RESUMO
OBJECTIVE: To evaluate the prevalence of sexual abuse in the pediatric population of the Federal District and discuss the difficulties in interpreting the examination of the genitalia in this age group, both by general practitioners as medical expert forensic officers. METHODOLOGY: This is a retrospective, transversal, and epidemiological study on children younger than 12 years, who attended the Institute of Forensic Medicine of DF (IML-DF), Brasilia, Brazil, with suspicion of sexual abuse between 2008 and 2009. RESULTS: During this period, 3607 persons with suspected sexual abuse and 1762 (48.8%) children younger than 12 years were treated in IML-DF. Of this total, 238 (13.5%) were boys, and 1524 (86.5%) were girls. Among the boys, the average age was 6.5 years, and 9.6% were found to have injuries consistent with sexual abuse. In 43.4% of these cases, the perpetrator was known. The main lesions found were anal fissures and lacerations, bruises, and anal dilatation. In 20 cases (8.4%), the time interval between fact and examination precluded any conclusion. The girls (1524 cases) referred to the IML-DF were subjected to two types of tests: libidinous acts (773 to 50.7%) and rape (751 to 49.3%). In tests of libidinous acts, 5.3% had signs of sexual abuse perpetrated by acquaintances (68.2%), and 3.0% were inconclusive because of the long time lag between the examination and fact. In survey of rape cases, only 2.1% of subjects examined had lesions consistent with abuse. In 57 of 1524 cases, specimens were sampled for sperm test, and five cases (8.7%) showed positive results. The average age of girls being sexually abused (10.7 years) was higher than that for boys (6.5 years). DISCUSSION: Our findings confirm the discrepancy between the expectations of parents and the general practitioner, and the reality of the findings in specialized centers. Approximately 90% of child victims of abuse do not show evidence of physical damage. These were found in less than 10% of abused children. Physical signs of abuse often are difficult to recognize and should not be the only indicators.
Assuntos
Abuso Sexual na Infância/estatística & dados numéricos , Genitália Feminina/lesões , Genitália Feminina/patologia , Genitália Masculina/lesões , Genitália Masculina/patologia , Distribuição por Idade , Canal Anal/patologia , Brasil , Criança , Abuso Sexual na Infância/diagnóstico , Contusões/patologia , Estudos Transversais , Dilatação Patológica , Feminino , Fissura Anal/patologia , Patologia Legal , Humanos , Lacerações/patologia , Masculino , Exame Físico , Estupro/diagnóstico , Estupro/estatística & dados numéricos , Estudos Retrospectivos , Distribuição por SexoRESUMO
Sperm detection can be an important factor in confirming sexual assault in cases of rape. A large number of cases received in a forensic laboratory involve sexual offenses, making it necessary to examine exhibits for the presence of seminal stains. The objective of this paper is to provide an overview of the most important methods and tests used in the identification of spermatozoa or constituents ofseminal fluid during the investigation ofalleged sexual assault cases in forensic medical practice. Furthermore, this paper focusses on the basic knowledge that is necessary to the graduate students who wish to specialize in forensic sciences.
La detección de esperma puede ser un factor importante a la hora de confirmar un ataque sexual en los casos de violación. Un gran número de los casos recibidos en el laboratorio forense tienen relación con ofensas sexuales, lo cual hace necesario examinar muestras de presencia de manchas seminales. El objetivo de este trabajo es proporcionar una apreciación global de los métodos y pruebas más importantes usados en la identificación de espermatozoos o constituyentes del fluido seminal durante la investigación de supuestos casos de ataque sexual, en la práctica médica forense. Además, este trabajo presta atención al conocimiento básico necesario para los estudiantes graduados que desean especializarse en las ciencias forenses.
Assuntos
Humanos , Medicina Legal , Delitos Sexuais , Fosfatase Ácida/análise , Estupro/diagnóstico , Análise do Sêmen , Esfregaço VaginalRESUMO
Sperm detection can be an important factor in confirming sexual assault in cases of rape. A large number of cases received in a forensic laboratory involve sexual offenses, making it necessary to examine exhibits for the presence of seminal stains. The objective of this paper is to provide an overview of the most important methods and tests used in the identification of spermatozoa or constituents of seminal fluid during the investigation of alleged sexual assault cases in forensic medical practice. Furthermore, this paper focusses on the basic knowledge that is necessary to the graduate students who wish to specialize in forensic sciences.
Assuntos
Medicina Legal , Delitos Sexuais , Fosfatase Ácida/análise , Humanos , Estupro/diagnóstico , Análise do Sêmen , Esfregaço VaginalAssuntos
Humanos , Masculino , Feminino , Estupro/diagnóstico , Estupro/prevenção & controle , Estupro/psicologiaAssuntos
Masculino , Feminino , Humanos , Estupro/diagnóstico , Estupro/prevenção & controle , Estupro/psicologiaRESUMO
En 2004 la Sociedad de Obstetricia y Ginecología del Norte y Noroeste del Conurbano de la Provincia de Buenos Aires (SOGIN), organizó una reunión de consenso de caracter multidisciplinario para la atención a estas víctimas. Se presenta el documento resultante de la reunión, y la metodología utilizada en su redacción.(AU)
Assuntos
Masculino , Humanos , Feminino , Estupro/diagnóstico , Estupro/legislação & jurisprudência , Protocolos Clínicos , Planejamento de Assistência ao Paciente , Vítimas de CrimeRESUMO
En 2004 la Sociedad de Obstetricia y Ginecología del Norte y Noroeste del Conurbano de la Provincia de Buenos Aires (SOGIN), organizó una reunión de consenso de caracter multidisciplinario para la atención a estas víctimas. Se presenta el documento resultante de la reunión, y la metodología utilizada en su redacción.
Assuntos
Masculino , Humanos , Feminino , Protocolos Clínicos , Vítimas de Crime , Planejamento de Assistência ao Paciente , Estupro/diagnóstico , Estupro/legislação & jurisprudênciaRESUMO
La violencia sexual es un problema social de grandes dimensiones que afecta de manera sistemática a un número significativo de personas de todos los sectores de nuestra sociedad. Este Protocolo de atención a personas en situación de violencia sexual busca dar respuestas a una de las necesidades en el campo de la atención a la salud de las personas víctimas de violencia sexual.
Assuntos
Humanos , Estupro/diagnóstico , Estupro/psicologia , Estupro/reabilitação , ParaguaiRESUMO
In an investigation of suspected rape, proof of sexual assault with penetration is required. In view of this, detailed descriptions of the genitalia, the thighs and pubic region are made within the forensic medical service. In addition, vaginal swabs are taken from the rape victim and some of the biological material collected is then transferred to glass slides. In this report, we describe two rape cases solved using DNA typing from cells recovered from vaginal smear slides. In 1999, two young women informed the Rio de Janeiro Police Department that they had been victims of sexual assaults. A suspect was arrested and the victims identified him as the offender. The suspect maintained that he was innocent. In order to elucidate these crimes, vaginal smear slides were sent to the DNA Diagnostic Laboratory for DNA analysis three months after the crimes, as unique forensic evidence. To get enough epithelial and sperm cells to perform DNA analysis, we used protocols modified from the previously standard protocols used for DNA extraction from biological material fixed on glass slides. The quantity of cells was sufficient to perform human DNA typing using nine short tandem repeat (STR) loci. It was 3.3 billion times more probable that it was the examined suspect who had left sperm cells in the victims, rather than any other individual in the population of Rio de Janeiro.
Assuntos
Impressões Digitais de DNA , Estupro/diagnóstico , Espermatozoides , Esfregaço Vaginal , Feminino , Humanos , MasculinoRESUMO
Na suspeita de casos de estupro, é necessária a realização de exames para constatar a prática do abuso sexual com penetração. Com esse objetivo, nos serviços de medicina legal, é realizada, entre outros exames, a feitura de esfregaços vaginais com a transferência do material biológico para lâmina. Neste trabalho, são descritos dois casos forenses, elucidados pela tipagem de DNA realizada a partir de células de esfregaço vaginal. Em 1999, duas jovens relataram ao Departamento de Polícia do Rio de Janeiro que haviam sido vítimas de abuso sexual. Um suspeito foi detido e apontado pelas vítimas como o agressor. Apesar das acusações, o suspeito alegou sua inocência. Com objetivo de elucidar os fatos, lâminas de esfregaço vaginal representando as únicas evidências biológicas dos suspeitosos casos de estupro foram enviadas ao Laboratório de Diagnósticos por DNA três meses após o crime. Os protocolos utilizados para recuperação celular e extração de DNA baseiam-se em técnicas preexistentes, porém adaptadas para se obter quantidade de DNA suficiente para realização das análises. A quantidade de células foi suficiente para a utilização da técnica de extração diferencial de DNA e sua tipagem por meio de 9 loci "short tandem repeats" (STR). A análise estatística mostrou ser 3,3 bilhões de vezes mais provável que o relatado suspeito seja o doador das células espermáticas encontradas no material biológico coletado das vítimas que qualquer outro indivíduo na população do Rio de Janeiro.