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[An initially unexplained death during prison sentence. Diagnostic verification by atomic absorption spectrometry].

The authors report on the death of a 25-year-old man due to electric current in prison, which was not recognized at first. The fatal accident was caused by a self-made electric kettle. The only electrothermal skin lesions were some pinhead-sized electric marks on the left thumb. Careful external inspection of the body in combination with an analysis of the conductor material (aluminium) by means of atomic absorption spectrometry (AAS) revealed the cause of death and the source of accidental electrocution.

Adult↗

[Lhermitte's sign].

Besides Babinski's, Lhermitte's sign is likely the eponym mostly used in the neurological literature. We review here the history of this eponym as well as recent advances on its pathophysiology and treatment. Lhermitte's phenomenon is, on one hand, a symptom as it is spontaneously explained by patients, and, on the other hand, a sign as it may be triggered by flexion of the nape. Initially described after head and cervical spine trauma, firstly by Marie and then by Babinski, it was Jean Lhermitte who recognized on it an etiological specificity, namely, a demyelinating sign of cervical spinal posterior cords. He also made a pathophysiological interpretation of the phenomenon, namely, a stretching of posterior cords during flexion of the neck. All authors agree that this phenomenon is more common in multiple sclerosis, although it has been descibed in many other conditions. The history of how this sign was hatched, whose pathophysiology remains a mystery, is fascinating. And it is fascinating the fact that patients compare the phenomenon with a current, especially if we bear in mind that few people may have suffered an electrocution, mainly in that time when just a few ones could actually enjoy domestic electricity.

Cervical Vertebrae↗

Bilateral anterior shoulder dislocation--a case report and review of the literature.

Bilateral dislocations of the shoulders are uncommon. Of the cases which do present, the majority are posterior and occur secondary to seizures associated with epilepsy, electrocution and hypoglycaemia. Bilateral anterior dislocations are thought to be very rare. This report describes such a case which occurred following minor trauma in an elderly lady. The literature review which follows would seem to suggest that this may not be as rare as previously thought.

Accidental Falls↗

Medical aspects of capital punishment executions.

Between 1976 and the middle of 2001, approximately 718 human executions occurred in the U.S. (a small segment of worldwide executions). Data regarding the medical aspects of these executions are not readily available. We searched all public domain data in the U.S. to obtain specific data for all persons executed in the U.S. since 1976. Of the five methods of execution used (lethal injection, lethal gas, electrocution, hanging, and firing squad), significant differences emerged as measured by rate of complications, duration of time spent by the condemned in the "death chamber," as well as duration of time from the onset of execution procedures to pronouncement of death. These data suggest that human executions are difficult to carry out. Human executions are associated with significant physical complications. These data may help inform future discussions on human executions.

Capital Punishment↗

[Ultrastructure changes of electrical injury in rats].

OBJECTIVE: To observe ultrastructure changes of electrical injury in rats. METHODS: An experimental model of rats suffered from the low voltage were designed. Ultrastructure changes of electrical injured tissues were observed under transmission electron microscope. RESULTS: (1) Plasma of epithelium was concreted in the affected areas and inner membrane system was broken. (2) Hypercontraction bands were observed in skeleton muscles. (3) There was dissolved necrosis and hypercontraction bands in the myocardium. (4) Vacuoles were found in plasma of endothelium of blood vessels on electrical current path, and myelin sheath of nerve fiber were loosed. CONCLUSION: The above mentioned ultrastructure changes could be used as assistant diagnostic index of electrocution. The mechanism of the changes were discussed.

Animals↗

[Evaluation of anti-muscle actin monoclonal antibody HHF35 in the diagnosis of early myocardial infarction].

In order to explore the specificity of anti-muscle actin monoclonal antibody HHF35 in the postmortem diagnosis of early myocardial infarction, the changes of HHF35 staining in the infarcted myocardia and other non-infarcted myocardia with direct or indirect myocardial injury were studied with immunohistochemical S-P method. The results showed that the loss of HHF35 staining of different degrees was found in the infarcted myocardia, but also in the other non-infarcted myocardia with direct or indirect myocardial injury, such as cardiac contusion, myocarditis, hemorrhagic shock, electrocution, mechanical asphyxia. So it should be cautious in diagnosing early myocardial infarction with HHF35 immunohistochemistry.

Actins↗

Lightning injuries.

Lightning strikes may cause a constellation of injuries. Blunt head trauma, neurologic injury, and cardiac injury are common in these patients. In contrast to high-voltage electrocutions, blunt trauma after a lightning strike is common. Thorough evaluation of all organ systems is crucial. This report discusses mechanism of injury and describes initial evaluation and treatment of lightning strike victims.

Emergency Medical Services↗

Hospital electrical safety.

Electrocution is an environmental hazard for hospital personnel and patients. The source is low-level alternating current, accidentally applied through indwelling electrodes which invade the normally protective high resistance of the body. Probably the greatest offender is the combination of electronic monitoring and the electrically operated bed. Preventive measures include education of medical personnel and the establishment of guidelines on leakage, coupled with periodic maintenance and inspection by trained technicians.

Electric Injuries↗

Design hazards of electrosurgical devices.

The tremendous lifesaving value of adjunct electrosurgery to the medical profession is not without potential hazards. The hazards, which can be classified as radio-frequency burn hazards, shock hazards, electrocution hazards, and explosion hazards, may result from equipment design circuitry, possible failure modes, or operator error. The three basic electrosurgery systems currently being marketed--grounded output systems, referred-to-ground output systems, and floating output systems--are described, and the hazard potential of each system, as well as the hazard potentials of modifications of these systems, are identified. The authors propose a safety system to eliminate most of the hazards cited for the other systems, recommend minimum circuit performance requirements, and evaluate an electrosurgery standard.

Electricity↗

Electric shock during pregnancy.

QUESTION: A 24-year-old patient of mine, who was 23 weeks pregnant at the time, suffered a minor electric shock while using her hair dryer. She said she felt the current in her right hand and she was wearing shoes. She was observed in an emergency room for several hours and then discharged home. Is her pregnancy or fetus at risk now or later in the pregnancy? ANSWER: There are conflicting reports on how harmful electric shock is to a fetus. The clinical spectrum of electrical injury ranges from a transient unpleasant sensation felt by a mother and no effect on her fetus to fetal death either immediately or few days later. Several factors, such as the magnitude of the current and the duration of contact, are thought to affect outcome. In this case, it appears the current did not travel through her abdomen. Recommendations for fetal monitoring after electrocution have been published.

Adult↗

The Minnesota Fatal Accident Circumstances and Epidemiology Study. Surveillance of occupational fatalities.

This report describes the Minnesota Fatal Accident Circumstances and Epidemiology Study (MN FACE), a new federally funded initiative to study fatal injuries in the workplace. Its primary objective is to reduce occupational fatalities. Fatalities due to falls, electrocutions, and asphyxiation caused by entry into confined spaces are currently investigated in Minnesota. MN FACE determines risk factors associated with fatalities then develops interventions for their mitigation or elimination. A comprehensive, statewide surveillance system, including state agencies, associations, organized labor, and industry, has been established to reduce the amount of bias in reporting.

Accidents, Occupational↗

THE NEUROLOGICAL SEQUELAE OF ELECTRICAL INJURY.

Electricity is a potentially very dangerous commodity. Community safeguards, however, result in remarkably efficient control of this hazard. Mortality figures appear to be small and constant. No satisfactory morbidity figures are available with regard to general and neurological complications in non-fatal cases. Study of relevant features of such electrical phenomena as voltage level, resistance factors, current pathway, current diffusion and grounding reveals many difficulties in reconstruction of the sequence of events involved in these injuries. These features underline our frequent inability to understand the mechanisms of initiation of unconsciousness and even of differentiation between death by cardiac arrest and death by respiratory paralysis. Fourteen cases of electrical injury with a variety of neurological complications and sequelae are discussed, and the findings in these cases are compared with those of other observers. An attempt is made to present a comprehensive picture of immediate, secondary and late neurological effects, and to illustrate some of the pathological findings in electrocution material.

Accidents↗

Lightning and electrical injuries.

Lightning and electrical injuries are similar in that both produce immediate tissue injury from burn and trauma induced by fall and both can arrest the heart and respiratory center. Immediate support of circulation and respiration is life-saving. Subsequently the nervous system may show signs of injury, and seizures, cerebral edema, and muscle and nerve lesions should be handled as the indications arise. Prevention of the injury is more effective than any postinjury treatment. Outdoors hikers and campers must take shelter to minimize their exposure; indoors properly installed equipment and attention to the relation of the equipment user to the electrical ground are the key elements in avoiding electrocution.

Electric Injuries↗

Paediatric accidental deaths in Port Harcourt, Nigeria: a 10-year retrospective study.

BACKGROUND: Some studies on medicolegal autopsies have been conducted in Nigeria. This study was carried out to highlight the causes, peculiarities and possible factors responsible for paediatric accidental deaths in Port Harcourt, Nigeria. METHODS: All 3058 medicolegal autopsies referred to the coroner and performed in the department of Anatomical Pathology University of Port Harcourt Teaching Hospital, over a 10 year period covering January 1986 to December 1995 were analyzed. The accidental death subset was specially analyzed with respect to the paediatric age group of 0-16 years. RESULTS: A total of 3084 coroners autopsies were carried out during the study period. Of these 356 (11.5%) were paediatric accidental deaths. The commonest cause of death was road traffic accidents constituting 84.3% (n=300). The male:female ratio was about the same. The head was the commonest body region affected (n=90). Cars and buses were the commonest vehicles involved. Pedestrians were most at risk constituting 66 percent. Bulk of the cases occurred over the weekends. Drowning, electrocution and burns accounted for 8.7%, 2.8% and 4.2% respectively. CONCLUSION: Most of the deaths are avoidable. Parental monitoring, control of movements, legislation and general concern of the adult population for children's welfare will reduce these largely preventable deaths.

Accidents↗

Hind limb paralysis from electrical shock in three gilts.

Three crossbred gilts developed hind limb paralysis attributable to multiple vertebral body fractures after nonfatal electrical shock. Fractures have been reported in swine and other animals that died from electrocution, but in this case, the pigs were not killed, and lesions that suggested electrical shock were not observed. Electrical shock should be considered as a cause of unexplained spinal cord injury in swine in intensive production units, and electrical service to the pens should be carefully checked.

Animals↗

On the mechanisms of ischaemic myocardial lesions.

The examination of the myocardium in 609 natural and violent death cases by using Lie's histochemical method revealed recent ischaemic lesions, extended or microfocal, in 511 cases. These lesions were prevailingly extended in sudden cardiac deaths, alcoholic intoxication and electrocution, while in the various kinds of shock, in asphyxia and pesticide poisoning cases they were of a predominantly microfocal nature. According to these morphological changes, the vascular and metabolic factors involved in producing ischaemic cardiomyopathy are discussed.

Animals↗

High tension electricity burns: a case report.

BACKGROUND: Recently in some areas there has been an upsurge in rural electrification. Though electricity is desirable, it is one of the most potentially dangerous commodities in the society. OBJECTIVE: We present this report highlighting the need for prevention as high tension electricity injury though uncommon is reputed for significant morbidity and mortality. METHOD: A case report of a 30 year old female trader with high tension electricity burns in a rural community seen in the University of Calabar Teaching Hospital, Calabar. RESULT: Successful management of 10% burn involving multiple sites. Patient's husband was electrocuted in the incident. CONCLUSION: High tension burns are reputed for significant morbidity and mortality hence the need for prevention. Strategies recommended should include safety of electrical installations, protective apparels for electricity workers as well as health education for consumers.

Adult↗

Implementing NFPA 70E at your facility.

The likelihood of an incident with one of your workers involving an electrocution or electric arc flash is significantly reduced by maintaining a safe electrical work environment that includes three major components: proper installation, safe electrical work practices, and an effective, ongoing electrical maintenance program.

Accidents, Occupational↗