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Biomedical subjects

E Baccino

Publications and source records attributed to E Baccino.

At least 19 recordsLinked to original sources
PubMed2005

A multicentre and prospective study of suspected cases of child physical abuse.

In this multicentre prospective study, the authors aim to describe the social and clinical characteristics of a population of children who arrived with a suspicion of physical abuse at five Emergency Services across France and who underwent clinical and thorough radiological screening according to a common predetermined protocol. A total of 185 cases of children seen at the Emergency units of five French hospitals over a 4-year period was assessed via a specific protocol and included in this study. The results of this study show socio-cultural factors consistent with previous reports on abused populations, and in particular give interesting data concerning the type and severity of lesions present, on the whole, in 80% of the population studied. In particular this study revealed a high prevalence (30%) of bone fractures. Apart from giving a perspective on the French population, this study adds some information to the too few preexisting studies of its kind-and stresses the importance of effective identification of possible cases of child abuse and of a thorough and sensitive screening protocol.

Age Distribution↗
PubMed1999

Determination of age at death: assessment of an algorithm of age prediction using numerical three-dimensional CT data from pubic bones.

The determination of age at death is an important part of physical and forensic anthropology. Because of resistance to decomposition and the simplicity/accuracy ratio, the direct observation of the os pubis by Suchey-Brooks phase analysis is the preferred reference system for determination of age at death. We propose an age-prediction system using a pubic symphysis numerical database obtained from CT x-ray through quantification of age-linked parameters. Our system increases the accuracy of age estimation and at the same time preserves the integrity of the archeological material.

Adult↗
PubMed1999

Evaluation of seven methods of estimating age at death from mature human skeletal remains.

Different approaches to the estimation of age at death in mature human skeletal remains were evaluated utilizing samples from 19 recent French autopsy individuals of known age at death. Methods of estimating age at death from single-rooted teeth, the sternal ends of the fourth ribs, the symphyseal face of the pubis and femoral cortical remodeling were evaluated by two independent observers (three observers for the teeth). Comparison included ages estimated from three more comprehensive approaches utilizing data from the application of two or more of the individual methods. The results indicate that the comprehensive approaches are superior to the individual ones and the success of the latter reflects not only the morphological expression of the aging process, but also the technique complexity and the experience of the investigator. Of the individual techniques, the "Lamendin" dental technique was most effective for individuals of ages greater than 25 years.

Adult↗
PubMed1998

[Teaching ethics in French medical schools: evolution or revolution ?].

Ethics was introduced as subject matter in French medical schools only recently despite a rich historical context where scientific legitimacy, humanistic exigencies and anglo-saxon influence have all played a role. Ten years after the thesis presented by Bastian in 1986, a survey of French medical schools shows that ethics has become an integral part of the curriculum. Ethics has tended to become a discipline on its own, separate from law and deontology. However, the lack of specific courses on concentration in the first years of the curriculum show that there is much room for growth in the discipline of medical ethics.

Curriculum↗
PubMed1996

Outer ear temperature and time of death.

From a research sample of 138 corpses, divided into four subgroups of ambient storage temperature (0-5 degrees C, 6-10 degrees C, 11-15 degrees C and 16-23 degrees C) four linear regression formulae of actual versus estimated post-mortem interval were obtained ('interval' formulae) using a single outer ear temperature measurement on both sides. This method showed the best correlation coefficient among five other methods previously proposed for time of death determination (rectal temperature, vitreous K+, CSF K+, blood log NA+/K+ and log Cl-), however its results were less accurate than those obtained with a multivariate equation combining several of the above mentioned methods. Eventually an equation expressing time of death (TOD) as a function of outer ear temperature (OE T degrees) and ambient temperature was also established from the whole research sample ('global' formulae). On a different sample of 141 corpses the regression formulae ('interval' and 'global') for the outer ear temperature were compared to three methods based on a single rectal temperature measurement ('rule of thumb' 1 and 2, Henssge nomogram) and therefore useful at the scene; the results of all methods were compared within the four subgroups of ambient temperature as well as in three subgroups of different post-mortem interval lengths (< 7 h, < 10 h, < 15 h). In all cases the outer ear temperature formulae provided better results than the rectal temperature methods (especially Henssge nomogram and rule of thumb 1). Moreover they did not show any post-mortem plateau which was present in almost 30% of cases when rectal temperature was measured in corpses kept at ambient temperature above 15 degrees C. Our results show that outer ear temperature measurement is the method which provides the best simplicity/quality ratio and should therefore be proposed for use at the scene when conditions are similar to those of our experiment (within buildings). A software equipped thermometer is required in order to use in each case the appropriate formula and confidence interval.

Aged↗
PubMed1996

Headspace GC/MS testing for chlorodifluoromethane in two fatal cases.

Two cases of lethal poisoning due to chlorodifluoromethane (Freon 22) inhalation are described. The fluorocarbon was determined in biological tissues by headspace gas chromatography/mass spectrometry. Ions monitored were m/z 67, 86 and 51, the latter being used for quantification. Blood concentrations were 26.0 and 37.1 microliters/ml. In both cases, the drug was also identified in urine, vitreous humor and bile, but in much lower concentrations.

Accidents, Occupational↗
PubMed1995

[Hospital procedures and surgical management of patients with stab wounds to the heart].

Stab wounds of the heart are frequent: one case every two and a half months in our service. In our series of 9 cases, only three were alive at arrival to the emergency ward, but in all of these three, treatment was simple requiring only simple wound suture without extra-corporeal circulation. Based on our experience and the data in the literature, we propose cooperation between three teams for managing these patients: anaesthesists, echocardiographists and cardiothoracic surgeons. The patients are admitted directly to the cardiothoracic operating theatre where the echocardiographist and the surgery team take charge. The surgical procedure depends on the general situation and especially on whether or not the echocardiologist can confirm haemopericardium immediately. Every patient with possible wound to the heart or major vessels should be managed directly by the cardiothoracic surgery team before of formal diagnosis has been established.

Adolescent↗
PubMed1992

A simple technique for age estimation in adult corpses: the two criteria dental method.

A method for age determination of adults from single rooted teeth is presented. It is based on the measurement of two dental features: periodontosis height times 100/root height (P) and transparency of the root height times 100/root height (T). These measurements are made on the labial surface of the entire tooth without section and do not require special equipment or training. The application of multiple regression analysis to a working sample of 306 teeth of known age, sex and race provided the following equation: Age (years) = 0.18 x P + 0.42 x T + 25.53. The mean error between the actual and estimated age was +/- 10 years on the working sample and +/- 8.4 years on a control sample made of 45 forensic science cases. Upper incisors showed a better precision than the other single rooted teeth and accuracy was not sex related. A comparison of the Gustafson and Lamendin methods on a control sample of 39 teeth resulted in an advantage of the latter considering the mean error on the estimation (14.2 +/- 3.4 years for Gustafson versus 8.9 +/- 2.2 for Lamendin). The Lamendin method can be practical interest for any forensic pathologist or dentist as it is fast, easy to use, and reasonably accurate except for cases of individuals under age 40 where other methods must be preferred.

Adult↗
PubMed1988

Exploration of acid gastroesophageal reflux by 24-h pH metry in infants at risk of sudden infant death syndrome: a study of 50 cases.

This study focused on the frequency of pathological acid gastroesophageal reflux (AGER) on 50 children considered to be at risk for sudden infant death syndrome: that is to say, 30 near misses and 20 subsequent siblings. Four parameters were studied in a 24-h pH metry: (1) The percentage of time spent at pH less than 4. (2) The length of the longest reflux. (3) The number of refluxes greater than 5 min/h. (4) Esophageal clearance. In comparison to a control group of 46 normal children, we noted a rate of 20% of AGER on the near misses and 31% on children whose siblings had died from sudden infant death syndrome. The pH level of these two groups was significantly more often less than 4, compared to the normal children. The role of AGER in sudden infant death syndrome will, therefore, be discussed.

Gastroesophageal Reflux↗
PubMed1988

Acetaldehyde adducts with haemoglobin: determination of acetaldehyde released from haemoglobin by acid hydrolysis.

Acetaldehyde, the first metabolite of ethanol, reacts with haemoglobin in vitro to produce acetaldehyde-haemoglobin adducts. Some clinical studies on the minor haemoglobins have suggested that these adducts may be formed in people abusing alcohol. Under hydrolysis of haemoglobin, with oxalic acid at 100 degrees C in sealed vials, some acetaldehyde was released and then specifically determined by HPLC. The kinetics of hydrolysis were studied using haemoglobin previously labelled with 14[C] acetaldehyde. The maximum liberation of 14 [C] acetaldehyde was obtained after 3 hr 30 min hydrolysis and this time factor was then utilized in the analysis of alcoholic and control haemoglobin. Thus, we have confirmed the formation of acetaldehyde haemoglobin adducts in vivo. It must be noted that the released acetaldehyde corresponds only to an index of the stable adducts. The levels were higher in alcoholics than in controls (1.417 +/- 0.171 and 1.295 +/- 0.139 nmol/mg Hb, respectively, P less than 0.001). In conclusion, this marker is not a convenient tool for the monitoring of alcohol exposure levels because of the low differences between alcoholic and control haemoglobins.

Acetaldehyde↗
PubMed1987

[Attempt at preventive treatment of esophagitis caused by intubation during intensive care].

A randomized prospective trial was designed to evaluate the preventive treatment of esophagitis in 31 intensive care patients who had a nasogastric feeding tube for at least 10 days. Fourteen patients (group B) received no preventive treatment while 17 patients (group A) received 300 mg of cimetidine every 6 h intravenously and 11 g of colloidal aluminium phosphate every 4 h per os. All patients were fed a standard diet through their nasogastric tube at a constant rate of 30 Kcal/kg/day. Endoscopic controls at day 1 and 10 showed that the number of initial and final esophagitis was not different in groups B and A: 7 and 8 at day 1, 11 and 10 at day 10, respectively. The inefficiency of this preventive treatment suggested that acid gastroesophageal reflux is not a major factor in the occurrence of nasogastric feeding tube-induced esophagitis. However as esophagitis is associated with a more severe Knaus index and a greater number of gastric stress ulcer risk factors, it is suggested that decreased defense of the mucosa may be a key factor in the occurrence of this type of esophagitis.

Adult↗