The relative risks of death for CAPD and HD reported in the literature and at recent meetings most likely reflect case-mix differences and varying percentages of adequately dialyzed patients within the compared populations. A prospective randomized comparison of CAPD and HD patients will be unlikely because of the expense. Therefore, ...

BACKGROUND: Two cases of sudden unexpected deaths in patients with multiple sclerosis were investigated by the Office of The Chief Forensic Pathologist. METHOD: Case studies. RESULTS: Marked similarities of the deaths, including circumstances, scene examination, and autopsy findings including a complete drug screen were recorded. CONCLUSIONS: Exposure to high ambient ...

Autopsy was performed on 221 of the 223 neonatal deaths that occurred over a period of 3 years (1989-1991). Clinically active problems at the time of death were identified in a combined clinicopathological approach. Prematurity associated conditions accounted for 51 per cent of deaths. Autopsy alone gave the diagnosis in ...

Most cases of sudden unexpected 'natural' death are due to primary disorders of the cardiovascular, respiratory and central nervous system. Sudden death due to a previously undiagnosed malignancy is rare in young, apparently healthy subjects. We report an unusual cause of sudden unexpected death due to pulmonary tumour embolism complicating ...

We describe the case of a 40 year old woman, who had suffered from asthma since infancy, with a negative case history of asthma induced by aspirin or nonsteroidal anti-inflammatory (NSAID) agents, who died after ingesting 400 mg of ibuprofen. The autopsy specimens collected 3 months after death had all ...

To determine whether relatives and others can provide valid information about the dates of survey respondents' deaths, informants' reports were compared with death certificates for 328 deceased respondents from the MESA study of older adults. About two-thirds (64.6%) of the informants accurately reported the complete date of death. A somewhat ...

We present a review of the circumstances and medical findings of 280 fatalities due to hanging in Western Australia (WA) during the 5 yr period 1988-1992. Two hundred and forty one (241) of the cases were examined prospectively; the completed Coroner's files of a further 39 cases, from rural WA, ...

Sudden death can occur in drunk individuals who are severely beaten about the face. The structural basis for this forensic syndrome is unknown. We herein describe the case of an intoxicated 23-year-old man (blood alcohol 234 mg%, 51 mmol/l) who was involved in an altercation and received blows and kicks ...

A case report illustrates possible pathophysiological mechanisms of sudden death in psychiatric patients. Difficulties with the tendency to implicate phenothiazines as the cause of death are discussed in light of evidence that the death investigation and autopsy are often incomplete. Some suggestions are made to reduce the risk of a ...

Sudden cardiac death (SCD) has not been investigated separately in Greece. The aim of this study is to describe the epidemiological characteristics of people dying suddenly out of hospital in an area of Greece. In 1990, a population based study was started to detect the cases of people dying suddenly ...

Death as a result of anaphylaxis remains rare and is only occasionally related to ingestion of common substances. This article reports a death due to an allergic reaction to ethanol, as well as a review of the reported deaths in the literature attributed to ethanol. This report emphasizes the importance ...

Case ascertainment for an epidemiologic study of Creutzfeldt-Jakob disease (CJD) can be difficult. This report investigates the efficiency of various sources of case ascertainment for CJD. Cases were identified utilizing neuropathologists, hospitals and death certificates from 11 targeted states. For the period of 1986-1988, 247 death certificates indicating a diagnosis ...

The aim of this study was to create a scoring method to distinguish between sudden infant death syndrome (SIDS) and cases of sudden death resulting from life-threatening conditions (LTC). Four hundred infants less than one year old who died suddenly out of hospital in St Petersburg between 1983 and 1990 ...

The deliberate inhalation of solvents among children and adolescents "for kicks" is becoming more common in the West. It was generally regarded as a relatively harmless practice and consequently little attention had been paid to the isolation of the toxic agent from the variety of substances used. It is now ...

Gunshot wounds are well characterised in forensic textbooks and atypical or unusual ballistic characteristics feature regularly in forensic literature. Forensic practitioners receive continuing education in recognising a variety of gunshot wounds which are created by bullet missiles. Awareness of a non-missile penetrating injury mimicking a gunshot wound is also relevant ...

Two cases of sudden death due to arrhythmogenic right ventricular dysplasia (ARVD) occurring in the pediatric age group are described. One of the subjects, at the age of 7 years, is believed to be the youngest child in whom ARVD has been diagnosed at autopsy. The clinical and pathological characteristics ...

OBJECTIVE: To investigate the quality of coronial postmortem examinations performed in rural New South Wales by Government Medical Officers. METHODS: We reviewed 100 cases, examining the history of the case provided by police officers, referral letters from Government Medical Officers and macroscopic reports of the postmortem findings. Tissue specimens received ...

We report on deaths associated with renal agenesis among 211,704 consecutive births. Sources included birth and death certificates and an active birth defects surveillance system. Medical review and classification of cases were performed for 1985-1990 events. Sixty-one cases of renal agenesis were identified, and review of records was possible for ...

Autoerotic death refers to the accidental death of individuals of either sex due to failure of devices, or unexpected effect of materials, that were being used to enhance the sexual experience. Although asphyxia from hanging has been described most frequently, a wide variety of other lethal situations have been reported. ...

Sertraline is a potent inhibitor of serotonin reuptake in the central nervous system and is used clinically to treat depression and obsessive-compulsive behavior. Over the course of one year, there were seven cases investigated by the Office of the Chief Medical Examiner, State of Maryland, in which sertraline was identified ...

Cocaine availability has been increasing in Spain in the past few years. A review of all the toxicological analyses carried out at the Madrid Department of the Instituto Nacional de Toxicología, with subjects who had died of drugs from 1990 to 1992, found 533 persons who had cocaine in their ...

A survey of 76 cases of fatal intoxication with Ketogan which occurred in Eastern Denmark over the period 1985-1991 showed that the cause of death was Ketogan alone in 27 cases, in combination with alcohol in 23 cases, and in combination with other drugs in 26 cases. The average age, ...

One adult and one childhood case of concealed homicide by strangulation are presented. Both cases were first recognised on formal neck dissection at necropsy. Neither showed any obvious external trauma to the neck or laryngeal fracture. External petechiae were absent in the child. The pattern of internal injuries in both ...

Nine deaths involving oxycodone were investigated to assess the contribution of this opiate to these fatalities. All except one of the bodies were subjected to a full autopsy by specialist pathologists with a subsequent thorough toxicological examination. No significant anatomical pathology was found at autopsy. All deaths gave concentrations of ...

We describe the circumstances and post mortem medical findings of 4 unusual fatalities where death occurred during autoerotic practice. Three cases occurred in young to middle-aged men--hanging, electrocution and inhalation of a zucchini. The manner of death in each was accidental. The fourth case was an elderly man who died ...

Four cases of postmortem injuries caused by indoor pets (three by dogs and one by cats) are presented. A pattern which is associated with this phenomenon is described. The important common factors appear to be the presence of free-moving pets inside the house, social isolation of the deceased, and the ...

Four cases from the Philadelphia Medical Examiner's Office are presented and the literature is reviewed to define further the syndrome of sudden death occurring during cocaine-induced agitated delirium and struggle during restraint in individuals who also sustain minor head injury. The mechanism of death involves a terminal arrhythmia, most likely ...

A flight surgeon presents with severe diarrhea of sudden onset. The unusual cause could be traced to sorbitol, a common sweetener that is widely available and could easily affect many aviators. The symptoms are exacerbated in the aerospace environment and close investigation of the dietary history may be the only ...

Unavailable in the literature is any reference to an investigation of death after evidence has been destroyed. In this presentation two firearms and the bullet were melted after the death was certified as a suicide. A team of investigators conducted a psychological autopsy as well as shot patterns to determine ...

This is a brief review of the findings in the conduction system in cases of sudden death victims who were living "normal" active lives. Twenty-two representative samples from more than 100 cases of sudden cardiac death, especially in young and asymptomatic individuals, revealed a plethora of findings that varied from ...

Eleven cases of sudden death of men restrained in a prone position by police officers are reported. Nine of the men were hogtied, one was tied to a hospital gurney, and one was manually held prone. All subjects were in an excited delirious state when restrained. Three were psychotic, whereas ...

BACKGROUND: Community-based registers participating in the MONICA Project of the World Health Organization show markedly different attack and death rates of coronary heart disease. This variation is a function of both the incidence and case fatality occurring within countries. The contribution of case fatality to the international variation in coronary ...

A retrospective study of post-mortem examinations of abortions and perinatal deaths (104 cases) were undertaken in order to evaluate the clinical importance of the findings. The major disease and the cause of death were clinically diagnosed in about 50% of cases (usually medical abortions and liveborn infants). Only one clinical ...

The sudden death of an infant may be due to a variety of causes. In such cases, complete autopsy with radiologic, gross, microscopic, and toxicologic examination is warranted. We present a case of a previously healthy 15-month-old girl with no known disease, who experienced witnessed cardiac arrest, ventricular fibrillation, and ...

Dying in a head-down position is rare and autopsy may reveal no morphological findings which explain the cause of death sufficiently. Functional changes, mainly postural changes of circulation must be considered to explain the cause of death. Two cases of death are reported where death occurred in a head-down position, ...

We describe the tenth reported case of neonatal pemphigus that mimicked Bart's syndrome and review previously published cases. Unlike previous cases, the child was born with significant blistering to a mother who was in complete remission throughout the pregnancy. High antepartum maternal titers of anti-intercellular space antibodies, increased maternal disease ...

A study of eight deaths involving the benzodiazepine flunitrazepam was performed to assess the contribution of this drug to the fatalities. Coronial deaths in Victoria in the 2-year period to mid-1991 were selected in which either flunitrazepam or flunitrazepam and ethanol were the principal toxicological findings. All bodies were subject ...

The objective of this study was to investigate the possibility of using Coroner's reports on accidental deaths as the basis of a surveillance system. The Coroner's reports of childhood accidental deaths in Northern Ireland over a five-year period (224 deaths) were reviewed. Outcome measures included the delay between time of ...

Two cases of alleged dowry deaths are presented from Haryana State, India. In each case a young lady died after receiving burn injuries. Forensic examination unveiled the mysteries of both deaths and helped in apprehending and prosecuting the culprits. Case 1, allegedly a dowry death, proved to be an accidental ...

A case of autoerotic asphyxiation is presented. The incident demonstrates 12 of the 13 characteristics particular to autoerotic asphyxias. The elements of attire and bondage used are unique in comparison with previously reported cases. The addictive nature of this behavior is well demonstrated in the victim's sexual history. Interestingly, his ...

The Pittsburgh protocol relies heavily on traditional moral distinctions, particularly the principle of double effect, to justify "managing" the dying process of a prospective organ donor in order to yield viable organs for transplantation. These traditional moral distinctions can be useful, particularly in casuistic or case-specific moral analysis, but their ...

In cases of unusual death, scene investigation plays an important role in assisting the investigator to determine the manner of death. The following case history describes an unusual suicide in which scene investigation was essential in assisting the authorities in determining the manner of death.

OBJECTIVE: To report two cases of fatal brown snake envenomation in adults despite the use of appropriate antivenom. CLINICAL FEATURES: Two men, aged 42 and 39, one with a history of hypertension, suffered fatal brown snake envenomation in Queensland. One believed he had been stung by a wasp. Both developed ...

Life review and tunnel sensation in near-death experiences appear to be culture-bound phenomena, confined largely to societies where historic religions are dominant. The clinical literature postulating biological theories for life review and tunnel sensations, therefore, may have been developed somewhat prematurely. The present review argues that social and historical explanations ...

As asphyxial episodes during autoerotic activity are rarely reported in women, a review of eight fatal cases and one near-fatal case was conducted to delineate more clearly the characteristics of this syndrome in women. Six cases involved characteristic fatal autoerotic asphyxial activity. The remaining two fatal cases were atypical in ...

Accidental mechanical asphyxia is an unusual cause of death. In reviewing 73 cases occurring during a 10-year-period in Sweden, young boys and elderly women seemed to be most prone to this type of fatality. A striking number of victims had deliberately put a noose-like structure around the neck, and yet ...

The protocols of 1,000 consecutive adult patients autopsied during the period June 1983 to December 1988 were retrospectively analyzed and the findings were compared with clinical diagnoses. The autopsy rates during this period ranged between 23% and 27% of hospital deaths. Eighty-seven percent of the autopsied patients were between 15 ...

In the nearly thirty years since Butler first proposed the life review, the notion that older persons review their lives in the face of approaching death has become firmly entrenched in both the literature and practice of gerontology. This article examines the commonly-held assumptions underlying the life review and reviews ...

Bilateral xanthogranulomatous pyelonephritis is a rare condition with 7 previously reported cases, all of which required dialysis and/or resulted in death of the patient. We report a case in which bilateral partial nephrectomy was performed successfully for bilateral xanthogranulomatous pyelonephritis. The etiology, symptomatology, radiographic findings and treatment of this rare ...

Identification of soft tissue sarcomas (STSs) in epidemiologic mortality studies is complicated by nosologic coding rules that require that STSs arising in a visceral organ must be coded in the International Classification of Diseases (ICD) category for that organ, rather than in the ICD category for malignant neoplasms of connective ...