Legal Medicine最新文献

Introduction

Hypothermia is defined as a body core temperature below 35 °C and can be caused by internal or external stress. Primary hypothermia is caused by excessive exposure to low environmental temperature without any medical conditions prior to that. Secondary hypothermia is caused by alteration in thermoregulation by disease, trauma, surgery, drugs, or infections. The aim of the research is to investigate core temperature values in rats subjected to specific water temperatures at five different time points. It focuses on distinguishing between primary and secondary hypothermia in these rats.

Methods

The total 21 Wistar rats were divided into three experimental groups as: Control group rats exposed only to hypothermic condition (n = 7); Alcohol + hypothermia (n = 7); and Benzodiazepines + hypothermia (n = 7). The temperature spots analyzed in the study were: normal core temperature, core temperature during injection of 0,3 ketamine, temperature of immersion and the temperature at the onset of hypothermia and temperature at the time of death.

Results

In our study the comparative analysis of body temperatures at various time points following submersion in water revealed significant differences among the study groups treated with either alcohol or benzodiazepines and the control group. Notable differences were observed in baseline temperature, post-anesthesia induction temperature, and immediate post-submersion temperature. Specifically, significant differences were discovered among the alcohol and benzodiazepine groups (p < 0.001) and ranging from the alcohol and control groups (p < 0.001). The analysis of survival times following induced hypothermia revealed a statistically significant difference among the three experimental groups (p = 0.04), though subsequent post-hoc comparisons did not demonstrate significant differences in mean survival times.

Conclusion

There is a difference in survival time between primary and secondary hypothermia groups, depending on consumption and intoxication with alcohol or benzodiazepines. The analysis of survival times following induced hypothermia showed a statistically significant difference among the groups.

Pregabalin is a new drug used for treating neuropathic pain, epilepsy, and anxiety disorders. Since 2010, the number of pregabalin prescriptions has dramatically increased in many countries. Although pregabalin has been considered to have a low potential for abuse and toxicity, fatal cases associated with pregabalin misuse or abuse have been increasing with an increased number of prescriptions. In addition, these fatalities are likely under-reported because pregabalin is commonly not part of postmortem routine drug screens. By contrast, pregabalin-related death has not yet been reported in Japan. We encountered a fatal case of pregabalin overdose. The patient has visited hospitals for benzodiazepine dependence, insomnia and anxiety disorder and has been prescribed pregabalin, flunitrazepam, and zolpidem. One day, his home caregivers, who were his constant companions to the hospitals, found him dead. Comprehensive drug screening performed in the police crime laboratory detected 7-aminoflunitrazepam and zolpidem, but not pregabalin in the cardiac blood. By contrast, we could find all drugs, including pregabalin, in our autopsy because pregabalin was a part of our routine drug screening. The pregabalin concentration was fatal at 18.5 μg/mL in the femoral blood, whereas 7-aminoflunitrazepam (0.1 μg/mL) and zolpidem (0.2 μg/mL) were lower than the fatal levels. We concluded that pregabalin played a primary role in the cause of death but not independently. This report addresses Japanese clinicians and forensic toxicologists to the risk of pregabalin poisoning, and pregabalin should be added in postmortem routine drug screening.

Severe bleeding due to various traumatic injuries can cause hemorrhagic shock, which is difficult to diagnose using forensic medicine. Therefore, we defined the difference in color between the renal cortex and medulla observed in hemorrhagic shock deaths as “shock kidney-like appearance (SKLA)” and digitally analyzed the color difference with a digital camera and color analysis software. The aim of this study was to develop and evaluate a method for objectively determining SKLA and improve the accuracy of forensic diagnosis. We examined the kidneys of 122 cases (83 males and 39 females; average age, 64.8 years) autopsied at our facility. Using Image J, we analyzed the color of the cortex and medulla from photographs of bisected kidneys. We defined the color difference between the cortex and medulla in the L*a*b* color space as cortical-medullary color difference and performed a comparative analysis between the hemorrhage and control groups. Significant differences were observed in ΔL* and Δa* values between the two groups (p < 0.05 and p < 0.001, respectively). Analysis of Δa* values showed that the cortex was less reddish than the medulla in the hemorrhage group. The cutoff value for determining SKLA was set at Δa* = −1.33 (sensitivity, 0.79; specificity, 0.81; AUC, 0.859). Traditional evaluations of color rely on subjective assessments, which raise issues of reliability and reproducibility. This study successfully overcame the limitations of subjective evaluation by objectively assessing cortical-medullary color difference in the kidneys. Our results represent an important step towards improving the objectivity of color evaluations.

Differential diagnosis of agents of chemical burns can be challenging in neonates, especially in absence of a clear history of the event. A wide variety of chemical agents, from acids to basics, can be involved. Massive chemical burns over 21% of the body surface of a four-day-old male neonate were observed. At the physical examination, lower chest, abdomen, genital area and upper limbs showed full-thickness contact burns with a clear demarcation line of the skin breakdown related to necrosis of the subcutaneous layer. Head and fingers exhibited small hard brownish eschars. No clear history was referred by the parents, raising the suspect of a child neglect. Due to the critical conditions, it was not possible to identify the chemical agents causing the burns. The prompt excision and synthetic skin grafting was successfull and the baby survived. Considering all the different chemical agents found in the domestic environment, a combination of acid-basic agents may have been involved. Both parents were sentenced to nine years imprisonment for child neglect and wounding with intent.

This review comprehensively explores the molecular characterization, genetic insights, and functional implications of human DNase II, an enzyme crucial for DNA hydrolysis under acidic conditions. We discuss its purification, identification, and characterization, emphasizing the importance of highly purified samples for accurate analyses as well as for understanding the biochemical properties. The discovery and analysis of DNase II’s cDNA and gene have provided crucial insights into its genetic regulation and chromosomal location. Genetic polymorphism in DNase II activity levels, characterized by distinct alleles, provides valuable information on the diversity of enzyme function among individuals. Tissue distribution studies reveal its widespread presence across human tissues, hinting at potential endocrine connections. Clinical implications of DNase II variants, including therapeutic strategies targeting the JAK1 pathway, offering insights into disease mechanisms and potential treatments. Overall, this review serves as a valuable resource for advancing our knowledge of DNase II and its impact on human health and disease.

We have studied the allele frequencies for 23 STR autosomal loci (CSF1PO, FGA, TH01, vWA, D1S1656, D2S1338, D2S441, D3S1358, D5S818, D7S820, D8S1179, D10S1248, D12S391, D13S317, D16S539, D18S51, D19S433, D21S11; with the purpose to increase the power of discrimination, the markers Penta D, Penta E, D22S1045, TPOX and SE33 were included), from a sample of 100 unrelated individuals of Lenca ethnic group in Honduras, Central America.

Introduction

The postmortem diagnosis of acute myocardial ischemia (AMI) represents a challenging issue in forensic practice. Immunohistochemical studies and gene expression studies are becoming a promising field of research in forensic pathology. The present study aims to evaluate HIF-1α expression through immunohistochemistry (IHC), and mRNA-210 level using real-time polymerase chain reaction (RT-PCR), in order to define if HIF-1α and mRNA-210 in post-mortem myocardium could be adopted in the diagnosis of AMI.

Materials and Methods

Thirty-five deceased individuals, who underwent forensic autopsy at the Legal Medicine Service of the University of Parma, between 2010 and 2018, were investigated. The cohort was divided into two groups according to the cause of death (sudden deaths caused by AMI vs control cases). Cardiac specimens were collected during autopsy, then samples were processed for morphological evaluation using haematoxylin–eosin staining, for IHC, and for RT-PCR. HIF-1α expression and mRNA-210 levels were investigated.

Results

Statistical evaluation demonstrated statistically significant differences in terms of number of IHC positive vessels, leukocytes, and cardiomyocytes between the two groups. Moreover, in the majority of cases, immunostaining positivity was observed only in myocardial and subendocardial samples. With reference to mRNA-210, the difference between the two groups proved to be statistically significant.

Conclusions

The present study indicates that HIF-1α and mRNA-210 in post-mortem cardiac specimens could represent appropriate biomarkers in the diagnosis of AMI. The current study was primarily limited by the scarcity of the cohort, so further research is required to confirm these preliminary observations.

Fentanyl is a potent synthetic opioid widely used in medicine for its effective analgesic properties, particularly in surgical procedures and in the treatment of severe, chronic pain. In recent decades, however, there has been a worrying increase in the illicit use of fentanyl, particularly in North America. This rise in illicit use is concerning because fentanyl is associated with polydrug abuse, which adds layers of complexity and dangerous. This review provides a comprehensive examination of fentanyl, focusing on its synthesis and medical use. It also discusses the significance of the piperidine ring in medicinal chemistry as well as the critical role of fentanyl in pain management and anesthesia. Furthermore, it addresses the challenges associated with the abuse potential of fentanyl and the resulting public health concerns. The study aims to strike a balance between the clinical benefits and risks of fentanyl by advocating for innovative uses while addressing public health issues. It examines the chemistry, pharmacokinetics and pharmacodynamics of fentanyl and highlights the importance of personalized medicine in the administration of opioids. The review underscores the necessity of continuous research and adaptation in both clinical use and public health strategies.

Smartphone ownership and social media use are increasing worldwide, and children are not exempt from these trends. Past studies on this issue have mainly focused on educational campaigns to prevent the prolonged use of smartphones, social media, and video games. Recently, harm to children from engagement with bad actors through social media has become a major problem in Japan, and preventive measures need to be based on close analysis of the facts. The present study was performed descriptive epidemiology and comparison between two groups.

This study investigated the number of children in Japan who fell victim to criminal offense through their use of social media, categorized by level of schooling, type of offense, and means of accessing social media over the 8-year period from 2016 to 2023. The 8-year period was divided into 2016–2019 (4 years prior to the COVID-19 pandemic) and 2020–2023 (4 years during the pandemic). Statistical analysis was conducted to compare these periods.

The number of elementary school students victimized by criminal offense through social media in Japan increased significantly in 4 years during the pandemic. Furthermore, in 4 years during the pandemic, there was also a notable rise in felony-related incidents, and an increase in the number of victims accessing social media via smartphones.

Schools, parents/guardians, and personnel and organizations in relevant fields need to collaborate in addressing and educating students about the proper use of smartphones and the risks of social media starting at the elementary school age.

The mechanical properties and thickness of adult temporal and occipital bones were examined in modern Japanese forensic samples. Cranial bones were obtained from 293 Japanese corpses (179 men and 114 women). During autopsy, left temporal (LT), right temporal (RT), and occipital (O) bone samples were extracted from each skull. Sample thickness (ST) was measured using multidetector computed tomographic imaging. The fracture load (FL) of each sample was measured by a bending test, in which the flexural strength (FS) was calculated. The FL and ST values for O were significantly greater compared with those of the LT and RT bones. The temporal bones were thinner compared with other parts of the skull and at greater risk for fracture. There is a need to take precautions to prevent temporal bone fractures. There were no significant differences in any of the values between LT and RT, indicating bilateral symmetry of the temporal bones. There were significant negative correlations between age and the FL and FS values for all sites in both sexes, except for O in the male samples, suggesting that older individuals are at increased risk for fractures. No significant correlations were observed between age and ST values in any of the samples. There were significantly positive correlations between FL and ST values at all sites regardless of sex.