Prostate cancer is the most commonly diagnosed malignancy in men and continues to be a leading cause of cancer-related mortality. Accurate and timely diagnosis is essential for distinguishing clinically significant tumors from indolent lesions and for informing treatment decisions. Multiparametric magnetic resonance imaging (mpMRI) has revolutionized prostate cancer detection by enabling precise lesion localization, risk stratification, and improved biopsy targeting. Fusion biopsy, which combines mpMRI findings with real-time transrectal ultrasonography (TRUS), has emerged as a highly effective method for sampling suspicious lesions. This review provides an integrated anatomical, epidemiological, technical, and clinical overview that highlights the evolving role of fusion biopsy in contemporary prostate cancer diagnostics. We also explore emerging strategies such as penumbra-targeted sampling, discuss ongoing clinical challenges, and examine the impact of biopsy underestimation and lack of standardization. Compared to conventional systematic biopsy, mpMRI-TRUS fusion biopsy improves the detection of clinically significant prostate cancer while reducing the overdiagnosis of low-risk tumors. To our knowledge, few recent reviews have comprehensively synthesized current clinical guidelines, emerging biopsy techniques, and future directions within a single narrative. mpMRI-TRUS-guided fusion biopsy represents a major advancement in the prostate cancer diagnostic pathway, promoting precision oncology by reducing overtreatment and facilitating individualized patient care. This review aims to assist clinicians in adopting biopsy innovations that enhance diagnostic accuracy and improve patient outcomes.

Aim of the study The aim of the study was to assess the suitability of vitreous humour (VH) for determining alcoholaemia in deceased bodies. The study presents a correlation between the content of ethyl alcohol in vitreous humour and the concentration of ethyl alcohol in venous blood (femoral...

The alternative light source (ALS) is a helpful technique for the detection of biological traces at a crime scene, which allows preservation of the material without destroying it. The aim of this study was to differentiate the human blood from a group of simulated bloodstains, which included: red borscht, raspberry juice, cherry liqueur, cranberry juice, tomato bruschetta, tomato paste, raspberry jam, rust, red spray, red wine and tomato ketchup. Stains, made of different types of material, were illuminated with the ALS emitted by the Mini-CrimeScope 400 (SPEX Forensics) with yellow, dark yellow, orange and red filters. The results of the analysis were presented as a description and also documented in photographs. The usage of light sources without color cut-off filters does not allow us to differentiate unequivocally real bloodstains from the trace evidence imitating or resembling bloodstains. The usage of different color cut-off filters (especially red filter) allowed us to exclude simulated bloodstains made of food and alcohol by using CSS light and light with a wavelength of 535 nm, 515 nm, 455 nm, 415 nm and 300-400 nm. Due to the different optical properties of blood and substances containing vegetable ingredients, forensic experts can differentiate human blood from simulated bloodstains by using the ALS in a non-destructive and quick way already at the crime scene. The ALS may be an example of a method which can replace more commonly used chemical-based screening tests.

Aim of the study: The study presents the analysis of suicides based on the material consisting of the results of medico-legal autopsies and case files of the Department of Forensic Medicine of the Medical University of Bialystok. Material and methods: The material consisted of 6752 protocols of medico-legal autopsies carried out in the years 2003-2015 and case files, which enabled to classify cases as suicidal. The analysis included the dynamics of suicides over the years, basic demographic characteristics of victims, the ways, the time and place of suicide, the state of sobriety, the frequency of injuries in different regions of the body. The data were analyzed statistically using tests such as: Shapiro-Wilk test, Mann-Whitney U test, nonparametric Kruskal-Wallis test by programme Statistica 10.0 by StatSoft. Results: The research showed that suicides represented 11.09% of all post-mortem examinations. A statistically significant association was found between the age of the person committing suicide and the place chosen for suicide (p = 0.038). Post hoc analysis demonstrated statistically significant differences (p = 0.046) between suicide committed outdoors and in the supervised area. There was a statistically significant association between the sex and the preferable place of committing suicide (p = 0.0001). A high percentage of suicides were committed in the place of residence. There was a statistically significant difference in blood alcohol levels in women and in men at the time of suicide (p = 0.0029). Conclusions: The study revealed the increase of the percentage of suicides in relation to previous years. Hanging is still the most popular method of suicide.Cel pracy: W pracy przedstawiono analizę samobójstw na podstawie sądowo-lekarskich sekcji zwłok i akt spraw Zakładu Medycyny Sądowej Uniwersytetu Medycznego w Białymstoku. Materiał i metody: Materiał stanowiły 6752 protokoły sądowo-lekarskich sekcji zwłok przeprowadzonych w latach 2003–2015 w Zakładzie Medycyny Sądowej w Białymstoku oraz akta sprawy, których ostateczne ustalenia pozwoliły na zakwalifikowanie przypadku jako samobójstwa. Analizą objęto dynamikę samobójstw w poszczególnych latach, cechy demograficzne ofiar, sposoby, czas i miejsce popełnienia samobójstwa, stan trzeźwości, częstość występowania obrażeń w różnych regionach ciała. Autorzy określili najczęściej zażywane substancje. Dane poddano analizie statystycznej przy użyciu testów χ2 niezależności, Shapiro-Wilka, U Manna-Whitneya, nieparametryczny test ANOVA rang Kruskala-Wallisa z testem post hoc wielokrotnych porównań średnich rang dla wszystkich prób. Wyniki istotne statystycznie uznano na poziomie p < 0,05. W obliczeniach wykorzystano pakiety Statistica 10.0 firmy StatSoft. Wyniki: Samobójstwa stanowiły 11,09% wszystkich badań pośmiertnych, 15% z nich popełniły kobiety, zaś 85% mężczyźni. Stwierdzono, istotny statystycznie związek pomiędzy wiekiem osoby popełniającej samobójstwo oraz wybieranym przez nią miejscem dokonania samobójstwa (p = 0,038). Analiza post hoc wykazała istotne statystycznie różnice (p = 0,046) pomiędzy popełnieniem samobójstwa na łonie natury, gdzie mediana wieku wynosiła 42 oraz na obszarze nadzorowanym, gdzie mediana wieku wynosiła 48 lat. Stwierdzono istotną statystycznie zależność pomiędzy płcią a preferowanym miejscem popełnienia samobójstwa (p = 0,0001). Samobójstwa w miejscu zamieszkania dokonało 89,32% kobiet i 65,97% mężczyzn. Stwierdzono istotną statystycznie różnicę w poziomie alkoholu we krwi u kobiet oraz u mężczyzn w chwili samobójstwa (p = 0,0029). Mediana poziomu alkoholu u kobiet wynosiła 0 zaś u mężczyzn 0,3. Wnioski: Badania wykazały wzrost odsetka samobójstw w stosunku do lat poprzednich. Powieszenie nadal jest preferowanym sposobem samobójstwa.

Background/Objectives: Prostate cancer is the second most prevalent malignancy in men globally, typically suspected following abnormalities found during digital rectal examination (DRE) or elevated PSA levels. This study aimed to evaluate and compare the effectiveness of two biopsy techniques—TRUS-Bx and ComBx—in detecting prostate cancer, particularly focusing on the identification of clinically significant prostate cancer (csPCa) with an International Society of Urological Pathology (ISUP) grade ≥ 2. Methods: This retrospective cohort study involved 500 men (aged 46 to 79, with an average age of 65) who had prostate biopsies at our institution between 2017 and 2022. The patients were divided into two groups: 250 men received a transrectal US-guided biopsy (TRUS-Bx) with a standard 12-core sampling, while the other 250 underwent a transperineal combined fusion biopsy (ComBx) with MRI guidance. The ComBx group targeted areas classified as PI-RADS ≥ 3 and also included additional systematic samples. Tumor detection rates for both techniques were assessed, with a particular focus on overall PCa detection and the identification of csPCa. Results: In the TRUS-Bx group, the mean PSA level was 8.2 ng/mL (1.8–45.2 ng/mL), and in the ComBx group, the mean PSA level was 7.5 ng/mL (0.8–32.4 ng/mL). ComBx demonstrated superior detection rates for PCa compared to TRUS-Bx, with statistically significant differences observed in the overall detection of PCa with ISUP grade ≥ 1 (61% for ComBx vs. 45% for TRUS-Bx; p < 0.001) and csPCa (40% for ComBx vs. 30% for TRUS-Bx; p = 0.019). In the ComBx group for csPCa, the detection rates in targeted biopsies of MRI-identified lesions assessed as PIRADS 3, 4, and 5 were 17%, 51%, and 78%, respectively. Conclusions: ComBx offers significantly improved efficacy in detecting prostate cancer, particularly in identifying clinically significant cases, compared to systematic TRUS-Bx. These findings support ComBx as a valuable tool in enhancing diagnostic accuracy for csPCa.

Background/Objectives: Accurate histopathological grading of prostate cancer at the time of biopsy is essential for guiding treatment decisions and minimizing the risks of both overtreatment and undertreatment. A key challenge in prostate cancer diagnostics is the phenomenon of upgrading, wherein the cancer appears more aggressive in the radical prostatectomy specimen than initially indicated by biopsy. Such discrepancies can compromise therapeutic planning. This study investigates whether transperineal combined fusion biopsy (ComBx), incorporating MRI-targeted and systematic sampling, achieves greater concordance with final prostatectomy histopathology compared to conventional transrectal ultrasound-guided systematic biopsy (TRUS-Bx). Methods: This retrospective cohort study analyzed 500 men aged 46 to 79 years (mean age 65) who underwent prostate biopsies between 2017 and 2022 at a single tertiary institution. Patients were stratified into two groups: 250 underwent TRUS-Bx using a 12-core systematic approach, and 250 underwent ComBx guided by software-based MRI–ultrasound fusion targeting PI-RADS ≥ 3 lesions, followed by systematic sampling. Histopathological grading from biopsies was compared with final pathology following radical prostatectomy. Concordance, upgrading, and downgrading rates were analyzed using appropriate statistical methods. Results: Prostate cancer was diagnosed in 113 patients in the TRUS-Bx group and 152 in the ComBx group. Among these, 89 TRUS-Bx and 68 ComBx patients underwent radical prostatectomy at our center. Histological upgrading occurred statistically significantly more often in the TRUS-Bx group (35%) compared to the ComBx group (16%) (p = 0.004). Concordance between biopsy and prostatectomy grading was statistically significantly higher in the ComBx group (63%) than in the TRUS-Bx group (49%) (p = 0.042). No significant difference in downgrading rates was observed between groups. Conclusions: Transperineal combined fusion biopsy substantially improves concordance with final prostatectomy histology and significantly reduces the risk of upgrading compared to transrectal systematic biopsy. These findings support the adoption of ComBx as a more reliable diagnostic strategy for accurate grading of clinically significant prostate cancer, with implications for improving treatment precision and patient outcomes.