Journal of forensic and legal medicine最新文献

Airway obstruction by foreign bodies or laryngospasms often results in negative pressure pulmonary edema (NPPE). NPPE can develop despite the removal of airway obstruction. This is well-known among clinicians, particularly anesthesiologists, emergency physicians, pediatricians, and radiologists. Computed tomography (CT) features of NPPE include diffuse central ground-glass opacities and thickening of the bronchovascular bundles and bronchial walls. NPPE can also occur after strangulation or smothering with a plastic bag, and is sometimes fatal. Nevertheless, no reports of NPPE are available in forensic journals, and forensic practitioners may not be dedicating the necessary attention to this condition. Recently, the use of postmortem CT as an auxiliary imaging modality for autopsies has increased among forensic institutions in Japan. Understanding the mechanisms and CT findings of NPPE will be useful for forensic practitioners. Herein, we present a case wherein the postmortem CT image revealed NPPE resulting from the obstruction of the airway induced by rice cakes.

Postmortem interval (PMI) estimation is important for forensic pathological autopsy. It has been reported that there is a correlation between certain protein changes in cadavers and PMI. However, no specific protein(s) has been used to determine the PMI so far. In this study, the total protein contents of mouse liver and spleen at different time of death were measured. The data showed that they were negatively correlated with the PMI. The degradation of β-actin was found to be positively correlated with the PMI in the liver. Additionally, proteomic technique was used to study the changes of protein expression related to PMI in the liver of mice. By using Two-dimensional electrophoresis, the expressions of four proteins were found to be significantly decreased and those of other three proteins were unchanged with the increase of PMI. Among the seven proteins, six were identified with peptide mass fingerprinting using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The three altered proteins were SBP2, ENOA, ALDH2 and three unchanged ones were 3HAO, TPIS, CATA, respectively. In the future, those unchanged proteins could be used as internal references to more accurately and reliably infer the time of death by assessing the level of changed proteins.

Background

Sexual violence is common in contemporary society and disproportionally affects adolescents. In order to develop effective treatment, awareness and prevention strategies it is vital that we understand the epidemiology of adolescent sexual assault (SA). The aim of this study is to evaluate attendances by female adolescents to the national sexual assault treatment unit (SATU) network in the Republic of Ireland and compare these attendances with adult women accessing the service.

Methods

This is a cross-sectional study analysing the attendances of all adolescent female attendances at the 6 SATUs in the Republic of Ireland and comparing them with all adult female attendances between 1/1/2017 and 31/12/2022.

Results

There were 1014 female adolescent attendances and 3951 female adult attendances over the timeframe studied. Adult attenders were more likely to attend within 7-days of the alleged assault compared with adolescent attenders (80.3% V 70.2% OR1.513 CI 1.35-1.697 p < 0.001). When compared with adult attenders, adolescent attenders were significantly more likely to disclose being assaulted outdoors (40.9% V 15.7% OR2.607 CI 2.346-2.898 p < 0.01), during the day (58.4% V 34.4% OR1.673 CI 1.565-1.790 p < 0.01), assaulted by a friend/family member (28.9% V 16% OR 1.812 CI1.603-2.049 p < 0.01) and less likely to have consumed alcohol prior to the incident (45.6% V 25.3% OR1.807 CI 1.653-1.975 p < 0.001). Physical injuries were less likely in adolescent attenders (30% V 35.5% OR0.845 CI 0.758-0.942 p = 0.02).

Conclusion

A comparison of the characteristics of adolescent and adult female sexual assault disclosures identifies differences regarding location of the incident, relationship to perpetrator and prevalence of alcohol consumption. Knowledge of these factors support appropriate tailoring of treatment, prevention and awareness strategies to help modify the impact and reduce the incidence of SA in the vulnerable adolescent cohort.

Fractures of the laryngohyoid complex are classically associated with deaths due to strangulation. Recent studies, however, indicate the possible presence of such fractures in fatal falls. The primary focus of this systematic review is to analyze the characteristics of laryngohyoid fractures in the context of falls to aid in a more accurate interpretation of autopsy findings. Search for relevant literature occurred on PubMed on the 26th of October 2022, and Embase and Web of Science on the 5th of November 2022. Inclusion criteria included being a primary study, published in English, involving fatal falls and injuries to the laryngohyoid complex, and presenting sufficient details about the relevant cases. Four case reports and six descriptive retrospective studies were included in the final analysis yielding a sum of 38 cases. The risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Potential limitations of this study include the inclusion of case reports and studies published in English only. The cumulative male-to-female ratio was 23:15 with a mean age of 48 years old. The fall height ranged from standing height to 60 m. Forty-three fractures to the laryngohyoid complex were identified with the thyroid cartilage most commonly affected, followed by fracture of the hyoid bone, and finally the cricoid cartilage. While cases of falls did indeed display hallmark laryngohyoid findings classically displayed in strangulation, they also featured unique presentations such as fractures of the clavicle and a reduced prevalence of conjunctival petechiae.

A primary objective of a medico-legal autopsy is to determine the identity of the deceased. The act of praying for prolonged periods of time can lead to the development of skin marks in Muslims, commonly referred to as “Naamaj signs” or prayer marks. An elderly male of unknown identity was brought dead to the hospital, where a post-mortem examination was performed. The patient's name in the treatment records suggested that the deceased was a member of the non-Muslim community, conflicting with the post-mortem examination report indicating circumcision and belonging to the Muslim Community. The disposal authority questioned whether cremation or burial was more suitable for the deceased. When it comes to cases involving religious identification, basing a decision on a single feature alone is not enough to permit the disposal of a deceased body. It is crucial to take into account other characteristics before determining the appropriate disposal method.

Purpose

develop and validate a formula, through a discriminant analysis of sex estimation, evaluating maxillary sinus in cone beam computed tomography scans in a Brazilian population, comparing this formula with two other existing ones.

Methods

190 cone beam CT scans of Brazilian adults were retrospectively evaluated by an independent examiner. Measurements were performed in the right and left MS region: height, width, length, distance between the breasts, distance between infraorbital foramina, and volume in the ITK software. The sample was divided into female and male. T test, ANOVA, Tukey test and the ROC Curve was performed (p > 0,05).

Results

statistically significant differences were found in relation to the maximum height of the MS both right (p = 0,001) and left (p = 0,026) between sexes and the maximum length in the right MS (p = 0,01). Regarding the comparison of MS volume according to the different analysis methods, statistically significant differences were found between sexes for the right MS when using the method by Bangi et al. (p = 0,012) and the volume of the left MS in females (p < 0,001). Comparing the three classification models, statistically significant differences were found between the proposed method and the classification by Bangi et al. (p < 0.007). The ROC curve showed greater accuracy in the classification proposed in this work.

Conclusion

the new proposed formula obtained better predictions of sexual dimorphism, when compared to classifications already described in the literature.

Vaginal fluids are one of the most common biological samples in forensic sexual assault cases, and their characterization is vital to narrow the scope of investigation. Presently, approaches for identifying vaginal fluids in different regions are not only rare but also have certain limitations. However, the microbiome has shown the potential to identify the source of body fluids and reveal the characteristics of individuals. In this study, 16S rRNA gene high-throughput sequencing was used to characterize the vaginal microbial community from three regions, Sichuan, Hainan and Hunan. In addition, data on relative abundance and alpha diversity were used to construct a random forest model. The results revealed that the dominant genera in the three regions were Lactobacillus, followed by Gardnerella. In addition, Ureaplasma, Nitrospira, Nocardiodes, Veillonella and g-norank-f-Vicinamibacteraceae were significantly enriched genera in Sichuan, llumatobacter was enriched in Hainan, and Pseudomonas was enriched in Hunan. The random forest classifier based on combined data on relative abundance and alpha diversity had a good ability to distinguish vaginal fluids with similar dominant microbial compositions in the three regions. The study suggests that combining high-throughput sequencing data with machine learning models has good potential for application in the biogeographic inference of vaginal fluids.

Straddle injuries are those to the perineum region brought on by straddling or riding over something, such as a horse, vehicle, or other object. The motorcycle fuel tank or handlebars are primarily responsible for the typical injury to the perineum area in motorcycle accidents. Motorcycle straddle injury usually manifest as abrasions to the scrotum or penis, and severe cases can cause pelvic fractures or even testicular dislocation. Because these injuries are usually closed with unclear internal damage, diagnosis presents a significant challenge and can easily lead to misdiagnosis. However, pelvic fractures and the bleeding and nerve damage associated with perineal injury are often fatal, and testicular dislocation can also have serious consequences for patients. Therefore, a clear diagnosis and timely treatment are crucial for patients with this type of injury. This article reports the case of a motorcycle rider who died 4 h after a traffic accident with only minor surface injury visible, showing only bruising in the waist and scrotum. A forensic examination revealed multiple fractures throughout the patient's body, with a slightly more severe pelvic fracture and testicular dislocation on the left side in the left inguinal area. This article analyzes the cause of death and related issues in this case, aiming to provide assistance to clinical physicians and forensic practitioners and to emphasize the importance of handling straddle injury in treatment and related investigations to avoid serious consequences.