Is routine histopathologic examination beneficial in all medicolegal autopsies?

Postmortem examinations are performed for a number of reasons. Medical autopsies are performed at the request of and with the consent of the next of kin of a decedent and are often requested to determine the extent of a disease process or to evaluate therapy. In contrast, medicolegal autopsies are performed by a forensic pathologist primarily to determine cause and manner of death but also to document trauma, diagnose potentially infectious diseases and report them to the appropriate agencies, provide information to families about potentially inheritable diseases, provide information to family members and investigative agencies, and testify in court. As medicolegal and hospital autopsies differ in their purpose, so do they differ in procedure. Medicolegal autopsies often include histologic analysis, but not always, as with medical autopsies. We designed a prospective study to address the question of whether or not routine histologic examination is useful in medicolegal cases, defining a routine case as one where histology would not normally be performed and where the cause and manner of death were readily apparent during the gross autopsy. We reviewed brain, heart, liver, kidney, and lung sections on 189 routine forensic cases and compared the results to the gross anatomic findings. Of the 189 cases, in only 1 case did microscopic examination affect the cause of death and in no case did microscopic examination affect the manner of death. Thus, we feel that routine microscopic examination (performing histologic examination in all cases regardless of cause and manner of death) in forensic autopsy is unnecessary. Microscopic examination should be used, as needed, in certain circumstances but is not necessary as a matter of routine.     

Increasing the Human Capital of Children in Latin American Countries: The Role of Parents’ Time in Childcare

In this paper, we focus on the relationship between parents’ education and activities aimed at increasing the human capital of children (for example, educational childcare). Using time use surveys from Mexico, Peru, Ecuador, and Colombia we find that in Mexico, Peru, and Colombia the level of education of both father and mother has a positive association with the time devoted to educational childcare, while in Ecuador only fathers’ level of education has a positive association with father’s time devoted to educational childcare. Furthermore, we find that the time devoted to educational childcare by parents is positively related in all four countries.     

The Presidential and Parliamentary Elections of the Bolivarian Revolution in Venezuela: Change and Continuity (1998–2000)

The paper examines to what extent electoral behaviour in Venezuela, as it appeared in the elections of 1998 and 2000, is different from that observed between 1958 and 1988. The paper reaches the conclusion that given the decline in party identification (dealignment), the short-term variables specific to each election, in particular the attitude towards government performance and personalities, have grown in weight vis-à-vis the structural factors (party identification, institutions, long-standing political predispositions). However, the latter were still relevant and important in the 1998 and 2000 elections and it is very likely they will carry on as such for the future. It is also concluded that, even though the party system has become unstable due to the decline in identification with the traditional government parties, new stabilising factors seem to have appeared and should be taken into account. These are ideology and negative party identification.     

The reliability of immunoassay for determining the presence of opiates in the forensic setting

Urine immunoassays are commonly used as a rapid screen for drugs of abuse in emergency room, hospital, clinic, and forensic settings. The authors were concerned whether or not a negative screen of the urine for opiates was of significance and indicative that analysis of blood for opiates was not necessary. Specifically, we wished to determine whether a negative test for opiates by immunoassay absolutely rules out an acute overdose, and if not, what percentage of cases with negative results have opiates in the blood. A retrospective analysis was performed using the toxicology results for cases ruled an acute narcotic overdose at the Bexar County Medical Examiner's Office between 1998 and 2003. One hundred eighty-three cases met the criteria for the study. A false-negative rate of approximately 15% was found using an immunoassay as compared with blood analysis for narcotics. The authors feel that while this rate may be acceptable in a clinical setting, it is unacceptable in a forensic setting.