Serum biochemical markers in drowning: diagnostic efficacy of Strontium and other trace elements

The aim of our study was to analyse several serum biochemical markers in order to evaluate the discriminant capacity of trace elements individually and jointly in drowning (seawater drowning and freshwater drowning) and their correlation with age, sex, postmortem interval, time in water and concentrations of the trace elements in the drowning medium. Sixty-seven cases of drowning (53 seawater drownings (SWD); 14 freshwater drownings (FWD) and 73 control cases (other asphyxias, n=44, and other causes of death, n=29) were selected according to the scene, cause and circumstances of death, together with autopsy findings. Serum strontium (Sr), magnesium (Mg), sodium (Na), chloride (Cl), calcium (Ca), iron (Fe), urea, creatinine (Cr) and cardiac Troponine T (cTn-T) were measured in the left ventricle (Lv), right ventricle (Rv) and peripheral blood. Lv-Rv differences for each marker and Sr, Mg, Na, Cl, Ca and Fe concentrations in the drowning medium were determinated. Mean concentrations of Sr, Cl and Mg in both ventricles and peripheral serum and Lv-Rv differences and Ca Lv and Na Rv were significantly higher in cases of drowning than for other causes of death. In SWD, Sr, Mg, Ca, Na and Cl were significantly higher in Lv than in Rv as a result of aspirating water. In contrast, haemodilution is evident from the significantly higher levels of Fe and urea in Rv than in Lv in cases of SWD, and from the higher Mg and Cr levels in Rv in FWD. In the case of SWD, serum levels of Sr are confirmed as the best parameter for diagnosis, although other trace elements may also be useful, such as the serum concentrations of Mg and Cl. In the case of FWD, the joint determination of Sr and other biochemical markers, especially Fe, may increase correct diagnosis.     

Is There an Informative Effect of Law? An Experimental Test

Debates on how the law affects citizens' behaviour have traditionally focused on two mechanisms: deterrence and perceptions of legitimacy. In recent years, some scholars have suggested that the law may also affect compliance through expressive mechanisms that reveal information about the world (for example, by eliciting the risks associated with a particular behaviour). Dharmapala and McAdams have called this the informative effect of law. However, to date very little empirical evidence of the existence of such an effect has emerged. In this article, we present the results of an experiment that tests for three different hypotheses as to how this effect may be produced. Our findings show that legislators' sincerity or their access to expert knowledge is not sufficient to produce information effects. Instead, we suggest an ‘asymmetry’ hypothesis: the fact that a law is passed or rejected has an asymmetrical information effect on subjects' risk perceptions.     

Violence and the U.S. prohibitions of drugs and alcohol

This paper examines the relation between prohibitions and violence,using the historical behavior of the homicide rate in the UnitedStates. The results document that increases in enforcement ofdrug and alcohol prohibition have been associated with increasesin the homicide rate, and auxiliary evidence suggests this positivecorrelation reflects a causal effect of prohibition enforcementon homicide. Controlling for other potential determinants ofthe homicide rate does not alter the conclusion that drug andalcohol prohibition have substantially raised the homicide ratein the U.S. over much of the past 100 years.     

Diagnostic efficacy of biochemical markers in diagnosis post-mortem of ischaemic heart disease

In forensic medicine, there is a need for more sensitive biochemical markers for the post-mortem diagnosis of acute myocardial infarction. A study of the distribution of biochemical markers in different fluids is of great significance in post-mortem diagnosis, because their distribution depends on the location of tissue damage and release kinetics. The aim of this study is to compare the sensitivities and specificities of creatine kinase-MB (CK-MB), myoglobin and cTnI in serum and pericardial fluid for the post-mortem diagnosis of acute myocardial infarction (AMI). We studied 188 cadavers selected during 1 year from medicolegal autopsies. The groups were as follows: (1) myocardial infarction (n = 52); (2) asphyxia (n = 59); (3) multiple trauma (n = 41); (4) natural deaths excluding myocardial infarction (n = 36). We obtained statistically significant differences in pericardial fluid for all the biochemical markers, the highest levels being obtained in the group of cadavers who had died from myocardial infarction. A common factor is the high negative predictive value found in biochemical markers, which is contrary to the findings obtained in clinical practice, when the percentages of sensitivity are very high.