Legal Medicine最新文献

{"title":"Estimation of sex using dimensions around the metatarsal diaphyseal nutrient foramen: Application of discriminant function analysis and logistic regression models","authors":"Arthur Tsalani Manjatika ,&nbsp;Joshua Gabriel Davimes ,&nbsp;Pedzisai Mazengenya","doi":"10.1016/j.legalmed.2024.102417","DOIUrl":"10.1016/j.legalmed.2024.102417","url":null,"abstract":"<div><p>Sex estimation equations are population-specific, and a wider use of multiple bones to generate equations will increase the accuracy of sex estimation in forensic settings. The metatarsal bones have been used previously, however the dimensions around the diaphyseal nutrient foramen have not been utilised in sex estimation. The current study aimed to determine the utility of the dimensions around the nutrient foramen of metatarsal bones in estimating sex in the South Africans of European descent (SAED). Five measurements around the nutrient foramen were taken from a total of 876 metatarsal bones (first to fifth) from 186 individual skeletons (99 males, 87 females) obtained from the Raymond A. Dart Modern Skeletal Collection. Measurements subjected to direct and stepwise discriminant function (DFA) and logistic regression (LRA) analyses included total length, distance from proximal end to nutrient foramen, circumference, and mediolateral and dorsoplantar diameters at the level of the nutrient foramen. The original classification accuracies for multivariable functions of the stepwise and direct DFA ranged from 83.1–88.3% to 85.5–88.3%, respectively. The original classification accuracies for multivariable functions of the stepwise and direct LRA ranged from 83.3%–88.7% to 86.2%–88.3%, respectively. The cross-validation classifications showed a drop of 0–2.4% for DFA and 0.2–1.1% for LRA. The width measurements were better predictors of sex than length. The dimensions around the metatarsal bone nutrient foramen exhibit sexual dimorphism in the SAED. The generated DFA and LRA functions produced high average classification accuracies which are useful in sex estimation during forensic human identification.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139578212","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":"An optimal skeletal element for DNA testing: Evaluation of DNA quantity and quality from various bone types in routine forensic practice","authors":"Tomomi Otagiri,&nbsp;Noriko Sato,&nbsp;Tetsuya Shiozaki,&nbsp;Yuta Harayama,&nbsp;Momoe Matsumoto,&nbsp;Kanya Kobayashi,&nbsp;Hideki Asamura","doi":"10.1016/j.legalmed.2024.102415","DOIUrl":"10.1016/j.legalmed.2024.102415","url":null,"abstract":"<div><p>For human identification, the quality and quantity of DNA must be sufficient for amplification and analysis. When DNA extraction from bone tissues and teeth is required, the optimal skeletal elements should be selected as samples for DNA extraction because DNA yield differs among elements. Recently, some studies have reported that a high quantity of high-quality DNA can be extracted from the small cancellous bones of the hands and feet. In this study, we evaluated the effectiveness of small cancellous bones in the human identification of skeletal remains in routine forensic genetic casework. Cancellous bones [phalanges, (meta)carpal bones, and (meta)tarsal bones)] and the cortical bones (femur and petrous bones) and teeth, which have generally been recommended as samples, were collected from the same individuals that needed identifying using DNA analysis in our laboratory. The quantity of DNA from small cancellous bones tended to be higher than that from cortical bones, and the quality from the former was as high as that from the latter. This study showed that in routine forensic casework, the small cancellous bones of the hands and feet should be actively selected as samples for DNA testing.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1344622324000257/pdfft?md5=891ecce5552656a478056f273a64e694&pid=1-s2.0-S1344622324000257-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139507359","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":"Extracorporeal bullet trajectory determination from scanned phantoms with bullet defects","authors":"G.A.J.C. Crombag ,&nbsp;B.J.M. Hofman ,&nbsp;F. Riva ,&nbsp;P.A.M. Hofman ,&nbsp;W. Kerkhoff","doi":"10.1016/j.legalmed.2024.102410","DOIUrl":"10.1016/j.legalmed.2024.102410","url":null,"abstract":"<div><p>Shots with two different calibres (0.32 Auto and 9 mm Luger) were fired through phantoms that simulated human torsos, mounted on undercarriages with witness panels. The perforated phantoms were scanned with computed tomography (Siemens) using 80 kV and 140 kV and a slice thickness of 1 mm. The intracorporeal trajectories in the phantoms were compared to the known extracorporeal trajectories, derived from the perforations in witness panels. The discrepancy between the intracorporeal and extracorporeal trajectories, denoted as the absolute angle, was calculated for the trajectories before (front) and after (rear) the phantoms. Mean absolute angles at the front were lower than at the rear (2.27° vs. 4.54°) and the difference was statistically significant (p &lt; 0.001). The results of the study imply that the line between the entrance and the exit wound in a scanned victim can be extended to the extracorporeal bullet trajectory leading towards the entrance wound. The absolute angles presented in this study give an impression of the expected errors with the two calibres. This can be helpful in shooting investigations to assess the position of the shooter from entrance and exit wounds in a scanned victim.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1344622324000208/pdfft?md5=a24c8d5462c603bc0fe3bc71aa370fd9&pid=1-s2.0-S1344622324000208-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139496680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The changes in tissue histomorphology and quality of DNA in healthy human autopsied tissues stored at −20 °C and −150 °C","authors":"Dusan N. Radojevic ,&nbsp;Milos S. Todorovic ,&nbsp;Katarina M. Vitosevic ,&nbsp;Vanja Canovic ,&nbsp;Milena Pavicevic ,&nbsp;Zivana S. Slovic ,&nbsp;Ivana M. Andric ,&nbsp;Stevan Matic ,&nbsp;Danijela V. Todorovic","doi":"10.1016/j.legalmed.2024.102396","DOIUrl":"10.1016/j.legalmed.2024.102396","url":null,"abstract":"<div><p>The aim of this study was to compare the changes in tissue histomorphology and DNA quality in six different healthy tissues (brain, heart, lung, liver, spleen and kidney) exempted during autopsy of healthy individuals and storage at −20 °C and −150 °C three month. Tissue samples were obtained, divided by tissue and temperature group, and for each sample, tissue histomorphology and DNA (isolated from all tissues in duplicated − 72 samples of DNA) quality were analysed. Morphology of tissue samples was studied using H&amp;E staining. DNA was isolated using the phenol–chloroform-isoamyl alcohol method. To assess the concentration and purity of the DNA samples, we used a spectrophotometer to measure absorbance at wavelengths of 280 nm and 260 nm. The fragments of human telomerase reverse transcriptase (hTERT) gene were amplified from the DNA using PCR reaction and then visualised using the 2 % agarose gel. Samples stored at −150 °C sustained the highest degree of histomorphological damage, while samples stored at −20 °C were less degraded, compared to control. The liver samples stored at −20 °C had a mean DNA concentration (1030.4 ± 51.5 ng/μl) higher than the samples of liver tissue stored at −150 °C (497.4 ± 167.1 ng/μl) (p &lt; 0.001). Other tissues did not have statistically significantly different DNA concentration at both temperatures. Liver samples at −20 °C had degraded DNA, showed as the absence of hTERT gene in most of samples. Other tissue samples in both temperature groups had unfragmented DNA. Storing tissue samples at −20 °C is not inferior in terms of DNA yield and integrity, and possibly superior for tissue histomorphology, comparing with samples stored at −150⁰C.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139459787","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 suicide to accident – Case report – The significance of the medico-legal autopsies","authors":"Živana Slović ,&nbsp;Miloš Todorović ,&nbsp;Ivana Andrić ,&nbsp;Vanja Čanović ,&nbsp;Filip Mihajlović ,&nbsp;Katarina Vitošević ,&nbsp;Danijela Todorović","doi":"10.1016/j.legalmed.2024.102397","DOIUrl":"10.1016/j.legalmed.2024.102397","url":null,"abstract":"<div><h3>Introduction</h3><p>Suicide is the intentional and voluntary act of destroying one's own life, while an accident is an unintended event that involuntarily causes injury to one's health or destruction of life.</p></div><div><h3>Case presentation</h3><p>We report a case of a 54-year-old male who was found in a forest in late November, approximately 500 m away from his car. He was positioned bent over a trunk of a tree with his head beneath the rest of his body. His pants were down to his knees, and there were soiled blades of grass and leaves on his body. Investigation of the case circumstances revealed that he had attempted suicide by carbon monoxide poisoning, using a hose connected to the exhaust pipe and running it through the window into the cabin. Window on the driver’s side was broken with glass particles on the driver's seat. Wrappers from “Rivotril” tablets, a generic benzodiazepine, were also found in the car.</p><p>Autopsy revealed the following: postmortem hypostasis was of a cherry red color and well pronounced on the upper part of the front of the body and face. Numerous bruises, contusions, and erosions were present all over the body. Frostbites were especially pronounced in the knees and elbows area. The synovial membranes were partially bloodstained and reddish in color. Opening the stomach revealed erosions of the gastric mucosa (Wischnewsky sign).</p><p>Chemical toxicological analysis detected presence of benzodiazepines and carboxyhemoglobin (25%).</p></div><div><h3>Conclusion</h3><p>Based on the autopsy findings, chemical toxicological analyses, and investigation of the case circumstances, it has been concluded that the death occurred due to the combined effects of hypothermia, postural asphyxia and carboxyhemoglobin and benzodiazepine intoxication. The manner of death in this case is a combination of accidental and suicidal, as the victim attempted suicide but ultimately died due to exposure to low external temperature.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139423261","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 suicide case of liquid nicotine intoxication","authors":"Ayumi Motomura ,&nbsp;Hiroyuki Inoue ,&nbsp;Namiko Ishii ,&nbsp;Kie Horioka ,&nbsp;Keisuke Okaba ,&nbsp;Chihiro Moue ,&nbsp;Ryuto Ohashi ,&nbsp;Daisuke Yajima","doi":"10.1016/j.legalmed.2024.102400","DOIUrl":"10.1016/j.legalmed.2024.102400","url":null,"abstract":"<div><p><span><span>A man in his 50 s, who was found vomiting and in a disturbed state when the emergency medical team<span><span> arrived, then went into cardiopulmonary arrest during transport and died without responding to resuscitation. The hospital initially suspected that the death may have been caused by internal causes, but since the deceased had previously been transported to the hospital in a suicide attempt, the hospital called police regarding suspicions of unnatural death. The police investigation revealed two empty bottles of nicotine liquid for e-cigarettes in his house and a search history of “nicotine suicide” on his cellphone. In a </span>forensic autopsy<span><span>, he was found to be highly obese, and abundant fat deposits were observed in his organs. A stent was placed in the aorta, but no abnormality was found. There was no obvious stenosis or obstruction in the </span>coronary arteries. Drug screening using </span></span></span>liquid chromatography tandem mass spectrometry<span> (LC-MS/MS) was performed on cardiac blood, urine, and stomach contents collected at autopsy, which revealed the presence of some medical products such as aripiprazole, nicotine, and </span></span>cotinine<span><span>. Further quantitative testing revealed high concentrations of nicotine in all samples. The left and right femoral venous blood concentrations were above the lethal dose, suggesting that </span>arrhythmia or respiratory failure due to nicotine intoxication was the cause of death. With the widespread use of e-cigarettes, high concentrations of nicotine are readily available, and case reports of serious nicotine addiction are increasing. It is important to always consider addiction when conducting forensic evaluations in the medical field.</span></p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139423974","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":"Exploring the feasibility of smartphone cameras for 3D modelling of bite patterns in forensic dental identification","authors":"Arofi Kurniawan ,&nbsp;Janice Hamdani ,&nbsp;An'nisaa Chusida ,&nbsp;Haryono Utomo ,&nbsp;Beta Novia Rizky ,&nbsp;Beshlina Fitri Widayanti Roosyanto Prakoeswa ,&nbsp;Azra Rahma Yuniar ,&nbsp;Rodrigo Salazar-Gamarra ,&nbsp;Aspalilah Alias ,&nbsp;Mohd Yusmiaidil Putera Mohd Yusof ,&nbsp;Anand Marya","doi":"10.1016/j.legalmed.2024.102399","DOIUrl":"https://doi.org/10.1016/j.legalmed.2024.102399","url":null,"abstract":"<div><p>The field of bitemark analysis involves examining physical alterations in a medium resulting from contact with teeth and other oral structures. Various techniques, such as 2D and 3D imaging, have been developed in recent decades to ensure precise analysis of bitemarks. This study assessed the precision of using a smartphone camera to generate 3D models of bitemark patterns. A 3D model of the bite mark pattern was created using 3Shape TRIOS^TM and a smartphone camera combined with monoscopic photogrammetry. The mesiodistal dimensions of the anterior teeth were measured using Rapidform Explorer and OrtogOnBlender, and the collected data were analyzed using IBM® SPSS® Statistics version 23.0. The mean mesiodistal dimension of the anterior teeth, as measured on the 3D model from 3Shape TRIOS^TM and smartphone cameras, was found to be 6.95 ± 0.7667 mm and 6.94 ± 0.7639 mm, respectively. Statistical analysis revealed no significant difference between the two measurement methods, <em>p</em> &gt; 0.05. The outcomes derived from this study unequivocally illustrate that a smartphone camera possessing the specific parameters detailed in this study can create a 3D representation of bite patterns with an accuracy level on par with the outputs of a 3D intraoral camera. These findings underscore the promising trajectory of merging smartphone cameras and monoscopic photogrammetry techniques, positioning them as a budget-friendly avenue for 3D bitemark analysis. Notably, the monoscopic photogrammetry methodology assumes substantial significance within forensic odontology due to its capacity for precise 3D reconstructions and the preservation of critical measurement data.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139436227","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":"On tackling abuse of older people: The forensic challenges in fatal cases investigation","authors":"Arianna Giorgetti ,&nbsp;Guido Pelletti ,&nbsp;Clara Fiorentini ,&nbsp;Maria Carla Mazzotti ,&nbsp;Paolo Fais ,&nbsp;Susi Pelotti","doi":"10.1016/j.legalmed.2024.102398","DOIUrl":"10.1016/j.legalmed.2024.102398","url":null,"abstract":"<div><p>The World Health Organization recently presented the priorities for tackling abuse of older people in a coordinated and strategic way. However, data on the forensic scenario is still lacking. In this context, the aim of the present work was to provide a comprehensive literature review of this inherently complex phenomenon in the post-mortem setting, in order to better characterize it from a forensic point of view. A comprehensive literature search was performed in three electronic databases following the PRISMA guidelines. Sociodemographic and medical data of victims and perpetrators, post-mortem data, types of abuse and risk factors were extracted from non-aggregated data. Forty-eight papers dealing with abuse in the post-mortem setting were included, with a predominance of case reports and case series. The review showed that neglect was the most common type of abuse and victims are predominantly older women who are abused in a domestic setting by trusted family member. To generate more and better data, expanded research in the forensic field requires standardized methods and the raise of professional awareness about abuse of older people.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1344622324000087/pdfft?md5=3971036c32abf2936ff1468875d7e20a&pid=1-s2.0-S1344622324000087-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139455619","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":"Beyond the virus: Examining the impact of COVID-19 on violent fatalities","authors":"Ivana Andrić ,&nbsp;Živana Slović ,&nbsp;Miloš Todorović ,&nbsp;Vanja Čanović ,&nbsp;Filip Mihajlović ,&nbsp;Danijela Todorović ,&nbsp;Katarina Vitošević","doi":"10.1016/j.legalmed.2024.102392","DOIUrl":"10.1016/j.legalmed.2024.102392","url":null,"abstract":"<div><h3>Introduction</h3><p>The COVID-19 pandemic has had a significant impact on various aspects of society, including crime rates. In Serbia, it is important to examine the changes in violent deaths before and during the pandemic to inform public health and safety policies.</p></div><div><h3>Materials and methods</h3><p>We conducted a retrospective, epidemiological, cross-sectional analytical study of medico-legal autopsies in the Department of Forensic Medicine and Toxicology at the University Clinical Center of Kragujevac. Our study sample comprises all forensic autopsy cases examined from January 2017 to December 2019 (151 cases), labeled as “Before,” and from January 2020 to December 2022 (192 cases), labeled as “During” the pandemic period. Natural deaths, skeletal remains, and undetermined cases were excluded from our sample.</p></div><div><h3>Results</h3><p>The data show an increase in the total number of incidents reported from 152 in the “Before” period to 191 in the “During” period. The proportion of incidents involving males remained relatively stable at around 70%, while the proportion of incidents involving females increased. There was no statistically significant change in the proportion of incidents classified as accidental, while the proportion of incidents classified as homicide and suicide increased. The results show a statistically significant association between gender and incident type for both the “Before” and “During” periods. Deaths due to domestic violence have increased by 22.2% during the pandemic, which is cause for concern. In terms of demographic characteristics, males and younger individuals were more likely to be victims of violent deaths both before and during the pandemic.</p></div><div><h3>Conclusions</h3><p>The COVID-19 pandemic had a significant impact on violent deaths in the Šumadija region (Central Serbia), with an overall increase in the number of violent deaths and a major impact on deaths due to domestic violence. Policies to address domestic violence should be prioritized during the pandemic and beyond, and strategies should be developed to mitigate the effects of future pandemics or lockdowns.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139374891","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":"Plastic bag suffocation and codeine overdose: An unusual case of complex suicide and review of the literature","authors":"Ilaria Tarozzi ,&nbsp;Lorenzo Franceschetti ,&nbsp;Silvio Chericoni ,&nbsp;Amalia Rizzo ,&nbsp;Valentina Bugelli","doi":"10.1016/j.legalmed.2024.102393","DOIUrl":"10.1016/j.legalmed.2024.102393","url":null,"abstract":"<div><p>The term “planned complex suicide” refers to cases where two or more suicide methods are applied simultaneously. Plastic bag suffocation is a suicidal method commonly combined with self-poisoning by inhalation of volatile compounds or pharmacological substances at poisoning dosage. A 67-year-old woman was found dead on the couch. The head was wrapped in a plastic bag knotted at the front of the neck. No signs of struggle were present on the scene. In the fireplace, there were two blisters of acetaminophen/codeine phosphate tablets. Postmortem examination showed congestion of the face and the neck and pulmonary edema with patchy emphysema. There was no evidence of physical duress. Toxic levels of codeine were detected in the blood. The death was related to a complex suicide involving codeine overdose and asphyxia by plastic bag suffocation. The hypoxic/cardioinhibitory effects of plastic bag suffocation combined to codeine-induced deep reduction of respiratory rate, making the suicide hypothesis the more likely scenario. In order to assess what elements contribute to postmortem diagnosis in complex suicides with plastic bag suffocation, a review of the forensic literature published between 2002 and 2022 was performed. This article emphasizes the complexity of diagnosing deaths involving plastic bag suffocation in suicides, particularly when combined with other methods like inert gas inhalation or drug intake. It underscores the importance of comprehensive toxicological analyses, careful scene examination, and histological studies, not forgetting a thorough comparative analysis of the existing literature, to accurately determine the cause and manner of death in such cases.</p></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139104393","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}