Sudden death resulting from lesions of the cardiac conduction system

Sudden unexpected deaths in young persons with noncontributory histories, autopsy results, and drug screen results are a common problem in forensic pathology. As part of the evaluation of such cases, the cardiac conduction system (CCS) should be studied. To determine the type and incidence of lethal CCS lesions, the authors reviewed their files of sudden unexpected cardiac deaths with particular attention to cases with causes of death in the conduction system. Cases of sudden cardiac death in patients aged < or=40 years during a 10-year period (Michigan) and a 4 year-period (Spain) were selected from the files. From this group, cases were identified in which the cause of death was a lethal change in the CCS. The portions of the heart containing the CCS were excised, and at least one hematoxylin and eosin slide and at least one trichrome or elastic trichrome slide per block were studied. In the two centers, 381 cases of sudden cardiac death were identified. The most common causes of sudden cardiac death were arteriosclerotic narrowing of the coronary arteries, cardiomyopathy, and myocarditis. In 82 cases, there was no identifiable cause of death even after complete gross and microscopic autopsy was performed, a medical history was obtained, and a drug screen was performed. In 11 cases, the CCS contained lesions that were considered lethal: narrowing of the atrioventricular node artery by fibromuscular hyperplasia (7 cases) and atrioventricular node tumors (4 cases). The 11 cases accounted for 2.9% of the 381 cases of sudden cardiac death and 11.8% of the indeterminable cases. It was concluded that examination of the CCS in deaths in which the gross and microscopic autopsy, history, and drug screen fail to provide a cause of death can yield a cause of death in a significant percentage of cases. If heart block was not documented during life and no explanatory lesions were found during routine cardiac examination, examination of the CCS can yield valuable information.     

Luis Alfredo Garavito Cubillos: criminal and legal aspects of serial homicide with over 200 victims

This is the first scientific report on the crimes of the homosexual paedophile sadist Luis Alfredo Garavito Cubillos, based on a research stay of the authors in Columbia, and including discussions with the investigators, and the offender. Between 1992 and 1999, Garavito killed more than 200 children in the core age span between 8 and 13 years (as an exception, 6 to 16 years). His modus operandi remained stable. During daytime, he lured children of a lower social status out of crowded parts of the city into hidden areas that were overgrown with high plants. Garavito promised either payment for easy work, or drugs, or made other socially believable offers. The children were tied up, tortured, raped, and killed by at least one cut in the lateral part of the neck, or by decapitation. During the killings, Garavito was drunk. Even after his arrest (for attempted sexual abuse under a wrong identity) it was not immediately possible to track his crimes since Garavito had frequently changed his places of stay and his jobs. He also grew different hairdos and used wrong names. During his still ongoing confessions, he directs the investigators correctly to all scenes of crime spread over large parts of Columbia. In our report, we give an overview over the course of investigations, hint to similarities in the cases of the German serial killer Denke (1920's) and homosexual paedophile serial killer Jürgen Bartsch (1960's), and give preliminary impressions on the offender's personality. Furthermore, the violent environment and juridical peculiarities in Columbia are discussed. In spite of a total penalty of 2600 years in prison, it is formally well possible that Garavito will be released out of prison within the next 10 to 20 years, i.e. even before the maximum sentence of 40 years will be over.     

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“Everybody's looking at you!”: Girls negotiating the “femininity deficit” they incur in physical education

There is a growing awareness of the complex and largely negative attitudes many girls in the UK hold towards physical activity in general and Physical Education (PE) in particular. This research in the UK involves a qualitative study of six Year 9 girls' experiences and motivations in PE.Reflexive interpretation and biographical analysis of in-depth interviews are utilized to explore the themes of the relationship between “sportiness” and heterosexual desirability; and the polarized images of “tomboy” and “girlie.” Work by Connell [Connell, R.W. (1987). Gender and power. Cambridge: Polity Press.] on the gender order, and theories arising from the cultural analysis tradition on teenage girls' subcultures and identity formation are drawn on in order to make sense of the girls' narratives.The findings of this research reveal that images of teenage girls and young women being physically active are non-congruous with the traditional ideologies of acceptable femininity. This paper describes how these girls negotiate the contradictions and the tensions caused by the “femininity deficit” incurred in PE by creating “double identities” and living “split lives.”