Modern suicide trend from internet.

INTRODUCTION: The most common suicide methods vary slightly from country to country, partly related to the availability of effective means. Societal development over the years and especially the advent of the Internet has enabled the sudden spread of new suicide methods. Recently, especially since 2019, intentional sodium nitrite poisoning has appeared on many social networks as an increasingly popular method of suicide. MATERIAL AND METHODS: There was performed a retrospective-prospective study of the autopsy protocols of the Medico-Legal Departments of the Healthcare Surveillance Authority in Slovakia, in a period of 15 years (2008-2022). We performed the analysis of cases of death due to nitrite poisoning, focusing on cases of intentional self-harm. In all selected cases, we present complete information, including photo documentation from the place of death, as well as the results of the performed autopsy and the results of additional laboratory examinations. RESULTS: We did not record any fatal cases of unintentional, accidental consumption of sodium nitrite in Slovakia, nor any fatal cases of homicidal poisoning by this substance. However, there were three cases of intentional self-harm (completed suicide) by sodium nitrite poisoning (in 2019, 2020 and 2022). CONCLUSIONS: The correct diagnosis of the cases of sodium nitrite poisoning deaths is possible only based on evaluating all the information obtained, a thorough examination of the body and the crime scene, and the correct interpretation of the findings found during a subsequent autopsy and the results of the toxicological analysis.

[Addictive substances in fatal cases of fall/jump from height]. / Návykové látky vo fatálnych prípadoch pádov/skokov z výsky.

The aim of the study is to analyse causes of fatal cases of falls from height focusing on the occurrence of addictive substances. The authors performed a retrospective analysis of cases dealing with falls/jumps autopsied at the Institutes of Forensic Medicine in Bratislava in the years 2005-2014 accounting for a catchment area with approximately 1.2 m population. Selection criteria were met in 360 cases, i.e. approximately 4 % of all cases autopsied. There were 68 % of men and 32 % of women involved. The age interval ranged from 10 up to 93 years (mean age 50 years). Addictive substances were found in a total of 32 % of cases, ethanol alone in 22 % of cases. The cases were divided into groups according to the cause as follows: accidental falls (24%) also involving occupational accidents (11 %), jumps in suicidal ideation (63 %) and cases with the unspecified cause of falling (13 %). Most of the cases with detected addictive substances were in the group of suicidal jumps (35 %). In this group, 32 % of patients were treated for psychiatric disorders. The most common diagnosis was a depressive disorder and schizophrenia. In the group of occupational accidents, ethanol was found in 25 % of cases. The results of the study show that it is essential to pay more attention to psychiatric patients as not even regular psychiatric care and treatment can always prevent suicide. Accordingly, there is a need to strictly monitor the ban on alcohol consumption at work and the observance of safety regulations for working at heights, and thus to minimise the occurrence of falls with fatal outcomes.

[Multiple firearm injury caused with a blank pistol]. / Viacnásobné strelné poranenie spôsobené expanznou strelnou zbranou.

The authors present a case of a complex suicide of a 60-year-old woman found dead on her bed. A blank pistol Umarex caliber 9-mm, several blank cartridges and a lot of drug packages were discovered near the body. The woman suffered from a psychiatric depression. There were three gunshot wounds on the body: in the right temporal region, on the palatum of the mouth and on the left chest wall. The gunshot wounds in the right temporal region and in the mouth had central circle defects with the margins of stellate or star-like appearance and blackening. In the right temporal region the temporal muscle was contused but skull and intracranial tissues were without any injury. On the palatum of the mouth there was neither facial skeleton nor skull injury. The numerous small tears of lips and contusions of buccal mucosa were observed. On the left chest wall there was an abrasion with a bruise on the skin and contusion of thoracic muscles. Neither ribs nor intrathoracic organs were inflicted. At autopsy blood in the amount of 600 ml and a few tablets were found in the stomach as well as an insignificant blood aspiration into lungs. In spite of the fact that all the gunshot wounds were caused by shots fired at contact range they were not lethal. The woman died of lethal intoxication with tramadol and dibenzepin. Although this report differs from the ones published in literature, the authors believe that can contribute to the issue of gunshot wounds caused by gas weapons.

The analysis of dyadic deaths.

In the work we analyze three cases of unusual dyadic deaths when the perpetrator of homicide committed suicide shortly after the murder. In the first case a man stabbed his girlfriend with a knife and subsequently committed a car crash suicide. In the second case an apparent simultaneous hanging of a married couple turned out to be homicide-suicide act. In the last case a man shot his ex-wife while she was on a walk with their dog and in a short time turned the gun against himself.