INMLCF - Instituto Nacional de Medicina Legal e Ciências Forenses, IP
URI permanente desta comunidade:
O Instituto Nacional de Medicina Legal e Ciências Forenses, I. P., é um instituto público tutelado pelo Ministério da Justiça, tem a natureza de Laboratório do Estado e é considerado instituição nacional de referência na área da medicina legal e ciências forenses. Com sede em Coimbra, dispõe de 3 Delegações (Porto, Coimbra e Lisboa) e uma rede de gabinetes médico-legais e forenses com cobertura no território nacional.
O INMLCF tem como missão assegurar as perícias médico-legais e forenses, a coordenação científica da atividade na área da medicina legal e ciências forenses, promover a formação e investigação, superintender e orientar a atividade dos serviços médico-legais.
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- Deteção de infeções sexualmente transmissíveis -contributo do LAC-ML no contexto de agressões sexuaisPublication . Fadoni, Jennifer; Mofreita, Vânia; Rodrigues, Joana; Franco, Magda; Shastakova, Alena; Magalhães, Jéssica; DE SOUSA MAGALHÃES, JÉSSICA; Correia Dias, Maria Helena; Balsa, Filipa; Cainé, Laura; Amorim, AntónioIntrodução: Os crimes de natureza sexual constituem um grave problema de saúde pública, com elevada prevalência, particularmente entre mulheres, e possíveis consequências físicas, psicológicas e reprodutivas para os sobreviventes. Entre estas, as infeções sexualmente transmissíveis (IST) assumem particular relevância, tanto pelo seu caráter frequentemente assintomático como pelo potencial de causar complicações a longo prazo. A deteção de IST em contextos de agressão sexual é crucial não só para a adequada gestão clínica das vítimas, como também para fornecer suporte probatório no âmbito da investigação criminal. Objetivos: Foram analisadas amostras colhidas no âmbito de casos de possíveis agressões sexuais, com o objetivo de detetar a presença de IST. Material e Métodos: Foram analisadas 59 amostras biológicas incluindo soro sanguíneo (n=49), urina (n=5), e exudados vaginal (n=1), vulvar (n=1), anal (n=1), cervical (n=1) e perianal (n=1), nas quais foram pesquisadas a presença de Chlamydia trachomatis (IgG, IgM, DNA), Neisseria gonorrhoeae (IgG, IgM, DNA), Trichomonas vaginalis (IgG, IgM, DNA), Treponema pallidum (IgG, IgM, DNA), Ureaplasma urealyticum e Ureaplasma parvum (DNA), Mycoplasma hominis e Mycoplasma genitalium (DNA), HIV 1/2 (Ac Totais, Ag p24, RNA), Hepatite B (Ag HBs, Ac HBs, Ac totais, IgM HBc), Hepatite C (IgG), Papiloma virus humano (IgG), Herpes-virus simplex tipo 2 (IgG, IgM), de acordo com o solicitado pela entidade requisitante. Resultados e Discussão: Os indivíduos analisados possuíam idades entre 12 e 72 anos. Todas as supostas vítimas eram do sexo feminino (22 amostras), enquanto 36 amostras eram provenientes de agressores do sexo masculino e 2 do sexo feminino. Nos supostos agressores, foi detetada C. trachomatis (IgG) em 1 indivíduo do sexo feminino e 3 do sexo masculino, incluindo em um desses a deteção de T. pallidum (IgG); e HIV 1/2 (Ac Totais) em 1 indivíduo do sexo masculino. Entre as alegadas vítimas, foi detetada C. trachomatis (DNA) em uma mulher de 73 anos de idade; e Hepatite B, (Ag HBs) numa jovem de 12 anos de idade, sugerindo uma infeção ativa. Estes achados reforçam a importância da investigação laboratorial em casos de alegada agressão sexual, e reforçam a sensibilidade dos métodos utilizados, que permitem a deteção de agentes infeciosos mesmo em indivíduos assintomáticos. Conclusões: A deteção laboratorial de IST em contexto forense revela-se fundamental na abordagem integrada a vítimas de violência sexual, permitindo não só um acompanhamento clínico mais eficaz, como também a produção de informação relevante para fins judiciais. O papel dos laboratórios forenses, como o Laboratório de Análises Clínicas e Médico-Legais (LAC-ML), é determinante na resposta coordenada às agressões sexuais, promovendo uma abordagem baseada em evidência científica, respeito pela vítima e suporte à justiça. Reforça-se, assim, a necessidade de protocolos bem definidos e da capacitação contínua dos profissionais envolvidos neste tipo de perícias.
- Drug related deaths (DRD) in Portugal update from the toxicological examinations) and liaison and interactions with hospitalsPublication . Castañera, Antonio; Simões, Susana
- Fatal poisoning by Hemlock water dropwort roots (Oenanthe Crocata )Publication . Costa, Suzel; Franco, João; Barroso, Mário; Carvalho, S.; Fonseca, SuzanaIntrodution : This report describes the history and investigation of a suspected plant poisoning event in Portugal, involving the death of two adult males, who have mistakenly ingested Hemlock water dropwort roots Oenanthe crocata during a 36 h resistance path in May 2017 in Santarém Portugal Six hours after beginning the path, they have called to emergency services for assistance because they suddenly become unwell reporting plants ingestion and describing that they felt nauseated, vomits, seizures and disorientation Both were found dead a few hours later in a rural area In their backpacks, in addition to food supplies, they had fennel and spearmint that were probably picked up on the route Further investigations by police authorities found that during that morning they shared several photos in social media, including screenshots of wild parsnips Pastinaca sativa.
- Forensic Microbiology: challenges in detecting sexually transmitted InfectionsPublication . Eira, Ana; Fadoni, Jennifer; Amorim, António; Cainé, LauraSexual assault crimes consist of acts committed without consent and represent a major global issue with serious implications for victims. These acts have both short- and long-term consequences on the physical, mental, and sexual health of victims, with sexually transmitted infections (STIs) being one of the direct outcomes of such crimes. Sexually transmitted infections constitute a serious global public health problem and can lead to severe consequences. These infections may be caused by bacteria, viruses, or parasites and are transmitted through sexual contact. Some of the most common STIs among the general population and victims of sexual crimes include gonorrhoea, chlamydia, trichomoniasis, and syphilis. In most carriers, these infections are asymptomatic, making their detection particularly challenging. Considering the importance of further research in this field, the primary objectives of this study are to review the existing literature on the incidence of major STIs in victims of sexual crimes, to identify the various risk factors associated with these infections, and to explore their public health implications. Additionally, this study aims to assess different STI detection techniques, analyzing their advantages and disadvantages. Studies on this topic are crucial for better understanding the role of sexually transmitted infections in the context of sexual crimes. However, throughout this work, it was verified that point-of-care methods are a good option to allow the diagnosis to be faster and more accurate, when compared to other methods of detecting sexually transmitted infections.
- The Genetic Structure of Cape Verdean Population Revealed by Y-Chromosome STRsPublication . Cainé, Laura; Costa, Rita; Fadoni, Jennifer; Amorim, António; AmorimBackground/Objectives: Y-chromosomal short tandem repeats (Y-STR) are genetic markers widely used in forensic and population genetics. However, despite their importance, many populations remain under-represented in published studies and genetic databases. One such population is the Cape Verdean, which, despite its unique history of admixture between European and sub-Saharan African populations, continues to be under-represented in global Y-STR reference databases. This study aims to characterize the Y-STR haplotype diversity and paternal lineage composition of the Cape Verdean population using a high-resolution STR panel. Methods: A total of 143 unrelated Cape Verdean men were analyzed using a set of 26 Y-STR loci, including rapidly mutating markers. Allele and haplotype frequencies were calculated, along with standard forensic parameters such as gene and haplotype diversity. Paternal lineages were inferred, and genetic relationships with other populations were evaluated using distance-based and graphical methods. Results: A total of 135 haplotypes were detected, with 88.8% being unique, yielding a haplotype diversity of 0.999. The most common haplogroups reflected both West African and European ancestry. Genetic distance analysis positioned the Cape Verdean population between African and European groups, supporting its intermediate and admixed genetic background. Conclusions: This study provides the first high-resolution Y-STR dataset for Cape Verdeans, contributing valuable reference data for forensic casework and population genetic studies. The results highlight the utility of extended Y-STR panels in admixed populations and underscore the need to enhance the representation of admixed populations in international forensic reference databases
- Interactions between tramadol and selective serotonin reuptake inhibitors anti depressants in post mortem casesPublication . Fonseca, Suzana; Franco, JoãoBackground & Objectives Tramadol is very often prescribed for pain management in patients with depression in treatment with selective serotonin reuptake inhibitors (SSRI). Serotonergic antidepressants and its concomitant use with tramadol can lead to a drug–drug interaction, resulting in a decrease in the tramadol analgesic effect and a higher risk of serotonin syndrome caused by the accumulation of serotonin in the central nervous system. These interactions can also change the post-mortem concentrations of the therapeutic drugs and its metabolites, increasing the difficulty in the interpretation of forensic toxicology results, mainly when the concentrations are higher than the therapeutic level. The aim of this study was to review a five-year period of post-mortem cases, in order to examine the prevalence of concomitant use of tramadol and SSRI and the influence in the concentrations found.
- Intraventricular brain tumor: report of three casesPublication . Costa, Margarida; Henriques de Gouveia, Rosa; Simoes da Silva, BeatrizIntroduction: Colloid cysts are considered congenital non invasive benign lesions, enlarging very slowly. They account for less than 1% of symptomatic brain tumors, being the most common tumor of the 3rd ventricle (...)
- Munchausen by Proxy with Haloperidol: A case reportPublication . Fonseca, Suzana; Dias, MárioIntroduction: An 8-year-old male child with extrapyramidal symptoms was admitted at 3 pm at the Urgency of Pediatric Hospital. Extrapyramidal syndrome (EPS), sometimes referred to as neuroleptic malignant syndrome, is a neurological side effect of antipsychotic medication characterized by a set of symptoms, that include: hyperpyrexia (an early sign of this syndrome), generalized muscle rigidity, tremors, hypersalivation, altered mental status (including catatonic signs), and evidence of autonomic dysfunction (irregular pulse or blood pressure. This child had previous Hospital admissions with similar symptoms and the possibility of a Munchausen by Proxy Syndrome (MBPS) was considered for evaluation. This syndrome is a form of child abuse in which the carer (usually the mother) simulates, manipulates or produces symptoms of illness in the victim. In most cases the detrimental effect is caused by applying foreign substances, sometimes difficult to detect in the clinical laboratories. Serum and urine samples were collected and a toxicological screening in urine was performed at the hospital by immunoassay revealing positive results for barbiturates and amphetamines. A second urine sample, collected 2 hours later, tested negative to all groups screened. The analytical results didn´t matched with clinical disturbances of the patient and further diagnosis procedures yielded no pathological findings. The serum and urine samples were sent to the Department of Chemistry and Forensic Toxicology of National Institute of Legal Medicine and Forensic Sciences (INMLCF) for an extensive screening for drugs and medicines.
- Oral health professional intervention and child physical abuse: European legal approachPublication . Corte-Real, Ana; Almiro, Pedro Armelim; Silva, Mafalda; Nunes, Tiago; Abreu, João; Carreira, Carla; Vieira, Duarte NunoPhysical violence against children and adolescents is an issue of Global Public Health. This study aims to identify traumatic injuries and the medicolegal temporary framework of the victim’s profile in the European legal approach. Participants and setting include the following: the clinical reports of a Portuguese European Clinical Academic Center database were analysed. An observational and prospective cohort study was performed. A descriptive analysis of the variables was conducted, considering gender, bimodal age groups, place of residence, offender data, place of occurrence, aetiology, localization, type of injuries, personal injury assessment by Quantum doloris, and injury time. The statistical analysis was performed by Spearman’s rho and Kendall’s tau-b correlation tests, Pearson’s chi-square test of independence (χ2), and Mann Whitney and Kruskal–Wallis nonparametric tests (P < 0.05). The relationship between age groups and the place of occurrence was statistically significant (P = 0.001). Orofacial and non-orofacial injuries were related (P = 0.035). The General Data Protection Regulation is not a barrier to the treatment and sharing of justified data but a framework for safeguarding individuals’ fundamental rights, including the Right to Health. Meticulous reporting of the clinical situation involves the victim, the occurrence, and the potential offender. Key points: • An oral health professional’s notification of the event is a fundamental step of the judicial process. • The timeline is the core of traumatic injury assessment in a child physical abuse scenario. • Medicolegal evaluation impacts disability prevention, imputability, and notification of the crime.
- Reading between the lines. Older people’s maltreatment: from detection to reporting in primary healthcarePublication . Frazão, S.; Morais, C.; Norton, P.; Pinto, P. Vieira; Magalhães, T.The issue of older people’s maltreatment (OPM) is gaining increased attention worldwide because of its significant short and long-term severe consequences. Healthcare professionals play a crucial role in detecting, reporting, and managing these cases, but many difficulties in these procedures exist, and underreporting is very frequent. Thus, the aim of this study was to identify the extent of and difficulties in detecting and reporting suspected OPM cases by general practitioner physicians in Portugal. A cross-sectional survey was conducted among general practice physicians (GPPs) to assess their perceptions, experiences, and challenges in detecting and reporting older people maltreatment (OPM). The 13-item questionnaire explored sociodemographic factors, responsibility, confidence, reporting practices, and training needs, providing an updated insight into OPM management in primary healthcare. It was anonymous and conducted through a self-report questionnaire distributed in paper format to GPPs working in the National Health Service in the Northern of Portugal. We received 356 completed questionnaires for further analysis. The findings indicate that, on average, physicians suspect fewer than one OPM case per year; only 32% suspected at least one case in the previous year, although 55.3% and 54.5% of the physician’s revealed confidence in identifying signs of physical abuse and neglect, respectively. The ambiguity of the psychological symptoms was identified as a great challenge in detection (50.3%). Only 36.5% of the physicians were acquainted with the procedures for reporting suspected cases; however, of the 32% who suspected at least of one case in the previous year, only 39.5% reported all or at least some suspected cases; 16.9% chose not to report the case when requested by the victim or his/her caregivers. Most (91.6%) expressed a willingness to adopt protocols to assist them in managing such cases. A correlation was found between physicians’ satisfaction with OPM reporting training during undergraduate and postgraduate education and their ability to report (p=0.024), as well as with the number of reported cases (p=0.003). Thus, the detection and reporting of OPM by physicians remain major challenges that need to be overcome. Further research and greater awareness of the importance of these procedures are essential to ensure victims’ protection, safety, and health.