| 1. |
- Guggenheimer, Denise, et al.
(författare)
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Criminal mutilation in Sweden from 1991 to 2017
- 2021
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Ingår i: Journal of Forensic Sciences. - : John Wiley & Sons. - 0022-1198 .- 1556-4029. ; 66:5, s. 1788-1796
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Tidskriftsartikel (refereegranskat)abstract
- We identified 43 cases of mutilation homicides in a nationwide population-based study in Sweden during the period of 1991-2017. 70% of cases were classified as defensive mutilations where the main motive was disposal of the body, while 30% were classified as offensive, that is, due to an expression of strong aggression, necro-/sexual sadism, or psychiatric illness. In comparison with a previous study covering mutilation homicides in Sweden between 1961 and 1990, we noted an increase in incidence. The percentage of cases involving mutilation had increased from 0.5% of all homicides in the 1960s to 2.4% in the 2010s. The most common cause of death was sharp force, but in 28% of the cases, the cause of death could not be determined. The clearance rate in cases of mutilation homicide was 67%, and in a large majority of the cases, the offender was known to the victim. With regards to gender women made up 44% of the victims, whilst men constituted 56% of the victims and a total of 95% of the offenders. Half of the offenders had a personality disorder, however, only 13% were sentenced to forensic psychiatric care.
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| 2. |
- Walz, Lotta, et al.
(författare)
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Risk Factors for Fatal Hyperglycaemia Confirmed by Forensic Postmortem Examination - A Nationwide Cohort in Sweden
- 2016
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 11:10, s. e0164950-
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Tidskriftsartikel (refereegranskat)abstract
- Aims/Hypothesis The aim of this study was to identify risk factors associated with confirmed fatal hyperglycaemia, which could predispose potentially preventable deaths in individuals on glucose lowering drugs. Methods A retrospective register-based case-control study conducted on a nationwide cohort with individuals who died due to hyperglycaemia as determined by forensic postmortem examination, in Sweden August 2006 to December 2012. Vitreous glucose was used to diagnose hyperglycaemia postmortem. The forensic findings stored in the National Forensic Medicine Database were linked to nationwide registers. Cases that died due to confirmed hyperglycemia with dispensed glucose lowering drugs were identified and living controls with dispensed glucose lowering drugs were randomly selected in the Swedish prescribed drug register and matched on age and sex. Information on comorbidities, dispensed pharmaceuticals, clinical data and socioeconomic factors were obtained for cases and controls. Adjusted multiple logistic regression models were used to identify risk factors associated with fatal hyperglycaemia. Results During the study period 322 individuals, mostly males (79%) with the mean age of 53.9 years (SD. +/- 14) died due to confirmed hyperglycaemia. Risk factors for fatal hyperglycaemia included; insulin treatment (OR = 4.40; 95% CI, 1.96, 9.85), poor glycaemic control (OR = 2.00 95% CI, 1.23, 3.27), inadequate refill-adherence before death (OR = 3.87; 95% CI, 1.99, 7.53), microvascular disease (OR = 3.26; 95% CI, 1.84, 5.79), psychiatric illness (OR = 2.30; 95% CI, 1.32, 4.01), substance abuse (OR = 8.85; 95% CI, 2.34, 35.0) and/or living alone (OR = 2.25; 95% CI, 1.21, 4.18). Conclusions/ Interpretation Our results demonstrate the importance of clinical attention to poor glycaemic control in subjects with psychosocial problems since it may indicate serious non-adherence, which consequently could lead to fatal hyperglycaemia.
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| 3. |
- Zilg, Brita, et al.
(författare)
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A Rapid Method for Postmortem Vitreous Chemistry - Deadside Analysis
- 2022
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Ingår i: Biomolecules. - : MDPI. - 2218-273X. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Vitreous fluid is commonly collected for toxicological analysis during forensic postmortem investigations. Vitreous fluid is also often analyzed for potassium, sodium, chloride and glucose for estimation of time since death, and for the evaluation of electrolyte imbalances and hyperglycemia, respectively. Obtaining such results in the early phase of a death investigation is desirable both in regard to assisting the police and in the decision-making prior to the autopsy. We analyzed vitreous fluid with blood gas instruments to evaluate/examine the possible impact of different sampling and pre-analytical treatment. We found that samples from the right and left eye, the center of the eye as well as whole vitreous samples gave similar results. We also found imprecision to be very low and that centrifugation and dilution were not necessary when analyzing vitreous samples with blood gas instruments. Similar results were obtained when analyzing the same samples with a regular multi-analysis instrument, but we found that such instruments could require dilution of samples with high viscosity, and that such dilution might impact measurement accuracy. In conclusion, using a blood gas instrument, the analysis of postmortem vitreous fluid for electrolytes and glucose without sample pretreatment produces rapid and reliable results.
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| 4. |
- Zilg, Brita
(författare)
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Postmortem analyses of vitreous fluid
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The identification of various various medical conditions postmortem is often difficult. Results from analysis of postmortem blood and urine samples are not as appropriate as in living subjects, due to bacterial contamination and postmortem cell degradation. Therefore, vitreous humour – the fluid in the eyeball – has been of substantial value in forensic pathology. Vitreous fluid is easily collected, isolated, and almost bacteria- and cell free, and shows relatively stable conditions after death, making it a better matrix for postmortem biochemical analyses than e.g. blood and serum. Although postmortem analyses of vitreous fluid have been studied quite extensively, there are still many unanswered questions. Vitreous fluid from over 3,000 deceased subjects were consecutively collected and analysed for glucose, lactate, pH, electrolytes and gas pressures. Paper I focuses on the postmortem diagnosis of hyperglycemia. We show that vitreous glucose levels decrease the first 12-24 hours after death and are relatively stable after that. We also suggest that lactate should not be used to diagnose antemortem hyperglycemia, due to massive lactate increase from other sources – instead, glucose alone should be used. A vitreous glucose level of 10 mmol/L indicates severe antemortem hyperglycemia. In paper II, we studied the postmortem increase in vitreous potassium levels, which can be used to estimate the time of death. Our results show that postmortem potassium levels are affected by the surrounding temperature and the age of the deceased. We have developed a new equation for the estimation of the time of death that includes potassium, surrounding temperature and decedent age. To facilitate the calculation for the user, we have developed a web application. Paper III deals with the interpretation of postmortem vitreous sodium and chloride levels. We show that vitreous sodium and chloride levels slowly decrease with time of death. Postmortem vitreous sodium and chloride levels correlate well with antemortem serum sodium and chloride levels if corrected for time since death, and may be used to diagnose various antemortem sodium/chloride imbalances, such as dehydration or water intoxication. Sodium imbalances in cases of drownings are most likely due to postmortem diffusion between water and vitreous, rather than the drowning process.
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