Postmortem tissue embolisms. Report of 3 cases

In three cases of autopsy (cause of death - intoxication and drowning) we found in the lung intraalveolar und intravasal lymphatic tissue and bone-marrow. The results cannot be explained with violence during lifetime, but in tow cases as an effect of fracture of rips caused by external cardiacmassage, in one case by embalming with injection of conservation fluids.     

The role of hydrogen cyanide and carbon monoxide in fire casualties: a prospective study

Determinations of blood cyanide and carboxyhemoglobin concentrations were performed in 18 victims found dead in buildings after fires during a 2-year period. The results indicated that 50% of the victims had been exposed to toxic levels of hydrogen cyanide and 90% to toxic levels of carbon monoxide. Lethal concentrations of carbon monoxide were found in 83% of the victims. In one case a lethal blood cyanide but a non-toxic blood carboxyhemoglobin value was found. It is concluded that carbon monoxide appears to be more important than hydrogen cyanide as a toxic agent in the fire atmosphere, but cyanide poisoning without carbon monoxide poisoning may, under certain circumstances, be the cause of death in fire victims.     

Performance-based partnership Agreements for the reconstruction of the health system in Afghanistan

The reconstruction of the health system in Afghanistan is in its early stages, and donors have proposed Performance-based Partnership Agreements (PPAs) through which to subcontract the delivery of health services to private organisations, both for-profit and not-for-profit. Beyond ideological debates, this article sets out to explain the model underlying the PPA initiative and sheds light on empirical data concerning the assumed benefits of such an approach. The article studies privatisation and the contracting-out of health services, though there is as yet no information that can demonstrate the superiority of private over public service provision. Similarly, the merits of subcontracting have not been fully proven and such arrangements raise several ethical issues. Where PPAs are to be attempted, it is important to remain cautious and to ensure that operations are organised in such a way as to permit proper comparison. The paper concludes with recommendations to organisations involved in or considering the advantages of PPAs.     

Child abuse with fatal sequelae in an Essen autopsy sample]

In the Institute of Forensic Medicine in Essen/Germany 24 cases of lethal child battering or neglect have been observed over 17 years from 1973 to 1989. The medicolegal and morphologic findings in these cases are presented and compared to the literature. The patterns of abuse/neglect in Essen compare to those frequently reported in the literature: skull/brain traumas caused by blunt impact, multiple hematomas, bone fractures, and symptoms of malnutrition, vitamin deficiency, and general neglect. In many cases the abuse could be shown to have been chronic. In the seven years 1983-1989 the cases of lethal child mistreatment and neglect amounted to 0.18 percent of all autopsies. Five cases of lethal sexual assault in children during the same period are compared to the mistreated cases.     

The detection of aromatic substances in biological material]

The author presents experimental data and suggests a method for extraction of aromatic substances from the blood, urine, lavage water, stomach and its contents, liver and kidneys. The extract is dissolved in 96% ethanol and the aromatic substances are detected in reactions with hydrochloric acid, Marki's reagent, 2,4-dinitrophenylhydrazine, diazotized o-dianisidine, phthivazide, chromotropic acid by UV spectrophotometry, thin-layer and gas-liquid chromatography. The sensitivity of the method is 0.1-0.5 mg %.     

Family violence as a determinant factor in juvenile maladjustment.

The family is one of the major socialization agencies for children. Parents are one of the most important models from whom the child and adolescent acquire a wide variety of behavior patterns, attitudes, values, and norms. The aim of this study was to determine the importance of factors related to family conflicts in the genesis of social maladjustment. A total of 189 young people (110 boys and 79 girls) from training schools connected with the juvenile court in Murcia (Spain) were studied. The subjects' ages ranged from 11 to 18 years (mean 13.51, SD 0.16). Our sample comprised a group of minors who experienced a high incidence of intrafamilial pathology, which was found to be a significant discriminant factor. Aggressive behavior, rules, norms, values, opinions, and attitudes toward aggressivity can be learned in the family setting.     

Unusual suicides with chain saws

Two cases of suicide with bandsaws, undertaken by workers in carpenters' workshops are reported and discussed. Their choice of this method was based on the fact that they knew how dangerous such machines were. Both cases were watched by witnesses, who could not intervene due to the speed of the events. It was possible to exclude accident or homicide.     

Suicide with an unusual shotgun

The authors describe a special case of suicide, committed by a self-constructed nailgun. The inshot-wound, localized in the mouth, primarily remained undiagnosed. The patient survived two weeks and died of pulmonary embolism.