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PubMed2006

Accidental autoerotic death by volatile substance abuse or nonsexually motivated accidents?

In contrast to typical autoerotic fatalities, when death is due to asphyxia mostly by mechanical compression of the neck, atypical autoerotic accidental deaths (AADs) involve sexual self-stimulation by other means such as electrocution or inhalation of chemical agents. Especially in lethal cases of volatile substance abuse (VSA), a differentiation between suicide or sexually or nonsexually motivated accident is often complicated in practical casework. Considering the small number of AADs involving chemical substance abuse reported in the literature, the number of unreported cases seems to be very high. We report about 5 lethal cases of VSA; analysis was performed using headspace solid-phase microextraction (HS-SPME) and gas chromatography-mass spectrometry (GC/MS). When headspace sampling is not performed at autopsy, the analysis of volatile substances can be very complicated. In 2 cases, an AAD was diagnosed considering findings at the scene, reconstruction of the event, and discussion of the circumstances of the death. These findings demonstrate the importance of VSA in atypical autoerotic asphyxia. Therefore, in cases of suspected lethal inhalational intoxications, as a matter of principle, headspace asservation should be performed at autopsy and an autoerotic motivational background should be taken into consideration for differential diagnosis.

Accidents↗
PubMed2006

Cardiac troponin T (cTn T) and the postmortem diagnosis of sudden death.

PURPOSE: To evaluate the effectiveness of the increase of postmortem cardiac troponin T (cTn T) in acute disease-related deaths. METHODS: Peripheral venous blood was sampled from 39 autopsies performed. Thirty nonhemolyzed specimens were considered in the final analysis (n = 30).Only the calculation of the cTn T was performed using the Roche Diagnostics Elecsys 2010 Immunoassay System. The high limit and the cutoff are 25 ng/mL. Deaths were divided into 2 groups, according to sudden cardiac deaths (group 1, n = 15) and non-cardiac-related deaths without resuscitation (group 2, n = 15). RESULTS: All the cases with visual myocardial infarction had elevated concentrations of cTn T. The difference of the postmortem cTn T concentrations between resuscitated and nonresuscitated is nonsignificant. In the non-cardiac-related deaths, the elevated concentrations of cTn T were only noted in all cases of electrocution. CONCLUSION: In clinical practice, several biochemical markers are used for the diagnosis of myocardial infarction. Because of its extreme specificity for myocardial damage, cTn T and cardiac troponin I (cTn I) are frequently used. The results of these assays could then be used to facilitate selection for cases that may be released following histologic examinations.

Biomarkers↗
PubMed1993

Attracting adult New World screwworm, Cochliomyia hominivorax, to odour-baited targets in the field.

A field study in Libya investigated aspects of Cochliomyia hominivorax behaviour relevant to the operation of a target-based control system. Flies were readily caught by electrified targets, but only when baited with the attractant 'swormlure-4'. Target size (0.25-1 m2) did not affect catch, but black targets caught twice as many flies as red ones. Omitting the most volatile component of swormlure-4, dimethyl disulphide, significantly reduced catches of both sexes of C.hominivorax in wind-orientated traps, but only reduced the capture of females significantly on targets. A new polythene sachet dispenser for odours was tested; four to six such sachets filled with swormlure-4 less dimethyl disulphide gave an equivalent catch to one of the standard bottle plus wick dispensers using the same attractant, although they dispensed odour at about half the rate. From direct observations, fewer than 40% of flies contacted the target for more than 10 s on any one visit. From catches on an intermittently-active electrocuting grid, it was calculated that there is a c. 40% rate of multiple contacts of flies with the target.

Animals↗
PubMed1995

Orientation of agents of wound myiasis to hosts and artificial stimuli in Hungary.

The orientation of adults of the myiasis species Wohlfahrtia magnifica and Lucilia sericata to artificial visual stimuli (cloth targets) and olfactory stimuli ('swormlure-4', a potent screwworm attractant), was studied in sheep pastures near to Sárbogard in Hungary. Experiments with odour-baited cloth targets, enclosed in electrocuting grids, demonstrated that colour was an important factor influencing catches on targets: a black target caught most flies of both species, with other colours in the following order of effectiveness, blue > white > yellow. Wohlfahrtia magnifica did not respond to swormlure-4 in the strong manner that L.sericata did. The sex ratios of W.magnifica caught on targets (67.2% males) and hand-netted from fence posts (68.8% males) were similar and biased towards males, whereas that of L.sericata on targets was strongly biased towards females (15.6% males), indicating a fundamental difference in the response of these two myiasis species towards the swormlure-baited targets. The orientation of these two species towards hosts was also recorded together with that of a third species, Phormia regina. Electric nets placed beside infested sheep caught significantly more flies of all three species than those placed beside uninfested sheep or in the absence of sheep. The sex ratio of W.magnifica caught around infested sheep was the reverse of that on targets, with 68.5% females. Wohlfahrtia magnifica responded more strongly to healthy, uninfested sheep than did L. sericata and P.regina. The potential for use of targets both for population monitoring and control is discussed.

Animals↗
PubMed1996

The role of cattle as hosts of Glossina longipennis at Galana Ranch, south-eastern Kenya.

Glossina longipennis were recorded visiting and engorging on cattle in an enclosure and on a single ox in a crush using transparent electrocuting nets in an incomplete ring. Of the total flies caught, 3-6% of males and 5-6% of females in the total catches were engorged (a feeding success rate of up to 16.6% and 12.6%, respectively, depending on assumptions made about the proportion which had an opportunity to feed). Direct observation of tsetse from an observation pit showed 57% landing on the front legs, 13% on the hind legs, and 11% on the belly of the host. The largest number of bloodmeals was taken from the front legs, although only 14% of landings there terminated in feeding; a higher proportion of the flies alighting on the hind legs and flank succeeded in feeding (28% and 21% respectively). Glossina longipennis were attracted to targets baited with ox odour from an underground pit in a dose-dependent manner. Odour of humans was much less attractive to G. longipennis than that of oxen (for equivalent biomass). Analysis of bloodmeal samples from tsetse caught in two sites on the ranch showed that G. longipennis preferentially feeds on suids, bovids and hippopotamus.

Animals↗
PubMed1991

Electroporation of cardiac cell membranes with monophasic or biphasic rectangular pulses.

During defibrillation, cardioversion, and electrocution trauma, heart cells are exposed to potential gradients that increase the transmembrane potential (Vm). At sufficiently high Vm, pathological increases in cell permeability can occur. With enzymatically isolated frog heart cells (n = 29) we investigated the voltage and time sufficient for electroporation or cardiac cell membranes with rectangular voltage pulses, particularly with 5-msec monophasic, and 5- or 10-msec biphasic pulses. The rectangular voltage pulse (monophasic 0.1-1.5 V, 0.1-100 msec or symmetric biphasic 0.1-1 V, 0.4-10 msec [total duration]) was applied to the cell membrane using the cell-attached patch clamp technique, and a low voltage pulse train was added so that membrane conductance could be monitored continuously. Step increases in membrane conductance (breakdown) were observed, indicative of electroporation, and occurred with different combinations of pulse amplitude and duration; for example, for monophasic square pulses: (1 V, 0.2 msec) or (0.5 V, 0.5 msec), and for biphasic pulses: (1 V, 0.4 msec total duration) or (0.5 V, 0.8 msec). Using 5- or 10-msec rectangular pulses, breakdown occurred at a voltage around 0.4 V independent of polarity or waveform. The recovery of the permeabilized cell membrane after the voltage pulse was highly variable, in some cases not recovering at all while in other cases recovering after a lapse of seconds to minutes. These results suggest that monophasic and biphasic pulses of approximately 1 V, 0.2-0.4 msec and approximately 0.4 V, 5 msec can permeabilize the heart cell membrane even for minutes, time enough to cause an alteration in the cellular ionic composition leading to depressed or unexcitable tissue, a precursor for cardiac arrhythmia.

Animals↗
PubMed2006

Appropriate result from an inappropriate ICD shock.

A case of inappropriate detection of an ungrounded external AC current by an implantable cardioverter defibrillator (ICD) is reported. The resultant ICD shock dislodged the patient from the electrical source, thus preventing injury or electrocution.

Defibrillators, Implantable↗
PubMed2006

Autoerotic deaths in the literature from 1954 to 2004: a review.

Autoerotic death by hanging or ligature is a method of autoeroticism well known by forensic pathologists. In order to analyze autoerotic deaths of nonclassic hanging or ligature type, this paper reviews all published cases of autoerotic deaths from 1954 to 2004, with the exclusion of homicide cases or cases in which the autoerotic activity was not solitary. These articles were obtained through a systematic Medline database search. A total of 408 cases of such deaths has been reported in 57 articles. For each case, the following characteristics are presented here: sex, age, race, method of autoerotic activity, cause of death, and location where the body was found. Autoerotic death practioners were predominantly Caucasian males. Victims were aged from 9 to 77 years and were mainly found in various indoor locations. Most cases were asphyxia by hanging, ligature, plastic bags, chemical substances, or a mixture of these. Still, atypical methods of autoerotic activity leading to death accounted for about 10.3% of cases in the literature and are classified here into five broad categories: electrocution (3.7%), overdressing/body wrapping (1.5%), foreign body insertion (1.2%), atypical asphyxia method (2.9%), and miscellaneous (1.0%). All these atypical methods are further discussed individually.

Age Distribution↗
PubMed2006

Accidental deaths caused by electricity in Sweden, 1975-2000.

This study analyzes accidental fatalities caused by electricity--at work and during leisure time--to evaluate risk factors, the role of alcohol, and to identify possible preventive strategies. In Sweden, data on fatalities by electrocution from 1975 through 2000 were collected from the National Cause-of-Death Register. Additional cases were found in the archives of The Swedish National Electrical Safety Board. Suicides and deaths by lightning were excluded. Two hundred and eighty-five deaths were found, including occupational (n=132), leisure time (n=151), and unknown (n=2). Most deaths were caused by aerial power lines, and the most common place for an electrical injury was a railway area or residential property. Postmortem blood from 20% (n=47) of the tested cases was found positive for alcohol, and these persons were killed mainly during leisure time. During the study period, the overall incidence of electricity-related fatalities has decreased, in spite of increased use of electricity. This indicates that safety improvements have been successful.

Accidents↗
PubMed1997

Pattern of motor neurone disease in eastern India.

A clinical study about the pattern of motor neurone disease in eastern India was carried out from July 1993 to June 1995 at Bangur Institute of Neurology, Calcutta and SSKM Hospital, Calcutta. A total of 110 cases were studied and they constituted 0.11% of all neurological cases seen in the general OPD. Of 110 cases, amyotropic lateral sclerosis (ALS) constituted 43.6%, progressive muscular atrophy (PMA) 10.9%, post-polio progressive muscular atrophy (PPMA) 1.8%, spinal muscular atrophy (SMA) 20%, atypical form Madras pattern of MND (MMND) 0.9% and monomelic amyotrophy (MMA) 22.7% of cases. Disease is more common in males than females and average duration of symptoms before presentation varied from 1 to 12 months. Most of the patients were either agricultural labourers or manual workers in ALS variety whereas MMA variety was evenly distributed in both hard labourers and sedentary workers. Most of the patients in MMA and SMA groups presented before 30 years of age whereas ALS and PMA group presented after 30 years. Trauma was the commonest antecedent event in ALS and MMA followed by electrocution in the same two groups. Family history was found to be absent in SMA group though the disease is considered as a hereditary one. Weakness of the limbs and wasting of the muscles were common presenting symptoms and signs. Bulbar symptoms and signs were found only in the ALS group. EMG showed neurogenic pattern and mixed pattern in most of the patients in all groups. Only a few patients showed myopathic pattern. Neuroimaging study helped in exclusion of compressive lesion excepting two cases of MMA where facetal hypertrophy was present. Monomelic amyotrophy, a special variety of motor neurone disease, is not rare in this part as compared to other parts of India and Asia.

Female↗
PubMed1999

Facial burns in children: a series analysis with implications for resuscitation and forensic odontology.

This study comprises a continuous (1981-1995) unselected series of all children who died from thermal injuries in the State of Queensland, Australia. One hundred and six children, so identified, died from incineration (35 per cent), respiratory burns with smoke or carbon monoxide inhalation (33 per cent), body surface area burns comprising greater than 60 per cent (9 per cent) and electrocution (20 per cent). The burn fatality rate was 0.98 per hundred thousand children (0-14 years) per year, with no secular trend and, specifically, no reduction in the annual rate of such fatalities. Eighty-two children (49 males) had concomitant facial injuries, both thermal and nonthermal; of whom 55 per cent were under the age of five years. Sixty (73 per cent) child burn victims died in house fires. Forensic odontology is important in confirming the age of such victims in single incinerations but is of limited value when larger numbers of children are incinerated, because of the relative lack of dental restorations in the infant and pre-school age group. Of the 82 children with facial and airway injuries, 12 per cent had only mild or superficial facial damage and only seven (8 per cent) were alive or resuscitable at the time of rescue from the conflagration or burning injury. child deaths from burns contributed an annual loss rate of 506 years of potential life lost (YPLL) in a population of 3 million of whom 21.5 per cent were children under the age of 15 years. Airway management and resuscitation, in the context of managing surviving burn victims of any age with facial injuries, pose special difficulties. Inhalational burns (smoke and the gases of conflagration) result in a mortality greater than 60 per cent. Although 81 per cent of children showed evidence of airway obstruction, analysis of current data indicates that a maximum of 8 per cent could have survived with airway maintenance and protection. Inhalational burns (to both upper and lower airways) grossly reduce survivability. Primary prevention would seem vital and thus remains a major challenge to reduce the incidence of such deaths. Some strategies include advocacy to promote the compulsory installation of smoke alarms, family drills to practise escape and the teaching of 'first aid for all'

Adolescent↗
PubMed1995

Injury prevention program in primary care: process evaluation and surveillance.

OBJECTIVES: To carry out process evaluation and surveillance in a community oriented primary care program for injury prevention among children 0-2 years old (n = 306). SETTING: Mother and child health clinic in a defined area of Western Jerusalem. METHODS: An injury prevention program was integrated into the routines of the mother and child health clinic. The program consisted of injury surveillance and counselling using a developmental approach, regarding car safety and the prevention of falls, burns, suffocation, poisonings, cuts, drowning, and electrocution. Process evaluation and surveillance were based on records integrated into the child's personal file in the clinic. RESULTS: Process evaluation indicated that counselling coverage was 73% in the 0-5 month age group and decreased to 48% in the second year of life. The mean number of topics discussed with the parents was 6.6 (out of nine) for the 0-5 months age group, 13.6 (out of 18) for the 6-11 month group, and 15.7 (out of 18) for those 1-2 years old. Injury surveillance activities were complete for 66% of the children, incomplete in 32%, and not done in 2%. CONCLUSIONS: The results indicate that it is feasible to integrate an injury prevention program into primary care, and that process evaluation is important in detecting problems and improving performance of the program's activities.

Accident Prevention↗
PubMed2001

Use of narrative analysis for comparisons of the causes of fatal accidents in three countries: New Zealand, Australia, and the United States.

OBJECTIVES: To investigate the utility of narrative analysis of text information for describing the mechanism of injury and to compare the patterns of the mechanism of injury for work related fatalities in three countries. METHODS: Three national collections of data on work related fatalities were used in this study including those for New Zealand, 1985-94 (n=723), for Australia, 1989-92 (n=1,220), and for the United States, 1989-92 (16,383). The New Zealand and Australian collections used the type of occurrence standard code for the mechanism of injury, however the United States collection did not. All three databases included a text description of the circumstances of the fatality so a text based analysis was developed to enable a comparison of the mechanisms of injury in each of the three countries. A test set of 200 cases from each country dataset was used to develop the narrative analysis and to allow comparison of the narrative and standard approaches to mechanism coding. RESULTS: The narrative coding was more useful for some types of injury than others. Differences in coding the narrative codes compared with the standard code were mainly due to lack of sensitivity in detecting cases for all three datasets, although specificity was always high. The pattern of causes was very similar between the two coding methods and between the countries. Hit by moving objects, falls, and rollovers were among the five most common mechanisms of workplace fatalities for all countries. More common mechanisms that distinguished the three countries were electrocutions for Australia, drowning for New Zealand, and gunshot for the United States. CONCLUSION: Narrative analysis shows some promise as an alternative approach for investigating the causes of fatalities.

Accidents, Occupational↗
PubMed1987

Levels of short (1-15 ms) electrical shocks from a 50 Hz supply inducing ventricular fibrillation in hyperbaric helium and oxygen.

An investigation was undertaken to determine the ventricular fibrillation (VF) threshold of anaesthetised dogs subjected to external application of electric shocks between a foreleg and a hindleg. The shocks were 2-15 ms sections of 50 Hz sine waveform starting at peak current and were applied at a known time in the heart cycle. The object of the experiment was to determine if there was an increase in cardiac susceptibility to electrically induced VF at 31 atmospheres absolute (atm abs) in a helium and oxygen environment. The duration and position of that part of the cardiac cycle most vulnerable to induction of VF by electrocution was found (seven animals) using 4 ms shocks and then the minimum fibrillating current for shocks of 2-15 ms (min FC2-15) delivered at the most vulnerable point of the cycle (five animals). Body resistance was calculated from the data so gathered. Fibrillation thresholds were not changed by compression and there were no significant changes in the vulnerable period of the cardiac cycle. Min FC2 was significantly higher than for other durations under both control (3.21 A, SD 1.08) and test conditions (3.26 A, SD 0.39), p = 0.001. There was no difference in body resistance at 31 atm abs (395.5, SD 12.9) from control values at 1 atm abs (396.7, SD 10.9). From these data it was concluded that the heart is no more susceptible to the induction of VF at 31 atm abs in a helium oxygen environment and additional safety factors are unnecessary from this point of view.

Animals↗
PubMed2001

Factors associated with the introduction of classical swine fever virus into pig herds in the central area of the 1997/98 epidemic in The Netherlands.

A matched case-control study of 135 infected and 99 uninfected pig herds from the central area of the 1997 to 1998 epidemic of classical swine fever (CSF) in The Netherlands was undertaken to identify factors associated with the introduction of the virus. The herds were matched on the basis of herd type and the shortest geographical distance between pairs of herds. Data on management, hygienic measures, experiences during the depopulation of an infected nearest neighbour, and the frequency of contact with professionals and other agencies were collected by means of a questionnaire taken by personal interview. There were no significant differences between the infected and uninfected herds in the median total number of contacts per year with professionals and other agencies either with or without contact with the pigs. On the basis of a multivariable analysis, five variables were found to be significantly associated with an increased risk of infection: (1) the presence of commercial poultry on the premises; (2) visitors entering the pig units without wearing an overcoat or overalls and boots supplied by the farm; (3) the driver of the lorry transporting pigs for the Pig Welfare Disposal Scheme (PWDS) using his own boots instead of boots supplied by the farm; (4) herds of moderate size (500 to 1,000 animals) and very large herds (>7,000 animals) were at greater risk than small herds (<500 animals); and (5) an aerosol, produced during high-pressure cleaning of the electrocution equipment used to kill the pigs on a neighbouring infected herd less than 250 m away was carried by the wind on to the premises. Two variables were significantly associated with a decreased risk of CSFV-infection: (1) more than 30 years of experience in pig farming; and (2) additional cleaning of the lorries used to transport pigs for the PWDS before they were allowed on to the premises. In the opinion of the cooperating farmers, airborne transmission of the virus and its transmission during the depopulation of an infected neighbour were among the most important routes of infection.

Animal Husbandry↗
PubMed2006

Slaughter of poultry during the epidemic of avian influenza in the Netherlands in 2003.

During an outbreak of avian influenza in the Netherlands in spring 2003, the disease was controlled by destroying all the poultry on the infected farms and on all the farms within a radius of 3 km. In total, 30 million birds were killed on 1242 farms and in more than 8000 hobby flocks, by using mobile containers filled with carbon dioxide, mobile electrocution lines and by gassing whole poultry houses with carbon monoxide or carbon dioxide. Observations of these methods were used to compare their effectiveness and capacity, and their effects on the welfare of the birds. Gassing whole poultry houses had a much greater capacity than mobile equipment, and catching live birds to bring them to a mobile killing device caused extra stress and could cause pain due to injuries inflicted when catching and handling them. Gassing whole poultry houses with carbon monoxide requires strict safety regulations and, therefore, gassing with carbon dioxide was considered preferable. However, this method is not suited to all types of housing, and in these circumstances mobile killing devices were a useful alternative.

Animal Husbandry↗
PubMed2000

Transurethral vaporization-resection of the prostate versus standard transurethral prostatectomy: comparative changes in histopathological features of the resected specimens.

OBJECTIVES: Transurethral vaporization resection of the prostate (TUVRP) is a recent modification of the standard transurethral resection of the prostate (TURP). TUVRP uses a band electrode coupled to a high electrocuting energy to achieve simultaneous resection, vaporization and coagulation of the prostate. We evaluated the histopathological resection specimens of patients treated with TUVRP to see whether the higher energy used will result in thermal artifacts that will interfere with the pathological evaluation of the prostate, and compared the results to TURP specimens. MATERIAL AND METHODS: The histopathological specimens of 50 patients that underwent TUVRP or TURP were reviewed. Artifactual pathological patterns that were identified in the specimens included: abnormal cellular orientation and spindling, artifactual cellular detachment from the underlying basement membrane, atypical cytological changes or areas of stromal coagulative necrosis. Each identified pattern was awarded 1 point. The severity of cautery artifact was graded into mild, moderate or severe according to the sum of points in each specimen. RESULTS: Mild cautery artifact changes were noted in 1 patient who underwent TURP. Moderate changes were noted in 21 patients in each TURP and TUVRP groups while severe changes were noted in 4 and 3 patients undergoing TUVRP and TURP respectively. There were no statistically significant differences between the groups with regard to the severity of the cauterization- induced changes. CONCLUSIONS: The quality of histopathological specimens produced by TUVRP is similar to the standard TURP. It seems that the higher energy use in electrovaporization technique does not result in greater thermal injury to the tissues possibly because of the cooling effect of the irrigation fluids used intraoperatively.

Artifacts↗
PubMed1978

The surgical diathermy: principles of operation and safe use.

An understanding of the principles of operation and hazards of the surgical diathermy is necessary for the safety of the anaesthetized patient. The surgical diathermy performs its function by the application of high density radio frequency current which can be used to cut or coagulate tissue. Its improper use can result in electrical burns and even electrocution. The principles underlying its safe use are outlined, and detailed recommendations are made to ensure the patient's safety.

Disposable Equipment↗