Journal of forensic and legal medicine
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Fatal firearm injuries in autopsy cases at central Bangkok, Thailand: a 10-year retrospective study.
Even though there have been previously published reports on firearm injuries in various countries, the incidence and pattern of death from firearm injuries in Thailand have not been studied before. In present study, 149 fatal firearm injuries from 2002 to 2011 were reviewed. At total of 7126 autopsies, fatal firearm injuries comprised of 2.09% (n = 149) of total autopsies cases. ⋯ Blood alcohol concentration was examined in 122 cases and 38 victims showed positive results, 11 cases revealed using of illegal substances in blood and urine analysis. This study also included the association between manner of death and other factors. Age group, time of incidence, place of incidence, number of entrance wound and range showed statistically significant association with manner of death.
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Intimate partner violence (IPV) is a common occurrence in Australian society and has far reaching health, social and economic impacts, particularly for females who are the most common victims. It is theorised that paramedics frequently encounter IPV in the field and in some cases are the only agency which deal with IPV victims in the out-of-hospital setting. Thus paramedics have a unique opportunity to increase discovery, treatment and reporting, however there is little formal training in managing IPV for most Australian paramedics. ⋯ The vast majority of participants stated that they felt additional education and training would be most helpful to improving their ability to manage IPV cases. Participants had a poor knowledge and poor preparedness for IPV prior to undertaking a targeted education session. There is an urgent need for additional research of the needs and best methods to educate and train paramedics to appropriately respond to IPV cases.
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Computerised tomography (CT) is being increasingly advocated to support post mortem investigation of death but the value of using CT data already captured during emergency imaging, prior to treatment of life threatening injuries, remains under recognised and inadequately explored. We demonstrate the value of three dimensional computerised tomography (3D CT) reconstructions of such data, in interpreting the injuries sustained by a male who survived after being subjected to an assault with an axe and whose surface injuries had been debrided and sutured, before any photography was undertaken. ⋯ This case also illustrated the effectiveness of joint interpretation of 3D CT reconstructed images in medico-legal casework, by experienced consultants in forensic pathology and radiology and the potential value of reviewing emergency pre-treatment CT imaging in any serious head injury allegedly sustained in an assault. This is likely to be particularly valuable when sharp or blunt weapon damage to bone is suspected.
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The purpose of this study was to evaluate the postmortem distributions of procalcitonin (PCT), C-reactive protein (CRP), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and soluble interleukin-2 receptor (sIL-2R) levels in postmortem serum from femoral blood, pericardial fluid and pleural fluid in a series of sepsis-related fatalities (12 subjects) and control cases (20 subjects) that underwent medico-legal investigations. Our aim was to assess the diagnostic potential of the results obtained from pericardial and pleural fluid analysis in identifying sepsis-related deaths. All sepsis-related cases had a documented, clinical diagnosis that was established in vivo during hospitalization. ⋯ Pseudomonas aeruginosa, Klebsiella pnemoniae and Escherichia coli were the most commonly identified bacteria in blood and lung tissue cultures. The preliminary results corroborate the usefulness of PCT, CRP, sTREM-1 and sIL-2R determination in postmortem serum for the identification of sepsis-related deaths. Moreover, the data suggest that, as far as PCT, CRP, sTREM-1 and sIL-2R measurements are concerned, pericardial and pleural fluids can be considered suitable alternatives to postmortem serum should femoral blood prove unavailable at autopsy.