Iatrogenic deaths following treatment for hypertrophic obstructive cardiomyopathy: case reports and an approach to the autopsy and death certification

Hypertrophic cardiomyopathy (HCM) is a disease process which results in a large, heavy heart, with hypertrophy of the interventricular septum (IVS) and left ventricle. HCM accounts for a significant number of cases of sudden cardiac death each year, most infamously in young athletes. The prevalence of the disease has increased over the past several years due to advances in clinical diagnosis and molecular genetic studies. Over this same period, new forms of treatment also have emerged. One such treatment is alcohol septal ablation (ASA). ASA is a procedure performed by a cardiologist, via cardiac catheterization, by injecting pure ethanol into selected arteries which supply the IVS, resulting in a targeted myocardial infarction. This infarct then retracts and forms a scar, decreasing the outflow obstruction and improving the patient's clinical symptoms.The authors report 2 cases of death following ASA treatment of HCM. The first, a 56-year-old male, had his ASA procedure 10 days prior to death. The second decedent, a 76-year-old female, had her procedure only 30 hours before death. These case reports are followed by a discussion about HCM, including pathology, treatments, and treatment-related pathology, before closing with a discussion about death certification in the cases presented and therapy-related deaths in general.     

Mediation in Italy: Exploring the Contradictions

This article sets Italy in the context of three primary approaches to promoting mediation use in Europe: cultural, pragmatic, and legalistic. Despite the fact that Italy could be considered a "front-runner" in the latter category, the actual number of cases going to mediation to date has remained low. Drawing on both data from a recent CPR European Committee survey and aspects of the broader Italian legal and social context, this article explores reasons for this apparent contradiction and concludes by suggesting general principles that can be extrapolated from the Italian experience.     

Breastfeeding Duration and Reported Child Maltreatment in a Population-based Alaskan Birth Cohort

Journal of Family Violence - Research suggests that breastfeeding may reduce child maltreatment risk. Alaska has high rates of both breastfeeding initiation and maltreatment reports to Child...     

Fear of terrorism: media exposure and subjective fear of attack

In many Western countries, citizen knowledge of terrorist events is intrinsically shaped by the style of broadcasted messages published by the media. Media discourses regarding terrorist acts raise questions about how such rhetoric elicits fear in people who typically experience such events through news reports. However, we do not fully understand the impact of the media on perceptions of terrorism as clearly as we understand the relationship between the media and fear of crime. This study examines how media sources accessed actively (e.g. through newspapers; Internet) or passively (e.g. through television; radio) influence knowledge and fear of terrorism. We find receiving information about terrorism from multiple media sources increases fear of terrorism, but media sources accessed passively are not as influential as media sources accessed more actively. These results highlight how media consumption from various sources may affect one’s fear of terrorism, and further illustrates how the role of perceived knowledge may exacerbate or mitigate fear. Implications for policy and practice are discussed.     

Perceiving others as different: a discussion on the stigmatization of the mentally ill

This commentary on the stigmatization of people with mental illness explores social perceptions of them as dangerous and uncivilized. The authors discuss how the legal system suggests that these are people who should be ousted from the community while mental health professionals attempt to reiterate the fact that these individuals are simply human. The authors describe ways people with mental illness have been subjected to discrimination, ridicule, and humiliation. This commentary discusses multiple perspectives of mental illness, from past to present, and how those perspectives influenced social, legal, and psychological frameworks.     

Drug and chemical blood-level data 2001.

Current blood-level data are presented for drugs and chemicals of toxicologic interest. The data represent an update of previously published compilations of therapeutic, toxic and lethal blood-levels.     

The tension between might and rights: Siberians and energy developers in post-socialist binds

One of the flashpoints of post-socialist life has been the conflict between indigenous peoples and energy developers in the Russian Federation North. As a result of tensions over land and resources, multiple identities and political rivalries have been revealed. Such tensions spark the uncertainties that are not only a hallmark of post-socialism, but also hallmarks of post-colonial and post-welfare societies. The many levels of social interaction in ‘transition societies’ provide a challenge for anthropologists accustomed to focus refined ethnographic lenses at the nomadic camp, village or ‘ethnic’ level. This article covers conflicts of values and expectations for several Siberian groups regarding ecology, land and homeland, as well as cultural rights and revitalisation. Featured cases derive from West Siberia (Yamal and Khanty-Mansi okrug) as well as the Far East (Sakha Republic), and highlight the author's field experience in Siberia for over 25 years. Conclusions urge greater sensitivity to internal debates and trans-national comparisons as we struggle to define a range of analytical categories that both embrace and go beyond ‘post-socialist’ and ‘post-Soviet’ studies. In the process, dilemmas of advocacy are probed, as well as dilemmas of defining ‘homelands’ for indigenous peoples.     

Nail-gun injuries. Accident, homicide, or suicide?

It may be difficult to distinguish industrial accidents from suicide attempts or even assaults or homicide. Nail guns are relatively new industrial tools that can produce severe or fatal injuries. The configuration of the nail on patients' radiographs after such injuries can be helpful in determining the cause of injury. Steel nails that are bent are due to a ricochet and thus indicate accidental injury. Straight-nail injuries to the co-workers of nail-gun users are most likely due to over-penetration of the substance being nailed or accidental mid-air firing; however, intentional injury cannot be ruled out. Extremity injuries caused by straight steel nails in nail gun users are the result of carelessness or poor technique, but suicide should be considered when straight nails cause wounds to the chest, head, or abdomen.