Medico-Legal Journal最新文献_第2页

Distal femoral metaphyseal fractures in children: A systematic review and meta-analysis of their significance in the context of child abuse. 儿童股骨远端干骺端骨折：系统回顾和荟萃分析其在儿童虐待背景下的意义。

Medico-Legal Journal Pub Date : 2025-03-27 DOI: 10.1177/00258172241293885

Shrayash Khare

{"title":"Distal femoral metaphyseal fractures in children: A systematic review and meta-analysis of their significance in the context of child abuse.","authors":"Shrayash Khare","doi":"10.1177/00258172241293885","DOIUrl":"https://doi.org/10.1177/00258172241293885","url":null,"abstract":"BackgroundDistal femoral metaphyseal fractures in children pose diagnostic challenges due to potential accidental and non-accidental aetiologies. This review aims to critically analyse the evidence on the association between distal femoral metaphyseal fractures and child abuse, as well as fracture patterns aiding in distinguishing inflicted injuries from accidental injuries.MethodsA systematic review of studies involving children with distal femoral metaphyseal fractures was conducted, examining the reported associations with child abuse, fracture patterns and proposed mechanisms.ResultsThe review revealed a significant association between distal femoral metaphyseal fractures and child abuse, particularly in non-ambulatory infants. However, some fractures may occur accidentally, often from short falls with direct impact on the knee. Certain fracture patterns, such as transverse or oblique configurations, suggest abuse, while spiral or buckle patterns are more likely accidental. Case series and retrospective studies reported varying findings, with some studies supporting a strong association with abuse and others highlighting the potential for accidental mechanisms.ConclusionsA comprehensive evaluation, including history, physical examination, skeletal survey and multidisciplinary collaboration, is crucial for accurate diagnosis and management. Healthcare professionals should maintain a high index of suspicion for child abuse while recognising accidental mechanisms. Specific recommendations for healthcare professionals and future research directions are provided.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"258172241293885"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731967","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

Pendulums in medical practice. 医学实践中的钟摆

Medico-Legal Journal Pub Date : 2025-03-27 DOI: 10.1177/00258172241304558

Mathias E Kant

{"title":"Pendulums in medical practice.","authors":"Mathias E Kant","doi":"10.1177/00258172241304558","DOIUrl":"https://doi.org/10.1177/00258172241304558","url":null,"abstract":"Medicine is taught as a science, but in reality, as with other areas that undergo much public scrutiny, it is often more of an art than a science. Particularly when dealing with controversial areas, physicians often attempt to employ the \"standard of care\" as a guide to practising medicine, and to protect themselves. However, the standard of care itself is often a reactive and temporary construct. A number of practices serve as good examples of accepted patient care that has swung completely from one extreme to another. The history of opiate prescribing in this country exemplifies a complete swing in practice fundamentals among US physicians, where opiates have been repeatedly embraced, and then vilified. Numerous other practices demonstrating this phenomenon can be cited, including the use of electroconvulsive therapy for depression, and hormone replacement for postmenopausal women. Research funding itself has been subject to pendulum swings, such as occurred during the recent pandemic. Currently, there are a number of similar, very active issues of debate, such as marijuana for widespread medical use, and the employment of hallucinogens for addiction and other mental health disorders. Considerable harm has occurred to some patients when extremes of these pendulum swings have impacted their medical care. It is urged that in practising medicine, physicians consider the entire body of medical evidence accumulated during these pendulum swings, and then have the courage and wisdom to represent the best interests of their patients.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"258172241304558"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721710","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

Injury pattern(s) in electric iron-related fatal electrocutions in the home. 家庭中与电铁相关的致命触电的伤害模式。

Medico-Legal Journal Pub Date : 2025-03-26 DOI: 10.1177/00258172241288019

Sangram S Yadav, Mohit Chauhan

引用次数: 0

Fatal entrapment under a lift-up storage bed: Accidental death from positional asphyxia. 致命困在升降式储物床下：因体位性窒息而意外死亡。

Medico-Legal Journal Pub Date : 2025-03-24 DOI: 10.1177/00258172241288010

Camilla Cecannecchia, Stefania De Simone, Simona Vittorio, Benedetta Baldari, Luigi Cipolloni, Andrea Cioffi

引用次数: 0

Comparing cerebral palsy costs: Private healthcare vs medico-legal claims in South Africa. 比较脑瘫的费用：南非的私人医疗保健与医疗法律索赔。

Medico-Legal Journal Pub Date : 2025-03-13 DOI: 10.1177/00258172241287654

Gregory Whittaker

引用次数: 0

External challenges for specialists dealing with forensic autopsies. 法医尸检专家面临的外部挑战。

Medico-Legal Journal Pub Date : 2025-03-01 Epub Date: 2023-10-06 DOI: 10.1177/00258172231195733

Manoj K Mohanty, Sindhu S Sahu, Sudipta R Singh, Manas R Sahu, Rajanikanta Swain, Preetam K Lenka, Biswa M Padhy, Alagarasan Naveen

{"title":"External challenges for specialists dealing with forensic autopsies.","authors":"Manoj K Mohanty, Sindhu S Sahu, Sudipta R Singh, Manas R Sahu, Rajanikanta Swain, Preetam K Lenka, Biswa M Padhy, Alagarasan Naveen","doi":"10.1177/00258172231195733","DOIUrl":"10.1177/00258172231195733","url":null,"abstract":"Background: In addition to poor infrastructure, and human resource constraints, forensic medicine specialists in developing countries face many external challenges.Objectives: We aimed to investigate the prevalence, type, and source of external challenges confronting them including sex, age, religion, deceased's place of residence and the number of accompanying relatives.Materials and methods: This cross-sectional, observational study was conducted between August 2020 and July 2022 at the Mortuary of AIIMS, Bhubaneswar with the approval of the ethical committee.Results: Of note, forensic medicine specialists faced external challenges in about one in five cases (20.5%). Most demands were to either minimise the autopsy procedure (n = 65) or to conduct the autopsy at inappropriate times (n = 58). The demands to minimise the autopsy procedure were significantly associated with the deceased's age (p = 0.046), religion (p = 0.010), socioeconomic class (p = 0.020) and manner of death (p = 0.019).Conclusions: Our study found that forensic medicine specialists in India face significant external challenges. Avoiding unnecessary complete autopsies, implementing night autopsies, and embracing minimally invasive autopsies are recommended to mitigate these challenges.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"19-24"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41142347","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

A critical analysis of the impact of early marriage on girls based on published autobiographies and a contemporary scholarly text - Īḍāḥ al-bayān fī nikāḥ al-ṣibyān. 基于已出版的自传和当代学术文本对早婚对女孩影响的批判性分析- Īḍāḥ al-bayān f ā nikāḥ al-ṣibyān。

Medico-Legal Journal Pub Date : 2025-03-01 Epub Date: 2025-02-08 DOI: 10.1177/00258172241286642

John F Mayberry

{"title":"A critical analysis of the impact of early marriage on girls based on published autobiographies and a contemporary scholarly text - Īḍāḥ al-bayān fī nikāḥ al-ṣibyān.","authors":"John F Mayberry","doi":"10.1177/00258172241286642","DOIUrl":"10.1177/00258172241286642","url":null,"abstract":"Background: This work emerged from a need to better understand the \"lived experience\" of early marriage for girls and how it should impact on contemporary attitudes in the Muslim community and encourage it to support the international movement with the aim of a minimum common age of 18 years for marriage of young people.Objective: To identify from contemporary published literature, including autobiographies and religious texts dealing specifically with early marriage, the effects of early marriage on individuals and to set this as a background to the extensive literature on its medical, psychological and social impact.Participants and setting: The setting is the published words of two women and a man who were involved in early marriages and a commentary on the topic by an Ibadi theologian.Methods: The documents were identified through searching a range of databases using various search engines. Texts were then analysed for key terms describing the impact of early marriage and these were then grouped into themes.Findings: The extracts raise questions linked to the issue of consent and the role of adult coercion, including physical force and threat of harm. In practice girls are given in marriage by their guardians against their wishes and international conventions on the rights and care of children, as well as that outlined in Qur'an 4 v6.Conclusion: Modern Muslim states face a real challenge in implementing 18 as the minimum age for marriage, especially in how to manage opposition to appropriate new legislation from some traditionalist groups.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"37-41"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374888","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

Informed consent in neurosurgery with particular reference to alternatives to proposed surgery. Updated case law including McCulloch. 神经外科的知情同意，特别参考拟议手术的替代方案。包括麦卡洛克在内的最新判例法。

Medico-Legal Journal Pub Date : 2025-03-01 Epub Date: 2025-02-11 DOI: 10.1177/00258172241275085

Nicholas Todd, James Wright-Todd

{"title":"Informed consent in neurosurgery with particular reference to alternatives to proposed surgery. Updated case law including McCulloch.","authors":"Nicholas Todd, James Wright-Todd","doi":"10.1177/00258172241275085","DOIUrl":"10.1177/00258172241275085","url":null,"abstract":"Introduction: Informed consent is a crucial element in neurosurgical practice; failures of the consenting process are a common cause of litigation in neurosurgery and judgments that have particular relevance to neurosurgical practice will be reviewed here. Guidance for consent based upon current case law is discussed.Methods: The legal databases BAILII and WestLaw were searched using the search term \"informed consent\". The BAILII search yielded 86 abstracts, WestLaw yielded 33. There were 15 duplicates. Ten of the remaining 104 abstracts were commentaries, leaving 94 judgments. From those judgments a further 21 cases were added. A total of 115 judgments were reviewed by both authors.Results: A total of 23 judgments dealing with issues of informed consent in neurosurgical and other surgical practice were selected. The cases and their implications for neurosurgical consent are discussed below.Discussion: When proposing a surgical procedure to a competent adult, the treating surgeon must discuss the benefits, risks and alternatives to treatment with the patient. The surgeon can be guided by professional guidance from the GMC, or another professional body, and/or case law. Relevant issues include: (i) the risks and benefits of surgery; (ii) information that is accurate (or inaccurate, incorrect, missing or late information); (iii) established practice; (iv) the current state of knowledge; (v) reasonable alternative treatments; and (vi) surgery performed on a different day or by a different surgeon.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400066","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

An uncommon case of self-strangulation by ligature and the importance of a crime scene visit by a forensic pathologist. 一个罕见的案件，自我勒死的案件和法医病理学家访问犯罪现场的重要性。

Medico-Legal Journal Pub Date : 2025-03-01 Epub Date: 2023-04-25 DOI: 10.1177/00258172231164293

Aditya Anand, Manav Sharma, Vikash Chandra, Mukul Sharma, Ankit Kumar

{"title":"An uncommon case of self-strangulation by ligature and the importance of a crime scene visit by a forensic pathologist.","authors":"Aditya Anand, Manav Sharma, Vikash Chandra, Mukul Sharma, Ankit Kumar","doi":"10.1177/00258172231164293","DOIUrl":"10.1177/00258172231164293","url":null,"abstract":"Self-strangulation is an uncommon method of suicide. The body was found lying on the floor in front of the \"multi-gym\" inside the gym in the basement of the deceased's house. It was initially presented as a case of sudden death, but during autopsy, a ligature mark was noted over the deceased's neck and bilateral temporal regions along with findings supportive of ligature strangulation. A visit was made to the crime scene. A plausible reconstruction of events suggested that the deceased had used the metallic rope of the multi-gym for this purpose. The rope was connected to weights from one end, passed through a pulley and connected to a rod at the other end. Its width and pattern matched with the ligature mark. The deceased wound the rod end of the rope around his neck and entangled the rod to the rope over his head so that the weight attached to the other end tightened the rope around his neck and strangled him. As the rope unravelled, gravity caused the body to fall to the ground while the rope with the rod resumed its normal position due to the pull of the weight attached at the opposite end. This case is reported for its rarity and the unusual means used to commit suicide by self-strangulation.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"25-27"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9390387","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

Jaw bombs: Rampantly used indigenous explosives causing human-wildlife conflict in a few regions of India and Sri Lanka. 下颚炸弹：在印度和斯里兰卡的一些地区，肆意使用的本地爆炸物造成了人类与野生动物之间的冲突。

Medico-Legal Journal Pub Date : 2025-03-01 Epub Date: 2024-10-18 DOI: 10.1177/00258172241264779

Devendra Jadav

引用次数: 0