Legal Medicine最新文献

Prevalence and analysis of Amussat’s, Martin’s and Simon’s signs in suicide by hanging in socio-demographic context in the Poznan metropolitan area and surrounding provinces in Poland in 2007–2022 2007-2022年波兰波兹南大都市区及周边省份社会人口背景下上吊自杀中Amussat、Martin和Simon症状的流行及分析

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-06-12 DOI: 10.1016/j.legalmed.2025.102656

Piotr Adamski , Marta Golik , Piotr Kawalec , Maria Krzemińska , Julia Malinowska , Sandra Przybysz , Jan Radomski , Szymon Rzepczyk, Klaudia Dolińska-Kaczmarek, Paweł Świderski, Czesław Żaba, Bartosz Burchardt

{"title":"Prevalence and analysis of Amussat’s, Martin’s and Simon’s signs in suicide by hanging in socio-demographic context in the Poznan metropolitan area and surrounding provinces in Poland in 2007–2022","authors":"Piotr Adamski , Marta Golik , Piotr Kawalec , Maria Krzemińska , Julia Malinowska , Sandra Przybysz , Jan Radomski , Szymon Rzepczyk, Klaudia Dolińska-Kaczmarek, Paweł Świderski, Czesław Żaba, Bartosz Burchardt","doi":"10.1016/j.legalmed.2025.102656","DOIUrl":"10.1016/j.legalmed.2025.102656","url":null,"abstract":"<div><div>Hanging is the most common method of suicide worldwide and is characterized by a high mortality rate. The purpose of this study is to determine the incidence of Martin’s, Amussat’s, and Simon’s signs in hanging cases and to investigate the epidemiology of suicide by hanging. Amussat’s sign is a transverse laceration of the intimal layer of carotid arteries, Martin’s sign is definied as a hematoma in the adventitia of the carotid arteryand Simon’s sign is a haemorrhage into the anterior surface of the intervertebral discs of the lumbar region. Study analyzed 6072 autopsy protocols performed between 2007 and 2022 in the Department of Forensic Medicine of Poznan University of Medical Sciences, of which 367 were cases of suicide by hanging, that meet the inclusion criteria. The analysis took into account: age, gender, place of death, month and year of death, and presence of typical post-mortem signs of hanging. In this study, there was no clear trend in mortality due to suicides by hanging. Men more often committed suicide by hanging than women (84,7%). The average age is 44 years. The results suggest that in more than half of the deaths resulting from suicide hangings, the postmortem examination did not reveal any of the three symptoms studied, and Simon’s sign is the most common. Simon’s symptom occurred more frequently among younger people and men. Moreover, Simon’s sign was more often identified in cases revealed in the public space in summer.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"76 ","pages":"Article 102656"},"PeriodicalIF":1.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308137","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

Pattern, characterization and outcomes of blunt and penetrating cardiothoracic injuries. A medico-legal comparative study 钝性和穿透性心胸损伤的模式、特征和结果。医学与法律的比较研究

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-06-08 DOI: 10.1016/j.legalmed.2025.102654

Heba Ibrahim Lashin , Nadia Ezzat Helal , Mai Mohammed Mahran , Asmaa Fady Sharif

{"title":"Pattern, characterization and outcomes of blunt and penetrating cardiothoracic injuries. A medico-legal comparative study","authors":"Heba Ibrahim Lashin , Nadia Ezzat Helal , Mai Mohammed Mahran , Asmaa Fady Sharif","doi":"10.1016/j.legalmed.2025.102654","DOIUrl":"10.1016/j.legalmed.2025.102654","url":null,"abstract":"<div><div>Cardiothoracic injuries are crucial aspect of traumatology, resulting in significant morbidities and mortalities. Little is understood about the interrelationship between mechanism of trauma, and the associated outcomes. This work aimed to investigate the association between the mechanism of trauma and the induced pattern of injuries, as well as their association with adverse outcomes, namely mortality and the need for mechanical ventilation (MV). The current study is a prospective cohort study involving 229 patients diagnosed with acute cardiothoracic injuries. This work reveals an overall mortality of 22.3%, while 42.4% needed MV. Exsanguination was the leading cause of death, followed by respiratory failure. Cardiac, great vessels, and other mediastinal injuries, as well as diaphragmatic injuries, were significantly higher in penetrating trauma. Though blunt trauma was primarily unintentional, they are graver and more lethal than penetrating ones, denoted by significantly higher injury severity score, need for MV (49.6% vs. 32.3%), and mortality (28.6% vs. 13.5%). Cardiac injuries significantly predicted death and MV (<em>P</em> < 0.05). Other significant mutual predictors of mortality and MV were blunt trauma, diaphragmatic injuries, hemothorax and hemopericardium, facial and intracranial injuries (subdural hemorrhage), and clavicular fractures. Two proposed models explained 74.6% and 60.5% of variances in probability of mortality and MV, respectively. Those models demonstrated high accuracy, above 89.21%. The proven association between the mechanism of trauma and pattern of injuries, as well as the need for MV and death, warrants precise interpretation and rapid response in various settings to improve outcomes for patients affected with cardiothoracic trauma.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"76 ","pages":"Article 102654"},"PeriodicalIF":1.3,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240517","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

Increased expression of calpain-1 and −2 within cardiac mitochondria and adjacent to the contraction bands in rat myocardium after 14-day cocaine administration: A preliminary study 给药14天后，大鼠心肌心肌线粒体内和收缩带附近calpain-1和- 2表达增加：一项初步研究

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-06-03 DOI: 10.1016/j.legalmed.2025.102651

Shuheng Wen, Toshihiko Aki, Kana Unuma

引用次数: 0

Determination of multiple psychostimulants and antipsychotics in postmortem dried blood spot samples by liquid chromatography–tandem mass spectrometry 液相色谱-串联质谱法测定死后干血斑样品中多种精神兴奋剂和抗精神病药物

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-06-03 DOI: 10.1016/j.legalmed.2025.102650

Tadashi Nishio, Yoko Toukairin, Tomoaki Hoshi, Tomomi Arai, Makoto Nogami

{"title":"Determination of multiple psychostimulants and antipsychotics in postmortem dried blood spot samples by liquid chromatography–tandem mass spectrometry","authors":"Tadashi Nishio, Yoko Toukairin, Tomoaki Hoshi, Tomomi Arai, Makoto Nogami","doi":"10.1016/j.legalmed.2025.102650","DOIUrl":"10.1016/j.legalmed.2025.102650","url":null,"abstract":"<div><div>When dealing with psychostimulant and antipsychotic poisoning deaths in forensic practice, detection and accurate quantification of the causative drug are essential for a definitive diagnosis. If post-mortem changes have resulted in the presence of various adulterants in the blood, commercially available simple screening kits may produce false positives. In this study, we focused on applying dried blood spot (DBS) samples to develop a simple and accurate method for forensic toxicological analysis of drugs of interest in poisoning deaths.</div><div>To test our novel analytical method we used liquid chromatography coupled with electrospray ionization−tandem mass spectrometry to quantify two psychostimulants (amphetamine, methamphetamine) and eight antipsychotics (chlorpromazine, haloperidol, levomepromazine, aripiprazole, clozapine, quetiapine, risperidone, and paliperidone) in cadaveric DBS samples. The linearities of the calibration curves were good in the concentration range of 0.05–1.0 μg/mL. The method allowed for repeatable and accurate quantification of the 10 target drugs with intra- and inter-assay coefficients of variation of below 10.6 % and 12.4 %, respectively. In addition, the concentrations of all drugs stored at −80 °C in DBSs remained almost stable for at least 2 weeks. Comparison with our general practice method (known as QuEChERS) showed good positive correlations of the quantifiable concentrations of all drugs. In addition, for all drugs, the concentrations obtained by the DBS method were almost well coincident with those obtained by the QuEChERS method.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"76 ","pages":"Article 102650"},"PeriodicalIF":1.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221400","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

Investigating sexual dimorphism of the mastoid, bimastoid, occipital, and facial triangles in different craniofacial skeletal patterns using three dimensional models generated from CT scans 利用CT扫描生成的三维模型研究不同颅面骨骼模式下乳突、乳突、枕和面部三角形的两性二态性

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-06-02 DOI: 10.1016/j.legalmed.2025.102648

Gülay Açar , Demet Aydoğdu

{"title":"Investigating sexual dimorphism of the mastoid, bimastoid, occipital, and facial triangles in different craniofacial skeletal patterns using three dimensional models generated from CT scans","authors":"Gülay Açar , Demet Aydoğdu","doi":"10.1016/j.legalmed.2025.102648","DOIUrl":"10.1016/j.legalmed.2025.102648","url":null,"abstract":"<div><div>We aimed to introduce a new approach to sex determination using 3D models of skull triangles including mastoid (MT), bimastoid (BMT), occipital (OCT) and facial (FT) triangles to explore how to achieve better accuracy, and also to assess the influence of skeletal malocclusion parameters (ANB, SNA), cephalic index (CI), and Welcher basal angle (WBA). The study was conducted on152 3D computed tomography scans, in which the dimensions of skull triangles, ANB, SNA, WBA, cranial length (CL) and breadth (CB) were measured. All parameters except the angular measurements were higher in males than in females. Univariate discriminant function analysis (DFA) yielded an average accuracies ranging from 54.6% to 79.6%. Multivariate DFA increased the percentage of correct predictions of gender to vary from 79.6 to 89.5%. Receiver operator characteristic curve (ROC) analysis showed that the area under ROC curve value to vary from 0.458 to 0.870. There was a general tendency for a decrease in all triangle dimensions except FT with increasing CI. In some cases, skeletal malocclusion, CI, and WBA influenced the area of triangles. In general, dolichocephalic individuals with larger WBA had lower RMT and LMT areas, whereas dolichocephalic and mesocephalic individuals with Class III had higher BMT and OCT areas. In FT, brachycephalic subjects with Class III had the lowest and Class I had the highest area value. Our results suggest that the MT, BMT, FT, and CL can be used effectively for sex determination and skeletal malocclusion, CI, and WBA had some influence in dimensions of skull triangles.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"76 ","pages":"Article 102648"},"PeriodicalIF":1.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205192","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

Suicidal hanging with complete decapitation: A forensic case report with review of biomechanics 自杀上吊完全斩首：法医案例报告与生物力学回顾

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-06-02 DOI: 10.1016/j.legalmed.2025.102649

Athul Vivek, Aparna Jayakala, Inesh Vij, Shankar M Bakkannavar, Anitta Joseph

{"title":"Suicidal hanging with complete decapitation: A forensic case report with review of biomechanics","authors":"Athul Vivek, Aparna Jayakala, Inesh Vij, Shankar M Bakkannavar, Anitta Joseph","doi":"10.1016/j.legalmed.2025.102649","DOIUrl":"10.1016/j.legalmed.2025.102649","url":null,"abstract":"<div><div>Decapitation resulting from hanging is an infrequent phenomenon, often influenced by multiple biomechanical factors. We report a case of a 72-year-old male who committed suicide by hanging, leading to complete decapitation. The drop height was approximately 10.668 m, with a static nylon rope of 9 mm thickness used as ligature material. Autopsy findings showed complete severance at the cervical spine level, primarily at the junction of C4/C5 with an additional anterior hemi-transection at the C6/C7 junction. Calculations revealed axial and radial forces acting at the neck to be 534.1 N and 3354.15 N, respectively, which were found within the range of required forces described in the literature. Biomechanical analysis indicated the significant roles played by body weight, drop height, ligature material, and anatomical vulnerability due to advanced age. This report emphasizes the necessity for further research into biomechanics of different ligature materials and how aging affects the mechanical strength of cervical soft tissues, influencing susceptibility to cervical injuries and decapitation in hanging.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"76 ","pages":"Article 102649"},"PeriodicalIF":1.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212063","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

Age estimation using CT images of the pubic symphysis of Lebanese living individuals 利用CT图像估计黎巴嫩人耻骨联合的年龄

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-06-01 DOI: 10.1016/j.legalmed.2025.102647

Cindy Mansour , Nicholas Márquez-Grant , Javier Lescure , Sarah Eid , María García Velasco , María Benito Sánchez

引用次数: 0

Histological insight into the fatal case of Guillain-Barre syndrome with atypical incidental presence of Marinesco bodies and corpora amylacea: an autopsy case report 组织学洞察格林-巴利综合征的不典型偶然存在的Marinesco体和淀粉体致命病例：尸检病例报告

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-05-24 DOI: 10.1016/j.legalmed.2025.102646

Pulagura Siva Sai Kumar , Vikas Meshram , Divya Aggarwal , Aasma Nalwa , Kanishka Chaurasia

{"title":"Histological insight into the fatal case of Guillain-Barre syndrome with atypical incidental presence of Marinesco bodies and corpora amylacea: an autopsy case report","authors":"Pulagura Siva Sai Kumar , Vikas Meshram , Divya Aggarwal , Aasma Nalwa , Kanishka Chaurasia","doi":"10.1016/j.legalmed.2025.102646","DOIUrl":"10.1016/j.legalmed.2025.102646","url":null,"abstract":"<div><div>Guillain-Barre syndrome (GBS) is an inflammatory demyelinating polyneuropathy clinically characterized by ascending motor paralysis, autonomic dysfunction, and respiratory failure etc. Though generally associated with a good prognosis, a few cases may turn fatal. On autopsy, gross findings are nonspecific. Hence, autopsy diagnosis is based on clinical manifestations and histopathological examination. We report an autopsy case of GBS, which showed remarkable diagnostic features of unusual incidental neurodegenerative findings atypical for that age. A 43-year-old male presented with fever, respiratory infection, paraesthesia, and motor weakness in both upper and lower limbs. The clinical features were suggestive of GBS with autonomic system involvement; subsequently, the patient developed paralytic ileus and died due to septicemia after two weeks of treatment. Postmortem examination revealed pleural effusion, pulmonary edema, and gangrenous ileal perforation. Histopathological analysis of the brain and cranial nerves, using different special stains and IHC, confirmed demyelination, evident by loss of myelin and myelin-engulfing macrophages. In addition to changes consistent with GB syndrome, the incidental discovery of Marinesco bodies, which are typically found in neurodegenerative diseases, is noted in this case. Corpora amylacea was also reported in multiple sections of the brain and cranial nerves, which are frequent in the old age group. GBS-associated dysautonomia, leading to rare complications such as paralytic ileus, proved fatal in this case. This case gives an account of various histopathological findings that assist in the diagnosis and confirmation of GBS. It also discusses incidental neurodegenerative changes that are atypical for age and unusual in neuroinflammatory cases like GBS.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"76 ","pages":"Article 102646"},"PeriodicalIF":1.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134146","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

A completed gastromalacia after brainstem hemorrhage within 24 h: A case report and literature review 脑干出血后24小时内完全性胃软化1例并文献复习

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-05-23 DOI: 10.1016/j.legalmed.2025.102645

Jingzhou Yang , Longjin Zi , Fahui Duan , Ping Wang , Huan Liu

{"title":"A completed gastromalacia after brainstem hemorrhage within 24 h: A case report and literature review","authors":"Jingzhou Yang , Longjin Zi , Fahui Duan , Ping Wang , Huan Liu","doi":"10.1016/j.legalmed.2025.102645","DOIUrl":"10.1016/j.legalmed.2025.102645","url":null,"abstract":"<div><div>Gastromalacia is a postmortem feature characterized by rapid autolysis of the stomach, typically leading to a large rupture, predominantly in the gastric fundus. The pathophysiology of gastromalacia remains enigmatic. This study presents a novel case of a 32-year-old male who succumbed to respiratory failure after brainstem hemorrhage after sexual intercourse, which ultimately resulted in complete gastromalacia. Autopsy revealed hyperpyrexia (38.1 °C, 6 h post-mortem) and a substantial laceration (32 mm × 8 mm, irregular margins) in the inferior ventrolateral region of the pons on the right side. Additionally, the occurrence of complete gastromalacia within 24 h challenged our previous understanding that gastromalacia typically presents as a smaller lesion one day after death. Misdiagnosis of gastromalacia can arise from both forensic and clinical practices. This study raised the potential factors contributing to the rapid development of complete gastromalacia within 24 h. Through a literature review, we identified several key diagnostic indicators that may aid in distinguishing this condition, including a history of gastric ulceration, hyperthermia, and certain neurological disorders.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"76 ","pages":"Article 102645"},"PeriodicalIF":1.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138510","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

NF-κB and SIRT1 evaluation to discriminate antemortem from postmortem wounds. Potential markers of skin wound vitality in forensic practice 评价NF-κB和SIRT1对死前和死后伤口的区别。法医实践中皮肤伤口生命力的潜在标志

IF 1.3 4区医学

Legal Medicine Pub Date : 2025-05-23 DOI: 10.1016/j.legalmed.2025.102635

Gabriella Teti , Filippo Pirani , Simone Gavelli , Alberto Gualandi , Maria Carla Mazzotti , Luca Berti , Mirella Falconi , Susi Pelotti , Paolo Fais

{"title":"NF-κB and SIRT1 evaluation to discriminate antemortem from postmortem wounds. Potential markers of skin wound vitality in forensic practice","authors":"Gabriella Teti , Filippo Pirani , Simone Gavelli , Alberto Gualandi , Maria Carla Mazzotti , Luca Berti , Mirella Falconi , Susi Pelotti , Paolo Fais","doi":"10.1016/j.legalmed.2025.102635","DOIUrl":"10.1016/j.legalmed.2025.102635","url":null,"abstract":"<div><div>Background many studies have been conducted on wound age estimation, but to date no marker has been validated to use in routine forensic practice. To explore novel markers for vitality of wounds, we investigated the expression of the inflammatory-related marker nuclear factor kappa B (NF-κB) and analyzed its correlation with the silent information regulator sirtuin 1 (SIRT1) protein in skin wounds. Methods: on 8 amputated human limbs we collected human skin tissue samples from the amputation site, as antemortem samples, and from wounds produced on the stored corresponding limbs, as postmortem samples. Samples were processed for western blot and immunohistochemistry analysis to evaluate the ex-pression of NF-κB and SIRT1 proteins. Results: cytoplasmic and nuclear staining of NF-κB in epidermal cells of antemortem wounds was higher than in postmortem wounds, where the NF-κB signal was mainly localized in the nuclei of keratinocytes. Quantitative analysis demonstrated a 2-fold increase in NF-κB protein in antemortem wounds. On the contrary, SIRT-1 levels were almost absent in antemortem wounds, while high nuclear staining was detected in keratinocytes in postmortem wounds. Quantitative analysis of the stained area demonstrated a 3-fold increase in SIRT1 protein in postmortem wounds. Conclusions: analysis of NF-κB and SIRT1 showed a different qualitative and quantitative pattern of expression in antemortem and postmortem wounds. They represent good candidates as biomarkers in wound vitality estimation in forensic pathology eventually to include them in a panel of biomarkers.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"76 ","pages":"Article 102635"},"PeriodicalIF":1.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131004","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