Fatal hemorrhage from a periumbilical wound: Stabbing or hemorrhage from a caput medusae?

Varices are the main clinical manifestation of portal hypertension, and their bleeding is the predominant cause of mortality from this condition. Periumbilical varices are known as “caput medusae.” Reports of their bleeding are rare, with only three fatal cases described in the literature. The antemortem diagnosis is relatively simple, while the postmortem diagnosis is more complex. This paper is the first report of fatal hemorrhage from a caput medusae for which the diagnosis was made postmortem, thanks to a complete diagnostic process including scene and circumstances, medical history, and autopsy with detailed histology. The circumstantial analysis showed the presence of a large amount of blood at the scene, blood which originated from a small abdominal wound; an analysis of the subject's clinical data reported that he was affected by portal hypertension. The autopsy revealed some dilated and convoluted veins in the subcutaneous tissue of the umbilical region; a fistula between these veins and the abdominal wound was detected. The histological study confirmed the presence of periumbilical varices, one of them ruptured and connected with the overlying skin. The cause of death was attributed to a massive hemorrhage generated by a periumbilical varix in a patient affected by portal hypertension.     

Examining the role of pornography and rape supportive cognitions in lone and multiple perpetrator rape proclivity

ABSTRACT

Since a substantial proportion of sexual offenders are not apprehended, researchers have introduced methods to test the propensity to sexually offend among the general public. Proclivity measures assess self-reported sexual interest in lone and multiple perpetrator sexual offending or rape (MPR), and can examine students and community members who indicate a proclivity to sexually offend. This study examines the role of pornography use and rape supportive cognitions to influence proclivity. Anonymous online data was collected from 295 male university students to assess the role of rape supportive cognitions and pornography use in predicting lone and MPR proclivity. Only rape supportive cognitions predicted scores on lone and MPR proclivity measures.     

Self‐Strangulation Through A Sphygmomanometer: An Uncommon Suicide

Suicide by asphyxia is quite a common event in forensic practice and may be implemented in different ways. The authors report a unique case of a 16‐year‐old youth who committed suicide by means of a standard mercury sphygmomanometer. This manner of suicide has never been described in the literature reviewed. A complete forensic investigation led to the conclusion that the cause of death was mechanical asphyxia, ascribed to self‐strangulation by means of an atypical item. The victim suffered from attention‐deficit/hyperactivity disorder (ADHD) syndrome and was assisted by support teachers. He had a solitary and depressive personality. The exceptional nature of this case suggests that sphygmomanometers may be regarded as possible means of self‐strangulation. The case also highlights the importance of managing patients with psychiatric or cognitive disorders; indeed, particular caution is required to keep them away from objects that, although apparently harmless, can become lethal.     

Mental Health Services for ‘Difficult’ women: Reflections on Some Recent Developments

The provision of mental health services to women has come sharply into focus for providers of secure psychiatric services in the UK. Women's services are being developed in response to the known risks of mixed-sex provision, and a growing appreciation of the ways that women in secure services can be further disadvantaged by their minority status. Our intention here is to present evidence and reflections to help inform this development. The evidence is drawn from our recent work in this field, which includes carrying out a review of local mental health services for ‘difficult’ women, and developing and piloting a national training programme for staff working with women in secure services. The reflections we offer are informed by the conviction that taking social inequalities into account is central to making sense of women's mental health difficulties, and improving service responses to women's needs. While there are signs that many mental health workers in secure services are beginning to share these convictions, the challenge now is to provide the necessary authorization, training and support that will enable them to translate these understandings into empowerment practice with women.     

Race,Medicine, and Social Justice: Pharmacogenetics,Diversity, and the Case of BiDil

In this article, I probe an example of high‐technology medicine as a case study in the problems of the regulation of advancing technology. Specifically, I address the implications of pharmacogenomics—an emerging form of population‐based health care intervention—for public policies designed to eliminate racial disparities in health. Using the case of BiDil, a historical precursor to pharmacogenetic technology, I offer a framework for further studies of high‐technology medicine in which policy analysis is part of a social review based on the justice standard of ex ante mutual advantage. It is the contention in this article that the most just and reasonable deployment of pharmacogenomics is as a compensatory tool to alleviate health disparities.     

Across the border and into the cold: hieleras and the punishment of asylum-seeking Central American women in the United States

Thousands of Central American families are fleeing from violence in their own countries and seeking protection in the US. However, once they enter the country they are immediately confined in temporary holding cells – also called hieleras (iceboxes) due to their extremely low temperatures, where they undergo violence and neglect. The hieleras become the site where the categories of the asylum-seeker, the immigrant, and the criminal become conflated. Asylum-seekers entering the country also enter an already existing racialized structure where Latina/o subjects have been criminalized. This article analyzes the hieleras through a Foucauldian and a transnational feminist lens, and argues that these holding cells work as a site for punishing border crossers and deterring them (and others like them) from pursuing the asylum process; which are displays of both sovereign power and disciplinary power.