Forensic Science, Medicine and Pathology最新文献

Aspergillus fumigatus significantly threatens immunocompromised individuals by causing potentially fatal diseases, primarily invasive aspergillosis (IA). IA, mostly affecting the lungs, can disseminate to other organs, including the central nervous system (CNS), leading to high mortality rates. We present the case of an 84-year-old immunocompetent male with a history of significant comorbidities, who developed a lethal subarachnoid and tetraventricular hemorrhage. Initial symptoms included paroxysmal neuralgic pain and ophthalmic manifestations. Despite diagnostic efforts, the infection was confirmed only after a positive Aspergillus galactomannan antigen test on cerebrospinal fluid, post-mortem microbiological culture, and mass spectrometry (MS) authentication. The patient exhibited rapid deterioration and succumbed due to the erosion of a mycotic cerebral aneurysm of the left internal carotid artery. Diagnosing IA, particularly isolated CNS IA in immunocompetent patients, is challenging due to its nonspecific symptoms and difficulty detecting the pathogen in standard diagnostic tests. This article emphasizes the pivotal role of pathological examination to obtain a definitive diagnosis, assess fungal infiltration of brain vessels, and thus clarify the accurate source of fatal brain hemorrhages.

A female senior dialysis patient was found dead in her apartment, covered in blood. Bloodstains were observed in different rooms of the apartment. During the post-mortem examination on site, a small, roundish opening of the skin was observed on the flexor side of the upper arm, within a longitudinal scar, from which blood was draining. Throughout police investigation, the possibility of an accident, a suicidal act, or medical malpractice during dialysis care was considered. An autopsy was ordered for further clarification. The autopsy identified exsanguination from a fistula on the flexor side of the left upper arm as the cause of death. The fistula could be traced into an arteriovenous shunt vessel that had been created a long time ago for dialysis. Upon projection onto the shunt vessel, punctiform crusts with underlying hemorrhages in the subcutaneous fatty tissue were identified in the skin. Histological examinations of the fistula and its surrounding tissue revealed no evidence of vasculitis or perivascular inflammatory changes, but puncture sites of varying ages with connective tissue texture disruption of the vessel wall and the adjacent subcutaneous tissue. Forensic medical examination concluded that death was caused by bleeding from an arteriovenous dialysis shunt vessel as a complication of hemodialysis. This case illustrates the relevance of comprehensive forensic medical case processing as the basis for a well-founded assessment.

We present a case of complex suicide concerning a 55-year-old man who hanged himself using a rope anchored to a beam on the terrace of his apartment. Multiple parallel linear wounds were observed on his head. At the crime scene, an axe stained with blood and hair was found resting against the wall adjacent to the stairs leading to the upper floor. Forensic investigations identify the cause of death as mechanical asphyxia due to the hanging, in a complex suicide characterized by hesitation marks inflicted on the head with an axe. This specific type of complex suicide has never been described in the literature.

Conducting sex estimation based on bones through morphometric methods increases the need for automatic image analyses, as doing so requires experienced staff and is a time-consuming process. In this study, sex estimation was performed with the EfficientNetB3, MobileNetV2, Visual Geometry Group 16 (VGG16), ResNet50, and DenseNet121 architectures on patellar magnetic resonance images via a developed model. Within the scope of the study, 6710 magnetic resonance sagittal patella image slices of 696 patients (293 males and 403 females) were obtained. The performance of artificial intelligence algorithms was examined through deep learning architectures and the developed classification model. Considering the performance evaluation criteria, the best accuracy result of 88.88% was obtained with the ResNet50 model. In addition, the proposed model was among the best-performing models with an accuracy of 85.70%. When all these results were examined, it was concluded that positive sex estimation results could be obtained from patella magnetic resonance image (MRI) slices without the use of the morphometric method.

Determination of the minimum postmortem interval remains an important factor in the investigation of deaths, especially homicides. It is important for near-accurate reconstruction of the fatal event, especially after putrefaction has commenced. It helps to weigh the alibi of suspects, and to include or exclude these individuals. The science of forensic entomology, acarology, palynology and taphonomy have been applied with varying degree of accuracy depending on a plethora of biotic and abiotic factors. Each of these specialties is most useful at specific times during decomposition and depending on local environmental factors. As decomposition progresses, the estimation of the PMI becomes more difficult. Here, we review how different forensic techniques are most appropriate for estimating the postmortem interval at different times since death. Ultimately, the determination of the interval is a difficult task requiring a multidisciplinary approach comprising many forensic specialists.

This is the most intriguing museum specimen of cardiovascular syphilis, collected in the Forensic Museum founded by professor Milovan Milovanović (1884-1948) in 1923, the first professor of Forensic Pathology in the newly established University School of Medicine in Belgrade. We aimed to analyze the specimen of an autopsy case from the year 1929 in which severe thoracic spine erosion occurred due to syphilitic aneurism and to demonstrate findings by multi-detector computed tomography (MDCT). The specimen comprises an en-block-eviscerated heart, thoracic aorta, thoracic spine, and posterior segments of the ribs, with a partial section of the heart and a longitudinal section of the aorta. We performed histology and MDCT analyses almost a century after the autopsy and revised the original case documentation. The conducted analyses confirmed the characteristic pathology. Most importantly, MDCT imaging revealed intriguing destruction of the vertebral bodies by the pulsatile saccular aneurysm of the descending aorta. The calcified aneurysm led to the extensive irregular mechanically caused osteolysis of the anterior segments of the several vertebral corpora. After the analysis and revision of the original case documentation, we discussed these findings, as well as additional characteristic autopsy findings in syphilis-related deaths, some of which might be forgotten. The direct close contact of the syphilitic aortic aneurysm with the thoracic spine was preserved. By utilizing postmortem MDCT and 3D reconstruction, we better visualize the thoracic spine bone resorption and alteration: in the time of Milovanović, only roentgenography was available, providing less detail.

High-speed tear liquid ejectors, as novel less-lethal weapons, demonstrate significant potential in public security, counter-terrorism, and riot control applications. However, critical gaps persist in understanding their kinetic energy dissipation dynamics and associated injury risks, particularly when using traditional specific kinetic energy methods. Therefore, this study establishes an integrated experimental framework combining transient trajectory acquisition systems, ballistic gelatin targets, and dynamic impact force measurements. Key findings reveal that as the launch distance varies from 10 cm, 30 cm to 100 cm, and 200 cm, the trajectory transitions from a coherent stream to dispersed filaments with unstable energy density evolution. Initially, the jet velocity rises from 93.3 m/s to 101.1 m/s, then decreases to 91.7 m/s and 80.8 m/s. Additionally, the penetration depth in the ballistic gelatin decreases progressively with launch distance, measuring 91 mm, 80 mm, 38 mm, to 0 mm respectively, and the depths of penetration at 10 and 30 cm are similar to those of a 4.5 mm steel ball at 180 m/s. The transient impact force follows a similar pattern with velocity, first increasing and then decreasing, to 464 N, 518 N, 95 N, and 48 N respectively, underscoring potential injury risks within 100 cm ranges. This work establishes a framework for evaluating high-speed jet injuries and informs safety protocols for less-lethal weapon deployment.

The scene of events involving incinerated victims presents significant challenges for forensic teams. Dental evidence has been reported as highly valuable to the identification process. However, given its commingling with debris and its fragility in these contexts, the participation of a forensic odontologist (FO) at the scene has been recommended to enhance the identification, recovery, conservation, and transport of this evidence. We present a scoping review of case reports in which the FOs have actively participated at the scene, facilitating or enhancing the identification of human remains in these contexts. The leadership of Norway and Australia has demonstrated that the inclusion of FOs has been deemed crucial to prevent the loss of dental evidence in this type of scene; however, it is essential that FOs possess the appropriate training and preparation for these tasks. The implementation of appropriate protocols, including wrapping and protection of the victim's head and the utilization of stabilization agents for the remains to ensure protected transport to the mortuary, has also been recommended. Nevertheless, these best practices do not appear to be widespread and are likely dependent on circumstances specific to each country; therefore, it has been suggested, at minimum, that first responders should be trained in these skills.

In this review, we holistically consider healthcare as an ecosystem that includes forensic pathology and legal medicine and probe why these areas have largely ignored the use of Metaverse. This effort is directed at understanding the potential impact of virtual worlds on these areas and ultimately asks if forensic sciences are missing an opportunity or multiple opportunities. We reviewed the scientific literature to identify clinical trials and observational or other study types using PubMed Central, Web of Science, Scopus, and Cochrane, including terms related to the Metaverse and healthcare, with a screen of 1,200 relevant articles. Applications were from future clinical applications, training, treatment, prediction/prevention, and diagnosis, focusing on finding blanks in forensic and legal medicine. The study carried out in-depth research with the Metaverse regarding all areas of medicine. Despite this, significant forensic pathology or legal medicine research has yet to be identified. The gap may implicate a critical oversight in forensic areas, specifically autopsies, crime scene investigation, and field reconstruction of legal cases that could benefit from implementing virtual simulations. In this regard, incorporating virtual environments in these areas can provide new training tools, case scenarios, and even a revision mechanism for cold cases, leading to an essential trend in the evolution of legal medicine.