The present study aims to assess the effects of alcohol and drug consumption on the cerebral status of a newborn with risk. Although there is a vast literature on the quality of life in terms of health, there is no uniform point of view, since the well-being of a person implies other elements that consider not only health but also the economic and educational environment in which the individual evolves and often these factors are connected. Besides, there is no valid instrument for measuring the quality of life either for an adult or for a child. In most cases, alcohol consumption intensifies in time, significantly decresing the quality of life for the mother and especially for the conception product. The study focuses on showing the The study focuses on highlighting the psychosocial and pharmacological aspects relevant to the diagnosis and management of neonatal cerebral status. The study participants, whose responses were the base for the quantitative analyzes, were individually interviewed using a standardized interview protocol. The interviews were conducted between October 2015 and September 2017. The interview protocol included three sections, in this chapter focusing our attention on the following sections: a) socio-demographic characteristics: age of gestation, sex of the newborn; b) clinical data: Presentation, Weight at Birth, Apgar Score, Cerebral Saturation (rSO2), Peripheral saturation (SpO2), The extraction fraction (FTOE), Parameters harvested from the umbilical cord at birth (pH, Base excess (BE), pCO2, pO2, MetHb, COHb), c) risk profile: mother�s alcohol consumption, including during pregnancy and drug use. The study group consisted of 90 infants born full term in Elena Doamna Maternity Hospital in Iasi, between 2015-2017, included in the programme of follow-up of the newborn with risk with the purpose of performing an non-invasive assessment of the fetal and neonatal cerebral status, in order to prevent and establish treatment methods for perinatal asphyxia. Based on the information obtained through the preliminary documentation, 30 newborns with alcohol and / or drug-consuming mothers and 60 neonates with risk-free mothers were selected - the control batch, who accepted to participate in the study.The cases studied showed the homogeneity of the groups depending on the mother�s age and gestational age, as well as the sex of the newborn and the weight at birth (p]0.05). In neonates from mothers at risk, the under-reference level of 1-minute brain saturation, combined with a lower gestational age and the 62.5% probability of performing a caesarean section at low levels of cerebral saturation was noted in 66.7% of newborns.The cut off value of SpO2, was established at 70 mL/ 100g/1 min, with a sensitivity of 50.9% and a specificity of 51.3%, after reading the coordinates of ROC curve, but the prediction was not significant from the statistical point of view (p=0.670). The mean level of base excess was al excesului de baze was slightly lower in newborns with the extraction fraction below the cut off value (-4.64 vs -4.18; p=0.560). According to the cases studied, 1 min after birth, 23.3% of the newborns showed an increased level of pCO2 associated with a reduced level of peripheral saturation (r= -0.231; p=0.05). The correlation between the pO2 level and the cerebral saturation, recorded 1 min after birth, was direct, but reduced as intensity (r= +0.295; p=0.049). About 27% of the newborns associated increased values of pO2 with reduced values of the extraction fraction (r=-0.272; p=0.047). The newborns with an extraction fraction over the cut off value had a level of COHb below 1% (p=0.756) more frequently. Newborns from mothers who have consumed alcohol and / or drugs, including during pregnancy, show a reduced level of cerebral saturation and peripheral saturation 1 minute after birth. In 16.7% of newborns, the extraction limit was below the baseline 1 minute after birth.
The European Union has 27 member states, and the Council of Europe comprises 47 member states; in the context of population migration and differences between cultures, it is necessary to standardize the forensic psychiatric practices, methods of evaluation and treatment.Also, the legal and social framework of forensic psychiatry is influenced by society and it`s wider tendencies so it undergoes a constant evolution.The laws are rules created by people and they guide human behavior.Responsibility or psychic competence are normative issues rather than clinical problems, and are different from country to country, sometimes in a significant manner.Ethical problems of forensic psychiatry are similar in all cultures and depend on certain legal problems and the provision of medical services in each country.In the present paper we want to gather unitary aspects of European forensic psychiatric practice, as well as the differences in approach of a patient with psychiatric condition witch commits an anti-social act.
Abstract Recognition of abuse and the treatment of child victims are recent concepts in the history of mankind. Increasing the awareness of the need to treat and prevent such abuse is a characteristic of modern society. The beaten child syndrome was described by Ambroise Tardieu in 1860, and Shaken Baby Syndrome (SBS) was clearly illustrated in medical literature a century later by Caffey in 1972. The definition of SBS is based on the association of major intracranial lesions with minimal external lesions and the diagnosis is still difficult to establish. The authors describe a reduced number of 7 cases of pediatric patients addressed for forensic expertise and where suspicion of SBS has arisen. The lesion mechanisms involved in the production of this syndrome are still controversial and are sources of frequent debates in legal medicine. These uncertainties can make legal punishment inoperable. The therapeutic management of these children in neurosurgery is not subject to international consensus, and discrepancies between different clinics impede a comparative cohort assessment. However, SBS is a major public health problem due to severe neurological injuries caused to child victims during brain development.
Death by intoxication represents an important cause of violent deaths which could be easily prevented. Accidental ethanol and carbon monoxide intoxications produce the most frequent causes of violent deaths among civilians in Romania. To provide an insight in these types of deaths and to bring attention upon the clinical and biological manifestations as well as of the typical morphologically findings, the authors present a strange case of fatal intoxication due to carbon monoxide in an 88 years old male, found in his bed. Moreover, because of the simultaneous death of the male�s wife in the attic of the house, with ethanol intoxication, we would also like to bring attention to the juridical notion of commorientes, since in the establishing of its constituting characteristics the forensic expertise plays a decisive role.
In the heavy and light industry, the food and pharmaceutical industry, there are chemicals that contain metals with high toxic potential. Toxicity of metals is due to the harmful effect in certain forms and doses. Some metals become toxic when they form soluble compounds or in a certain chemical structure at certain doses (eg lead, mercury and candium). Not only heavy metals are toxic metals, there are also light metals that can become toxic, some of which are essential elements (iron, selenium, copper, chromium, zinc) and metals used therapeutically in medicine (aluminum, bismuth, gold, gallium, lithium and silver) may have negative effects when administered in large quantities or the elimination from the human body is deficient. Metal poisoning occurs through nutrition, medication, environmental factors. Most professional pollutants with intraoral manifestations appear in the heavy industry. The oral cavity is an entry gate for various toxic pathogens, so intoxications can be detected early due to the manifestations inside the mouth.
Cardiac disease is the leading cause of death, and sudden cardiac death occupies the first place in sudden deaths of natural causes. Sudden cardiac death due to lethal arrhythmia may be the first manifestation of a cardiac disease, such cases becoming suspect dead, thus forensic cases. The autopsy performed in such cases may reveal important cardiovascular disease but not obvious macroscopic or histological changes of acute myocardial infarction (IMA), except for cases of survival for several hours after the onset of the symptomatology. Biochemical markers were used to test for myocardial lesions in the absence of morphological changes. Methods for determining myoglobin, CK-MB, troponin T (cTn T), troponin I (cTn I) were introduced to the clinic to diagnose the condition of patients with chest pain as early as the 1990s. The lack of pathognomonic elements in corps investigations, where part of the analysis cannot be carried out, requires verification of the value of the investigations that can be carried out, with reference to the biochemical in the present case, in establishing the diagnosis with certainty.
Since ancient times, alcohol has been present at both happy and unhappy events in the human's life.Consumed in excess, it has come to be an enemy of society, being associated with most of the current serious problemsantisocial deeds (crimes, suicides, domestic violence and abuse), but also an enemy of the physical and mental well-being, given the many negative effects it has on human health.Through this work we aim to bring in the foreground the main clinical, paraclinical and social manifestations that the consumption in large quantities and repetitively of alcohol involves.
Poisoning with household substances is responsible for a significant morbidity in children. The objective of this study is to specify the epidemiological characteristics of accidental and voluntary poisoning with these products at pediatric age. Research Design and Method.The study was observational, retrospective and included acute intoxication by ingestion of household substances in children aged 0-18 years hospitalized in The Regional Toxicology Center of the Emergency Hospital for Children "St. Maria “Iasi. Results.The study group included 230 children admitted in the last 6 years with this diagnosis. Data were obtained from patient observation sheets, centralized and subsequently processed statistically. Conclusion.Knowing the epidemiological aspects of these poisonings can contribute to the elaboration and application of appropriate prevention strategies
Since the twentieth century, studies have demonstrated the impact of media channels on their beneficiaries, especially children and adolescents. From the transmission of moving images, the concept of information rapidly expanded both vertically, through technological development and improved information quality in terms of details, and horizontally, by broadening the target audience. Gradually, in the contemporary society the written press, television and radio have entered almost all the houses in various ways.The impact of mass media has evolved with technology, currently a large number of social events having the press as their trigger element. In this paper the authors start with a case study to illustrate the negative impact that violence conveyed through media channels can have on children and adolescents by generating or increasing their aggressiveness.
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