Intimate partner sexual violence (IPSV) is a common form of intimate partner violence (IPV). This study aimed to (a) identify a typology of intimate partner sexual victimization among French women ...victims of IPV on the basis of the frequency of various forms of sexual violence and (b) evaluate whether these profiles differ in several clinical characteristics. A total of 93 women consulting a specialized hospital service were recruited. Cluster analyses suggested four profiles: highly frequent rapes (5.4%), predominant sexual coercion (20.4%), medium frequency of all forms (20.4%), and low frequency of all forms (19.4%). Further person-centered research focusing on IPSV is warranted.
•Case of a 63-year-old cocaine body packer who died of an aortic dissection.•Cocaine impregnation causing high blood pressure might have played a role in the aortic dissection.•Case highlighting the ...need for blood pressure monitoring in patients with cocaine packets.
Body packing is defined as the ingestion of drug packets, to conceal them during transportation. We report the case of a 63-year-old cocaine body packer, who died from an aortic dissection. He was arrested in Paris as he disembarked from a flight from Cayenne (French Guinea) and custom officers found cocaine in his suitcase. The patient admitted the ingestion of cocaine packets. He was transferred to the hospital where an initial computerized tomography scan showed hyperdense, uniformly shaped packets located in the colon. On admission, his blood pressure was elevated but he did not exhibit any other signs of adrenergic syndrome. The diagnosis of chronic hypertension unrelated to the cocaine body packing was retained. During hospitalization, 40 h after the ingestion of the cocaine packets, the patient showed acute agitation, sweat and a high blood pressure. Given the context, an emergency thoraco-abdominal-pelvic CT-scan was carried out to rule out a cocaine leakage. None of the packets showed evidence of leakage but the CT-scan assessed an aortic dissection extending to the entire descending aorta. Despite intensive care, the patient passed away on the fifth day. This aortic dissection could have appeared spontaneously in a patient with significant atherosclerosis lesions of the aortic network. Nevertheless, we believe that cocaine impregnation causing high blood pressure might have played a role in the aortic dissection, even without a cocaine leakage from the packets. This case highlights the need to achieve an effective control of the blood pressure in cocaine body packers.
The main aims of a medico-judicial unit are to ensure the examination of assault victims or persons in custody and to perform sampling necessary for investigations. Forensic examination is essential ...to describe the wounds and to evaluate the consequences of an assault by determining days of total incapacity for work (ITT). After the Paris attack on November 13, 2015, 121 victims were examined at the medico-judicial units of Paris. An initial forensic certificate was issued by forensic physicians with an assessment of physical ITT. A consultation with a forensic psychiatrist was systematically scheduled on the same day to obtain a forensic certificate for the psychological ITT. The average age of the victims was (33 ± 7) years and the sex ratio was 1.26. Most victims were in the Bataclan concert hall (78/121 or 64.5%). Of the 121 victims, 73 (60.3%) had projectile lesions (bullets, bolts and nuts, metal fragments, etc.) and 48 (39.7%) had non-projectile lesions (bruises, hematomas, etc.). The average physical ITT was 27 days (0; 190). The evaluation of the number of days of physical ITT was often complicated as some patients were still in medical care at the time of the initial examination. This experience enabled the Paris medico-judicial unit to anticipate the management required should any future event of this magnitude occur. It also reinforced cooperation between the medico-judicial unit and other departments, mostly emergency services and the forensic psychiatric unit. The Paris medico-judicial unit was thus able to offer a unique place of care by providing both physical and psychological examinations.
Because of availability and low radiation dose level, low dose computed tomography (CT) is now commonly used to identify illicit in corpore drug transportation. This review illustrates the most ...common CT findings of in corpore drug transportation and describes complications due to in corpore drug transportation, with a special emphasis on low dose CT. Major information such as number of packets, exact location and aspect of packets must be assessed. Radiologist must be aware of the imaging characteristics of “in corpore” illicit drug transportation, and should know situations that may alter drug smugglers management.
•Low dose CT is commonly used to identify in corpore drug transportation.•While drug packets are mainly hyperdense on CT, they can sometimes have a lower density.•Sagittal and coronal reconstructions, as well as three-dimensional rendered views are often helpful to detect hyperattenuating drug packets•If too many packets are located in the stomach, the patient should be transferred to intensive care unit for surveillance because of a high risk of rupture.
Sexual violence is a common and under-reported form of violence that affects all categories of individuals. We sought to provide epidemiological data on men aged 15 years and over, victims of rape or ...suspecting a rape, and who reported it to the police. We conducted a retrospective study at the Department of Forensic Medicine of Hôtel-Dieu, Paris, France, between 2018 and 2021. Two-hundred men were included in the study, with an average age of 28.8 years. A vulnerability was mentioned for 17.5% of them. Most of the patients reported anal penetration, committed by a single male assailant, whom they met on the day of the assault. More than 60% of the patients reported the voluntary consumption of alcohol and/or illicit substances prior to the assault. Most patients were examined shortly after the assault (median 1 day). Anal lesions were found on examination in 37.0% of patients reporting anal penetration regardless of the time frame. The presence of anal lesions was statistically higher when patients were examined within 48 h. Our results reinforce the data in the literature on the risk factors associated with sexual violence among men, notably the consumption of alcohol and illicit substances, and psychological, economic, and social vulnerability.
Introduction
Proactive drug facilitated crime (DFC) is the administration of psychoactive substances (PAS) for criminal purposes without the victim’s knowledge or by force. In Paris, France, patients ...who report suspected proactive DFC to the police are examined at the Department of Forensic Medicine (DFM) of the Hôtel-Dieu Hospital. Preventively blood and urine samples are collected but not systematically analyzed by the judicial authority. We aimed to assess the proportion of probable proactive DFC in patients examined at the Hôtel-Dieu DFM following a police report for suspected proactive DFC.
Method
Blood and urine samples were collected from 100 patients. Toxicological analyses were performed by the toxicology laboratory of the Lariboisière Hospital. The results were correlated with the clinical data collected at the initial and follow-up consultations.
Results
At least one PAS was detected in 86% of the cases (voluntary or involuntary intake). After correlation with clinical data, 32% of the cases were classified as probable proactive DFC. In these cases, 49% of the substances identified were illicit substances (amphetamines, MDMA, etc.); 16% were benzodiazepines and related substances; 16% were antihistamines and sedatives; 14% were opioids; and 5% were antidepressants and anti-epileptics. In 90% of the cases, patients reported a voluntary ethanol consumption in the hours prior to the suspected proactive DFC.
Conclusion
Toxicological analyses revealed a high proportion of both probable proactive DFC and probable opportunistic DFC. Our results indicate the need to perform systematical toxicological analysis in cases of suspected DFC.
La prostitution des mineurs est un phénomène mal connu, alors que les institutions et les associations constatent son augmentation et son évolution. Aucune donnée statistique française n’est ...actuellement disponible dans la littérature scientifique pour évaluer son ampleur. Cet article a pour objectif d’effectuer une revue de la littérature des publications internationales s’intéressant à la prévalence de ce phénomène dans les pays à revenu élevé.
Une recherche par mots-clés sur des bases de données de publications scientifiques a été réalisée concernant des articles sur l’évaluation des pratiques prostitutionnelles chez les mineurs, publiés de 2000 à 2020, dans les pays à revenu élevé selon la classification de la Banque mondiale.
Onze études originales ont été sélectionnées, provenant de pays scandinaves (Suède et Norvège), d’Amérique du Nord (États-Unis et Québec), de Suisse et de Hong Kong, interrogeant entre 815 à 15 197 participants âgés de 12 à 26 ans. Elles évaluent un taux de prévalence en population générale de vente de services sexuels contre une rémunération compris entre 0,2 % et 4,9 %, et d’achat de services sexuels contre une rémunération compris entre 2 % et 3 %. Ces études précisent la prévalence par âge et sexe, l’âge de début des pratiques prostitutionnelles, la fréquence des échanges sexuels, ainsi que la prévalence en population adolescente à risque psychosocial spécifique.
Ces études utilisent des méthodologies différentes et révèlent parfois des résultats contradictoires, notamment concernant les taux de prévalence entre garçons et filles. Ces données révèlent une évolution des pratiques prostitutionnelles chez les mineurs qui rapportent moins de mises sous contrainte. Les limites de ces études sont discutées. Des recommandations pour mener de futures recherches sont formulées.
Cette revue de littérature met en exergue la faible quantité de recherches estimant la prévalence de la prostitution des mineurs au niveau international et l’absence de données concernant la France. Elle révèle la nécessité de réaliser des enquêtes épidémiologiques auprès des adolescents sur le territoire national, afin de mieux comprendre et mieux prévenir ce phénomène.
Child and adolescent prostitution is a phenomenon little known, despite the observation by institutions and associations of its increase and its evolution. No French statistical data is currently available in the scientific literature to assess its magnitude. The objective of this article is to review the literature of international publications interested in the prevalence of this phenomenon in high-income countries.
A keyword search on databases was carried out from January to May 2021 for articles on the evaluation of child and adolescent prostitution, published from 2000 to 2020, in high income countries according to the World Bank classification.
Eleven original studies were identified, from Scandinavian countries (Sweden and Norway), North America (United States and Quebec), Switzerland and Hong Kong. They estimate a prevalence rate in the general population of the sale of sexual services for remuneration of between 0.2% and 4.9%, and of the purchase of sexual services for remuneration of between 2% and 3%. These studies specify the prevalence by age and sex, the age of the first sexual exchanges, the frequency of sexual exchanges, and the prevalence in adolescent population at specific psychosocial risk.
These studies use different methodologies and sometimes reveal contradictory results, in particular concerning the prevalence rates between boys and girls. These data reveal an evolution of prostitution practices among minors who report fewer forced under duress. The limitations of these studies are discussed. Recommendations for further research are made.
This literature review highlights the small amount of research estimating the prevalence of child and adolescent prostitution at the international level and the lack of data for France. It reveals the need to carry out epidemiological surveys among adolescents on the national territory in order to better understand and better prevent this phenomenon.
The population of people in police custody is a sentinel niche that is poorly represented in the "usual panels" of public health studies. The aim is to make an overview of their diversion of drugs.
A ...retrospective study based on cases of misuse in a sample of people in custody examined between 2015 and 2016 at the forensic medicine unit of the hospital Hôtel-Dieu-Paris.
Of the 5149 medical examinations, 302 were for substance use disorder or drug misuse. In 2016, the number of notifications for misuse of clonazepam increased (n=65); the user population appears to be getting younger (average age=23.5 years) and to be supplied mainly by deal (63%). Regarding opioid substitution treatments, the indicators of abuse and diversion are confirmed, while morphine sulfate stands out with a strong deal (>75%), IV injection (62%) and polydrug use, including methadone, cocaine (62%).
From our results, national surveys in general population and studies carried out in the context of deprivation of liberty, people in police custody constitute a real barometer of the parallel market for street drugs. Clinical impacts can be major; a better monitoring is needed. For caregivers, it is also a matter of better identification of misuse, substance use disorder for a future orientation of the patient.
Purpose
The purpose of this paper is to give an overview of management of the COVID-19 epidemic in a French immigration detention center.
Design/methodology/approach
During containment in France ...because of COVID-19, the judicial authorities had to deal with the risk of contamination within immigration detention centers (IDC). In the Paris IDC, which can usually receive up to 240 individuals, measures have been taken to limit the risk of contamination by releasing individuals without prior judicial conviction and testing the others by a nasal swab.
Findings
The test was done for all the present individuals (48), except two who refused. Eight tests (17.4%) were positive and only one was symptomatic. Individuals testing positive for COVID-19 were transferred into COVID-centers specially created during this health crisis.
Originality/value
Management of the COVID-19 epidemic in this French IDC illustrates the necessity of good cooperation between judicial authorities and medical teams in charge of those centers and the difficulty of balancing public health actions with state security.
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