Forensic science international
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The international medical literature described sporadical cases of an exceptional event called the "Lazarus phenomenon". This is the spontaneous reviviscence of an individual after a long time of asystolia following a cardiac accident depending on different pathogenesis (i.e. arrhythmia, ischaemic stroke, haemorrhage, brainstem death). ⋯ We report the case of an 81-year-old woman who experienced a cardiac accident on the street. Once the cardiopulmonary resuscitation was interrupted, the patient presented life activities after some minutes.
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A zero-concentration limit for controlled scheduled drugs in the blood of motorists was introduced in Sweden in 1999 and the annual number of arrests for driving under the influence of drugs (DUID) has since increased eight-fold. However, for prescription drugs that might cause impairment (e.g. benzodiazepines) additional proof is needed to justify prosecution, such as whether the medication was being misused. Over a 2-year period, we found 94 cases of DUID in which the concentrations of diazepam in blood was 1.1 microg/g or more. ⋯ Other psychoactive prescription drugs were identified in blood including alprazolam, flunitrazepam, oxazepam, zolpidem and zopiclone. This case series of DUID suspects demonstrate the high frequency of polydrug use showing preference for illicit drugs like amphetamine, cannabis and heroin, in that order. Furthermore, Swedish traffic delinquents frequently overdose with prescription drugs as exemplified here by unusually high concentrations of D and its active metabolite ND.
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Delta9-Tetrahydrocannabinol (THC) and 11-nor-Delta9-tetrahydrocannabinol-9-carboxylic acid (THCA) are equally used to indicate consumption of cannabis (hashish and marijuana). Publications of the early 90's demonstrate the possibilities of determining THC, cannabinol (CBN), and cannabidiol (CBD). All these substances are present in cannabis smoke and can be incorporated into the hair only by contamination. ⋯ Thirteen were negative for THC and positive for THCA, and six were positive for THC but negative for THCA. The cases were selected by an ELISA test or re-examined when the blood/urine results or the statement of the accused did not match with a THC outcome. The most appropriate strategy to prove cannabis consumption is immunochemical initial test followed by a GC/MS/MS confirmation of THCA.
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Historical Article
Textbooks on legal medicine in the German-speaking countries.
In this survey, the textbooks on legal medicine which were published in the German-speaking countries from the 17th century up to now are briefly reviewed. The textbooks with the most impact on the further development of legal medicines were those published by Johann Ludwig Casper in Berlin and Eduard Ritter von Hofmann in Vienna in the 19th century. The main textbooks of the 20th century are addressed as well, also the different development in both German countries.
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Historical Article
Malpractice--role of the forensic pathologist in Germany.
Medicolegal malpractice assessments have been an important part of the work of forensic pathologists. Not only botchers are concerned but also physicians of all clinical subjects, especially malpractice charges claiming a malpractice leading to death. ⋯ After World War II systematic studies of malpractice charges first were published in the 1960s. Meanwhile the attention focuses more and more on the role of forensic pathologists to help in prevention of malpractice.