Frontal osteitis complicated with bone necrosis is rare.In addition,the condition has various etiologies,such as frontal sinusitis,penetrating head injury,postoperative complications after sinus surgery,and hematogeno...Frontal osteitis complicated with bone necrosis is rare.In addition,the condition has various etiologies,such as frontal sinusitis,penetrating head injury,postoperative complications after sinus surgery,and hematogenous spread from distant sites.In frontal osteitis,early diagnosis is important,and fistulization of pus in the scalp or on the traumatized forehead may raise the suspicion of osteitis in one of the skull bones.The exclusion of osteonecrosis is such cases is an emergency;hence,a magnetic resonance imaging and a computed tomography scan are required in the absence of skull radiography.Early administration of the appropriate treatment in the immediate post-trauma period ensures effective prevention of frontal osteitis;however,the treatment of bone necrosis involves debridement and antibiotic therapy to prevent fatal intracranial complications.This report presents the case of a 16-year-old female patient who experienced sexual and physical assault that resulted in undetected frontal trauma complicated with frontal osteonecrosis.Thorough clinical examination of the patient was performed,and follow-up and multidisciplinary management enabled the social integration of the patient.展开更多
Introduction: Sexual assault is an act of a sexual nature perpetrated on another person without their consent. Goal: To describe the epidemio-clinical aspects and the medical management of sexual assault in the Segou ...Introduction: Sexual assault is an act of a sexual nature perpetrated on another person without their consent. Goal: To describe the epidemio-clinical aspects and the medical management of sexual assault in the Segou region. Methodology: This was a retro-prospective descriptive study from September 2010 to September 2018 on the alleged female victims of sexual assault registered in the Gynecology and Obstetrics departments of the hospital and the sanitary quarters of Ségou. Results: We recorded 107 cases of sexual assault out of 47,729 gynecological consultations, representing a hospital prevalence of 0.22%. The victims were between 10 and 15 years old in 48.59% of the cases. Students were the most represented with 53.27% (57/107) of cases. Genito-genital contact was recorded in 90.65% (97/107) of cases. Vulvo-perineal lesions were present in 44.86% (48/107) of survivors. Hymenial deflowering was the most frequent traumatic genital lesion accounting for 43.70% (21/48) of old cases and 27.00% (13/48) of recent cases. Sexual assault was committed by a single individual in 60.75% (65/107) of cases and by a friend of the victim in 21.5% (23/107) of cases. The survivors had consulted within 24 hours of the sexual assault in 53.27% (57/107) of the cases, the treatment was medical in 68.22% (73/107) and medical-surgical in 4.7% (5/107), post-exposure prophylaxis to the Human Immunodeficiency Virus (HIV) was performed in only 26.16% (28/107) of survivors. Conclusion: Sexual assault remains a concern although its frequency is low. This scourge mainly affects children and adolescents, and the lesions are mainly genitals.展开更多
Background: The authors report cases of sexual assault reported to the obstetrics and gynecology department of the Bamako’s 5th municipality medical center during a prospective study of eight months from 1st January ...Background: The authors report cases of sexual assault reported to the obstetrics and gynecology department of the Bamako’s 5th municipality medical center during a prospective study of eight months from 1st January to 31st August 31st, 2012. Results: Twenty-one cases of assault were reported out of a total of 13,482 consultations, representing a frequency of 0%, 15%. Most victims were represented by students and accounted 43% of the study population. In 76% of cases the victims knew their assailant. The type of sexual contact was genito-genital vaginal penetration in 67% of cases and the condom was used in only one case. The average time before consultation was 3 days. The preventive ARV treatment was administered in 24% of cases and emergency contraception in 43% of cases. Conclusion: Sexual assault is common in Bamako. The reality is probably underestimated because many cases are not reported. The victims are mostly children and adolescents. The risk of transmission of STIs and HIV is very high during the sexual assault. Education and awareness of the population are essential for early consultation. Training of health workers to care for victims of sexual assault is needed.展开更多
Objective: The aim of the present study was to investigate the psychic repercussions of sexual assault among female students in Parakou in 2023. Methods: Descriptive cross-sectional study conducted from December 2022 ...Objective: The aim of the present study was to investigate the psychic repercussions of sexual assault among female students in Parakou in 2023. Methods: Descriptive cross-sectional study conducted from December 2022 to July 2023 among all students at the University of Parakou. The sampling technique was stratified non-proportional at two levels. The dependent variable was self-reported sexual assault. The psychopathological repercussions linked to sexual assault and explored in these students were: post-traumatic stress disorder assessed with the Post Traumatic Stress Disorder Checklist-5 (PCL-5) scale;and current depression screened with the Patient Health Questionnaire-9 (PHQ-9) scale. Results: A total of 376 female students from the University of Parakou meeting the inclusion criteria were surveyed. The average age of the subjects surveyed was 20.56 ± 2.46 years, with extremes of 16 and 32 years. A predominance of subjects under 25 was observed. The prevalence of sexual assault among female students at the University of Parakou was 10.63%. The types of aggression suffered were mostly rape (18 people;45%) and sexual touching (16 people;40%), and the aggressors were mainly friends/boyfriends (13;32.5%), family members (12;30.0%) and people from the house/neighborhood (9;22.5%). Psychological repercussions included depression in 72.5% (29) of cases, with mild depression in 30% (12), moderate depression in 37.5% (15) and severe depression in 5% (2). Anxiety disorders were present in 27.50% (11) of victims. The risk factors associated with sexual assault in these students were gravidity (p = 0.014;OR = 15.32), unhappy life events (p = 0.01;OR = 17.24), and age of first sexual intercourse (p = 0.016;OR = 4.608). Conclusion: One in ten female students in Parakou has been sexually assaulted. Once again, preventive action through effective sex education is a means of fighting the problem that should be prioritized for every girl and boy from an early age. Psychological support by specialists should be offered to any victim discovered without delay. Communication on the subject should be multiplied in all family and academic educational environments, from the lowest to the highest levels.展开更多
Objective:This study provides a preliminary evaluation of the usability and acceptability of a mobile application(sexual assault care algorithm,SACA).Methods:An explanatory sequential mixed methods research was used.A...Objective:This study provides a preliminary evaluation of the usability and acceptability of a mobile application(sexual assault care algorithm,SACA).Methods:An explanatory sequential mixed methods research was used.A quantitative survey was followed up by a qualitative study.A convenience sample of participants(n=4)was recruited.The research was conducted on a one-on-one basis.In the quantitative phase,a random assignment technique was used to divide four participants into two groups of two participants each.Post-Study System Usability Questionnaire(PSSUQ)and Acceptability e-Scale were used to collect quantitative data.In the qualitative phase,interview,observation,and documentation were used to collect qualitative data.Data were analyzed both quantitative and qualitatively.The qualitative data were linked with the initial quantitative data to determine how the follow-up qualitative data helped explain the initial quantitative results.Results:The quantitative results suggested that SACA has high usability(5.05±1.83)and acceptability(3.81±1.22).The qualitative results further indicate that the participants thought SACA was easy to use and useful,and most of them would recommend it to others.Areas of improvement include adding features that would calculate and validate the elapsed time since the sexual assault,adding explanations to some buttons,and providing training.Conclusions:Our findings highlight the value of using a mixed methods research design to conduct a usability and acceptability test.Nurses are more likely to adopt a new technology for their evidencebased practice when the technology is easy to use and useful and requires less time to find the right piece of guideline evidence.Individualized training needs to be designed based on users'characteristics.展开更多
In recent years,benzodiazepines and benzodiazepine-like drugs are the most common substances associated with drug-facilitated sexual assaults(DFSA);however,barbiturates are also detected occasionally.Segmental hair an...In recent years,benzodiazepines and benzodiazepine-like drugs are the most common substances associated with drug-facilitated sexual assaults(DFSA);however,barbiturates are also detected occasionally.Segmental hair analysis provides useful information on the historic pattern of drug use,enabling differentiation between single exposure in DFSA cases and chronic use.However,sensitive and specific methods for barbiturate analysis in hair samples are needed.Herein,we present an ultra-high-performance liquid chromatography coupled with high-resolution mass spectrometry(UHPLC-HRMS)method for qualitative and quantitative determination of seven barbiturates in hair samples.Firstly,a hair strand was decontaminated and then freeze-milled in liquid nitrogen.Next,50mg of powdered hair was extracted with methanol in an ultrasonic bath for 10 min in the presence of 10 ng phenobarbital-d5.The supernatant was dried under nitrogen gas,and the pellet was dissolved in 100 μL mobile phase.Afterwards,10 μL of the suspension was injected into the UHPLC-HRMS system.The present method involved two UHPLC conditions for determination of barbiturates(I)and identification of the structural isomers amobarbital and pentobarbital(II).This method showed satisfactory linearity in a range of 0.02–20.00 ng/mg for UHPLC conditions I and II,both with a high determination coefficient(0.9991–0.9999).The selectivity,intra-and interday precision,accuracy and matrix effect of the method were acceptable.Next,the validated method was applied to investigate an authentic DFSA case.Hair samples(black,approximate 25cm long)were collected 3 months after the assault,and the proximal segments(0–5 cm from the root;each segment was 1 cm long)were analysed.Amobarbital was detected at a concentration of<LOQ(limit of quantification)and 0.09 ng/mg in the second and third 1-cm hair segment but not in the other segments.Thus,our method was successful in determining barbiturate concentration in human hair after a single-dose exposure,showing its potential for application in the investigation of DFSA cases.展开更多
In recent years,a significant number of investigations have discovered up to 200000 unsubmitted sexual assault kits(SAKs)in the US.While the public outcry was largely directed towards DNA analysis,the SAKs also contai...In recent years,a significant number of investigations have discovered up to 200000 unsubmitted sexual assault kits(SAKs)in the US.While the public outcry was largely directed towards DNA analysis,the SAKs also contained biological specimens specifically designated for toxicological analysis.Due to the sensitivity of analytes in potential drug facilitated sexual assaults,the preservation and maintenance of the specimens is crucial in providing accurate toxicological measurements.The investigations into the unsubmitted SAKs have identified subjective law enforcement officer(LEO)rationale for the unsubmitted kits,however the impact on toxicological specimens has not been examined.This brief review of policies and guidelines with respect to forensic specimens has identified potential sources of evidentiary degradation,despite the use of chemical preservatives.With respect to temperature-controlled environments,the variation in SAK submission policies established throughout the US are potentially detrimental to the preservation of toxicological evidence.Degradation as a result of time-delayed collection and poorly maintained storage temperatures plays a crucial role for/in the interpretation of qualitative and quantitative toxicological results.This review finds these delays can be addressed through modernisation of facilities;electronic tracking of unsubmitted SAKs;mandated transfer of biological evidence within 72 h;and documentation of temperature within the chain of custody or other records.Without identifying the range of temperatures in which the evidence was exposed,forensic toxicologists may unintentionally provide erroneous interpretations of toxicological analyses-potentially casting doubt on the survivor’s recall of events and negatively impacting future sexual assault investigations.展开更多
Body fluid identification through messenger RNA(mRNA)has been proposed as a useful supplement to presumptive and confirmatory tests by previous laboratory studies;however,its application in routine clinical forensic e...Body fluid identification through messenger RNA(mRNA)has been proposed as a useful supplement to presumptive and confirmatory tests by previous laboratory studies;however,its application in routine clinical forensic examination was rare.We report a case of sexual assault in which body fluid identification by mRNA profiling was used.Vaginal secretions mRNA markers(MUC4,HBD1,and CYP2B7P1)were used to test the sample,being obtained positive results.This case demonstrates that mRNA profiling of body fluids could be applied to routine case examinations as an aid,acting as a scientific collaborative evidence to strengthen the medicolegal opinion.展开更多
选注者言:男性所受到的性骚扰比人们想象的要严重得多。这是最近在英国召开的英国心理学会的一次会议上透出的信息。而且被骚扰人基本孤立无援:…men, as well as women, are forced into having unwanted sexual contact but few servi...选注者言:男性所受到的性骚扰比人们想象的要严重得多。这是最近在英国召开的英国心理学会的一次会议上透出的信息。而且被骚扰人基本孤立无援:…men, as well as women, are forced into having unwanted sexual contact but few services are provided to help them deal with the assault.展开更多
Sexual assault evidence often contains sperm cells,which are typically separated from nonsperm cells using manual differential lysis procedures.The goal of this study was to evaluate the automated QIAGEN QIAcube for t...Sexual assault evidence often contains sperm cells,which are typically separated from nonsperm cells using manual differential lysis procedures.The goal of this study was to evaluate the automated QIAGEN QIAcube for this purpose and to compare it to manual QIAGEN and manual organic differential methods using DNA yields and STR profile data for assessment.DNA yields were determined by qPCR,followed by multiplex STR amplification,CE analysis,and mixture interpretation.The automated method was capable of effective cell separation,producing DNA yields sufficient for STR amplification.Further,sperm fraction human:male DNA ratios from the QIAcube samples were consistently closer to the desired 1:1 and STR profiles were less likely to result in mixtures,with 6–8fewer female alleles detected(median 1.5 alleles).Ultimately,using the QIAcube for automated differential processing of semen-containing mixtures reduces the need for downstream mixture interpretation and improves STR profile quality with substantially less hands-on time.展开更多
文摘Frontal osteitis complicated with bone necrosis is rare.In addition,the condition has various etiologies,such as frontal sinusitis,penetrating head injury,postoperative complications after sinus surgery,and hematogenous spread from distant sites.In frontal osteitis,early diagnosis is important,and fistulization of pus in the scalp or on the traumatized forehead may raise the suspicion of osteitis in one of the skull bones.The exclusion of osteonecrosis is such cases is an emergency;hence,a magnetic resonance imaging and a computed tomography scan are required in the absence of skull radiography.Early administration of the appropriate treatment in the immediate post-trauma period ensures effective prevention of frontal osteitis;however,the treatment of bone necrosis involves debridement and antibiotic therapy to prevent fatal intracranial complications.This report presents the case of a 16-year-old female patient who experienced sexual and physical assault that resulted in undetected frontal trauma complicated with frontal osteonecrosis.Thorough clinical examination of the patient was performed,and follow-up and multidisciplinary management enabled the social integration of the patient.
文摘Introduction: Sexual assault is an act of a sexual nature perpetrated on another person without their consent. Goal: To describe the epidemio-clinical aspects and the medical management of sexual assault in the Segou region. Methodology: This was a retro-prospective descriptive study from September 2010 to September 2018 on the alleged female victims of sexual assault registered in the Gynecology and Obstetrics departments of the hospital and the sanitary quarters of Ségou. Results: We recorded 107 cases of sexual assault out of 47,729 gynecological consultations, representing a hospital prevalence of 0.22%. The victims were between 10 and 15 years old in 48.59% of the cases. Students were the most represented with 53.27% (57/107) of cases. Genito-genital contact was recorded in 90.65% (97/107) of cases. Vulvo-perineal lesions were present in 44.86% (48/107) of survivors. Hymenial deflowering was the most frequent traumatic genital lesion accounting for 43.70% (21/48) of old cases and 27.00% (13/48) of recent cases. Sexual assault was committed by a single individual in 60.75% (65/107) of cases and by a friend of the victim in 21.5% (23/107) of cases. The survivors had consulted within 24 hours of the sexual assault in 53.27% (57/107) of the cases, the treatment was medical in 68.22% (73/107) and medical-surgical in 4.7% (5/107), post-exposure prophylaxis to the Human Immunodeficiency Virus (HIV) was performed in only 26.16% (28/107) of survivors. Conclusion: Sexual assault remains a concern although its frequency is low. This scourge mainly affects children and adolescents, and the lesions are mainly genitals.
文摘Background: The authors report cases of sexual assault reported to the obstetrics and gynecology department of the Bamako’s 5th municipality medical center during a prospective study of eight months from 1st January to 31st August 31st, 2012. Results: Twenty-one cases of assault were reported out of a total of 13,482 consultations, representing a frequency of 0%, 15%. Most victims were represented by students and accounted 43% of the study population. In 76% of cases the victims knew their assailant. The type of sexual contact was genito-genital vaginal penetration in 67% of cases and the condom was used in only one case. The average time before consultation was 3 days. The preventive ARV treatment was administered in 24% of cases and emergency contraception in 43% of cases. Conclusion: Sexual assault is common in Bamako. The reality is probably underestimated because many cases are not reported. The victims are mostly children and adolescents. The risk of transmission of STIs and HIV is very high during the sexual assault. Education and awareness of the population are essential for early consultation. Training of health workers to care for victims of sexual assault is needed.
文摘Objective: The aim of the present study was to investigate the psychic repercussions of sexual assault among female students in Parakou in 2023. Methods: Descriptive cross-sectional study conducted from December 2022 to July 2023 among all students at the University of Parakou. The sampling technique was stratified non-proportional at two levels. The dependent variable was self-reported sexual assault. The psychopathological repercussions linked to sexual assault and explored in these students were: post-traumatic stress disorder assessed with the Post Traumatic Stress Disorder Checklist-5 (PCL-5) scale;and current depression screened with the Patient Health Questionnaire-9 (PHQ-9) scale. Results: A total of 376 female students from the University of Parakou meeting the inclusion criteria were surveyed. The average age of the subjects surveyed was 20.56 ± 2.46 years, with extremes of 16 and 32 years. A predominance of subjects under 25 was observed. The prevalence of sexual assault among female students at the University of Parakou was 10.63%. The types of aggression suffered were mostly rape (18 people;45%) and sexual touching (16 people;40%), and the aggressors were mainly friends/boyfriends (13;32.5%), family members (12;30.0%) and people from the house/neighborhood (9;22.5%). Psychological repercussions included depression in 72.5% (29) of cases, with mild depression in 30% (12), moderate depression in 37.5% (15) and severe depression in 5% (2). Anxiety disorders were present in 27.50% (11) of victims. The risk factors associated with sexual assault in these students were gravidity (p = 0.014;OR = 15.32), unhappy life events (p = 0.01;OR = 17.24), and age of first sexual intercourse (p = 0.016;OR = 4.608). Conclusion: One in ten female students in Parakou has been sexually assaulted. Once again, preventive action through effective sex education is a means of fighting the problem that should be prioritized for every girl and boy from an early age. Psychological support by specialists should be offered to any victim discovered without delay. Communication on the subject should be multiplied in all family and academic educational environments, from the lowest to the highest levels.
基金The development of the application for SACA was partially supported by funding from the Upstate Foundation,a 501(c)3 nonfor-profit corporation (upstatefoundation.org)
文摘Objective:This study provides a preliminary evaluation of the usability and acceptability of a mobile application(sexual assault care algorithm,SACA).Methods:An explanatory sequential mixed methods research was used.A quantitative survey was followed up by a qualitative study.A convenience sample of participants(n=4)was recruited.The research was conducted on a one-on-one basis.In the quantitative phase,a random assignment technique was used to divide four participants into two groups of two participants each.Post-Study System Usability Questionnaire(PSSUQ)and Acceptability e-Scale were used to collect quantitative data.In the qualitative phase,interview,observation,and documentation were used to collect qualitative data.Data were analyzed both quantitative and qualitatively.The qualitative data were linked with the initial quantitative data to determine how the follow-up qualitative data helped explain the initial quantitative results.Results:The quantitative results suggested that SACA has high usability(5.05±1.83)and acceptability(3.81±1.22).The qualitative results further indicate that the participants thought SACA was easy to use and useful,and most of them would recommend it to others.Areas of improvement include adding features that would calculate and validate the elapsed time since the sexual assault,adding explanations to some buttons,and providing training.Conclusions:Our findings highlight the value of using a mixed methods research design to conduct a usability and acceptability test.Nurses are more likely to adopt a new technology for their evidencebased practice when the technology is easy to use and useful and requires less time to find the right piece of guideline evidence.Individualized training needs to be designed based on users'characteristics.
基金This study was financially supported in part by the National Key R&D Program of China[grant number 2016YFC0800704]the Natural Science Foundation of China[grant number 81501633].
文摘In recent years,benzodiazepines and benzodiazepine-like drugs are the most common substances associated with drug-facilitated sexual assaults(DFSA);however,barbiturates are also detected occasionally.Segmental hair analysis provides useful information on the historic pattern of drug use,enabling differentiation between single exposure in DFSA cases and chronic use.However,sensitive and specific methods for barbiturate analysis in hair samples are needed.Herein,we present an ultra-high-performance liquid chromatography coupled with high-resolution mass spectrometry(UHPLC-HRMS)method for qualitative and quantitative determination of seven barbiturates in hair samples.Firstly,a hair strand was decontaminated and then freeze-milled in liquid nitrogen.Next,50mg of powdered hair was extracted with methanol in an ultrasonic bath for 10 min in the presence of 10 ng phenobarbital-d5.The supernatant was dried under nitrogen gas,and the pellet was dissolved in 100 μL mobile phase.Afterwards,10 μL of the suspension was injected into the UHPLC-HRMS system.The present method involved two UHPLC conditions for determination of barbiturates(I)and identification of the structural isomers amobarbital and pentobarbital(II).This method showed satisfactory linearity in a range of 0.02–20.00 ng/mg for UHPLC conditions I and II,both with a high determination coefficient(0.9991–0.9999).The selectivity,intra-and interday precision,accuracy and matrix effect of the method were acceptable.Next,the validated method was applied to investigate an authentic DFSA case.Hair samples(black,approximate 25cm long)were collected 3 months after the assault,and the proximal segments(0–5 cm from the root;each segment was 1 cm long)were analysed.Amobarbital was detected at a concentration of<LOQ(limit of quantification)and 0.09 ng/mg in the second and third 1-cm hair segment but not in the other segments.Thus,our method was successful in determining barbiturate concentration in human hair after a single-dose exposure,showing its potential for application in the investigation of DFSA cases.
文摘In recent years,a significant number of investigations have discovered up to 200000 unsubmitted sexual assault kits(SAKs)in the US.While the public outcry was largely directed towards DNA analysis,the SAKs also contained biological specimens specifically designated for toxicological analysis.Due to the sensitivity of analytes in potential drug facilitated sexual assaults,the preservation and maintenance of the specimens is crucial in providing accurate toxicological measurements.The investigations into the unsubmitted SAKs have identified subjective law enforcement officer(LEO)rationale for the unsubmitted kits,however the impact on toxicological specimens has not been examined.This brief review of policies and guidelines with respect to forensic specimens has identified potential sources of evidentiary degradation,despite the use of chemical preservatives.With respect to temperature-controlled environments,the variation in SAK submission policies established throughout the US are potentially detrimental to the preservation of toxicological evidence.Degradation as a result of time-delayed collection and poorly maintained storage temperatures plays a crucial role for/in the interpretation of qualitative and quantitative toxicological results.This review finds these delays can be addressed through modernisation of facilities;electronic tracking of unsubmitted SAKs;mandated transfer of biological evidence within 72 h;and documentation of temperature within the chain of custody or other records.Without identifying the range of temperatures in which the evidence was exposed,forensic toxicologists may unintentionally provide erroneous interpretations of toxicological analyses-potentially casting doubt on the survivor’s recall of events and negatively impacting future sexual assault investigations.
文摘Body fluid identification through messenger RNA(mRNA)has been proposed as a useful supplement to presumptive and confirmatory tests by previous laboratory studies;however,its application in routine clinical forensic examination was rare.We report a case of sexual assault in which body fluid identification by mRNA profiling was used.Vaginal secretions mRNA markers(MUC4,HBD1,and CYP2B7P1)were used to test the sample,being obtained positive results.This case demonstrates that mRNA profiling of body fluids could be applied to routine case examinations as an aid,acting as a scientific collaborative evidence to strengthen the medicolegal opinion.
文摘选注者言:男性所受到的性骚扰比人们想象的要严重得多。这是最近在英国召开的英国心理学会的一次会议上透出的信息。而且被骚扰人基本孤立无援:…men, as well as women, are forced into having unwanted sexual contact but few services are provided to help them deal with the assault.
文摘Sexual assault evidence often contains sperm cells,which are typically separated from nonsperm cells using manual differential lysis procedures.The goal of this study was to evaluate the automated QIAGEN QIAcube for this purpose and to compare it to manual QIAGEN and manual organic differential methods using DNA yields and STR profile data for assessment.DNA yields were determined by qPCR,followed by multiplex STR amplification,CE analysis,and mixture interpretation.The automated method was capable of effective cell separation,producing DNA yields sufficient for STR amplification.Further,sperm fraction human:male DNA ratios from the QIAcube samples were consistently closer to the desired 1:1 and STR profiles were less likely to result in mixtures,with 6–8fewer female alleles detected(median 1.5 alleles).Ultimately,using the QIAcube for automated differential processing of semen-containing mixtures reduces the need for downstream mixture interpretation and improves STR profile quality with substantially less hands-on time.
