Archiwum medycyny sa̧dowej i kryminologii
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Arch Med Sadowej Kryminol · Apr 2008
[Thromboembolic complications in orthopedic surgery--medico-legal assessment in evaluation of correctness of medical treatment in selected cases].
Thromboembolic events continue to account for a high percentage of complications after orthopedic surgery. Of significance in prevention of these diseases is appropriate pharmacotherapeutic prophylaxis, both pre and postoperative, as well as orthopedic and trauma surgeons being aware of the risk of such complications and of possibilities of avoiding or minimizing thromboembolic events. The authors present some cases that were certified in Chair of Forensic Medicine, Silesian Medical University in Katowice, in which thromboembolic complications did develop after conservative or surgical orthopedic treatment, emphasizing possible difficulties in unequivocal assessment of the cause-effect relationship between the employed treatment and the thromboembolic event in the aspect of medico-legal certification.
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Arch Med Sadowej Kryminol · Apr 2008
[Medico-legal assessment of medical management in "chest pain" cases based on the review of cases analyzed in the Chair and Department of Forensic Medicine, Medical University of Silesia, Katowice, in the years 2000-2006].
Among all investigations aiming at assessing medical management carried out in our department between 2000 and 2006, the cases of "chest pain" constituted the largest percentage. In 70% of such cases, the employed medical procedures were found to be incorrect; what might be qualified as medical decisive errors, committed in rescue ambulances, outpatient clinics or in admission rooms. The authors present some examples of causes of such incorrect management strategies, such as neglecting proper and profound clinical examination (with medical history taking); lack or incomplete differential diagnosis; failure to observe appropriate critical attitude and prudence; focusing only on one, most common disease.
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Arch Med Sadowej Kryminol · Apr 2008
[Total permanent or major permanent inability to work in profession. Remarks about the possibility of criteria verification in medico-legal opinionating in criminal cases].
Despite the fact that some criteria of medico-legal certification in criminal proceedings have been established, there are still some areas that--parallel to changes occurring in contemporary society--have started to be controversial. This phenomenon has prompted the authors to attempt establishing new criteria for certification in total/major permanent inability to work in profession. This work is a continuation of a cycle devoted to interpretation of article 156 of the Penal Code to meet the needs of medico-legal opinionating.
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Arch Med Sadowej Kryminol · Apr 2008
[Injuries of the vertebral column--differentiating between natural illnesses manifested at work and illnesses caused by work accidents. Opinionating problems in cases associated with recognizing an event as a work accident in the analysis of materials of the Chair and Department of Forensic Medicine, Medical University of Silesia].
In opinionating practice of the Department of Forensic Medicine, Medical University of Silesia, a substantial problem is posed by cases associated with qualifying an event as a work accident or a "natural" illness manifested at work, when the consequence is spinal injury, especially of the overwork (surcharge; overstrain) character. Between 1998-2007, among all 284 medicolegal opinions concerning work accidents and their consequences, 76 opinions (27%) referred to vertebral column injuries or radicular pain syndromes. ⋯ The paper constitutes a preliminary report and material for more extensive deliberations, demonstrating problems faced by experts passing opinions in cases of this type. In addition, the authors present their observations addressing legal regulations in force and common opinionating practices.
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Arch Med Sadowej Kryminol · Apr 2008
[Scope and interpretation of laboratory tests in HBV/HCV infections--interpretation for medico-legal certification aspects].
Determination of medical effects of HBV/HCV infections, assessment of detriment to health and/or evaluation of effectiveness of therapy and prognosis are essential in medico-legal certification and are of a high value in civil, compensative cases. The author presents the scope of diagnostic laboratory tests, imaging examinations and determinations of HBV/HCV infection markers that are necessary for a possibly complete and objective assessment of future health consequences. ⋯ Based on approximately 400 reviewed and evaluated cases, the author emphasizes divergences between standards imposed by contemporary diagnostic management practices and organs of hepatological supervision, recommendations of university-affiliated centers in chronic liver pathologies, and the "real-life" diagnostic practices in hospital wards and specialist outpatient clinics. The limitations (usually financial in character) that affect diagnostic management often cause severe difficulties in medico-legal opinionating.