Journal of forensic and legal medicine
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The aim of this study was to characterize acute poisoning cases admitted to two hospitals in Kampala, Uganda. ⋯ Acute poisoning involved more men, who spent more than 2 days being hospitalized, and resulted in a case fatality rate of 1.4% due to alcohol, carbon monoxide, and organophosphates. These findings suggest that further studies are warranted in order to understand the motivation(s) for this emerging problem, and plan appropriate interventions.
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Positional asphyxia refers to a situation where there is compromise of respiration because of splinting of the chest and/or diaphragm preventing normal respiratory excursion, or occlusion of the upper airway due to abnormal positioning of the body. Examination of autopsy files at Forensic Science SA revealed instances where positional asphyxia resulted from inadvertent positioning that compromised respiration due to intoxication, multiple sclerosis, epilepsy, Parkinson disease, Steele-Richardson-Olszewski syndrome, Lafora disease and quadriplegia. ⋯ We would not exclude the possibility of individuals with significant cardiac disease succumbing to positional asphyxia, as cardiac disease may be either unrelated to the terminal episode or, alternatively, may result in collapse predisposing to positional asphyxia. Victims of positional asphyxia do not extricate themselves from dangerous situations due to impairment of cognitive responses and coordination resulting from intoxication, sedation, neurological diseases, loss of consciousness, physical impairment or physical restraints.
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A 21-year-old man, in whom abnormal nodules had been detected in bilateral lung fields with no clinical symptoms for two years, was admitted to the hospital with sudden cardiopulmonary arrest. Acute pulmonary embolism with a large embolus was diagnosed, but the patient died soon after admission. When the examination was compared with X-ray taken 4 days earlier by chance, a large tumor was now detected in the right heart and was suspected to be the cause of this complication after his death. ⋯ Many old myxoma fragments were noted in the bilateral peripheral branch of the pulmonary artery. It was concluded that the abnormal nodules were old pulmonary fragments and the cause of death was pulmonary embolism of a large fragment originated from the atrial myxoma. An asymptomatic right atrial myxoma is extremely rare but nevertheless possible to unexpected death like this case.
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Multicenter Study
Preferred choice of gender of staff providing care to victims of sexual assault in Sexual Assault Referral Centres (SARCs).
A Sexual Assault Referral Centre (SARC) is a model of service developed in the UK to provide immediate medical care, forensic and after care services for the victims of serious sexual assault. National guidelines recommend female medical staff for victims of serious sexual assault, although there has been few studies specifically undertaken to ask victims themselves about their choice of gender of staff in a SARC. ⋯ SARCs should continue to consider female staff as the primary gender of staff providing services, as part of their recruitment policy, within the realms of employment law.
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Comparative Study
No cash no whiplash?: Influence of the legal system on the incidence of whiplash injury.
Whiplash injury has been a continuous source of controversy due to its association with litigation. We studied the incidence of whiplash associated disorder (WAD) in two similar socioeconomic areas and carried out a retrospective study based on the hypothesis that the Spanish law 30/1995 might have an affect on the incidence and duration of cervical symptoms and the persistence of impairment. More than 10,000 patients injured in traffic accidents were studied over a period three years. ⋯ Statistical analysis was made using SPSS 13.0 and Statistix 8.0. We found a statistically significant difference between Spain and Portugal in the incidence of WAD and in the duration of symptoms. The incongruities caused by the compulsory application of Spanish law arise from the fact that evaluation on a points scale of impairment does not always reflect the functional state of the injured person.