Legal Medicine最新文献

{"title":"Testing age progression technique: evaluation of reliability and accuracy","authors":"Laura Donato ,&nbsp;Michele Treglia ,&nbsp;Douglas H. Ubelaker ,&nbsp;Margherita Pallocci ,&nbsp;Chiara De Cagna ,&nbsp;Anna Laura Santunione ,&nbsp;Rossana Cecchi ,&nbsp;Jessika Camatti ,&nbsp;Pierluigi Passalacqua ,&nbsp;Luigi Tonino Marsella","doi":"10.1016/j.legalmed.2025.102731","DOIUrl":"10.1016/j.legalmed.2025.102731","url":null,"abstract":"<div><div>Age progression is increasingly applied in forensic practice to assist in the identification of long-term missing persons, yet its reliability requires systematic validation.</div><div>This study analysed childhood and adult photographs of an Italian family to assess the accuracy of the technique. Eight images were examined: five portraying the parents and three children at age 2, and three depicting the parents and daughter at age 30. A morphological analysis of facial features (face shape, eyebrows, eyelid folds, nasal bridge and tip, lips) was performed to identify hereditary traits. Age progressions of the two sons were generated to age 30 and subsequently adjusted to their current ages (45 and 43 years). Reconstructions were created using Adobe® Photoshop, combining low-resolution parental photographs with high-resolution reference images.</div><div>Results showed variable accuracy: the progression of Brother 2 closely resembled his current appearance, whereas discrepancies were noted for Brother 1, particularly in nasal morphology, largely due to poor source resolution. Overall, accuracy improved with higher image quality and a larger number of reference photographs.</div><div>This validation demonstrates that age progression can approximate the real appearance of missing persons but emphasizes image quality as a critical limitation. Expanding datasets and refining morphological protocols are essential to increase its reliability in forensic casework.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"79 ","pages":"Article 102731"},"PeriodicalIF":1.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248023","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":"Congenital transmesocolic internal hernia as a cause of sudden death – autopsy case report","authors":"Veljko Milošević ,&nbsp;Milenko Bogdanović ,&nbsp;Milena Kontić-Žarčanin ,&nbsp;Tijana Petrović ,&nbsp;Bojana Radnić","doi":"10.1016/j.legalmed.2025.102732","DOIUrl":"10.1016/j.legalmed.2025.102732","url":null,"abstract":"<div><h3>Introduction</h3><div>Internal abdominal hernias (IAHs) are rare causes of intestinal obstruction and unexpected death, with transmesocolic hernias being particularly uncommon and typically diagnosed in children. Autopsy-confirmed congenital cases in the elderly are exceptionally rare.</div></div><div><h3>Case presentation</h3><div>An 89-year-old woman presented with a three-day history of abdominal pain and constipation. Despite supportive treatment, her condition rapidly deteriorated, leading to death within nine hours of hospital admission. Autopsy revealed a 180 cm segment of necrotic small intestine herniated through a 3 cm smooth-edged defect in the transverse mesocolon, consistent with a congenital transmesocolic hernia. No prior abdominal surgeries, trauma, or intra-abdominal inflammation were noted.</div></div><div><h3>Discussion</h3><div>Transmesocolic hernias are a rare subset of IAHs and can be life-threatening due to bowel strangulation and ischemia. Congenital mesenteric defects are typically identified in pediatric populations, making this elderly case highly unusual. The nonspecific clinical presentation often delays diagnosis, and imaging may fail to detect small mesenteric defects, contributing to high mortality rates.</div></div><div><h3>Conclusion</h3><div>This case represents the first reported autopsy-confirmed congenital transmesocolic hernia in an elderly individual. It emphasizes the importance of considering rare congenital anomalies in differential diagnoses of acute abdomen and unexplained sudden death, even in the absence of surgical or traumatic history.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"79 ","pages":"Article 102732"},"PeriodicalIF":1.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271308","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":"Estimation of postmortem interval in decomposed remains using insect evidence: A report of two cases","authors":"Siqi Liu ,&nbsp;Yundi Gao ,&nbsp;Jiangtao Mei ,&nbsp;Rui Zhu ,&nbsp;Lan Gao ,&nbsp;Mingqing Liao ,&nbsp;Shuixiu Xia ,&nbsp;Yu Wang","doi":"10.1016/j.legalmed.2025.102722","DOIUrl":"10.1016/j.legalmed.2025.102722","url":null,"abstract":"<div><div>Accurate postmortem interval (PMI) estimation is crucial in forensic cases. Forensic entomology, analyzing insect species, developmental stages, and environmental factors associated with decomposing remains, has proved to be an effective method for estimating extended PMIs, especially when traditional postmortem indicators are no longer viable. This study presents two cases demonstrating how to estimate the minimum postmortem interval (PMI_min) by integrating seasonal insect activity, developmental anomalies, and environmental factors. In Case 1, the body was discovered in early spring under low-temperature conditions. However, empty puparia of <em>Chrysomya megacephala</em> <!-->(Fabricius, 1794) and<!--> <em>Chrysomya rufifacies</em> (Macquart, 1844) were found on the corpse, indicating that the death occurred during warm weather. Additionally, the presence of developmentally abnormal pupae suggests that the insects may have been exposed to extreme weather, such as a sudden drop in temperature. Based on these observations, the PMI_min was estimated to be in late summer or early autumn of the previous year. Similarly, limited insect evidence on the remains, combined with local climatic data, supported an estimated PMI_min in early autumn of the previous year for Case 2. These findings highlight the significant influence of seasonal insect activity and environmental factors on insect development and distribution, providing critical insights for estimating longer PMIs. This study emphasizes forensic investigations should consider species-specific seasonal and geographical distribution patterns, as well as the environmental adaptability of insects. Moreover, given global climate change and resultant species migration, continuous insect succession experiments are essential for updating forensic entomological databases and improving their practical applicability.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102722"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214172","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":"Retrohepatic IVC injury after PTBD: Practical reporting details and risk-mitigation suggestions","authors":"Hiroyuki Tokue,&nbsp;Yoshito Tsushima","doi":"10.1016/j.legalmed.2025.102719","DOIUrl":"10.1016/j.legalmed.2025.102719","url":null,"abstract":"","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102719"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220226","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":"Atypical suicide by thermal injury to the femoral artery caused by a hot glue gun: A case report and review of the literature","authors":"Greta Seveso,&nbsp;Federica Bagini,&nbsp;Giacomo Belli,&nbsp;Luca Morini,&nbsp;Silvia Damiana Visonà,&nbsp;Giovanni Cecchetto,&nbsp;Luca Tajana","doi":"10.1016/j.legalmed.2025.102721","DOIUrl":"10.1016/j.legalmed.2025.102721","url":null,"abstract":"<div><div>Analyzing suicidal behavior and methods is crucial to gain a deeper understanding of this complex phenomenon, which affects over 700,000 individuals annually and ranks among the leading causes of death worldwide. The global scope of this issue explains why suicide represents a significant public health concern and why it is so important to unveil the complex mechanisms behind its occurrence.</div><div>We report a case of a fatal thermal injury to the left femoral artery, self-inflicted with a hot glue gun. The uniqueness of this case lies primarily in the instrument used, which, to the best of our knowledge, has never been reported in the literature as a means of suicide. In fact, the only previously documented case involving a hot glue gun resulted in non-fatal injuries inflicted in a context of maltreatment. Furthermore, the anatomical region involved is unusual, as self-inflicted injuries typically target specific “elective sites” based on the chosen method.</div><div>Forensic experts may occasionally encounter atypical suicide cases involving unusual methods or tools, as well as morphologically peculiar injuries. Reporting such cases is essential for expanding our knowledge of the subject, providing valuable references for medico-legal practice, and improving preventive strategies.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102721"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202068","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":"Medicolegal entomology in an elder neglect investigation: A case study from South Korea","authors":"Jae-Bong Jung ,&nbsp;Kyung Min Lee ,&nbsp;Seong Hwan Park ,&nbsp;Sang-Hyun Park","doi":"10.1016/j.legalmed.2025.102720","DOIUrl":"10.1016/j.legalmed.2025.102720","url":null,"abstract":"<div><div>Medicolegal entomology, once primarily utilized for estimating the post-mortem interval (PMI), now serves an expanding role in evaluating abuse and neglect in vulnerable populations. This case study examines a pivotal 2022 ruling by the Busan District Court, where forensic entomological evidence led to a conviction for negligent homicide by abandonment. The victim, an 82-year-old woman with dementia and multiple chronic conditions, was discovered in a severely unsanitary environment. Numerous third-instar larvae of <em>Lucilia sericata</em> were retrieved from necrotic pressure ulcers, and developmental analysis indicated colonization had begun at least 72 h before death. These findings underscore the need for routine integration of entomological expertise into medicolegal protocols, particularly in jurisdictions where the discipline is still underutilized.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102720"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208152","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":"Towards a standard of scientific evidence in on-site inspection: compilation of the ECLM on-site inspection form in a broad case history","authors":"Jessika Camatti ,&nbsp;Anna Laura Santunione ,&nbsp;Monica Bolognini ,&nbsp;Denis Cusack ,&nbsp;Stefania Zerbo ,&nbsp;Antonina Argo ,&nbsp;Maria Puntarello ,&nbsp;Giovanni Scalzo ,&nbsp;Fattorini Paolo ,&nbsp;Tommaso Bruscagin ,&nbsp;Lorenzo Desinan ,&nbsp;Laura Battistig ,&nbsp;Fabrizio Tosku ,&nbsp;Guido Viel ,&nbsp;Giorgia Franchetti ,&nbsp;Biagio Solarino ,&nbsp;Laura Ambrosi ,&nbsp;Giovanni Cecchetto ,&nbsp;Silvia Damiana Visonà ,&nbsp;Emanuele Sala ,&nbsp;Rossana Cecchi","doi":"10.1016/j.legalmed.2025.102717","DOIUrl":"10.1016/j.legalmed.2025.102717","url":null,"abstract":"<div><div>The <em>European Council of Legal Medicine (ECLM) on-site inspection</em> form allows the collection of data relevant to the identification, collection, sampling and preservation of all elements that, during the on-site inspection, may be useful as forensic evidence. The aim of this study is to assess the completeness of the information collected in a large number of on-site inspections, the records of which were drawn up without the use of the <em>ECLM on-site inspection form</em>, in order to verify the usefulness and the application of this form.</div><div>The authors present a multicentre study involving 20 Italian forensic medicine institutes. For each institute, the reports of on-site inspections carried out without the use of the <em>ECLM on-site inspection form</em> were collected and a forensic pathologist was asked to analyse the individual cases and to identify, for each case, the presence or absence of information regarding all the points examined by the <em>ECLM on-site inspection form</em>. A practical database was prepared and sent to each institute for this analysis.</div><div>Data were collected and analysed from a total of 1721 on-site inspection reports. Our results document that certain items on the <em>ECLM on-site inspection form</em> are not always investigated in reports written without the use of this tool.</div><div>The use of the <em>ECLM on-site inspection form</em> proves to be a valid tool to assist the forensic pathologist during the on-site inspection. We therefore hope that the forms developed by the ECLM will be systematically adopted in the forensic practice of the forensic pathologist.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102717"},"PeriodicalIF":1.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151832","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":"From evidence to proof: case series application of 3d reconstructions in forensic analysis of dog bite injuries","authors":"Marco Piraino ,&nbsp;Bianca Beltrame ,&nbsp;Salvatore Nigliaccio ,&nbsp;Davide Fontana ,&nbsp;Antonina Argo ,&nbsp;Tommaso D’Anna ,&nbsp;Stefania Zerbo ,&nbsp;Giuseppe Davide Albano ,&nbsp;Pietro Messina ,&nbsp;Giuseppe Alessandro Scardina","doi":"10.1016/j.legalmed.2025.102718","DOIUrl":"10.1016/j.legalmed.2025.102718","url":null,"abstract":"<div><div>The use of three-dimensional (3D) reconstruction technologies in forensic science is gaining increasing relevance for the documentation and analysis of traumatic injuries. This approach provides an innovative, non-invasive, precise, and reproducible method that is particularly well-suited for evidentiary purposes in judicial contexts.</div><div>This study presents two forensic cases of suspected death from dog attacks, in which 3D models were reconstructed to analyze bite-related injuries identified on the victims’ bodies, with the aim of distinguishing them from bite marks caused by other species. Specifically, the Dexis 3600 intraoral scanner was used for data acquisition, Agisoft Metashape software was employed for photogrammetric processing and Geomagic Control X was utilized for 3D analysis. In the first case, five bite wounds were analyzed; in the second case, ten lesions were examined.</div><div>The findings demonstrate that the integration of 3D scanning and photogrammetry in forensic and forensic odontology practice can significantly enhance the accuracy of animal bite mark assessment. This integration provides objective support in both identifying the lesion typology and attributing the injuries to a specific animal species, as well as reconstructing the overall dynamics of the attack − an essential aspect of forensic expert analysis.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102718"},"PeriodicalIF":1.4,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158101","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":"Retrospective study on solitary deaths (kodoku-shi) from the aspects of forensic and social medicine","authors":"Yumiko Hashizume,&nbsp;Akiko Ishigami,&nbsp;Yuko Ishida,&nbsp;Mizuho Nosaka,&nbsp;Yumi Kuninaka,&nbsp;Hiroki Yamamoto,&nbsp;Satoshi Hata,&nbsp;Jumpei Matsuki,&nbsp;Haruki Yasuda,&nbsp;Tatsunori Takayasu,&nbsp;Fukumi Furukawa,&nbsp;Akihiko Kimura,&nbsp;Toshikazu Kondo","doi":"10.1016/j.legalmed.2025.102712","DOIUrl":"10.1016/j.legalmed.2025.102712","url":null,"abstract":"<div><div>This retrospective study evaluated 637 forensic autopsy cases of solitary deaths (<em>kodoku-shi</em> in Japanese) and clarified the current status of solitary deaths from the viewpoint of forensic medicine. Of the 637 cases of solitary death, 471 were men and 166 were women, indicating that solitary death predominantly occurred in men. This tendency increased from the age of 40 years in men to 60 years in women. Among these, 349 and 199 were natural and external deaths, respectively. Ischemic heart disease and fire-related fatalities were the most common causes of natural and external death, respectively. Suicidal deaths were more frequent among women than men. We found two peaks of postmortem interval until finding (PMI-f): &lt;1 day (182 cases, 28.6 %) and 7 days to &lt; 1 month (164 cases, 25.7 %). The PMI-f was significantly shorter in women than in men. The PMI-f of external death cases was significantly shorter than that of natural death cases. Kushimoto and Shingu, located in Southern Japan (Kinan region), had a high solitary death rate in forensic autopsy cases because of the high aging rate and high rate of individuals in single-person households aged ≥ 65 years. Few cases of solitary deaths in the Kinan region (non-urban area) were welfare recipients, and 23 of the 36 welfare recipients lived in Wakayama City, indicating that the economic state contributed more to the occurrence of solitary deaths in Wakayama City (urban area). We identified several risk factors and regional characteristics of solitary deaths. Our observations could contribute to administrative welfare measures for the prevention of solitary deaths.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102712"},"PeriodicalIF":1.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151815","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 systematic review of the diagnostic value of post-mortem blood tryptase in fatal anaphylaxis: assessment of sensitivity and specificity","authors":"Enrico Pilia ,&nbsp;Andrea Mastrostefano ,&nbsp;Tommaso Germanò ,&nbsp;Giuseppe Amato ,&nbsp;Gozzelino Camilla ,&nbsp;Corrado Ciccu ,&nbsp;Ernesto d’Aloja ,&nbsp;Emanuela Locci ,&nbsp;Alberto Chighine","doi":"10.1016/j.legalmed.2025.102716","DOIUrl":"10.1016/j.legalmed.2025.102716","url":null,"abstract":"<div><h3>Objective</h3><div>The post-mortem diagnosis of fatal anaphylaxis presents significant challenges due to the absence of pathognomonic findings. Serum tryptase has been proposed as a potential biomarker to support forensic diagnosis, but optimal post-mortem thresholds remain undefined. This systematic review investigates the sensitivity and specificity of post-mortem blood tryptase in diagnosing fatal anaphylaxis.</div></div><div><h3>Methods</h3><div>We conducted a systematic literature review adhering to the PRISMA guidelines, with searches across major databases. Studies published between 1990 and 2024 were screened to identify those addressing fatal anaphylactic shock, applying strict inclusion criteria to ensure relevance. A total of 20 studies met our criteria, representing 1033 individuals, including 221 anaphylactic deaths. Sensitivity and specificity of tryptase were analyzed using various thresholds, with data synthesis conducted using the Mann–Whitney–Wilcoxon test and ROC analysis to identify optimal diagnostic cut-offs.</div></div><div><h3>Results</h3><div>Our findings demonstrated that the cut-off of 30.4 ng/mL proposed by the most recent <em>meta</em>-analysis offers a balanced sensitivity (88.20 %) and specificity (87.00 %). Sensitivity remains stable across tryptase values ranging from 30 to 60 ng/mL, while specificity tends to increase. Youden’s J index was applied to identify the cut-off with the optimal combination of sensitivity and specificity, namely 74.2 ng/mL. Additionally, Negative Likelihood Ratio allowed to identify 12.00 ng/mL as the cut-off at which the possibility of an anaphylactic death can be ruled out.</div></div><div><h3>Conclusion</h3><div>This review highlights the optimal balance of sensitivity and specificity of post-mortem blood tryptase enhancing forensic diagnostic accuracy for fatal anaphylaxis cases.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102716"},"PeriodicalIF":1.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109633","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}