Search Results (121)

Port wine production involves the addition of grape spirit to halt fermentation and retain natural sweetness. This spirit, produced by distilling wine and its by-products, must comply with legal standards, including a mandatory sensory assessment. Because grape spirit influences Port wine’s volatile composition, this study investigated the odour-active compounds present in several grape spirits intended for fortification. Volatile compounds were extracted by liquid–liquid extraction, concentrated, and analysed using gas chromatography–olfactometry (GC-O) and gas chromatography–mass spectrometry (GC-MS). In GC-O, based on frequency detection, a panel of assessors sniffed the extracts to determine the presence of aroma compounds. The results revealed a wide range of odour-active compounds in grape spirits, belonging to several chemical families such as esters, alcohols, terpenic compounds and acids. These compounds exhibited both pleasant aromas, such as fruity, floral and caramel notes as well as undesirable ones like cheese and foot odour. Most of these compounds originate from the fermentation process and are also found in other unaged distilled beverages, including young Cognac, Calvados and fruit spirits. This research highlights the aromatic complexity of grape spirits and, for the first time, determined the aroma thresholds for 25 of 36 the compounds studied at an ethanol content of 20%. Full article

Rates of alcohol use and exposure to adverse childhood experiences (ACEs) are elevated among youth in the legal system (YILS) compared to their non-legally involved peers. Exposure to ACEs has been associated with later alcohol use and delinquency, and YILS often engage in delinquent behavior while under the influence of alcohol. The associations between ACEs, alcohol use, and delinquency among YILS are complex and multidirectional; research has yet to explore how these experiences and behaviors influence each other over time, or whether they differ based upon the reason for legal system involvement (status or delinquent petition). This study examined whether YILS’ ACEs were prospectively associated with self-reported delinquent behaviors, and whether self-reported recent alcohol use was an explanatory mechanism for this association. Multigroup mediation analyses were utilized to examine if these pathways differed based on youth’s court petition type. Results indicated that YILS report high rates of ACEs. Frequency of recent alcohol use mediated the associations between ACEs and subsequent delinquency for youth with a delinquent, but not status, petition. Concurrent assessment of trauma exposure and alcohol use when youth first enter the legal system is imperative to inform early intervention needs to reduce the likelihood of continued system involvement. Full article

Background: Free fatal falls (FFF) are a frequent occurrence in forensic medicine. Many variables, such as the victim’s sex, BMI, intoxication, height of the fall, and mental illness, can influence injury patterns. Previous studies identified fracture patterns and frequencies mostly with general anatomical detail, focusing on broad areas. As specific fractures might be roots for new statistical connections, this leaves a gap in our understanding. Using postmortem computed tomography, we aim to establish fracture frequencies and identify possible new statistical connections. Methods: In total, we retrospectively analyzed seventy-nine cases of confirmed deaths due to falls using the database of the Department and Institute of Forensic Medicine in Lublin. Our inclusion criteria were death due to free fall onto hard, non-deformable surfaces. We excluded cases of ground-level falls. All victims must have undergone postmortem computed tomography. Furthermore, each analyzed case documented individual intrinsic variables (sex, age, body mass, height, pre-existing mental conditions, and drug or alcohol use) and extrinsic variables (fall height, landing surface, time between the fall and death, and known cause of the fall). Results: Injuries in free fatal falls tend to focus on the axial skeleton. Suicides experience more severe, bilateral fractures, often involving the pelvis and limbs, while accidents tend to have unilateral injuries with rare limb involvement. We established new correlations with the height of the fall for the maxilla, mandible, anterior and posterior regions of the occipital bone, and the temporal bone. Moreover, our research confirmed previously noted correlations between the height of the fall and fractures of the limbs (and their individual bones), the lumbar vertebrae, and the chest. Conclusions: Our findings highlight that free fatal falls are characterized by distinct skeletal injury patterns that differ between accidents and suicides, with bilateral pelvic and limb fractures being particularly indicative of intentional falls. The integration of PMCT with autopsy improves the detection of these patterns. It provides valuable diagnostic and medico-legal insights, supporting a more precise determination of the cause and manner of death. Full article

Background/Objectives: Cannabis is the most widely used illicit substance worldwide, particularly among young adults, with growing acceptance following medical and recreational legalization. Although generally perceived as a drug with low acute toxicity, an expanding body of evidence indicates that cannabinoids can exert relevant cardiovascular effects, including arrhythmias, myocardial ischemia, and sudden cardiac death (SCD). These mechanisms are mediated through complex, dose-dependent interactions among CB1 and CB2 receptors, autonomic imbalance, and endothelial dysfunction. Nevertheless, cannabis-related fatalities remain underestimated in both clinical and forensic settings. Case presentation: Three cases of sudden unexpected death in previously healthy men aged 28, 37, and 37 years are described. All were found deceased at home under non-suspicious circumstances. Forensic autopsies ruled out trauma, coronary atherosclerosis, congenital malformations, or cardiomyopathy. Histological analyses consistently revealed polymorphic myocardial alterations, including interstitial edema, fiber disruption, and focal myocytolysis, without inflammatory infiltrates or necrosis. Toxicological examinations demonstrated the presence of Δ9-tetrahydrocannabinol (THC) and metabolites in peripheral blood and urine, while alcohol and other illicit drugs tested negative. In each case, the cause of death was attributed to arrhythmic sudden cardiac death in temporal association with cannabis use. Conclusions: This case series, integrated with a narrative review of current literature, supports the hypothesis that cannabis consumption can contribute to fatal arrhythmias even in young adults without conventional cardiovascular risk factors. The convergence of autopsy, histopathological, and toxicological findings suggests a potential causal link between THC exposure and sudden unexpected death. These results highlight the importance of systematic postmortem investigations in suspected drug-related fatalities and underscore the need for greater awareness among clinicians, forensic pathologists, and policymakers regarding the underestimated cardiovascular toxicity of cannabis. Full article

Ethyl carbamate, a genotoxic chemical contaminant present in fermented alcoholic beverages and foods, is formed from naturally occurring substances in these beverages and foods. Studies have shown that the content of ethyl carbamate can increase significantly during product storage and maturation, especially if favorable conditions are present. Higher levels of ethyl carbamate have been associated with distilled alcoholic beverages, mainly obtained from stone fruits. Ethyl carbamate content is lower in fermented foods, such as bread, yogurt, and fermented sauces. EC formation occurs through several different pathways in food systems. A primary pathway involves select compounds reacting with ethanol (EtOH); therefore, the majority of the research has focused on the occurrence of EC in alcoholic beverages Due to health risks, some countries have imposed legal limits on carbamate content in alcoholic beverages. Full article

Drug abuse is a chronic, relapsing disorder marked by compulsive drug-seeking behavior and profound neurobiological consequences. Each year, millions of individuals face serious social and legal repercussions due to addiction. This review synthesizes findings from both preclinical and clinical studies to examine how chronic exposure to substances such as alcohol, cocaine, methamphetamine, and opioids affects the central nervous system. Specifically, it explores the epigenetic modifications induced by these substances, including DNA methylation, histone modifications, and noncoding RNA regulation. The literature was selected using a thematic approach, emphasizing substance-specific mechanisms and their effects on gene expression, synaptic plasticity, and the brain’s reward circuitry. Emerging evidence links these epigenetic changes to long-term behavioral adaptations and even transgenerational inheritance. This review underscores the complex molecular pathways contributing to addiction, vulnerability, and relapse, offering insights into potential therapeutic targets. Full article

Spontaneous human combustion, today scientifically discredited, was considered a legitimate medical entity in Europe beginning in the 17th century. The aim of this study is to analyze Spanish medical conceptions about this phenomenon between the 18th and 19th centuries, starting from the world context. Primary sources were used with a deductive–inductive approach. Beyond providing an account of a discarded medical theory, this work explores how certain categories of knowledge persist, disappear, and resurface under different belief systems. We analyze how the Spanish medical discourse on SHC evolved in three stages: exposure, debate, and rejection. This allows us to observe changes in medical mentality regarding factors such as searching for sources of ignition and moderating alcohol consumption as a preventive health measure. This study and its historiographical approach enable us to explore broader issues relating to ignorance, alternative ideas, the stability of scientific knowledge over time, and shifts in the field of legal and forensic medicine. This research provides a model for analyzing the complex dynamics of knowledge and its evolution at the intersection of science, culture, and power. Full article

Background: Alcoholic liver disease (ALD) contributes substantially to global liver-related morbidity and mortality. In conservative societies such as Oman, data on ALD are scarce due to stigma and legal constraints. This study aims to characterize the clinical spectrum, complications, and outcomes of ALD in Oman, providing the first detailed analysis from a tertiary care setting in the country. Methods: We retrospectively analyzed 131 Omani patients with documented unhealthy alcohol use from 2012 to 2018 at Sultan Qaboos University Hospital. ALD diagnosis was based on clinician judgment per EASL guidelines and DSM-5 criteria, where applicable. Data included demographics, clinical/laboratory findings, and radiologic/endoscopic features. Associations with complications and mortality were assessed using chi-square tests and logistic regression. Results: Of 131 patients, 84 (64.1%) were diagnosed with ALD: fatty liver (34.5%), alcoholic hepatitis (20.2%), cirrhosis (40.5%), and hepatocellular carcinoma (4.8%). Cirrhosis was significantly more prevalent in patients aged 50 years or older (OR = 2.53, 95% CI: 1.02–6.28; p = 0.048). Ascites and portal hypertension were strongly associated with mortality (OR = 5.20, CI: 1.85–14.6 and OR = 6.13, CI: 2.04–18.4, respectively; p < 0.01). Overall mortality in ALD was 28.6%, increasing to 44.1% in cirrhotics. Conclusion: ALD is a significant yet underrecognized problem in Oman, with high rates of late-stage presentation and mortality. Early detection and culturally tailored strategies are needed to improve care outcomes. Full article

Autobrewery syndrome is a rare condition characterized by the endogenous fermentation of carbohydrates by gut microbiota, which exceeds the liver’s detoxification capacity and leads to signs and symptoms of acute alcohol intoxication. This condition has significant clinical, social, and legal implications. Beyond the acute effects, the role of excessive endogenous ethanol production in the progression of chronic diseases—particularly liver disease—is still under investigation. In this review, we aim to describe the key clinical features of autobrewery syndrome, identify the main microbial pathogens involved, and explore the potential impact of endogenous ethanol production on the development and progression of chronic liver disease. Although robust data and standardized treatment protocols are currently lacking, we discuss the general principles of management and outline possible therapeutic strategies and future perspectives. Full article

Purpose: Suicide is a leading cause of death among children and adolescents worldwide. This study examined the prevalence and characteristics of suicides among children and adolescents (aged ≤ 19 years) over a 13-year period in the broader area of Athens, Greece. Key aspects analyzed included victim demographics, circumstances surrounding the incidents, and methods employed. Methods: A retrospective analysis was conducted on autopsy cases performed at the Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, from 1 January 2011, to 31 December 2023. Results: Out of 5819 autopsies conducted between 2011 and 2023, 371 were classified as suicides. Among these, 12 cases (representing 3.2% of suicides) involved children and adolescents aged ≤ 19 years and met the study’s inclusion criteria for detailed forensic analysis. The average age of the victims was 17.7 ± 2.1 years (range: 14–19), with males representing 58.3% of cases. Hanging was the most common method of suicide (9 cases, 75.0%), followed by firearm use, falls from height, and hydrogen sulfide inhalation (one case each). Death occurred in the home in 10 cases (83.3%), with 6 specifically taking place in the bedroom. Scars indicative of prior self-harming behavior were present in two cases (16.7%), while suicide notes were found in three cases (25.0%). Toxicological analysis revealed alcohol and cannabis use in one case, cannabis alone in one case, and alcohol alone in two cases. Four victims (33.3%) had a documented psychiatric diagnosis, with two of them under antidepressant treatment at the time of death. Conclusions: This study highlights the forensic value of autopsy-based investigations in unveiling hidden patterns of adolescent suicidality and informs targeted prevention strategies. Integrating medico-legal findings into public health responses may enhance early identification and intervention in vulnerable youth populations. Full article

Background/Objectives: The legalization of recreational cannabis in Germany in 2024 has increased the relevance of cannabis use in maternal healthcare. Although prenatal cannabis exposure is associated with potential risks to fetal development, the topic remains underrepresented in midwifery research and education. Germany, midwives play a key role in prenatal care. This study investigates midwives’ self-rated knowledge, perceived risks, and the frequency of screening and counseling on cannabis use during pregnancy. Methods: This study presents a secondary analysis of cross-sectional survey data collected from midwives and physicians in Germany (N = 284) between May and October 2024. Statistical analyses included descriptive statistics, Wilcoxon signed-rank tests, chi-square tests, Spearman’s rank correlations, and multiple linear regression models. Results: Midwives rated their knowledge about cannabis-related risks during pregnancy as moderate. While most reported that substance use was addressed in initial training, only continuing education and older age were associated with higher self-rated knowledge. Knowledge was positively correlated with risk perception and communication frequency. Overall, risk perception was high—particularly regarding fetal outcomes—though cannabis was perceived as less harmful than alcohol and addressed less often. Fewer than half of the midwives routinely screened for cannabis use, and only 22% always provided counseling. Conclusions: To strengthen midwives’ preparedness, both the integration of cannabis-specific content into initial training and the expansion of continuing education may be beneficial. Clear, evidence-based, and non-stigmatizing communication strategies are essential to support maternal and fetal health in a changing legal and cultural landscape. Full article

Probiotic microorganisms from sugary kefir were incorporated into Brazilian non-alcoholic beers to enhance their functional and nutritional properties through aerobic static fermentation over 24 h. Non-alcoholic beers inoculated with sugary kefir showed appropriate acidity (pH reduction from ~3.74 to ~3.52), color, and microbial balance, along with excellent sensory acceptance (scores of 6.9–8.4 on a 9-point hedonic scale). The kefir microbiota included Lacticaseibacillus paracasei, Lacticaseibacillus casei, Lacticaseibacillus paracasei subsp. paracasei, Lacticaseibacillus paracasei subsp. tolerans, Lactobacillus delbrueckii subsp. lactis, Lentilactobacillus parabuchneri, Lentilactobacillus kefiri, Lactococcus lactis, Leuconostoc citreum, Acetobacter lovaniensis, and yeasts such as Saccharomyces cerevisiae, Kluyveromyces lactis, Lachancea meyersii, and Kazachstania aerobia. Genetic analysis confirmed the absence of undesirable or pathogenic microorganisms. Fermentation led to reductions in sucrose (~0.35 to ~0.22 g/L) and °Brix (~5.55 to ~3.80), with increases in lactic acid (~0.55 to ~1.25 g/L) and acetic acid (~0.08 to ~0.14 g/L), confirming active microbial metabolism. Ethanol levels remained within legal limits for non-alcoholic beverages. The process preserved sensory attributes while enriching the beverage with well-documented kefir microorganisms. These findings highlight sugary kefir as a promising biotechnological tool to enhance the functional profile of non-alcoholic beers without compromising their sensory quality. Full article

Background and Objectives: Alcohol consumption has been a longstanding public health concern and known link to violence. The aims of this study were to analyze alcohol-related homicide cases in Lithuania, focusing on the prevalence of binge drinking among perpetrators and victims, the situational and behavioral patterns leading to violence, and the legal outcomes of these cases. Materials and Methods: This study employed a retrospective analysis of court case law of criminal cases of the year 2019. The analysis was conducted by combining qualitative and quantitative analytical approaches. Results: The findings revealed that 84.6% of homicides occurred during binge drinking events. Alcohol intoxication was prevalent among both perpetrators (92.3%) and victims (86.5%), emphasizing the dual role of alcohol in homicide cases. Interpersonal violence was the primary pattern of homicide (78.8%), while planned homicides accounted for 21.2%. Thematic content analysis of the cases revealed that Lithuanian courts consistently regard alcohol consumption as an aggravating factor that contributes to the commission of violent crimes and influences the severity of criminal punishment. This reflects a judicial position that voluntary intoxication does not lessen legal responsibility, despite its effects on impairing judgment, heightening aggression and impulsivity, and escalating conflicts into deadly violence. Conclusions: Our findings revealed that the majority of alcohol-involved homicides occurred during binge drinking events, in a domestic environment, and because of unplanned acts of interpersonal violence. Targeted public health interventions should focus on strengthening alcohol control policies and enforcing stricter regulations to discourage binge drinking environments. Full article

Cannabis use among young adults in the U.S. has nearly doubled in recent years, driven by diverse methods of consumption and evolving cannabis legalization. Multi-modal cannabis use among young adults is an emerging public health issue that remains underexplored. This study examines the prevalence, patterns, and predictors of multi-modal cannabis use, defined as the use of two or more administration methods of cannabis use (e.g., smoking, vaping, edibles, dabbing, other forms) in the past month, among U.S. young adults aged 18–34 years. Data from the 2022–2023 Behavioral Risk Factor Surveillance System (BRFSS) across 23 states (n = 7635; weighted n = 7,482,134) show that 57% of young adults reporting current cannabis use engaged in multi-modal use, with dual- and triple-mode use being the most common. Factors associated with higher odds of multi-modal use include sexual minority status, poor physical health, frequent cannabis use, and co-use of electronic cigarettes and alcohol. Recreational cannabis legalization (RCL) is significantly linked to higher odds of multi-modal use. These findings underscore the interplay between individual risk factors and cannabis policy environments in shaping multi-modal cannabis use behaviors. To mitigate potential harms, targeted prevention strategies should prioritize young adults at risk for cannabis use, addressing both personal and policy-related factors influencing multi-modal cannabis use. Full article

Saccharomyces cerevisiae is a species of industrial significance in the production of alcoholic beverages; it is the main species responsible for the fermentation of grape must. One of the main current problems in the wine industry is high alcohol levels caused by climate change. Pre- and post-fermentation strategies are used to reduce the alcohol content in wines; however, they are inefficient, affect organoleptic properties, face legal restrictions, and/or increase production costs, which has motivated efforts to obtain microbiological solutions. In the present work, we carried out a two-round breeding program to obtain improved yeast strains with lower ethanol yield. The trait under study showed high heritability (0.619), and we were able to lower the ethanol yield by 10.7% in just one generation. We finally obtained a population composed of 132 strains, of which 6 were used to produce wine from natural grape musts on a pilot scale, highlighting improved strains “C2-1B4” and “C7-1B7” as those that showed the best results (alcohol levels between 0.3 and 1.5% ABV less than expected). Further studies are required to understand the connection between initial sugar concentration and ethanol yield, as well as the genetic variants underlying this phenotype. Full article