International journal of legal medicine
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In clinical medicine, severe keto- or lactic acidosis associated with vomiting, nausea, abdominal pain, tachycardia or pathological respiration, has been described in chronic alcoholics. This study reports on fatalities of chronic alcoholics where the cause of death could not be determined by thorough autopsy, histology and toxicology including determination of alcohol concentration. In a first series, acetone was determined in the blood of such chronic alcoholics (n = 24), diabetics with metabolic decompensation (n = 7), cases of hypothermia (n = 7) and controls (n = 218). ⋯ Other causes of a ketoacidosis or lactic acidosis (e.g. diabetes) were excluded in both groups of alcoholics. Consequently, ketoacidosis and lactic acidosis can be the cause of death of chronic alcoholics in a considerable number of cases where no pathomorphological or toxicological changes are present. A scheme for medical and laboratory examination is described.
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A quantification of different forms of acute myocardial necrosis, myocardial leukocytic infiltrates and myocardial fibrosis was accomplished in 26 chronic cocaine abusers who died of cocaine intoxication and compared to 45 normal subjects who died from head trauma and 38 who died of acquired immunodeficiency syndrome. The findings were: absence of infarct necrosis, a similar frequency and extent of coagulative myocytolysis (contraction band necrosis) and leukocytic infiltrates in cocaine abusers and normal controls, and an absence of myocardial fibrosis in cocaine abusers. These findings question both the acute and chronic cardiotoxicity of cocaine. The infarct-like pattern in some predisposed subjects may be due to an excess of catecholamine release induced by the drug resulting in coagulative myocytolysis and platelet thrombi.
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Soft body armour is designed to give protection against fragments and some low velocity bullets but is not designed to stop high velocity rifle bullets. Reports have claimed that soft body armour might disturb the stability of bullets that penetrate it, and that this might increase the size of the lesions. The reason for such an effect might be early yaw of the bullet, so we studied the behaviour of bullets which had passed through soft body armour. ⋯ The semiquantitative approach of the Doppler radar measurement was in agreement with the more concise measurement using the photographic technique. Velocity loss and loss of spin rate from penetrating 14 or 28 ply Kevlar was negligible. We observed induced instability after penetration of 14 and particularly 28 ply Kevlar, dependence of yaw with respect to the number of layers of Kevlar as well as to the angle of the body armour with respect to the line of fire.
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Accidental hunting firearm injuries and fatalities (257 cases from 1961 to 1992) were evaluated in detail. Most persons responsible for the accident were more than 40 years old and experienced in hunting, and 26% of the gunshot wounds were fatal. In 77% of cases the victim was shot by another person and in 23% the wound was self-inflicted. ⋯ In some cases more than one factor contributed to the accident. Defective firearm/ammunition, as the only non-human factor, was involved in only 1.6% of accidents. Some aspects of the prevention and the forensic investigation of hunting accidents are discussed.