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1.
Stud Health Technol Inform ; 266: 1-6, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31397293

RESUMO

Identifying those patient groups, who have unwanted outcomes, in the early stages is crucial to providing the most appropriate level of care. In this study, we intend to find distinctive patterns in health service use (HSU) of transport accident injured patients within the first week post-injury. Aiming those patterns that are associated with the outcome of interest. To recognize these patterns, we propose a multi-objective optimization model that minimizes the k-medians cost function and regression error simultaneously. Thus, we use a semi-supervised clustering approach to identify patient groups based on HSU patterns and their association with total cost. To solve the optimization problem, we introduce an evolutionary algorithm using stochastic gradient descent and Pareto optimal solutions. As a result, we find the best optimal clusters by minimizing both objective functions. The results show that the proposed semi-supervised approach identifies distinct groups of HSUs and contributes to predict total cost. Also, the experiments prove the performance of the multi-objective approach in comparison with single- objective approaches.


Assuntos
Acidentes , Algoritmos , Análise por Conglomerados , Serviços de Saúde , Humanos , Medição de Risco
2.
J Forensic Leg Med ; 65: 124-132, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31153007

RESUMO

Poisoning is recognized as a major factor for deaths in majority of low-income and middle-income countries. Although it is considered as a global burden, the nature of poisoning may vary in different areas across the world. The Charutar region in the state of Gujarat in western India has a unique topography and cultivation practises which sets it apart from the rest of the state. Due to the dearth of studies pertaining to the access of the population at this area to different types of poisons and pattern of poisoning, we planned this study to find magnitude, morbidity and mortality of poisoning with a specific consideration of gender, age and poison in contrast to the usual adopted cumulative approach. In a retrospective study, 1092 cases were identified as poisoning cases. The study revealed a higher vulnerability to poisoning in males, married individuals, during the third decade of life, from rural areas, due to accidental causes, during day time events and during the monsoon seasons. The gender specific approach clarified additional comparative data. More deaths were reported from suicidal poisoning than accidental ones. 49 specific poisons were found in the study, among which accidental snake bite poisoning, insecticidal substances and aluminium phosphide were prevalent. Aluminium phosphide and quinalphos were responsible for the highest fatalities (in terms of number of persons died). Gender predominance was observed for specific poisons. Age wise distribution of specific poisons was derived. Treatment duration and survival period for specific poisons were calculated.


Assuntos
Envenenamento/mortalidade , Acidentes/mortalidade , Adolescente , Adulto , Distribuição por Idade , Idoso , Compostos de Alumínio/envenenamento , Criança , Toxicologia Forense , Humanos , Índia/epidemiologia , Inseticidas/envenenamento , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Fosfinas/envenenamento , Estudos Retrospectivos , Fatores de Risco , População Rural/estatística & dados numéricos , Estações do Ano , Distribuição por Sexo , Mordeduras de Serpentes/mortalidade , Venenos de Serpentes/envenenamento , Suicídio/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto Jovem
3.
J Forensic Leg Med ; 66: 25-32, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31176278

RESUMO

BACKGROUND: Mortality is conditioned by biological, political and social factors, as well as by culturally defined behaviors and attitudes that historically characterize the stage of development of a country or a region. Women are often in great danger, where they should be safest. Violence against women is the most pervasive yet the least recognized human rights violation in the world. It is a profound health problem and femicide, is often the tragic end-point of violence. Females represent more than half of the Egyptian population, however, they remain vulnerable. AIM OF THE STUDY: To describe and analyze data obtained from Zeinhom Morgue records in Cairo, regarding female deaths, throughout two years. To evaluate female deaths regarding age, cause, manner of death, location, perpetrator and motive. To describe the incidence of female homicides and their related injury patterns. To identify the risk factors and nature of violence from victimologic point of view. Finally, to describe the manner of death whether natural, homicidal, suicidal or accidental aiming for early identification of vulnerable females so that actions can be taken to prevent further mortality. SUBJECTS AND METHODS: This is a national two year retrospective descriptive mortuary based study. The study population comprised of all adult females, aged 18 years and older, whose death was suspicious and medico-legal examination was ordered. Each investigation included a detailed case history, investigation, gross examination, histo-pathological and toxicological examinations. Data was collected from autopsy reports, hospital records and police records. From the available data the victim profile was made. RESULTS: All female deaths aged 18 years and older were retrospectively reviewed for 2 years at Zeinhom morgue of Medico-legal Authority from a total of 1858 autopsy cases. The most common manner of death was homicide. The commonest cause of death in homicides was due to sharp traumatic injuries. Natural death was the least common manner of death and ischemic heart disease constituted the commonest cause. Falling from height was the most common method of suicidal related deaths. Regarding poisoned cases, insecticides and carbon monoxide were the most common detected poisons. According to the cause of death (trauma), blunt trauma injuries were the most common. Falling from height constituted the largest percent of cases under this group. CONCLUSION AND RECOMMENDATIONS: Females in the third decade of life with blunt injuries to the head and neck were the majority of adult female autopsies. Homicide was the most common manner of female death using sharp instruments after domestic arguments mainly by a spouse or relative. Accidental death came second mainly due to post-operative complications. In cases of suicide, falling from height was the commonest cause followed by poisoning. These findings could be useful for forensic pathologists and healthcare promoters in predicting and preventing female deaths. Moreover, this emphasizes the need for raising public awareness about the scale of female violence problem in our society. The results of this study indicates that, by not only a strong legal support network, but also by opportunities for economic independency, essential education and awareness, alternative accommodation and a change in attitude and mindset of society, judiciary, legislature, executive, men and most importantly women themselves can lower or even prevent such deaths specially suicidal.


Assuntos
Causas de Morte , Acidentes/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Encefálicas/mortalidade , Hemorragia Cerebral/mortalidade , Criança , Egito/epidemiologia , Feminino , Medicina Legal , Homicídio/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Necrotério , Isquemia Miocárdica/mortalidade , Complicações Pós-Operatórias/mortalidade , Estudos Retrospectivos , Suicídio/estatística & dados numéricos , Ferimentos e Lesões/mortalidade , Adulto Jovem
4.
Am J Forensic Med Pathol ; 40(3): 246-250, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31205058

RESUMO

Separation of the head from the body can occur for a variety of reasons and in various locations across the neck. This study presents a review of the literature to identify the patterns of decapitations in forensic cases in relation to manner of death, age, and anatomical location (n = 88). The most common manner of death was suicide, followed by homicide and then accident. Ages ranged from 32 weeks prenatal to 85 years. Decapitation is reported at higher rates for individuals between 19 and 65. The majority of decapitations occurred at the midneck (second to fifth cervical vertebrae), followed by the upper neck and then the lower neck. This pattern holds true for all manners of death; however, in homicides, the percentage occurring at the midneck decreases. The findings of this study indicate some patterns in terms of manner of death, age, and location of decapitation, which could aid the medicolegal community in interpreting neck trauma. A case study is also briefly presented to illustrate findings.


Assuntos
Decapitação/mortalidade , Decapitação/patologia , Acidentes/mortalidade , Distribuição por Idade , Vértebras Cervicais/lesões , Vértebras Cervicais/patologia , Feminino , Patologia Legal , Homicídio/estatística & dados numéricos , Humanos , Gravidez , Lesões Pré-Natais , Suicídio/estatística & dados numéricos , Vácuo-Extração/efeitos adversos
5.
Am J Forensic Med Pathol ; 40(3): 298-301, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31246582

RESUMO

Foreign body ingestion is not uncommonly seen in children, with most such ingestions occurring between 6 months to 3 years of age. Button battery ingestion constitutes approximately 2% of all ingested foreign bodies in children. Button batteries are disc-shaped power units used for various electronic appliance, gadgets, and toys and often contain various toxic chemical substances such as heavy metal salts and alkali. Button batteries may become lodged in the upper digestive tract, producing severe damage to the adjacent tissues by various mechanisms. A death of a neonate due to a button battery lodging in the upper digestive tract leading to tracheoesophageal fistula and esophageal perforation is presented. To the best of authors' knowledge, the present case is the youngest death reported due to button battery lodgment, and the challenges of investigation in such a case are discussed.


Assuntos
Fontes de Energia Elétrica/efeitos adversos , Corpos Estranhos/patologia , Trato Gastrointestinal/patologia , Pneumonia/etiologia , Fístula Traqueoesofágica/etiologia , Acidentes , Evolução Fatal , Corpos Estranhos/complicações , Humanos , Recém-Nascido , Masculino , Pneumonia/patologia , Fístula Traqueoesofágica/patologia
6.
Artigo em Chinês | MEDLINE | ID: mdl-31177694

RESUMO

Objective: To investigate an occupational hazardous gas poisoning incident caused by gas leakage in the process of hazardous waste treatment. Methods: An investigation was conducted on a case of occupational acute hazardous gas poisoning caused by waste treatment gas leakage in Shandong province in December 2017. Meanwhile, the clinical data of 5 cases of poisoning patients were analyzed, and the accident related poison test report and other relevant data were analyzed. Results: The incident was caused by the toxic waste did not do labeling work, the workers' protection measures were not in place, the illegal operation and the blind rescue, resulting in a total of 5 people died on the spot, 12 people were hospitalized with poisoning. Among them, 5 patients admitted to our hospital showed varying degrees of damage to the nervous system and respiratory system. After active treatment, they all got better and were discharged. Conclusion: The poisoning is mainly caused by hydrogen sulfide dichloromethane hydrogen cyanide gas leakage serious production liability accident, clinical main performance for the nervous system circulatory system respiratory system and other system damage.


Assuntos
Intoxicação por Gás , Substâncias Perigosas , Acidentes , Acidentes de Trabalho , Substâncias Perigosas/envenenamento , Resíduos Perigosos , Humanos , Sulfetos
7.
Mar Pollut Bull ; 142: 290-302, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31232306

RESUMO

The potential risk to the marine environment of oil release from potentially polluting wrecks (PPW) is increasingly being acknowledged, and in some instances remediation actions have been required. However, where a PPW has been identified, there remains a great deal of uncertainty around the environmental risk it may pose. Estimating the likelihood of a wreck to release oil and the threat to marine receptors remains a challenge. In addition, removing oil from wrecks is not always cost effective, so a proactive approach is recommended to identify PPW that pose the greatest risk to sensitive marine ecosystems and local economies and communities. This paper presents a desk-based assessment approach which addresses PPW, and the risk they pose to environmental and socio-economic marine receptors, using modelled scenarios and a framework and scoring system. This approach can be used to inform proactive management options for PPW and can be applied worldwide.


Assuntos
Poluição por Petróleo , Medição de Risco/normas , Navios , Poluição Química da Água , Acidentes , Ecossistema , Monitoramento Ambiental , Água do Mar , Incerteza
8.
J Forensic Leg Med ; 65: 39-44, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31078102

RESUMO

BASE jumping, or fixed object parachuting, is a high-risk sport that has evolved significantly since its inception in the 1960s. Differences in parachute technology, teaching methods, jumping locations, practices, and popularity, among other factors, have qualitatively transformed the sport, particularly since 2000. The current study seeks to better understand how the rate of BASE jumping fatalities have changed as BASE jumping has grown. Using data from the BASE Fatality List, a resource continuously compiled by the BASE community with information on all known BASE fatalities, temporal trends in BASE fatalities that accompanied these changes over time are explored. The number of annual fatalities stayed between 0 and 5 from 1981 to 1999, but around the year 2000 began an upward trend that has continued through 2018. There appears to be large seasonal variation in monthly fatality rate, with the most deaths occurring in the northern hemisphere's summer months, the peak being in August, and the fewest deaths occurring in the northern hemisphere's winter months. The years 2013-2018 have continued the increasing fatality trend, but have otherwise deviated through increased variability in short-term and seasonal trends. Potential causes of these short-term trends, changing trends in the causes of fatal accidents, factors potentially unique to anomalous events, and directions for future research are also discussed.


Assuntos
Acidentes/mortalidade , Esportes , Bases de Dados Factuais , Humanos , Estações do Ano
9.
J Forensic Leg Med ; 65: 76-80, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31112932

RESUMO

According to World Health Organization (WHO) estimations, approximately 6 million people lose their lives yearly due to some kind of injury, while one-third of these incidents are due to violent acts. Violent deaths include accidents (road traffic accidents, drownings, falls, heat effects etc), suicides as well as homicides. Elderly people seem to be at greater risk due to their special characteristics as a vulnerable social group. The aim of this study was to investigate violent deaths (accidents, suicides and homicides) among elderly people in Attica, Greece, during the period 2011-2015 by examining manner of death with respect to demographic data (gender and age) and toxicological examination results. A total of 546 violent deaths among people over 65 years old were included in this study. Autopsy findings along with toxicological examination results were collected from the archives of the Department of Forensic Medicine and Toxicology of the National and Kapodistrian University of Athens. The findings of the study showed that most of the victims were male (63.74%). The overwhelming majority of violent deaths (425 cases) were accidents, 92 cases suicides, and the remaining 29 cases homicides. Drowning was the leading cause of all accidental deaths, followed by road traffic accidents. Hangings prevailed among violent suicide methods and asphyxiation presented as a predominant homicide method.


Assuntos
Acidentes/mortalidade , Homicídio/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Asfixia/mortalidade , Queimaduras/mortalidade , Afogamento/mortalidade , Feminino , Grécia/epidemiologia , Humanos , Masculino , Lesões do Pescoço/mortalidade , Envenenamento/mortalidade , Estudos Retrospectivos , Distribuição por Sexo , Detecção do Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/sangue , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Ferimentos não Penetrantes/mortalidade , Ferimentos Penetrantes/mortalidade
10.
Forensic Sci Int ; 300: 82-84, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31079011

RESUMO

Muscular hemorrhages around the scapula are frequently found in fatal drowning cases without injuries in the upper back at time of autopsy. The present study investigated the frequency of muscular hemorrhages around the scapula and determined the mechanism responsible for this phenomenon. Muscular hemorrhages around the scapula were found in 104 of 164 (63.4%) bodies assessed. Hemorrhage in the infraspinatus muscle was most common, followed by the supraspinatus muscle. These muscular hemorrhages were not associated with upper extremity injuries and were most frequently found in accidental drowning cases (78.7%), followed by cases of suicide (56.0%), and in natural disease prior to drowning (19.0%). We examined muscular hemorrhage around the scapula and cervical injuries that restricted the active motion of upper extremities in drowning cases. The vertebral level of cervical injuries were related to muscular hemorrhages around the scapula. These results suggested that muscular hemorrhages around the scapula were not a result of agonal convulsions but were caused by consciously active excessive motion of the upper extremities while drowning. Investigations of the muscular hemorrhages around the scapula can provide insights towards the manner of fatal drowning.


Assuntos
Afogamento/diagnóstico , Hemorragia/patologia , Músculo Esquelético/patologia , Manguito Rotador/patologia , Escápula , Acidentes , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Vértebras Cervicais/lesões , Criança , Pré-Escolar , Patologia Legal , Humanos , Masculino , Pessoa de Meia-Idade , Suicídio , Adulto Jovem
11.
Managua; s.n; may. 2019. 60 p. graf, tab.
Tese em Espanhol | LILACS | ID: biblio-1007301

RESUMO

OBJETIVO: Caracterizar los accidentes laborales del personal en el Hospital "Carlos Roberto Huembes" Managua, Nicaragua, Enero 2016 - Diciembre 2018. METODOLOGÍA: Estudio descriptivo, corte transversal, constituido por unamuestra de 119 casos, se obtuvo del registro de las hojas de Notificación de Accidentes de Trabajo (NAT) suministradas por la Dirección de Recursos Humanos. La recolección de la información se realizó a partir del llenado de ficha elaborada por la autora, con los datos de interés de las hojas NAT por cada objetivo, para el procesamiento de la información se utilizó Microsoft Word, Power Point y Excel, para cruce de variables se empleó programa estadístico SPSS versión 21. RESULTADOS: La edad de los trabajadores afectados en su mayoría fue de 26 ­ 35 años 56 casos (47%), con predominio en mujeres 83 casos (70%), siendo el personal de limpieza con 27 casos (23%) los que presentaron más accidentes. El área de mayor ocurrencia de accidentes fue la vía pública con 48 casos (40%), antigüedad en el puesto de trabajo fue menor de dos años 44 casos (37%), cumpliendo una jornada laboral de 8 horas 114 casos (96%). CONCLUSIONES: La fecha de ocurrencia fue mayor durante el primer semestre (en los meses mayo y junio), habiendo ocurrido en el turno matutino, siendo más frecuente el accidente de tipo laboral, según la forma fue por caídas al mismo nivel. El diagnóstico según la naturaleza de la lesión fue por contusiones y lesiones internas y la región anatómica más afectada fueron los miembros inferiores. La afectación según la gravedad de las lesiones fue leve con baja, con incapacidad laboral de 1 ­ 7 días


Assuntos
Humanos , Acidentes , Saúde do Trabalhador , Epidemiologia Descritiva , Estudos Transversais , Saúde do Trabalhador
12.
Wilderness Environ Med ; 30(2): 177-185, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31036376

RESUMO

INTRODUCTION: The Northern Territory is sparsely populated with a distinctive climate, geography, and wildlife compared with other states and territories in Australia. Environmental deaths (including drowning, heat-related deaths or environmental exposure, fatal animal attacks or envenomation, and lightning deaths) are reportable to the Northern Territory coroner for further investigation. METHODS: Databases of the Northern Territory coroner's office and the Royal Darwin Hospital Forensic Pathology Unit were searched to identify all environmental deaths over a 15-y period (July 1, 2003-June 30, 2018). RESULTS: A total of 4535 cases were reported to the Northern Territory coroner's office during the studied period, of which 167 (4%) were environmental deaths. Drowning was the most common type of environmental death, followed by heat-related deaths and fatal crocodile attacks. Deaths resulting from lightning and animals other than crocodiles are rare. Local resident, male victims in rural locations were the most commonly affected. Alcohol intoxication played a role in about one-third of cases, and in approximately one-third of cases a known underlying medical condition was identified. CONCLUSIONS: The Northern Territory has a challenging environment that is hot, humid, remote, and isolated. Circumstantial information and thorough police investigations are essential in the medicolegal investigation of environmental deaths.


Assuntos
Acidentes/mortalidade , Jacarés e Crocodilos , Mordeduras e Picadas/mortalidade , Adolescente , Adulto , Intoxicação Alcoólica , Animais , Afogamento/mortalidade , Feminino , Transtornos de Estresse por Calor/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Northern Territory/epidemiologia
13.
Ulus Travma Acil Cerrahi Derg ; 25(3): 303-306, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31135944

RESUMO

Emergency thoracotomy can be a life-saving procedure in critically injured patients who present with chest injuries. Currently, the indications for an on-the-scene thoracotomy are penetrating trauma of the chest or upper abdomen with cardiac arrest that has occurred in the presence of an emergency team or within 10 minutes prior to their arrival. The indications for an emergency thoracotomy in blunt chest trauma are less clearly defined. In the present case, a helicopter emergency medical service (HEMS) team performed an emergency thoracotomy at the scene. To the best of our knowledge, it is the first description of such a procedure in Poland. A 41-year-old male was crushed in a tractor accident. Though all available measures were taken, a sudden cardiac arrest occurred. The HEMS team performed an emergency thoracotomy at the scene as an integral part of prehospital cardiopulmonary arrest management. The patient survived, and was later discharged from the hospital in good physical condition. No neurological deficit was identified (cerebral performance category 1). The patient returned to his previous activities with no complications or deficits. The presence of a fully trained crew allows for the performance of a potentially critical on-the-scene emergency thoracotomy. In a well-selected group of patients with blunt thoracic injury, a prehospital emergency thoracotomy may be a significant and life-saving procedure.


Assuntos
Aeronaves , Lesões por Esmagamento/cirurgia , Serviços Médicos de Emergência/métodos , Toracotomia/métodos , Acidentes , Adulto , Humanos , Masculino
14.
Ulus Travma Acil Cerrahi Derg ; 25(3): 311-315, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31135947

RESUMO

A venous air embolism can occur as a result of circumstances that include blunt head or chest trauma, thoracentesis, arterial catheterization, neurosurgery, cardiac surgery, and Caisson disease. The formation of a venous air embolism requires an air source, interaction between the air source and the vessel, and a pressure gradient supporting air migration into the vessel. Air enters through the impaired venous structure and travels to the right side of the heart and the pulmonary arteries, and depending on the amount of air, may occasionally be fatal. This report is the description of the case of a 3-year-old child who developed a fatal venous and cerebral embolism during neurosurgery for the treatment of skull fractures with epidural and subdural bleeding due to blunt head and chest trauma resulting from a television falling on her. The pathophysiology of death and notes regarding the medico-legal autopsy procedure in such cases are discussed. Meticulous autopsy techniques must be used to determine the presence of an air embolism in cases of blunt trauma, especially in patients with blunt trauma to the head who die during neurosurgery, and possible future malpractice claims should be kept in mind.


Assuntos
Embolia Aérea , Traumatismos Cranianos Fechados , Embolia Intracraniana , Procedimentos Neurocirúrgicos/efeitos adversos , Acidentes , Pré-Escolar , Embolia Aérea/diagnóstico , Embolia Aérea/etiologia , Evolução Fatal , Feminino , Traumatismos Cranianos Fechados/complicações , Traumatismos Cranianos Fechados/cirurgia , Humanos
15.
Medicine (Baltimore) ; 98(14): e15135, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30946385

RESUMO

The purpose of this study was to determine the need of repeat follow-up computed tomography imaging in patients with renal trauma.All patients who were admitted in the trauma center of the Military Institute of Medicine with a diagnosis of kidney injury from January 2008 to December 2017 were identified. A retrospective review of all patients' medical records and radiologic imaging was conducted.Data on the following factors were collected - patients' demographics, mechanism of trauma, American Association for the Surgery of Trauma renal injury scale, injury severity score, laboratory examinations, multiorgan injuries, transfusion of fresh frozen plasma and packed red blood cells, time of surgical procedure in multiorgan injuries, length of hospital stay, and acute kidney injury.This group consisted of 37 patients with left renal injuries, 32 with right renal injuries, and 5 with bilateral renal injuries. Renal trauma due to blunt injury secondary to a motor vehicle accident was noted in 45 patients, falling from a height in 14 patients, injury from battery in 4 patients, sports-related activities in 1 patient, and other factors in 10 patients.Of the 63 patients treated conservatively due to multiorgan trauma or isolated trauma, values of morphology, serum creatinine and blood urea nitrogen, and ultrasonography in all patients did not reveal any pathological changes within earlier kidney damage.The conservative treatment of grade I-IV renal injury in the American Association for the Surgery of Trauma scale provided good outcome and only involved noninvasive ultrasonography.This study confirms that routine follow-up computed tomography imaging can be safely omitted in renal injuries graded I-IV providing that the patient remains in good clinical state.


Assuntos
Tratamento Conservador/métodos , Rim/lesões , Ferimentos não Penetrantes/diagnóstico por imagem , Acidentes/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Escala de Gravidade do Ferimento , Rim/diagnóstico por imagem , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Centros de Traumatologia/estatística & dados numéricos , Resultado do Tratamento , Ultrassonografia , Ferimentos não Penetrantes/terapia , Adulto Jovem
16.
J Forensic Leg Med ; 64: 49-51, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31003064

RESUMO

Tattoos have been previously linked to high-risk behaviours involving drug use, sexual promiscuity, mental health disorders such as depression and subsequent suicidality, aberrant personality traits including lack of sociability and reduced inhibition, psychopathy and schizophrenia. All of these have been associated with violent and early deaths. Given the recent increase in numbers of individuals being tattooed in Western communities, a retrospective study was undertaken of 100 consecutive autopsy cases with tattoos over a 5-year period from 2013 to 2017, with age and sex-matched controls. Although those with ≥5 tattoo regions were slightly younger than those with <5, 47.4 compared to 49.7 years, this did not reach statistical significance (p = 0.35). Similarly, there were no significant differences in the cause and manner of death among the groups (p = 0.09). This study has, therefore, shown no significant association between the number of tattoos and premature mortality, or between the cause and manner of death and the presence or absence of tattoos. Previous stereotypes regarding tattooed individuals may no longer apply.


Assuntos
Causas de Morte , Tatuagem/estatística & dados numéricos , Acidentes/estatística & dados numéricos , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Homicídio/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Distribuição por Sexo , Suicídio/estatística & dados numéricos , Adulto Jovem
17.
Forensic Sci Int ; 299: 1-5, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30952069

RESUMO

The presented manuscript describes the carbon monoxide (CO) related deaths in Portugal over a period of 3 years, based on autopsies carried out at the National Institute of Legal Medicine and Forensic Sciences, from January 2012 to December 2014. Three hundred and forty-seven forensic autopsy reports with carboxyhaemoglobin (COHb) analysis requests were analysed and subdivided into three main groups: (1) improbable CO intoxication; (2) possible CO intoxication; (3) highly probable CO intoxication. In group 1, COHb analysis was negative, and the death circumstances, as well as the post mortem findings, didn't corroborate an exposition to CO. In group 2, with COHb positive in 1/3 of the cases, the death circumstances corroborated an exposition to CO, but the post mortem findings weren't enough to confirm an exposition to this substance. In group 3, the results of COHb were positive, and both circumstances of death and post mortem findings corroborated an exposition to CO. The first group (113 cases) had no specific suspicion of a CO intoxication and, thus, the request of a COHb analysis had no particular basis, reflected in the low COHb achieved percentage (between 0 and 12). In the second group (164 cases), 29% of the cases were directly or indirectly related to CO exposure (between 0% and 94%). In the third group (70 cases), 56 deaths were due to CO intoxication and 14 due to burns after CO inhalation (between 18% and 91%). This study intended to do, not only a 3-year assessment of CO poisoning, but also to enhance the fact that circumstantial information, as well as a correct evaluation at the forensic autopsy data are crucial, and allow an enhanced diagnosis of possible intoxication, as well as a better guidance for the consequent toxicological analysis requests.


Assuntos
Intoxicação por Monóxido de Carbono/mortalidade , Acidentes/mortalidade , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Queimaduras/patologia , Monóxido de Carbono/sangue , Carboxihemoglobina/análise , Criança , Esôfago/patologia , Feminino , Fogo , Medicina Legal , Utensílios Domésticos , Humanos , Masculino , Pessoa de Meia-Idade , Portugal/epidemiologia , Estações do Ano , Distribuição por Sexo , Fuligem , Suicídio/estatística & dados numéricos , Emissões de Veículos , Adulto Jovem
18.
Rev Col Bras Cir ; 46(2): e2104, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31017178

RESUMO

OBJECTIVE: to investigate the main causes and most common risk situations related to childhood accidents, in our local reality. METHODS: an observational, cross-sectional, retrospective, descriptive, and analytical study from the medical records of patients attended in the pediatric emergency services of the hospital complex of Hospital das Clínicas, Botucatu Medical School - UNESP, in 2016. We included patients from zero to 15 years old who had received medical care related to accidents, determining age, gender, type of accident, period of the day, accident place, and history of previous accidents. RESULTS: considering all consultations with appropriate medical records, 936 (27.5%) were related to accidents: 588 (62.8%) in male patients and 348 (37.2%) in female patients. As to age, 490 (52.3%) happened with children from zero to five years, 245 (26.2%) with children from six to ten years, and 201 (21.5%) with children over ten years. Falls and local traumas were the most common types of accidents in all analyzed age groups. Most accidents occurred in the afternoon (46.1%), at home (60.7%), and 26.6% of the patients had a history of previous accidents. CONCLUSION: accidents were responsible for a large portion of urgent care. The high rate of patients with previous accident records indicated the repeated exposure of these children to risk situations.


Assuntos
Acidentes/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Distribuição por Idade , Brasil/epidemiologia , Criança , Maus-Tratos Infantis/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Humanos , Lactente , Masculino , Registros Médicos , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Estatísticas não Paramétricas , Centros de Atenção Terciária/estatística & dados numéricos
19.
Forensic Sci Int ; 298: 351-358, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30928775

RESUMO

For this study all autopsy reports of non-natural deaths performed at the Institute of Legal Medicine at the University of Cologne from a 10-year period (2008-2017) were examined in regards to the manner of non-natural death and their frequency and distribution of bone injuries (BI). 2026 cases (220 homicides, 421 suicides, 760 accidents, 393 possible suicides, 232 possible accidents) were reviewed. The highest frequency of BI was registered within homicides with 89.1%, second being accidents (79.3%), while suicides and poss. suicides were at 53.4% and 43.3%. Gunshots/explosions split between 52% for suicides and 33.6% for homicides, sharp force was to 56% found within homicides and with 29.8% in suicides. 63.7% of all blunt force was found in the accident category. The highest participation of BI and injuries across all body regions was found with gunshot homicides (100% BI, over every region). Intoxication showed the lowest BI over all with only 19.9% of all cases. Albeit several distinctive patterns were found, e.g. distinction between gunshots in suicides and homicides or high amount of BI in decayed corpses in homicides, a close examination on case by case basis, utilizing the forensic toolkit to its fullest, should always be attempted when examining decomposed or skeletal remains.


Assuntos
Acidentes/mortalidade , Fraturas Ósseas/patologia , Homicídio/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Alemanha/epidemiologia , Humanos , Estudos Retrospectivos , Ferimentos e Lesões
20.
Int Marit Health ; 70(1): 1-10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30931511

RESUMO

BACKGROUND: There is very limited systematic analysis of the causes and consequences of maritime accidents across the whole passenger sector during the twentieth century either in United Kingdom (UK) or in other maritime nations, but some of the larger events have been the subject of detailed investigations that led to improved safety measures. In recent years, there has been increased attention to the analysis of passenger ship accidents, especially in relation to the two now dominant markets: vehicle/passenger ferries and cruise ships. MATERIALS AND METHODS: Long-term trends since 1900 in passenger and crew deaths on UK seagoing pas- senger ships that have sustained a maritime accident, as defined by Lloyds Register, have been collated and analysed. RESULTS: Over the course of the 20th century, there has been a continuous fall in the number of incidents and in their severity. This may be a reflection of improved vessel safety, however the scale and nature of UK passenger shipping has also changed markedly over the period. CONCLUSIONS: In addition to the reducing frequency of deaths it is apparent that the majority of fatalities in both crew and passengers came from a very small number of major events during the study period. Altho- ugh there has been no major disaster involving a UK passenger ship in the last 30 years, major casualties with heavy loss of life continue in the world passenger fleet, in recent years involving flags such as Greece, Indonesia, Italy, Panama and The Philippines.


Assuntos
Acidentes/mortalidade , Navios/estatística & dados numéricos , Acidentes/estatística & dados numéricos , Acidentes de Trabalho/mortalidade , Acidentes de Trabalho/estatística & dados numéricos , História do Século XX , História do Século XXI , Humanos , Medicina Naval/estatística & dados numéricos , Reino Unido/epidemiologia
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