Multiple deaths caused by a fire in a factory: identification and investigative issues.

The article presents a case of multiple casualties following a textile factory fire. The incident required a full DVI team similar to large mass-disaster because of the specific operational aspects and identification difficulties. The autopsy results were consistent with death by fire and the toxicological investigations revealed carbon monoxide poisoning in four cases (HbCO% ranging between 88,05 and 95,77), two deaths by cyanide intoxication (with concentrations between 5,17 and 8,85 mcg/ml), and in one case there was a synergistic effect of the two substances (carbon monoxide and cyanide). The identification, carried out in accordance with INTERPOL protocols, encountered serious difficulties in the AM phase primarily due to a language barrier and the lack of any dental or medical information relating to the victims. Secondary identifiers proved to be very useful in corroborating possible identities. As a result of the combined efforts of a team of experts the identity of each victim was determined and in all cases at least one primary identifier was used in the identification process. The deployment of DVI teams composed of forensic experts from different fields of expertise and well acquainted with DVI procedures, is essential in events involving multiple casualties that may also include foreign victims. The DVI team should intervene not only in PM examinations but also in the collection of AM data for those individuals not accounted for and by helping police in contacting families of missing people.

Serum phosphate concentration with relation to the hematocrit value in uremic patients on chronic hemodialysis.

The acute effects of hemodialysis on the serum inorganic phosphorus levels (sPi) with relation to the predialysis plasma volume (PV) and the hematocrit (Ht) values were studied in a group of chronic uremic patients on regular hemodialysis. The results obtained confirmed the close direct correlation between predialysis sPi and fall in sPi induced by hemodialysis. Furthermore, the present fall in sPi induced by hemodialysis was found to be directly correlated to the PV values, and inversely to the HT values. An equation was derived from these data to predict in the individual patients the postdialysis sPi levels, utilizing both the predialysis sPi and the Ht values; this equation showed a better predictive capability than similar expression based on the use of the predialysis sPi value alone.

The determination of whole blood magnesium concentration in uremics on chronic dialysis.

The determination of whole blood magnesium concentration (MgT) was investigated in uremics on chronic dialysis with a broad range of hematocrit (Ht) and of plasma magnesium concentration (MgP). In view of the inverse correlation between erythrocyte magnesium concentration (MgC) and Ht in dialyzed uremics, as shown in our previous paper, it was possible to derive a formula which expressed MgT in terms of MgP and Ht. By exploring the predictive power of this formula, it can be concluded that MgT can be calculated directly from MgP and Ht.

The investigation of the relationship between whole blood potassium concentration and hematocrit in uremic patients undergoing hemodialysis.

The correlation between whole blood potassium (K) concentration and hematocrit (Ht) was investigated in chronically dialyzed uremics with a broad range of Ht. This correlation was found to be represented by a curve and its form was derived by the manipulation of the formula concerning the inverse relationship between erythrocyte K concentration and Ht. These findings show that in dialyzed patients the whole blood K concentration can be correctly predicted from any Ht value, despite their wide range of plasma K concentration.

Comparison of outward and inward Na+/K+ cotransport-mediated fluxes in erythrocytes of essential hypertensive patients. Preliminary results.

A hereditary defect in the outward ouabain-resistant, furosemide-sensitive (ORFS) Na+/K+ cotransport has recently been reported by Garay and Meyer in erythrocytes of essential hypertensive patients and some of their normotensive offsprings. Since Na+/K+ cotransport in erythrocytes operates bidirectionally, the same defect might be detectable in the ORFS component of K+ influx rate. To test this hypothesis outward and inward Na+/K+ cotransport measurements were performed in erythrocytes of hypertensives and normotensive controls. Our preliminary results confirm the observation of a reduced outward cotransport in essential hypertension and also suggest that inward cotransport may be reduced in essential hypertension.

Investigation of the correlation between total blood potassium concentration and hematocrit.

The correlation between whole blood potassium concentration (Kt) and hematocrit (Ht) was investigated in subjects with a broad range ofHt. This relationship was found to be represented by a curve, and its form was derived by the manipulation of the formula concerning the inverse correlation between Ht and erythrocyte potassium concentration (Kc).

Serum levels of PTH, Mg, Ca, inorganic phosphate and alkaline phosphatases in uraemic patients on differentiated Mg dialysis.

The serum levels of PTH, Mg, Ca, inorganic phosphate (Pi) and alkaline phosphatases (AlkPase) were determined in 22 uraemic patients on chronic haemodialysis with different Mg levels in th dialysate, in an attempt to clarify the pathogenesis of uraemic osteodystrophy. Baseline levels of all the considered parameters were obtained over a four month period whilst on standard Mg concentration in the dialysis solution (1.5 mEq/L). Patients were then divided into three groups: 10 patients were dialysed for six months with 0.5mEq/L of Mg, seven patients with 1.5mEq/L and five patients with 2.5mEq/L in the dialysate. At the end of the six months with differentiated Mg dialysis, the three groups had significantly different Mg serum levels, whereas no significant changes were observed in the PTH and Ca serum levels. All the patients on high-Mg dialysis showed a significant reduction of the Pi serum levels, whereas a significant increase of AlkPase was observed in the low-Mg dialysis group. The overall results obtained in the present study indicate a possible beneficial effect of low-Mg dialysis on the progression of uraemic osteodystrophy of patients on maintenance haemodialysis.

The relationship between Ht and erythrocyte potassium concentration in patients on regular hemodialysis.

Plasma and erythrocyte potassium (K) concentrations were measured in uremics of chronic dialysis and in a control group composed of healthy persons and of patients with anemia due to causes other than renal failure. The behavior of the erythrocyte K content in uremics did not differ from that of the control group and in both cases a close inverse relationship was present between hematocrit and erythrocyte K concentration, irrespective of its plasma level. These findings suggest that the red blood cell count, rather than renal failure, may affect the erythrocyte K content.

The relationship between hematocrit and erythrocyte magnesium concentration in patients on regular hemodialysis.

Plasma and erythrocyte magnesium (Mg) concentrations were measured in uremics on regular hemodialysis, in healthy persons and in patients with anemia due to causes other than renal failure. The mean plasma Mg concentration was found to be significantly higher in the uremic patients than in other subjects. The erythrocyte Mg concentration in anemic uremics and in nonuremic anemics was found to be higher than in normal subjects and a close inverse relationship was found between this figure and the hematocrit. It seems reasonable to argue that anemia, rather than renal failure, is related to the high concentration of Mg in erythrocytes.