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A History On The Use Of Blood Transfusions In Cycling

November 21, 2018October 13, 2017 by admin

The recent revelations by the Dutch newspaper De Volksrant concerning the PDM team's doping regime at the 1988 Tour de France raise more questions than they answer, particularly with regard to the use of blood transfusions in 1980s cycling. Here we consider what is known about the use of transfusions in general and some of the questions these latest PDM revelations raise in relation to the history of blood doping in cycling.

Part I

What is known about the use of blood transfusions in sport, particularly in cycling? Most people will be able to tell you that the Finnish middle-distance runner Lasse Virén is said to have made use of transfusions when winning at the Munich and Montreal Olympics in 1972 and 1976. Most people will also be able to tell you that Francesco Moser broke Eddy Merckx's Hour Record in 1984 with the help of blood transfusions....

Medicolegal Assessment Of Blood Transfusion Errors–an Interdisciplinary Challenge.

November 21, 2018October 13, 2017 by admin

Abstract

Given a current total incidence of erroneously administered blood transfusions of 1:12,000-1:36,000 (AB0 incompatible 1:38,000), the percentage of lethal outcomes ranges between 2 and 5%; i.e. the sole fact of an erroneous transfusion does not mandatorily result in a causal connection with lethal outcome, which can give rise to problems in the medicolegal assessment. We report on the conception and results of a novel interdisciplinary approach to assess the lethal significance of blood transfusion errors. Besides autopsy, histological investigation and immunohistochemical detection of AB0 incompatible foreign red blood cells in autopsy specimens, transfusion medicine investigations offer the opportunity to assess several immunohaematologic features. We assessed the immunohaematologic gel card ("microcolumn") technique for suitability in the forensic assessment of an AB0 incompatible transfusion incident in a septic patient, who had had no history of previous blood transfusions, with lethal outcome. After such an erroneous transfusion had been simulated in vitro, pre-transfusion...

Affective Neuroscience Of Pleasure: Reward In Humans And Animals

November 21, 2018October 13, 2017 by admin

Abstract

Introduction Pleasure and reward are generated by brain circuits that are largely shared between humans and other animals.

Discussion Here, we survey some fundamental topics regarding pleasure mechanisms and explicitly compare humans and animals.

Conclusion Topics surveyed include liking, wanting, and learning components of reward; brain coding versus brain causing of reward; subjective pleasure versus objective hedonic reactions; roles of orbitofrontal cortex and related cortex regions; subcortical hedonic hotspots for pleasure generation; reappraisals of dopamine and pleasure-electrode controversies; and the relation of pleasure to happiness.

Introduction Affective neuroscience has emerged as an exciting discipline in recent years (Berridge 2003a; Damasio 2004; Davidson et al. 2003; Davidson and Sutton 1995; Feldman Barrett and Wager 2006; Kringelbach 2005, 2008; LeDoux and Phelps 2000; Leknes and Tracey 2008; Panksepp 1991; 1998; Rolls 2005). Many important insights have been gained into brain mechanisms of affect, motivation, and emotion through studies of both animals and humans....

Please Don’t Say Anything: Partner Notification and the Patient-Physician Relationship

November 21, 2018October 13, 2017 by admin

Commentary by Ronald Epstein, MD, James C. Thomas, PhD, MPH, and Gregory W. Rutecki, MD

On Dr. Singh's recommendation, one of her patients, Mr. Henry Roland, consented to be tested for HIV and had a positive test result, which he feared but suspected. Mr. Roland has a longtime girlfriend, Lisa, whom he sometimes mentions to Dr. Singh. When talking to Mr. Roland about his positive test result, Dr. Singh brought up the topic of notifying Mr. Roland's past and present partners so they could be tested themselves. Mr. Roland refused to agree to tell Lisa, or even allow Dr. Singh to notify the health department so they could call her to suggest that she be tested.

"If she's positive, she'll know it was me. Please don't say anything or she'll know I gave it to her."

Mr. Roland told Dr. Singh that he intended to continue having sexual relations with Lisa,...

y-Hydroxybutyrate Concentrations in Pre- and Postmortem Blood and Urine

November 21, 2018October 13, 2017 by admin

To the Editor:

With γ-hydroxybutyrate (GHB) becoming popular as a drug of abuse in the US and elsewhere (1), we are receiving increasing requests for the analytical determination of GHB in blood or urine in criminal investigations, especially in sexual assault cases. In a recent report of a fatal poisoning with GHB, the victim had a postmortem blood GHB concentration of 27 mg/L (2), and another three GHB-related fatalities were reported with postmortem blood GHB concentrations of 52–121 mg/L (3).

As a part of a validation study before instituting a GC-MS method described by others (4), we tested for GHB presence in a series of forensic specimens submitted routinely to us by law enforcement agencies and medical examiner offices in cases not known to be GHB-related. No GHB was detected (detection limit, 1 mg/L) in the blood or urine of living persons or in postmortem urine, but very substantial concentrations,...

The Plethysmograph: A Review of Recent Literature James G. Barker and Robert J. Howell

November 21, 2018October 13, 2017 by admin

The penile plethysmograph is an individually applied physiological test, that measures the flow of blood to and from the genital area. Over the past 20 years the plethysmograph has evolved into a sophisticated computerized instrument capable of measuring slight changes in the circumference of the penis. Despite the sophistication of the current equipment technology, a question remains whether the information emitted is a valid and reliable means of assessing sexual preference. Much research has accompanied the evolution of the seismography. Generally, the plethysmograph is recognized as the best objective measure of male sexual arousal because blood flow into the penis is the only measure of sexual arousal that doesn't seem to be influenced by other factors. The objectiveability to measure penile arousal has helped the plethysmograph evolve into one of the important tests in the assessment and treatment of male sex offenders.

Ideally,

Acute Lung Injury Following Blood Transfusion: Expanding the Definition

November 21, 2018October 12, 2017 by admin

Abstract and Introduction

Abstract

Objective: Acute lung injury (ALI) is a well known complication following the transfusion of blood products and is commonly referred to as transfusion-related acute lung injury (TRALI). The objectives of this review are to summarize current knowledge of TRALI with an emphasis on issues pertinent to the intensivist and to define the newly recognized Delayed TRALI syndrome.

Data synthesis: The classic TRALI syndrome is an uncommon condition characterized by the abrupt onset of respiratory failure within hours of the transfusion of a blood product. It is usually caused by anti-leukocyte antibodies, resolves rapidly, and has a low mortality. A single unit of packed cells or blood component product is usually implicated in initiating this syndrome. It has, however, recently been recognized that the transfusion of blood products in critically ill or injured patients increases the risk (odds ratio 2.13; 95% confidence interval 1.75-2.52)...

Sexual Homicide A Motivational Model

November 21, 2018October 12, 2017 by admin

Abstract

Reports findings from an exploratory study of the background characteristics of 36 male sexual murderers, their behaviors and experiences in connection with their developmental stages, and the central role of sadistic fantasy and critical cognitive structures that support the act of sexual murder. All Ss were born in the 1940s and 1950s; 33 were White, and 80% were of average to superior intelligence. A 5-phase motivational model is presented: (1) ineffective social environment, (2) formative events, (3) critical personal traits and cognitive mapping process, (4) action toward others and self, and (5) feedback filter. Clinical implications are noted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)...

Drug-Related Deaths With Evidence Of Intracorporeal Drug Concealment At Autopsy: Five Case Reports.

November 21, 2018October 12, 2017 by admin

Abstract

Intracorporeal concealment of illicit drugs is a rare observation at coronial autopsy examinations. The article reports 5 cases of accidental drug overdoses at the Westmead Coronial Morgue, Sydney New South Wales, over a 6-year period with evidence of intracorporeal drug concealment known as body packing or body stuffing. Three different forms of anatomic concealment of drugs are illustrated, Case 2 involving therapeutic medication in the form of glass ampoules for parenteral injection not previously reported. Three deaths were the result of acute toxicity due to polydrug abuse rather than as a consequence of the body packing behavior and rupture of the drug packaging, with the intracorporeal drug concealments an adjunct finding at the autopsy examinations. The cause of death in Case 3 was the direct result of acute cocaine intoxication due to rupture of drug packages in the rectum and mucosal absorption. The article details forensic sociological aspects of drug concealment...

Shootings: What EMS Providers Need to Know

November 21, 2018October 12, 2017 by admin

Firearm-related injuries continue to be a significant public health problem, accounting for almost 20% of injury-related deaths in the United States.

From January 1993 to December 1998, an estimated 115,000 firearm-related injuries occurred annually in the U.S. Males were seven times more likely to die or be treated in emergency departments for gunshot wounds than females. In 2006 more than 30,000 persons died from firearm injuries in the United States.

Gunshot wounds to the head are the most lethal of all firearm injuries. It is estimated they have a fatality rate greater than 90%. Those to the myocardium have fatality rates reaching 80%. Intra-abdominal injuries from gunshot wounds tend to involve the small bowel (50%), colon (40%), liver (30%) and abdominal vascular structures (25%).

PENETRATING MOI

Gunshot wounds involve the transfer of energy to a target. The damage that occurs is directly related to the amount of energy exchanged between the penetrating...

The Plausibility of Adaptations for Homicide

February 20, 2019October 12, 2017 by admin

1 Introduction

People kill other people in every known culture around the world. The question is why. This chapter presents a new theory of homicide, Homicide Adaptation Theory, which proposes that humans evolved adaptations to facilitate killing. The new theory is contrasted with two competing conceptions of why people kill: The Byproduct Hypothesis and the Evolved Goal Hypothesis. Prior to presenting these competing views of homicide, we discuss the concept of “innateness” in relation to our conception of evolved homicide adaptations. 2 The Concept of Innateness from the perspective of Evolutionary Psychology The term “innateness” is used to refer to many different phenomena (see Elman, Johnson, & Bates, 1996). Our conceptualization of innateness falls in line with the standard definition used by evolutionary psychologists and biologists when referring to any adaptation. Selection has shaped the genes that pattern human ontogeny. These genes provide the blueprint for the development of... ...

Homicide in Black and White

November 21, 2018October 12, 2017 by admin

Abstract

African-Americans are six times as likely as white Americans to die at the hands of a murderer, and roughly seven times as likely to murder someone. Young black men are Öften times as likely to be murdered as young white men. This disparity is historic and pervasive, and cannot be accounted for by individual characteristics. Culture-of-violence and tail-of-the-distribution theories are also inadequate to explain the geographic and demographic pattern of the disparity. We argue that any satisfactory explanation must take into account the fact that murder can have a preemptive motive: people sometimes kill simply to avoid being killed. As a result, disputes can escalate dramatically in environments (endogenously) perceived to be dangerous, resulting in self-fulflling expectations of violence for particular dyadic interactions, and significant racial disparities in rates of murder and victimization. Because of strategic complementarity, small differences in fundamentals can cause large differences in murder rates..

Organized/Disorganized Continuum Phase 3 Individual Project Forensic Psychology

November 21, 2018October 12, 2017 by admin

Physical and Behavioral Evidence Based Crime Scene Analysis

The crime scene analysis approach that is taken in profiling works under the assumption that the crime scene will reflect the personality of the perpetrator. FBI profilers have been able to identify the characteristics of the organized and disorganized rapists and murderers. (Thorton, 2002) The profiler’s will use information that they gather from the crime scene and reflect on the nature of the crime in order to produce a psychological profile that would be consistent with the offender in question. The offender can be classified as organized or disorganized based on the information they were able to obtain from the crime scene and other aspects of the crime itself.

“An organized offender is thought to be very intelligent, socially competent and very charismatic.” (Curt Bartol, 2012) The disorganized offender is described as being of average intelligence, immature socially and a loner by default....

Multiple Murder And Criminal Careers: A Latent Class Analysis Of Multiple Homicide Offenders.

November 21, 2018October 12, 2017 by admin

Abstract

PURPOSE: To construct an empirically rigorous typology of multiple homicide offenders (MHOs).

METHOD: The current study conducted latent class analysis of the official records of 160 MHOs sampled from eight states to evaluate their criminal careers.

RESULTS: A 3-class solution best fit the data (-2LL=-1123.61, Bayesian Information Criterion (BIC)=2648.15, df=81, L(2)=1179.77). Class 1 (n=64, class assignment probability=.999) was the low-offending group marked by little criminal record and delayed arrest onset. Class 2 (n=51, class assignment probability=.957) was the severe group that represents the most violent and habitual criminals. Class 3 (n=45, class assignment probability=.959) was the moderate group whose offending careers were similar to Class 2.

CONCLUSION: A sustained criminal career with involvement in versatile forms of crime was observed for two of three classes of MHOs. Linkages to extant typologies and recommendations for additional research that incorporates clinical constructs are proffered.

The Self and the Psychology of Domestic Homicide-Suicide

November 21, 2018October 12, 2017 by admin

Abstract

Men commit the vast majority of domestic homicide-suicides (H-Ss) wherein a person kills their intimate partner (and/or other family members) before taking their own life. Studies of men who commit H-S have looked at the act from psychopathology and evolutionary psychology viewpoints. To complement those approaches, this article presents additional views of domestic H-S. Applications of theories from social (escape from self), developmental (evolution of self and continuity of self), gender role (power and the male role), and family violence psychology (abusive personality and proximal antecedents of abuse) are outlined. These conceptualizations are offered because they pertain to instability and deconstruction of the self amidst the life changes and intimate distress that precede many cases of domestic H-S....

Serving Survivors of Homicide Victims During Cold Case Investigations: A Guide for Developing a Law Enforcement Protocol

February 15, 2019October 12, 2017 by admin

INTRODUCTION

Statement of the Problem

Advancements in DNA technology and other forensic investigative tools have enabled law enforcement agencies to reopen cases left dormant for years. Although the number of cold cases investigated by agencies on a nationwide basis each year is currently not tracked, the Federal Bureau of Investigation (FBI) does track the number of offenses cleared. In 2009, 66.6 percent of the 13,242 murder and non-negligent manslaughter crimes in the United States were cleared by arrest or exceptional means.1 While this is a significant clearance rate, it leaves many homicides unsolved each year. In response to the advances in forensic technology, many law enforcement agencies have established cold case units with the hope that reexamining evidence will help solve more crimes. As cases are reopened, investigators are contacting survivors of homicide victims. Although survivors may be grateful that their loved one’s murder has renewed attention, the reopening of a case can...