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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.
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.

4.
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
5.
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
6.
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
7.
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
8.
Journal of Forensic Medicine ; (6): 596-600, 2023.
Article in English | WPRIM | ID: wpr-1009392

ABSTRACT

Wound age estimation is the core content in the practice of forensic medicine. Accurate estimation of wound age is a scientific question that needs to be urgently solved by forensic scientists at home and abroad. Metabolomics techniques can effectively detect endogenous metabolites produced by internal or external stimulating factors and describe the dynamic changes of metabolites in vivo. It has the advantages of strong operability, high detection efficiency and accurate quantitative results. Machine learning algorithm has special advantages in processing high-dimensional data sets, which can effectively mine biological information and truly reflect the physiological, disease or injury state of the body. It is a new technical means for efficiently processing high-throughput big data. This paper reviews the status and advantages of metabolomic techniques combined with machine learning algorithm in the research of wound age estimation, and provides new ideas for this research.


Subject(s)
Algorithms , Machine Learning , Forensic Medicine , Metabolomics , Big Data
9.
Journal of Forensic Medicine ; (6): 571-578, 2023.
Article in English | WPRIM | ID: wpr-1009389

ABSTRACT

OBJECTIVES@#To analyze the cases of medical damage after misdiagnosis of tubal pregnancy, to explore the causes of medical damage, the causal relationship between medical malpractice and the damage consequences, as well as the causative potency, in order to provide evaluation ideas for forensic identification of such cases.@*METHODS@#Eighteen cases of forensic identification of tubal pregnancy related medical damage were collected and retrospectively analyzed from the aspects of age, maternity history, fertility requirements, risk factors, diagnosis and treatment, medical malpractice, damage consequences, and causative potency.@*RESULTS@#All 18 cases were tubal pregnancy, of which 17 cases had medical malpractice, resulting in 14 cases of affected tubal resection, 2 cases of hemorrhagic shock death, 1 case of intrauterine fetal death and affected tubal resection. The other case had the consequence of affected tubal resection, but there was no malpractice in the treatment.@*CONCLUSIONS@#Correct diagnosis is helpful to make appropriate treatment plan, prevent disease progression and reduce serious adverse consequences and the occurrence of medical disputes. Scientific and reasonable analysis of the causal relationship between medical malpractice and damage consequences and the causative potency is of great significance to the successful settlement of medical disputes.


Subject(s)
Pregnancy , Female , Humans , Retrospective Studies , Pregnancy, Tubal/surgery , Salpingectomy/methods , Fertility , Malpractice
10.
Journal of Forensic Medicine ; (6): 564-570, 2023.
Article in English | WPRIM | ID: wpr-1009388

ABSTRACT

OBJECTIVES@#To establish a method for the simultaneous quantitative analysis of etomidate and its metabolite etomidate acid in blood, and to discuss its application value in actual cases.@*METHODS@#Acetonitrile precipitate protein method was used, and C18 column was selected. Gradient elution was performed with acetonitrile and 5 mmol/L ammonium acetate within 6 min. Electrospray ionization source in positive ion mode was used. The internal standard etomidate acid-d5 was obtained by etomidate-d5 alkaline hydrolysis reaction. Ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used for quantitative analysis. The methodological verification was conducted.@*RESULTS@#Etomidate and etomidate acid in blood showed good linear relationship in the quantitative linear range (r>0.999), with the lower limit of quantification was 2.5 ng/mL and 7.5 ng/mL, respectively. The accuracy, precision, recovery rate, and matrix effect of the method met the professional verification standards. The practical application results showed that etomidate and etomidate acid could be detected in the blood of the abusers, and their mass concentrations ranged from 17.24 to 379.93 ng/mL.@*CONCLUSIONS@#The method established in this study can simultaneously quantify etomidate and etomidate acid in blood, which is simple and convenient to operate with accuracy. It can meet the detection needs of actual cases and provide technical support for law enforcement to crack down on etomidate abuse.


Subject(s)
Chromatography, High Pressure Liquid/methods , Chromatography, Liquid , Etomidate , Tandem Mass Spectrometry/methods , Liquid Chromatography-Mass Spectrometry , Acetonitriles
11.
Journal of Forensic Medicine ; (6): 549-556, 2023.
Article in English | WPRIM | ID: wpr-1009386

ABSTRACT

OBJECTIVES@#To study the changes of protein levels in peripheral blood after it dried.@*METHODS@#The proteins from whole blood and bloodstains were detected by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and normalized by the label-free quantification (LFQ) method. The differential proteins were analyzed by using R 4.2.1 software, limma and edgeR package. The analysis of biological function, signaling pathway and subcellular localization for the differential proteins was then performed.@*RESULTS@#A total of 623 and 596 proteins were detected in whole blood and bloodstains, respectively, of which 31 were statistically significant in the quantitative results, including 10 up-regulated and 21 down-regulated proteins in bloodstains.@*CONCLUSIONS@#The protein abundances in whole blood and bloodstains are highly correlated, and the variation of protein abundances may be related to the changes of endogenous and structural proteins in cells. The application of proteomics technology can assist the screening and identification of protein biomarkers, thereby introducing new biomarkers for forensic research.


Subject(s)
Chromatography, Liquid/methods , Tandem Mass Spectrometry/methods , Proteomics/methods , Blood Stains , Biomarkers
12.
Journal of Forensic Medicine ; (6): 406-416, 2023.
Article in English | WPRIM | ID: wpr-1009373

ABSTRACT

In recent years, the types and quantities of fentanyl analogs have increased rapidly. It has become a hotspot in the illicit drug control field of how to quickly identify novel fentanyl analogs and to shorten the blank regulatory period. At present, the identification methods of fentanyl analogs that have been developed mostly rely on reference materials to target fentanyl analogs or their metabolites with known chemical structures, but these methods face challenges when analyzing new compounds with unknown structures. In recent years, emerging machine learning technology can quickly and automatically extract valuable features from massive data, which provides inspiration for the non-targeted screening of fentanyl analogs. For example, the wide application of instruments like Raman spectroscopy, nuclear magnetic resonance spectroscopy, high resolution mass spectrometry, and other instruments can maximize the mining of the characteristic data related to fentanyl analogs in samples. Combining this data with an appropriate machine learning model, researchers may create a variety of high-performance non-targeted fentanyl identification methods. This paper reviews the recent research on the application of machine learning assisted non-targeted screening strategy for the identification of fentanyl analogs, and looks forward to the future development trend in this field.


Subject(s)
Fentanyl , Substance Abuse Detection/methods , Mass Spectrometry/methods , Illicit Drugs/analysis
13.
Journal of Forensic Medicine ; (6): 388-392, 2023.
Article in English | WPRIM | ID: wpr-1009370

ABSTRACT

OBJECTIVES@#To establish a rapid method for the analysis of bucinnazine in blood by UPLC-MS/MS and to apply the method to the practical case.@*METHODS@#After the internal standard was added to blood, the protein was precipitated with 900 μL mixed solution (Vacetonitrile∶Vwater=8∶2). After vortex and centrifugation, the protein was measured through 0.22 μm filter membrane. The separation was performed on C18 chromatography column, with acetonitrile and 5 mmol/L ammonium acetate containing 0.1% formic acid aqueous as mobile phase gradient elution at the flow rate of 0.4 mL/min. Multiple reaction monitoring scan was performed in electrospray positive ion mode, quantitative measurement was performed by internal standard method, and methodological verification was carried out.@*RESULTS@#The linear relationship of bucinnazine in blood was good in the range of 0.5-200 μg/L, the correlation coefficient (r) was 0.999 7, the limit of detection was 0.1 μg/L, the limit of quantitation was 0.5 μg/L, and the recovery was 78.3%-83.8% at 1, 10 and 100 μg/L mass concentration levels. The matrix effect was 69.4%-73.8%, the intra-day precision was 1.9%-2.8%, and the inter-day precision was 2.8%-3.2%, the accuracy was 3.1%-3.5%. The stability test results of 1 and 100 μg/L mass concentrations at -25 ℃ showed that the accuracy (bias) of 10 d was less than 4.5%.@*CONCLUSIONS@#This method has the advantages of simple pre-treatment process, fast sample processing speed, high sensitivity of instrument analysis, good stability of content determination and reliable identification results, and can meet the needs of case identification.


Subject(s)
Tandem Mass Spectrometry/methods , Chromatography, Liquid , Chromatography, High Pressure Liquid/methods , Acetonitriles
14.
Journal of Forensic Medicine ; (6): 382-387, 2023.
Article in English | WPRIM | ID: wpr-1009369

ABSTRACT

OBJECTIVES@#To study the virtual reality-pattern visual evoked potential (VR-PVEP) P100 waveform characteristics of monocular visual impairment with different impaired degrees under simultaneous binocular perception and monocular stimulations.@*METHODS@#A total of 55 young volunteers with normal vision (using decimal recording method, far vision ≥0.8 and near vision ≥0.5) were selected to simulate three groups of monocular refractive visual impairment by interpolation method. The sum of near and far vision ≤0.2 was Group A, the severe visual impairment group; the sum of near and far vision <0.8 was Group B, the moderate visual impairment group; and the sum of near and far vision ≥0.8 was Group C, the mild visual impairment group. The volunteers' binocular normal visions were set as the control group. The VR-PVEP P100 peak times measured by simultaneous binocular perception and monocular stimulation were compared at four spatial frequencies 16×16, 24×24, 32×32 and 64×64.@*RESULTS@#In Group A, the differences between P100 peak times of simulant visual impairment eyes and simultaneous binocular perception at 24×24, 32×32 and 64×64 spatial frequencies were statistically significant (P<0.05); and the P100 peak time of normal vision eyes at 64×64 spatial frequency was significantly different from the simulant visual impairment eyes (P<0.05). In Group B, the differences between P100 peak times of simulant visual impairment eyes and simultaneous binocular perception at 16×16, 24×24 and 64×64 spatial frequencies were statistically significant (P<0.05); and the P100 peak time of normal vision eyes at 64×64 spatial frequency was significantly different from the simulant visual impairment eyes (P<0.05). In Group C, there was no significant difference between P100 peak times of simulant visual impairment eyes and simultaneous binocular perception at all spatial frequencies (P>0.05). There was no significant difference in the P100 peak times measured at all spatial frequencies between simulant visual impairment eyes and simultaneous binocular perception in the control group (P>0.05).@*CONCLUSIONS@#VR-PVEP can be used for visual acuity evaluation of patients with severe and moderate monocular visual impairment, which can reflect the visual impairment degree caused by ametropia. VR-PVEP has application value in the objective evaluation of visual function and forensic clinical identification.


Subject(s)
Humans , Evoked Potentials, Visual , Vision, Ocular , Vision, Binocular/physiology , Vision Disorders/diagnosis , Virtual Reality
15.
Journal of Forensic Medicine ; (6): 360-366, 2023.
Article in English | WPRIM | ID: wpr-1009367

ABSTRACT

The qualitative, quantitative, and localization analysis of hearing loss is one of the important contents of forensic clinical research and identification. Pure-tone audiometry is the "gold standard" for hearing loss assessment, but it is affected by the subjective cooperation of the assessed person. Due to the complexity of the auditory pathway and the diversity of hearing loss, the assessment of hearing loss requires the combination of various subjective and objective audiometric techniques, along with comprehensive evaluation based on the case situation, clinical symptoms, and other examinations to ensure the scientificity, accuracy and reliability of forensic hearing impairment assessment. Objective audiometry includes acoustic impedance, otoacoustic emission, and various auditory evoked potentials. The frequency-specific auditory brainstem response (ABR), 40 Hz auditory event related potential, and auditory steady-state response are commonly used for objective hearing threshold assessment. The combined application of acoustic impedance, otoacoustic emission and ABR can be used to locate hearing loss and determine whether it is located in the middle ear, cochlea, or posterior cochlea. This article reviews the application value of objective audiometry techniques in hearing threshold assessment and hearing loss localization, aiming to provide reference for forensic identification of hearing loss.


Subject(s)
Humans , Reproducibility of Results , Auditory Threshold/physiology , Evoked Potentials, Auditory, Brain Stem/physiology , Hearing Loss/diagnosis , Audiometry, Pure-Tone/methods , Clinical Medicine
16.
Journal of Forensic Medicine ; (6): 350-359, 2023.
Article in English | WPRIM | ID: wpr-1009366

ABSTRACT

OBJECTIVES@#To investigate the characteristics and objective assessment method of visual field defects caused by optic chiasm and its posterior visual pathway injury.@*METHODS@#Typical cases of visual field defects caused by injuries to the optic chiasm, optic tracts, optic radiations, and visual cortex were selected. Visual field examinations, visual evoked potential (VEP) and multifocal visual evolved potential (mfVEP) measurements, craniocerebral CT/MRI, and retinal optical coherence tomography (OCT) were performed, respectively, and the aforementioned visual electrophysiological and neuroimaging indicators were analyzed comprehensively.@*RESULTS@#The electrophysiological manifestations of visual field defects caused by optic chiasm injuries were bitemporal hemianopsia mfVEP abnormalities. The visual field defects caused by optic tract, optic radiation, and visual cortex injuries were all manifested homonymous hemianopsia mfVEP abnormalities contralateral to the lesion. Mild relative afferent pupil disorder (RAPD) and characteristic optic nerve atrophy were observed in hemianopsia patients with optic tract injuries, but not in patients with optic radiation or visual cortex injuries. Neuroimaging could provide morphological evidence of damages to the optic chiasm and its posterior visual pathway.@*CONCLUSIONS@#Visual field defects caused by optic chiasm, optic tract, optic radiation, and visual cortex injuries have their respective characteristics. The combined application of mfVEP and static visual field measurements, in combination with neuroimaging, can maximize the assessment of the location and degree of visual pathway damage, providing an effective scheme for the identification of such injuries.


Subject(s)
Humans , Optic Chiasm/pathology , Visual Pathways/pathology , Visual Fields , Evoked Potentials, Visual , Random Amplified Polymorphic DNA Technique , Hemianopsia/complications , Vision Disorders/pathology , Optic Nerve Injuries/diagnostic imaging , Brain Injuries, Traumatic/diagnostic imaging
17.
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
18.
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
19.
Journal of Forensic Medicine ; (6): 193-199, 2023.
Article in English | WPRIM | ID: wpr-981854

ABSTRACT

Talent is one of the basic and strategic supports for building a modern socialist country in all aspects. Since the 1980s, the establishment of forensic medicine major and the cultivation of innovative talents in forensic medicine have become hot topics in higher education in forensic medicine. Over the past 43 years, the forensic medicine team of Shanxi Medical University has adhered to the joint education of public security and colleges, and made collaborative innovation, forming a training mode of "One Combination, Two Highlights, Three Combinations, Four in One" for innovative talents in forensic medicine. It has carried out "5+3/X" integrated reform, and formed a relatively complete talent training innovation mode and management system in teaching, scientific research, identification, major, discipline, team, platform and cultural construction. It has made a historic contribution to China's higher forensic education, accumulated valuable experience for the construction of first-class major and first-class discipline of forensic medicine, and provided strong support for the construction of the national new forensic talent training system. The popularization of this training mode is conducive to the rapid and sustainable development of forensic science, and provides more excellent forensic talents for national building, regional social development and the discipline construction of forensic science.


Subject(s)
Humans , Forensic Medicine/education , Aptitude
20.
Journal of Forensic Medicine ; (6): 176-185, 2023.
Article in English | WPRIM | ID: wpr-981852

ABSTRACT

Biological matrix reference material is a reference material that combines the target material with the biological matrix. The biological matrix reference material has higher consistency with the authentic specimens in forensic toxicology, and its application has a positive effect on improving the accuracy of test results. This paper reviews the research on the matrix reference materials corresponding to three common biological test materials (blood, urine and hair). In order to provide reference for the development and application of biological matrix reference materials in forensic toxicology, this paper mainly introduces the research progress of preparation technology of biological matrix reference materials and some existing products and their parameters evaluation.


Subject(s)
Forensic Toxicology/methods , Hair , Body Fluids
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