Notiuni Generale de Medicina Legala - Curs Universitar

8/17/2019 Notiuni Generale de Medicina Legala - Curs Universitar

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CUPRINS

CAPITOLUL IDEFINIŢIA, PREOCUPĂRILE, ISTORICUL ŞI

ORGANIZAREA REŢELEI DE MEDICINĂ LEGALĂ ……………………………….41. Istori…………………………………………………………………………...4!. D"#i$i%i", &r"o'&(ri )i or*+$i+r"+ r"%"-"i " /"ii$( -"*+-( ………….0

CAPITOLUL IITANATOLOGIA MEDICO LEGALĂ………………………………………………...2

1. D"#i$i%i"……………………………………………………………………… 2!. C-+si#i+r"+ /or%ii. Mo+rt"+ s'3it(……………………………………….....15. Et+&"-" /or%ii…………………………………………………………………11

4. S"/io-o*i+ t+$+to-o*i( 6$"ro&si+7……………………………………….1!0. Pro3-"/" 8'rii" +-" st(ri-or t"r/i$+-"…………………………………….!1

CAPITOLUL IIITANATOMORFOLOGIE………………………………………………………………!1

CAPITOLUL I9RAPORTUL DE CAUZALITATE MEDICO LEGALĂ……………………………..!4

CAPITOLUL 9TRAUMATOLOGIA MEDICO LEGALĂ…………………………………………...!0

1. A*"$%i tr+'/+tii /"+$ii…………………………………………………..!:!. L"i'$i tr+'/+ti" &ri/+r"…………………………………………………..!;5. R"+%i+


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2. L"i'$i )i /o+rt"+ &ri$ +r/" " #o………………………………………….01. As#i>ii /"+$i"……………………………………………………………..…021.1. S&?$'r+r"+………………………………………………………………..….:11.!. Ştr+$*'-+r"+…………………………………………………………………...:5

1.5. S'*r'/+r"+…………………………………………………………………….:41.4. Co/&r"si'$"+ tor+o +3o/i$+-(…………………………………….…:41.0. S'#o+r"+……………………………………………………………………..:01.:. O3str'%i+ (i-or r"s&ir+torii…………………………………………………::1.:.1. $"'-……………………………………………………………………..…::11. L"i'$i-" )i /o+rt"+ &ro's" &ri$ +*"$%i #iii…………………………..…..:@11.1. 9+ri+%ii " t"/&"r+t'r(………………………………………………………:@11.1.1. L"i'$i-" )i /o+rt"+ &ri$ t"/&"r+t'r( =$+-t(……………………………:@11.1.!. L"i'$i-" )i /o+rt"+ &ri$ #ri*………………………………………………;

11.!. L"i'$i-" )i /o+rt"+ &ri$ "$"r*i" "-"tri(…………………………….…..;!11.5. L"i'$i-" )i /o+rt"+ &ri$ io-o*i" /"io -"*+-(7…………………….;01!.1. To>i" /"tB"/o*-o3i$i+$t"…………………………………………..….;;1!.!. I$to>i+%i+ ' CO……………………………………………………………;;1!.5. I$to>i+%i+ ' +-oo- "ti-i……………………………………………..…...;;1!.4. I$to>i+%i+ ' CN )i "rii+%i+ ' &"stii" or*+$o #os#ori"……………………………….;21!.:. I$to>i+%i+ ' &"stii" or*+$o -or'r+t"……………………………….;21!.;. I$to>i+%i+ ' +$ti*"-……………………………………………………..…;21!.@. I$to>i+%i+ ' o&i+"" 6o&i'-7………………………………………………@1!.2. Co+i$+……………………………………………………………………… @1!.1. I$to>i+%i+ ' 3+r3it'ri"……………………………………………….…@1!.11. I$to>i+%i+ ' s'3st+$%" +'sti" ………………………………………...@15. A*"$%i tr+'/+tii 3io-o*ii………………………………………………..…..@1

15.1. L"i'$i "t"r/i$+t" " +$i/+-"……………………………………………@115.!. L"i'$i "t"r/i$+t" " r"&ti-"……………………………………………...@!

CAPITOLUL 9IPRUNCUCIDEREA…………………………………………………………….…@0:.1. E>+/"$'- /"io -"*+- +- +++/"$'- /+/"i…………………………………………………………….@::.5. E>+/"$'- -o'-'i #+&t"i………………………………………………………@:

2


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CAPITOLUL 9IIPROLEME DE OSTETRICĂ GINECOLOGIEMEDICO LEGALĂ……………………………………………………………...@;

CAPITOLUL 9IIISEOLOGIE MEDICO LEGALĂ………………………………………….....@[email protected]. 9io-'-………………………………………………………………………….@2

CAPITOLUL IEPERTIZA MEDICO LEGALĂ A FILIAŢIEI……………………………....2

CAPITOLUL SIMULAREA ŞI DISIMULAREA………………………………………….…....25

CAPITOLUL IEPERTIZA MEDICO LEGALĂ PSIIATRICĂ…………………………....2011.1. E>&"rti+ /"io -"*+-( -+ /i$ori………………………………….…2@11.!. E>&"rti+ /"io -"*+-( )i r"*i/'- 8'rii =$ +-oo-is/…………….2@

CAPITOLUL IIELEMENTE DE DEONTOLOGIE MEDICALĂŞI RĂSPUNDERE PROFESIONALĂ…………………………………………11!.1. C'-&+ /"i+-(………………………………………………………..….111!.!. M+-&r+>is'- /"i+-…………………………………………………..….15

CAPITOLUL IIIGENETICĂ MEDICO LEGALĂ……………………………………………..1415.1. Str't'r+ /o-"'-+r( + ADN'-'i $'-"+r……………………………..1415.!. Or*+$i+r"+ ADN'-'i $'-"+r………………………………………….1;15.5. T"B$ii " +$+-i( + ADN'-'i =$ &r+ti+ /"io -"*+-(……….…1@

15.4. T"B$ii-",/"to"-" " &r"-"


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CAPITOLUL 9ENTOMOLOGIA MEDICO LEGALĂ ………………………………………..1!5

CAPITOLUL 1DEFINIŢIA, PREOCUPĂRILE, ISTORICUL

ŞI ORGANIZAREA REŢELEI DE MEDICINĂ LEGALĂ

1. ISTORICM"ii$+ -"*+-( "st" o s&"i+-it+t" /"i+-( +r" +&-i( &ri$i&ii-" si

/"too-o*i+ )tii$%"-or /"i+-" -+ o/"$i'- 8'rii 6s" +#-+ -+ *r+$i%+ i$tr" /"ii$+si )tii$%"-" 8'rii"7. E+ 'r/(r")t", i$ i$t"r"s'- 8'sti%i"i, s+ o3i"ti


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Pri/'- tr+t+t " /"ii$+ -"*+-+ =- *(si/ i$ s". 9I *r+ti" -'i A/3rois"P+r", +r" tr+t"+( "s&r" r($i /ort+-", +s#i>ii, /or%i s'3it", i$to>i+%ii, i+r i$ s".9II P+'-o Z+Bi+ "-+3or"+( o o&"r+ i$ 1


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I$ Ro/?$i+, r"%"+'+ " /"ii$+ -"*+-+ "st" or*+$i+t+ -+ $i&"rti" /"io-"*+-" is&'s" " or*+$"-" "'r/(rir" &"$+-+ s+' i$st+$%"-" 8'"(tor")ti, &r"'/ si =$ +'ri-" " "#ii"$t"&ri


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S"r&"rti"/"io-"*+-" &siBi+tri"

37 "#"t'"+( ori" +-t+ ">&"rti+ s+' o$st+t+r" /"io-"*+-+, =$ +'- =$ +r" s" +&r"i+( + +"+st+ $' &o+t" #i "#"t'+t+ " +3i$"t'- " /"ii$+-"*+-+

7 "#"t'"+(, ' &-+t+, ">+/i$(ri /"io-"*+-", -+ "r"r"+ &"rso+$"-ori$t"r"s+t", &r"'/ si ori" +-t" -'r(ri /"io-"*+-", ' ">"&%i+ "-or +r" i$tr+ =$

o/&"t"$t+ +3i$"t'-'i " /"ii$+ -"*+-+7 "#"t'"+( $oi ">&"rti" /"io-"*+-", ' ">"&%i+ "-or +r" i$tr+ =$

o/&"t"$t+ i$stit't"-or " /"ii$+ -"*+-+"7 &'$ -+ is&oi%i" +t"r"-or " /"ii$+ -"*+-+ i$ '$i


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• E>+/i$(ri /"io -"*+-" + -"i'$i-or tr+'/+ti", +&r"i"r"++&+it(%ii " /'$( s+' + st(rii " s($(t+t" +


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0. +&r"i"r"+ *r+


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I$ 'rs'- ist+ it"r$

+s'&r+ or*+$is/'-'iJ si$'i"ri, +i"$t" )i o/'i"ri.L+ -i/it+ i$tr" /o+rt"+


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• I$st+-+r"+ "i &o+t" s( #i" s+' $' &r""+t( " +'" &r"+-+3i-"+t'$i ?$ +"st"+ ">ist(, "-" s'$t /i$or" )i $"s&"i#i".

• L+ +'to&si" s" r"-"


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F*$!"! ('ni!iJ• Co$)ti"$t( s+' -'i(,?$ i$i+/i$+r"+ ++


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/iri+( #i>( $' r(s&'$" -+ sti/'-ii -'/i$o)i. is&+ri%i+ s"$si3i-it(%ii o3i"tit"rior s&r" i$t"rior,o$"-""so&"rit" r(i$'s" /+i ')or. S" +/it" (,=$ +'- '$'i ++i/+ti< 10 *r+", r(ir"+ s" #+" ' 1 *r+or+ =$&ri/"-" 4 or" +&oi ' ! *r+"or(. Di('nsti%" #! $(*t! *!("& s! 4n! (tn%i

%:n# t!$4!*(t*( int*(*!%t("& !st! #! 2;; C.A&r"i"r"+ i$t"r 20 5! 1 C 55,@ F "sBir+t+r"+ ++


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5. faza de imbibiţie – "+ /+i /+r" &+rt" + s?$*"-'i s" +#-( =$ %"s't'ri,+&+r -+ ! !4 or" " -+ ""s,i$t"r


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Fi*. !• U$"ori ori"$t"+( +s'&r+ +'"i /or%iiJ =$ i$to>i+%i+ ' o>i "

+r3o$ s+' ' i+$'ri s'$t ro)ii +r/i$, =$ i$to>i+%i+ ' $itri%i s'$t 3r'$".• Ri*iit+t"+ ++


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• " i$st+-+r", +&+r" -+ 15 or" " -+ ""s, i$i%i+- -+ /')Bii/+sti+tori )i /')Bii "#"i, &"$tr' + '-t"rior s( s" ">ti$( =$ s"$s "s"$"$t )i"-"-+-t" *r'&" /'s'-+r" " #+&t ri*iit+t"+ '&ri$" to+t" *r'&"-" /'s'-+r" +r"st" /+i "t"$sori.• A'to-i+ ++


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47. P+t+


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• 1 s(&t(/?$( =$ +"r "Biio-o*i "#"t'+t &" /+t"ri+-'-++


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Fi*. @• P"tri#i+r"+ 6#i*.27 +r" + s'3str+t &ro"s'- " /i$"r+-i+r"

&ost/ort"/6' s(r'ri " +-i'7 +&+r" =$ s&"i+- -+ #"%ii /or%i )i r"t"$%io$+%ii$tr+'t"ri$.

Fi*. 2• Co$*"-+r"+ ++


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r"&r""$t+t s+' -i&s")t". D" r"*'-( s+&o$i#i+r"+ +&+r" =$ o$+ +r" "st" =$ o$t+t' +&+ 6#i*. 17,"-"-+-t" &(r%i +-" or&'-'i


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/"io-"*+-( 6si$o$i/( ' $"ro&si+7. A"+st+ o$st( =$ ">+/i$+r"+o/&-"t(,">t"r$( )i i$t"r$(,/+roso&i( )i " -+3or+tor + ++i-i+r63r+$+ri"r7. $ '$"-" sit'+%ii -++'to&si" &ot &+rtii&+ /+i /'-%i -"*i)ti, /+i +-"s +t'$i ?$ "st" ist( o

+$'/it( &"rio+( " ti/&• /o+rt" " +'( $"'$os't(s's&"t(• ""s" +&(r't" =$ +$'/it" sit'+%ii, '/ +r #iJ ""s s'rB'/(ri.

D+t"-" o3%i$'t" s'$t =$sris" " /"i'- -"*ist =$ os+r'- " AML.

22


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S&r" "os"3ir" " AML, $"ro&sii-" "#"t'+t" =$ s"r&r"s( + #+/i-i"i.

At!n/i!• Ni%i ($i"i( #!%!#(t"i i ni%i 4!*sn("" $!#i%(" n 4(t!

(%*#( Hs%ti*! #! (t4si! n %(5" AML• În %i*%$st(n/!"! n %(*! AML !st! 0"i'(t*i!, n s! 4(t!

!!%t( (t4si! n s!*+i%ii"! #! (n(t$i! 4(t"'i%&• D(%& n %*s" n!i AML !!%t(t! n s4it(", $!#i%"

(n(t$4(t"' %nst(t& !3ist!n/( n* !"!$!nt! %(*! n%(#*!(5& %(5" nsit(/ii"! %(*! i$4n !!%t(*!( n!i AML, (%!st( !st! 0"i'(t s& 4*!(s%&

(t4si( i s& (nn/! *'(n!"! #! %!*%!t(*! 4!n("&. A-t" "os"3iri =$tr" AML )i "+ +$+to/o&+to-o*i(J- "r"t+r"+ $"ro&ti( "st" /+i o/&-">( =$tr'?t i/&'$" $""sit+t"+

'$or ">+/"$" o/&-"/"$t+r" " -+3or+tor ' so&'- " + i"$ti#i+ =$ #i$+- +'+">+t( + /or%ii

- AML s" "s#()o+r( &" ori" ti& " ++t"rio+r( )i i$t"rio+r( + +++/"$" " -+3or+tor.E>+/"$'- ">t"r$ i/&-i(, '&( i"$ti#i+r"+ +++/"$'- i$t"r$ &r"s'&'$" "sBi"r"+ t't'ror +


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E>+/"$"-" " -+3or+tor o$stit'i" o "t+&( "isiio-o*i",s"ro-o*i", /iro3io-o*i", t+$+toBi/i", r+io-o*i". R"o-t+r"+ &ro's"-or3io-o*i" "st" '$ /o/"$t i/&ort+$t " +r" "&i$" =$ /+r" /(s'r( r"'-t+t'- #i$+-.

Pr"-"+/i$+r" +++B'/+r" +r" "st" r"*-"/"$t+t(&ri$ +rt. 1@: CPP, +r" +r+t( (J

- +-i$.1 ">B'/+r"+ &o+t" #i is&'s( " (tr" &ro'ror s+' " (tr"i$st+$+ " 8'"+t( =$ "'t( =$ &r""$+ or*+$"-or " 'r/(rir"

&"$+-(St(0i"i*!( #(t!i $*/ii 9T(n(t%*n"'i()Fr"


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L"*(t'r+ " +'+-it+t" "st" o $o%i'$" " ">&ri/( or"-+%i+6"&"$"$%+7i$tr" tr+'/+tis/ )i &r"8'ii'- *"$"r+t6-"i'$" tr+'/+ti( s+' ""s7' +-t"'


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A'!nt t*($(ti% ori" s'3st+$%( 6so-i(,-iBi(,*+o+s(7s+' #or/( ""$"r*i" 6$+t'r+-( s+' +rti#ii+-(7+r" +%io$?$ +s'&r+ or*+$is/'-'i '/+$ &o+t"&ro'" -"i'$i tr+'/+ti".

As'&r+ or*+$is/'-'i '/+$ &ot +%io$+ /+i /'-t" ti&'ri " +*"$%i

tr+'/+tii,+r" &ot #i -+si#i+%i '&( /+i /'-t" rit"riiJ• A*"$%i tr+'/+tii /"+$iiJ or&'ri o$to$"$t"or&'ri 'r".• A*"$%i tr+'/+tii #iiiJ


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• C' s'&r+#+%+ &-+$(Jtri'$*Bi'-+r(,&(tr+t(,"t.

• C' s'&r+#+%+ 'r3(,i-i$ros#"ri(.• $ #'$%i" " r"-i"#'- s'&r+#"%"i " i/&+tJ

• C' s'&r+#+%+ $"t"(r"*'-+t(• C' s'&r+#+%+ r'*o+s(

$"r"*'-+t(,o-%'ro+s(.• $ #'$%i" " i/"$si'$i-" s'&r+#"%"i " i/&+tJ

• C' s'&r+#+%( /i(6s'3 1: /!7.• C' s'&r+#+%( /+r"6&"st" 1: /!7.

• O3i"t"i$str'/"$t"+r/" +s'%it" 6"$'/it" )i +r/" +-3"7J• O3i"t" =$%"&(to+r", '


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• Tr+'/+tis/" " tr+#i r'ti"r,#"rot"r$" s+'

"-"/"$t+r". -"i'$i tr+'/+ti" sist"/i" " i$t"r"s"+( #i"+r" sist"/ +- or&'-'i

'/+$. -"i'$i to&o*r+#i",-o+-i+t" =$ +$'/it" o$" s+' r"*i'$i +$+to/i".

#eziuni traumatice e$terne: +"st" -"i'$i r"&r"i$t( /oi#i+r"+ +r"+&+r" -+ $i&-i+t( &ri$tr'$ /"+$is/


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tr+'/+ti +r" -"+ &ro's. Lo+-i+r"+ -or i$i( +$'/it" ir'/st+$%" "&ro'"r"J =$ r"*i'$"+ "#+-i(, "Bi/o" o


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+- or*+$is/'-'i,' &osi3i-it+t"+ &(tr'$"rii *"r/"$i-or &+to*"$i. A"st" -"i'$i s"


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• P-+*+ t(i+t(J "st" &ro's( " o3i"t" ' -+/( +s'%it(6t(i"to+r"7&ri$tro +%i'$" o/3i$+t( " +&(s+r" +-'$"+r" &" s'&r+#+%+ t"*'/"$t+r(.P-(*i-" t(i+t" &ot #iJ -i$i+r",?$ +*"$t'- +%io$"+( &"r&"$i'-+r &" t"*'/"$t, &ot #i-+/3o', ?$ +%io$"+( o3-i +s'&r+ t"*'/"$t'-'i )i ' +/&'t+r" + '$'i #r+*/"$t

" /"/3r', + 'r"Bii, "t. C+r+t"ristii-" '$"i &-(*i t(i+t" s'$tJ /+r*i$ir"*'-+t",$"t"",&"r"%ii s'$t $"t"i,'$*Bi'ri-" s'$t +s'%it",#ii$ /+i &ro#'$" -+"3't6+&'- &-(*ii7 #+%( " &+rt"+ #i$+-( 6o+( " )ori"-7, +r" r"&r"i$t( o -"i'$"tr+'/+ti( s'&"r#ii+-( t"r/i$+-(. A"+st( -"i'$" tr+'/+ti( i$i( ir"%i+ "+%i'$" + +*"$t'-'i tr+'/+ti. D" +s"/"$"+ +?$i/"+ &-(*ii "st" " r"*'-( /+i/i( "?t -'$*i/"+ s+ 't+$+t(.

• P-+*+ t(i+t(=$%"&+t(J "st" "- /+i #r"


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• oau$area – B"+*'ri-" " s?$*" +r" s" #or/"+( =$ ti/&'-


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-"i'$i tr+'/+ti" s+' +#"t+r"+ s($(t(ii '$"i &"rso+$", +r" +' $""sit+t&"$tr' &ri/( =$ *r+" i '$o+t" 5 *r+"J &ri/"-" ! *r+" I i IIs" r"#"r( -+ &i"r"r"+ tot+-( s+' +&ro+&" tot+-( + +&+it(ii " /'$( 6i#"r"$+"st" +t( " i$soitor'- $""s+r &"$tr' *r+'- I7, i *r+'- III +r" s" r"#r( -+s("r"+ +&+it(ii " /'$(.

E>&"rti+ /"io -"*+-( =$ +"st" +'ri tr"3'i" s( '&ri$( 'r/(to+r"-"o3i"ti


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+r" r"&r"i$t( tot')i '$ &r"8'ii' i/&ort+$t "st"ti ' to+t" ( /oi#i+r"+ $' s"-i/it"+( -+ #+%(.

Di+*$osti'- " s-'%ir" s" o$#ir/( =$ /o/"$t'- =$ +r" to+t" /"to"-"t"r+&"'ti", " Bir'r*i" &-+sti( )i r"&+r+tori" +' #ost "&'i+t".

U$ +-t +s&"t " +r" tr"3'i" s( s" %i$( s"+/+ =$ +&r"i"r"+ +r+t"r'-'i "s-'%ir" (- o$stit'i" )i '$"-" rit"rii -"*+t" " "- ">&"rti+t )i +$'/" s">'-,


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&ot"$%i+-'- " &"ri'-oit+t" +- '$"i -"i'$i, r"s&"ti< " /o'- o3i)$'it " "ist"$t"7 +t+ tr+'/+tis/'-'i /"+$is/'- " &ro'"r" 'r+t+ =$*ri8iri-or /"i+-" &r"i+r"+ s"B"-"-or.

$ #'$%i" " /"+$is/'- " &ro'"r", #r+t'ri-" s" =/&+rt =$J

ir"t", ?$ iso$ti$'it+t"+ +&+r" -+ -o'- " i/&+t i$ir"t", ?$ +"st"+ +&+r -+ ist+$%( " -o'- " i/&+t. S" &ot &ro'"

&ri$ #-">i", r(s'ir", ?$ +&+r #r+t'ri s&iroi" )i tr+%i'$" s+' s/'-*"r", ?$ s"&ro' "- /+i "s #r+t'ri &+r"-+r".

C-+si#i+r"+ #r+t'ri-or s" /+i #+" =$ #'$%i" " s"i' 6"&i#i+r", i+#i+r",i$tr++rti'-+r", i+#io "&i#i+r"7 s+' " +s&"t'- /or#o-o*i +r" '&ri$"J #r+t'rii$o/&-"t", #r+t'ri o/&-"t" 7si/&-", /'-ti&-", o/i$'titr"/it(%ii "#+-i" &ot #i i


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*rosi/" +&ro>i/+ti< "*+-(, ' s'&r+#+%+ ">o )i "$or+$i+$ r"-+ti< $"t"(, #(r(+s&"rit(%i i/&ort+$t"

• ++ r+$i+$( 6#i*. 157#or/+t( i$ o+s" s'3%iri )i i$ o+s"&$"'/+ti" "st" i


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L"i'$i-" tr+'/+ti" s'$t r"&r""$t+t" =$ s&"i+- &ri$ #r+t'ri, -'>+%ii-" s'$tr+r" )i +&+r =$ s&"i+- -+ o&iii /ii &?$( -+ o$so-i+r"+ -or oso+s(.

Fr+t'ri-" r+$i"$" &ot #i ir"t" s+' i$ir"t", -o+-i+t" -+ 3+( s+' -+3o-t+ r+$i+$(J

1. #r+t'ri-" ir"t" +-" 3+"i r+$i"$" &ot #i /"i+t" s+' i/"i+t". C"-"i/"i+t" +&+r +t'$i ?$ +*"$t'- tr+'/+ti -o"/&-'-o


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D+( i/"$si'$"+ +*"$t'-'i tr+'/+ti "st" '&ri$s( =$tr" 4 1: /!,+&+r" o #r+t'r( o/i$'ti


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B"/+to/ "st" ">-'si< tr+'/+ti(, #ii$ =$so%it( " #r+t'ri r+$i"$". Lo+-i+r"+#r"tr+'r+-, +r ' -o+-i+r" i#"rit(, =$


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Fi*. 1;• "/+to/'- s'3+r+B$oii+$ "st" sit'+t =$tr" s+' s'3 str+t'ri-"

/"$i$*"-'i. Ar" "tio-o*i" tr+'/+ti( s&r" "os"3ir" " B"/or+*i+ s'3+r+B$oii+$(,+r" "st" $"tr+'/+ti( #ii$ o$s"i$%+ r'&t'rii '$'i +$"


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C"r"t+r"+ #i-i+%i"i "st" -"*i#"r+t( &ri$ Co'- F+/i-i"i. Co&i-'- $(s't =$+#+r+ (s(tori"i, o$#or/ Co'-'i F+/i-i"i, +r" +"-"+)i r"&t'ri ' "- $(s't =$ti/&'- (s(tori"i, ' o$i%i+ + &+t"r$it+t"+ s(i #i" r"'$os't(.

R"'$o+)t"r"+ &+t"r$it(%ii s" #+" &" ! (iJ- -+ o#ii'- " st+r" i&"rti( &o+t" ">-'" &+t"r$it+t"+ '$'i 3(r3+t #+%( " '$+$'/it o&i-, +r $iio+t( $' o &o+t" +#ir/+. C' ?t $r. " ">&"rti" "st" /+i /+r"' +t?t )+$s"-" " + st+3i-i &+t"r$it+t"+ "st" /+i /+r"..

$ 'r/+ i$


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R"&r"i$t( &ri/'- sist"/ +$ti*"$i "so&"rit, #o+rt" i/&ort+$t &"$tr'tr+$s#'ii-" " s?$*", 3o+-+ B"/o-iti( + $o'$(s't'-'i, tr+$s&-+$t'- " or*+$", "t.

E>ist( 4 #"$oti&'ri 6"-" +r" +&+r =$ 3'-"ti$'- " i"$tit+t"7 )i : *"$oti&'riJ

FENOTIP

GENOTIP

I A II AA

A III

A I9 A

G*4(9L(n#st!in!*)

G*4(9(ns)

A'"tin'!n9(nti'!n)

A'"tinin!9(nti%*4i)

; 6"ro7 I $' +r" )i

A II A

6 III 6

A6 IK A i 6 $' +r"

93


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1. s?$*"-" r"&r"i$t( +&ro>i/+ti< @] i$ *r"'t+t"+ or&or+-( "- "st"o/&'s i$ &-+s/( 6 '$ -iBi *+-3"$ itri$ 7 )i "-"/"$t"-" #i*'r+t" 6 "-'-"-"ro)ii, "-'-"-" +-3" si tro/3oit"-"7 +r"H&-'t"s =$ &-+s/+.

!. (nti'!n" "st" o s'3st+$%( r"'$os't( " sist"/'- i/'$it+r + #ii$str(i$( 5. B"/+ti+ 6"-'-+ ro)i" s+' "ritroit'- 7


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Si$"(*!( =$"r+r"+ o$)ti"$t( )i &r"/"it+t( " + i/it+, &ro&"rti+ /"io -"*+-( =$ si/'-+r" =$t?/&i$( +$'/it" &ro3-"/" -"*+t"" $"&+rtii&+r"+ s+' r"+'+ r"i$%( + si/'-+$t'-'i =$ #+%+ ">+/"$'-'i /"i+-. U$ro- i/&ort+$t =$ "&ist+r"+ si/'-+$t'-'i =- o$stit'i" +$B"t+ soi+-(.

E>ist( =$s( o s"ri" " &ri$i&ii /"too-o*i" +-" EML =$ +'- si/'-(rii'$"i 3o-i i$">ist"$t". $ &ri/'- r?$, /"i'- tr"3'i" s( "+ i/&r"si+ ( "st" o$


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&ro'" &ri$ +$'/it" /i8-o+" )i ' +8'tor'- +$'/itor /+$""'t+t" " "- =$+'(, -"i'$i-" &ro+/i$+t", =$


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Art. 1@4 CPP &r"ist( s"r&"rti+ &"rti+%i-or +( "st" +'-,

&ro"?$'s" -+ to+t" i$


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- " str't'r+ o$)tii$%"i +"st'i+ =$ /o/"$t'-o/it"rii #+&t"i.

E>&"rti+ tr"3'i" s( st+3i-"+s( +r" "st" str't'r+ &"rso+$"i, *r+'- ""&"rti( "st"

+-(t'it( i$tr'$ /"i -"*ist )i ! /"ii &siBi+tri. C+r'- " "s#()'r+r" "st" "-/+i #r"+/"$ $"'ro&siBi. E>+/i$+r"+-i$i( tr"3'i" s( #i" ?t /+i o/&-"t( )i +/($'$%it( &ri


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$ #i$+-, ">&"rti+ /"io -"*+-( , &" 3++ oro3or(rii t't'ror +t"-or/"i+-" )i *"$"r+-" o3%i$'t", tr"3'i" s( st+3i-"+s( o$-'ii-" r+&ort'-'i /"io -"*+-, +r" tr"3'i" s( &r"i"" 'r/(to+r"-"J

- 3o+-+ &siBi( " +r" s'#"r( s'3i"t'-

- t'-3'r(ri-" &siBi" +r+t"risti" *"$"r+t" " 3o+-+ " 3+( )i-"*(t'r+ +'+-( i$tr" +"st" t'-3'r(ri )i s(


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$ +'ri-" /i$ori-or +r" $""sit( tr+t+/"$t /"i+- =$tr'$ s"r


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3ormele cronice ale etilismului cronic+7 "ti-is/'- ro$i s" +r+t"ri"+( &ri$ i$*"sti+ otii+$( +

'$or +$tit(%i " 3('t'ri +-oo-i" " (tr" &"rso+$" " si/t $"


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/"i+-( s" =$%"-"* &ri$i&ii-" " o/&ort+r" +-" &"rso$+-'-'i /"i+-, ori"$t+t"s&r" rii+r"+ /+>i/( + "#ii"$%"i


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$ -it"r+t'r+ 8'rii( t"r/"$ii H"ro+r" )i H*r")"+-( +' s"/$i#i+%i" i#"rit("os"3it " i/&ort+$t( -+ i$t"r&r"t+r"+ #+&t"-or. E*(*!( "st" &osi3i-it+t"+ +/is( )ir"'$os't( + *"$"r+to+r" " i$t"r&r"t(ri *r")it". E*(*!( r"&r"i$t( '$o+)t"r"+#+-s( + '$"i sit'+%ii " #+&t , sit'+%i" &osi3i-( Bi+r )i =$ o$i%ii-" '$"i +ti


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$ -it"r+t'r+ " s&"i+-it+t" s'$t '$os't" /+i /'-t" t"" &ri


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-?$*( +"st" rit"rii st+$+r +r" #'$%io$"+( =$ =$tr"+*+ -'/" ">ist( )i +-t" rit"rii" + +&-i+ +"st st+$+r )i +$'/" s"rist" o legătură de cauzalitate =$tr" =$(-+r"+st+$+r'-'i )i &r"8'ii'- #ii s+' &siBi "/o$str+t. L+ "ist( sit'+%ii =$ +r"&r"8'ii'- "st" "&"ri"$%(. S'$t =$s( sit'+%ii =$ +r" ">ist( &ro"'ri /"i+-" i#"rit" #('t" "/"ii ' +"-+)i *r+ &ro#"sio$+- ">ist?$ &r"#"ri$%" &ro#"sio$+-" i$i"/&-'J o o&"r+%i" " +&"$iit( tr"3'i" s( +i3( +"-+)ist+$+r &ro#"sio$+- #i" ( o&"r+%i+ +r" -o =$tr'$ s&it+- o/'$+- #i" =$tr'$ s&it+-'$i


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I$#or/+%i+ *"$"ti( "st" o$"$tr+t( =$ $'-"'- "-'-"-or -+ $i"&%i+ B"/+tii-or s+' *-o3'-"-or ro)ii, +r" s'$t "-'-"-i&sit" " $'-"' 6+$'-"+t"7.

$ /o-"'-+ " ADN s" +#-( =$sris s'3 #or/( oi#i+t( /"s+8'- *"$"ti, +

(r'i ">&ri/+r" "t"r/i$( "i/+ti< 1 /. M+ro/o-"'-+ " ADN +r" ostr't'r( -i$i+r( '3-' "-ioi+-(, #ii$ +-(t'it( i$ ! -+$%'ri s+' +t"$" r'-+t" '$'-

=$ 8'r'- "-'i-+-t )i +r" #or/"+( +)+ $'/it+ H s&ir+-( +


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A = TG ≡ C

T = A

A = T

C ≡ G

T

C

C

A

G

GT

A

G C

T = A

T = A

C ≡ G

A = T

A = TG ≡ C

5’

3’

5’

3’

5’ 3’

3’ 5’ADN denaturat

Dublu helix

Punţi de Hidrogen

C ≡ G

C ≡ G

G ≡ C

108

http://stiri.zoot.ro/Stresul-in-copilarie-poate-modifica-structura-ADN-ului,313954.html


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&" "i ! *+/"%i &+r"$t"r+-i s" o/3i$( )i r"#+ s"t'- " !5 " &"r"Bi " ro/oo/i =$ ist"$t(. Si$t"+ "st" " ti& (t-%4i(ti+, =$ s"$s'- ( $o'+ /o-"'-(

si$t"ti+t( "st" i"$ti( str't'r+- ' /o-"'-+ " ADN /+/(, o&i+ s+ #i"-( s+'r"&-i+ s+.

Pro"s'- " r"&-i+r" =$"&" &ri$ s"&+r+r"+ "-or ! #i-+/"$t" " ADN.Tr""r"+ " -+ str't'r+ 3i+t"$+r( -+ "+ /o$o+t"$+r( s" #+" &ri$ r'&"r"+-"*(t'ri-or " ! i$tr" +t"$"-" " ADN o/&-"/"$t+r )i &o+rt( $'/"-" "#!n(t*(*!. D"$+t'r+r"+ s" r"+-i"+( i$


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Diist( ?t"


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U$ ADN o$s"rtr+%i+ ADN. D+(">tr+%i" $' &o+t" +


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$ ti/&'- &r"-"


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Mo-"'-"-" " ADN "'+riot 6"-'-( ' $'-"'7 +' o -'$*i/" #o+rt" /+r" )i " +""+ =$ ti/&'- &ro"""-or " ">tr+%i" s" #r+*/"$t"+(.

Io-+r"+ ADN'-'i '&ri$" 5 "t+&" /+8or"J1. -i+ "-'-+r( "t+&+ =$ +r" s" istr'*" /"/3r+$+ "-'-+r( '

"-i3"r+r"+ /+t"ri+-'-'i *"$"ti =$tr'$ o/o*"$+t +r" o$%i$" to%i o$stit'"$%ii"-'-+ri, "$'/it -i+t "-'-+r. Li+ "-'-+r( s" r"+-i"+( #r"tr+%i"i ADN "sti/+r"+ +$tit(%ii )i +-it(%ii ADN o$st( =$ "t"r/i$+r"+ &'rit(%ii ADN =$ so-'%i+ " ADN r"'-t+t(. U$ ADN i$s'#ii"$t+$tit+ti< s+' +-it+ti< &o+t" +&o$"$%i+-( + +$tit(%ii " /+t"ri+- *"$"ti.

Et+&"-" PCRJ- "$+t'r+r"+ ADN'-'i '3-'+t"$+r ' o3%i$"r"+ ADN'-'i

/o$o+t"$+r &ro"s'- s" r"+-i"+( t"r/i, &ri$ =$(-ir" -+ 2 , )i Bi/i '+8'tor'- +*"$%i-or "$+t'r+$%i " ti&'- #or/+/i"i.

- '&-+r"+ "-or ! &ri/"ri 6 #r+*/"$t" si$t"ti" " ADN7 r"'-t+%i =$&ri/+ "t+&(, &" /o$o+t"$+ " ADN, '&-+r" +r" s" #+" -+ +&"t"-" s"t"$si", &+s '

&+s, o $o'( +t"$( " ADN, o/&-"/"$t+r( ' s"*/"$t'- %i$t(.

114


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A


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Lo'- i$#r+%i'$ii "st" "- + (r'i ">+/i$+r" o/&"t"$t( &o+t" &"r/it"i"$ti#i+r"+ s's&"%i-or )i +


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O+t( r"'$os't( &ro3+ 3io-o*i(,io-+t( )i #"rit( " ori"o$t+/i$+r",s" #+" o "sri"r" or"t( + -o'-'i '$" + #ost i"$ti#i+t(,#o-osi$'s" " r"*'-( #oto*r+#i+ )i /(s'r(tori-".

Ur/(to+r"+ "t+&( "st" r"o-t+r"+ )i o$s"r&-oii 6 '/ s"$t?/&-( =$ +t+stro#"7. S" &"rt'- s( +i3( '$o)ti$%( " to+t" ir'/st+$%"-" +'-'i

117


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- +ti&"rti+ #i-i+%i"i.!. st+3i-ir"+ i"$tit(%ii 'r/"-or 3io-o*i" 6s?$*", s"r"%i"


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• s?$*" &r"-"tr+*" ADN ' *r"'t+t" /o-"'-+r(

o$i/+ti< ! "+i"$t" +


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s'rt ti/& " -+ "o-+r" o +"ro$+"'t+r"+ #oto*r+#ii-or &+$or+/i", +&oi -+ "-i/it+r"+ =$ &(tr+t" 6+-t"orir+i+r7 +"st" s"to+r" s" &-oii " /+r" &'t"r" s+' =$ +'- =$ +r" #r+*/"$t"-" '/+$" s'$t s'&'s"t"/&"r+t'ri-or rii+t" 6+r3o$i(ri7, +&(r?$ '$"ori $'/+i "$')+. $ +st#"- "

120


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+'ri, #r+*/"$t"-" s'$t, i$ &'$t "


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CAPITOLUL 18IDENTIFICAREA MEDICO @ LEGALĂ

I"$ti#i+r"+ /"io -"*+-( r"&r"i$t( '$ o/"$i' =$ +r" i$t"r


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• r+s+"t$i+.A"st"+ +' '$ ro- " sr""$i$* + &ot"$%i+-i-or +$i+%i &"$tr' i"$ti#i+r",

=$+r?$ &"rso+$+ i$tro +$'/it+ +t"*ori" "


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r"#"r( -+J %i$'t+ or&'-'i, &oi%i+ +&'-'i, /"rs'-, /o'- =$ +r" +&-i( &iior'- &" so-,#iio$o/i+,


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"r/+to*-i#"-or #i"(r'i "*"t =$ &+rt" )i =$ /o s&"i+- + "-or " &"


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+"&t+t" =$ 12; " F""r+%i+ D"$t+r( I$t"r$+%io$+-( #or/'-+ "$t+r( s" sri" s'3#or/+ '$"i #r+%ii =$ +r" i#r+ " -+ $'/(r(tor i$i( i$%ii /+>i-+ri, i+r $'/itor'-i$i( i$%ii /+$i3'-+ri. Pri$i&+-'- "+


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C+ )tii$%(, "$to/o-o*i+ 8'ii+r( + =$"&'t s(și i+ +


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Artro&o"-" s'$t +$i/+-" $"


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Fi*. 1 C+--i&Bor+ 9ii$+

C(""i4*( K$it*i( "st" o /'s( " +r$" +r" /(so+r( =$tr" ; )i 15 // =$ -'$*i/". Est" #o+rt" +s"/($(to+r" ' C+--i&Bor+ 9ii$+, +


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"sBis" +-" i/+ti< o tr"i/" i$ $'/(r'- tot+- +- i$s"t"-or.A&+rți$(torii +"st'i ori$ &o+rt( "$'/ir"+ " *?$+i și +' 'r/(to+r"-" tr(s(t'rio/'$"J &(rți +-" *'rii #o-osit" &"$tr' + /'ș+, $'/it" /+$i3'-", /+8orit+t"+

&r"i$t( +$t"$" #or/+t" i$ 11 s"*/"$t", i+r &ri/+ s"ți'$" + tor+"-'i "st"isti$ti


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Fi*. : G?$+ i$ #+/i-i+ ist"ri+"

A-t" #+/i-ii " o-"o&t"r"J si-&Bi+", st+&BQ-i$i+", tro*i+".At?t /'șt"-" ?t și *?$+ii +' '$ i-' " "


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r(oro+s", &+r'r*?$ o ist+$ț( " &?$( -+ 5 " /"tri, s+' =$"+r( s( s" =$*ro+&" -+ ?ți


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-'$i și ( &o+t" s( = și =$t?ri" "-o+r"+ +( o$iții-" " /"i' s'$t osti-"6t"/&"r+t'ri #o+rt" /ii7.

T"ori+ i$ s&+t"-" "sti/(rii i$t"r


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• -+r


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$ Ro/?$i+, $' +' &'t't #i #o-osit" i$#or/+ții &"rti$"$t" și $""s+r" &"$tr'r"o-&"rți-or ri/i$+-iști, =$tr'?t &?$( =$ &r""$t $' +' #ost#('t" st'ii +&ro#'$+t" &ri

Notiuni Generale de Medicina Legala - Curs Universitar

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