Diagnosis of Vitality in Skin Wounds in the Ligature Marks Resulting From Suicide Hanging.

Ascertaining the vital origin of skin wounds is one of the most challenging problems in forensic pathology. The forensic literature describes biomarkers and methods for differentiating vital and postmortem wounds, although no clear conclusions have been reached. The aim of this study was to characterize human vital wounds by analyzing the concentrations of metallic ions and the expression of P-selectin and cathepsin D in skin wounds in the ligature marks in a cohort of suicidal hangings for which vitality was previously demonstrated.A total of 71 skin wounds were analyzed within a postmortem interval of 19 to 36 hours. The concentration of Fe, Zn, Mg, and Ca and the expression of P-selectin and cathepsin D were analyzed together and separately. The majority of autopsied suicidal hangings were men (86%) with complete hanging mode (60.7%) in which there was a high frequency of subcutaneous injuries (78.3%). High concentrations of Ca and Mg compared with Fe and Zn were found. Ca and Zn concentrations decreased, and Fe concentration increased with the seriousness of the injury. A high percentage of moderately negative expression of both proteins was correlated with subcutaneous injury and low or medium concentrations of Fe.In conclusion, the joint study of metallic ions and proteins allows to characterize and to differentiate an injured vital wound of noninjured skin, especially when the damage in the tissue affects to the majority of the structures of the skin, but these results will need to be complemented with other biomarkers in time-controlled samples to further help in the differentiation of vital and postmortem wounds.

Risk and limits in dental practice: a Portuguese approach to medical-legal evaluation and professional liability.

Patient safety and quality of healthcare delivery systems are an objective of WHO. This study aims to present and analyse Portuguese clinical data on risk and malpractice in dental practice. Data from the Forensic Dentistry Laboratory (Faculty of Medicine, University of Coimbra) was analysed, between the years of 2013 to 2018. One hundred and seven technical reports were selected, and seventy nine files were included in the iatrogenic sequelae group. Data included the analysis of the performance of dental professionals. Sequelae were divided in descending order of occurrence:1) mandibular dysfunction (53,2%)[(42)79]; 2) neurological deficit (39,2%)[(31)79]; 3) tooth loss (6,3%)[(5)79]; and 4) opening deficit (1,3%)[(1)79].Three major areas with significant expression in the field of expert evaluations were analysed: 1) orthodontic treatment (51,9%), implant rehabilitation (29,1%), and oral surgery. Given the prevalence of malpractice, the need to assess its causes and recognise standards for its prevention is necessary.

El sistema médico-legal y forense portugués / The Portuguese medico-legal and forensic system

Los primeros textos legales que contienen algunas normas relacionadas con las pericias médico-legales en Portugal se remontan al siglo XVI, pero no sería hasta el siglo XIX cuando aparecen los primeros servicios públicos y cuando surge la enseñanza de la medicina legal en la universidad como disciplina autónoma. Se crearon los primeros servicios médico-legales oficiales (morgues) que existieron hasta 1918 cuando fueron suprimidas pasando a denominarse Institutos de Medicina Legal de Coimbra, Oporto y Lisboa. Posteriormente se unificaron en un único Instituto Nacional de Medicina Legal que tiene su sede en Coimbra e integra las tres delegaciones de él dependientes, localizadas en Oporto, Coimbra y Lisboa. En las Delegaciones existen 4 servicios técnicos periciales: Patología Forense, Clínica Forense, Toxicología Forense y Genética y Biología Forense. Así mismo existe una red de 31 Gabinetes Médico-Legales dispersos por el país con dependencia orgánica de los anteriores. En el aspecto formativo e investigador cabe mencionar que las Delegaciones funcionan íntimamente articuladas con las Facultades de Medicina del país. La disciplina de Medicina Legal es obligatoria en todas las licenciaturas de medicina y también en las Facultades de Derecho de todas las universidades públicas. En este ámbito de la enseñanza debe destacarse finalmente la existencia, desde 1918, de un postgrado específico en el ámbito de la medicina legal. Portugal dispone también del llamado Laboratorio de Policía Científica (LPC), en el ámbito de la policía judicial, perteneciendo a ésta y teniendo competencias solo en el ámbito de la investigación criminal (AU)

In Portugal, the first regulatory texts referring to medico- legal practice date back to the sixteenth century, but it was not until much later, in the nineteenth century, with the development of legal medicine as an independent university discipline, that the first medico-legal public services (morgues) appeared. In 1918, these morgues were renamed Institutes of Legal Medicine of Coimbra, Oporto and Lisbon. After successive reforms, the old Institutes of Legal Medicine disappeared and were replaced by a single unified National Institute of Legal Medicine. This organisation is located in Coimbra, and comprises the three dependent delegations of Oporto, Coimbra and Lisbon. Each delegation has four expert services: Forensic Pathology, Clinical Forensic Medicine, Forensic Toxicology and Forensic Biology and Genetics. There is also a network of 31 Medico-Legal Bureau distributed throughout the country. With regard to training and research it should be mentioned that the Delegations work in close contact with the universities. Legal Medicine is a compulsory component of all degree courses in Medicine and Law in public universities, and a post-graduate degree in Legal Medicine has been in existence since 1918.Portugal also has a Scientific Police Laboratory at its service, which is only authorised for cases of criminal investigation (AU)