Complex suicide by drowning and stabbing: first italian case reported in literature.

Background: "Complex suicide" refers to suicides in which more than one suicide method is applied. The victim can either plan different and simultaneous ways of death, to prevent any failures, or change the method because the first one fails or turns out to be too painful. Case report: A Middle-age-man was found dead inside a car, in a field, near the seaside. Clothes were intact, wet, and smeared with mud and gravel. His shirt had dried whitish biological material on the thoracic area, referable to oedema fluid, his trousers were down to his ankles exposing external genitalia. Inside the car, a kitchen-serrated blade knife and scissors were found, both smeared with dried blood material. Cadaveric inspection showed: multiple superficial stab/cut injuries; nasal cavities leaking aqueous-like fluid; triangular and linear stab lesions all over the body; hesitation marks on both latero-cervical regions and both wrists; no defensive injuries referrable to third parties; maceration over both palmar and plantar surfaces. Autopsy showed: hemorrhagic infiltration for thoracic muscles; expanded and heavily congested lungs. Conclusions: This is the first Italian case, and one of the few cases reported in major literature (third case worldwide), of unplanned complex suicide achieved through stabbing and drowning by a man with no psychiatric or substances abuse history. Therefore, analyzing any evidence to distinguish this kind of sudden/unnatural death from accidental or homicidal ones is mandatory. Such cases require a flawless approach to judicial inspection, autopsy, and toxicological exams. Moreover, a multidisciplinary perspective including psychiatric criminological investigation is needed.

Psychosis in cocaine intoxication.

Background: Cocaine overdose is a condition in which an increase in blood pressure, heart rate and depth of breath is observed. Cocaine consumption also causes a wide and well-known neuropsychiatric symptomatology that is characterized by incomprehensible behavior, confused and disordered thoughts, and paranoia. Cocaine addiction is a worldwide public health problem, which has somatic, psychological, psychiatric, socio-economic, and judicial complications. Case series: This work shows three cases in which cocaine poisoning and overdose caused a psychotic and extremely violent behavior in the hours leading up to the death of the subjects. Conclusion: The aim of this brief case series is to suggest some diagnostic criteria for the correct definition of this psychosis in order to make an early diagnosis crucial to prevent deaths related to it.

Reverse engineering in forensic investigations: a new approach to bite mark analysis.

The study of bite marks provides crucial elements that contribute towards identifying the biter. In many cases, it assumes importance when bite marks are detected on the body of a victim of violence, but it could also be relevant when the bite marks are seen on food substances at the crime scene. In both circumstances, comparing the bite marks with a suspect's dentition can be decisive in confirming or excluding the culpability. In this case report, a bun (bread roll) with the sign of a bite was found at the crime scene. We report a pilot study using 3D reproduction of the bite mark on the bun and dental models of the alleged biter and the victim. A reverse engineering process was used to obtain digital 3D models of the bitten bun and the dental models by taking numerous photographs and stitching them together using a software called Metashape by Agisoft. The last step was to compare the bitemark to the two dental models, evaluating the spatial distance, the degree of overlap, and the degree of interpenetration. The results confirmed the usefulness of reverse engineering in forensic investigations showing the compatibility between the victim's teeth and the bite mark on the bun.

Phlegmasia Cerulea Dolens: a sudden unexpected death with hypothesis of medical malpractice.

ABSTRACT: Phlegmasia Cerulea Dolens (PCD) is a severe and rare form of venous thrombosis of the lower extremities, caused by a subtotal or complete occlusion of venous outflow by a thrombus. PCD should be considered a real medical emergency; complications include necrosis and gangrene of the affected limb, amputation, massive pulmonary embolism and, in extreme cases, the death of the patient. Case Report. A 63-years-old man was admitted to the Emergency room with localized pain on the right calf, hyperthermia, cold sweating and vomiting episodes. Five days prior he developed flu-like symptoms, joint pain and cold sensation unresponsive to treatment. Ultrasound examination showed a deep venous thrombosis of the lower right limb with partial occlusion of common iliac and femoral veins. The patient was treated with low molecular weight heparin given twice daily. He began to develop severe hypotension and metabolic acidosis, with tachycardia and atrial fibrillation. Despite the treatment, there was no improvement and he developed severe sinus node dysfunction. He failed to respond to all resuscitative efforts and died. Family members complained Authority, assuming it was a medical error. The clinical-forensic investigation is essential to determine the causes and manner of death and to assess medical responsibility and liability.

Energetic analysis for self-powered cochlear implants.

Cochlear implants (CIs) are used for compensating the so-called deep sensorineural deafness. CIs are usually powered by rechargeable or long-lasting batteries. In this paper, the feasibility of a fully implanted stand-alone device able to provide the electric power required for stimulating the auditory nerve, without external recharging, is investigated. At first, we demonstrate that the sound wave entering the ear is not a sufficient power source. Then, we propose a solution exploiting the mechanical energy associated to head vibration during walking. The energetic feasibility of this approach is demonstrated based on experimental measurements of head motions. Preliminary considerations on the technical feasibility of a fully implanted energy harvester are finally presented.

Public empowerment through accessible health information.

The Public Library Association (PLA) is developing plans for cooperative consumer health information services. Foremost for developing this program is the need for partnerships with health agencies and mechanisms to attract grant funding. The proposed project will expand the role of public librarians to address the health information queries they receive effectively. The project plans include the use of new technologies for delivery of health information, and the provision of tools, training, and resources.

Consumer health information and the not-for-profit health agency.

Driven by increasing consumer demand, not-for-profit health agencies are responding by providing accurate, current information about the disorders they deal with. A case history of the information service at the National Multiple Sclerosis Society and the role of the health sciences librarian in the development of such information centers is described. The librarian, as information provider in the health agency setting, obtains professional advisory support, thus assuring delivery of the most responsible information to the constituency represented by the organization. An overview of the decision-making process for development of such a service is provided, including a description of the Cuadra STAR integrated online system. This system offers an infinite number of databases with immediate access to cross database searching of pertinent internal files and standard library records. A random survey of consumers, based on questioning repeat callers, has indicated an overwhelmingly positive response to this service.