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Pierced by Force: Forensic reconstruction of two fatal High-Energy Workplace impalements. 武力刺穿:两个致命的高能工作场所刺穿的法医重建。
IF 1.4 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2026-02-03 DOI: 10.1016/j.legalmed.2026.102806
Julia Babigian, Alberto Amadasi, Marc Windgassen

Impalement injuries represent a rare but forensically relevant form of penetrating trauma that combines characteristics of both blunt and sharp force injury. The mechanisms and reconstruction of such injuries are often complex, particularly in the context of high-energy occupational accidents. Two fatal occupational cases with unusual impalement-like mechanisms are presented. In the first case, a construction worker was struck by a falling metal scaffold tube, resulting in a vertical cranial impalement with destruction of the occipital region and posterior skull base. In the second case, a worker in a high-voltage tunnel sustained fatal injuries caused by a recoiling steel cable, leading to complete transection of the trachea and near-complete rupture of the aorta. Postmortem computed tomography (PMCT) in both cases enabled detailed three-dimensional reconstruction of the injury mechanisms and confirmed the high-energy trajectories of impact. These findings illustrate that impalement injuries, from a forensic perspective, should not be restricted to classical transfixion events. Complex high-energy mechanisms involving secondarily accelerated objects-such as falling rods or recoiling cables-can produce functionally equivalent injury patterns. Their forensic assessment requires interdisciplinary analysis integrating radiological, biomechanical, and technical expertise.

刺穿伤是一种罕见但与法医相关的穿透性创伤形式,它结合了钝力和锐器伤的特征。这种伤害的机制和重建往往是复杂的,特别是在高能职业事故的背景下。两个致命的职业案例与不寻常的刺穿样机制提出。在第一起案件中,一名建筑工人被落下的金属支架管击中,导致头部垂直穿刺,枕区和后颅底受损。在第二起事故中,一名在高压隧道工作的工人被一根回弹的钢缆造成致命伤害,导致气管完全横断,主动脉几乎完全破裂。在这两个病例中,尸检计算机断层扫描(PMCT)能够对损伤机制进行详细的三维重建,并确认了撞击的高能轨迹。这些发现表明,从法医的角度来看,刺穿伤不应局限于经典的刺穿事件。涉及二次加速物体的复杂高能机制,如落杆或反冲电缆,可以产生功能相同的伤害模式。他们的法医评估需要综合放射学、生物力学和技术专业知识的跨学科分析。
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引用次数: 0
Preliminary study of mixed traces on cigarette butts and non-self DNA transfer, persistence, prevalence and recovery in different forensic scenarios. 烟头混合痕迹与非自体DNA在不同法医场景中的转移、持续、流行和恢复的初步研究。
IF 1.4 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2026-02-02 DOI: 10.1016/j.legalmed.2026.102803
Denise Gianfreda, Beatrice Corradini, Gianmarco Ferri, Francesca Ferrari, Ilaria Borciani, Rossana Cecchi, Anna Laura Santunione

Recent studies focus on the different ways in which DNA can be transferred from and individual to another or to a surface. This work investigates how mixed DNA profiles can be generated on items commonly collected at the crime scene, specifically on cigarette butts. The aim is to determine how biological material exchanged during intimate contact (kissing or sharing a cigarette) can be secondarily transferred onto cigarettes, and how long non-self DNA persists and remains recoverable under different conditions and time intervals. The preliminary experimental study involved one investigative couple: each volunteer smoked a cigarette at fixed intervals after kissing (from 0 to 120 min) and both partners smoked a shared cigarette. DNA was extracted from cigarette butts immediately and after 30 days using the QIAamp DNA Investigator Kit on the QIAcube Connect. Quantification was performed with PowerQuant® System Kit and genetic profiles were obtained using PowerPlex® Fusion and Y23 Kits. Results showed non-self DNA alleles up to 2 h after kissing, even in non-immediate extractions, partial Y-STRs profiles in female butts after 1 h: individual variability and degradation made interpretations harder. Based on preliminary findings, the study will be expanded including more partner pairs, more smoking devices and longer processing timeframes. Our findings suggest the possibility of reconstructing transfer scenarios leading to mixed DNA traces on cigarette butts and of assessing a time window within which non-self DNA can be secondarily transferred to the cigarette, highlighting the impact of processing times and smoking device on DNA results.

最近的研究集中在DNA从一个个体转移到另一个个体或表面的不同方式上。这项工作研究了如何在犯罪现场通常收集的物品上生成混合DNA档案,特别是在烟头上。目的是确定在亲密接触(接吻或共用一支香烟)中交换的生物物质是如何二次转移到香烟上的,以及在不同的条件和时间间隔下,非自体DNA能持续存在多长时间,并能恢复多长时间。初步的实验研究涉及一对调查对象:每位志愿者在接吻后每隔一段时间抽一支烟(从0分钟到120分钟),双方共用一支烟。使用QIAamp DNA调查员试剂盒在QIAcube Connect上立即和30天后从烟头中提取DNA。使用PowerQuant®System Kit进行定量,使用PowerPlex®Fusion和Y23 Kit获得基因图谱。结果显示,在接吻后2小时,即使在非立即提取的情况下,女性臀部的部分y - str等位基因在1小时后仍然存在:个体差异和降解使得解释更加困难。根据初步调查结果,这项研究将扩大,包括更多的伴侣,更多的吸烟设备和更长的处理时间框架。我们的研究结果表明,有可能重建导致烟头上混合DNA痕迹的转移情景,并评估非自体DNA可以二次转移到香烟上的时间窗口,突出了处理时间和吸烟设备对DNA结果的影响。
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引用次数: 0
Toxicological risk profiles in suicide: The forensic value of hair-based substance detection. 自杀的毒理学风险概况:基于毛发的物质检测的法医价值。
IF 1.4 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2026-02-02 DOI: 10.1016/j.legalmed.2026.102805
L Tomassini, M Lancia, R Scendoni, A Raimondi, A Gili, K Aroni, C Gambelunghe

Introduction: Suicide is a major global cause of premature mortality and a critical public health concern. Chronic alcohol misuse and illicit drug use are well-established risk factors, but conventional post-mortem toxicology frequently fails to detect long-term substance exposure. Hair analysis represents a valuable forensic tool, enabling the reconstruction of pre-mortem behavioral patterns and offering insight into chronic substance use and its association with suicidal behavior.

Materials and methods: This retrospective study examined 74 suicide cases (59 males, 15 females) from 2023 to 2024. Hair samples were analyzed for ethyl glucuronide to assess chronic alcohol consumption and screened for psychoactive substances. Demographic data, previous suicide attempts, and methods of suicide were also considered.

Results: Chronic excessive alcohol use was identified in 75.7% of cases, with higher prevalence in females (93.3%) and individuals aged ≥ 65 years (88.9%). Illicit drugs were detected in 25.7% of cases, mainly cocaine (23.0%) and cannabis (17.6%). Polydrug use was found in 66.2% of subjects. Psychoactive drugs were frequently present: benzodiazepines in 63.5%, antidepressants in 36.5%, and antipsychotics in 10.8%. A prior suicide attempt was reported in 23.0% of individuals, with the highest rate among adolescents and young adults (29.4%).

Discussion and conclusion: These findings highlight age- and sex-specific toxicological patterns and support the forensic relevance of hair analysis in detecting chronic substance use. Integrating toxicological, clinical, and demographic data enhances post-mortem risk profiling and informs suicide prevention strategies targeting high-risk, underserved populations.

导言:自杀是全球过早死亡的一个主要原因,也是一个重要的公共卫生问题。长期酒精滥用和非法药物使用是公认的危险因素,但传统的死后毒理学常常无法发现长期接触物质。毛发分析是一种有价值的法医工具,可以重建死前的行为模式,并深入了解慢性药物使用及其与自杀行为的关系。材料与方法:本研究回顾性分析了2023 - 2024年自杀病例74例(男59例,女15例)。对头发样本进行葡萄糖醛酸乙酯分析,以评估慢性酒精消耗,并筛查精神活性物质。人口统计数据、以前的自杀企图和自杀方法也被考虑在内。结果:75.7%的病例中存在慢性过度饮酒,其中女性(93.3%)和年龄≥65岁的个体(88.9%)的患病率较高。在25.7%的案件中检出非法药物,主要是可卡因(23.0%)和大麻(17.6%)。66.2%的受试者使用多种药物。精神活性药物经常出现:苯二氮卓类药物占63.5%,抗抑郁药占36.5%,抗精神病药占10.8%。23.0%的人曾有过自杀企图,其中青少年和年轻人的自杀率最高(29.4%)。讨论和结论:这些发现强调了年龄和性别特异性毒理学模式,并支持头发分析在检测慢性药物使用方面的法医相关性。综合毒理学、临床和人口统计数据可增强死后风险分析,并为针对高风险、服务不足人群的自杀预防策略提供信息。
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引用次数: 0
Forensic DNA phenotyping: Prediction of eye and hair colour and allelic frequency estimation in the Italian population for the development of a reference dataset. 法医DNA表型:预测眼睛和头发的颜色和等位基因频率估计在意大利人口的参考数据集的发展。
IF 1.4 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2026-02-02 DOI: 10.1016/j.legalmed.2026.102802
Giulia Fazio, Denise Gianfreda, Sara Amurri, Beatrice Corradini, Gianmarco Ferri, Francesca Ferrari, Ilaria Borciani, Carla Bini, Rossana Cecchi, Susi Pelotti, Anna Laura Santunione

In recent years, Forensic DNA Phenotyping (FDP) has emerged as an innovative "DNA intelligence approach" aimed at predicting externally visible individual characteristics from biological traces collected at crime scenes or from biological samples of unidentified corpses or skeletal remains. This study aims to analyse the allele frequency distribution of genetic markers involved in the prediction of eye and hair colour in an Italian population sample, to enhance the existing European dataset. A large cohort of Italian individuals with at least three generations of ancestry was recruited, ensuring representation of phenotypic variability. The 24 SNP markers included in the HIrisPlex panel were analysed using SNaPshot sequencing technique, and the genotypic data were uploaded to the FDP web tool validated for forensic use by the international VISAGE Consortium's. This tool provides prediction probabilities for three eye colour categories (blue, brown, and intermediate) and four hair colour categories (black, blonde, brown, and red). The results confirmed a high predictive accuracy for the Italian population as well; however, the complex genetic structure of intermediate phenotypic traits highlights the need for novel prediction models that include genetic markers associated with complex phenotypes. The strong north-south European gradient in eye colour, along with the hypothesis that variation in eye colour is associated with skin pigmentation and UV environmental adaptation, underscores the importance for further research. These should focus on novel genetic markers to refine the European dataset, in which the Italian population may be included to enhance the accuracy of predictive models.

近年来,法医DNA表型(FDP)作为一种创新的“DNA情报方法”出现,旨在从犯罪现场收集的生物痕迹或从身份不明的尸体或骨骼遗骸的生物样本中预测外部可见的个体特征。本研究旨在分析意大利人口样本中涉及预测眼睛和头发颜色的遗传标记的等位基因频率分布,以增强现有的欧洲数据集。招募了至少有三代祖先的意大利人的大型队列,以确保表型变异性的代表性。使用SNaPshot测序技术分析HIrisPlex面板中的24个SNP标记,并将基因型数据上传到FDP网络工具,该工具经过国际VISAGE联盟的法医验证。这个工具提供了三种眼睛颜色类别(蓝色、棕色和中间颜色)和四种头发颜色类别(黑色、金色、棕色和红色)的预测概率。结果也证实了对意大利人口的高预测准确性;然而,中间表型性状的复杂遗传结构突出表明需要新的预测模型,包括与复杂表型相关的遗传标记。欧洲南北眼睛颜色的强烈梯度,以及眼睛颜色变化与皮肤色素沉着和紫外线环境适应有关的假设,强调了进一步研究的重要性。这些研究应该集中在新的遗传标记上,以完善欧洲数据集,其中可能包括意大利人口,以提高预测模型的准确性。
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引用次数: 0
Drug-related suicidal events in children and teenagers: Age-stratified insights from FAERS 儿童和青少年的药物相关自杀事件:来自FAERS的年龄分层见解
IF 1.4 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2026-01-27 DOI: 10.1016/j.legalmed.2026.102800
Fatih Hitami Usluoğulları , Volkan Aydin , Selin Cabuk , Narin Akici , Ahmet Akici

Objective

Medications are frequently reported in association with suicidality in youth, yet age-specific risks within reported cases remain unclear. We aimed to analyze drug-related suicide among children and adolescents in the FDA Adverse Event Reporting System (FAERS).

Methods

We conducted a retrospective study of FAERS reports from 1997 to 2024 that involved 5–19-year-olds and any suicide-related events. We described demographics and age-/sex-stratified adjusted reporting-odds ratios (aOR) for fatality; a 2014–2024 window confirmed robustness.

Results

We identified 18,779 cases, most from 13 to 17-years; girls constituted the majority (58.3%) except in the 5–12-years group. Completed-suicide reports accounted for 22.3% overall, rising from 6.9% (5–12 years) to 32.0% (18–19 years). Diphenhydramine showed the highest odds of reported death (aOR 8.2, 95% CI: 6.3–10.7), followed by oxycodone (6.7, 4.7–9.5) and bupropion (5.6, 4.6–6.9), stable in the last-decade subset. Age-dependent increase in reporting odds of death for risperidone (7.4, 3.3–16.5), atomoxetine (3.3, 1.6–7.1), and montelukast (2.8, 1.2–6.3) reversed after 18 years. Fluoxetine and quetiapine were associated with death predominantly in girls, whereas venlafaxine and paroxetine were more prominent in boys.

Conclusion

Across FAERS youth suicide reports, drug-associated fatality risk varies markedly by drug, surges in mid- to late adolescence, diverges by sex and shifts at both age extremes. These heterogeneities underscore the need for age-appropriate pharmacovigilance and trial strategies rather than direct extrapolation from adult data, particularly regarding the safety of drugs associated with suicide.
目的药物经常被报道与青少年自杀有关,但报告病例的年龄特异性风险尚不清楚。我们的目的是分析FDA不良事件报告系统(FAERS)中儿童和青少年与药物相关的自杀行为。方法对1997年至2024年5 - 19岁青少年的FAERS报告和任何与自杀相关的事件进行回顾性研究。我们描述了死亡率的人口统计学和年龄/性别分层调整报告优势比(aOR);2014-2024年的窗口期证实了其稳健性。结果共发现18779例,年龄在13 ~ 17岁;除5 - 12岁年龄组外,女孩占多数(58.3%)。自杀未遂报告占总体的22.3%,从6.9%(5-12岁)上升到32.0%(18-19岁)。苯海拉明报告的死亡几率最高(aOR 8.2, 95% CI: 6.3-10.7),其次是羟考酮(6.7,4.7-9.5)和安非他酮(5.6,4.6-6.9),在最近十年的亚组中稳定。利培酮(7.4,3.3 - 16.5)、托莫西汀(3.3,1.6-7.1)和孟鲁司特(2.8,1.2-6.3)的年龄依赖性死亡报告几率在18年后逆转。氟西汀和喹硫平主要与女孩死亡相关,而文拉法辛和帕罗西汀在男孩中更为突出。结论:在FAERS青少年自杀报告中,药物相关死亡风险因药物而异,在青春期中后期激增,因性别而异,并在两个极端年龄发生变化。这些异质性强调了适合年龄的药物警戒和试验策略的必要性,而不是从成人数据中直接推断,特别是关于与自杀有关的药物的安全性。
{"title":"Drug-related suicidal events in children and teenagers: Age-stratified insights from FAERS","authors":"Fatih Hitami Usluoğulları ,&nbsp;Volkan Aydin ,&nbsp;Selin Cabuk ,&nbsp;Narin Akici ,&nbsp;Ahmet Akici","doi":"10.1016/j.legalmed.2026.102800","DOIUrl":"10.1016/j.legalmed.2026.102800","url":null,"abstract":"<div><h3>Objective</h3><div>Medications are frequently reported in association with suicidality in youth, yet age-specific risks within reported cases remain unclear. We aimed to analyze drug-related suicide among children and adolescents in the FDA Adverse Event Reporting System (FAERS).</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of FAERS reports from 1997 to 2024 that involved 5–19-year-olds and any suicide-related events. We described demographics and age-/sex-stratified adjusted reporting-odds ratios (aOR) for fatality; a 2014–2024 window confirmed robustness.</div></div><div><h3>Results</h3><div>We identified 18,779 cases, most from 13 to 17-years; girls constituted the majority (58.3%) except in the 5–12-years group. Completed-suicide reports accounted for 22.3% overall, rising from 6.9% (5–12 years) to 32.0% (18–19 years). Diphenhydramine showed the highest odds of reported death (aOR 8.2, 95% CI: 6.3–10.7), followed by oxycodone (6.7, 4.7–9.5) and bupropion (5.6, 4.6–6.9), stable in the last-decade subset. Age-dependent increase in reporting odds of death for risperidone (7.4, 3.3–16.5), atomoxetine (3.3, 1.6–7.1), and montelukast (2.8, 1.2–6.3) reversed after 18 years. Fluoxetine and quetiapine were associated with death predominantly in girls, whereas venlafaxine and paroxetine were more prominent in boys.</div></div><div><h3>Conclusion</h3><div>Across FAERS youth suicide reports, drug-associated fatality risk varies markedly by drug, surges in mid- to late adolescence, diverges by sex and shifts at both age extremes. These heterogeneities underscore the need for age-appropriate pharmacovigilance and trial strategies rather than direct extrapolation from adult data, particularly regarding the safety of drugs associated with suicide.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"81 ","pages":"Article 102800"},"PeriodicalIF":1.4,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Modular tools for the analysis of pulmonary histological images: A pilot study on the differential thanatological diagnosis between born alive and stillbirth 用于分析肺组织学图像的模块化工具:一项关于活产和死产之间鉴别死亡诊断的初步研究
IF 1.4 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2026-01-27 DOI: 10.1016/j.legalmed.2026.102797
Nappi Mariarita , Cardinale Andrea Nicola , Turco Massimiliano , Cazzato Gerardo , Ingravallo Giuseppe , Valle Francesco , Sablone Sara
The determination of autonomous life signs in neonatal bodies is crucial in forensic practice, given its numerous legal implications. Current techniques, not individually exhaustive, often focus on verifying the occurrence of autonomous respiration, despite potential artifacts from decomposition and/or resuscitation efforts. This preliminary study proposes a novel technique for more accurate differential diagnosis by using modular tools to histologically analyze neonatal lungs. Lung sections, obtained from one fetal intrauterine death, two postnatal deaths due to intrapartum asphyxia, and one neonatal death (control case), were processed using a high-resolution scanner, converting stained histological slides into digital optical microscopy images. Based on their expertise, two forensic pathologists conducted a double-blind image analysis using two different open-source software, thereby marking areas (called “grains”) corresponding to the aerated alveoli, and obtaining consistent quantitative parameters. The results, showing significant differences between the cases according to the circumstances of death, aligned with available clinical and thanatological data, thus providing a proof-of-concept. Although based on the operator’s expertise, the tested modular tool proved promising for future forensic applications in this specific field. However, it would be worthy of further research to make the results reproducible, of high predictive value in differential thanatodiagnosis, and usable in courtrooms. Moreover, a casuistry extension and an experimental estimation of all factors potentially affecting results are advisable for the full implementation of this novel method in forensic investigations.
新生儿身体自主生命体征的确定在法医实践中至关重要,因为它具有许多法律含义。目前的技术,不是单独详尽的,通常侧重于验证自主呼吸的发生,尽管分解和/或复苏努力可能产生伪影。本初步研究提出了一种新的技术,更准确的鉴别诊断,使用模块化的工具,组织学分析新生儿肺。使用高分辨率扫描仪对一例胎儿宫内死亡、两例分娩时窒息导致的产后死亡和一例新生儿死亡(对照病例)的肺切片进行处理,将染色的组织学切片转换为数字光学显微镜图像。根据他们的专业知识,两位法医病理学家使用两种不同的开源软件进行了双盲图像分析,从而标记出与充气肺泡对应的区域(称为“颗粒”),并获得一致的定量参数。结果显示,根据死亡情况不同,病例之间存在显著差异,这与现有的临床和死亡学数据一致,从而提供了概念证明。虽然基于作业者的专业知识,但经过测试的模块化工具在该特定领域的法医应用前景广阔。然而,为了使结果具有可重复性,在鉴别死亡诊断中具有较高的预测价值,并在法庭上可用,值得进一步研究。此外,诡辩的延伸和所有可能影响结果的因素的实验估计是建议在法医调查中充分实施这种新方法。
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引用次数: 0
A single-center autopsy study: postmortem diagnosis of hypothermia 单中心尸检研究:体温过低的死后诊断
IF 1.4 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2026-01-25 DOI: 10.1016/j.legalmed.2026.102798
Veysel Osman Soğukpınar , Muhsin Gürkan Gürsoy , Mesut Dincer , Kasım Bulut , Koray Yılmaz , Koray Büyükatak
Hypothermia is a critical clinical condition characterized by a drop in core body temperature below 35 °C, leading to life-threatening physiological disturbances. The absence of specific and pathognomonic findings in forensic cases complicates diagnosis and necessitates a multidisciplinary evaluation. This study aims to assess hypothermia-related forensic death cases in light of autopsy, toxicological, histopathological, and scene findings. A retrospective review was conducted on 56 cases diagnosed with hypothermia as the cause of death between 01/01/2020 and 31/12/2024. Sociodemographic data, scene investigation reports, external and internal examination findings, radiology (scopy), histopathological and toxicological analyses were evaluated. Descriptive statistics and chi-square test were used, with p < 0.05 considered statistically significant. 94.6% of the cases were male, predominantly young adults. All individuals with available nationality data were foreign nationals. 89.2% were found in rural areas, and 66.1% during the spring season. Wet clothing was observed in 57.1%, and undressing in 42.9%. Scopy was performed in 10.7%. Cold burns and pink-red livor mortis were found in 71.4% and 60.7%, respectively. Gastric erosion was noted in 21.4%, and pulmonary edema in 42.9%. Toxicology revealed psychiatric drugs in 30.4%, and narcotics/volatile substances in 3.6%. Healthcare access was documented in only 5.4%. Autopsy findings alone are insufficient for diagnosing hypothermia. Integrating scene, clinical, and laboratory data enhances diagnostic accuracy. Hypothermia-related deaths should be addressed as public health issues involving medical, socioeconomic, and environmental factors. Standardization of postmortem diagnostic tools and early intervention models for risk groups are recommended.
体温过低是一种关键的临床症状,其特征是核心体温降至35℃以下,导致危及生命的生理紊乱。在法医案件中缺乏具体和病理特征的发现使诊断复杂化,需要多学科评估。本研究旨在根据尸检、毒理学、组织病理学和现场调查结果评估与低温相关的法医死亡病例。回顾性分析了2020年1月1日至2024年12月31日56例诊断为低体温死亡的病例。对社会人口统计数据、现场调查报告、外部和内部检查结果、放射学(镜检查)、组织病理学和毒理学分析进行评估。采用描述性统计和卡方检验,以p <; 0.05为差异有统计学意义。94.6%的病例为男性,以青壮年为主。所有有国籍数据的个人都是外国人。89.2%发生在农村,66.1%发生在春季。湿衣服占57.1%,脱衣占42.9%。10.7%的患者行镜检查。冷烧伤和粉红色尸斑分别占71.4%和60.7%。胃糜烂占21.4%,肺水肿占42.9%。毒理学显示精神药物占30.4%,麻醉品/挥发性物质占3.6%。只有5.4%的人记录了获得医疗保健的情况。尸检结果本身不足以诊断体温过低。整合现场、临床和实验室数据可提高诊断准确性。低温相关死亡应作为涉及医疗、社会经济和环境因素的公共卫生问题加以处理。建议为危险群体标准化死后诊断工具和早期干预模式。
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引用次数: 0
Computed tomography and 3D visualization in forensic shooting distance estimation - A ballistic gelatine pilot study. 法医射击距离估计中的计算机断层扫描和三维可视化。弹道明胶试验研究。
IF 1.4 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2026-01-25 DOI: 10.1016/j.legalmed.2026.102799
Juho-Antti Junno, Mikael Brix, Eveliina Lammentausta, Alina Junno, Timo Liimatainen, Jaakko Niinimäki, Juha Kiljunen, Petteri Oura

Accurate estimation of shooting distance is one of the main aspects in forensic gunshot case reconstruction. Reliable methods to estimate shooting distance are thus important for forensic practitioners. In this pilot study we test how computed tomography (CT) based evaluation of bullet cavitation could potentially be utilized to differentiate shooting distance. To conduct our study, we utilized ballistic gelatine blocks as a soft tissue simulant. Test shooting was performed from two distances, 20 and 100 m. Four expanding monolithic bullets were used all in 0.30 caliber (Barnes TTSX, Sako Blade, Norma Ecostrike, Lapua Naturalis). The gelatine blocks were CT-scanned after the experiment. The scans were processed and segmented using an open-source 3D Slicer software to provide a 3D reconstruction of the cavitation and obtain numerical cavitation parameters (total volume and surface area of cavitation; maximum crack diameter; location of maximum cavitation). Our results indicated that all four bullets had distinct terminal ballistic performance. This could be detected from the bullet parameters such as maximum diameter and also from the pattern of cavitation. Shooting distance had a consistent, measurable association with bullet diameter and surface area of the gelatine cavity in all four bullets. Our preliminary pilot study underscores the potential of CT in the comprehensive analysis of gelatine cavitation in terminal ballistics. Our results suggest that it would be essential to know exact bullet type when shooting distance is estimated from terminal ballistic findings.

准确估计射击距离是法医枪击案件重建的重要内容之一。因此,估计射击距离的可靠方法对法医从业者来说非常重要。在这项初步研究中,我们测试了基于计算机断层扫描(CT)的子弹空化评估如何潜在地用于区分射击距离。为了进行我们的研究,我们使用弹道明胶块作为软组织模拟物。测试射击从两个距离进行,20米和100米。四颗膨胀整体式子弹均为0.30口径(Barnes TTSX, Sako Blade, Norma Ecostrike, Lapua Naturalis)。实验结束后对明胶块进行ct扫描。利用开源的3D Slicer软件对扫描结果进行处理和分割,获得空化的三维重建,并获得数值空化参数(空化的总体积和表面积、最大裂纹直径、最大空化的位置)。我们的结果表明,这四种子弹都有不同的末端弹道性能。这可以从子弹的参数,如最大直径和空化模式来检测。射击距离与子弹直径和所有四颗子弹的明胶腔表面积有一致的、可测量的关联。我们的初步试点研究强调了CT在末段弹道中对明胶空化的综合分析中的潜力。我们的研究结果表明,当根据末端弹道结果估计射击距离时,知道确切的子弹类型是至关重要的。
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引用次数: 0
Chorioamnionitis in intrauterine fetal death: A forensic histopathological case study 子宫内胎儿死亡中的绒毛膜羊膜炎:一个法医组织病理学案例研究
IF 1.4 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2026-01-24 DOI: 10.1016/j.legalmed.2026.102796
Giorgia Franchetti , Eva Grosso , Pasquale Padalino , Pietro Fabris , Laura Secco , Stefano Palumbi , Renzo Giordano , Pantaleo Greco , Guido Viel

Introduction

Acute chorioamnionitis is a placental inflammatory condition often implicated in adverse pregnancy outcomes, including intrauterine death. The histopathological identification of maternal and fetal inflammatory responses (MIR and FIR) is critical for diagnosis and understanding potential causal mechanisms. Chorioamnionitis frequently warrants medico-legal investigation, particularly for suspected medical malpractice.

Material and methods

Two forensic cases of intrauterine fetal death with histological finding of acute chorioamnionitis are presented. Each case has been investigated with a complete autopsy with histological examination of fetal organs and placenta. The investigations were conducted following the Royal College of Pathologists’ Guidelines on autopsy practice for fetal death and the European Guidelines for forensic investigations involving suspected healthcare professional liability.

Results and Discussion

In Case 1, histopathology revealed acute necrotizing chorioamnionitis associated with chorionic vasculitis, funisitis and fetal organ involvement (stage 3/grade 2 MIR; stage 2/grade 1 FIR), supporting a causal role in fetal death. In Case 2, only focal chorioamnionitis with minimal fetal inflammatory response (stage 2/grade 1 MIR; stage 1/grade 1 FIR) was detected. A definitive and certain causal relationship with the death cannot be established due to the absence of systemic fetal involvement. No substandard medical care was identified in either case.

Conclusion

These cases underscore the importance of integrating clinical and histological data to determine the pathophysiological significance of chorioamnionitis in fetal death. The evaluation of FIR and organ involvement are critical for distinguishing between causal and incidental findings. Thorough histopathological evaluation is essential for accurate cause of death determination and medicolegal assessment.
急性绒毛膜羊膜炎是一种胎盘炎症,常与不良妊娠结局有关,包括宫内死亡。母体和胎儿炎症反应(MIR和FIR)的组织病理学鉴定对于诊断和理解潜在的因果机制至关重要。绒毛膜羊膜炎经常需要进行法医学调查,特别是对疑似医疗事故的调查。材料与方法报告了两例以急性绒毛膜羊膜炎为病理表现的宫内胎儿死亡的法医病例。每个病例都进行了完整的尸检,并对胎儿器官和胎盘进行了组织学检查。调查是根据皇家病理学家学院关于胎儿死亡尸检实践的指导方针和涉及可疑医疗保健专业责任的法医调查的欧洲指导方针进行的。结果和讨论在病例1中,组织病理学显示急性坏死性绒毛膜羊膜炎伴绒毛膜血管炎、绒毛膜炎和胎儿器官受累(3期/ 2级MIR; 2期/ 1级FIR),支持胎儿死亡的因果作用。在病例2中,仅检测到局灶性绒毛膜羊膜炎,胎儿炎症反应最小(2期/ 1级MIR; 1期/ 1级FIR)。由于没有系统性胎儿受累,无法确定与死亡的明确和确定的因果关系。在这两起案件中都没有发现不合格的医疗服务。结论这些病例强调结合临床和组织学资料来确定绒毛膜羊膜炎在胎儿死亡中的病理生理意义的重要性。评估FIR和器官受累是区分因果和偶然发现的关键。彻底的组织病理学评估是准确确定死亡原因和法医评估的必要条件。
{"title":"Chorioamnionitis in intrauterine fetal death: A forensic histopathological case study","authors":"Giorgia Franchetti ,&nbsp;Eva Grosso ,&nbsp;Pasquale Padalino ,&nbsp;Pietro Fabris ,&nbsp;Laura Secco ,&nbsp;Stefano Palumbi ,&nbsp;Renzo Giordano ,&nbsp;Pantaleo Greco ,&nbsp;Guido Viel","doi":"10.1016/j.legalmed.2026.102796","DOIUrl":"10.1016/j.legalmed.2026.102796","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute chorioamnionitis is a placental inflammatory condition often implicated in adverse pregnancy outcomes, including intrauterine death. The histopathological identification of maternal and fetal inflammatory responses (MIR and FIR) is critical for diagnosis and understanding potential causal mechanisms. Chorioamnionitis frequently warrants medico-legal investigation, particularly for suspected medical malpractice.</div></div><div><h3>Material and methods</h3><div>Two forensic cases of intrauterine fetal death with histological finding of acute chorioamnionitis are presented. Each case has been investigated with a complete autopsy with histological examination of fetal organs and placenta. The investigations were conducted following the Royal College of Pathologists’ Guidelines on autopsy practice for fetal death and the European Guidelines for forensic investigations involving suspected healthcare professional liability.</div></div><div><h3>Results and Discussion</h3><div>In Case 1, histopathology revealed acute necrotizing chorioamnionitis associated with chorionic vasculitis, funisitis and fetal organ involvement (<em>stage</em> 3/<em>grade</em> 2 MIR; <em>stage</em> 2/<em>grade</em> 1 FIR), supporting a causal role in fetal death. In Case 2, only focal chorioamnionitis with minimal fetal inflammatory response (<em>stage</em> 2/<em>grade</em> 1 MIR; <em>stage</em> 1/<em>grade</em> 1 FIR) was detected. A definitive and certain causal relationship with the death cannot be established due to the absence of systemic fetal involvement. No substandard medical care was identified in either case.</div></div><div><h3>Conclusion</h3><div>These cases underscore the importance of integrating clinical and histological data to determine the pathophysiological significance of chorioamnionitis in fetal death. The evaluation of FIR and organ involvement are critical for distinguishing between causal and incidental findings. Thorough histopathological evaluation is essential for accurate cause of death determination and medicolegal assessment.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"81 ","pages":"Article 102796"},"PeriodicalIF":1.4,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors influencing the incidence of cervical spine/cord injury and severe injury caused by falls. 影响跌倒致颈椎/脊髓损伤及严重损伤发生率的因素。
IF 1.4 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2026-01-22 DOI: 10.1016/j.legalmed.2026.102791
Masaki Inoue, Takahiro Tomioka, Takato Murai, Marin Takaso, Mami Nakamura, Kazuki Takaoka, Masahito Hitosugi

Falls are major causes of trauma in older people, often resulting in cervical spine/cord injury, and may even be fatal. We aimed to identify factors associated with cervical spine/cord injury and severe injury caused by falls to aid forensic evaluation. We retrospectively analyzed data for 83 individuals who fell between 2011 and 2023 at Shiga University of Medical Science. The characteristics of the victim, cause of death, presence of cervical spine/cord injury, injury severity, part of the body making contact with the impact surface, properties of the impact surface, and fall height were evaluated. Injury severity was assessed using the Abbreviated Injury Severity score and Injury Severity Score (ISS). Severe injury with ISS ≥ 16 occurred in 39.8% of victims and cervical spine/cord injury in 21.7%. Logistic regression analyses revealed that body mass (odds ratio [OR] 1.063, 95% confidence interval [CI] 1.003-1.126) and the part of the body making contact with the impact surface (chest/abdomen vs. head/face, OR 0.074, CI 0.007-0.723) significantly influenced the incidence of cervical spine/cord injury, and fall height >3 m was significantly associated with severe injury (OR 11.473, CI 2.163-60.868). These findings demonstrate that the severity of injury depends on the fall height, whereas cervical spine/cord injury is influenced by body mass and the part of the body making contact with the impact surface. Therefore, the collection of scene information, including the fall height, and body mass and posture are critical for postmortem examinations. Autopsy should be considered when cervical spine/cord injury is suspected.

跌倒是老年人外伤的主要原因,经常导致颈椎/脊髓损伤,甚至可能致命。我们的目的是确定与颈椎/脊髓损伤和跌倒引起的严重损伤相关的因素,以帮助法医评估。我们回顾性分析了2011年至2023年在滋贺医科大学(Shiga Medical Science University)住院的83名患者的数据。评估了受害者的特征、死亡原因、有无颈椎/脊髓损伤、损伤严重程度、与撞击面接触的身体部位、撞击面性质和坠落高度。使用简略损伤严重程度评分和损伤严重程度评分(ISS)评估损伤严重程度。ISS≥16的严重损伤发生率为39.8%,颈椎/脊髓损伤发生率为21.7%。Logistic回归分析显示,身体质量(优势比[OR] 1.063, 95%可信区间[CI] 1.003-1.126)和身体与撞击面接触部位(胸/腹vs头/脸,OR 0.074, CI 0.007-0.723)显著影响颈椎/脊髓损伤的发生率,跌落高度bbbb3 m与严重损伤显著相关(OR 11.473, CI 2.163-60.868)。这些研究结果表明,损伤的严重程度取决于坠落高度,而颈椎/脊髓损伤受身体质量和与撞击面接触的身体部位的影响。因此,收集现场信息,包括坠落高度、体重和姿势,对尸检至关重要。当怀疑颈椎/脊髓损伤时,应考虑尸检。
{"title":"Factors influencing the incidence of cervical spine/cord injury and severe injury caused by falls.","authors":"Masaki Inoue, Takahiro Tomioka, Takato Murai, Marin Takaso, Mami Nakamura, Kazuki Takaoka, Masahito Hitosugi","doi":"10.1016/j.legalmed.2026.102791","DOIUrl":"https://doi.org/10.1016/j.legalmed.2026.102791","url":null,"abstract":"<p><p>Falls are major causes of trauma in older people, often resulting in cervical spine/cord injury, and may even be fatal. We aimed to identify factors associated with cervical spine/cord injury and severe injury caused by falls to aid forensic evaluation. We retrospectively analyzed data for 83 individuals who fell between 2011 and 2023 at Shiga University of Medical Science. The characteristics of the victim, cause of death, presence of cervical spine/cord injury, injury severity, part of the body making contact with the impact surface, properties of the impact surface, and fall height were evaluated. Injury severity was assessed using the Abbreviated Injury Severity score and Injury Severity Score (ISS). Severe injury with ISS ≥ 16 occurred in 39.8% of victims and cervical spine/cord injury in 21.7%. Logistic regression analyses revealed that body mass (odds ratio [OR] 1.063, 95% confidence interval [CI] 1.003-1.126) and the part of the body making contact with the impact surface (chest/abdomen vs. head/face, OR 0.074, CI 0.007-0.723) significantly influenced the incidence of cervical spine/cord injury, and fall height >3 m was significantly associated with severe injury (OR 11.473, CI 2.163-60.868). These findings demonstrate that the severity of injury depends on the fall height, whereas cervical spine/cord injury is influenced by body mass and the part of the body making contact with the impact surface. Therefore, the collection of scene information, including the fall height, and body mass and posture are critical for postmortem examinations. Autopsy should be considered when cervical spine/cord injury is suspected.</p>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"81 ","pages":"102791"},"PeriodicalIF":1.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Legal Medicine
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