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Correspondence regarding "Suicide trends in Germany during the COVID-19 pandemic and the war in Ukraine" by D. Radeloff et al. Psychiatry Res 2024; 333:115732. [PMID: 38232569 DOI: 10.1016/j.psychres.2024.115732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/06/2024] [Accepted: 01/10/2024] [Indexed: 01/19/2024]
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Comparison of all completed suicides in Frankfurt am Main (Hessen) before and during the early COVID-19 pandemic. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00754-8. [PMID: 38017259 DOI: 10.1007/s12024-023-00754-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 11/30/2023]
Abstract
To research the effect of the COVID-19 pandemic on mental health, the prevalence and characteristics of all completed suicides in the city of Frankfurt am Main were compared for a 10-month period before the pandemic (March 2019-December 2019) with one during the early pandemic (March 2020-December 2020). Medicolegal data collected in the context of the FraPPE suicide prevention project were evaluated using descriptive statistical methods. In total, there were 81 suicides during the early pandemic period, as opposed to 86 in the pre-pandemic period. Though statistically not significant, the proportion of male suicides (73%) was higher during the early pandemic period than before (63%). The age-at-death was comparable in the pre-pandemic and pandemic periods (average, 54.8 vs. 53.1 years). Between these two periods, there was no difference in respect to the three most commonly used suicide methods by men: fall from a height (26% vs. 22%), intoxication, and strangulation (each 24% vs. 19%). For women, there was, however, a shift in methods from strangulation (38%), intoxication (28%), and fall from a height (19%) to fall from a height (50%), strangulation (18%), intoxication, and collision with a rail vehicle (14% each). There was a trend towards more suicides among non-German nationals during the early pandemic (suicide rate/100,000 inhabitants: German, 14.3 vs. 11.5; non-German, 4.4 vs. 8.8). Before the pandemic, 54% of the suicides were known to have a mental illness in contrast to 44% during the early pandemic. Overall, no increase in completed suicides could be observed in Frankfurt am Main during the early pandemic.
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How to prove neglect in the context of the post-mortem examination. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00695-2. [PMID: 37578627 DOI: 10.1007/s12024-023-00695-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
Understanding the causes, extent, and period of neglect is not only a medical but also a forensic task when it comes to legal investigations. In this study, we evaluated 46 autopsied cases where there was clear evidence of physical neglect during the last period of the deceased's life. The age of the deceased ranged from 21 to 96 years; most of them were female (71.7%). The majority of cases (89.9%) took place in a domestic environment, with partners or relatives providing care. The most frequent post-mortem findings were pressure sores, followed by inflammatory skin changes, and signs of malnutrition and dehydration. Neglect was the cause or co-cause of death in 23% of the cases. More than half of the deceased showed severe contamination of the skin surface by excrement, and in almost 40% of the cases, fly infestation was found. The majority of insects belonged to the group of house flies (Diptera: Muscidae), mainly the common house fly, Musca domestica. By analyzing the entomological evidence, it was possible to prove an insect infestation period of at least several days ante-mortem. Since the period of neglect may be relevant in terms of legal proceedings, the present work demonstrates the particular importance of insect traces in providing this evidence. While prosecution and conviction of caregivers remain challenging, it is all the more essential that entomology and legal medicine collaborate on the analysis of findings of neglect.
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Bone finds and their medicolegal examination: a study from Hesse, Germany. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00599-1. [PMID: 37067670 DOI: 10.1007/s12024-023-00599-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 04/18/2023]
Abstract
Bones found by chance can be of great criminal or historical interest. The nature of their appraisal depends on the individual case, the locally effective legislation and the available resources. To assess whether a find is relevant with respect to criminal investigation, the circumstances of the find and the results of the forensic examination carried out by trained personnel must be considered. The aim of this study was to obtain an overview of the circumstances and nature of the finds as well as the results of the subsequent expert opinions by evaluating bone finds from the federal state of Hesse, Germany. For this purpose, over a 10-year period from 2011 to 2020, all bone finds examined at the Institutes of Legal Medicine in Gießen and Frankfurt am Main, Germany, were evaluated retrospectively with regard to the locations and circumstances of the finds, their nature (human or non-human), the postmortem interval, possible traces of violent impact and the results of further examinations. Of the 288 bone finds evaluated, 38.2% were found in forests, meadows and parks. In 50.7%, the finds contained human bones, of which 37.0% had a forensically relevant postmortem interval of 50 years or less. Evidence of trauma was described in 77.4% of the human bone cases: postmortem damage in 78.8%, peri-mortem injury in 9.7% and ante-mortem injury in 11.5%. DNA examinations were performed in 40.4% of the human bone finds. They yielded STR profiles in 81.3%, leading to a definite identification in 35.4%. Among the non-human bones sent in, the most common were bones from pigs (23.4%), deer (18.1%), cattle (16.4%), roe deer (11.7%) and sheep (11.7%). The macroscopic examination is the first step of the forensic-osteological evaluation and sets the course for further examinations or investigations. DNA examinations are of great importance for the reliable identification of human bones. They were responsible for 70.8% of successful identifications.
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Respiratory viruses in medicolegal autopsies during the winter season 2021/2022: observations after reduction of coronavirus disease-19 (COVID-19) pandemic restrictions. Int J Legal Med 2023; 137:897-902. [PMID: 36807752 PMCID: PMC9937855 DOI: 10.1007/s00414-023-02974-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 02/08/2023] [Indexed: 02/20/2023]
Abstract
In the context of the coronavirus disease (COVID-19) pandemic, measures were taken to protect the population from infection. These were almost completely lifted in several countries in the spring of 2022. To obtain an overview of the spectrum of respiratory viruses encountered in autoptical routine case work, and their infectivity, all autopsy cases at the Institute of Legal Medicine in Frankfurt/M. with flu-like symptoms (among others) were examined for at least 16 different viruses via multiplex PCR and cell culture. Out of 24 cases, 10 were virus-positive in PCR: specifically, 8 cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 1 with respiratory syncytial virus (RSV), and 1 with SARS-CoV-2 and the human coronavirus OC43 (HCoV-OC43), as a double infection. The RSV infection and one of the SARS-CoV-2 infections were only detected due to the autopsy. Two SARS-CoV-2 cases (postmortem interval of 8 and 10 days, respectively) showed infectious virus in cell culture; the 6 other cases did not show infectious virus. In the RSV case, virus isolation by cell culture was unsuccessful (Ct value of 23.15 for PCR on cryoconserved lung tissue). HCoV-OC43 was measured as non-infectious in cell culture, with a Ct value of 29.57. The detection of RSV and HCoV-OC43 infections may shed light on the relevance of respiratory viruses other than SARS-CoV-2 in postmortem settings; however, further, more extensive studies are needed for a robust assessment of the hazard potential due to infectious postmortem fluids and tissues in medicolegal autopsy settings.
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Euthanasie im Nationalsozialismus – Untersuchungen an drei Skeletten der Kriegsgräberstätte Idstein-Kalmenhof (Hessen). Rechtsmedizin (Berl) 2023. [DOI: 10.1007/s00194-022-00612-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Zusammenfassung
Hintergrund
Der Kalmenhof wurde 1888 vom „Verein für die Idiotenanstalt zu Idstein“ gegründet. Während der NS-Zeit wurden in der „Kinderfachabteilung“ hunderte Kinder und Jugendliche von Ärzten und Pflegern getötet.
Material und Methoden
Nachdem ein historisches Gutachten und Georadaruntersuchungen Hinweise auf Gräber außerhalb einer als Kriegsgräberstätte ausgewiesenen Fläche erbrachte, erfolgten im Sommer 2020 Grabungen.
Ergebnisse
Außerhalb der Kriegsgräberstätte fanden sich keine Gräber. Innerhalb des Areals wurde eine Mehrfachbestattung von drei Individuen in einer 160 × 65 cm großen Grube entdeckt. Die knöchernen Überreste wurden exhumiert und makroskopisch, radiologisch, toxikologisch und molekulargenetisch untersucht. Zwei Individuen waren männlich, das Sterbealter betrug etwa 2,0 bis 2,25 Jahre und 2,5 Jahre. Das dritte Individuum war eine Jugendliche, die Untersuchungen ihrer sterblichen Überreste erbrachten Hinweise auf wiederholte und längere Zeit bestehende Phasen mit unzureichender Nährstoffversorgung. An keinem der Individuen fanden sich Zeichen einer körperlichen Behinderung, prä- oder perimortale Verletzungen. Die toxikologischen Untersuchungen verliefen für alle Individuen negativ. Für die beiden kindlichen Skelette konnte ein vollständiges STR-Profil erstellt werden, an dem jugendlichen Skelett gelang lediglich eine Geschlechtsbestimmung.
Diskussion
Die Ergebnisse stützen historische Angaben, wonach Gräber mehrfach belegt wurden. Demgegenüber war eine Unterteilung des Friedhofes nach dem Sterbealter nicht nachvollziehbar, ebenso wenig, dass sich auf angrenzenden Grundstücken Gräber befinden. Durch die gewonnenen Erkenntnisse wurde ein konkreter Identitätsverdacht für die drei Individuen erarbeitet. Die knöchernen Überreste wurden am Volkstrauertag 2020 im Rahmen einer Gedenkveranstaltung wieder beigesetzt.
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Correction to: A guide to classify tattoo motives in Mexico as a tool to identify unknown bodies. Int J Legal Med 2022; 136:1517. [PMID: 35790538 PMCID: PMC9375737 DOI: 10.1007/s00414-022-02864-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Detection and infectivity of SARS-CoV-2 in exhumated corpses. Int J Legal Med 2021; 135:2531-2536. [PMID: 34302215 PMCID: PMC8302458 DOI: 10.1007/s00414-021-02670-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/13/2021] [Indexed: 12/19/2022]
Abstract
Postmortem detection of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) after the exhumation of a corpse can become important, e.g. in the case of subsequent medical malpractice allegations. To date, data on possible detection periods [e.g. by reverse transcription polymerase chain reaction (RT-PCR)] or on the potential infectivity of the virus after an exhumation are rare. In the present study, these parameters were examined in two cases with a time span of approximately 4 months between day of death and exhumation. Using SARS-CoV-2 RT-PCR on swabs of both lungs and the oropharynx detection was possible with cycle threshold (Ct) values of about 30 despite signs of beginning decay. RT-PCR testing of perioral and perinasal swabs and swabs collected from the inside of the body bag, taken to estimate the risk of infection of those involved in the exhumation, was negative. Cell culture-based infectivity testing was negative for both, lung and oropharyngeal swabs. In one case, RT-PCR testing at the day of death of an oropharyngeal swab showed almost identical Ct values as postmortem testing of an oropharyngeal swab, impressively demonstrating the stability of viral RNA in the intact corpse. However, favorable climatic conditions in the grave have to be taken into account, as it was wintertime with constant low temperatures. Nevertheless, it was possible to demonstrate successful postmortem detection of SARS-CoV-2 infection following exhumation even after months in an earth grave.
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Aspiration-related pneumonia after Taser exposure - A multiple causations mechanism. Forensic Sci Int 2021; 326:110906. [PMID: 34298206 DOI: 10.1016/j.forsciint.2021.110906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/17/2021] [Accepted: 07/11/2021] [Indexed: 11/23/2022]
Abstract
Arrest-related deaths in the context of Conducted Electrical Weapon (CEW) deployment are rare. The evaluation of such complex events is a challenge for the forensic scientist. We present a case of a 49-year old man, who was exposed to a Taser X26P during a confrontation with the police. He lost consciousness, vomited, aspirated and died after having been hospitalized for several days at the ICU. Based on the patient´s medical history, autopsy findings, witness testimonies, and reliable clinical and toxicological blood parameters, the most probable cause and mechanisms of his death are discussed. The present work demonstrates, based on one case report, the possibilities as well as limitations of forensic assessment in CEW-related deaths.
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Das Projekt rechtsmedizinische Leichenschau in Frankfurt am Main – Erste Leichenschau vs. Sektionsergebnisse. Rechtsmedizin (Berl) 2021. [DOI: 10.1007/s00194-021-00480-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Zusammenfassung
Hintergrund
In Frankfurt am Main (~750.000 Einwohner) wird die erste Leichenschau im Auftrag der Polizei tagsüber durch einen dafür eingerichteten rechtsmedizinischen Dienst vorgenommen. Nachts und am Wochenende führen diese Tätigkeit Ärzte des ärztlichen Bereitschaftsdienstes (ÄBD) der kassenärztlichen Vereinigung durch.
Material und Methoden
Für das Jahr 2019 wurden die im Rahmen dieser ersten Leichenschauen ausgestellten Leichenschauscheine hinsichtlich der attestierten Todesart ausgewertet und die Ergebnisse mit denen einer ggf. im Nachgang durchgeführten Sektion, inklusive Zusatzuntersuchungen, verglichen. Von den Ärzten des ÄBD konnten 461 Leichenschauen in die Auswertung eingeschlossen werden, davon erfolgte in 76 Fällen eine Obduktion. Im Nachgang der 364 rechtsmedizinischen Leichenschauen wurden 78 Obduktionen durchgeführt.
Ergebnisse
Veränderungen in der Todesart nach Sektion ergaben sich für die Leichenschauen des ÄBD in 57, bei den rechtsmedizinischen Leichenschauen in 49 Fällen, wobei insbesondere eine bei Leichenschau attestierte ungeklärte Todesart in einen natürlichen Tod spezifiziert werden konnte. Nach der Obduktion fanden sich bei den rechtsmedizinischen Leichenschauen 8 Fälle, bei denen des ÄBD 19 Fälle eines nichtnatürlichen (statt weiterhin ungeklärten) Todes. Bei den rechtsmedizinisch beschauten Fällen änderte sich zudem nach der Sektion in einem Fall die Todesart von natürlich zu nichtnatürlich, bei denen des ÄBD kam es in einem Fall zu einer Änderung von nichtnatürlich zu natürlich.
Diskussion
Die Veränderung bzw. Spezifizierung der Todesart nach der Sektion beider Kollektive verdeutlicht, wie wichtig eine Steigerung der Sektionsrate wäre, und dass auch bei professioneller Durchführung der Leichenschau das Erkennen der Todesart Probleme bereitet.
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Abstract
The duration of infectivity of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) in living patients has been demarcated. In contrast, a possible SARS-CoV-2 infectivity of corpses and subsequently its duration under post mortem circumstances remain to be elucidated. The aim of this study was to investigate the infectivity and its duration of deceased COVID-19 (coronavirus disease) patients. Four SARS-CoV-2 infected deceased patients were subjected to medicolegal autopsy. Post mortem intervals (PMI) of 1, 4, 9 and 17 days, respectively, were documented. During autopsy, swabs and organ samples were taken and examined by RT-qPCR (real-time reverse transcription-polymerase chain reaction) for the detection of SARS-CoV-2 ribonucleic acid (RNA). Determination of infectivity was performed by means of virus isolation in cell culture. In two cases, virus isolation was successful for swabs and tissue samples of the respiratory tract (PMI 4 and 17 days). The two infectious cases showed a shorter duration of COVID-19 until death than the two non-infectious cases (2 and 11 days, respectively, compared to > 19 days), which correlates with studies of living patients, in which infectivity could be narrowed to about 6 days before to 12 days after symptom onset. Most notably, infectivity was still present in one of the COVID-19 corpses after a post-mortem interval of 17 days and despite already visible signs of decomposition. To prevent SARS-CoV-2 infections in all professional groups involved in the handling and examination of COVID-19 corpses, adequate personal safety standards (reducing or avoiding aerosol formation and wearing FFP3 [filtering face piece class 3] masks) have to be enforced for routine procedures.
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Abstract
ZusammenfassungBei Suizidformen mit mehreren Suizidenten und Opfern werden teilweise in Literatur und Rechtsprechung eine unterschiedliche Nomenklatur und Interpretation der Begrifflichkeiten vorgenommen. Der Beitrag analysiert die Begrifflichkeiten und befasst sich im Speziellen mit dem Phänomen des Doppelsuizids. Historische Fälle von Doppelsuiziden werden angeführt. Anhand von Fallkonstellationen werden rechtliche Bewertungen vorgenommen, die beim einseitig fehlgeschlagenen Doppelsuizid praxisrelevant werden können. Dabei werden die mitunter konträren Auffassungen in der einschlägigen Literatur und der Rechtsprechung dargestellt und Lösungsansätze aufgezeigt. Zudem verdeutlichen die Fallkonstellationen die Relevanz einer umfassenden Tatortarbeit und einer tatnahen Klärung der Motivationslage bei dem Überlebenden bzw. den Verstorbenen.
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Befragung von Medizinstudierenden zu der ärztlichen Aufklärung und zu den ärztlichen Informationspflichten sowie zur medizinrechtlichen Ausbildung im Studium. Rechtsmedizin (Berl) 2020. [DOI: 10.1007/s00194-020-00421-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Zusammenfassung
Hintergrund
Mit dem Masterplan 2020 und den an mehreren Universitäten eingeführten Modellstudiengängen befindet sich das Medizinstudium aktuell im Umbruch. Sowohl im Regel- als auch im Modellstudiengang werden medizinrechtliche Aspekte überwiegend im Rahmen rechtsmedizinischer Ausbildungsabschnitte unterrichtet. Allerdings werden Studierende bereits während Famulaturen oder im praktischen Jahr mit juristischen Fragen konfrontiert.
Ziel der Studie war es herauszufinden, ob und in welchem Umfang Studierende der Humanmedizin insbesondere zur ärztlichen Aufklärung und zu den ärztlichen Informationspflichten bis zum Beginn des 4. bzw. 5. klinischen Semesters auf medizinrechtliche Aspekte vorbereitet wurden, und ob Verbesserungen bei der medizinrechtlichen Lehre gewünscht werden.
Material und Methoden
Zwischen den Sommersemestern 2017 und 2019 wurde zu Beginn des Kurses für Rechtsmedizin eine quantitative, standardisierte Umfrage mit insgesamt 373 Studierenden durchgeführt.
Ergebnisse
Wenngleich 98,8 % der Studierenden angaben, Aufklärungsgespräche bereits (mehrfach) praktisch ausgeübt zu haben, bestanden deutliche Defizite in Bezug auf die juristischen Anforderungen an das ärztliche Aufklärungsgespräch und dessen Delegation. So gaben lediglich 5,1 % der Studierenden an, die rechtlichen Grundlagen der ärztlichen Aufklärung sowie die entsprechende Norm aus dem Zivilrecht zu kennen. Über 80 % der Befragten fühlten sich unzureichend auf die rechtlichen Aspekte des praktischen Jahres vorbereitet. Über 90 % der Studierenden wünschten sich eine bessere medizinrechtliche Ausbildung.
Diskussion
Eine fächerübergreifende Etablierung sowie eine über das gesamte Studium verteilte Lehre von Medizinrecht könnte die Vorbereitung auf das praktische Jahr verbessern und das Verständnis für die rechtlichen Anforderungen an die ärztliche Berufstätigkeit fördern. Nach dem derzeitigen Stand der Umsetzung des Masterplans 2020 soll das Medizinrecht in der Learning Opportunities, Objectives and Outcomes Platform (LOOOP) als verbindlicher Ausbildungs- und Lehrinhalt etabliert werden.
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Death abroad: Medico-legal autopsy results of repatriated corpses: A retrospective analysis of cases at the Department of Legal Medicine in Frankfurt am Main. Forensic Sci Int 2020; 310:110257. [PMID: 32224431 DOI: 10.1016/j.forsciint.2020.110257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 03/01/2020] [Accepted: 03/12/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Repatriated corpses may have been autopsied abroad. The aim of the study was to compare the findings from second medico-legal autopsies with those from primary autopsies abroad to spotlight possible implications for the management of repatriated corpses. MATERIAL AND METHODS All autopsies from a 20-year period at the Institute of Legal Medicine in Frankfurt am Main on repatriated corpses of German citizens were reviewed. The results were compared with the information from the body passports, the protocols of the autopsies in the country of death, and the police files. RESULTS In total, 151 corpses repatriated from 56 different countries were autopsied. The interval between death and autopsy in Germany was 2-603 days (median: 11 days). 91 of the repatriated corpses (59.5%) had previously been autopsied abroad. Three body cavities had been opened in 78.0% (71/91) of the original autopsies; among them, there were 11 cases (15.5%) with dissection of all organs, as opposed to 7 cases (9.9%) with all organs intact and in situ. Of the previously autopsied corpses, 62.6% were accompanied by a body passport that noted the cause of death. In nearly 75% of these cases, the stated cause of death was compatible with that established at second autopsy. In 5 cases (10.2%), the cause of death established in the second autopsy disagreed with that on the body passport. The most prominent disparity was a cranial gunshot wound rather than the stated fatal fall. DISCUSSION This analysis of individual cases spotlights the problematics of an uncritical approval of the body passport. In light of the different procedural autopsy standards around the world, the validity of an autopsy abroad is discussed in the context of the second autopsy results. CONCLUSION A second external postmortem examination by qualified medical practitioners should be obligatory in all cases of repatriated corpses, with notification of the criminal police in all cases of non-natural or undetermined death. A timely second autopsy is recommended even in cases with previous autopsy abroad.
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Religious denomination influencing attitudes towards brain death, organ transplantation and autopsy—a survey among people of different religions. Int J Legal Med 2019; 134:1203-1212. [DOI: 10.1007/s00414-019-02130-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 07/26/2019] [Indexed: 10/26/2022]
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Lochfrakturen der Schädelbasis durch dislozierte Mandibulaköpfchen. Rechtsmedizin (Berl) 2019. [DOI: 10.1007/s00194-019-0326-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Trisomy 21 in forensic autopsies: Review of a 20-year period. Forensic Sci Int 2019; 297:302-306. [PMID: 30852413 DOI: 10.1016/j.forsciint.2019.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 01/27/2019] [Accepted: 02/12/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Trisomy 21 is the most common human chromosomal abnormality. Its manifestation includes intellectual impairment and more or less typical anatomical malformations and functional deficiencies that can cause sudden or unexpected deaths. Typical medicolegal questions at autopsy are related to medical malpractice, improper care, neglect, or abuse, and, depending on the cause of death, whether the death might have been avoidable. The aim of this study was to examine whether the causes of death in individuals with trisomy 21 were linked to the known health risks for this condition and to consider how these deaths might have been prevented. MATERIAL AND METHODS A retrospective study was performed at the Institutes for Legal Medicine in Giessen and Frankfurt am Main, Hesse, Germany. All records for forensic autopsy cases within a 20-year period from 1998 to 2017 were reviewed for the diagnosis trisomy 21", respectively, "Down's syndrome". RESULTS Twenty-three cases complied with the inclusion criteria trisomy 21 and autopsy. The age of the deceased ranged from 23 days to 61 years. Infectious diseases, mainly respiratory, were the leading cause of death, followed by accidental deaths. CONCLUSION The medicolegal relevance of the known health risks in Down's syndrome could be illustrated by the autopsy findings and the results of the additional examinations. The known high susceptibility to infections, with an increased risk of a rapid course and lethal outcome, in individuals with Down's syndrome could be confirmed in our study. A sound knowledge of the risks and abnormalities associated with trisomy 21 are helpful in medicolegal assessments, particularly, in relation to medical malpractice charges.
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Beneath cover-up tattoos: possibilities and limitations of various photographic techniques. Int J Legal Med 2019; 134:697-701. [PMID: 30706194 DOI: 10.1007/s00414-019-02007-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND The goal of this study was to investigate the usefulness of various photographic techniques in visualizing previous tattoos under cover-up tattoos. MATERIAL AND METHODS Ten volunteers with 11 known cover-up tattoos were examined using different photographic techniques: A Canon EOS 6D full-frame digital single-lens reflex camera used in conjunction with a SB600 off-camera flash system and an extension cord; and a Leica M8 digital imaging system camera in conjunction with two different infrared filters (715 nm and 850 nm) and a Metz CL-45 handle-mount flash. A Lumatec Superlite 400 forensic light source was used along with the Canon EOS 6D as a third system. RESULTS The best results for black cover-up tattoos were achieved with the full-frame digital single-lens reflex camera in conjunction with the off-camera flash system and, for colored cover-up tattoos, with IR-photography at a wavelength of 850 nm. The Lumatec Superlite 400 light source did not provide better results for conventional photography than those obtained with flash lighting. DISCUSSION In nine out of eleven cover-up tattoos, the previous tattoos could, at least, be partially visualized. The quality of the visualization depended on the color, pattern, density, and quality of the cover-up tattoo as well as on the photographic technique. None of the examined photographic techniques could satisfactorily image the previous tattoo if the cover-up tattoo was large and black, especially not if it was densely inked. CONCLUSION Depending on the color of the cover-up tattoo, a full-frame digital single-lens reflex camera in conjunction with a SB600 off-camera flash system (for black cover-ups) or infrared photography with flash lighting and an 850 nm filter (for colored cover-ups) proved to be the best of the investigated techniques to visualize a previous tattoo under a cover-up tattoo.
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Huhn oder Ei – Brustwanddefekt als Ursache oder Folge der Reanimationsversuche? Rechtsmedizin (Berl) 2018. [DOI: 10.1007/s00194-018-0288-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Minimum time since death when the body has either reached or closely approximated equilibrium with ambient temperature. Forensic Sci Int 2017; 281:63-66. [PMID: 29102846 DOI: 10.1016/j.forsciint.2017.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 09/05/2017] [Accepted: 09/12/2017] [Indexed: 11/16/2022]
Abstract
In temperature based death time estimation the construction of a death time interval using the conventional Nomogram method (NM) is not permissible for bodies in which rectal temperature (Tr) has reached or closely approximated equilibrium with ambient temperature (Ta). We provide a logic approach to compute a minimum time since death with high probability. We also provide a simple graphical solution to be used at the crime scene for preliminary estimation. Special attention is advised in regards to cases with Ta>23°C as well as borderline cases. Proof by induction, application to test cases and one example of use are presented.
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Tod im Schwimmbad. Rechtsmedizin (Berl) 2017. [DOI: 10.1007/s00194-016-0143-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Of pigs and men—comparing the development of Calliphora vicina (Diptera: Calliphoridae) on human and porcine tissue. Int J Legal Med 2016; 131:847-853. [DOI: 10.1007/s00414-016-1487-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 10/20/2016] [Indexed: 12/11/2022]
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Der (Hirn-)Tod und seine Feststellung. Rechtsmedizin (Berl) 2016. [DOI: 10.1007/s00194-016-0097-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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30
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Studien und statistische Ergebnisse in der Forensik. Rechtsmedizin (Berl) 2016. [DOI: 10.1007/s00194-015-0063-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Renaissance of criticism on the concept of brain death--the role of legal medicine in the context of the interdisciplinary discussion. Int J Legal Med 2015; 130:587-95. [PMID: 26174445 DOI: 10.1007/s00414-015-1224-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 06/22/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND In the practice of legal medicine in Germany, the assessment of brain death is of minor importance and attracts little attention. However, since several years, international criticism on the concept of brain death has culminated. By reviewing literature and the results of a questionnaire distributed among the participants of the 93rd Annual Congress of the Germany Society of Legal Medicine, the state of knowledge and the current views on brain death were evaluated. MATERIALS AND METHODS Literature search of recent publications regarding brain death was performed (PubMed database, references of legal medicine, Report of the President's Council on Bioethics, USA 2008). A questionnaire was developed and distributed among the participants of the Congress. RESULTS The assumption that individual and brain death are synonymous is criticized. Internationally, there are trends to harmonize the very different clinical criteria to assess brain death. The diagnostic advantage of novel techniques such as CT angiography is controversially discussed. It becomes apparent that procedures which record the blood flow and perfusion of the brain will be applied more in the future. Regrettably, these developments are not described in the literature of legal medicine. Moreover, among German forensic scientists, different views concerning brain death exist. The majority favors its equivalent treatment with individual death. The thanatological background can be improved concerning certain aspects of brain death as well as its legal implications. CONCLUSION Teaching and research in legal medicine should include the subject brain death. Expertise in forensic science may contribute to the interdisciplinary discussion on brain death. The transfer of actual knowledge, also on disputed ethical aspects of thanatology, to physicians of all disciplines is of great importance.
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De novo transcriptome analysis and highly sensitive digital gene expression profiling of Calliphora vicina (Diptera: Calliphoridae) pupae using MACE (Massive Analysis of cDNA Ends). Forensic Sci Int Genet 2014; 15:137-46. [PMID: 25468442 DOI: 10.1016/j.fsigen.2014.11.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 11/10/2014] [Accepted: 11/11/2014] [Indexed: 11/17/2022]
Abstract
Determining a post-mortem interval using the weight or length of blow fly larvae to calculate the insect's age is well established. However, to date, there are only a handful studies dealing with age estimation of blow fly pupae, in which weight or length cannot be used as a relevant parameter. The analysis of genetic markers, which indicate a certain developmental stage, can extend the period for a successful post-mortem interval determination. In order to break new ground in the field of age determination of forensic relevant blow flies, we performed a de novo transcriptome analysis of Calliphora vicina pupae at 15 different developmental stages. Obtained data serve as base to establish molecular age determination techniques. We used a new, deeper, and more cost-effective digital gene expression profiling method called MACE (Massive Analysis of cDNA Ends). We generated 15 libraries out of 15 developmental stages, with 3-8 million reads per library. In total, 53,539 distinct transcripts were detected, and 7548 were annotated to known insect genes. The analysis provides high-resolution gene expression profiles of all covered transcripts, which were used to identify differentially expressed genetic markers as candidates for a molecular age estimation of C. vicina pupae. Moreover, the analysis allows insights into gene activity of pupal development and the relationship between different genes interesting for insect development in general.
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Contrast enhancement using curd and contrast agent mixtures for ex vivo vessel imaging in computed tomography. ROFO-FORTSCHR RONTG 2014; 186:959-61. [PMID: 24648237 DOI: 10.1055/s-0034-1366098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We describe a cheap and efficient method for filling the vascular space of ex vivo tissue samples with a radiopaque material that can be used in computed tomography imaging. The filling material consists of curd, water, and a radiological contrast agent. Viscosity ranges and the degree of attenuation of X-rays of the filling material can be easily adjusted to the requirements of a specific application. The method is non-destructive and without negative effects on subsequent histological examinations.
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Forensische Bildgebung. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/978-3-642-55022-5_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kindesmisshandlung. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/978-3-642-55022-5_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Medizinrecht. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/978-3-642-55022-5_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Spezielle Fallkonstellationen bei natürlichen, unklaren und nichtnatürlichen Todesfällen. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/978-3-642-55022-5_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Forensische DNA-Analyse. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/978-3-642-55022-5_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Identifizierung. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/978-3-642-55022-5_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Obduktion (Sektion, Autopsie, innere Leichenschau). Rechtsmedizin (Berl) 2014. [DOI: 10.1007/978-3-642-55022-5_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kindesmissbrauch. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/978-3-642-55022-5_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Forensische Osteologie. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/978-3-642-55022-5_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Einleitung. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/978-3-642-55022-5_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tod im Wasser. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/978-3-642-55022-5_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Charakterisierung von geschlechtsspezifischen Strukturunterschieden in der menschlichen Kalotte zur Altersschätzung mit hochauflösendem Flat-Panel CT und fraktaler Geometrie. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Forensische Osteologie. Rechtsmedizin (Berl) 2011. [DOI: 10.1007/978-3-642-16651-8_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Forensische Psychopathologie. Rechtsmedizin (Berl) 2011. [DOI: 10.1007/978-3-642-16651-8_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Einleitung. Rechtsmedizin (Berl) 2011. [DOI: 10.1007/978-3-642-16651-8_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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50
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Kindesmissbrauch. Rechtsmedizin (Berl) 2011. [DOI: 10.1007/978-3-642-16651-8_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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