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Evaluation of in-house drug evidence testing by King County Medical Examiner's Office in “real-time” fatal overdose surveillance 评估金县法医办公室在 "实时 "致命用药过量监控中的内部药物证据检测。
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-04-22 DOI: 10.1111/1556-4029.15526
Richard C. Harruff MD, PhD, William L. Barbour BS, Nicole A. Yarid MD

With the escalating overdose epidemic, many surveillance efforts have appeared. In 2018, King County Medical Examiner's Office (KCMEO) initiated a fatal overdose surveillance project aimed at expediting death certification and disseminating timely information. In this project, KCMEO investigators collected items of evidence of drug use from overdose death scenes, which were tested by five in-house methods, four using handheld devices: TruNarc Raman spectrometer, with and without the manufacture's H-Kit, Rigaku ResQ Raman spectrometer, and MX908 mass spectrometer. The fifth in-house method used fentanyl-specific urine test strips. Results from in-house testing were compared with results from Washington State Patrol (WSP) Materials Analysis Laboratory. From 2019 to 2022, there were 4244 evidence items of drugs and paraphernalia collected from 1777 deaths scenes. A total of 7526 in-house tests were performed on collected specimens, and 2153 tests were performed by the WSP laboratory using standard analytical methods. The WSP results served as reference standards to calculate performance metrics of the in-house methods. Sensitivities, specificities, and predictive values ranged from good to poor depending on the method, drug, and evidence type. Certain drugs were often associated with specific evidence types. Acetaminophen was frequently found in combination with fentanyl. Fentanyl test strips gave good scores for detecting fentanyl; otherwise, in-house methods using handheld devices had poor performance scores with novel drugs and drugs diluted in mixtures. The results showed that in-house testing of drug evidence has value for medical examiner overdose surveillance, but it is resource intensive, and success depends on collaboration with forensic laboratories.

随着吸毒过量疫情的不断升级,出现了许多监测工作。2018 年,金县法医办公室(King County Medical Examiner's Office,KCMEO)启动了一个致命用药过量监测项目,旨在加快死亡认证和及时发布信息。在该项目中,KCMEO 调查人员从吸毒过量死亡现场收集了吸毒证据物品,并通过五种内部方法进行检测,其中四种使用手持设备:TruNarc 拉曼光谱仪(含或不含生产商提供的 H-Kit)、理学 ResQ 拉曼光谱仪和 MX908 质谱仪。第五种内部方法使用芬太尼特异性尿试纸。内部测试结果与华盛顿州巡警(WSP)材料分析实验室的结果进行了比较。从 2019 年到 2022 年,共从 1777 个死亡现场收集到 4244 件毒品和用具证据。对收集到的样本共进行了 7526 次内部测试,华盛顿州警察局实验室使用标准分析方法进行了 2153 次测试。WSP 的结果可作为计算内部方法性能指标的参考标准。根据方法、药物和证据类型的不同,灵敏度、特异性和预测值从好到差不等。某些药物往往与特定的证据类型有关。对乙酰氨基酚经常与芬太尼混合使用。芬太尼试纸在检测芬太尼方面得分较高;此外,使用手持设备的内部方法在检测新型毒品和稀释混合物中的毒品方面得分较低。结果表明,药物证据的内部测试对法医监测用药过量具有价值,但需要大量资源,而且成功与否取决于与法医实验室的合作。
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引用次数: 0
Use of carbonyldiimidazole as a derivatization agent for the detection of pinacolyl alcohol, a forensic marker for Soman, by EI-GC–MS and LC-HRMS in official OPCW proficiency test matrices 使用羰基二咪唑作为衍生剂,通过 EI-GC-MS 和 LC-HRMS 在禁化武组织官方能力测试基质中检测频哪醇(一种用于索曼的法医标记)。
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-04-22 DOI: 10.1111/1556-4029.15527
Carlos A. Valdez PhD, Derrick C. Kaseman PhD, Mark L. Dreyer BSc, Saphon Hok PhD, Alexander K. Vu BSc

Pinacolyl alcohol (PA), a key forensic marker for the nerve agent Soman (GD), is a particularly difficult analyte to detect by various analytical methods. In this work, we have explored the reaction between PA and 1,1′-carbonyldiimidazole (CDI) to yield pinacolyl 1H-imidazole-1-carboxylate (PIC), a product that can be conveniently detected by gas chromatography–mass spectrometry (GC–MS) and liquid chromatography-high-resolution mass spectrometry (LC-HRMS). Regarding its GC–MS profile, this new carbamate derivative of PA possesses favorable chromatographic features such as a sharp peak and a longer retention time (RT = 16.62 min) relative to PA (broad peak and short retention time, RT = 4.1 min). The derivative can also be detected by LC-HRMS, providing an avenue for the analysis of this chemical using this technique where PA is virtually undetectable unless present in large concentrations. From a forensic science standpoint, detection of this low molecular weight alcohol signals the past or latent presence of the nerve agent Soman (GD) in a given matrix (i.e., environmental or biological). The efficiency of the protocol was tested separately in the analysis and detection of PA by EI-GC–MS and LC-HRMS when present at a 10 μg/mL in a soil matrix featured in the 44th PT and in a glycerol-rich liquid matrix featured in the 48th Official Organization for the Prohibition of Chemical Weapons (OPCW) Proficiency Test when present at a 5 μg/mL concentration. In both scenarios, PA was successfully transformed into PIC, establishing the protocol as an additional tool for the analysis of this unnatural and unique nerve agent marker by GC–MS and LC-HRMS.

频哪醇(PA)是神经毒剂索曼(GD)的一个关键法医标记,是一种特别难以用各种分析方法检测的分析物。在这项研究中,我们探讨了 PA 与 1,1'-羰基二咪唑(CDI)反应生成 1H-咪唑-1-羧酸频哪醇酯 (PIC) 的过程,这种产物可方便地通过气相色谱-质谱法(GC-MS)和液相色谱-高分辨质谱法(LC-HRMS)进行检测。在气相色谱-质谱(GC-MS)谱图方面,PA 的这种新型氨基甲酸酯衍生物具有良好的色谱特征,如相对于 PA(峰宽、保留时间短,RT = 4.1 分钟)而言,峰尖锐、保留时间长(RT = 16.62 分钟)。该衍生物还可通过 LC-HRMS 检测到,这为使用该技术分析这种化学物质提供了一条途径,因为除非 PA 浓度很高,否则几乎检测不到。从法医学的角度来看,检测到这种低分子量的酒精表明神经毒剂索曼(GD)已经或潜在地存在于给定的基质(即环境或生物基质)中。在第 44 次能力测试中,当 PA 在土壤基质中的浓度为 10 μg/mL 时,通过 EI-GC-MS 和 LC-HRMS 对其进行了分析和检测;在第 48 次禁止化学武器组织(OPCW)官方能力测试中,当 PA 在富含甘油的液体基质中的浓度为 5 μg/mL 时,通过 EI-GC-MS 和 LC-HRMS 对其进行了分析和检测。在这两种情况下,PA 都成功地转化为 PIC,从而使该方案成为利用 GC-MS 和 LC-HRMS 分析这种非天然的独特神经毒剂标记物的额外工具。
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引用次数: 0
A template for creating and sharing ground truth data in digital forensics 数字取证中创建和共享地面实况数据的模板
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-04-21 DOI: 10.1111/1556-4029.15524
Graeme Horsman PhD

Ground truth data (GTD) is used by those in the field of digital forensics (DF) for a variety of purposes including to evaluate the functionality of undocumented, new, or emerging technology and services and the digital traces left behind following their usage. Most accepted and reliable trace interpretations must be derived from an examination of relevant GTD, yet despite the importance of it to the DF community, there is little formal guidance available for supporting those who create it, to do so in a way that ensures any data is of good quality, reliable, and therefore usable. In an attempt to address this issue, this work proposes a minimum standard of documentation that must accompany the production of any GTD, particularly when it is intended for use in the process of discovering new knowledge, proposing original interpretations of a digital trace, or determining the functionality of any technology or service. A template structure is discussed and provided in Appendix S1 which sets out a minimum standard for metadata describing any GTD's production process and content. It is suggested that such an approach can support the maintenance of trust in any GTD and improve the shareability of it.

地面实况数据(GTD)被数字取证(DF)领域的人员用于多种目的,包括评估未记录的、新的或新兴技术和服务的功能,以及使用这些技术和服务后留下的数字痕迹。大多数公认和可靠的痕迹解释都必须从相关 GTD 的检查中得出,然而,尽管 GTD 对 DF 社区非常重要,却几乎没有正式的指导来支持创建者,以确保任何数据都具有良好的质量、可靠性和可用性。为了解决这个问题,这项工作提出了制作任何 GTD 时必须附带的最低标准文档,特别是当 GTD 被用于发现新知识、对数字痕迹提出原创性解释或确定任何技术或服务的功能时。附录 S1 讨论并提供了一个模板结构,其中规定了描述任何 GTD 制作过程和内容的元数 据的最低标准。我们认为,这种方法有助于维护对任何 GTD 的信任,并提高其可共享性。
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引用次数: 0
Validation of the lead-in method in a practical shooting scenario 在实际射击场景中验证引信方法
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-04-17 DOI: 10.1111/1556-4029.15523
Maddie Keldson MScFS, Eugene Liscio BE

The ability to determine bullet trajectories after a shooting incident can allow investigators to reconstruct the locations of individuals and the sequence of events that took place. By using trajectory rods, investigators can be provided with an immediate visual estimate as to what the path of the projectile may have been. In certain instances, the use of the probing method with trajectory rods is not appropriate due to their being a single, thin target material, or no secondary bullet impact site. In these cases, other methods such as the lead-in or the ellipse method may be useful. Overall, the lead-in method has not been well studied in the application to practical scenarios, such as those including bullet impacts on vehicle metal surfaces. This study has explored the accuracy of the lead-in method when a bullet impacts a typical vehicle metal surface using three firearm calibers, three blind participants, and two non-blind participants. The results of this study have shown that each caliber has its own characteristic error curve. In general, it was found that the lower the impact angle, the less errors were made by the participants. As the impact angle increases, the measurement errors increased, due to the smaller lead-in area present. The errors were found to have a wide range, with some being as low as 1° and some being as high as 13.9°. Further, it was found there was no significant effect on the errors of blind versus non-blind participants.

在枪击事件发生后,确定子弹轨迹的能力可以让调查人员重建人员的位置和事件发生的顺序。通过使用弹道棒,调查人员可以立即直观地估计出子弹的轨迹。在某些情况下,由于目标材料单一、较薄或没有二次弹着点,不适合使用弹道棒探测法。在这些情况下,其他方法(如导入法或椭圆法)可能会有用。总体而言,在实际应用中,如子弹撞击车辆金属表面等情况下,对导入法的研究并不深入。本研究使用三种枪支口径、三名盲人参与者和两名非盲人参与者,探索了子弹撞击典型车辆金属表面时的导入法准确性。研究结果表明,每种口径都有自己的误差曲线。一般来说,撞击角度越小,参与者的误差越小。随着撞击角的增大,测量误差也随之增大,这是因为前导区变小了。误差的范围很大,有的低至 1°,有的高达 13.9°。此外,还发现盲人与非盲人参与者的误差没有明显影响。
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引用次数: 0
Evaluating layperson interpretation of actuarial sexual violence risk data: A multi-method comparison of risk communication with attention to gender bias 评估外行人对性暴力风险精算数据的解读:关注性别偏见的风险交流多方法比较
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-04-11 DOI: 10.1111/1556-4029.15525
Lauren C. Coaker MS, Ashley B. Batastini PhD, Riley M. Davis PhD, Michael E. Lester PhD

Forensic clinicians are often called upon to help courts determine the likelihood that someone will continue to commit sexually violent acts in the future. The utility of these evaluations depends largely on how effectively the results are communicated to and understood by the trier of fact. Actuarial results, such as those commonly reported in sexual offense risk assessments, appear particularly challenging for laypersons to understand. Using a representative sample of 206 U.S. adults, this study examines three methods of communicating actuarial risk via simulated expert testimony on participants' ratings of a hypothetical evaluee's risk of sexual re-offending. The results suggested that all participants, regardless of how results were communicated, over-estimated the examinee's risk level relative to the expert's probabilistic findings, but tended to agree with the expert's categorical predictions. Participants who were only shown actuarial data consistently rated the evaluee as more dangerous and likely to commit future sexually violent acts. Additionally, it was found that gender significantly impacted participants' perceptions, such that women found the evaluee more dangerousness and desired greater social distance from him. This study has implications for best practices regarding expert communication of actuarial results in cases involving sexual violence.

法医临床医生经常被要求帮助法庭确定某人将来继续实施性暴力行为的可能性。这些评估的效用在很大程度上取决于如何有效地将评估结果传达给审判者并使其理解。精算结果,比如性犯罪风险评估中通常报告的那些结果,似乎特别难以被外行人理解。本研究使用了 206 个美国成年人的代表性样本,通过模拟专家证词,对参与者对假定被评估者的性犯罪再犯风险的评级,研究了三种传达精算风险的方法。结果表明,所有参与者,无论以何种方式传达结果,相对于专家的概率结论,都高估了被评估者的风险水平,但倾向于同意专家的分类预测。只看到精算数据的参与者一致认为被评估者更危险,更有可能在未来实施性暴力行为。此外,研究还发现,性别对参与者的看法有很大影响,比如女性认为被评估者更危险,并希望与他保持更大的社会距离。本研究对涉及性暴力案件中专家交流精算结果的最佳实践具有启示意义。
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引用次数: 0
Sex estimation research trends in forensic anthropology between 2000 and 2022 in five prominent journals 2000 年至 2022 年期间五种著名期刊上法医人类学的性别估计研究趋势
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-04-10 DOI: 10.1111/1556-4029.15522
Morgan J. Ferrell MA, John J. Schultz PhD, Donovan M. Adams PhD

In forensic anthropology, osteological sex estimation methods are continuously reevaluated and updated to improve classification accuracies. Therefore, to gain a comprehensive understanding of recent trends in sex estimation research in forensic anthropology, a content analysis of articles published between 2000 and 2022 in Forensic Science International, the Journal of Forensic Sciences, the International Journal of Legal Medicine, the American Journal of Biological Anthropology, and Forensic Anthropology, was performed. The main goals of this content analysis were to (1) examine trends in metric versus morphological research, (2) examine which areas of the skeleton have been explored, (3) examine which skeletal collections and population affinities have been most frequently utilized, and (4) determine which statistical methods were commonly implemented. A total of 440 articles were coded utilizing MAXQDA and the resulting codes were exported for analysis. Statistical analyses were conducted utilizing the Cochran-Armitage and Jonckheere-Terpstra tests for trends, as well as Fisher–Freeman–Halton tests. The results demonstrate that sex estimation research published in these journals has prioritized metric over morphological methods. Further, the most utilized skeletal regions continue to be the skull and pelvis, while the most popular classification statistics continue to be discriminant function analysis and logistic regression. This study also demonstrates that a substantial portion of research has been conducted utilizing U.S. and Europe-based collections and limited populations. Based on these results, future sex estimation research must continue exploring the use of long bones and other postcranial elements, testing newer methods of analysis, as well as developing population-inclusive methods.

在法医人类学中,骨学性别估计方法不断被重新评估和更新,以提高分类的准确性。因此,为了全面了解法医人类学性别估计研究的最新趋势,我们对 2000 年至 2022 年期间发表在《国际法医学》、《法医学杂志》、《国际法律医学杂志》、《美国生物人类学杂志》和《法医人类学》上的文章进行了内容分析。内容分析的主要目的是:(1) 研究度量研究与形态学研究的趋势;(2) 研究骨骼的哪些领域得到了探索;(3) 研究哪些骨骼集合和人群亲缘关系最常被利用;(4) 确定哪些统计方法被普遍采用。共使用 MAXQDA 对 440 篇文章进行了编码,并将编码结果导出进行分析。统计分析采用了 Cochran-Armitage 和 Jonckheere-Terpstra 趋势检验以及 Fisher-Freeman-Halton 检验。结果表明,在这些期刊上发表的性别估计研究优先采用的是度量方法,而不是形态学方法。此外,使用最多的骨骼区域仍然是头骨和骨盆,而最流行的分类统计仍然是判别函数分析和逻辑回归。这项研究还表明,相当一部分研究是利用美国和欧洲的采集和有限的人群进行的。基于这些结果,未来的性别估计研究必须继续探索长骨和其他颅骨后元素的使用,测试更新的分析方法,以及开发包含人群的方法。
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引用次数: 0
Real-time object-removal tampering localization in surveillance videos by employing YOLO-V8 利用 YOLO-V8 对监控视频中的篡改对象进行实时定位
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-04-04 DOI: 10.1111/1556-4029.15516
Sandhya MSc, Abhishek Kashyap MTech, PhD

Videos are considered as most trustworthy means of communication in the present digital era. The advancement in multimedia technology has made video content sharing and manipulation very easy. Hence, the video authenticity is a challenging task for the research community. Video forensics refer to uncovering the forgery traces. The detection of spatiotemporal object-removal forgery in surveillance videos is crucial for judicial forensics, as the presence of objects in the video has significant information as legal evidence. The author proposes a passive max–median averaging motion residual algorithm for revealing the forgery traces, successfully giving visible object-removal traces followed by a deep learning approach, YOLO-V8, for forged region localization. YOLO-V8 is the latest deep learning model, which has a wide scope for real-time application. The proposed method utilizes YOLO-V8 for object-removal forgery in surveillance videos. The network is trained on the SYSU-OBJFORG dataset for object-removal forged region localization in videos. The fine-tuned YOLO-V8 successfully classifies and localizes the object-removal tampered region with an F1-score of 0.99 and a precision of 0.99. The observed high confidence score of the bounding box around the forged region makes the model reliable. This fine-tuned YOLO-V8 would be a better choice in real-time applications as it solves the complex object-based forgery detection in videos. The performance of the proposed system is far better than the existing deep learning approach.

视频被认为是当今数字时代最值得信赖的通信手段。多媒体技术的进步使得视频内容的共享和操纵变得非常容易。因此,视频的真实性对研究界来说是一项具有挑战性的任务。视频取证是指发现伪造痕迹。监控视频中时空物体去除伪造的检测对于司法取证至关重要,因为视频中物体的存在具有重要的法律证据信息。作者提出了一种用于揭示伪造痕迹的被动最大中值平均运动残差算法,成功地给出了可见的物体移除痕迹,随后又提出了一种深度学习方法--YOLO-V8,用于伪造区域定位。YOLO-V8 是最新的深度学习模型,具有广泛的实时应用前景。所提出的方法利用 YOLO-V8 对监控视频中的物体进行移除伪造。该网络在 SYSU-OBJFORG 数据集上进行训练,用于视频中的物体去除伪造区域定位。经过微调的 YOLO-V8 成功地对物体去除篡改区域进行了分类和定位,F1 分数为 0.99,精度为 0.99。在伪造区域周围的边界框中观察到的高置信度使该模型非常可靠。经过微调的 YOLO-V8 可以解决视频中复杂的基于对象的伪造检测问题,因此在实时应用中是一个更好的选择。拟议系统的性能远远优于现有的深度学习方法。
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引用次数: 0
Between the hammer and the anvil: An unusual power hammer fatality 在锤子和铁砧之间:不寻常的电锤致命事故
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-04-04 DOI: 10.1111/1556-4029.15521
Richard Sivulič MD, Martin Janík MD, Petr Hejna MD, Ivan Kocan MD, PhD, Ľubomír Straka MD

Power hammers are mechanised forging devices that constitute a pivotal part of steel manufacturing. Power hammer-associated injuries are a rare occurrence. We report a noteworthy case of a 52-year-old man who sustained a high-energy penetrating injury while working with a power (counterblow) hammer. The man used a sizable disc-shaped metallic object to dislodge the forging wedged in the machine by applying the force of the striking ram on it. On impact, the object ejected and struck the man in the right lateral portion of the chest. The autopsy disclosed extensive damage to the thoracic and abdominal organs. The cause of death was opined to be exsanguination due to penetrating trauma of the heart and transection of the descending aorta. The investigation confirmed a breach of safety regulations. To the best of our knowledge, this is the first power (counterblow) hammer-related fatality in medico-legal literature.

动力锤是一种机械化锻造设备,是钢铁生产的重要组成部分。与动力锤相关的伤害很少发生。我们报告了一例值得注意的病例,一名 52 岁的男子在使用动力(反击)锤工作时遭受了高能穿透伤。该男子使用一个较大的圆盘状金属物体,通过对其施加打击力,使楔入机器中的锻件脱落。在撞击时,该物体弹出并击中该男子的右胸外侧。尸体解剖显示,胸腔和腹腔器官严重受损。死因被认为是心脏穿透性创伤和降主动脉横断造成的失血过多。调查证实这违反了安全条例。据我们所知,这是医学法律文献中第一例与动力(反击)锤相关的死亡事故。
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引用次数: 0
Contextual bias in forensic toxicology decisions: A follow-up empirical study from China 法医毒理学决策中的情境偏差:中国的后续实证研究
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-04-03 DOI: 10.1111/1556-4029.15520
Ning He PhD, Hongxia Hao PhD

The impact of contextual bias has been demonstrated repeatedly across forensic domains; however, research on this topic in forensic toxicology is very limited. In our previous study, experimental data from only one context version were compared with the actual forensic biasing casework. As a follow-up, this controlled experiment with 159 forensic toxicology practitioners was conducted, to test whether knowledge of different contextual information influenced their forensic decision-making. Participants in different context groups were tasked to identify testing strategies for carbon monoxide and opiate drugs. The results of chi-squared tests for their selections and two context groups exhibited statistically significant differences (p < 0.05 or p < 0.01). These findings show contextual information can bias forensic toxicology decisions about testing strategies, despite it is a relatively objective domain in forensic science.

语境偏差的影响已在法医领域被反复证明;然而,在法医毒理学领域对这一主题的研究却非常有限。在我们之前的研究中,只有一个语境版本的实验数据与实际的法医偏差案例工作进行了比较。作为后续研究,我们对 159 名法医毒理学从业人员进行了对照实验,以检验对不同情境信息的了解是否会影响他们的法医决策。不同背景组的参与者负责确定一氧化碳和鸦片类药物的检测策略。对他们的选择和两个情境组的卡方检验结果显示出显著的统计学差异(p < 0.05 或 p < 0.01)。这些研究结果表明,尽管法医毒理学是法医学中一个相对客观的领域,但背景信息可能会使法医毒理学对检测策略的决策产生偏差。
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引用次数: 0
Pediatric poisoning management: How clinical practice can benefit from forensic approach 小儿中毒管理:临床实践如何从法医方法中获益。
IF 1.5 4区 医学 Q2 MEDICINE, LEGAL Pub Date : 2024-04-01 DOI: 10.1111/1556-4029.15517
Pascale Basilicata PhD, Mariagrazia Marisei MD, Rossella Guadagni PhD, Michelina Sibilio MD, PhD, Massimo Niola MD, PhD, Maria Pieri PhD

Pediatric population represents the most vulnerable and at risk for unintentional poisoning, with children younger than 6 years old accounting for nearly half of poison exposures. Poisoning is a time-dependent emergency. The need to reach a scientific agreement on diagnostic protocol and treatment seems to be crucial to reduce morbidity and mortality. Starting from a buprenorphine pediatric intoxication case, this article highlights the limits and pitfalls of the traditional diagnostic approach. Diagnosis of drug intoxication was achieved after several days when an in-depth diagnostic investigation became necessary and complete forensic toxicological analyses were performed. Results evidenced an alarming lack of an unequivocal diagnostic protocol in case of suspect intoxication in structures not provided with a forensic toxicological service/unit. Collection of biological specimens according to forensic protocols at hospitalization plays a paramount role in the definitive diagnosis of intoxication. A diagnostic algorithm that focuses on medical history and biological specimen collection timing is herein proposed, in order to unify emergency approaches to the suspected poisoned child.

儿科人群是最易受到意外中毒伤害的高危人群,6 岁以下儿童占中毒人数的近一半。中毒是一种与时间有关的紧急情况。需要就诊断方案和治疗达成科学共识,这对于降低发病率和死亡率似乎至关重要。本文从一个丁丙诺啡儿科中毒病例入手,强调了传统诊断方法的局限性和隐患。经过几天的深入诊断调查和完整的法医毒理学分析后,才确诊为药物中毒。结果表明,在未配备法医毒理学服务/单位的机构中,在发生疑似中毒事件时缺乏明确的诊断规程,这一点令人震惊。住院时按照法医规程采集生物标本对明确诊断中毒起着至关重要的作用。本文提出了一种以病史和生物标本采集时间为重点的诊断算法,以统一处理疑似中毒儿童的急救方法。
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引用次数: 0
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Journal of forensic sciences
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