Factitious disorder comorbid with bipolar I disorder. A case report

We describe a case of factitious disorder with physical and psychological symptoms comorbid with bipolar I disorder in a 37-year-old woman. Since the onset of bipolar disorder, which occurred at the age of 31, she increasingly complained of physical symptoms, compulsively seeking medical and surgical interventions. She has been hospitalised several times and her Munchausen-type factitious disorder recently appeared to be developing into Munchausen by proxy, involving her 11-year-old daughter. The patient adhered poorly to stabilising and antipsychotic drug treatment and did not improve through the years. We here analyse her mood phases, which were always associated with changes in the quality of factitious symptoms, according to whether the disorder was in its depressive phase (somatic complaints and suicidal ideation prevail), or in its manic or mixed phase (medical intervention-seeking and manipulation of clinicians to obtain surgical interventions). We also briefly discuss some important forensic issues to consider in similar cases, mainly stemming from the psychotic aspects of these two co-occurring disorders. Clinicians should be aware of some patients' ability to produce signs and symptoms of physical and/or psychological illness and consult psychiatrists before giving consent to invasive diagnostic procedures or surgery.     

Mineralization of mandibular third molars can estimate chronological age--Brazilian indices

Forensic age estimation is an important element of anthropological research, as it produces one of the primary sources of data that researchers use to establish the identity of a person living or the identity of unknown bodily remains. The aim of this study was to determine if the chronology of third molar mineralization could be an accurate indicator of estimated age in a sample Brazilian population. If so, mineralization could determine the probability of an individual being 18 years or older. The study evaluated 407 panoramic radiographs of males and females from the past 5 years in order to assess the mineralization status of the mandibular third molars. The evaluation was carried out using an adaptation of Demirjian's system. The results indicated a strong correlation between chronological age and the mineralization of the mandibular third molars. The results indicated that modern Brazilian generation tends to demonstrate an earlier mandibular third molar mineralization than older Brazilian generation and people of other nationalities. Males reached developmental stages slightly earlier than females, but statistically significant differences between the sex were not found. The probability that an individual with third molar mineralization stage H had reached an age of 18 years or older was 96.8-98.6% for males and females, respectively.     

Voltammetric determination of Δ9-THC in glassy carbon electrode: An important contribution to forensic electroanalysis

Teeth are recently drawing attention for their potential as biological modeling investigation samples due to their ability to be collected and their slow substance metabolism. There is no active metabolism of elements after the completion of dentin. Dentin is surrounded by enamel and cementum, and is not affected by the oral environment. Therefore, the amount of trace elements in dentin may change with age, and this is considered to be a reliable biological load index. The objectives in this study are to demonstrate concentrations of elements in the dentin of healthy Japanese subjects by sex and age, and to reveal the relationship between element levels and age. 121 healthy teeth samples were extracted due to periodontal disease or orthodontic treatment. Each tooth was sliced from the crown to the root apex into 0.5-1mm thickness, then enamel, cementum, and the pulp were removed; the dentins were used as samples. The concentration of 10 trace elements (B, Mn, Co, Cu, Zn, Rb, Sr, Mo, Cd, and Pb) in the dentin was measured using inductively coupled plasma mass spectrometer (ICP-MS). The differences Co and Pb in the dentin between men and women were significant (p<0.01). Significant positive correlation was observed between B, Co, Cu, Zn, Sr and Pb concentrations in the dentin and age (p<0.001). The results of the present study suggest that human dentin is an appropriate substance for relativity with sex and age at further future research.     

The role of alcohol and victim sexual interest in Spanish students' perceptions of sexual assault

Two studies investigated the effects of information related to rape myths on Spanish college students' perceptions of sexual assault. In Study 1, 92 participants read a vignette about a nonconsensual sexual encounter and rated whether it was a sexual assault and how much the woman was to blame. In the scenario, the man either used physical force or offered alcohol to the woman to overcome her resistance. Rape myth acceptance (RMA) was measured as an individual difference variable. Participants were more convinced that the incident was a sexual assault and blamed the woman less when the man had used force rather than offering her alcohol. In Study 2, 164 college students read a scenario in which the woman rejected a man's sexual advances after having either accepted or turned down his offer of alcohol. In addition, the woman was either portrayed as being sexually attracted to him or there was no mention of her sexual interest. Participants' RMA was again included. High RMA participants blamed the victim more than low RMA participants and were less certain that the incident was a sexual assault, especially when the victim had accepted alcohol and was described as being sexually attracted to the man. The findings are discussed in terms of their implications for the prevention and legal prosecution of sexual assault.     

Personality Disorder Symptoms in Women as a Result of Chronic Intimate Male Partner Violence

This study explores the personality disorder symptoms of women victims of intimate male partner violence (IPV), after controlling for the contribution of experiences of childhood abuse. Victims of both physical and psychological violence (n = 73) or psychological violence alone (n = 53) were compared with non-abused control women (n = 52). Information about sociodemographic characteristics, childhood abuse, and personality characteristics (MCMI-II) was obtained through face-to-face structured interviews. Women victims of IPV had higher scores than controls in schizoid, avoidant, self-defeating personality scales, as well as in the three pathological personality scales (schizotypal, borderline and paranoid). Both physical and psychological IPV were strongly associated with personality disorder symptomatology, regardless of the effects of childhood abuse. These findings underscore the need to screen for personality disorder symptoms in women victims of IPV when dealing with therapeutic interventions.     

Determination of phosphoglucomutase (PGM1), acid phosphatase (ACP), and esterase D (ESD) in human bloodstains by hybrid isoelectric focusing (HIEF)

PGM1, ESD, and ACP were determined in bloodstain extracts by isoelectric focusing (IEF) with carrier ampholytes (CA) and HIEF. HIEF yields superior results in PGM typing from bloodstain extracts, whereas for ESD and ACP typing isoelectric focusing with carrier ampholytes seems to be the method of choice.     

Unexpected sudden death from coronary sinus thrombosis. An unusual complication of central venous catheterization

Coronary sinus thrombosis is an unusual but potentially serious complication of the use of central venous devices. We report a fatal case of coronary sinus thrombosis in relation to a malpositioned central venous catheter. The death occurred very soon following the beginning of symptoms and the cause could not be suspected. Direct trauma of the catheter on the coronary sinus endothelium seems the most probable cause of the thrombosis.