Fatal α-PVP and amphetamine poisoning during a sauna and autoerotic practices

We describe the sudden death of a middle-aged man while having a sauna under the influence of alpha-pyrrolidinovalerophenone (alpha-PVP) (PM blood concentration: 0.8 mg/L), amphetamine (0.34 mg/L), and other drugs (buprenorphine, benzodiazepines), and engaging in solitary sexual activities. The drugs' effects on the cardio-circulatory system and on body thermoregulation combined with the high temperatures are likely to have been central mechanisms leading to death. The high levels of adrenaline triggered by sexual arousal and the respiratory depression caused by buprenorphine, in association with benzodiazepines, may have also contributed to his death. This previously unreported type of accidental autoerotic death illustrates the risk of using amphetamine-like sympathomimetic drugs (e.g. cathinone derivates) in hot environments such as a sauna, and during sexual activities therein.Non peer reviewe

Land-traffic crash leading to passenger vehicle submersion, drowning and other fatal injuries: A 44-year study based on records from the Finnish Crash Data Institute

Background: Land motor traffic crash (LMTC) -related drownings are an overlooked and preventable causeof injury death. The aim of this study was to analyze the profile of water-related LMTCs involving passen-ger cars and leading to drowning and fatal injuries in Finland, 1972 through 2015.Materials and methods: The database of the Finnish Crash Data Institute (FCDI) that gathers detailed information on fatal trafficaccidents provided records on all LMTCs leading to drowning during the study period and, from 2002 to2015, on all water-related LMTCs, regardless of the cause of death. For each crash, we considered vari-ables on circumstances, vehicle, and fatality profiles.Results: During the study period, the FCDI investi-gated 225 water-related LMTCs resulting in 285 fatalities. The majority of crashes involved passengercars (124), and the cause of death was mostly drowning (167). Only 61 (36.5%) fatalities sufferedsome–generally mild–injuries. The crashes frequently occurred during fall or summer (63.7%), in a riveror ditch (60.5%), and resulted in complete vehicle’s submersion (53.7 %). Half of the crashes occurred inadverse weather conditions and in over 40% of the cases, the driver had exceeded the speed limit. Amongdrivers, 77 (68.8%) tested positive for alcohol (mean BAC 1.8%).Conclusion: Multidisciplinary investiga-tions of LMTCs have a much higher potential than do exclusive police and medico-legal investigations.The risk factors of water-related LMTCs are similar to those of other traffic crashes. However, generallythe fatal event in water-related LMTC is not the crash itself, but drowning. The paucity of severe physicalinjuries suggests that victims’ functional capacity is usually preserved during vehicle submersion.Practical Applications: In water-related LMTCs, expansion of safety measures is warranted from generaltraffic-injury prevention to prevention of drowning, including development of safety features for sub-merged vehicles and simple self-rescue protocols to escape from a sinking vehicle.The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license(http://creativecommons.org/licenses/by/4.0/).</p

Fatal α-PVP and amphetamine poisoning during a sauna and autoerotic practices

We describe the sudden death of a middle-aged man while having a sauna under the influence of alpha-pyrrolidinovalerophenone (alpha-PVP) (PM blood concentration: 0.8 mg/L), amphetamine (0.34 mg/L), and other drugs (buprenorphine, benzodiazepines), and engaging in solitary sexual activities. The drugs' effects on the cardio-circulatory system and on body thermoregulation combined with the high temperatures are likely to have been central mechanisms leading to death. The high levels of adrenaline triggered by sexual arousal and the respiratory depression caused by buprenorphine, in association with benzodiazepines, may have also contributed to his death. This previously unreported type of accidental autoerotic death illustrates the risk of using amphetamine-like sympathomimetic drugs (e.g. cathinone derivates) in hot environments such as a sauna, and during sexual activities therein

Autopsy-Based Learning is Essential But Underutilized in Medical Education: A Questionnaire Study

To this day, autopsies and dissections have been essential in medical education, but declining autopsy numbers have endangered this long-standing tradition. Students' perceptions of these teaching methods should be constantly updated to help educators understand how to achieve their teaching goals. The purpose of this study was to explore the state of autopsy- and dissection-based teaching in two Finnish universities based on the experiences of the students, survey their perceptions of such teaching, and to compare the Finnish situation with students' perceptions in other countries as it emerges from medical literature. A questionnaire went to 859 second-, fourth-, and sixth-year medical students. The questions concerned dissection and autopsy classes these students had attended, the views of the students in regard to the number of classes, and the benefits of and attitudes towards autopsy teaching. An open question of how to improve autopsy teaching was included. The response rate was 19.4%. Most respondents requested more autopsy and dissection classes, especially practical education. They found autopsies most beneficial in learning anatomy and dealing with one's own emotions related to death. Their experiences proved least beneficial for interaction with the relatives of a deceased patient and for people skills. Integrational methods and focusing on the main learning outcomes were suggested as improvements. Overall, students found dissection and autopsy teaching important, but felt concerned about the diminishing autopsy numbers. Focusing on main learning objectives and better integration of autopsies in the teaching of different specialties could help to utilize autopsies to a greater extent

Land-traffic crash leading to passenger vehicle submersion, drowning and other fatal injuries:a 44-year study based on records from the Finnish Crash Data Institute

Abstract Background: Land motor traffic crash (LMTC) -related drownings are an overlooked and preventable cause of injury death. The aim of this study was to analyze the profile of water-related LMTCs involving passenger cars and leading to drowning and fatal injuries in Finland, 1972 through 2015. Materials and methods: The database of the Finnish Crash Data Institute (FCDI) that gathers detailed information on fatal traffic accidents provided records on all LMTCs leading to drowning during the study period and, from 2002 to 2015, on all water-related LMTCs, regardless of the cause of death. For each crash, we considered variables on circumstances, vehicle, and fatality profiles. Results: During the study period, the FCDI investigated 225 water-related LMTCs resulting in 285 fatalities. The majority of crashes involved passenger cars (124), and the cause of death was mostly drowning (167). Only 61 (36.5%) fatalities suffered some–generally mild–injuries. The crashes frequently occurred during fall or summer (63.7%), in a river or ditch (60.5%), and resulted in complete vehicle’s submersion (53.7 %). Half of the crashes occurred in adverse weather conditions and in over 40% of the cases, the driver had exceeded the speed limit. Among drivers, 77 (68.8%) tested positive for alcohol (mean BAC 1.8%). Conclusion: Multidisciplinary investigations of LMTCs have a much higher potential than do exclusive police and medico-legal investigations. The risk factors of water-related LMTCs are similar to those of other traffic crashes. However, generally the fatal event in water-related LMTC is not the crash itself, but drowning. The paucity of severe physical injuries suggests that victims’ functional capacity is usually preserved during vehicle submersion. Practical Applications: In water-related LMTCs, expansion of safety measures is warranted from general traffic-injury prevention to prevention of drowning, including development of safety features for submerged vehicles and simple self-rescue protocols to escape from a sinking vehicle

Autopsy-based learning is essential but underutilized in medical education:a questionnaire study

Abstract To this day, autopsies and dissections have been essential in medical education, but declining autopsy numbers have endangered this long-standing tradition. Students’ perceptions of these teaching methods should be constantly updated to help educators understand how to achieve their teaching goals. The purpose of this study was to explore the state of autopsy- and dissection-based teaching in two Finnish universities based on the experiences of the students, survey their perceptions of such teaching, and to compare the Finnish situation with students’ perceptions in other countries as it emerges from medical literature. A questionnaire went to 859 second-, fourth-, and sixth-year medical students. The questions concerned dissection and autopsy classes these students had attended, the views of the students in regard to the number of classes, and the benefits of and attitudes towards autopsy teaching. An open question of how to improve autopsy teaching was included. The response rate was 19.4%. Most respondents requested more autopsy and dissection classes, especially practical education. They found autopsies most beneficial in learning anatomy and dealing with one’s own emotions related to death. Their experiences proved least beneficial for interaction with the relatives of a deceased patient and for people skills. Integrational methods and focusing on the main learning outcomes were suggested as improvements. Overall, students found dissection and autopsy teaching important, but felt concerned about the diminishing autopsy numbers. Focusing on main learning objectives and better integration of autopsies in the teaching of different specialties could help to utilize autopsies to a greater extent