Pub Date : 2025-09-05DOI: 10.1016/j.legalmed.2025.102699
Koichi Saito, Tomonori Asanuma, Rie Ito
This study investigated headspace solid-phase microextraction (HS–SPME)–gas chromatography (GS)/mass spectrometry as a low-complexity method for accurate measurement of blood alcohol concentration (BAC) changes in humans over time following alcohol consumption. The aim was to develop an analytical method that would require as small blood samples as possible—smaller than that required for the conventional method—thereby reducing the burden on the subject. Polyethylene glycol (PEG) was used as the fiber material for SPME, and a DB-WAX capillary column was used for GC. For sample extraction via SPME, 50 µL of blood sample obtained via fingertip puncture was added to a vial already containing 3 mL of 20 % aqueous sodium chloride solution, following which an SPME fiber was inserted into the vapor phase (headspace) of the vial and heated at 70 ℃ for 20 min to sorb ethanol onto the fiber. The experiment for ethanol recovery in whole blood yielded recoveries of 71.1 % when spiked at 100 µg/mL and 95.1 % when spiked at 1000 µg/mL. Blood samples were obtained periodically with consent from a human volunteer who had actually consumed alcohol, and the BAC was shown to decrease with a peak 1.5 h after drinking, confirming the applicability of this method in BAC assessment when compared with the conventional Widmark method. Furthermore, the applicability of this method was also investigated in the case of saliva, which can be collected more easily and non-invasively than blood.
{"title":"Determination of alcohol concentration in a single drop blood obtained via fingertip using gas chromatography/mass spectrometry coupled with solid-phase microextraction","authors":"Koichi Saito, Tomonori Asanuma, Rie Ito","doi":"10.1016/j.legalmed.2025.102699","DOIUrl":"10.1016/j.legalmed.2025.102699","url":null,"abstract":"<div><div>This study investigated headspace solid-phase microextraction (HS–SPME)–gas chromatography (GS)/mass spectrometry as a low-complexity method for accurate measurement of blood alcohol concentration (BAC) changes in humans over time following alcohol consumption. The aim was to develop an analytical method that would require as small blood samples as possible—smaller than that required for the conventional method—thereby reducing the burden on the subject. Polyethylene glycol (PEG) was used as the fiber material for SPME, and a DB-WAX capillary column was used for GC. For sample extraction via SPME, 50 µL of blood sample obtained via fingertip puncture was added to a vial already containing 3 mL of 20 % aqueous sodium chloride solution, following which an SPME fiber was inserted into the vapor phase (headspace) of the vial and heated at 70 ℃ for 20 min to sorb ethanol onto the fiber. The experiment for ethanol recovery in whole blood yielded recoveries of 71.1 % when spiked at 100 µg/mL and 95.1 % when spiked at 1000 µg/mL. Blood samples were obtained periodically with consent from a human volunteer who had actually consumed alcohol, and the BAC was shown to decrease with a peak 1.5 h after drinking, confirming the applicability of this method in BAC assessment when compared with the conventional Widmark method. Furthermore, the applicability of this method was also investigated in the case of saliva, which can be collected more easily and non-invasively than blood.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102699"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010646","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 : 2025-09-05DOI: 10.1016/j.legalmed.2025.102703
Rossana Cecchi , Anna Laura Santunione , Jessika Camatti , Alice Buzzelli , Alessandra De Martina , Alessandra Sannella , Marco Vinceti , Graziamaria Corbi , Carlo Pietro Campobasso , Matilde Sassani , Giovanna Laura De Fazio , Paolo Fais , Susi Pelotti , Arianna Giorgetti , Elena Lacchè , Andrea Verzeletti , Bianca Beltrame , Riccardo Zoia , Lorenzo Franceschetti , Giulia Vignali , Raffaella Marino
Understanding the motives behind femicides is crucial to design effective prevention strategies and to support women’s self-determination, free from threats to their mental and physical integrity.
We conducted a retrospective, multicenter forensic study involving 27 Italian Institutes of Legal Medicine, analyzing 1238 female homicides (1950–2023). Cases were classified as femicide or non-femicide female homicide according to the medico-legal definition of femicide as the murder due to the failure to recognize women’s right to self-determination. Motives were categorized into 12 groups, and relevant anamnestic and circumstantial data were collected.
Of the 1238 cases, 410 were identified as femicides, 395 as non-femicides, and 433 were excluded for insufficient information. Femicides were most frequently driven by jealousy/rejection (n = 185; 45.1 %) and separation/divorce (n = 144; 35.1 %), often in the context of intimate partner violence or inability to accept the end of a relationship. Non-femicides were predominantly associated with the perpetrator’s psychiatric disorder and/or drug addiction (n = 126; 31.9 %), violent aggression without gender-related motive (n = 69; 17.5 %), victim’s illness (n = 63; 15.9 %), or economic reasons (n = 58; 14.7 %).
In the Italian context, most femicides stem from relational dynamics − particularly jealousy, rejection, and separation − whereas non-femicides are more often linked to psychiatric illness, substance abuse, or non-gender-related aggression. Incorporating these findings into clinical risk assessment protocols, especially in emergency and primary care settings, may help identify women at high risk and guide targeted prevention strategies.
{"title":"A nationwide forensic case-series of femicides in Italy – Part 1: Clues to the motives of the murder","authors":"Rossana Cecchi , Anna Laura Santunione , Jessika Camatti , Alice Buzzelli , Alessandra De Martina , Alessandra Sannella , Marco Vinceti , Graziamaria Corbi , Carlo Pietro Campobasso , Matilde Sassani , Giovanna Laura De Fazio , Paolo Fais , Susi Pelotti , Arianna Giorgetti , Elena Lacchè , Andrea Verzeletti , Bianca Beltrame , Riccardo Zoia , Lorenzo Franceschetti , Giulia Vignali , Raffaella Marino","doi":"10.1016/j.legalmed.2025.102703","DOIUrl":"10.1016/j.legalmed.2025.102703","url":null,"abstract":"<div><div>Understanding the motives behind femicides is crucial to design effective prevention strategies and to support women’s self-determination, free from threats to their mental and physical integrity.</div><div>We conducted a retrospective, multicenter forensic study involving 27 Italian Institutes of Legal Medicine, analyzing 1238 female homicides (1950–2023). Cases were classified as <em>femicide</em> or <em>non-femicide female homicide</em> according to the medico-legal definition of femicide as the murder due to the failure to recognize women’s right to self-determination. Motives were categorized into 12 groups, and relevant anamnestic and circumstantial data were collected.</div><div>Of the 1238 cases, 410 were identified as femicides, 395 as non-femicides, and 433 were excluded for insufficient information. Femicides were most frequently driven by jealousy/rejection (n = 185; 45.1 %) and separation/divorce (n = 144; 35.1 %), often in the context of intimate partner violence or inability to accept the end of a relationship. Non-femicides were predominantly associated with the perpetrator’s psychiatric disorder and/or drug addiction (n = 126; 31.9 %), violent aggression without gender-related motive (n = 69; 17.5 %), victim’s illness (n = 63; 15.9 %), or economic reasons (n = 58; 14.7 %).</div><div>In the Italian context, most femicides stem from relational dynamics − particularly jealousy, rejection, and separation − whereas non-femicides are more often linked to psychiatric illness, substance abuse, or non-gender-related aggression. Incorporating these findings into clinical risk assessment protocols, especially in emergency and primary care settings, may help identify women at high risk and guide targeted prevention strategies.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102703"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019576","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 : 2025-09-01Epub Date: 2025-08-07DOI: 10.1016/j.legalmed.2025.102682
Tadashi Ogawa, Kyoko Maebashi, Tomohito Matsuo, Masae Iwai, Kana Sakamoto, Mamiko Fukuta, Katsutoshi Kubo, Fumio Kondo, Hiroshi Seno
We developed a simultaneous analysis method for 13 neonicotinoids and related insecticides in whole blood by liquid chromatography-tandem mass spectrometry (LC-MS/MS) using a Novum simplified liquid extraction column. The extraction method, which employs an extraction solvent of 16% acetonitrile in ethyl acetate, demonstrated the best performance in terms of balancing phospholipid removal ability, recovery efficiency and matrix effects. Calibration curves showed good linear relationships, with r2 values exceeding 0.995. The intra- and inter-day accuracies and precisions were 85.5-108.8% and 0.2-13.0%, respectively. The recovery efficiencies were in the range of 52.7-92.7%. Matrix effects were between 60.6 and 201.0%; higher effects were seen for fipronil, which represents a significant challenge that resulted in substantial ion enhancement. Nevertheless, both the accuracy and precision of the method were enhanced by utilization of a stable isotopically-labeled internal standard followed by LC-MS/MS. The method was applied to a human postmortem blood sample collected during a forensic autopsy to demonstrate feasibility; results suggest that this method will be useful for forensic toxicological investigations.
{"title":"Development of a simultaneous analysis method for 13 neonicotinoids and related insecticides in whole blood by LC-MS/MS using a Novum simplified liquid extraction column.","authors":"Tadashi Ogawa, Kyoko Maebashi, Tomohito Matsuo, Masae Iwai, Kana Sakamoto, Mamiko Fukuta, Katsutoshi Kubo, Fumio Kondo, Hiroshi Seno","doi":"10.1016/j.legalmed.2025.102682","DOIUrl":"10.1016/j.legalmed.2025.102682","url":null,"abstract":"<p><p>We developed a simultaneous analysis method for 13 neonicotinoids and related insecticides in whole blood by liquid chromatography-tandem mass spectrometry (LC-MS/MS) using a Novum simplified liquid extraction column. The extraction method, which employs an extraction solvent of 16% acetonitrile in ethyl acetate, demonstrated the best performance in terms of balancing phospholipid removal ability, recovery efficiency and matrix effects. Calibration curves showed good linear relationships, with r<sup>2</sup> values exceeding 0.995. The intra- and inter-day accuracies and precisions were 85.5-108.8% and 0.2-13.0%, respectively. The recovery efficiencies were in the range of 52.7-92.7%. Matrix effects were between 60.6 and 201.0%; higher effects were seen for fipronil, which represents a significant challenge that resulted in substantial ion enhancement. Nevertheless, both the accuracy and precision of the method were enhanced by utilization of a stable isotopically-labeled internal standard followed by LC-MS/MS. The method was applied to a human postmortem blood sample collected during a forensic autopsy to demonstrate feasibility; results suggest that this method will be useful for forensic toxicological investigations.</p>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"77 ","pages":"102682"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812638","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}
We report a case of a minimally invasive autopsy using postmortem contrast-enhanced computed tomography (PMeCT) by direct large-vessel puncture combined with CT-guided myocardial biopsy as a novel method to determine the cause of death. The case involved a man in his 60 s who was found dead at his residence. Postmortem CT revealed a hematoma around the heart, suggesting the possibility of a post-myocardial infarction cardiac rupture or aortic dissection. PMeCT revealed contrast agent infiltration into the myocardium and leakage into the pericardium, indicating pericardial hematoma, likely due to cardiac rupture. A CT-guided percutaneous biopsy was performed on the area of contrast infiltration, and subacute myocardial infarction was observed 3-7 days after onset. Postmortem CT angiography provides detailed vascular images and is a valuable tool for evaluating pericardial hematomas and cardiac ruptures; however, the cost of the equipment and time constraints have limited its widespread use. To address these challenges, a relatively inexpensive technique called PMeCT by direct large-vessel puncture has been developed. To our knowledge, this is the first practical demonstration of combining PMeCT by direct large-vessel puncture with CT-guided myocardial biopsy in an actual forensic death investigation. This case illustrates how this minimally invasive approach can yield both radiological and histopathological insights, potentially offering a viable alternative in cases where a conventional autopsy is not feasible. As a supplementary report to our previous technical study, this case highlights the real-world applicability and diagnostic value of the technique, especially for identifying cardiac rupture.
{"title":"Diagnosis of cardiac rupture using PMeCT by direct large-vessel puncture and CT-guided biopsy: A case report.","authors":"Shogo Shimbashi, Motoo Yoshimiya, Sakon Noriki, Hideki Hyodoh","doi":"10.1016/j.legalmed.2025.102683","DOIUrl":"10.1016/j.legalmed.2025.102683","url":null,"abstract":"<p><p>We report a case of a minimally invasive autopsy using postmortem contrast-enhanced computed tomography (PMeCT) by direct large-vessel puncture combined with CT-guided myocardial biopsy as a novel method to determine the cause of death. The case involved a man in his 60 s who was found dead at his residence. Postmortem CT revealed a hematoma around the heart, suggesting the possibility of a post-myocardial infarction cardiac rupture or aortic dissection. PMeCT revealed contrast agent infiltration into the myocardium and leakage into the pericardium, indicating pericardial hematoma, likely due to cardiac rupture. A CT-guided percutaneous biopsy was performed on the area of contrast infiltration, and subacute myocardial infarction was observed 3-7 days after onset. Postmortem CT angiography provides detailed vascular images and is a valuable tool for evaluating pericardial hematomas and cardiac ruptures; however, the cost of the equipment and time constraints have limited its widespread use. To address these challenges, a relatively inexpensive technique called PMeCT by direct large-vessel puncture has been developed. To our knowledge, this is the first practical demonstration of combining PMeCT by direct large-vessel puncture with CT-guided myocardial biopsy in an actual forensic death investigation. This case illustrates how this minimally invasive approach can yield both radiological and histopathological insights, potentially offering a viable alternative in cases where a conventional autopsy is not feasible. As a supplementary report to our previous technical study, this case highlights the real-world applicability and diagnostic value of the technique, especially for identifying cardiac rupture.</p>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"77 ","pages":"102683"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812639","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 : 2025-08-30DOI: 10.1016/j.legalmed.2025.102698
Fabio De-Giorgio , Beatrice Benedetti , Matteo Mancino , Andrea Arcangeli , Luigi Carbone
Percutaneous transhepatic biliary drainage (PTBD) is a widely utilized procedure for managing biliary obstructions, particularly in patients with unresectable pancreatic cancer. While generally effective, PTBD carries a risk of complications, including hemobilia, intra-abdominal hemorrhage, catheter-related issues, and, rarely, vascular injuries.
We present the case of a 90-year-old woman with pancreatic cancer who underwent PTBD for biliary obstruction. Shortly after the procedure, she developed hypovolemic shock and succumbed within hours. A forensic autopsy revealed a massive hemoperitoneum (2.5 L) resulting from a rupture of the inferior vena cava (IVC), an exceedingly rare complication of PTBD.
To our knowledge, this is the first reported case of an IVC rupture directly associated with PTBD. This case underscores the critical importance of operator expertise and meticulous technique during PTBD, as well as the need for heightened awareness of potential, albeit rare, vascular complications. It also highlights the role of autopsy in elucidating unexpected causes of death and in assessing procedural outcomes.
{"title":"A rare and fatal injury to the retrohepatic inferior vena cava following percutaneous transhepatic biliary drainage","authors":"Fabio De-Giorgio , Beatrice Benedetti , Matteo Mancino , Andrea Arcangeli , Luigi Carbone","doi":"10.1016/j.legalmed.2025.102698","DOIUrl":"10.1016/j.legalmed.2025.102698","url":null,"abstract":"<div><div>Percutaneous transhepatic biliary drainage (PTBD) is a widely utilized procedure for managing biliary obstructions, particularly in patients with unresectable pancreatic cancer. While generally effective, PTBD carries a risk of complications, including hemobilia, intra-abdominal hemorrhage, catheter-related issues, and, rarely, vascular injuries.</div><div>We present the case of a 90-year-old woman with pancreatic cancer who underwent PTBD for biliary obstruction. Shortly after the procedure, she developed hypovolemic shock and succumbed within hours. A forensic autopsy revealed a massive hemoperitoneum (2.5 L) resulting from a rupture of the inferior vena cava (IVC), an exceedingly rare complication of PTBD.</div><div>To our knowledge, this is the first reported case of an IVC rupture directly associated with PTBD. This case underscores the critical importance of operator expertise and meticulous technique during PTBD, as well as the need for heightened awareness of potential, albeit rare, vascular complications. It also highlights the role of autopsy in elucidating unexpected causes of death and in assessing procedural outcomes.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102698"},"PeriodicalIF":1.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921741","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}
Reports on the quantification of fluvoxamine (FLV) in human tissues have been quite limited, although FLV has been used as an antidepressant since 1986. Fluvoxamine acid (FLA) was shown to be the major metabolite of FLV in human urine in 1983, but its quantification is also limited to only three works using human plasma. The existence of desmethyl fluvoxamine (FLD) in human specimens was recently reported in 2025; therefore, its quantification has not yet been performed. Therefore, the present work deals with the quantifications of FLV, FLD and FLA in the human samples of blood, cerebrospinal fluid, pericardial fluid, bile, urine, liver, kidney and cerebrum obtained from a human cadaver; for the quantification, the standard addition method was employed using liquid chromatography–tandem mass spectrometry (LC–MS/MS). The three top concentrations of FLV, FLD and FLA were observed in bile > liver > cerebrum, bile > liver > kidney and bile > kidney > urine, respectively. The three top relative ratios of FLD/FLA were observed in cerebrum > liver > bile, and the lowest ratio was observed in urine, and this may be one of the reasons why the previous work on FLV metabolites using urine in 1983 could not detect FLD. To our knowledge, this is the first report on the validated quantification of the new metabolite FLD by LC–MS/MS in the authentic human body fluids and solid tissues.
{"title":"Quantification of fluvoxamine, desmethyl fluvoxamine and fluvoxamine acid by LC–MS/MS in body fluids and solid tissues obtained from a deceased using the standard addition method","authors":"Hideki Nozawa , Kayoko Minakata , Itaru Yamagishi , Kenta Yuyama , Masako Suzuki , Osamu Suzuki , Takuya Kitamoto , Minako Kondo , Koutaro Hasegawa","doi":"10.1016/j.legalmed.2025.102684","DOIUrl":"10.1016/j.legalmed.2025.102684","url":null,"abstract":"<div><div>Reports on the quantification of fluvoxamine (FLV) in human tissues have been quite limited, although FLV has been used as an antidepressant since 1986. Fluvoxamine acid (FLA) was shown to be the major metabolite of FLV in human urine in 1983, but its quantification is also limited to only three works using human plasma. The existence of desmethyl fluvoxamine (FLD) in human specimens was recently reported in 2025; therefore, its quantification has not yet been performed. Therefore, the present work deals with the quantifications of FLV, FLD and FLA in the human samples of blood, cerebrospinal fluid, pericardial fluid, bile, urine, liver, kidney and cerebrum obtained from a human cadaver; for the quantification, the standard addition method was employed using liquid chromatography–tandem mass spectrometry (LC–MS/MS). The three top concentrations of FLV, FLD and FLA were observed in bile > liver > cerebrum, bile > liver > kidney and bile > kidney > urine, respectively. The three top relative ratios of FLD/FLA were observed in cerebrum > liver > bile, and the lowest ratio was observed in urine, and this may be one of the reasons why the previous work on FLV metabolites using urine in 1983 could not detect FLD. To our knowledge, this is the first report on the validated quantification of the new metabolite FLD by LC–MS/MS in the authentic human body fluids and solid tissues.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102684"},"PeriodicalIF":1.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019577","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 : 2025-08-30DOI: 10.1016/j.legalmed.2025.102697
Laurence Désirée Wolf , Eva Scheurer , Kathrin Gerlach
Background
Female genital injuries are often underreported or misinterpreted, particularly in cases of sexual violence. Until now, most research has focused on injuries caused by sexual intercourse, while injuries arising from everyday activities or anatomical variations have received less attention. This study aims to document genital injuries in healthy women, regardless of sexual assault, in order to contribute to an understanding of genital injury patterns and improve forensic interpretation.
Methods
A monocentric observational study was conducted including 100 healthy female volunteers (aged 20–70) who underwent a standardized external genital examination including photographic documentation. Data was analysed regarding the presence of injuries and anatomical variations, injury type, and affected anatomical structures. Injuries were categorized as erosions, lacerations, petechiae, and ecchymoses, excluding redness and swelling.
Results
Genital injuries were observed in 30% of the participants. Erosions and petechiae were the most common types of injuries, each accounting for 12% of all cases. In terms of the affected structures, the clitoris (32.4%) and the labia majora and minora (23.5% each) were most frequently affected.
Conclusion
This study provides valuable insights into the prevalence, distribution, and characteristics of genital injuries occurring in everyday life. Exposed structures, such as the clitoris and labia, are more susceptible to external accidental trauma compared to anatomically protected areas like the vaginal introitus. By providing information on the frequency of genital injuries, this study contributes to the understanding of genital injury patterns and will help improve forensic assessment in the future, particularly in cases of sexual violence.
{"title":"Injuries and anatomical variations of the female genitalia","authors":"Laurence Désirée Wolf , Eva Scheurer , Kathrin Gerlach","doi":"10.1016/j.legalmed.2025.102697","DOIUrl":"10.1016/j.legalmed.2025.102697","url":null,"abstract":"<div><h3>Background</h3><div>Female genital injuries are often underreported or misinterpreted, particularly in cases of sexual violence. Until now, most research has focused on injuries caused by sexual intercourse, while injuries arising from everyday activities or anatomical variations have received less attention. This study aims to document genital injuries in healthy women, regardless of sexual assault, in order to contribute to an understanding of genital injury patterns and improve forensic interpretation.</div></div><div><h3>Methods</h3><div>A monocentric observational study was conducted including 100 healthy female volunteers (aged 20–70) who underwent a standardized external genital examination including photographic documentation. Data was analysed regarding the presence of injuries and anatomical variations, injury type, and affected anatomical structures. Injuries were categorized as erosions, lacerations, petechiae, and ecchymoses, excluding redness and swelling.</div></div><div><h3>Results</h3><div>Genital injuries were observed in 30% of the participants. Erosions and petechiae were the most common types of injuries, each accounting for 12% of all cases. In terms of the affected structures, the clitoris (32.4%) and the labia majora and minora (23.5% each) were most frequently affected.</div></div><div><h3>Conclusion</h3><div>This study provides valuable insights into the prevalence, distribution, and characteristics of genital injuries occurring in everyday life. Exposed structures, such as the clitoris and labia, are more susceptible to external accidental trauma compared to anatomically protected areas like the vaginal introitus. By providing information on the frequency of genital injuries, this study contributes to the understanding of genital injury patterns and will help improve forensic assessment in the future, particularly in cases of sexual violence.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102697"},"PeriodicalIF":1.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932669","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}
Dextromethorphan has antitussive effects and therefore is mainly used in over-the-counter cold remedies. However, abuse of this addictive substance as a ‘recreational drug’ has become problematic. We recently experienced two autopsy cases in which dextromethorphan intoxication likely contributed significantly to the cause of death. In one of these cases, the femoral vein blood concentration of dextromethorphan was in the lethal range (17.7 µg/mL), and death was considered to be solely due to poisoning with this drug. In the other case, the direct cause of death was hanging, but the dextromethorphan concentration was in the intoxication range (3.9 µg/mL), and through the associated abnormal behavior, may have contributed to the cause of death. In addition, multiple liquid and tissue samples from the autopsies of these two subjects were used to examine the distribution of dextromethorphan in the body by liquid chromatography–mass spectrometry.
{"title":"Analysis of dextromethorphan concentrations in autopsy samples from two cases of self-poisoning","authors":"Tadashi Nishio, Yoko Toukairin, Tomoaki Hoshi, Tomomi Arai, Makoto Nogami","doi":"10.1016/j.legalmed.2025.102696","DOIUrl":"10.1016/j.legalmed.2025.102696","url":null,"abstract":"<div><div>Dextromethorphan has antitussive effects and therefore is mainly used in over-the-counter cold remedies. However, abuse of this addictive substance as a ‘recreational drug’ has become problematic. We recently experienced two autopsy cases in which dextromethorphan intoxication likely contributed significantly to the cause of death. In one of these cases, the femoral vein blood concentration of dextromethorphan was in the lethal range (17.7 µg/mL), and death was considered to be solely due to poisoning with this drug. In the other case, the direct cause of death was hanging, but the dextromethorphan concentration was in the intoxication range (3.9 µg/mL), and through the associated abnormal behavior, may have contributed to the cause of death. In addition, multiple liquid and tissue samples from the autopsies of these two subjects were used to examine the distribution of dextromethorphan in the body by liquid chromatography–mass spectrometry.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102696"},"PeriodicalIF":1.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144919871","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 : 2025-08-27DOI: 10.1016/j.legalmed.2025.102695
Naoto Tani , Tomoya Ikeda , Takaki Ishikawa
We report a case of death due to thallium (Tl) poisoning and discuss the findings with reference to the literature on Tl poisoning. A woman in her 20 s with a history of asthma developed symptoms such as coughing, vomiting, and fatigue, and visited a primary-care physician. She was rushed to another hospital on suspicion of an asthma attack, but her condition suddenly worsened and she died 3 days later. Postmortem computed tomography (CT) performed immediately before autopsy revealed high-density foreign material in the stomach and intestines. Autopsy findings revealed severe edematous changes under the skin and in various organs, and multi-organ failure was identified. In addition, large amounts of pleural effusion, severe pulmonary edema, pulmonary hemorrhage, and hyaline membrane formation in the lung tissue suggested acute respiratory distress syndrome (ARDS). Tl was detected in the blood at concentrations of 28.39–36.77 mg/L, about three times the lethal concentration. The cause of death in this case was thus determined to be ARDS caused by acute Tl poisoning. Many reports have described acute Tl poisoning affecting the lungs, as in this case. Generally, Tl is rarely included in toxicological analyses, but in cases such as this where ARDS is accompanied by severe pulmonary edema and a highly radio-opaque foreign material has been identified in the stomach or intestines on CT, Tl analysis using inductively coupled plasma mass spectrometry or other methods may facilitate determination of the cause of death.
{"title":"Acute thallium poisoning: An autopsy case report and review of the literature","authors":"Naoto Tani , Tomoya Ikeda , Takaki Ishikawa","doi":"10.1016/j.legalmed.2025.102695","DOIUrl":"10.1016/j.legalmed.2025.102695","url":null,"abstract":"<div><div>We report a case of death due to thallium (Tl) poisoning and discuss the findings with reference to the literature on Tl poisoning. A woman in her 20 s with a history of asthma developed symptoms such as coughing, vomiting, and fatigue, and visited a primary-care physician. She was rushed to another hospital on suspicion of an asthma attack, but her condition suddenly worsened and she died 3 days later. Postmortem computed tomography (CT) performed immediately before autopsy revealed high-density foreign material in the stomach and intestines. Autopsy findings revealed severe edematous changes under the skin and in various organs, and multi-organ failure was identified. In addition, large amounts of pleural effusion, severe pulmonary edema, pulmonary hemorrhage, and hyaline membrane formation in the lung tissue suggested acute respiratory distress syndrome (ARDS). Tl was detected in the blood at concentrations of 28.39–36.77 mg/L, about three times the lethal concentration. The cause of death in this case was thus determined to be ARDS caused by acute Tl poisoning. Many reports have described acute Tl poisoning affecting the lungs, as in this case. Generally, Tl is rarely included in toxicological analyses, but in cases such as this where ARDS is accompanied by severe pulmonary edema and a highly radio-opaque foreign material has been identified in the stomach or intestines on CT, Tl analysis using inductively coupled plasma mass spectrometry or other methods may facilitate determination of the cause of death.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102695"},"PeriodicalIF":1.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913383","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}
Post-mortem microbial communities (microbiota and microbiome) have emerged as promising tools for forensic investigations, particularly in estimating the post-mortem interval (PMI). However, experimental variability in sampling protocols, analytical methods, and reporting standards has limited the comparability and reproducibility of findings across studies.
Methods
A systematic review was conducted in accordance with PRISMA guidelines to evaluate the current literature on human post-mortem microbiota and microbiome. Inclusion criteria focused on studies that examined microbial communities in human cadavers using culture-based techniques, next-generation sequencing (NGS), or both. Data were extracted regarding sample types, microbial targets, analytical methods, decomposition stages, insect activity, and study objectives.
Results
A total of 24 studies were included, revealing substantial heterogeneity in methodological approaches. NGS techniques dominated recent literature, targeting bacterial 16S rRNA gene sequences to characterize microbial succession during decomposition. While some studies have shown promising correlations between microbial taxa and PMI, the inconsistent use of controls and variable decomposition conditions impeded cross-study comparisons. Culture-based approaches were generally limited to early investigations and provided narrower taxonomic resolution.
Conclusions
Despite encouraging results, the forensic application of post-mortem microbiome and microbiota remains hindered by methodological inconsistencies and a lack of standardization. Establishing unified protocols and adopting interdisciplinary approaches will be essential for validating microbial signatures as reliable forensic tools.
{"title":"Microbial succession after death: genomic and culture-based insights from external sampling sites in forensic science","authors":"Luca Tomassini , Virginia Goracci , Martina Onofri , Cristiana Gambelunghe , Piergiorgio Fedeli , Nicoletta Vanni , Michele Guarino , Roberto Scendoni , Massimo Lancia","doi":"10.1016/j.legalmed.2025.102685","DOIUrl":"10.1016/j.legalmed.2025.102685","url":null,"abstract":"<div><h3>Background</h3><div>Post-mortem microbial communities (microbiota and microbiome) have emerged as promising tools for forensic investigations, particularly in estimating the post-mortem interval (PMI). However, experimental variability in sampling protocols, analytical methods, and reporting standards has limited the comparability and reproducibility of findings across studies.</div></div><div><h3>Methods</h3><div>A systematic review was conducted in accordance with PRISMA guidelines to evaluate the current literature on human post-mortem microbiota and microbiome. Inclusion criteria focused on studies that examined microbial communities in human cadavers using culture-based techniques, next-generation sequencing (NGS), or both. Data were extracted regarding sample types, microbial targets, analytical methods, decomposition stages, insect activity, and study objectives.</div></div><div><h3>Results</h3><div>A total of 24 studies were included, revealing substantial heterogeneity in methodological approaches. NGS techniques dominated recent literature, targeting bacterial 16S rRNA gene sequences to characterize microbial succession during decomposition. While some studies have shown promising correlations between microbial taxa and PMI, the inconsistent use of controls and variable decomposition conditions impeded cross-study comparisons. Culture-based approaches were generally limited to early investigations and provided narrower taxonomic resolution.</div></div><div><h3>Conclusions</h3><div>Despite encouraging results, the forensic application of post-mortem microbiome and microbiota remains hindered by methodological inconsistencies and a lack of standardization. Establishing unified protocols and adopting interdisciplinary approaches will be essential for validating microbial signatures as reliable forensic tools.</div></div>","PeriodicalId":49913,"journal":{"name":"Legal Medicine","volume":"78 ","pages":"Article 102685"},"PeriodicalIF":1.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890232","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}
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