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An unplanned complex suicide with 6 mm Flobert revolver and train crash: a case report. 意外复杂自杀与6毫米弗洛伯特左轮手枪和火车相撞:一个案例报告。
Q4 Medicine Pub Date : 2023-01-01
Richard Sivulič, Martin Janík, Veronika Rybárová, Ján Bajaj, Ubomír Straka

A complex suicide defines a combination of multiple suicidal methods the victim successively or concurrently carries out. We present a case of a 72-year old man found dead on the railtrack, seemingly committing simple train-related suicide. Flobert revolver - a small caliber handgun was found nearby. Herein, we emphasize the significance of a thorough external examination, stress the fact that victim can act after low-energy projectile trauma and match our case to a similar complex suicide.

复杂自杀指的是受害者先后或同时实施的多种自杀方法的组合。我们提出一个病例,一个72岁的男子被发现死在铁轨上,似乎是简单的火车相关自杀。Flobert左轮手枪,一把小口径手枪在附近被发现。在此,我们强调彻底的外部检查的重要性,强调受害者在低能抛射创伤后可以采取行动的事实,并将我们的案例与类似的复杂自杀相匹配。
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引用次数: 0
Issues of electric shock in forensic medical practice. 法医实践中的电击问题。
Q4 Medicine Pub Date : 2023-01-01
Markéta Kulvajtová, Radoslav Matěj, Jiří Hladík

The authors summarize the current state of knowledge of electric shock as a minority group of injuries in forensic practice. Initially, they deal with electric current as a physical quantity and its effect on the human body, how it enters and moves in the body, which tissues due to their electrical activity and properties are the best conductors and which, on the contrary, due to their high resistance, practically do not conduct current. Subsequently, different pathways of current passage through the body are mentioned, leading to different types of damage, the most serious of which appears to be damage to the cardiovascular system, which can lead to immediate death due to disturbed heart rhythm with subsequent arrest, but is also likely to leave permanent effects leading to late health complications. The effect of electric current at the cellular level is demonstrated in experimental animal models exposed to both low- and high-voltage electric current, with damage described not only at the site of entry but also by microscopic examination in organs distant from the site of direct electric current. Since the effect of electric current on the organism is not fully understood and experimental studies have produced results indicating damage mainly to the cardiovascular system, this opens up certain possibilities for improving not only the diagnosis of deaths due to electric shock but also the follow-up care of patients who survive these injuries.

作者总结了目前的认识状态的电击作为一个少数群体的伤害在法医实践。最初,他们把电流作为一个物理量来处理,以及它对人体的影响,它是如何进入人体并在体内运动的,哪些组织由于其电活动和性质是最好的导体,相反,由于它们的高电阻,实际上不导电。随后,提到电流通过身体的不同途径,导致不同类型的损害,其中最严重的似乎是对心血管系统的损害,这可能导致由于心律紊乱而立即死亡,随后骤停,但也可能留下永久性影响,导致晚期健康并发症。电流在细胞水平上的影响在暴露于低压和高压电流的实验动物模型中得到了证明,不仅在进入部位出现了损伤,而且在远离直流电部位的器官中也通过显微镜检查发现了损伤。由于电流对机体的影响尚不完全清楚,而且实验研究的结果表明,损伤主要是对心血管系统造成的,因此,这不仅为提高对触电死亡的诊断,而且为改善对这些受伤的幸存者的后续护理提供了一定的可能性。
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引用次数: 0
Alcohol and addictive substances in deceased active participants of traffic accidents. 死亡的交通事故积极参与者体内的酒精和成瘾物质。
Q4 Medicine Pub Date : 2023-01-01
Monika Másilková, František Vorel

The content of this paper is the evaluation of data related to alcohol (ethanol, ethyl alcohol) and drugs in deceased active participants of traffic accidents for the years 2016-2021 obtained from the National Registry of Autopsies and Toxicological Examinations performed at the Department of Forensic Medicine and their comparison with the data of the Police Presidium of the Czech Republic. The sample included 2,715 deceased active road users, and their required data is available in both these sources. Only 72% of them were tested for alcohol, of whom 24% were found to have a blood alcohol concentration higher than 0.2 g/kg. Toxicological testing for substances other than alcohol was carried out in only 49% of the whole research file. Some substance from the list of addictive substances was detected in 120 deceased active road users (9% of those toxicologically examined). The concentration of these substances reached values affecting the ability to drive safely in 7 persons and excluding the ability to drive safely in 11 persons. The low percentage of toxicological tests carried out may be partly explained by the fact that in some cases the persons concerned may have survived for a certain period of time when toxicological testing was no longer considered relevant. Since there were no persons in our cohort who died more than 24 hours after death, we consider such reasoning to be not entirely correct. Therefore, we believe that the low number of examinations is mainly due to an attempt to save funds when toxicological examination was not required by the Police of the Czech Republic (if a forensic autopsy was ordered at all). The Police of the Czech Republic does not keep statistics on the presence of alcohol or other addictive substances in road accident deaths, but only in those who are at fault in road accidents. Data from the Police Presidium of the Czech Republic show that in 2016-2021, 57 persons were killed in traffic accidents where drugs were detected in the culprit in the accident. However, in our cohort, narcotic and psychotropic substances were detected in the blood (blood serum) of 120 deceased active participants of traffic accidents. This could be explained by the fact that at least 63 deceased active road users who were found to have narcotic and psychotropic substances were not at fault for the accident in which they died. However, a much more likely explanation is that the statistics of the Police Presidium of the Czech Republic are far from recording all culprits in the accident who are under the influence of drugs. This will especially apply to drivers who died in an accident that they were at fault for and when the police often did not order a forensic autopsy and thus a toxicological examination. In practice, toxicological examination of deceased active participants in traffic accidents applied only selectively means a significant distortion of statistical data on the presence of alcohol or addictive substances in the de

本文的内容是评估2016-2021年间交通事故中死亡积极参与者的酒精(乙醇、乙醇)和药物相关数据,这些数据来自法医部门进行的国家尸检和毒理学检查登记处,并与捷克共和国警察主席团的数据进行比较。样本包括2715名已故的活跃道路使用者,他们所需的数据可在这两个来源中获得。只有72%的人接受了酒精检测,其中24%的人血液酒精浓度高于0.2 g/kg。在整个研究文件中,只有49%对酒精以外的物质进行了毒理学测试。在120名死亡的活跃道路使用者(占毒理学检查人数的9%)中发现了成瘾性物质清单中的某些物质。这些物质的浓度达到影响7人安全驾驶能力的值,11人无法安全驾驶。进行的毒理学试验的百分比很低,部分原因可能是,在某些情况下,有关人员可能已经存活了一段时间,而毒理学试验已不再被认为是相关的。由于我们的队列中没有人在死后24小时内死亡,因此我们认为这种推理并不完全正确。因此,我们认为检查次数少主要是由于在捷克共和国警察不要求进行毒理学检查(如果下令进行法医解剖)的情况下试图节省经费。捷克共和国警方没有关于道路交通事故死亡人数中是否存在酒精或其他成瘾物质的统计数据,而只是关于道路交通事故中有过错的人的统计数据。捷克共和国警察主席团的数据显示,2016-2021年,在肇事者身上发现毒品的交通事故中,有57人死亡。然而,在我们的队列中,120名死亡的交通事故积极参与者的血液(血清)中检测到麻醉和精神药物。这可以用以下事实来解释:至少有63名被发现有麻醉药品和精神药物的死亡的活跃道路使用者在他们死亡的事故中没有过错。然而,一个更可能的解释是,捷克共和国警察主席团的统计数字远远没有记录下所有受毒品影响的事故罪犯。这将特别适用于那些在事故中死亡的司机,而事故是他们自己造成的,而且警察通常没有下令进行法医尸检,因此没有进行毒理学检查。在实践中,对交通事故中积极参与者的死亡进行毒理学检查只是选择性地意味着对死者体内存在酒精或成瘾物质的统计数据的严重歪曲,这不仅可能影响行政当局(特别是捷克共和国警察)对公路运输参与者的行动,而且还可能影响捷克共和国立法机关在运输中具体涉及毒品问题的政策。但总的来说。保险公司也应该对强制检测酒精和成瘾物质的存在感兴趣。如果伤害是由于酗酒或滥用药物造成的,保险人有权减少保险金。具体而言,保险公司是否应当减少赔偿以及减少到何种程度的依据是由执法机构作出最终决定。但是,如果该主管部门没有下令进行毒理学检查,也不知道结果,则应通知保险人未检测出酒精或成瘾物质,保险人应全额付款。
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引用次数: 0
Multiple forms of suffocation used in double murder. 双重谋杀中使用的多种窒息方式。
Q4 Medicine Pub Date : 2022-01-01
Handlos Petr, Uvíra Matěj, Klabal Ondřej, Joukal Marek, Handlosová Klára

This paper presents a case of double murder in which different mechanisms of suffocation, involving smothering, burking, and manual strangulation, were used. The victims are usually elderly people with disabilities and social isolation. The cases described here involve two women who were disabled and were murdered through blockage of the airway. Even though similar suffocating mechanisms were used in the murders, the autopsy findings differed between the two cases. This difference between the two can be explained by a preexisting medical condition that the younger victim had, which was quadriplegia resulting from cerebral hemorrhage, which limited herself-defense ability.

本文提出了双重谋杀的情况下,其中不同的窒息机制,涉及窒息,burking,和手动扼杀,被使用。受害者通常是残疾和社会孤立的老年人。这里描述的案例涉及两名残疾妇女,她们因呼吸道阻塞而被谋杀。尽管两起谋杀案都使用了类似的窒息机制,但两起案件的尸检结果却有所不同。这两者之间的差异可以用年轻受害者先前存在的医疗状况来解释,即脑出血导致的四肢瘫痪,这限制了她的自卫能力。
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引用次数: 0
Confectionary containing alcohol and their effect on breath analyzer results: a preliminary study. 含酒精的糖果及其对呼气分析仪结果的影响:初步研究。
Q4 Medicine Pub Date : 2022-01-01
Krajsa Jan, Straka Ubomír, Rybárová Veronika, Kumičíková Ivana, Hirt Miroslav

Breath analyzers are commonly used to test alcohol intoxication, most often to detect elevated systemic levels of ethanol by employees during working hours or drink-driving drivers. Many scientific studies describe the effect of inhaled ethanol vapors in the ambient air or the application of mouthwash before the breath test. This preliminary study interprets false positivity of the breath test after consumption over-the-counter confectionery.

呼气分析仪通常用于检测酒精中毒,最常见的是检测员工在工作时间或酒驾司机的全身乙醇水平升高。许多科学研究描述了吸入周围空气中的乙醇蒸气或在呼吸测试前使用漱口水的影响。这项初步研究解释了食用非处方糖果后呼吸测试的假阳性。
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引用次数: 0
Self-ligature strangulation by multiple cable ties. 用多根绳子捆扎自己勒死。
Q4 Medicine Pub Date : 2022-01-01
Thube R Harshal, Sane R Mandar

This article reports an autopsy of a 39-year-old deceased male who had done suicidal strangulation using multiple self-locking cable ties. The deceased used seven ligatures, constricting at a different level around the neck to accomplish the suicidal strangulation. Each ligature was made up of two cable ties attached to each other. The detailed autopsy examination and crime scene investigation confirm the manner of strangulation as suicidal. Suicidal strangulation is uncommon but not rare. Varying ligature materials and different locking methods were used for this purpose. The present case is remarkable because of the use of multiple self-locking zip cable ties as ligature material.

这篇文章报告了一名39岁死亡男性的尸体解剖,他使用多个自锁电缆扎完成了自杀式勒死。死者用了七根绳子,在脖子上不同的高度勒紧,以完成自杀式的勒死。每根绳都是由两根相互连接的缆绳组成的。详细的尸检和犯罪现场调查证实了勒死的方式是自杀。自杀式勒死不常见,但也不罕见。为此,使用了不同的结扎材料和不同的锁定方法。目前的情况是显着的,因为使用多个自锁拉链电缆扎作为结扎材料。
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引用次数: 0
Outcomes of a multicenter study of the causes of sudden cardiac death (SCD) in the Czech Republic and primary prevention of cardiac arrest in relatives. 捷克共和国心源性猝死(SCD)病因和亲属心脏骤停一级预防的多中心研究结果
Q4 Medicine Pub Date : 2022-01-01
Kučerová Pohlová Štěpánka, Krebsová Alice, Votýpka Pavel, Peldová Petra, Kulvajtová Markéta, Dohnalová Petra, Bílek Matěj, Stufka Veronika, Rücklová Kristina, Grossová Iva, Wünschová Hanka, Tavačová Terezia, Hašková Jana, Segeťová Markéta, Gřegořová Andrea, Zoubková Veronika, Petřková Jana, Dobiáš Martin, Makuša Michal, Blanková Alžběta, Veitr David, Řehulka Hynek, Šubrt Ivan, Pilin Alexander, Tomášek Petr, Janoušek Jan, Kautzner Josef, Macek Milan

Sudden cardiac death (SCD) in individuals younger than 40 years has a heritable cause in a significant part of the cases. Identification of SCD, post mortem genetic analysis along with the cardiological screening examination in first degree represents an important diagnostic tool for the primary prevention of cardiac arrest in victim´s relatives and requires multicentric and multidisciplinary collaboration. Between 2016 and 2021 the complex cardiogenetic analysis was performed in 115 deaths with post mortem diagnosis of cardiomyopathy, acute aortic dissection and cases without morphological finding explaining the cause of death (sudden arrhythmic death or sudden unexplained death). DNA was isolated from post mortem collected tissue samples or relative´s blood and subjected to massively parallel sequencing (Illumina, USA) in extent of 100 to 20 000 genes. Sequencing results were analysed using the SOPHiA GENETICS DDM bioinformatics platform (Switzerland). Genetic counselling and cardiological examinations were carried out in 328 family members. Highly likely or certain molecular aetiology (i.e. based on presence of ACMG.net Class 4 to 5 variants) was disclosed in 19,8 % of analysed cases in RYR2, KCNH2, KCNQ1, SCN5A, FLNC (stop), GLA, TTN, TNNT2, RBM 20, MYBPC3, MYPN, FHL1, TGFBR1, and COL3A1 genes. With cardiogenetic screening we identified 25 % relatives at risk of life threating arrhythmias and offered them an individualised care.

年龄小于40岁的心脏性猝死(SCD)在很大一部分病例中有遗传原因。SCD的鉴定、死后遗传分析以及一级心脏病筛查检查是受害者亲属心脏骤停一级预防的重要诊断工具,需要多中心和多学科合作。在2016年至2021年期间,对115例尸检诊断为心肌病、急性主动脉夹层和未发现形态学解释死因(突发性心律失常死亡或不明原因猝死)的死亡病例进行了复杂的心脏遗传学分析。从死后收集的组织样本或亲属的血液中分离DNA,并进行大规模平行测序(Illumina,美国),测序范围为100至20,000个基因。测序结果使用SOPHiA GENETICS DDM生物信息学平台(瑞士)进行分析。对328名家庭成员进行了遗传咨询和心脏病检查。在分析的RYR2、KCNH2、KCNQ1、SCN5A、FLNC (stop)、GLA、TTN、TNNT2、RBM 20、MYBPC3、MYPN、FHL1、TGFBR1和COL3A1基因的病例中,有19.8%的病例揭示了高度可能或某些分子病因(即基于ACMG.net 4至5类变异的存在)。通过心脏遗传学筛查,我们确定了25%有危及生命的心律失常风险的亲属,并为他们提供个性化护理。
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引用次数: 0
Suicidal electrocution: a report of three unusual cases. 自杀式电刑:三个不同寻常的案例报告。
Q4 Medicine Pub Date : 2021-01-01
Kumičíková Ivana, Putško Mária, Straka Ubomír, Novomeský František, Janík Martin, Krajčovič Jozef

Electricity is a modern technology that can be used as method of suicide. Authors presents three cases of suicidal electrocution. The first case is a 55-year-old man who wrapped his chest and arms with electrically active wires connected to a timer. In second case, a 69-year-old man constructed electric mechanism from a disassembled extension cord. The last case describes a 53-year-old woman who was found dead in a water-filled bathtub.

电是一种现代技术,可以用来作为自杀的方法。作者提出了三个自杀式电刑的案例。第一个病例是一名55岁的男子,他用连接计时器的带电电线包裹了他的胸部和手臂。在第二个案例中,一名69岁的男子用一根拆卸的延长线构造了一个电动机构。最后一个案例描述了一名53岁的妇女,她被发现死在一个装满水的浴缸里。
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引用次数: 0
Aspects of forensic entomology in forensic medicine. 法医学中法医昆虫学的几个方面。
Q4 Medicine Pub Date : 2021-01-01
Mikuláš Ubomír, Kutišová Dana, Šikuta Ján, Kuruc Roman, Šidlo Jozef

ntomology, as a vast scientific discipline of zoology, deals with the study of insects, which are an integral part of the ecosystem of our planet and are closely linked to the activity and life cycle of all organisms, including humans. As a result of this natural connection, insects often become a direct “living witness” of a crime and thus an invaluable part of the evidence in a comprehensive forensic investigation, which in such cases necessarily includes a specialized field of science - forensic entomology. The goals of forensic entomology include comprehensive analysis of entomological evidence material and the use of knowledge about insects and other invertebrates for the purpose of investigating and verifying evidence in civil and criminal law. In practice, forensic entomology falls into several categories, including the issue of food pests in industry or agriculture, human and animal parasitology (especially myiasis) and very often the field of criminology and forensic medicine, where the results are mainly applied to determine the length of post mortem interval (PMI), evidence of manipulation of the corpse, or other forensic facts that results from entomological analysis. The conclusions of the entomology study are in many cases an invaluable part of the amount of information that leads to the answer of key questions in complex forensic evidence, especially in the group of serious crimes.

昆虫学是动物学的一门广泛的科学学科,主要研究昆虫,昆虫是我们星球生态系统的一个组成部分,与包括人类在内的所有生物的活动和生命周期密切相关。由于这种自然联系,昆虫经常成为直接的“活生生的见证人”。因此,在全面的法医调查中,这是非常宝贵的证据。在这种情况下,法医调查必然包括一个专门的科学领域——法医昆虫学。法医昆虫学的目标包括对昆虫学证据材料进行全面分析,并利用有关昆虫和其他无脊椎动物的知识来调查和核实民事和刑事法律中的证据。在实践中,法医昆虫学分为几个类别,包括工业或农业中的食品害虫问题,人类和动物寄生虫学(特别是蝇蛆病)以及犯罪学和法医学领域,其结果主要用于确定死亡间隔(PMI)的长度,操纵尸体的证据或昆虫学分析得出的其他法医事实。在许多情况下,昆虫学研究的结论是大量信息的宝贵部分,这些信息有助于回答复杂的法医证据中的关键问题,特别是在一组严重犯罪中。
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引用次数: 0
The extension, importance and function of eponymous terms in forensic medicine. 同名词在法医学中的外延、重要性和作用。
Q4 Medicine Pub Date : 2021-01-01
Kučerová Pohlová Štěpánka, Nečas Pavel, Hejna Petr

Forensic medicine is a multidisciplinary medical field that cooperates with a number of complementary medical disciplines and receives knowledge from many other non-medical disciplines. Cooperation with forensic toxicologists and forensic radiologists is routine in forensic practice, as well as with traffic engineers, forensic ballistics, forensic biomechanics, anthropologists, geneticists, and forensic entomologists is well established in expert practice and scientific research. Our work focuses on the connection of forensic medicine with linguistics. The essence of the article is the evaluation of the function, importance and use of eponymic terms in the field of forensic medicine. Total of 28 eponymous terms were searched and analysed in four Czech written textbooks of forensic medicine from different time periods (published in years 1937, 1976, 1999 and 2015/2016). The occurrence and extension of eponymous terms in field of forensic medicine is presented. The origin, the authorship, advantages or disadvantages of eponymous terms are discussed. Function of these terms in professional communication, in communication with police, in court, and with lay people is evaluated.

法医学是一个多学科医学领域,与许多互补的医学学科合作,并从许多其他非医学学科获得知识。与法医毒理学家和法医放射学家的合作在法医实践中是常规的,与交通工程师、法医弹道学、法医生物力学、人类学家、遗传学家和法医昆虫学家的合作在专家实践和科学研究中已经建立起来。我们的工作重点是法医学与语言学的联系。本文的核心是对同名名词在法医学领域的作用、重要性和使用进行评价。在四本捷克法医学书面教科书中(分别出版于1937年、1976年、1999年和2015/2016年),共检索和分析了28个同名术语。介绍了同名名词在法医学领域的出现和引申。讨论了同名名词的来源、作者、利弊。评估这些术语在专业交流、与警察交流、在法庭上以及与非专业人士交流中的作用。
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引用次数: 0
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Soudni Lekarstvi
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