Intimate Partner Sexual Violence: An Exploratory Study on Sexual Victimization Profiles Among Survivors of Intimate Partner Violence in France.

Intimate partner sexual violence (IPSV) is a common form of intimate partner violence (IPV). This study aimed to (a) identify a typology of intimate partner sexual victimization among French women victims of IPV on the basis of the frequency of various forms of sexual violence and (b) evaluate whether these profiles differ in several clinical characteristics. A total of 93 women consulting a specialized hospital service were recruited. Cluster analyses suggested four profiles: highly frequent rapes (5.4%), predominant sexual coercion (20.4%), medium frequency of all forms (20.4%), and low frequency of all forms (19.4%). Further person-centered research focusing on IPSV is warranted.

Pro-active drug-facilitated crimes (DFC): a study in the Department of Forensic Medicine of Paris, France.

INTRODUCTION: Proactive drug facilitated crime (DFC) is the administration of psychoactive substances (PAS) for criminal purposes without the victim's knowledge or by force. In Paris, France, patients who report suspected proactive DFC to the police are examined at the Department of Forensic Medicine (DFM) of the Hôtel-Dieu Hospital. Preventively blood and urine samples are collected but not systematically analyzed by the judicial authority. We aimed to assess the proportion of probable proactive DFC in patients examined at the Hôtel-Dieu DFM following a police report for suspected proactive DFC. METHOD: Blood and urine samples were collected from 100 patients. Toxicological analyses were performed by the toxicology laboratory of the Lariboisière Hospital. The results were correlated with the clinical data collected at the initial and follow-up consultations. RESULTS: At least one PAS was detected in 86% of the cases (voluntary or involuntary intake). After correlation with clinical data, 32% of the cases were classified as probable proactive DFC. In these cases, 49% of the substances identified were illicit substances (amphetamines, MDMA, etc.); 16% were benzodiazepines and related substances; 16% were antihistamines and sedatives; 14% were opioids; and 5% were antidepressants and anti-epileptics. In 90% of the cases, patients reported a voluntary ethanol consumption in the hours prior to the suspected proactive DFC. CONCLUSION: Toxicological analyses revealed a high proportion of both probable proactive DFC and probable opportunistic DFC. Our results indicate the need to perform systematical toxicological analysis in cases of suspected DFC.

Assessment of 19 years of a prospective national survey on drug-facilitated crimes in France.

Drug facilitated-crime or chemical submission (DFC/CS) is defined as the concealed or forced administration of psychoactive substances to a victim for criminal purposes. This is a national program set up in the early 2000 s in the form of a prospective multicenter survey, the results of which this manuscript presents. Over this 19-year period, 5487 cases were collected, analyzed and classified into 54 % of suspected cases, 29 % of chemical vulnerability (CV) cases and 17 % of proven DFC/CS cases. In the overall data, the most prevalent victims were female (81 %), with an average age of 27 years. Sexual assault was the most frequent aggression (77 %), followed by theft (14 %). Victims of proven DFC/CS cases were from of all ages including children and elderly. In 934 victims of DFC/CS, 100 various psychoactive substances were detected mostly represented by benzodiazepines and z-drugs (55 %), various sedatives including antihistamines (16 %) and non-therapeutic substances (16 %). Gamma-hydroxybutyric acid (GHB) was found in 4 % cases. In CV cases, alcohol (90 %) and cannabis (32 %) intake were mainly involved. In France, despite prevention messages, DFC/CS has been an epidemic for many years and has been proven by our national study. This national program has the aim to identifying the substances used but unfortunately not the goal to fight against this phenomenon. Since 2009, we observed a new modus operandi of the aggressors who pose as taxi drivers facilitating the reception of the victims leaving nightclubs. We can emphasize that GHB is not the "date rape drug" but rather the benzodiazepine class is.

Male Victims of Rape: An Observational Study over Four Years in Paris, France.

Sexual violence is a common and under-reported form of violence that affects all categories of individuals. We sought to provide epidemiological data on men aged 15 years and over, victims of rape or suspecting a rape, and who reported it to the police. We conducted a retrospective study at the Department of Forensic Medicine of Hôtel-Dieu, Paris, France, between 2018 and 2021. Two-hundred men were included in the study, with an average age of 28.8 years. A vulnerability was mentioned for 17.5% of them. Most of the patients reported anal penetration, committed by a single male assailant, whom they met on the day of the assault. More than 60% of the patients reported the voluntary consumption of alcohol and/or illicit substances prior to the assault. Most patients were examined shortly after the assault (median 1 day). Anal lesions were found on examination in 37.0% of patients reporting anal penetration regardless of the time frame. The presence of anal lesions was statistically higher when patients were examined within 48 h. Our results reinforce the data in the literature on the risk factors associated with sexual violence among men, notably the consumption of alcohol and illicit substances, and psychological, economic, and social vulnerability.

Body packing, body stuffing and body pushing: Characteristics and pitfalls on low-dose CT.

Because of availability and low radiation dose level, low dose computed tomography (CT) is now commonly used to identify illicit in corpore drug transportation. This review illustrates the most common CT findings of in corpore drug transportation and describes complications due to in corpore drug transportation, with a special emphasis on low dose CT. Major information such as number of packets, exact location and aspect of packets must be assessed. Radiologist must be aware of the imaging characteristics of "in corpore" illicit drug transportation, and should know situations that may alter drug smugglers management.

Emerging issues related to the management of patients in custody during the COVID-19 outbreak in France.

PURPOSE: This paper aims to give an overview of emerging issues relating to the management of patients in custody during the COVID-19 outbreak in France. DESIGN/METHODOLOGY/APPROACH: During custody in France, a medical consultation is provided for any patient who requests it. In the Paris area, this consultation is carried out by a practitioner in forensic medicine, based in a general hospital. Usually, most medical consultations for patients in custody take place directly in police stations. With the COVID-19 outbreak, the authors chose to suspend this activity, asking law enforcement to bring patients directly to their hospitals. Patients presenting with severe infections or indicative symptoms of the severe acute respiratory syndrome Coronavirus 2 infection and a comorbidity are tested for COVID-19. Such patients remain hospitalized until results of the test are received. If the result is positive, they are hospitalized for the length of their custody. If sent to prison, they are transferred to a medical facility in detention. FINDINGS: From the onset of the outbreak, the authors observed increased pressure from law enforcement to obtain medical information. According to the French Code of Medical Ethics, no medical information should be disclosed regarding the authors' patients' medical situations. The authors are also concerned about sending a potentially infected patient back to a police station, to prison or to his/her home. ORIGINALITY/VALUE: This paper provides a snapshot of issues relating to the management of patients in custody during the COVID-19 outbreak in France. Unfortunately, the current situation in France does not permit a wider range of testing for the specified population in this paper.

Management of the COVID-19 epidemic in a French immigration detention center.

PURPOSE: The purpose of this paper is to give an overview of management of the COVID-19 epidemic in a French immigration detention center. DESIGN/METHODOLOGY/APPROACH: During containment in France because of COVID-19, the judicial authorities had to deal with the risk of contamination within immigration detention centers (IDC). In the Paris IDC, which can usually receive up to 240 individuals, measures have been taken to limit the risk of contamination by releasing individuals without prior judicial conviction and testing the others by a nasal swab. FINDINGS: The test was done for all the present individuals (48), except two who refused. Eight tests (17.4%) were positive and only one was symptomatic. Individuals testing positive for COVID-19 were transferred into COVID-centers specially created during this health crisis. ORIGINALITY/VALUE: Management of the COVID-19 epidemic in this French IDC illustrates the necessity of good cooperation between judicial authorities and medical teams in charge of those centers and the difficulty of balancing public health actions with state security.

[Population of people placed in police custody, hidden barometer of diverted medicines]. / La population des personnes placées en garde à vue à Paris, baromètre du détournement invisible des médicaments.

PURPOSE OF THE STUDY: The population of people in police custody is a sentinel niche that is poorly represented in the "usual panels" of public health studies. The aim is to make an overview of their diversion of drugs. PATIENTS AND METHODS: A retrospective study based on cases of misuse in a sample of people in custody examined between 2015 and 2016 at the forensic medicine unit of the hospital Hôtel-Dieu-Paris. RESULTS: Of the 5149 medical examinations, 302 were for substance use disorder or drug misuse. In 2016, the number of notifications for misuse of clonazepam increased (n=65); the user population appears to be getting younger (average age=23.5 years) and to be supplied mainly by deal (63%). Regarding opioid substitution treatments, the indicators of abuse and diversion are confirmed, while morphine sulfate stands out with a strong deal (>75%), IV injection (62%) and polydrug use, including methadone, cocaine (62%). CONCLUSION: From our results, national surveys in general population and studies carried out in the context of deprivation of liberty, people in police custody constitute a real barometer of the parallel market for street drugs. Clinical impacts can be major; a better monitoring is needed. For caregivers, it is also a matter of better identification of misuse, substance use disorder for a future orientation of the patient.

The attack on November 13, 2015: organisation of the medico-judicial unit of the Hôtel-Dieu Hospital in Paris.

The main aims of a medico-judicial unit are to ensure the examination of assault victims or persons in custody and to perform sampling necessary for investigations. Forensic examination is essential to describe the wounds and to evaluate the consequences of an assault by determining days of total incapacity for work (ITT). After the Paris attack on November 13, 2015, 121 victims were examined at the medico-judicial units of Paris. An initial forensic certificate was issued by forensic physicians with an assessment of physical ITT. A consultation with a forensic psychiatrist was systematically scheduled on the same day to obtain a forensic certificate for the psychological ITT. The average age of the victims was (33 ± 7) years and the sex ratio was 1.26. Most victims were in the Bataclan concert hall (78/121 or 64.5%). Of the 121 victims, 73 (60.3%) had projectile lesions (bullets, bolts and nuts, metal fragments, etc.) and 48 (39.7%) had non-projectile lesions (bruises, hematomas, etc.). The average physical ITT was 27 days (0; 190). The evaluation of the number of days of physical ITT was often complicated as some patients were still in medical care at the time of the initial examination. This experience enabled the Paris medico-judicial unit to anticipate the management required should any future event of this magnitude occur. It also reinforced cooperation between the medico-judicial unit and other departments, mostly emergency services and the forensic psychiatric unit. The Paris medico-judicial unit was thus able to offer a unique place of care by providing both physical and psychological examinations.

[Medical certificates, determination of the total work incapacity, and elementary traumatic injuries]. / Certificats médicaux, incapacité totale de travail et lésions élémentaires traumatiques.

Medical certificates, determination of the total work incapacity, and elementary traumatic injuries. The drafting of medical certificates is an essential act in the practice of every doctor. Its importance on the medico- legal level obliges us to write these certificates in an applied and rigorous way. In the case of assault and battery, the doctor must issue an initial medical certificate describing all the medical findings. The judicial authority will require a forensic doctor from a Forensic Unit to determine the total incapacity to work, a period during which the patient is unable to carry out all the gestures of daily life independently.

Certificats médicaux, incapacité totale de travail et lésions élémentaires traumatiques. La rédaction des certificats médicaux est un acte essentiel dans la pratique de chaque médecin. Son importance sur le plan médico-légal implique une rédaction appliquée et rigoureuse. En cas de coups et blessures, le médecin doit réaliser un certificat médical initial descriptif de l'ensemble des lésions élémentaires constatées cliniquement ainsi que leur retentissement fonctionnel. L'autorité judiciaire requerra un médecin légiste d'une unité médico- judiciaire pour déterminer une incapacité totale de travail, période pendant laquelle le patient est dans l'incapacité de réaliser tous les gestes de la vie quotidienne de manière autonome.