• 文章类型: Journal Article
    一些研究已经评估了蝶鞍(ST)的正常性参数,这对于面对可能影响这种结构的不同颅面综合征很重要。因此,这项研究总结了关于ST在非综合征个体性别估计中的作用的科学证据.研究方案已注册(前瞻性国际注册系统审查#CRD42021256469),然后在六个数据库中进行电子搜索(PubMed,LILACS,WebofScience,Scopus,EMBASE,和LIVIVO)和灰色文学(谷歌学者和OpenGrey)。线性元分析(宽度,长度,高度,和直径)和体积测量,除了对偏见风险(RoB)和证据确定性的评估之外,被执行了。经过986篇文章的筛选,13人通过荟萃分析进行了评估(男性1307人,女性1231人)。在亚组分析中,女性的宽度值较低(横向X光片;-0.67mm;P=0.040),长度(计算机断层扫描;-0.23mm;P=0.020),与男性相比,直径(计算机断层扫描;-0.27mm;P<0.001)。身高差异无统计学意义(P=0.95),面积(P=0.72),和体积(P=0.21)。大多数研究显示适度的RoB,结果证据的确定性非常低。在这次审查中,在ST的长度和直径方面,性别之间存在显着差异;但是,必须考虑研究的异质性。
    来自不同地理区域的研究根据性别评估了ST的形态,并将这种解剖结构作为二态性的重要指标。Meta分析显示女性ST长度和直径较短。亚组分析发现,根据侧颅X光片,女性的ST宽度较低。亚组分析根据CT扫描发现女性的长度和直径较小。
    Several studies have evaluated the parameters of normality of the sella turcica (ST), which is important to face different craniofacial syndromes that may affect this structure. Therefore, this research summarized the scientific evidence on the role of ST in the sex estimation of non-syndromic individuals. The research protocol was registered (Prospective International Registry of Systematic Reviews # CRD42021256469), followed by an electronic search in six databases (PubMed, LILACS, Web of Science, Scopus, EMBASE, and LIVIVO) and gray literature (Google Scholar and OpenGrey). Meta-analysis of linear (width, length, height, and diameter) and volumetric measurements, in addition to an assessment of risk of bias (RoB) and certainty of evidence, were performed. After the screening of 986 articles, 13 were evaluated by meta-analysis (1 307 males and 1 231 females). In subgroup analysis, females had lower values for width (lateral radiograph; -0.67 mm; P = 0.040), length (computed tomography; -0.23 mm; P = 0.020), and diameter (computed tomography; -0.27 mm; P < 0.001) compared to males. There was no statistically significant difference regarding height (P = 0.95), area (P = 0.72), and volume (P = 0.21). Most studies exhibited moderate RoB, and the certainty of evidence of the outcomes was very low. In this review, significant differences were observed between the sexes for the length and diameter of the ST; however, the heterogeneity of the studies must be considered.
    UNASSIGNED: Studies from different geographic regions evaluated the morphology of ST according to sex and showed this anatomical structure as an important indicator of dimorphism.Meta-analysis showed shorter ST length and diameter in women.Subgroup analysis found lower ST width in women based on lateral skull radiographs.Subgroup analysis found smaller lengths and diameters in women based on CT scans.
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  • 文章类型: Journal Article
    法医化学通过应用分析技术来分析证据,在协助执法调查中起着至关重要的作用。虽然犯罪现场经常遇到血迹,区分外周和经血是一个挑战。这是由于它们在干燥后的相似外观。拉曼光谱已经成为一种有前途的技术,能够区分两种类型的血迹,提供无价的证明性信息。此外,估计血迹沉积(TSD)后的时间有助于犯罪现场重建,并优先考虑收集哪些证据。尽管广泛的研究集中在TSD估计上,主要在外周血迹中,在确定经血的TSD时存在一个关键的差距。这项研究证明了拉曼光谱如何有效地分析月经血等生物样本,显示出与外周血相似的衰老模式,并提供了用于确定月经血TSD的概念验证模型。虽然这项工作在创建血迹年龄确定的通用模型方面显示了有希望的结果,在将该方法应用于法医实践之前,需要对更多的捐助者进行进一步的测试。
    Forensic chemistry plays a crucial role in aiding law enforcement investigations by applying analytical techniques for the analysis of evidence. While bloodstains are frequently encountered at crime scenes, distinguishing between peripheral and menstrual bloodstains presents a challenge. This is due to their similar appearance post-drying. Raman spectroscopy has emerged as a promising technique capable of discriminating between the two types of bloodstains, offering invaluable probative information. Moreover, estimating the time since deposition (TSD) of bloodstains aids in crime scene reconstruction and prioritizing what evidence to collect. Despite extensive research focusing on TSD estimations, primarily in peripheral bloodstains, a crucial gap exists in determining the TSD of menstrual bloodstains. This study demonstrates how Raman spectroscopy effectively analyzes biological samples like menstrual blood, showing similar aging patterns to those of peripheral blood and provides proof-of-concept models for determining the TSD of menstrual blood. While this work shows promising results for creating a universal model for bloodstain age determination, further testing with more donors needs to be conducted before the implementation of this method into forensic practice.
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  • 文章类型: Journal Article
    本研究通过调查在医疗机构工作的韩国放射技师的观念和经验,评估了放射技师对法医学和法医放射学教育的需求。对参与者进行了结构化问卷,收集,并分析。结果表明,尽管经常收到法医案件,由于缺乏对法医方面的认识和知识,韩国放射技师在对法医放射学采取适当措施方面面临困难。参与者表示,法医学和法医放射学的大学教育是必要的。因此,必须制定和实施法医教育计划的政策,以提高放射技师的法医知识和能力。大学应开设法医放射学课程,并为在这一领域工作的放射技师提供继续教育。
    This study assesses the need for education in forensic medicine and forensic radiology among radiographers by investigating the perceptions and experiences of Korean radiographers working in medical institutions. A structured questionnaire was administered to participants, collected, and analyzed. The results showed that despite receiving frequent forensic cases, Korean radiographers face difficulties in taking appropriate measures about forensic radiology due to a lack of awareness and knowledge of its forensic aspects. The participants indicated that university education in forensic medicine and forensic radiology is necessary. Therefore, it is imperative to develop and implement policies for forensic education programs to enhance radiographers\' forensic knowledge and capabilities. Universities should conduct courses on forensic radiology and provide continuing education for radiographers working in this field.
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  • 文章类型: Journal Article
    这项研究旨在检查日本自杀死亡的法医信息对自杀流行病学研究的有用性,并确定导致有自杀意念的人在试图自杀之前寻求精神病治疗的因素。
    我们关注的是2019年在大阪市发生的514例自杀死亡的法医信息。首先,为了检查这项研究中使用的数据是否可以推广到这些病例,我们将大阪官方公布的自杀死亡信息与本研究中使用的信息进行了比较,利用皮尔逊χ2检验。接下来,我们使用多因素logistic回归分析法医学数据,以确认人口学因素与自杀前有精神病会诊史的可能性之间的关系.
    这项研究中使用的官方信息和数据都表明,死于自杀的男性人数高于女性,数据集之间的值没有显着差异。多因素logistic回归分析显示显著相关。更多的女性与寻求精神病咨询有关。然而,那些有固定工作或学生的人更有可能避免精神病咨询。
    这项研究的发现通过使用法医的观点来提供对自杀死亡现象的见解。这项研究的结果表明,精神病咨询可以有效减少自杀死亡。应将法医数据纳入日本预防自杀政策的制定中,以进行更多方面的分析并改善自杀预防措施。
    UNASSIGNED: This study aimed to examine the usefulness of forensic information on suicide deaths in Japan for epidemiological studies on suicide and determine the factors that lead people with suicidal ideation to seek psychiatric care prior to attempting suicide.
    UNASSIGNED: We focused on forensic information of 514 suicide deaths that occurred in Osaka City in 2019. First, to examine whether the data used in this study can be generalized to these cases, we compared the information on suicide deaths officially published by Osaka City with that used in this study, utilizing Pearson\'s χ 2 test. Next, the forensic data were analyzed using multivariate logistic regression analysis to confirm the relationship between demographic factors and the likelihood of having a history of psychiatric consultation before suicide.
    UNASSIGNED: Both the official information and the data used in this study showed a higher number of males than females who died by suicide, with no significant differences in values between the data sets. Multivariate logistic regression analysis showed significant correlations. More females were associated with seeking a psychiatric consultation. However, those with regular jobs or students were more likely to avoid a psychiatric consultation.
    UNASSIGNED: The findings of this study provide insights into the phenomenon of suicide deaths by using a forensic perspective. The results of this study suggest that psychiatric consultation may be effective in reducing deaths by suicide. Forensic data should be incorporated into the formulation of suicide-prevention policies in Japan to conduct a more multifaceted analysis and improve suicide-prevention measures.
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  • 文章类型: Journal Article
    准确测量和记录病变的长度或面积会影响法医报告的判断,外科伤口管理和,在一些国家,医疗保健服务的账单。这项研究的目的是确定医生通过估计描述的病变的长度和面积是否准确。
    这项研究被设计为一项横断面描述性研究,并与OndokuzMayüs大学的494名参与者一起进行,参与者包括内科医生和内科医生,医学院。要求参与者在不使用测量仪器的情况下,以问卷形式估计6种不同形状的长度或面积。
    在参与者中,216名(43.7%)是实习医师,278名(56.3%)是医师。大多数122人(24.7%)回答长度为4厘米的曲线形状为“精确值”。内科医生对每个形状给出的值的平均值高于医生对每个形状给出的值的平均值,并且发现离真实值更远。确定超过一半的参与者给出的值高于形状的实际长度和面积值。观察到,无论是精确值还是±10%的误差范围,线形的正确估计率都高于面积形状的正确估计率。对于线条形状,据观察,给出精确值的人数随着线长的增加而减少。
    在准备法医报告时,确定手术伤口管理和计费,估计数据不应用于病变描述。开发使医生能够在易于使用方面进行测量的工具也将是有用的。
    UNASSIGNED: Accurately measuring and recording the length or area of lesions affects the judgement of the forensic report, surgical wound management and, in some countries, the billing of health care services. The aim of this study was to determine whether the length and area of lesions described by physicians by estimation are accurate.
    UNASSIGNED: This study was designed as a cross-sectional descriptive study and was conducted with 494 participants consisting of internists and physicians at Ondokuz Mayıs University, Faculty of Medicine. The participants were asked to estimate the lengths or areas of 6 different shapes in the questionnaire form without using a measuring instrument.
    UNASSIGNED: Of the participants, 216 (43.7%) were interned physicians and 278 (56.3%) were physicians. Most 122 people (24.7%) answered the curved line shape with a length of 4 cm as \"exact value\". The average of the values given by the internists to each shape was higher than the average of the values given by the physicians to each shape and was found to be further away from the true value. It was determined that more than half of the participants gave values above the actual length and area values of the shapes. It was observed that the rate of correct estimation of line shapes was higher than the rate of correct estimation of area shapes both as exact values and with ±10% margin of error. For line shapes, it was observed that the number of those who gave exact values decreased as the line length increased.
    UNASSIGNED: When preparing forensic reports, determining surgical wound management and billing, estimated data should not be used in lesion description. It would also be useful to develop tools that will enable physicians to make measurements in terms of easy use.
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  • 文章类型: Journal Article
    目的:玻璃体液(VH)用于死后生化研究,因为即使在死亡后也能在未污染的状态下得到很好的保护。这项研究的目的是调查有或没有玻璃体切割手术史的人眼中VH中的电解质浓度。
    方法:我们分析了钠(Na),钾(K),来自34名患者的34个VH样品的氯化物(Cl)和镁(Mg)浓度。11个样本来自有玻璃体切除术史的眼睛,其余23只眼无玻璃体切除术史。Na的相关性,K,Cl和Mg浓度随患者年龄的变化,第一次和第二次玻璃体切除术之间的间隔,还评估了晶状体状态(白内障手术史).
    结果:Na,K,玻璃体切除眼的VH中的Cl和Mg浓度为134.1±7.9mmol/L,3.7±0.2mmol/L,99.7±6.7mmol/L和0.59±0.09mmol/L,分别;均显着低于对照组眼中VH中的相应浓度(降低5.0%,11.0%,11.7%,和22.6%,分别)。Na,K,玻璃体切除眼的VH中的Cl和Mg浓度与患者年龄或第一次和第二次玻璃体切除之间的间隔没有显着相关性。Na、K,有晶状体眼和人工晶状体植入眼之间VH中的Cl和Mg浓度。
    结论:随着玻璃体切除术数量的增加,在法医检查中使用受试者的VH时,有必要考虑玻璃体切除术的病史。
    OBJECTIVE: Vitreous humor (VH) is used for postmortem biochemical studies because it is well protected in an uncontaminated state even after death. The goal of this research was to investigate electrolyte concentrations in the VH from human eyes with and without a history of vitrectomy surgery.
    METHODS: We analyzed the sodium (Na), potassium (K), chloride (Cl) and magnesium (Mg) concentrations from 34 VH samples from 34 patients. Eleven samples were from eyes with a history of vitrectomy, and the remaining 23 eyes had no history of vitrectomy. The correlations of Na, K, Cl and Mg concentrations with patient age, interval between first and second vitrectomy, and lens status (history of cataract surgery) were also evaluated.
    RESULTS: The Na, K, Cl and Mg concentrations in VH from vitrectomized eyes were 134.1 ± 7.9 mmol/L, 3.7 ± 0.2 mmol/L, 99.7 ± 6.7 mmol/L and 0.59 ± 0.09 mmol/L, respectively; all were significantly lower than the corresponding concentrations in VH from control eyes (lower by 5.0%, 11.0%, 11.7%, and 22.6%, respectively). Na, K, Cl and Mg concentrations in VH from vitrectomized eyes did not show significant correlations with patient ages or the interval between their first and second vitrectomies. There were no significant differences in Na, K, Cl and Mg concentrations in VH between phakic eyes and intraocular lens-implanted eyes.
    CONCLUSIONS: With the increasing number of vitrectomies being performed, it is necessary to consider the history of vitrectomy when using a subject\'s VH in forensic examination.
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  • 文章类型: Journal Article
    在美国,体检医师和验尸官(MEC)在我们的公共卫生和公共安全系统中扮演着重要角色。这些专业人员主要负责确定死亡原因和死亡方式,因为他们调查死亡并应对相关场景和大规模死亡,还可以通过法医学死亡调查帮助确定公共卫生危机的趋势。尽管他们发挥了重要作用,它们被组织在不同的系统中,具有不同的治理结构,功能,人员配备,案件量,预算,和获取资源。本文研究了2018年体检医师和验尸官人口普查的数据,以评估美国MEC的运营情况。调查结果表明,MEC办事处的组织和运营治理结构极大地影响了资源,工作负载,以及获取信息和服务。独立的MEC办公室通常比与执法部门有联系的办公室资源更好,公共卫生,法医学,地方检察官,或其他机构1.
    In the United States, medical examiners and coroners (MECs) fill critical roles within our public health and public safety systems. These professionals are primarily charged with determining the cause and manner of death as they investigate deaths and respond to associated scenes and mass fatalities and can also help identify trends in public health crises through medicolegal death investigations. Despite their instrumental role, they are organized in disparate systems with varying governing structures, functions, staffing, caseload, budget, and access to resources. This paper examines data from the 2018 Census of Medical Examiner and Coroners to evaluate MEC operations in the United States. The findings show that MEC offices\' organizational and operational governance structures greatly influence resources, workloads, and access to information and services. Standalone MEC offices were generally better resourced than those affiliated with law enforcement, public health, forensic science, district attorneys, or other agencies.1.
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  • 文章类型: Journal Article
    自从世界卫生组织(世卫组织)总干事宣布COVID-19为大流行以来,这是艰难的一年。包括马来西亚在内的许多国家一直在努力采取紧急和积极的措施来提供建议,检测,屏幕,test,隔离和治疗他们的公民,以抗击病毒。所有国家都必须在保护健康之间取得平衡,尽量减少经济和社会混乱,同时,维护人权,包括有尊严和尊重地管理死者。自2020年2月爆发以来,马来西亚国家法医学研究所(IPFN)一直在积极与各机构共同努力,以确保所有COVID-19和非COVID-19病例的死亡管理顺利进行。这符合该国有关感染预防和控制的所有现有准则和法规。然而,大流行期间出现的新情况总是充满挑战和动态。COVID-19危机揭示了围绕法医学兄弟会边缘的过多问题。因此,本文重点介绍了IPFN遇到的各种新出现的问题,以及如何通过良好的领导来解决这些问题,以指导和指导马来西亚COVID-19感染呈指数增长期间的运营和活动。在提供死者的管理方面,最重要的是要指出,即使在疫情爆发时,也需要强调人道主义方面,以关闭家庭并有机会哀悼亲人。
    It has been a difficult year ahead since the announcement of COVID-19 as a pandemic by the Director General of the World Health Organization (WHO). Many countries including Malaysia have struggled to take urgent and aggressive measures to advise, detect, screen, test, isolate and treat their citizens in order to fight against the virus. All countries must strike a balance between protecting health, minimizing economic and social disruption and at the same time, preserving human rights which includes managing the dead with dignity and respect. The National Institute of Forensic Medicine (IPFN) Malaysia has been proactively engaging the various agencies involved in a concerted effort to ensure smooth flow in the management of the dead for all COVID-19 and non-COVID-19 cases since the beginning of the outbreak in February 2020. This is in accordance with all existing guidelines and regulations vis-a-vis infection prevention and control in the country. However, new situations that arise during the pandemic are always challenging and dynamic. The COVID-19 crisis has uncovered a plethora of issues surrounding the margin of the Forensic Medicine fraternity. Therefore, this article highlights various emerging issues encountered by the IPFN and how they are resolved through good leadership to guide and direct operations and activities during the exponential rise of COVID-19 infection in Malaysia. In the provision of the management of the dead, it is of utmost importance to note that the humanitarian aspect needs to be emphasized even in times of an outbreak to give closure to the family and the opportunity to mourn their loved ones.
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  • 文章类型: Review
    暂无摘要。
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  • 文章类型: Journal Article
    过敏反应是一种罕见但众所周知的猝死原因,尽管来自过敏性死亡的法医尸检数据有限。在这里,2009年至2019年上海一系列过敏性死亡的回顾性研究,中国,是为了调查人口统计,medical,和致命过敏反应的法医病理学特征,以提高法医学对过敏性死亡的认识。在这项研究中登记了62例过敏性死亡的尸检病例。男性占多数(74.2%),女性占多数(25.8%),平均年龄38.8岁.药物(98.4%),特别是抗生素(72.6%),是过敏反应最常见的原因,44例(71.0%)发生在无证临床医生非法管理的诊所。53例患者的过敏性症状在几分钟内开始至不到1小时。呼吸困难(56.5%)和突然休克(46.8%)是最常见的临床体征。30例(48.4%)过敏反应导致1h内死亡。喉水肿和多组织嗜酸性粒细胞浸润(85.5%)是最常见的尸检结果。其次是肺水肿和充血(24.2%),它们被认为是非特异性的,但具有启发性。合并症主要为心血管疾病(33.9%),肺炎(8.1%)和哮喘(8.1%)。62例患者中有11例检测血清IgE,范围从43.3到591IU/ml,被切断作为一个有用的标记。因此,我们建议对过敏原暴露进行彻底分析,目前诊断过敏性死亡需要有临床病史和尸检结果.
    Anaphylaxis is a rare but well-known cause of sudden unexpected death, although data from forensic autopsies in anaphylactic deaths are limited. Herein, a retrospective study of a series of allergic deaths from 2009 through 2019 in Shanghai, China, was conducted to investigate the demographic, medical, and forensic pathological characteristics of fatal anaphylaxis to improve medicolegal understanding on anaphylactic death. Sixty-two autopsy cases of anaphylactic death were registered in this study. Males dominated the cases (74.2%) against females (25.8%), with an average age of 38.8 years. Medications (98.4%), particularly antibiotics (72.6%), were the most frequent cause of anaphylaxis, and 44 cases (71.0%) occurred in clinics administered illegally by unlicensed clinicians. The anaphylactic symptoms began within a few minutes to less than 1 h in 53 cases, with dyspnea (56.5%) and sudden shock (46.8%) being the most common clinical signs. Thirty cases (48.4%) of anaphylaxis resulted in death within 1 h. Laryngeal edema and multiple tissue eosinophil infiltration (85.5%) were the most prevalent autopsy findings, followed by pulmonary edema and congestion (24.2%), which were considered to be non-specific but suggestive. The comorbidities were mainly cardiovascular disease (33.9%), pneumonia (8.1%) and asthma (8.1%). Serum IgE were measured in 11 of 62 cases, ranging from 43.3 to 591 IU/ml, severed as a helpful marker. Therefore, we suggested a thorough analysis of allergen exposure, clinical history and autopsy findings is required for the diagnosis of anaphylactic death currently.
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