Journal of forensic and legal medicine最新文献_第4页

Fatal acute methotrexate intoxication resulting from medication error in a rheumatoid arthritis patient: a case report 致死性急性甲氨蝶呤中毒导致的用药错误在类风湿关节炎患者：一个案例报告。

IF 1.2 4区医学

Journal of forensic and legal medicine Pub Date : 2026-05-01 Epub Date: 2026-04-24 DOI: 10.1016/j.jflm.2026.103159

Xiangting Gao , Zhonghao Yu , Yuhao Yuan , Jiaxin Zhang , Longda Ma , Ying Dong , Yiwu Zhou

{"title":"Fatal acute methotrexate intoxication resulting from medication error in a rheumatoid arthritis patient: a case report","authors":"Xiangting Gao , Zhonghao Yu , Yuhao Yuan , Jiaxin Zhang , Longda Ma , Ying Dong , Yiwu Zhou","doi":"10.1016/j.jflm.2026.103159","DOIUrl":"10.1016/j.jflm.2026.103159","url":null,"abstract":"<div><div>Methotrexate (MTX) has long been a first-line anti-rheumatic agent due to its efficacy and cost-effectiveness. While generally safe at the recommended weekly dosage of 5–25 mg for rheumatoid arthritis, medication errors can lead to acute toxicity, severe adverse effects, and potentially fatal outcomes. We report a case of a 51-year-old male who experienced fatal pancytopenia following an MTX medication error during treatment for rheumatoid arthritis. His blood MTX concentration measured 0.04 μmol/L 11 days after discontinuation. Postmortem examination revealed MTX-related toxicity in multiple organs, including the liver and intestines. The spleen showed a prominent increase in plasma cells, including numerous Mott cells. Forensic analysis established the cause of death as acute MTX intoxication, directly stemming from a chain of medical negligence involving prescribing, verification, and administration failures. This case underscores the necessity of rigorous therapeutic drug monitoring, individualized dosing, and robust systemic safeguards to prevent iatrogenic fatalities, highlighting its critical medicolegal and educational implications for forensic and clinical practice.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"120 ","pages":"Article 103159"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792932","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

Enhancing forensic DNA recovery: Addressing gaps in washing treatment studies 加强法医DNA恢复：解决清洗处理研究中的差距。

IF 1.2 4区医学

Journal of forensic and legal medicine Pub Date : 2026-05-01 Epub Date: 2025-10-15 DOI: 10.1016/j.jflm.2025.103010

Yihang Wang , Baowen Cheng

引用次数: 0

Invisible harm after lethal violence: Victims of homicide by offenders with mental disorders 致命暴力后的无形伤害：精神障碍罪犯杀人的受害者

IF 1.2 4区医学

Journal of forensic and legal medicine Pub Date : 2026-05-01 Epub Date: 2026-05-21 DOI: 10.1016/j.jflm.2026.103173

Josep Maria Tamarit, Laura Arantegui-Arràez, Alba Marsol-Gutiérrez

{"title":"Invisible harm after lethal violence: Victims of homicide by offenders with mental disorders","authors":"Josep Maria Tamarit, Laura Arantegui-Arràez, Alba Marsol-Gutiérrez","doi":"10.1016/j.jflm.2026.103173","DOIUrl":"10.1016/j.jflm.2026.103173","url":null,"abstract":"<div><div>In examining the relationship between mental disorder and criminal behavior, the research agenda has shifted substantially from a paradigm of dangerousness to one centered on victimization. However, the impact of homicides perpetrated by individuals with mental disorders on victims—particularly regarding limited access to justice and reparation—has remained largely absent from victimological research. Through a review of 2586 homicide cases adjudicated by Spanish courts, of which 278 (10.75%) involved perpetrators with mental disorders, the distinctive characteristics of these cases were examined. Most involved lethal attacks against family members, with 26.1% constituting parricides. A key finding was that these victims received compensation in only a small number of cases, a disadvantage largely attributable to the intrafamilial nature of most incidents. A further shift in the victimization paradigm may therefore redirect attention toward the specific characteristics of this form of victimization—frequently experienced within the perpetrator's immediate family circle—and promote a more preventive, victim-oriented institutional and professional response to such cases.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"120 ","pages":"Article 103173"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147995874","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

Diagnostic pitfalls in zip tie ligature strangulation: Findings from a 16-case series and literature review 拉链勒绳绞杀的诊断缺陷：来自16例系列和文献回顾的发现。

IF 1.2 4区医学

Journal of forensic and legal medicine Pub Date : 2026-05-01 Epub Date: 2026-04-20 DOI: 10.1016/j.jflm.2026.103130

Ingo von Both

{"title":"Diagnostic pitfalls in zip tie ligature strangulation: Findings from a 16-case series and literature review","authors":"Ingo von Both","doi":"10.1016/j.jflm.2026.103130","DOIUrl":"10.1016/j.jflm.2026.103130","url":null,"abstract":"<div><div>This study describes 16 deaths from Alberta, Canada, caused by ligature strangulation using self-locking zip tie(s), also known as cable ties. All decedents were male, and all ligatures were horizontally oriented. The manner of death was classified as suicide in 15 cases and undetermined in one. Notably, one quarter of cases lacked petechiae, explained by the highly constrictive nature of zip ties and their ratchet locking mechanism. In half of the cases, neck compression resulted from a single ligature formed by one heavy-duty zip tie (6 cases) or several smaller zip ties interconnected to create one ligature (2 cases). The remaining half of the cases involved multiple zip tie ligatures. Most cases (14/16) demonstrated congestion of the head and neck above the ligature mark, occasionally accompanied by ear or nose bleeding. Review of previously published cases revealed similar findings, except for one reported double homicide involving an adult female and her child, a vulnerable population as further corroborated by several news stories. This study emphasizes the importance of recognizing the unique properties of zip ties, particularly their ratchet mechanism, when evaluating ligature strangulation. Without such awareness, the absence of petechiae or congestion may lead to diagnostic uncertainty and the mistaken assumption that neck compression did not contribute to death. One case involving an elderly male showed neither congestion nor petechiae, raising the possibility of reflex cardiac arrest triggered by carotid sinus stimulation.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"120 ","pages":"Article 103130"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848025","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

Continuous hymenal rim following first Penile–Vaginal intercourse: A case series and review 第一次阴茎-阴道性交后连续的处女膜边缘：一个病例系列和回顾

IF 1.2 4区医学

Journal of forensic and legal medicine Pub Date : 2026-05-01 Epub Date: 2026-04-17 DOI: 10.1016/j.jflm.2026.103146

Mohanad Jaber , Alaa R. AL-Ihribat

{"title":"Continuous hymenal rim following first Penile–Vaginal intercourse: A case series and review","authors":"Mohanad Jaber , Alaa R. AL-Ihribat","doi":"10.1016/j.jflm.2026.103146","DOIUrl":"10.1016/j.jflm.2026.103146","url":null,"abstract":"<div><h3>Background</h3><div>The hymen has long been symbolically associated with virginity, particularly in conservative societies. However, from a medical and anatomical standpoint, the presence of an intact hymen is not a reliable indicator of sexual history.</div></div><div><h3>Objective</h3><div>To document and analyze seven clinical cases in which women presented with intact hymens following consensual first sexual intercourse, and to compare these findings with the existing scientific literature.</div></div><div><h3>Methods</h3><div>Seven women between ages 19–23 presented to a forensic medicine clinic between January 2024 and May 2025. All underwent detailed clinical examination with documentation. A literature review was conducted using PubMed and Scopus.</div></div><div><h3>Results</h3><div>All patients demonstrated estrogenized hymens with a central orifice and a continuous hymenal rim, without complete posterior transection, despite reported penile–vaginal penetration. Examination revealed structural patterns that support distension without rupture.</div></div><div><h3>Conclusion</h3><div>Hymen integrity is anatomically variable and does not confirm or negate previous sexual activity. Misconceptions about its role in determining virginity must be challenged through education, legal reform, and forensic objectivity.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"120 ","pages":"Article 103146"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803183","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

The natural history of paraquat-associated stomatitis: A four-stage model 百草枯相关性口炎的自然历史：一个四阶段模型。

IF 1.2 4区医学

Journal of forensic and legal medicine Pub Date : 2026-05-01 Epub Date: 2026-04-24 DOI: 10.1016/j.jflm.2026.103161

Rooban Thavarajah , Anusa Arunachalam Mohandoss

{"title":"The natural history of paraquat-associated stomatitis: A four-stage model","authors":"Rooban Thavarajah , Anusa Arunachalam Mohandoss","doi":"10.1016/j.jflm.2026.103161","DOIUrl":"10.1016/j.jflm.2026.103161","url":null,"abstract":"<div><h3>Background</h3><div>Paraquat-associated stomatitis (PAS) is a poorly characterized feature of paraquat poisoning and is presented as a binary finding. Despite its diagnostic potential, its evolution and prognostic value remain undefined. This pooled individual-patient analysis aimed to delineate the natural history of PAS and develop a structured, clinically applicable staging system.</div></div><div><h3>Methods</h3><div>Data from 170 published paraquat poisoning cases were aggregated at the individual-patient level. Variables included exposure-to-symptom interval, lesion morphology, topography, and survival outcome. Temporal and morphological patterns were analyzed using statistical tests to identify predictors of severe mucositis and mortality.</div></div><div><h3>Results</h3><div>Analysis of 170 cases revealed PAS in 78.8% of patients. Lesion severity and distribution followed a predictable, time-dependent progression. Severe mucositis (WHO Grade 3–4) increased from 13.9% in patients presenting within 6 h to 58.3% in those presenting at 1–3 days (p = 0.027). Anatomically, early presentations (≤6 h) were characterized by focal involvement, predominantly on the tongue (35.8%). With increasing treatment delay, lesions progressed to a multifocal and diffuse pattern, significantly involving the buccal mucosa (Absolute Risk Difference, ARD: 55.6%; p = 0.049) and oropharynx/oesophagus. A strong association existed between severe PAS and systemic complications like acute kidney injury. These patterns formed a four-stage model (Contact-Caustic, Reactive-Inflammatory Spread, Established Ulcerative/Systemic Coupling, Necrotic-Complicative), providing a structured framework for clinical staging and prognosis of PAS.</div></div><div><h3>Conclusion</h3><div>PAS follows a predictable, time-dependent four-stage evolution—reflecting progressive mucosal and systemic toxicity. This structured model provides a reliable framework for diagnosis, prognostication, and forensic timing of paraquat exposure.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"120 ","pages":"Article 103161"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792906","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

AgeMiner: A novel metadata-integrated chronological age predictor based on bone mineral density data AgeMiner：一种基于骨密度数据的新型元数据集成实足年龄预测器。

IF 1.2 4区医学

Journal of forensic and legal medicine Pub Date : 2026-05-01 Epub Date: 2026-04-17 DOI: 10.1016/j.jflm.2026.103149

Fanzhang Lei , Yuanyuan Wang , Xi Yuan , Chengkai Wu , Jing Fu , Chen Mao , Bofeng Zhu

{"title":"AgeMiner: A novel metadata-integrated chronological age predictor based on bone mineral density data","authors":"Fanzhang Lei , Yuanyuan Wang , Xi Yuan , Chengkai Wu , Jing Fu , Chen Mao , Bofeng Zhu","doi":"10.1016/j.jflm.2026.103149","DOIUrl":"10.1016/j.jflm.2026.103149","url":null,"abstract":"<div><div>The estimation of chronological age based on bone mineral density (BMD) metrics for specific anatomical sites is a critical task in forensic anthropology. Although dual-energy X-ray absorptiometry (DXA) scans of the distal 1/3 of radius and ulna are widely used in large-scale osteoporosis screenings, forensic studies leveraging such data remain scarce. This study utilized a retrospective dataset (spanning ages 12-96) of 5,134 DXA scans from the distal 1/3 radius and ulna. We analyzed these DXA scans with metadata, including sex, body mass index (BMI), and osteoporosis diagnoses, to train machine learning models. Linear regression (LR), support vector regression (SVR), random forest regression (RFR), XGBoost (XGB), and LightGBM (LGBM) models were optimized via Bayesian cross-validation. Results indicate that the simplest model constructed solely based on <em>BMD data + Diagnoses</em> showed good performance with a mean absolute error (MAE) of 2.40 years. The best-performing model was the RFR model built using the combination of <em>Female + Diagnoses</em>, with an MAE of 2.18 years. When only considering BMI, the best model was the RFR model for the <em>Normal weight + Diagnoses</em> combination, with an MAE of 2.54 years. These models have been integrated into the AgeMiner tool (<span><span>https://github.com/Rarapie/AgeMiner</span><svg><path></path></svg></span>), allowing forensic users to select the optimal model according to metadata of the tested person, thereby enabling fast and end-to-end chronological age estimation. In summary, AgeMiner and its integrated ML models provide an efficient, accurate, and customizable tool for forensic age estimation in adults and the elderly.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"120 ","pages":"Article 103149"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848003","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

Forensic evaluation of variations in Digital Fingerprint Ridge Density (FPRD) in Gujarati ethnicity 古吉拉特族数字指纹脊密度（FPRD）变化的法医鉴定

IF 1.2 4区医学

Journal of forensic and legal medicine Pub Date : 2026-05-01 Epub Date: 2026-04-27 DOI: 10.1016/j.jflm.2026.103157

Utsav Parekh, Sanjay Gupta, Prashant Ratadiya

引用次数: 0

Skin colour, injury rates and sexual violence. Time to even the playing field. A retrospective analysis of 292 forensic medical records 肤色，受伤率和性暴力。是时候公平竞争了。292份法医病历的回顾性分析。

IF 1.2 4区医学

Journal of forensic and legal medicine Pub Date : 2026-05-01 Epub Date: 2026-04-24 DOI: 10.1016/j.jflm.2026.103143

Catherine White , Sarah DeConinck , Rachel Harris , Katie Lawton , Glen P. Martin , Nicola Murray , Farah Yusuf , Rabiya Majeed-Ariss

引用次数: 0

A comprehensive review of structural risk assessment tools for detecting violent recidivism 对检测暴力累犯的结构性风险评估工具进行全面审查。

IF 1.2 4区医学

Journal of forensic and legal medicine Pub Date : 2026-05-01 Epub Date: 2026-04-24 DOI: 10.1016/j.jflm.2026.103162

Aratrika Roy, Priyanka Verma

引用次数: 0