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PubMed2003

Filicidal mothers and the impact of psychosis on maternal filicide.

The objective of this study was to examine a sample (n = 55) of filicidal mothers to compare those with and without psychotic symptoms at the time of the filicide. Clinical data were gathered through retrospective chart review of filicidal women referred for criminal responsibility/competence to stand trial evaluations from 1974 to 1996 at Michigan's Center for Forensic Psychiatry. Most (52.7%) women had psychotic symptoms at the time of filicide. Women with psychosis were more likely than those without to have a history of substance abuse; to have past and ongoing psychiatric treatment; and to be older, unemployed, more educated, and divorced or separated. They were less likely to be first time mothers or to have had prior contact with Children's Protective Services. The psychotic mothers more often confessed, attempted suicide at the time of the filicide, used weapons, killed multiple children, and expressed homicidal thoughts and/or concerns about their children to psychiatrists and family before the filicide. Psychotic women were as likely as nonpsychotic women to have used alcohol or illegal drugs at the time of the filicide.

Adolescent↗
PubMed2004

[Silicone granuloma of the lip].

Silicone is considered a biocompatible material, and therefore has many applications in medicine. It can be used in a liquid form for subcutaneous injection, in gel form for implants, and in a solid state for prostheses, hemodialysis tubing, etc. The use of injectable liquid silicone for tissue augmentation is widespread, but there are many reports of side effects, some severe and debilitating such as the granulomatous reaction. We report on a patient with an upper lip swelling, who denied having been subjected to any type of lip augmentation. An incisional biopsy was taken, and the pathologist reported an atypical lyphomatous tumor. The patient was informed that a wide excision of the lip was necessary, and then she confessed she underwent silicone injections in the past. This is a case of a granulomatous reaction after silicone injection in the lip. The article also reviews the literature on the subject.

Adult↗
PubMed1992

The evidence notwithstanding--a case report on a rape.

This report concerns the rape of a woman by a stranger. The complainant stated that, during the course of the rape, penetration took place without ejaculation: these details were later confirmed by a suspect. This suspect, who was identified by the complainant, confessed and was convicted. Laboratory findings, however, indicated that the suspect could not have been the source of the semen found on the complainant's underpants. Further, a vaginal swab taken from the complainant contained intact sperm cells, an indication of a recent sexual contact. In spite of the presence of semen on the underwear which could not have come from the suspect, and the nonoccurrence of an ejaculation during the rape, the complainant maintained that she had not had a sexual contact for a month prior to the rape. This apparent contradiction and its implications are discussed.

ABO Blood-Group System↗
PubMedDate not supplied

[Homicide with postmortem opening of the thoracic and abdominal cavity--morphological, criminological and forensic-psychiatric aspects].

During a walk a man found the partially unclothed body of a 16-year-old girl in a field near a village in South Baden. The body showed numerous injuries caused by sharp force. Several stab wounds were discernible on the neck, the chest, the genital region, the back and the right thigh. Postmortem, the anterior wall of the trunk had been severed with one long cut reaching from the mons pubis to the jugular fossa. The injuries and the scene suggested homicide with a sexual motive. Already on the next day a male suspect was ascertained. Blood traces of the victim could be demonstrated on his car. The man confessed the homicide, but did not describe the course of events in detail. He denied a sexual motive for the homicide. The psychiatric examination did not furnish any clues to internal, neurological or psychiatric disorders. The perpetrator did not claim intoxication for the time of the offence, which might have been relevant for the question of criminal responsibility. Psychodiagnostically, it was found that he had a narcissistic personality structure with a pronounced lack of self-esteem, deficits in affect processing and control as well as anxiety and aggression problems. The man was sentenced to life imprisonment for murder.

Abdominal Injuries↗
PubMed2004

[Rectal tears in the horse: malpractice or an unfortunate accident?].

Rectal tears are a relatively rare complication of rectal palpation, mating or dystocia, and idiopathic spontaneous occurrence of rectal perforation has also been described. Rectal tears have been classified in a three or a four-grade system. Immediate recognition of the fact that a tear has been made and prompt action will improve the horses chance of survival, and is the best defence of the veterinarian against legislation. There is no clear explanation why rectal tears sometimes occur. A questionnaire of the Netherlands Equine Veterinary Association revealed that rectal tears occurred both to inexperienced veterinarians and to very experienced colleagues, working with or without a probe for ultrasonography. In the opinion of the authors, the approach in the legislation of rectal tears should be that a rectal tear is only considered 'malpractice' if the veterinarian obviously acted carelessly. However, this would create the ridiculous situation that it seems better for the veterinarian-client relationship when the veterinarian confesses to 'careless' rectal palpation. This point needs further clarification, and perhaps an 'insurance of the horse for rectal palpation' will be the solution. Further, retrospectively over the last ten years, the problem is often not 'making a rectal tear', but 'lacking recognition of making a tear'. Whenever a rectal tear is suspected, the veterinarian must assess its severity, discuss the problem openly with the owner and apply appropriate treatment including referral.

Animals↗
PubMed2004

[Defense of Ovid: annotations on Metamorphoses IV 119-123)].

The description of Pyramus' suicide in the Metamorphoses has been commented on by many scholars. There has been particular criticism of the comparison between the unfortunate lover's wound, squirting out blood, and a burst water-main. This has been supposed to show yet again how Ovid, in spite of his undoubtedly great talent, is capable of ruining a story by exaggeration. Nevertheless, a medical look at his wording leads to quite a different judgement. In his simile of the burst water-main Ovid obviously had in mind the haemorrhage from a damaged femoral artery, which can shoot blood to a considerable distance, sometimes over several yards. Only in this way can the fruits of the mulberry tree, hanging high over the wounded Pyramus, be moistened with blood and painted dark. This is, after all, the metamorphosis which justifies the inclusion of the story in the whole corpus. As it is possible for a person fatally wounded in this way to survive for some hours, the poet has to guarantee that Pyramus dies within minutes of turning his sword against himself. Only so can Thisbe, returning quickly, confess her love for Pyramus in such a heartfelt way and follow him at once. The haemorrhage from a femoral artery my indeed kill a person within a few minutes. Therefore Ovid's description is neither gruesome nor tasteless but simply natural and dramatically conclusive. The comparison with the water-main is one which would easily have occurred to the poet. From Ovid' point of view and that of his contemporaries, who had no knowledge of the circulation of the blood, no better comparison can be imagined than that between the blood vessels of the human body and urban water-pipes, a technical achievement of which the Romans were particularly proud.

Blood Circulation↗
PubMed2005

Cocaine smuggling in the gastrointestinal tract resulting in mechanical pylorostenosis.

A 45-year-old male, body packer, who confessed to have swallowed 44 packages of cocaine in a total dose of approx. 360 g, was admitted to hospital because of clinical signs of acute intoxication with cocaine followed by ileus. The emergency surgical gastrotomy was initiated, and the conglomerate of Scotch tape and packages with cocaine were removed. Small rupture of one package of cocaine in a body packer stomach caused acute poisoning with cocaine, confirmed additionally by the presence of its metabolites in the urine. Mechanical pylorostenosis provoked by cocaine packages required emergency surgical operation.

Acute Disease↗
PubMed2005

Primary mesenteric liposarcoma of jejunum: presentation like a cystic mass.

This report describes a rare case of intra-abdominal liposarcoma in a 67-year-old woman. The patient presented at Internal Medicine Unit in May 2004, to study of thyroid pathology. The clinical examination was normal, except for the finding of an asymptomatic mass in the abdomen. The patient knew the existence of tumor since time ago, but she confesses to have only occasional discomfort. In the abdominal ultrasonography a solid mass with large cystic component was detected but relation with other organs was not clear. Computed tomography revealed the presence of a mass with solid and cystic components, in contact with small intestine in the left side of abdomen. A complete resection of tumor arising from mesentery of jejunum was performed successfully with end to end anastomosis. The gross specimen was lobulated and measured 8.5 x 7.5 cm. The histopathology analysis showed proliferating lipoblasts with irregular nuclei on a myxoid background, with plexiform vascular pattern, characteristics belongs to myxoid type liposarcoma. The patient is alive and well one year after removal of tumor. The uncommon site and the exceptional cystic morphology of tumor are discussed, and so it must be included the primary mesenteric liposarcoma in the differential diagnosis of intra-abdominal tumors with cystic large areas.

Aged↗
PubMed2006

[One hundred and forty years of Turkish civilian and Turkish military hospital in Sarajevo].

This year BIH health celebrates two anniversaries: One hundred and forty years of Turkish civilian and Turkish military hospital in Sarajevo. During Ottoman period in Bosnian pasha region, Oman authorities have founded several military (in each bigger center it has been established military hospital of the Turkish Army) and five civil hospitals, mostly financed from vakuf (Islamic charity) funds. However, first hospital institution in BIH was located in Hadzi Sinan tekija at Mihrivode in Sarajevo, where was located special room for treatment, of mostly physiological patients, using zikr (spiritual ritual). By second half of 19th century civil populations were cured in homes, and wealthy citizens had their own private physicians who used to come with purpose or temporary from Dalmatian or neighboring countries bringing with them appropriate medications. By establishment of mentioned hospitals, other populations were treated by barbers, ranar (specialist for wounds), travar (person who treats patients with grass), and attars who had attar shops with medications purchased from Osman imperia or neighboring western countries. Drugs were prescribed to patients from Ijekarusa (drug prescription book), who were copied from generations and religion books, religion authorities of all confessions or from originals and copies of Arabic medical books which were brought by individuals going to Arabic countries (Mecca, Istanbul, Cairo, etc.). Mentioned hospitals, founded during Osman period (Sarajevo, Tuzla, Mostar, Travnik, Bihac) had key role in the history of BIH health, and they were basis for latter established regional and municipality hospitals founded in the Austria-Hungarian period. In the paper are described Turkish military and Turkish civil hospital established in June 1866 and in October 1866.

Bosnia and Herzegovina↗
PubMed2005

[Some nutritional habits of a group of overweight and obese women].

The aim of the project was to research the nutritional habits of overweight and obese women. The group under investigation consisted of 100 randomly chosen women from the region of Malopolska. Their diet turned out to be inconsistent with proper nutrition. The majority of the women (80%) confessed not to reducing the cholesterol intake. About 50% of the researched did not pay attention to the food products containing the salt and sugar. Fast-food products and fat meat were commonly. The women were aware that their diet was not proper from the nutritional point of view.

Adult↗
PubMedDate not supplied

Medical ethics in Russia before the October revolution (1917).

The evolution of medical ethics in Russia was determined by several factors. First, such Russian concepts as "obshina" (community" and "sobornost" (counciliarism) determined the supremacy of the collective body over the individual body, the state over a person etc. There is no analogue for "privacy" in the Russian language. Second, Russian medical doctors with university degrees appeared only in the 18th century after the politics of westernization by Peter the Great (1672-1725). Medical ethics probably starts from Prof. Matvei Mudrov (1776-1831) of Moscow who followed the Hippocratic credo "to treat not a disease but a patient". Third, after serfdom had been abolished in 1861 medical care in many rural regions was provided by zemstva (local elected councils). Zemskie medical doctors had idealistic views of self-sacrificing for the service to society and to the people. On the other hand, while dealing with illiterate peasants paternalism was a necessity. Ethical problems of healthcare and medicine were a subject of intense discussions both in professional and popular literature. A weekly periodical "Vrach" edited by V. Manassein played an important role in this discourse. Local medical societies adopted their own ethical codes but an All-Russian code of medical ethics was never formulated because the country lacked a national medical society. "Confessions of a physician" by Vikenty Veresaev published in 1901 put problems of doctor-patient relationship and human experimentation in the centre of public debates both nationally and internationally. Two Russian editions of "Aerztliche Ethik" by Albert Moll also contributed to the discourse on medical ethics in Russia. Medicine as a money-making activity was criticized and ridiculed in Russian literature (see, for example, Tolstoy's novels and Chekhov's stories). Medical morality was generally understood as moral life in action when deeds are much more important than words (e.g. formal codes of medical ethics).

Bioethical Issues↗
PubMed2006

[Molecular mechanisms and chemotaxonomy in the indole alkaloids derived from secologanin. (One drop in the sea, the sea in one drop)].

On the occasion of having won the Lajos Winkler Medal, at first the author confessed his intellectual relation to the famous scientist. Then he presented his results in the study on the three-dimensional molecular structure and chemotaxonomy of the more than 2500 alkaloids derived from secologanin and tryptamine, and isolated from three plant families, only. The multiple genetic and structural connections among the individual compounds were supported by current and common organic reaction mechanisms. The unified and well articulated picture obtained on detailed search in electronic data bases demonstrated the order of the parts in the whole. The final section of the lecture appreciated the interplay of multiplicity and unity in our culture and education as well.

Electronic Data Processing↗
PubMed2006

Lies and coercion: why psychiatrists should not participate in police and intelligence interrogations.

Police interrogators routinely use deceptive techniques to obtain confessions from criminal suspects. The United States Executive Branch has attempted to justify coercive interrogation techniques in which physical or mental pain and suffering may be used during intelligence interrogations of persons labeled unlawful combatants. It may be appropriate for law enforcement, military, or intelligence personnel who are not physicians to use such techniques. However, forensic psychiatry ethical practice requires honesty, striving for objectivity, and respect for persons. Deceptive and coercive interrogation techniques violate these moral values. When a psychiatrist directly uses, works with others who use, or trains others to use deceptive or coercive techniques to obtain information in police, military, or intelligence interrogations, the psychiatrist breaches basic principles of ethics.

Coercion↗
PubMed1991

Schooling without learning: thirty years of cheating in high school.

A survey instrument, developed in 1968 and administered to 1,629 high school students in 1969, 1,100 students in 1979, and 1,291 students in 1989, asked them to respond to items regarding the following: (1) the amount of cheating believed going on, (2) who was most guilty, (3) reasons given for cheating, (4) the courses in which most cheating occurred, (5) how to punish cheaters and by whom, (6) beliefs regarding dishonesty in society, and (7) confessions of their own dishonest behaviors in school. Between 1969 and 1989, student responses reflected increasingly pessimistic opinions about dishonesty in school and society. Fear of failure remained the most common reason for cheating. Math and science were the courses in which cheating most often occurred. The home was considered the best place and school the worst place to inculcate honesty. Over the three decades covered by this study, dishonesty was viewed as increasingly necessary, more people believed advertising was suspect, and success in business was attributed to fraudulent activities. More students admitted to cheating on tests and homework. More parents were not aiding and abetting students in avoidance of school rules. Polls, studies, and reports recently published by state, federal, and private agencies appear to confirm these findings.

Adolescent↗
PubMed1991

ABO grouping of highly-dilute blood by the absorption-elution technique using nitrocellulose beads--application to a casework investigation.

This paper reports a homicidal case in which the absorption-elution technique using nitrocellulose beads as immunoadsorbents was successfully applied to ABO grouping from highly-diluted blood. A 21-year-old man was found dead in bed while staying in a hotel. He had multiple wounds over the entire body. By autopsy the cause of death was decided to be traumatic shock. The victim's blood group was A. A bucket filled with faint-colored water was found at the scene. By means of the absorption-elution technique using nitrocellulose beads the water was grouped as B. Later, a 32-year-old man staying in the hotel together with the victim was suspected and arrested. The suspect's blood group was B. He confessed that he had injured himself in the hands with a knife during the struggle and washed them in the water.

ABO Blood-Group System↗
PubMed1990

[Pictures of diseases].

It very often happens that the general practitioner by his investigations draws near to the diagnosis of a disease but fails to reach the level of certainty. Then he has to confess reality by a correct denomination: it is a classification of the "picture of a disease". This way he demonstrates that he did not make an unshakable diagnosis. Making diagnoses does mean to have come to an end with the diagnostic work. Having classified a picture of a disease on the other hand stands for diagnostically "remaining in watchful expectancy". That situation usually is veiled by undue making use of the word diagnosis.

Classification↗
PubMed1990

[Karl Sudhoff's contribution and position to history of stomatology].

Among the few German medicohistorians of the 19th and the early 20th century contributing essentially to the formation of history of stomatology and to its methodologic and cognitive progress. Karl Sudhoff was the most eminent one. He was already very early aware of the full responsibility for stomatology--transferred with the stomatologie examination regulations in 1909--as a task relevant also for his special branch. Therefore, he had already announced stomatologicohistoric lectures at the University of Leipzig in 1913. Sudhoff published his "Geschichte der Zahnheilkunde" ("History of Stomatology") in 1921. Of topical interest is Sudhoff's confession that modern history of stomatology can be dealt with in an experienced and scientific manner only by a medico-historically aducated dentist familiar with the necessary methodologic equipment.

History of Dentistry↗