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981.
Koehler SA Weiss HB Shakir A Shaeffer S Ladham S Rozin L Dominick J Lawrence BA Miller TR Wecht CH 《The American journal of forensic medicine and pathology》2006,27(1):30-35
Historically, fatal injury monitoring and surveillance have relied on mortality data derived from death certificates (DC). However, problems associated with utilizing DC have been well documented. Recently, access to and utilization of hospital discharge data (HDD) have offered a new and important secondary source of data regarding in-hospital deaths. However, studies have shown that discrepancies between the HDD and the corresponding DC often exist. This discrepancy was especially evident when comparing HDD to the vital statistics data (VSD) for deaths by falls among those aged 65 and over in 19 states.This was a retrospective forensic review of elderly (age 65 and over) fall-associated fatalities (E880-E888) identified from HDD and VSD in Allegheny County, Pennsylvania, between 1997 and 1998. Seventy-seven cases were identified, with the original manner of death listed as natural (34), suicide (1), and accidental (42) on the DC. Following a forensic review of the cases, the manner of the death on the DC should have been changed from natural to accidental in 28% (n = 12) of the cases, representing an undercount in the VSD. Undercounts were due to a failure of clinicians to account for the significance of a fall event that contributed to subsequent pathology and death. In addition, in that 22% (n = 17) of the HDD fall-associated deaths, the fall did not contribute directly or sequentially to the underlying cause of death, thereby representing an overcount in the HDD.Based on these findings we recommend (1) elderly fall surveillance systems should only count HDD E-coded falls that demonstrate a serious traumatic injury which directly or subsequently results in death, (2) all in-hospital fall-associated deaths should be reported to and reviewed by coroner/Medical Examiner offices for determination of the cause and manner of death, and (3) physicians should be better educated in properly completing death certificates. 相似文献
982.
In the period 1995-1999 there were 388 car exhaust-gas suicides in Denmark. Of these 343 (88.4%) were men and 45 (11.6%) were women, the average age being 47 years. The car exhaust-gas suicides made up 9.3% of all suicides in Denmark in the period. The corresponding rate was 11.7% for men and 3.7% for women. In rural areas a larger part of all suicides were committed with car exhaust-gas compared to the more densely populated areas. Mental disease was diagnosed in 124 (32.0%) cases. A suicide note was found in 165 (42.5%) cases. A hose was fitted to the exhaust pipe in 334 (86.1%) cases. Of these the 234 (60.3%) occurred outside, typically in a forest area, while 76 (19.6%) occurred in a closed garage. All the 54 (13.9%) cases with no hose fitted to the exhaust pipe occurred in a garage. Seven (1.8%) victims were found in a burning or burnt-out car, where the following investigation revealed that it was actually a car exhaust-gas suicide. Carboxyhemoglobin was measured in 26 (6.7%) victims. In two of these victims no carboxyhemoglobin was found, as they had survived for some time after the poisoning. The average saturation of the remaining victims was 67%, the lowest saturation being 20% and the highest being 84%. In the period 1969-1987 the number of car exhaust-gas suicides in Denmark increased from 50 to approximately 190 per year and the rate of car exhaust-gas suicides compared to all suicides increased from approximately 5% to approximately 13%. In 1987-1999 these figures decreased from approximately 190 to 63 per year and from 13% to approximately 8%. During these 30 years the number of passenger cars in Denmark doubled, which explains the increase in car exhaust-gas suicides during 1969-1987. A possible explanation for the decrease in 1987-1999 is the introduction of the catalytic converter, which was made mandatory in 1990. We anticipate that car exhaust-gas suicides will continue to decrease in numbers, as more cars are equipped with catalytic converters. 相似文献
983.
Padosch SA Dettmeyer RB Schmidt PH Musshoff F Madea B 《Forensic science international》2006,159(2-3):230-234
Spinal epidural haematomas (sEDH) can be regarded as rare events, in principle a spontaneous and a traumatic aetiology can be distinguished. Spontaneous spinal epidural haematomas can arise, e.g. from vascular malformations, coagulopathies, etc. On the other hand, traumatic sEDH are related to, e.g. spinal trauma or intraoperative vascular injuries. With regard to clinical significance, spinal epidural haematomas accompanied by transient mild neurological symptoms up to lethal outcomes have been observed. We report on a 53-year-old male alcoholic who was found in the kitchen of his asylum in a grotesquely fixed body position, with his head and cervical spine in a maximum anteflected position. A general practitioner had ruled for a non-natural manner of death due to "broken neck" and alcohol intoxication, therefore, the prosecution authorities called for a medicolegal autopsy. At autopsy, paravertebral soft tissue haemorrhage in between the shoulder blades was disclosed. Furthermore, a spinal epidural haematoma, extending from the foramen magnum down to the middle portion of the thoracic spine was found. No fractures of vertebrae nor lesions of spine ligaments or bleedings of intervertebral discs were found. Blood alcohol concentration was determined 1.92 g/l and urine alcohol concentration was 1.76 g/l. Further morphological findings were cerebral oedema and cardiac hypertrophy; the urinary bladder was found filled to bursting. Neuropathological investigations confirmed the presence of the spinal epidural haematoma and assigned lethal significance to this finding. There were no histological signs of axonal injury. Reconstruction revealed that when sitting on a chair in a drunk condition, the individual's upper part of the body had fallen backwards in the corner and subsequently got stuck with maximum anteflection of the head and cervical spine, causing rupture of vessels and spinal epidural haematoma. Acute respiratory failure caused by impairment of the phrenic nerve following spinal epidural haematoma with potential synergism of alcohol intoxication was ascertained as the cause of death. 相似文献
984.
Lowenstein JM Reuther JD Hood DG Scheuenstuhl G Gerlach SC Ubelaker DH 《Forensic science international》2006,159(2-3):182-188
In forensics and archaeology, it is important to distinguish human from animal remains and to identify animal species from fragmentary bones and bloodstains. We report blind tests in which a protein radioimmunoassay (pRIA) was used to identify the species of six bone fragments lacking morphological specificity and 43 bloodstained lithic tools, knapped experimentally and soaked in blood of known animal and human origin. The submitters of the bone fragments and the bloodstained tools each listed a number of possible species, from which the testers selected the best match with the pRIA results. All six bone fragments were correctly identified: three humans, a deer, a dog, and a cow. Forty-three tools were stained with blood from a wide variety of species including ungulates, carnivores, a fish, and a bird. On 40 of these 43, at least one species (or blood-free control) was identified correctly. Some of the tools were stained with blood of two different species. A mixture of sheep and musk ox blood was correctly identified; in several other mixtures, only a single species was detected. Two tools with human blood and one with human sweat were correctly reported as human. There was a single false positive (one of three controls reported as weakly bovine) and no false negatives. We conclude that the pRIA technique shows a high degree of accuracy in discriminating human from animal bone fragments and bloodstains and in identifying animal species. 相似文献
985.
Mura P Chatelain C Dumestre V Gaulier JM Ghysel MH Lacroix C Kergueris MF Lhermitte M Moulsma M Pépin G Vincent F Kintz P 《Forensic science international》2006,160(2-3):168-172
A collaborative study was conducted in France in order to determine the prevalence of cannabinoids, opiates, cocaine metabolites and amphetamines in blood samples from drivers killed in road accidents in 2003 and 2004 and to compare these values with those of a previous study performed during the period 2000-2001 involving 900 drivers. Blood samples were provided from 2003 under 30-year-old drivers, killed in a traffic accident. Drugs of abuse were determined by gas chromatography-mass spectrometry using the same analytical procedures in all the 12 laboratories. The most frequently observed compounds were by far cannabinoids, that tested positive in 39.6% of the total number of samples. Delta9 tetrahydrocannabinol (THC), the most active of the principle constituents in marijuana (cannabis sativa), was detected in the blood of 28.9% drivers and was the single drug of abuse in 80.2% of the positive cases. It was associated with amphetamines in 7.4% and with opiates and cocaine in 1.9 and 4.8%, respectively. Amphetamines were present in 3.1% of the total number of samples, cocaine metabolites in 3.0% and opiates in 3.5%. When comparing these results with those of a previous study performed 3 years before, a significant increase is observed for THC (28.9% versus 16.9%), cocaine metabolites (3.0% versus 0.2%) and amphetamines (3.1% versus 1.4%). This study demonstrates the critical necessity of implementing in France as soon as possible systematical roadside testing for drugs of abuse. 相似文献
986.
987.
988.
Scott H. Decker 《Journal of criminal justice》1985,13(3):207-216
This analysis focuses on the operation of a juvenile diversion program in a large metropolitan area. In particular, the impact of the program on referrals made by the police to the juvenile court is examined. Consistent with most studies of diversion, a significant amount of net widening was found to occur following the introduction of the program. A time-series design using a four-year-preprogram and four-year-program period was employed to examine the trends in processing over time. Referrals for all categories of offenses rose significantly during the program years. The implications of these results are discussed in light of both police commitment to the goals of diversion and the legal safeguards in juvenile processing. 相似文献
989.
During emergency thoracotomy, an artifactual injury complex consisting of laceration, abrasion, and, rarely, contusion may be formed by application of a surgical instrument called a rib spreader. Six cases demonstrating this confusing injury are presented, and its formation is discussed. 相似文献
990.