Pub Date : 2026-02-03DOI: 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.
{"title":"Pierced by Force: Forensic reconstruction of two fatal High-Energy Workplace impalements.","authors":"Julia Babigian, Alberto Amadasi, Marc Windgassen","doi":"10.1016/j.legalmed.2026.102806","DOIUrl":"https://doi.org/10.1016/j.legalmed.2026.102806","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"81 ","pages":"102806"},"PeriodicalIF":1.4,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137445","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}
Pub Date : 2026-02-02DOI: 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.
{"title":"Preliminary study of mixed traces on cigarette butts and non-self DNA transfer, persistence, prevalence and recovery in different forensic scenarios.","authors":"Denise Gianfreda, Beatrice Corradini, Gianmarco Ferri, Francesca Ferrari, Ilaria Borciani, Rossana Cecchi, Anna Laura Santunione","doi":"10.1016/j.legalmed.2026.102803","DOIUrl":"https://doi.org/10.1016/j.legalmed.2026.102803","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"81 ","pages":"102803"},"PeriodicalIF":1.4,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120956","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}
Pub Date : 2026-02-02DOI: 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.
{"title":"Toxicological risk profiles in suicide: The forensic value of hair-based substance detection.","authors":"L Tomassini, M Lancia, R Scendoni, A Raimondi, A Gili, K Aroni, C Gambelunghe","doi":"10.1016/j.legalmed.2026.102805","DOIUrl":"https://doi.org/10.1016/j.legalmed.2026.102805","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Discussion and conclusion: </strong>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.</p>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"81 ","pages":"102805"},"PeriodicalIF":1.4,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127294","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}
Pub Date : 2026-02-02DOI: 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.
{"title":"Forensic DNA phenotyping: Prediction of eye and hair colour and allelic frequency estimation in the Italian population for the development of a reference dataset.","authors":"Giulia Fazio, Denise Gianfreda, Sara Amurri, Beatrice Corradini, Gianmarco Ferri, Francesca Ferrari, Ilaria Borciani, Carla Bini, Rossana Cecchi, Susi Pelotti, Anna Laura Santunione","doi":"10.1016/j.legalmed.2026.102802","DOIUrl":"https://doi.org/10.1016/j.legalmed.2026.102802","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"81 ","pages":"102802"},"PeriodicalIF":1.4,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138111","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}
Pub Date : 2026-01-27DOI: 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.
{"title":"Drug-related suicidal events in children and teenagers: Age-stratified insights from FAERS","authors":"Fatih Hitami Usluoğulları , Volkan Aydin , Selin Cabuk , Narin Akici , 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}
Pub Date : 2026-01-27DOI: 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.
{"title":"Modular tools for the analysis of pulmonary histological images: A pilot study on the differential thanatological diagnosis between born alive and stillbirth","authors":"Nappi Mariarita , Cardinale Andrea Nicola , Turco Massimiliano , Cazzato Gerardo , Ingravallo Giuseppe , Valle Francesco , Sablone Sara","doi":"10.1016/j.legalmed.2026.102797","DOIUrl":"10.1016/j.legalmed.2026.102797","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"81 ","pages":"Article 102797"},"PeriodicalIF":1.4,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079632","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}
Pub Date : 2026-01-25DOI: 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.
{"title":"A single-center autopsy study: postmortem diagnosis of hypothermia","authors":"Veysel Osman Soğukpınar , Muhsin Gürkan Gürsoy , Mesut Dincer , Kasım Bulut , Koray Yılmaz , Koray Büyükatak","doi":"10.1016/j.legalmed.2026.102798","DOIUrl":"10.1016/j.legalmed.2026.102798","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"81 ","pages":"Article 102798"},"PeriodicalIF":1.4,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079626","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}
Pub Date : 2026-01-25DOI: 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.
{"title":"Computed tomography and 3D visualization in forensic shooting distance estimation - A ballistic gelatine pilot study.","authors":"Juho-Antti Junno, Mikael Brix, Eveliina Lammentausta, Alina Junno, Timo Liimatainen, Jaakko Niinimäki, Juha Kiljunen, Petteri Oura","doi":"10.1016/j.legalmed.2026.102799","DOIUrl":"https://doi.org/10.1016/j.legalmed.2026.102799","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"81 ","pages":"102799"},"PeriodicalIF":1.4,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121016","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}
Pub Date : 2026-01-24DOI: 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.
{"title":"Chorioamnionitis in intrauterine fetal death: A forensic histopathological case study","authors":"Giorgia Franchetti , Eva Grosso , Pasquale Padalino , Pietro Fabris , Laura Secco , Stefano Palumbi , Renzo Giordano , Pantaleo Greco , 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}
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}