Clinical Forensic Medicine - Methodologies

As we mentioned before, clinical forensic medicine is a component of forensic medicine that is intented to alive victims. So, it analyzes mainly victims of crimes against physical integrity (aggression), sexual crimes and abuse.

The techniques related to clinical forensic medicine, are done in two different places: in the surgery and in the laboratory.

In the surgery…

Here, the doctor adopts a different procedure depending on the crime. But, in general, he always follow two activities: observation of injuries and collection of traces.

- Observation of injuries:

In this phase the doctor examines injuries. This process may have 3 levels of accuracy depending on the case. In this review the doctor should considerer aspects such as: posture and displacement; communication; control of sphincters; senses and perception; mastication and intake; phenomenons of pain...

The review includes the following areas: skull, face, neck, spine and cord, chest, abdomen, upper and lower limbs.

Here are some of the scenarios that the doctor can find:

On the left you can see is a recent ecchymosis, in the right a old ecchymosis and down a burning caused by acid .

To examine the interior of the body, it is necessary to ask for another kind of examinations, such as x rays or scans. Other professionals are needed to make this medicals.

- Collection of traces:

The collection of substances is needed because of the effectuation of the following tests:

- Examination of carnal conjunction - to situations of sexual abuse involving the relationship penis-vagina. There is collection of semen.

- Examination of alcohol content - to identify the quantity of alcohol. There is collection blood or urine.

- Toxicological examination - to detect certain psychotropic substances. There is collection of urine or, preferably, blood.

Naturally, all traces collected should be carefully preserved.

In the laboratory…

The tests made in this place are not made by doctors but by specialists of more specific areas. However, the test results are received and analyzed by a technical of clinical forensic medicine In the next months we are going to post information about some of these specialties.

Soon we are going to post the methodologies used in tanatology. You can't miss it!

Written by: Vera Gonçalves

Translated by: Vera Gonçalves

Sources:http://www.inml.mj.pt/

http://www.geocities.com/HotSprings/Villa/1696/atlas.html

Results of the poll!

In the first poll on forensic medicine, the question was: "Which component of forensic medicine deals with phenomenons of death and the factors related to them?". 20 people took part of this poll and the results were: Forensic entomology - 3 votes Victimology - 5 votes Forensic Tanatology - 12 votes Forensic traumatology - 0 votes The correct answer is forensic tanatology, which has already been mentioned in the last post (if you paid attention you certainly noticed). We conclude that our readers are informed because this was the most voted option. For the most confused, forensic entomology is the study of insects, the victimology is the study of victims in various plans and not only when they are dead and, finally, forensic traumatology deals with physical traumas. We hope your ideas are clearer now! Do not forget: vote in the poll that is already available!

Forensic Medicine

What is it?

Forensic medicine is a range of knowledge that conjugates justice and medicine by the same time. It uses all areas that support the medical knowledge to explain the most mysterious enigmas of crime!

This connection between justice and medicine is essentially based in the studies of the victims, alive or not. Yes! Many people think that forensic medicine is the "medicine of the dead people" but, in fact this idea is a myth. It’s true that it involves an area that deals with phenomenons of death - the tanatology. But there is also a medical-legal clinic that is intended victims alive. In the next posts we are going to deal whit this duality of forensic medicine constantly!

What's its function?

It is important to distinguish a difference between forensic medicine as an experimental science and as a social science!

First, we can say that its main functions are: collect and preserve traces; determinate if the lesions are the result of a crime, an accident or nature; identification of bodies; articulate themselves with professionals in more specific areas to check suspicions…

By the other side, it is also correct to say that it is a weapon against crime because, by contributing to solve crimes it dissipates the enthusiasm for anti-social activities.

Soon we are going to publish details about the techniques used the specialists of the area! Don’t forget: continue following the next posts!

Written by: Vera Gonçalves

Translated by: Vera Gonçalves

Sources: www.angelfire.com/ak/medicinalegal/index.html

http://www.inml.mj.pt/

This month...

Legal Medicine is a theme that has always intrigued crowds and that causes lots of speculation! The vast majority of the population knows that this is an area of medicine that helps justice, by assisting it in the resolution of crimes! But, which are the secrets of forensic medicine? What is its real function in society? This month, these and other mysteries will be discovered by the readers of this blog!! Yes, because the theme of the month is legal medicine! Soon I'm going to start writing about this strong component of the forensic science! So if you are really concerned about the resolution of crimes you can not fail the next post...

See You Soon !!!!!

Image created by Leonardo Da Vinci in the sequence of his studies about human anatomy. His contribute to medicine was enormous and Legal Medicine benefited too.

Written By: Vera Gonçalves

Translated by: Vera Gonçalves

The Fatal Cure - 4 part

Here is a littlebit more of this crime solving! Who have committed it? The next step is to find persons suspected of having committed this crime. Are considered possible suspects, people with close relationship with David Soares, which are:



• André de Mello;

• Carlota de Vasconcelos - couple who found the body;

• Beatriz Soares - wife;

• Rita Carneiro - lover;

• Afonso Albuquerque - head of the group of scientists at the laboratory Deslixelab:

• Sofia Ferreira - scientist;

• Pedro de Almeida - scientist;

• Luis Pinto - scientist;



From samples of traces of blood, hair and fingerprints found at the crime scene are made studies of DNA for comparison with the DNA extracted from blood, hair and fingerprints of possible suspects. Doing the DNA analysis of the samples of organic traces and comparing it with the biological samples of suspects, it is intended to identify those who have biological marks at the crime scene and traces found there. After these studies the pathologist concludes that:



• the blood found on the lamp belongs to David Soares;

• the blood drops on the floor belongs to André de Mello;

• the box of tablets contains fingerprints of David Soares and Afonso de Albuquerque.

• the hair on the dead's coat belongs to Rita Carneiro and Beatriz Soares;

(The video is not available in english, only in portuguese)

(Teresa Felgueiras)

Summary of the month and The fatal cure - 3 part

Summary of the month...


During this last month, the bi126 group was commit in several tasks: search for laboratory activities related to our areas, to expose them to the students of the 3 and 4 years of V.N. Anha primary school. From experimental procedures we made a list of needed materials, to ordering reagents that didn´t have at school. Under this visit made up of identification cards of each of these students. The bi126 were attentive to the continuation of the crime solving - the Fatal Cure, setting the next steps to be taken: suspects, surveys and tests conducted from traces, among other things. Being already prepared the next crime that will be filmed and interpreted by bi126.

The Fatal Cure - 3 part:

As was said in the last post here is the photograph record of the nexts steps to take in solving this crime!


After the action of the criminalist it´s time to the pathologist enter in scene, that does at first the identification of the body found at the crime scene. It is through a card identifying the research laboratory - Deslixelab, found in the jacket of the dead, the pathologist concluds that it is a famous researcher named David Soares.


It is in the laboratory that the pathologist examines the traces found at the crime scene, beginning exeminating drops apparently of blood found on the floor and on the lamp, checking whether they are actually blood through a test.Looking carefully to the samples after doing this test, the pathologist concluds that it is blood.


Next, is analysed the tablets box, where she verifies that there are fingerprints that are which are taken for analyzis through technical. Thirdly, it's examinated the dead's clothes where are found two hairs. Regarding to the mobile phone found at the crime scene with a intriguing code,the pathologist with the help of the criminalist concludes that the code 83783032 refers to the term "test fa" in intelligently writting. After analyzing the box of tablets, this together with the tablets found on the ground are brought to the toxicologist for studies within this area.





(the video is not available in english, only in portuguese)




Don't lose this crime solving... - Who are the suspects?

(Teresa Felgueiras)

Forensic genetics and biology - techniques used...

Techniques used ... In expertise in the research of biological kinship, genetic identification of biological criminalitcs and indiviual genetic identification.

Genetic identification in the scope of the biological criminalistics

The complexity of this expertise is in the diveristy of samples received for analysis (blood, semen, hair), and being sometimes very little degraded genetic material. In the implementation of this skill are collected traces at the site of the crime, the victim (mainly for sexual assault) and in the garments of the victim and / or the suspect, and subsequently sent to laboratories in order to study the DNA.

DNA Study

The interest in forensic expertise requires the extraction of DNA (acid Desoxirribonucleico) of nucleated cells and then using the PCR (Polymerase Chain Reaction), the amplification of DNA sequences, using commercial kits that allow, simultaneously to analyse several DNA polymorphisms.

The main DNA polymorphisms are studied STR (Short Tandem Repetas) autossómicos, the Y chromosome and cromossomaX. When it comes to samples with small quantities of degraded genetic material, proceed the analysis of the control of mitochondrial DNA region, for sequencing. Currently, there are other genetic markers that can be used in the study of "difficult samples", as the SNP (Single Nucleotide Polymorphisms), the MiniSTR and analysis LCN (Low Cpy Number).

The final part of consites of the analysis of results.For this to be possible, in addition to determining the genetic profile of the biological sample, you have to get the genetic profile of a sample as a reference taken from the suspect for comparison.

After conduction of this analysis is produced a final report in which, among other things, will contain the conclusions that include the probability of matching results, in the case of identical genetic profiles being listed.

Individual genetic identification

Sometimes, the only traces that can be withdrawn from the scene of the crime are traces of contact of skin with any surface, being the most detected, fingerprints.

The analysis of these anatomic traces, traditionally lofoscópica today may have a completely different approach, through the determination of their genetic profile.

In a fingerprint present on the surface of an object may be adhering some nucleated cells that allow with, if appropriate treatment, the extraction of DNA and subsequent analysis. Indeed, several authors have shown that it is possible to obtain genetic profiles from residues of latent fingerprints, left by simple skin contact with certain surfaces, such as paper, knives, pens, ropes, wires and firearms.

Research on biological kinship

Experts in possession of cells of the criminals, analyze the DNA, identifying the fragments in the laboratory. Moreover, the police takes samples of blood from suspects of having committed that crime. When crossing the results of the examination of DNA of suspects with the result obtained from the criminal still unidentified, it is possible to reach identification.

Here is an interesting question:

If the identification of the perpetrator is given by the identification of fragments of DNA that he inherited both by the father and the mother, how can you be sure that the DNA analyzed is not of the of brother of the suspect?

Although they are brothers that does not mean that they have inherited exactly the same genetic baggage. A certain sperm carries snippets of DNA that are different from the father excerpts loaded by neighbouring sperm. The same can be said with regard to ova that the mother produces.

Therefore, the combinations of maternal and paternal DNA occurring in fertilizations producing each of the children are different. In conclusion each person is unique in the world with respect to its genetic composition, and the result provided by DNA testing shows a kind of molecular fingerprint that gives no room for doubt.

Curiosities...

With only a 1cm-dryer it is possible to extract DNA;

• Only the monozygotic twins have the same DNA; The dermatóglifos are lines formed by the crist on superficy of the skin;


• The dermatoglifos form in the third and fourth months of fetal life and emerge to the surface in the fifth month. During their lives,they only change in size, without changing its configuration. In cases ofphysical or chemical injury the crests regenerate to its original form.
  

This was the last post on genetics and forensic biology! I hope you have enjoyed it! Do not miss the next post that will be about the crime solved month to month!

Written by: Teresa Felgueiras

Translated by: Teresa Felgueiras

Bibliography:

http://www.angelfire.com/falcon/biologiaunip/identificacao_DNA.htm
A química na investigação policial
Pelas pontas dos dedos

http://www.vemaprender.com/moodle/file.php/39/Introducao.pdf

Results of the poll

Let us see which is the right answer and if the most voted option is right!

The question was: What is the examination done to see if there are malignant cells in the tissues?

The options were:

• normal histology examination, with 6 votes;
• normal cytology examination, with 4 votos;
• imunocitoquimic studies, with 9 votes;
• ultra structural examination, with 5 votes;

The correct answer was the least voted, it was the second option - normal cytology examination, which checks the presence of malignant cells.

Visit us...

Forensic genetics and biology

What is it?


Forensic genetics and biology is one of the areas of forensic science, using the knowledge and techniques of genetic and molecular biology, to support and assist justice, solve cases under police investigation and or prosecution. This area is also known in Forensic as DNA.



For what purpose?


Francisco Corte-Real, vice president of INML (Instituto de Medicina Legal) and expert in forensic genetic biology says that the knowledge of this area is extremely important to help solve cases which, otherwise, would never be solved.


In the case of a homicide, for example, teams of experts from INML moving to the site of the crime, collect traces considered important, of the aggressor fragmetos of skin, hair, blood stains, among other things, protecting all that may be liable to destruction.


The role of INML, recalls Francisco Corte-Real, "is not to assign blame or criminal responsibility for any acts." Technicians of genetics and forensic biology are limited to analyze facts, based on knowledge and scientific rigour, and to prepare reports for consideration by the courts, which decide, after being confronted with other means of proof.


In the service of genetics and forensic biology competes him the conduct of surveys and examinations of laboratories of:


• forensic hematology;

• organic traces of blood stains found at sites of the crimes, semen left on the victims of crimes of a sexual nature, hair that belongs to the suspect of a crime;

• identification of biological relationships (identification of paternity or maternity, among others);

• Individual genetic identification (identification of a body or fragments of a body);







History ...




Genetics and Forensic Biology originated during the first uses of genetic characteristics in paternity tests, helping justice.

The modern phase of Forensic Genetics began in the decade of 1980 when researchers discovered highly variable regions of DNA, able to specifically identify a person.


In 1985, Sir Alec Jeffreys calls the unique DNA of a person "DNA fingerprinting".

During the decade of 1990, with the popularization of PCR, were developed techniques of increasing sensitivity, able to identify the origin of biological samples with very little DNA.




Thanks to advances in technology, this area of forensic science has developed considerably, in the world. As a result there are an abundance of laboratories in existance in Portugal and elsewhere, that perform paternity and maternity tests, examinations of individual genetic identification among others, showing a great adherence by the people.

Written by: Teresa Felgueiras

Translated by: Teresa Felgueiras

Bibliography:

Http://jn.sapo.pt/2005/09/07/sociedade/genetica_forense_servico_justica.html Http://pt.wikipedia.org/wiki/Gen% C3% A9tica_forense Http://medicina.med.up.pt/legal/IntroducaoML.pdf

Forensic Pathological Anatomy and...

Relation to other areas ...

In addition to cytology and histology, the intervention of the pathologists can extend to other more specific areas:

• Molecular Biology - these technicians study the nucleus of the cells in order to, for example, investigate abnormalities of the fetus (prenatal diagnosis), detect and quantify viral loads (such as hepatitis B), or study tumurais diseases (especially the cancer) ;

• Forensic Toxicology - proceeding the study of tissues from cadavers, determine, for example, whether the ingestion of chemicals in the event of a poisoning;

• Imunocitoquímica - determines a malignant tumour, for example, what type, degree of development and severity,as on this knowledge depends the prognosis of the disease and the treatment to administer;

• Veterinary - for example, a veterinarian can use the help of these professionals, if they come across a dog, carrier of a disease that can not be identified. • Anatomy - which is the study of macroscopic bodies;

• Morphology - which studies the shape of the bodies;

Curiosities...

When a sample or specimen arrives in a laboratory of pathological anatomy, Accompanied by the requisition duly completed, is initiated a series of complex Events that will culminate in the issuance of a final report, the pathological report. This report is usually composed of five major fields:

1. History pregressa - contains clinical data essences (species, gender, age, race, etc.);

2. Examination macroscopico - contains a description of the specimen (s) (s);

3. Microscopic examination;

4. Diagnosis;

5. Notes or comments where anatomopatologist can mention the different diagnoses.

Anyone interested in taking a course in this area, has two sites that can be visited, in order to obtain information:

• http://www.egasmoniz.edu.pt/essem/apct.html

• http://www.acessoensinosuperior.pt/detcursopi.asp?codc=1026&code=7220

In Portugal there are a large number of laboratories that perform examinations and surveys as part of pathological anatomy and consequently, forensic pathological anatomy. It is good to note that in our country, there are movements and associations of pathologists and experts of pathological anatomy promoting the development of this area.

Here are two sites of such associations:

• http://www.apomepa.com/-Portuguese Association of Doctors Patologistas

• http://www.aptap.pt/-Portuguese Association of Technicians of Pathological Anatomy

This is the last post on pathological anatomy, and the next will be based on genetics and forensic biology. Come visit this site and vote on the question!

(Teresa Felgueiras)

Bibliography:

Http://www.dgct.msst.gov.pt/profissoes2005/tecanatomiapatologica.htm Http://horta.0catch.com/congressospcv/33.pdf

Techniques used...(exames)

The expertise and achievemnet of the pathologists that are in charge of most examinations, as was said in the previous post, have recourse to histology and cytology, because it is based on these areas that the examinations are held.

Histology and Histopathology

What is it?


Histology is a science that is dedicated to the research of the structure and functioning of organic tissue.
The histopathology refers to the microscopic examination of tissues, in order to study the manifestations of the disease.






For what purpose?

In the field of histology is carried out examinations of normal histology and examinations of histology extempotanêo. In the area of histopathology histopathological examinations take place. In recent examinations resorts to histology, to the extent that the tissue harvested from an autopsy, surgery or biopsy go through various processes (histological methods) to become suitable for microscopic observation. So the histology and histopathology are closely related. These are two areas that allow living organisms to be identified, for example, a liver cirrhosis - through a liver biopsy, in dead bodies it is possible to determine the cause of death, and is used either within the autopsy clinics, or within the autopsy medico-legal.


Techniques used ...


For the implementation of the histological and histopathological studies, the technicians in Pathologic follow a very specific methodology.


1. Fixation, dehydration and turning transparent the tissue to be examined, and finally immersion in paraffin;

2. The bloc formed is cut into ultra fine sections with the help of a microtome;

3. The ultra fine sections are placed on slides and stained with colouring substances that allow to highlight the structure of tissues, number of cells, microorganisms and pigments;
4. Observation of microscopic slides and evaluation of the results, communicating them to the doctor anatomo-pathologist.


History ....


Histology was born with those who used the microscope in their studies, as Robert Hook, Malpighian, Gram, Ham, Fontana and others, have made great advances parallel to the progress in the field of cell biology, as this provides important knowledge about the cell. Also of importance in the development of histology was the invention and development of many techniques such as tissue culture, vital colour, the use of radioactive markers, specific staining, among others.

Cytology and citopathology

What is it?

Cytology is the branch of biology that studies the cells with regard to its structure, its functions and its importance in the complexity of living beings. The citopatology is a branch of pathology that studies and diagnoses diseases at the cell level.



For what purpose?
Cytology and citopatology are involved in the procedure of examinations of normal cytology, in that it is a study done by microscopic observation of cells of the tissues spontaneously or technically processed. These two areas are a means of early diagnosis of malignant lesions permitting the identification of malignant cells.



Techniques used ...




The cytological study of the samples is done through the application of techniques: fixing, centrifugation, citocentrifugation, smear and colouring after which they are observed under the microscope by technicians. After analyzation and evaluation, the negative citologies are separated from the positive neoplastic cells, sending the later to the pathologist.

(Teresa Felgueiras)

Bibliography:

Http://en.wikipedia.org/wiki/Histopathology

www.dgct.msst.gov.pt/profissoes2005/tecanatomiapatologica.htm

Http://en.wikipedia.org/wiki/Cytopathology

Http://pt.wikipedia.org/wiki/Citologia

Diciopedia 2003

Forensic Pathological Anatomy

What is it?

First, the word Pathological anatomy comprises two main subjects: anatomy and pathology, and it is essential to their understanding, the study of the area that is closely related to forensic science.

• Anatomy is the branch of biology in which is studied the structure and organisation of living beings, both external and internally.



• Pathology is the study of diseases in general and in certain respects, is designed mainly to study the structural and functional changes of the cells, tissues and organs that are or may be subject to diseases.
  
  

CONCEPT: Pathological anatomy is a branch of pathology that deals with the diagnosis of diseases based on the examination of macroscopic and microscopic surgical cuts for the examination of cells and tissues. The forensic science uses this discipline for the completion of its work, so it talks about forensic pathological anatomy.



History ...




Giovsnni Battista Morgagni is considered the father of modern pathological anatomy because of the book he published "The otigins and causes of diseases anatomically verified" in describing the life of their patients, how they died and how the autopsy was led





For what purpose?

Technicians of pathological anatomy and the anatomical-medical pathologists assess, plan and process samples of tissue and isolated cells, harvested in organisms living or dead, by electronic or optical observation, at macroscopic and microscopic level.Their work aims essentially, at the diagnosis and prognosis of diseases in the human species, being the main areas of intervention that of histology and citology.



Examinations and expertise in the field of forensic pathological anatomy:


1-examinations of normal histology (biopsy / piece);

2-Examination of normal cytology (Papanicolau, urine, CSF, percutaneous needle aspiration, pericardial fluid, liquid Pleural, etc);

3-Examination ultra-structural (electron microscopy);

4 - Study immuno-histocitochemistry;

5-Special Techniques;

6-Histological examination out (fat embolism);

7-Consultation with review of records or repetition of studies in material sent to another department or laboratory with preparation of the final report.

If you want to learn more about the techniques used to achieve these examinations and expertise do not cease to visit us.

Written by: Teresa Felgueiras

Translated by: Teresa Felgueiras

Bibliography:: http://pt.wikipedia.org/wiki/Anatomia
http://pt.wikipedia.org/wiki/Patologia
http://pt.wikipedia.org/wiki/Anatomia_patologica
http://www.apadac.net/docs/Portaria_652_2005.pdf

Results of the poll

Here are the results of the question!

The question was: On what kind of tests do the pathologists base their opinion?

The options were:

• Legal medical exames, with 5 votes


• Histopathological exames, with 12 votes


• Pathological exames, with 14 votes


• Cytological exames, with 4 votes

As in the poll done earlier, the correct answer was not the one most voted.The second option - histopathological exames was the correct answer. In the next few posts you will be able to read and learn about pathological anatomy. Hope you will continue to visit this site.

The fatal cure....(2º part)

s was said in an earlier post here is the continuation of this story that will be solved month by month.

The suspense continues.

With the arrival of the criminalist and legal physician begins to the isolate the area so that any trace of evidence will not be altered. Secondly the criminalist will photograph the site and observe carefully the whole area, seeing that the first traces of evidences are fundamental to the resolution of any crime.

In this case there are many indications of evidence, being drops of blood found beside the body, pills scattered on the floor, box of tablets, flowers, the cellphone with an intriguing code "83783032" and splashes of blood on a lamp post. Thus the criminalist will take photographs and collect evidence with the correlative numbering. After this ardous field work the specialist delivers all the evidence to the laboratory to be analysed.

Here is a photographic record of the crime: (the film is not available in english)

Do not miss the next steps in solving this crime.

Stay vigilant ....

Written by: Andreia Faria

Translated by: Teresa Felgeuiras