The regulation and control of psychoactive substances and their precursors is constantly counteracted by the imagination, inventiveness, experimentation and targeted research that consumers/manufacturers use in order to elude the laws, which during the last few years has led to a surge in the marketing and use of these products in the context of a missing or unclear legal framework. We are witnessing an explosion in the use of some products and substances which are either new intoxicants, or have been considered benign until recently (such is the case with numerous species of plants). The legal and medical systems are currently facing conceptual problems: how to define or characterise the product of interest (considering its ubiquitous availability and marketing forms), which of its active principles should be controlled (including by-products created by spicing the basic product), which are the applicable criminal, civil or commercial laws, how to control the "rerouting" of pharmaceutical/parapharmaceutical remedies, common drugs, nutritional supplements, exotic aromas, fertilizers or spices-the so-called unconventional intoxicants. The limitations of scientific knowledge, the novelty of various psychoactive blends, the appearance of new classes of substances, the mix with different plants etc. are major impediments for the increase in the reaction time and consequently for an efficient control by the authorities. In order to provide evidence for intoxication, a certain flexibility is needed for the on-site forensic investigation, analysis of the corpus delicti (toxicology and botanics), and the clinical examination, while toxicological detection may be of support in the context of technical-scientific difficulties. Driving under influence thus becomes a challenge for the traffic safety and for the authorities or persons authorised to conduct the inquiry and limit the phenomenon. The present article aims to provide a synthesis of the current scientific knowledge on legal highs and an overview of the limitative, but also promising toxicological issues which are needed for the description of the phenomenon.
The posttraumatic Morel-Lavallée seroma (MLS) completes, in medico-legal traumatology, the group of closed soft tissue injuries, along with the bruise, the hematoma and the muscular contusion. It is defined as a closed soft tissue injury produced most commonly as a result of direct trauma with tangential impact, followed by the shearing of the hypodermis from the underlying fascia, which results in a cavity filled with blood, lymph and both viable and necrotic fatty tissue. It can be seen in association with pelvic trauma, typically in the region of the hip, the thigh, the lower lumbar aria, the gluteal area and the abdominal wall. Studies and articles on the subject are scarce in the medical literature in general, and even more so in the medico-legal one, although the problems it raises are complex. The present paper starts with an updated presentation of the MLS clinical aspects, followed by an analysis of the medico-legal implications with regard both to the interpretation of MLS injury mechanisms, and to the medico-legal criteria for the evaluation of diagnostic accuracy, evolution and complications for this post-traumatic entity that often has a prolonged trajectory, marked by repeated medical and surgical interventions and multiple medico-legal evaluations. Hence, an indirect change in the medico-legal interpretation of the severity of this initially benign type of injury can appear. Difficulties in establishing the causal link between the initial trauma and certain belated complications may also occur.
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