Research Progress on Forensic Molecular Phenotyping in the Age of Precision Medicine / 法医学杂志

With the development of new technologies, such as whole genome sequencing and big data, many countries have constructed large cohorts as strategic resources for precision medicine study. Related studies have significantly promoted research progress in many fields, such as medicine and biology, creating the genetic testing industry. In the forensic field, characterization technologies for features, such as biogeographic ancestry, genetic genealogy and physical appearance have emerged and developed rapidly. Compared with traditional forensic DNA technology, the new technology can search for characteristics and provide clues, quickly becoming an important means to solve difficult cases such as cold cases and accumulated cases. This paper briefly reviews the current status of the construction of large cohorts at home and abroad, and the research progress of forensic molecular phenotyping in the context of precision medicine in the context of precision medicine.

Research Progress on Forensic Toxicology of Z-drugs / 法医学杂志

The Z-drugs (zolpidem, zopiclone, and zaleplon), as the innovative hypnotics, have an improvement over the traditional benzodiazepines in the management of insomnia. Z-drugs have significant hypnotic effects by reducing sleep latency and improving sleep quality, though duration of sleep may not be significantly increased. As benzodiazepines, Z-drugs exert their effects through increasing the transmission of γ-aminobutyric acid. Z-drugs overdose are less likely to be fatal, more likely would result in poisoning. Z-drugs can be detected in blood, urine, saliva, and other postmortem specimens through liquid chromatography-mass spectrometry techniques. Zolpidem and zaleplon exhibit significant postmortem redistribution. Z-drugs have improved pharmacokinetic profiles, but incidence of neuropsychiatric sequelae, poisoning, and death may prove to be similar to the other hypnotics. This review focuses on the pharmacology and toxicology of Z-drugs with respect to their adverse effect profile and toxicity and toxicology data in the field of forensic medicine.

Advances in Event-related Potential and Its Forensic Application Value / 法医学杂志

The event-related potential (ERP) is considered as one of the most effective methods to study and analyze objectively human mental activity based on nerve electrophysiology. At present, ERP is not only used in the study of lie detection, but also in the clinical medicine for the cognitive assessment on patients with cerebrovascular disease, dementia or traumatic brain injury and auxiliary diagnosis of mental illness. With the further development of ERP detection technology, it would have a wider application prospect in the field of forensic medicine.

O ensino da medicina legal na formação profissional da carreira jurídica / The teaching of forensic medicine in the training of the legal profession

A introdução do ensino médico-legal nos currículos de Direito, já assegura longa data e teve sua proposta relatada por Rui Barbosa e aprovada na Câmara dos Deputados, após o que o Governo brasileiro determinou a criação da cátedra de Medicina Legal nas Faculdades de Direito do país a partir de 1891. Ao longo de muitos anos foi disciplina obrigatória nos cursos de Direito transparecendo a importância da matéria na formação dos profissionais, mormente aqueles que militam na esfera criminal, mas também aplicável a, praticamente, todas as especialidades da área jurídica. A despeito da evolução das ciências forenses, que introduziram no século XXI novos horizontes da sua aplicação no contexto jurídico, ressalto ainda a própria cobrança da matéria nos concursos, para aqueles que almejam a carreira Policial. No entanto, independente da indiscutível importância da matéria, na formação acadêmica do profissional de direito, o Ministério da Educação decidiu estabelecer a Medicina Legal como disciplina optativa nos cursos de Direito. Essa medida veio ao de encontro dos interesses sociais, pois a sociedade, na busca de seus direitos, requer profissionais bem formados, com conhecimento compatível com a evolução científica. Ensinar Medicina Legal é uma árdua tarefa, pois há necessidade de valorizar mais a atividade docente e proporcionar meios para que esse ensino seja amplamente desenvolvido na formação da carreira jurídica. No presente trabalho são expostas as argumentações técnicas e pedagógicas para a manutenção de disciplina como obrigatória nos Cursos de graduação em Direito, visando, com isso, uma formação acadêmica mais completa, que corresponda a sua importante aplicação nas diversas áreas do Direito, bem como sua implantação como disciplina obrigatória nos exames de ordem da OAB.

The introduction of legal medicine teaching in the curricula of Law dates back a long time and had its proposal reported by Rui Barbosa and approved at the House of Representatives, after the Brazilian government determined the creation of the Cátedra of Forensic Medicine in the Law School from 1891.Throughout the years it was compulsory in Law course showing the importance of the subject in the formation of professionals, mainly those who work in the criminal sphere, but also applicable to all the specialties in the legal area. Regarding the evolution of the forensics science, that introduced in the XXI century new horizons in its implementation within the legal context, I would like to emphasize the importance of the subject in public contests, for those who aim the police career. However, regardless the relevance of the subject, in the academic formation of the Professional in Law, the Education Ministry decided to establish the Legal Medicine as an optional subject in Law courses. This measure has been against the social interests, since society, in search for their rights, demands well trained professionals, with knowledge compatible to the scientific evolution. Teaching legal medicine today is a hard task, since there`s more need in focusing on the teaching activity and providing means so that this teaching can be widely developed in the formation of the legal career. In this paper the technical and pedagogical arguments are shown to keep the subject as compulsory in the undergraduate course of law, and thus aiming at a more complete academic formation, portraying its important application in different areas of Law, as well as its implementation as a compulsory subject in the bar exams of OAB.

Development of clinical forensic medicine in India A need of time.

Forensic medicine is the medical specialty that is practiced at the interface with the law. It involves the assessment and interpretation in an individual who has become involved either as a suspect or victim in some form of alleged criminal action. In practice however, the role of practitioners of forensic medicine has widened to include civil jurisdictions and matters of medical ethics. Clinical Forensic Medicine is the application of forensic medical techniques to living. To address the un-met forensic needs of victims who are survivors of violent crimes and trauma there is urgent need of examination of victims of violence by a specially trained person in medicolegal matters i.e. clinical forensic physicians. In this program, the clinical forensic physicians will evaluate adult and pediatric victims of blunt and penetrating trauma, sexual and physical abuse and collect evidentiary material when indicated. In this paper the importance of Clinical Forensic Medicine Program and recommendations made by the “Survey Committee Report on Medico-Legal Practices in India, 1964” regarding its implementation are presented.

Avaliação do atendimento e percepção dos usuários do Departamento Médico-Legal de Porto Alegre / Evaluation of the Legal Medicine Department of Porto Plegre: process analysis and customer’s satisfaction

Introdução: O estudo tem delineamento transversal visa a avaliar a atividade do Departamento Médico-Legal de Porto Alegre, analisando passos e procedimentos realizados pelos usuários da Seção de Clínica Médico-Legal (análise do processo). Também objetiva avaliar a percepção do usuário do DML (satisfação do usuário). Metodologia: Foram atendidos 2.488 periciados de 1o de junho a 15 de julho de 2005, sendo pesquisados 561 indivíduos, satisfazendo cálculo da amostra. Resultados: O perfil dos periciados mostrou, em sua maioria, sexo feminino (54,9%), cor branca (78,4%), idade entre 20 e 49 anos, procedente de Porto Alegre, escolaridade até primeiro grau completo (50,7%), classes sociais C, D e E (81,4%). O fluxo de atendimento mostrou tempo médio de permanência no DML de 30 minutos, a grande maioria permanecendo menos de 60 minutos, com maior demora no período das 8 h às 16 h, quando ocorre o maior fluxo de atendimentos. Dos 561 pesquisados, 136 manifestaram-se espontaneamente em lista livre. A medida de satisfação foi positiva (regular, bom e muito bom) para 91,2% dos periciados pesquisados. Conclusão: O estudo possibilitou a identificação de indicadores de qualidade da instituição, viabilizando sua melhor qualificação e satisfação do usuário com o estudo de mudanças no processo de atendimento.

Introduction: This is a cross-sectional study designed to evaluate the performance of the Legal Medicine Department (DML) of Porto Alegre by analyzing the steps and procedures taken by users of the Medico-legal Clinic Section (process analysis). It was also intended to evaluate user’s perception of the DML (user satisfaction). Methods: There were 2.488 cases investigated from June 1st July 15th, 2005, with 561 individuals surveyed, which meets sample calculation requirements. Results: Most of the surveyed cases were females (54.9%), white (78.4%), aged between 20 and 49 years, from Porto Alegre, had an elementary school degree (50.7%) and were in social classes C, D and E (81.4%). The mean time of permanence in the DML was 30 minutes, the great majority under 60 minutes, with the longest delays from 8 a.m. to 4 p.m., when more people are being attended to. Of the 561 people surveyed, 136 manifested themselves spontaneously through free list. The satisfaction measure was positive (moderate, good and very good) for 91.2% of the respondents. Conclusion: The study allowed the identification of the quality indicators of the institution, making it viable to improve its quality as well as user satisfaction through a study of changes to the ways the service is delivered.

Virtopsy: One step forward in the field of forensic medicine - A review.

Forensic medicine aims for the documentation of medical and other forensic findings in living and deceased persons, for the police and the judiciary system. Though in other branches of the specialty, newer techniques are part of daily routine, in autopsy, the same century old techniques are still being used. Virtopsy is one step ahead in this field which literally means virtual autopsy. New methods like 3D-surface scanning and modern radiological procedures like computed tomography (CT) or magnetic resonance imaging (MRI) are becoming more and more part of scientific research in forensic sciences and are today part of the routine workflow in a some institutes of legal medicine. This paper is aimed to discuss a few points in the field of Virtopsy.

Evolution of forensic medicine in India.

Development of the mankind took millions and millions of years and along with it, medicine also developed to leap and bounds. With development of medicine, legal aspects of it also came into picture, which lead to the development of the subject Forensic Medicine or Medical Jurisprudence. Our religious and mythological literature contains the detailed description of issues related to law and medicine and there solutions.

Reconstruction: A recipe of forensic medicine.

Mostly in medicolegal cases for the purpose of investigation in the right direction it is important to know and see whether findings or injuries present over the body are consistent with the history or not. This becomes more important in certain cases like death in police custody and death in police encounter, where the integrity of law enforcing agencies is at stake and for that consistency of findings with the history given by them is important. This is only possible by meticulous examination of the body and then reconstruction of the findings, which leads to a particular outcome. And that is why it is said, that “Reconstruction of the crime is like a recipe of forensic medicine”.

Teaching, training and practice of forensic medicine in India - An overview.

Forensic medicine & Toxicology, an important and integral part of medical education, has been a silent spectator to its ups and downs in the recent past. Having had its glory at times, playing pivotal role at places in aiding criminal justice, it has unfortunately failed to sustain the impetus and its importance. Furthermore, Medical Council of India (MCI) - the national medical supreme body, has come down heavily on this specialty in general and on its curriculum in particular at the undergraduate level, pushing it down to the cross roads. The increasing legal awareness among the masses, frequent unsavory remarks on the doctors by the judiciary, bringing medical profession under the purview of the Consumer Protection Act in contrast to the decreasing of importance of the subject in the medical curriculum coupled with casual approach to the subject both by the teacher and the taught have all culminated into a situation where fate of the subject befits the words of Sir Winston Churchill, "This is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning."

Muertes por causa externa en niños. Instituto de Medicina Legal, Regional Nor-Oriente 1990-1992

El objetivo del presente trabajo es conocer la verdad, sexo, distribución mensual y diaria, mecanismo de lesión y causa de muerte de los menores de 15 años a quienes se les practicó necropsia médico legal por razón de causa externa en el Anfiteatro Municipal de Bucaramanga entre 1990 y 1992. Se revisan los protocolos de autopsia y se incluyen los casos con la información completa. Se estudiaron 170 casos, 115 varones (67.6 por ciento) y 55 mujeres (32.4 por ciento) correspondientes a 15 recién nacidos (8.8 por ciento), 12 lactantes (7.1 por ciento), 59 pre-escolares (34.7 por ciento), 47 escolares (27.6 por ciento) y 37 púberes (21.8 por ciento). Hay predominio de mujeres en los menores de 2 años y de varones en los mayores (p<0.00015), por lo que la edad promedio es menor en estas (4.7ñ 45 años) que en aquellos (7.0 ñ 4.2 años) (p<0.00143). La distribución en los tres años, a lo largo de los meses del año y de los días del mes no es uniforme, sin tendencia definida. La lesión contusa fue el mecanismo más frecuente de muerte en 91 casos (53.3 por ciento), seguido por inmersión en 20 (11.8 por ciento), quemadura en 19 (11.2 por ciento), herida con arma de fuego en 17 (19 por ciento) y sofocación en 5 casos (2.9 por ciento), siendo desconocido en diez (5.9 por ciento), todos ellos recién nacidos; las heridas por arma de fuego fueron encontradas en niños mayores (9.6ñ4.2 años), mientras que la inmersión en menores (4.9ñ3.5 años) del promedio. La causa de muerte más frecuente fue la lesión encefálica en 68 casos (40 por ciento), anoxia en 27 (15.9 por ciento), ruptura de visceras abdominales en 16 (9.4 por ciento), lesión múltiple en 14 (8.2 por ciento) y sepsis en 9 (5.3 por ciento); excluyendo los neonatos, no hay diferencia significativa en la edad según causa de muerte (p<0.26578). No hay diferencia significativa en el sexo según mecanismo de lesión y causa de muerte. Se concluye que las causas de muerte y mecanismos de lesión de origen externo en menores de 15 años son similares a los registrados en la literatura, excepto a los informes de las zonas en conflicto donde predominan las lesiones por arma de fuego

Causas de muerte en pacientes a quienes se practicó autopsia entre 1977 y 1988 en el Hospital Universitario Ramón González Valencia

El presente estudio permite conocer las causas de muerte encontradas en autopsias realizadas por el Departamento de Morfopatología de la Facultad de Salud de la Universidad Industrial de Santander (UIS) entre el 1 de enero de 1977 y el 31 de diciembre de 1988, practicadas a pacientes fallecidos en el Hospital Universitario Ramón González Valencia (HURGV) de la ciudad de Bucaramanga. Además de los datos obtenidos se presentan, como punto de comparación, los publicados a nivel nacional por el Departamento Administrativo Nacional de Estadística (DANE), regional con el Boletín Epidemiológico del servicio de Salud de Santander y local con los archivos de estadística del HURGV. Se muestran los resultados para el total de la población estudiada (1004 casos) por causa general de muerte, grupo etiológico, grupo de edad y sexo