Y. Albalooshi

Extended suicide by use of a chain saw

Injuries caused by chain saws are mostly seen due to accidents. Suicides by chain saws are rare, but some cases have already been described. We present the case of homicide on a child by a chain saw followed by the suicide of his father. For the homicide and the suicide chain saws of different sizes were used. Fatal injuries in the homicide and suicide were located on the neck. Cause of death in both cases was fatal haemorrhage with blood aspiration respectively decapitation. Normally, in suicide by use of chain saws individuals suffering from schizophrenia, major depression and alcohol or drug dependence are concerned. In the presented case, the background was a litigation of a divorced couple for child custody.

The evidential value of intra-alveolar haemosiderin-macrophages in cases of sudden infant death syndrome (SIDS)

Intra-alveolar deposits of haemosiderin have repeatedly been brought into connection with some diagnostic value, such as markers for previous imposed suffocation, smothering due to Munchausen syndrome by proxy or sudden infant death syndrome (SIDS). This study is based on 104 SIDS cases and 14 controls (causes of death, e.g. inflammatory changes, internal haemorrhages, asphyxia, blunt force trauma or acute toxicity). The SIDS group comprised 44 females (aged 7 days to 12 months) and 60 males (aged 12 days to 16 months 8 days) with the ages of the controls ranging from 2 months 3 days to 47 months. Routine histology samples from the lungs were stained with Prussian blue and haemosiderin foci were counted in 20 hpf for each lung lobe by a pathologist blinded to the cause of death. Results were assigned to one of five categories for haemosiderin positivity. Data were analysed by the Levene-test revealing identical variances in both groups and with a two-sample t-test showing the mean values for haemosiderin counts not being significantly different between SIDS and control groups. Although the sizes of both samples differed considerably it is our opinion that the haemosiderin counts did not show sufficient diagnostic value. This outcome supports the latest results of other comparable investigations. Furthermore, it highlights the necessity to assess carefully positive haemosiderin findings to avoid false suspicion.

Letale Magenruptur bei einem Mädchen mit Rett-Syndrom

Die klinische Diagnose einer lebensbedrohlichen Erkrankung bei mental retardierten Patienten kann aufgrund fehlender oder eingeschränkter Kommunikationsmöglichkeit, physischer Einschränkungen, variabler Schmerztoleranz und dem Einfluss psychotroper Medikamente erheblich erschwert sein. Dies gilt insbesondere dann, wenn andere Erkrankungen die Symptomatik zusätzlich überlagern.