Forensic evaluation of sudden death due to tuberculosis.

The emergence of drug-resistant tuberculosis (TB) poses a major threat to TB control efforts. We report a case of a 50-year-old man with pulmonary TB. The scene investigation had initially suspected for homicide; however, the result of medico-legal autopsy demonstrated natural cause of death. Statistical data suggest that the rates of national mortality by respiratory TB decreased in the last decades in Hungary; however, an increasing TB mortality was detected in the capital Budapest. Facing a new mortality trend in TB, the forensic scene investigation and determination of manner of death represent new challenges for practitioners.

Jumping and falling death in children, adolescents, and young adults.

INTRODUCTION: Evaluation of fatal jumps and falls from height in children, adolescents and young adults needs careful medico-legal investigation. The aim of this study was to examine the distribution of undetermined falling from height, accidental falling, and suicidal jumping cases between 1990-2003. METHODS: Copies of death certificates relating to falling from height and jumping deaths in Hungarian youths from the ages of 0-24 years of those resident in Hungary were obtained. RESULTS: 215 (34.1%) accidental falls, 394 (62.6%) suicidal jumping, and 21 (3.3%) undetermined intent were investigated. A significant increase was detected in suicidal jumping death in the age group of 15-19 years (OR=0.7, CI=0.49-0.98, p=0.039), and in the age group of 20-24 years (OR=0.72, CI=0.54-0.96, p=0.025) in the most recent 5 year study period. CONCLUSION: Data concerning the scene investigation, detailed forensic autopsy, and family history have important role in the differentiation of fatal jumping or falling cases. Further investigation about the characteristics injuries may help the final determination of violent death causes at youth, and more effort should be directed to an effective prevention strategy for jumping or falling death cases.

Change in immunisation schedule and sudden infant death syndrome in Hungary.

Infant mortality in Hungary was higher than in other European countries; however, the reported incidence of sudden infant death syndrome (SIDS) has been lower than those for Western Europe and the United States. Childhood immunisation has been reported to be a protective factor for SIDS. In Britain, the change to an earlier immunisation schedule for diphtheria, pertussis, and tetanus appeared to be associated with a shift in the age distribution of SIDS. In 1999, immunisation for Haemophilus influenzae type b (Hib) was introduced for Hungarian infants at the age of 2 months. Data for total infant mortality and SIDS in Hungary were analysed between 1990 and 2002. Infection was the major cause of death among Hungarian infants followed by SIDS. Following introduction of Hib immunisation, there was a decrease in deaths due to meningitis from an average of 3.5% of all infant deaths between 1990 and 1998 to an average of 1% of all infant deaths between 1999 and 2002 (p=0.00). There was also a significant decrease in the proportion of SIDS in the age range > or =2 months from 48% in the earlier period to 39% after introduction of the vaccine (p=0.03). The decrease in SIDS might be due in part to decrease in unrecognised Hib infections or to induction of antibodies by the tetanus toxoid to which the Hib polysaccharide is conjugated that are cross reactive with bacterial toxins implicated in SIDS.