Child barbarity and torture: a case report

Penile strangulation with a strand of hair, acting as a tourniquet, and perforation of the eyes with a knife are uncommon accidental injuries in children. In such a situation, a mistreatment must be evoked. We present a case of barbarity and torture involving a young boy 3 years old. He was a victim of penis strangulation and perforation of the eyes, performed on previous surgical and infectious lesions. The mistreatment was performed by his mother's boyfriend. The perpetrator used the previous lesions to hide his misdeed. This amazing case of mistreatment points out the violence of the wounds and their being performed on previous lesions.     

Fatal accidental intrathecal injection of vindesine

ABSTRACT: A 25-year-old woman being treated for non-Hodgkin's lymphoma was accidentally given vindesine intrathecally. The error was recognized immediately and a spinal cord washing was performed through syringing with isotonic saline. However, the patient died 6 weeks later with increasing paralysis, which was followed by neurologic failure. The deceased was autopsied and the central nervous system was removed for a microscopic examination. The results showed microscopic lesions extending from the lumbar to the thoracic portion of the spinal cord, which included pseudocystic transformation of the cells, degeneration of myelin, and microhemorrhages. The brain was edematous and, in the cerebellum, the vermis showed a loss of granule and Purkinje cells. The authors compare this report on vindesine toxicity with cases in the literature involving vincristine. The treating physician admitted responsibility and was sentenced to both a fine and imprisonment.     

Homogeneous National Management Policies or Autonomous Choices by Administrative Units? Inter- and Intra-Country Management Tools Use Variations in European Central Government Administrations

ABSTRACT

This article presents an original research on the use of management tools in central government departments and agencies in 16 European countries. It is based on a survey conducted among senior managers (n?=?5,998). The analysis shows that the use of management tools results from a combination of top-down implementation of a list of management tools at the national level, combined with a bottom-up independent selection of tools by administrative units. The variation in management tool use depends on the type of tool. While the uses of a HRM tool, such as performance-related pay, or a financial tool, such as risk management, are heavily influenced by national public management policies, service quality-type tools, such as user surveys or quality management systems, tend to be chosen in a more autonomous manner by different administrative units, especially agencies.     

Can Labelling Policies Do More Harm Than Good? An Analysis Applied to Environmental Labelling Schemes

In certain plausible circumstances, the introduction of labelling schemes can lead to adverse effects. In the case of ecolabelling, the adverse effects are an environmental degradation rather than an environmental improvement. To take into account the environmental sensitiveness or responsiveness of consumers, we introduce the concept of environmental elasticity which enables us to classify goods. In a basic analytical model, we describe the conditions under which different outcomes—overall impacts of change in environmental quality due to environmental labelling—arise after the introduction of an ecolabelling scheme. We show that an ecolabelling scheme can lead to an increase in purchases of environmentally sustainable products. The net effect on the environment can be worse than the initial situation without ecolabelling, because the environmental unit improvement is compensated by an over-consumption. We suggest several tests to detect this potential perverse effect, some policy implications to avoid it and stress the need for further research.JEL Classification: D11, L15, Q28     

Extensive Necrotic Purpura in Levamisole‐Adulterated Cocaine Abuse – A Case Report

Levamisole, which is used as an adulterated compound of cocaine, is currently being seen year after year in cocaine intoxication. For a few cases in the last decade, necrotic purpura and neutropenia after levamisole/cocaine intoxication have been described in the medical community. Herein, we present an original case of levamisole intoxication of a 40‐year‐old woman who smoked heroin and cocaine few during a month. She rapidly presented an extensive necrotic purpura of the nose, cheeks and extremities (lower and upper), and immunologic reactions (positive anti‐MPO and anti‐HNE). Levamisole was detected on hairs with ultra‐high performance liquid chromatography and tandem mass spectrometry. The case reports also a probable cocaine supplier deceit, which bring pure drug for hospital investigation after the intoxication of his client. The intoxicated woman had survived with several skin and chronic pain complications. That case recalls the knowledge about levamisole with a short review of the forensic literature.     

Suicidal hanging resulting in complete decapitation--forensic, radiological, and anthropological studies: a case report

The authors report a case of complete posthanging decapitation. The decapitated corpse lay against a pillar of a road bridge. The head had rolled 5 m from the trunk. The bridge was 7.2 m above the road level. The rope was 3.6 m long, its lower end was 3.6 m from the ground and its diameter was 10 mm. The noose used was a slip knot. Plain X-rays of the skull and cervical spine were obtained. The skull X-rays showed air in the meningeal spaces, in both lateral and third ventricles. The severance plane of the cervical spine was between the third and the fourth cervical vertebrae. No other cervical vertebral injuries were noted. At autopsy, the brain was macroscopically unremarkable except for air in the meningeal veins. The decapitation injuries of the head and the torso corresponded perfectly, without apparent loss of substance. The severance plane was confirmed. Dry bone study was carried out. Except for fractures of the extremities of the spinous processes of the second and third cervical vertebrae, no other bone injury of the spine was seen. The cervical vertebrae displayed numerous osteoarthritic lesions. The traditional hangman's fracture was not found. To the best of our knowledge, this is the first report of complete posthanging decapitation with a severance plane between the third and fourth cervical vertebrae.     

A case of fatal salt water intoxication following an exorcism session

In response to a recent article published in this review, we present in this paper, an unusual case of fatal salt water intoxication. In this case, we point out three special features, the type of water ingested, the physiopathologic consequences of the ingestion and the very strange context of occurrence. This complex case allows us to point out complications due to salt poisoning and others caused by water intoxication.     

Interpretation of neuropathological lesions: Its limitations in medico-legal experts’ reports

Aggressive or paradoxical behaviour may reflect an organic dementia. The most frequent is Alzheimer's disease, which results from an abnormal structural conformation of tubulin-associated protein (tau) and beta-amyloid protein that, respectively, aggregate in certain neurons as intracellular neurofibrillary tangles (NFTs) and in the extracellular environment as senile plaques.These lesions progress in the brain tissue according to the stages described by Braak and Braak. Staging of neurofibrillary pathology has proven anatomical and clinical correlation, which can be used in a medico-legal procedure. We report two cases demonstrating discrepancies between anatomical and clinical features, which should encourage medical expert to prudence when interpreting neuropathological reports.