1/8. diving-related fatalities caused by underwater explosions: a report of two cases.The authors report two cases of diving-related water blast with fatal outcome resulting from nearby underwater explosions. water blast with fatal outcome almost exclusively occurs in wars at sea. Underwater explosions are extremely rare in diving because of the limited exposure. Forensic findings in both cases reported included expected injuries to gas-filled organs such as the middle ear, lungs, and intestine; some rarely described injuries such as rupture of the liver, spleen, and kidneys; and also some lesions that were not found in a search of the literature: rupture of the heart and contusion of the hypophysis. Injuries caused by fatal underwater explosions should be carefully evaluated in forensic medicine to provide data that may support a criminal investigation.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
2/8. Expanding tissue viability practice through telemedicine.telemedicine can be defined as the electronic transfer of medical information to remote sites in order to support patient care and medical education (Norton et al, 1997). The concept of telemedicine has been around for more than 20 years; however, with the advantages of affordable technology it is set to play a major role in the future of health care. The use of telemedicine within the field of dermatological practice is well documented in the literature but the use of this referral system by clinical nurse specialists in tissue viability appears to be in its infancy. This article seeks to dispel the myths around the use of technology to enhance clinical practice and uses the authors' personal experience to describe its effectiveness for referring patients with complex tissue viability needs.- - - - - - - - - - ranking = 7keywords = medicine (Clic here for more details about this article) |
3/8. The significance of medico-legal findings for behavioural analysis in unsolved homicide cases.In recent years, behavioural analysis in unsolved homicide cases is playing a more and more important role in the field of police work in germany. The method of behavioural analysis was developed in the USA and first carried out in germany at the end of the 80s by the Federal Criminal police Office (BKA). Since 1998 each Federal State has set up behavioural analysis units. In germany, behavioural analysis is defined as complex information processing system for the purpose of enabling an overall view of a case and of supporting the case work in ongoing investigations. The procedure of behavioural analysis is based on empirically and scientifically proven knowledge, on case information (e.g. crime scene characteristics, medico-legal findings) and on methods of combining the existing knowledge on statements relevant to the case. To assess the role of legal medicine in the process of behavioural analysis, a retrospective examination of more than 40 case analyses in unsolved homicide cases was performed. It turned out that medico-legal findings played a major role in the process of case analysis because the results were of central importance for the case reconstruction and further deductions (e.g. offender aims, organized/disorganized components, escalation). In a vast majority of cases though, the autopsy reports did not provide sufficiently detailed information, explanations and/or interpretations of injuries, wound patterns and sequence of events. Various examples are presented to elucidate the significance of medico-legal findings for the process of behavioural analysis. As a basic principle, the role of the forensic scientist as independent, unbiased, unprejudiced expert for the court should not be influenced by speculative interpretations within the process of behavioural analysis. This can be established by a very precise and comprehensive autopsy protocol on the one hand and - separately - an interpretation by another experienced specialist who works for the behavioural analysis unit but not for the court.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
4/8. Massacre over civilians during the war in croatia.The 1991-1995 war for independence of croatia was a cruel armed conflict, provoked by the conquering aspirations of the "Yugoslav Federal Army" under Serbian command and Serbian terrorists. It took place on the territory of the Republic of croatia and gave rise to a mass destruction of civilian and sacral buildings and civilian massacres. Here we present three representative cases as an example of the massacre over civilians that happened in the vicinity of Vrhovine, in northwestern croatia. Seven civilians were taken from their homes in the village of Dabar, exposed to unprecedented, savage torture and cruel execution. forensic medicine experts revealed that victims were beaten with blunt objects, probably the butt end of rifles or high boots, stabbed with sharp objects as they were dying, and finally killed by gunshots. Their dead bodies were mutilated by cutting auricles and exposed to post-mortem humiliation. Events at Vrhovine have all the characteristics of crimes against humanity and inapprehensible breaches of the Geneva Convention at the very end of 20th century.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
5/8. Physical medicine and rehabilitation in the military: Operation Iraqi freedom.This article describes the role of a physical medicine and rehabilitation (physiatry) physician (physiatrist) as a general medical officer within a forward support battalion during the invasion and nation-building phases of Operation Iraqi freedom. Between March 10 and May 3, 2003 (invasion phase), 364 patients were evaluated. Thirty-two percent had musculoskeletal noncombat injuries, 9% had combat-related traumatic injuries, and the remaining 59% had nontrauma/nonmusculoskeletal conditions. Between May 4 and July 25, 2003 (nation-building phase), 1,387 patients were evaluated. Of these, 19% had musculoskeletal injuries, 1% had combat-related traumatic injuries, and the remaining 80% had nontrauma/nonmusculoskeletal conditions. During this nation-building phase, the musculoskeletal workload seen at the division-level combat support hospital was 4 times the workload seen in the forward support battalion. This experience underscores the role of physiatry in wartime casualty management and profiles the combat support hospital as the most suitable place for the physiatrist during wartime. Interventions focused on acute management and rehabilitation counseling for all musculoskeletal injuries, as well as consultation services to the combat support hospital and local civilian hospitals for the evaluation of complex neuromusculoskeletal trauma cases.- - - - - - - - - - ranking = 5keywords = medicine (Clic here for more details about this article) |
6/8. Medicinal leeches: once again at the forefront of medicine.Medical grade leeches have recently been used in the management of acute problems relative to venous congestion in patients with traumatic injuries and surgical problems. Specific cases, especially in the realm of reconstructive microsurgery, have demonstrated the effectiveness and application of leech therapy. Specific contraindications include arterial insufficiency from either anatomic or mechanical obstruction. We present five illustrative cases of successful therapeutic intervention.- - - - - - - - - - ranking = 4keywords = medicine (Clic here for more details about this article) |
7/8. methanol intoxication in multiple trauma.Management of inflicted or self-inflicted trauma to accomplish homicide or suicide is no novelty in the practice of medicine. However, it takes an astute clinician to recognize serious poisoning in the midst of life-threatening injuries. We describe two cases where homicide and suicide attempts were accompanied with the ingestion of methanol. Both patients recovered with proper management of the injuries as well as early recognition and treatment of the methanol poisoning.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
8/8. Post-traumatic pain syndromes.A number of post-traumatic pain syndromes may be grouped as causalgia or mimocausalgia. These are important entities and should be well known to most disciples of medicine. Our concern is the early recognition of patients whose complaints have an organic basis but whose physical signs are not of sufficient degree to make this fact readily apparent. These patients are often misunderstood and discredited. They are all too often mismanaged or neglected for so long that the underlying pathologic physiology secures supremacy over normal function. Recognized and treated properly by means of sympathetic ablation, either medical or surgical, the vast majority of symptoms can be relieved. The extremities then can be rehabilitated by appropriate measures.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |