Forensic Science, Medicine and Pathology最新文献

In forensic entomology, postmortem interval (PMI) estimation relies on the age, development, and succession patterns of insects on decomposing remains; however, the presence of drugs in the body can disrupt insect development and compromise the accuracy of these estimates. Paracetamol, a commonly used over-the-counter drug in Southern Africa, is often implicated in both intentional and accidental overdose cases. This study investigates the effects of paracetamol on insect development using spiked pig carcasses as experimental models to simulate human overdose. Three pigs received paracetamol at ascending doses 75 mg/kg (toxic), 150 mg/kg (lethal), and 300 mg/kg (double lethal), and the fourth pig served as an untreated control. The experimental carcasses were placed in separate metal cages in a natural outdoor environment during the autumn season, and insect samples were collected daily over a 32-day period. Observations and morphological measurements of the length, width, and weight were recorded for selected dipteran and coleopteran species of forensic value. Results showed that Chrysomya putoria and Chrysomya megacephala exhibited an increased larval length, width, and weight at double lethal doses. Lucilia sericata showed significant reductions in weight at all paracetamol doses (p = 0.012, 0.001 and 0.001) in comparison to the control, while Chrysomya albiceps and Thanatophilus micans were not affected by the drug. Furthermore, results showed that the mortality rates of newly emerged Ch. putoria, Ch. megacephala, Ch. albiceps and L. sericata were higher in paracetamol-treated groups compared to those observed from the control group, with the rates of 22.2% at the toxic dose, 35.0% at the lethal dose, 45.0% at the double lethal dose, and 11.1% in the control group. Morphological abnormalities were observed in newly emerged adults of Ch. putoria and L. sericata that showed progressive wing deformities at the toxic and lethal doses and discoloration at the double lethal dose. Ch. albiceps exhibited no observable deformities across all doses. These findings show that paracetamol disrupts critical developmental processes in certain species in a dose-dependent manner, highlighting the need to study its effects on other forensically important insects. Moreover, these findings contribute towards enhancing PMI precision and advancing forensic entomotoxicology in the region by generating local baseline data for KwaZulu Natal province, South Africa.

As an effective alternative therapy, acupuncture is increasingly recognized and utilized worldwide. While acupuncture is used to treat neurological, respiratory, and circulatory disorders, its clinical efficacy is influenced by various factors. Even minimal stabbing wounds may cause physical injury or be life-threatening if done improperly. We report the case of a young man who died suddenly after receiving acupuncture treatment. Autopsy revealed multiple needlestick wounds in the bilateral lungs, liver, and spleen, leading to traumatic pneumothorax and hemoperitoneum, and the man ultimately died of respiratory failure. Notably, the case documentation mentioned only dorsal acupuncture. However, during the autopsy, we discovered additional puncture sites in the bilateral lateral regions, with dimensional discrepancies compared to the dorsal needlestick. We hypothesized that these discrepancies were caused by the use of needles of varying sizes and raised reasonable suspicion of multiple perpetrators. A subsequent law enforcement investigation confirmed that the man's dorsal and lateral acupuncture were performed separately by a masseur at a private clinic and by his partner. A detailed analysis clarified how injuries to different anatomical regions contributed to the fatal outcome, providing a foundation for legal accountability. The uniqueness of this case lies in the involvement of multiple suspects, multiple organ injuries, and unlicensed medical practice. This case not only enriches the report on adverse events associated with acupuncture but also highlights the critical importance of meticulous forensic examination and comprehensive case investigation.

In the early post-war period in Poland (1945-1950), abortion was severely restricted under the 1932 Penal Code. Despite the significant risks, many women chose to have abortions, often in dangerous, non-medical conditions, which led to severe complications or death. The analysis is based on archival materials from the State Archives in Łódź, in particular autopsy reports and court cases concerning deaths and complications related to abortion. This study specifically examines cases from 1945 to 1950. Six court-documented cases meeting inclusion criteria were analyzed - three resulting in the death of the woman and three without fatal consequences but with serious complications requiring surgery. Fatal complications included uterine perforation with accompanying peritonitis and massive hemorrhage, often caused by improper use of instruments. Non-fatal cases also resulted in permanent damage that required surgical treatment. Court judgments ranged, with penalties ranging from acquittal to imprisonment, often mitigated by amnesties or the defendant's circumstances. These cases reveal the brutal nature of illegal abortions and the disastrous effects of restrictive abortion laws. Fear of criminal prosecution often delays medical assistance, worsening treatment outcomes, or leading to death. Archival evidence highlights how the criminalization of abortion threatens women's health and lives, especially during periods of social instability and inadequate access to healthcare. These findings underscore the historical value of archival forensic records in revealing how restrictive legal frameworks shaped patterns of harm and contributed to preventable maternal deaths.

Blue Rubber Bleb Nevus Syndrome (BRBNS) is a rare congenital disorder characterized by multiple venous malformations, most frequently affecting the skin and gastrointestinal tract, but occasionally involving the central nervous system and other visceral organs. Fatal outcomes are exceedingly rare and usually result from acute hemorrhage or airway compromise. This report describes a fatal case of BRBNS in a 31-year-old woman who developed uncontrollable bleeding from vascular malformations following an emergent tracheostomy performed for anaphylaxis secondary to lidocaine administration during dental treatment. Despite aggressive resuscitative measures, the patient succumbed to hemorrhagic shock. External examination revealed bluish subcutaneous lesions in the perioral region, periorbital ecchymosis, and multiple bluish, compressible subcutaneous vascular "blebs" on the right upper extremity, extending to the right hemithorax. Internally, multiple submucosal, hemorrhagic-appearing lesions were identified on the base of the tongue, hypopharynx, larynx, and aryepiglottic folds, with additional vascular malformations in the posterior mediastinum and right temporalis muscle. Histologic examination confirmed cavernous hemangiomas at the tracheostomy site. A review of the English-language literature revealed only a small number of fatal cases associated with BRBNS. This case highlights the potential for fatal airway hemorrhage in BRBNS, particularly during emergent procedures involving the upper airway. Awareness of possible laryngeal and tracheal involvement is crucial to avoid iatrogenic complications. Comprehensive autopsy remains essential to determine the cause of death, document lesion distribution, and distinguish disease-related hemorrhage from procedural injury.