Forensic Significance of Skin Injury and Fracture Caused by Child Abuse.

ABSTRACT: In recent years, cases of child abuse that result in injuries and death have occurred from time to time in China, and there may be more undetected child abuse cases. However, many pediatricians and forensic doctors lack professional knowledge and formal training in detecting child abuse, which leads to the missed diagnosis, misdiagnosis and misidentification of many cases of child abuse. This paper reviews a large number of relevant domestic and foreign literatures, combined with practical work experience and China's national conditions, preliminarily summarizes the main points of clinical diagnosis and forensic identification of child abuse cases, in order to provide some help for early detection, accurate identification of child abuse cases and timely and effective treatment and protection for abused children.

Efeitos da carboxiterapia na cicatrização de feridas cutâneas / Effects of carboxiterapy in the healing of skin wounds

INTRODUÇÃO: Novas terapêuticas para as lesões de difícil cicatrização têm-se tornado necessárias e estão sendo pesquisadas. Nesse contexto, a carboxiterapia tem se destacado pelos seus efeitos sobre a microcirculação tecidual. OBJETIVO: avaliar os efeitos da carboxiterapia, infusão no tecido subcutâneo de CO2 medicinal, na cicatrização de lesões cutâneas em ratos Wistars. MATERIAIS E MÉTODOS: Trata-se de um estudo experimental e quantitativo, com uma amostra de 10 animais, divididos em grupo controle e grupo carboxiterapia. Todos os animais sofreram uma lesão com punch metálico de 5mm de diâmetro na região dorsal e, o grupo com terapia, tratado por 10 dias consecutivos. A região foi fotografada em vários momentos da pesquisa e, em seguida, as imagens foram analisadas pelo software ImageJ. RESULTADOS: Na análise descritiva dos dados o GC apresentou redução progressiva da área de 0,205±0,025 para 0,155±0,017 no 3º dia, 0,109±0,034 no 7º dia e 0,028±0,092 após o 10º dia. O GCa apresentou aumento da área de 0,198±0,040 para 0,207±0,035 no 3º dia, com redução para 0,109±0,012 no 7º dia e 0,044±0,030 após o 10 dia, demonstrando ser menos eficiente na cicatrização de feridas cutâneas do que a ausência de tratamento. CONCLUSÃO: A carboxiterapia não mostrou resultado significativo para acelerar o processo de cicatrização de lesões cutâneas na fase aguda, sugerindo esse período como não ideal para sua utilização.

INTRODUCTION: New therapies for difficult-toheal injuries have become necessary and are being researched. In this context, carboxytherapy has been highlighted by its effects on tissue microcirculation. OBJECTIVE: evaluate the effects of carboxytherapy, infusion in the subcutaneous tissue of medicinal CO2, in the healing of skin lesions in Wistars rats. MATERIALS AND METHODS: This is an experimental and quantitative study, with a sample of 10 animals divided into a control group and a carboxytherapy group. All the animals suffered a metallic punch injury of 5mm diameter in the dorsal region and the group with therapy, treated for 10 consecutive days. The region was photographed at various times of the research and then the images were analyzed by ImageJ software. RESULTS: In the descriptive analysis of the data, the CG presented a progressive reduction of the area of 0.205 ± 0.025 to 0.155 ± 0.017 on the 3rd day, 0.109 ± 0.034 on the 7th day and 0.028 ± 0.092 after the 10th day, GCa presented an area increase of 0.198 ± 0.040 for 0.207 ± 0.035 on the 3rd day, with reduction to 0.109 ± 0.012 on the 7th day and 0.044 ± 0.030 after 10 days, demonstrating to be less efficient in the healing of cutaneous wounds than the absence of treatment. CONCLUSION: Carboxitherapy did not show significant results to accelerate the healing process of cutaneous lesions in the acute phase, suggesting this period as not ideal for its use.

Analysis of risk factors of skin lesion of population exposed to arsenic via drinking water in Inner Mongolia / 中国地方病学杂志

Objective To study the risk factors of skin lesion (keratosis and abnormal skin pigmentation) of population exposed to arsenic via drinking water in Inner Mongolia.Methods A cluster sampling method was used to select 902 cases from Linhe district,Hanghou and Wuyuan county in Inner Mongolia and physical examination was done.They were interviewed for information by questionnaire.The sample of fingernails and drinking water were collected.Water arsenic (As) was analyzed by inductively coupled plasma mass spectrometry (ICPMS); fingernail As and Se content were analyzed by instrumental neutron activation analysis(INAA).Data were analyzed by univariate and multivariate non-conditional Logistic regression.Results Single factor analysis showed that risk factors of keratosis were age,pesticide,arsenic in nails,smoking,years of smoking,drinking of alcohol,arsenic content in drinking water,fluorosis and duration of drinking arsenic-containing water,while occupation,nail selenium content and vitamin were protective factors.There were 10 risk factors for pigment abnormalities,which were age,pesticide,arsenic in nails,smoking,years of smoking,numbers of cigarette smoked daily,drinking of alcohol,fluorosis,the arsenic content in drinking water and duration of drinking arseniccontaining water,while sex,occupation and nails with selenium were protective factors.The multivariate factor analysis showed that the risk factors of keratosis were age,pesticide and arsenic content in drinking water(OR =1.387,1.583,1.321,all P ＜ 0.05),while occupation and vitamin were protective factors(OR =0.307,0.260,all P ＜ 0.05).The risk factors of abnormal skin pigmentation were age,pesticide,arsenic in nails,fluorosis and arsenic content in drinking water(OR =1.724,2.636,2.741,3.699,1.863,all P ＜ 0.05),while sex was protective factor(OR =0.255,P ＜ 0.01 ).Conclusions Many factors have influence on endemic arsenism and a composite measure should be implemented to prevent it such as excluding arsenic from drinking water,health education,and a reasonably intake of nutrients.