Rupture of a giant splenic artery aneurysm. Report of an autopsy case.

We describe an autopsy case of a 61-year-old woman with von Recklinghausen's disease, who died suddenly following intraperitoneal hemorrhage due to the rupture of a giant splenic artery aneurysm. The aneurysm measured 16 x 13 x 5.5 cm--much larger than those in most previous reports. The pancreatic body, which was pressed by the aneurysm, was widely atrophic. In general, splenic artery aneurysms are more frequent in pregnant women or patients with portal hypertension. The pathogenesis of this aneurysm is presumed to be arterial dysplasia, focal arterial inflammation, or portal hypertension, unlike other aneurysms due to arteriosclerosis or syphilis. Since the patient had not been pregnant and had not had liver cirrhosis or arteriosclerosis, the pathogenic factor could not be determined in this case. The relationship between the genesis of the aneurysm and von Recklinghausen's disease was not clear either.     

Accidental poisonings involving carbon monoxide, heating systems, and confined spaces

Eleven incidents of carbon monoxide (CO) intoxication resulting in sixteen fatalities are reported. All of the cases involved heating systems as either the source or the means of distributing the CO. Blood samples were analyzed for ethanol and CO. Elevated blood CO saturations were found in 14 of the 16 victims while none of the victims had a blood ethanol concentration greater than 0.10% (w/v).     

Dermal surface in electric and thermal injuries. Observations by scanning electron microscopy

The dermal surface (after enzymatic digestion of the dermo-epidermal junction) in electric and heat lesions is described. There do not appear to be elements that help in forming a precise differential diagnosis. It is possible, however, to differentiate these lesions from all traumatic cutaneous injuries and some limited nontraumatic lesions (e.g., verrucae). Remarkably good preservation of the dermal surface even in an advanced state of decomposition does suggest the possibility of certain diagnosis of electric and heat lesions even when postmortem phenomena have greatly damaged or even totally removed the epithelial part of the skin.     

Suicide by Cop Among Officer-Involved Shooting Cases

Abstract: The frequency and characteristics of suicide by cop cases (SBC) among a large (n = 707) nonrandom sample of North American officer-involved shootings (OIS) were investigated. “Suicide by cop” is when a subject engages in behavior which poses an apparent risk of serious injury or death, with the intent to precipitate the use of deadly force by law enforcement against the subject. Thirty-six percent of the OIS in this sample were found to be SBC with high interrater agreement (intraclass correlation coefficient = 0.93) for category classification. SBC cases were more likely to result in the death or injury of the subjects than regular OIS cases. Most SBC cases were spontaneous, but had clear verbal and behavioral indicators that occurred prior to, and during the event. Findings confirm the trend detected in earlier research that there was a growing incidence of SBC among OIS. SBC individuals had a high likelihood of possessing a weapon (80%), which was a firearm 60% of the time. Half of those with a firearm discharged it at the police during the encounter. Nineteen percent simulated weapon possession to accomplish their suicidal intent. Other findings highlight the histories and commonalities in this high risk group.     

Using the Referral Decision Scale to Screen Mentally Ill Jail Detainees: Validity and Implementation Issues

The prevalence of serious mental illnesses in jail populations is significantly greater than in the general population. Identifying individuals who warrant psychiatric evaluations is important and benefits correctional staff as well as detainees. One widely used screening instrument intended for this task is the Referral Decision Scale (RDS). This paper reviews the development and validation of the RDS. Using data from a multisite study which assessed postrelease outcomes for detainees with mental illness, various types of validity are addressed. The results confirm that the RDS has some inherent characteristics that seriously limit its practical application as a screening instrument for use by correctional staff.