Journal of forensic and legal medicine最新文献

{"title":"Infant life-threatening accidental head injury from 45 cm fall causing traumatic dissecting aneurysm and delayed rebleeding","authors":"Catherine Skellern ,&nbsp;Michael Stuart","doi":"10.1016/j.jflm.2025.102983","DOIUrl":"10.1016/j.jflm.2025.102983","url":null,"abstract":"<div><div>Whilst short falls within the home are a common cause for infants under 12 months to present to hospital emergency departments, serious injuries or fatalities are exceptionally rare. Forensic evaluation of injuries is essential and considers a range of factors ascertained from investigation of the circumstances alongside findings from medical evaluations to consider injury plausibility. We report a case of a rare mechanism involving occipital-cervical distraction causing cerebrovascular dissection of the posterior inferior cerebellar artery and delayed rebleeding following a verified short distance fall of 45 cm from a sofa to highlight factors that assist in timely recognition of this injury which can be life-threatening or even fatal if overlooked.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102983"},"PeriodicalIF":1.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154697","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 autopsy case of eosinophilic coronary periarteritis with coronary arterial degeneration and repaired dissection","authors":"Hidenori Yoshizawa ,&nbsp;Yoshihiko Ikeda ,&nbsp;Eiich Morii ,&nbsp;Kinta Hatakeyama","doi":"10.1016/j.jflm.2025.102977","DOIUrl":"10.1016/j.jflm.2025.102977","url":null,"abstract":"<div><div>Eosinophilic coronary periarteritis (ECPA) is a rare disease, almost exclusively diagnosed postmortem, characterized by a clinical course of vasospastic angina (VSA) attacks and histologically observed periarterial eosinophilic infiltration in the coronary arteries. Although the etiology of ECPA remains uncertain, its pathogenesis may be attributed to an allergic reaction. In addition, ECPA is often associated with spontaneous coronary artery dissection (SCAD); however, the pathogenesis underlying the link between inflammation and dissection remains unclear.</div><div>In the current case, a 45-year-old female experienced VSA attacks and succumbed to a fatal exacerbation of VSA approximately six years after the first onset of symptoms. Pathological examination at autopsy revealed periarterial eosinophilic infiltration in the coronary artery, suggesting ECPA. Characteristically, the pathological findings further showed localized SCAD with a repair response and deposition of a degenerative matrix in the tunica media. These findings may provide insights into the pathogenesis of ECPA.</div><div>This case highlights the importance of autopsy examinations for discussing and elucidating the pathophysiology of ECPA.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102977"},"PeriodicalIF":1.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152526","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":"Comparison of the accuracy of two different methods in dental age estimation","authors":"Merve Kucuk Kurtgoz,&nbsp;Zarif Ece Hammudioglu,&nbsp;Elif Cecen Erol,&nbsp;Ceren Aktuna Belgin","doi":"10.1016/j.jflm.2025.102980","DOIUrl":"10.1016/j.jflm.2025.102980","url":null,"abstract":"<div><h3>Introduction</h3><div>Age estimation plays a crucial role in forensic medicine, particularly in countries facing significant refugee-related challenges. There are many parameters used for age estimation. The aim of this study is to evaluate the visibility of the pulp and periodontal ligament space in the mandibular third molar using cone beam computed tomography (CBCT) images and to compare the effectiveness of these two methods in chronological age estimation, specifically in assessing the 18–21 age thresholds.</div></div><div><h3>Method</h3><div>CBCT images of 359 patients (189 females, 170 males), aged between 16 and 29 were analyzed by three independent observers. Patients with a history of trauma and/or surgery in the maxillofacial region, developmental anomalies or pathologies in the mandible, or systemic diseases affecting growth and development were excluded. Additionally, third molars with incomplete root development, developmental or acquired dental anomalies, pulp calcification etc. were excluded from the study. After recording the patients' age and sex, the mandibular third molars were classified according to the Olze (visibility of the root pulp) and Guo classification (visibility of the periodontal ligament) into grades 0, 1, 2, and 3. Each observer re-evaluated the CBCT images of 140 randomly selected patients two weeks later to assess intra-observer reliability.</div></div><div><h3>Results</h3><div>The simple correlations between Olze and Guo grades were examined regardless of sex, the relationship between both methods and age was found to be significant and positive (Olze vs age r = 0.493 and p &lt; 0.001, Guo vs age r = 0.445 and p &lt; 0.001). Additionally, for both the Olze and Guo methods, it was observed that as the grade increased, mean age also increased at a statistically significant level (p &lt; 0.001). Olze and Guo's grades changed statistically significantly in the 18 and 21 age thresholds in total (p &lt; 0.001). When both methods were evaluated on a grade basis, it was seen that both Olze and Guo grade 0 increased statistically significantly in the under-18 age group, while Olze Grade 1 and Grade 2, and Guo Grade 2 increased statistically significantly in the 18 and over age group (p &lt; 0.001). Olze method's cutoff value was found to be &gt; 0, and Guo method's cutoff value was found to be &gt; 1 in distinguishing between those under 18 and over. Both Olze and Guo's methods were found to be more successful in predicting the 18-year-old threshold.</div></div><div><h3>Conclusion</h3><div>Although they offer a high probability of being accurate, both Olze and Guo classifications do not provide 100 % accuracy in determining the 18 and 21 age thresholds in forensic dental age estimation. However, for both the Olze and Guo methods, the mean age increased as the grade increased. Both the Olze and Guo methods were found to be successful in estimating the 18 and 21 age thresholds.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102980"},"PeriodicalIF":1.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117868","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":"Histopathology in medico-legal autopsies: Clinical foundation, legal mandate, and judicial guarantee","authors":"Jose Manuel Tortosa Lopez","doi":"10.1016/j.jflm.2025.102974","DOIUrl":"10.1016/j.jflm.2025.102974","url":null,"abstract":"<div><div>Histopathological examination remains a cornerstone of the medico-legal autopsy. It provides essential insights into the vitality and chronology of injuries, as well as the functional mechanisms of death—elements that cannot be reliably assessed through gross examination or postmortem imaging alone. Despite this, a growing number of forensic institutions are progressively excluding histological analysis from standard protocols, particularly in cases of violent death. This shift is often justified by operational, financial, or doctrinal arguments, but represents a methodological regression with serious implications for diagnostic accuracy and legal certainty.</div><div>This article reviews the clinical, technical, and normative foundations of histopathology in forensic practice, with particular emphasis on its role in trauma-related deaths. It addresses the limitations of relying solely on macroscopy or imaging, and underscores the value of microscopy in identifying vital tissue reactions, timing of lesions, and subtle mechanisms such as asphyxia, inhibition, or embolic phenomena. The discussion includes examples from the literature and institutional practice, as well as a critique of the current trend toward minimal or absent histological sampling.</div><div>Finally, the authors propose a minimum protocol for histological sampling in cases of violent or suspicious death, integrating this with scene analysis and targeted dissection. Histopathology is presented not as an optional complement, but as an integral part of the medico-legal diagnosis—both as a scientific tool and as a safeguard of forensic accountability.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102974"},"PeriodicalIF":1.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088239","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 analysis of psychiatric disorder-related deaths: A retrospective study in southern China","authors":"Jinqi Wang ,&nbsp;Kexin Ye ,&nbsp;Chengdong Ma ,&nbsp;Ying Fang ,&nbsp;Yangchang Ou ,&nbsp;Erwen Huang ,&nbsp;Shu-Quan Zhao","doi":"10.1016/j.jflm.2025.102975","DOIUrl":"10.1016/j.jflm.2025.102975","url":null,"abstract":"<div><h3>Background</h3><div>Mental health issues have become increasingly severe globally over the last decade. The aim of the present study is to explore the characteristics of psychiatric disorder-related deaths in southern China and to provide a reference for forensic practice.</div></div><div><h3>Methods</h3><div>Upon examining forensic autopsy cases from the Faculty of Forensic Medicine at Zhongshan School of Medicine, Sun Yat-sen University, spanning from 2014 to 2023, we identified cases of death related to psychiatric disorders. We then analyzed pertinent data, including age, gender, forensic autopsy details, and medication records.Our findings indicated that out of 6013 forensic autopsies conducted, 63 deaths were associated with psychiatric disorders. Cardiovascular disease emerged as the primary cause of death. Notably, individuals who had died from psychiatric disorders exhibited heavier heart weights and smaller perivalvular diameters of the pulmonary artery, as well as coronary artery disease. Antipsychotic drug therapy was prevalent, with most patients being prescribed more than two medications.</div></div><div><h3>Conclusion</h3><div>Cardiovascular disease is the leading cause of death in psychiatric disorders, deaths related to psychiatric disorders are emerging as a challenge in forensic practice and require the concerted efforts of forensic scientists worldwide.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102975"},"PeriodicalIF":1.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082791","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":"Elevator-related deaths in Western Turkiye between 2011 and 2023","authors":"Yusuf Atan ,&nbsp;Ahmet Sedat Dündar","doi":"10.1016/j.jflm.2025.102971","DOIUrl":"10.1016/j.jflm.2025.102971","url":null,"abstract":"<div><div>Elevator-related deaths can be seen as a result of various mechanisms such as asphyxia, blunt force, and avulsion injuries. In one of the largest autopsy centres in the west of Turkiye, 27 cases of elevator-related death occurring over a period of 12.5 years (01 Jan 2011–30 June 2023) were retrospectively examined. The current study is the first to have investigated elevator-related deaths in Turkiye. The victims were seen to be in the age range of 1–88 years and 85.2 % were male. Of the total incidents, 59.3 % were occupational accidents with the location most frequently being a construction site. The victims were most often construction workers and factory workers. The elevator was determined to have been actively working in 74.1 % of the incidents. A fall into the elevator shaft was determined in 40.7 % of the cases and crushing below the elevator was the most common injury (25.9 %). The accidents were seen to be due to insufficient workplace safety precautions (44.4 %) and maintenance/preventative deficiencies (40.7 %). Internal doors were absent in 66.7 % of the elevators and present in 25.9 %. A single person in the elevator was injured in 81.5 % of the accidents, two people in 11.1 %, and 4 people in 7.4 %. The cause of death was most often general body trauma and blunt head trauma. Examination of the scene of the incident is complementary to autopsy in elevator-related deaths. Precautions to be taken against the factors affecting elevator-related deaths will ensure a safer life for workers and daily users.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102971"},"PeriodicalIF":1.2,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095938","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":"Minor perpetrators of violence - forensic medical approach. Analysis of the phenomenon in the years 2015–2020 in Poznan and neighboring municipalities – a retrospective study","authors":"Klaudia Dolińska-Kaczmarek ,&nbsp;Bartosz Burchardt ,&nbsp;Ilona Małecka ,&nbsp;Aleksandra Bielecka ,&nbsp;Szymon Rzepczyk ,&nbsp;Paulina Horwat ,&nbsp;Sylwia Skałecka ,&nbsp;Dagmara Skowrońska ,&nbsp;Przemysław Hałasiński ,&nbsp;Jacek Wysocki ,&nbsp;Czesław Żaba","doi":"10.1016/j.jflm.2025.102966","DOIUrl":"10.1016/j.jflm.2025.102966","url":null,"abstract":"<div><h3>Background</h3><div>Violence is a multifaceted phenomenon that commonly occurs in society. It can take many forms. A particular phenomenon is violence involving minors.</div></div><div><h3>Materials and methods</h3><div>The analysis covered 7689 events in the Wielkopolskie Voivodeship in 2015–2020. The mean, median, and standard deviation were used to describe the group. The significance level was p = 0.05.</div></div><div><h3>Results</h3><div>In 142 cases, minors were perpetrators of violence, of which 129 cases committed violent acts against other minors. Of the events analyzed, 137 took place in a public place. Both victims and perpetrators were most often men.</div></div><div><h3>Conclusions</h3><div>The obtained results are higher than the available Polish statistical data, because of the low reporting level. Among the foreign data, most of the perpetrators were young men. Programs are being launched worldwide to support, rehabilitate, and educate juvenile abusers and their families. Programs with a holistic approach to the issue bring the best results. The problem of violence by juvenile offenders remains a challenge for countries worldwide. The main task for state institutions is to collect adequate data on incidents in a given region. However, keeping statistics is difficult due to the small percentage of reports of this type of violence. In the Wielkopolska region, only cases of peer violence were registered. Lack of adequate support and education of families may translate into non-reporting of aggressive behavior of minors towards guardians.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102966"},"PeriodicalIF":1.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109441","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":"Analysis of suicide-related deaths among children aged 0–14 years in Türkiye","authors":"Erdem Hösükler,&nbsp;Zehra Zerrin Erkol","doi":"10.1016/j.jflm.2025.102969","DOIUrl":"10.1016/j.jflm.2025.102969","url":null,"abstract":"<div><div>Child suicide is a significant public health issue that profoundly impacts not only parents but also society. Each country needs to analyse child suicide rates to formulate effective prevention strategies. This study retrospectively analyses suicide deaths among children under 15 years in Türkiye between 2013 and 2023, focusing on demographic characteristics, methods, and reasons for suicide, using data from the Turkish Statistical Institute. A total of 868 child suicides were detected. More than half of the child suicides (51.5 %) were female. Child suicide rates remained significantly lower than those in the general population. The highest suicide rate occurred in 2014, and the lowest in 2020. A significant decreasing trend in child suicides was detected over time, and this decrease was replaced by an increase in 2020, the start of the pandemic. Hanging and firearms were the most common methods across genders, while jumping from height (OR: 2.18, p &lt; 0.001) and chemical poisoning (OR: 6.50, p &lt; 0.001) were more frequent among females. Illness was a more common suicide reason in females (OR: 2.03, p &lt; 0.01), whereas family incompatibility predominated among males. Although child suicides represent a small proportion of overall suicides in Türkiye, gender-specific differences in methods and reasons were observed. The temporal fluctuations, particularly the peak in 2014 and the post-2020 increase, underscore the importance of monitoring child suicide trends and implementing preventive mental health strategies tailored to children.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102969"},"PeriodicalIF":1.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044777","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":"Regarding “Wischnewski spots and ethylene glycol fatal poisoning: a case report”","authors":"Aleksa Leković ,&nbsp;Slobodan Nikolić","doi":"10.1016/j.jflm.2025.102970","DOIUrl":"10.1016/j.jflm.2025.102970","url":null,"abstract":"","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102970"},"PeriodicalIF":1.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018822","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 R-I-M-E framework: Origin, application, advantages, disadvantages, and impact on forensic pathology teaching","authors":"Pragnesh Parmar ,&nbsp;Gunvanti Rathod","doi":"10.1016/j.jflm.2025.102968","DOIUrl":"10.1016/j.jflm.2025.102968","url":null,"abstract":"<div><div>The R-I-M-E framework, an acronym for Reporter, Interpreter, Manager, and Educator, is a developmental model designed to evaluate and enhance clinical competence among medical trainees. Introduced by Dr. Louis Pangaro in the 1990s, it has gained widespread acceptance in medical education due to its clarity, structured approach, and applicability across specialties. In the context of forensic pathology - a field that demands precision, analytical reasoning, and interdisciplinary coordination - the R-I-M-E framework offers a promising structure for competency-based education. This article explores the origin, educational application, pedagogical advantages and limitations, and specific impact of the R-I-M-E framework on forensic pathology teaching and training. This narrative review synthesizes existing literature on the R-I-M-E framework and its application within medical education, emphasizing its relevance and adaptability to forensic pathology. The framework's stages were analyzed with illustrative examples specific to forensic competencies. The framework provides a sequential model for learner development, starting from accurate reporting (Reporter) and progressing through data interpretation (Interpreter), decision-making and case management (Manager), to professional contribution through teaching and research (Educator). In forensic pathology education, this approach enables learners to build skills systematically while receiving structured feedback. Despite its strengths in clarity and adaptability, limitations such as rigid progression and subjectivity in evaluation were noted. The R-I-M-E framework significantly enhances forensic pathology education by offering a competency-based, developmental structure that aligns with the cognitive and professional demands of the specialty. It promotes learner accountability, fosters reflective practice, and supports the cultivation of skilled forensic practitioners prepared to meet medico-legal responsibilities.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102968"},"PeriodicalIF":1.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003887","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}