Morphological cardiac changes in electrocution deaths: A literature review

2021 ◽  
Vol 61 (1_suppl) ◽  
pp. 130-135
Author(s):  
Matteo Favia ◽  
Federica Mele ◽  
Francesco Introna ◽  
Antonio De Donno

Electrical injury may lead to damage to the conducting tissue, myocardial changes and even sudden cardiac death. Victims of low-voltage electrocution may have no electric marks, burns or other signs typical of electrical injuries. In these cases, the absence of other specific findings could make the identification of the cause of death very difficult. A broad spectrum of cardiac changes in cases of electrocution has been described in the literature, including the break-up of myocardial fibres, cardiomyolysis, haemorrhagic areas, the separation of myofibres and alternating hypercontracted–hyperdistended myocytes. All the described alterations, however, cannot be exclusively attributed to electrocution, since no specific morphological cardiac findings have so far been identified in electrocution. However, a few histological patterns recur, and their knowledge may be important for the forensic pathologist. This literature review describes the main pathological patterns observed in cases of fatal electrocution based on a literature search carried out up to September 2019 in the databases PubMed and Scopus. The search criteria included the keywords for cardiac lesions and electrocution. On the grounds of the literature data, a list of major and minor diagnostic markers for the passage of the electrical current through the heart tissue was created.

2021 ◽  
pp. 193-204
Author(s):  
David C.G. Sainsbury ◽  
Joel Fish

Though responsible for just 4% of burn centre admissions, electrical injuries present in a myriad of ways. From small, innocuous, partial-thickness injuries on the fingertip, to a high-voltage injury requiring amputation and complex reconstruction, the burn surgeon must be equipped with the knowledge and skill to deal with such varying injuries. This chapter describes the epidemiology of electrical injury and the pathophysiology of electrical current passing through the patient. The management of high- and low-voltage wounds is described, as is the treatment of the systemic effects of the electrical injury.


Author(s):  
Daisy Vyas Shirk ◽  
Sarah D. Williams

Background: Ehlers-Danlos Syndromes (EDS) comprise a group of heterogeneous hereditary connective tissue disorders [1, 2]. Psychiatric disorders such as depression, anxiety, panic disorder, agoraphobia, schizophrenia, neurodevelopmental disorders, personality disorder, eating disorders, substance misuse and interpersonal issues have been reported in the literature to be associated with EDS [1-3]. Objectives: The case of a 15-year -old male who was hospitalized after a suicide attempt by gunshot was discovered to have symptoms suggestive of EDS is presented in this paper along with the results of a literature search of psychiatric manifestations of EDS in children and adolescents. Methods: Literature review was conducted on the UpToDate website on March 11, 2020 to review symptoms of EhlersDanlos Syndrome for the purpose of preliminary diagnosis of this patient. Additional literature search was conducted on PubMed on 4/2/20 at 12:10 P.M. and on 4/9/20 at 10:51 P.M. and on the search engine Google on 4/2/20 at 12:25 P.M. On May 11, 2020 at 2 P.M., another web search was conducted with review of 6 different websites pertaining to EhlersDanlos Syndrome. Results: A systematic review of psychiatric manifestations of Ehlers-Danlos Syndromes revealed a strong incidence of psychiatric symptoms. Conclusion: Our patient’s psychiatric symptoms of depression, suicidal ideations, anxiety and social and educational struggles may have been at least partially due to chronic pain- abdominal, headache and musculoskeletal, and social ostracization associated with Ehlers-Danlos Syndrome. Education regarding this illness helped our patient’s recovery as he came to understand why he was so “odd” and the cause of his multisystemic chronic pain.


2020 ◽  
Vol 37 (12) ◽  
pp. 841.1-841
Author(s):  
Lucy Hall ◽  
Sophie Dando ◽  
Anthony Hanks

Aims/Objectives/BackgroundIn the Emergency department (ED), noise is a frequent and often unavoidable consequence of work undertaken and levels can often be raised during the day and night. Raised ambient noise levels have potential implications for the workforce, patients and relatives.Investigation into the problem of noise levels in the ED follows feedback from a young patient who couldn’t sleep during a prolonged stay. His complaint focused on loud, irregular banging noises such as those from closing bins that kept him awake.The team felt work should be done to see if it was a wider spread problem or just isolated to his case. A simple sound recording experiment and literature search was conducted.Methods/DesignThe literature search was conducted using electronic/online databases (Medline; Cochrane library) with a fixed date range and specific inclusion criteria.The noise exposure experiment was conducted using a verified phone app to record the sound levels. They were measured at 3 times, during a night shift, in the paediatric emergency department of UHW. All measurements were at a fixed distance and were averaged and compared with WHO recommendations.Results/ConclusionsThere are many sources of noise pollution in the ED, some are unavoidable for safety and clinical reasons.The literature review produced a small number of papers all of which found that sound levels were raised above recommended levels. Similarly, all the sounds measured in the ED also exceeded the recommendations.The most consistent finding across the papers, matched by findings from recordings, was that human behavioural modification is an easy and effective way to reduce noise levels.There are simple steps that can be taken to reduce and eliminate soundsRaising awareness regarding this problem is of great importance and focussing future work on assessing the impact in younger patients within the Emergency Department is paramount.


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S130-S131
Author(s):  
Andrew Khalifa ◽  
Anzar Sarfraz ◽  
Jacob B Avraham ◽  
Ronnie Archie ◽  
Matthew Kaminsky ◽  
...  

Abstract Introduction Electrical injuries represent 0.4–3.2% of admissions to burn units and are responsible for >500 deaths per year in the United States. Approximately half occur in the workplace and are the fourth leading cause of work-related-traumatic death. The extent of injury can be drastically underestimated by total body surface area percentage (TBSA). Along with cutaneous burns, high voltage electrical injuries can lead to necrosis of muscle, bone, nervous tissue, and blood vessels. Aggressive management allows for patient survival, but at significant cost. Newer technologic advances help improve functional outcomes. Methods This case-report was conducted via retrospective chart review of the case presented. Results A 43-year-old male sustained a HVEI (>10, 000 V) after contacting an active wire while working as a linesman for an electric company. He presented after less than 15-minute transport from an outside hospital with full thickness burns and auto-amputation to all fingers on both hands and the distal third of the left hand (Images 1 and 2). There were full thickness circumferential burns to the entire left and right upper extremities with contractures, with the burns extending into the axilla, and chest wall musculature. The patient had 4th degree burns and a large wound to the left shoulder with posterior extension to the scapula, flank and back with approximately 25% TBSA (Image 3). Compartments were tense in both upper extremities. Patient was sedated and intubated to protect the airway and placed on mechanical ventilation. A femoral central line was then placed, and the patient was given pain control, continued fluid resuscitation, and blood products. Dark red colored urine from a foley catheter that was immediately identified as rhabdomyolysis induced myoglobinuria. Labs drawn demonstrated elevated troponin I, CK >40,000. BUN 18, creatinine 1.0, K+ 5.2 and phosphate 5.6. Decision was made immediately for operative intervention with emergent amputation of both upper extremities in the light of rhabdomyolysis secondary to tissue necrosis and oliguria. During the patient’s hospital course, he underwent multiple operations for further debridement with vacuum-assisted closure therapy and skin grafting of sites, as well as targeted muscle reinnervation (TMR) 6 months later at an outside hospital. Conclusions Although HVEI only account for a small percentage of burn admissions, they are associated with greater morbidity than low-voltage injuries. Patients with HVEI often incur multiple injuries, more surgical procedures, have higher rates of complications, and more long term psychological and rehabilitative difficulties. Despite the need for amputation in some of these critically ill patients, options exist that allow for them to obtain long term functional success.


2004 ◽  
Vol 04 (02) ◽  
pp. L345-L354 ◽  
Author(s):  
Y. HADDAB ◽  
V. MOSSER ◽  
M. LYSOWEC ◽  
J. SUSKI ◽  
L. DEMEUS ◽  
...  

Hall sensors are used in a very wide range of applications. A very demanding one is electrical current measurement for metering purposes. In addition to high precision and stability, a sufficiently low noise level is required. Cost reduction through sensor integration with low-voltage/low-power electronics is also desirable. The purpose of this work is to investigate the possible use of SOI (Silicon On Insulator) technology for this integration. We have fabricated SOI Hall devices exploring the useful range of silicon layer thickness and doping level. We show that noise is influenced by the presence of LOCOS and p-n depletion zones near the edges of the active zones of the devices. A proper choice of SOI technological parameters and process flow leads to up to 18 dB reduction in Hall sensor noise level. This result can be extended to many categories of devices fabricated using SOI technology.


Author(s):  
Rutika, B. Maske

The purpose of this review is to provide the latest information on Down syndrome. The author conducted a literature search of available sources describing the issue of down syndrome with special focus on syndrome and made a comparison and evaluation of relevant findings.The results of this review indicate that Down syndrome (DS) is one of the commonest disorders with huge medical and social cost. DS is associated with number of phenotypes including congenital heart defects, leukemia, Alzeihmer’s disease, Hirschsprung disease etc. DS individuals are affected by these phenotypes to a variable extent thus understanding the cause of this variation is a key challenge. In the present review article, we emphasize an overview of DS, DS-associated phenotypes diagnosis and management of the disease.


2016 ◽  
Vol 37 (2) ◽  
pp. 126-133 ◽  
Author(s):  
C. Miller ◽  
V. Pradeep ◽  
M. Mohamad ◽  
Z. Izmeth ◽  
M. T. P. Reynolds ◽  
...  

IntroductionThe direct involvement of patients and carers in psychiatric education is driven by policy in the United Kingdom and Ireland. The benefits of this involvement are well known, however, it is important to consider the ethical aspects. This paper suggests how further research could explore and potentially mitigate adverse outcomes.MethodA literature search evaluating the role of patients and carer involvement in psychiatric education was undertaken to summarise existing evidence relating to the following: methods of involvement, evidence of usefulness, patient’s/carer’s views and learners’ views.ResultsThe Medline search produced 231 articles of which 31 were included in the literature review based on the key themes addressed in the paper.Discussion/conclusionThe available evidence is generally positive regarding the use of patients and carers in psychiatric education. However, available research is varied in approach and outcome with little information on the ethical consequences. More research is required to inform policies on teaching regarding potential adverse effects of service user involvement.


2011 ◽  
Vol 1 (2) ◽  
pp. 32 ◽  
Author(s):  
Mohammed Mohsin Uzzaman ◽  
Muhammed Rafay Sameem Siddiqui

The most commonly encountered complication after haemorrhoidectomy is post-operative pain. Relief of this pain may aid earlier recovery. A literature search was performed examining the different surgical and medical agents for the relief of post haemorrhoidectomy pain using Pubmed, MEDLINE, EMBASE, CINAHL and Cochrane library databases. Pain can be relieved by surgical or medical agents. Surgery incorporates a risk of incontinence. A number of studies examine the role of medical agents.A variety of surgical techniques and medical agents are available to the clinician in the treatment of post haemorrhoidectomy pain. Tailored management to individual patients should ensure appropriate symptomatic control and prompt recovery.


2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Prima Dewi Novalia ◽  
Lina Handayani

At the end of 2019, the world was shocked by the new virus called the corona virus (COVID-19), this virus was first discovered in the Wuhan area, China. COVID-19 is an infectious disease that attacks the respiratory tract. Humans exposed to this virus usually experience mild to severe symptoms. The purpose of this literature study is to discuss how the 3M health protocols application . the method us the literature review. The literature consists of journals with a travel year from 2011 to 2021. Literature collection is done through google scholar using the keywords “3M health protocol”, “COVID-19 pandemic”, and “community”. The results of the literature search were 73 articles that were relevant to the keywords, as many as 60 articles were excluded because they were not relevant to the author’s criteria. Total 13 articles using inclusion and exclusion criteria were obtained 5 articles with good quality. Review results show that most people have not implemented 3M health protocols properly and correctly, this is one of the causes of the increase in COVID-19 cases.


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