The Future Israeli-Palestinian Relationship

In this concept paper, the Joint Working Group on Israeli‐Palestinian Relations‐a group of influential Palestinians and Israelis that has been meeting periodically since 1994 to discuss final‐status issues in the Israeli‐Palestinian negotiations‐explores the future relationship between the two societies after the signing of a peace agreement. The paper considers a relationship based on total separation between the two societies and states as neither realistic nor desirable. Instead, it envisages a future relationship based on mutually beneficial cooperation in many spheres, conducive to stable peace, sustainable development, and ultimate reconciliation. The basis for such a relationship must be laid in the process and outcome of the final‐status negotiations and in the patterns of cooperation established on the ground. Efforts at cooperation and reconciliation cannot be pursued apart from their political context. The paper argues that the only feasible political arrangement on which a cooperative relationship can be built is a two‐state solution, establishing a genuinely independent Palestinian state alongside of Israel. The resolution of final‐status issues must be consistent with the sovereignty, viability, and security of both states. The paper then proceeds to describe several models for the relationship between the two states and societies. It advocates a model of close cooperation, but proposes that this relationship be built in stages. The scope and speed of expanding and institutionalizing cooperative activities must be determined by experience‐by the extent to which such activities meet the needs of both parties, enhance mutual trust, and reduce inequalities between the parties. Finally, the paper discusses three avenues for promoting a cooperative relationship based on equality, reciprocal benefit, and mutual trust and respect: the development of functional ties and civil‐society institutions across national borders; programs directed toward attitude change and stereotype reduction; and efforts to close the economic and political gap between the two societies.     

Origin and development of forensic medicine in the Kingdom of Saudi Arabia

The medicolegal death investigation system in the Kingdom of Saudi Arabia (KSA) is unique in the world. It is exclusively derived from Islamic judiciary based on Shari'ah law, which is the definitive Islamic law or doctrine. This law is applied on Saudi citizens as well as foreigners. This is different from other Islamic countries, which have a combination of Islamic and other judiciary systems.The forensic medicine centers in KSA are related administratively to the Ministry of Health (MOH) and its subdivisions in the different governorates. They are concerned with forensic medical examination and autopsy, as well as the clinical forensic medical examination of sexual assault cases, and those injured in civil and criminal cases. The assisting laboratories (forensic histopathology, microbiology, serology, forensic chemistry) are working independently under the funding of MOH, whereas the DNA laboratory and other departments of forensic sciences, for example, counterfeiting and forgery unit are related administratively to the Ministry of Interior represented by the Administration of Criminal Evidences. Efforts concerning crime scene investigations are shared with Administration of Criminal Evidences' crime scene investigators.Forensic medicine education in KSA developed in the past few years after the foundation of Saudi specialty certificate in forensic medicine. The certificate is a postgraduation qualification equivalent to a doctorate degree in forensic medicine and requires completion of a 4-year training program in both MOH- and Ministry of Interior-related departments, as well as passing annual evaluation and examination.This review is aimed at providing in the next decade the medicolegal centers with national forensic specialists throughout the kingdom and granting skillful headships for the next generations. Moreover, this review suggests more scientific associations with the academic universities in the various fields of forensic sciences through academic cooperation.     

Pleural pearl. An immature pleural ball?

An incidental, pearl-like body was attached to the visceral pleura of a young man who committed suicide. The lesion consisted of concentric laminations of collagen and mesothelial type cells, and was associated with a resolved pleurisy. The possible relationship of this lesion to previously reported "pleural balls" is discussed.     

Influenza A virus infection complicated by fatal myocarditis

Influenza virus typically causes a febrile respiratory illness, but it can present with a variety of other clinical manifestations. We report a fatal case of myocarditis associated with influenza A infection. A previously healthy 11-year-old girl had malaise and fever for approximately 1 week before a sudden, witnessed fatal collapse at home. Autopsy revealed a pericardial effusion, a mixed lymphocytic and neutrophilic myocarditis, a mild lymphocytic interstitial pneumonia, focal bronchial/bronchiolar mucosal necrosis, and histologic changes consistent with asthma. Infection with influenza A (H3N2) was confirmed by virus isolation from a postmortem nasopharyngeal swab. Attempts to isolate virus from heart and lung tissue were unsuccessful. Immunohistochemical tests directed against influenza A antigens and in situ hybridization for influenza A genetic material demonstrated positive staining in bronchial epithelial cells, whereas heart sections were negative. Sudden death is a rare complication of influenza and may be caused by myocarditis. Forensic pathologists should be aware that postmortem nasopharyngeal swabs for viral culture and immunohistochemical or in situ hybridization procedures on lung tissue might be necessary to achieve a diagnosis. Because neither culturable virus nor influenza viral antigen could be identified in heart tissue, the pathogenesis of influenza myocarditis in this case is unlikely to be the result of direct infection of myocardium by the virus. The risk factors for developing myocarditis during an influenza infection are unknown.     

Rupture of a cardiac diverticulum resulting in sudden death

Cardiac diverticula have been documented in approximately 80 patients. In over 70% of cases, this lesion is associated with midline thoracoabdominal defects or other congenital malformations of the heart. The diverticulum is thought to occur early in embryogenesis from an outpouching of the endomyocardium through a weak region in the left ventricular wall, but its exact etiology is uncertain. The case of a 6-year-old white boy who died suddenly while playing is presented. Autopsy revealed a ruptured diverticulum of the left ventricular apex with massive hemopericardium and cardiac tamponade. No other abnormalities were found. The pertinent literature is reviewed.