Journal of clinical forensic medicine
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J Clin Forensic Med · Oct 2005
Case ReportsSudden death with clinically undiagnosed pulmonary hypertension.
Four cases of sudden unexpected death associated with pulmonary hypertension are described. In all cases, the presence of pulmonary hypertension had not been clinically detected. In each case, the underlying etiology of the pulmonary hypertension was different with one case each of occult adult congenital heart disease, pulmonary sarcoidosis, pulmonary tumour microembolism from gastric adenocarcinoma, and familial primary pulmonary hypertension. These cases indicate that the forensic pathologist must be aware of occult pulmonary hypertension as a cause of sudden unexpected death in a variety of age groups.
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J Clin Forensic Med · Aug 2005
Underlying causes of cocaine, amphetamine and opioid related deaths in Australia.
To examine the characteristics of deaths in Australia where opioids, cocaine or amphetamines were mentioned, taking into account changes in the use and availability of these drugs in recent years. ⋯ Compared with opioid-related deaths, there are small numbers of deaths related to psychostimulants in Australia. Accidental drug induced deaths account for the majority of deaths in which these drugs are mentioned, although minorities of drug related deaths are attributed to suicide.
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Forensic medicine services (medico-legal services) as it is provided today in Uganda is discussed with special reference to forensic pathology and also to future plans for improvement to ensure quality service. Forensic medicine services are divided into clinical forensic medicine and forensic pathology. ⋯ Currently there is no qualified forensic pathologist in Uganda. Suggestions are made with regard to the enactment of a Forensic Medicine Services Act by the Department of Health, the creation of a forensic medicine unit with, under the administrative umbrella of pathology department, in medical schools and imparting of forensic medicine training to anatomical pathologists to act as a qualified, specialist forensic pathologists.
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J Clin Forensic Med · Apr 2005
Case ReportsFemoral and tibial fractures in a child with myelomeningocele.
Femoral and tibial fractures can occur from accidents, child abuse or pathological causes. It is often very difficult to distinguish the cause among those cases. Radiological diagnosis may be needed for clinicians and medical examiners in order to assist determining the reason of fractures. ⋯ This patient was diagnosed as child abuse by clinicians. On review it was decided that her fractures were not because of non-accidental injury. The values of bone mineral density of the upper limb were low and illness caused her fractures.
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Trauma is a significant cause of death and suffering in society and there is strong evidence that mortality and morbidity may be reduced by provision of effective medical care through a trauma care system. It is reasonable to believe that severely injured patients should be transported as quickly as possible to a center where definitive medical care is possible. Conversely, it is also an argument that the resources of a trauma center must not be overwhelmed by assessment and treatment of minor trauma for patients who could be reasonably expected to do well with care in a clinic or a primary care hospital. ⋯ However, the goal in setting triage criteria to provide a protocol for properly categorising injured patients, transporting them to appropriate hospitals, and ensuring an appropriate response to all trauma patients is yet to be achieved. Whatever the reasons and rate of failure due to different reasons, it is not unusual to read the reports wherein the quality of care becomes suspect in an increasingly litigious society. This paper examines the evolution of triage systems in trauma care from a forensic viewpoint.