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The phenomenon of child abuse/maltreatment is underestimated and often represents a difficult challenge for healthcare professionals and forensic pathologists who must proceed with the differential diagnosis with accidental or self-induced events, or with lesions due to pathologies that overlap with that of mistreatment, defined as “Mimics”. This study presents a case series with the aim of discussing lesions that may mimic signs of physical abuse in children but are due to a different etiology to raise awareness and train healthcare professionals and forensic pathologists on possible confounding factors in order to avoid diagnostic errors. Six cases of “Mimics” out of 418 cases of suspected mistreatment (1.43% of cases) were identified, presenting skin lesions initially classified as injuries of abuse due to their location and type and, in particular, sexual abuse for three cases. Then, the lesions and the subjects, in particular the anamnestic history, were examined by a multidisciplinary team and the diagnosis of genital lichen sclerosus et atrophicus in three cases, and the results of popular healing techniques (i.e., “cupping”) in the other three cases were ascertained. These situations require specific skills and a forensic background from healthcare professionals to conduct a correct differential diagnosis and the intervention of a multidisciplinary team to investigate every possible pathology or alternative therapeutic practice that could simulate child abuse. In particular, when “mimics” are due to alternative medicine, it should not strictly be considered child abuse, but professionals must be aware of the hypothesis of mistreatment in case of non-medical indication or potential personal injuries from other crimes, such as illegal practice of the medicine. This awareness is also crucial to direct the child toward appropriate medical care, and it is essential to recognize that these conditions can coexist within the same clinical presentation.

The study is based on a wide international research study, the International Self-Report Delinquency Study 3 (ISRD-3), with the aim of understanding if there is a relationship between having lived traumatic intrafamily experiences and potentially being a victim of cyberbullying. The data have been collected by a questionnaire ISRD-3 administered to a 20 European country sample of 57.463 students from 7th to 9th grade. Results show a statistically significant relationship between traumatic intrafamilial experiences such as a serious illness of one of the parents, episodes of violence suffered and assisted, separation or divorce of the parents, and being victimized in adolescence of cyberbullying.

Many studies have examined the genetic contribution to suicide. However, data on suicide in the Italian population are scarce. We therefore aimed to address this gap by investigating a cohort of 111 Italians for whom a verdict of suicide had been declared in court in Florence, Italy between 2007 and 2017. This cohort included 86 men and 25 women. DNA samples were obtained from tissues or blood, and 22 genes from multiple neurobiological pathways previously shown to be associated with the pathogenesis of suicide were analysed. Next-generation sequencing was used to compare these gene sequences with those from a large, normal population. In this study, we identified 19 gene variants that were present at significantly lower frequencies in our Italian cohort than in the general population. In addition, four missense mutations were identified in four different genes: Monoamine Oxidase A (MAOA), 5-Hydroxytryptamine Receptor 2 A (HTR2A), Sodium Voltage-Gated Channel Alpha Subunit 8 (SCN8A), and Nitric Oxide Synthase 3 (NOS3). Our study identified several potential genetic links with suicide in a cohort of Italians and supports a relationship between specific genetic variants and suicidal behaviour in this population. Key pointsThis study shows a genetic analysis of suicide.This study examines a cohort of 111 Italians for whom a verdict of suicide had been declared in court in Florence, Italy between 2007 and 2017. DNA samples were obtained from tissues or blood, and 22 genes from multiple neurobiological pathways were investigated.The study supports a relationship between specific genetic variants and suicidal behaviour.

Abstract Background Suicides or suicidal attempts with power tools such as band or circular saws are rarely encountered in forensic medicine practice; in the forensic literature, only a few cases have been reported. We present the case of a “combined suicide” (self-injurious actions using different methods and involving various bodily sites) carried out with uncommon deadly methods: chainsaw and hanging. Case presentation A 58-year-old Caucasian man was found dead by his wife, hanging from the basement ceiling of the cellar in which he lived. During the investigation of the crime scene, external examination revealed a wide incised wound in the umbilical area showing the muscular and adipose tissues below. On inspection of the garden around the courtyard, the police found a chainsaw with blood spatter on both the blade and the handle. The blade appeared to be compatible with the abdominal injuries. Conclusions Since the corpse presented this incised wound, it was crucial to establish the manner and the causes of death, as well as to exclude any third-party involvement. In this case, the presence of multiple injuries, potentially lethal, required a differential diagnosis between suicide or homicide. A detailed post-mortem examination, in association with a precise study of the circumstantial data, led the authors to assume that they were dealing with a “complex suicide.”

Lysergic acid diethylamide (LSD) is a powerful hallucinogen. Its detection is limited by its low dosage; moreover, LSD is rapidly metabolized into 2-oxo-3-hydroxy-LSD (O-H-LSD). In this study we validated two methods for determination of LSD and O-H-LSD in blood. Method #1 consisted in the upgrade of a previously developed procedure for detection of 163 compounds. Method #2 was specific for LSD and O-H-LSD. Analyses were performed through LC-MS/MS by dynamic (#1) and/or MRM mode (#2), in positive ionization. Transitions were: 324→223,208 m/z for LSD; 356→237,222 m/z for O-H-LSD. Validations were performed following the AAFS’s guidelines. Linearity was good for both methods. Sensitivity was in line with previously validated methods with LOQs at 0.0375 (#1) and 0.025 (#2) ng/mL for LSD and 0.01875 (#1) and 0.0125 (#2) ng/mL for O-H-LSD. Bias and %CV always met the acceptance criteria. RRs were >83%, except for O-H-LSD with method #1. The methods were successfully applied to two real cases. Method #1 proved to be useful for screening purposes, while method #2 can represent a sensitive and reliable tool for confirmation procedures.