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Pulagura SSK, Jadav D, Meshram VP, Shekhawat RS, Kanchan T. Ant bite artifacts in a case of hanging. J Forensic Sci 2024; 69:1102-1105. [PMID: 38379244 DOI: 10.1111/1556-4029.15494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/19/2024] [Accepted: 02/09/2024] [Indexed: 02/22/2024]
Abstract
Artifacts produced by postmortem animal scavenging are commonly encountered at autopsy. Knowledge of the pattern of artifacts produced by postmortem animal scavenging is essential for the correct interpretation of the autopsy finding. In household deaths, such artifacts are usually caused by domestic animals and by small insects such as flies, ants, beetles, etc. Ants are one of the early scavengers which feed on the dead bodies. The artifacts produced by the postmortem ant activity are usually superficial and non-bleeding type. Rarely, in the congested body regions and areas of marked hypostasis, postmortem bleeding artifacts due to ant bites are possible. In the reported case of hanging, such postmortem bleeding artifacts were present over both the legs, predominantly over the left leg. Typical ant bite lesions in the form of superficial excoriations were also present over the peri-ligature area, over and around both nipples and over the lower part of the abdomen. Morphologically, postmortem bleeding artifacts produced by ant bites exhibit four patterns: droplet pattern, stripe pattern, pool pattern, and mixed pattern. In this case, a mixed pattern (droplet pattern and stripe pattern) of postmortem bleeding artifacts was observed. The presence of postmortem bleeding artifacts over the lower limbs was attributed to the pooling of the blood due to suspension of the body, followed by passive escape of blood due to ant bites. The possibility of such artifacts produced by ant bites should be considered when the origin of the lesion is unclear.
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Affiliation(s)
- Siva Sai Kumar Pulagura
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Devendra Jadav
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vikas P Meshram
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Raghvendra Singh Shekhawat
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Martin CL, Richey M, Richardson DB, Nocera M, Cantrell J, McClure ES, Martin AT, Marshall SW, Ranapurwala SI. 25-Year fatal workplace suicide trends in North Carolina: 1992-2017. Am J Ind Med 2024; 67:214-223. [PMID: 38197263 DOI: 10.1002/ajim.23563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/06/2023] [Accepted: 12/21/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Suicide is a serious public health problem in the United States, but limited evidence is available investigating fatal suicides at work. There is a substantial need to characterize workplace suicides to inform suicide prevention interventions and target high-risk settings. This study aims to examine workplace suicide rates in North Carolina (NC) by worker characteristics, means of suicide used, and industry between 1992 and 2017. METHODS Fatal workplace suicides were identified from records of the NC Office of the Chief Medical Examiner system and the NC death certificate. Sex, age, race, ethnicity, class of worker, manner of death, and industry were abstracted. Crude and age-standardized homicide rates were calculated as the number of suicides that occurred at work divided by an estimate of worker-years (w-y). Rate ratios and 95% confidence intervals (CIs) were calculated, and trends over calendar time for fatal workplace suicides were examined overall and by industry. RESULTS 81 suicides over 109,464,430 w-y were observed. Increased rates were observed in workers who were male, self-employed, and 65+ years old. Firearms were the most common means of death (63%) followed by hanging (16%). Gas service station workers experienced the highest fatal occupational suicide rate, 11.5 times (95% CI: 3.62-36.33) the overall fatal workplace suicide rate, followed by Justice, Public Order, and Safety workers at 3.23 times the overall rate (95% CI: 1.31-7.97). CONCLUSION Our findings identify industries and worker demographics that were vulnerable to workplace suicides. Targeted and tailored mitigation strategies for vulnerable industries and workers are recommended.
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Affiliation(s)
- Chelsea L Martin
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, Chapel Hill, North Carolina, USA
| | - Morgan Richey
- Department of Population Sciences, Duke University, Durham, North Carolina, USA
| | - David B Richardson
- Susan and Henry Samueli College of Health Sciences, Irvine, California, USA
| | - Maryalice Nocera
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - John Cantrell
- Injury Prevention Research Center, Chapel Hill, North Carolina, USA
| | - Elizabeth S McClure
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, Chapel Hill, North Carolina, USA
| | - Amelia T Martin
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, Chapel Hill, North Carolina, USA
| | - Stephen W Marshall
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, Chapel Hill, North Carolina, USA
| | - Shabbar I Ranapurwala
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, Chapel Hill, North Carolina, USA
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Balint L, Osvath P, Rihmer Z, Dome P. Recovering from the first shock? Changes in suicidality during the first two years of the COVID-19 pandemic in a country with traditionally high levels of completed suicides. J Affect Disord 2024; 347:230-236. [PMID: 38007107 DOI: 10.1016/j.jad.2023.11.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/14/2023] [Accepted: 11/18/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Hungary was among the few countries where suicidality increased in the first year of the COVID pandemic. In this study, we sought to investigate whether that elevated suicide mortality had changed by 2021, when the number of fatalities due to COVID-19 was much higher than in 2020. METHODS We used an interrupted time-series analysis with (quasi-) Poisson regression, controlling for linear trend and seasonal effects, to estimate the effect of the pandemic on the suicide rates of various subpopulations. For both pandemic years the changes in risk of suicide were compared to the period between 2015 and 2019. RESULTS Although the pandemic had a significant adverse effect on suicidality in 2020 in the Hungarian total population and in males, by 2021 this effect had vanished. In the total population, those aged 25 years and older had elevated suicidality in 2020 but neither age group in the total population had elevated suicidality in 2021. In the total population, increased risks of suicide death could be observed among residents of the capital city (in 2020 and 2021), villages (in 2020), and - in terms of regions - "Central Hungary" (in 2020 and 2021). Only the risk of violent suicides was significantly higher for both the total and male populations (and only in 2020). LIMITATIONS We used non-individual level data. CONCLUSIONS The increased suicidality in 2020 had abated by 2021. In the paper, we discuss the possible explanations for our findings.
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Affiliation(s)
- Lajos Balint
- Demographic Research Institute of the Hungarian Central Statistical Office, Budapest, Hungary; Department of Sociology, University of Pecs, Pecs, Hungary.
| | - Peter Osvath
- Department of Psychiatry and Psychotherapy, Medical School, University of Pecs, Pecs, Hungary
| | - Zoltan Rihmer
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary
| | - Peter Dome
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.
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Babajani F, Salari N, Hosseinian-Far A, Abdoli N, Mosafer H, Heidarian P, Mohammadi M. Prevalence of suicide attempts across the African continent: A systematic review and meta-analysis. Asian J Psychiatr 2024; 91:103878. [PMID: 38142521 DOI: 10.1016/j.ajp.2023.103878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Over 700,000 people worldwide lose their lives through suicide every year. The prevalence of suicide has increased, especially in low- and middle-income countries such as many African countries. For every fatal suicidal attempt, there are approximately 20 other non-fatal suicide attempts within the population. The purpose of this study is to investigate the prevalence of attempts of suicides in the African continent through a systematic review and meta-analysis. METHODS To identify relevant sources, the PubMed, Scopus, Web of Science, Embase, ScienceDirect and Google Scholar repositories and databases were systematically searched without a lower time limit and until July 2023. The heterogeneity of the studies was checked with the I2 index, and accordingly random effects model was adopted to perform the analysis. Data analysis was conducted within the Comprehensive Meta-Analysis software (v.2). RESULTS In the review of 48 studies with a sample size of 244,701 people, the prevalence of suicide attempts in Africa was found to be 9.9% (95%CI: 8.5%-11.6%). With the increase in the year of study, the prevalence of suicide attempt in the African continent increases. Also, with the increase in the sample size, the prevalence of suicide attempts in Africa decreases. The suicide attempt prevalence among African men and woman slightly differed with 7.6% and 8.2%, respectively. CONCLUSION Suicide attempt is an important public health concern in Africa. The findings of this study are important not only for African health policy making, but also to contribute to the accuracy of global estimates with respect to suicide attempts.
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Affiliation(s)
- Fateme Babajani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amin Hosseinian-Far
- Department of Business Systems & Operations, University of Northampton, Northampton, UK
| | - Nasrin Abdoli
- Department of Psychiatry, Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hadis Mosafer
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Pegah Heidarian
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
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Dhungel B, Shand F, Nguyen P, Wang Y, Fujita-Imazu S, Khin Maung Soe J, Xie J, Wang X, Li J, Gilmour S. Method-Specific Suicide Mortality in the United States in the 21st Century. Ann Intern Med 2024; 177:110-113. [PMID: 38109737 DOI: 10.7326/m23-2533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2023] Open
Affiliation(s)
- Bibha Dhungel
- School of International Liberal Studies, Waseda University, and Department of Health Policy, National Centre for Child Health and Development, Tokyo, Japan
| | - Fiona Shand
- The Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
| | - Phuong Nguyen
- Graduate School of Public Health, St. Luke's International University, and Division of Surveillance and Policy Evaluation, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Yijing Wang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Sayuri Fujita-Imazu
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - July Khin Maung Soe
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Jinzhao Xie
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xinran Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jinghua Li
- School of Public Health and Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
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Flesher N, Zayat MN, Ablah E, Okut H, Lightwine K, Haan JM. Characteristics of Attempted and Completed Suicides During the COVID-19 Pandemic. Am Surg 2023; 89:5795-5800. [PMID: 37164366 PMCID: PMC10183328 DOI: 10.1177/00031348231173968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND This study aimed to describe patients admitted for attempted or completed suicide during the COVID-19 pandemic. METHODS A 1-year retrospective review was performed of adult patients admitted for attempted or completed suicide. RESULTS Of the 30 patients included, most injuries involved firearms (37%) and cutting/piercing (30%). Sixty-three percent of patients presented with an Injury Severity Score ≥16, and 37% of injuries involved the head. Upon admission, an alcohol test was completed for 83% of patients, 56% of whom tested positive. Thirty percent of patients died from their injuries, with all but one involving a firearm. Most of those who survived to discharge (62%) were discharged to an inpatient behavioral health facility. DISCUSSION The current study indicated a large proportion of suicides during the COVID-19 pandemic involved firearms and alcohol use. These findings point to the need for interventions aimed at preventing suicide and substance abuse during pandemic situations.
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Affiliation(s)
- Nathan Flesher
- Department of Population Health, The University of Kansas School of
Medicine Wichita, Wichita, KS, USA
| | - Marisa-Nicole Zayat
- Department of Population Health, The University of Kansas School of
Medicine Wichita, Wichita, KS, USA
| | - Elizabeth Ablah
- Department of Population Health, The University of Kansas School of
Medicine Wichita, Wichita, KS, USA
| | - Hayrettin Okut
- Department of Population Health, The University of Kansas School of
Medicine Wichita, Wichita, KS, USA
| | - Kelly Lightwine
- Departments of Trauma Services, Ascension Via Christi Hospital Saint
Francis, Wichita, KS, USA
| | - James M. Haan
- Department of Population Health, The University of Kansas School of
Medicine Wichita, Wichita, KS, USA
- Departments of Trauma Services, Ascension Via Christi Hospital Saint
Francis, Wichita, KS, USA
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Darke S, Duflou J, Peacock A, Farrell M, Lappin J. Characteristics and circumstances of cocaine-related completed suicide in Australia, 2000-2021. Drug Alcohol Depend 2023; 244:109803. [PMID: 36774805 DOI: 10.1016/j.drugalcdep.2023.109803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND There has been a substantial global increase in cocaine use and associated harms. The current study aimed to: 1. Determine the case characteristics and circumstances of death of cocaine-related suicide in Australia 2000-2021; and 2. Determine the toxicological profiles of cases. METHODS Retrospective study of cocaine-related death in Australia, 2000-2021, retrieved from the National Coronial Information System (NCIS). Suicide intent was based upon the NCIS code for "Intentional Self-harm", derived from case circumstances and coroners' conclusions. Sex comparisons were made for all major variables. RESULTS A total of 157 cases were identified, 82.2% male, 79.5% employed, with a mean age of 32.3 years. Concerns for mental health were documented in 65.6%, a previous suicide attempt in 21.0%, a history of substance use treatment and/or negative consequences of substance use in 45.9% and injecting drug use in 14.6%. Manner of death amongst both sexes was predominantly by physical means (82.8%). Written intent was documented in 29.3%. Intense agitation prior to the incident was noted in 28.0% and conflict in 24.8%. The median blood cocaine concentration was 0.060 mg/L (range 0.007-5.500). Other drugs were present in 95.5%, most commonly alcohol (63.1%) with a median concentration of 0.140 g/100 ml. Psychostimulants other than cocaine were present in 31.2%. CONCLUSIONS The 'typical' cocaine-related suicide case was a male, aged in their early thirties, who was highly likely to be employed. The majority of cases used physical means, and a substantial minority were highly agitated and engaged in conflict prior to the fatal incident.
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Affiliation(s)
- Shane Darke
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia.
| | - Johan Duflou
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia; Sydney Medical School, University of Sydney, NSW, Australia
| | - Amy Peacock
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia
| | - Michael Farrell
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia
| | - Julia Lappin
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia; School of Psychiatry, University of New South Wales, NSW, Australia
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Pouquet M, Launay T, Rivière M, Chan-Chee C, Urbain F, Coulombel N, Bardoulat I, Pons R, Guerrisi C, Blanchon T, Hanslik T, Younes N. Trends and characteristics of attempted and completed suicides reported to general practitioners before vs during the COVID-19 pandemic in France: Data from a nationwide monitoring system, 2010-2022. PLoS One 2022; 17:e0278266. [PMID: 36520827 PMCID: PMC9754243 DOI: 10.1371/journal.pone.0278266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Most studies published to date have investigated the impact of the COVID-19 pandemic on suicidal acts using hospital data. Trends from primary care in a country such as France are crucial, as individuals may not consult hospital services after suicide attempts (SAs) but rather see their general practitioner (GP). OBJECTIVES We aimed to evaluate whether the incidence and characteristics of SAs and completed suicides (CSs) reported to French GPs were different during the COVID-19 pandemic than those of before. METHODS AND FINDINGS We conducted a retrospective observational study using data from a nationwide monitoring system, the French Sentinel Network (FSN). All SAs and CSs reported by GPs to the FSN from January 1, 2010, to March 10, 2022 were included. The annual incidence rates (IRs) and the characteristics of SAs and CSs during the pandemic (March 11, 2020, to March 10, 2022) were compared to those of before. In total, 687 SAs and 169 CSs were included. The IRs remained stable for SAs and CSs before and during the pandemic (overlap in confidence intervals). The mean IRs were 52 (95%CI = 44; 57) per 100,000 inhabitants for SAs during the pandemic versus 47 [36; 57] during the pre-pandemic period (p = 0.49), and 5 (95%CI = 2; 9) for CSs versus 11 [6; 16] (p = 0.30). During the pandemic, SA were slightly different from those before in terms of age and occupational status (young/students and older/retirees over-represented), history of consultation and expression of suicidal ideas to GP (more frequent), and CS in terms of occupational status (students over-represented) (p<0.05). CONCLUSION The COVID-19 pandemic had no major effect on the overall incidence of SAs and CSs reported to French GPs. However, more suicidal acts were reported among younger and older individuals. Suicidal patients and GPs have adapted by improving the expression of suicidal ideas.
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Affiliation(s)
- Marie Pouquet
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
- * E-mail:
| | - Titouan Launay
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Mathieu Rivière
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | | | - Frédéric Urbain
- Unité de Formation et de Recherche des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | | | | | - Romain Pons
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Caroline Guerrisi
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Thierry Blanchon
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Thomas Hanslik
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
- Unité de Formation et de Recherche des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
- Service de Médecine Interne, Hôpital Ambroise-Paré, Assistance Publique - Hôpitaux de Paris, Boulogne-Billancourt, France
| | - Nadia Younes
- Unité de Formation et de Recherche des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
- Université Versailles Saint Quentin, Université Paris Saclay, Team DevPsy, Villejuif, France
- Centre Hospitalier Versailles, Service Hospitalo-Universitaire de Psychiatrie de l’Adulte et d’Addictologie, Le Chesnay, France
- Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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Affiliation(s)
- Masahito Fushimi
- Akita University Health Center, Akita University, 1-1 Tegatagakuen-machi, Akita 010-8502, Japan.
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10
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Pandey GN, Zhang H, Sharma A, Ren X. Innate immunity receptors in depression and suicide: upregulated NOD-like receptors containing pyrin (NLRPs) and hyperactive inflammasomes in the postmortem brains of people who were depressed and died by suicide. J Psychiatry Neurosci 2021; 46:E538-E547. [PMID: 34588173 PMCID: PMC8526128 DOI: 10.1503/jpn.210016] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/07/2021] [Accepted: 06/14/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Abnormalities of inflammation have been implicated in the pathophysiology of depression and suicide, based on observations of increased levels of proinflammatory cytokines in the serum of people who were depressed and died by suicide. More recently, abnormalities in cytokines and innate immunity receptors such as toll-like receptors have also been observed in the postmortem brains of people who were depressed and died by suicide. In addition to toll-like receptors, another subfamily of innate immunity receptors known as NOD-like receptors containing pyrin (NLRPs) are the most widely present NOD-like receptors in the central nervous system. NLRPs also form inflammasomes that play an important role in brain function. We studied the role of NLRPs in depression and suicide. METHODS We determined the protein and mRNA expression of NLRP1, NLRP3 and NLRP6 and the components of their inflammasomes (i.e., adaptor molecule apoptosis-associated speck-like protein [ASC], caspase1, caspase3, interleukin [IL]-1β and IL-18) postmortem in the prefrontal cortex of people who were depressed and died by suicide, and in healthy controls. We determined mRNA levels using quantitative polymerase chain reaction, and we determined protein expression using Western blot immunolabelling. RESULTS We found that the protein and mRNA expression levels of NLRP1, NLRP3, NLRP6, caspase3 and ASC were significantly increased in people who were depressed and died by suicide compared to healthy controls. LIMITATIONS Some people who were depressed and died by suicide were taking antidepressant medication at the time of their death. CONCLUSION Similar to toll-like receptors, NLRP and its inflammasomes were upregulated in people who were depressed and died by suicide compared to healthy controls. Innate immunity receptors in general - and NLRPs and inflammasomes in particular - may play an important role in the pathophysiology of depression and suicide.
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Affiliation(s)
- Ghanshyam N Pandey
- From the Department of Psychiatry, University of Illinois at Chicago Ringgold Standard Institution, Chicago, Illinois
| | - Hui Zhang
- From the Department of Psychiatry, University of Illinois at Chicago Ringgold Standard Institution, Chicago, Illinois
| | - Anuradha Sharma
- From the Department of Psychiatry, University of Illinois at Chicago Ringgold Standard Institution, Chicago, Illinois
| | - Xinguo Ren
- From the Department of Psychiatry, University of Illinois at Chicago Ringgold Standard Institution, Chicago, Illinois
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Liu YE, Lemos EF, Gonçalves CCM, de Oliveira RD, Santos ADS, do Prado Morais AO, Croda MG, de Lourdes Delgado Alves M, Croda J, Walter KS, Andrews JR. All-cause and cause-specific mortality during and following incarceration in Brazil: A retrospective cohort study. PLoS Med 2021; 18:e1003789. [PMID: 34534214 PMCID: PMC8486113 DOI: 10.1371/journal.pmed.1003789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/01/2021] [Accepted: 09/01/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Mortality during and after incarceration is poorly understood in low- and middle-income countries (LMICs). The need to address this knowledge gap is especially urgent in South America, which has the fastest growing prison population in the world. In Brazil, insufficient data have precluded our understanding of all-cause and cause-specific mortality during and after incarceration. METHODS AND FINDINGS We linked incarceration and mortality databases for the Brazilian state of Mato Grosso do Sul to obtain a retrospective cohort of 114,751 individuals with recent incarceration. Between January 1, 2009 and December 31, 2018, we identified 3,127 deaths of individuals with recent incarceration (705 in detention and 2,422 following release). We analyzed age-standardized, all-cause, and cause-specific mortality rates among individuals detained in different facility types and following release, compared to non-incarcerated residents. We additionally modeled mortality rates over time during and after incarceration for all causes of death, violence, or suicide. Deaths in custody were 2.2 times the number reported by the national prison administration (n = 317). Incarcerated men and boys experienced elevated mortality, compared with the non-incarcerated population, due to increased risk of death from violence, suicide, and communicable diseases, with the highest standardized incidence rate ratio (IRR) in semi-open prisons (2.4; 95% confidence interval [CI]: 2.0 to 2.8), police stations (3.1; 95% CI: 2.5 to 3.9), and youth detention (8.1; 95% CI: 5.9 to 10.8). Incarcerated women experienced increased mortality from suicide (IRR = 6.0, 95% CI: 1.2 to 17.7) and communicable diseases (IRR = 2.5, 95% CI: 1.1 to 5.0). Following release from prison, mortality was markedly elevated for men (IRR = 3.0; 95% CI: 2.8 to 3.1) and women (IRR = 2.4; 95% CI: 2.1 to 2.9). The risk of violent death and suicide was highest immediately post-release and declined over time; however, all-cause mortality remained elevated 8 years post-release. The limitations of this study include inability to establish causality, uncertain reliability of data during incarceration, and underestimation of mortality rates due to imperfect database linkage. CONCLUSIONS Incarcerated individuals in Brazil experienced increased mortality from violence, suicide, and communicable diseases. Mortality was heightened following release for all leading causes of death, with particularly high risk of early violent death and elevated all-cause mortality up to 8 years post-release. These disparities may have been underrecognized in Brazil due to underreporting and insufficient data.
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Affiliation(s)
- Yiran E. Liu
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford, California, United States of America
- Cancer Biology Graduate Program, Stanford University School of Medicine, Stanford, California, United States of America
| | - Everton Ferreira Lemos
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | - Andrea da Silva Santos
- Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | | | - Mariana Garcia Croda
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Maria de Lourdes Delgado Alves
- Division of Prison Health Assistance, Agência Estadual de Administração do Sistema Penitenciário, Campo Grande, Mato Grosso do Sul, Brazil
| | - Julio Croda
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Oswaldo Cruz Foundation, Campo Grande, Mato Grosso do Sul, Brazil
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Katharine S. Walter
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford, California, United States of America
| | - Jason R. Andrews
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford, California, United States of America
- * E-mail:
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12
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Abstract
ABSTRACT Nail guns are pneumatically driven or powder-actuated tools, which are used to drive nails into wood or concrete. A 42-year-old man, who was a builder by profession and history of antidepressant use, was found dead in his vehicle, holding a "Ramset" nail gun in his right hand. A straight metal nail and a book with a small hole were recovered from the scene.At autopsy, an irregularly circular puncture wound was seen on the forehead and a cruciate laceration was seen on the posterior aspect of the scalp. No burning, blackening, or tattooing was present around either injury. Both internal and external beveling was present with the latter being relatively larger. Toxicological analysis revealed alcohol and methamphetamine in blood. Psychiatric history and substance abuse must also be considered when individuals in construction industry are given access to tools like nail guns.Several unique features not previously reported were observed in this case. The deceased had overcome the built-in safety mechanism of the nail gun, by placing a book in between his forehead and muzzle. Another unique feature is that the nail had exited the cranium. Beveling, a feature commonly found in firearm injuries, was also seen in this case.
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13
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Bigner JA, Fiester SE, Fulcher JW, Schammel CMG, Ward ME, Burney HE, Wheeler JF, Wheeler SK, Teuber JM. Glyphosate and Polyoxyethyleneamine Ingestion Leading to Renal, Hepatic, and Pulmonary Failure. Am J Forensic Med Pathol 2021; 42:282-285. [PMID: 33491949 DOI: 10.1097/paf.0000000000000660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Glyphosate is an organophosphorus compound and the active ingredient in commonly used herbicides, whereas polyoxyethyleneamine (POEA) is a nonionic surfactant often coupled with glyphosate in these herbicides to increase their efficacy. Cases of glyphosate-POEA ingestion have shown a variety of outcomes, ranging from skin and mucosal surface irritation to death. Here, we report mortality after ingestion of at least 237 mL of an herbicide confirmed to contain both glyphosate and POEA. The decedent's electronic medical record indicates presentation to the emergency department shortly after ingestion and rapid decompensation, with death occurring on the fourth day of admission. The autopsy report showed extensive pulmonary edema and congestion with no alimentary tract abnormalities. Microscopically, airway inflammation, edema, and hemorrhage were shown as well as pericentral necrosis and macrovascular hepatic steatosis. This case is unusual for several reasons including the fatal outcome in a young 30-year-old patient, the large volume of the herbicide consumed, the associated large volume aspirated, and the lung pathology associated with exposure to glyphosate-POEA since inhalation, and in this case, aspiration is an uncommon route of glyphosate-POEA exposure. This report therefore offers rare respiratory tract pathological findings and the clinical course after aspiration of a large volume of glyphosate-POEA.
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Affiliation(s)
- Jessica A Bigner
- From the Department of Biomedical Sciences, School of Medicine Greenville, University of South Carolina
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14
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Abstract
ABSTRACT Forensic pathologists may sometimes encounter cases of suicide with ingestion of unusual compounds. Herein, we describe a case of suicide by ingestion of barium acetate. Deaths by ingestion of this compound have not previously been reported in literature. This case shows the clinical presentation of the toxicity of barium compounds and highlights the importance of scene investigation and clinicopathologic correlation in suicides by unusual ingestion.
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Affiliation(s)
- Elena M Fenu
- From the Wake Forest Baptist Health, Winston Salem
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15
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Yazdi-Ravandi S, Khazaei S, Shahbazi F, Matinnia N, Ghaleiha A. Predictors of completed suicide: Results from the suicide registry program in the west of Iran. Asian J Psychiatr 2021; 59:102615. [PMID: 33774533 DOI: 10.1016/j.ajp.2021.102615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/11/2021] [Accepted: 02/16/2021] [Indexed: 11/17/2022]
Abstract
Suicide is a crucial public health problem with a serious harmful impact on individuals, families, and societies. Therefore, the current study aimed to evaluate the predictors of death or serious injury related outcome regarding this lethal phenomenon in Hamadan Province. In this registry-based study we used all of suicide attempt entered in Hamadan Suicide Registry Program from January 2016 to the end of 2017. Serious injury and death were considered as suicide worse outcome and its prognostic factors were examined using logistic regression model. From 2493 patients with suicide attempts in 5.61 % and 4.09 % of them, suicide behaviour led to serious injury and death, respectively. Males had 2.83 times higher odds of the worse suicide outcomes ([OR = 2.83, 95 % CI: 1.71, 4.68)], P < 0.001). Moreover, the odds of worse outcomes of suicide in individuals with low level of education, advanced age and with the history of suicidal ideation was significantly higher (P < 0.05). Among different suicide methods, the highest odds of suicide worse outcomes were related to self-immolation, falls, hanging, self-harm, poisoning, and drugs (P < 0.001). We found that the increase odds of suicide worse outcomes were associated with individuals advance age, low level of education, time of suicide attempt, previous history of suicidal ideation and choosing self-immolation, falls, hanging, self-harm, poisoning, and drugs as a suicide method.
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Affiliation(s)
- Saeid Yazdi-Ravandi
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Shahbazi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nasrin Matinnia
- Department of Nursing, College of Basic Science, Hamedan Branch, Islamic Azad University, Hamedan, Iran
| | - Ali Ghaleiha
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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16
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Nie J, O'Neil A, Liao B, Lu C, Aune D, Wang Y. Risk factors for completed suicide in the general population: A prospective cohort study of 242, 952 people. J Affect Disord 2021; 282:707-711. [PMID: 33445097 DOI: 10.1016/j.jad.2020.12.132] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 11/29/2020] [Accepted: 12/24/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The estimated global burden of suicide is almost 1 million deaths per year, representing 57% of all violent deaths worldwide. In order to better identify at risk individuals and develop effective prevention strategies at the population level, a comprehensive understanding of the biological, psychological and social risk factors is required. METHOD Data from the National Health Interview Survey (1997- 2004) were analyzed. Multivariable Cox proportional hazards regression models were used to compute hazard ratios (HRs) and accompanying 95% confidence intervals (CI). RESULTS During a mean 6.3 years of follow-up of 242, 952 people (1.56 million person-years), 180 deaths due to suicide occurred. Of 18 risk factors, eight revealed associations with suicide. Participants who had never been married (HR, 2.58; 95% CI, 1.44-4.62), current smokers (HR, 2.26; 1.49-3.43), current drinkers (HR, 1.93; 1.14-3.27]), participants with serious psychological distress (HR, 3.34; 1.81-6.18), and a history of emphysema (HR, 2.79; 1.18-6.59), liver disease (HR, 4.63; 2.10-10.20), kidney disease (HR, 2.26; 1.00-5.06) and cancer (HR, 2.18; 1.32-3.59) were at increased risk of completed suicide. LIMITATIONS Due to the observational nature of this study, we cannot exclude the possibility of reverse or bi-directional causality. CONCLUSIONS This large, prospective cohort study identified a series of biopsychosocial risk factors that may have utility in suicide prevention.
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Affiliation(s)
- Jing Nie
- Department of Sociology & Institute for Empirical Social Science Research, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Adrienne O'Neil
- The Centre for Innovation in Mental and Physical Health and Clinical Treatment, Deakin University, Geelong, Australia; Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Bing Liao
- School of Nursing, Guangdong Pharmaceutical University, Haizhu District, Guangzhou, China
| | - Chuntian Lu
- Department of Sociology & Institute for Empirical Social Science Research, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Nutrition, Bjørknes University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Yafeng Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China.
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17
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Otter J, Cantrell FL. Death by Copper Ammonium Complex-Containing Fungicide. Am J Forensic Med Pathol 2021; 42:62-63. [PMID: 32925210 DOI: 10.1097/paf.0000000000000613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT There is a paucity of published reports of copper ammonium complex ingestion, as most published data describe overdoses of copper sulfate formulations. We report a case of suicide by ingestion of copper ammonium complex-containing fungicide with an elevated postmortem copper level. A 77-year-old woman was found dead at home by her relative after ingesting a fungicide containing 8% copper ammonium complex solution. Turquoise emesis was found at the scene, and on autopsy, turquoise material was found throughout the gastrointestinal tract. Postmortem central blood copper level was 500 μg/dL. Cause of death was determined to be acute copper toxicity.
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18
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Handlos P, Klabal O, Uvíra M. Regarding "Isolated Right Atrial Rupture From Blunt Chest Trauma in Motor Vehicle Collisions: Mechanisms of Injury and Outcomes". Am J Forensic Med Pathol 2021; 42:101-102. [PMID: 33074841 DOI: 10.1097/paf.0000000000000631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Aquila I, Ricci C, Sacco MA, Gratteri S, De Aloe L, De Pasquale CC, Ricci P. The role of ethanethiol in deaths from acute poisoning by gas mixtures: A suicide case involving a decomposed corpse and a review of the literature. Med Leg J 2020; 88:199-204. [PMID: 32228376 DOI: 10.1177/0025817219891948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The most common volatile substances used in suicide are liquefied petroleum gas mixtures, which consist of propane and butane gases mixed in different proportions. These substances are odourless and colourless. Some substances, such as ethanethiol, are added to liquefied petroleum gas mixtures to provide a garlic scent. The main causes of death in acute liquefied petroleum gas inhalation are cardiac arrest and asphyxia, but determining the manner of death is difficult. We present a case of a 30-year-old man found dead at home. On his head was a black plastic bag with a hole through which he had run a gas hose connected to a domestic liquefied petroleum gas cylinder tank. Toxicological analysis revealed butane and ethanethiol in his body. This study aims at understanding the lethal role of ethanethiol through the analysis of its chemical action and its influence on decomposition.
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Affiliation(s)
| | | | | | | | - Luigi De Aloe
- Magna Græcia University of Catanzaro, Catanzaro, Italy
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20
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Carfora A, Petrella R, Borriello R, Aventaggiato L, Gagliano-Candela R, Campobasso CP. Fatal poisoning by ingestion of a self-prepared oleander leaf infusion. Forensic Sci Med Pathol 2020; 17:120-125. [PMID: 33237522 PMCID: PMC7889672 DOI: 10.1007/s12024-020-00338-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2020] [Indexed: 11/26/2022]
Abstract
An unusual case of poisoning by the ingestion of oleander leaves is reported. A 71 year old male laboratory technician committed suicide at home in this unusual manner. At the death scene a steel pan and other paraphernalia, used for the extraction of oleandrin and other cardiac glycosides from the leaves of the Nerium oleander plant were found.Toxicological investigations for oleandrin, oleandrigenin, neritaloside, and odoroside were performed by LC-MS/MS on all biological samples (peripheral blood, vitreous humor, urine, liver, gastric contents) and on the yellow infusion found at the death scene.In all samples, toxic levels of oleandrin were detected (blood 37.5 ng/mL, vitreous humor 12.6 ng/mL, urine 83.8 ng/mL, liver 205 ng/mg, gastric content 31.2 µg/mL, infusion 38.5 µg/mL). Qualitative results for oleandrigenin, neritaloside, and odoroside were obtained. Oleandrigenin was present in all tissue samples whereas neritaloside and odoroside were absent in the blood and vitreous humor but present in urine, liver, gastric content, and in the leaf brew.The purpose of this study was the identification of oleandrin and its congener oleandrigenin, detected in the vitreous humor. The blood/vitreous humor ratio was also calculated in order to assess of the likely time interval from ingestion to death. According to the toxicological results death was attributed to fatal arrhythmia due to oleander intoxication. The manner of death was classified as suicide through the ingestion of the infusion.
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Affiliation(s)
- Anna Carfora
- Department of Experimental Medicine, Forensic Toxicology Unit, University of Campania “L. Vanvitelli”, Via L. Armanni, 5, 80138 Napoli, Italy
| | - Raffaella Petrella
- Department of Experimental Medicine, Forensic Toxicology Unit, University of Campania “L. Vanvitelli”, Via L. Armanni, 5, 80138 Napoli, Italy
| | - Renata Borriello
- Department of Experimental Medicine, Forensic Toxicology Unit, University of Campania “L. Vanvitelli”, Via L. Armanni, 5, 80138 Napoli, Italy
| | - Lucia Aventaggiato
- Department Interdisciplinary of Medicine (DIM), Forensic Toxicology Laboratory, University of Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy
| | - Roberto Gagliano-Candela
- Department Interdisciplinary of Medicine (DIM), Forensic Toxicology Laboratory, University of Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy
| | - Carlo Pietro Campobasso
- Department of Experimental Medicine, Forensic Toxicology Unit, University of Campania “L. Vanvitelli”, Via L. Armanni, 5, 80138 Napoli, Italy
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21
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Rossi LH, Dubourg O, Malbranque S, Jousset N. Gunshot suicides caused by cane-gun and alarm garden gun cannon: Two cases report.". J Forensic Leg Med 2020; 77:102090. [PMID: 33242743 DOI: 10.1016/j.jflm.2020.102090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/03/2020] [Accepted: 11/14/2020] [Indexed: 11/17/2022]
Abstract
Obtaining a firearm is not always easy, which is why some firearms that are antique or whose use is not intended to kiss are modified for suicide purposes. The two cases report a suicide with an original historical firearm as the canegun, a walking stick which conceals a firearm and a suicide with a modified alarm cannon, which is a small cannon, which fires blanks to scare away garden animals. The aims of the study were to describe the scene, the corpse external examination and the autopsy to understand the death mechanism. We wish to highlight the importance of the forensic pathologist's fieldwork, especially in complex or atypical suicides.
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Affiliation(s)
- L H Rossi
- Service de Médecine Légale, CHU Angers, Angers, France.
| | - O Dubourg
- Service de Médecine Légale, CHU Angers, Angers, France
| | - S Malbranque
- Service de Médecine Légale, CHU Angers, Angers, France
| | - N Jousset
- Service de Médecine Légale, CHU Angers, Angers, France; Université d'Angers, France
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22
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Durão C, Pedrosa F, Dinis-Oliveira RJ. Suicide by inhalation of butane gas through a homemade adaptation of a continuous positive airway pressure (CPAP) face mask. Forensic Sci Med Pathol 2020; 16:732-734. [PMID: 32519317 DOI: 10.1007/s12024-020-00271-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2020] [Indexed: 11/26/2022]
Abstract
Fatal poisoning due to butane inhalation has been described in the clinical and forensic literature. We report the first case of a seventy-year-old obese man with a history of sleep apnea and depression, who was found dead in bed after inhaling butane gas through a homemade adaptation of his own continuous positive airway pressure (CPAP) face mask. The death scene investigation, autopsy findings and toxicological results are described. The cause of death was suspected to be due to asphyxia through butane inhalation.
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Affiliation(s)
- Carlos Durão
- Portuguese National Institute of Legal Medicine and Forensic Sciences, Lisbon, Portugal
- Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Frederico Pedrosa
- Portuguese National Institute of Legal Medicine and Forensic Sciences, Lisbon, Portugal
| | - Ricardo Jorge Dinis-Oliveira
- Department of Sciences, IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technologies, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, Portugal.
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.
- UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.
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23
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Clements PT, O'Neal BJ. When a Child Is Found Dead: The Role of the Forensic Nurse Death Investigator and Psychosocial Impact for Parents. J Forensic Nurs 2020; 16:240-243. [PMID: 33214540 DOI: 10.1097/jfn.0000000000000306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The traumatic death of a child is an immediately life-changing event. In all cases, a parent who finds that their child has died suddenly and violently is no longer the same person. Early in the chaotic aftermath of this journey, they will likely be disoriented and affectively numb because their sense of an otherwise predicted life trajectory has been destroyed in an instant. Subsequently, early in the arrival of the forensic nurse death investigator, there will be multidimensional challenges to be strategically navigated during scene investigation while simultaneously ensuring awareness of psychosocial issues that will have an enduring impact on an adaptive trajectory of bereavement for a surviving parent.
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24
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Sheftall AH, Tissue JL, Schlagbaum P, Singer JB, Young N, Stevens JH, Ackerman JP. Newspaper Adherence to Media Reporting Guidelines for the Suicide Deaths of Kate Spade and Anthony Bourdain. JAMA Netw Open 2019; 2:e1914517. [PMID: 31675079 PMCID: PMC6826645 DOI: 10.1001/jamanetworkopen.2019.14517] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
This cross-sectional study examines newspaper adherence to reporting guidelines for suicide after the deaths of Kate Spade and Anthony Bourdain.
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Affiliation(s)
- Arielle H. Sheftall
- Department of Pediatrics, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
- Center for Innovation in Pediatric Practice, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
| | - Jaclyn L. Tissue
- Center for Innovation in Pediatric Practice, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
| | - Paige Schlagbaum
- Center for Innovation in Pediatric Practice, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
| | | | - Nerissa Young
- E.W. Scripps School of Journalism, Ohio University, Athens
| | - Jack H. Stevens
- Department of Pediatrics, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
- Center for Biobehavioral Health, Nationwide Children’s Hospital, Columbus, Ohio
| | - John P. Ackerman
- Department of Pediatrics, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus
- Department of Behavioral Health, Nationwide Children’s Hospital, Columbus, Ohio
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25
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Supervía A, Galtés I, Errasti J, Barbal M, Gallardo P, Cirera I. Poisoning by Chinese rocks: fatal outcome of a suicide attempt. Emergencias 2019; 31:369-370. [PMID: 31625319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- August Supervía
- Unitat Funcional de Toxicologia, Servicio de Urgencias, Hospital Universitario del Mar, Barcelona, España
| | - Ignasi Galtés
- Departamento de Patología Forense, Institut de Medicina Legal i Ciències Forenses de Catalunya, Barcelona, España
| | - Julián Errasti
- Servicio de Urgencias, Hospital Universitario del Mar, Barcelona, España
| | - María Barbal
- Departamento de Laboratorio Forense, Institut de Medicina Legal i Ciències Forenses de Catalunya, Barcelona, España
| | - Patricia Gallardo
- Unitat Funcional de Toxicologia, Servicio de Urgencias, Hospital Universitario del Mar, Barcelona, España
| | - Isabel Cirera
- Unitat Funcional de Toxicologia, Servicio de Urgencias, Hospital Universitario del Mar, Barcelona, España
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Abstract
A high risk of suicide has been observed in adults with end-stage renal disease who are undergoing haemodialysis. Since suicide is preventable, early screening, a prompt multidisciplinary approach and appropriate treatment of depression are critical and are recommended to treating physicians. Recently, the case of a woman with end-stage renal disease who had been undergoing haemodialysis was encountered. She died by suicide after self-severing the temporary haemodialysis catheter secured to the right side of her neck. This method of suicide is unusual and rare. This case not only underscores the association between haemodialysis and suicide in patients with end-stage renal disease but also raises awareness of the possibility of such deaths.
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Affiliation(s)
- Supawon Srettabunjong
- Department of Forensic Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand
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27
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Ansari RZ, Khosa AH, Yadain SM, Shafi S, Haq AU, Khalil ZH. Incidence Of Paraphenylene-Diamine Poisoning In Three Districts Headquarter Hospitals Of Pakistan. J Ayub Med Coll Abbottabad 2019; 31:544-547. [PMID: 31933308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Paraphenylene-diamine (PPD) poisoning is an emerging problem of developing African and South Asian countries. This study was done with the objective to determine the clinical lab diagnostic accuracy of serum creatinine phosphokinase in cases initially reporting facial oedema followed by renal failure and rhabdomyolysis due to paraphenylene-diamine (PPD) poisoning. METHODS It was a cross-sectional study in which data was retrospectively collected at District Head Quarter (DHQ) Hospitals. Data was collected over a period of one year from Jan- Dec 2018. Data was collected from the patient file records. Data was analysed on SPSS version 20. RESULTS In the present study, 658 cases of Kala Pathar poisoning presented and treated. M: F ratio was 5:20. There were 518 (78.8%) females. Majority of the female patients were married 488 (94%). Most common clinical manifestations included marked facial oedema; dysphagia and stridor. Post complications include rhabdomyolysis and acute renal failure which developed after two to five days. Initial lab investigations within 6-8 hours after ingestion showed marked increase in TLC count, ALT and Na+ ions. There was marked elevation of serum CPK (1400±200 U/L) levels after 24 hours. CONCLUSIONS PPD poisoning is more common in females of younger age group belonging to rural areas. Early diagnosis and prompt supportive treatment within 2-12 hours of ingestion can save many lives. There is no specific antidote available for this poison.
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Affiliation(s)
- Rizwan Zafar Ansari
- Department of Forensic Medicine, Northwest School of Medicine, Peshawar, Pakistan
| | - Abrar Hussain Khosa
- Anaesthesia & ICU Department, DG Khan Medical College, Dera Ghazi Khan, Pakistan
| | - Syed Muhammad Yadain
- Dept of Forensic Medicine, Abbottabad International Medical College, Abbottabad, Pakistan
| | - Shagufta Shafi
- Dept of Forensic Medicine, Abbottabad International Medical College, Abbottabad, Pakistan
| | - Anwar Ul Haq
- Dept of Forensic Medicine, Khyber Girls Medical College, Peshawar, Pakistan
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Padoan CS, Cardoso TDA, Martini M, Farias CDA, Contessa JC, Magalhães PVDS. Case report on the multiple pathways to posttraumatic stress disorder following suicide. Death Stud 2019; 44:384-391. [PMID: 30747056 DOI: 10.1080/07481187.2019.1572675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Trauma pathology is not only a sum of risk factors, but emerges as a result of complex causal interaction. The case presented here illustrates the pathway from suicide exposure to the development of fully-fledged treatment-resistant posttraumatic stress disorder (PTSD), demonstrating how recognized risk factors can act in tandem to generate a difficult to treat syndrome. From a clinical perspective, bottom-up approaches that take into account real coping experiences of people bereaved by suicide are more effective to facilitate recovery and prevent adverse outcomes. Finally, even though treatment is often implemented, the diagnosis can be missed further complicating coping and treatment.
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Affiliation(s)
- Carolina Stopinski Padoan
- Postgraduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Murilo Martini
- Postgraduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Clarisse de Azambuja Farias
- Postgraduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Julia Camargo Contessa
- Postgraduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pedro Vieira da Silva Magalhães
- Postgraduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Abstract
The impact of exposure to suicide death or attempt remains ill-understood. This article aims to investigate this impact among 3010 community residing Australian adults. An online survey investigated the burden of exposure to suicide, psychological distress, and predictors of distress. The following variables were most significant in predicting distress among those exposed to suicide death: perceived impact of the most impactful death, non-kin relationship to the deceased, number of close suicide attempt exposures, time since the most impactful death, and frequency of contact. Results demonstrate suicide is a highly impactful experience and this impact reaches well beyond kin.
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Affiliation(s)
- Myfanwy Maple
- School of Health, University of New England, Armidale, Australia
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