Forensic Science, Medicine and Pathology最新文献

Peer review of submitted manuscripts refers to the process of sending out papers for evaluation by suitably qualified academics/practitioners working in the same area. After their assessments and recommendations have been addressed by submitting authors editors will decide on whether publication is warranted or not. Unfortunately, 'peer review' has achieved a high status in courts without a real understanding of the way that the system works. Given that it has been deemed: 'a flawed process, full of easily identified defects with little evidence that it works', greater understanding of the nature of peer review is required. The following paper provides an overview of its strengths and weaknesses.

Fingermarks are an important form of evidence in forensic science, routinely used for identification or exclusion purposes within the criminal justice system. The increasing use of fingerprint recognition in technology and biosecurity, such as for unlocking devices and accessing banking information, highlights the need for forensic fingermark recovery methods that serve both traditional forensic needs and modern technological demands. Current fingerprint development techniques, however, are not designed to fulfil this dual-purpose. This paper presents a novel approach that introduces the use of conductive paint and silicone to develop, recover, and preserve latent, patent, and plastic fingermarks. The innovative method produces conductive casts that capture detailed ridge patterns, thereby facilitating forensic examination as well as being used for unlocking capacitive and ultrasonic fingerprint scanners in a range of mobile devices.

Despite various preventative measures, cocaine smuggling is still a major problem worldwide. A recent method of smuggling is the transportation of cocaine with various chemicals or with impregnated materials such as cloth and paper. This study aims to examine the change in the amount of cocaine on the paper surface and attempts to decide the best fingermark development method in the case of smuggling trafficking in the form of impregnated paper with the least effect on the cocaine concentration on the paper. The papers (n = 6 + 1) were prepared for each fingermark development method, including a blank paper, were dipped into a working solution prepared by dissolving 0.38 mg cocaine in 500 mL methanol. Fingermarks were developed by applying various chemicals, including Iodine vapor, 1,2-Indandione, DFO (1,8-diazafluoren-9-one), ThermaNin, 5-MTN (5-methylthioninhydrin), and silver nitrate chemicals and Ninhydrin, which is the most commonly used reagent for visualizing latent prints, particularly on paper surfaces. Also, the natural fingermarks of four different donors, two women and two men between 20 and 50 years of age, were used to compare with the presence of cocaine. Different from others, this study examined the application of DFO and 1,2-Indandione as alternatives to other chemicals and revealed that it is possible to identify cocaine using these methods. The order of success was Ninhydrin > DFO > 1,2-Indandione > ThermaNin > Iodine vapor = 5-MTN. To the best of our knowledge, the current study is the first to investigate fingermark identification methods along with the amounts of cocaine on cocaine-impregnated papers.

A 46-year-old man with a history of secundum atrial septal defect and interstitial lung disease was admitted to the hospital for a planned transcatheter closure of the atrial septal defect. Following multiple failed attempts to place a right femoral vein catheter, the procedure was aborted. Another attempt was made to the left femoral vein, but that attempt was complicated by an unfamiliar resistance. Even though resistance was met during insertion, the catheter was further inserted until a position in the inferior vena cava above the liver was obtained at fluoroscopy. Simultaneously, the patient became unresponsive. The procedure was immediately aborted and the atrial septal defect closure was not completed. Air embolism to the heart and brain was detected using echocardiography and computed tomography. The patient died 15 days after the procedure. Death was attributed to severe cerebral edema due to air embolism. The autopsy revealed a left-sided inferior vena cava. This case report demonstrates that unexpected congenital vascular anomalies complicating a routine transcatheter closure of the atrial septal defect can result in a fatal outcome.

Aluminum phosphide (AlP) poses a significant health challenge in developing countries, primarily because of its accessibility to the unregulated market and the absence of specific antidotes. Although chemical analysis of routine viscera can provide valuable information regarding the type of poison present in the body during poisoning incidents, numerous factors can alter the test results of chemical analysis, such as decomposition changes, postmortem redistribution, and the chemical nature of drugs. Analytical methods are frequently impeded by the interference caused by coextracted putrefactive compounds, which can mask or alter the detection of drugs. This series of three cases is particularly noteworthy because it involves the postmortem detection of AlP in the abdominal subcutaneous fat of the deceased, a previously unreported occurrence. In the first case, the body showed findings of late postmortem changes, with stomach mucosa being congested and hemorrhagic, along with routine viscera, and abdominal subcutaneous fat was sent for toxicological analysis. To confirm these findings, in two further cases of suspected AlP poisoning, subcutaneous fat was sent along with routine viscera. Stomach mucosa in the other two cases showed findings similar to those in the first. In the third case, black paste-like material was noted as stomach content. All the cases revealed the presence of AlP in routine viscera samples and abdominal subcutaneous fat on gas chromatography-mass spectrometry (GC‒MS) analysis. Therefore, abdominal fat can serve as a suitable sample for toxicological analysis to identify the presence of AlP, even in cases with advanced putrefactive changes.

A 52-year-old woman with of neck pain underwent percutaneous neck injection of local anesthetic and a corticosteroid without image guidance. She collapsed asystolic during the procedure was resuscitated and then died after 2 weeks in the intensive care unit with hypoxic encephalopathy. Complete postmortem examination included additional posterior neck dissection and cervical spinal cord removal with intact dura mater. The entire cervical spinal cord with the dura and leptomeninges was embedded in an oriented sequence of several paraffin blocks. Serial sections of each selected blocks were then studied to locate a putative puncture site. Serial sections from the third and fourth cervical levels (C3-C4) were stained with luxol fast blue-hematoxylin-eosin, iron stain, trichrome stain, and immunostained for b-amyloid precursor protein, and CD68. Histological examination revealed a linear needle track with a subacute healing reaction. The path included the dorsal spinal dura, arachnoid, and the left dorsal column. Clinicopathological correlation and the cause of death are discussed. Careful planning, dissection, sampling, and oriented serial sectioning with immunostaining were key points to document the injuries and understand this case.

To provide example cases within the peer-reviewed literature of a phenomenon related to certain gunshot wounds of the head where the bullet pathway courses along the inner table of the skull. Presentation of two cases discovered at medicolegal autopsy. The two cases provide radiologic and autopsy demonstration of bullet pathways within the head where the projectiles track along the inner aspect of the cranium, in a circumferential manner, such that the bullets are recovered in a location on the opposite side of the brain/head, with no projectile pathway within the intervening deep structures of the brain. The cases provide photographic and radiologic autopsy documentation of the phenomenon, which is described in forensic pathology textbooks and rare peer-reviewed literature sources, but without photographic demonstration. Recognition of this phenomenon in the clinical setting, or when correlating autopsy external and radiologic findings with historical information, may provide an explanation for situations where immediate incapacitation does not occur following a gunshot wound of the head.

Frailty syndrome occurs in elderly individuals with declining muscle mass (sarcopenia), unintentional weight loss, decreasing physical strength and activity, exhaustion, and slow ambulation. It significantly increases morbidity and mortality with cardiovascular, renal disease and neurological disorders, osteoporosis and fractures, endocrine and immunological dysfunction and a variety of malignancies. It is increasing in incidence as the population ages. However, unfortunately as identification relies on clinical and not pathological evaluations, its contribution to a wide range of comorbidities and its role in terminal episodes may not be recognized in a forensic context.

Purpose: The risk factors that modulate one's susceptibility for severe COVID-19 have been well documented. Despite this, hypercoagulability remains an often overlooked risk factor for severe disease for COVID-19. Because COVID-19 infection is a risk factor for hypercoagulability, a reasonable presumption/hypothesis is that patients with hereditary thrombophilia would be at a higher risk of thrombotic complications associated with COVID-19 infection.

Methods: This case report details two cases where previously unknown hereditary thrombophilias likely contributed to the mortality of COVID-19 patients.

Results: The first COVID-19 patient's cause of death was pulmonary thromboemboli from deep vein thrombosis due to heterozygous MTHFR C667T and heterozygous PAI-1 4G/5G mutations. The second COVID-19 patient's cause of death was an acute myocardial infarct due to a coronary artery thrombosis in the setting of heterozygous MTHFR A1298C and homozygous PAI-1 4G/5G mutations. In each case, COVID-19 infection was also considered contributory to death.

Conclusion: The occurrence of these fatal thrombotic events in COVID-19 patients with hereditary thrombophilias raises questions as to whether this combination of thrombotic risk factors for hypercoagulability may have placed patients at a significant enough risk to experience these fatal thrombotic complications. Thus, while not sufficient alone to prove that SARS-CoV-2 patients with hereditary thrombophilias are at increased risk for thrombotic complications, these two cases indicate that further investigation is warranted into elucidating the relationship between thrombotic risk factors as it may identify an additional high-risk medical condition for COVID-19 and have important diagnostic and therapeutic ramifications.