George Cristian Curca

Particularities Regarding the Etiology of Sepsis in Forensic Services

If in clinical practice definitive diagnostic criteria had been established, after death sepsis is often difficult to diagnose, especially if a site of origin is not found or if no clinical data are available. This article will analyze the etiology of sepsis in a medical‐legal service with emphasis on the differences in diagnosing it in clinical and forensic environments. A total of 78 cases of sepsis cases diagnosed or confirmed at the autopsy were selected. The etiological agent was determined either during the hospitalization or by postmortem bacteriology. A high prevalence of Gram‐negative sepsis was found, especially multidrug‐resistant micro‐organisms. Most frequent etiological agents were Acinetobacter baumannii, Escherichia coli, Enterobacter, Enterococcus, Pseudomonas, and Klebsiella. Polymicrobial sepsis is much more frequent than in nonforensic cases. In legal medicine, the prevalence of Gram‐negative sepsis is much higher than in nonforensic autopsies, and the point of origin is shifted toward the skin and the gastrointestinal system.

Patterns of Injuries in Domestic Violence in a Romanian Population

In Romania, the quantification of traumatic injuries is achieved in medical- legal services; therefore, each domestic violence (DV) victim needs a medical-legal certificate to prove in a court of law the presence of traumatic injuries. In this study, we aimed to determine the pattern of traumatic injuries in DV. A total of 219 consecutive DV cases were included. For each victim, a detailed medical-legal examination was performed, including specialized consults, if needed. Results were analyzed statistically using the SPSS software. Traumatic injuries in DV cases were usually located in the head, face, and neck areas and had a low severity index. Severe lesions were found in less than 10% and no sexual aggression was found. The severity increases with age and is higher for males than females. The pattern of DV–associated injuries we have encountered is similar to the one found in other similar studies. Knowing this pattern may be useful in clinical practice to detect cases of DV.

Psychosocial factors associated to violence against women

Domestic violence has an important dimension in the contemporary world, as it has become not only an epidemiologically meaningful phenomenon, but also a matter of concern for the society. Our study explores several predictive psychosocial factors, associated to domestic violence in Romanian women attending a Legal Medicine service and seeking for a clinical legal medicine examination. A number of n = 46 female participants were finally recruited in the study (mean age = 43.77, min. = 24, max. = 81, SD = 12.05). They were administered a semi-structured interview, consisting of 12 questions exploring the role of the social and demographic factors in the occurrence of violence, the types of violence, and the self-awareness regarding the implications of violence and subsequent life decisions. Parametric (Pearson correlations, linear regression) and non-parametric tests (Spearman correlations, chi-square tests) were used to explore the relationship between scores derived from the interview and domestic violence. RESULTS show that low education, alcohol abuse of the aggressor and age of the victim higher than the age of the aggressor (in informal relationships) were correlated significantly to a higher frequency of aggressions (p =.036 and p =.0003, respectively), whereas early report on the aggressions correlated significantly to high education of the victim (p =.03). Intentions on reaction to aggression were numerous and distributed widely, however 6 months after the events only 6.52% of participants took any kind of measures against their aggressor. This study has implications in better tailoring education and psychological interventions in support of women victims of domestic violence. Keywords: violence, domestic, victim, education. Language: en

Drug related deaths between 2008 and 2011. A retrospective study in 32 Romanian counties

The purpose of this study is to determine the pattern of drug related deaths in Romania between 2008 and 2011 by analyzing the medical-legal cases, from a significant proportion of Romanian Counties (out of 41 plus the capital), in which the direct causal link between drug overdose and death was drug related. Material and methods. 446 forensic toxicology cases were analyzed in a four year period, obtained from more than two thirds of the counties in Romania. Results. 54.26% yielded a positive toxicological analysis, most often with benzodiazepines, opiates, barbiturates and cannabinoids. Males around 31 years old represented the most affected group. Illegal drug related deaths were more frequent in males and non-illegal drug related deaths were proportionally more frequent in females. Discussions and conclusions. The pattern of consumption is similar to the one obtained by similar studies in neighboring countries. The city capital has a very distinct pattern of consumption compared to other cities/counties.