Sudden death due to asphyxia by esophageal polyp: two case reports and review of asphyxial deaths

Asphyxia, not an uncommon cause of sudden death, may result from numerous etiologies. Foreign-body aspiration and strangulation are 2 extrinsic causes. Airway obstruction may also be caused by laryngeal edema, asthma, infection, or anaphylaxis. Chronic causes of asphyxia include musculoskeletal diseases (eg, muscular dystrophy, amyotrophic lateral sclerosis), neurologic disorders (eg, myasthenia gravis, multiple sclerosis), respiratory disease (eg, emphysema, chronic bronchitis), or tumors. The manner of death in cases of asphyxiation may be natural, accidental, homicide, or suicide. For the death investigator, determining the cause and manner of death can often be quite challenging.We report here 2 cases of an esophageal fibrovascular polyp causing sudden asphyxial death, review of the literature, and discussion of other differential diagnoses in the case of asphyxial death.     

Some limitations of the groves-ledyard optimal mechanism

Public Choice - The tax rule suggested by Groves and Ledyard is certainly an ingenious one, although there is no indication as to how one might fall upon that specific scheme. If offers Pareto...     

Applying a forensic actuarial assessment (the Violence Risk Appraisal Guide) to nonforensic patients

The actuarial Violence Risk Appraisal Guide (VRAG) was developed for male offenders where it has shown excellent replicability in many new forensic samples using officially recorded outcomes. Clinicians also make decisions, however, about the risk of interpersonal violence posed by nonforensic psychiatric patients of both sexes. Could an actuarial risk assessment developed for male forensic populations be used for a broader clientele? We modified the VRAG to permit evaluation using data from the MacArthur Violence Risk Assessment Study that included nonforensic male and female patients and primarily self-reported violence. The modified VRAG yielded a large effect size in the prediction of dichotomous postdischarge severe violence over 20 and 50 weeks. Accuracy of VRAG predictions was unrelated to sex. The results provide evidence about the robustness of comprehensive actuarial risk assessments and the generality of the personal factors that underlie violent behavior.     

Death by chainsaw: fatal kickback injuries to the neck

Each year over 3 million new chainsaws are sold in the United States. The operation of these newer saws combined with the millions of older chainsaws in circulation results in over 28,000 chainsaw-related injures annually. The majority of the injuries involve the hands and lower extremities with less than 10% involving injuries to the head and neck regions. Deaths while operating a chainsaw are extremely rare. The most common hazards associated with chainsaws are injuries caused by kickback, pushback, and pull-in. Kickback is the most common and poses the greatest hazard. Kickback occurs when the rotating chain is stopped suddenly by contact with a more solid area throwing the saw rapidly backward toward the operator. The cause of most injuries can be traced to improper use of the saw or poor judgment on part of the operator. We present two fatal chainsaw deaths; one with an older style saw, and the other with a modern type. In both cases the victims died from fatal injuries received to the neck region from a chainsaw kickback. The first case involved a 49-year-old white male operating an older style chainsaw with limited safety features. The second case involved a 38-year old white male who was operating a newer model chainsaw equipped with a low kickback chain in an unsafe manner.     

Genipin--a novel fingerprint reagent with colorimetric and fluorogenic activity

Genipin, the hydrolytic product of geniposide, which is extracted from gardenia fruit, shows good potential as a fingerprint reagent. It develops latent fingerprints on paper as blue impressions with good contrast and resolution. Even very faint impressions that are barely visible in ambient light will fluoresce brightly upon illumination at ca. 590 nm and are best viewed with a barrier filter above 630 nm. Potential advantages of genipin are the combination of colorimetric and fluorogenic activity in one reagent as well as its being a safe and environmentally friendly natural product.     

The rarity of "unusual" [corrected] dispositions of victim bodies: staging and posing

The act of leaving a victim's body in an unusual position is a conscious criminal action by an offender to thwart an investigation, shock the finder and investigators of the crime scene, or give perverted pleasure to the killer. The unusual position concepts of posing and staging a murder victim have been documented thoroughly and have been accepted by the courts as a definable phenomenon. One staging case and one posing case are outlined and reveal characteristics of those homicides. From the Washington State Attorney General's Homicide Investigation and Tracking System's database on murder covering the years 1981-2000 (a total of 5,224 cases), the relative frequency of unusual body dispositions is revealed as a very rare occurrence. Only 1.3% of victims are left in an unusual position, with 0.3% being posed and 0.1% being staged. The characteristics of these types of murders also set them apart: compared to all other murders, in staged murders the victims and killers are, on average, older. All victims and offenders in the staged murders are white, with victims being disproportionately white in murders with any kind of unusual body disposition. Likewise, females stand out as victims when the body is posed, staged, or left in other unusual positions. Whereas posed bodies are more likely to include sexual assault, often in serial murders, there is no evidence of either in the staged cases. Lastly, when a body is left in an unusual position, binding is more likely, as well as the use of more "hands on" means of killing the victim, such as stabbing or cutting weapons, bludgeons, ligatures, or hands and feet.