Legal Medicine最新文献_第3页

Non-Fatal accidental strangulation in a stroke patient 一名中风患者的非致命性意外扼颈

IF 1.3 4区医学

Legal Medicine Pub Date : 2024-07-22 DOI: 10.1016/j.legalmed.2024.102497

{"title":"Non-Fatal accidental strangulation in a stroke patient","authors":"","doi":"10.1016/j.legalmed.2024.102497","DOIUrl":"10.1016/j.legalmed.2024.102497","url":null,"abstract":"<div><p>Non-fatal strangulation poses a significant concern in clinical forensic medicine. Indeed, surviving victims often present a diverse array of signs and symptoms. In rare instances, acute pathological events that manifest with symptoms similar to those secondary to neck compression (e.g., stroke with subsequent neurological symptoms, etc.) can lead to loss of consciousness, inadvertently resulting in strangulation. Therefore, in this context, forensic investigation plays a crucial role in interpreting the signs and symptoms presented by the victim and determining whether they are the cause or consequence of neck compression. This report presents a case of a middle-aged previously healthy woman who was found by her husband on the bathroom floor and then brought to the medical attention exhibiting signs of neck compression in combination with neurological symptoms. Since a previous episode of domestic violence involving the husband has been recorded in the hospital database, a medico-legal investigation was initiated at the behest of the prosecutor. The integration of all clinical, radiological, forensic pathological findings and circumstantial data allowed the exclusion of homicidal strangulation by ligature perpetrated by the husband, as well as suicidal hanging; instead, it classified the case as an accidental hanging, with a stroke being the underlying cause of the accident. The case provides valuable insights into the complexity of interpreting injuries associated with neck compression and emphasizes the need for comprehensive investigative approach in such cases.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S134462232400107X/pdfft?md5=a9521ea0a203e2617137f521f35afaa1&pid=1-s2.0-S134462232400107X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141776662","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}

引用次数: 0

The influence of fixing condition on myoglobin stainability of striated muscle as a tool for forensic diagnosis 固定条件对作为法医诊断工具的横纹肌肌红蛋白染色性的影响

IF 1.3 4区医学

Legal Medicine Pub Date : 2024-07-20 DOI: 10.1016/j.legalmed.2024.102496

{"title":"The influence of fixing condition on myoglobin stainability of striated muscle as a tool for forensic diagnosis","authors":"","doi":"10.1016/j.legalmed.2024.102496","DOIUrl":"10.1016/j.legalmed.2024.102496","url":null,"abstract":"<div><p>It is reported that immunostaining of Myoglobin (Mb) is useful for forensic diagnosis. In this study, we investigated the condition of fixation of striated muscle in 10 % neutral-buffered formalin to obtain appropriate stationarity of Mb in immunostaining. Firstly, criteria for staining intensity and definition of the stainability of examined were determined for sheep muscle tissue. Sheep myocardial tissue was fixed using 10 % neutral-buffered formalin under the 21 different conditions based on combinations of the following: three ratios of volume of formalin (mL) to weight of myocardium (g) (RFM) of 1, 4 or 9, 7 durations of fixation (DF) of 0.5, 3 or 6 h, and 1, 2, 5 or 7 days. Secondly, detection of Mb diffused form skeletal muscle from autopsy cases into formalin during fixation were confirmed by ELISA. Finally, the evaluation of stainability of Mb of striated muscle in routine autopsy examinations was confirmed using sheep staining intensity standards. From this experimental investigation, it has been demonstrated that the most suitable formalin fixation condition for using Mb staining in forensic diagnosis is RFM4 with a fixation time of at least DF 3 h up to 1 day. It was evident that staining intensity decreases with fixation durations exceeding 2 days, irrespective of the RFM. Thus, the fixation time was deemed the most influential factor affecting the staining properties of Mb staining in skeletal muscle tissue. When conducting Mb staining using striated muscle as an evaluation sample, particular attention should be paid to the fixation time.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851166","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

Background characteristics and neuropathology findings of medico-legal autopsy cases with and without β-amyloid precursor protein positive diffuse traumatic axonal injury 伴有和不伴有β-淀粉样前体蛋白阳性弥漫性创伤性轴索损伤的医学法律尸检病例的背景特征和神经病理学发现。

IF 1.3 4区医学

Legal Medicine Pub Date : 2024-07-18 DOI: 10.1016/j.legalmed.2024.102495

{"title":"Background characteristics and neuropathology findings of medico-legal autopsy cases with and without β-amyloid precursor protein positive diffuse traumatic axonal injury","authors":"","doi":"10.1016/j.legalmed.2024.102495","DOIUrl":"10.1016/j.legalmed.2024.102495","url":null,"abstract":"<div><p>The postmortem diagnosis of diffuse traumatic axonal injury (dTAI) relies on β-amyloid precursor protein (β-APP) immunohistochemistry. Most reports of factors associating with dTAI are decades old. We compared background characteristics and neuropathology findings of today’s Finnish medico-legal autopsy cases with and without β-APP-positive dTAI (dTAI+ and dTAI–, respectively). The cases had suffered a head injury prior to death and underwent a full neuropathological examination including β-APP stain. Background and circumstantial data as well as neuropathology findings were collected from police documents, medical records, and autopsy and neuropathology reports. Prevalence ratios were calculated for each factor to facilitate comparisons between the dTAI+ and dTAI– groups. The dataset comprised 57 cases (66.7% males), with 17 classified as dTAI+ and 40 as dTAI–. Based on prevalence ratios, the factors that had at least two-fold prevalence among dTAI+ cases compared to dTAI– cases were: an unknown injury mechanism; concurrent epidural or subdural haemorrhage; and an accidental manner of death. In contrast, the factors that had at least two-fold prevalence among dTAI– cases compared to dTAI+ cases were: a short postinjury survival (<30 min); concurrent intracerebral/ventricular haemorrhage or contusion; vermal atrophy; and a natural or homicidal manner of death. This study revealed differences in circumstantial features and neuropathology findings between dTAI+ and dTAI– cases in today’s medico-legal autopsy material. Data on typical case profiles may help estimate the prior probability of dTAI not only in medico-legal autopsies but also among living patients with head injuries.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1344622324001056/pdfft?md5=71a263ca4282de13d442a16f74895a90&pid=1-s2.0-S1344622324001056-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762112","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}

引用次数: 0

Characteristics of indoor and outdoor fatal hypothermia cases in Chiba, Japan 日本千叶县室内和室外致命低体温症病例的特征

IF 1.3 4区医学

Legal Medicine Pub Date : 2024-07-15 DOI: 10.1016/j.legalmed.2024.102494

{"title":"Characteristics of indoor and outdoor fatal hypothermia cases in Chiba, Japan","authors":"","doi":"10.1016/j.legalmed.2024.102494","DOIUrl":"10.1016/j.legalmed.2024.102494","url":null,"abstract":"<div><p>In forensic medicine, hypothermia is a frequently encountered cause of death, and this characteristic provides public health information to prevent similar deaths in the future. Previous studies revealed regional differences in hypothermia occurrence (indoors or outdoors). However, to our knowledge, no recent studies in Japan have directly compared the characteristics of indoor- and outdoor-onset cases based on forensic autopsy reports. Hence, this study aimed to determine the characteristics and risks of unexpected hypothermia-related death. It included 218 cases from the Chiba Prefecture, Japan, wherein forensic autopsies were performed and hypothermia was diagnosed; these cases were categorized into indoor- and outdoor-onset cases, and their characteristics were examined. The results showed no significant differences between the two groups in relation to the age of onset or residential environment (i.e., the presence or absence of cohabitants). The outdoor-onset group tended to have a higher incidence of dementia. Regarding the causes of hypothermia, the indoor group had more internal causes (<em>p</em> < 0.0001), whereas the outdoor group had more primary and external causes (<em>p</em> < 0.0001 and <em>p</em> = 0.0029, respectively). The indoor group was more undressed than the outdoor group. Atypical antipsychotic components were predominantly detected in the blood in the outdoor group (<em>p</em> = 0.0077). The body mass index tended to be lower in the indoor group than in the outdoor group. Broadening public awareness of the present study findings may aid in developing preventative strategies for hypothermia based on the location of onset.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696181","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

Fetal movement during delivery can lead to damage to the umbilical vessels and endanger the life of the fetus 分娩过程中的胎动会导致脐带血管受损，危及胎儿生命

IF 1.3 4区医学

Legal Medicine Pub Date : 2024-07-14 DOI: 10.1016/j.legalmed.2024.102493

{"title":"Fetal movement during delivery can lead to damage to the umbilical vessels and endanger the life of the fetus","authors":"","doi":"10.1016/j.legalmed.2024.102493","DOIUrl":"10.1016/j.legalmed.2024.102493","url":null,"abstract":"<div><h3>Introduction</h3><p>Fetal umbilical cord hematoma has a low incidence but high mortality, and its cause during delivery is often unclear. We report an autopsy case in which it was concluded that umbilical cord hematoma resulted from fetal movements during childbirth.</p></div><div><h3>Case presentation and autopsy findings</h3><p>A 27-year-old primigravida at 39 + 2 weeks gestation with normal antenatal visits suffered a fetal heart rate decrease during active labor. Bedside ultrasound revealed fetal death in utero 22 min later. Forensic pathologists found that the umbilical vessels were torn and bleeding on almost the same plane, and the hematoma compressed both umbilical arteries, which is the cause of fetal stillness in utero. A total of 32 cases were reported, including 6 umbilical cord ruptures and 26 umbilical cord hematomas. The cause of hematoma was unknown in 77 % of cases, while dysplasia was present in 56.25 % of umbilical cords.</p></div><div><h3>Discussion</h3><p>This case indicates that fetal movements may cause umbilical cord vessel injury, particularly when oxytocin is used to induce labor. When fetal heart sounds decrease for no apparent reason, the possibility of cord injury should be considered, and cesarean delivery should be performed as soon as possible. Therefore, rigorous fetal heart tracing during active delivery is necessary.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141623403","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

When fire burns the evidence – Lesson 1: It is not always what it seems 当烈火焚烧证据时--第 1 课：事情并不总是看起来那样

IF 1.3 4区医学

Legal Medicine Pub Date : 2024-07-09 DOI: 10.1016/j.legalmed.2024.102483

{"title":"When fire burns the evidence – Lesson 1: It is not always what it seems","authors":"","doi":"10.1016/j.legalmed.2024.102483","DOIUrl":"10.1016/j.legalmed.2024.102483","url":null,"abstract":"<div><p>When a charred corpse is found, a primary unavoidable phase of the subject’s identification is performed. Then, the medico-legal investigation must clarify whether the charring occurred before or after death, and so establish a differential diagnosis between accidental, homicidal, or suicidal modality.</p><p>We report three cases of charred corpses in which a death dynamic was initially suspected but subsequently disproved: a suicidal intoxication in arson at first thought to be homicidal strangulation, a suicidal hanging revealed by neck haemorrhages in a suspected accidental fire, a femicide through ligature strangulation concealed with the simulation of a car accident.</p><p>Many of the events are accidental, related to fires or traffic accidents. However, it must be considered that charring following a murder was deliberately provoked to prevent the identification of the subject and to conceal evidence of how the murder occurred. Because of the complex operational conditions in the study of a charred corpse, all the diagnostic tools proper to forensic science should be held beyond the preliminary circumstantial suggestions.</p><p>We aim to emphasise the importance of a multidisciplinary approach since the solution of the three cases was possible thanks to the combination of crime scene investigation, radiological exams, autopsy, and histopathological and genetic analysis.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704518","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

An autopsy case of intoxication caused by drug interaction with multiple psychotropic drugs, fluvoxamine, levomepromazine, and trihexyphenidyl 一个因与多种精神药物、氟伏沙明、左旋美丙嗪和三苯氧胺相互作用而导致中毒的尸检病例。

IF 1.3 4区医学

Legal Medicine Pub Date : 2024-07-01 DOI: 10.1016/j.legalmed.2024.102482

Sella Takei , Hiroshi Kinoshita , Mostofa Jamal , Tadayoshi Yamashita , Etsuko Tanaka , Sachiko Kawahara , Hiroko Abe , Kunihiko Tsutsui , Takehiko Murase

{"title":"An autopsy case of intoxication caused by drug interaction with multiple psychotropic drugs, fluvoxamine, levomepromazine, and trihexyphenidyl","authors":"Sella Takei , Hiroshi Kinoshita , Mostofa Jamal , Tadayoshi Yamashita , Etsuko Tanaka , Sachiko Kawahara , Hiroko Abe , Kunihiko Tsutsui , Takehiko Murase","doi":"10.1016/j.legalmed.2024.102482","DOIUrl":"10.1016/j.legalmed.2024.102482","url":null,"abstract":"<div><p>A case of death due to combined use of multiple drugs is reported, and the pharmacokinetic interactions are discussed. A woman in her thirties was found dead in her home. A medico-legal autopsy found no findings suggestive of injury or natural disease.</p><p>Toxicological analysis using liquid chromatography tandem mass spectrometry (LC-MS/MS) identified a toxic level of fluvoxamine (0.947 µg/mL), and concentrations greater than the therapeutic levels of levomepromazine (0.238 µg/mL) and trihexyphenidyl (0.225 µg/mL) were present, while bromazepam, haloperidol, sulpiride, and 7-aminoflunitrazepam were within or below their therapeutic ranges.</p><p>Fluvoxamine is mainly metabolized by cytochrome P450 2D6 (CYP2D6), and levomepromazine is a potent CYP2D6 inhibitor. A high concentration of levomepromazine may increase the blood fluvoxamine level. Since the combined use of levomepromazine and fluvoxamine induces seizures, it may have been involved in causing the subject’s death. In addition, combined use of trihexyphenidyl may potentiate anticholinergic effects of fluvoxamine overdose, including convulsions and coma. It was concluded that the cause of the subject’s death was the interaction of multiple drugs.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499479","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

Facial morphological analysis for the development of a representative atlas of the brazilian population 为编制巴西人口代表性图集而进行的面部形态分析

IF 1.3 4区医学

Legal Medicine Pub Date : 2024-07-01 DOI: 10.1016/j.legalmed.2024.102473

Tainá Nascimento Falcão , Laíse Nascimento Correia Lima , Lucas Faria Porto , Carlos Eduardo Palhares Machado , Bianca Marques Santiago

{"title":"Facial morphological analysis for the development of a representative atlas of the brazilian population","authors":"Tainá Nascimento Falcão , Laíse Nascimento Correia Lima , Lucas Faria Porto , Carlos Eduardo Palhares Machado , Bianca Marques Santiago","doi":"10.1016/j.legalmed.2024.102473","DOIUrl":"10.1016/j.legalmed.2024.102473","url":null,"abstract":"<div><p>The objective of this study was to propose categories of morphological classification for the face and its anatomical structures, as well as to propose illustrations to support the development of an atlas that facilitates facial morphological analysis of adult Brazilians. It was a descriptive study based on the analysis of the frequency and distribution of 13 photoanthropometric facial ratios (RFAs) obtained from a representative sample of the Brazilian population. RFAs related to facial height and width, eye width, intercanthal distance, nose length and width, philtrum ridge height and width, mouth thickness and width, upper and lower lip thickness, and chin height were analyzed. The study included a sample of 5.000 individuals aged between 18 and 22 years, evenly distributed between genders. Data normality was assessed using the Shapiro-Wilk test, considering them as parametric when p > 0.05. For the RFAs that showed normal distribution, mean ± 1.5 standard deviations (SD) were used to categorize facial measurements as regular, below average, or above average. Non-parametric RFAs were analyzed based on the median and 10th and 90th percentiles of the data. Based on the established average iris diameter, which is considered the most stable facial measurement, the values of the described RFAs were converted to a numerical scale in centimeters, allowing for the illustration of female and male faces. In this way, it was possible to categorize the facial anatomical structures and, consequently, visualize the facial morphological pattern of the adult Brazilian population.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141400884","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

Population specific dental age estimation model for South Indian children based on normalized open apices method: A cross sectional study 基于归一化开尖法的南印度儿童特定人群牙龄估计模型：横断面研究

IF 1.3 4区医学

Legal Medicine Pub Date : 2024-06-30 DOI: 10.1016/j.legalmed.2024.102481

{"title":"Population specific dental age estimation model for South Indian children based on normalized open apices method: A cross sectional study","authors":"","doi":"10.1016/j.legalmed.2024.102481","DOIUrl":"10.1016/j.legalmed.2024.102481","url":null,"abstract":"<div><p>Age estimation plays significant role in forensic science especially when there is unavailability of the information concerned to the deceased. Use of population specific models of age estimation results in questionable evidence legally when tried on Indian children. The present study was designed to assess the accuracy of Cameriere’s Italian and Balwant Rai Indian model on South Indian children and to derive and validate a novel model for south Indian children by considering a sample from a larger geographical area with a greater sample size of 2500. Accuracy of both the models for South Indian children was analysed using root mean square error. Significant differences were observed in estimated age across all age groups and between sexes, using above models. Root mean square error using Cameriere’s Italian model was 1.54 and for Balwant Rai Indian model, it was found to be 1.78. The error for all the age groups was found to be 1.49 to 1.60 using Cameriere’s model and 1.41 to 2.1 using Rai’s model. A novel Population specific model was derived based on open apices of left mandibular seven teeth. Root mean square error with novel derived Population specific model was found to be less than 1 year overall being 0.94 and for all the age groups ranged from 0.91 to 0.96. The derived Population specific model exhibits superior accuracy compared to both the models and hence it can be considered for dental age estimation of the south Indian children in medico-legal cases.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141638713","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

Massive bleeding from an infected pseudoaneurysm in an arteriovenous graft that resulted in death: A case report 动静脉移植感染性假性动脉瘤大出血致死：病例报告。

IF 1.3 4区医学

Legal Medicine Pub Date : 2024-06-26 DOI: 10.1016/j.legalmed.2024.102480

Akiko Tashiro , Shogo Shimbashi , Motoo Yoshimiya , Sakon Noriki , Hideki Hyodoh

引用次数: 0