Medicine, science, and the law
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Anaesthesia-related death is one of the most complex events to be studied in forensic pathology because of its rarity and its doubtful presentation. Particularly, the difficulties in assessing the cause of deaths in such circumstances are underlined. A scale must be considered in order to determine the causal role of anaesthesia in the process leading to death. ⋯ The number of deaths totally related to anaesthesic care is rather low with 0.32% of autopsies due to medical malpractice claims and 0.16% of all autopsies. Anaesthesia-related deaths were due to lack of or delay in intubation (2 cases), acute cardio-respiratory failure (2 cases) and anaesthetic-induced hepatotoxicity (1 case). The importance of a careful forensic investigation (clinical and familial history, medical records, complete autopsy and toxicology), which can lead to a clear understanding of anaesthesia-related deaths, is also stressed.
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Case Reports
A state of reversed hypoxic encephalopathy following attempted suicidal hanging: a boon.
Normal functional condition of the brain is achieved by maintaining the normal structure and normal function of brain parenchyma. Reduced blood supply and deficiency of available oxygen alter brain perfusion which causes hypoxia or anoxia, and, depending on the severity, alters brain functions temporarily or permanently. ⋯ Here we present a case report in which even though the patient was hanged for more than five minutes until the formation of a ligature mark and exhibited cyanosis, unconsciousness and seizures, the outcome was favourable with prompt and early intervention. Recovery was complete such that there were no residual signs and symptoms of reduced brain perfusion.
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This research reports on the views of detainees and their carers of their experiences of being detained under Section 136 (S136) of the Mental Health Act 1983. Individual interviews were conducted with 18 detainees and six carers. ⋯ Detainees and carers would like to see the provision of a place of safety other than emergency departments or police stations, and this study reinforces the Mental Health Code of Practice 2008 which states that police stations should only be used on an exceptional basis.
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Case Reports
An anomalous origin of left coronary artery and sudden death in a soccer player: a case report.
Coronary artery anomalies, after hypertrophic cardiomyopathy, are the second most common cause of exercise-related sudden cardiac deaths. These anomalies have been associated with myocardial ischaemia, arrhythmia and sudden death during exercise. Anomalous origin of the left coronary artery from the right sinus of Valsalva with anterior or posterior courses is not always thought to be a benign anomaly. ⋯ At autopsy, there was an abnormal origin of the left coronary artery from the right sinus of Valsalva. The abnormal course of the artery between the aorta and pulmonary trunk had limited victim's functional capacity. The history, cause of death and patho-physiology are discussed, and some preventive strategies suggested.
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Case Reports
Aluminium phosphide (tank pill) poisoning in the Transkei region of South Africa: a case report.
About half a million people die each year as a result of various kinds of poisoning. The incidence of pesticide poisoning, which is high in developing countries, has doubled over the past 10 years. Aluminium phosphide is a deadly fumigant pesticide. ⋯ He was taken to a nearby hospital, where he was dead within an hour of arriving. The mechanism of action, symptoms and signs will be discussed in this report. The purpose of this case report is to highlight the problem of aluminium phosphide poisoning in the Transkei region of South Africa.