核医学显像评估生殖与性功能障碍

生殖道是一个复杂的解剖器官,它同时具有内分泌学和解剖学上的功能特征。核医学在检查生殖和性功能方面有一定价值,包括男性睾丸和阴茎海绵体的灌注情况,女性输卵管的传输情况及亚临床型精索静脉曲张。这些检查方法的成功应用证实了它们具有重要的临床实用价值。     

Scintigraphy in the evaluation of disorders of reproductive and sexual function.

The genital tract is a complex anatomic region with overlapping endocrinologic, anatomic, and functional features. Nuclear medicine has value in examining functional aspects of reproductive and sexual function, ranging from testicular or cavernosal perfusion in the male, to fallopian tube transport in the female. Blood pool imaging has been helpful in detecting subclinical varicoceles. Proper understanding of the role that these tests play is important for their success and credibility.     

Analysis of 756 cases of sexual assault in Tours (France): medico-legal findings and judicial outcomes

We describe the medico-legal findings in a population of sexual assault cases assessed in an urban French referral centre, analyse the subsequent legal dispositions in each case and determine whether the characteristics of the assault and the medico-legal findings were associated with conviction of the assailant. We performed a retrospective study of medicolegal reports in all the sexual assault cases reported in Tours (France) during a seven-year period. We defined two groups of victims: children under 15 years old and victims aged 15 years or more. Legal outcomes were obtained from courtroom proceedings. The relationship between the outcomes and the circumstances of the case was analyzed by logistic regression. We enrolled a total of 756 cases during the study period. The mean age of the study population was 16.5 years and 68.3% of the cases involved children under 15 years old. In 57% of these cases, the assailant was a family member. 31.7% of all the victims were aged 15 years or more. The assailant was an acquaintance of the victim in 62.2% of the cases. Drug-facilitated assault was suspected in 2.9% of the cases. In 46.2% of the cases, formal criminal charges were not filed due to insufficient evidence; 36.3% of the assailants were convicted. Examination at the request of the police authorities and previous acquaintance of the assailant by the victim were significantly associated with conviction. Allegations of penetration, the presence of general body trauma and the presence of genital trauma were not necessarily associated with conviction. Medical examiners need to be circumspect when they record non-medical variables. Physical evidence of trauma was neither predictive nor essential for conviction. Successful prosecution depends on the quality of the testimony provided by the victim.     

Psychological and judicial parenthood

The article proposes a distinction between parental care and parental authority, founded on recent trends exhibited by the nuclear family. Legislative practices in the Netherlands are examined regarding the recognition of this de facto distinction by courts and welfare bodies.     

Methodical and practical approaches to the management of health care quality control in a large military polyclinic

The experience of creation and practical use of the medical care quality (MCQ) control system in the Diagnostic center N 52 is summarized. The measures realizing the functions of planning, motivation and organization during MCQ control are described. The goals, objects and system elements, functional duties and algorithm of officials' actions during the continuous MCQ support are substantiated. Introduction of some elements of MCQ control system caused the decrease in the number of patients' complaints, defects in rendering of medical care and complications.     

Prevalence of mental health problems and deliberate self-harm in complainants of sexual violence

The Haven Whitechapel, a sexual assault referral centre, provides a forensic service and after care to victims of serious sexual violence across North East London. Survivors of sexual assault display psychological sequelae including elevated rates of suicide ideation/attempts. Prevalence of mental health problems of 121 forensic cases seen between June and August 2004 was established. Of female clients aged over 13 years 8% had learning difficulties, 21% gave a past history of deliberate self-harm (DSH) and 20% psychiatric history. We formally assessed levels of safety and vulnerability prior to clients leaving the Haven. When mental health problems were identified additional screening questions were asked, followed by a flow chart outlining appropriate care pathways. Such practice was carried out over 6 months (September 2004 to February 2005). Of the 240 clients, 8% reported learning difficulties, 26% DSH and 21% psychiatric history. 4% of clients required urgent follow-up and 3% immediate referral to a psychiatric liaison team. There is a high background prevalence of mental health problems and DSH in our study population. Vulnerable people are at increased risk following sexual violence. Risk needs to be recognised and addressed. These findings have implications for the expansion of the SARC network.     

空军基层部队男性生殖健康状况调查分析及干预对策

目的了解空军基层部队男性生殖健康状况,探讨有效的预防措施。方法采用男性生殖健康调查表,对2686名官兵统一进行病史询问,外生殖器检查,前列腺液常规、精液常规等检查,登记结果进行统计分析。结果调查患病率为55．92％,其中包皮过长（15．49％）、前列腺炎（14．37％）发病率较高;雷达作业人员精液量、精子活力、精子密度下降明显。结论空军基层部队男性官兵生殖健康状况尚需进一步提高。     

Intra-familiar homicides: From 2006 to 2021 in the judicial district of Milan

IntroductionThe present research aims at analyzing criminological and medico-legal characteristics of intra-familiar homicides occurred in two major Italian cities (Milano and Monza) from the beginning of 2006 to the end of 2021.MethodsCases were identified using the Institutional database of the Institute of Legal Medicine of Milan, where all the autopsies of victims were performed. Data about these cases were obtained from autopsies findings, preliminary investigation reports, local papers and victim relatives’ interviews.In this period 11,480 autopsies were performed: 392 were homicides and, among these, 94 were confirmed as intra-familiar homicides (as a result of 84 events).Cases were classified according to the classic definition of intimate partner violence (referring only to an intra-familiar context), parricides, filicides, fratricides, familicides and grannicides.Age, sex, nationality and risk factors of the victims and perpetrators, as well as methods of murder were registered for each case. Only in some cases, motives for murder were known.ResultsThe most frequent type of intra-familiar homicides was intimate partner violence (41.5%), followed by parricides (16%, mainly matricides), filicides (10.7%) and fratricides (6.4%). 9.6% of the total number of events were familicides.Risk factors were frequently involved, in particular among perpetrators and in the group of parricides, while among siblicides they showed minimal relevance. Overall, psychiatric pathologies were the main risk factors involved (at least 23.8%), unlike extrafamiliar homicides, where previous criminal report or involvement in illicit traffics are frequently reported among perpetrators. This finding enlightens the difficulties of caring for a relative with a mental disorder, who can become dangerous for the domestic caregiver.Furthermore, the high number of physical illness and the advanced age of victims points out the tragical consequences of the lack of social support system for these categories of people.Methodsof murder were mainly cold steel (30–31.9%) and firearms (21–22.3%). However choking/manual ligature (9–9.6%), blunt force trauma inflicted using objects found on the scenario or bare handed (16–17%) and combined methods (11–11.7%) were frequently represented confirming the expected high level of impulsivity related to this kind of crime.     

武警某部2011年新兵生殖健康知识水平调查

目的 了解武警某部新兵对生殖健康知识的知晓度,提供有针对性、目的 性的生殖健康服务.方法 采用自行设计的问卷,分层抽样2000名新兵进行生殖健康相关知识的问卷调查.结果 新兵性行为、性观念比较开放,性安全意识不强,生殖健康、节育、预防艾滋病及性传播性疾病有关知识相对缺乏.结论 新兵入伍前生殖健康知识知晓率比较低,只有为新兵提供有效的生殖健康服务,才能提高部队生殖健康水平.     

Anthropo-ecological aspects of occupational health and various biochemical approaches to the problem of its evaluation in workers in high risk occupations

This paper presents the concept of occupational health of man, interpreted as the process of maintenance and development of regulatory properties of the body and his physical, psychic and social well-being, which provide high reliability of his professional activities, professional longevity and maximal lifetime. The paper discusses the main areas of biochemical investigations to evaluate occupational health of the flying personnel, which include identification of correlates between biochemical or immune changes and pathological or premorbid states, that reduce tolerance to environmental effects, as well as study of functional specificities related to the reserves and mechanisms of implementation of adaptive capabilities of the human body. It gives detailed biochemical data derived from pilots with neurotic problems and biochemical indicators of stress tolerance measured during exposure to +Gz acceleration, angular acceleration, hyperthermia, hypoxia, and exercise.     

The decline of judicial deference to medical opinion in medical negligence litigation in Malaysia

The decision of the Federal Court of Malaysia in abandoning the Bolam principle in relation to doctor's duty to disclose risks has clearly marked the decline of judicial deference to medical opinion in medical negligence litigation in Malaysia. It is undeniable that the Bolam principle has acted as a gatekeeper to the number of claims against medical practitioners. This has always been seen as necessary to protect the society from unwanted effects of defensive medicine. However, will these changes contribute significantly to the growth of medical negligence cases in Malaysia? This article will trace the development of the Bolam principle in medical negligence litigation in Malaysia since 1965 and analyse the influence of selected Commonwealth cases on the development. The implications of the Federal Court ruling will also be discussed.     

Results of the reproductive health education program for soldiers and noncommissioned officers

The Turkish Armed Forces Commando Brigade has started a continuous and systematic education program, called the Patriotic Awareness Acquirement Project (PCAP), to inform soldiers who will be demobilized. Within the PCAP, topics such as Turkish history, the Armenian question, and manners/etiquette, as well as healthy living, reproductive health, family planning, general hygiene, and sexually transmitted diseases were included. The aim of Reproductive Health Education (RHE) conducted within the PCAP is to inform male individuals about reproductive health and to increase their knowledge, awareness, and sensitivity. In the RHE, the privates were provided with information regarding male and female reproductive organs, the menstruation mechanism, pregnancy, determination of gender, fertility-infertility, and sexually transmitted diseases. After the evaluation, it was reported that the privates indicated they were satisfied with RHE, were informed, took notice of the incorrect information, and, for postmilitary life, would visit health clinics for counseling.     

低强度微波辐射环境对男性生殖健康的影响

目的　了解低强度微波作业环境对男性生殖及其子代健康的影响。方法　采用面对面问卷调查方式对已婚的 4 2 4名雷达作业人员 (实验组 )、2 0 4名对照组人员进行现场调查。结果　实验组性功能减退发生率为 2 3 8% ,对照组为 14 7% ,两组相比差异有统计学意义 (P <0 0 5 )。实验组婚后半年、1年自然受孕率分别为 13 8%、39 8% ,对照组分别为 31 3%、4 9 6 %。婚后 2年、3年后自然受孕率 ,实验组为 30 4 %、12 5 % ,对照组为 10 9%、6 1% ,组间差异显著 (P <0 0 0 1)。两组人员生殖结局及子代性别比例未见异常。结论　长期低强度微波辐射对男性性功能有不良影响 ,导致女性自然受孕时间滞后 ,但对妊娠结局及子代健康无明显影响。     

影响高原部队官兵生殖健康知识水平的因素分析

基层部队官兵对性生理知识和艾滋病传播及防治知识了解不多,有的甚至还存在一定的认识误区。本研究对高原部队官兵性生理及艾滋病知识进行了问卷调查,旨在了解高原部队官兵生殖健康知识水平,并探讨其可能的影响因素,以提供更有针对性、目的性的生殖健康保健服务,提高高原部队官兵对性生理知识和艾滋病防治知识的认知水平和生殖健康水平。