Forensic science international
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The Abbreviated Injury Scale (AIS), Injury Severity Scale and TRISS methodology comprise a mathematically sound system for the analysis of injuries and injured patients. This system is of value for research and audit and has potential applications in forensic medicine, such as its use as a tool to assist the classification and analysis of injuries sustained by those injured in mass disasters.
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Review Comparative Study
Review of active compression-decompression cardiopulmonary resuscitation (ACD-CPR). Analysis of iatrogenic complications and their biomechanical explanation.
Our review takes a critical look at the active compression-decompression technique (ACD) for cardiopulmonary resuscitation (CPR). ACD-CPR was developed following a report of successful resuscitation performed by a medical amateur using a household plunger. The efficacy of the principle of active decompression has been demonstrated by animal and human studies. ⋯ The lower the sternum is sunken compared with the surrounding structures, the higher the force which is transmitted via the central area of the device onto the sternum. The rubber cushion pad shortens the distance between CardioPump and sternum by 5 mm and therefore increases the sternal loading. Sex differences in the shape of the sternum and especially the thickness may account for the significant correlation between sternum fractures and female sex.
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Review Case Reports
Lethal suicidal intoxication with propafenone, after a history of self-inflicted injuries.
Report of a suicidal mono-intoxication with the class IC antiarrythmic drug propafenone. A 20-year-old female physician's assistant secretly ingested the substance (presumably 20 tablets per 300 mg) about 4-6 h before her death, and in the interim remained under the supervision of her physician. ⋯ After about 4 h without serious symptoms acute loss of consciousness and cardiac failure occurred, resuscitation efforts remained unsuccessful. At autopsy propafenone was found in blood (12 micrograms ml-1), liver (60 micrograms g-1) and cardiac muscle (11 micrograms g-1).
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Comparative Study
Site of entrance wound and direction of bullet path in firearm fatalities as indicators of homicide versus suicide.
In a retrospective study, 288 firearm deaths were analysed to identify factors indicating homicide. The cases were classified as suicides (213), homicides (54), accidents (14) and undetermined cases (7). A number of factors, related to the circumstances and the autopsy findings, were studied. ⋯ Whereas 38% of the homicidal gunshot wounds had their entrances at anatomical regions typical of suicide, the direction of the bullet path often differed from the directions recorded in suicides. Hence, in this material, an entrance wound in the right temple indicated suicide, but in combination with a direction back-to-front, the wound was more likely to be homicidal. This study suggests that an estimation of the direction of the internal bullet path should be conducted in firearm fatalities, and that this factor may assist in the determination of the manner of death.
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We have described a rapid and simple solid-phase extraction on C18 cartridges of moclobemide suitable for the analysis of post-mortem whole blood and urine. The methods used for identification were GC-MS and HPLC-PDA. Quantification was performed by the HPLC-PDA technique with detection at 238 nm. ⋯ A second case concerned a polyintoxication including moclobemide as one of the main toxins. The post-mortem whole blood concentrations were 15.5 and 13.8 micrograms/ml respectively. Determination of the drug in other biological specimens is also reported.