Another death due to ingestion of Nicotiana glauca

Deaths attributed to ingestion of Nicotiana glauca are extremely rare. We report here a case where a 43-year-old man was found dead after apparently drinking a water extract of Nicotiana glauca. The primary alkaloid in the plant is anabasine. Toxicological analysis by capillary gas chromatography showed the deceased had a blood anabasine concentration of 2.2 mg/L. Clinically, the features of poisoning are nicotine-like and if death occurs it results from respiratory paralysis. The case further supports the view that, in the human, anabasine is considerably more toxic than nicotine.     

The law and the public's health: a study of infectious disease law in the United States

Law plays crucial roles in the field of public health, from defining the power and jurisdiction of health agencies, to influencing the social norms that shape individual behavior. Despite its importance, public health law has been neglected. Over a decade ago, the Institute of Medicine issued a report lamenting the state of public health administration, generally, and calling, in particular, for a revision of public health statutes. The Article examines the current state of public health law. To help create the conditions in which people can be healthy, public health law must reflect an understanding of how public health agencies work to promote health, as well as the political and social contexts in which these agencies operate. The authors first discuss three prevailing ways in which the determinants of health are conceptualized, and the political and social problems each model tends to create for public health efforts. The analysis then turns to the core functions of public health, emphasizing how law furthers public health work. The Article reports the results of a fifty-state survey of communicable disease control law, revealing that few states have systematically reformed their laws to reflect contemporary medical and legal developments. The Article concludes with specific guidelines for law reform.     

Lethal child abuse (through the use of physical force) in the German Democratic Republic during the period 1 January 1985 to 2 October 1990. Results of a multicenter study

No reliable data are available on cases of lethal child abuse (by active force) in the area of the former German Democratic Republic. In a multicenter study we therefore examined the police and court records for such cases occurring in the period 1 January 1985 to 2 October 1990 in the entire area of the former German Democratic Republic. RESULTS: The study center received information on 39 cases of lethal child abuse which correspond to approximately 7 cases per year. However, a low percentage of undetected crimes which cannot be determined more precisely has to be taken into consideration. Almost 40% of the victims were younger than 1 year, 73% of the victims showed indications of repeated ill-treatment. The effects caused by using direct blunt forces, against the head in particular, were by far the most frequent causes of death. The male contact person (the victim's father, brother or stepfather as well as the life companion of the child's mother in particular) killed the child in most of the cases. As far as it is known, 37% of the male/female offenders suffered from chronic alcoholism; 32% of the male/female offenders were under the influence of alcohol when the crime happened. 83% of the male/female offenders who were found guilty made a confession shortly after the crime had happened or during the interrogations. Almost all the male/female offenders were sentenced to prison (the duration of the imprisonment varied between one year and for life). Due to the considerably lower section rate compared to the one in the German Democratic Republic, it is to fear that each second fatal child abuse is not detected in the new federal states.     

Fatal child abuse (caused by physical violence) in Germany during 1 January 1985 to 2 October 1990. Results of a multicenter study]

No reliable data are available on cases of lethal child abuse (by active force) in the area of Federal Republic of Germany prior to reunification (the former West Germany). In a multicenter study we therefore examined the police and court records for such cases occurring in the period 1 January 1985 to 2 October 1990 in nearly the entire area of Federal Republic of Germany. RESULTS: The study center received information on 58 cases of lethal child abuse. Extrapolated to all institutes of legal medicine, this corresponds to 62 cases in all of West Germany in the period studied. An approximately equal number of unreported cases should be added to this figure. Including unreported cases, at least 20 cases of lethal child abuse occurred per year; thus only one in every two cases ever came to light. Almost two thirds of the victims were younger than one year old. At autopsy 59% exhibited signs of repeated abuse at autopsy. By far the most common cause of death was direct impact from a blunt object, usually to the head. Mostly, the male person to whom the victim relates most closely (father, stepfather, partner of the mother) has killed the child. Twenty-one of the 74 persons charged saw the charges against them dropped or were acquitted due to lack of evidence; 51 received sentences ranging from one year probation to life. In the remaining two cases the outcome of the trial was unknown. Signs of abuse were readily apparent at autopsy in almost all cases. The high number of unreported cases underscores the need to educate medical students and practicing physicians to be on the look-out for signs of abuse and argues for an increase in the rate of autopsy.     

COLLECTIVE ACTION IN PRISONS: PROTESTS,DISTURBANCES, AND RIOTS*

This study assesses competing explanations of inmate collective action using data from a nationwide sample of 317 adult maximum-and medium-security state prisons. Most previous studies have relied on data from only those prisons that have experienced riots. Hence, the conditions thought to cause collective outbursts may be equally present in prisons that did not experience such action. The current design allows for a comparison of riot and nonriot prisons. Additionally, this study examines the forces that generate other forms of collective action in prison, such as minor disturbances and inmate work stoppages. The results show that the variables under the administrative-control theory heading, but not the inmate-balance theory heading, help account for these events. Some consideration is given to the possibility that these two theories are complementary explanations.     

Estimating time of death of deer in Missouri; a comparison of three indicators

Estimation of time of death (TOD) of white-tailed deer is important to wildlife law enforcement officers. The purpose of this study was to develop and test a model for estimating TOD of white-tailed deer in Missouri. We compare the utility of carcass temperature, pupil diameter, and rigor mortis as TOD indicators. The effects of body size, ambient temperature, and various carcass handling methods on the estimate were also examined. Data were collected from 1484 deer during the 1995-96 and 1996-97 hunting seasons. Stepwise regression indicated that all three indicators were significant and that body size and ambient temperature could influence the model. Predictive equations were developed for various combinations of the indicators based on practicality and statistical probabilities. TOD was estimated for 28 animals where the exact TOD was known. There was no significant difference between the estimated and known TOD (p = 0.759) and the average of the absolute differences in 1 h and 28 min.     

Population data on the thirteen CODIS core short tandem repeat loci in African Americans, U.S. Caucasians, Hispanics, Bahamians, Jamaicans, and Trinidadians

Allele distributions for 13 tetrameric short tandem repeat (STR) loci, CSF1PO, FGA, TH01, TPOX, VWA, D3S1358, D5S818, D7S820, D8S1179, D13S317, D16S539, D18S51, and D21S11, were determined in African American, United States Caucasian, Hispanic, Bahamian, Jamaican, and Trinidadian sample populations. There was little evidence for departures from Hardy-Weinberg expectations (HWE) in any of the populations. Based on the exact test, the loci that departed significantly from HWE are: D21S11 (p = 0.010, Bahamians); CSF1PO (p = 0.014, Trinidadians); TPOX (p = 0.011, Jamaicans and p = 0.035, U.S. Caucasians); and D16S539 (p = 0.043, Bahamians). After employing the Bonferroni correction for the number of loci analyzed (i.e., 13 loci per database), these observations are not likely to be significant. There is little evidence for association of alleles between the loci in these databases. The allelic frequency data are similar to other comparable data within the same major population group.     

Fulminant liver failure in a young child following repeated acetaminophen overdosing

Acetaminophen (paracetamol), a widely used analgetic drug, is well tolerated at therapeutic doses, but may cause severe hepatotoxicity when ingested in large overdose. Self-poisoning is still very popular in adults and accidental ingestion of one single overdose occurs occasionally in children. In contrast, lethal intoxication in children after repeated administration of therapeutic doses is a very rare event. This case report describes an iatrogenic acetaminophen overdosing in a 5-year-old child receiving 8.5 g acetaminophen in 48 h. Fulminant liver failure developed within 60 h. Autopsy findings included panlobular liver cell necrosis. Acetaminophen serum levels were rather low compared to cases with ingestion of one single overdose. Postmortem diagnosis of chronic acetaminophen intoxication as cause of death should include the clinical history as well as, if available, the calculated drug serum half-life.