Revista Espanola de Medicina Legal最新文献

Estudio sobre el conocimiento de la Ley orgánica de regulación de la eutanasia entre profesionales médicos de Andalucía oriental 东安达卢西亚医疗专业人员对《关于安乐死的组织法》的认识调查

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-10-01 DOI: 10.1016/j.reml.2025.500490

Lucas González-Herrera, Ana Belén Márquez-Ruiz, Elena Miguel-García, Aurora Valenzuela-Garach

Introduction

The incorporation of the provision of aid in dying to the common portfolio of services of the National Health System, after the approval of the Organic Law for the Regulation of Euthanasia (LORE), raises the need to investigate the knowledge of medical professionals about the processes of application of this procedure.

Material and methods

A self-administered online questionnaire of 25 questions was distributed among 2,386 medical practitioners involved in the clinical training of the students enrolled in the Degree in Medicine at the University of Granada.

Results

436 medical professionals (50.2% women) answered the survey. The specialty of Family and Community Medicine contributed the highest number of participants (20.4%). Around 60% of the physicians did not know the legal requirements that must be met by the patient requesting aid in dying or the role of the responsible physician and the consultant physician. 33.5% of the respondents declared that they would request conscientious objection if necessary and only 14.4% stated that they had received any specific training course in their workplace. More than 80% of the specialists did not consider themselves prepared to deal with this procedure.

Conclusions

The results of this study indicate that the level of knowledge of the medical professionals surveyed about key aspects of LORE may still be insufficient, pointing out the need to reinforce their training to offer a better response to euthanasia contexts and ensure adequate access to this service for patients.

在《安乐死管理组织法》获得批准后，将提供死亡援助纳入国家卫生系统的共同服务组合，这就需要调查医疗专业人员对这一程序的应用程序的了解情况。材料和方法在参与格拉纳达大学医学学位学生临床培训的2,386名医生中分发了一份包含25个问题的自填在线问卷。结果共有436名医学专业人员参与调查，其中女性占50.2%。家庭和社区医学专业贡献了最多的参与者（20.4%）。大约60%的医生不知道请求协助死亡的病人必须满足的法律要求，也不知道负责任的医生和咨询医生的作用。33.5%的受访者表示，如有需要，他们会要求出于良心拒服兵役，而只有14.4%的受访者表示曾在工作场所接受过任何具体的培训课程。超过80%的专家认为自己没有准备好处理这个程序。结论本研究的结果表明，接受调查的医疗专业人员对安乐死的关键方面的知识水平可能仍然不足，指出需要加强他们的培训，以更好地应对安乐死情况，并确保患者充分获得这项服务。

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引用次数: 0

Epidemiología del consumo de sustancias lícitas e ilícitas en muertes violentas en una región del sur de Chile, entre los años 2015 y 2022 2015年至2022年智利南部地区合法和非法药物使用在暴力死亡中的流行病学

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-10-01 DOI: 10.1016/j.reml.2025.500486

Cristóbal Reyes , Nicolas Huaiquinao , Francisca Acevedo

Introduction

Drug and alcohol consumption is closely associated with social determinants such as poverty, inequality, and violence. The Araucanía Region in southern Chile, one of the country's poorest areas, was the focus of this epidemiological study analyzing the relationship between licit and illicit substance use and violent deaths from 2015 to 2022.

Methods

Data from the Legal Medical Service (SML), responsible for forensic examinations in judicial cases, were standardized and analyzed to allow comparisons with national and international studies.

Results

Homicides showed the highest correlation with positive toxicological findings (23.8%), primarily involving cocaine combined with alcohol and cannabis. Suicide recorded 22.3% of cases with detected substances, notably elevated cocaine and alcohol consumption linked to impulsive behavior. In traffic accidents, with 14.0% of positive cases, benzodiazepines were the most frequently found, followed by cannabis. A sustained increase in fatal cases involving polydrug use was also observed.

Conclusions

These results highlight the significant role of substance use in violent death contexts and underscore the urgent need to strengthen prevention, control, and treatment strategies for drug use within a comprehensive public health and security framework.

毒品和酒精消费与诸如贫穷、不平等和暴力等社会决定因素密切相关。这项流行病学研究的重点是智利南部的Araucanía地区，该地区是智利最贫穷的地区之一，该研究分析了2015年至2022年合法和非法药物使用与暴力死亡之间的关系。方法对负责司法案件法医鉴定的法律医疗服务处（SML）的数据进行标准化分析，以便与国内和国际研究进行比较。结果杀人案与毒理学阳性结果相关性最高（23.8%），主要涉及可卡因、酒精和大麻。有22.3%的自杀案例检测到药物，特别是与冲动行为有关的可卡因和酒精消费量增加。在交通事故中，苯二氮卓类药物最常见，占阳性病例的14.0%，其次是大麻。还观察到涉及多种药物使用的死亡病例持续增加。结论这些结果强调了药物使用在暴力死亡情境中的重要作用，并强调了在综合公共卫生和安全框架内加强药物使用预防、控制和治疗策略的迫切需要。

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引用次数: 0

Can dorsal knuckle creases facilitate human identification in forensic medicine? A pilot study 指关节背的折痕能在法医学上方便人体鉴定吗？一项初步研究

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-10-01 DOI: 10.1016/j.reml.2025.500478

Ana Tellez-García , Juan Suárez , Leticia Rubio , Stella Martín-de-las-Heras , Ignacio Santos

Introduction

In many forensic investigations into cases of cyberbullying and online violence against minors, video footage can serve as crucial evidence, as it allows the identification of the perpetrator's physical features. Although the face is often concealed, other parts of the body are frequently exposed and can be revealing.

Objective

This study analyzes the horizontal linear folds (HLFs) on the dorsal aspect of the proximal interphalangeal joint (PIPJ) of the dorsum of the hands as a unique anatomical feature for human identification with legal value in forensic medicine.

Material and methods

Real and ideal scenarios were performed to obtain doubtful and doubtless images of the dorsal hands by a webcam and a high-resolution camera, respectively. The presence and number of HLF from 112 dorsal PIPJs (4 fingers, 2 hands, 14 individuals) were quantified and statistically compared by analyzing the similarity between sample groups using Sorensen-Dice coefficient and Jaccard index.

Results

HLF resulted in a sensitivity (positive identification) of 78.57%, but a specificity (negative identification) of 26.1% (area under ROC curve = 55.3%). Visual inspection of doubtful and doubtless samples achieved a 100% match in human identification.

Conclusions

The morphological variability and unique pattern of the HLF can be used as a simplified method to delimit human identification in forensic medicine.

在许多针对未成年人的网络欺凌和网络暴力案件的法医调查中，视频片段可以作为关键证据，因为它可以识别肇事者的身体特征。虽然脸经常被遮住，但身体的其他部位经常暴露出来。目的分析手背近端指间关节（PIPJ）背侧的水平线性褶皱（HLFs），作为一种独特的人体鉴定解剖特征，在法医学上具有法律价值。材料和方法通过网络摄像头和高分辨率摄像头分别进行了真实和理想的场景，以获得可疑和毫无疑问的手背图像。采用Sorensen-Dice系数和Jaccard指数分析样本组间相似性，定量分析112例（4指，2手，14人）背侧PIPJs中HLF的存在及数量，并进行统计学比较。结果shlf的敏感性（阳性鉴定）为78.57%，特异性（阴性鉴定）为26.1% （ROC曲线下面积 = 55.3%）。对可疑和可疑样本的目视检查在人类鉴定中达到100%匹配。结论HLF的形态变异性和独特的形态特征可作为法医学鉴定的简化方法。

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引用次数: 0

Non-fatal injuries caused by corrosive chemical agents in Colombia between 2018 and 2021: Characterization of victims, perpetrators, and contextual factors 2018年至2021年期间哥伦比亚腐蚀性化学制剂造成的非致命伤害：受害者、肇事者和背景因素的特征

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-10-01 DOI: 10.1016/j.reml.2025.500479

Daniela María Romero-Chacón , Laura Marcela Chavez-Rodríguez , Sergio Andres León-Ariza , Daniela Pulido-Díaz

Introduction

Attacks involving corrosive chemical agents represent an extreme form of violence, frequently linked to gender-based violence, resulting in irreversible physical injuries, psychosocial harm, and functional loss. In Colombia, the phenomenon has been underestimated due to imprecise classifications. This study aims to characterize the victims, alleged perpetrators, and contextual factors related to non-fatal injuries caused by corrosive chemical agents between 2018 and 2021.

Materials and methods

This is a retrospective observational study. A total of 800 cases recorded by the Colombian National Institute of Legal Medicine and Forensic Sciences (INML) were reviewed. After applying inclusion criteria based on the Natalia Ponce de León Law, 105 cases were classified as corrosive chemical injuries. Descriptive statistics were applied, followed by logistic regression to identify associated risk factors.

Results

In total, 72.4% of the victims were women, and 71.8% of perpetrators were men. 77% of the attacks occurred in the context of interpersonal violence, and 48.6% of the victims had a low level of education. Both female sex (OR = 2.73; p < 0.001) and single marital status (OR = 1.78; p = 0.041) showed independent and significant associations with the likelihood of experiencing such an attack. Most cases occurred in urban settings and public spaces.

Conclusions

Corrosive chemical injuries in Colombia reflect a gender-based violence pattern, with close male aggressors and structurally vulnerable victims. There is an urgent need to improve forensic data accuracy, enhance comprehensive victim care, and implement public policies aimed at prevention, legal protection, and access to justice, especially in rural and socioeconomically disadvantaged areas.

涉及腐蚀性化学剂的袭击是一种极端形式的暴力，通常与性别暴力有关，造成不可逆转的身体伤害、社会心理伤害和功能丧失。在哥伦比亚，由于分类不精确，这种现象被低估了。本研究旨在描述2018年至2021年间腐蚀性化学剂造成的非致命伤害的受害者、涉嫌肇事者以及相关背景因素。材料与方法本研究为回顾性观察性研究。审查了哥伦比亚国家法律医学和法医科学研究所（INML）记录的总共800起案件。根据《纳塔利亚·庞塞·德León法》的纳入标准，将105例归为腐蚀性化学伤害。采用描述性统计，然后采用逻辑回归来确定相关的危险因素。结果受害女性占72.4%，施暴者男性占71.8%。77%的攻击发生在人际暴力背景下，48.6%的受害者受教育程度较低。女性性别（OR = 2.73;p <； 0.001）和单身婚姻状况（OR = 1.78;p = 0.041）与经历此类攻击的可能性显示出独立且显著的关联。大多数病例发生在城市环境和公共场所。结论哥伦比亚的腐蚀性化学伤害反映了基于性别的暴力模式，亲密的男性施暴者和结构上弱势的受害者。迫切需要提高法医数据的准确性，加强对受害者的全面护理，并实施旨在预防、法律保护和诉诸司法的公共政策，特别是在农村和社会经济弱势地区。

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引用次数: 0

La evolución de Revista Española de Medicina Legal 西班牙法律医学杂志的演变

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-10-01 DOI: 10.1016/j.reml.2025.500491

Carles Martin-Fumadó, Amadeo Pujol-Robinat, Eneko Barbería-Marcalain, Esperanza L. Gómez-Durán, Alexandre Xifró-Collsamata, Josep Arimany-Manso

引用次数: 0

Psicogeriatría en el ámbito penal: particularidades y recomendaciones 刑事领域的老年精神病学：特点和建议

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-10-01 DOI: 10.1016/j.reml.2025.500480

Marc Peraire , Aitana Fillol , Anna Moreno-Beltrán , Mar Cabañés-Suñer , Vicenç Tort , María Sampedro-Vidal

Population aging is leading to an increase in the number of older adults interacting with the criminal justice system. These individuals present specific characteristics, as they suffer from mental disorders (affective, cognitive, substance abuse) that increase their vulnerability, explain some criminal behaviors, and determine their criminal involvement. However, no studies delve into the need to adapt the judicial process to psychogeriatrics. A narrative review is conducted to synthesize the existing evidence regarding pre-trial considerations (competency assessment), during prison stays (adapting the context to their vulnerability), and regarding security measures. Published works, in Spanish or English, up to May 2025 are examined, including 32 publications. The scientific literature analyzed concludes that older adults require a specific competency assessment before becoming involved in judicial proceedings, to rule out intellectual impairments that impair their ability to argue or defend themselves. The existence of mental disorders that may have contributed to the characteristics of the crime (which tend to be impulsive, recurrent, and sexual) should be studied, and the prison environment should be adapted in the case of a custodial sentence, considering the fragility of the inmate. Finally, post-sentence reintegration plans should be promoted, supported by community support and adapted to the particular vulnerability of the offenders due to physical and psychological comorbidities.

人口老龄化导致与刑事司法系统互动的老年人数量增加。这些人表现出特定的特征，因为他们患有精神障碍（情感、认知、药物滥用），这增加了他们的脆弱性，解释了一些犯罪行为，并决定了他们的犯罪参与。然而，没有研究深入探讨司法程序适应老年精神病学的必要性。对审前考虑（能力评估）、服刑期间（根据其脆弱性调整情况）和安全措施等方面的现有证据进行了叙述性审查，以综合这些证据。评审截止到2025年5月的西班牙语或英语出版作品，包括32篇出版物。经过分析的科学文献得出结论，老年人在参与司法程序之前需要进行特定的能力评估，以排除损害他们辩论或辩护能力的智力障碍。应该研究可能导致犯罪特征的精神障碍的存在（这些特征往往是冲动的、反复的和性的），并且考虑到囚犯的脆弱性，在监禁判决的情况下，应该调整监狱环境。最后，应促进判刑后重返社会计划，在社区支持下加以支持，并适应罪犯由于身体和心理合并症而特别容易受到伤害的情况。

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引用次数: 0

Avances en nomenclatura para la implementación de la genómica forense 法医学基因组学实施命名法方面的进展

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-10-01 DOI: 10.1016/j.reml.2025.500477

Mayra Elizabeth García-Aceves , José Alonso Aguilar-Velázquez , Héctor Rangel-Villalobos

This review provides an overview of the main commercial platforms and kits available for forensic genomics based on massively parallel sequencing (MPS). Different possibilities and advantages are described, such as the definition of sequence-based (SB) alleles to increase the capacity to establish complex kinship relationships, compared to length-based (LB) alleles generated by capillary electrophoresis (CE). Recently, the International Society for Forensic Genetics (ISFG) made recommendations on the nomenclature of SB alleles based on the definition of a minimum range of sequence for the most commonly used STRs in forensic genetics. This makes it possible to unify results across kits, software, and laboratories to compare STR profiles and develop population databases. The three essential bioinformatics resources for these purposes are described: (1) FSSG (Forensic Sequence STRucture Guide); (2) STRiDER (STR for the identity of the ENFSI reference database); and (3) STRSeq (STR sequencing project). In addition, for the automatic and consistent application of this nomenclature, the ISFG suggests the software FDSTools and STRNaming for allelic designation based on the STR structure (e.g., D13S317 CE11_TATC[12]AATC[1]ATCT[3]). However, for routine forensic casework, it would be more useful to use short, human-readable sequence codes that facilitate interlaboratory comparisons. In this regard, the ISFG describes the SID (Sequence Identifier) platform, which uses an algorithm to generate automatically STR sequence codes (e.g., D13S317_11_IUSW). Although more work remains to be done, this is a major step towards the global implementation of forensic genomics, and understanding it is essential for future progress. This review aims to contribute to this goal.

本文综述了基于大规模平行测序（MPS）的法医基因组学的主要商业平台和试剂盒。描述了不同的可能性和优势，例如与毛细管电泳（CE）产生的基于长度的（LB）等位基因相比，基于序列的（SB）等位基因的定义增加了建立复杂亲属关系的能力。最近，国际法医遗传学学会（ISFG）在对法医遗传学中最常用的STRs最小序列范围定义的基础上，对SB等位基因命名提出了建议。这使得统一试剂盒、软件和实验室的结果成为可能，以比较STR概况和开发人口数据库。描述了用于这些目的的三个基本生物信息学资源：(1)FSSG（法医序列结构指南）；(2) STRiDER（用于标识ENFSI参考数据库的STR）；(3) STRSeq （STR测序项目）。此外，为了自动和一致地应用该命名法，ISFG建议使用FDSTools和STRNaming软件基于STR结构进行等位基因命名（例如，D13S317 CE11_TATC[12]AATC[1]ATCT[3]）。然而，对于常规的法医案件工作，使用简短的、人类可读的序列代码将更有用，以便于实验室间的比较。在这方面，ISFG描述了SID （Sequence Identifier）平台，该平台使用一种算法自动生成STR序列码（例如，D13S317_11_IUSW）。尽管还有更多的工作要做，但这是向全球实施法医基因组学迈出的重要一步，了解它对未来的进展至关重要。本综述旨在为实现这一目标作出贡献。

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引用次数: 0

La especialidad de Medicina Legal y Forense desde la Unidad Docente de Zaragoza: organización interna y particularidades 萨拉戈萨教育单位的法医学和法医学专业：内部组织和特点

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-07-01 DOI: 10.1016/j.reml.2025.500435

Elena Giraldo Pedraza, Laura Arricibita Aspurz, José David Blázquez Alcázar, Salvador Baena Pinilla

The figure of the internship doctor (MIR) in Legal and Forensic Medicine was born in 2022, after the abolition of the specialty as a school-based formula (2014) and the modification of access to the National Corps of Forensic Doctors due to the necessity of a specialist degree (2015, 2020). This led to the definitive accreditation, in 2022, of the first teaching units in the Institute of Legal Medicine and Forensic Science, being one of them Zaragoza. This article explains basic characteristics of this unit and its peculiarities, in which the close link between the intern routine and the forensic activity since the beginning of the training period, and the different levels of responsibility acquired, approved by the High Court of Justice of Aragon, stand out. The main difficulties encountered during these years, as well as the future challenges to be faced and possible solutions are also presented.

法律和法医学领域的实习医生（MIR）这一数字诞生于2022年，这是在2014年取消了该专业的校本配方（2014年）和2015年、2020年由于专科学位的必要性而修改了进入国家法医学兵团的机会（2015年、2020年）之后。这导致了最终的认证，在2022年，第一个教学单位在法律医学和法医学研究所，其中一个萨拉戈萨。本文解释了该单位的基本特点及其特点，其中突出的特点是，自培训开始以来，实习生日常工作与法医活动之间的密切联系，以及获得阿拉贡高等法院批准的不同级别的责任。提出了这些年来遇到的主要困难，以及今后面临的挑战和可能的解决办法。

引用次数: 0

Caracterización forense de las lesiones causadas por armas menos letales en Colombia (2017–2021) 2017 - 2021年哥伦比亚较不致命武器造成伤害的法医特征

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-07-01 DOI: 10.1016/j.reml.2025.500455

Juan Camilo Castrillón Parada, Daniela Jurado Portilla, César Andrés Cortés Castro, Fideligno Pardo Sierra

Introduction

Less than lethal weapons (LLW) are devices used to produce pain or inability with less risk of death. This study focuses on lesions caused by less than lethal weapons in Colombia between 2017 and 2021, by using data from Instituto Nacional de Medicina Legal y Ciencias Forenses (INMLCF).

Materials and methods

A retrospective cross-sectional descriptive study was carried out based on the review of clinical records and medical-legal autopsies of the INMLCF.

Results

Were found 4,900 cases, revealing that the majority of victims were young men, mainly affected by police batons and kinetic impact projectiles. The most common injuries were ecchymosis and wounds on the extremities and face, and five deaths related to the use of less lethal weapons were documented.

Conclusions

The findings highlight the need for greater regulation and training in the use of LLW due to its potential to cause serious and fatal injuries.

非致命武器（LLW）是用来产生疼痛或丧失能力的装置，死亡风险较小。本研究使用了国家法医医学研究所（INMLCF）的数据，重点研究了2017年至2021年期间哥伦比亚非致命武器造成的损伤。材料和方法在对INMLCF的临床记录和法医尸检进行审查的基础上，进行了一项回顾性横断面描述性研究。结果共发现4900例，受害者以年轻男性居多，以警棍和动能弹丸为主。最常见的伤害是瘀斑和四肢和面部的伤口，记录了5起与使用不太致命的武器有关的死亡。结论：研究结果强调，由于LLW可能造成严重和致命伤害，因此需要加强对其使用的监管和培训。

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引用次数: 0

Concordancia interobservador en la interpretación de pruebas radiológicas para la estimación de la edad en menores migrantes sin referentes familiares 对没有亲属关系的移徙未成年人的年龄估计的放射检验的解释各观察员之间的一致意见

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-07-01 DOI: 10.1016/j.reml.2025.500456

Fernando Rodes Lloret , Gloria Isabel Pérez Campello , Pedro Galiana Vila , Andrea Alegre Requena , Mar Pastor Bravo , Elisa Gavilán Turiño

Introduction

This study aims to study the degree of interobserver agreement in the interpretation of radiological tests used for forensic age estimation in migrant minors without family references between the radiologist and the forensic doctor and between the two forensic doctors who evaluated each case.

Materials and methods

This is a prospective study of the 69 cases studied at the Institute of Legal Medicine and Forensic Sciences of Alicante during 2023 and 2024. Each observer assessed and assigned a stage, following the Greulich and Pyle atlas for hand and wrist radiographs, the Demirjian stages for panoramic radiographs, and the Schmeling and Kellinghaus classifications for computed tomography scans of the proximal clavicle.

The IBM SPSS Statistics 28.0 statistical package was used; obtaining both the percentage of observed agreement and the Kappa index, which corrects for chance.

Results

The degree of agreement between the two forensic physicians was very good for the hand and wrist radiograph (k = 0.931), very good for the panoramic radiograph (k = 0.828), and substantial for the computed tomography (k = 0.671). However, the degree of agreement between the radiologist and the forensic physician was lower for all three tests: substantial for the hand and wrist radiograph (k = 0.748), moderate for the panoramic radiograph (k = 0.434), and modest for the computed tomography (k = 0.285).

Conclusions

These results highlight the importance of training and instruction in the forensic medical evaluation of these radiological tests.

本研究旨在研究在没有家庭参考资料的移民未成年人的法医年龄估计中，放射科医生和法医之间以及评估每个病例的两名法医之间用于解释放射检查的观察者之间的一致程度。材料和方法本研究是对2023年至2024年期间在阿利坎特法医学和法医学研究所研究的69个案例进行的前瞻性研究。根据Greulich和Pyle图谱的手部和手腕x线片，Demirjian的全景x线片，Schmeling和Kellinghaus的锁骨近端计算机断层扫描分级，每个观察者评估并分配一个阶段。采用IBM SPSS Statistics 28.0统计软件包；得到观察到的一致性百分比和Kappa指数，Kappa指数修正了偶然性。结果两名法医在手、腕部x线片（k = 0.931）、全景x线片（k = 0.828）和计算机断层扫描（k = 0.671）上的一致性非常好。然而，放射科医生和法医之间的一致程度在所有三种测试中都较低：手部和手腕x线片的一致程度很高（k = 0.748），全景x线片的一致程度一般（k = 0.434），计算机断层扫描的一致程度一般（k = 0.285）。结论对这些放射检验进行法医学鉴定的培训和指导十分重要。

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引用次数: 0