Journal of forensic and legal medicine
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Crush asphyxia involving motor vehicles usually occurs when a victim is trapped beneath a vehicle that slips from a jack while being worked on, or beneath a car that has rolled over during a crash. Two cases are reported where crush asphyxia resulted from quite different circumstances. Case 1: A 58-year-old woman was found dead trapped between her car door and frame. ⋯ This form of automobile door entrapment represents a distinct subset of automobile-related asphyxial deaths and illustrates a particular and unusual set of circumstances that may result in unexpected traumatic death. Getting, or leaning, out of a vehicle that does not have the handbrake engaged may result in wedging of the victim between the semi-opened door and car frame if the car rolls forward and the door impacts against a nearby unyielding object. Correlation of the physical dimensions of the door and frame with markings on the victim's body will assist in reconstructing the terminal events.
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Forensic pathologists often hesitate to use biochemical blood markers due to the risk of large postmortem changes and deviations from healthy subjects. Biochemical analyses of postmortem blood, if possible, may help to evaluate pathological status and determining the cause of death in forensic diagnosis, for example, in sudden unexpected death without obvious cause, or young adults with no apparent cause of death or antemortem information. Even commercially available biochemical markers were re-evaluated in the blood samples of 164 forensic autopsy cases. ⋯ For the evaluation of changes due to postmortem intervals, none of the markers except for triglyceride showed significant changes up to three days postmortem. As for sampling sites, femoral vein blood is generally recommended considering postmortem changes, but left cardiac blood was suitable for creatinine, pChE, and total cholesterol. For clinical forensic diagnosis of biochemical blood markers, we must determine the "forensic abnormal value" after collecting more cases by known causes with more information about the population.
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Previous published research suggests there are a diverse, yet relatively consistent, set of factors present in sudden, unexpected, and initially inexplicable deaths in police custody. This retrospective analysis examines police custodial deaths in Maryland, USA. Police custody death is operationalized to include deaths which occurred suddenly and unexpectedly during police/citizen encounters. ⋯ Although individual-specific, these factors include a relatively static constellation of behavioral (e.g., erratic and/or violent behavior, and physical struggle) and physical (e.g., stimulant abuse, natural disease, and obesity) dimensions. While the presence of these factors has been well-documented, their empirical significance, interactions and causal sequence have yet to be established. To increase the methodological rigor of subsequent research, we have developed a comprehensive, national custody death database by which multivariate models may be analyzed.
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A case of poisoning with highly lipid soluble organophosphate compound, fenthion is reported in which cholinergic crisis recurred upto 25 days following a suicide attempt. Subcutaneous injection of fenthion in the antecubital fossa by the patient produced massive swelling, cellulitis and compartment syndrome of the left arm. Emergency fasciotomy helped in restoration of circulation and saved the limb from being amputated.
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This study examined the incidence of suicide and self-harm in asylum seekers in the UK, both those in detention and in the community. The investigation revealed that data recording is seriously flawed or sometimes non-existent. ⋯ It is suggested that this could be attributed to routine failure to observe and mitigate risk factors. The author makes the following recommendations: coroners should record asylum seeker status and ethnicity of deceased, self-harm monitoring in the community should record asylum seeker status and ethnicity, health care in immigration removal centres should meet the same standards as UK prisons as a minimum, allegation of torture by immigration detainees should trigger a case management review and risk assessment for continued detention, and this process should be open to audit, and interpreters should be used for mental state examinations unless their English has been shown to the fluent.