ChatGPT in forensic sciences: a new Pandora's box with advantages and challenges to pay attention.

ChatGPT is a variant of the generative pre-trained transformer (GPT) language model that uses large amounts of text-based training data and a transformer architecture to generate human-like text adjusted to the received prompts. ChatGPT presents several advantages in forensic sciences, namely, constituting a virtual assistant to aid lawyers, judges, and victims in managing and interpreting forensic expert data. But what would happen if ChatGPT began to be used to produce forensic expertise reports? Despite its potential applications, the use of ChatGPT and other Large Language Models and artificial intelligence tools in forensic writing also poses ethical and legal concerns, which are discussed in this perspective together with some expected future perspectives.

Drug Overdose-Induced Coma Blisters: Pathophysiology and Clinical and Forensic Diagnosis.

BACKGROUND: Coma blisters or coma bullae are bullous lesions that have been associated with cases of drug overdose-induced coma. Previous history of suicide attempt by administering benzodiazepines, barbiturates, ethanol, antipsychotics, antidepressants or opioids have been particularly implicated. Patients may present also painful deep skin and soft tissue involvement, edema and functional impairment. The pathophysiology remains unknown and lesions are usually self-limited and typically resolve without scarring. OBJECTIVE: This work aims to fully review the state of the art regarding the causes pathophysiology, diagnosis and treatment of drug overdose-induced coma blisters. CONCLUSION: Coma blisters are a benign, self-limiting condition that should be suspected in patients who develop pressure blisters several hours after an altered state of consciousness.

L-Threonine Supplementation During Colitis Onset Delays Disease Recovery.

Dietary nutrients have emerged as potential therapeutic adjuncts for inflammatory bowel disease (IBD) given their impact on intestinal homeostasis through the modulation of immune response, gut microbiota composition and epithelial barrier stability. Several nutrients have already been associated with a protective phenotype. Yet, there is a lack of knowledge toward the most promising ones as well as the most adequate phase of action. To unveil the most prominent therapy candidates we characterized the colon metabolic profile during colitis development. We have observed a twofold decrease in threonine levels in mice subjected to DSS-induced colitis. We then assessed the effect of threonine supplementation in the beginning of the inflammatory process (DSS + Thr) or when inflammation is already established (DSS + Thr D8). Colitis progression was similar between the treated groups and control colitic mice, yet threonine had a surprisingly detrimental effect when administered in the beginning of the disease, with mice displaying a delayed recovery when compared to control mice and mice supplemented with threonine after day 8. Although no major changes were found in their metabolic profile, DSS + Thr mice displayed altered expression in mucin-encoding genes, as well as in goblet cell counts, unveiling an impaired ability to produce mucus. Moreover, IL-22 secretion was decreased in DSS + Thr mice when compared to DSS + Thr D8 mice. Overall, these results suggest that supplementation with threonine during colitis induction impact goblet cell number and delays the recovery period. This reinforces the importance of a deeper understanding regarding threonine supplementation in IBD.

Fatal Intoxications in the North of Portugal: 12 Years of Retrospective Analysis.

BACKGROUND: Fatal intoxications are a topic of great relevance in today's society. They typically occur by accidental or voluntary ingestion, but its characterization by a forensic perspective was not fully explored. OBJECTIVE: This study retrospectively reviews fatal intoxication cases autopsied at the northern forensic medicine services of Portugal, between 2001 and 2013. METHOD: For this purpose, we analyzed postmortem forensic medical reports with positive qualitative analysis for xenobiotics. RESULTS: A total of 27,778 autopsy reports were analyzed, of which 1,269 cases fulfilled the selection criteria, representing 4.6% of total number of individuals autopsied during the period under analysis. Men were involved in most of the cases (73.8%) and most individuals were adults with ages between 36 and 65 years old (57.0%). The highest incidences were medicines (22.9%) and alcohol (15.8%), followed by their association. Cases of fatal intoxications involving opioids come on fifth place (5.8%) namely due to accidental overdoses. Moreover, intoxications appeared as the leading cause of death in reports concerning accidental etiology, with drugs and alcohol associations having a great expression. CONCLUSION: Due to morbidity and relevant number of fatal cases, risk prevention measures, such as public health policies should be implemented to reduce the number of intoxications.

Interleukin-1ß genotype and circulating levels in cancer patients: metastatic status and pain perception.

OBJECTIVES: Proinflammatory cytokines released during inflammation can cause hyperexcitability in pain transmission neurons, leading to hyperalgesia and allodynia. Polymorphisms in interleukin 1 (IL-1) family of genes (IL1A, IL1B) and in IL-1 receptor antagonist (IL-1Ra, coded by IL1RN) may therefore induce alterations in cytokine levels/effects and pain related response. Our purpose was to investigate the influence of polymorphisms in IL1A/B/RN on cytokine serum levels and its correlation with pain intensity, performance status, adverse effects, metastases and breakthrough pain in Caucasian cancer patients. DESIGN AND METHODS: Serum IL-1α/ß levels of 74 cancer patients were measured by competitive enzyme immunosorbent assay. All patients were also genotyped for the polymorphisms in IL1A (rs17561), IL1B (rs1143634) and IL1RN (rs419598) with Real-Time PCR. Results were then correlated to the appearance of bone or CNS metastases and several pain-related parameters. RESULTS: IL-1ß rs1143634 homozygous for T allele were associated with lower levels of IL1-ß (p=0.032, Mann-Whitney test) and presented a trend for lower levels of pain (p=0.06, Fisher's Exact Test). Also, IL1-ß levels were related with cancer onset status, since a four-fold increase probability of metastatic disease was observed in high IL-1ß individuals (OR=4.074, p=0.010, Pearson χ(2) test). Among the female patients presenting metastatic disease and carriers of the TT genotype we observed a trend to lower levels of IL1-ß (p=0.053, Pearson χ(2) test). CONCLUSIONS: Our results indicate that genetic variation at IL1-ß gene may influence serum levels of IL1-ß, with proportional consequences in cancer-related pain.

Alleged biological father incest: a forensic approach.

Paternal incest is one of the most serious forms of intrafamilial sexual abuse with clinical, social, and legal relevance. A retrospective study was performed, based on forensic reports and judicial decisions of alleged cases of biological paternal incest of victims under 18 years old (n = 215) from 2003 to 2008. Results highlight that in a relevant number of cases: victims were female; the abuse begun at an early age with reiteration; the alleged perpetrator presented a history of sexual crimes against children; sexual practices were physically poorly intrusive, which associated with a forensic medical evaluation performed more than 72 h after the abuse, explain partially the absence of physical injuries or other evidence-these last aspects are different from extrafamilial cases. In conclusion, observations about paternal incest are likely to exacerbate the psychosocial consequences of the abuse and may explain the difficulty and delay in detect and disclose these cases. Few cases were legally prosecuted and convicted.

Cumulative mitoxantrone-induced haematological and hepatic adverse effects in a subchronic in vivo study.

Mitoxantrone (MTX) is an antineoplastic agent that can induce hepato- and haematotoxicity. This work aimed to investigate the occurrence of cumulative early and late MTX-induced hepatic and haematological disturbances in an vivo model. A control group and two groups treated with three cycles of 2.5 mg/kg MTX at days 0, 10 and 20 were formed. One of the treated groups suffered euthanasia on day 22 (MTX22) to evaluate early MTX toxic effects, while the other suffered euthanasia on day 48 (MTX48), to allow the evaluation of MTX late effects. An early immunosuppression with a drop in the IgG levels was observed, causing a slight decrease in the plasma total protein content. The early bone marrow depression was followed by signs of recovery in MTX48. The genotoxic potential of MTX was demonstrated by the presence of several micronuclei in MTX22 leucocytes. Increases in plasma iron and cholesterol levels in the MTX22 rats were observed, while in both groups increases in the unconjugated bilirubin, C4 complement, and decreases in the triglycerides, alanine aminotransferase, alkaline phosphatase and transferrin were found in plasma samples. On MTX 48, the liver histology showed more hepatotoxic signs, the hepatic levels of reduced and oxidized glutathione were increased, and ATP hepatic levels were decreased. However, the hepatic total protein levels were decreased only in the livers of MTX22 group. Results demonstrated the MTX genotoxic effects, haemato- and direct hepatotoxicity. While the haematological toxicity is ameliorated with time, the same was not observed in the hepatic injury.

Acute paraquat poisoning: report of a survival case following intake of a potential lethal dose.

When properly used, paraquat (PQ) is a widely used bipyridil herbicide with a good safety record. Most cases of PQ poisoning result from intentional ingestion, with death resulting from hypoxemia secondary to lung fibrosis in moderate to severe poisonings. With high ingestion volumes (>50 mL of a 20% wt/vol formulation), death results from multiple organ failure and cardiovascular collapse within 1 week after intoxication. The present report describes a successful clinical case regarding the intoxication of a 15-year-old girl by a presumed lethal dose of PQ. The adolescent ingested approximately 50 mL of a commercialized concentrate (20% wt/vol of dichloride salt) formulation of PQ. High serum and urinary levels of PQ confirmed the bad prognosis. However, the therapeutic protocol followed in the present clinical case led to a positive outcome. Besides the measures for decreasing PQ absorption and increasing its elimination, other protective procedures were applied in aiming to reduce the production of reactive oxygen species (ROS), to scavenge ROS, to repair ROS-induced lesions, and to reduce inflammation. The status-of-the-art concerning the biochemical and toxicological aspects of PQ poisoning and the pharmacologic basis of the respective treatment is also presented.