Alzheimer’s disease (AD) is the most prevalent neurodegenerative disorder and represents a major public health challenge. With increasing life expectancy, the incidence of AD has also increased, highlighting the need for early diagnosis and improved monitoring. Traditionally, diagnosis has relied on clinical symptoms and neuroimaging; however, the introduction of biomarkers has revolutionized disease assessment. Traditional biomarkers, including the Aβ42/Aβ40 ratio, phosphorylated tau (p-Tau181, p-Tau217, and p-Tau231), total tau (t-tau), and neurofilament light chain (NfL), are fundamental for staging AD progression. Updated guidelines introduced the ATX(N) model, which extends biomarker classification to include additional promising biomarkers, such as SNAP-25, YKL-40, GAP-43, VILIP-1, progranulin (PGRN), TREM2, IGF-1, hFABP, MCP-1, TDP-43, and BDNF. Recent advancements have allowed for the detection of these biomarkers not only in CSF but also in plasma and neuron-derived exosomes, offering less invasive and more accessible diagnostic options. This review explores established and emerging biomarkers and emphasizes their roles in early diagnosis, patient stratification, and precision medicine.

Killer Ig-like Receptors (KIRs) regulate immune responses, maintaining the balance between activation and inhibition of the immune system. KIRs are expressed on natural killer cells and some CD8 T cells and interact with HLA class I molecules, influencing various physiological and pathological processes. KIRs’ polymorphism creates a variability in immune responses among individuals. KIRs are involved in autoimmune disorders, cancer, infections, neurological diseases, and other diseases. Specific combinations of KIRs and HLA are linked to several diseases’ susceptibility, progression, and outcomes. In particular, the balance between inhibitory and activating KIRs can determine how the immune system responds to pathogens and tumors. An imbalance can lead to an excessive response, contributing to autoimmune diseases, or an inadequate response, allowing immune evasion by pathogens or cancer cells. The increasing number of studies on KIRs highlights their essential role as diagnostic and prognostic biomarkers and potential therapeutic targets. This review provides a comprehensive overview of the role of KIRs in all clinical conditions and diseases, listed alphabetically, where they are analyzed.

Musculoskeletal imaging plays a pivotal role in the evaluation of trauma, with applications spanning medical, forensic, and insurance contexts. Precisely dating musculoskeletal injuries is vital for reconstructing the timeline of events leading to trauma and verifying their accuracy. In forensic medicine, radiologists are frequently called upon by law enforcement and insurance companies to estimate the age of such injuries. This review aims to provide an overview of musculoskeletal imaging findings that can be used in medico-legal issues related to trauma to reach a comprehensive understanding of the causal relationship between the traumatic event and the clinical findings, with a particular focus on assessing causality, timing estimation and post-traumatic injury and impairment. Imaging plays a pivotal role in the precise and comprehensive evaluation of musculoskeletal traumatic injuries, with applications extending from immediate clinical care to legal and insurance considerations. Through various imaging modalities, it is possible to estimate the time elapsed since the injury and assess the impact of any pre-existing conditions. Effective collaboration between the forensic physician and the radiologist is essential to accurately determine the causal link between the injurious event and the resulting damage. This interdisciplinary approach ensures appropriate compensation and addresses the complex forensic aspects involved.

Forensic radiology training significantly enhances the diagnostic accuracy of postmortem computed tomography (PMCT) in firearm-related deaths, reducing inter-reader variability and improving injury detection. This study examines the impact of forensic expertise on PMCT interpretation, evaluating whether specialized training supersedes clinical radiology experience (non-forensic). A retrospective observational analysis was conducted at the University of Palermo, examining 10 firearm fatalities (homicides or suicides) between 2021 and 2024. The sample included individuals aged 25 to 66, with injuries from both short- and long-barrel firearms. Four radiologists with varying forensic experience analyzed the PMCT scans: an experienced forensic radiologist, an experienced clinical radiologist without forensic training, a radiology resident with forensic training, and a radiology resident without forensic expertise. Findings were compared against autopsy results as the gold standard. A lesion-based analysis was carried out in performance metrics considering the total number of findings ( n = 960) and the number of findings in each subgroup (ranging from 40 up to 230 lesions). Inter-rater agreement was assessed using Fleiss’ kappa and Cohen’s kappa, while diagnostic performance was evaluated with ROC curve analysis. Results showed significantly higher diagnostic accuracy among radiologists with forensic training, particularly in detecting entrance and exit wounds, as well as organ injuries. These findings underscore the critical role of forensic radiology training in enhancing PMCT reliability, particularly for firearm-related injuries. Standardized reporting protocols and structured training programs are crucial for strengthening medicolegal investigations, thereby ensuring accurate and reproducible forensic imaging assessments. Future research should explore advanced imaging techniques, including radiomics and AI-driven analysis, to optimize forensic radiology practices.

Asylum seekers often report exposure to persecution in their home countries, during transit, or while in detention. The primary purpose of a forensic medical certification is the objective documentation of physical and psychological findings associated with torture, abuse, or other forms of inhumane treatment. The study had two main objectives: (1) to analyze the demographic, clinical, and medico-legal data of individuals referred to the Specialized Outpatient Service for Survivors of Torture (SVT) at the Policlinic Hospital of the University of Palermo and (2) to evaluate how professional experience and specialized training shape the formulation of compatibility judgments according to the Istanbul Protocol, through a multicenter inter-rater analysis. This is a retrospective observational study that analyzed all consecutive forensic medical evaluations of asylum seekers at the Institute of Legal Medicine, University of Palermo, Italy, between January 1, 2018, and December 31, 2024. In total, 324 patients were examined at the institute's outpatient clinic for survivors of torture. Our findings highlight the essential role of specialized forensic experience in the medico-legal assessment of asylum seekers reporting torture and ill-treatment. Comparative analysis across multiple international centers confirmed that physical trauma, particularly blunt injury, was the most commonly documented form of abuse. The study demonstrated high inter-rater agreement for injury identification, classification, and recognizing associated physical and psychological sequelae. However, discrepancies emerged in assigning consistency levels under the Istanbul Protocol, highlighting the need for structured training and standardized protocols to ensure the accuracy, reproducibility, and evidentiary value of forensic assessments.

Background/Objectives: Suicide in prison is a significant medico-legal and public health concern, with rates several times higher than in the general population. Vulnerability is heightened by psychiatric disorders, substance use, and custodial stressors such as isolation, overcrowding, and restricted healthcare access. This study examines custodial suicides to identify diagnostic complexities, systemic shortcomings, and possible prevention strategies, including technological innovations. Methods: We conducted a retrospective forensic investigation of sixteen confirmed custodial suicides between 2022 and 2024. Each underwent a standardized protocol comprising crime scene inspection, complete autopsy, histopathology, toxicology, and review of prison medical and psychiatric records. Data on suicide methods, psychiatric comorbidities, and substance use were analyzed. Results: Hanging was the predominant method (12/16), displaying classical forensic signs such as pale, oblique ligature marks and petechial hemorrhages. Four cases involved acute intoxication, often with non-prescribed drugs. Psychiatric disorders were identified in 14 cases, including major depressive disorder, bipolar disorder, and substance use disorder. Toxicological analyses revealed both prescribed and illicit substances, highlighting unauthorized exchanges within facilities. Autopsy findings consistently excluded homicide or natural causes, confirming the vitality of lesions and the mechanism of death. Conclusions: Custodial suicides are strongly associated with untreated or inadequately managed psychiatric conditions, compounded by restrictive prison environments. Comprehensive forensic autopsies are essential for accurate cause-of-death determination and institutional accountability. Preventive strategies should combine psychiatric care, architectural modifications to reduce ligature points, and ethical integration of AI-based surveillance for early detection of suicidal behavior. A multidisciplinary, rights-based approach is crucial to reduce suicide rates and safeguard the dignity and life of incarcerated individuals.