Commotio cordis as a result of a fight: Report of a case considered to be imprudent homicide

Commotio cordis is a clinic-pathological syndrome related to sudden death in young people involved in sports activities. It has been described, mainly, in athletes without previous cardiac anomalies who received a minor blow to the chest which produces ventricular fibrillation and cardiac arrest in the absence of structural damage to the ribs, sternum, or heart. There are few reported cases of commotio cordis associated with violent, non-sports related actions, which are commonly considered to be imprudent homicides. We present the case of a 20-year-old man, who was kicked in the chest during a fight; he suddenly collapsed although advanced cardio-respiratory resuscitation started shortly. Autopsy showed no cardiac lesions concluding that death was due to commotio cordis (blunt trauma to the chest). Toxicological analysis determined the presence of 5.14 mg/L benzoylecgonine in blood. On the basis of medico-legal investigation, the official prosecution considered the death to be imprudent homicide and the aggressor was sentenced to 4 years in prison. We emphasize the importance of the knowledge of the death circumstances through the witnesses’ testimony, prior to beginning the autopsy, to confirm this important medico-legal diagnosis. Arrhythmogenic effects of cocaine and its contribution in the production of these deaths are also exposed.     

Past and Future Directions of the APS: Some Personal Reflections

Reform of the public service has not been just some management fad, nor is it even driven by purely management considerations. Fundamentally, public service reform, both in the last decade and in the future, is being driven by basic changes in our society, economy and technology, which in turn influence what the public expects from government.
The reforms of the last decade or so have concentrated on changing the management framework and culture. Future reforms are likely to impact more heavily on the responsibilities of the APS and what it actually does. However, the underlying rationale will continue to be to ensure the delivery of services which respond more effectively to the needs of the community.     

The Gun Control Debate: Why Experience and Culture Matters

The article revisits the gun control debate policy comparing the varied and diverse perspectives and viewpoints held by both the culturalist and empiricist, pro-gun society and gun less society on how the gun debate may be properly resolved through a pragmatic approach of policy-making- putting emphasis on culture, experience and observation with regards to gun control. In the process of employing an idea-based coalition approach and argumentative discourse analysis towards the brewing gun control debate, the article consequently realizes the convergent role of both cultural worldviews and public opinion plays at the very heart of deliberation on gun debate.