Historical moment of a specialty

Os autores fazem um breve relato histórico da Medicina Legal ressaltando que é, como especialidade médica, uma das mais antigas e que vive um momento de grande relevância histórica: a fusão de duas sociedadesmédicas que disputavam o direito de emitir certificado de área de atuação para os médicos que a exercem. Os pontos principais dessa disputa são destacados, incluindo a alteração do nome da especialidade que passou a ser Medicina Legal e Perícia Médica, não se tratando de nova especialidade, apenas uma pequena mudança de denominação da antiga.  This article presents a brief history of Forensic Medicine in Brazil and emphasizes the current relevantmoment the specialty is facing: fusion of two medical societies which disputed the right to issue specialty certification for forensic medical doctors working in the area. The main dispute points are discussed, including the change in denomination of the specialty with the addition of Perícia Médica to the original name (Medicina Legal).  

Relação Médico-Paciente e Relação Perito-Periciando: diferenças e semelhanças

Introdução: A relação médico-paciente é a base da Medicina e está fundamentada nos princípios da beneficência, não-maleficência, justiça e autonomia. A perícia médica surgiu diante da necessidade da aplicação de conhecimentos técnicos no âmbito do Direito. As diferenças entre essas duas atuações médicas é objeto de conflitos que dificultam a atuação do médico perito. Objetivo: Estabelecer as diferenças e semelhanças entre a relação médico-paciente e a relação perito-periciando. Material e Métodos: Revisão de literatura de artigos e periódicos em língua portuguesa na base de dados Scielo e em livros especializados sobre o assunto. Discussão: A relação médico-paciente se baseia em confiança mútua, estabelecimento de vínculo mútuo, busca por um resultado em comum: diagnóstico e tratamento; há coerência entre a comunicação verbal e não verbal, a anamnese constitui o principal método propedêutico, sendo os exames complementares solicitados para auxiliar o diagnóstico e há o compromisso com o sigilo profissional. Já a relação perito-periciando possui uma natureza investigativa, não havendo uma relação de confiança mútua, a finalidade é o esclarecimento da Justiça e o sigilo profissional não fica restrito ao binômio perito-periciando. A semelhança entre essas duas relações está relacionada à conduta do médico que deve ser pautada na técnica, no respeito, educação e abstenção de julgamentos morais e de valores, além da necessidade de atualização por parte do profissional. Conclusão: A relação médico-paciente e a relação perito-periciando apresentam características peculiaridades e algumas delas são inconfundíveis. Em ambas as situações observamos a importância da atuação médica como essência desta relação e suas consequentes implicações morais, jurídicas e éticas.Introduction: Physician-patient relationship is the basis of Medicine. It is founded on the principles of beneficence, non-maleficence, justice, and autonomy. The field of legal medical developed from the need to apply technical knowledge to assist legal processes. The differences between these two medical practices are at the origin of conflicts that hinder the performance of the medical examiner. Objective: To establish the differences and similarities between the physician-patient relationship and the –examiner-patient relationship. Methods: Literature review of articles and journals in Portuguese in Scielo databases and in specialized books on the subject. Discussion: Physician-patient relationship is based on mutual trust and mutual bond; the physician and patient both seek for diagnosis and treatment; there is consistency between verbal and nonverbal communication; establishing the case history is the main diagnostic method, while further tests are requested to assist the diagnosis; and there is a commitment to professional secrecy. The examiner-patient relationship has an investigative nature; it is not based on mutual trust; the purpose is to assist Court decisions by clarifying medical aspects of the case; and professional confidentiality is not restricted to the examiner-patient binomial. The similarity between these two relations is seen in the physician’s conduct, which must always be based on technique, respect, appropriate behavior, a non-judgmental approach, and also being up to date on professional advances . Conclusion: The Patient-Physician Relationship and the Patient-Examiner Relationship have peculiarities and some of them are unmistakable. In both situations, we observe the importance of medical practice as the essence of this relationship and its consequent moral, legal, and ethical implications

Estimated time of death through the cadaveric entomofauna in decomposing cadavers: a case report

This study reports a case of a sixty-nine years old lady who was found dead in her house, in state ofputrefaction. The study of cadaveric phenomena was imprecise and determined the post mortem time as two weeks and some days. The entomofauna analysis resulted to be a more accurate cronotanatognosis method, showing that the death had occurred exactly eight days before the body was found.Relato do caso de uma senhora de sessenta e nove anos encontrada morta em sua residência, já em estado de putrefação, no qual a análise dos fenômenos cadavéricos foi imprecisa para determinar a cronotanatognose (de dois dias a algumas semanas). Foi, então, realizado o estudo da entomofauna cadavérica para determinar o PMI (post morten interval) e concluiu-se que a morte havia ocorrido oito dias antes

Phenotypic association among performance, feed efficiency and methane emission traits in Nellore cattle.

Enteric methane (CH4) emissions are a natural process in ruminants and can result in up to 12% of energy losses. Hence, decreasing enteric CH4 production constitutes an important step towards improving the feed efficiency of Brazilian cattle herds. The aim of this study was to evaluate the relationship between performance, residual feed intake (RFI), and enteric CH4 emission in growing Nellore cattle (Bos indicus). Performance, RFI and CH4 emission data were obtained from 489 animals participating in selection programs (mid-test age and body weight: 414±159 days and 356±135 kg, respectively) that were evaluated in 12 performance tests carried out in individual pens (n = 95) or collective paddocks (n = 394) equipped with electronic feed bunks. The sulfur hexafluoride tracer gas technique was used to measure daily CH4 emissions. The following variables were estimated: CH4 emission rate (g/day), residual methane emission and emission expressed per mid-test body weight, metabolic body weight, dry matter intake (CH4/DMI), average daily gain, and ingested gross energy (CH4/GE). Animals classified as negative RFI (RFI0). Nonetheless, more efficient animals emitted more CH4/DMI and CH4/GE (P < 0.0001), suggesting that the difference in daily intake between animals is a determinant factor for the difference in daily enteric CH4 emissions. In addition, animals classified as negative RFI emitted less CH4 per kg mid-test weight and metabolic weight (P = 0.0096 and P = 0.0033, respectively), i.e., most efficient animals could emit less CH4 per kg of carcass. In conclusion, more efficient animals produced less methane when expressed as g/day and per kg mid-test weight than less efficient animals, suggesting lower emissions per kg of carcass produced. However, it is not possible to state that feed efficiency has a direct effect on enteric CH4 emissions since emissions per kg of consumed dry matter and the percentage of gross energy lost as CH4 are higher for more efficient animals

Status and prospects of discovery of 0νββ decay with the CUORE detector

In this contribution we present the achievements of the CUORE experiment so far. It is the first tonne-scale bolometric detector and it is in stable data taking since 2018. We reached to collect about 1800 kg×yr of exposure of which more than 1ton×year have been analysed. The CUORE detector is meant to search for the neutrinoless double β decay (0νββ) of the 130Te isotope. This is a beyond Standard Model process which could establish the nature of the neutrino to be Dirac or a Majorana particle. It is an alternative mode of the two-neutrinos double β decay, a rare decay which have been precisely measured by CUORE in the 130Te. We found no evidence of the 0νββ and we set a Bayesian lower limit of 2.2×1025yr on its half-life. The expertise achieved by CUORE set a milestone for any future bolometric detector, including CUPID, which is the planned next generation experiment searching for 0νββ with scintillating bolometers

Twelve-crystal prototype of Li2_2MoO4_4 scintillating bolometers for CUPID and CROSS experiments

An array of twelve 0.28 kg lithium molybdate (LMO) low-temperature bolometers equipped with 16 bolometric Ge light detectors, aiming at optimization of detector structure for CROSS and CUPID double-beta decay experiments, was constructed and tested in a low-background pulse-tube-based cryostat at the Canfranc underground laboratory in Spain. Performance of the scintillating bolometers was studied depending on the size of phonon NTD-Ge sensors glued to both LMO and Ge absorbers, shape of the Ge light detectors (circular vs. square, from two suppliers), in different light collection conditions (with and without reflector, with aluminum coated LMO crystal surface). The scintillating bolometer array was operated over 8 months in the low-background conditions that allowed to probe a very low, $\mu$Bq/kg, level of the LMO crystals radioactive contamination by $^{228}$Th and $^{226}$Ra.Comment: Prepared for submission to JINST; 23 pages, 9 figures, and 4 table

A first test of CUPID prototypal light detectors with NTD-Ge sensors in a pulse-tube cryostat

CUPID is a next-generation bolometric experiment aiming at searching for neutrinoless double-beta decay with ~250 kg of isotopic mass of $^{100}$Mo. It will operate at $\sim$10 mK in a cryostat currently hosting a similar-scale bolometric array for the CUORE experiment at the Gran Sasso National Laboratory (Italy). CUPID will be based on large-volume scintillating bolometers consisting of $^{100}$Mo-enriched Li$_2$MoO$_4$ crystals, facing thin Ge-wafer-based bolometric light detectors. In the CUPID design, the detector structure is novel and needs to be validated. In particular, the CUORE cryostat presents a high level of mechanical vibrations due to the use of pulse tubes and the effect of vibrations on the detector performance must be investigated. In this paper we report the first test of the CUPID-design bolometric light detectors with NTD-Ge sensors in a dilution refrigerator equipped with a pulse tube in an above-ground lab. Light detectors are characterized in terms of sensitivity, energy resolution, pulse time constants, and noise power spectrum. Despite the challenging noisy environment due to pulse-tube-induced vibrations, we demonstrate that all the four tested light detectors comply with the CUPID goal in terms of intrinsic energy resolution of 100 eV RMS baseline noise. Indeed, we have measured 70--90 eV RMS for the four devices, which show an excellent reproducibility. We have also obtained outstanding energy resolutions at the 356 keV line from a $^{133}$Ba source with one light detector achieving 0.71(5) keV FWHM, which is -- to our knowledge -- the best ever obtained when compared to $\gamma$ detectors of any technology in this energy range.Comment: Prepared for submission to JINST; 16 pages, 7 figures, and 1 tabl