Revista Espanola de Medicina Legal最新文献

{"title":"Modificación legislativa y controversias médico-legales con relación a la incapacidad permanente como causa de extinción del contrato de trabajo","authors":"M. Teófila Vicente-Herrero ,&nbsp;Pilar Moreno-Torres ,&nbsp;Carmen Muñoz Ruipérez ,&nbsp;Luisa Capdevila García ,&nbsp;M. Victoria Ramírez Iñiguez de la Torre ,&nbsp;José Ignacio Torres Alberich ,&nbsp;Alfonso Torres Vicente ,&nbsp;Santiago Delgado Bueno","doi":"10.1016/j.reml.2025.500498","DOIUrl":"10.1016/j.reml.2025.500498","url":null,"abstract":"<div><div>The recent amendment to Article 49 of the Workers' Statute, driven by a ruling from the Court of Justice of the European Union, eliminates the automatic termination of the employment contract due to permanent disability. Companies must now assess and document the possibility of making reasonable accommodations or reassigning the worker to a compatible position, unless this represents an undue burden. The occupational physician plays a central role by evaluating work capacity and proposing adaptations. Termination of the contract will only be lawful if it is demonstrated that no viable alternatives exist and the entire process is properly justified. This reform aims to prevent discrimination based on disability, protect the rights of affected workers, and balance employer obligations with labor inclusion, requiring preventive and coordinated management between medical services and human resources.</div></div>","PeriodicalId":35705,"journal":{"name":"Revista Espanola de Medicina Legal","volume":"52 1","pages":"Article 500498"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418463","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":"Pregabalin use in drug-facilitated sexual assault cases","authors":"Lokmane Dali Braham ,&nbsp;Feriel Hadji ,&nbsp;Abderrahmane Kori Yahia ,&nbsp;Imane Bekkouche ,&nbsp;Souad Nagoudi ,&nbsp;Dalanda Benchrik ,&nbsp;Nour El Yakine Keraghel ,&nbsp;Mohamed Amine Kerdoun ,&nbsp;Djamil Azzouz ,&nbsp;Rachid Belhadj","doi":"10.1016/j.reml.2025.500492","DOIUrl":"10.1016/j.reml.2025.500492","url":null,"abstract":"<div><h3>Background</h3><div>Pregabalin, a gamma-aminobutyric acid (GABA) analog, is increasingly misused for its sedative, euphoric, and disinhibitory effects. Although not traditionally listed among classic drug-facilitated sexual assault (DFSA) agents, its pharmacological profile raises concerns about its potential use in chemical submission.</div></div><div><h3>Objective</h3><div>To describe and analyze a series of DFSA cases in which pregabalin was identified through forensic toxicological investigations, and to evaluate its implications as a chemical submission agent.</div></div><div><h3>Methods</h3><div>This case series includes nine DFSA victims assessed at the Department of Forensic Medicine, Mustapha Pasha University Hospital, between September 2023 and September 2024. Biological samples were collected promptly and analyzed using immunoassays followed by confirmatory gas chromatography–mass spectrometry (GC–MS). The qualitative GC–MS method was validated according to SFBC-SFTA 2019 recommendations.</div></div><div><h3>Results</h3><div>Pregabalin was detected in all urine samples and in one blood sample. It was the only common substance across all cases, though MDMA and tramadol were also identified in three and one cases, respectively. Victims (aged 13–18) were predominantly female, and all presented with marked drowsiness and confusion. Genital injuries were observed in 55% of cases, and anal or other bodily injuries in 100%. In six cases, the substance was administered without consent.</div></div><div><h3>Conclusion</h3><div>This is the first documented case series in North Africa implicating pregabalin as a primary agent in DFSA. Its psychoactive effects including sedation, confusion, amnesia, and disinhibition make it particularly conducive to chemical submission. These findings support the systematic inclusion of pregabalin in DFSA toxicology screenings and highlight the need for heightened clinical and forensic awareness.</div></div>","PeriodicalId":35705,"journal":{"name":"Revista Espanola de Medicina Legal","volume":"52 1","pages":"Article 500492"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418462","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":"Perspectiva médico-legal de la imputabilidad penal en personas con trastornos mentales","authors":"Ruth Salmón Maroto","doi":"10.1016/j.reml.2025.500499","DOIUrl":"10.1016/j.reml.2025.500499","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze, from a medico-legal perspective, the relationship between mental disorders and criminal responsibility, identifying clinical-criminal patterns and judicial assessments in cases involving serious offenses.</div></div><div><h3>Material and methods</h3><div>A descriptive study was conducted, combining a specialized literature review with the analysis of judicial decisions. The study included rulings issued in Spain in which the presence of a clinically diagnosed mental disorder was recognized. Each case was examined in relation to the type of offense, psychiatric diagnosis, degree of criminal responsibility, and the penalty imposed.</div></div><div><h3>Results</h3><div>Psychotic disorders were more frequently associated with homicide, while personality disorders predominated in sexual offenses. Most defendants were deemed fully responsible, even in the presence of severe mental disorders. Semi-responsibility did not lead to a significant reduction in sentences, and psychiatric hospitalization was applied only in cases of non-responsibility. Although psychopathy could be identified in some clinical-criminal profiles, it did not appear as a formal diagnosis in any of the rulings.</div></div><div><h3>Discussion</h3><div>Findings reveal a restrictive application of mental disorder exemptions within the Spanish judicial system, consistent with the mixed (biological-psychological) model of criminal responsibility. Despite the recognition of psychopathology, ordinary imprisonment was prioritized over therapeutic measures. The results highlight the need for more specific diagnostic tools and adequate forensic and penitentiary resources to integrate both clinical and legal perspectives in the assessment of criminal responsibility.</div></div>","PeriodicalId":35705,"journal":{"name":"Revista Espanola de Medicina Legal","volume":"52 1","pages":"Article 500499"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418464","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":"Estudio comparativo entre la tomografía computarizada post mortem y la autopsia: experiencia en un instituto de medicina legal y ciencias forenses","authors":"David Martínez-Esquiva ,&nbsp;Juan Pedro Hernández del Rincón ,&nbsp;Cristina Sánchez Pérez ,&nbsp;Eulalia Moya Cánovas ,&nbsp;Úrsula María Gil Martínez ,&nbsp;Eduardo Osuna","doi":"10.1016/j.reml.2026.500503","DOIUrl":"10.1016/j.reml.2026.500503","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Post mortem</em> computed tomography (PMCT) is a non-invasive complementary tool that enables triage and three-dimensional reconstruction in forensic pathology. The objective of this study is to evaluate the diagnostic efficacy of PMCT compared to traditional autopsy at the IMLCF of Murcia, the first center in Spain with a dedicated forensic computed tomography unit.</div></div><div><h3>Materials and methods</h3><div>A retrospective observational study (2020–2023) was conducted, analyzing 44 cases where PMCT was performed prior to the necropsy. A total of 560 forensic findings were categorized, and statistical analysis was applied using the McNemar test, with significance set at a value of <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>PMCT demonstrated statistically significant superiority in detecting skeletal injuries (<em>p</em> &lt; 0.001), with particular relevance in the skull (<em>p</em> = 0.001) and the pelvic ring (<em>p</em> = 0.031). However, autopsy maintained a significant advantage in identifying pathology in soft tissues, parenchyma, the vascular system, and fluids in cavities (<em>p</em> &lt; 0.001). A progressive improvement in the accuracy of PMCT reports was observed, linked to the team’s learning curve.</div></div><div><h3>Conclusions</h3><div>PMCT is superior for diagnosing bone trauma, especially in anatomical regions that are difficult to dissect. Its routine integration requires the implementation of standardized reporting protocols and specialized technical training in forensic imaging for medical examiners.</div></div>","PeriodicalId":35705,"journal":{"name":"Revista Espanola de Medicina Legal","volume":"52 1","pages":"Article 500503"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418471","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":"Estrategias de éxito para la transformación digital en los Institutos de Medicina Legal y Ciencias Forenses","authors":"Mar Pastor-Bravo ,&nbsp;Ezequiel Domínguez-Lucena ,&nbsp;Marta Grijalba-Mazo ,&nbsp;Eneko Barbería-Marcalain ,&nbsp;Rosana Marcos-Ramos ,&nbsp;Alfonso Colorado-Casado de Amezua ,&nbsp;Carmen Negre-Muñoz","doi":"10.1016/j.reml.2025.500502","DOIUrl":"10.1016/j.reml.2025.500502","url":null,"abstract":"<div><div>Digital transformation represents a strategic opportunity to modernize the Institutes of Legal Medicine and Forensic Sciences (IMLCF) and align them with the current challenges of the Administration of Justice. This article proposes a generalizable model to drive such transformation from a comprehensive perspective, not only technological but also organizational, cultural, and data-oriented. Based on an internal and external analysis of the institutional environment, which each institute must undertake, the main strengths, weaknesses, opportunities, and threats can be identified, as well as the possibilities that technological advances offer to legal medicine and forensic sciences. This diagnosis enables the definition of the digital strategic vision of each institute. A progressive roadmap is proposed, grounded in best practices and focused on leadership, staff involvement, and sustainability of actions. Digital transformation is not an end in itself but a means to deliver a more effective, human, transparent, and citizen-centered forensic public service.</div></div>","PeriodicalId":35705,"journal":{"name":"Revista Espanola de Medicina Legal","volume":"52 1","pages":"Article 500502"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418465","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":"Calidad en los institutos de medicina legal y ciencias forenses","authors":"Rosa Ana Marcos Ramos ,&nbsp;Mar Pastor Bravo ,&nbsp;Marta Grijalba-Mazo","doi":"10.1016/j.reml.2026.500507","DOIUrl":"10.1016/j.reml.2026.500507","url":null,"abstract":"","PeriodicalId":35705,"journal":{"name":"Revista Espanola de Medicina Legal","volume":"52 1","pages":"Article 500507"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147402281","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":"Suicidio con propofol. A propósito de un caso","authors":"Esperanza Navarro Escayola ,&nbsp;Clara Vega Vega","doi":"10.1016/j.reml.2026.500506","DOIUrl":"10.1016/j.reml.2026.500506","url":null,"abstract":"","PeriodicalId":35705,"journal":{"name":"Revista Espanola de Medicina Legal","volume":"52 1","pages":"Article 500506"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418466","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":"Estudio sobre el conocimiento de la Ley orgánica de regulación de la eutanasia entre profesionales médicos de Andalucía oriental","authors":"Lucas González-Herrera,&nbsp;Ana Belén Márquez-Ruiz,&nbsp;Elena Miguel-García,&nbsp;Aurora Valenzuela-Garach","doi":"10.1016/j.reml.2025.500490","DOIUrl":"10.1016/j.reml.2025.500490","url":null,"abstract":"<div><h3>Introduction</h3><div>The incorporation of the provision of aid in dying to the common portfolio of services of the National Health System, after the approval of the Organic Law for the Regulation of Euthanasia (LORE), raises the need to investigate the knowledge of medical professionals about the processes of application of this procedure.</div></div><div><h3>Material and methods</h3><div>A self-administered online questionnaire of 25 questions was distributed among 2,386 medical practitioners involved in the clinical training of the students enrolled in the Degree in Medicine at the University of Granada.</div></div><div><h3>Results</h3><div>436 medical professionals (50.2% women) answered the survey. The specialty of Family and Community Medicine contributed the highest number of participants (20.4%). Around 60% of the physicians did not know the legal requirements that must be met by the patient requesting aid in dying or the role of the responsible physician and the consultant physician. 33.5% of the respondents declared that they would request conscientious objection if necessary and only 14.4% stated that they had received any specific training course in their workplace. More than 80% of the specialists did not consider themselves prepared to deal with this procedure.</div></div><div><h3>Conclusions</h3><div>The results of this study indicate that the level of knowledge of the medical professionals surveyed about key aspects of LORE may still be insufficient, pointing out the need to reinforce their training to offer a better response to euthanasia contexts and ensure adequate access to this service for patients.</div></div>","PeriodicalId":35705,"journal":{"name":"Revista Espanola de Medicina Legal","volume":"51 4","pages":"Article 500490"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486132","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":"Epidemiología del consumo de sustancias lícitas e ilícitas en muertes violentas en una región del sur de Chile, entre los años 2015 y 2022","authors":"Cristóbal Reyes ,&nbsp;Nicolas Huaiquinao ,&nbsp;Francisca Acevedo","doi":"10.1016/j.reml.2025.500486","DOIUrl":"10.1016/j.reml.2025.500486","url":null,"abstract":"<div><h3>Introduction</h3><div>Drug and alcohol consumption is closely associated with social determinants such as poverty, inequality, and violence. The Araucanía Region in southern Chile, one of the country's poorest areas, was the focus of this epidemiological study analyzing the relationship between licit and illicit substance use and violent deaths from 2015 to 2022.</div></div><div><h3>Methods</h3><div>Data from the Legal Medical Service (SML), responsible for forensic examinations in judicial cases, were standardized and analyzed to allow comparisons with national and international studies.</div></div><div><h3>Results</h3><div>Homicides showed the highest correlation with positive toxicological findings (23.8%), primarily involving cocaine combined with alcohol and cannabis. Suicide recorded 22.3% of cases with detected substances, notably elevated cocaine and alcohol consumption linked to impulsive behavior. In traffic accidents, with 14.0% of positive cases, benzodiazepines were the most frequently found, followed by cannabis. A sustained increase in fatal cases involving polydrug use was also observed.</div></div><div><h3>Conclusions</h3><div>These results highlight the significant role of substance use in violent death contexts and underscore the urgent need to strengthen prevention, control, and treatment strategies for drug use within a comprehensive public health and security framework.</div></div>","PeriodicalId":35705,"journal":{"name":"Revista Espanola de Medicina Legal","volume":"51 4","pages":"Article 500486"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486094","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":"La evolución de Revista Española de Medicina Legal","authors":"Carles Martin-Fumadó,&nbsp;Amadeo Pujol-Robinat,&nbsp;Eneko Barbería-Marcalain,&nbsp;Esperanza L. Gómez-Durán,&nbsp;Alexandre Xifró-Collsamata,&nbsp;Josep Arimany-Manso","doi":"10.1016/j.reml.2025.500491","DOIUrl":"10.1016/j.reml.2025.500491","url":null,"abstract":"","PeriodicalId":35705,"journal":{"name":"Revista Espanola de Medicina Legal","volume":"51 4","pages":"Article 500491"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486131","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}