Malpractice issues in heart transplantation

As organ transplantation procedures become accepted as standard medical practice, it is anticipated that the frequency of liability claims against transplant care providers will increase. This article examines current statutory and common law analyses of malpractice issues in transplantation, with particular attention given to issues of informed consent as they arise both for the organ donor and donee.     

Methodology and interpretation of morphiate detection in urine samples

In TLC screenings of 335 urine samples taken because of suspicion of heroin consumption, positive evidence of morphine was found in about 50% of the cases, which was confirmed without exception by gas chromatography-mass spectrometry. In 66% of the positive cases, morphine and codeine were found; in about 31% only morphine was found, and the median value of 0.4 mg/l free morphine and 1.0 mg/l conjugated morphine was considerably lower than in the whole collection of samples. Comparison of the codeine/morphine quotients (Q), especially the free bases, proves that the groups of heroin/morphine or codeine consumers can be distinctly differentiated. The critical conditions of the conjugated bases worked out by Dutt et al. (1983) proved to be right. Using the equation Qf less than 0.5 square root c, a boundary condition for the free flare bases can also be developed, which is dependent on the sum of the codeine and morphine concentrations and which proves heroin/morphine consumption with 98% certainty.     

Toxicologic aspects of deaths due to falls from height

A prospective study of 161 victims of falls from height is reported. The aim was to determine the interest of systematic qualitative and quantitative toxicological analysis in such fatalities. The primary cause of death was suicide (84.5%), followed by accidents (7%) and homicide (1%). In the remaining 7.5%, cause of death was undetermined. In the suicides, there was evidence of psychotropic medicines in 57% of the observations, with a much higher proportion of benzodiazepines and antidepressants in women than in men. Quantitative toxicologic analysis showed overdosing on medication in 16 suicide victims, with toxic levels in 11 of these. Systematic qualitative and quantitative toxicologic analysis made a significant contribution to the diagnosis of suicide by revealing either an unknown psychiatric treatment or a toxic level.     

Associations of dating violence victimization with lifetime participation, co-occurrence, and early initiation of risk behaviors among U.S. high school students

This study examined the association of victimization in a physically violent dating relationship with risk behaviors, age of risk behavior initiation, and co-occurrence of risk behaviors among students in grades 9 through 12 in the United States. Data were from the 2003 national Youth Risk Behavior Survey (YRBS). Nearly 9% of students reported experiencing dating violence victimization. Dating violence victimization was associated with alcohol use, marijuana use, and having ever had sexual intercourse among female students and having ever had sexual intercourse among male students. Dating violence victimization also was associated with early initiation of alcohol use among female students. The odds of dating violence victimization increased as the number of risk behaviors increased and as the number of lifetime sexual partners increased. These risk behavior patterns should serve as warning signs of elevated risk for dating violence victimization and may be helpful in identifying adolescents who could benefit from targeted, preventive interventions.     

Screening practices for adolescent dating violence

This study sought to determine the screening practices of child and adolescent psychiatrists regarding adolescent dating violence (DV). A questionnaire regarding screening practices for DV and other risk behaviors was administered to 817 child and adolescent psychiatrists via the Internet and mail. Twenty-one percent of clinicians screened for DV "more than 90% of the time," and 65% had identified it in the past year. Multiple logistic regression analyses found that screening for DV was associated with consistent screening for either substance use or interparental violence (OR=3.0 and 6.3, respectively). Despite the prevalence of DV, only a minority of psychiatrists screen their adolescent patients for this type of risk. These data suggest that screening for DV is associated with consistent screening practices for other risk behaviors. Screening rates may be improved with training and adherence to specific protocols.     

Working women making it work: intimate partner violence, employment, and workplace support

Partner violence may have significant consequences on women's employment, yet limited information is available about how women cope on the job with perpetrators' tactics and the consequences of her coping methods on employment status. This article investigates whether there is an association between workplace disclosure of victimization and current employment status; and whether there is an association between receiving workplace support and current employment status among women who disclosed victimization circumstances to someone at work. Using a sample of partner victimized women who were employed within the past year (N = 485), cross-tabulation and ANOVA procedures were conducted to examine the differences between currently employed and unemployed women. Binary logistic regressions were conducted to examine whether disclosure and receiving workplace support were significantly associated with current employment. Results indicate that disclosure and workplace support are associated with employment. Implications for clinical practice, workplace policies, and future research are discussed.     

Partner stalking and implications for women's employment

In general research suggests partner violence has a negative impact on women's employment. However, there has been limited examination of partner stalking and consequences for employment. The purpose of this study was to examine partner stalking and employment consequences among two samples of women. One sample was women who had obtained a protective order against a violent partner and had worked in the prior year (n = 482), about one half of these women were stalked by their violent partner and one half were not. The second study examined qualitative information from women recently stalked (n = 62) by a violent partner. Results from both studies suggest that women who were stalked by a violent partner were significantly more susceptible to on-the-job harassment and problems. Also, women reported that stalking by a partner interfered in their work through on-the-job harassment, work disruption, and job performance problems. Implications for policy and research are discussed.     

Juvenile delinquency and victimization: a theoretical typology

It is a widely voiced notion that juvenile delinquency and victimization co-occur extensively in the youth population, in particular because delinquent youth engage in risky activities. But theory from the bullying and traumatic stress literatures suggests that there may be additional pathways by which delinquency and victimization are connected. This analysis looks for possible subtypes of delinquents and victims consistent with such pathways. Using the Developmental Victimization Survey, a national sample of 1,000 youth aged 10 to 17 were interviewed over the phone. Support emerges for three distinct types of delinquent-victims, who are termed bully-victims, delinquent sex/maltreatment- victims, and property delinquent-victims. There is also evidence for substantial groups of youth who are primarily delinquent but not seriously victimized, as well as youth who are primarily victimized but not delinquent.     

Genetic variation of 13 STR loci in the four endogamous tribal populations of Eastern India

We have analysed 13 autosomal STR loci in four endogamous tribal populations from two eastern states (Orissa and Nagaland) of India. The Gadaba, Kuvi Khond and Lotha Naga populations have not been analysed for microsatellite genetic variation previously. The allele frequencies for all loci are within the range observed in the geographical region and racial background, though some alleles showed greater variation. Departures from the Hardy-Weinberg equilibrium were tested by three methods and two loci (THO1 and TPOX) showed significant departures for all measures in Gadaba and Lotha Naga populations. The exclusion probability and discrimination probability were high for all analysed loci in all populations. There is no evidence for association of alleles among the STR loci studied. This allele frequency information will be useful for forensic, paternity and population genetic studies.     

Wischnewsky's spots in an ectopic stomach

Wischnewsky's spots in the mucosa of the stomach have been a well-known sign of death due to hypothermia for many years. Furthermore it is reported that those spots can rarely be found in the esophagus as well. We now report on a case concerning a 93-year-old woman who presented an ectopic stomach with erosions of the mucosa in the intrathoracic part of the stomach that were assessed as Wischnewsky's spots. When she was found dead in her flat, she was completely undressed and showed an injury to the head. The autopsy findings are presented and discussed in view of a possible genesis and pathophysiology of Wischnewsky's spots.