30% selected the midpoint, and 26% selected ratings of 1-2. Cooperation did not differ significantly by gender (U = 349.0, p = 0.106), and distress was not significantly associated with satisfaction (ρ = -0.11, p = 0.459). Qualitative themes included trauma during evidence collection, shame and stigma, perceptions of justice, professional support, privacy concerns, and service-access challenges. Some male participants emphasized anticipated disbelief, masculinity-related stigma, and social judgment. Cooperation, distress, and satisfaction represented distinct dimensions of survivor experience. The findings support trauma-informed, context-responsive practices emphasizing continuing consent, clear communication, privacy, professional sensitivity, and equitable access while maintaining evidentiary standards.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818011","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

Renal rupture associated with electrocution in a man with polycystic kidney disease. 多囊肾病患者伴电刑的肾破裂

IF 1.6 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2026-08-25 DOI: 10.1007/s12024-026-01339-x

Roxane Rouah, Alice Matheux, Stéphanie Cavard, Mélanie Loiseau, Elise Orillus

引用次数: 0

Challenges in the forensic toxicological analysis of CB1 receptor‑active substances using liquid chromatography-tandem mass spectrometry: categorisation of total hexahydrocannabinol concentrations in road traffic samples. 使用液相色谱-串联质谱法对CB1受体活性物质进行法医毒理学分析的挑战：道路交通样本中总六氢大麻酚浓度的分类。

IF 1.6 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2026-08-21 DOI: 10.1007/s12024-026-01343-1

Marek Dziadosz, Lisa Marquenie, Wolfgang Rosenberger, Michael Klintschar, Jörg Teske

引用次数: 0

Acute neurosyphilis as a cause of death in the 21st century - autopsy case report in a prisoner. 急性神经梅毒作为21世纪的死因——一名囚犯的尸检病例报告。

IF 1.6 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2026-08-20 DOI: 10.1007/s12024-026-01341-3

Veljko Milošević, Ivana Petrović, Katarina Đurđević, Aleksandra Ćibić, Borivoje Savić, Snežana Pavlekić

{"title":"Acute neurosyphilis as a cause of death in the 21st century - autopsy case report in a prisoner.","authors":"Veljko Milošević, Ivana Petrović, Katarina Đurđević, Aleksandra Ćibić, Borivoje Savić, Snežana Pavlekić","doi":"10.1007/s12024-026-01341-3","DOIUrl":"https://doi.org/10.1007/s12024-026-01341-3","url":null,"abstract":"Syphilis, a chronic sexually transmitted infection caused by Treponema pallidum, has become a rare cause of death in the antibiotic era when diagnosed and treated promptly. Nevertheless, severe and fatal complications may still occur in vulnerable populations. We report the case of a 45-year-old imprisoned intravenous drug user who died following acute neuroinflammation most likely associated with neurosyphilis. The patient was admitted with loss of consciousness and generalized tonic-clonic seizures. Medical records documented a diagnosis of neurosyphilis established five months earlier, while cerebrospinal fluid analysis demonstrated inflammatory changes consistent with central nervous system involvement. Despite anticonvulsive and antibiotic therapy, he died shortly after admission. Autopsy revealed mild cerebral edema and cloudy leptomeninges. Histopathological examination demonstrated chronic lymphoplasmacytic meningoencephalitis with perivascular inflammatory infiltrates, leptomeningeal inflammation, gliosis, neuronal loss, and chronic vascular changes. Warthin-Starry staining and immunohistochemistry for Treponema pallidum were negative. Although these findings were compatible with neurosyphilis, they were not pathognomonic. In the absence of complete clinical documentation and comprehensive ancillary investigations, the diagnosis was based on integration of the available clinical history, autopsy, histopathological, and toxicological findings, together with exclusion of more likely alternative causes. This case highlights the diagnostic challenges of postmortem evaluation of suspected neurosyphilis and emphasizes the importance of cautious clinicopathological correlation in forensic practice, particularly when supporting diagnostic investigations are incomplete.","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790244","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 fatal case of bupivacaine-induced local anesthetic systemic toxicity following neonatal circumcision: clinical lessons. 新生儿包皮环切术后布比卡因致局麻全身性毒性致死1例：临床教训。

IF 1.6 4区医学

Forensic Science, Medicine and Pathology Pub Date : 2026-08-17 DOI: 10.1007/s12024-026-01337-z

Miyeong Park, Soo Hee Lee, Ju-Tae Sohn

引用次数: 0