Search

Resume But de l’etude Cette etude retrospective s’interesse a la typologie des victimes de « violences volontaires » qui viennent a plusieurs reprises a l’unite medico-judiciaire de Toulouse pour le meme motif de violence. Patient et methode Entre mai et septembre 2019, 1821 individus ont ete vus a consultations de l’unite medico-judicaire pour des « violences volontaires ». Parmi ces individus, 284 avaient deja consulte durant les 10 annees precedentes dont 165 pour au moins 2 fois le meme motif. Resultats Le principal motif pour lequel les femmes consultent a l’unite medico-judicaire a plusieurs reprises est les violences conjugales (p Conclusion Cette approche devrait permettre d’identifier plus facilement les situations de violences a risques de devenir chroniques et repetees. Les UMJ pourraient prendre en compte ces donnees afin de faciliter une prise en charge globale de la victime pour l’aider a sortir de ce cycle de violences.

Age estimation is an essential element in the field of forensics and is also of judicial interest in forensic medicine of the living. Despite all the methods, age estimation is often imprecise with many biases, especially in mature individuals. The main objective of our study is to assess the correlation between age and computed tomography bone mineral density of the medial end of the clavicle. A sample of 180 chest multi-slice computed tomography scans without contrast injection performed in living individuals, with suspected respiratory infection, aged 15 to 100 years was used. Bone density measurement was performed on the medial meta-epiphyseal region of the clavicles. A significant negative correlation was found between bone density and age of individuals (p-value 0.05). The mean absolute error was calculated for men at 13.4 years and 13.1 years for women, which was associated with an absence of bias. Good precision of the estimate for both sexes was also calculated on a subgroup of individuals whose age was greater than 40 years, with average absolute errors of about 12 years, which was associated with an absence of relative error. In view of our preliminary results, the study of bone density of the medial end of the clavicle could be of interest in the estimation of age. Several studies will be necessary to evaluate the reproducibility of these results on independent bone samples and in the estimation of age in the living individual.

The objective of this study is to assess, using cone-beam CT (CBCT) examinations, the correlation between hard and soft anatomical parameters and their impact on the characteristics of the upper airway using symbolic regression as a machine learning strategy. Methods: On each CBCT, the upper airway was segmented, and 24 anatomical landmarks were positioned to obtain six angles and 19 distances. Some anatomical landmarks were related to soft tissues and others were related to hard tissues. To explore which variables were the most influential to explain the morphology of the upper airway, principal component and symbolic regression analyses were conducted. Results: In total, 60 CBCT were analyzed from subjects with a mean age of 39.5 ± 13.5 years. The intra-observer reproducibility for each variable was between good and excellent. The horizontal soft palate measure mostly contributed to the reduction of the airway volume and minimal section area with a variable importance of around 50%. The tongue and the position of the hyoid bone were also linked to the upper airway morphology. For hard anatomical structures, the anteroposterior position of the mandible and the maxilla had some influence. Conclusions: Although the volume of the airway is not accessible on all CBCT scans performed by dental practitioners, this study demonstrates that a small number of anatomical elements may be markers of the reduction of the upper airway with, potentially, an increased risk of obstructive sleep apnea. This could help the dentist refer the patient to a suitable physician.

Despite an extensive number of existing methods, age estimation of human remains is still an unsolved matter in the field of forensic anthropology, especially when it comes to mature adults. The specific aim of this work was to propose a combined method for age estimation, for forensic purposes, by coupling the Suchey-Brooks method and the measure of the pubic bone density. For this purpose, we used an independent test sample comprising 339 CT scans of living individuals aged 15 to 99 years old. Measurement of bone density and staging according to the Suchey-Brooks phases were performed, followed by estimation of ages based on a combined method and an existing virtual reference sample. Results highlighted a significant negative correlation between bone density and age. Good accuracy was obtained for the measurement of pubic bone density for age estimation of men and women, especially concerning mature adults, with an absolute error ranging from 9 to 16 years for all individuals. The authors propose a practical combined method consisting of, first, allocating phases according to the scannographic approach of the Suchey-Brooks method. For phases I to IV, the age estimation is given using the Suchey-Brooks method. For phases V to VI, the pubic bone density measurement is used. Further study will be needed to assess the reproducibility of these results on cadavers and dry bones, as the post-mortem process could interfere with the measurement of mineral bone density.

Summary Worldwide, suicide remains a major public health problem whose impact in human and economic terms is important. Many studies have been carried out on this subject, including the study of risk factors for suicide. Nevertheless, in the absence of an effective and strengthened collaboration between the forensic institutes and the Epidemiological Centre on the Medical Causes of Death (CepiDc), epidemiological data concerning suicide in France remain underestimated, which impedes the implementation of an effective and necessary means of prevention against this scourge. In this work, we conducted an epidemiological profile of suicides at the forensic institute of Toulouse for 3 years. During the study period 715 cases of suicide were collected, with an overwhelming male predominance of 534 men (75%) and 181 women (25%). The average age was 53.94 years, with extremes of 12 and 101 years. Hanging was the most common method of suicide (41.7%) for both sex. Seasonal variations in the frequency of suicides were also reported during our study: lower frequencies in winter and higher frequencies in summer. Among the determinants of suicidal acts, depression (34.7%) was predominant among mental disorders in suicides.

ObjectivesVaccine-induced immune thrombotic thrombocytopenia (VITT), a recently described entity characterized by thrombosis at unusual locations such as cerebral venous sinus and splanchnic vein, has been rarely described after adenoviral-encoded COVID-19 vaccines. In this study, we report the immunohistological correlates in 3 fatal cases of cerebral venous thrombosis related to VITT analyzed at an academic medical center.MethodsDetailed neuropathologic studies were performed in 3 cases of cerebral venous thrombosis related to VITT after adenoviral COVID-19 vaccination.ResultsAutopsy revealed extensive cerebral vein thrombosis in all 3 cases. Polarized thrombi were observed with a high density of neutrophils in the core and a low density in the tail. Endothelial cells adjacent to the thrombus were largely destroyed. Markers of neutrophil extracellular trap and complement activation were present at the border and within the cerebral vein thrombi. SARS-CoV-2 spike protein was detected within the thrombus and in the adjacent vessel wall.DiscussionData indicate that neutrophils and complement activation associated with antispike immunity triggered by the vaccine is probably involved in the disease process.

Resume Dans un certain nombre de situations, les sequelles secondaires a une pathologie carcinologique necessitent une evaluation des prejudices dans un but indemnitaire. C’est notamment le cas quand des tiers responsables ont ete reconnus a l’origine de la maladie: pathologies professionnelles en cas de faute inexcusable de l’employeur, exposition a un risque radio induit par exemple dans le cadre de la reparation integrale des prejudices subis par les victimes des essais nucleaires francais ou enfin dans les sequelles liees a un retard diagnostic. Cet article n’aborde pas l’imputabilite des pathologies cancereuses a un evenement, mais propose une adaptation des methodes d’evaluation des prejudices, pour tendre vers une reparation integrale des dommages.

Dental age, one of the indicators of biological age, is inferred by radiological methods. Two of the most commonly used methods are using Demirjian’s radiographic stages of permanent teeth excluding the third molar (Demirjian’s and Willems’ method). The major drawbacks of these methods are that they are based on population-specific conversion tables and may tend to over- or underestimate dental age in other populations. Machine learning (ML) methods make it possible to create complex data schemas more simply while keeping the same annotation system. The objectives of this study are to compare (1) the capacity of ten machine learning algorithms to predict dental age in children using the seven left permanent mandibular teeth compared to reference methods and (2) the capacity of ten machine learning algorithms to predict dental age from childhood to young adulthood using the seven left permanent mandibular teeth and the four third molars. Using a large radiological database of 3605 orthopantomograms (1734 females and 1871 males) of healthy French patients aged between 2 and 24 years, seven left permanent mandibular teeth and the 4 third molars were assessed using Demirjian’s stages. Dental age estimation was then performed using Demirjian’s reference method and various ML regression methods. Two analyses were performed: with the 7 left mandibular teeth without third molars for the under 16 age group and with the third molars for the entire study population. The different methods were compared using mean error, mean absolute error, root mean square error as metrics, and the Bland-Altman graph. All ML methods had a mean absolute error (MAE) under 0.811 years. With Demirjian’s and Willems’ methods, the MAE was 1.107 and 0.927 years, respectively. Except for the Bayesian ridge regression that gives poorer accuracy, there was no statistical difference between all ML tested. Compared to the two reference methods, all the ML methods based on the maturation stages defined by Demirjian were more accurate in estimating dental age. These results support the use of ML algorithms instead of using standard population tables.

Homicide by stab wound is common worldwide. However, the use of unusual edged weapons is rarely reported in the forensic literature. Here, we report two cases of homicide involving a Japanese sword, or katana, and a sickle. Both of these weapons can create either stab or incised wounds with some particularities. In our cases, characteristics of the external wounds, internal injuries, and the depth of penetration raised the possibility of an unusual weapon. Meticulous forensic examination of these injuries (morphological characteristics, depth of penetration, trajectories, and cut marks in the bone) may allow the forensic expert to determine the type of weapon used.

In forensic anthropology, age estimation is a major element in the determination of a biological profile and the identification of individuals. Thus, many anatomical structures have been studied, such as the pubic symphysis, which is a source of major interest due to its late maturation. One of the most well-known methods of assessment is the Suchey-Brooks (SB) system based on the morphological characteristics of the pubic symphysis. The aim of this study was to propose linear regression formulae in order to deduce chronological age from bone density, using both Hounsfield unit (HU), and mean bone density (mBD) values of the pubic symphysis. Moreover, we intended to test the reliability and then to explore the feasibility of using HU instead of mBD values for age estimation. We built retrospectively a reference sample of 400 pubic symphyses using computed tomography at a French hospital and a test sample of 120 pubic symphyses. Equations were created to establish linear regression models for age estimation. Inaccuracy and bias were calculated for individuals aged more or less than 40 years. We highlighted homogeneous mean absolute errors for both HU and mBD values, most of them being less than 10 years. Moreover, we reported a moderate overestimation for younger individuals and a very small underestimation for older individuals. This study proposes a correlation between the bone density and age of individuals with a valuable level of reliability. Finally, HU measurements seem to be suitable for linking bone density with the age of individuals in forensic practice.

(1) Background: contact between indigenous and European populations has often resulted in changes in oral health attributed to the introduction of sucrose. Most studies are per tooth over considerable periods and with few ethnological references. (2) Aim: dental epidemiology of 96 autochthonous frozen bodies from Yakutia between the early 17th century and the late 19th century, comparisons with historical texts and ethnographic data. (3) Material and methods: we use descriptive statistics and discriminant factorial analyses to identify dominant variables in the dataset and compare periods and subjects, considering all variables. (4) Results: the peculiarities of the population are the rarity of cavities and the relative frequency of dental pathologies leading to death. Assimilation into the Russian Orthodox culture has led to decreased tooth wear and an increase in tooth loss. Dental health evolves only two centuries after the contact. (5) Conclusions: the confrontation with historical data suggests that changes are not related to the growing importance of sucrose but to a combined action: the substitution of dendrophagy by cereal flour, the decrease in immunity linked to the development of chronic infectious diseases, tobacco addiction and the mandibular torus: a risk factor promoting apical cysts.

The purpose of this study was to analyze the respective contribution of the skull and mandible to sex estimation in an entire cranium using metric and geometric morphometric methods and multislice computed tomography (MSCT) analysis. The study sample comprised 120 individuals aged 23 to 84 years and divided into three groups (whole sample and over or under 40 years of age). Forty-eight osteometric landmarks were positioned using Osirix®, 34 for the cranium and 14 for the mandible. The data were analyzed using univariate analyses and logistic regression using backward stepwise selection with cross-validation of the classification results. Generalized procrustes analysis (GPA) was used, and Goodall’s F test and Mahalanobis D2 matrices allowed an assessment of statistical significance. The classification accuracy of cranium models ranged from 87% to 88.3%, and from 68% to 81.4% for the mandibular models. With geometric morphometry, accuracy was of 94–100% for the cranium and 84.2% for the mandible. We conclude that the mandible had a higher accuracy rate for individuals over 40 years than individuals under 40 years of age, although the accuracy of geometric morphometry did not differ significantly between the age groups. The cranium, however, presented greater predictability for all the parameters assessed.

Cone Beam Computerized Tomography (CBCT) is an imaging technology increasingly used in dentistry. Depending on the size of the examination area, visualization of anatomical structures outside the indication area may reveal incidental findings (IF). The aims of this systematic review and meta-analysis were to 1) evaluate the frequency, location and different types of incidental findings (IF) revealed during CBCT examinations; 2) identify potential influencing factors such as gender or age; 3) highlight what the family doctor should know about CBCT and the benefits for medical care. 70 retrospective studies were included. 60% of IF are in the naso-oropharyngeal airway and paranasal sinuses. Carotid calcifications were observed with a mean prevalence of 9% CI95% [2-21]). Meta-regression showed a significant association of this prevalence with age, irrespective of gender. Given the high frequency of IF, with varying severity, the whole medical community is fully involved, and its opinion should be sought to ensure the best possible management for the patients. Physicians may also require CBCT examinations that would have been previously prescribed by a dentist, that may serve to better orientate investigations toward another imaging technique. The family doctor is therefore the dentist’s main interlocutor and the main coordinator of the follow-up of IF.

Hyperostosis frontalis interna is a common phenomenon, which may have been overrated in its significance in the past, and may, currently be underrated in its significance. We present three cases of hyperostosis frontalis interna found during medicolegal autopsies and discuss their forensic considerations. The patients were all middle-aged women with metabolic and endocrine manifestations and psychiatric ailments; thickening of the inner table of the frontal bone of the skull was found during each autopsy. We describe the relationship between hyperostosis frontalis interna, metabolic manifestations, and neuropsychiatric symptoms as part of Morgagni-Stewart-Morel syndrome. There is still considerable disagreement in the scientific community as to whether this syndrome is a clinical entity. Nonetheless, awareness of Morgagni-Stewart-Morel syndrome can be of help in understanding the circumstances surrounding death. In some other cases, hyperostosis frontalis interna could be used by forensic pathologists as criteria for sexing and aging a skeleton.

Summary The use of scanning electron microscopy (SEM) coupled with energy dispersive spectroscopy (EDS) is routinely used by scientific police and increasingly described on biological samples in forensic context. However, the pre-analytical conditions of such analyses are not standardised in forensic context and each operator designs its own protocol depending on his practice. Using SEM-EDS on unprepared samples can be destructive but above all encounters technical problems. In the judiciary system, using non-destructive techniques (or less destructive as possible) is attractive to allow reiterate analyses or complementary techniques. So, in this study we try to design a SEM-EDX pre-analytical protocol for hydrated biological samples considering forensic requirement. We tested a protocol with five fragments of the legs of pigs on which a sharp wound was produced. Samples were fixed in 4% formalin for 7 days then dehydrated with absolute ethanol over 48 hours. Samples were dried in ambient air for 24 hours and analysed with SEM-EDS. Anatomo-pathologic examination was performed afterward. Samples were then stored again for 7 days with the same protocol before being examined again. Particle detection was possible without any technical problems on each analysis. This protocol allows reiterated SEM-EDS analyses and anatomo-pathologic examination afterward. This technique is easy to enforce and cheap, and no adaptation of forensic practice is required. Such a protocol is a prerequisite to the spread of EDS analysis use in French forensic practice.

Resume Introduction La personne en detention est sous la responsabilite et la protection de l’autorite judiciaire qui a decide de la mesure. De ce fait, tout deces chez une personne detenue est a priori considere comme suspect jusqu’a preuve du contraire. Objectifs Etudier les particularites des deces parmi les personnes detenues dans la region de Toulouse en France et proposer des mesures preventives afin de reduire les taux de mortalite dans les prisons. Materiels et methodes Une etude retrospective descriptive, colligeant tous les dossiers des personnes detenues decedees sur la region de Toulouse et qui ont ete autopsies dans le service de medecine legale CHU Rangueil de Toulouse durant une periode de 7 ans allant de 2011 a 2017. Resultats Nous avons collige 25 dossiers. Les decedes etaient de sexe masculin dans 24 cas avec une moyenne d’âge de 44,2 ans. Pres de la moitie des personnes detenues etaient celibataires, et 25 % etaient en couple. La mort des personnes detenues etait de cause naturelle dans 8 cas et de cause violente dans 17 cas. La mort suicidaire representait la quasi-totalite des morts violentes (16/17), et 4 moyens suicidaires differents ont ete retrouves : la pendaison, la phlebotomie, l’asphyxie mecanique par obstruction des voies aeriennes et l’auto-immolation. Conclusion Tout deces en detention est considere comme suspect parce que la personne privee de liberte a droit comme toute autre personne au respect de sa vie et de sa dignite. Ces deces relevent pour la plupart de causes violentes necessitant une reflexion en termes de prevention.

The identification of gunshot residue (GSR) on wounds enables the differentiation of entry and exit wounds. Unfortunately, studies analyzing GSR on degraded bodies have been poorly documented, and no data exist regarding GSR detection after stagnant water immersion. The aim of this preliminary experimental study was to detect GSR on wounds altered in stagnant water, using scanning electron microscopy coupled with energy-dispersive X (SEM-EDX) and inductively coupled plasma mass spectrometry (ICP-MS). Shots were performed on sheep limbs with a 22LR at a distance of 20 cm. The limbs were then submerged in stagnant water and analyzed on days 0, 6, and 14. SEM-EDX was performed on previously dehydrated wounds. For ICP-MS analysis, the wounds were rubbed with a cotton swab that was then analyzed. In the SEM studies, a higher number of particles were detected in entry wounds compared to exit wounds under every set of experimental conditions. Unfortunately, SEM-EDX failed to detect GSR particles, even on day 0. ICP-MS enabled the detection of Pb, Sb, and Ba at every stage with higher quantities on entry than in exit. These elements remained detectable following limb immersion. ICP-MS enabled differentiate entry from exit wounds, even after immersion in stagnant water. Nevertheless, when manually swabbing the wounds, quantities of matter collected is highly variable. ICP-MS is a more suitable technique than SEM-EDX for GSR identification of wounds after decomposition in stagnant water; however, standardization is needed.

Mass graves are usually key historical markers with strong incentive for archeological investigations. The identification of individuals buried in mass graves has long benefitted from traditional historical, archaeological, anthropological and paleopathological techniques. The addition of novel methods including genetic, genomic and isotopic geochemistry have renewed interest in solving unidentified mass graves. In this study, we demonstrate that the combined use of these techniques allows the identification of the individuals found in two Breton historical mass graves, where one method alone would not have revealed the importance of this discovery. The skeletons likely belong to soldiers from the two enemy armies who fought during a major event of Breton history: the siege of Rennes in 1491, which ended by the wedding of the Duchess of Brittany with the King of France and signaled the end of the independence of the region. Our study highlights the value of interdisciplinary approaches with a particular emphasis on increasingly accurate isotopic markers. The development of the sulfur isoscape and testing of the triple isotope geographic assignment are detailed in a companion paper [1].

International audience; Mass graves are usually key historical markers with strong incentive for archeological investigations. The identification of individuals buried in mass graves has long benefitted from traditional historical, archaeological, anthropological and paleopathological techniques. The addition of novel methods including genetic, genomic and isotopic geochemistry have renewed interest in solving unidentified mass graves. In this study, we demonstrate that the combined use of these techniques allows the identification of the individuals found in two Breton historical mass graves, where one method alone would not have revealed the importance of this discovery. The skeletons likely belong to soldiers from the two enemy armies who fought during a major event of Breton history: the siege of Rennes in 1491, which ended by the wedding of the Duchess of Brittany with the King of France and signaled the end of the independence of the region. Our study highlights the value of interdisciplinary approaches with a particular emphasis on increasingly accurate isotopic markers. The development of the sulfur isoscape and testing of the triple isotope geographic assignment are detailed in a companion paper [13].

International audience

International audience

Resume Les souffrances endurees ont une forte valeur symbolique et leur evaluation necessite, pour l’expert, d’ecouter et de reproduire l’expression des souffrances dans toutes leurs particularites, notamment quand un accident medical fautif ou non est a l’origine de celles-ci. L’evaluation des souffrances, endurees dans le cadre des missions de responsabilite medicale, est aussi rendue plus complexe en raison, d’une part, de leur imbrication avec un etat anterieur et/ou les consequences normales de l’intervention et, d’autre part, des referentiels inadaptes, construits autour de lesions, en rapport avec la traumatologie routiere essentiellement. La souffrance represente une notion plus vaste que la douleur et son appreciation necessite de prendre en compte les differentes composantes de la perception douloureuse par la victime. L’expert doit integrer : la dimension sensorielle (douleur au sens propre) et les dimensions cognitivo-comportementale et emotionnelle, c’est-a-dire les circonstances de survenue et/ou de diagnostic de la complication, contexte, vecu de mort imminente, la souffrance induite par l’astreinte aux soins, le retentissement de la douleur sur le comportement quotidien. L’evaluation des souffrances endurees, dans le cadre des expertises en responsabilite medicale, necessite, pour le medecin expert, une bonne connaissance du cadre juridique qui peut conduire a des questionnements differents quant au perimetre de l’evaluation des souffrances. L’expert doit laisser la possibilite aux ayants droit de discuter d’un eventuel prejudice d’angoisse de mort imminente, dans le cas du deces du patient, ou d’un prejudice d’angoisse dans le cas d’une errance diagnostique.

The aging process has an impact on mandibular bone morphology and can therefore affect shape sexual dimorphism. Understanding the effect of senescence on mandibular shape changes is particularly important to correctly estimate the sex of an individual and predict age-related conformational modifications. The purpose of this study was to assess age-related changes in mandibular shape and sexual dimorphism. The study sample comprised 160 Multi Slice Computed Tomography examinations of individuals aged 40 to 79 years. Geometric morphometric analysis of fourteen osteometric landmarks was used to examine sexual dimorphism and patterns of mandibular shape variation with age. Results showed that mandibular sexual dimorphism of shape remained significant with aging. Conformational changes occurred between 50 and 70 years and were different for male and female individuals. Females presented earlier and more marked age-related shape changes than males. These observations suggest that mandibular senescence is a sexually dimorphic process since its onset, rate, and the areas subjected to conformational changes differ from male to female individuals. Senescence-related changes present substantial variability, and further investigation is required to determine precisely the age that marks their onset.

Dental age, one of the indicators of biological age, is inferred by radiological methods. Two of the most commonly used methods are using Demirjian's radiographic stages of permanent teeth excluding the third molar (Demirjian's and Willems' method). The major drawbacks of these methods are that they are based on population-specific conversion tables and may tend to over- or underestimate dental age in other populations. Machine learning (ML) methods make it possible to create complex data schemas more simply while keeping the same annotation system. The objectives of this study are to compare (1) the capacity of ten machine learning algorithms to predict dental age in children using the seven left permanent mandibular teeth compared to reference methods and (2) the capacity of ten machine learning algorithms to predict dental age from childhood to young adulthood using the seven left permanent mandibular teeth and the four third molars.Using a large radiological database of 3605 orthopantomograms (1734 females and 1871 males) of healthy French patients aged between 2 and 24 years, seven left permanent mandibular teeth and the 4 third molars were assessed using Demirjian's stages. Dental age estimation was then performed using Demirjian's reference method and various ML regression methods. Two analyses were performed: with the 7 left mandibular teeth without third molars for the under 16 age group and with the third molars for the entire study population. The different methods were compared using mean error, mean absolute error, root mean square error as metrics, and the Bland-Altman graph.All ML methods had a mean absolute error (MAE) under 0.811 years. With Demirjian's and Willems' methods, the MAE was 1.107 and 0.927 years, respectively. Except for the Bayesian ridge regression that gives poorer accuracy, there was no statistical difference between all ML tested.Compared to the two reference methods, all the ML methods based on the maturation stages defined by Demirjian were more accurate in estimating dental age. These results support the use of ML algorithms instead of using standard population tables.

Aim of the work In forensic anthropology, the estimation of age at death is required to establish a biological profile and facilitate individual identification. The pubic symphysis represents one of the most studied skeletal structures due to its late maturation. In this respect, the Suchey-Brooks (SB) system is one of the most commonly used methods of assessment based on the morphological characteristics of the pubic symphysis. However, the SB method has certain drawbacks, including frequently inaccurate estimation for individuals over 40 years old. The main aim of this work was to study the inter-observer agreement in the SB method then to test the errors of estimation by three observers with heterogeneous experience from a computed tomography sample for individuals aged between 15 and 98 years old. Patients and methods We retrospectively studied pubic bones from 50 males and 50 females undergoing clinical multislice computed tomography (MSCT) in a French hospital between November 2017 and April 2018. Results The inter-observer reliabilities, with or without the early and advanced patterns, were excellent between the observers (kappa values between 0.8 and 0.95). By focusing on the first three phases (I–III) versus the last three phases (IV–VI), there was no significant difference between the inter-observer reliabilities (kappa values between 0.44 and 0.85). Conclusion The inaccuracy rose with age, showing a growing underestimation from 40 years old and beyond. Besides, we highlighted a moderate overestimation for younger individuals. These errors of estimation were slightly dependent on the experience of the observer.

In a few situations, the consequences secondary to a carcinological pathology require an assessment of damages for compensatory purposes. This is particularly the case when liable parties have been found to be at cause of the disease: occupational pathologies in the case of inexcusable employer's fault, exposure to a radioactive risk, for example in the context of full compensation for damages suffered by the victims of nuclear experiments performed by France, or lastly, in the after-effects of late diagnosis. This article does not discuss the imputability of cancer pathologies to an event, but it proposes an adaptation of methods for assessing damages, in an attempt to provide full compensation for damages.

Summary Objective It is essential that health professionals who practice medicine in prison rely on accurate knowledge about their patients to provide them with adapted care. The use of cannabis can influence the health status of prisoners, but data are lacking regarding the potentially related adverse health consequences. The objective of this descriptive study was to describe the cardiovascular outcomes related to cannabis use in prisoners from several detention centres hospitalised in a French hospital. Methods In France, prisoners who require a longer than 48-hour hospitalisation are admitted in specific secured polyvalent units called inter-regional secured hospital units (ISHU). Hospitalisations in the ISHU of Toulouse University Hospital between 2012 and 2016 for cardiovascular disorders potentially related to the use of cannabis were extracted from the French hospital database and analysed using a previously validated methodology. Included patients were those hospitalised for an inaugural cardiovascular event or deterioration of a preexisting cardiovascular illness who declared having used cannabis while imprisoned. Results Overall, 31 cardiovascular outcomes were identified in cannabis-using hospitalised prisoners among 411 hospitalisations for cardiovascular disorders (all men, mean age 43 ± SD years old). All used cannabis (daily: 56%) and tobacco (more than 15 PY: 83.3%), 5 used cocaine, and none used alcohol. The most frequent were coronaropathy (n = 13), followed by obliterating arteriopathy of the lower limb (OALL, n = 7), arrhythmic cardiomyopathy (n = 4), venous thrombosis (n = 3), infectious cardiopathy (n = 2), and ischemic stroke (n = 2). Conclusion This description of serious cardiovascular outcomes in prisoners who use cannabis provides insights into the clinical features possibly observed in this vulnerable population The findings indicate that 7.5% of hospitalizations of prisoners for cardiovascular disorders are potentially linked to cannabis used in prison.

Summary Spatial data has been used to examine the distribution of intimate partner violence (IPV) against women in the city of Toulouse (France). The addresses of women who have consulted at the forensic unit has been geocoded and represented on a map. We geocoded 484 addresses. The Duncan dissimilarity index showed moderate segregation. Global Moran's I was present and positive and local Moran's I analysis reported ten hot-spots which were not superimposed on priority district delimitations. The results reveal a heterogenic distribution of IPV against women across the territory but no correlation with the poorest blocks as defined by priority districts. Spatial analysis offers an interesting approach to violence analysis and assessing the neighborhood environment.

Resume Contexte La torsion epiphysaire femorale distale (TEFD) est l’angle forme par l’axe condylien posterieur et l’axe biepicondylien. L’objectif premier de notre etude etait d’analyser la distribution de la valeur de la TEFD (anatomique) en fonction de l’ethnie (Caucasien versus Asiatique). Les objectifs secondaires etaient d’analyser cette variabilite en fonction de l’âge, de la lateralite et du sexe. Notre hypothese etait que la valeur de la TEFD est soumise a une variabilite interethnique. Methodes Une analyse de 515 TDM de femurs sains de patients asiatiques (Chine) (n = 259) et caucasiens (France) (n = 256) a ete realisee. Quatre reperes osteometriques ont ete definis pour mesurer la TEFD (les deux epicondyles et le point le plus dorsal des deux condyles). Le test de Mann-Whitney a ete utilise pour comparer la TEFD entre les groupes d’ethnie, lateralite et sexe. Le coefficient de correlation de Spearman a ete utilise pour evaluer les effets de l’âge. La variabilite inter- et intra-observateur de ces mesures a ete analysee. Resultats La TEFD moyenne etait de 6° ± 2,5 (0 a 14°). Elle etait de 6,4° (0,31°–14,1°) chez les Asiatiques et de 5,5° chez les Caucasiens (0°–13,1°) (p Conclusion Il existe une variabilite inter ethnique de la TEFD qui s’ajoute a la variabilite inter individuelle deja documentee, apportant un argument supplementaire de l’interet d’une mesure par imagerie de la TEFD avant la pose d’une prothese totale de genou. Niveau de preuve III, etude comparative retrospective.

Few studies have looked at lung cancer in prisoners, despite this population is possibly at increased risk of malignancy. In a previous study, we found an early onset of lung cancer in prisoners. Thus, the present CARCAN study was aimed at assessing the epidemiological characteristics, management, prognosis, and incidence of lung cancer in prisoners compared to a sample of non-prisoner patients. We performed a multi-center observational case–control study. Cases were prisoners diagnosed with lung cancer from 2005 to 2013. Controls were non-prisoner lung cancer patients selected from hospital databases and randomly matched to cases (targeted case–control ratio: 1:3). Incidence rates in both groups were calculated using national statistics. Seventy-two cases and 170 controls met inclusion criteria. Cases were mainly men (99%). Mean age at diagnosis was 52.9 (± 11.0) in cases and 64.3 (± 10.1) in controls (p

Resume L’analyse des traces de morsures est une specialite de l’odontologie legale. Une morsure peut contenir des elements tels que la salive ou des indentations permettant d’identifier un individu. But de l’etude Cet article decrit la mise en place d’un protocole photographique et l’analyse semiologique des morsures ainsi photographiees au sein de l’UMJ de Toulouse. Materiels et methodes Plusieurs criteres des morsures ont ete etudies : le delai, l’exploitabilite, la classe de severite, le diametre et la description des indentations. Resultats De fevrier a octobre 2016, 58 cas de morsures ont ete observes. Le delai moyen est de 3,5 jours entre la morsure et la photographie. Dans 17 % des cas, les morsures presentaient un fort interet en odontologie legale par la presence d’indentations caracteristiques. Conclusion Un protocole photographique peut etre facilement mis en place au sein d’une UMJ. La photographie facilite la description et la semiologie de la morsure. Elle est essentielle dans l’analyse de la morsure en apportant rapidement des informations aussi bien morphologiques que metriques.

Posttraumatic stress disorder (PTSD) is commonly acknowledged to be associated with reduced specificity of autobiographical memory (AM). However, very few studies have assessed AM in the peritraumatic phase. The aim of the present study was to examine whether the AM impairment reported in PTSD is present a few days after a traumatic event. We assessed AM in 41 participants who had recently been exposed to trauma, and 34 controls who had never experienced a traumatic situation. The trauma-exposed participants also completed the Impact of Event Scale-R (IES-R), the Inventory of Peritraumatic Distress, and the Peritraumatic Dissociative Experiences Questionnaire. Results showed that autobiographical memories cued by negative words were significantly less specific in the group of trauma-exposed participants than in the control group (p = .008; d = 0.40). Thus, mild AM impairment was already present three days after trauma exposure, long before acute PTSD set in.