scholarly journals Ultrasound in legal medicine—a missed opportunity or simply too late? A narrative review of ultrasonic applications in forensic contexts

Author(s):  
Dustin Möbius ◽  
Antonia Fitzek ◽  
Niels Hammer ◽  
Axel Heinemann ◽  
Alexandra Ron ◽  
...  

Abstract Objectives Conventional autopsies remain the gold standard of postmortem healthcare quality assurance and help gathering extended knowledge on diseases. In answer to constantly declining autopsy rates non- or minimally invasive autopsy methods were introduced. Ultrasound is a well-established tool for imaging commonly used in clinical practice. This narrative review aims to summarize the current literature regarding the feasibility and validity of ultrasound in a forensic context. Material and methods A PubMed database search was carried out. Abstracts were scanned for pre-defined ex- and inclusion criteria, followed by a snowball search procedure applied to the primarily included articles. Results Forty-five publications met our inclusion criteria. The selected articles concern the feasibility of ultrasound in pre- or postmortem settings, forensic age estimation, and minimally invasive approaches. For imaging, ultrasound was deemed a reliable tool for the examination of epiphyses und superficial wounds, with limitations regarding internal organs and image quality due to postmortem changes. Ultrasound-guided minimally invasive approaches yielded higher success rates for adequate tissue sampling. Many investigations were carried out in low- and middle-income countries focusing on infectious diseases. Conclusion Ultrasound seems a promising but underutilized imaging tool in legal medicine to date. Promising approaches on its feasibility have been conducted. Especially for minimally invasive methods, ultrasound offered significant improvements on qualified biopsy sampling and thus appropriate diagnostics. Moreover, ultrasonic evaluation of epiphyses for age estimation offered valuable results. Nevertheless, further assessment of ultrasonic feasibility in forensic contexts is needed.

2021 ◽  
Vol 5 (2) ◽  
pp. 90
Author(s):  
Shintya Rizki Ayu Agitha ◽  
Icha Artyas Annariswati

Objectives: Age estimation is a key point in forensics, archeology, pediatrics and pediatric dentistry. Analysis using the development of teeth is one of the available methods that are used for physical identification, as well as age, in children. This article reviewed several journals about the methods of age identification, especially in children. The purpose of this review was to briefly inform about the recent researches regarding the application of age identification methods in children by using panoramic radiography as it is the most widely used method, in the years 2020-2021. Review: This article was a narrative review. Analyzed articles were searched from the PubMed database which were published between 2020 until 2021. There were 12 journals in accordance with the inclusion criteria of age estimation method in children using panoramic radiography. Conclusion: 7 of 12 journals that met the inclusion criteria used Willems method in the researches, 5 journals used Demirjian method, 3 journals used Cameriere method, 2 journals used Nolla method. Willems method was the most used analysis for identifying age and proved to be effective for identification in various populations, such as Belgium, Caucasian, Turkish, Saudi Arabian, Kenyan, Chinese and Taiwanese.


2021 ◽  
Vol 12 (1) ◽  
pp. e31-e31
Author(s):  
Carlo Fornaini ◽  
Reza Fekrazad ◽  
Jean-Paul Rocca ◽  
Shiying Zhang ◽  
Elisabetta Merigo

Introduction: Blue and blue-violet diode lasers (450 and 405 nm) seem to represent an interesting approach for several clinical treatments today. The aim of this narrative review is to describe and comment on the literature regarding the utilization of blue and blue-violet lasers in dentistry. Methods: A search for "blue laser AND dentistry" was conducted using the PubMed database, and all the papers referring to this topic, ranging from 1990 to April 2020, were analyzed in the review. All the original in vivo and in vitro studies using 450 nm or 405 nm lasers were included in this study. All the articles on the LED light, laser wavelengths other than 405 and 450 nm and using lasers in specialties other than dentistry, as well as case reports, guideline papers and reviews were excluded. Results: From a total of 519 results, 47 articles met the inclusion criteria and were divided into 8 groups based on their fields of application: disinfection (10), photobiomodulation (PBM) (4), bleaching (1), resin curing (20), surgery (7), periodontics (1), endodontics (1) and orthodontics (3). Conclusion: Blue and blue-violet diode lasers may represent new and effective devices to be used in a large number of applications in dentistry, even if further studies will be necessary to fully clarify the potentialities of these laser wavelengths.


2020 ◽  
Vol 22 (1) ◽  
pp. 103-110
Author(s):  
D. S. Epifanov ◽  
V. B. Lebedev ◽  
S. K. Oshchepkov ◽  
А. А. Zuev

The study objective is to analyze literature and evaluate based on the obtained data the effectiveness of decompression of neural structures using different methods of facet fixation.Materials and methods. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following inclusion criteria were used: full-text article in English, patient age above 19 years, presence of evaluation of the results of facet fixation, degenerative disease of the lumbar spine in patients.Results. First search in the PubMed database returned 198 results. Among them, 38 articles complied with the inclusion criteria, and 33 articles didn’t contain full data on patient outcomes in the context of the studied stabilization methods. The selected 5 articles contained data on treatment results, rates of fixation and complications. Many authors note good clinical effect and decreased rate of intra- and postoperative complications for facet fixation compared to transpedicular fixation.Study limitations. Absence of systematic reviews and availability of only 1 article for each method of facet fixation. Small patient samples and short follow-up.Conclusion. Decompression and facet fixation in a single spinal motion segment in combination with posterior lumbar, transforaminal and lateral lumbar interbody fixation including use of minimally invasive technologies and other methods in many cases allows to achieve good clinical effect and firm stabilization.


2021 ◽  
Vol 6 (2) ◽  
pp. 86
Author(s):  
Mark Tefero Kivumbi ◽  
Claire J. Standley

The global burden of antimicrobial resistance is on the rise, resulting in higher morbidity and mortality in our communities. The spread of antimicrobial resistance in the environment and development of resistant microbes is a challenge to the control of antimicrobial resistance. Approaches, such as antimicrobial stewardship programmes and enhanced surveillance, have been devised to curb its spread. However, particularly in lower- and middle-income countries, the overall extent of antimicrobial resistance and knowledge on ongoing surveillance, stewardship or investigation efforts, are often poorly understood. This study aimed to look at the efforts that have been undertaken to detect and combat antimicrobial resistance in Uganda as a means of establishing an overview of the situation, to help inform future decisions. We conducted a systematic literature review of the PubMed database to assess these efforts. A search combining keywords associated with antimicrobial resistance were used to find relevant studies between 1995 and 2020 on surveillance of antimicrobial resistance in Uganda, and susceptibility of microbes to different drugs. The search yielded 430 records, 163 of which met the inclusion criteria for analysis. The studies were categorized according to country and region, the type of antimicrobial resistance, context of the study, study design and outcome of the study. We observed that antibacterial resistance and antimalarial resistance had the most published studies while antiviral and antifungal resistance were represented by very few studies each. Most studies were conducted in humans and hospital settings, with few in veterinary and One Health contexts, and only one that included environmental sampling. The majority of studies have focused on surveillance, susceptibility testing or resistance genes; none of our included papers had a policy or stewardship focus. The results from our work can inform public health policy on antimicrobial stewardship as it contributes to understanding the status of antimicrobial resistance surveillance in Uganda, and can also help to guide future research efforts. Notably, a One Health approach needs to be followed with respect to surveillance of antimicrobial resistance to better understand the mechanisms of resistance transfer across the human-animal–environment interface, including additional investigation in antiviral and antifungal resistance.


BJPsych Open ◽  
2018 ◽  
Vol 4 (6) ◽  
pp. 427-440 ◽  
Author(s):  
Anthony F. Jorm ◽  
Anna M. Ross

BackgroundExpert-consensus guidelines have been developed for how members of the public should assist a person with a mental health problem or in a mental health crisis.AimsThis review aimed to examine the range of guidelines that have been developed and how these have been implemented in practice.MethodA narrative review was carried out based on a systematic search for literature on the development or implementation of the guidelines.ResultsThe Delphi method has been used to develop a wide range of guidelines for English-speaking countries, Asian countries and a number of other cultural groups. The primary implementation has been through informing the content of training courses.ConclusionFurther work is needed on guidelines for low- and middle-income countries.Declaration of interestA.F.J. is an unpaid member of the Board of Mental Health First Aid International (trading as Mental Health First Aid Australia), which is a not-for-profit organisation.


2019 ◽  
Author(s):  
Blessings M. Kapumba ◽  
Kondwani Jambo ◽  
Jamie Rylance ◽  
Markus Gmeiner ◽  
Rodrick Sambakunsi ◽  
...  

Abstract Background: Human infection studies (HIS) are valuable in vaccine development. Deliberate infection, however, creates challenging questions, particularly in low and middle-income countries (LMIC) where HIS are new and ethical challenges may be heightened. Consultation with stakeholders is needed to support contextually appropriate and acceptable study design. We examined stakeholder perceptions about the acceptability and ethics of HIS in Malawi, to inform decisions about planned pneumococcal challenge research and wider understanding of HIS ethics in LMIC. Methods: We conducted 6 deliberative focus groups and 15 follow-up interviews with research staff, medical students, and community representatives from rural and urban Blantyre. We also conducted 5 key informant interviews with clinicians, ethics committee members and district health government officials. Findings: Stakeholders perceived HIS research to have potential population health benefits, but they also had concerns, particularly related to safety of volunteers and negative community reactions. Acceptability depended on a range of conditions related to procedures for voluntary and informed consent, inclusion criteria, medical care or support, compensation, regulation, and robust community engagement. These conditions largely mirror those in existing guidelines for HIS and biomedical research in LMICs. Stakeholder perceptions pointed to potential tensions, for example balancing equity, safety and relevance in inclusion criteria. Conclusions: Our findings suggest HIS research could be acceptable in Malawi, provided certain conditions are in place. Ongoing assessment of participant experiences and stakeholder perceptions will be required to strengthen HIS research during development and roll-out. Key words: Human Infection Studies, pneumococcal, Malawi, acceptability, ethics


2020 ◽  
Vol 2 (2(May-August)) ◽  
pp. e342020
Author(s):  
Luciano Lopes Furlanetti ◽  
Matheus Fernando Manzolli Ballestero ◽  
Ricardo Santos De Oliveira

Introduction: Hydrocephalus is the most common neurosurgical condition among children worldwide and shunt diversion of the cerebral-spinal fluid (CSF) has been widely available. The aim of the present study was to perform a systematic review on types and models of shunt devices available and critically evaluate scientific evidence in favor of the usage of specific technologies. Methods: Searches of the PubMed database were performed for relevant articles published from until March 2020. Appropriate keywords were used to identify all studies, including: “shunt”, “technology”, “hydrocephalus”, “children”, “pediatric”. The indications and scientific evidence in favor of the usage of specific shunt technology for the treatment of hydrocephalus according to age, underlying pathology and other features of specific patients were discussed under the light of the current literature. Results: A total of 178 peer-reviewed papers were found. Out of them, only 21 matched our inclusion criteria and were finally selected. The papers were reviewed and described technology discussed below. A summary of the main types of shunts commercially available worldwide, including their respective working mechanism and construction was also included. Conclusion:Shunt technology has evolved during the last decades and continues to be intensively developed. Despite of the huge arsenal of different types of shunt systems currently available on the market, the treatment of hydrocephalus remains challenging. Investment in research, education and training, as well as prospective randomized multicentric controlled trials evaluating the role of specific valves in the treatment of individual group of hydrocephalic pediatric patients are urgently needed.


2021 ◽  
Vol 10 (20) ◽  
pp. 1532-1538
Author(s):  
Prathap M.S. ◽  
Reshma Pradeep

Indications for endodontic surgery include failed nonsurgical treatment or retreatment, anatomical problems or iatrogenic errors. Endodontic surgery was considered as the last option with instruments that were unsuitable, surgical sites with inadequate vision and increased incidence of post-operative complication. But today endodontic surgery has evolved into endodontic microsurgery with the advancement in illumination, magnification, instruments and materials. Higher magnification and micro-instruments have increased the clinical outcome of endodontic surgery. Traditional instruments used in endodontic surgery are too large for the small osteotomy sites of microsurgery. Few of the instruments used for microsurgery are the smaller version of the traditional instruments. Endodontic microsurgery represents a minimally invasive treatment option with predictable outcome with the use of micro-instruments. A high success rate of nearly 93.5 % is reported, thus, making microsurgery a predictable option for the management of periapical pathology where surgical root treatment is not possible. The advanced techniques developed to overcome the barriers seen in traditional endodontic surgery have allowed the clinicians to achieve higher success rates. Along with the micro-instruments, the introduction of biomimetic materials has also led to the favourable results after endodontic surgery. This article discusses the different microsurgical instruments available for microsurgical procedures. KEY WORDS Curette, Microblade, Microsurgery, Piezotomes, Retractor, Ultrasonic.


2021 ◽  
Author(s):  
Poliana Rafaela dos Santos Araújo ◽  
Kauan Alves Sousa Madruga ◽  
Bruna Alves Rocha ◽  
Lucas Oliveira Braga

Background: Coronavirus disease (COVID-19), once identified, soon spread globally, becoming a pandemic. Although patients present mainly with respiratory complaints, several neurological symptoms have been reported. Symptoms range from headache and nonspecific dizziness to seizures and cerebrovascular disease (CVD). It has also been shown that the severity of the infection is directly proportional to the development of neurological symptoms, especially CVD and changes in mental status. Objective: The present study aims to briefly review the neurological manifestations of COVID-19 and discuss the pathogenic mechanisms of Central Nervous System (CNS) involvement. Methods: This is an exploratory narrative review with a descriptive approach, consisting of an active search for scientific articles in the PubMed database. The descriptors “coronavirus infections”, “COVID-19” and “Nervous system” were used, with the Boolean operators “OR” and “AND”. Eighteen articles of systematic review and meta-analysis were included. Results: CNS manifestations included, among others: encephalitis, encephalopathy, consciousness decrease, headache, dizziness, acute myelitis, and stroke. As for the peripheral nervous system, skeletal muscle damage, chemosensory dysfunction, and Guillain-Barré syndrome were observed, with hyposmia being the most common symptom. CNS involvement may be related to a worse prognosis. Conclusion: The clinical involvement of the nervous system in COVID-19 is not uncommon, and can result in several neurological complications, especially in the most critical patients. The pathophysiological mechanisms of these events still need further investigation. In the meantime, physicians should value extra-respiratory symptoms ranging from hyposmia, to potentially fatal manifestations, such as stroke and encephalopathy.


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