Forensic science international
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According to Amnesty International government-sanctioned torture is verified in one third of the countries in the world. The physical and psychological sequelae are numerous. This study focuses on pain diagnosis, characterising pain types as nociceptive, visceral or neuropathic. ⋯ Nociceptive and neuropathic pain were demonstrated in all patients. Specific neuropathic pain conditions were related to the following four types of physical torture: Palestinian hanging, falanga, beating and kicking of the head, and positional torture. When treating torture victims, it is important to know about torture methods, to think differently than normal on etiological and pathogenetic factors and always consider the presence of neuropathic pain.
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A fatal case attributed to flecainide acetate (Tambocor), a class Ic antiarrythmic drug, is presented. Flecainide was detected by GC/MS in gastric contents, blood and liver as well. ⋯ The total amount of flecainide in gastric contents was about 43 mg. Even taking into account the postmortem redistribution of flecainide, its blood level still remains in the toxic range.
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Supravalvular aortic stenosis (SVAS) is an uncommon but well characterized congenital narrowing of the ascending aorta above the level of the coronary arteries. It can be a familial disorder, can occur sporadically, or associated with Williams syndrome (WS) which is a neurodevelopmental disorder affecting connective tissue and the central nervous system. Sudden death is a well-known complication of non-syndromic SVAS but few cases have been reported associated with WS. ⋯ At autopsy, the aorta and pulmonary trunk were narrowed and the walls showed peculiar microscopical characteristics. In the cardiac conduction system the His bundle was small and intramyocardial. The incidence, pathology, pathogenesis and prognosis of both conditions (SVAS and WS) are reviewed.
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A forensiometric model to discriminate between homicidal and suicidal firearm-fatalities is presented. It is based on a survey of all 45 homicidal and 251 suicidal firearm-fatalities that were examined at the Department of Forensic Medicine in Stockholm, Sweden during the period 1983-92. The model used 15 variables to describe 19.8% of the variation in the data and its goodness of prediction, Q2, was 0.742. ⋯ The model was thereafter validated on a test-set of 18 homicides and 84 suicides during 1993-95. All suicides and 16 homicides were classified by the model in agreement with the previous police and forensic medical examinations. Thus, the model's sensitivity to classify homicides is estimated to be 89% and its specificity 100%.
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The Authors describe an extremely rare fatal case (sixth case in the literature) of anaphylactic shock following a fluorescein angiography. This is the first report in which the diagnosis of anaphylactic reaction to the dye was made through laboratory analyses. ⋯ Mast-cell tryptase was dosed in serum and a pulmonary immunohistochemical evaluation was performed. Tryptase, a neutral protease of human mast-cells is a potentially important indicator of mast-cell involvement in anaphylactic events.