- Keywords
- ústavní soud,
- MeSH
- Adult MeSH
- Doulas legislation & jurisprudence MeSH
- Humans MeSH
- Mothers legislation & jurisprudence MeSH
- Perinatal Death * MeSH
- Home Childbirth * ethics adverse effects legislation & jurisprudence MeSH
- Patient Rights ethics legislation & jurisprudence MeSH
- Liability, Legal MeSH
- Forensic Sciences legislation & jurisprudence MeSH
- Pregnancy MeSH
- Medical Neglect MeSH
- Women's Rights legislation & jurisprudence MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Newspaper Article MeSH
- Legal Case MeSH
Pitvy zohrávali kľúčovú úlohu vo vývoji humánnej medicíny, možno ich teda právom označiť za kľúčové východisko medicínskeho poznania. Tieto finálne medicínsko-anatomické úkony tvoria aj v súčasnosti virtuálnu axis cognitionis medicinae, pričom naďalej zostávajú imanentne nenahraditeľné z viacerých dôvodov. Nálezy a závery pitiev vnášajú svetlo do klinického bremena diagnóz, majú eo ipso priamy impakt na optimalizáciu liečebných postupov, prevenciu šírenia chorôb, vzdelávanie zdravotníckych pracovníkov a tiež ovplyvňujú štátnu jurisdikciu. História identifikuje tri hlavné typy pitiev: pitvu anatomickú, ktorá skúma štruktúru a funkciu ľudského tela; pitvu klinickú, zameranú na príčinu, lokalizáciu a patogenézu chorôb a pitvu forenznú, ktorá definuje smrť indivídua z aspektu násilných javov a dejov, vonkajších i vnútorných. Takéto typy pitiev vygenerovala historická spoločenská objednávka na univerzitách v Padove, Viedni, Berlíne a Lipsku. V súčasnosti, napriek poklesu počtu vykonaných pitiev v ostatných desaťročiach, zostáva ich medicínsko-sociálny význam v podstate nemenný. Aj dnes pitvy zomrelých nezastupiteľne prispievajú k rozvoju medicíny a prospechu celej spoločnosti. Hoci niektoré kultúry či religiózne spoločenstvá majú aj dnes voči pitvám často neprekonateľné výhrady, pitvami získané poznatky i napriek tomu výrazne zlepšili zdravie mnohých, aj v týchto krajinách. Ukazuje sa, že aj napriek neskutočnému tempu rozvoja biofyziky a medicínskych vied či technológií zostane pitva ako symbolické gnozeologicky determinované vloženie ruky odborníka do tela mŕtveho nenahraditeľným zdrojom poznania.
Autopsies have played a crucial role in human medicine, forming a key foundation of medical knowledge. These final medical-anatomical procedures remain irreplaceable, shedding light on diagnoses, optimizing treatments, preventing disease spread, educating healthcare professionals, and influencing state jurisdiction. Despite the decline in the number of autopsies performed in recent decades, their medical-social significance remains essentially unchanged. Even today, autopsies contribute indispensably to the advancement of medicine and the benefit of society as a whole. Correspondence address: Veronika Rybárová, MD, PhD Department of Forensic Medicine and Medicolegal Expertise Jessenius Faculty of Medicine, Comenius University in Bratislava University Hospital Kollárova 2, 036 01 Martin, Slovak Republic tel.: +421434132770 e-mail: veronika.rybarova@uniba.sk Delivered: July 17, 2024 Accepted: August 17, 2024 * Toto je miesto kde sa smrť raduje pomáhajúc životu...
The purpose of this study was to evaluate the feasibility of using the expression profile of transforming growth factor beta (TGF-β-1-3) to assess the progression of L/S spine degenerative disease. The study group consisted of 113 lumbosacral (L/S) intervertebral disc (IVD) degenerative disease patients from whom IVDs were collected during a microdiscectomy, whereas the control group consisted of 81 participants from whom IVDs were collected during a forensic autopsy or organ harvesting. Hematoxylin and eosin staining was performed to exclude degenerative changes in the IVDs collected from the control group. The molecular analysis consisted of reverse-transcription real-time quantitative polymerase chain reaction (RT-qPCR), an enzyme-linked immunosorbent assay (ELISA), Western blotting, and an immunohistochemical analysis (IHC). In degenerated IVDs, we noted an overexpression of all TGF-β-1-3 mRNA isoforms with the largest changes observed for TGF-β3 isoforms (fold change (FC) = 19.52 ± 2.87) and the smallest for TGF-β2 (FC = 2.26 ± 0.16). Changes in the transcriptional activity of TGF-β-1-3 were statistically significant (p < 0.05). Significantly higher concentrations of TGF-β1 (2797 ± 132 pg/mL vs. 276 ± 19 pg/mL; p < 0.05), TGF-β2 (1918 ± 176 pg/mL vs. 159 ± 17 pg/mL; p < 0.05), and TGF-β3 (2573 ± 102 pg/mL vs. 152 ± 11 pg/mL) were observed in degenerative IVDs compared with the control samples. Determining the concentration profiles of TGF-β1-3 appears to be a promising monitoring tool for the progression of degenerative disease as well as for evaluating its treatment or developing new treatment strategies with molecular targets.
- Publication type
- Journal Article MeSH
INTRODUCTION: The addition of compulsive sexual behavior disorder (CSBD) into the ICD-11 chapter on mental, behavioral, or neurodevelopmental disorders has greatly stimulated research and controversy around compulsive sexual behavior, or what has been termed "hypersexual disorder," "sexual addiction," "porn addiction," "sexual compulsivity," and "out-of-control sexual behavior." OBJECTIVES: To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them. METHODS: A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues. RESULTS: CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent "unhealthy" sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed. CONCLUSIONS: Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related "out-of-control sexual behaviors" on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine-informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.
BACKGROUND: Secure forensic hospital treatments are resource-intensive, aiming to rehabilitate offenders and enhance public safety. While these treatments consume significant portions of mental health budgets and show efficacy in some countries, their effectiveness in Czechia remains underexplored. Previous research has highlighted various factors influencing the likelihood of discharge from these institutions. Notably, the role of sociodemographic variables and the length of stay (LoS) in the context of forensic treatments has presented inconsistent findings across studies. METHODS: The study, part of the 'Deinstitutionalization project' in Czechia, collected data from all inpatient forensic care hospitals. A total of 793 patients (711 male, 79 female and 3 unknown) were included. Data collection spanned 6 months, with tools like HoNOS, HoNOS-Secure, MOAS, HCR-20V3 and AQoL-8D employed to assess various aspects of patient health, behaviour, risk and quality of life. RESULTS: The study revealed several determinants influencing patient discharge from forensic hospitals. Key assessment tools, such as HoNOS secure scores and the HCR-20 clinical subscale, showed that higher scores equated to lower chances of release. Furthermore, specific diagnoses like substance use disorder increased discharge odds, while a mental retardation diagnosis significantly reduced it. The type of index offense showed no influence on discharge decisions. CONCLUSION: Factors like reduced risk behaviours, absence of mental retardation diagnosis, social support and secure post-release housing plans played significant roles. The results underscored the importance of using standardized assessment tools over clinical judgement. A standout insight was the unique challenges faced by patients diagnosed with mental retardation, emphasizing a need for specialized care units or tailored programmes.
- MeSH
- Deinstitutionalization MeSH
- Length of Stay * MeSH
- Adult MeSH
- Mental Disorders * therapy MeSH
- Quality of Life MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Patient Discharge * MeSH
- Forensic Psychiatry MeSH
- Hospitals, Psychiatric * MeSH
- Criminals psychology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
This case report presents a rare case of an atypical head stab wound suffered by a drug addict and inflicted with a screwdriver during drug-induced psychosis. It describes the diagnostic and treatment procedures in the hospital and the findings of the subsequent autopsy. It also analyzes the review of the interpretation of the CT scans made upon admission and the subsequent treatment by an independent medical review panel, which revealed signs of medical mismanagement. Therefore, it also discusses the legal consequences that the case may have involved for the attending physicians in addition to the consequences for the suspected perpetrator. The report raises many issues encountered in the case in terms of the clinical treatment and forensic determination of the manner of death in cases of injuries caused by sharp instruments and highlights the importance of comprehensive evaluation of the circumstantial evidence together with the clinical or autopsy findings, since such evidence may sometimes be overlooked in clinical practice.
- MeSH
- Wounds, Stab * pathology MeSH
- Adult MeSH
- Humans MeSH
- Head Injuries, Penetrating pathology MeSH
- Tomography, X-Ray Computed MeSH
- Psychoses, Substance-Induced * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
Pôrodný plán je dokument, v ktorom sa spresňujú preferencie a očakávania rodičky týkajúce sa pôrodu a včasného šestonedelia. Účelom pôrodného plánu je nadviazať a vhodne sprostredkovať komunikáciu o prianiach rodičky týkajúcich sa pôrodu s poskytovateľmi zdravotnej starostlivosti. So zvyšovaním informatizácie spoločnosti je pôrodný plán v súčasnosti veľmi diskutovanou témou. V článku uvádzame historický pohľad na pôrodný plán ako aj aktuálnu legislatívu týkajúcu sa pôrodného plánu, keďže nepovažujeme právne povedomie pôrodníkov v súčasnosti za dostatočné. Cieľom článku je osloviť odbornú verejnosť, aby mala aktuálne informácie o pôrodnom pláne najmä v diskusii s pacientkami, ale aj pri forenzných konaniach. Udržanie výborných výsledkov v perinatológii je možné v našich podmienkach len zabezpečením odbornej, empatickej a veľmi intímnej zdravotnej starostlivosti v nemocničných zariadeniach.
A birth plan is a document that defines mother’s preferences and expectations regarding childbirth and early puerperium. The purpose of the birth plan is to establish communication about mother’s birth wishes and to properly convey them to the health care providers. With increasing computerization of society, birth plan is currently the subject of heated debate. In this article, we present historical view of the birth plan, as well as current legislation regarding the birth plan, as we do not consider legal awareness of obstetricians to be sufficient at the moment. The purpose of this article is to appeal to the professional public so they have up-to-date information about the birth plan, especially in discussions with patients, but also during forensic procedures. The preservation of excellent perinatological results under our circumstances is only possible by providing professional, empathetic and very intimate health care in hospital institutions.
- Keywords
- porodní plán,
- MeSH
- Informed Consent MeSH
- Humans MeSH
- Parturition * MeSH
- Patient Rights classification MeSH
- Patient Satisfaction MeSH
- Pregnant People MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Review MeSH
UNLABELLED: Human age estimation from trace samples may give important leads early in a police investigation by contributing to the description of the perpetrator. Several molecular biomarkers are available for the estimation of chronological age, and currently, DNA methylation patterns are the most promising. In this study, a QIAGEN age protocol for age estimation was tested by five forensic genetic laboratories. The assay comprised bisulfite treatment of the extracted DNA, amplification of five CpG loci (in the genes of ELOVL2, C1orf132, TRIM59, KLF14, and FHL2), and sequencing of the amplicons using the PyroMark Q48 platform. Blood samples from 49 individuals with ages ranging from 18 to 64 years as well as negative and methylation controls were analyzed. An existing age estimation model was applied to display a mean absolute deviation of 3.62 years within the reference data set. KEY POINTS: Age determination as an intelligence tool during investigations can be a powerful tool in forensic genetics.In this study, five laboratories ran 49 samples and obtained a mean absolute deviation of 3.62 years.Five markers were analyzed on a PyroMark Q48 platform.
- Publication type
- Journal Article MeSH
A large proportion of the world's disease burden is attributable to mental illnesses. Although effective interventions are available, many patients still have limited access to evidence-based treatments. Aside from access, treatment gaps, including inappropriate medication selection and monitoring, are also routinely recognised. Mental health clinical pharmacists can help address these gaps and enable patients to receive optimised pharmaceutical care, particularly appropriate medication selection and monitoring. The European Society of Clinical Pharmacy (ESCP) Special Interest Group on Mental Health was established to improve standardised service provision in mental health settings across Europe. The Special Interest Group identified significant barriers (predominantly associated with reimbursement and position within the multidisciplinary team) to effective pharmaceutical care amongst those with mental illnesses. This commentary presents recommendations to address these gaps through improved mental health clinical pharmacy service provision.
- MeSH
- Mental Health MeSH
- Pharmacists psychology MeSH
- Pharmacy * MeSH
- Humans MeSH
- Pharmacy Service, Hospital * MeSH
- Public Opinion MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
... 61 -- Unit 10: HIV and AIDS 67 -- Unit 11: Cancer 74 -- Unit 12: Homeopathy and Other Alternative Treatment ...
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