Sudden Death by Spontaneous Epiglottic Hematoma Secondary to High Blood Levels of Warfarin

A 67‐year‐old man was found dead, at his home. On external examination, we found a voluminous purplish black ecchymosis of the anterior neck area. On internal examination, we found a voluminous epiglottis hematoma completely obstructing the upper airway. It was associated with other sites of intra‐abdominal hemorrhage. Toxicological studies revealed the presence of warfarin at a concentration of 8.4 mg/L in peripheral blood, which supposes an INR well above 4.5. To conclude, we supposed death was due to asphyxia secondary to a spontaneous epiglottic hematoma caused by a high blood concentration of warfarin. Hemorrhage in the epiglottis is very rare. To our knowledge, our patient is the only case of “sudden death” reported with spontaneous epiglottic hematoma due to high blood concentration of warfarin. In forensic practice, an anterior neck ecchymosis, without trauma, may suggest hemorrhage into soft airway tissues. Pathology findings make it possible to exclude exogenous trauma.     

Psychometric properties of the inventory of callous-unemotional traits short version (ICU-12) among detained female juvenile offenders and community youths*

The presence of callous-unemotional (CU) traits delineates a subgroup of male youth with severe conduct problems and antisocial behavior. To date however, existing research into these features among females is markedly limited. Drawing on 377 female adolescents (103 selected from forensic settings and 274 selected from school settings) from Portugal, the current study is the first to simultaneously examine the psychometric properties of the 12-item shortened version of the Inventory of Callous-Unemotional Traits (ICU-12) in incarcerated and community female youth. Results provide support for the construct validity and reliability of the ICU-12 among this unique sample. Findings from this study also reveal evidence of convergent and discriminant validity with a number of theoretically relevant constructs (e.g. psychopathic features, aggression, and substance use). Clinical implications for using the ICU-12 with females are discussed.     

Cold-blooded women can detect lies with greater accuracy than other women

Lies are notoriously difficult to detect. But it appears that some people are better at accomplishing this task than others even though the factors contributing to deception detection accuracy are not well understood. This study explored the influence of empathy on the detection of deception as a function of the detectors’ gender while dark personality traits were statistically controlled. Eighty men and 80 women were requested to judge whether individuals viewed in videos were giving their true opinion or not on current debatable issues (50% truthful and 50% deceptive narratives). Judges were divided into four groups according to their gender and their degree of empathy, as assessed using the Questionnaire Measure of Emotional Empathy. It was found that women with lower levels of empathy distinguished false from true opinions better than women with higher empathy, whereas no such difference was found in men. These results suggest that the degree of empathy in women influences their ability to detect deception and supports recent studies showing that emotional skills negatively affect deception detection ability. We suggest that less empathic women are less affected by emotional contagion and thus may be more able to focus on non-emotional cues that might reveal deception.     

Tobacco status,impulsivity, and the five-factor of the PANSS in paranoid schizophrenia

There is consistent evidence that impulsivity is linked to tobacco consumption and to symptomatology in schizophrenia. In the current study, we propose a new integrative model of the relationship between impulsivity, psychopathological symptoms, and tobacco status in patients with paranoid schizophrenia. We investigated 33 paranoid schizophrenia patients and 37 healthy controls using a battery of psychopathological scales included the Structured Clinical Interview for DSM-IV (SCID), the five-factor model of the Positive and Negative Symptom Scale (PANSS), the Barratt Impulsiveness Scale (BIS-10), and the UPPS Impulsive Behavior scale (UPPS). Step-wise regression analysis revealed that positive factor of the PANSS and tobacco status contributed positively and significantly to the explained variance of impulsivity. In addition, non-planning impulsivity and sensation-seeking emerged as significant predictors of tobacco status, while smoking predicted non-planning impulsivity and sensation-seeking. Our results suggest that the relationship between sensation-seeking and tobacco use is reciprocal and proposes a new integrative model of the relationship between impulsivity, positive symptoms and tobacco status in patients with paranoid schizophrenia. However, the exact mechanisms for these relationships deserve further investigation.     

Intracranial migrating bullet

Retained bullets and fragments following a civilian gunshot injury are quite frequent in practical neurosurgery. It is usually possible to extract the foreign body surgically, while rare cases are conservatively treated because of technical reasons. Conservative treatment may present complications, and a rare form of this presentation is migration of the bullet. A 20-year-old man presented with migrating bullet from a supratentorial to opposite infratentorial area. We consider that in the migrating bullet fragment cases, if there is no contraindication, the most reasonable treatment is its urgent surgical removal. This report reveals a supratentorial bullet migrating to the infratentorial contralateral area, and related literature considering the different mechanisms of migration is discussed.     

Simultaneous determination of thirteen beta-blockers and one metabolite by gradient high-performance liquid chromatography with photodiode-array UV detection

A new rapid and sensitive high-performance liquid chromatography (HPLC) method has been developed for the simultaneous identification and quantification in human plasma of the 13 most commonly prescribed beta-blockers and one active metabolite-atenolol, sotalol, diacetolol, carteolol, nadolol, pindolol, acebutolol, metoprolol, celiprolol, oxprenolol, labetalol, propranolol, tertatolol and betaxolol. It involves liquid-liquid extraction procedures followed by liquid chromatography coupled to photodiode-array UV detection with a fixed wavelength at 220 nm for quantification. Compounds were separated on a 5 microm Hypurity C(18) (ThermoHypersil) analytical column (250 mm x 4.6 mm, i.d.) using a gradient of acetonitrile-phosphate buffer pH 3.8 at a flow rate of 1.0 ml/min. The total analysis time was 26 min per sample. Extraction recoveries were between 74 and 113% for the polar compounds and between 20 and 56% for the most apolar compounds. Calibration lines were linear in the range from 25 to 1000 ng/ml for all compounds excepted carteolol and nadolol (50-1000 ng/ml), all of them with coefficients of determination (r2 values) >/=0.994. Limits of detection (LODs) ranged from 5 to 10 ng/ml. Intra-assay and inter-assay precision and accuracy were studied at two concentration levels (100 and 500 ng/ml). The intra-assay coefficients of variation (CVs) for all compounds were 相似文献