Journal of forensic and legal medicine最新文献

{"title":"A critical assessment of the diatom test of rib bone marrow as a supporting procedure in the case of drowning","authors":"Iwona Bogusz ,&nbsp;Marek Bogusz ,&nbsp;Beata Borowska ,&nbsp;Łukasz Szleszkowski ,&nbsp;Joanna Żelazna-Wieczorek","doi":"10.1016/j.jflm.2024.102753","DOIUrl":"10.1016/j.jflm.2024.102753","url":null,"abstract":"<div><p>Diatoms (Bacillariophyta), being single-celled photosynthetic organisms, are widely distributed in aquatic ecosystems around the globe. Their exoskeletons are resistant to most environmental factors as well as chemical reagents in laboratory settings. Moreover, the ornamentation featured on exoskeletons can be used to identify individual diatomaceous species. As a result, the detection of diatoms in the internal organs, and especially rib marrow, of corpses found in water can serve as an important tool for diagnosing drowning as the cause of death as long as passive postmortem penetration of diatoms into those organs is excluded. In the environmental experiments described in this paper, diatoms were detected in rib marrow only when contamination resulted from a mechanical breach of bone integrity and structure, irrespective of the residence time of bone material in the aquatic environment. Our research suggests that the presence of diatom in the rib marrow may be the gold standard in the diagnosis of drowning in the future. Our animal model research dispels one of the doubts, such as the possibility of passive penetration of diatoms into the bone marrow, which is still under discussion in the forensic medicine community.</p></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239480","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":"Risk factor analysis of medical litigation outcomes in obstetrics and gynecology: A retrospective cohort study of 344 claims in Japan","authors":"Kyosuke Kamijo ,&nbsp;Ayako Shibata ,&nbsp;Norio Yamamoto ,&nbsp;Jun Watanabe ,&nbsp;Takashi Watari","doi":"10.1016/j.jflm.2024.102752","DOIUrl":"10.1016/j.jflm.2024.102752","url":null,"abstract":"<div><h3>Aim</h3><div>Medical errors are critical in obstetrics and gynecology (OB/GYN) and contribute to high litigation risks. However, few studies have examined system and diagnostic errors as potential preventable problems. This study aimed to enhance medical safety and reduce litigation by identifying and addressing key contributory factors.</div></div><div><h3>Methods</h3><div>We retrospectively searched the national Japanese malpractice claims database for OB/GYN cases between 1961 and 2017. We evaluated provider characteristics and background information of the patients (plaintiffs). The main outcome was litigation (acceptance or rejection) in the final judgment. Using multivariable logistic regression models, we assessed the associations between medical malpractice variables (system and diagnostic errors, facility size, situation, place, time, and clinical outcomes) and litigation outcomes (acceptance).</div></div><div><h3>Results</h3><div>Overall, 344 malpractice claims were analyzed. Among these, 277 (80.5 %) were obstetric, and 67 (19.5 %) were gynecological. Of the obstetric cases, 193 were perinatal, and 84 were maternal. Malpractice claims were accepted (OB-GYN losses) in 185 cases (53.8 %). In multivariable analyses, system errors (odds ratio 97.4, 95 % confidence interval 35.2–270.0), diagnostic errors (odds ratio 4.5, 95 % confidence interval 1.8–11.3), and clinic (odds ratio 2.7, 95 % confidence interval 1.2–4.8) had a significant statistical association with accepted claims.</div></div><div><h3>Conclusion</h3><div>System errors, diagnostic errors, and clinics were significantly associated with acceptance claims. These findings underscore the necessity of addressing modifiable factors at the physician level and within the healthcare management system to enhance patient safety and reduce litigation risks, thereby ensuring a safer and more reliable healthcare environment for patients and medical professionals.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1752928X24001148/pdfft?md5=1d3a89edb634d6daf5ae67be3cbc306b&pid=1-s2.0-S1752928X24001148-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311326","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":"Three-dimensional visualization of gunshot cavities in ballistic gelatine with computed tomography – A forensic ballistics case study","authors":"Petteri Oura ,&nbsp;Mikael Brix ,&nbsp;Eveliina Lammentausta ,&nbsp;Timo Liimatainen ,&nbsp;Juha Kiljunen ,&nbsp;Alina Junno ,&nbsp;Jaakko Niinimäki ,&nbsp;Juho-Antti Junno","doi":"10.1016/j.jflm.2024.102740","DOIUrl":"10.1016/j.jflm.2024.102740","url":null,"abstract":"<div><p>Three-dimensional (3D) imaging, primarily computed tomography (CT), has proven valuable in the documentation and analysis of gunshot injuries. Explicit visualization of findings may play a pivotal role in judicial settings. This forensic ballistics case study aimed to examine the potential of CT-based 3D reconstruction to digitally visualize gunshot cavities in ballistic gelatine. Three .30 caliber bullets of different types (full metal jacket, soft point, and expanding monolithic) were fired into standardized blocks of 10% ballistic gelatine. The blocks underwent CT scanning with clinical equipment. Gelatine and air were segmented from the CT data using an open-source software. 3D reconstruction views of the segmented gelatine and air components were created. The gunshot cavities were clearly observed in both gelatine and air segmentation. The differences in cavitation between bullet types were evident in both reconstruction approaches, although gelatine segmentation produced higher resolution of small details. The obvious benefit of digital reconstruction was the ability to freely tilt and rotate the 3D images, with the possibility of taking measurements manually or automatically from any plane. Moreover, all the data can be stored for future analysis. This study introduces a preliminary method for digital visualization and documentation of gunshot cavitation in ballistic gelatine, to be fine-tuned and implemented for research purposes and routine practice in forensic institutions.</p></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1752928X24001021/pdfft?md5=26c94dd835839fb85bf2631572116d3c&pid=1-s2.0-S1752928X24001021-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095647","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":"Sudden infantile death due to left ventricular myocardial ischemia associated with undiagnosed single coronary artery of Lipton's type LII-B","authors":"Kyoko Hasuwa ,&nbsp;Hideki Uemura ,&nbsp;Takeshi Kondo ,&nbsp;Shogo Kasuda","doi":"10.1016/j.jflm.2024.102738","DOIUrl":"10.1016/j.jflm.2024.102738","url":null,"abstract":"<div><p>Single coronary artery (SCA) is a rare malformation, particularly in isolation without other congenital heart defects. Here, we describe a case of sudden infantile death due to myocardial ischemia associated with undiagnosed SCA. A 1-year-and-7-month-old female infant died suddenly after vomiting at home. A medicolegal autopsy revealed that the orifice of the right coronary artery (RCA) was absent. As expected, the left coronary artery was detached from the left coronary sinus; however, the ostium was covered with a flap-like fibrous ridge. The thin RCA originated from the left main trunk (LMT) and passed between the aorta and pulmonary artery trunk. The left circumflex artery branched from the LMT at a right angle. Judging from the origin and course of the anomalous RCA, the deceased was diagnosed with SCA of Lipton's type LII-B. Microscopic examination revealed ischemic changes around the endocardium of the lateral wall of the left ventricle (LV) rather than on the side of the abnormal RCA. This evoked attention, as there appeared to be some discrepancy. To the best of our knowledge, this is the first case report describing sudden infantile death related to LV myocardial ischemia associated with undiagnosed SCA of Lipton's type LⅡ-B.</p></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095646","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 machine learning approach for age prediction based on trigeminal landmarks","authors":"Youssef Keyrouz ,&nbsp;Marianne Saade ,&nbsp;Mona Nahas Gholmieh ,&nbsp;Antoine Saadé","doi":"10.1016/j.jflm.2024.102742","DOIUrl":"10.1016/j.jflm.2024.102742","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study was to estimate the chronological age (CA) of a growing individual using a new machine learning approach on Cone Beam Computed Tomography (CBCT).</p></div><div><h3>Materials and methods</h3><p>The dataset included 48 CBCT and hand-wrist radiographs of growing individuals. 12 landmarks related to trigeminal trajectories were plotted on each CBCT and principal component analysis was applied for dimensionality reduction. The estimated CA was obtained using a decision tree. Finally, a genetic algorithm was implemented to select the best set of landmarks that would optimize the estimation. The age was also assessed following Greulich and Pyle's (GP) method on hand-wrist radiographs. The results (GP and Machine Learning) were then compared to the true CA.</p></div><div><h3>Results</h3><p>Among the 12 landmarks, the genetic algorithm selected 7 optimal features, and 12 principal components out of 36. The best results for age prediction were obtained by a combination of genetic algorithm, principal component analysis, and regression tree where the Mean Squared Error (MSE) and Mean Absolute Error (MAE) were respectively 1.29 and 0.92. These outcomes showed improved accuracy compared to those of the hand-wrist method (MSE = 2.038 and MAE = 1.775).</p></div><div><h3>Conclusions</h3><p>A numerical application on a dataset of CBCT showed that the proposed machine learning method achieved an improved accuracy compared to conventional methods and had satisfying performance in assessing age for forensic purposes. Validation of the presented method on a larger and more diverse sample would pave the way for future applications in forensic science as a tool for age prediction.</p></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095643","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 medical child abuse case with spurious bleeding; importance of collecting the evidence","authors":"Hasan Fatih Çakmaklı ,&nbsp;Mehmet Ertem ,&nbsp;Elif Ünal İnce ,&nbsp;Zhala Abdullayeva ,&nbsp;Talia İleri ,&nbsp;Betül Ulukol","doi":"10.1016/j.jflm.2024.102741","DOIUrl":"10.1016/j.jflm.2024.102741","url":null,"abstract":"<div><h3>Background</h3><p>Medical Child Abuse (MCA) is a severe form of child abuse. In MCA, the caregiver abuses the child by exaggerating, fabricating, simulating, or inducing symptoms, and unnecessary, potentially harmful medical care harms the child. Bleeding is one of the most common manifestations of MCA. Diagnosis of MCA is challenging, and late diagnosis may increase the severity and complications. Once suspected, it is essential to apply all relevant methods of investigation to support and confirm the diagnosis, as soon as possible, as late diagnosis increases the risks.</p></div><div><h3>Case presentation</h3><p>An 18-month-old boy was referred to the Pediatric Hematology by the Department of the Emergency with multiple admissions in a 2-week period for recurrent said-to-be bleeding episodes from different sites. Previously, he had been investigated for recurrent bleeding episodes in different hospitals for 4 months. In our center, the review of medical history, examination findings, and laboratory results showed some important inconsistencies leading to suspicion of MCA and the mother as the perpetrator. Then he was hospitalized for close observation. During hospitalization, multiple episodes of said-to-be bleeding were reported by the mother, but active bleeding was never observed by any hospital staff. No bleeding foci were detected in the nose or ears, supporting the diagnosis of MCA. After the file was forwarded to the prosecutor's office, the child was taken for institutional care, and no further bleeding was observed after separation from the mother. DNA, which was obtained from a so-called nosebleed during hospitalization, was analyzed and was reported to belong to the mother, confirming the diagnosis.</p></div><div><h3>Conclusions</h3><p>This case report draws attention to timely diagnoses by focusing on inconsistencies in the history and clinical signs and good clinical practices for the management of MCA, with a special emphasis on collecting evidence, including DNA samples, to confirm the diagnosis and help the legal process.</p></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142088641","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":"Suspicion of needle pricking/spiking in 2022 in Paris, France, an observational study from the Department of Forensic Medicine","authors":"Clément Harmel ,&nbsp;Marc Liautard ,&nbsp;Marjorie Chèze ,&nbsp;Elizabeth Alcaraz ,&nbsp;Noémie Bergot ,&nbsp;Catherine Dang ,&nbsp;Saad Sarraj ,&nbsp;Arame Mbodje ,&nbsp;Charlotte Gorgiard ,&nbsp;Céline Deguette ,&nbsp;Laurène Dufayet","doi":"10.1016/j.jflm.2024.102739","DOIUrl":"10.1016/j.jflm.2024.102739","url":null,"abstract":"<div><h3>Background</h3><p>Needle pricking, the act of being intentionally pricked by an assailant, and needle spiking, the covert injection of substances using a needle, have historical precedents and recently resurfaced in Europe in 2022. This resurgence presented a challenge for emergency and forensic medicine departments.</p></div><div><h3>Methods</h3><p>We conducted a retrospective study in the forensic medicine department of Paris, France, including all patients who consulted for suspected needle pricking/spiking in 2022, following a police report. The study aimed to provide epidemiological data on victims, circumstances, and the results of toxicologic and serological analyses.</p></div><div><h3>Findings</h3><p>Of all assault victims in 2022, patients reporting or suspecting needle pricking/spiking represented 1.2 % of the total (171 cases). Most cases involved women (81.9 %) with a median age of 21.75 years. Incidents often occurred in festive contexts (84.8 %). Over a third of the patients didn't report any symptoms (37.5 %). Amnesia, nausea, and dizziness were common symptoms among those who did. Patients reporting alcohol consumption were more likely to experience symptoms (p &lt; 0.05). Over half of the patients displayed physical examinations consistent with needle pricking, with pricks mostly on their arms. Not all patients underwent toxicologic analyses (30.6 %), but all results were negative. Despite most patients not providing follow-up serology results, all received results were negative.</p></div><div><h3>Interpretation</h3><p>Overall, our data are more suggestive of needle pricking than spiking. Although women were overrepresented, there was no evidence of sexual motivation on the part of the perpetrators. It's possible that the perpetrators wanted to instill fear in the population without a specific goal. This form of violence necessitates preventive measures in festive venues and enhanced efforts to detect psychoactive substance.</p></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095645","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":"Storage of evidence and delayed reporting after sexual assault: Rates and impact factors on subsequent reporting","authors":"D. Kane ,&nbsp;J. Walshe ,&nbsp;D. Richardson ,&nbsp;C. Pucillo ,&nbsp;M. Noonan ,&nbsp;S. Maher ,&nbsp;K. Flood ,&nbsp;M. Eogan","doi":"10.1016/j.jflm.2024.102731","DOIUrl":"10.1016/j.jflm.2024.102731","url":null,"abstract":"<div><h3>Background</h3><p>Sexual assault (SA) is alarmingly prevalent, yet reporting rates remain disproportionately low. Forensic examinations (FE) play a crucial role in both immediate medical care and evidence collection, yet many victims/survivors may not report the crime initially, leading to the loss of vital forensic evidence. The storage of evidence “Option 3″ care alternative provides post-SA care including FE without initial police involvement.</p></div><div><h3>Methods</h3><p>This is a cross-sectional study analysing the attendances of people who chose to store evidence at the Dublin Sexual assault Treatment Unit (SATU) between January 1, 2017 and December 31, 2023.</p></div><div><h3>Results</h3><p>There were 238 storage of evidence FEs (‘Option 3’) performed during the study period, which represented 12.8 % of all FEs. The majority identified as female (89.1 %), with an average age of 26.6 years. 31.9 % attended within 24 h of the incident, and 51.3 % self-referred. Most assaults occurred over weekends (64.7 %), with alcohol consumption reported in 82.2 % of cases and drug-facilitated SA concerns in 20.2 %. Genital injuries were present in 17.9 % of females and 19 % of males.</p><p>Those that availed of storage of evidence (compared with those who initially reported to the police) were significantly more likely to have consumed alcohol (p &lt; 0.001) and the assault was more likely to have occurred indoors (p = 0.002). There was no significant difference in care option choice for those ‘unsure’ of the assault occurrence (p = 0.353).</p><p>Among storage of evidence cases, 20.2 % subsequently reported to the police, with females more likely to report (p = 0.02), while people who were uncertain whether an assault had occurred were less likely to report (p = 0.04). Genital injury (p = 0.822), victim-assailant relationship (p = 0.465), assault location (p = 0.487), and substance consumption (p = 0.332) did not significantly affect subsequent reporting rates.</p></div><div><h3>Conclusions</h3><p>The availability of storage of evidence has afforded people the opportunity to access prompt, responsive SATU care including collection of forensic evidence which may have significant evidential value. This approach provides further opportunity for comprehensive detection of a crime, even if reporting to the police is delayed.</p></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1752928X24000933/pdfft?md5=7ab6ac1fb6270c2e0936959161af4c61&pid=1-s2.0-S1752928X24000933-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918400","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 role of miRNA-21 and hypoxia inducible factor-1 in predicting post mortem interval in cardiac muscles of aluminum phosphide deaths","authors":"Manar A. Ahmad ,&nbsp;Sherien S. Ghaleb ,&nbsp;Amr R. Zaki ,&nbsp;Abeer O. Kamel ,&nbsp;Amir Eid","doi":"10.1016/j.jflm.2024.102726","DOIUrl":"10.1016/j.jflm.2024.102726","url":null,"abstract":"<div><h3>Background</h3><p>The assessment of the postmortem interval (PMI) represents one of the major challenges in forensic pathology. Because of their stability, microRNAs, or miRNAs, are anticipated to be helpful in forensic research.</p></div><div><h3>Objective</h3><p>To see if estimation of PMI is possible using miRNA-21 and Hypoxia-inducible factor-1α (HIF-1α) expression levels in the heart samples from aluminum phosphide toxicity (Alpt).</p></div><div><h3>Methods</h3><p>This was a cross sectional study on 60 post-mortem samples (heart tissues) collected at different intervals during forensic autopsies. The two groups were allocated equally according to the cause of death into Group I (non-toxicated deaths, n = 30): Deaths caused by other than toxicity, and Group II (toxicated deaths, n = 30): Deaths due to Alpt. MDA (Malondialdehyde) and GSH (Glutathione), were measured in heart tissues using ELIZA. MiRNA- 21and HIF-1α expression levels were measured in heart tissues at different PMI using RT-Q PCR. ROC curve for detection of toxicated deaths using miRNA-21 and HIF was carried out.</p></div><div><h3>Results</h3><p>miRNA-21 and HIF-1α expression levels in Alp deaths were up regulated while GSH was downregulated with statistically significant difference. There was positive correlation between miRNA-21, HIF-1α and MDA with PMI while there was negative correlation between GSH and PMI in Alp deaths. In prediction of post mortem interval in Alp deaths miRNA-21 sensitivity and specificity were (75.9 %, 51.7 %, respectively) while HIF-1α sensitivity and specificity were 100 %.</p></div><div><h3>Conclusion</h3><p>PMI can be calculated using the degree to which particular miRNA-21 and HIF-1α are expressed in the heart tissue. The combination of miRNA-21 with HIF-1α in post mortem estimation is precious indicators.</p></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840831","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":"Ethanol concentrations in various biological specimens: Living and postmortem forensic toxicology analysis and comprehensive literature review","authors":"Sahar Y. Issa ,&nbsp;Amr Khattab","doi":"10.1016/j.jflm.2024.102737","DOIUrl":"10.1016/j.jflm.2024.102737","url":null,"abstract":"<div><p>Alcohol use upsurges the risk for many chronic ill-health consequences such as hepatitis, malignancies, and disastrous outcomes like road traffic accidents ending in fatal injuries. Biochemical and toxicological analysis of different body fluids is crucial for identifying the cause of death and postmortem interval in many forensic cases. Blood, urine, and vitreous fluid are the most valuable body fluids for detecting alcohol during any toxicological analysis. Alcohol is responsible for widespread morbidity and mortality worldwide. Blood alcohol concentration (BAC) is a necessary toxicological test to investigate various crime and accident scenes. This study comprehensively explores the demographic characteristics, BAC distribution, and correlations of alcohol concentrations in postmortem and living cases. Postmortem cases (N = 166) reveal intriguing demographic patterns, with notable variations in year distribution, nationality, sex, age groups, occupation, smoking habits, place of death, and psychiatric history. Living cases (N = 483) exhibit distinct demographic profiles, emphasizing differences in year distribution, nationality, sex, age groups, and smoking habits.</p><p>Analysis of BAC distribution reveals diverse patterns in both postmortem and living cases, providing valuable insights into the prevalence of different BAC levels in each group. Correlation analyses unveil strong associations between alcohol concentrations in various biological samples in postmortem cases, highlighting the interdependence of blood, vitreous, and urine alcohol concentrations. Conversely, living cases display a moderate positive correlation between blood and urine alcohol concentrations.</p><p>Comparative analyses showcase significant differences in mean alcohol concentrations between postmortem and living cases, suggesting variations in alcohol metabolism and distribution. These findings underscore the importance of considering temporal factors in interpreting alcohol concentrations in forensic and clinical contexts.</p><p>In conclusion, this study enhances our understanding of alcohol-related incidents by delineating demographic profiles, BAC distributions, and correlations between different biological samples. Such insights are crucial for refining investigative and clinical approaches, contributing to the broader fields of forensic science and public health.</p></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038050","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}