Journal of forensic and legal medicine最新文献

{"title":"The interagency approach in Barbados for an infant with unexplained injuries","authors":"La-Toniá Arthur","doi":"10.1016/j.jflm.2025.102934","DOIUrl":"10.1016/j.jflm.2025.102934","url":null,"abstract":"<div><div>Despite only having one tertiary institution on the island, Barbados has eight other community clinics where free healthcare is obtained and numerous private options where one can access care. Ultimately, any significant or urgent case is referred to the Queen Elizabeth Hospital for further management. In the case of unexplained injuries in an infant, regardless of the route of healthcare access, the interagency approach ultimately involves other key entities. An interagency approach encompasses collaboration among various organizations to address this complex issue. This written work will highlight what works well and discuss the challenges faced when approaching unexplained injuries in an infant.</div><div>The interagency approach in Barbados to the management of an infant with unexplained injuries has the tendency to be a long process that occurs over weeks to months. However, the collaboration and teamwork that occurs between agencies for each case is and admirable feat that often leads to improved circumstances for the child of concern. It is acknowledged that, when compared to first world countries, the time taken for this multidisciplinary approach to garner any plausible result be seem mindboggling but it is a system that leads to thorough assessment of the child's physical state as well as the home circumstances and for that Barbados should be proud. Once the Child Protection Bill is passed in parliament then a greater push can be made at holding persons accountable for non-accidental injury in this country.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102934"},"PeriodicalIF":1.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679675","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":"Contributions of betahydroxybutyrate (BHB) determination and thanatological biochemistry in postmortem diagnosis of ketoacidosis-related fatalities: two case reports","authors":"Aurélien Bauduin ,&nbsp;Chadi Abbara ,&nbsp;Stéphane Malbranque ,&nbsp;Laura Renard ,&nbsp;Donca Zabet ,&nbsp;Séverine Ferec ,&nbsp;Xavier Dieu ,&nbsp;Nathalie Jousset ,&nbsp;Marie Briet ,&nbsp;Guillaume Drevin","doi":"10.1016/j.jflm.2025.102933","DOIUrl":"10.1016/j.jflm.2025.102933","url":null,"abstract":"<div><div>Postmortem biochemical analyses are increasingly recognized as valuable tools to complement traditional forensic investigations, particularly in cases where the cause of death remains unclear after autopsy and toxicological analyses. Among these, the quantification of β-hydroxybutyrate (BHB) in femoral blood (FB) and/or vitreous humor (VH) has proven crucial in identifying fatal ketoacidosis. The authors report two forensic cases in which targeted biochemical markers (including BHB, vitreous glucose, creatinine, and blood HbA1c) were evaluated to support the diagnosis of metabolic fatal metabolic disturbances. The first case involved a 57-year-old man with a known history of mellitus diabetes and chronic alcohol abuse, found deceased at home with postmortem genital mutilations. The second case concerned a 75-year-old diabetic man discovered in a neglected state after several weeks of insulin withdrawal. In both cases, toxicological findings were non-conclusive. However, markedly elevated BHB concentrations were observed in FB and VH, strongly supporting a diagnosis of ketoacidosis. In <em>Case 1</em>, the combination of chronic alcohol abuse together with elevated BHB concentrations in FB and VH suggested alcoholic ketoacidosis (AKA), with possible contribution from underlying diabetic condition. In <em>Case 2</em>, the history of prolonged insulin deprivation, abnormally high vitreous glucose concentration, and markedly increased BHB concentrations in FB and VH were consistent with diabetic ketoacidosis (DKA). Elevated vitreous creatinine and reduced estimated glomerular filtration rate (eGFR) further supported pre-existing renal dysfunction in both cases. These findings highlight the importance of integrating biochemical markers into routine postmortem protocols, as they may provide critical insights into otherwise unexplained deaths.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102933"},"PeriodicalIF":1.2,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679578","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":"PTSD assessments in sexual assault trials in Taiwan: Interdisciplinary Challenges and Implications for Judicial Policy Reform","authors":"Jun-Chien Liu ,&nbsp;Kuan-Ying Hsieh ,&nbsp;Tzu-Hsing Chen","doi":"10.1016/j.jflm.2025.102931","DOIUrl":"10.1016/j.jflm.2025.102931","url":null,"abstract":"<div><div>This study investigates the impact of forensic post-traumatic stress disorder (PTSD) evaluations on judicial outcomes in sexual offense cases in Taiwan, while also analyzing associated risks and proposing potential improvements.</div><div>In light of the limited statistical data and judicial assessments of such reports in Taiwan, the study employs a quantitative research design, analyzing sexual assault rulings from 2020 to 2023 across six district courts (Kaohsiung, Ciaotou, Taichung, New Taipei, Taipei, and Shilin). Additionally, in-depth interviews were conducted with three judges to gather qualitative insights into judicial perceptions of PTSD evaluation reports.</div><div>The results indicate a statistically significant correlation between the presence of PTSD forensic assessments and guilty verdicts. Judges generally recognized the evidentiary value of such reports, though the degree of reliance varied by region. Courts in southern Taiwan (Kaohsiung and Ciaotou) showed higher usage rates, whereas courts in central and northern regions tended to rely more on general medical diagnoses, likely due to limited collaboration with evaluation institutions, budget constraints, and lengthy assessment procedures. Moreover, the structure of Taiwan's National Health Insurance system may contribute to risks of overdiagnosis, potentially affecting the fairness of trials. Based on these findings, the study offers four key recommendations: (1) formal PTSD evaluations by certified institutions for suspected victims; (2) allocation of sufficient resources and budgets for assessments across all jurisdictions; (3) development of a national registry of forensic psychiatric units to support legal practitioners; and (4) enhanced collaboration between judicial and medical institutions to improve case processing efficiency. Limitations regarding sample size and geographic scope are acknowledged, and future research is encouraged to broaden the dataset and explore additional factors influencing judicial decisions, in order to strengthen the institutionalization and application of PTSD assessments in sexual assault litigation.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102931"},"PeriodicalIF":1.2,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781777","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":"Wischnewski spots and ethylene glycol fatal poisoning: a case report","authors":"Emanuele Capasso ,&nbsp;Pascale Basilicata ,&nbsp;Claudia Casella ,&nbsp;Ilenia Bianchi ,&nbsp;Andrea Ronchi ,&nbsp;Gaetano Di Donna","doi":"10.1016/j.jflm.2025.102930","DOIUrl":"10.1016/j.jflm.2025.102930","url":null,"abstract":"<div><div>We present the case of a woman who was found dead in a countryside 11 days after disappearing from home. At the examination of the scene of death a black plastic can of antifreeze fluid was found near the body.</div><div>The autopsy and complementary analysis allowed us to establish that the cause of death was an irreversible cardio-circulatory arrest caused by acute poisoning by the ingestion of ethylene glycol.</div><div>Moreover, the gastric mucosa showed numerous black hemorrhagic spots, histologically diagnosed to be “Wischnewski spots”.</div><div>Therefore, because most of the toxicity of ethylene glycol comes from its acid metabolites, we suggest that the presence of WSs in this case is strictly related to metabolic acidosis, supporting the thesis that acidosis plays a crucial role in the pathogenesis of WSs.</div><div>This is the first paper, to the best of our knowledge, that shows a correlation between ethylene glycol poisoning and Wischnewski spots.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102930"},"PeriodicalIF":1.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634102","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 retrospective survey of legal complaints on cosmetic procedures in Isfahan, Iran","authors":"Arash Ghodousi ,&nbsp;Sosan Sohrabi ,&nbsp;Mehdi Rasti Ardakani ,&nbsp;Alireza Sighari Deljavan ,&nbsp;Sina Ghertasi Oskouei ,&nbsp;Fariba Jokar","doi":"10.1016/j.jflm.2025.102929","DOIUrl":"10.1016/j.jflm.2025.102929","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Iran has one of the world's highest rates of cosmetic procedures, raising concerns about malpractice and related complaints. This study aimed to evaluate the profile and circumstances of legal complaints related to cosmetic procedures in Isfahan to inform preventive strategies.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, all complaints filed at Isfahan's Legal Medical Center between 2008 and 2012 were reviewed. Cases involving alleged negligence in cosmetic procedures and the resulting wergild evaluation were included. Data collected covered incidence, demographic characteristics, and details of complications or undesired outcomes. Statistical analysis was conducted using t-tests and chi-square tests.</div></div><div><h3>Results</h3><div>Among 128 cases analyzed, the mean age of plaintiffs was 35.1 ± 10.0 years, with females comprising 77.3 %. The majority of complaints (43.8 %) were related to cosmetic surgeries; deformity was the most frequently cited reason (50 %). Practitioners were specialists in 48.4 % of cases, non-specialists in 28.1 %, and of undetermined specialty in 23.4 %. Convictions were issued in 52.3 % of cases, including 17.9 % specialists, 38.8 % non-specialists, and 43.3 % with unknown specialty status among convicted practitioners. Both conviction rates and the involvement of non-specialists were significantly higher in cosmetic dental procedures than in other categories (P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Deformity was the most common reason for legal complaints related to cosmetic procedures, with dental procedures contributing substantially to the overall complaint rate. These findings emphasize the importance of enhanced oversight and regulatory control in cosmetic practice.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102929"},"PeriodicalIF":1.2,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679577","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":"Hyperostosis frontalis interna, a clue in the reconstructive identification of skeletons. Epidemiology of an autopsy population at Limoges University Hospital (France)","authors":"Anaïs Du Fayet de la Tour ,&nbsp;Henri Duday ,&nbsp;Christine Couture ,&nbsp;Pierre Raguin ,&nbsp;François Paraf","doi":"10.1016/j.jflm.2025.102928","DOIUrl":"10.1016/j.jflm.2025.102928","url":null,"abstract":"<div><h3>Background</h3><div>Hyperostosis Frontalis Interna (HFI) is a localized thickening of the inner table of the frontal bone, frequently observed in postmenopausal women. Although often overlooked, it may provide valuable information for reconstructive identification in forensic contexts.</div></div><div><h3>Methods</h3><div>We conducted a macroscopic analysis of 195 autopsied individuals at Limoges University Hospital (France) to assess the prevalence of HFI and its associations with age, sex, and medical history.</div></div><div><h3>Results</h3><div>HFI was identified in 13.8 % of cases, with a striking sex disparity: 38.8 % of females presented with HFI compared to only 0.78 % of males (p &lt; 0.0001). A significant association with older age was observed (mean age 66.3 years in HFI-positive vs. 48.4 years in HFI-negative individuals, p &lt; 0.00001). The presence of HFI predicted female sex with a positive predictive value of 96.3 %. A significant association was also found with a history of depression.</div></div><div><h3>Conclusion</h3><div>Although HFI has limited sensitivity, its high specificity and ease of detection make it a useful auxiliary marker in reconstructive identification. It may help narrow the biological profile in cases involving degraded or incomplete remains. Further multicenter studies are needed to validate its forensic utility.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102928"},"PeriodicalIF":1.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604122","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":"Systematic review on age assessment using Schmeling and Kellinghaus scoring of the medial end of the clavicle by various diagnostic imaging techniques","authors":"Swapnil Akhade ,&nbsp;Kiran Akhade ,&nbsp;Lina Bhoyar ,&nbsp;Pankaj Ghormade ,&nbsp;Veena Vaswani","doi":"10.1016/j.jflm.2025.102924","DOIUrl":"10.1016/j.jflm.2025.102924","url":null,"abstract":"<div><div>Estimating age is crucial in legal cases to determine if an individual has reached adulthood, with the medial clavicular epiphysis being the last skeletal part to ossify. X-rays, CT scans, and MRIs are commonly used to assess it, making the evaluation of their accuracy important. This review, adhering to PRISMA guidelines, analyses studies from PubMed, ScienceDirect, and Google Scholar published between 1990 and 2024. Of the 1927 articles initially identified, 32 met the inclusion criteria after screening. Two authors independently conducted the screening process as part of the study selection. A spreadsheet was used for data extraction, and the QUADAS-2 tool was utilized for quality assessment. The study findings indicate that CT scans provide the highest accuracy for age determination in late adolescence and early adulthood due to better imaging resolution. MRI is promising as a non-X-ray alternative, especially when combined with hand/wrist evaluations. Although useful, X-rays have their limitations. Overall, the review suggests that advancing imaging techniques, particularly CT scans, represent the most accurate method for forensic age evaluation from the medial end of the clavicle in late teens and early adolescents, and that establishing population-specific standards is also essential for improving age estimation in forensic and legal contexts.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102924"},"PeriodicalIF":1.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556819","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":"My role as a forensic physician in the COVID-19 pandemic and as President of the Faculty of Forensic & Legal Medicine of the Royal College of Physicians of London","authors":"Margaret Stark","doi":"10.1016/j.jflm.2025.102927","DOIUrl":"10.1016/j.jflm.2025.102927","url":null,"abstract":"","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102927"},"PeriodicalIF":1.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570174","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":"Russian forensic Medicine: Institutional evolution, operational contradictions, and their implications","authors":"Daria Nikitina ,&nbsp;Arina Gegelman ,&nbsp;Ekaterina Khodzhaeva ,&nbsp;Marina Zaitseva","doi":"10.1016/j.jflm.2025.102926","DOIUrl":"10.1016/j.jflm.2025.102926","url":null,"abstract":"<div><div>The article provides the first detailed English-language analysis of the forensic medical system in Russia, exploring its historical development and institutional design. Forensic medical experts in Russia play a crucial role in criminal and civil proceedings. With historical roots in the Russian Empire and the Soviet Union, the current system is built on an integrated and police-based model. Russian forensic medicine ensures professional specialization and standardization, but it faces challenges such as underfunding and excessive workloads. The paper highlights a funding mismatch: regional healthcare authorities are responsible for financing forensic medical services even though the primary beneficiaries are federal law enforcement and the courts. This produces systemic organizational gaps—including resource shortages, outdated infrastructure, and overworked personnel—that affect the quality and efficiency of forensic examinations. By addressing institutional path dependence and the coupling of forensic medicine with judicial and law enforcement systems, the study offers valuable insights for comparative research on forensic practices in post-Soviet countries.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102926"},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549092","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":"Perthe's syndrome in building collapse fatalities: A forensic examination","authors":"Nagendra Singh Sonwani ,&nbsp;Kishor Singh Thakur ,&nbsp;Navneet Ateriya ,&nbsp;Biliana Mileva ,&nbsp;Arvind Kumar","doi":"10.1016/j.jflm.2025.102925","DOIUrl":"10.1016/j.jflm.2025.102925","url":null,"abstract":"<div><h3>Introduction</h3><div>Perthe's syndrome, or traumatic asphyxia, is a rare form of mechanical asphyxia caused by sudden, intense chest compression, leading to cervicofacial congestion, petechiae, and subconjunctival haemorrhages. Despite its forensic significance, limited literature exists on cases resulting from building collapses.</div></div><div><h3>Objective</h3><div>This study examines forensic autopsy findings in victims of a building collapse, highlighting characteristic diagnostic features, pathophysiology, and the role of forensic experts, local authorities, and disaster management teams.</div></div><div><h3>Methods</h3><div>A forensic investigation was conducted on multiple victims who sustained fatal thoracic compression due to a collapsed building following heavy rainfall. Detailed external and internal autopsy findings were recorded, including congestion patterns, petechiae distribution, and associated injuries. The role of first responders and forensic pathologists in determining the cause of death and guiding disaster response was also evaluated.</div></div><div><h3>Observations</h3><div>The autopsies revealed hallmark features of traumatic asphyxia, including cervicofacial congestion, petechiae, subconjunctival haemorrhages, and lung edema. Additional injuries such as rib fractures and intracranial haemorrhages were noted in select cases. The investigation emphasized the need for rapid rescue operations and improved building safety regulations.</div></div><div><h3>Conclusion</h3><div>This study reinforces the importance of forensic pathology in diagnosing traumatic asphyxia and underscores the necessity of coordinated emergency response strategies in structural collapse disasters.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102925"},"PeriodicalIF":1.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517443","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}