Journal of forensic and legal medicine最新文献

{"title":"A child fatality as a result of electric shock while Urinating: an example of a rare penis injury","authors":"Ahmet Sedat Dündar ,&nbsp;İsmail Altın","doi":"10.1016/j.jflm.2025.102878","DOIUrl":"10.1016/j.jflm.2025.102878","url":null,"abstract":"<div><h3>Aim</h3><div>This report presents the case examination of a 23-month-old male who died as a result of electric shock after urinating on a 3-way electric socket. It was aimed to contribute to the literature with this case of an extremely rarely seen atypical electricity entry wound in the penis.</div></div><div><h3>Case</h3><div>Seasonal agricultural workers were living together with their families in a tent in a field in the province of Şanlıurfa, on the border of Türkiye with Syria. It was learned that the 23-month-old male child was found lying motionless on the ground on July 17, 2022, due to electric shock as a result of urinating on a 3-way electrric socket in the tent. The child was pronounced dead in the hospital and was transferred to our centre for a medicolegal autopsy to be performed. In the autopsy, an electricity entry wound was determined on the 2nd finger of the right hand and in the periurethral region at the tip of the penis. The histopathological examination of samples taken from these wounds determined findings consistent with electric shock and the consequent thermal effect.</div></div><div><h3>Conclusion</h3><div>There is a need for more widespread education to increase the awareness of parents about the prevention of accidents originating from electrical systems set up in temporary living areas such as tents without sufficient safety precautions having been taken. It can be considered that deaths will be able to be reduced in Türkiye with increased inspections of those who have to live in tents for various reasons.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"113 ","pages":"Article 102878"},"PeriodicalIF":1.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874173","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":"Prognostic value of hepatorenal markers to predict mortality in Paraquat Poisoning: a meta-analysis and retrospective validation","authors":"Harsimran Kaur ,&nbsp;A.S. Prathiksha ,&nbsp;Aieshel Serafin Johnson ,&nbsp;Muhammed Rashid ,&nbsp;Vijayanarayana Kunhikatta ,&nbsp;Pooja Gopal Poojari ,&nbsp;Shankar M. Bakkannavar ,&nbsp;Jayaraj Mymbilly Balakrishnan ,&nbsp;Girish Thunga","doi":"10.1016/j.jflm.2025.102877","DOIUrl":"10.1016/j.jflm.2025.102877","url":null,"abstract":"","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"113 ","pages":"Article 102877"},"PeriodicalIF":1.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878963","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":"Patterns of suicide by jumping from height in Northern Tunisia: a 16-year autopsy study","authors":"Ikram Kort ,&nbsp;Ons Hmandi ,&nbsp;Syrine Azza Manoubi ,&nbsp;Khaled Bchir ,&nbsp;Mohamed Bellali ,&nbsp;Mohamed Allouche","doi":"10.1016/j.jflm.2025.102881","DOIUrl":"10.1016/j.jflm.2025.102881","url":null,"abstract":"<div><h3>Background</h3><div>Suicide by jumping from height is a violent and relatively common method of suicide. There is little data on suicide by jumping from height in the Arab region and North African countries. In this study, we aim to analyze the patterns of suicide by jumping from height in Northern Tunisia.</div></div><div><h3>Methods</h3><div>Autopsy records of all cases of suicide by jumping from height were included over a period of 16 years (January 2005 to December 2020). The collected data included epidemiological characteristics, medical history and autopsy observations.</div></div><div><h3>Results</h3><div>we collected a total of 147 cases of suicide by jumping from height. Among the cases, 69.4 % were men. The average age of the cases was 41.8 <strong>±</strong> 16.4 years (range 15–85 years). A history of psychiatric disorder was reported in 58.5 % of cases. Schizophrenia was the most common psychiatric diagnosis (23.8 %), followed by depression (13.6 %). Among the cases, 27.9 % had a history of previous suicide attempt. The suicidal fall occurred most frequently in a private residence (70.8 %). The average height of the falls was 10.4 ± 7.3 m (range 2–50 m). The most frequent injury site was determined to be the head (70.1 %) followed by the chest (68 %), the spine (56 %). Skeletal trauma mainly included fractures of the ribs (75.5 %), the spine (56 %), the skull (53.5 %) and the pelvis (29.3 %).</div></div><div><h3>Conclusions</h3><div>Suicide by jumping from height is most common in young unemployed men, with psychiatric history, who jump from a private residence. This pattern would help planning preventive strategies.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102881"},"PeriodicalIF":1.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864938","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":"Assessing the importance of post-mortem interval and other variables on the analysis of ethanol in the vitreous humour with a focus on ethyl glucuronide and ethyl sulfate: A critical review","authors":"Beatrice Benedetti ,&nbsp;Matteo Marti ,&nbsp;Franco Tagliaro ,&nbsp;Fabio De-Giorgio","doi":"10.1016/j.jflm.2025.102876","DOIUrl":"10.1016/j.jflm.2025.102876","url":null,"abstract":"<div><div>Vitreous humour is used to assess intoxication at the time of death due to its anatomical isolation, which reduces contamination risk. Toxicological analysis typically includes drugs and alcohol. For interpreting post-mortem ethanol concentrations, distinguishing between ante-mortem ingestion and post-mortem production from putrefaction is essential. For this purpose, biomarkers like ethyl glucuronide (EtG) and ethyl sulfate (EtS) are crucial for confirming alcohol consumption.</div><div>Factors such as post-mortem interval (PMI), the cause of death, individual characteristics like sex, age, body mass index (BMI), ambient temperature at corpse discovery, and body storage temperature may affect vitreous humour analysis. The present review explores how these factors have been integrated into the current scientific discussion on the quantification of ethanol, EtG and EtS in vitreous humour, and how they ultimately impact the determination of the cause of death.</div><div>Our findings indicate that the PMI is often unspecified in reviewed cases (64 %), and when mentioned, it is under 24 h (17 %). Individual characteristics like sex, age, and BMI are frequently omitted (43 %, 46 %, and 86 %, respectively), and details on ambient and storage temperatures are rarely provided. Although post-mortem alterations in ocular anatomy are well-documented, there are limited studies that report ethanol stability in vitreous humour across various PMIs. For EtG and EtS, no studies have evaluated quantitative changes in vitreous humour in relation to PMI. Despite these data gaps, available studies suggest that age and BMI may influence the analysis of ethanol in cases of alcohol-related deaths, underscoring the need for further research on factors affecting substance levels in vitreous humour.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"113 ","pages":"Article 102876"},"PeriodicalIF":1.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877534","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":"Validation of an in-house Dutch Forensic Death Coding system (FDC)","authors":"V. Soerdjbalie-Maikoe ,&nbsp;E.H.W. Hendriks ,&nbsp;H.G.T. Nijs ,&nbsp;I. Alberink ,&nbsp;W.L.J.M. Duijst","doi":"10.1016/j.jflm.2025.102856","DOIUrl":"10.1016/j.jflm.2025.102856","url":null,"abstract":"<div><h3>Background</h3><div>The International Classification of Diseases (ICD-11), developed by the WHO, is widely used to code and classify causes of death. While it is a suitable system for clinical data, it is not tailored for forensic diagnoses. This article explores the basic principles and methods for classification of cause of death in a forensic setting. An in-house Dutch coding system, the FDC system, was developed in the Netherlands.</div></div><div><h3>Purpose</h3><div>To determine the validity and applicability of the FDC system.</div></div><div><h3>Methods</h3><div>The FDC system was used to code 138 deaths based on the forensic autopsy reports of the Netherlands Forensic Institute. This was performed by three investigators (one forensic pathologist and two forensic physicians, all of whom are forensic experts) to compute the inter-investigator agreement using Krippendorff's alpha (kalpha) statistics. To measure the intra-investigator agreement, 46 cases per investigator (for each investigator different cases) were presented twice in random order. The coding system has five parameters: Main category, Subcategory, Other contributing factor category, Mode of death category, and Certainty of death category.</div></div><div><h3>Results</h3><div>The Krippendorff's alphas (kalphas) for the inter-investigator agreement were as follows: Main category 0.91, Subcategory 0.74, Mode category 0.49 and Certainty category 0.55. Inter-investigator agreement showed high kalpha scores for both Main category and Subcategory.</div><div>There was a good intra-investigator agreement. The kalphas were as follows: Main category 0.95, Subcategory 0.87, Mode category 0.65, and Certainty category 0.78.</div></div><div><h3>Conclusion</h3><div>The FDC system is an in-house Dutch system that is useful for coding causes of death from a forensic perspective. This system could make the notation of forensic pathologists and forensic physicians less ambiguous, which could improve the understanding of cases by professionals such as public prosecutors, lawyers and judges who have to make decisions based on autopsy reports. In the future, this system could also be used in forensic medicine by forensic physicians and for (forensic) mortality reporting in public health statistics.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"113 ","pages":"Article 102856"},"PeriodicalIF":1.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899193","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":"Electrifying evidence: Ten years of fatal encounters with electricity at Tygerberg mortuary","authors":"Faith Beukes,&nbsp;Zandré Smith,&nbsp;Candice Wilscott-Davids,&nbsp;Ilze Mentoor","doi":"10.1016/j.jflm.2025.102875","DOIUrl":"10.1016/j.jflm.2025.102875","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to determine the prevalence of electrical fatalities in the Eastern Metropole of the City of Cape Town from 2013 to 2022. It explores demographic, geographic, and seasonal patterns, circumstances surrounding death, and pathological findings to understand the nature of these fatalities comprehensively. This study can provide insights to assist governmental agencies in enhancing safety awareness and developing effective strategies to prevent electrical-related fatalities.</div></div><div><h3>Methods</h3><div>A retrospective descriptive study was conducted and included all cases of electrocution-related deaths admitted to Tygerberg Forensic Pathology Services Mortuary from January 1, 2013 to December 31, 2022.</div></div><div><h3>Results</h3><div>One hundred and forty-five cases were included in this study, with an annual prevalence between 0.09 % and 0.76 %. Electrical fatalities mostly occurred in 20-39-year-olds (59.7 %) and children under 10 (17.2 %), with males (88.9 %) predominantly affected. Most incidents occurred in summer (33.8 %) and December (13.10 %), often outdoors, with illegal connections being the main source of electricity. Geographically, Khayelitsha and Mfuleni reported the highest number of cases. Entrance wounds were primarily on the hands, while exit wounds were commonly on the feet and chest. Most fatalities had abrasions (52.8 %), and histopathology revealed streaming of nuclei in the basal layer of the skin and coagulative necrosis as prevalent findings. Most cases were ruled accidental (97.9 %), and medical intervention was needed in 25.5 %.</div></div><div><h3>Conclusions</h3><div>This study reveals the prevalence and descriptive profile of electrical fatalities in the Eastern Metropole of the City of Cape Town, highlighting the urgent need for targeted prevention strategies in identified high-risk areas and during peak times. By improving safety measures and enhancing public awareness, we can effectively reduce these preventable electrical fatalities. A collaborative approach involving governmental agencies, community organizations, and the public is crucial in fostering a safer environment and safeguarding lives.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102875"},"PeriodicalIF":1.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859703","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":"Femicide in Ireland 2012–2023","authors":"Kate McGoldrick ,&nbsp;SallyAnne Collis ,&nbsp;Linda Mulligan","doi":"10.1016/j.jflm.2025.102858","DOIUrl":"10.1016/j.jflm.2025.102858","url":null,"abstract":"","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"112 ","pages":"Article 102858"},"PeriodicalIF":1.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859704","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":"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}