Gastric mucosa lesions in drowning: its usefulness in forensic pathology.

In a retrospective study of 52 autopsy cases of drowning fatalities, death circumstances, macroscopical and histological findings of the stomach mucosa were carefully studied. Results were compared with a control group, composed by 80 cases of different kinds of asphyxia (hanging, chocking and suffocation), skull injuries, sudden cardiac death and poisonings. The spectrum of gastric lesions observed during autopsy in drowning group, are presented. Stomach mucosa tears were found in 21.1% of the cases of drowning, preferably on fundus (54.5%). The control group does not show similar lesions. The physiopathological mechanism of its production, are also discussed. On sight of these results, it is concluded that the macro and microscopical examination of the stomach could be useful as an adjunct procedure for drowning diagnosis. The presence of gastric mucosa lesions has an intravital significance and could be correlated with other anatomical or histological signs of drowning for the diagnosis. In every case, necropsic examination must be carried out as soon as possible in order to avoid putrefactive artifacts.

Proteínas estructurales y mediadores de la inflamación: marcadores para el diagnóstico postmortem de la isquemia miocárdica (estudio inmunohistoquímico) / Structural proteins and mediators of inflammation: markers for the diagnostic postmortem of myocardial ischemia (inmunohistochemical study)

El diagnóstico histopatológico post-mortem del infarto de miocardio presenta múltiples problemas en material humano procedente de autopsias. Hasta el presente momento, el problema no ha podido ser resuelto con el uso de las técnicas histológicas convencionales (hematoxilina-eosina, tricrómico de Masson y técnicas histoquímicas).Otra desventaja de este último método es que solo son aplicables sobre tejido fresco.En este estudio, se han recopilado muestras pertenecientes a 50 corazones, procedentes de autopsias de individuos fallecidos por muerte súbita de origen cardíaco. Además, se incluyeron seis casos de infarto de miocardio macroscópico (controles positivos) y ocho casos de muertes rápidas de origen no cardíaco (controles negativos). Se ha investigado la expresión de actina, desmina, mioglobina y factores de Complemento (C5b-9) mediante el método del Complejo avidita-biotina-peroxidasa y su posible utilidad en el diagnóstico postmorten de las muertes cardíacas.Los resultados del estudio, muestran que el método inmunohistoquímico sobre tejido fijado en formol e incluido en parafina es útil para el diagnóstico postmortem de la isquemia miocárdica (AU)

Proteínas estructurales y mediadores de la inflamación: marcadores para el diagnóstico postmortem de la isquemia miocárdica (estudio inmunohistoquímico) / Structural proteins and mediators of inflammation: markers for the diagnostic postmortem of myocardial ischemia (inmunohistochemical study

El diagnóstico histopatológico post-mortem del infarto de miocardio presenta múltiples problemas en material humano procedente de autopsias. Hasta el presente momento, el problema no ha podido ser resuelto con el uso de las técnicas histológicas convencionales (hematoxilina-eosina, tricrómico de Masson y técnicas histoquímicas). Otra desventaja de este último método es que solo son aplicables sobre tejido fresco. En este estudio, se han recopilado muestras pertenecientes a 50 corazones, procedentes de autopsias de individuos fallecidos por muerte súbita de origen cardíaco. Además, se incluyeron seis casos de infarto de miocardio macroscópico (controles positivos) y ocho casos de muertes rápidas de origen no cardíaco (controles negativos). Se ha investigado la expresión de actina, desmina, mioglobina y factores de Complemento (C5b-9) mediante el método del Complejo avidita-biotina-peroxidasa y su posible utilidad en el diagnóstico postmorten de las muertes cardíacas. Los resultados del estudio, muestran que el método inmunohistoquímico sobre tejido fijado en formol e incluido en parafina es útil para el diagnóstico postmortem de la isquemia miocárdica (AU)

Postmortem histopathological diagnosis of myocardial infarction has many problems in human material coming from autopsy. Until the present moment, this matter hasn’t been resolved by conventional histological procedures (hematoxilin-eosin, Masson´s trichrome and histochemical techniques). Another disadvantage of the enzyme-histohemical technique is that it is only applicable to un-fixed specimens. In this study, 50 myocardial tissue specimens were taken at autopsy from victims who died of sudden cardiac death. In addition, six cases of macroscopic myocardial infarction (positive controls) and 8 cases of rapid and non-cardiac causes of death (negative controls) were included in the study. The expression of actin, desmin, myoglobin and Complement factor (C5b-9) by avidin-biotin-peroxidase complex method, and its possible utility in post-mortem diagnosis of human heart failure, were studied. Results of our study, show that the inmunohistochemical method using formalin-fixed, paraffin-embebed tissue is valuable for post-mortem detection of myocardial ischemia (AU)

Resultados de una encuesta de salud aplicada a trabajadores de un hospital general / Results of a health survey administered to workers of a general hospital

Noventa y seis trabajadores de un hospital general fueron sometidos a una encuesta con el fin de conocer sus características de salud. La gran mayoría refería algún tipo de enfermedad o alteración patológica, predominando las de tipo gastrointestinal. Se observó influencia de la edad en patología osteomuscular, e influencia del sexo en patología gastrointestinal y alteraciones genitourinarias. Se halló asociación entre algunas variables sociolaborales y de salud. La percepción de riesgo profesional era menor por parte de los trabajadores con mayor antigüedad en la profesión, horario de trabajo, y en los trabajadores sin atención directa al paciente (AU)

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Distrés psicológico en trabajadores de un hospital general / Psychological distress in workers of a general hospital

Se realiza un estudio epidemiológico descriptivo transversal sobre una muestra de 96 trabajadores de un hospital general para evaluar psicopatología utilizando como instrumento el General Health Questionnaire (GHQ-28) de Goldberg. Se demuestra la existencia de elevados niveles de distrés psicológico (son probables casos psicopatológicos el 15,6 por ciento de la muestra). Predominan los trastornos por angustialansiedad, en el 12,5 por ciento, seguida por el 10,4 por ciento que presentan síntomas somáticos de origen psicológico. No se han encontrado diferencias significativas en la distribución de la morbilidad en función de ninguna variable sociodemográfica (edad, sexo, estado civil, lugar de procedencia, hijos), aunque el grupo con niveles inadecuados de distrés psicológico se caracterizaba por estar constituido en el 80 por ciento por mujeres, y el 66,7 por ciento tenía menos de 40 años. Los trabajadores con 15 o más años a turnos con noches poseían los niveles más elevados de morbilidad psicológica, (71,4 por ciento), mientras que los trabajadores con menos de quince años trabajados en ese horario presentaban una tasa del 11,1 por ciento (AU)

Delayed presentation of carotid dissection, cerebral ischemia, and infarction following blunt trauma: two cases.

Carotid artery dissection followed by cerebral infarction as a result of blunt trauma can occur in a number of forensically relevant situations. We describe two such cases. In the first case, a 19-year-old female was involved in a road traffic accident, when her car crashed into the rear of another car. Initially, the young woman presented a minor head injury without loss of consciousness and minor bruising to the left side of the neck. After 48 h, she had developed confusion, speech difficulties, right facial nerve paralysis, and right hemiplegia. CT scan and carotid angiography showed cerebral ischemia with infarction in the territory of the middle left cerebral artery and complete dissection of the left carotid artery. In the second case, a 33-year-old male with depression attempted to hang himself. The rope gave way and he fell down. He had also taken a paracetamol, and a non-steroidal anti-inflammatory drug overdose. He did not lose consciousness but appeared withdrawn and depressed. Approximately 6 h later, his conscious state deteriorated. A CT scan revealed thrombosis of the left internal carotid artery, extending to the middle cerebral artery. The patient died. Both cases reinforce the need for full neurological assessment and review of any individual subject to blunt trauma to the neck, whether accidental or deliberate or where the history is incomplete. In the forensic setting, in particular, RTAs, suspension by the neck, strangulation, and garotting are all instances when examination and assessment must be thorough--and clear advice given--in the absence of any immediate signs or symptoms--that any new symptoms or signs require immediate and thorough neurological investigation. There should be low threshold for prolonged neurological observation or further neurovascular investigations such as ultrasound, CT or MRI scan or angiography, to minimize the risk of developing potentially fatal or incapacitating sequelae.

Allele frequency distribution of the STR loci HUMTPOX, HUMTH01 and HUMVWA in Asturias (north Spain).

In order to use genetic loci in forensic identity testing, some population data are needed. This paper presents a report of allele frequency data for the loci HUMTH01, HUMTPOX and HUMVWA in a population sample from Northern Spain. No deviation from the Hardy-Weinberg equilibrium was detected in any of the three markers investigated and there was no evidence of association between the alleles of these loci. Statistical analysis was also carried out to obtain some parameters of medicolegal interest and comparative studies were carried out with other populations studied to date for these five loci. The Asturian sample does not differ substantially from other Caucasian and Spanish populations.

[Epidemiologic differences in delinquents relative to their psychiatric records]. / Diferencias epidemiólogicas en delincuentes con relación a sus antecedentes psiquiátricos.

We report the results of a survey carried out by us in the penitentiary from 1989 to 1992. The aim of it was to determine a possible relationship between criminal behaviour and previous psychiatric pathology. A total of 121 individuals imprisoned from February to april 1989 were studied. Only those convicts who had been free taken into account. Individuals who had been imprisoned before in other prisons were not included in our study. A questionnaire was elaborated by us to carry out this survey. The convicts were tested as soon ad they came into the Oviedo penitentiary. The convicts were classified within two groups. In the first group only those who had previous psychiatric pathology were included. The rest of them, including drug addicts were part of the second group of our study. Our results show that criminal behaviour is much common between those who do not have suffered previously from psychiatric pathology. Furthermore, relationship between psychiatric pathology of the convict and his mother's criminal behaviour was proven. It aslo was shown between psychiatric pathology and suicide or own-inflected injuries.

Medicolegal problems arising from AIDS and health care personnel with special reference to Spanish law.

The ethical and judicial problems that surround the risk of HIV occupational transmission among health care workers are considered. Problems concerning the continued employment of the health providers once they are infected are also taken into account. The relevant Spanish legislation is analysed.

[Suicide in the elderly]. / El suicidio en la tercera edad.

Being the suicide a conduct very old, it's at present a problem with the epidemic characteristics and it's for this question that it has aroused a great interest. But, we have observed that the interest is only about the suicide youngest persons. They are little the factors and tendencies suicides studies in years old persons ("third age"), though also the suicide in years old persons is augmenting. We have analyzed 74 suicides in greater 60 years old persons occurred in our community. We have studied several epidemiological factors: sex, age, civil condition, the suicide mechanism, place where it's occurred, hour, day, month, the pathological antecedents and the other case antecedents.

[Prison psychosis: apropos of a case]. / Psicosis carcelaria: a propósito de un caso.

We have realized a review and actualization of prisons psychosis; an important problem at present in prison's ambit because it generates a great number of recoveries and graves questions to prison's doctors and psychiatry's doctor which they work in this world. Also, this problem origins a numbers judicial's questions in relation with the imputability. Further, we expose a clinic case of our practice.

Characteristics of a population undergoing treatment for drug addiction in a therapeutic community setting in Spain.

The authors discuss the findings of a study of the personal history characteristics of a population of 223 individuals who underwent treatment for drug addiction at the Masma Therapeutic Community, Lugo, Spain, during the period September 1984 to March 1986. The population consisted of 58 females and 165 males, predominantly from middle-class backgrounds. Nearly all were multiple drug abusers, cannabis and heroin being the most widely abused drugs. Over half the population received treatment prior to admission to the Masma Community for the abuse of either barbiturates or opiates. The research instrument used was a self-report questionnaire, completed by participants anonymously and on a voluntary basis. It included items relating to personal and family background, aspects of drug abuse and type of prior treatment.

Drug use among adolescents in Asturias (Spain).

A survey of drug use, based on a sample of 2,537 school students in the 15-17 year age group selected from 11 schools in central Asturias (Spain), showed that 697 respondents, or 29.1 per cent, were drug users. Cannabis was the most widely abused drug: 500 respondents, or 20.8 per cent of the total sample, became involved with this drug at some time in their lives. The percentages of the total sample show that the use of cannabis at any time ("ever" use) was followed by use of: tranquillizers (10.3 per cent), amphetamines and amphetamine-like substances (7.9 per cent), inhalants (2.3 per cent), hallucinogens (2.0 per cent), sedatives (1.7 per cent), opiates (1.4 per cent) and cocaine (1.2 per cent). Males were generally more involved with drugs than females were. The average age at first drug use was 15.4 for males and 15.5 for females.