Deaths by Choking with Food in Children: Legal Medical Aspects by Suffocation

The asphyxia by suffocation (choking) with foreign bodies are dramatic. Among these, the choking with food are responsible for most of these deaths. Children under four years old are particularly vulnerable due to not having a well-developed posterior dentition. The paper presents the report of two cases of suffocation with food and discusses some legal medical concepts, warning of the further prevention of such cases

Dislocation of the Metacarpophalangeal Joint of the Thumb in a Child

Luxações isoladas das articulações metacarpofalângicas nas crianças são muito raras, sendo escassos os relatos na literatura. Isto pela fragilidade das físes, que pelo traumatismo associado, normalmente se separam em vez da ocorrência da luxação da articulação adjacente. Este trabalho apresenta o relato de um caso, discutindo a importância da atempada redução e as eventuais complicações descritas nestas lesões

VOMIT – victims of modern imaging tecnologies: aspectos médico legais dos incidentalomas nos acidentes de trabalho

A obstinação terapêutica e a solicitação indiscriminada de exames complementares de diagnóstico têm feito aumentar o diagnóstico de lesões assintomáticas, verdadeiros achados imagiológicos conhecidos na literatura como incidentalomas. A descoberta destes achados leva à indicação de mais exames de diagnóstico, que habitualmente são mais exagerados quanto menor a especialização ou experiência do médico assistente. A descoberta de um aneurisma da aorta num exame de ressonância da coluna pode alterar o prognóstico da evolução natural permitindo um tratamento atempado deste. Mas o excesso de diagnóstico também pode levar a tratamentos de lesões assintomáticas, confundidas com queixas que podem ser sobreponíveis. Variações anatómicas podem ser confundidas com alterações patológicas ou pós traumáticas, como alguns ossos acessórios que são interpretados como avulsões ósseas. Tumores ósseos benignos que são exaustivamente estudados, submetendo o doente a excessos de radiação e um stress desnecessário. Nos acidentes de trabalho, a precocidade na realização de exames complementares de diagnóstico, como a IRM, ao mesmo tempo que permite um diagnóstico mais preciso e imediato, também permite que lesões extremamente prevalentes possam ser confundidas com as queixas agudas do sinistrado. São exemplos as hérnias discais, lesões ligamentares do punho e tornozelo. A crença de que “é melhor prevenir do que remediar” ou prática da medicina extremamente defensiva pode mesmo submeter o sinistrado a exames que oneram o sistema ou estarem na origem de indicações cirúrgicas que não irão alterar o resultado final do doente, aumentando apenas a sua IPP. O exame físico deve ser soberano, a anamnese objetiva e os exames complementares criteriosos. As discussões entre especialistas e as reuniões multidisciplinares são fundamentais na troca de experiência entre a medicina curativa e a Avaliação do Dano Corporal

Undiagnosed intracranial lipoma associated with sudden death

Intracranial lipomas represent less than 0.1% of all intracranial tumors. They are usually located in the callus area and often asymptomatic. This paper presents a sudden death case after an episode of convulsions on a 39 years old woman with a history of migraines and seizures since adolescence. The autopsy revealed the presence of an undiagnosed massive brain lipoma (60 × 35 mm) associated with atrophy of the corpus callosum. Although very rare and seldom malignant these may be associated with seizures and sudden deathinfo:eu-repo/semantics/publishedVersio

Death by chumbinho: aldicarb intoxication—regarding a corpse in decomposition

Chumbinho is the popular name given to carbamate aldicarb (Temik), an insecticide commonly used in agriculture and highly toxic (LD50 = 0.9 mg/kg oral in rats) that has been sold clandestinely in several regions of Brazil. Chumbinho is sold illegally as raticide and is available in a formulation of small black granules which are easily mixed with food for criminal purposes, its use often being attributed to accidents and suicides, hence the importance of its inclusion in the toxicology studies of suspicious deaths. With the corpse putrefaction, many pathological and toxicological anatomical parameters are damaged or lost. This study emphasizes the importance of the gastric content observation, which in this case has, despite the advanced putrefaction, recognized the presence of chumbinho and guide its toxicological confirmation

Still Exists Space for Conservative Treatment in Complex Fracture of Humeral Shaft?

As fraturas da diáfise do úmero representam cerca de 1 a 3% de todas as fraturas, e cerca de 20% das fraturas umerais. A maioria das fraturas da diáfise do úmero, nomeadamente as oblíquas longas e as cominutivas, pode ser tratada conservadoramente, porém a tendência atual vai no sentido do tratamento cirúrgico, mesmo nas fraturas que se obtinham bons resultados com o tratamento não cirúrgico. O presente trabalho descreve o bom resultado diante de um tratamento conservador numa fratura diafisária complexa do úmero, demonstrando ainda existir espaço para o tratamento não cirúrgico, e discute a importância da relação médico-doente diante diversas opções terapêuticas.info:eu-repo/semantics/publishedVersio

InterInterpretação das lesões ortopédicas dos ocupantes dos veículos na reconstrução forense dos acidentes de viação

Road Traffic accidents are the leading cause of violent death and a major cause of death and sequelae in young and economically active population in developed and developing countries. Numbers that can only be compared to wars, which exemplifies the consequences of these lesions in economic and social terms. In 2002, about 1.2 million people died in traffic accidents, and in 2020, it is estimated that this number will double according to the World Health Organization (WHO). Only a small percentage of these are generated by vehicle faults or adverse conditions. The vast majority of accidents are caused by carelessness, negligence or malpractice of drivers or pedestrians, which makes the reconstruction of accidents a key step in the investigation and prevention of further accidents

Typical wounds and your eponyms in forensic ballistics

Os epônimos são parte da história da Medicina e representam, sobretudo, uma homenagem aos pioneiros na descrição de um sinal, doença, técnica, manobra ou estrutura anatômica. Este trabalho tem como objetivo revisar a literatura médico-legal clássica e apresentar epônimos referentes aos resultados mais significativos da balística terminal. Os epônimos podem facilitar a comunicação entre os peritos, encurtando a descrição, mas não deve ser utilizado em relatórios que irão ser lido por leigos, uma vez que o seu uso neste caso, poderia conduzir à confusão de termos

Importance of a National arthroplasty register for Identification by medical examiner

ABSTRACTMass catastrophes are realities that come to pass with lamentable frequency. In such situations, one of the fundamental forensic problems is in relation to identifying the victims. All the elements that might be capable of contributing towards this identification process are essential, and among these are orthopedic prostheses, which frequently remain intact. These prostheses consist basically of polymers, ceramics or metals. Metal components, which are usually composed of titanium, chromium, cobalt or steel alloys, are resistant to violent trauma or high temperatures. Human identification is possible if the identity of the implant is established and if this can be correlated with the individual in whom it was implanted. The logo on the prosthesis establishes who the manufacturer was and the serial number can be compared with the clinical process or with a prosthesis register, as has been implemented in several countries. The information in the database should include the patient's name, the implant model and its serial number, for consultation only in cases of forensic identification, while obviously respecting ethical issues of privacy. This article highlights the importance of creating a national prosthesis register

Weight following birth and childhood dietary intake: A prospective cohort study

Objectives: Unhealthy childhood dietary habits track through life and are independent and modifiable risk factors for disease. Therefore, it is essential to understand the factors involved. We aimed to evaluate the associations of birthweight (BW) and newborn weight change (NWC) during the first 96 h of life and childhood longitudinal weight trajectories with dietary intake at age 4. Methods: As part of the Generation XXI birth cohort (G21), children were recruited in 2005 and 2006 at all public units providing obstetrical and neonatal care in Porto, Portugal. Information was collected by face-to-face interview and abstracted from clinical records. At age 4, weight measurements recorded from birth to current age were abstracted and weight trajectories estimated. Food frequency questionnaires were applied, and three dietary patterns (DPs) were identified: “Energy-dense food (EDF)+Dairy,” “Lower in Healthy Food,” and “Healthier.” Logistic regression models were used to compute the odds ratio (OR) and 95% confidence intervals (CIs) (OR [95% CI]) in a sample of 775 children. Results: Children with higher BW were less frequently in the “EDF+Dairy” DP (0.94 [0.89–0.98] per 100 g increase in BW). Children with higher NWC had lower odds of eating fruit ≥3/d (0.93 [0.87–0.99] per 1% increase in NWC). Children with higher weight during childhood had higher odds of belonging to the “EDF+Dairy” DP (1.90 [1.04–3.47]) and lower odds of eating vegetable soup ≥2/d (0.56 [0.34–0.91]). Children showing catch-up grow in the first year of life had higher odds of eating dairy products ≥3/d (3.76 [1.31–10.80]). Conclusions: The way that children grow during childhood played a major role on dietary intake at age 4