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1.
Med. leg. Costa Rica ; 40(2)dic. 2023.
Article in Spanish | SaludCR, LILACS | ID: biblio-1514475

ABSTRACT

Resumen: En 2022 el Código Penal cubano incorporó una nueva fórmula de inimputabilidad. Este artículo aborda el problema de cómo interpretarla y aplicarla durante las pericias psiquiátricas a imputados. Es su objetivo analizar desde la Psiquiatría dicha fórmula penal para su interpretación forense. Se muestran las críticas que, en publicaciones y ámbitos académicos, fueron hechas a la anterior fórmula; así como la norma complementaria del organismo rector para su interpretación pericial. Se expone y analiza la actual fórmula, elaborada con asesoría de psiquiatras al proceso legislativo, para superar aquellas críticas, pero que, precisamente por diferente, demanda actualizar su interpretación y los métodos periciales para calificar casos acertadamente, detectar simulación y ser controlable como prueba por los jueces. Un criterio de interpretación fue elaborado por el autor y se le sometió a grupos de expertos para consensuar una propuesta final normativa, consistente en considerar pericialmente pretenso inimputable a quién actuó ilícitamente por un trastorno psicótico diagnosticado que se manifestó directamente en el delito, lo que debe quedar demostrado en el informe. En su generalidad, estos criterios pueden aplicarse a valoración de inimputabilidad según otros códigos penales.


Introduction: In 2022 a new Cuban Penal Code incorporated a new requirement of non-imputability. This article approaches to the problem of how to interpret and apply this new non-imputability formula to the psychiatric examination of defendants and has the objective of analyzing it in forensic interpretation. It shows the academic and publisher's criticism made of the previous Cuban non-imputability formula and the complementary precept of the health ministry for forensic interpretation. The new non-imputability formula, elaborated with psychiatrists' assistance during a legislative process to surpass those previous criticisms, is exposed and analyzed. This new different penal requirement put under obligation to change in forensic interpretations and methods to identify criminal non-imputability, pretenders and to be a clue controlled by judges. A new forensic interpretation criterion was elaborated and submitted to groups of psychiatrist experts, to obtain a normative proposition that considered in possible non-imputability of the person who committed the crime during a diagnosed psychotic disorder that was the certain direct determinant of the fact. The psychiatric report may show all mentioned below and, in general view, according to other penal codes, these criteria can be applied in the forensic expertise relative to non-imputability.


Subject(s)
Psychotic Disorders/diagnosis , Imputability , Mental Status Schedule , Cuba , Civil Codes
2.
Pap. psicol ; 43(3): 235-242, Sept. 2022. ilus, tab
Article in English, Spanish | IBECS | ID: ibc-212857

ABSTRACT

Antecedentes: La responsabilidad criminal de una persona con trastorno mental puede modificarse si las capacidades cognitivas y/o volitivas están alteradas. El objetivo es conocer la repercusión que los trastornos mentales tienen en la determinación de la imputabilidad en la jurisprudencia española actual. Método: Estudio descriptivo retrospectivo mediante la revisión de 360 sentencias del Tribunal Supremo entre 2015 y 2019. Resultados: Se modificó la responsabilidad en un 37.9% de los casos: 5.1% eximentes completas, 13.3% eximentes incompletas y 81.3% atenuantes. Los trastornos del espectro de la esquizofrenia y trastornos psicóticos fueron los más frecuentes en la exención completa y los trastornos de personalidad en la incompleta. Los trastornos relacionados con sustancias y trastornos adictivos fueron los más representados en la atenuación de la responsabilidad. Conclusiones: El diagnóstico de un mismo trastorno mental puede conllevar diferentes grados de imputabilidad. La adopción de medidas terapéuticas es excepcional.(AU)


Background: The criminal responsibility of a person with a mental disorder can be modified if their cognitive and/or volitional capacities are altered. The aim is to ascertain the repercussions that mental disorders have on the determination of imputability in current Spanish jurisprudence. Method: A retrospective descriptive study is presented through the review of 360 sentences of the Supreme Court from 2015 to 2019. Results: The results show that responsibility was modified in 37.9% of the cases: 5.1% complete exemptions, 13.3% incomplete exemptions, and 81.3% mitigating circumstances. The most represented disorders among the complete exemption cases were those on the schizophrenia spectrum and other psychotic disorders, and personality disorders were the most represented for incomplete exemption. Substance-related and addictive disorders were the ones most represented in responsibility attenuation. Conclusion: The diagnosis of the same mental disorder can lead to different degrees of imputability. The adoption of therapeutic measures is the exception, not the rule.(AU)


Subject(s)
Humans , Supreme Court Decisions , Mental Disorders , Criminal Psychology , Schizophrenia , Psychotic Disorders , Imputability , Forensic Psychology , Spain , Psychology , Psychology, Clinical , Psychology, Social , Retrospective Studies , Epidemiology, Descriptive
3.
Cureus ; 14(3): e23127, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35425676

ABSTRACT

Autoimmune bullous diseases (AIBDs) are a heterogeneous group of diseases characterized by cutaneous and mucosal vesicles, blisters, and erosions. Several factors can trigger this disease, including vaccines; but this entity remains very rare. We hypothesized that vaccination against coronavirus disease 2019 (COVID-19) could trigger an immunological response in genetically predisposed individuals. We report five cases of new-onset autoimmune bullous diseases triggered by the COVID-19 vaccine. Clinical and histopathological examinations confirmed the diagnosis of bullous pemphigoid (BP) in three patients and pemphigus in the other two. According to the French method of imputability, the pharmacovigilance investigation showed an I5B4 causality assessment score for the vaccines, interpreted as highly probable, for all the patients. The diagnosis of vaccine-induced autoimmune bullous dermatosis was highly suspected. One patient's condition improved by dermocorticoids alone, while the other four required oral corticosteroid therapy at 0.5 mg/kg/day, which led to a favorable outcome.

5.
Afr J Reprod Health ; 24(s1): 32-40, 2020 Jun.
Article in English | MEDLINE | ID: mdl-34077050

ABSTRACT

Except for such rare situations where it might be determined absence of physician's imputability, physicians cannot ̳save the most lives while respecting the legal rights of the patient' without violating the overarching principle ̳every human life has equal value'. Arguing to the contrary is a conscious hypocritical attitude, or in other words, a fiction. Medical law and ethics long since carry with its various fictions. Furthermore, in a public health emergency such as the current COVID-19 crisis, medical law and ethics change and shift the focus from the patient-centered model towards the public health-centered model. Under these particular circumstances, this fiction becomes striking, and it can no longer be swept under the rug. As health emergencies can happen anywhere, anytime, the patient prioritization in circumstances of limited resources should be accepted. Medical law and ethics should back away from strict commitment to placing paramount emphasis on the value of human life. It is time for medical law and ethics to leave taboo-related hypocritical attitudes, and venture to make a historic compromise. To do so, three principles should be met: subsidiarity, proportionality, and consensus and social proof.


Subject(s)
COVID-19/epidemiology , Health Care Rationing/ethics , Health Care Rationing/legislation & jurisprudence , Public Health/ethics , Public Health/legislation & jurisprudence , Humans , Pandemics , Respiration, Artificial/ethics , SARS-CoV-2 , Withholding Treatment/ethics , Withholding Treatment/legislation & jurisprudence
6.
Infection ; 48(1): 43-50, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31165445

ABSTRACT

PURPOSE: The treatment of tuberculosis is associated with a high incidence of adverse reactions with different degrees of severity. The aim of this study was to determine the incidence of adverse reactions caused by first-line anti-tuberculosis drugs and to evaluate the treatment outcome of TB patients in a large region of Morocco. METHODS: It is a multi-centric observational cohort study conducted from January 01, 2014 to January 01, 2016. A questionnaire was established for data collection from clinical charts of TB patients. The study was carried out in all the 18 centers located in the Rabat-Salé-Kénitra region of Morocco where tuberculosis is treated. Adverse reactions are evaluated from the start of TB treatment until its end by a specialist clinician. The treatment outcomes are evaluated, and the definitions and classifications of these outcomes are defined according to World Health Organization guidelines. RESULTS: Among a total number of 2532 patients treated for TB, the average age is 37.3 ± 16.4 years, 10.0% of patients produced adverse reactions. 7.4% of adverse reactions are gastrointestinal, 3.7% are cutaneous, 2.0% are hepatic, 1.14% are articular, 1.07% are immunoallergic, 0.7% are neuropsychiatric, and 0.1% are ocular. The treatment outcome of TB patients is 79.1% rate for successful treatment and 15.6% for unsuccessful treatment. CONCLUSION: Adverse reactions caused by anti-TB drugs are frequent among patients with TB. These ADRs must be followed up by a closer monitoring during anti-TB treatment period. Treatment success outcome in our study is slightly lower than the success rate target of WHO of at least 85%.


Subject(s)
Antitubercular Agents/therapeutic use , Drug-Related Side Effects and Adverse Reactions/epidemiology , Tuberculosis, Pulmonary/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Cohort Studies , Drug-Related Side Effects and Adverse Reactions/etiology , Female , Humans , Incidence , Male , Middle Aged , Morocco/epidemiology , Treatment Outcome , Young Adult
7.
Therapie ; 74(3): 347-354, 2019 Jun.
Article in French | MEDLINE | ID: mdl-30173896

ABSTRACT

INTRODUCTION: Drug-induced vasculitis is reported in almost 10-20 % of vasculitis. Several drugs may be incriminated in their occurrence. Our study aimed to study the epidemiological, clinical, histopathological and evolutionary characteristics of drug-indced vasculitis from a series of cases and to specify the different drugs involved. METHODS: We conducted a retrospective study during the period from January 2006 to December 2015 from the cases notified to the regional pharmacovigilance center of Sousse, Tunisia. The diagnosis was established according to the criteria proposed by the group of the American college of rheumatology (ACR). RESULTS: Our study included thirteen cases of drug-induced vasculitis over a ten-year period, with an mean incidence of 1.3 new cases per year. Mean age of patients was 40.84 years. The mean delay from the treatment onset was 14.46 days with extremes ranging from 5 days to six weeks. Most patients had pure skin involvement. Association with other extracutaneous complaints was present in five cases. Cutaneous biopsy was performed in all patients showing a pathological pattern of leukocytoclastic vasculitis, associated with fibrinoid necrosis, extravasation of red blood cells and allergic capillaritis. The outcome was favorable for all patients. The offending drugs in our series were amoxicillin, pristinamycin, rifampicin, fluconazole, metformin, glimepiride, phenobarbital, gabapentin, fenofibrate, ibuprofen, allopurinol, rituximab and tinzaparin. CONCLUSION: Anamnestic, clinical, biological and histopathological findings allow the early recognition of drug-induced vasculitis. Adequate treatment prevents systemic spreading and a worse prognosis.


Subject(s)
Drug-Related Side Effects and Adverse Reactions/epidemiology , Vasculitis, Leukocytoclastic, Cutaneous/chemically induced , Vasculitis/chemically induced , Adolescent , Adult , Aged , Drug-Related Side Effects and Adverse Reactions/diagnosis , Female , Humans , Incidence , Male , Middle Aged , Pharmacovigilance , Retrospective Studies , Tunisia , Vasculitis/diagnosis , Vasculitis/epidemiology , Vasculitis, Leukocytoclastic, Cutaneous/diagnosis , Vasculitis, Leukocytoclastic, Cutaneous/epidemiology , Young Adult
8.
Br J Clin Pharmacol ; 85(3): 570-579, 2019 03.
Article in English | MEDLINE | ID: mdl-30511379

ABSTRACT

AIMS: Linear immunoglobin A (IgA) bullous dermatosis is a rare autoimmune dermatosis considered spontaneous or drug-induced (DILAD). We assessed all DILAD cases, determined the imputability score of drugs and highlighted suspected drugs. METHODS: Data for patients with DILAD were collected retrospectively from the French Pharmacovigilance network (from 1985 to 2017) and from physicians involved in the Bullous Diseases French Study Group and the French Investigators for Skin Adverse Reactions to Drugs. Drug causality was systematically determined by the French imputability method. RESULTS: Of the 69 patients, 42% had mucous membrane involvement, 20% lesions mimicking toxic epidermal necrolysis (TEN), 21% eosinophil infiltrates and 10% keratinocytes necrosis. Direct immunofluorescence, in 80%, showed isolated linear IgA deposits. Vancomycin (VCM) was suspected in 39 cases (57%), 11 had TEN-like lesions, as compared with three without VCM suspected. Among the 33 patients with a single suspected drug, 85% had an intrinsic imputability score of I4. Among them, enoxaparin, minocycline and vibramycin were previously unpublished. For all patients, the suspect drug was withdrawn; 15 did not receive any treatment. First-line therapy for 31 patients was topical steroids. Among the 60 patients with available follow-up, 52 achieved remission, 10 without treatment. Four patients experienced relapse, four died and five had positive accidental rechallenges. CONCLUSIONS: There is no major clinical difference between DILAD and idiopathic linear IgA bullous dermatosis, but the former features a higher prevalence of patients mimicking TEN. VCM, suspected in more than half of the cases, might be responsible for more severe clinical presentations. We report three new putative drugs.


Subject(s)
Drug Monitoring/statistics & numerical data , Linear IgA Bullous Dermatosis/epidemiology , Pharmacovigilance , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Databases, Factual/statistics & numerical data , Diagnosis, Differential , Doxycycline/adverse effects , Enoxaparin/adverse effects , Female , France/epidemiology , Humans , Linear IgA Bullous Dermatosis/chemically induced , Linear IgA Bullous Dermatosis/diagnosis , Male , Middle Aged , Minocycline/adverse effects , Prevalence , Retrospective Studies , Severity of Illness Index , Stevens-Johnson Syndrome/diagnosis , Vancomycin/adverse effects , Young Adult
9.
Ann Dermatol Venereol ; 145(6-7): 395-404, 2018.
Article in French | MEDLINE | ID: mdl-29792286

ABSTRACT

AIM: Our aim was to assess the prevalence of adverse effects (AEs) pertaining to the use and withdrawal of hydroxychloroquine (HCQ) in dermatological outpatients. PATIENTS AND METHODS: We conducted a retrospective study between January 2013 and June 2014 that included consecutive patients currently or previously receiving HCQ seen in our department. AEs were collated using a standardized questionnaire and validated by clinical and laboratory examination. Drug causality was evaluated using the updated French drug reaction causality assessment method. The main evaluation criterion was the prevalence of AEs in which HCQ had an intrinsic imputability score of I>2. RESULTS: We included 102 patients (93 of whom were women, with a median age of 44.5; range: 22-90years). HCQ was given for cutaneous lupus in most cases (n=70). At least one AE was reported for 55 patients. Among the 91 reported AEs, 59 (65%) had an HCQ intrinsic imputability score I>2. AEs were responsible for permanent HCQ discontinuation in 19 cases. Of these, 8 were unrelated to HCQ based on imputability score. The most common AEs associated with HCQ were gastrointestinal and cutaneous signs. Of the 8 patients diagnosed with retinopathy, only 3 were confirmed after reevaluation. CONCLUSION: AEs associated with HCQ were reported for over 50% of patients and were responsible for permanent HCQ discontinuation in one-third of cases. A more in-depth evaluation of imputability seems necessary, particularly regarding ophthalmological symptoms, since in two thirds of cases the reasons for discontinuation were not related to HCQ.


Subject(s)
Hydroxychloroquine/adverse effects , Skin Diseases/drug therapy , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies , Young Adult
10.
Rev. habanera cienc. méd ; 17(1): 73-79, ene.-feb. 2018. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-901800

ABSTRACT

Introducción: El trastorno esquizotípico se manifiesta desde edades tempranas como un patrón general de déficit social e interpersonal, comportamiento excéntrico, capacidad reducida para las relaciones personales y distorsiones cognoscitivas, incomprensibles psicológicamente. Objetivo: Fundamentar la responsabilidad médico-legal de un caso de trastorno esquizotípico que cometió homicidio. Presentación de caso: Individuo de 22 años, soltero, sin hijos, técnico medio, sin historia de trastornos mentales que es peritado por psiquiatría forense debido a que agredió a su abuelo materno con un arma blanca, y causó la muerte. Se le realizó examen psiquiátrico, se aplicó la Escala de Valoración de Impulsividad, se realizó electroencefalograma y valoración psicológica, que incluyó la aplicación de las pruebas proyectivas Bender, Machover y Rorschach. El diagnóstico propuesto por el equipo evaluador fue trastorno esquizotípico, sin enajenación mental. Conclusiones: El trastorno esquizotípico no es un diagnóstico frecuente en Psiquiatría. Cuando se involucra en conductas delictivas, estas ocurren en solitario y suelen estar relacionadas con agresiones hacia otras personas. Es determinante de semi-imputatibilidad o imputabilidad y no se recomienda su permanencia en régimen penitenciario(AU)


Introduction: Schizotypical disorder appears at very early ages as a general pattern of social and interpersonal deficit; eccentric behavior; reduced capacity to maintain personal relations; and cognitive distortions, which are psychologically inexplicable. Objective: To establish the medico-legal implications in a case of schizotypical personality disorder that committed homicide. Case presentation: A 22 years old individual, single, without children, technician, without history of mental disorders who is studied by Forensic Psychiatry because he attacked his maternal grandfather with a knife, which caused his death. Psychiatric examination was done; the Impulsiveness Scale was applied; and an enlectroencephalogram (EEG) and a psychological evaluation were carried out, which included Bender, Machover, and Rorschach tests. The evaluating staff made the diagnosis of Schizotypical disorder, without mental derangement. Conclusions: Schizotypical disorder is not a frequent diagnosis in Psychiatry. When it is involved in criminal behaviors, they occur in isolation and they are usually related to attacks to other persons. It is a determinant condition of semi-imputability or imputability. Prison system is not recommended(AU)


Subject(s)
Humans , Male , Adult , Schizotypal Personality Disorder/complications , Schizotypal Personality Disorder/diagnosis , Forensic Psychiatry/ethics , Imputability , Criminal Behavior/ethics , Homicide/psychology
11.
Pan Afr Med J ; 28: 277, 2017.
Article in French | MEDLINE | ID: mdl-29942411

ABSTRACT

Post-traumatic anterior pituitary insufficiency (PTAPI) is a rare but established disease caused by ischemic lesions after severe cranial trauma. This case study aims to highlight the criteria for imputability of PTAPI to a cranial trauma as well as the specific principles of legal redress in relation to this disease. We conducted a forensic study of a patient with diagnosed PTAPI followed up in the Division of Endocrinology and Legal Medicine at the University Hospital, Sousse (Tunisia). The patient included in the study was a 45-year old woman with no particular past medical history. (6 gynaecological procedures, 4 parities and 2 abortions) having regular menstrual cycles, without a history of hemorrhagic childbirth, who had been involved in a road accident (pedestrian got hit by a car) causing occipital trauma without initial knowledge loss. She developed hypothyroidism three years after the accident. The hormonal assessment showed the involvement of all the other axes. Neuroradiological examination objectified pituitary gland and pituitary stalk integrity. The definitive diagnosis of PTAPI was made. Medical examination (performed 4 years after the accident) concluded that PTAPI was imputable to the accident. Permanent partial disability rate according to ordinary law has been assessed at 25%. PTAPI diagnosis is made by elimination. The evaluation of physical injury should be based on residual symptoms, on therapeutic constraints and on its impact on daily and professional activity. Patient's evolution under hormone replacement therapy is often favorable, however, complications may occur, hence the necessity to establish these complications in order to preserve the right of the patient to underwent new treatments.


Subject(s)
Accidents, Traffic/legislation & jurisprudence , Craniocerebral Trauma/complications , Hypopituitarism/etiology , Disability Evaluation , Female , Hormone Replacement Therapy , Humans , Hypopituitarism/diagnosis , Hypothyroidism/etiology , Middle Aged , Time Factors , Tunisia
12.
Therapie ; 71(2): 179-86, 2016 Apr.
Article in English, French | MEDLINE | ID: mdl-27080836

ABSTRACT

The methods for causality assessment of adverse drug reactions were developed in the 1970s and 1980s, alongside the development of pharmacovigilance. The French method is one of the earlier of these, following on from the pioneering works by Irey and Karch and Lasagna. Initially published in 1978, it was updated in 1985, and again in 2011. The main alterations to the original method are presented in tables annexed to this paper. The successive versions improved the presentation, provided more formalised definitions of the criteria for assessing causality, while at the same time ensuring the method remained easy to use. Causality assessment enables the causal link between a drug and the occurrence of an adverse reaction to be formalised and explained. It contributes to diagnosis, and to determining the action to be taken in case of an adverse drug reaction. It can contribute to the quality and the relevance of the data stored in pharmacovigilance databases.


Subject(s)
Adverse Drug Reaction Reporting Systems , Drug-Related Side Effects and Adverse Reactions/etiology , Pharmacovigilance , Causality , Databases, Factual , Drug-Related Side Effects and Adverse Reactions/diagnosis , France , Humans
13.
J Clin Diagn Res ; 10(11): EE05-EE09, 2016 Nov.
Article in English | MEDLINE | ID: mdl-28050389

ABSTRACT

Haemovigilance is an organised scheme of monitoring, identifying, reporting, investigating and analysing adverse events and reactions pertinent to transfusion and manufacturing blood products. This system is also an elemental part of quality control in a blood system, bringing about corrective and preventive measures, and for the perpetual advancement of the quality and safety of blood products and the transfusion process. Nowadays haemovigilance setups have been enforced throughout the globe in most developed countries, to monitor the adverse reactions and episodes associated with blood donations and transfusions. Indian Pharmacopoeia Commission has started a Haemovigilance Program of India (HvPI) in 2012 under its Pharmacovigilance Program of India (PvPI) in collaboration with National Institute of Biologicals, Noida, Uttar Pradesh, under Ministry of Health and Family welfare, Government of India with a primary objective to track adverse reactions/events and incidences associated with blood transfusion and blood product administration and to identify trends, recommend best practices and interventions required to improve patient care and safety. This review article is a detail update of current scenario of haemovigilance in India.

14.
Rev Med Liege ; 71(10): 435-439, 2016 Oct.
Article in French | MEDLINE | ID: mdl-28383851

ABSTRACT

Cutaneous drug eruptions are frequently encoun¬tered. Their putative diagnosis is based on a set of imputability arguments. The histopathological aspect is often suggestive of the dermatosis nature, and varies according to the type of drug reaction. Some drug eruptions follow a benign course, but others including the toxic epidermal necrolysis are severe and life-threatening. It corresponds to a dermatological emer¬gency to be managed in a specialized burn unit.


Les toxidermies sont des réactions médicamenteuses cutanées indésirables. Elles représentent des pathologies fré¬quentes dont le diagnostic de présomption est fondé sur un faisceau d'arguments structurés. L'aspect histopathologique est souvent évocateur, et il est diversifié en fonction de la nature de la toxidermie. Certaines toxidermies ont un décours indolent et d'autres, comme la nécrolyse épidermique toxique, grèvent de manière sévère le pronostic vital. Il s'agit d'une urgence dermatologique à prendre en charge dans une unité de soins spécialisée pour les grands brûlés.


Subject(s)
Drug Eruptions/diagnosis , Emergencies , Stevens-Johnson Syndrome/diagnosis , Algorithms , Diagnosis, Differential , Drug Eruptions/therapy , Humans , Iatrogenic Disease , Stevens-Johnson Syndrome/therapy
16.
Immunol Allergy Clin North Am ; 34(3): 461-71, vii, 2014 Aug.
Article in English | MEDLINE | ID: mdl-25017672

ABSTRACT

Poorly documented and often self-reported drug hypersensitivity (DH) is a frequent problem in daily clinical practice and has a considerable impact on prescription choices. Little is known about the natural history of true DH. The suspicion of DH starts on clinical grounds. When assessing a patient with a presumed DH reaction in the symptomatic phase, it is mandatory to look for severity signs and, after doing so, to update the risk/benefit balance of exploring the suspected drug(s) on a case-by-case basis. With the help of allergy tests and a careful approach, a firm diagnosis is often possible.


Subject(s)
Drug Hypersensitivity/diagnosis , Comorbidity , Desensitization, Immunologic , Disease Management , Drug Hypersensitivity/etiology , Drug Hypersensitivity/therapy , Humans , Pharmacovigilance , Risk Factors , Severity of Illness Index , Skin Tests
17.
J Forensic Leg Med ; 20(7): 861-6, 2013 Oct.
Article in English | MEDLINE | ID: mdl-24112337

ABSTRACT

Chronological age (CA) plays a fundamental role in forensic dentistry (i.e. personal identification and evaluation of imputability). Even though several studies outlined the association between biological and chronological age, there is still great variability in the estimates. The aim of this study was to determine the possible correlation between biological and CA age through the use of two new radiographic indexes (Oro-Cervical Radiographic Simplified Score - OCRSS and Oro-Cervical Radiographic Simplified Score Without Wisdom Teeth - OCRSSWWT) that are based on the oro-cervical area. Sixty Italian Caucasian individuals were divided into 3 groups according to their CA: Group 1: CAG 1 = 8-14 yr; Group 2: CAG 2 = 14-18 yr; Group 3: CAG 3 = 18-25 yr; panorexes and standardised cephalograms were evaluated according Demirjian's Method for dental age calculation (DM), Cervical Vertebral Maturation method for skeletal age calculation (CVMS) and Third Molar Development for age estimation (TMD). The stages of each method were simplified in order to generate OCRSS, which summarized the simplified scores of the three methods, and OCRSSWWT, which summarized the simplified DM and CVMS scores. There was a significant correlation between OCRSS and CAGs (Slope = 0.954, p < 0.001, R-squared = 0.79) and between OCRSSWWT and CAGs (Slope = 0.863, p < 0.001, R-squared = 0.776). Even though the indexes, especially OCRSS, appear to be highly reliable, growth variability among individuals can deeply influence the anatomical changes from childhood to adulthood. A multi-disciplinary approach that considers many different biomarkers could help make radiological age determination more reliable when it is used to predict CA.


Subject(s)
Age Determination by Skeleton/methods , Age Determination by Teeth/methods , Cervical Vertebrae/diagnostic imaging , Molar, Third/diagnostic imaging , Tooth/diagnostic imaging , Adolescent , Adult , Cervical Vertebrae/growth & development , Child , Female , Forensic Anthropology , Forensic Dentistry , Humans , Italy , Linear Models , Male , Models, Biological , Molar, Third/growth & development , Odontometry , Pilot Projects , Retrospective Studies , Tooth/growth & development , White People , Young Adult
18.
ROBRAC ; 22(60)jan.-mar. 2013. tab, ilus
Article in Portuguese | LILACS | ID: lil-681405

ABSTRACT

Objetivo: a estimativa da idade em indivíduos vivos, com finalidade legal, reveste-se de complexidade e necessita de uma abordagem multidisciplinar para determinar um intervalo de tempo confiável para a idade cronológica do periciando. Objetivou-se relatar um caso de estimativa de idade no vivo em um indivíduo que alegou ter menos de 18 anos (idade de maior idade legal), a despeito de documentos oficiais apontarem o contrário. Relato de caso: indivíduo do sexo masculino, detido por prática criminosa executada em 21/01/2010 foi encaminhado para perícia odonto legal para exame de estimativa de idade. Durante aidentificação do indiciado, apresentou certidão que exibia data de nascimento de 05/04/1991, tendo 18 anos e 10 meses quando cometeu o crime. Porém, alegou ser menor de idade, tendo nascido em 12/07/1992, possuindo, então, a idade de 17 anos e 6meses na data do delito. A alegação de menoridade sustentava--se no fato de seu registro teria sido incorreto, com erro na data de nascimento. Realizados exames intraoral e radiográfico panorâmico constatou-se maioria de dentes hígidos e presentes. À análise do desenvolvimento dentário por quatro metodologias diferentes ao exame radiográfico carpal por outras seis metodologias,constatou-se que os caracteres de desenvolvimento ematuração óssea eram incompatíveis com indivíduo maior de18 anos. Baseado na análise pericial, a sentença judicial determinou a imputabilidade legal baseado na legislação aplicável a menores de idade, a despeito de documentos oficiais apontarem o contrário, destacando a importância do exame pericial para estimativa de idade no vivo, com finalidade de determinação de imputabilidade legal.


Objective: age estimation of live individuals with legal purposes is complex and requires a multidisciplinary approach to determine a reliable time interval for the examined person. Objective was to report a case of age estimation in live individual who claimed to be younger than 18 years (age of legal majority), in spite of official documents state otherwise. Case report: a male, arrested for criminal practice perpetrated on 01/21/2010 was sent for forensic examination to forensic dental age estimation. During the identification of the suspect, it was presented a birth certificate dating of 04/05/1991, wich therefore indicated age of 18 years and 10 months when crime was commited. However, suspect claimed to be a minor, having been born on 07/12/1992, therefore being 17 years and 6 months old at the time of the offense. The claim of minority based in the fact that his record would have been done incorrectly, with a mistake on the date of birth. Intraoral and orthopantomographic radiological exams showed up most of teeth present and sound. Analysis of dental development by four different methodologies and radiographic examinationcarpal bones by six other methodologies, pointed out that developmentaland maturation features were incompatible with an individual older than 18 years. Based on forensic analysis, the court of law determined legal liability of the suspect based upon legislation applicable to minors, despite official documents that suggested otherwise, highlighting the importanceof expert examination to estimate age in live individuals, when determining legal liability of suspects.

19.
Psicol. ciênc. prof ; 33(3): 656-671, 2013. ilus, tab
Article in Portuguese | Index Psychology - journals | ID: psi-63367

ABSTRACT

O projeto de redução da maioridade penal no Brasil encontra-se em adiantado processo de tramitação no Congresso Nacional. Apresentamos aqui o estudo das representações sociais dos parlamentares brasileiros responsáveis pelos rumos da maioridade penal no País. Trata-se de pesquisa documental que visa a analisar a consistência jurídica e psicossocial dos argumentos favoráveis e contrários à redução da maioridade penal presentes nos documentos em trâmite legislativo na Câmara dos Deputados e no Senado Federal. Os dados foram tratados e analisados com a ajuda do software ALCESTE, e os resultados revelam que as representações sociais dos parlamentares favoráveis à redução da maioridade penal se coadunam com aquelas do discurso do antigo Código de Menores, e que os adolescentes brasileiros se encontram em sério risco de perderem os direitos conquistados historicamente.(AU)


The project of reducing the full legal age in Brazil is in an advanced process in the National Congress. This is a study of the social representations of Brazilian legislators responsible for the decisions on legal age in the country. This documentary research aims to analyze the consistency of psychosocial and legal arguments for and against the reduction of the full legal age found in the documents that are processed at the Legislative Chamber of Deputies and Senate. Data were processed and analyzed using the software ALCESTE, and the results showed that the social representations of parliamentaries that are in favor of reducing the full legal age are consistent with those of the former Code for Minors and that Brazilian adolescents are at serious risk of losing their historically acquired rights.(AU)


El proyecto de reducción de la mayoría de edad penal en Brasil se encuentra en adelantado proceso de tramitación en el Congreso Nacional. Presentamos el estudio de las representaciones sociales de los parlamentarios brasileros responsables por los rumbos de la mayoría de edad penal en el país. Se trata de un estudio documental que busca analizar la consistencia jurídica y psicosocial de los argumentos favorables y contrarios a la reducción de la mayoría de edad penal presentes en los documentos en trámite legislativo en la Cámara de los Diputados y en el Senado Federal. Los datos fueron tratados y analizados con la ayuda del software ALCESTE. Los resultados revelan que las representaciones sociales de los parlamentarios favorables a la reducción de la mayoría de edad penal se relacionan a aquellas del discurso del antiguo Código de Menores y que los adolescentes brasileros se encuentran en serio riesgo de perder sus derechos conquistados históricamente.(AU)


Subject(s)
Male , Female , Adolescent , Adolescent , Imputability , Human Rights , Federal Government , Criminal Liability , Legislation as Topic , Dehumanization , Social Marginalization , Socialization
20.
Psicol. ciênc. prof ; 33(3): 656-671, 2013. ilus, tab
Article in Portuguese | LILACS | ID: lil-690144

ABSTRACT

O projeto de redução da maioridade penal no Brasil encontra-se em adiantado processo de tramitação no Congresso Nacional. Apresentamos aqui o estudo das representações sociais dos parlamentares brasileiros responsáveis pelos rumos da maioridade penal no País. Trata-se de pesquisa documental que visa a analisar a consistência jurídica e psicossocial dos argumentos favoráveis e contrários à redução da maioridade penal presentes nos documentos em trâmite legislativo na Câmara dos Deputados e no Senado Federal. Os dados foram tratados e analisados com a ajuda do software ALCESTE, e os resultados revelam que as representações sociais dos parlamentares favoráveis à redução da maioridade penal se coadunam com aquelas do discurso do antigo Código de Menores, e que os adolescentes brasileiros se encontram em sério risco de perderem os direitos conquistados historicamente.


The project of reducing the full legal age in Brazil is in an advanced process in the National Congress. This is a study of the social representations of Brazilian legislators responsible for the decisions on legal age in the country. This documentary research aims to analyze the consistency of psychosocial and legal arguments for and against the reduction of the full legal age found in the documents that are processed at the Legislative Chamber of Deputies and Senate. Data were processed and analyzed using the software ALCESTE, and the results showed that the social representations of parliamentaries that are in favor of reducing the full legal age are consistent with those of the former Code for Minors and that Brazilian adolescents are at serious risk of losing their historically acquired rights.


El proyecto de reducción de la mayoría de edad penal en Brasil se encuentra en adelantado proceso de tramitación en el Congreso Nacional. Presentamos el estudio de las representaciones sociales de los parlamentarios brasileros responsables por los rumbos de la mayoría de edad penal en el país. Se trata de un estudio documental que busca analizar la consistencia jurídica y psicosocial de los argumentos favorables y contrarios a la reducción de la mayoría de edad penal presentes en los documentos en trámite legislativo en la Cámara de los Diputados y en el Senado Federal. Los datos fueron tratados y analizados con la ayuda del software ALCESTE. Los resultados revelan que las representaciones sociales de los parlamentarios favorables a la reducción de la mayoría de edad penal se relacionan a aquellas del discurso del antiguo Código de Menores y que los adolescentes brasileros se encuentran en serio riesgo de perder sus derechos conquistados históricamente.


Subject(s)
Male , Female , Adolescent , Adolescent , Criminal Liability , Federal Government , Human Rights , Imputability , Dehumanization , Legislation as Topic , Social Marginalization , Socialization
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