Counterfeit 'Xanax®' tablets: A comparative study of clinical and seizure data in Victoria, Australia.

Background And Aim: There is growing evidence of counterfeit benzodiazepine products containing other substances, including non-regulated benzodiazepine-type new psychoactive substances (NPSs). This study sought to compare detections of seized suspect counterfeit alprazolam products with clinical cases that reported use of an alprazolam-containing product to better characterise community use.

Design And Setting: Observational study set in Victoria, Australia, using data from the Victoria Police Drug Sciences Group (which compiles information about seized drugs submitted for evidential analysis and intelligence purposes) and the Emerging Drugs Network of Australia - Victoria (EDNAV) project (a prospective, observational study collecting clinical and analytical data for illicit drug-related presentations across a network of hospitals in Victoria, Australia).

Novel psychoactive substances in Australian emergency departments: implications for public health practice from multi-centre prospective toxicosurveillance across five states, 2022-2023.

Background: Comprehensive toxicology testing of emergency department (ED) presentations has become a prominent data source on novel psychoactive substances (NPS) in Australia. We describe the type and frequency of analytically confirmed NPS across five Australian states and 28 EDs between 2022 and 2023.

Methods: This is a prospective series of ED presentations with at least one confirmed NPS detection identified by the Emerging Drugs Network of Australia (EDNA) and Emerging Drugs Network of Australia Victoria (EDNAV).

Evaluation of interventions for trauma care in older adults: a consensus study.

Background: Trauma care of older adults is an important and growing public health issue. Countries such as the United States and United Kingdom have published best-practice guidelines on the management of older trauma patients. In Australia, there are no such guidelines.

Advancing All-Terrain Vehicles Safety in Agriculture: An Insightful Summary from Global Experts.

Highlights: Decrease fatalities and injuries in agricultural ATV incidents. Protect youth ATV riders in agricultural incidents Use engineering controls to reduce agricultural ATV crashes. Comprehensive perspectives on ATV incidents (Australia, Canada, Israel, Sweden, and the USA).

The SCVP and AECVP 'Seaport criteria' for lymphocytic myocarditis: Retrospective application to an autopsy cohort.

Background: Diagnosing lymphocytic myocarditis in non-biopsy specimens remains challenging due to sampling variability, subjective interpretation of histology, and lack of standardized criteria. In 2025, the Society for Cardiovascular Pathology (SCVP) and the Association for European Cardiovascular Pathology (AECVP) proposed the "Seaport criteria" to address these limitations.

Objective: To assess the practical applicability of the Seaport criteria in a retrospective cohort of forensic autopsy cases with myocardial lymphocytic-predominant inflammation.

Evaluation of ultra-low and low-dose CT skeletal survey for fracture detection in assessments for suspected non-accidental injury: a prospective post-mortem study.

Objective: This prospective study aimed to evaluate the capabilities of two novel vertex-toes CT protocols (ultra-low and low-dose) compared to a standard high-dose CT protocol plus radiographic skeletal survey (SS) in a post-mortem setting. The study sought to assess perceived image quality (IQ) and the fracture detection capabilities of each CT protocol.

Materials And Methods: Participants aged 2 years and under received three whole-body CT scans, followed by a SS.

Sustainability of the de-implementation of low-value care in infants with bronchiolitis: 2-year follow-up of a cluster randomised controlled trial.

Background: In 2017, the PREDICT (Paediatric Research in Emergency Departments International Collaborative) network conducted a cluster randomised controlled trial (cRCT) at 26 Australian and New Zealand hospitals to improve bronchiolitis care. Findings demonstrated that targeted interventions significantly improved adherence with five evidence-based low-value bronchiolitis practices (no chest radiography, salbutamol, glucocorticoids, antibiotics and epinephrine) in the first 24 hours of hospitalisation (adjusted risk difference, 14.1%; 95% CI: 6.

Post-mortem cardiac-specific troponin-I (cTnI) to determine the cause of non-traumatic hemopericardium.

Hemopericardium is regularly seen at autopsy and post-mortem imaging. Once traumatic cases and resuscitation artefact are excluded, hemopericardium is almost always due to either ruptured myocardial infarction or aortic dissection. In this study, we explored whether post-mortem cardiac-specific troponin I (cTnI) can be helpful when autopsy is not feasible and post-mortem imaging findings are inconclusive.

Lymphocytic myocarditis: A histopathologic definition and classification from the Society for Cardiovascular Pathology and Association for European Cardiovascular Pathology. II: Surgical and autopsy specimens.

Background And Aim: Lymphocytic myocarditis, characterized by lymphocyte-predominant myocardial inflammation with associated myocyte injury, is a term that has decades-old histopathologic criteria when encountered on endomyocardial biopsy. However, the interpretation of non-biopsy specimens such as surgical resections and autopsy samples has lacked standardized histopathologic criteria, despite their growing clinical and forensic relevance. The aim was to develop and establish criteria for the diagnosis and classification of lymphocytic myocarditis in non-biopsy ventricular myocardial specimens.

A cross sectional study of case and injury characteristics in domestic and family violence patients reporting nonfatal strangulation to forensic practitioners in Victoria, Australia.

This Australian study examined the frequency and clinical signs of neck injury among domestic and family violence (DFV) patients reporting strangulation in Victorian police regions and the forensic service response during a physical and/or sexual assault. The study compared the characteristics between patients with/without clinical signs of neck injury and between physical and sexual assault where a forensic practitioner performed a medical examination. Of 522 eligible patients of physical and/or sexual assault, 84 (16 %) self-reported strangulation.

The influence of sex on early postoperative opioid administration after cardiac surgery.

Background: Female patients are at an increased risk of experiencing severe postoperative pain and developing chronic pain after cardiac surgery. However, the impact of sex on postoperative opioid administration is underexplored.

Methods: This single-centre retrospective cohort study included adults undergoing coronary artery bypass grafting, valve surgery, or a combined procedure at a quaternary referral hospital, between November 2012 and June 2021.

Patterns of skeletal trauma resulting from motor vehicle collisions: a scoping literature review.

As a leading cause of fatality, motor vehicle collisions comprise a significant proportion of medico-legal cases worldwide. During death investigations into such events, forensic practitioners may be asked to make inferences about the relationship between traumatic injuries and the circumstances of the collision. These interpretations require a thorough understanding of the hard and soft tissue blunt force trauma that results from vehicle collisions.

Cardiac-specific troponin-I (cTnI) in a post-mortem setting.

Cardiac-specific troponin (cTn) is widely used in clinical medicine to support a diagnosis of acute myocardial infarction. Several studies have explored the value of cTn testing in deceased individuals. These studies suggest that -although there are important limitations associated with its use- post-mortem cTn can be useful in selected cases.

Determination of normal post-mortem computed tomography (PMCT) parameters for the temporomandibular joint.

Post-mortem radiology, particularly post-mortem computed tomography (PMCT), has become an important tool in forensic death investigation, offering valuable insights into the cause and manner of death. However, the interpretation of post-mortem findings requires understanding the normal anatomical changes that occur after death, as artifacts can mimic pathology, complicating diagnosis. The objective of this study was to define the normal configuration of the temporomandibular joint (TMJ) in the post-mortem setting, using a newly developed measurement method, the TMJ PAT (perpendicular assessment tool), to assess the relationship between the mandibular condyle and the articular eminence on PMCT scans.

A Study of Sudden Cardiac Death in Schizophrenia.

Background: The incidence of sudden cardiac death (SCD) in patients with schizophrenia is three to four times higher than in the general population. While the majority of SCD in patients with schizophrenia are due to ischaemic or structural heart disease, about 10% of deaths remain unexplained. In recent reviews of premature deaths in patients with schizophrenia, these deaths were postulated to be secondary to malignant cardiac arrhythmias.

Changes over time in novel benzodiazepines contributing to fatal overdoses in Victoria, Australia.

Introduction: Novel benzodiazepines (NBZN) have increased in availability and use since the mid-2000s, with a corresponding rise in associated harms including deaths.

Methods: The study used data from the Victorian Overdose Deaths Register to explore which specific NBZNs and combinations of NBZNs contributed over time to Victorian overdose deaths between January 2009 and December 2023.

Results: There were 140 NBZN-involved overdose deaths in Victoria, with an observable increase in deaths from 2019 onward.

Investigation of Myocardial Substrate for Sudden Arrhythmic Death in Coronary Artery Disease Without Acute Coronary Thrombosis or Myocardial Infarction.

Background: This cohort study aimed to evaluate the potential myocardial arrhythmic substrate in people with coronary artery disease who died from sudden arrhythmic death (SAD) without acute coronary thrombosis or myocardial infarction.

Methods And Results: We performed histological analysis of the left ventricular free wall obtained at autopsy from decedents with ≥1 coronary artery and ≥75% area stenosis who died suddenly from either noncardiac causes (25 men, 23 women) or SAD (25 men, 25 women), matched for age and sex. Decedents with acute coronary thrombosis, myocardial infarction, or other myocardial abnormality were excluded.

AI and Expert Medical Evidence.

Courts and legal processes are being challenged by the increasing utilisation of artificial intelligence (AI) applications. At the same time practitioners in many disciplines involved in providing expert evidence are increasingly using artificial intelligence tools in their investigations, examinations and analysis. These technologies, while increasingly of value in analytical techniques including interpretation and diagnostics, raise significant challenges for the legal system charged with evaluating, reviewing and testing expert opinion evidence.

Post-mortem urine dipstick analysis for hyperglycemia and ketoacidosis: observer agreement and diagnostic value.

The post-mortem diagnosis of hyperglycemia and/or ketoacidosis is challenging and usually requires costly ancillary testing of vitreous humor or serum samples. A screening tool that would help to determine whether ancillary testing is needed is therefore desirable. The aim of this study was to add to the literature testing the validity and diagnostic utility of post-mortem dipstick urinalysis.

Ischemic and non-ischemic myocardial injuries at autopsy- an overview for forensic pathologists.

Cardiovascular diseases are major causes of morbidity and death worldwide, and most cardiac deaths are related to ischemic injury of the myocardium (myocardial infarction). As underlined in the current clinical definition and classification of myocardial infarctions, not all myocardial injuries are due to ischemia: irreversible injury, ending in necrosis, can be induced also by various other factors, such as infections, immune disorders, physical and chemical agents, and trauma. This is supported by clinical studies showing that elevated serum levels of cardiac troponins, as a measure of myocardial damage, are also a common finding in the non-ischemic types of myocardial injury.

Early identification of the use of potent benzylbenzimidazoles (nitazenes) through wastewater analysis: Two years of data from 22 countries.

Background And Aims: The use of new synthetic opioids, such as the highly potent 2-benzylbenzimidazoles (i.e. nitazene) drugs, is a global health concern because of their increased risk of fatal overdose.

The impacts on paediatricians testifying in cases of child maltreatment: A systematic scoping review.

Background: Paediatricians serve as expert witnesses in child maltreatment cases, informing decision-makers about injury mechanisms, likely injury-dates, and consequences. Despite paediatricians' multifaceted role in responding to child maltreatment, the impacts on paediatricians of their involvement in legal processes are not well understood.

Objective: This systematic scoping review identified and synthesized scientific research findings on the benefits and harms to doctors, particularly paediatricians, who testify in child maltreatment cases.