Spanish Journal of Legal Medicine最新文献

{"title":"Obstetrics and gynecology: An analysis of malpractice in the Spanish public health system","authors":"Mónica Hernández Herrero ,&nbsp;Jorge Tomillo Urbina","doi":"10.1016/j.remle.2024.07.001","DOIUrl":"10.1016/j.remle.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><p>Obstetrics and gynecology is one of the specialties most involved in malpractice claims. However, there are few studies that provide scientific information on this topic. The aim was to analyse the characteristics of medical liability rulings in Spain in public healthcare in the speciality of obstetrics and gynecology.</p></div><div><h3>Methods</h3><p>Cross-sectional observational study that analysed the rulings handed down in the contentious-administrative jurisdiction by the Superior Courts of Justice (2008–2020), in the speciality of obstetrics and gynecology. The variables were administrative, clinical, judicial, and compensatory.</p></div><div><h3>Results</h3><p>We analysed 1015 rulings, of which 142 (13.99%) related to the speciality of obstetrics and gynecology. A total of 67.61% of the rulings were dismissed at first instance and 89.28% at second instance. The most frequent reasons for an upheld ruling were diagnostic and/or therapeutic malpractice (40.90%), lack of information (20.45%), and loss of opportunity (18.18%). The most frequently claimed damage was sequelae (66.14%). The median award was 53 758.50 euros (2000–800 000).</p></div><div><h3>Conclusions</h3><p>The high frequency of claims in obstetrics and gynecology indicates that these are “high risk” specialties for litigation. The vast majority of judgements are dismissed, i.e. in favour of the administration. The analysis of these results helps to structure the role of lawsuits and to increase professionals' knowledge of the medico-legal aspect of healthcare.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"50 3","pages":"Pages 92-99"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272094","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}

{"title":"Postmortem visceral staining due to methylene blue","authors":"Marc Rueda Ruiz ,&nbsp;Santiago Crespo Alonso ,&nbsp;Jordi Carrillo Pintos ,&nbsp;Maria Luisa Ortega Sanchez","doi":"10.1016/j.remle.2024.04.003","DOIUrl":"10.1016/j.remle.2024.04.003","url":null,"abstract":"","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"50 3","pages":"Pages 132-134"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272092","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}

{"title":"The evolution of extrajudicial expert advice in motor vehicle accidents: Situation in 2024","authors":"Rafael Bañón González","doi":"10.1016/j.remle.2024.06.001","DOIUrl":"https://doi.org/10.1016/j.remle.2024.06.001","url":null,"abstract":"","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"50 2","pages":"Pages 45-46"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141423257","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}

{"title":"Exploring the genetic landscape of the Doukkala population (Morocco) using 15 autosomal short tandem repeats (STRs)","authors":"Abderrazak El Khair ,&nbsp;Khadija Cheffi ,&nbsp;Noura Dahbi ,&nbsp;Jalal Talbi ,&nbsp;Abderraouf Hilali ,&nbsp;Hicham El Ossmani","doi":"10.1016/j.remle.2024.05.001","DOIUrl":"https://doi.org/10.1016/j.remle.2024.05.001","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><p>Situated in West Central Morocco, the Doukkala region carries the distinction of being one of North Africa's oldest human settlement zones. Nonetheless, it has been notably understudied in the realm of population genetics. Through allele frequency analysis and integration of forensic parameters, the research aims to gain insights into the genetic structure and neighboring affiliations of the Doukkala population.</p></div><div><h3>Methods</h3><p>This study employed the AmpFlSTR Identifiler PCR system to assess the allelic frequencies and forensic parameters of 15 autosomal STRs in a cohort of 134 unrelated, healthy individuals from the Doukkala region who identify as Arab-speakers. Additionally, we explored the genetic relationships between the Doukkala population and other reference groups, considering both our dataset and previously published population data.</p></div><div><h3>Results</h3><p>A total of 180 alleles were observed in the study population. With a count of 19 alleles, D18S51 proved to be the most diverse marker in the study. After Bonferroni's correction, 3 loci (FGA, TH01, and TPOX) deviated from Hardy–Weinberg equilibrium. The combined power of discrimination (PD) was 0.99999999999999999526 and the combined probability of exclusion (PE) was 0.99999664790900144592. The Arabic-speaking population of Rabat-Salé–Zemmour-Zaer and Southern population from Morocco exhibit the shortest genetic distance from population of Doukkala. No significant difference was observed between the Arabic-speaking population of Doukkala and all North African populations at all loci, except for the Egyptian population (North-East Africa), where a difference was observed at 2 specific loci (CSF1PO and TH01).</p></div><div><h3>Conclusions</h3><p>These results indicate that the diversity found in populations from North Africa transcends geographic and linguistic barriers. The dataset's relevance to this research could stem from its capacity to offer valuable reference data for forensic, anthropological, and genetic investigations.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"50 2","pages":"Pages 54-61"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141423259","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}

{"title":"Psychological–forensic expert assessment of complex post traumatic stress disorder in victims of gender-based violence","authors":"Laura Fátima Asensi Pérez ,&nbsp;Elena Flores Fernández ,&nbsp;Kora Nevado Duarte","doi":"10.1016/j.remle.2023.09.001","DOIUrl":"10.1016/j.remle.2023.09.001","url":null,"abstract":"<div><p>Given the inclusion of the Complex Post-Traumatic Stress Disorder (C-PTSD) in the International Classification of Diseases (ICD-11), this article analyses the C-PTSD as a possible new diagnosis in women victims of gender-based violence to explain a wide range of symptoms resulting from interpersonal, persistent, continuous, severe, and uncontrollable traumas that may occur in this context. Thus, it describes the psychological impact and the psychopathological consequences it produces on the victims, which are most serious when the violence suffered has occurred repeatedly and over time. In addition, it delves into the differential diagnosis of C-PTSD with other psychopathologies. Finally, a protocol for forensic psychological assessment is proposed based on C-PTSD as a clinical disorder, which explains the serious psychological impact on the evaluation of women victims of gender-based violence, considering this disorder as an alternative diagnostic hypothesis in the forensic psychological assessment of the psychological injury.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"50 2","pages":"Pages 76-81"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S244542492400013X/pdfft?md5=9c057d871275e73555d44a34fdd9400f&pid=1-s2.0-S244542492400013X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141393890","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}

{"title":"Study of the difference between the assessment of bodily injury by insurance entities and by extrajudicial experts advice in Valladolid during the years 2021 and 2022. Presentation of a comparison methodology","authors":"Carmen Domínguez González,&nbsp;José Domingo Sánchez Pérez","doi":"10.1016/j.remle.2023.11.005","DOIUrl":"10.1016/j.remle.2023.11.005","url":null,"abstract":"<div><h3>Introduction</h3><p>After the approval of Law 35/2015, the insurer is obliged to submit motivated offers in cases of traffic accidents and the possibility of requesting an extrajudicial expert advice from the Institutes of Legal Medicine in case of disagreement with the previous one.</p></div><div><h3>Objective</h3><p>The objective of this paper is to describe the differences between the motivated offers of insurers and the forensic reports of the 409 extrajudicial expert advice requested to the Institute of Legal Medicine in Valladolid from 2021–2022 and to propose a methodology for comparing.</p></div><div><h3>Material and methods</h3><p>All extrajudicial expert advice data from 2021 to 2022 was obtained, analysing the days of personal injury and sequelae and translating them into compensation variables.</p></div><div><h3>Results</h3><p>Forensic reports are more favourable for traffic injuries in about 81% of cases, granting on average an amount of almost €1400 more. This difference is mainly due to a greater consideration of sequelae, as well as a higher proportion of days of moderate particular damage in the forensic report. However, this difference is more or less accentuated, depending on the company that makes the motivated offer.</p></div><div><h3>Conclusion</h3><p>Translating the data from the forensic reports and motivated offers to compensation variables, allows us to make a comparison of the differences between both reports, observing that the forensic reports are more favourable than those issued by the insurers, at least in the province studied, and more studies are needed to have a more complete view.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"50 2","pages":"Pages 47-53"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141404433","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}

{"title":"Ethical and legal aspects of Aesthetic Medicine's advertising in social media in Spain","authors":"Miguel Antonio Lasheras-Pérez ,&nbsp;Rodolfo David Palacios-Diaz ,&nbsp;Begoña Martínez-Jarreta ,&nbsp;Mercedes Rodríguez-Serna","doi":"10.1016/j.remle.2024.05.003","DOIUrl":"10.1016/j.remle.2024.05.003","url":null,"abstract":"","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"50 2","pages":"Pages 86-87"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141391658","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}

{"title":"Cholecystoduodenal fistula: An unusual finding at autopsy","authors":"Roger W. Byard","doi":"10.1016/j.remle.2024.03.001","DOIUrl":"https://doi.org/10.1016/j.remle.2024.03.001","url":null,"abstract":"<div><p>A 56-year-old man who collapsed in the street was found at autopsy to have died from mixed drug toxicity. Also present was a cholecystoduodenal fistula with an inflamed gallbladder adherent to an area of duodenal ulceration. The fistula was longstanding with significant fibrous scarring and predominantly chronic inflammation, but also with bacterial colonies, ulcer slough, and a polymorphonuclear leukocyte infiltration. It is uncertain whether the fistula originated from acute inflammation of the gallbladder with adherence to the duodenum (the most common aetiology) or from a penetrating duodenal ulcer, or from a combination of dual pathologies. Non-specific clinical features and illicit drug usage may have contributed to failure of diagnosis during life This case demonstrates significant rare pathology that may be more completely demonstrated with an internal autopsy examination.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"50 2","pages":"Pages 82-85"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141423256","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}

{"title":"The improvements in forensic toxicology and its role in the forensic process. The interpretation of results (II)","authors":"Maria Luisa Soria","doi":"10.1016/j.remle.2024.05.002","DOIUrl":"10.1016/j.remle.2024.05.002","url":null,"abstract":"<div><p>Despite progress in the development and validation of analytical methods. In the meantime, the challenges in interpretive forensic toxicology remain persistent, since it is no easy to establish a causal link between the concentration of a compound in biological samples and its impact on a real case. A proper interpretation of results is required to ascertain their relevance and to ensure that the investigator or jurist can make the most of the utility of the trace within the framework of the investigation or within the courtroom.</p><p>Because of their complexity and frequent presence at toxicology laboratories, in this article, we have focused our attention on the interpretation of results in drug-facilitated offences, in cases where hair samples are involved and in cases related with postmortem investigation. Following this review, the advances in analytical results interpretation in the selected cases, are being mainly conducted towards metabolic studies.</p><p>In cases of drug-facilitated crimes, it allows to extend the detection window and identify low concentration consumption markers for fast-clearing compounds. Regarding hair metabolomics analysis, recent studies can assist us to determine the deterioration caused by cosmetic treatments or to elucidate the difference between consumption and extern contamination, which are a well-known factor affecting the interpretation of hair analysis. Concerning postmortem results, progress is intended to ensure better reference data, to the study of drug-to-drug interactions as well as to the application of metabolomics and to the acknowledgment of the genetic variances related with drugs metabolism, location, and mechanism of action.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"50 2","pages":"Pages 62-75"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141415170","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}

{"title":"Treatment of the information on gender-based violence. With contributions from artificial intelligence","authors":"M. Eulàlia Trias Capella ,&nbsp;Raquel Guardia Villalba ,&nbsp;Ramon Trias Capella","doi":"10.1016/j.remle.2024.01.001","DOIUrl":"10.1016/j.remle.2024.01.001","url":null,"abstract":"<div><h3>Introduction/objectives</h3><p>Violence against women is still a serious social and health problem, despite the measures implemented in recent years. The examination of the victims by the forensic doctor in the courts is of great interest since it provides information related not only to the aggression, but also to their social, family, and economic environment. The objective is to use this information to identify groups at risk and improve/implement the necessary measures.</p></div><div><h3>Material and methods</h3><p>In this work, the forensic has collected, for 8 years, abundant data on the victims examined in l'Hospitalet de Llobregat. The sample includes 1622 cases of women who have been victims of gender violence. A descriptive study of the population and of the lesions has been carried out.</p></div><div><h3>Results</h3><p>The paper presents the main variables studied, both socioeconomic and referring to the aggression itself. This study also analyzes the re-entry of the victims, the repetition of aggressions (revictimization), which are 10.9% of the sample. Finally, the results obtained after applying artificial intelligence techniques—in this case, CaRT classification trees—are presented.</p></div><div><h3>Conclusions</h3><p>With the results obtained, we conclude that the treatment of the information collected and systematized from the medical–forensic intervention allows a better understanding of Violence Against Women, from which we can extract suggestions on the adoption of care and support measures for the victims and the most vulnerable groups, as well as administrative resources and the optimization of prevention programs.</p></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"50 1","pages":"Pages 29-39"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139540130","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}