Soudni Lekarstvi最新文献

It is not easy to characterize a problem patient or bereaved relatives because identifying a patient or his bereaved family as a “problem” is not considered quite ethical. The approached emergency medical service employees and coroner service physicians were asked to complete a specific targeted anonymous survey. 100 % of survey questionnaires were returned. The questionnaire with a request for filling and returning was submitted to forty employees working full-time, twenty of whom were physicians, ten paramedics and ten lower-level healthcare professionals. The questionnaire comprised ten questions aimed at obtaining clear answers to questions about personal experience with problem patients, specifically aggressive patients, and more specifically whether the health care professionals (HCP) has ever felt immediately threatened by a patient in their work, whether they were exposed to verbal or even physical attack in the context of the patients basic diagnosis established during pre-hospital care. Seventy-five percent of respondents answered Yes to Question No. 5: “Have you ever felt threatened by a patient or bereaved relative in your work?” Eighty percent of respondents answered Yes to Question No. 6: “Have you ever been exposed to a verbal attack by a patient or bereaved relative?” Seventy-five percent of them answered Yes to Question No. 7: “Have you ever been exposed to a physical attack by a patient?” The rate of cases in which emergency medical service employees are exposed to verbal or physical attacks is high. The primary experience hypothesis that this happens has been proven as well as the fact that it is a highly topical and therefore unresolved issue that threatens the whole society with its social implications.

We present an autopsy case involving ingestion of methidathion, an organothiophosphate pesticide. A headspace gas chromatography mass spectrometry system was used for screening of volatile compounds. Subsequent toxicological analysis was performed using liquid chromatography tandem mass spectrometry. Xylene and ethylbenzene were detected in stomach contents. We also identified methidathion at concentrations of 3.07 and 2240 µg/ml in femoral venous blood and stomach contents, respectively. We concluded that the victim ingested methidathion insecticide, with an estimated dose of at least 9.2 g.

Alcohol-affected road users - pedestrians or drivers are a significant risk factor for road accidents and injuries. Therefore, the issue of alcohol-related traffic accidents is logically a subject of great attention. However, the statistics results of the General Prosecutor's Office of the Slovak Republic and of the Police Force of the Slovak Republic clearly confirm the fact that in the Slovak Republic the above-mentioned problem of the whole society is not sufficiently eliminated. The legislation implemented since 2011 should therefore lead to more substantial and effective prevention in this area. From the point of view of the current knowledge from the Forensic Medicine Department, the current legislative regulation of the Slovak Republic is still insufficient and will require some changes. It can be assumed that the issue of controlling the influence of alcohol on road users will be a subject of harmonization throughout the European area. The aim of this thesis is to analyse individual aspects of the present state and their epicritical evaluation. Keywords: alcohol - driver - prevention - forensic medicine - legislation.

Spinal subdural hematoma is a rare and potentionally life-threatening condition associated with trauma and other pathological conditions. In this paper we report the autopsy findings of a 64 year old male who was repeatedly hospitalized with traumatic head injuries in the past. In this case spinal subdural hematoma was diagnosed post-mortem and later comfirmed by ante-mortem CT scan revaluation. Keywords: intracranial subdural hematoma - recurrent spinal subdural hematoma - diffuse axonal injury - autopsy findings.

Scientific bloodstain pattern analysis was appeared at the end of the 19th century in Kraków. Nowadays, bloodstain pattern analysis is the forensic science involving analysis of blood traces on the crime scene. One topic is an estimation of the point of origin of given blood spatter. The processes behind the formation of the blood spatter are quite complicated, some simplifications are necessary. For example, the true trajectory of the blood drop is rather the ballistic curve than the line, though the line is often used as a sufficient model of the trajectory. Next, the blood is a non-Newtonian complex fluid, it differs from common fluids like water. Moreover, qualities of the surface are also involved in the formation of the final spatter. Some of these properties of blood must be neglected in order to make the modeling of the formation of the spatter possible. The crucial question is how to determine the angle of impact of the blood drop. The widely used method is the ellipse fitting method which is based on the assumption that the blood drop is ball-shaped and the spatter is chiefly the ellipse-shaped imprint of the falling drop. Other methods are using rather in experiments than in practice. Unfortunately, all these simplifications lead to the increasing uncertainty and, therefore, the point of origin is rather estimated than determined. Selection of an appropriate model of the behavior of the blood drop and estimation of uncertainty of obtained results should be based on related knowledge close to the physics of blood. Keywords: bloodstain pattern analysis - biomechanics.

Authors Poprad, since the establishment of the Department of Forensic Medicine in Poprad in 1991 up to now. As mountainous environment is considered an area above the border of Tatranská magistrálna (a tourist footpath which leads across the High Tatras and partially Western Tatras). The file discusses the causes and mechanisms of death and their causal relationships, shows the nationality, age, gender or place of death of deceased people, amounts of deaths in the months of year and also in the days of week. Some results are shown in the graphs, the percentage results are described in a text. Valuable and complete results were reached only in cases with describe statistically a group of people who died in the mountainous environment of the High and Belianske Tatras for the last 25 years and who were dissected on the Department of Forensic Medicine in complete documentation (and also after autopsy, not every case of death was autopsied). At the same time, the authors describe the system of cooperation between the Department of Forensic medicine and Pathological Anatomy of Health care surveillance Poprad with Mountain rescue components and the Police force of Slovak Republic, operating in the territory of the High and Belianske Tatras. These components help us to gain information about the case, which are not usually known during the first inspection of dead body in a mortuary or at the moment of an autopsy (hikers and climbers are often alone in the mountains, so their accidents are without witnesses).

Massive progress in developing even more precise imaging modalities influenced all medical branches including the forensic medicine. In forensic anthropology, an inevitable part of forensic medicine itself, the use of all imaging modalities becomes even more important. Despite of acquiring more accurate informations about the deceased, all of them can be used in the process of identification and/or age estimation. X - ray imaging is most commonly used in detecting foreign bodies or various pathological changes of the deceased. Computed tomography, on the other hand, can be very helpful in the process of identification, whereas outcomes of this examination can be used for virtual reconstruction of living objects. Magnetic resonance imaging offers new opportunities in detecting cardiovascular pathological processes or develompental anomalies. Ultrasonography provides promising results in age estimation of living subjects without excessive doses of radiation. Processing the latest information sources available, authors introduce the application examples of X - ray imaging, computed tomography, magnetic resonance imaging and ultrasonography in everyday forensic medicine routine, with particular focusing on forensic anthropology.

After the new Civil Code had come into force, the Compensation Statute lost the efficiency. The injury compensation should not have been provided according medical report with respect to the Compensation Statute but according decency basis. So the Highest Court has accepted the Methodology of compensation. The article deals with the first reflection of the Methodology in the judicature of the Constitutional Court as well as the opinion of the Constitutional Court of the Government Statute which regulates the injury compensation in labour law. The Metodology of compensation is based on the ICF (International Classification of Functioning, Disability and Health), while the Compensation Statute was based on the etiology principe. ICF is a classification of health and health-related domains. As the functioning and disability of an individual occurs in a context, ICF also includes a list of environmental factors. ICF is the WHO framework for measuring health and disability at both individual and population levels.

The aim of the present study is to investigate incidence and seriousness of CPR-associated injuries on a cohort of CPR non-survivors after out-of-hospital cardiac arrest in the Moravian-Silesian region. In total, 80 persons were included in the study within the study period (2012 - 2015). CPR-associated injuries were identified in 75 (93.7 %) persons, multiple injuries were found in 73 persons. Spectrum of identified injuries covered skin injuries of the upper half of the body, head and neck injuries, rare abdominal injuries and very frequent thorax injuries. Sternal fractures were found in 53 (63.3 %) persons. Rib fractures were identified in 59 (73.0 %) persons; rib fractures were usually multiple (mean number of broken ribs was 7.6 per person). Intra-thoracic injuries were diagnosed in 33 (41.2 %) persons - findings of lung contusions and lacerations, transmural heart contusions, hemothorax and hemopericard. The vast majority of identified intra-thoracic injuries were considered clinically relevant (provided the fact that return of spontaneous circulation had been achieved). Intraabdominal injuries (liver and spleen injuries) were identified in 15 (18.7 %) of persons. Vast majority of these injuries was clinically irrelevant. We have found clinically serious injuries (spleen rupture and liver dilacerations) in 3 (3.7 %) persons. Outcomes of our study suggest that CPR-associated injuries are very common, usually multiple, and in some cases they might be even potentially lethal (if return of spontaneous circulation is achieved).Key words: cardiopulmonary resuscitation - cardiac arrest - injuries - autopsy study - sternal and rib fractures.

We present an autopsy case involving benzodiazepines and diphenidine. Quantitative toxicological analysis showed concentrations of 7-aminoflunitrazepam (a flunitrazepam metabolite), 7-aminonimetazepam (a nimetazepam metabolite), chlorpheniramine and diphenidine in femoral blood of 0.086 µg/ml, 0.027 µg/ml, 0.066 µg/ml, and 0.073 µg/ml, respectively. Death was attributed to combined toxicity due to the influence of multiple drug interactions.