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Breast damage is likely to result in compensation according to the principle of full compensation. However, breast damage, little covered in the scales usually used, requires a specific methodology. The quantification of functional prejudice must be done with regard to the age of the victim and must take into account the possible repercussions on mobility (shoulder and/or spine) as well as the psychological repercussions. Whether or not the nipple and areola are preserved should be described. Temporary aesthetic damage (before breast reconstruction) must be assessed on the basis of objective elements, its duration and quantification on a scale of 0 to 7. Permanent aesthetic damage takes into account scars, deformities, amputations and quality of the prosthesis. A new scale for evaluating permanent aesthetic damage is proposed. Sexual prejudice must take into account an impairment of the pleasure related to sexuality and its erotic function, in line with the concept of sexual health. However, even after reconstruction, the areas of quality of sexual life and sexual satisfaction often remain affected. An exploration using standardized questions from validated questionnaires such as BREAST-Q can be useful. The sequelae linked to the damage on a breast can also lead the woman to limit certain pleasure activities, in particular because of psychological discomfort or even be the cause of a loss of opportunity to carry out a family's life plan.

Summary Worldwide, suicide remains a major public health problem whose impact in human and economic terms is important. Many studies have been carried out on this subject, including the study of risk factors for suicide. Nevertheless, in the absence of an effective and strengthened collaboration between the forensic institutes and the Epidemiological Centre on the Medical Causes of Death (CepiDc), epidemiological data concerning suicide in France remain underestimated, which impedes the implementation of an effective and necessary means of prevention against this scourge. In this work, we conducted an epidemiological profile of suicides at the forensic institute of Toulouse for 3 years. During the study period 715 cases of suicide were collected, with an overwhelming male predominance of 534 men (75%) and 181 women (25%). The average age was 53.94 years, with extremes of 12 and 101 years. Hanging was the most common method of suicide (41.7%) for both sex. Seasonal variations in the frequency of suicides were also reported during our study: lower frequencies in winter and higher frequencies in summer. Among the determinants of suicidal acts, depression (34.7%) was predominant among mental disorders in suicides.

In forensic anthropology, age estimation is a major element in the determination of a biological profile and the identification of individuals. Thus, many anatomical structures have been studied, such as the pubic symphysis, which is a source of major interest due to its late maturation. One of the most well-known methods of assessment is the Suchey-Brooks (SB) system based on the morphological characteristics of the pubic symphysis. The aim of this study was to propose linear regression formulae in order to deduce chronological age from bone density, using both Hounsfield unit (HU), and mean bone density (mBD) values of the pubic symphysis. Moreover, we intended to test the reliability and then to explore the feasibility of using HU instead of mBD values for age estimation. We built retrospectively a reference sample of 400 pubic symphyses using computed tomography at a French hospital and a test sample of 120 pubic symphyses. Equations were created to establish linear regression models for age estimation. Inaccuracy and bias were calculated for individuals aged more or less than 40 years. We highlighted homogeneous mean absolute errors for both HU and mBD values, most of them being less than 10 years. Moreover, we reported a moderate overestimation for younger individuals and a very small underestimation for older individuals. This study proposes a correlation between the bone density and age of individuals with a valuable level of reliability. Finally, HU measurements seem to be suitable for linking bone density with the age of individuals in forensic practice.

Aim of the work In forensic anthropology, the estimation of age at death is required to establish a biological profile and facilitate individual identification. The pubic symphysis represents one of the most studied skeletal structures due to its late maturation. In this respect, the Suchey-Brooks (SB) system is one of the most commonly used methods of assessment based on the morphological characteristics of the pubic symphysis. However, the SB method has certain drawbacks, including frequently inaccurate estimation for individuals over 40 years old. The main aim of this work was to study the inter-observer agreement in the SB method then to test the errors of estimation by three observers with heterogeneous experience from a computed tomography sample for individuals aged between 15 and 98 years old. Patients and methods We retrospectively studied pubic bones from 50 males and 50 females undergoing clinical multislice computed tomography (MSCT) in a French hospital between November 2017 and April 2018. Results The inter-observer reliabilities, with or without the early and advanced patterns, were excellent between the observers (kappa values between 0.8 and 0.95). By focusing on the first three phases (I–III) versus the last three phases (IV–VI), there was no significant difference between the inter-observer reliabilities (kappa values between 0.44 and 0.85). Conclusion The inaccuracy rose with age, showing a growing underestimation from 40 years old and beyond. Besides, we highlighted a moderate overestimation for younger individuals. These errors of estimation were slightly dependent on the experience of the observer.

Summary Spatial data has been used to examine the distribution of intimate partner violence (IPV) against women in the city of Toulouse (France). The addresses of women who have consulted at the forensic unit has been geocoded and represented on a map. We geocoded 484 addresses. The Duncan dissimilarity index showed moderate segregation. Global Moran's I was present and positive and local Moran's I analysis reported ten hot-spots which were not superimposed on priority district delimitations. The results reveal a heterogenic distribution of IPV against women across the territory but no correlation with the poorest blocks as defined by priority districts. Spatial analysis offers an interesting approach to violence analysis and assessing the neighborhood environment.

Background The aim of this systematic review is to identify, in a comprehensive manner, the impact of lung cancer on the employment status of survivors. Methods The Preferred Reported Items for Systematic Reviews and Meta-analyses (PRISMA) statement was used as a formal guideline. The systematic review includes scientific papers published between January 2000 and October 2018. The search strategy queried the database MEDLINE. Inclusion criteria comprised: (1) inclusion of patients diagnosed with lung cancer (LC) (2); assessment of employment status or employment outcomes or work adjustments or return to work (3); inclusion of scientific papers published in peer-reviewed journals (4); inclusion of articles written either in English or in French. Literature reviews were not included. Results A total of 642 scientific papers were retrieved. Twenty-three articles were included in the systematic review: 5 longitudinal studies and 18 cross-sectional studies. LC survivors are 2–3 times more likely to be unemployed as compared with control groups. Previous studies highlight a median duration of sickness absence increased for LC survivors compared to control groups. The strongest decline in earnings was observed among LC survivors as compared to other cancer types. Conclusions LC is associated with a significant impact on employment of patients. The promising results of recent therapeutic strategies could lead to a better social and professional prognosis. A reduction of indirect costs is to be expected.

In forensic anthropology, the estimation of age at death is mainly required to establish a biological profile and facilitate individual identification. The Suchey–Brooks (SB) system represents one of the most commonly used and tested methods of assessment based on the morphological characteristics of the pubic symphysis. However, this method has certain drawbacks, including frequently inaccurate estimation for older individuals. The aim of this work was to test the evolution of pubic bone mineral density (BMD) according to age, especially for individuals over 40 years old. We retrospectively studied pubic bones from males (n = 88) and females (n = 113) over 40 years of age undergoing clinical multi-slice computed tomography (MSCT) in a French hospital between November 2017 and April 2018. The results revealed a significant negative correlation between BMD and age for males (R = −0.62) and females (R = −0.55). The intra- and inter-observer reliabilities of the phase allocation were moderate for males (kappa values at 0.72 and 0.65) and strong for females (kappa values at 0.93 and 0.86). Moreover, a significant difference in BMD between stages 6-1 and 6-2 for males was observed. We hypothesize that BMD might help improve the reliability of the SB system for older individuals. In addition to the pubic bone, numerous other anatomical regions such as the area of Ward could represent interesting areas of study in order to relate bone density to age.

Through a comprehensive review of the literature on sexual assault, the authors propose to clarify the different stages of the exam and help the practitioner to the forensic interpretation of lesions. The authors describe the basic principles that make consensus in how to interview victims in order to increase the reliability of the information collected. The various medical data that must be collected allowing to guide diagnosis (urogenital symptoms, sexual behaviour disorder) or facilitate the interpretation of lesions (age of puberty, use of tampons…) are specified as well as the different positions of examination and their association to other complementary techniques (Foley catheter, colposcopy, toluidine blue). The authors present a simple decision tree that can help the practitioner to interpret the laceration of the hymen. They detail the description and forensic interpretation of all genital lesions that may be encountered as a result of sexual assault, and the pitfalls to avoid. Finally, two main problems in the interpretation of lesions are described, the absence of injury after penetration and the accidental genital lesions.

Resume L’electrocution est une cause rare de deces. Peu d’articles decrivent les lesions anatomopathologiques dans les cas de deces par electrocution. Nous rapportons deux cas d’electrocution bien distincts tant sur le plan clinique que des conclusions finales. Pour chaque cas, les resultats de l’autopsie et de l’examen anatomopathologique sont decrits et la contribution des resultats de l’examen microscopique a la reflexion medico-legale est discutee. Le premier cas concerne une femme retrouvee morte a proximite d’un câble electrique de 380 volts non isole situe au sol. L’autopsie mettait en evidence des lesions suggerant une asphyxie et de multiples brulures cutanees evocatrices de brulures electriques. L’examen microscopique confirmait l’asphyxie mecanique au niveau pulmonaire et retrouvait des signes de brulure cutanee avec une metallisation epidermique. Cette derniere attestait le contact direct avec le câble. Le syndrome d’asphyxie mecanique etait evocateur de spasmes respiratoires dans le contexte d’ « electrocute bleu ». Le second cas concernait un jeune homme dont l’echelle a bascule sur une ligne haute tension de 20 000 volts. Il a fait l’objet de manœuvres de reanimation invasives avant de mourir a l’hopital. L’autopsie retrouvait des lesions cutanees a type de brulures electriques des membres superieurs et inferieurs. L’examen microscopique du cœur mettait en evidence des aspects ischemiques et hemorragiques ainsi que des lesions evocatrices de fibrillation ventriculaire (FV). Dans les deux cas presentes, l’examen anatomopathologique apportait des arguments qui, associes aux donnees de l’enquete et aux resultats de l’autopsie, permettaient d’emettre des hypotheses quant au mecanisme lesionnel.

International audience; Introduction: Among 800 burials dated between the 15th and 18th centuries and found in the center of Rennes (Brittany, France), a collection of five heart-shaped lead urns was discovered. This material was studied using classical methods (external study, autopsy and histology), and also modern imaging like computed tomography (CT), magnetic resonance (MR) before and after coronary opacification. The aim of this manuscript is to describe different steps of ancient soft tissues study, especially using imaging techniques.Methods: The study gathered various specialists: anthropologists, archeologists, forensic pathologists, radiologists, pathologic physicians, and physicists. Imaging techniques were performed, before and after coronary opacification. Finally, hearts were autopsied and different histological samples were analyzed.Results: Only heart n°2 was too damaged to be studied. Heart n°3 was considered as normal using all investigation techniques. The study of Hearts n°s 4 and 5 revealed dilated cardiomyopathy while Heart n°1 showed important signs of diffuse hypertrophic cardiomyopathy. Different fibro lipid plaques were identified using imaging techniques, and were confirmed by histology.Conclusions: The study of archeological soft tissues using modern imaging is possible if the material is well-preserved. This type of research can uncover principal findings, allowing scientists to establish diseases of ancient times.