1,721,014 research outputs found
Medicolegal Implications of Deaths due to Agricultural Accidents
No full textAgriculture encompasses a variety of activities that carry with them a variety of different risks. The unsafe use of vehicles, machinery, and tools as well as animal husbandry, working at heights, and exposure to chemical, biological, and weather events may result in the deaths of agricultural workers. Inexperienced operators and/or their inappropriate conduct may lead to avoidable fatalities. Forensic pathologists operating with the support of agricultural engineers or other professionals must evaluate the death scene, the case background and circumstances, the autopsy findings, and the toxicological data to establish the factors and dynamics responsible for such accidents and deaths.The aim of this review is to focus on the diagnostic approach required, by means of an interdisciplinary approach, to identify the cause of some typical agricultural fatalities, to confirm that death was accidental, and to help exclude the possibility of homicide or suicide
Fatal anaphylactic shock due to hymenoptera venom in a farmer suffering from indolent systemic mastocytosis. The comparative diagnostic relevance of perimortem serum tryptase levels
Full text linkHymenoptera anaphylaxis led to the death of a bee and wasp venom sensitized 41-year-old man suffering from systemic indolent mastocytosis. While at work in a vineyard, the man suffered a serious anaphylactic crisis and cardiovascular arrest; despite ongoing attempts of resuscitation, he died in hospital 12 h after being stung. Autopsy confirmed that death was due to post-anoxic brain damage, cardiovascular shock, disseminated intravascular coagulation (DIC) and multi-organ failure (MOF). ICU blood samples drawn before the patient’s death from the distal extremity of the pulmonary catheter revealed central blood tryptase levels of 8955 ng/mL; samples drawn 6 days after death, at autopsy, confirmed anaphylaxis diagnostic central blood total tryptase levels (4977 ng/mL) and peripheral blood levels (319 ng/mL); IgE levels in ICU blood sample suggested that the farmer was a responder to venom immunoteraphy (VIT) for Apis Mellifera (IgE 0.44 kUI/L) but not for Polistes Dominulus (IgE 3.13 kUI/L) yet. The comparison of perimortem laboratory results was crucial, in association with autopsy findings and circumstantial data, in ascertaining that death was caused by a wasp venom anaphylactic reaction, with key findings being: 1) Significantly high pre-mortem (8955 ng/mL) and post-mortem (4977 ng/mL) central blood tryptase levels. 2) High post-mortem peripheral blood tryptase levels (319 ng/mL). 3) High pre-mortem central blood IgE antibodies against Polistes Dominulus.Full Tex
Postmortem IgE determination in coronary artery disease
No full textAllergic, IgE-mediated inflammation is thought to play a role in atherogenesis and atherosclerotic disease progression. In this study, total IgE and mast cell tryptase were measured in a series of forensic autopsy cases including non-allergic cardiac deaths (14 cases with minimal or no coronary atherosclerosis, 14 cases with significant coronary artery atherosclerosis without acute coronary thrombosis, and 14 cases with significant coronary artery atherosclerosis and acute coronary thrombosis or myocardial infarction) and non-allergic non-cardiac deaths (21 cases with death due to hanging and 21 cases with death due to intracranial gunshot wounds), in order to correlate laboratory results with morphological findings and compare them to conclusions reported in the clinical setting. In cardiac death cases, postmortem serum total IgE levels were increased in 7 out of 42 cases and mast cell tryptase levels were increased in 3 out of 42 cases. In non-cardiac death cases, postmortem serum total IgE levels were not increased in 39 out of 42 cases and mast cell tryptase levels were not increased in any of these cases. These preliminary findings seem to indicate that a portion of coronary deaths characterized by coronary artery atherosclerosis of various severities are also characterized by increased total IgE and mast cell tryptase levels, thus corroborating the data previously reported in both clinical and forensic literature on this topic as well as the necessity of combining morphological investigations focusing on the heart and coronary arteries with biochemical analyses
Medicolegal Implications of Fatalities Because of Entanglement in the Augers of Feed Mixer Wagons
No full textABSTRACT: Feed mixer or total mixed ration mixer wagons are powerful agricultural machines used to shred and mix silage with other ingredients and deliver it direct to the feeding troughs on livestock farms. Fatalities involving these feed mixers may occur when operators become trapped in the augers or, less frequently, are crushed by moving wagons. Death can occur very rapidly because of dismemberment, multiple lesions, or crushing. The aim of this review is to focus on the diagnostic evaluations that need to be performed to confirm that the death was accidental and to exclude a hypothesis of murder or suicide. Forensic investigations in such cases must involve the detailed analysis of the death scene and the mechanical characteristics of the machinery with an accurate postmortem and toxicological examination
Post Mortem Vitreous Electrolyte Analysis as an Adjunct in the Diagnosis of Salt Water Drowning
No full textDrowning is a potential cause of death in a deceased individual immersed in water. The diagnosis of drowning can be challenging because the post mortem findings are variable, transient, and non-specific and, thus, non-diagnostic. Traditionally, contextual investigation followed by a full post mortem examination has been required for all suspected drowning deaths. However, in cases of strong contextual evidence and the family's objection to a full post mortem examination, the availability of a non-invasive adjunct test to aid the diagnosis of drowning would be ideal. Although it was previously studied and subsequently abandoned in the 1970s and 1980s, post mortem vitreous electrolyte analysis (a non-invasive test) has recently been re-examined and showed promising results. This thesis examined and established post mortem vitreous electrolyte analysis as a useful adjunct in the diagnosis of salt water drowning. Three sections are presented that examine different aspects in the use of post mortem vitreous electrolytes as an adjunct in the diagnosis of salt water drowning. Each section contains published original studies and illustrative case(s). The first section established that the post mortem vitreous sodium and chloride (PMVSC) level increases, first from salt water drowning and subsequently from immersion. It demonstrated that PMVSC is a useful adjunct in the diagnosis of salt water drowning when the immersion time is less than 1 hour. The second section established that the post mortem vitreous magnesium (PMVM) level increases from salt water immersion, but not from drowning, which is different from the changes in the PMVSC. Because of this difference, PMVM can be used to assess the effect of immersion when the immersion time is greater than 1 hour or is unknown to aid in the interpretation of PMVSC levels. The third section demonstrated that combining PMVSC and lung weight (in the form of lung-body ratio, LB) provides greater diagnostic certainty for salt water drowning death compared to using either PMVSC or LB alone. The results have practical implications for the approach to salt water drowning deaths. The traditional approach of performing a full post mortem examination in all cases of suspected drowning deaths is challenged and may not be necessary. The use of post mortem vitreous electrolytes provides a less invasive approach that can be used in selected cases. Furthermore, the methodology and analytical techniques presented in this thesis can be extended to fresh water drowning deaths and non-drowning deaths
Postmortem Biochemistry - Effects of Sampling Site and Methodology on Test Efficacy
No full textPostmortem biochemistry is one of the most common categories of ancillary testing used in forensic pathology practice to aid in the diagnosis of disease and cause of death determination. In contrast to the antemortem/clinical setting, postmortem biochemistry has access to sample mediums that would be impractical or harmful to sample in the living population (such as vitreous humour). At the same time, changes to the body after death can affect postmortem biochemistry testing and these changes affect different body regions and potential biochemical sample mediums in different ways. This has implications for the efficacy of postmortem biochemical tests. Furthermore, postmortem biochemical testing is frequently used in settings unique to forensic pathology practice, or under different circumstances to the antemortem setting. Postmortem biochemical tests are therefore not direct equivalents to their antemortem counterparts and require specialist application and interpretation.
The objectives of this thesis are to determine the effects of sampling site and methodology on postmortem biochemistry results. This will first be examined broadly and then with a focus on two main illustrative scenarios (drowning and anaphylaxis) that typify the unique nature of postmortem biochemical test applications.
Published papers are presented to address the thesis objectives. Methodologies utilised include case control and case series, with the inclusion of reviews of the literature and relevant case reports. In the first aspect, the general effects of sampling site and methodology on postmortem biochemistry results are investigated using case series and an illustrative case report. In the second aspect, the effects of sampling site and methodology on postmortem electrolyte testing in the diagnosis of drowning are investigated using case control studies and an illustrative case report. In the third aspect, the effects of sampling site and methodology on postmortem tryptase testing in the diagnosis of anaphylaxis are investigated using case series, a literature review, and a textbook chapter.
Despite both being relatively acellular sample mediums, vitreous humour and cerebrospinal fluid demonstrate different postmortem biochemical results. Cerebrospinal fluid also demonstrates different biochemical results depending on whether it is sampled from the brain ventricles or via lumbar puncture. When compared to lumbar puncture cerebrospinal fluid, ventricular cerebrospinal fluid shows statistically lower sodium, chloride and urea, and statistically higher magnesium, potassium, and creatinine. When compared to either source of cerebrospinal fluid, vitreous humour shows statistically higher sodium and chloride, and statistically lower magnesium, potassium, and creatinine. Whilst beta-hydroxybutyrate and glucose show no statistically significant differences between cerebrospinal fluid (of either source) and vitreous humour in a normal population, an example from a case of diabetic ketoacidosis suggests that glucose and beta-hydroxybutyrate may be higher in vitreous humour compared to cerebrospinal fluid in this population.
As with vitreous humour electrolyte testing, cerebrospinal fluid electrolyte testing is a useful adjunct test in the setting of saltwater drowning diagnoses. However, compared to vitreous humour, electrolyte testing of cerebrospinal fluid is less accurate in the diagnosis of saltwater drowning. However, in the setting of an immersion period of greater than 1 hour, vitreous humour testing is unsuitable and cerebrospinal fluid is a viable alternative. Cerebrospinal fluid from different sample sites varies in utility for electrolyte testing for drowning, with lumbar puncture cerebrospinal fluid being more sensitive and specific for saltwater drowning than ventricular cerebrospinal fluid. Combining ventricular cerebrospinal fluid electrolyte testing with lung-to-body-weight ratio can increase its accuracy beyond that of ventricular cerebrospinal fluid in isolation.
Sampling for postmortem tryptase testing in suspected anaphylaxis is recommended to be taken from peripheral blood to avoid contamination and artefactual elevation effects from central blood sources. For peripheral blood sampling, clamping and then aspirating the femoral vein is the recommended standard sampling technique. This method results in fewer outliers compared to central blood sampling, aspirated peripheral arterial blood and peripheral venous blood obtained by cut down instead of aspiration. This method may also eliminate confounding effects of haemolysis, and results in a lower cut-off level for normal range than that proposed in studies based on different or non-standardised sampling sites and methods.
As one of the most common categories of postmortem ancillary testing, variations in test efficacy of postmortem biochemistry depending on sampling site and methodology have serious implications for a wide range of diagnostic and cause of death determination purposes. Such variations can affect the accuracy and reliability of autopsy diagnoses, which in turn can affect court proceedings and wider epidemiological data. This work demonstrates the importance of documenting sampling methods used in forensic pathology practice, establishing sample method specific reference values, and developing recommended standards of sampling methodology where possible. These practices will increase the reliability of postmortem biochemical tests and reduce the risk of diagnostic error.Thesis (Professional Doctorate)Doctor of Philosophy by Prior PublicationSchool of Medicine & DentistryGriffith HealthNo Full Tex
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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