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Journal of Forensic and Legal Medicine
Journal Prestige (SJR): 0.622
Citation Impact (citeScore): 1
Number of Followers: 408  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1752-928X
Published by Elsevier Homepage  [3160 journals]
  • Why We Can't Determine Reliably The Age Of A Subject On The Basis Of His
           Maturation Degree
    • Abstract: Publication date: Available online 5 December 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Silvano Milani, Lodovico Benso BackgroundMaturation is the irreversible biological process leading to adult form or function. The degree of maturation can be derived from the examination of maturity indicators, i.e. of particular aspects of the overall maturation, such as pubertal status, skeletal and dental morphology. Rhythm of maturation of each indicator differs between populations and individuals, because of genetic, nutritional and environmental factors. Skeletal maturation is usually expressed as skeletal age, which is the median age at which a given degree of maturation is attained. Despite its name, skeletal age indicates a degree of maturation and not a chronological age. This misinterpretation still results in a confused, unprofitable, and endless debate about the reliability of forensic age and its ethical, deontological, legal and scientific aspects, while its estimation is gaining raising importance in forensic practice, due to increasing migration movements towards Europe.ContentsThis paper clarifies the meaning of biological age compared to chronological age, quantifies the uncertainty associated with forensic age in terms of biological variability (differences in the degree of maturation of subjects with the same chronological age), bias (systematic differences between ethnic groups), and lack of precision (random errors made in the evaluation of an X-ray image). Because of the inter-individual variability, the interval between the 3rd and 97th centile of chronological age distribution of healthy adolescents sharing the same skeletal age and belonging to a given population has width of at least ±2 years about the skeletal age (uncertainty interval). This – and not others – uncertainty interval (±2 years) is the only interval that should be specified by the expert witness, when he presents his estimate of the age of an adolescent without identification documents.ConclusionsExpert witnesses should be aware that the age of an adolescent can be determined only with rough approximation, even when they assess maturation with the most reliable method, and that, when they produce their conclusions to the judicial or public security authorities who requested to determine the age of an adolescent, they are determining for ever the fate of a young human being.
  • Fatal atlantoaxial dislocation due to an odontoid synchondrosis fracture
           in a child with chromosome 9 abnormality: A case report
    • Abstract: Publication date: Available online 29 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Rutsuko Yamaguchi, Yohsuke Makino, Go Inokuchi, Shinya Hattori, Fumiko Chiba, Suguru Torimitsu, Naoki Saito, Takashi Kishimoto, Hirotaro Iwase A 5-year-old boy with a chromosome-9 abnormality and multiple external and visceral malformations was found in cardiopulmonary arrest during a regular visit to the hospital; he did not respond to cardiopulmonary resuscitation and died. An odontoid process fracture and calcification and fibrosis of the muscles around the superior cervical vertebra were observed during the autopsy. Postmortem computed tomography revealed an anterior dislocation of the atlas; odontoid synchondrosis fracture; and delayed, incomplete bony fusion of the odontoid process relative to his age. The cause of his death was a superior spinal cord injury. The tissue surrounding the upper cervical spine presented with myositis ossificans, suggesting a prior injury. He experienced a minor traffic accident 3 months before his death. It was concluded that the odontoid synchondrosis fracture occurred during the accident based on the incomplete bony fusion and atlantoaxial instability, which were consistent with the findings of myositis ossificans. Delayed fatal dislocation may then have occurred under the influence of a minor external force. Odontoid process abnormalities and atlantoaxial instability are common in patients with trisomy 21 and other congenital diseases; however, the condition’s association with chromosome-9 abnormalities has not been reported. In children with various chromosomal abnormalities, periodic assessment of instability and morphology of the cervical spine, and a lowered examination threshold for the children at risk, could prove useful in the prevention injuries leading to fatality, and provide additional information to rule out abuse.
  • Sudden and unexpected death due to intracranial sellar extramedullary
    • Abstract: Publication date: Available online 26 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Jozef Sidlo, Henrieta Sidlova The incidence of sudden death caused by undiagnosed primary intracranial neoplasm in young adults is extremely low. The aim of the work is to present a case report of the sudden death of a 24-year-old woman. The autopsy has revealed enlargement of sella turcica with an intrasellar tumorous mass extending into the adjacent basal parts of the brain. A tumour was diagnosed as an extramedullary plasmacytoma. The cause of death was established as a failure of the central nervous system. Toxicological analyses of biological materials were negative. According to the case history, a woman reportedly had no serious health problems. Finding of an extensive intracranial tumour in the sella turcica was random and surprising. The presented case is an extremely rare case of sudden death caused by intracranial intrasellar extramedullary plasmacytoma without previous clinical manifestation.
  • Biomechanical analysis in osteoarchaeology: Reconstruction of
           pathomechanics, treatment and gait caused by a femur fracture in the late
           middle ages
    • Abstract: Publication date: Available online 24 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Marta Licata, Silvia Iorio, Piergiorgio Benaglia, Adelaide Tosi, Melania Borgo, Giuseppe Armocida, Alessandra Ruspi, Andrea Verzeletti, Chiara Rossetti In paleopathology, biomechanics allows us to investigate traumas in ancient skeletal remains. The aim of our current research is to reconstruct pathomechanics, treatment and gait of an individual from a Late Medieval femur with evident bone callus. In particular, to reconstruct the dynamic of the trauma that caused the injury and the adopted therapeutic measures, taking into account medical knowledges of that time.The femur was recovered during the archaeological investigation in the Sanctuary of Sacro Monte, Varese (Northern Italy). Classical physical anthropological methods and CT scans were used for macroscopic and radiological measurements of the bone. Finally, the reconstruction of the static and dynamic functional outcomes of the lesion were performed by Observation Gait Analysis (OGA) procedure.The femur shows an important callus at the middle third proximal of the shaft. The antemortem fracture was oblique and caused by a direct trauma probably related to occupational activities. The alignment of the segments in the frontal plane lead us to assume that the fracture was treated and the femur was immobilized with splints. The overlap and the angle of the segments indicate that the subject was not submitted to traction or fracture reduction. Good bone remodeling and consolidation of the fracture suggest that the subject had gradually led to the resumption of load and walking, although with important effects on posture and movement.The use of the OGA allow us to highlight the subject's kind of gait after healing.
  • Successful analysis of a 100 years old semen stain generating a complete
           DNA STR profile
    • Abstract: Publication date: Available online 19 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Alessandro Mameli, M.S.; Carmine Maria Scudiero, Giovanni Delogu, Maria Elena Ghiani We performed forensic investigations on a handkerchief containing seminal fluid deposited 100 years earlier. The aim was to verify the possibility to achieve a complete genetic profile exceeding the limit of success reached until today with a partial semen stain profile stored up to 50 years. The current forensic methods were carried out: Alternative Light Source (ALS), Prostate-Specific Antigen (PSA) Test, autosomal and Y-chromosome Short Tandem Repeats (STRs). ALS inspection was a crucial method in the success of the analysis. On a dried semen stain, fluorescence remains constant for a very long time, allowing possibility to minimize the fabric sample to analyze, in order to preserve specimen for future defense guarantees or to protect historical finding. We achieved positive results in 3 of 6 traces, PSA and DNA results were concordant, only those cuttings that tested positive for PSA yielded DNA profiles. A complete male profile was generated by AmpFlSTR Identifiler Plus and 16 loci profile by AmpFLSTR Yfiler. Considering some historical sources that attributed this handkerchief dated 1916, to a famous Italian poet, the DNA profile found on the handkerchief was compared with a living male descendant, and the comparison of the Y-STR between the two gave positive results, confirming the reliability of the outcomes. The findings achieved by the current forensic method empower the application of this methodology to other forensic cases, especially in past unresolved cases.
  • Not quite anyone's guess: Brexit, forensic science and legal medicine
    • Abstract: Publication date: Available online 15 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Tim J. Wilson Six months before 29th March 2019 - the date when the UK is due to leave the EU (‘Brexit’) - the nature of the future UK-EU relationship is highly uncertain. Some of the consequences of the new relationship – whatever form it takes - for legal cooperation and everything (including forensic science and legal medicine) that underpins it can be anticipated. Further analysis, however, of the scope and significance of Brexit for the professional and academic scientific and clinical work covered by this journal is needed urgently. This commentary ends with an invitation to its readers to join a new academic and professional network (including professional corporate bodies and NGOs) intended to help facilitate this.
  • Title: The Danger of a Single Story about Forensic Humanitarianism
    • Abstract: Publication date: Available online 15 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Adam Rosenblatt
  • Can pulmonary foam arise after postmortem submersion in water' An
           animal experimental pilot study
    • Abstract: Publication date: Available online 10 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Guido Reijnen, Petra Vos, Marcel Buster, Udo Reijnders It is difficult to differentiate drowning from postmortem submersion. Pulmonary foam can be found in bodies retrieved from water. It is unknown whether foam is a result of drowning or if it also forms after postmortem submersion. We divided deceased piglets into three groups: postmortem saltwater submersion (N = 20), postmortem freshwater submersion (N = 20) and dry-land controls (N = 20). All carcasses underwent endoscopic examination within 24 hours of death and the presence of external and internal pulmonary foam was scored. No external foam was detected in the postmortem freshwater or the postmortem saltwater group. Internal foam was seen in 35% of the postmortem freshwater and 40% of the postmortem saltwater group. No external or internal foam was detected in the dry land control group. The literature shows external as well as internal foam in drowned humans. Internal foam is seen in postmortem submersion in the current piglet study and antemortem submersion in the literature in humans, and can therefore not be used to support/refute the diagnosis of drowning. No external foam was present in the postmortem submersed piglets, yet has been described in drowned humans. Hence the presence of external foam in bodies recovered from water may be indicative for drowning. The presence of external foam is a potentially valuable clinical sign in distinguishing drowning from postmortem submersion.
  • Toxicological Findings in 1000 Cases of Suspected Drug Facilitated Sexual
           Assault in the United States
    • Abstract: Publication date: Available online 10 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Taís Regina Fiorentin, Barry Kerr Logan The purpose of this study was to identify the extent and types of drugs found in alleged drug facilitated sexual assaults (DFSA) in 37 states and 1 territory of the United States. In total, 1000 cases were reviewed. Between the cases that gender was provided (613), most of the victims (91.68%) were woman, mean age of 26.8 years old. Blood and/or urine samples were tested. Twenty-one point six percent of the cases were negative for intoxicating substances. A hundred and one different substances were detected. Overall, ethanol was the most prevalent substance, detected in 30.9% of the cases (309 cases), followed by cannabinoids (THC/THCCOOH/11-OH-THC) (28.8% of cases), amphetamine/methamphetamine (16.5% of cases), cocaine/metabolites (10.4% of cases), and clonazepam/metabolite (7.6% of cases). The mean, median and range concentrations of ethanol in blood (n=309) were 98.6 mg/dL, 82.0 mg/dL and 9.2 – 366 mg/dL, respectively. Ethanol and cannabinoids were the most frequent combination found. The absence of alcohol and drugs in some cases may represent delay in collecting samples.
  • Comparison of post-mortem ethanol level in blood and bone marrow
    • Abstract: Publication date: Available online 10 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): M. Iskierka, M. Zawadzki, P. Szpot, T. Jurek
  • The multi-factorial determinism of forensic expertise regarding sentence
           interruption on medical grounds and decision
    • Abstract: Publication date: Available online 10 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Cristian Gherman, Alexandra Enache, Cristian Delcea The topic proposed by this research is the complex determinism or requesting forensic expertise for the purpose of postponing or interrupting a sentence in medical ground. Within the topic, it was necessary to perform a complex analysis on several aspects of inmate life, from the point of view of their rights and especially the right to medical assistance. We have included aspects related to the evolution of the legal framework and current regulations, to the status of medical assistance in the penitentiary environment (illustrating realities related to morbidity and mortality) and to the doctor-patient relationship during a forensic expertise. To this end, this paper aims to reveal the realities of how inmates are informed about the framework in which the institution of forensic expertise operates, as well as to analyse the inmates’ perception on the accessibility and usability of this type of expertise. At the same time, we aimed to identify cases which abusively exceed the boundaries of requesting sentence interruption on medical grounds and the causes of these situations. In the first part, a retrospective statistical study was performed in mortality within the penitentiary population in the area included in the study. The characteristics particular to the doctor-inmate patient relationship were also explored.
  • Cranial sutures and age estimation – A few reflections
    • Abstract: Publication date: Available online 9 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Rutwik Shedge, Tanuj Kanchan
  • Review of a Forensic Pseudoscience: Identification of Criminals from
           Bitemark Patterns
    • Abstract: Publication date: Available online 3 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): C. Michael Bowers The forensic sciences are a combination of laboratory procedures and physical comparisons of objects associated with victims, perpetrators, and crime scenes. The former is largely university-based protocols adopted by crime labs. The latter is predominantly pattern-matching tools originally developed by police examiners or experts deemed by courts to be relevant to forensic matters. These Court accepted experts bring their reasoning and conclusions into the legal arena. This subgroup of forensics has undergone significant scrutiny in regards to its history of exaggerated claims and weak scientific foundations. This paper addresses the rise and fall of bitemark pattern analysis (i.e. “matching” bitemarks in human flesh to human teeth) in the environment of opposing interests and agendas.
  • Ethical Challenges of Kidney Sale: A Review of Three Major Assumptions
           Based on the Theories of Ṭabāṭabā’ī
    • Abstract: Publication date: Available online 1 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Rahim Dehghan This paper seeks to provide an ethical assessment of kidney sale based on the theories of a contemporary Shiite theologian, Muḥammad Ḥussain Ṭabāṭabā’ī. It aims to offer a mechanism to decide the justifiability or unjustifiability of kidney sale in ethical terms. Ṭabāṭabā’ī considers ''Divine Consent'' as the criterion for the morality of an action. An action meets the “Divine Consent” requirement if it is done with a sincere intention, confirmed by reason and Divine revelations, brings about an internal peace for the agent, and preserves the agent’s dignity and autonomy. Given this criterion and through an analytic and qualitative method, this paper aims to evaluate kidney sale in three cases: during one’s lifetime, during brain death when the agent has left no will, and during brain death when the agent has left a will. It seems that, based on the theories of Ṭabāṭabā’ī, the above requirements are only met in the first two cases. Thus, kidney sale is morally justifiable in the first two cases but not in the third.
  • Domestic-setting corpses, an urban problem'
    • Abstract: Publication date: Available online 25 October 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Natalie F. Runtuwene, Marcel C.A. Buster This study describes the domestic-setting corpses that remain unnoticed for two weeks or more. It compares the occurrence of this phenomenon in the city of Amsterdam with the surrounding municipalities of Amsterdam (SMA). Data of 437 cases were extracted from the forensic medical register of Amsterdam. Data of size and household situation of the population were extracted from Statistics Netherlands. A 3.7 (95%CI 2.8–4.9) times higher incidence rate, was observed in the city of Amsterdam (n = 379; 5.3/100,000 personyears) compared to the SMA (n = 58; 1.4/100,000 personyears). All but three cases lived alone. After limiting both cases and reference data to single households, the crude rate ratio was 2.1 (95%CI 1.6–2.7). Further adjustment for age and gender resulted in a Standardized Mortality Ratio of 0.36 (95%CI 0.28–0.47). This means the occurrence of domestic-setting corpses (14 + days) among people living alone is 2.7 times higher in the city of Amsterdam (95%CI 2.1–3.5).We conclude domestic-setting corpses are more likely to occur in an urban environment. This is partly explained by the higher proportion of single households in the city compared to the more rural areas. However, differences in social cohesion and architecture between urban and rural areas are expected to be important too.
  • The appearance of breast cancer metastases on dry bone: implications for
           forensic anthropology
    • Abstract: Publication date: Available online 25 October 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Lucie Biehler-Gomez, Gaia Giordano, Cristina Cattaneo Breast carcinoma is a major cause of morbidity and mortality in women. The study of bone pathologies presents considerable potential in anthropology, paleopathology, forensic science and medicine. In this paper, we present and discuss metastatic lesions found in the skeletons of known individuals from the CAL Milano Cemetery Skeletal Collection, clinically diagnosed with breast cancer during life. Fourteen skeletons from a contemporary and identified collection were macroscopically studied and metastases were identified by comparison with clinical literature. As a result, bone metastases were observed in 43% of the study sample. They were located most commonly on the ribs (28.1%), pelvic girdle (19.8%), vertebrae (15.6%), skull (15.6%), scapulae (10.2%) as well as proximal segment of the femora (8.4%) and humeri (2.4%) respectively, favoring sites of high vascularization. The majority of the lesions were osteolytic, although osteoblastic and mixed metastases did occur. Osteolytic metastases appear as coalescent porosity or round to oval perforating lesions on bones with denticulated margins and pitted surrounding bone, whereas osteoblastic metastases thickened the existing trabecula (spongiosclerosis). Mixed metastases were perforating lytic lesions exposing the osteoblastic activity in the underlying trabecular bone. These results, consistent with the data from the literature, strengthen the diagnostic criteria for metastases and illustrate the aspect of bone metastases in breast carcinoma.
  • Homicidal Poisoning in India: A Short Review
    • Abstract: Publication date: Available online 23 October 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Asit Kumar Sikary This review has analysed various studies and case reports on homicide by poison from different parts of India till date. This review shows that homicidal poisoning prevalence varies from 0.3% to 3.7% having varied prevalence from different regions with no homicidal cases too. The poisons used in homicide were mainly organophosphates, aluminium phosphide, paraquat, and arsenic. No age-group or gender was spared and the perpetrators were first degree relatives.
  • Sex Determination in a Spanish Population Based on Sacrum.
    • Abstract: Publication date: Available online 6 October 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Gaya-Sancho Benjamín, Alemán Aguilera Inmaculada, Navarro-Muñoz Juan Jesús, Botella López Miguel Sex determination is one of the essential steps when it comes to establishing an individual’s biological profile. It is important in both archaeology and forensic studies. The sacrum is not generally conserved, but in cases where it is, it can be used for determination of the sex of skeletal remains. Furthermore, the sacrum is not a commonly studied bone and has not been studied in a Spanish population. For this study, measurements of 170 sacra of individuals from the contemporary osteological collection of San José from Granada including only the adults were taken. Measurements based on the anatomical regions of the sacra were established in order to obtain some regression formulas to determine sex. Our results show that the Superior Transverse Line and Right Lateral Sacral Crest are the most dimorphic structures, achieving a 74% rate of correct classification of sex in a univariate analysis. In multivariate analysis, when the mentioned variables were combined, an 81.41% rate of correct classification was achieved. Our results show that our method can be applied with other methods at the same time to determine the sex of individuals in forensic and archeological contexts.
  • Use of Flow Cytometry in Forensic Medicine: Current Scenario and Future
    • Abstract: Publication date: Available online 1 October 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Kirti Amresh Gautam, Sachil Kumar, Vikash C. Mishra Several methodologies are being used on different biological, physical and chemical indicators to determine the postmortem interval (PMI); however, most of them are not completely accurate. Flow cytometry is an emerging technology widely used for single cell analysis in the field of clinical pathology. Studies on flow cytometry and its application in the field of forensic medicine were retrieved from systematic web searched of different databases including “MEDLINE”, “ScienceDirect”, “PubMed” and “Google Scholar” using keywords forensic science; forensic medicine; forensic investigation; flow cytometry; DNA; postmortem interval; vitreous humor with the last search performed in January 2018. A total of 43 publications have been reviewed, and out of them 22 studies met our criteria and have been cited in this article. A handful of studies have evaluated the application of flow cytometry in forensic medicine for estimation of the PMI and identification of the perpetrator of sexual assault cases. Flow cytometry is also useful for quantifying the ABH antigens in red blood cells as well as in other human samples that can be further used for personal identification. In conclusion, flow cytometry is more sensitive, faster and easy compared to the other methods of investigation, thus making it a preferred method. However, a large numbers of studies with the application of flow cytometry on different cases of death are required to establish a universally accepted rate of DNA degradation to avoid errors in judgment.
  • Factors associated with autopsy rates in a 6-year sample of Danish
           suicides in the Capital area of Copenhagen
    • Abstract: Publication date: Available online 27 September 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Astrid Kerstine Buch, Johannes Busch, Seija Ylijoki-Sørensen, Jytte Banner On average, two suicides occur in Denmark every day. In order to prevent suicides, it is important to understand their nature. The forensic autopsy plays an important role by providing detailed knowledge of the cause and manner of death. Unfortunately, the autopsy rate for suicides in Denmark is very low.The aim of this study was to elucidate the factors that may affect the decision to perform a forensic autopsy and thereby affect the autopsy rate of suicidal deaths in the Capital area of Copenhagen.Data from 6,211 death certificates from the Capital area of Copenhagen, Denmark, over a study period of six years, were investigated. For deaths classified as suicide, the presence of the following factors were registered: gender, age, date of birth, date of death, marital status, nationality, place of death, cause of death, psychiatric condition, former admissions at a psychiatric ward, former attempts of suicide, presence of suicide note, history of substance abuse (alcohol, narcotics or both), and presence of self-inflicted scars. These factors were cross-tabulated with whether a referral to a forensic autopsy was made. Significant association was calculated by using Chi2 and Fisher’s exact test.We found a total of 381 cases of suicide. The forensic autopsy rate was 21.3%. The following factors were associated with a significantly lower forensic autopsy rate: age above 50, history of psychiatric illness, the presence of a suicide letter, and cause of death registered as hanging/strangulation/suffocation, drowning/submersion, self-harm with sharp object, and jumping from height. Only the presence of a suicide letter remained significant after the Bonferroni correction for multiple testing. History of substance abuse and cause of death registered as intentional exposure to smoke, fire and flames were associated with a significantly higher forensic autopsy rate.A forensic autopsy can give more precise information on suicide methods, the impact of fatal lesions and comorbidity. Our study results showed that violent methods of suicidal death and psychiatric comorbidity led to a lower forensic autopsy rate. A higher autopsy rate would enable more thorough study and investigation of suicides, which would benefit the next-of-kin, general preventive procedures, and treatment of patients at risk of suicide.
  • Rare atlas fracture detected using postmortem computed tomography: A case
    • Abstract: Publication date: Available online 26 September 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Hajime Tsuboi, Ryutaro Takazakura, Nozomi Idota, Marin Takaso, Hiroshi Ikegaya We report the autopsy of a traffic accident victim with a rare atlas fracture. The deceased was 52-year-old man found dead on the road because of a traffic accident. We performed a postmortem computed tomography and an autopsy on the body. The sagittal reformation image of postmortem computed tomography showed a vertically separated anterior arch of atlas, suggesting a “horizontal fracture.” Therefore, we assumed that cervical hyperextension may have been one of the forces that affected him during the accident. Minor spinal cord injury was also noted. In this case, postmortem computed tomography played an important role in detecting the spinal cord injury, considering the mechanism of the traffic accident, and supported the autopsy.
  • Commentary. Fentanyl-related death and the underreporting risk.
    • Abstract: Publication date: Available online 21 September 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Stefano D’Errico Novel synthetic opioid overdose deaths have been rising largely worldwide as a result of fentanyl adulteration in the illegal drug supply. Interpretation of post mortem analytical results concerning fentanyl can be challenging in particular due to redistribution phenomena. Lacking of resources, infrastructures and expertise to perform forensic toxicological investigation when an unknown drug or complex mixture of drugs is suspected can affect failure in exactly reporting cause in drug related death. Public safety and public health entities are called working together to enhance the timeliness and accuracy of the analytical characterization and toxicology testing of novel synthetic opioids.
  • Validation of Cameriere's Medical-Legal Age Estimation Method using
           Seconds Premolars in a Portuguese Population
    • Abstract: Publication date: Available online 11 September 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Ana Catarina Anastácio, Cristina Serras, Rui Filipe Vargas de Sousa Santos, Cristiana Palmela Pereira The goal of this project is to validate the Cameriere’s method applied to the upper and lower second premolars in a Portuguese population, regarding the forensic estimate of age.The applied sample consisted in 100 panoramic radiographs, of 60 males and 40 females, patients of the Faculty of Dental Medicine of the University of Lisbon, whose ages vary between 15 and 35 years old. Thus, a total of 400 teeth were investigated (200 upper second premolars and 200 lower second premolars). Each radiograph was analysed using draw and measurement tools featured in Adobe Photoshop, applying the Cameriere’s method, and then the pulp/tooth ratio was computed for the 15, 25, 35 and 45 teeth. All data were statistically analysed with the SPSS program, using a significant level of 5%.It was not observed any kind of relation, linear or not linear, between age and the pulp/tooth ratio. Linear regressions with considerably low values for the coefficient of determination were achieved, which indicates a low reliability for these models.Accordingly, we conclude that the knowledge of the pulp/tooth ratio does not allow the identification of an individual based on the Cameriere’s method, in the scope of a forensic age estimate applied to panoramic radiograph. Further investigations with larger samples and broader age groups are required in order to provide suitable evidence to the legal and social aspects of age estimate in Forensic Dentistry.
    • Abstract: Publication date: Available online 10 September 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Roger W. Byard
  • Thymic changes and sudden infant death syndrome (SIDS)
    • Abstract: Publication date: Available online 10 September 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Roger W. Byard
  • Violent deaths of pregnant women in Egyptian governorates of Cairo and
    • Abstract: Publication date: Available online 7 September 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Nadia A. Kotb, Samah F. Ibrahim BackgroundPregnancy-associated deaths are a widely recognized phenomenon, that warrants in-depth investigation. Of the 319 suspicious deaths of adult women (>20 years) autopsied during 2011–2012, in the Cairo and Giza governorates, 37 (11.7%) women were pregnant at the time of the autopsy. This paper analyzes the corresponding demographic data, autopsy findings, and toxicological screening.The resultsReveal that the number of deaths of pregnant women were higher in 2012 than in 2011. In addition, the number of cases from Giza exceeded those from Cairo (62.2% and 37.8%, respectively). Most cases involved married women (62.2%) in the third trimester of pregnancy (67.5%). Most deaths were predominantly un-intentional (51.4%) attributed to peri-partum complications. Homicidal deaths contributed to 43% of cases, and the husband was the suspect perpetrator in 37.5% of cases. Only two cases were associated with substance abuse.Conclusionthe paper concludes that this analysis may inform future strategies to protect pregnant women from the hazards of violence and labor that threaten their lives.
  • Study of handling of medico-legal cases in governmental hospitals in Cairo
    • Abstract: Publication date: Available online 5 September 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Magda Mokhtar, Sonya M.S. Azab, Shaimaa Hassan, Hanan Said Ez-Elarab Medico-legal case (MLC) represents an integral part of medical practice in the emergency departments and causalities. Therefore, the physicians should have the sufficient knowledge of their roles and responsibilities while handling these cases to aid legal justice.This study on the physicians working in governmental hospitals in Cairo aimed to assess physicians' knowledge, practice and attitude regarding handling of MLCs.The study included 452 physicians working in 7 governmental hospitals in Cairo. There were non-significant differences in physicians' knowledge, practice and attitude scores according to their age groups, gender, job titles or duration of work experience. Physicians working in the day surgery centre had the lowest knowledge and attitude scores.Daily rate of confrontation with MLCs was reported by 42% the participants (190 physicians) and weekly rate was reported by 21.7% (98 physicians). Writing ML report was found as the most frequently encountered difficulty faced the participants during handling of MLCs (67.1%), followed by dealing with the patients' relatives.In conclusion, this study revealed absence of a well defined protocol for recognition and handling of MLCs in all included governmental hospitals in Cairo.
  • Cocaine toxicological findings in cases of violent death in Sao Paulo city
           - Brazil
    • Abstract: Publication date: Available online 28 August 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Ana Miguel Fonseca Pego, Sarah Carobini Werner de Souza Eller Franco de Oliveira, Tiago Franco de Oliveira, Vilma Leyton, Ivan Miziara, Mauricio Yonamine Violence is a dreadful phenomenon spread throughout the world, resulting in unfortunate events that can ultimately cause death. It is known that some countries play a much worrying role in this scenario than others. Brazil is one of them. The present work has focused on identifying the use of cocaine in 105 postmortem cases arriving at the Institute of Legal Medicine of Sao Paulo (IML-SP), the largest Brazilian city. Both blood and hair samples have been analyzed through ultra-performance liquid chromatography coupled to electrospray ionization tandem mass spectrometry (UPLC-ESI-MS/MS) in order to distinguish between recent or chronic cocaine use. The purpose of this work was to evaluate the proportion of cocaine use amongst violent individuals whose violence has ultimately led to their death. In order to do so, two previous methods, validated in-house, based on methanolic extraction for hair and protein precipitation for blood, have been used for this purpose and the final residue was analyzed through UPLC-ESI-MS/MS system. When looking at the demographics from the 105 postmortem cases analyzed, the results have shown the most critical age range to be between 18 to 25 years old and the least frequent between 37 to 45 years old. Gender wise, a rather extreme difference was found as 97 of the individuals were men and finally, considering the manner of death, the four-category criteria established appear to be fairly similar with 34 cases related to general violence and risk behavior, 26 to drug abuse suspicion, 23 to homicide resulting from opposition to police intervention and 22 to possible suicide.Graphical abstractImage 1
  • Potential forensic issues in overseas travellers exposed to local herbal
    • Abstract: Publication date: Available online 21 August 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Rachael Farrington, Ian Musgrave, Christine Nash, Roger W. Byard
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