Lethal mixed intoxication with propofol in a medical layman

The authors report on a drug fatality of a 21-year-old man with a propofol (2,6-di-isopropylphenol) dependency. Propofol was detected in tissues and body fluids using SPME-GC/MS methods. The postmortem concentrations of propofol were 364 ng/ml in urine, 71 ng/ml in heart blood and 79 ng/ml in femoral blood. The drug addict had only an autodidactic medical knowledge, but had inserted himself a permanent cannula for intravenous injection of propofol several times a day. The injection material was bought via online auctions from eBay. The case illustrates how job-related drug dependencies become indistinct due to the free access to information and goods via the Internet.     

Atypical "body packing syndrome"--a case report

A case of ingested cocaine is reported in which death must be classified as body packer syndrome although both the temporal relationship and the number of packets were atypical. The deceased, a consumer of hard drugs who smuggled for his own use, was found in his flat. He was resuscitated and survived for another four days in hospital. Only four intact drug packages were found in the upper gastro-intestinal tract. The concentrations of cocaine in blood and organs were relatively low but in a potentially lethal range. The case is presented, and its particularities as well as the option of induced vomiting as a way of preventing the fatal outcome are discussed.     

Resuscitation injuries complicating the interpretation of premortem trauma and natural disease in children

Minor soft tissues injuries are common in both adults and children who have had cardiopulmonary resuscitation (CPR). Potentially life-threatening injuries are rare. The pre-arrest history in a resuscitated adult often assists the pathologist to interpret autopsy findings. In contrast, an infant or child may not have a reliable history. In this situation, it may be difficult if not impossible to distinguish resuscitation injuries from pre-existing accidental or inflicted trauma. I describe two children who had significant autopsy-documented injuries initially attributed to abuse. The State filed murder charges against the caretaker in each case. However, further history and review of the medical records suggested that resuscitation rather than pre-arrest trauma caused almost all of the injuries. The State dismissed the charges in the first case. A jury returned a "not guilty" verdict in the second. It is essential to consider the entire history and not just autopsy findings when performing a death investigation.     

The RECON typology of stalking: reliability and validity based upon a large sample of North American stalkers

A new typology of stalking, RECON (relationship and context-based), is proposed, based upon the prior relationship between the pursuer and the victim, and the context in which the stalking occurs. The static typology yields four groups: Intimate, Acquaintance, Public Figure, and Private Stranger. The typology was tested on a large (N = 1005) nonrandom sample of North American stalkers gathered from prosecutorial agencies, a large police department, an entertainment corporation security department, and the authors' files. Interrater reliability for group assignment was 0.95 (ICC). Discriminant validity (p < 0.01) was demonstrated on a variety of demographic, clinical, pursuit, threat, and violence characteristics among and between groups. Findings confirm and extend the work of other researchers, most notably the very high risk of threats and violence among prior sexually intimate stalkers, the very low risk of threats and violence among public figure (celebrity) stalkers, and the negative relationship between stalking violence and psychosis.     

Three-dimensional surface topography acquisition and analysis for firearm identification

In the last decade, computer-based systems for the comparison of microscopic firearms evidence have been the subject of considerable research work because of their expected capability of supporting the firearms examiner through the automated analysis of large amounts of evidence. The Integrated Ballistics Identification System, which is based on a two-dimensional representation of the specimen surface, has been widely adopted in forensic laboratories worldwide. More recently, some attempts to develop systems based on three-dimensional (3D) representations of the specimen surface have been made, both in the literature and as industrial products, such as BulletTRAX-3D, but fundamental limitations in achieving fully automated identification remain. This work analyzes the advantages and disadvantages of a 3D-based approach by proposing an approach and a prototype system for firearms evidence comparison that is based on the acquisition and analysis of the 3D surface topography of specimens, with particular reference to cartridge cases. The concept of 3D virtual comparison microscope is introduced, whose purpose is not to provide fully automated identification, but to show how the availability of 3D shape information can provide a whole new set of verification means, some of them being described and discussed in this work, specifically, visual enhancement tools and quantitative measurement of shape properties, for supporting, not replacing, the firearm examiner in reaching the final decision.