Journal of forensic and legal medicine最新文献

{"title":"Feminicide: ideology and losing sense of proportion?","authors":"Alain Braillon","doi":"10.1016/j.jflm.2025.102874","DOIUrl":"10.1016/j.jflm.2025.102874","url":null,"abstract":"","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102874"},"PeriodicalIF":1.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807997","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":"Rare presentation of multiple sinuses of Valsalva Aneurysms with rupture into the right atrium: An autopsy case","authors":"Shujuan Wang,&nbsp;Shihao Yin,&nbsp;Lihua Lin,&nbsp;Xiang Liu,&nbsp;Jiaqi Hou,&nbsp;Qianqian Chai,&nbsp;Min Jiang,&nbsp;Qian Liu","doi":"10.1016/j.jflm.2025.102860","DOIUrl":"10.1016/j.jflm.2025.102860","url":null,"abstract":"<div><div>In forensic practice, multiple sinuses of Valsalva Aneurysm resulting in death have rarely been reported. Here, we present the case of a 55-year-old man who was admitted to hospital with vomiting and recurrent abdominal pain. Ultrasonography showed that the aorta non-coronary sinus had an expansion to the right atrium with a range of about 19mm × 16mm and a rupture at the top of the aorta with a width of about 5mm. The movement of the left ventricular wall was uncoordinated. During the autopsy, forensic scientists found that the deceased also had a right coronary sinus of the aorta. To be exact, the wall of the aorta at the bottom was enlarged in a tuberous manner and bulged into the right ventricular outflow tract, partially obstructing the right ventricular outflow tract. The cause of death was considered to be acute right heart failure caused by the sinus of Valsalva Aneurysm complicated with the non-coronary sinus aneurysm puncturing into the right atrium, followed by multiple organ failure. In cases of unexplained death, the sinus of the Valsalva Aneurysm should be carefully examined because the aneurysm may be asymptomatic and the possibility of rupture cannot be ignored. This case demonstrated an effective post-mortem diagnostic entity and highlights the significance of post-mortem examination in dealing with unexplained deaths.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102860"},"PeriodicalIF":1.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792194","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":"Infective endocarditis and litigation for compensation on healthcare-associated infections: An Italian sample analysis","authors":"Livio Pietro Tronconi ,&nbsp;Giuseppe Basile ,&nbsp;Elisa Mikus ,&nbsp;Luca Bianco Prevot ,&nbsp;Carlo Savini ,&nbsp;Gerardo Vito Lo Russo ,&nbsp;Diego Sangiorgi ,&nbsp;Vittorio Bolcato","doi":"10.1016/j.jflm.2025.102861","DOIUrl":"10.1016/j.jflm.2025.102861","url":null,"abstract":"<div><h3>Background</h3><div>Litigation related to Healthcare-Associated Infections (HAIs) in Italy represent a growing field of interest in establishing the medico-legal link between infection and the healthcare environment and practices for compensation; it is little explored in the cardiovascular surgery regarding infective endocarditis (IE).</div></div><div><h3>Methods</h3><div>We retrospectively analysed the civil judgements on infective endocarditis in the Italian region Emilia-Romagna from 2016 to July 2024 using Ministry of Justice national official database. The search was conducted on the online database on July 31, 2024, using the free word \"endocarditis”. Two authors independently analysed the full-text judgements: , those IE without relevance in the reason for the claim were excluded. Main items were the timeline and outcome, with complaint motivation and liability ascertainment. In-court confirmation of healthcare causal link was reported.</div></div><div><h3>Results</h3><div>Twenty-five judgments were retrieved. After screening for inclusion, nineteen judgements (11 of first instance and 8 of appeal) were included, for overall 15 cases of infective endocarditis. Of the fifteen cases, median age 60.5 years, 73 % males, median time for claim 6 years, for judgement 10 years and, if appealed, 16.5 years. Annual distribution of the claims was linear over time. Eleven (67 %) infective endocarditis were confirmed as healthcare-associated in trial. The prevalent reason for liability was improper or delayed diagnosis and/or treatment of the IE. Valvular surgery resulted in 40 %, while the more frequent pathogens were <em>Staphylococcus aureus</em> (40 %) and epidermidis (30 %). Of fifteen cases, 73 % was decided in favour of the patient-claimant, with an average cost of €289.872, plus an additional €55.296 in case of appeal. Only in 25 % the appeal's judge changed decision. In all cases, technical advisors were appointed.</div></div><div><h3>Conclusions</h3><div>This sample provides an initial insight into litigation for compensation related to infective endocarditis, highlighting specific characteristics compared to HAIs management in court. Medico-legal reasoning should be integrated into infection prevention and control policies and overall clinical risk management strategies.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"113 ","pages":"Article 102861"},"PeriodicalIF":1.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911846","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":"Common errors In medico-legal reporting by the first responders at A tertiary trauma unit In North India","authors":"Jhansi Lakshmi Mylapalli ,&nbsp;Govinda Balmuchu ,&nbsp;Vidhu Prabhakar ,&nbsp;Piyush Ranjan Sandhu ,&nbsp;Deki Palmo Bodh ,&nbsp;Nirupam Madan ,&nbsp;Sanjeev Lalwani","doi":"10.1016/j.jflm.2025.102859","DOIUrl":"10.1016/j.jflm.2025.102859","url":null,"abstract":"<div><h3>Background</h3><div>The Trauma unit deals with wide variety of medico-legal cases such as assaults, road traffic accidents, injuries due of self-harm, sexual violence, etc. The primary duty of first responders (attending physician/registered medical practitioner) is saving lives, besides recording the medico-legal report (MLR).</div></div><div><h3>Objectives</h3><div>To identify the frequently-encountered errors in medico-legal reporting by emergency physicians and also to signify the importance of efficient documentation of MLRs.</div></div><div><h3>Methodology</h3><div>Data acquisition done retrospectively from previous records after excluding the referral cases associated with outside hospital Medico-legal cases. A total of 400 MLRs were analyzed and score allotted based on the presence or absence of adequate documentation in MLRs. The minimum score is 1, while the maximum score is 5. Grading is done based on the cumulative score for each entity as Above average, average and below average.</div></div><div><h3>Results</h3><div>The treating emergency physicians documented injury in 343 out of 400 MLRs. A total of 309 were graded as \"Above average\" and injury-related description was deficient in 14.2 % (n = 57) cases. Size or dimensions of injury was not mentioned in 80.17 % (n = 186), age and colour of injury was described in none.</div></div><div><h3>Discussion</h3><div>Various factors lead of certain common errors while preparing such medico-legal reports. These errors lead to unnecessary courtroom visits and questioning of the medical fraternity during legal proceedings. Lack of standardization of uniform guidelines while writing an MLR across the nation leads to significant number of errors while documenting MLRs. We implemented a mandatory induction for all the first responders of each batch once in six weeks and observed mitigation of errors in documentation.</div></div><div><h3>Conclusion</h3><div>It is highly recommended to conduct fortnight training or induction of the first responders in preparing the MLRs and effectively enlighten doctors on the importance of medico-legal documentation. This would avoid unnecessary courtroom visits and questioning of the medical fraternity during legal proceedings.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102859"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859700","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":"Neurodegenerative disease findings in Finnish neuropathologically examined medico-legal autopsy cases with acute head injuries","authors":"Essi Laakko ,&nbsp;Petteri Oura","doi":"10.1016/j.jflm.2025.102866","DOIUrl":"10.1016/j.jflm.2025.102866","url":null,"abstract":"<div><div>Neurodegenerative diseases present diagnostic challenges due to their diverse clinical presentations, which emphasizes the importance of postmortem neuropathological examination. As neurodegenerative diseases become more common with age, they contribute to a higher risk of falls, accidents and head injuries. Our aims were to, first, report the prevalence of neurodegenerative disease findings in Finnish neuropathologically examined medico-legal autopsy cases with acute head injuries and, second, report the prevalence, injury circumstances, and types of specific brain injuries in the most common disease entities. We analyzed cases from the Helsinki office of the Forensic Medicine Unit, Finnish Institute for Health and Welfare, over the period 2016–2022. Cases were included if they had a suspected or confirmed head injury, and underwent a full neuropathological examination with neurodegenerative immunohistochemistry. Data on background characteristics, neurodegenerative immunostains and diagnoses, and head injuries were collected from cause-of-death investigation documents and neuropathology reports. Prevalences of neurodegenerative diagnoses were calculated, and head injury findings were presented for the most common disease entities. During the study period, there were a total of 128 neuropathologically examined cases with suspected or confirmed acute head injuries. Neurodegenerative immunohistochemistry was performed in 57 of them, and a neurodegenerative diagnosis was established in 47 cases. The most prevalent diagnoses were Alzheimer's disease neuropathologic change (ADNPC) (n = 34), cerebrovascular disease (CVD) (n = 34) and Lewy body disease (LBD) (n = 9). Old head injuries were common among cases with any neurodegenerative diagnosis (36.2 %). Of specific findings, subdural haemorrhage and hypoxic-ischaemic neuronal injury had the highest absolute prevalence in cases with ADNPC, although there were no major differences between ADNPC, CVD and LBD. In conclusion, the most prevalent neurodegenerative disease entities in this dataset were ADNPC, CVD and LBD. A history of head injuries was common regardless of the neurodegenerative entity.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102866"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799695","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":"Intimate partner violence in southernouthern Tunisia: A retrospective study of the sociodemographic and medicolegal clinical profile","authors":"Nihel Feki,&nbsp;Rakia Soiniya,&nbsp;Marwa Ouni,&nbsp;Hela Siala,&nbsp;Narjes Karray,&nbsp;Sami Bardaa,&nbsp;Zouhair Hammami,&nbsp;Wiem Ben Amar,&nbsp;Malek Zribi","doi":"10.1016/j.jflm.2025.102855","DOIUrl":"10.1016/j.jflm.2025.102855","url":null,"abstract":"<div><h3>Background</h3><div>Intimate partner violence (IPV) is a significant public health issue that severely affects women's health and well-being in Tunisia. Understanding the socio-epidemiological profiles of IPV victims and perpetrators, along with the medico-legal implications, is essential for developing effective prevention measures.</div></div><div><h3>Methods</h3><div>This was a cross-sectional, retrospective study that analyzed victims of intimate partner violence (IPV) in the Governorate of Sfax, Tunisia, from June 2022 to June 2023. Participants were interviewed face-to-face, and data were collected from medico-legal reports and police records based on the victims' complaints.</div></div><div><h3>Results</h3><div>Our study included 374 suspected IPV victims, 96 % of whom were women with a mean age of 36. Most alleged perpetrators were male, with a significant proportion having a history of alcohol abuse and criminal activity. Physical assault combined with verbal abuse was the predominant form of IPV, often triggered by financial difficulties. The average duration of temporary total disability was 6 days, with 6.9 % of victims at risk for partial permanent disability.</div></div><div><h3>Conclusion</h3><div>This study provides insights into the socio-epidemiological profiles of IPV victims and perpetrators in southern Tunisia. While the findings may underestimate the true prevalence due to underreporting, the adoption of domestic violence legislation represents a significant step forward. By understanding these dynamics, we can develop effective strategies to mitigate the risk of IPV and promote healthier relationships.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102855"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807996","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":"Unidentified: Simulation-based education in forensic odontology","authors":"Ranya Al Ghazi ,&nbsp;Scott McGregor ,&nbsp;Scheila Mânica","doi":"10.1016/j.jflm.2025.102865","DOIUrl":"10.1016/j.jflm.2025.102865","url":null,"abstract":"<div><div>We report on a prototype computer-simulated training programme in dental autopsy entitled <em>Unidentified</em>. This was developed to offer a simulated real-world experience of conducting dental identification procedures as a forensic odontologist. Unidentified is a tool developed as a proof of concept for a single case from an air crash disaster with a running time of 40 min to an hour. Standards of a disaster victim identification (DVI) guide and forms were followed. The game development platform ‘Unreal Engine’ was used by collaborators from a gaming enterprise and academic contributors from a leading institution in game development. Accessibility, practicality, and affordability are advantages of the training. Further developments will make ante-mortem and reconciliation phases available and expand the exercise to mass casualty incidents.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"113 ","pages":"Article 102865"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908041","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":"Mummification – An historical and cultural overview","authors":"Roger W. Byard","doi":"10.1016/j.jflm.2025.102863","DOIUrl":"10.1016/j.jflm.2025.102863","url":null,"abstract":"<div><div>Review was undertaken of historical mummifications which has shown that this process has occurred accidently and deliberately in many cultures globally for millennia in a wide variety of environments. Although Egypt is considered the major source of mummified material, mummification has occurred in Europe, Africa, Asia, Oceania, Greenland and the Americas. Changes to bodies after mummification, with distortion and loss of tissues and organs, present challenges to contemporary investigators who may have difficulties in determining the time, cause and manner of death. A good example of this was the mistaken assessment that Iron Age sacrifices of bodies found in bogs in Denmark represented present day homicides. Modern investigative tools such as conventional radiography, computed tomography (CT), magnetic resonance imaging (MRI), scanning electron microscopy, infrared spectroscopy, endoscopy and X-ray diffraction analysis have provided more accurate and less destructive ways of examining such remains to enable valid scientific analyses to be achieved.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102863"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783678","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":"Unusual autopsy, unusual tissue(s) for DNA, but a useful genetic profile: A case of the DNA profiling from the human tissue of challenged provenance","authors":"Enrica Macorano ,&nbsp;Bianca Beltrame ,&nbsp;Nunzia Ilaria Vacca ,&nbsp;Francesca Vacca ,&nbsp;Giacoma Mongelli ,&nbsp;Gerardo Cazzato ,&nbsp;Aldo Di Fazio ,&nbsp;Francesco Introna","doi":"10.1016/j.jflm.2025.102864","DOIUrl":"10.1016/j.jflm.2025.102864","url":null,"abstract":"<div><div>The autopsy of the non-fresh cadaver is characterized by inherent difficulties in that it requires the adoption of genetic and histological investigation techniques to the specific case. The case that the authors present in this paper concerns the corpse of a young woman who had already been autopsied, then treated with 20 % neutral buffered formaldehyde, a preserving agent, to enable its intercontinental transport, and then autopsied again. At the judge's request, a second judicial autopsy was performed in order to verify the cause of death and to carry out genetic investigations. As fresh tissue was not available to perform the genetic analysis, three different tissue matrices were taken: retina, liver, and iliopsoas muscle. The biological matrices taken were chosen as they were considered less likely to be in contact with formaldehyde and therefore probably less prone to artifacts caused by the action of formalin on the DNA structure. All three biological matrices were used to obtain a genetic profile. In particular, the genetic data obtained from the retina was found to be better than the genetic profile obtained from the iliopsoas muscle. In turn, the genetic profile obtained from the iliopsoas muscle was found to be better than the genetic data obtained from the liver sample.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102864"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768222","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":"“I can’t breathe” – A study of civil litigated cases on prone restraint deaths","authors":"Alon Steinberg ,&nbsp;Dhilan Patel ,&nbsp;Amanda Frugoli","doi":"10.1016/j.jflm.2025.102862","DOIUrl":"10.1016/j.jflm.2025.102862","url":null,"abstract":"<div><h3>Introduction</h3><div>Prone restraint by law enforcement has come under scrutiny due to its association with in-custody deaths and subsequent civil litigation. The true incidence, risk factors, and physiological mechanisms contributing to these fatalities remain poorly understood. This study aims to assess prone restraint-related death occurrences and identify associated risk factors by analyzing legal case records.</div></div><div><h3>Methods</h3><div>This retrospective study examined United States legal records from the National Legal Database, LexisNexis, covering 2010 to 2019. Cases were identified using the MeSH term “prone restraint cardiac arrest.” Data extracted included demographic and case-specific variables such as age, gender, body mass index (BMI), duration of prone restraint, application of additional body weight, race, use of a conducted electrical weapon (CEW), presence of body camera footage, reports of excited delirium, drug intoxication, settlement amounts, and documented statements of “I can't breathe.\"</div></div><div><h3>Results</h3><div>A total of 229 cases met the inclusion criteria for analysis. The majority of subjects (98 %) were male, with an average age at death of 37 years. Among cases with available data, 38 % were African American, 33 % had obesity, and 64 % involved recreational stimulant drug use. In 58 % of cases, death occurred after one to 5 min of prone restraint. Additional body weight was applied in 80 % of cases, while CEWs were used in 39 %. Excited delirium was reported in 31 % of cases. More than 20 % of individuals were recorded saying, “I can't breathe.” The average reported settlement in resolved cases was $2.5 million.</div></div><div><h3>Conclusion</h3><div>This study represents the largest case series of 229 reported prone restraint-related deaths to be reported in the medical literature, yet the true incidence remains uncertain. Further research is essential to better understand the prevalence, contributing risk factors, and potential mitigation strategies. Collaboration among the medical and forensic communities, law enforcement agencies, and policymakers is critical to accurately assess the scope of this issue and implement measures to reduce fatalities associated with prone restraint.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102862"},"PeriodicalIF":1.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859702","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}