Legal Medicine最新文献

{"title":"Fatal acute intoxication after snorting cocaine and fluoxetine","authors":"Alberto Chighine,&nbsp;Giulio Ferino,&nbsp;Matteo Nioi,&nbsp;Ernesto d’Aloja,&nbsp;Emanuela Locci","doi":"10.1016/j.legalmed.2025.102614","DOIUrl":"10.1016/j.legalmed.2025.102614","url":null,"abstract":"<div><div>A case report of a fatal acute intoxication following cocaine and fluoxetine snorting is described here. A 44-year-old woman with an history of drug abuse was found dead at home. On-site evaluation conducted by police highlighted evidence of recent cocaine consumption whereas no tablets or drug blisters were spotted. In the hypothesis of a drug-related crime the local Prosecutor ordered a judicial autopsy.</div><div>Pathological findings were consistent with an acute cardiac failure while toxicological analysis conducted on blood revealed the presence of fluoxetine and cocaine in reportedly fatal concentrations. A blood alcohol concentration of 1.9 g/L was also detected. Nasal swabs were positive for both fluoxetine and cocaine whereas no sign of tablets was spotted in the stomach, which appeared empty.</div><div>Death was hence ascribed to an acute cardiac failure secondary to fluoxetine and cocaine intoxication. To the best of the authors knowledge, this is the first post-mortem report of fluoxetine and its active metabolite norfluoxetine in fatal concentrations following intake by snorting.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"74 ","pages":"Article 102614"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776502","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":"Utility of biomarkers in the postmortem diagnosis of fatal Anaphylaxis: A scoping review","authors":"Bharath Karthikeyan ,&nbsp;Ranjit Immanuel James ,&nbsp;Jefferson Daniel ,&nbsp;Senthil Kumar R ,&nbsp;Benjy Tom Varughese ,&nbsp;Daniel Manoj ,&nbsp;Antony L. Arakkal ,&nbsp;Latif Rajesh Johnson","doi":"10.1016/j.legalmed.2025.102610","DOIUrl":"10.1016/j.legalmed.2025.102610","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosing anaphylactic deaths is a challenging task for forensic pathologists. Although serum tryptase is considered to be a reliable biomarker, there are limitations to it. Thus, there is an urgent need to explore various other potential biomarkers which could be of diagnostic value, along with Tryptase, to diagnose anaphylactic shock at autopsy.</div></div><div><h3>Aim</h3><div>We want to systematically review the accuracy of newer postmortem biomarkers for anaphylaxis, such as chymase or eosinophilic cationic protein. Before embarking on this project, we intend to assess the feasibility of conducting systematic reviews on this topic. and identify any deficiencies in the existing literature to guide research priorities.</div></div><div><h3>Methodology</h3><div>We followed PRISMA guidelines and conducted the search in four databases, namely Medline, Scopus, EBSCO-CINAHL, and TRIP. Rayyan AI software was used to screen the articles.</div></div><div><h3>Results</h3><div>A total of 6112 articles were retrieved from the search, and 5079 articles were screened after removing duplicates. Only 25 articles were finally available as per our inclusion criteria. Studies pertaining to post-mortem tryptase levels were found in large numbers, with two recently done systematic reviews on this topic. The number of studies available on other newer biomarkers was too few. More clinical studies are needed before a <em>meta</em>-analysis can be done. Hence, we could perform only a narrative review on the topic.</div></div><div><h3>Discussion</h3><div>There is a scarcity of literature with definite cutoff levels for markers other than Tryptase. Based on the available studies, it is not possible to do diagnostic accuracy reviews at the moment. Hence, we narrate the usefulness of biomarkers like Immunoglobulin E, Chymase, Carboxypeptidase A3, Diamine Oxidase, Histamine and Eosinophilic Cationic Protein.</div></div><div><h3>Conclusion</h3><div>Based on the available evidence, serum tryptase is recognized as the primary biomarker for the postmortem diagnosis of anaphylactic death, with elevated levels strongly indicating anaphylaxis. Additionally, serum IgE, particularly allergen-specific IgE, is a valuable complementary biomarker. Further research is needed to understand the performance of other biomarkers.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"74 ","pages":"Article 102610"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737826","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":"Forensic identification of rape and murder case based on morphological features of hair: A case report","authors":"Yuhao Yuan ,&nbsp;Zhonghao Yu ,&nbsp;Jiaxin zhang ,&nbsp;Yiling Li ,&nbsp;Zhaoxuan Wang ,&nbsp;Yubei Wang ,&nbsp;Shengxiao Wang ,&nbsp;Yiwu Zhou","doi":"10.1016/j.legalmed.2025.102613","DOIUrl":"10.1016/j.legalmed.2025.102613","url":null,"abstract":"<div><div>In forensic identification, there are many cases of hair poisoning detection and analysis to assist forensic identification, with fewer reported cases using morphological features to assist forensic identification. Herein, we report the case of a 13-year-old girl who had been raped and killed. The body was abandoned in a snowy wilderness and was discovered 5 months later. After an on-site investigation and forensic examination, the case conformed to the characteristics of a homicide, and a strand of hair left on the deceased’s scarf became key evidence. Through morphological methods such as stereomicroscopy, optical microscopy, and scanning electron microscopy, we believe that the hair conformed to the morphological and histological characteristics of pubic hair, which helped clarify the case. Based on this case, we believe that the morphological characteristics of hair are of great significance for forensic identification and that rich morphological observation methods can enhance the evidential value of hair in forensic cases.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"74 ","pages":"Article 102613"},"PeriodicalIF":1.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725413","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":"Generating accurate sex estimation from hand X-ray images using AI deep-learning techniques: A study of limited bone regions","authors":"Paniti Achararit,&nbsp;Haruethai Bongkaew,&nbsp;Thanapon Chobpenthai,&nbsp;Pawaree Nonthasaen","doi":"10.1016/j.legalmed.2025.102612","DOIUrl":"10.1016/j.legalmed.2025.102612","url":null,"abstract":"<div><div>Hand bone structure provides valuable features for sex estimation. This research introduces a novel approach using Artificial Intelligence (AI), specifically Convolutional Neural Networks (CNNs), to classify sex from hand X-ray images, focusing on the diagnostic potential of specific bone regions. We assess CNN performance on different hand skeleton areas, utilize Score-CAM to understand sex-discriminating features, and evaluate advanced CNN architectures. While the Xception model achieved the highest overall accuracy of 83.5% using complete hand X-rays, the InceptionResNetV2 model demonstrated remarkable efficiency by achieving 81.68% accuracy using only the proximal phalanx and metacarpal bones, maintaining a comparable AUC-ROC score of 0.92. Metacarpals of the first and second fingers were identified as key for differentiation. This approach demonstrates the power of AI in skeletal analysis and represents a significant step towards deployable AI tools for forensic and medical sex identification.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"74 ","pages":"Article 102612"},"PeriodicalIF":1.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679055","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":"The age progression technique: Study and evaluation of the results","authors":"Laura Donato ,&nbsp;Rossana Cecchi ,&nbsp;Douglas H. Ubelaker ,&nbsp;Jessika Camatti ,&nbsp;Mark Davis ,&nbsp;Anna Laura Santunione ,&nbsp;Michele Treglia ,&nbsp;Luigi Tonino Marsella","doi":"10.1016/j.legalmed.2025.102611","DOIUrl":"10.1016/j.legalmed.2025.102611","url":null,"abstract":"<div><div>Age progression technique involves a reworking of the photo of a missing person in accordance with the guidelines drawn up by medical sciences on aging. Here we present the age progression of photos of individuals who are not missing persons, so the photos of their current appearance are available. The creation of age progressions in blind starting from photos of them as children made it possible to evaluate the effectiveness of the technique.</div><div>The age progression was carried out based on a photo of Individual A and Individual B. First, the study of the facial features defined the morphology according to the standard classification, then reference images characterized by morphologies consistent with those of the original image were searched for. Thanks to Adobe Photoshop 2023 software, the creation of a collage was made. Finally, the result was compared with the current photo of the individual.</div><div>The analysis of the two age progressions carried out gave different results. In the age progression of Individual A, the morphology of the facial features reveals similarities with slight errors in the comparison with his photo at 19 years old. Regarding the age progression of Individual B’s face, doubts were raised regarding both skin tone and haircut.</div><div>The positive and negative aspects found in these age progressions are of great importance in evaluating the accuracy of the results. Thanks to continuous practice, the age progression technique can be improved so that it can be a real support tool for the search for long-time missing persons.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"74 ","pages":"Article 102611"},"PeriodicalIF":1.3,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642391","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 contribution of seawater in DNA degradation: Comparison of genetic results from skeletal remains affected by different taphonomic conditions in forensic contexts","authors":"Mattia Porcu ,&nbsp;Lorenzo Franceschetti ,&nbsp;Venusia Cortellini ,&nbsp;Lucia Casarino ,&nbsp;Debora Mazzarelli ,&nbsp;Francesco Ventura ,&nbsp;Cristina Cattaneo ,&nbsp;Andrea Verzeletti ,&nbsp;Camilla Tettamanti","doi":"10.1016/j.legalmed.2025.102609","DOIUrl":"10.1016/j.legalmed.2025.102609","url":null,"abstract":"<div><div>In the field of forensic genetics, the examination of compromised biological samples is a common investigative challenge. It is crucial to thoroughly assess the thanatological and taphonomic events affecting human samples for genetic analysis, including the environment surrounding the corpses or the skeletal remains, which, in the present cases, is represented by seawater.</div><div>This study aims to compare different conditions to determine the extent to which cadaveric submersion in seawater affects endogenous DNA, by evaluating the degree of degradation and nucleic acid quantity.</div><div>The samples selected consist of skeletal remains exposed to the marine environment and belonging to two different scenarios. The first context is characterized by a long-term submersion period, while the second involves bones exposed for a short-term period and unexposed ones. The analytical workflow on these remains includes pretreatment, DNA extraction, quantification, STR amplification and fragments analysis.</div><div>The results from the two scenarios were compared through statistical evaluation. It was possible to determine significant differences between the group of bones exposed to the water for an extended period and the two groups of samples originating from the second context. This highlights that prolonged submersion in seawater had preservative effects on the endogenous DNA.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"74 ","pages":"Article 102609"},"PeriodicalIF":1.3,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642446","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 cardiac death, altitude & physical activity: A retrospective analysis from the highest Italian region (Aosta valley)","authors":"V. Bugelli ,&nbsp;B. Guidi ,&nbsp;M. Gherardi ,&nbsp;C.P. Campobasso ,&nbsp;G.D. Aquaro ,&nbsp;A. Maiese ,&nbsp;M.Di Paolo","doi":"10.1016/j.legalmed.2025.102608","DOIUrl":"10.1016/j.legalmed.2025.102608","url":null,"abstract":"<div><div>The purpose of this retrospective study is to determine whether there is a link between high-altitude physical activity and sudden cardiac death (SCD). There is general agreement that no cause-and-effect relationship exists between altitude and SCD. However, altitude along with extreme temperatures could represent additional triggers to mortality over mountains. A series of sudden deaths occurred from 2013 to 2019 in the highest Italian region (Aosta Valley) has been revised. 18 SCDs occurred at altitudes from 1200 up to 3375 m were accounted in total. All hearts were explanted and examined according to the procedural guidelines for SCD as updated by the Association for European Cardiovascular Pathology in 2017. Most of the SCD cases were in males older than 42 years. 12 out of 18 deaths (66.67 %) occurred on the second day above 1500 m and 9 victims (50 %) died while engaged in physical exercise. Macroscopic analysis identified coronary artery disease (CAD) in 10 cases, Cardiac Hypertrophy in 4 out of 18 cases; dilated cardiomyopathy was assessed in one case, and hypertensive cardiomyopathy in one case. Microscopic analysis identified 3 Myocardial Infarction (MI) 1 arrhythmogenic cardiomyopathy of the right ventricle, 7 myocardial scleroses with coronary artery stenosis, 2 fibro-fatty infiltrations of the RV, 1 dilated cardiomyopathy and 1 Cardiac Hypertrophy. Although the small sample size, the results emphasize that altitude does not play a major role in triggering the cardiovascular events that can occur in the mountains.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"74 ","pages":"Article 102608"},"PeriodicalIF":1.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620594","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 impact of postmortem damage on 3D-3D superimposition in the pair-matching of skeletal remains: A cautionary note","authors":"Andrea Palamenghi ,&nbsp;Annalisa Cappella ,&nbsp;Riccardo Solazzo ,&nbsp;Debora Mazzarelli ,&nbsp;Eugenio Cosentini ,&nbsp;Danilo De Angelis ,&nbsp;Chiarella Sforza ,&nbsp;Daniele Gibelli ,&nbsp;Cristina Cattaneo","doi":"10.1016/j.legalmed.2025.102605","DOIUrl":"10.1016/j.legalmed.2025.102605","url":null,"abstract":"<div><div>The influence of incompleteness and fragmentation of skeletal remains on novel methods for pair-matching is still unaddressed.<!--> <!-->For this study 154 innominate bones from 77 male individuals were selected. The bones presented different rates of preservation, which was systematically assessed, including three classes.<!--> <!-->The models were acquired with a stereophotogrammetric device and edited to isolate the iliac region. For each class, the left model was mirrored and superimposed on the right one, and the point-to-point distance of each superimposition was recorded in terms of Root-Mean-Square (RMS) value. Seventy-seven superimpositions between true-matches and 30 superimpositions between mismatches (10 for each class of preservation) were performed. Statistical differences between RMS values of the three classes were investigated with a<!--> <!-->two-way analysis of variance (ANOVA)<!--> <!-->test (p &lt; 0.05).</div><div>ANOVA revealed significant main effects for both “Type of superimposition” (match or mismatch), and “Class of preservation”, both with a p-value &lt; 0.001. Significant differences between matches and mismatches within each level of “Class of preservation” were found (p &lt; 0.001), with matches having significantly lower RMS values compared to mismatches. Overall, the results showed the interaction between the Type of superimposition and Class of preservation, where the preservation state significantly affects the RMS outcome of the superimposition.</div><div>For the first time, this test systematically demonstrated that the RMS distance values of bones affected by postmortem damage differ according to the extent of the damage. Medium to considerable damage intensively affect the performance of the 3D-3D pair-matching, leaving this issue unresolved for future studies.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"74 ","pages":"Article 102605"},"PeriodicalIF":1.3,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549584","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":"Identifying blowfly species using posterior spiracle by Error-rate based morphometrics in third instar larvae","authors":"Tae Mo Kang ,&nbsp;Kyu Jin Youm ,&nbsp;Jieun Park ,&nbsp;Kyung Min Lee ,&nbsp;So Youn Im ,&nbsp;Kwang Soo Ko ,&nbsp;Jinhyuk Choi ,&nbsp;Seong Hwan Park","doi":"10.1016/j.legalmed.2025.102607","DOIUrl":"10.1016/j.legalmed.2025.102607","url":null,"abstract":"<div><div>Necrophagous flies are the first insects to colonize corpses in medicolegal cases, making the identification of their larvae species crucial for the utilization of forensic entomology data. However, morphological species identification of larvae is challenged by issues such as limited species range and difficulty. This study aimed to address the limitations of existing morphological identification methods by developing a straightforward and unified approach for identifying third instar larvae. We devised new classification indices—Angle Between Slits, Distance Between Slits, and Length BiSlits—using three pairs of posterior spiracular slits. Based on the error rate and morphometrics, we developed a classification method called Error-rate Based Morphometrics (EBM). Using the three indices and EBM, we developed a new species identification method.</div><div>This study targeted nine major species of necrophagous Calliphoridae flies found in Korea. Basic statistical data and species identification criteria for the three indices were established using a total of 151 samples from the nine species. Additionally, the accuracy of the species identification method and the significance of the three indices were statistically analyzed.</div><div>The morphological species identification method using EBM demonstrated an accuracy of 92.7% for all species. Additionally, the indices utilized for species identification were confirmed to be significant indicators with low correlation to larval development, as measured by body length.</div><div>This study developed a new species identification method using the classification indices along with EBM. The morphological species identification method for third instar larvae using EBM enable rapid species identification with high-magnification posterior spiracle images.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"74 ","pages":"Article 102607"},"PeriodicalIF":1.3,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620593","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":"Evaluation of acetic acid solution for rehydration of mummified skin tissues","authors":"Kochi Toyomane,&nbsp;Ai Asahi,&nbsp;Satoshi Kubota","doi":"10.1016/j.legalmed.2025.102606","DOIUrl":"10.1016/j.legalmed.2025.102606","url":null,"abstract":"<div><div>Histological characteristics such as transverse striation of skeletal muscle are preserved in mummified tissues compared with autolyzed or putrefied tissues, providing histological or forensic information upon histological analysis. However, processing dried tissue for histological examination is difficult due to its hardness. In addition, the histological architecture may be altered during the dehydration process, leading to alternation of the staining appearance. To overcome these problems, rehydration solutions such as Sandison’s solution have been utilized in both paleohistological and forensic contexts. In this study, we introduce another procedure utilizing acetic acid to rehydrate dried tissue for forensic trace evidence analysis. We prepared mock mummified tissue specimens by drying sliced animal skin tissues to simulate fragmented tissue specimens found at crime scene investigations. Acetic acid treatment improved the staining results efficiently for both hematoxylin-eosin staining and connective tissue staining compared with specimens without rehydration treatments. Notably, even 2-h treatment with acetic acid solution sufficiently improved the staining results, suggesting that acetic acid solution can be used to rapidly analyze fragmented and dried tissues for criminal investigations.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"74 ","pages":"Article 102606"},"PeriodicalIF":1.3,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563694","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}