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1.
Rev. Bras. Odontol. Leg. RBOL ; 11(1): 72-82, 20240601.
Article in English | LILACS-Express | LILACS | ID: biblio-1556126

ABSTRACT

Disaster victim identification is structured according to international recommendations on the attempt to optimize forensic logistics. The International Criminal Police Organization (INTERPOL) establishes primary and secondary methods for human identification. This study aimed to revisit the existing literature to address the forensic importance of tattoos. The scientific literature has shown advances in the forensic analyses of tattoos specially when it comes to the application of especial imaging techniques, namely photography with infrared light to visualize latent tattoo inks and cover-up tattoos, as well as the use of biochemical processing to distinguish components of the tattoo inks. Other relevant aspect is the fields dedicated to tattoo descriptions in software used worldwide for disaster victim identification, namely PlassData. Coding systems have been proposed as well to facilitate communication in the human identification process. The future of forensic analyses of tattoos is promising considering the increase of research in recent years. Forensic practice might benefit from it with more scientific evidence to support the utilization of tattoo analyses in casework


A identificação de vítimas de desastres em massa é estruturada de acordo com recomendações internacionais na tentativa de otimizar a logística forense. A INTERPOL (International Criminal Police Organization) estabelece métodos primários e secundários para identificação humana. Este estudo teve como objetivo revisitar a literatura existente para abordar a importância forense das tatuagens. A literatura científica tem mostrado avanços nas análises forenses de tatuagens, especialmente no que diz respeito à aplicação de técnicas especiais de imaginologia, como a fotografia com luz infravermelha para visualizar tintas latentes de tatuagens e tatuagens de cobertura, bem como a utilização de processamento bioquímico para distinguir componentes das tintas de tatuagem. Outro aspecto relevante são os campos dedicados à descrição de tatuagens em softwares utilizados mundialmente para identificação de vítimas de desastres em massa, como o PlassData. Sistemas de codificação também foram propostos para facilitar a comunicação no processo de identificação humana. O futuro das análises forenses de tatuagens é promissor considerando o aumento das pesquisas nos últimos anos. A prática forense pode beneficiar-se com mais evidências científicas para apoiar a utilização de análises de tatuagens na condução de casos periciais

2.
Med. leg. Costa Rica ; 41(1): 3-12, ene.-mar. 2024. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1558406

ABSTRACT

Resumen Introducción: La anemia de células falciformes se define como la hemoglobinopatía estructural autosómica recesiva más prevalente en todo el mundo, puede presentar fenómenos vasooclusivos y la anemia hemolítica que son los responsables de las principales complicaciones de esta enfermedad, una de estas es el síndrome torácico agudo, siendo una causa importante de morbilidad y mortalidad en estos pacientes. Objetivo: correlacionar los hallazgos de la autopsia médico legal, con las generalidades de la fisiopatología de la anemia de células falciformes actualizadas y disponibles. Materiales y métodos: Se realizó el análisis del protocolo de la autopsia médico legal efectuada, y revisión bibliográfica en un caso de una femenina de 37 años que en apariencia padecía de "dolor por nervio ciático", quien falleció en su casa de habitación, tras presentar un dolor intenso localizado en la espalda y disnea. Tras la autopsia médico legal se estableció como causa de muerte el síndrome torácico agudo por drepanocitosis. Conclusiones: La anemia de células falciformes se debe tener presente al momento de la valoración médico legal como una posible causa de muerte, para ello es necesario conocer la fisiopatología de esta enfermedad, y poder identificar dichas afectaciones al momento de realizar la autopsia médico legal, para esto es necesario contar con todas las herramientas posibles para poder realizar un diagnóstico certero.


Abstract Objective: To correlate the findings of the medical legal autopsy carried out with the updated and available generalities of the pathophysiology of sickle cell anemia. Materials and methods: The analysis of the protocol of the medical-legal autopsy carried out, and a bibliographic review, were carried out. A 37-year-old female who apparently suffered from "sciatic nerve pain," who died in her home after experiencing intense pain located in her back and dyspnea. After the medical-legal autopsy, acute chest syndrome due to sickle cell disease was established as the cause of death. Conclusions: Sickle cell anemia must be kept in mind at the time of the medical-legal evaluation as a possible cause of death, for this it is necessary to know the pathophysiology of this disease, and to be able to identify these effects when performing the Medical- Legal Autopsy, for this It is necessary to have all the possible tools to be able to make an accurate diagnosis.

3.
Rev. Fac. Med. Hum ; 24(1): 162-168, ene.-mar. 2024. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1565143

ABSTRACT

RESUMEN A pesar de los numerosos esfuerzos de la comunidad internacional en pos de erradicar todas las formas de violencia contra las mujeres, esta problemática se encuentra lejos de ser resuelta. Según la ONU, una de cada tres mujeres ha sufrido violencia física o sexual por parte de la pareja, violencia sexual fuera de la pareja, o de ambas, al menos una vez en su vida. El abordaje de esta problemática, en tanto necesidad social de salud de grupos poblacionales, permite una aproximación a la violencia de género como un problema de salud colectiva. En el plano de la violencia física, la estrangulación/sofocación ha sido identificada como una de las formas más letales de violencia doméstica y agresión sexual; se ha reportado que una víctima que es estrangulada una primera vez tiene 7,5 más probabilidades de ser asesinada posteriormente por el mismo abusador. Una víctima de estrangulación/sofocación puede perder la conciencia en segundos o morir en minutos, días o semanas después del ataque o sufrir daño cerebral permanente o invalidez, además del trauma emocional. Recientemente, se han generado cambios legales en la configuración de este delito; las penas han aumentado en el Reino Unido, Estados Unidos, Australia y Nueva Zelandia. El propósito de esta revisión de literatura de tipo narrativo, no sistemática, está orientada a presentar aspectos médico-legales actualizados de la estrangulación/sofocación no fatal en el contexto de la violencia de género, y se resaltan aquellas implicancias relevantes para la práctica clínica.


ABSTRACT Despite the numerous efforts of the international community to eradicate all forms of violence against women, this problem is far from being resolved. According to the UN, one in three women has suffered physical or sexual violence from an intimate partner, sexual violence outside the couple, or both at least once in their life. Addressing this problem as a social health need of population groups allows an approach to gender violence as a collective health problem. At the level of physical violence, strangulation/suffocation has been identified as one of the most lethal forms of domestic violence and sexual assault. Victims of domestic violence who have been choked or strangled are 7.5 times more likely to be killed by their partner. A victim of strangulation/suffocation can lose consciousness in seconds or die within minutes, days or weeks after the attack, as well as suffer permanent brain damage or disability or emotional trauma. Recently, legal changes have been generated in the configuration of this crime, the penalties have increased in United Kingdom, the United States, Australia and New Zealand. The current non-systematic narrative review of literature sought to explore updated medico-legal aspects of non-fatal strangulation/suffocation in the context of gender violence, and are highlightedrelevant implications for clinical practice.

4.
Article in Chinese | WPRIM | ID: wpr-1024042

ABSTRACT

Forensic medicine serves as a vital branch of medical science dedicated to aiding national and societal functions.Its longstanding application in practice and the role it plays in national governance make it evident that forensic medicine principally serves judicial and administrative bodies,earning it the moniker"State medicine".As a first-class discipline within the realm of medical sciences,forensic medicine is also a crucial part of evidential law,embodying both natural and social scientific characteristics.Over nearly a century of development,modern forensic medicine has evolved into an independent technological science discipline.Its comprehensive system encompasses forensic medicine knowledge system,academic system,disciplinary system,as well as technological system.The science and technology system of forensic medicine is inherently open,continuously interacting with other domains such as the knowledge of medicine,information science,mathematics,physics,and chemistry,which fosters a continuous influx of new insights and the adoption of interdisciplinary methods,effectively broadening the scope and depth of forensic science.Moreover,this system is characterized by its dynamism,propelled forward by the unyielding research and practical engagement of all the forensic experts.

5.
Article in Chinese | WPRIM | ID: wpr-1024057

ABSTRACT

XI Yuan Ji Lu is widely recognized as the earliest and most systematic forensic monograph in the world.It has a profound impact on Chinese society and the world in terms of prosecution system,forensic medicine and traditional Chinese medicine.It has a lengthy and systematic record of human organs and tissues.Given its exemplary role,it is a valuable corpus for the study of human body-part terms.This article conducted an inventory of the terms on the human body surface of XI Yuan Ji Lu.By examining the characteristics of vocabulary composition and usage,it explored the reasons for the formation of human body-part terms,aiming to gain a deeper understanding of the human body structure recognized by ancient people,provided a reference for deeply analyzing the semantic system of human body words,constructing ancient autopsy images and describing the formation of modern forensic medicine.

6.
Article in Chinese | WPRIM | ID: wpr-1017654

ABSTRACT

Objective To analyze the literature on artificial intelligence in forensic research from 2012 to 2022 in the Web of Science Core Collection Database,to explore research hotspots and developmen-tal trends.Methods A total of 736 articles on artificial intelligence in forensic medicine in the Web of Science Core Collection Database from 2012 to 2022 were visualized and analyzed through the litera-ture measuring tool CiteSpace.The authors,institution,country(region),title,journal,keywords,cited references and other information of relevant literatures were analyzed.Results A total of 736 articles published in 220 journals by 355 authors from 289 institutions in 69 countries(regions)were identi-fied,with the number of articles published showing an increasing trend year by year.Among them,the United States had the highest number of publications and China ranked the second.Academy of Forensic Science had the highest number of publications among the institutions.Forensic Science Inter-national,Journal of Forensic Sciences,International Journal of Legal Medicine ranked high in publica-tion and citation frequency.Through the analysis of keywords,it was found that the research hotspots of artificial intelligence in the forensic field mainly focused on the use of artificial intelligence technol-ogy for sex and age estimation,cause of death analysis,postmortem interval estimation,individual identification and so on.Conclusion It is necessary to pay attention to international and institutional cooperation and to strengthen the cross-disciplinary research.Exploring the combination of advanced ar-tificial intelligence technologies with forensic research will be a hotspot and direction for future re-search.

7.
Journal of Forensic Medicine ; (6): 15-19, 2024.
Article in Chinese | WPRIM | ID: wpr-1017655

ABSTRACT

Objective To study the application of CE-Chirp in the evaluation of hearing impairment in forensic medicine by testing the auditory brainstem response(ABR)in adults using CE-Chirp to ana-lyze the relationship between the V-wave response threshold of CE-Chirp ABR test and the pure tone hearing threshold.Methods Subjects(aged 20-77 with a total of 100 ears)who underwent CE-Chirp ABR test in Changzhou De'an Hospital from January 2018 to June 2019 were selected to obtain the V-wave response threshold,and pure tone air conduction hearing threshold tests were conducted at 0.5,1.0,2.0 and 4.0 kHz,respectively,to obtain pure tone listening threshold.The differences and statistical differences between the average pure tone hearing threshold and V-wave response threshold were compared in different hearing levels and different age groups.The correlation,differences and statistical differences between the two tests at each frequency were analyzed for all subjects.The lin-ear regression equation for estimating pure tone hearing threshold for all subjects CE-Chirp ABR V-wave response threshold was established,and the feasibility of the equation was tested.Results There was no statistical significance in the CE-Chirp ABR response threshold and pure tone hearing threshold dif-ference between different hearing level groups and different age groups(P>0.05).There was a good correlation between adult CE-Chirp ABR V-wave response threshold and pure tone hearing threshold with statistical significance(P<0.05),and linear regression analysis showed a significant linear correla-tion between the two(P<0.05).Conclusion The use of CE-Chirp ABR V-wave response threshold can be used to evaluate subjects'pure tone hearing threshold under certain conditions,and can be used as an audiological test method for forensic hearing impairment assessment.

8.
Journal of Forensic Medicine ; (6): 30-36, 2024.
Article in Chinese | WPRIM | ID: wpr-1017657

ABSTRACT

Objective To establish a rapid screening method for 34 emerging contaminants in surface water by ultra-high performance liquid chromatography-quadrupole-time of flight mass spectrometry(UHPLC-Q-TOF-MS).Methods The pretreatment conditions of solid phase extraction(SPE)were op-timized by orthogonal experimental design and the surface water samples were concentrated and ex-tracted by Oasis? HLB and Oasis? MCX SPE columns in series.The extracts were separated by Kine-tex? EVO C18 column,with gradient elution of 0.1%formic acid aqueous solution and 0.1%formic acid methanol solution.Q-TOF-MS'fullscan'and'targeted MS/MS'modes were used to detect 34 emerging contaminants and to establish a database with 34 emerging contaminants precursor ion,prod-uct ion and retention times.Results The 34 emerging contaminants exhibited good linearity in the con-centration range respectively and the correlation coefficients(r)were higher than 0.97.The limit of de-tection was 0.2-10 ng/L and the recoveries were 81.2%-119.2%.The intra-day precision was 0.78%-18.70%.The method was applied to analyze multiple surface water samples and 6 emerging contaminants were detected,with a concentration range of 1.93-157.71 ng/L.Conclusion The method is simple and rapid for screening various emerging contaminants at the trace level in surface water.

9.
Journal of Forensic Medicine ; (6): 37-42, 2024.
Article in Chinese | WPRIM | ID: wpr-1017658

ABSTRACT

Objective To investigate the toxicokinetic differences of 3,4-methylenedioxy-N-methylamphetamine(MDMA)and its metabolite 4,5-methylene dioxy amphetamine(MDA)in rats af-ter single and continuous administration of MDMA,providing reference data for the forensic identifica-tion of MDMA.Methods A total of 24 rats in the single administration group were randomly divided into 5,10 and 20 mg/kg experimental groups and the control group,with 6 rats in each group.The ex-perimental group was given intraperitoneal injection of MDMA,and the control group was given intraperi-toneal injection of the same volume of normal saline as the experimental group.The amount of 0.5 mL blood was collected from the medial canthus 5 min,30 min,1 h,1.5 h,2 h,4 h,6 h,8 h,10 h,12 h after administration.In the continuous administration group,24 rats were randomly divided into the experi-mental group(18 rats)and the control group(6 rats).The experimental group was given MDMA 7 d by continuous intraperitoneal injection in increments of 5,7,9,11,13,15,17 mg/kg per day,respectively,while the control group was given the same volume of normal saline as the experimental group by in-traperitoneal injection.On the eighth day,the experimental rats were randomly divided into 5,10 and 20 mg/kg dose groups,with 6 rats in each group.MDMA was injected intraperitoneally,and the con-trol group was injected intraperitoneally with the same volume of normal saline as the experimental group.On the eighth day,0.5 mL of blood was taken from the medial canthus 5 min,30 min,1 h,1.5 h,2 h,4 h,6 h,8 h,10 h,12 h after administration.Liquid chromatography-triple quadrupole tandem mass spectrometry was used to detect MDMA and MDA levels,and statistical software was employed for data analysis.Results In the single-administration group,peak concentrations of MDMA and MDA were reached at 5 min and 1 h after administration,respectively,with the largest detection time limit of 12 h.In the continuous administration group,peak concentrations were reached at 30 min and 1.5 h af-ter administration,respectively,with the largest detection time limit of 10 h.Nonlinear fitting equations for the concentration ratio of MDMA and MDA in plasma and administration time in the single-administration group and continuous administration group were as follows:T=10.362C-1.183,R2=0.974 6;T=7.397 3C-0.694,R2=0.961 5(T:injection time;C:concentration ratio of MDMA to MDA in plasma).Conclusions The toxicokinetic data of MDMA and its metabolite MDA in rats,obtained through single and continuous administration,including peak concentration,peak time,detection time limit,and the relationship between concentration ratio and administration time,provide a theoretical and data foundation for relevant forensic identification.

10.
Journal of Forensic Medicine ; (6): 43-49, 2024.
Article in Chinese | WPRIM | ID: wpr-1017659

ABSTRACT

Objective To analyze the high risk factors of obstetric brachial plexus palsy(OBPP),and to explore how to evaluate the relationship between fault medical behavior and OBPP in the process of medical damage forensic identification.Methods A retrospective analysis was carried out on 25 cases of medical damage liability disputes related to OBPP from 2017 to 2021 in Beijing Fayuan Judicial Science Evidence Appraisal Center.The shortcomings of hospitals in birth weight assessment,delivery mode selection,labor process observation and shoulder dystocia management,and the causal relation-ship between them and the damage consequences of the children were summarized.Results Fault medi-cal behavior was assessed as the primary cause in 2 cases,equal cause in 10 cases,secondary cause in 8 cases,minor cause in 1 case,no causal relationship in 1 case,and unclear causal force in 3 cases.Conclusion In the process of forensic identification of OBPP,whether medical behaviors fulfill diagno-sis and treatment obligations should be objectively analyzed from the aspects of prenatal evaluation,de-livery mode notification,standardized use of oxytocin,standard operation of shoulder dystocia,etc.Meanwhile,it is necessary to fully consider the objective risk of different risk factors and the diffi-culty of injury prevention,and comprehensively evaluate the causal force of fault medical behavior in the damage consequences.

11.
Article in Chinese | WPRIM | ID: wpr-1007269

ABSTRACT

The discrimination of the cause of death is an important part in forensic medicine. With the advantages of simple operation, high test efficiency, and easy sensitivity to the death mechanism of the deceased, postmortem biochemistry analysis has become a significant auxiliary analysis method for discrimination of the cause of death. In this paper, we discuss the development status, advantages and current problems of postmortem biochemical analysis, and then describe the application prospect of postmortem biochemistry in the discrimination of the cause of death by posing feasible solutions, so that to provide an idea for this research.

12.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1567289

ABSTRACT

Este estudo descritivo parte de pesquisa bibliográfica e documental, visando esboçar uma gênese e constituição das Perícias Médico-Previdenciárias (PMP) no país e buscando ressaltar seu conteúdo crítico. Foi empreendida então a Análise de Conteúdo para categorizar os núcleos temáticos em periodizações históricas que, a partir do método dialético, nos possibilitaram conjugar uma análise diacrônica e sincrônica do papel, do lugar e da função social das PMP. Desvela-se de sua institucionalização legal uma postura historicamente conservadora e antitrabalhadora, que sustenta a ação pericial no âmbito do Instituto Nacional do Seguro Social (INSS) e nos permite afirmar que sequer tal campo de poder têm relação com qualquer resolução dos problemas em Saúde do Trabalhador (ST), pois o paradigma da causalidade dos agravos à saúde se dá pela precedência das condições de trabalho em uma visão (a)histórica e descontextualizada das relações econômicas, políticas, ideológicas e sociais que influem nos nexos entre trabalho e saúde/doença


The descriptive study, based on bibliographic and documentary research, outlines the genesis and institutionalization of Social Security Medical Experts (PMP) in Brazil, highlight its critical content. Content Analysis categorized the thematic cores into historical periods that, based on the dialectical method, allowed us to combine a diachronic and synchronic analysis of the role, place, and social function of PMP. Their legal institutionalization reveals a historically conservative and anti-worker(s) stance that supports the expert action within the National Institute of Social Security (INSS), allowing us to affirm that such a field of power has no intention to solve occupational health issues, for the causality paradigm of health problems is given a priori by the working conditions under an ahistorical and decontextualized view of economic, political, ideological and social relations that influence the link between work and health/disease


Subject(s)
Social Security/history , Occupational Health , Expert Testimony/legislation & jurisprudence , Forensic Medicine/history , Ergonomics
13.
Univ. salud ; 25(3): [C18-C22], septiembre-diciembre. 2023. ilus
Article in English | LILACS | ID: biblio-1531205

ABSTRACT

Introduction: Judicially demanding the right to health involves different elements and can lead to changes in continuing education programs. The current trend is to follow this pathway to access low-frequency and high-cost medications. In addition, the Constitutional Court of Costa Rica requests a technical concept from forensic doctors. Objective: To raise the need for continuous updating in specific theoretical-practical academic knowledge required by forensic doctors to guarantee the right to health services. Reflection: The training of forensic medical doctors is focused on evidence and encourages continuous education. Nevertheless, a commitment is necessary in continuing medical education programs such as literature search strategies, critical assessment of evidence, and academic practices that incorporate particular circumstances comparing them with scientific studies. These programs must take into account prevalent medications and pathologies as well as technical-scientific factors that differ in each service provider. Conclusion: A continuing education program about the interpretation and assessment of scientific evidence for proper decision making on health issues would allow medical doctors to judge existing health problems and choose a medication that is the most beneficial for a patient.


Introducción: La judicialización del derecho a la salud involucra a distintos actores y puede propiciar cambios en programas de educación continua; pues la tendencia actual es recurrir a esta vía para acceder a medicamentos de baja frecuencia y alto costo. Adicionalmente, en Costa Rica la Sala Constitucional solicita el criterio técnico a médicos forenses. Objetivo: Plantear la necesidad de actualización continua en conocimientos académicos teóricos-prácticos específicos que requiere el médico forense para garantizar el derecho a los servicios de salud. Reflexión: El médico forense cuenta con formación basada en evidencias y se incentiva su formación continua, sin embargo, es necesario un compromiso con los programas de educación médica continua: en estrategias de búsqueda de literatura, valoración crítica de la evidencia encontrada y práctica académica que incorpore las circunstancias particulares, comparándolo con los resultados de estudios científicos; tomando en cuenta medicamentos y patologías prevalentes y los factores técnico-científicos de divergencia entre los prestadores de servicios. Conclusión: Un programa de formación continua sobre interpretación y valoración de la evidencia científica para la toma de decisiones en salud, permitiría a estos especialistas responder con mejor criterio si un medicamento es el tratamiento más beneficioso para un paciente debido a sus problemas de salud.


Introdução: A judicialização do direito à saúde envolve diferentes atores e pode promover mudanças nos programas de educação continuada; porque a tendência atual é recorrer a esta via para ter acesso a medicamentos de baixa frequência e alto custo. Além disso, na Costa Rica, o Tribunal Constitucional solicita critérios técnicos aos médicos forenses. Objetivo: Levantar a necessidade de atualização contínua em conhecimentos acadêmicos teórico-práticos específicos que o médico forense necessita para garantir o direito aos serviços de saúde. Reflexão: O médico forense tem formação baseada em evidências e sua formação continuada é incentivada, porém é necessário o compromisso com programas de educação médica continuada: em estratégias de busca bibliográfica, avaliação crítica das evidências encontradas e prática acadêmica que incorpore as circunstâncias particulares , comparando-o com resultados de estudos científicos; levando em consideração medicamentos e patologias prevalentes e fatores técnico-científicos de divergência entre prestadores de serviços. Conclusão: Um programa de formação contínua sobre interpretação e avaliação de evidências científicas para a tomada de decisões em saúde, permitiria a estes especialistas responder com melhores critérios se um medicamento é o tratamento mais benéfico para um paciente devido aos seus problemas de saúde.


Subject(s)
Humans , Male , Female , Delivery of Health Care , Education , Occupational Groups , Health Personnel , Education, Professional , Right to Health , Health Services Accessibility
14.
Med. leg. Costa Rica ; 40(2)dic. 2023.
Article in Spanish | LILACS, SaludCR | ID: biblio-1514470

ABSTRACT

El Trastorno del Espectro Autista (TEA), es trastorno del neurodesarrollo que se caracteriza por algún grado de dificultad en la interacción social y la comunicación, que comienza en el periodo de desarrollo temprano, y se clasifica según el grado de severidad en grado 1, 2 y 3, según lo establecido en el DSM-5. Dicho Trastorno se encuentra abarcado por la Ley 7125 de Pensión Vitalicia para Personas con Parálisis Profunda, y su reforma 8769. Con el objetivo de analizar los criterios establecidos para la valoración de estos procesos, se presenta el caso de una persona masculina de 6 años con diagnóstico de TEA, de quien se interpuso demanda para ser tomado en cuenta dentro de dicha Ley. En el mismo y tras el análisis respectivo, de acuerdo con los datos de la literatura científica actualizada, y de los criterios establecidos, se pudo constatar que si calificaba según lo indicado en la Ley 7125.


Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is characterized by some degree of difficulty in social interaction and communication, which begins in the early development period, and is classified according to the degree of severity in grade 1, 2 and 3, as established in the DSM-5. Said Disorder is covered by Law 7125 of Life Pension for people with deep cerebral palsy, and its reform 8769. In order to analyze the criteria established for the assessment of these processes, the case of a 6-year-old male person with diagnosis of ASD, of whom a lawsuit was filed to be taken into account within said Law. In it and after the respective analysis, according to the data of the updated scientific literature, and the established criteria, it was possible to verify that if qualified as indicated in Law 7125.


Subject(s)
Humans , Male , Child , Pensions , Autism Spectrum Disorder/diagnosis , Universal Health Coverage , Costa Rica
15.
Med. leg. Costa Rica ; 40(1)mar. 2023.
Article in Spanish | LILACS, SaludCR | ID: biblio-1430758

ABSTRACT

La fractura orbitaria por estallido o fractura en "blow out" es una de las fracturas más comunes a nivel facial por lo que su importancia reside en saber identificarlas por el enmascaramiento clínico que podría o no, estar presente. Es de vital importancia complementar la valoración clínica con estudios de imagenología que confirmen las sospechas clínicas. De no hacerlo si el paciente no consulta a un servicio médico quirúrgico la pérdida de la capacidad funcional o la debilitación persistente en la salud ocasionada por la fractura no podrá ser validada en un Dictamen Médico Legal de Secuelas.


The orbital blow out fracture is one of the most common fractures at facial level, so its importance lies in knowing how to identify them due to the clinical masking that may or may not be present. It is of vital importance to complement the clinical evaluation with imaging studies to confirm the clinical suspicions. Otherwise, if the patient does not consult a surgical medical service, the loss of functional capacity or the persistent debilitation in health caused by the fracture cannot be validated in a Forensic Medical Report of Sequelae.


Subject(s)
Humans , Male , Adult , Orbital Fractures/diagnosis , Diplopia , Facial Injuries/diagnostic imaging , Costa Rica , Forensic Medicine
16.
Acta méd. costarric ; 65(1): 26-31, ene.-mar. 2023.
Article in Spanish | LILACS, SaludCR | ID: biblio-1527610

ABSTRACT

Resumen La pericia médico legal es compleja y su resultado debe estar fundamentado considerando el análisis de varios elementos de juicio, como: la historia médico legal, el examen físico, el análisis de los expedientes médicos, estudios de laboratorio e imágenes radiológicas y en algunos casos, inclusive una interconsulta realizada a otros especialistas. El perito médico forense utiliza la interconsulta a especialistas para solventar la brecha que existe entre el conocimiento profesional y específico que posee una especialidad y una interrogante médico legal, por lo que difiere en gran manera en el objetivo, formulación y resultado de una interconsulta médica hospitalaria. Por esta razón, esta reflexión pretende contextualizar la importancia del recurso de interconsulta médica dentro del análisis pericial forense, que es un tema poco conocido en la medicina asistencial, y justificar la relevancia de la educación médica continua para los médicos especialistas que realizan las interconsultas y para quienes las solicitan.


Abstract The medical-legal report is complex and its result must be based on the análisis of various elements of judgment, such as: the legal medical history, the physical examination, the analysis of the medical records, laboratory and radiological images and in some cases, even an interconsultation with other specialists. The forensic medical expert uses the interconsultation with specialists to solve the gap that exists between the professional and specific knowledge that a specialty has and a legal medical question, for which it differs greatly in the objective, formulation and result of a hospital medical interconsultation. For this reason, this reflection aims to contextualize the importance of the resource of medical interconsultation within the forensic expert analysis, which is a little-known topic in healthcare medicine, and to justify the relevance of continuing medical education for medical specialists who perform interconsultations and for those who request them.


Subject(s)
Referral and Consultation , Expert Testimony , Forensic Medicine , Patient Care Team , Coroners and Medical Examiners
17.
Article in Chinese | WPRIM | ID: wpr-1024026

ABSTRACT

Objective To investigate the recognition efficiency of AI model based on deep learning for cardiac conduction system(CCS).Methods HE staining sections of cardiac muscle and CCS of 17 cases of non-sudden death were selected,and the gold standard was unanimous recognition by 2 forensic pathologists with more than 20 years of CCS diagnosis experience.Inception V3 algorithm was used to establish AI model and complete CCS identification training and testing.Confusion matrix,accuracy,precision,recall,F1 score,ROC curve and AUC value were used to evaluate the effectiveness of AI model,and accuracy,sensitivity and specificity were used to evaluate the efficiency of manual independent and AI-assisted manual recognition for CCS.Results The accuracy of AI model was 87.3%,the precision was 91.9%,the recall was 81.9%,the F1 score was 86.6%,and the AUC value was 95.3%.The accuracy of AI model was higher than that of senior forensic pathologists.There was no statistical significance in the accuracy of AI-assisted senior forensic pathologists in identifying CCS compared with manual independent detection(P>0.05),while the accuracy of AI-assisted intermediate and junior forensic pathologists in identifying CCS was increased by 8%and 14.33%,respectively,with statistical significance(P<0.05).The accuracy rate of AI-assisted junior forensic pathologists to identify CCS was higher than that of intermediate forensic pathologists in self-diagnosis.Conclusion The AI model could be used for the automatic recognition of CCS,and could improve the diagnostic efficiency of CCS and narrow the gap between the forensic pathologists with low experience and that with high experience.

18.
Chinese Journal of Forensic Medicine ; (6): 648-653,663, 2023.
Article in Chinese | WPRIM | ID: wpr-1024029

ABSTRACT

Objective To conduct a comprehensive visual analysis of the application of Artificial Intelligence(AI)in forensic medicine using bibliometric tools so as to create knowledge maps of cooperation network,research hotspots,important findings,and potential future trends in this field.Methods The Web of Science(WoSCC)was utilized as the primary data source,search formula incorporating AI and forensic medicine as core subject words was constructed,resulting in a dataset comprising 2 287 literature records.Vosviewer,Citespace,and Bibliometrix were employed for analyzing various aspects such as cooperation network,keyword co-occurrence networks,clustering dynamics,clusters,centrality degree and thematic strategic coordinate charts.These analyses facilitated the creation of corresponding visual maps.Results The collaboration among authors still requires further strengthening;however significant groups have emerged among institutions and countries.Research hotspots and important findings predominantly revolve around algorithmic applications.Furthermore,"identification"related research appears to become a prominent future research trend.Conclusion By employing bibliometric analysis techniques on the application of artificial intelligence in forensic medicine domain,this study successfully elucidats cooperation networks,research hotspots,important findings,future research directions,and provides objective support through empirical evidence for related studies.

19.
Journal of Forensic Medicine ; (6): 329-336, 2023.
Article in English | WPRIM | ID: wpr-1009364

ABSTRACT

In the personal injury compensation system, the protection and relief of the injured people's rights to life, rights to health, and body rights are generally based on the results of disability assessment. Over the years, with the increased number of personal injury compensation cases, the practice of disability assessment have been greatly developed, and the development of disability assessment standards tends to be mature. However, the lack of basic theories for disability assessment has seriously affected the construction and unification of standards. Starting from the tort legal system of personal injury compensation, this article systematically analyzes the legal theories of disability assessment, and holds that the loss of labor ability is the legal basis for disability assessment in China, and the essence of disability assessment should be understood as the quantitative assessment of an individual's permanent loss of labor ability. This article combines the international disability assessment models and the primary concepts of American Medical Association's Guides to the Evaluation of Permanent Impairment to refine the basic concepts of disability assessment in China, such as impairment, disability, handicap, disabled people and self-care ability, etc. At the same time, it sorts out the critical issues of identification time, promotion principles and compound calculation of multiple injuries in disability assessment. It is expected to be beneficial to the theory and practice of disability assessment in personal injury compensation.


Subject(s)
Humans , Disability Evaluation , Liability, Legal , China
20.
Journal of Forensic Medicine ; (6): 343-349, 2023.
Article in English | WPRIM | ID: wpr-1009365

ABSTRACT

OBJECTIVES@#The artificial intelligence-aided diagnosis model of rib fractures based on YOLOv3 algorithm was established and applied to practical case to explore the application advantages in rib fracture cases in forensic medicine.@*METHODS@#DICOM format CT images of 884 cases with rib fractures caused by thoracic trauma were collected, and 801 of them were used as training and validation sets. A rib fracture diagnosis model based on YOLOv3 algorithm and Darknet53 as the backbone network was built. After the model was established, 83 cases were taken as the test set, and the precision rate, recall rate, F1-score and radiology interpretation time were calculated. The model was used to diagnose a practical case and compared with manual diagnosis.@*RESULTS@#The established model was used to test 83 cases, the fracture precision rate of this model was 90.5%, the recall rate was 75.4%, F1-score was 0.82, the radiology interpretation time was 4.4 images per second and the identification time of each patient's data was 21 s, much faster than manual diagnosis. The recognition results of the model was consistent with that of the manual diagnosis.@*CONCLUSIONS@#The rib fracture diagnosis model in practical case based on YOLOv3 algorithm can quickly and accurately identify fractures, and the model is easy to operate. It can be used as an auxiliary diagnostic technique in forensic clinical identification.


Subject(s)
Humans , Rib Fractures/diagnostic imaging , Artificial Intelligence , Thoracic Injuries , Algorithms , Radiography , Retrospective Studies
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