Estimación de la edad cronológica a través de los métodos de Demirjian y Ubelaker en niños peruanos / Estimation of the Chronological Age Through the Methods of Demirjian and Ubelaker in Peruvian Children

RESUMEN Objetivo: Determinar el método de estimación de la edad dental más eficaz, Demirjian y Ubelaker, para estimar la edad cronológica en pacientes de 4 a 13 años del Instituto Nacional de Salud del Niño- Lima Perú. Materiales y métodos: Diseño transversal con una muestra conformada por 465 radiografías panorámicas, 229 de personas de sexo masculino (49.2%) y 236 de femenino (50.8%). La estimación de la edad se realizó mediante el protocolo establecido en cada método. La edad cronológica se estableció a través de la diferencia entre la fecha de toma radiográfica con la fecha de nacimiento. Se estableció la precisión y exactitud de cada método. El análisis inferencial se realizó con un nivel de significancia del 5% a través de las pruebas de correlación de Spearman, test de Wilcoxon. Resultados: Se comprobó que el método Ubelaker tuvo 270 casos errados o no coincidentes y 195 coincidencias mientas que el método Demirjian tuvo 360 casos errados y 105 coincidencias entre la edad cronológica estimada y la edad dental encontrándose diferencias significativas en la estimación en cada uno de los métodos p=0,001 y p<0,001 respectivamente. La exactitud obtenida con Ubelaker fue 0,112 y con Demirjian 1,039. Conclusión: El método Ubelaker es más eficaz con una exactitud mayor en comparación a Demirjian.

ABSTRACT Objective: To determine the most effective dental age estimation method, Demirjian y Ubelaker, for estimating the chronological age in patients from 4 to 13 years of the National Institute of Child Health- Lima Peru. Materials and methods: Cross-sectional design with a sample consisting of 465 panoramic radiographs, 229 of male (49.2%) and 236 of female (50.8%). The estimated age was made using the protocol established in each method. The chronological age was established through the difference between the date of radiographic capture and the date of birth. The precision and accuracy of each method was established. The inferential analysis was performed with a level of significance of 5% through the Spearman correlation tests, Wilcoxon test. Results: It was proved that the Ubelaker method had 270 erroneous or mismatched cases and 195 coincidences while the Demirjian method had 360 erroneous cases and 105 coincidences between the estimated chronological age and dental age, finding significant differences in the estimation in each of the methods p=0.001 and p <0.001 respectively. The accuracy obtained with Ubelaker was 0,112 and with Demirjian 1,039.

Suicídio de mulheres em um contexto psicossocial / Women's suicide in a psychosocial context

Introdução: O suicídio é um ato intencional e deliberado de pôr fim a própria vida. Diversos fatores estão relacionados a este tipo de morte autoprovocada, incluindo os fatores biológicos, psicológicos e sociais, configurando-se como grave problema de saúde pública, no Brasil e no mundo, destacando-se o suicídio feminino como interface ainda pouco explorada. Objetivo: conhecer o contexto psicossocial de mulheres que cometeram suicídio na cidade de Caicó estado do Rio Grande do Norte (RN). Método: Tratou-se de uma pesquisa com abordagem qualitativa, ancorada no método da autópsia psicossocial, buscando singularidades das dimensões femininas frente ao suicídio. Para tanto, foram entrevistados seis familiares de mulheres que cometeram suicídio no período de 2011 a 2016. Utilizou-se como técnica de coleta de dados a entrevista em profundidade com roteiro semiestruturado. A análise do material coletado se deu através da análise temática de conteúdo. Resultados: a análise dos dados resultou em três categorias temáticas: 1) Comportamento suicida na trajetória de vida das mulheres; 2) Transtornos mentais e suas relações sociais com o suicídio; 3) Conflitos familiares e questões de gênero instituídas. Considerações finais: Na trajetória de vida das mulheres que se suicidaram, identificou-se presença de ideação suicida e tentativa prévia ao ato, transtorno mental como depressão e esquizofrenia, além de situações conflitantes no seio familiar aliados a desigualdades de gênero e violência intrafamiliar. Evidenciou-se a necessidade de repensar políticas públicas de prevenção do suicídio em um plano coletivo e abrangente que possa atender especificidades de mulheres inclusive em áreas interioranas, bem como potencializar os dispositivos de saúde já existentes, ampliando à Atenção Básica em Saúde como norteadora de ações nos planos de identificação do risco suicida e de intervenções planejadas (AU).

Introduction: Suicide is an intentional and deliberate act of putting an end to own life. Several factors are related to this type of self-inflicted death, including biological, psychological and social factors, becoming a serious public health problem in Brazil and in the world, highlighting female suicide as an interface that has not yet been explored. Objective: to know the psychosocial context of women who committed suicide in the city of Caicó state of Rio Grande do Norte (RN). Method: This was a research with a qualitative approach, anchored in the psychosocial autopsy method, searching for singularities of the female dimensions in the face of suicide. For this purpose, six relatives of women who committed suicide during the period from 2011 to 2016 were interviewed. The interview in depth was used as a technique of collection of data, based in a semi-structured script interview format. The analysis of the collected material took place through the thematic content analysis. Results: data analysis resulted in three thematic categories: 1) Suicidal behavior in the life trajectory of women; 2) Mental disorders and their social relations with suicide; 3) Family conflicts and gender issues instituted. Final considerations: In the life trajectory of women who committed suicide, suicidal ideation and attempted suicide were identified, as well as mental disorders such as depression and schizophrenia, as well as conflicting situations within the family, allied to gender inequalities and intrafamily violence. The need to rethink public suicide prevention policies was considered in a collective and comprehensive plan that could meet the specific needs of women, including in the interior areas, as well as to enhance the existing health devices, thus expanding Basic Health Care as a guide to actions in plans for suicide risk identification and planned interventions (AU).

A forensic identification case and DPid - can it be a useful tool?

Abstract Objective The aim of this study was to show DPid as an important tool of potential application to solve cases with dental prosthesis, such as the forensic case reported, in which a skull, denture and dental records were received for analysis. Material and Methods Human identification is still challenging in various circumstances and Dental Prosthetics Identification (DPid) stores the patient's name and prosthesis information and provides access through an embedded code in dental prosthesis or an identification card. All of this information is digitally stored on servers accessible only by dentists, laboratory technicians and patients with their own level of secure access. DPid provides a complete single-source list of all dental prosthesis features (materials and components) under complete and secure documentation used for clinical follow-up and for human identification. Results and Conclusion If DPid tool was present in this forensic case, it could have been solved without requirement of DNA exam, which confirmed the dental comparison of antemortem and postmortem records, and concluded the case as a positive identification.

Verificação do potencial de atuação do cirurgião-dentista nas necrópsias realizadas pelo IMOL de Campo Grande (MS) / Verification of the potential of actuation of the dentist in the autopsies performed at Medical and Dental Legal Institute, Campo Grande (MS)

A atuação do cirurgião-dentista nos exames periciais que envolvem a região de cabeça e pescoço é prevista em leis federais e em normativas expedidas pelo Conselho Federal de Odontologia, mas ainda há estados brasileiros que não possuem um serviço efetivo de perícia odontológica em âmbito criminal. O objetivo deste estudo foi verificar o potencial de participação de cirurgiões-dentistas nos exames necroscópicos realizados no Instituto de Medicina e Odontologia Legal (IMOL) de Campo Grande ­ MS. Para tanto, foi realizado um levantamento dos laudos de necropsias realizadas no período de julho de 2009 a setembro de 2010. Os dados coletados foram analisados por meio de estatística descritiva. Obteve-se como resultado 411 necropsias no ano de 2009 e 479 em 2010. Observou-se predomínio do sexo masculino (80,6% em 2009 e 76,4% em 2010) em relação ao sexo feminino nos dois anos. A faixa etária entre 18 e 50 anos de idade representou 60,6% em 2009 e 63,7% em 2010, em relação as demais faixas etárias. As mortes acidentais foram as principais causas das mortes, sendo que em mais de 90% dos casos os exames foram realizados em corpos bem preservados. As vias de acesso a cabeça e pescoço foram utilizadas em 52,4% dos exames de 2009 e 50,5% dos de 2010. Conclui-se que embora os dados mostrem a necessidade de procedimentos odontolegais, não houve atuação do cirurgião-dentista nas necropsias realizadas no IMOL de Campo Grande, implicando em prejuízo à investigação criminal e à Justiça.

The role of dentist in forensic examinations when it involves the head and neck region is provided by Brazilian federal law and specific regulations, but there are Brazilian states that still do not have an effective dental expertise service in criminal context. The aim of this study was to investigate the potential involvement of dentists in postmortem examinations at the Medical and Forensic Dentistry Institute (MFDl) of Campo Grande - MS. For this, a survey was conducted searching for autopsy reports registered from July 2009 to September 2010. The data were analyzed using descriptive statistics. There were 411 necropsies in 2009 and 479 in 2010. It was observed a predominance of males (80.6% in 2009 and 76.4% in 2010) compared to females in both years. The age group between 18 and 50 years old represented 60.6% in 2009 and 63.7% in 2010, compared with other age groups. Accidental causes of death were more frequently observed than non-accidental ones. As regards to the tests, it was noted that over 90% were carried out in complete body. Head and neck access routes were used in 52.4% of the 2009 examinations and 50.5% of 2010. The conclusion is that although the data showed the need for forensic dentistry procedures, there was no activity of the forensic dentist in necropsies held in MFDI of Campo Grande, resulting in loss to the criminal investigation and to the justice.

Acinar autolysis and mucous extravasation in human sublingual glands: a microscopic postmortem study

Although some morphological investigations on aged human sublingual glands (HSG) found eventual phenomena identified as autolysis and mucous extravasation, the exact meaning of these findings has not been elucidated.Objective The aim of this work is to investigate whether acinar autolysis and mucous extravasation are related to the aging process in human sublingual glands. We also speculate if autolytic changes may assist forensic pathologists in determining time of death.Material and Methods 186 cadavers’ glands were allocated to age groups: I (0–30 years); II (31–60), and III (61–90). Time and mode of death were also recorded. Acinar autolysis and mucous extravasation were classified as present or absent. Ultrastructural analysis was performed using transmission electron microscopy (TEM). Data were compared using Mann-Whitney U, Spearman’s correlation coefficient, Kruskal-Wallis, and Dunn tests (p<0.05).Results There was correlation between age and acinar autolysis (r=0.38; p=0.0001). However, there was no correlation between autolysis and time of death. No differences were observed between genders. TEM showed mucous and serous cells presenting nuclear and membrane alterations and mucous cells were more susceptible to autolysis.Conclusion Acinar autolysis occurred in all age groups and increased with age while mucous extravasation was rarely found. Both findings are independent. Autolysis degrees in HSG could not be used to determine time of death.