Analyse spatiale des violences faites aux femmes au sein du couple dans la ville de Toulouse

Les violences faites aux femmes au sein du couple sont internationalement reconnues comme étant un problème d’ampleur épidémique de santé publique, de politique sociale et une violation des droits des femmes. La survenue de ces violences serait notamment corrélée au regroupement de conditions de désavantages socio-économiques au sein de l’environnement local. L’objectif de notre étude était de cartographier la répartition des violences faites aux femmes au sein du couple dans la ville de Toulouse afin de mettre en évidence la présence d’interactions spatiales. Les adresses postales de 840 femmes ayant consulté à l’unité médico-judiciaire de l’Hôpital Rangueil ont été géocodées. La distribution spatiale des adresses a été analysée à l’aide de fonctions de lissage spatial, de tests de corrélation spatiale et de modèles spatiaux d’estimation de risque. Une hétérogénéité marquée a été mise en évidence sous la forme de regroupements spatiaux significatifs dont certains présentent un sur-risque relatif estimé de violences faites aux femmes au sein du couple. Les unités médico-judicaires jouant un rôle central dans la prise en charge de ces femmes, l’utilisation des nombreuses données disponibles associée à l’utilisation de méthodes innovantes d’épidémiologie spatiale permettrait d’améliorer la compréhension des mécanismes en jeu afin de faciliter la mise en œuvre de politiques sociales, médicales et environnementales visant à lutter contre ces violences.Intimate partner violence against women is internationally recognized as a public health and social policy issue of epidemic proportions and a violation of women’s rights. In particular, the occurrence of such violence appears to be correlated with the clustering of socio-economically disadvantaged conditions within the local environment. The aim of our study was to map the distribution of intimate partner violence against women in the city of Toulouse, in order to highlight the presence of spatial interactions. The postal addresses of 840 women who consulted the forensic medicine unit at the Rangueil Hospital in Toulouse were geocoded. The spatial distribution of these addresses was then analysed using spatial smoothing functions, spatial correlation tests and spatial risk estimation models. These revealed a markedly heterogeneous pattern formed by significant spatial groupings, of which some present an estimated relatively high risk of intimate partner violence against women. Because forensic medicine units play a central role in the care of these women, using the large quantity of available data together with innovative methods of spatial epidemiology would help to better understand the mechanisms at play, in order to facilitate the implementation of social, medical and environmental policies aiming to combat violence of this kind

Effect of voxel size on the accuracy of 3D reconstructions with cone beam CT.

OBJECTIVES: The various types of cone beam CT (CBCT) differ in several technical characteristics, notably their spatial resolution, which is defined by the acquisition voxel size. However, data are still lacking on the effects of voxel size on the metric accuracy of three-dimensional (3D) reconstructions. This study was designed to assess the effect of isotropic voxel size on the 3D reconstruction accuracy and reproducibility of CBCT data. METHODS: The study sample comprised 70 teeth (from the Institut d\u27Anatomie Normale, Strasbourg, France). The teeth were scanned with a KODAK 9500 3D® CBCT (Carestream Health, Inc., Marne-la-Vallée, France), which has two voxel sizes: 200 µm (CBCT 200 µm group) and 300 µm (CBCT 300 µm group). These teeth had also been scanned with the KODAK 9000 3D® CBCT (Carestream Health, Inc.) (CBCT 76 µm group) and the SCANCO Medical micro-CT XtremeCT (SCANCO Medical, Brüttisellen, Switzerland) (micro-CT 41 µm group) considered as references. After semi-automatic segmentation with AMIRA® software (Visualization Sciences Group, Burlington, MA), tooth volumetric measurements were obtained. RESULTS: The Bland-Altman method showed no difference in tooth volumes despite a slight underestimation for the CBCT 200 µm and 300 µm groups compared with the two reference groups. The underestimation was statistically significant for the volumetric measurements of the CBCT 300 µm group relative to the two reference groups (Passing-Bablok method). CONCLUSIONS: CBCT is not only a tool that helps in diagnosis and detection but it has the complementary advantage of being a measuring instrument, the accuracy of which appears connected to the size of the voxels. Future applications of such measurements with CBCT are discussed

Bone age estimation based on multislice computed tomography study of the scapula

Progress in medical imaging has opened new areas of research in forensic anthropology, especially in the context of the study of bone age assessment. The study of bone age has become a useful tool for age estimation at death or age of young adult migrants in an anthropological context. We retrospectively evaluated multislice computed tomography (MSCT) explorations focused on scapulae of 232 individuals (123 males; 109 females) aged between 8 and 30 years old. Computed tomography (CT) scans were viewed in axial and multiplanar reconstructed images using OsiriX 5.9 (64 bit)®. The ossification centers of the scapula studied were as follows: acromial, sub-coracoid, glenoid, coracoid, coracoid apex, and inferior angle epiphyses. Fusion status was scored based on a five-stage system (stage 1: no ossification, stage 2: visualization of an ossification center, stage 3: partial ossification, stage 4: full ossification associated to an epiphyseal scar, and stage 5: full ossification without epiphyseal scar). Intra-observer variability was excellent, and inter-observer variability was good, demonstrating the reliability of this MSCT staging system. The fusion of scapular ossification centers was statistically associated with age (p  0.05). In conclusion, MSCT of the scapula is an efficient method for age assessment, which is complementary to preexisting methods particularly for specifying the 18-year threshold. Further studies with larger groups are needed to support our results

Tracing intensive fish and meat consumption using Zn isotope ratios: evidence from a historical Breton population (Rennes, France)

International audienceHere we report Sr and Zn isotope ratios of teeth of medieval to early modern Breton people a population whose diet is known from historical, archeological and collagen isotope data. Most of the population, buried in the Dominican convent of Rennes, France, consists of parliamentary nobles, wealthy commoners and ecclesiastics, who had a diet rich in animal products. Our aim is to assess how the Zn isotope ratios of their teeth compare to those of other French historical populations previously studied, which were characterized by cereal-based diets, and those of modern French individuals, who daily eat animal products. We describe a clear offset (∼0.35‰) between local and non-local human individuals in Zn isotope ratios. The δ 66 Zn tooth values of local individuals overlap that of modern French people, and are lower than those of local carnivores. Non-local δ 66 Zn values are similar to those of historical individuals analyzed previously. We conclude the lower Zn isotope ratios of local humans relative to the associated fauna can be explained by the consumption of carnivorous fish and pork, in agreement with historical, zooarchaeological and collagen (C, N, S) isotope data. Zn isotopes could therefore be a tracer of fish and/or substantial meat consumption in ancient populations

An unusual intracardiac foreign body following penetrating thoracic injury

Foreign bodies in the heart after thoracic trauma may result in fatal outcome. We report a pendant inside the pericardium after penetrating injury that did not cause major cardiac injury with a favorable outcome

Detection of the A189G mtDNA heteroplasmic mutation in relation to age in modern and ancient bones.

International audienceThe aim of this study was to demonstrate the presence of the A189G age-related point mutation on DNA extracted from bone. For this, a peptide nucleic acid (PNA)/DNA sequencing method which can determine an age threshold for the appearance of the mutation was used. Initially, work was done in muscle tissue in order to evaluate the sensitivity of the technique and afterwards in bone samples from the same individuals. This method was also applied to ancient bones from six well-preserved skeletal remains. The mutation was invariably found in muscle, and at a rate of up to 20% in individuals over 60 years old. In modern bones, the mutation was detected in individuals aged 38 years old or more, at a rate of up to 1%, but its occurrence was not systematic (only four out of ten of the individuals over 50 years old carried the heteroplasmy). For ancient bones, the mutation was also found in the oldest individuals according to osteologic markers. The study of this type of age-related mutation and a more complete understanding of its manifestation has potentially useful applications. Combined with traditional age markers, it could improve identification accuracy in forensic cases or in anthropological studies of ancient populations

L' état de santé des femmes victimes de violences physiques au sein du couple (étude prospective au sein de la consultation de constatation de coups et blessures volontaires du CHU de Rangueil à Toulouse)

TOULOUSE3-BU Santé-Centrale (315552105) / SudocSudocFranceF

L' impact de la réforme de la médecine légale sur un institut médico-légal (étude comparative sur 5 ans d'activité de l'Institut Médico-Légal de Toulouse)

TOULOUSE3-BU Santé-Centrale (315552105) / SudocSudocFranceF

Imagerie en coupe et anthropobiologie (applications médico-légales pour la détermination de l'âge)

TOULOUSE3-BU Sciences (315552104) / SudocSudocFranceF

Evidence-Based Medicine, quelle place dans la décision du médecin ?

TOULOUSE3-BU Santé-Centrale (315552105) / SudocSudocFranceF