The American journal of forensic medicine and pathology
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Am J Forensic Med Pathol · Mar 2013
Case ReportsSudden cardiac death associated with methylone use.
The rise in popularity of "bath salts" as safe alternatives to MDMA (3,4-methylenedioxymethamphetamine), methamphetamine, and other illicit substances has resulted in increased scrutiny of the contents and toxicology associated with these products. We report a case of sudden death related to the synthetic cathinone methylone (3,4-methylenedioxy-N-methylcathinonmethylone) in a previously healthy 19-year-old man. ⋯ Although lack of published data prevented a comparison of blood methylone concentrations between our case and existing reports, the amount of methylone we detected postmortem (0.07 mg/dL) is below those reported in MDMA-related fatalities. Our report suggests that methylone toxicity has been greatly underestimated by users of this synthetic cathinone.
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Assisted suicide is allowed in 3 states of the United States (Oregon, Washington, Montana) but only if performed by a physician. On the opposite, in Switzerland, at the beginning of the 20th century, the Swiss Penal Code referred to assisted suicide in the context of honor or an unhappy love affair. It was only in 1985 that Exit Deutsche Schweiz (Exit for German-speaking Switzerland) "medically" assisted the first patient to end his life. ⋯ Thus, according to the Swiss law, any person could perform assisted suicide; this is essentially performed by 3 main associations, using pentobarbital on medical prescription as lethal substance. Generally speaking, the Swiss population is rather in favor of assisted suicide. Among politics, the debate has been tough until 2010, when the Federal Council decided not to modify the Swiss Penal Code concerning assisted suicide.
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Am J Forensic Med Pathol · Dec 2012
Pontomedullary lacerations in unhelmeted motorcyclists and bicyclists: a retrospective autopsy study.
Pontomedullary lacerations (PMLs) have often been reported in car occupants and pedestrians, are less frequently described in motorcyclists, and are very rarely described in bicyclists. The aim of this study was to determine the frequency of brainstem PMLs among fatally injured motorcyclists and bicyclists as well as the frequency of concomitant cranial, facial, and cervical spine injuries in such cases. A possible underlying mechanism of PML in fatally injured motorcyclists and bicyclists might thus be established. ⋯ Impact to the chin, with or without a skull base fracture, most often led to this fatal injury due to impact force transmission, either through jawbone or vertebral column. Also, lateral head impact, the most frequent in bicyclists, with subsequent hinge fracture, PML, and frontoposterior hyperextension of the head that is associated with upper spine fracture, could be possible mechanisms of brainstem injury in fatally injured motorcyclists or bicyclists. Our study showed that the jawbone, as well as other facial bones, could act as shock absorbers, and their fracture could diminish energy transfer toward the skull and protect the brain and brainstem from injury.
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Am J Forensic Med Pathol · Dec 2012
Case ReportsAttempted suicidal hanging: an uncomplicated recovery.
Although hanging is common across the world, survival after attempted hanging is very rare with death usually occurring within minutes or over the first 24 hours. If the person survives the initial event, later he/she may die because of the severity of the initial hypoxic and ischemic brain damage. Survival from hanging is often associated with various complications including a large variety of neurological consequences. ⋯ On admission, he was unconscious and the Glasgow Coma Scale was 4 with tachycardia, weak pulse, bradypnea, and shallow breathing. With vigorous and prompt resuscitation methods, he gradually recovered without any residual neurological outcome. Prognostically good results could be achieved, if such victims are vigorously and promptly resuscitated, irrespective of their initial presentation.
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Am J Forensic Med Pathol · Dec 2012
Homicidal deaths in the Western suburbs of Paris: a 15-year-study.
The aim of our study was to analyze the homicide pattern in the Western suburbs of Paris and its evolution between 1994 and 2008. All autopsy reports regarding homicides from the period January 1, 1994, to December 31, 2008, were retrospectively reviewed. Five hundred eleven homicide cases were selected of 4842 autopsy cases. ⋯ A decrease of gunshot wounds as a cause of death was found over the studied period. Alcohol was the most common toxic detected in blood of the victim, in 48.5% of the cases when toxicological results were available. Blood alcohol concentration ranged from 1 to 500 mg/dL with a mean value of 150 mg/dL.