Spanish Journal of Legal Medicine最新文献_第10页

Litigation in cardiology and cardiovascular surgery: A cross-sectional observational study of liability in the Spanish public healthcare system 心脏病学和心血管外科诉讼:西班牙公共医疗保健系统责任的横断面观察研究

Spanish Journal of Legal Medicine Pub Date : 2022-10-01 DOI: 10.1016/j.remle.2022.10.001

Mónica Hernández-Herrero , Joaquin Cayón-De Las Cuevas

{"title":"Litigation in cardiology and cardiovascular surgery: A cross-sectional observational study of liability in the Spanish public healthcare system","authors":"Mónica Hernández-Herrero , Joaquin Cayón-De Las Cuevas","doi":"10.1016/j.remle.2022.10.001","DOIUrl":"10.1016/j.remle.2022.10.001","url":null,"abstract":"<div><h3>Introduction</h3><p>The overestimation by physicians of the risk of a lawsuit has, among other consequences, the stepped-up of defensive medicine. To analyse the characteristics of medical liability rulings in Spain in public health<span><span> care in the specialties of cardiology and </span>cardiovascular surgery.</span></p></div><div><h3>Materials and methods</h3><p>Cross-sectional observational study analysing the rulings handed down in the contentious-administrative jurisdiction by the High Courts of Justice in the period 2008–2020, in the specialties of cardiology and cardiovascular surgery. The variables were administrative, clinical, judicial, and compensatory.</p></div><div><h3>Results</h3><p>A total of 1015 rulings were analysed; 47 (4.63%) involved to the specialties of cardiology and cardiovascular surgery. Both obtained similar frequency percentages, cardiology 22 (2.2%) and cardiovascular surgery 25 (2.5%). A total of 74.1% of the rulings were dismissed in the first instance and 75% in the second instance. The 2 grounds for finding against the defendent were loss of chance 6 (42.85%) and diagnostic and/or therapeutic malpractice 5 (35.71%). Damages were usually claimed: death 21 (44.68%) and sequelae 26 (55.32%). The median award was 30 000 euros.</p></div><div><h3>Conclusions</h3><p>The low frequency of claims in cardiology and cardiovascular surgery indicates that these are \"low risk\" specialties for litigation. The vast majority of the rulings are, moreover, dismissive of the patients' claims. The data help to structure the role of lawsuits and to increase professionals' knowledge of the medical–legal dimension of health care.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"48 4","pages":"Pages 136-143"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76022818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Knowledge of legal dentistry and of health regulations by the dentists and stomatologists of the Valencian Community 瓦伦西亚社区的牙医和口腔医生对法律牙科和卫生条例的了解

Spanish Journal of Legal Medicine Pub Date : 2022-10-01 DOI: 10.1016/j.remle.2021.09.003

Martina Sánchez Gisbert , Marina Gisbert Grifo , Chirag C. Sheth

{"title":"Knowledge of legal dentistry and of health regulations by the dentists and stomatologists of the Valencian Community","authors":"Martina Sánchez Gisbert , Marina Gisbert Grifo , Chirag C. Sheth","doi":"10.1016/j.remle.2021.09.003","DOIUrl":"10.1016/j.remle.2021.09.003","url":null,"abstract":"<div><h3>Objectives</h3><p>The main objective of this study is to analyze the knowledge of the dentists and stomatologists registered in Alicante, Castellón, and Valencia, the 3 provinces that make up the Valencian Community, in Spain, with regard to legal dentistry and the current health legislation and regulations, and to quantify the relationship between level of training, specialization, work experience, position, and workplace with the degree of knowledge.</p></div><div><h3>Material and methods</h3><p>An anonymous survey was designed and validated, consisting of 33 multiple-choice questions. The survey included questions regarding their professional profile and key questions regarding current dental law, forensic science, and expertise.</p></div><div><h3>Results</h3><p>The level of knowledge is moderate, with only 63% of the questions answered correctly. Neither their level of training nor work experience correlates significantly with their degree of knowledge. Dentists specialized in General and Aesthetics Dentistry were found to be more knowledgeable about ethical issues. Regarding the workplace, those working as university teachers tended to stand out from the other professionals in terms of legal and ethical knowledge whilst self-employed and employee dentists show a lower level of knowledge than the rest of the sample.</p></div><div><h3>Conclusions</h3><p>The conclusions obtained from this study highlight the need for dentists to complete and update their knowledge of legal dentistry and current health legislation, as having proper knowledge is a means of avoiding possible legal problems, which not only means better legal protection for the dentist but is also a means of guaranteeing adequate patient care.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"48 4","pages":"Pages 151-157"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77083791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medico legal study of the organic law of the regulation of euthanasia in Spain compared to the rest of the countries that regulate euthanasia and / or assisted suicide 与其他规范安乐死和/或协助自杀的国家相比，西班牙安乐死法规的有机法律的医学法律研究

Spanish Journal of Legal Medicine Pub Date : 2022-10-01 DOI: 10.1016/j.remle.2022.01.006

Mercedes Martínez-León, Jorge Feijoo Velaz, Daniel Queipo Burón, Camino Martínez-León

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The hospital of today. The Oporto consensus 今天的医院。波尔图共识

Spanish Journal of Legal Medicine Pub Date : 2022-08-31 DOI: 10.24875/sjmed.22000003

J. Díez-Manglano, João Araújo-Correia, R. Gómez-Huelgas, Lélita Santos, M. Chimeno-Viñas, Luís Duarte-Costa, M. Martín-Escalante, Jorge Crespo, L. Manzano-Espinosa, Luís Campos, J. Barreto, J. Carretero-Gómez

引用次数: 0

Etiological differential diagnosis of the acute subdural hematoma in pediatric age 小儿急性硬膜下血肿的病因鉴别诊断

Spanish Journal of Legal Medicine Pub Date : 2022-07-01 DOI: 10.1016/j.remle.2021.12.001

Glòria Cabrera Borotau , Ignasi Galtés

引用次数: 0

Inter-observer variability of the traffic rate system (law 35/2015) and utility of biomechanical tests in the assessment of sequels 交通速率系统的观察者间可变性(第35/2015号法律)和生物力学测试在后续评估中的应用

Spanish Journal of Legal Medicine Pub Date : 2022-07-01 DOI: 10.1016/j.remle.2021.12.002

Cristina Herrera Ligero , María José Vivas Broseta , Carmen Ferrer Gómez , Helios de Rosario Martínez , Elvira Garrido-Lestache López-Belmonte , Ignacio Bermejo Ruiz

{"title":"Inter-observer variability of the traffic rate system (law 35/2015) and utility of biomechanical tests in the assessment of sequels","authors":"Cristina Herrera Ligero , María José Vivas Broseta , Carmen Ferrer Gómez , Helios de Rosario Martínez , Elvira Garrido-Lestache López-Belmonte , Ignacio Bermejo Ruiz","doi":"10.1016/j.remle.2021.12.002","DOIUrl":"10.1016/j.remle.2021.12.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Law 35/2015 assesses damages in traffic accidents and tries to guarantee an equal response to identical situations. The biomechanical functional assessment (BFA) is a complementary medical test that provides objectivity in the evaluation of post-traumatic neck pain. This study analyses the interobserver variability of the assessment system defined by Law 35/2015 and studies the effect of having BFA tests and the profile of the evaluator in determining sequelae.</p></div><div><h3>Materials and methods</h3><p>To do this, 49 professionals in the assessment of bodily injury evaluated 5 clinical cases of accident victims with post-traumatic neck pain; a month later, 35 of them assessed the same cases including a BFA report.</p></div><div><h3>Results</h3><p>The results show high variability in determining the days of personal injury (Kappa coefficients between 0.04 and 0.073) with or without BFA; high interobserver variability in the assessment of sequelae in cases without BFA (Kappa coefficients between 0.022 and 0.044), which slightly improves with BFA (Kappa coefficients between 0.128 and 0.26), even showing weak concordance. The BFA has an influence on the determination of sequelae (P < .01), but the profile of the evaluator does not. More than 79.4% of the evaluators found the BFA tests useful to reveal or to confirm symptoms, recovery, or simulation</p></div><div><h3>Conclusions</h3><p>There is variability in the application of Law 35/2015 for the assessment of traffic accidents among professionals of bodily injury. The BFA is useful for evaluators and influences the determination of sequelae.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"48 3","pages":"Pages 99-106"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S244542492200022X/pdfft?md5=abd96a4678f0773f45543dd4f327a7f5&pid=1-s2.0-S244542492200022X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82000491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early post mortem interval estimation in a mouse model using molecular analyses of the gut thanatomicrobiome 使用肠道死亡微生物组分子分析的小鼠模型的早期死后间隔估计

Spanish Journal of Legal Medicine Pub Date : 2022-07-01 DOI: 10.1016/j.remle.2022.02.002

Ángel Antonio Martínez Aragonés, Eduardo Martínez-Manzanares, Silvana Teresa Tapia-Paniagua

{"title":"Early post mortem interval estimation in a mouse model using molecular analyses of the gut thanatomicrobiome","authors":"Ángel Antonio Martínez Aragonés, Eduardo Martínez-Manzanares, Silvana Teresa Tapia-Paniagua","doi":"10.1016/j.remle.2022.02.002","DOIUrl":"10.1016/j.remle.2022.02.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Currently, the lack of reliable quantitative methods have led different research lines to find a model that predicts the post-mortem interval (PMI). The thanatomicrobiome, present from the moment of death, has been shown to change in predictable ways, allowing a correlation with PMI.</p></div><div><h3>Materials and methods</h3><p><span>In this study, the shifts of the thanatomicrobiome in the region of the posterior small intestine<span> and the ascending colon in </span></span><em>Mus musculus</em><span> during the first 24 h of decomposition have been analysed experimentally. For this purpose, a molecular approach based on the analysis of the 16S ribosomal gene (16S rRNA) and a denaturing gradient gel electrophoresis (DGGE) was adopted, followed by analyses of the ecological diversity indices Alpha and beta diversity.</span></p></div><div><h3>Results</h3><p>The results based on the analysis of the ecological diversity indices reflected statistically significant changes before 12 h, and a decrease in diversity after 12 h post mortem, this being statistically significant in the two intestinal regions analysed. Moreover, the comparative study of microbial communities indicated distinct and structured changes from the moment of death, with shifts in the degree of similarity from the composition detected in life (PMI 0 h).</p></div><div><h3>Discussion</h3><p>These results agree with other studies demonstrating a decrease in microbial diversity. However, under the conditions of the study, this decrease does not begin until 12 h after death.</p></div><div><h3>Conclusions</h3><p>In conclusion, by examining the dynamics of bacterial diversity, our study has identified phases during decomposition that could help to improve microbial correlation models for PMI estimation.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"48 3","pages":"Pages 107-114"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76983283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

DNA test evaluation in large-scale identification cases of missing persons 大规模失踪人员身份鉴定案件中的DNA检测评估

Spanish Journal of Legal Medicine Pub Date : 2022-07-01 DOI: 10.1016/j.remle.2021.08.002

Lourdes Prieto , Yarimar Ruiz , Elías Hernandis , Ángel Carracedo

{"title":"DNA test evaluation in large-scale identification cases of missing persons","authors":"Lourdes Prieto , Yarimar Ruiz , Elías Hernandis , Ángel Carracedo","doi":"10.1016/j.remle.2021.08.002","DOIUrl":"10.1016/j.remle.2021.08.002","url":null,"abstract":"<div><p>The evaluation of the DNA test in massive identification cases requires the use of Bayes’ Theorem to estimate the probability of identification from <em>a priori</em> data together with probabilities obtained from the DNA test itself. To apply it, one needs to specify the prior probabilities of the hypotheses. An interdisciplinary team and an identification coordinator are key stakeholders in this process. The statistical approach can be complex but there exists validated non-commercial software, such as Familias, which aid in estimating the likelihood ratios of the DNA test for the given hypotheses. Next, the posterior probabilities in massive identification events can be estimated using the one to one, PM-driven, AM-driven, or Global approaches published recently by Kling et al. (2021) which are discussed in this article. The Identification Coordinator has a key role in formulating the hypotheses of the case, in establishing the prior probabilities, the identification threshold, and in consolidating the integrated identification report together with the multidisciplinary team through the reconciliation of the case.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"48 3","pages":"Pages 124-132"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79879549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison between Screening Cognitive Impairment in Psychiatry (SCIP-S) and Minimental State Examination (MMSE) in Forensic Psychiatry. Pilot study 精神病学认知障碍筛查(SCIP-S)与法医精神病学最小状态检查(MMSE)的比较。试点研究

Spanish Journal of Legal Medicine Pub Date : 2022-07-01 DOI: 10.1016/j.remle.2022.01.004

Priscila Caballero Casanoves , César Jesús Correas Soto , Óscar Pino López , Judith Prió Silvestre

{"title":"Comparison between Screening Cognitive Impairment in Psychiatry (SCIP-S) and Minimental State Examination (MMSE) in Forensic Psychiatry. Pilot study","authors":"Priscila Caballero Casanoves , César Jesús Correas Soto , Óscar Pino López , Judith Prió Silvestre","doi":"10.1016/j.remle.2022.01.004","DOIUrl":"10.1016/j.remle.2022.01.004","url":null,"abstract":"<div><h3>Objectives</h3><p>The objective is to compare 2 brief cognitive screening tests, MMSE and SCIP-S, and determine their usefulness in assessing the cognitive status of subjects diagnosed with psychiatric pathology.</p></div><div><h3>Material and methods</h3><p><span>Pilot study of a series of 33 cases from the Institutes of Legal Medicine of Catalonia and Andorra, whose inclusion criterion was the existence of a psychiatric pathology categorised in ICD-10. In all cases, in addition to the forensic </span>medical interview, MMSE was administered followed by SCIP-S.</p></div><div><h3>Results</h3><p>In MMSE, 31 of the 33 interviewees obtained a total direct score ≥ 24 (normal cognitive performance). In SCIP-S, only 5 of the 33 participants were in a percentile ≥15 (normal cognitive performance). The difference between the results of both tests was statistically significant (P < 0.05).</p></div><div><h3>Conclusions</h3><p>This study suggests a greater usefulness of SCIP-S compared to MMSE in detecting cognitive deficits in psychiatric patients. Therefore, the use of the former is recommended in forensic medical practice.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"48 3","pages":"Pages 92-98"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83364069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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The beginning of the residency of the specialty in legal and forensic medicine in Spain 西班牙法律和法医学专业住院医师的开始

Spanish Journal of Legal Medicine Pub Date : 2022-07-01 DOI: 10.1016/j.remle.2022.07.001

Marta Grijalba-Mazo , Josep Arimany-Manso

引用次数: 0