An analysis of child suicide from three centers (2008-2017).

Although the overall suicide rate worldwide has changed minimally over the past 100 years, different trends have been observed over time in the USA, Australia, and New Zealand (NZ). However, few studies have focused on suicides in children (< 18 years), making evaluation of possible trends difficult. The last 20 years has also seen an increase in childhood obesity, eating disorders, and body image issues for children in many developed nations; however, few studies have shown whether a significant proportion of child suicides have an abnormal BMI. The current study evaluates child suicides (from 2008 to 2017) in South Australia (Australia), compared with the jurisdictions of Auckland (NZ) and Hennepin County (USA). Demographic data (age, sex, ethnicity), body mass index (BMI), the number of cases of youth suicide, and the method of suicide from these three regions were collected and analyzed. Across the 10-year period, the jurisdiction of Auckland had a downward trend, while Hennepin County and South Australia had increasing numbers of cases. The most common method of child suicide in all centers was hanging, occurring in > 80% of cases in South Australia and Auckland and 56% in Hennepin County. Hennepin County had a greater proportion of suicides using firearms (28%), compared to 1.9% in Auckland and 5.1% in South Australia. Unusual means of suicide were used less frequently by youth than previously.

Actinomyces in Forensic Practice.

ABSTRACT: A 19-year-old woman in septic shock with recent computed tomography findings of a loculated hepatic abscess was transferred to an intensive care unit where she went into asystolic cardiac arrest. After resuscitation, surgical exploration revealed a purulent pericardial effusion with tamponade and a liver abscess. Microbiological analyses from both sites were negative. Shortly after surgical exploration, she developed multiorgan failure and died. At autopsy, pus was observed both within the pericardial cavity and around the left lobe of the liver. Green "sulfur granules" suggestive of infection with Actinomyces spp. were able to be extruded from the liver during the postmortem examination and cultures returned positive for Actinomyces israelii. This case is a rare example of primary hepatic actinomycosis infection that resulted in the death of a young woman. Nonspecific clinical manifestations may delay diagnosis; however, the finding of "sulfur granules" in areas of abscess formation at autopsy should be taken as an indication of possible underlying Actinomyces infection.

Unexpected Death Associated With Clostridial Sepsis.

ABSTRACT: An 85-year-old woman with a history of breast carcinoma presented to hospital after gradual onset of abdominal pain with hypotension, jaundice, and massive intravascular hemolysis. This was caused by Clostridium perfringens septicemia originating from a liver abscess. Clostridium perfringens septicemia is a rare infection that has a high mortality rate, given that it is frequently unable to be diagnosed until postmortem examination. The source of the pathogen is usually intra-abdominal. Hepatic abscesses, although an uncommon source of primary clostridial infection, should be considered in such cases.

Evaluation of a model of bruising in pigmented skin for investigating the potential for alternate light source illumination to enhance the appearance of bruises by photography of visible and infrared light.

The purpose of this study was to evaluate the ability of alternate light source illumination to enhance bruises in pigmented skin. Previous work was limited to simulating bruises in non-pigmented (Caucasoid type) skin by injecting blood into pigskin. In this study, it was investigated if adding a layer of melanin to the surface of the skin would simulate pigmented skin. The study included evaluating the use of a filter that transmitted infrared light (wavelength greater than 720 nm) in place of the recommended visible light filters for the alternate light sources. The results obtained using pigskin with a layer of melanin were almost the same as results using the naturally pigmented goat ear. This indicated adding a layer of melanin could be used as a model for pigmented skin in this simulation of fresh bruising. Comparing the pigskin without melanin with pigskin with melanin revealed that the optimal light source to enhance the appearance of bruising, simulated by injection of blood, changed from violet to blue-green. Using the infrared transmitting filter resulted in greater enhancement than using the alternate light sources with their recommended visible light filter. The advantage of using the infrared transmitting filter was greater with the pigskin coated with melanin and the naturally pigmented goat ears than in the non-pigmented pigskin, however, the results remain to be validated using real bruises in naturally pigmented human skin.