Suicidal or Homicidal Sharp Force Injuries? A Review and Critical Analysis of the Heterogeneity in the Forensic Literature

The differential diagnosis between self-inflicted and nonself-inflicted, suicidal and homicidal, injuries is difficult or impossible in many cases and, above all, cannot be made on the basis of information obtained solely from the autopsy or the medicolegal clinical examination. The purpose of this study is to analyze the literature on suicidal and homicidal sharp force injuries and identify the relevant parameters that may help differentiate between suicidal and homicidal deaths. To achieve this goal, a review of 595 potentially relevant articles was performed. After excluding the nonrelevant papers by screening the titles, all abstracts were reviewed, and articles meeting the inclusion criteria underwent a full-text review. The following parameters were compiled into a table: number of cases, localization of the injuries, and number of injuries. The data were statistically analyzed and compared with those available in the forensic literature. On the basis of the heterogeneity of data revealed by the present review, a simple and short checklist of the parameters that should be included when reporting suicides and homicides by sharp force has been proposed.     

Refugee repatriation during conflict: Protection and post-return assistance

This article reports on the findings of the International Study of Spontaneous Voluntary Repatriation, begun by the authors in 1986, and involving case studies on return to countries in Asia, Africa, and Latin America. It discusses the lack of recognition in both policy and practice of the pervasiveness of refugee-induced repatriation, and of repatriation during conflict; and offers new assumptions regarding the pattern and process of contemporary repatriation and of refugee decision-making. Lastly, it examines some repatriation issues for the 1990s: fragile peace and tenuous security; protection of the voluntary nature of return; dealing with non-recognised entities; and post-return assistance, particularly the need to focus on rehabilitation before development and to provide refugee-centred aid.     

Social or political cleavages? A spatial analysis of?the?party system in post-authoritarian Chile

Lipset and Rokkan??s (Party system and voter alignments: cross national perspectives, Lipset and Rokkan eds., New York: Free Press, pp. 1?C64, 1967) sociological model of cleavages and the so-called ??freezing hypothesis?? dominate theorizing about party system formation. Torcal and Mainwaring (Br. J. Polit. Sci. 33:55?C84, 2003) show the relevance of a purely political cleavage for structuring the party system in the case of Chile, challenging the freezing hypothesis??s claims. They also dispute case-specific research that argues Chile??s party system still reflects a ??three-thirds?? division between Left, Right, and Center. Revisiting this debate, our study employs spatial maps of the party system. Such political-economy models are rare in studies of Latin American politics. The application here supports a democratic/authoritarian political cleavage in Chile.     

Subarachnoid hemorrhage during sexual activity after sildenafil intake: an accidental association?

We report and describe an autopsy case of a man dead for rupture of cerebral artery aneurysm with subsequent subarachnoid hemorrhage after sexual intercourse. Toxicologic analysis demonstrated that he had consumed sildenafil (Viagra). Although subarachnoid hemorrhage has been reported to be associated with sexual intercourse, it is not among the known adverse effects of sildenafil. However, sildenafil has been found to interact with vascular physiology via multiple mechanisms and in most of the vascular districts of the human body. This case provides an example of a very rare association between this drug and a fatal pathologic event and deserves to be added to the existing clinical knowledge about sildenafil and the pathophysiology of the events involved. This knowledge may be helpful in orienting further investigation into the mechanisms of action of sildenafil and their clinical implications.     

Homicide by methane gas

Two cases of sudden death due to myocardial infarction which were associated external injuries on the chest are discussed here. Injuries were in the form of abraded contusions on the anterior part of chest. Both the cases were declared dead on arrival to the casualty section (Accident and Emergencies Department). In these cases, mention of injuries was not made in the inquest report. In both the cases, suspicion of foul play or the trauma induced myocardial infarction were ruled out by inquiring into the incidents by the autopsy surgeon. The cases highlight the importance of detailed history by the autopsy surgeon in cases of sudden death with associated injuries on the front of the chest.