Vertebral artery dissection complicating occipital injection of heparin for treatment of thoracic outlet syndrome

A 38-year-old woman with a 2-year history of chronic neck pain radiating down her right arm underwent radiological and neurological evaluations, which revealed no anatomical cause for her pain. She sought alternative therapies including intramuscular heparin injections. Following a right occipital injection of heparin, cyanocobalamin, and lidocaine, she had a sudden cardiorespiratory arrest and was successfully resuscitated, but did not regain consciousness.Computed tomography of the head and neck and subsequent autopsy revealed a right vertebral artery dissection, but at autopsy, no significant subarachnoid hemorrhage was noted at the base of the brain. This is the first case report where heparin (a potent anticoagulant) used in an occipital injection was documented to cause a vertebral artery dissection. It is also the first reported case where radiographically and histologically documented vertebral artery dissection did not present with overwhelming subarachnoid hemorrhage at the base of the brain. The subtle gross anatomical findings in this case highlight the importance of evaluating the cervical spinal cord in any case of sudden cardiorespiratory arrest following even apparently minor neck injury.     

Fraud victimization: Risky business or just bad luck?

Victimology theory recognizes that the characteristics, attitudes, and behaviors of potential victims influence the likelihood of criminal victimization. An important question for victimologists is whether potential victims put themselves at risk by engaging in risky behavior or whether victimization is primarily a result of bad luck. While this question has been investigated extensively with respect to street crime victimization, little attempt has been made to apply it to victimization by fraud. This article investigates the influence of attitudes toward financial risk taking on the likelihood of fraud victimization. Using data from a telephone survey of 400 randomly sampled respondents, we find that age and attitudes toward financial risk taking are significantly related to the likelihood of attempted victimizations but not to successful victimizations.     

Reviews

E. Comisso and L. D'Andrea Tyson eds. Power, Purpose and Collective Choice. Economic Strategy in Socialist States. Cornell University Press: Ithaca and London, 1986, 422 pp. $43.45 h/b, $16.45 p/b.

Dietrich Andre Loeber ed. Ruling Communist Parties And Their Status Under Law. Dordrecht: Martinus Nijhoff Publishers, 1986, xxi + 550 pp. £101.50 h/b.

E. S. Williams, The Soviet Military: Political Education, Training and Morale. London: Macmillan, 1987, xv + 203 pp. £27.50.

John Erickson, Lynn Hansen and William Schneider, Soviet Ground Forces: An Operational Assessment. London: Croom Helm & Westview, 1986, xix + 267 pp. £25.00.

Kurt M. Campbell, Soviet policy towards South Africa. London: Macmillan, 1986, xii + 223 pp. £27.50.

David A. Korn, Ethiopia, the United States and the Soviet Union, London: Croom Helm, 1986, 199 pp. £19.95.

Samuel M. Makinda, Superpower Diplomacy in the Horn of Africa, London: Croom Helm, 1987, 241 pp. £22.50.

Ivan Volgyes, Politics in Eastern Europe. Chicago: Dorsey Press, 1986, xvii + 368 pp. $20.00.

Olga A. Narkiewicz, Soviet Leaders: from the Cult of Personality to Collective Rule. Brighton: Wheatsheaf, 1986, ix + 256 pp. £18.95.

Simon Bergstrand and Rigas Doganis, The Impact of Soviet Shipping. London: Allen & Unwin, 1987, xvi + 184 pp. £30.00.

Martin Kitchen, British Policy towards the Soviet Union during the Second World War. London: Macmillan, 1986, viii + 309 pp. £29.50.

Alexandre Popovi?, L'lslam balkanique. Les Musulmans du sud‐est européen dans la période post‐ottomane, Osteuropa‐Institut an der Freien Universitat Berlin, Balkanolo‐gische Veröffentlichungen, edited by Norbert Reiter, vol. 11, Berlin, in conjunction with Otto Harrassowitz, Wiesbaden, 1986, xii + 493 pp.

Bernard Lory, Le Sort de l'Héritage Ottoman en Bulgarie; l'Exemple des Villes Bulgares, 1878–1900. Published at the initiative and with the help of the Institut Français d'Etudes Anatoliennes d'Istanbul and l'Association pour le Développement des Etudes Turques, Paris, Editions Isis, Istanbul, 1985, viii + 235 pp.

Shirin Akiner, Islamic Peoples of the Soviet Union. 2nd ed. London: KPI, 1986. xiii + 462 pp.

Bruce W. Watson and Susan M. Watson, eds., The Soviet Navy: Strengths and Liabilities, Westview Press/Arms and Armour Press, London, 1986, xv + 333 pp. £19.95.

Robert Conquest, ed., The Last Empire: Nationality and the Soviet Future. Hoover Institution Press, Stanford, Calif, (distributed in UK by Clio), 1986, xiv + 406 pp. £23.45.

Jeffery Simon and Trond Gilberg, eds. Security Implications of Nationalism in Eastern Europe, Westview Press. Boulder, Colorado and London, 1986 xvi + 327 pp. £27.75.

K. R. M. Short, ed., Western Broadcasting over the Iron Curtain, Croom Helm, London, 1986, 274 pp. £22.50.

John Bushnell, Mutiny amid Repression: Russian Soldiers in the Revolution of 1905–1906. Bloomington: Indiana University Press, 1985, ix + 334 pp. £24.50.

Roger Woods, Opposition in the GDR under Honecker 1971–85. Macmillan, London, 1986, x + 257 pp. £27.50.

Yury Boshyk, ed., Ukraine during World War II— History and its Aftermath. Canadian Institute of Ukrainian Studies, University of Alberta, Edmonton, 1986, xix + 219 pp. no price quoted.

Peter Beilharz, Trotsky, Trotskyism and the Transition to Socialism, London: Croom Helm, 1987. 197 pp. £25.00.

A. Buick & J. Crump, State capitalism: the wages system under new management. Basingstoke, Macmillan, 1987, ix + 165 pp. £25.00 h/b, £8.95 p/b.     

Public‐private partnerships: consultation,cooperation and collusion

In late 2002, public‐private partnerships (PPP) rose to the attention of the New Zealand public and gained media attention due to what became known as the ‘Armstrong affair’. This paper provides an overview of the Armstrong affair and of the issues engendered by the affair for the formation of policy in relation to PPP. The most fundamental of these issues was the correct relationship between the public and private sectors. The Armstrong case illustrates the way in which the demarcation between the two sectors must be maintained—and seen to be maintained—in the conduct of public affairs. If it is not, the accusation may rightly be levelled that the processes of consultation and cooperation have crossed over into collusion. Copyright © 2003 Henry Stewart Publications     

CHILDREN'S AND PARENTS’ PERCEPTIONS ON CHILDREN'S PARTICIPATION IN DECISION MAKING AFTER PARENTAL SEPARATION AND DIVORCE*

This article outlines the views of children and parents involved in family law disputes, about the need for and appropriateness of children's participation in decisions regarding residence and contact arrangements. Ninety parents and 47 children (ranging in age from 6 to 18 years) who had been through parental separation, were interviewed. Both parents and children had a range of views about the general appropriateness and fairness of children being involved, but the great majority, particularly of parents, thought that children should have a say in these matters. Core findings of the study include the considerable influence that older children had over the arrangements either in the aftermath of the separation or in making further changes over time, and the higher stated need of children who had experienced violence, abuse, or high levels of conflict to be heard than those in less problematic and noncontested matters. Parents involved in contested proceedings supported the participation of children at a younger age than those who were not. There was a reasonable degree of agreement between parents and children about the need for children to be acknowledged and the value of their views being heard in the decision‐making process. Parents, however, expressed concern about the pressure and manipulation that children can face and exert in this process, whereas children were generally more concerned about the fairness of the outcomes, and maintaining their relationships with their parents and siblings.     

Postmortem analysis of anastomotic suture line disruption following carotid endarterectomy

The tensile strength of a surgical suture is essential in maintaining the integrity of vascular anastomoses. While faulty operative technique and the loading strength of individual sutures have been implicated in spontaneous suture line disruptions, there has, to date, never been a published postmortem analysis of a suture that has known to have failed. We present the case of suture line disruption leading to fatal exsanguination in a 77-year-old man following carotid endarterectomy with a facial vein patch. Using both dissecting and scanning electron microscopy, we determined that surgical technique (an untied knot) was the cause of the suture line disruption. The removal of a broken or untied suture at surgery or at autopsy should not preclude proper analysis of the failed suture, because the results can have both medico-legal and public health implications.     

The Spectre of Addis in Contracts of Employment in Canada and the UK

This article examines the legacy of the 1909 House of Lordsdecision in Addis in both Canada and the UK by closely analysinga key case from each jurisdiction: Wallace v United Grain Growersand Johnson v Unisys. It underlines the continuing strong tendencyto treat wrongful dismissal solely as breach of the notice termand considers the remedial consequences of that stance.     

Pharmacy practice developments: the potential impact on pharmacists' legal liability

The practice of pharmacy has changed over recent years with a greater emphasis on the patient and the provision of patient care services. This expanded role of pharmacists as medication managers has resulted in changes to their professional responsibility and potential legal liability. Recent international case law demonstrates an increased legal liability of pharmacists in certain instances. However, pharmacists' liability in this new context in Australia is yet to be clarified.