Commode Cardia—Death by Valsalva Maneuver: A Case Series

The Valsalva maneuver is used in clinical medicine for the diagnosis and/or treatment of various cardiovascular conditions. It can also be used in activities of daily living, such as defecation. Due to the cardiovascular effects produced during the Valsalva maneuver, it may be contraindicated in certain medical conditions and could be a trigger of sudden cardiac death. The incidence and prevalence of death following Valsalva maneuver in the presence of underlying cardiovascular disease, or “commode cardia,” has not been examined. In 2012, the Wayne County Medical Examiner's Office (Detroit, MI) investigated 21 deaths that occurred on the toilet, fourteen of which were due to cardiovascular disease. In another 31 deaths in the bathroom due to cardiovascular disease, the possibility that the decedent defecated immediately prior to death could not be excluded. Hence, the incidence of commode cardia in this population ranges from 2.3 to 7.4% of all cardiovascular‐related deaths.     

公共突发事件心理效应及民众心理干预

本文针对公共突发事件所产生的社会心理影响提出了社会心理效应"心理地震"理论模型,并且对心理效应产生的过程进行了分析。最后针对公共突发事件发生的不同时期,针对不同的人群提出了相应心理干预对策。     

KCNE、KCNQ1与心性猝死的相关性研究进展

部分心性猝死由于缺乏明确的病理学改变,其鉴定工作一直是法医工作者的一大难题。近年来,与长QT综合征、心房颤动等致死性心律失常疾病相关基因（KCNE基因家族与KCNQl）等研究逐渐增多。国内外研究发现KCNE和KCNQ1基因编码心肌钾离子通道,其基因异常可引起严重的心律失常,甚至导致心性猝死。因此,死后KCNE和KCNQl的基因检测对于心性猝死鉴定具有重要意义。本文对KCNE、KCNQl与心性猝死的相关性研究进展进行综述,希望能为法医学研究和实践提供参考。     

致死性心律失常的法医学研究进展

据文献报道,有很多心源性猝死是由于致死性心律失常所致。在法医学鉴定工作中,心律失常所引起的猝死往往很突然,尸检及镜下病理学检查又缺乏特征性的改变,使得鉴定其死亡机制成为一大难点。因此,寻找一种客观、准确的心律失常鉴定方法,对于致死性心律失常所致心源性猝死的鉴定尤为重要。本文将就上述问题,从致死性心律失常的定义、分类、产生原因、致死机制、形态学所见及死后生化检测指标等方面进行综述,以期为心源性猝死致死原因的法医病理学分析、鉴定提供帮助。     

A Review of the Forensic Implications of Pica

Pica is characterized by the persistent eating of non‐nutritive substances over some time that is inappropriate for the maturation stage of the individual and is not culturally sanctioned. A 9‐year‐old boy with Goldenhar syndrome, significant developmental delay and pica, collapsed and died after a short history of diarrhea and vomiting. Death was due to a sigmoid volvulus resulting from filling of the distal colon with feces containing dirt, stones, and rice with evidence of ischemic intestinal necrosis. Lethal complications of pica include intestinal obstruction and perforation with peritonitis and generalized sepsis. Other findings at autopsy may include airway obstruction, heavy metal poisoning, and parasitic infestation. Presenting symptoms and signs of such complications may be subtle or masked given the nature of underlying conditions, and so careful evaluation of the medical histories of individuals with pica may be necessary to provide pertinent details of associated medical and psychiatric conditions.     

Endobronchial/Tracheal Metastasis and Sudden Death

Endobronchial and endotracheal metastases are rare lesions that may cause acute occlusion of major airways. A case is reported of a 62‐year‐old man with history of renal cell carcinoma and hemoptysis who died after having suddenly become short of breath with cyanosis. At autopsy, recurrent renal cell carcinoma was identified with metastases to the lungs, pulmonary hilar lymph nodes, and brain. In addition, a solitary papillomatous metastasis arising from the mucosa of the carina was obstructing both the main bronchi and distal trachea. Death was due to acute airway obstruction by a metastatic deposit at the bifurcation of the trachea in a case of disseminated renal cell carcinoma. This case demonstrates an extremely rare cause of sudden death that may complicate disseminated malignancy.     

低钾型周期性麻痹猝死16例法医学分析

目的 探讨低钾型周期性麻痹猝死案例的法医学鉴定要点.方法 对中山大学法医鉴定中心2004～2010年间受理的16例低钾型周期性麻痹猝死案例进行回顾性分析.结果 16例案例中以20～39岁男性多见,平均年龄(35.12±8.54)岁;血清钾平均水平(2.29±0.60) mmol/L.结论 低钾型周期性麻痹猝死案例缺乏特异性组织病理学改变,法医学检案中应结合临床实验室检测结果综合评定.     

The Paradoxes of the Revolutions of 1989 in Central Europe

Abstract

The self-limiting revolutions of 1989 in Central Europe offer an alternative paradigm of revolutionary change that is reminiscent more of the American struggle for independence in 1776 than the Jacobin tendencies that grew out of the French Revolution of 1789. In order to understand the contradictory impulses of the revolutions of 1989—the desire for a radical renewal and the concern for preservation—this article takes as its point of departure the political thought of Hannah Arendt and Edmund Burke.     

Hungary's “anti-capitalist” far-right: Jobbik and the Hungarian Guard

The study analyzed whether the dissolution of Yugoslavia and the establishment of succeeding mono-national states was the expression of “longing” of mass proportions on the part of the nationalities within respective federal units. Using the data from two pan-Yugoslav surveys from the period preceding the dissolution, results were obtained that indicated a very limited support for this hypothesis. More specifically, results indicated that support for emancipation was rather weak, among youth in 1986 and even among the adult population in 1990, although some significant mean differences between the federal units and between major nationalities within them were evident. Specifically, opinions favoring independence were detected among Kosovo Albanians and later among Slovenians in Slovenia. In addition, findings also indicated that those with higher socioeconomic status were not more inclined toward independence. Results thus pointed more towards the idea that the dissolution was indeed instigated by a small group of “political entrepreneurs” not captured by the survey data.     

From Al-Itihaad to Al-Shabaab: how the Ethiopian intervention and the ‘War on Terror’ exacerbated the conflict in Somalia

Abstract

External intervention has frustrated and continues to frustrate peace and stability in the Horn of Africa and Somalia, adding various adverse layers to an already complicated and complex conflict. The level of forceful military engagement intended for regional domination has profoundly affected negatively the efforts of peacebuilding and statebuilding in Somalia. This article examines how the earlier Ethiopian policies towards Somalia has reshaped the (post)-Cold War politics of the Horn. In doing so, it traces the roots of the Ethiopian intervention in Somalia vis-à-vis new non-state armed groups to chart the changing political dynamics of the conflict in Somalia. By using historical approach, the article argues that Ethiopia’s agenda is central to understanding why the ‘War on Terror’ has strengthened and subsequently midwifed armed militant movements (e.g. new insurgency groups) in Somalia, starting from Al-Itihaad to today’s Al-Shabaab. In focusing upon various regional actors and groups, the article moves from the emphasis of internal systems to external power structures, considering the wider historical and political factors in the region that must be closely examined if the regional and local conflicts are to be deeply understood. While it is a context-specific study, the article aims to contribute fresh perspectives and insights to ongoing discussions on the consequences of the Ethiopian intervention in Somalia.