Legal Medicine最新文献

{"title":"Rare cases of nitrite poisoning by accidental ingestion: Clinical and medico-legal aspects","authors":"Kamil Synowiec ,&nbsp;Tomasz Gawlikowski ,&nbsp;Tomasz Konopka ,&nbsp;Renata Gajek ,&nbsp;Sebastian Rojek","doi":"10.1016/j.legalmed.2025.102573","DOIUrl":"10.1016/j.legalmed.2025.102573","url":null,"abstract":"<div><div>This paper reports three rare cases of accidental sodium nitrite poisoning, including one fatality, caused by the consumption of aspic purchased from a private vendor. Clinical symptoms included cyanosis, hypotension, and respiratory distress, with methemoglobin (MetHb) levels ranging from 5 % to 41.7 %. Toxicological analysis, performed using gas chromatography coupled with a mass spectrometry in the negative chemical ionization mode (GC-NCI-MS), revealed nitrite concentrations in blood samples ranging from 4.2 to 44 µg/mL and nitrate concentrations from 36 to 256 µg/mL. Urine analysis in the fatal case showed nitrite levels exceeding 100 µg/mL. The patients received symptomatic and supportive care, and methylene blue administration was considered in cases with elevated MetHb levels. One patient died despite aggressive resuscitation efforts, highlighting the rapid progression of severe nitrite poisoning. Postmortem findings included characteristic chocolate-brown discoloration of the blood and brown organ tissues, indicative of methemoglobinemia. This study emphasizes the clinical and toxicological importance of early diagnosis and intervention in nitrite poisoning and discusses the medico-legal implications of such cases, including the forensic challenges in interpreting postmortem toxicology results.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"73 ","pages":"Article 102573"},"PeriodicalIF":1.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015161","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":"Postmortem changes in porcine eyes on computed tomography images","authors":"Motoo Yoshimiya ,&nbsp;Sakon Noriki ,&nbsp;Shogo Shimbashi ,&nbsp;Hideki Uesaka ,&nbsp;Hideki Hyodoh","doi":"10.1016/j.legalmed.2025.102568","DOIUrl":"10.1016/j.legalmed.2025.102568","url":null,"abstract":"<div><div>Porcine eyes were examined using postmortem computed tomography (PMCT) under controlled postmortem time and temperature conditions to assess the mechanisms and timing of changes in ocular structure. Eight porcine heads were halved, and PMCT scans were conducted from postmortem interval (PMI) days 0 to 13. CT images were obtained to evaluate the vitreous volumes, vitreous CT values, axial lengths of the eyes, lens dislocation, and intraocular gas. The vitreous volume decreased over time, with the highest median rate of 17.7 % at PMI 1, followed by 12.0 %, 11.7 %, and 11.3 % at PMIs 6, 7, and 8, respectively. There was a significant decrease in the axial eye length from PMIs 0 to 1, while the transverse diameter remained unchanged. Lens dislocation was observed in all cases at PMI 9. Receiver operating characteristic analysis using the PMI as the predictive value for the presence of lens dislocation revealed a cutoff value of PMI 6, with an area under the curve of 0.98. Intraocular gas was observed in four cases. In two cases with intraocular gas, intravascular gas appeared to be continuous with the intraocular gas via the ciliary body. Lens dislocation occurred 6 days postmortem in porcine eyes at moderate temperatures. Intraocular gas was also observed 6 days postmortem, which may have been caused by the influx of intravascular gas into the eye via the ciliary body. These structural changes in the porcine model, may help in estimating the time of death.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"73 ","pages":"Article 102568"},"PeriodicalIF":1.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015159","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":"An autopsy case of encapsulated acute subdural hematoma presenting as an acute-on-chronic spontaneous subdural hematoma","authors":"Kazuhisa Funayama ,&nbsp;Akihide Koyama ,&nbsp;Rieka Katsuragi-Go ,&nbsp;Takashi Aoyama ,&nbsp;Hiraku Watanabe ,&nbsp;Naoya Takahashi ,&nbsp;Hisakazu Takatsuka","doi":"10.1016/j.legalmed.2025.102570","DOIUrl":"10.1016/j.legalmed.2025.102570","url":null,"abstract":"<div><div>Subdural hematoma (SDH) is bleeding between the dura mater and the brain surface, often visualized as a crescent-shaped lesion on computed tomography (CT). However, some SDHs can appear as a biconvex hyperdense lesion mimicking an acute epidural hematoma. Encapsulated acute SDH (EASDH), a rare subtype characterized by a fresh hematoma within the subdural fibrous capsule, presents with similar CT findings. Herein, we describe an autopsy case of EASDH and discuss its etiology based on the case findings and available literature. The autopsy revealed a rupture of the bridging arteries as the SDH bleeding source, confirming the development of an acute-on-chronic spontaneous SDH. To our knowledge, this is the first autopsy report of EASDH and the third case of spontaneous SDH due to bridging-artery rupture.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"73 ","pages":"Article 102570"},"PeriodicalIF":1.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015157","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":"Fatal bear attack in Russian Federation: A case report","authors":"Nikolaos Angelakopoulos ,&nbsp;Igor Valentinovich Vlasyuk ,&nbsp;Sudheer Babu Balla ,&nbsp;Rizky Merdietio Boedi ,&nbsp;Galina Zolotenkova","doi":"10.1016/j.legalmed.2024.102556","DOIUrl":"10.1016/j.legalmed.2024.102556","url":null,"abstract":"<div><div>Human-bear conflicts are a growing concern globally, with Russia harboring a significant population of brown bears. This case report details a fatal encounter between a male hunter and a brown bear in the greater Khabarovsk region. On October 2015, the hunter’s body was discovered approximately 400 m from a deceased brown bear, indicating a deadly confrontation. Forensic examination revealed extensive trauma and varied patterns of injuries, with the cause of death attributed to mixed shock from traumatic injuries and acute blood loss. Despite the limited dental information due to the missing maxilla, positive identification was achieved through the unique dental patterns in the victim’s mandible. This study emphasizes the need for specialized forensic knowledge in wildlife-related fatalities, highlighting the importance of accurate post-mortem examinations and the critical role of dental data in positively identifying victims under challenging circumstances.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"72 ","pages":"Article 102556"},"PeriodicalIF":1.3,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142719858","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":"Immunohistochemical and molecular study for differential diagnosis between freshwater and saltwater drowning","authors":"Rehab A. Azouz ,&nbsp;Alaa F. Bakr ,&nbsp;Marwa A. Ibrahim ,&nbsp;Mohamed Y. Mahmoud","doi":"10.1016/j.legalmed.2024.102545","DOIUrl":"10.1016/j.legalmed.2024.102545","url":null,"abstract":"<div><div>The postmortem identification of drowning in the field of forensic medicine is difficult due to unspecific autopsy findings, and usually, it is a “diagnosis of exclusion”. A model of drowning in salt and fresh water was established to discuss the postmortem changes after drowning and the differences between saltwater drowning (SWD) and freshwater drowning (FWD). The organs (brain and ‘lung) of 30 rats were extracted at three-time points (0 h, 24 h, and 48 h) after drowning. The histopathological, immunohistochemical,l, and molecular changes in the lung and brain of rats at different time points were investigated. Results show no significant difference in pathological findings between fresh and saltwater drowning. Casp3, JNK, and ERK all showed a rise in their postmortem expression in a time-dependent way; the expression of these three genes is much greater in cases of saltwater drowning compared to cases of freshwater drowning. So, it is concluded that after 24 h and 48 h from death, potent cellular oxidative stress occurred and caused the upregulation of the studied genes.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"72 ","pages":"Article 102545"},"PeriodicalIF":1.3,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693860","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 utility of drowning site inference through metagenomic diatom analysis","authors":"Hiroaki Nakanishi ,&nbsp;Aya Takada ,&nbsp;Katsumi Yoneyama ,&nbsp;Saki Kodama ,&nbsp;Kentaro Sakai ,&nbsp;Kazuyuki Saito","doi":"10.1016/j.legalmed.2024.102548","DOIUrl":"10.1016/j.legalmed.2024.102548","url":null,"abstract":"<div><div>The diatom test is one of the methods used to diagnose drowning in forensic autopsies. Metagenomic diatom analysis may reveal where a drowning occurred. We evaluated whether metagenomic diatom analysis could be used to infer waters, watersheds, and geographic locations using 166 water samples from 64 locations (freshwater: 55; seawater: 9). Principal component analysis (PCA) in all samples revealed no specific clusters for waters or watersheds. In one river, the three samples at the same site generally tended to be in close clusters, but there were some cases where the three sites were far from each other. The precise geographic location could thus not be reliably identified. However, PCA of data from dams, lakes, and retention basins revealed sites with independent clusters, suggesting unique diatom compositions. Diatoms of seawater were not detected in freshwater. The high number of <em>Actinoptychus</em>, <em>Chaetoceros</em>, and <em>Skeletonema</em> detected in seawater samples suggested that they are useful for seawater identification. This method required only 2 mL of water; it suggests that this method can be applied to actual samples. In summary, it was difficult to infer the geographic location and waters or watersheds, but the freshwater/seawater distinction could be easily made, and depending on the application, it may be useful in forensic science practice.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"71 ","pages":"Article 102548"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640092","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":"Research progress and application of the third-generation sequencing technologies in forensic medicine","authors":"Xiaoxin Hu ,&nbsp;Jinjie Liu ,&nbsp;Tingyu Xu ,&nbsp;Kaiyue Qin ,&nbsp;Yunpeng Feng ,&nbsp;Zhenjun Jia ,&nbsp;Xingchun Zhao","doi":"10.1016/j.legalmed.2024.102532","DOIUrl":"10.1016/j.legalmed.2024.102532","url":null,"abstract":"<div><div>Third-generation sequencing technologies, exemplified by single-molecule real-time sequencing and nanopore sequencing, provide a constellation of advantages, including long read lengths, high throughput, real-time sequencing capabilities, and remarkable portability. These cutting-edge methodologies have provided new tools for genomic analysis in forensic medicine. To gain a comprehensive understanding of the current applications and cutting-edge trends of third-generation sequencing technologies in forensic medicine, this study retrieved relevant literature from the China National Knowledge Infrastructure (CNKI) database and the Web of Science (WOS) database. Using bibliometric software CiteSpace 6.1.R6, the study visualized publication volume, countries, and keywords related to the application of third-generation sequencing technologies in forensic medicine from 2014 to 2023. The review then summarized the foundational principles, characteristics, and promising prospects of third-generation sequencing technologies in forensic medicine. Notably, it highlights their remarkable contributions in forensic individual identification, body fluid identification, forensic epigenetic analysis, microbial analysis and forensic species identification.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"71 ","pages":"Article 102532"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586609","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":"Complete aortic rupture following wakeboarding accident","authors":"Alberto Amadasi,&nbsp;Larissa Amadasi","doi":"10.1016/j.legalmed.2024.102547","DOIUrl":"10.1016/j.legalmed.2024.102547","url":null,"abstract":"<div><div>Wakeboarding is a sport associated with various types of injuries, primarily affecting the upper and lower limbs. In this case, a 44-year-old man fell from a ramp while wakeboarding and barely managed to reach the shore before dying shortly afterward. An autopsy revealed a complete rupture of the thoracic aorta along with a fracture of the fourth thoracic vertebra. It is likely that several mechanisms contributed to these injuries, either individually or in combination: concussive, rotational, and tensile forces. Additionally, it is plausible that the rupture occurred in two stages, with an initial partial injury worsening during subsequent movements or attempts at rescue and resuscitation. This is the first reported case of death resulting from a ruptured aorta due to wakeboarding, highlighting a potential consequence of this sport.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"71 ","pages":"Article 102547"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564031","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":"Evaluation of two scoring systems assessing the epiphyseal union at shoulder joint as predictors of chronological age among a sample of Egyptians","authors":"Asmaa F. Sharif ,&nbsp;Hadeel Eid ,&nbsp;Mahmoud Abdelaziz Abdelnaby Ghalab ,&nbsp;Asmaa Ali Ahmed Elfeky ,&nbsp;Mohamed Moharram Badawy ,&nbsp;Nagwa Mahmoud Habib ,&nbsp;Reham Hassan El-Farouny ,&nbsp;Heba A.A. Mabrouk","doi":"10.1016/j.legalmed.2024.102546","DOIUrl":"10.1016/j.legalmed.2024.102546","url":null,"abstract":"<div><div>Age estimation has extensive medicolegal implications in civil and criminal identification. Despite the surge in adopting radiological investigations to assess developmental bony changes, the shoulder joint is understudied. A cross-sectional study was conducted, enrolling 283 shoulder radiographs of Egyptians, investigating the reliability of two previously established scores as predictors of chronological age using the epiphyseal maturation of proximal humerus and acromion process. Epiphyseal union of proximal humerus commenced at age of 16.1–17 and completed around 21, while complete acromial union was observed around the age of 20.8. Females significantly preceded males and showed lower mean total Scores A and B at different maturation stages. There was a significant strong positive correlation between the chronological age and the epiphyseal maturation of humerus, acromion and total shoulder scores with correlation coefficients between 0.84 and 0.9. The receiver operating characteristic curves showed significant discriminating power of the total shoulder Scores A and B as predictors of the ages of 14 and 16, with area under curves above 0.9, minimal accuracy of 96.5 % and p values of 0.001. Six proposed models were established where the model <em>“age = 0.318 + (0.388) total shoulder Score A + (2.842) total shoulder Score B + 1.931 (sex)”</em> showed the best significant prediction power of radiographic evaluation of epiphyseal maturation in the proximal humerus and acromion in estimating the ages between 8 and around 20 years (R² of 0.812). Applying this model to assess the chronological age, especially if the results from the hand and teeth are inconclusive, is promising.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"71 ","pages":"Article 102546"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142579098","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 and ecological significance of necrophagous insects: Insights from animal carcasses, human cadavers, and myiasis patients","authors":"Swaima Sharif ,&nbsp;Chetan Pratap Singh ,&nbsp;Bushra Athar ,&nbsp;Mohd Kaleem Khan ,&nbsp;Ayesha Qamar","doi":"10.1016/j.legalmed.2024.102544","DOIUrl":"10.1016/j.legalmed.2024.102544","url":null,"abstract":"<div><div>Necrophagous insects, including flies and beetles, play pivotal roles in decomposition, ecology, and forensics. Their diversity and activities vary across environments, necessitating comprehensive studies for understanding and management. The aim of the study is to investigate insect infestation on animal carcasses, human cadavers, and myiasis patients to enhance ecological, forensic, and medical entomological understanding, aiding in ecosystem management, forensic investigations, and disease control.</div><div>Various species of flies and beetles were found associated with animal carcasses, human cadavers, and myiasis patients, as indicated by the comprehensive study. On animal carcasses, notable fly species included <em>Chrysomya rufifacies</em> (Macquart, 1842), <em>Chrysomya megacephala</em> (Fabricius, 1794), <em>Lucilia cuprina</em> (Wiedemann, 1830), and <em>Sarcophaga</em> sp., while beetles such as <em>Dermestes maculatus</em> (De Geer, 1774), <em>Necrobia rufipes</em> (Fabricius, 1781), <em>Saprinus quadrigatattus</em> (Fabricius, 1798), <em>Saprinus splendens</em> (Paykull, 1811), <em>Saprinus optabilis</em> (Marseul, 1855), <em>Saprinus chalcites</em> (Iliger, 1807), and <em>Omorgus</em> sp. (Erichson, 1847) were also observed. Similarly, human cadavers exhibited a presence of flies like <em>Chrysomya albiceps</em> (Wiedemann, 1819), <em>Chrysomya rufifacies</em> (Macquart, 1842), <em>Chrysomya megacephala</em> (Fabricius, 1794), and <em>Sarcophaga dux</em> (Thomson, 1869). In cases of myiasis patients, flies including <em>Chrysomya megacephala</em>, <em>Cochliomyia hominivorax</em> (Coquerel, 1858), and <em>Chrysomya bezziana</em> (Villeneuve, 1914) were identified.</div><div>These findings underscore the diverse range of insect species involved in carcass decomposition, forensic investigations, and medical entomology, illustrating their crucial roles in ecological processes, forensic assessments, and disease management.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"71 ","pages":"Article 102544"},"PeriodicalIF":1.3,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142537489","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}