Perspectivas em medicina legal e pericias medicas最新文献

{"title":"AUTOEROTIC ASPHYXIA – WHEN SHAME TAKES THE SCENE","authors":"C. Durão","doi":"10.47005/230309","DOIUrl":"https://doi.org/10.47005/230309","url":null,"abstract":"Autoerotic death is defined as accidental death that occurs during individual and solitary sexual activity in which some type of instrument or apparatus was used to increase the victim’s sexual stimulation leading to an unintentional death. We present the autopsy report of a 50-year-old man presented for autopsy with a history of suicide by hanging. The characteristics of the victim’s clothes, the semen stains on the clothes, with the presence of toilet paper next to them, suggesting masturbation and the absence of a hanging groove due to protective foam used by the victim, allowed the reconstitution of the probable mechanism produced by the victim in his asphyxia with the help of a rope and an elastic band attached to the heel of a high shoe, which, when broken, would have produced the fatal accident. The description of this case is important to alert to the concept of autoerotic death and avoid the misinterpretation of the legal medical etiology, allowing accidental cases to be interpreted as suicides, or even natural deaths to be interpreted as autoerotic deaths without fitting into the concept of autoerotic death, which must always be an accidental death. Keywords: autoerotic death, autoerotic asphyxia, autopsy.","PeriodicalId":366101,"journal":{"name":"Perspectivas em medicina legal e pericias medicas","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127283187","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":"PRECISELY LOCATED 0.5 CM LESION IN THE LEFT VENTRICLE OF A VICTIM OF SUICIDE BY TABLE KNIFE: CASE REPORT","authors":"Jairo Joaquim dos Santos Junior, Luciana Maria Prado Gomes, Danilo Guimarães Siqueira","doi":"10.47005/230102","DOIUrl":"https://doi.org/10.47005/230102","url":null,"abstract":"Between 2010 and 2019, there were 112,230 deaths by suicide in Brazil, with a 43% increase in the annual number of deaths, from 9,454 in 2010 to 13,523 in 2019 (1). In this paper, a case of a victim of self-harm by a sharp instrument will be reported, which caused cardiac tamponade and evolved to death, on the spot, with cause of death: cardiogenic shock. Reviewing the cadaveric report, obtained at the Instituto Médico Legal de Sergipe, in order to understand the mechanism of the cardiac trauma and its severity, which caused 600ml of hemorrhagic contente to fill in the pericardium. What draws attention would be the precision of the wound, as it is a self-inflicted injury, with ruptures of several anatomical physical barriers, reaching the heart with a 0.5 cm lesion, in the left ventricle, with a single blow and a malleable object, a table serrated knife, with characteristics of low resistance and low piercing power, when compared to other sharp instruments of greater lethality. There is a high prevalence in victims of penetrating cardiac injury who die before receiving advanced life support. Among those who arrive at the hospital, a small part may be hemodynamically stable and without clinical signs suggestive of cardiac injury. Exsanguination is responsible for most deaths from cardiac trauma and cardiac tamponade was present in second place. Keywords: Cardiogenic shock, cardiac tamponade, sharp injury, pericardium.","PeriodicalId":366101,"journal":{"name":"Perspectivas em medicina legal e pericias medicas","volume":"172 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114192455","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":"EXPERTISE THE WORK ENVIRONMENT IS NOT PART OF THE MEDICAL EXPERTISE","authors":"Marcos Alvarez, Renata Alvarez","doi":"10.47005/230518","DOIUrl":"https://doi.org/10.47005/230518","url":null,"abstract":"Some operators of law prescribe that the medical expert is obliged to inspect the workplace in all analyzes of the causal link between illness and work carried out in the scope of the Labor Court (JT). The allegation of occupational disease is enough to establish the obligation. Failure to carry out the inspection would imply, as has been happening, in the annulment of the report, regardless of the technical indications. It is argued that Resolution CFM 2323/2022 would impose this obligation. The absence of medical experts in this discussion is notorious. This article presents a legal, ethical and technical review of the subject, revealing the lack of grounds for the imposition, the misinterpretations of Resolution CFM 2323/22, the harmful consequences that this conduct brings to the quality of the judicial provision, to workers, to employers that comply with health and safety standards and expert doctors. It then proposes a sequence of steps to be followed in order to determine the indications of expertise in the workplace, as well as define its objectives.","PeriodicalId":366101,"journal":{"name":"Perspectivas em medicina legal e pericias medicas","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122809370","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":"PREVALENCE OF WORK-RELATED MENTAL DISORDERS IN BRAZIL: A PRE AND POST-PANDEMIC COMPARISON","authors":"Maria Clara Monteiro de Souza Lima, Anna Beatriz Vilas Boas Moreira, Daniel Nascimento Machado, Raul Coelho Barreto Filho","doi":"10.47005/230306","DOIUrl":"https://doi.org/10.47005/230306","url":null,"abstract":"Introduction: Work-related mental disorders are frequent and affect not only the work activity, but also the individual’s quality of life. During the COVID-19 pandemic – which began in 2019, there were changes in terms of society’s behavior in relation to its work activity – such as social isolation and teleworking – which brought uncertainties in the work dynamics of most professionals and functioned as one of the factors that influenced the emergence of mental disorders in the Brazilian population.(1) In this context, the importance of assessing the prevalence of these disorders in a pre- and post-pandemic comparison is evident. Material and method: Descriptive, cross-sectional study through data collection using the DATASUS platform, using available data for the years 2018 to 2021. Objective: To describe the annual prevalence of work-related mental disorders in Brazil, from the comparison data for the years 2018 to 2021. In addition, expose whether there was an increase in prevalence in the year of the beginning of the pandemic (2019), in relation to the pre-pandemic period (2018), and if the upward trend persisted with regard to the pandemic period (2019 and 2020) and post-pandemic period (2021). Results: Between 2018 and 2021, there were a total of 7337 cases. Of these, 1812 (24.7%) were registered in 2018, 2378 (32.4%) in 2019, 1343 (18.3%) in 2020 and 1804 (24.6%) in 2021. Thus, comparing by periods: from 2018 to 2019, cases increased from 1812 to 2378, which represents a percentage increase of 31.2%. From 2019 to 2020, the registered numbers fell by 43.5%, and from 2020 to 2021, a new increase corresponding to 34.3% was observed. Discussion: This analysis showed that the highest percentage increase occurred from 2020 to 2021, a transition period between telecommuting and working in a physical environment. In addition, in the year of the greatest spread of COVID-19 (2019), there was also a considerable increase in the number of cases.Conclusion: of the 7,337 total cases, the year with the highest number of cases of work-related mental disorders in Brazil was 2019, when the pandemic began in the country, a factor that promoted changes in Brazilian labor dynamics. However, it was possible to conclude that the post-pandemic period (2021), in relation to the number of cases, had a similar prevalence to the pre-pandemic period (2018), with an increase of 34.3% compared to the year 2020. This conclusion was possible since there was also a decline of 43.5% of cases, when comparing the years 2019 and 2020. Keywords: mental disorders, teleworking, COVID-19.","PeriodicalId":366101,"journal":{"name":"Perspectivas em medicina legal e pericias medicas","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131453928","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":"ANALYSIS OF THE PATIENT’S ABILITY TO UNDERSTAND THE INFORMED CONSENT FORM","authors":"Angelo dos Anjos Couto, Marcia Vieira da Motta","doi":"10.47005/230310","DOIUrl":"https://doi.org/10.47005/230310","url":null,"abstract":"Introduction: Medical Assistance, Assistance and research, the principles initiated by the Nuremberg Code, were materialized through written documents called Consent Forms. The present study aims to assess the understanding of the consent form in hospitals in the state of São Paulo. Method: Terms that meet the inclusion criteria were retrieved in the analysis with textual readability analysis, and the specific online assessment instrument of the textual readability program was used: Flesch Readability Test; Gulpease Index; Flesch-Kincaid graduation level; Adapted Gunning cloudiness index ; Automated readability index; Coleman-Liau index. Results: The present study presents data between texts of terms with: two at level 11 (high readability); eight are from level 13 to16 (medium readability) and three are from level 17 to18 (low readability). Therefore, the results of the present study indicated that in order to understand the analyzed terms the reader had to be at a univerisity level course ou have graduated from the university. Conclusion: It is recommended that sample be expanded and that they hospitals adopt measures that readability of terms. Keywords: Free and Informed Consent, Understanding, Operative Surgical Procedures","PeriodicalId":366101,"journal":{"name":"Perspectivas em medicina legal e pericias medicas","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130563451","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":"CHARACTERISTICS OF INJURIES CAUSED BY LESS-LETHAL AMMUNITION SHOOTING: A HISTORICAL VIEW","authors":"Orlando Victorino de Moura Junior, Ivan Dieb Miziara","doi":"10.47005/230413","DOIUrl":"https://doi.org/10.47005/230413","url":null,"abstract":"introduction: In the early 1970s, a new type of firearm was introduced into the military arsenal, with a format and function identical to those that had been used for centuries by forces from different countries, but now fed with rubber or plastic ammunition, whose use was intended to contain the targets without causing lethal damage. Until the present-day firearms with less lethal projectiles are used by police forces. objectives: This article aims to expose the characteristics of the injuries caused by this type of ammunition, which parts of the body are most affected, in addition to finding out which are the most frequent sequelae and whether there is a risk of death in its use. methods: A literature review was performed on PubMed and all articles and case reports involving injuries in live humans caused by this type of ammunition were analyzed. results: 37 articles were included in the present study and, together, they exposed a total of 932 injuries, of which 612 could be classified as simple blunt or perforated contusion. discussion: Shots by less-lethal ammunition, despite being known as “non-lethal ammunition”, can result in death or serious impairment by damaging organs, sense or function, especially when they reach more sensitive regions of the human body, such as the face or eyes. conclusion: Of the injuries that could be classified, 60% were blunt and 40% perforated-contuse. The head was the most affected region. The eyes accounted for 32% of the total number of injuries, which justifies visual loss as the most frequently reported sequelae. The risk of death exists; 26 people died from gunshot wounds.","PeriodicalId":366101,"journal":{"name":"Perspectivas em medicina legal e pericias medicas","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122270893","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":"ANALYSIS OF THE NUMBER OF RAPE CASES IN A MUNICIPALITY IN NORTH FLUMINENSE","authors":"Danillo Antunes Merat, Leticia Longue Correa, Rober Mathan Oliveira de Carvalho Hentzy, Thaynara Cabreira da Silva, Claudio dos Santos Dias Cola","doi":"10.47005/230307","DOIUrl":"https://doi.org/10.47005/230307","url":null,"abstract":"Introduction: Rape means any oppression to the free exercise of an individual’s sexuality, whether for the purpose of reproduction or the pursuit of pleasure. Objective: Analyzing the cases of rape in Campos dos Goytacazes/RJ, computing its incidence, percentage in different perspectives and identifying the prevalence. Material and methods: Conducted through an exploratory and descriptive research, with a survey of data available at the Institute of Public Security of the State of Rio de Janeiro, being computed the data referring to Campos dos Goytacazes, North Fluminense Region and State of Rio de Janeiro, for comparison of information, between January and September of the years 2019 and 2020. Results: There was a drop in rape reports between the years analyzed. Within this perspective, it is questioned whether there was a reduction in cases or notifications. Regarding victims, there is a prevalence of women in relation to men, with a preponderance of white victims, followed by brown and black victims. About age, there is a predominance of minors and a predominance of cases that occur in the family environment. Conclusion: From the data analyzed, we observed that Campos dos Goytacazes follows part of the national standards and the scientific literature regarding rape, occurring predominantly with women, minors and in the family environment, however, in the city there is a prevalence of crime with white women, while nationally there is a predominance of blacks and browns. Also, there was a decrease in reports of domestic violence, which may have occurred due to different factors.","PeriodicalId":366101,"journal":{"name":"Perspectivas em medicina legal e pericias medicas","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133990296","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":"DEMENCIA WITH LEWY BODIES IN EXPERT ASSESSMENT OF SOCIAL SECURITY","authors":"Alexandre Valença, C. Leal, Gustavo Oliveira, Talvane Moraes, Antonio NardiNardi, Mauro Mendlowicz","doi":"10.47005/230517","DOIUrl":"https://doi.org/10.47005/230517","url":null,"abstract":"Dementia is a clinical syndrome characterized by multiple, acquired and persistent cognitive deficits, capable of substantially interfering in the patient’s activities of daily living. The diagnosis of Dementia with Lewy Bodies (LBD) is characterized by fluctuation in cognitive functions, recurrent, well-formed, and detailed visual hallucinations, and parkinsonism, with stiffness, tremor, bradykinesia, and slurred speech. Our goal is to describe a case report of LBD that for several years was diagnosed and treated as depression. It is extremely important to have detailed medical research in these cases, including performing differential diagnosis with depression, in order to enable adequate treatment, family guidance and receipt of financial benefits provided by government authorities.","PeriodicalId":366101,"journal":{"name":"Perspectivas em medicina legal e pericias medicas","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132924047","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":"RELATIONSHIP BETWEEN THE COVID-19 PANDEMIC AND THE RESULTS OF DEATH FROM EXTERNAL CAUSES – BEFORE AND DURING","authors":"Maxbel Oliveira da Silva, M. L. Duarte","doi":"10.47005/230101","DOIUrl":"https://doi.org/10.47005/230101","url":null,"abstract":"ntroduction: Deaths from external causes are those that result from an exogenous and harmful action to the individual, or that worsen a preexisting pathological condition, so that there is a cause and effect relationship between aggression and death. These deaths are directly related to human activities, as well as existing environmental phenomena in the world, such as the pandemic that started in December 2019, as a result of covid-19, a disease caused by the SARS-CoV-2 virus. Objectives: This study aimed to analyze a possible change in the profile of deaths from external causes based on cadaveric reports from the Instituto Médico Legal Estácio de Lima, in Maceió/AL in a pre-pandemic period (2018 and 2019) and with the pandemic in force (2020 and 2021). Material and method: This was a documentary, epidemiological, descriptive, and analytical study through sampling. The research analyzed a sample of 1824 cadaveric reports from the IML Estácio de Lima archive from 2018 to 2021. Results: Comparing the period 2018-2019, without a pandemic, with the years 2020-2021 in which the pandemic was in progress, the percentage of deaths from external causes increased from 87.83% to 90.13%. The predominant gender was male, ranging from 82.24% to 87.5% of the cases. Homicides increased from 48.46% in the 2018/2019 biennium to 45.94% in the 2020/2021 biennium. Suicides decreased by 0.88%. Deaths from undetermined causes rose from 3.73% in the first biennium analyzed, to 10.42% in the pandemic period. Mechanical energy had the highest prevalence in all years, with the blunt punch instrument being the most prevalent in the years 2018, 2019 and 2020 and the blunt instrument in the year 2021. Discussion: The covid-19 pandemic has had an impact on deaths from external causes in its modalities and variables, in addition to generating changes in the forensic activities of the IML Estácio de Lima, leading to a greater number of deaths from undetermined causes, probably due to the limitations arising from the covid-19 pandemic, such as protocols created to prevent the spread of the virus to those involved in the necroscopic expertise. Conclusion: The covid-19 pandemic changed the social context, human activities and, consequently, the profile of deaths from external causes, due to changes aimed at containing cases of the disease.","PeriodicalId":366101,"journal":{"name":"Perspectivas em medicina legal e pericias medicas","volume":"114 41","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120826876","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":"SOCIAL SECURITY BENEFITS DUE TO DEPRESSIVE EPISODE IN BRAZIL (2008-2019)","authors":"Nilton da Silva Oliveira Junior, João Silvestre Silva Jr, Ivan Dieb Miziara","doi":"10.47005/230308","DOIUrl":"https://doi.org/10.47005/230308","url":null,"abstract":"Introduction: Mental and behavioral disorders corresponded to the third main cause of disability benefits granted by the National Institute of Social Security (INSS), especially the Major Depressive Episode (MDE). Objectives: Present the frequency of granting social security benefits for disability due to MDE in Brazil. Material and method: Ecological study of the INSS public database regarding work disability benefits granted between 2008 and 2019. Results and discussion: The average number of benefits granted by MDE was 56,643 (standard deviation – sd 6,201). The male mean was 16,837 (SD 2,227), or 29.67% (SD 1.13) and the female mean was 39,806 (SD 4,106), or 70.33% (SD 1.13). In the urban area, the average was 55,044 (SD 5,982), or 97.18% (SD 0.27) and, in the rural area, 1,599 (SD 267), or 2.82% (SD 0.27). Conclusion: Disabling MDE benefits were granted mainly to women from urban and non-work related regions. The data justify the need for effective measures to mitigate the impact of these leaves on workers and rehabilitate them for reintegration into the labor market. Keywords: Depressive Disorder, Occupational Health, Social Security, Sick Leave.","PeriodicalId":366101,"journal":{"name":"Perspectivas em medicina legal e pericias medicas","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133585917","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}