| 1. |
- Ahlm, Kristin, et al.
(författare)
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Blood loss in exsanguination deaths
- 2011
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Ingår i: Indian Journal of Forensic Medicine & Toxicology. - 0973-9122. ; 5:2, s. 5-8
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Tidskriftsartikel (refereegranskat)abstract
- Deaths by exsanguination among various underlying causes of death were analyzed in order to expand the knowledge on the relation of extravasated blood volume to other documented parameters. A consecutive series of 193 cases of ruptured thoracic aortic aneurysm (n=13), gunshot wounds (n=63), stab wounds (n=28), rib fractures (n=5), and blunt injury to thoracic aorta (n=84) were investigated. The amount of internal bleeding into pleural cavities only varied greatly (200-3,400 ml) with a mean value of 1,174 ml, slightly higher among males. Age, body weight, cause and manner of death, external bleeding, alcohol inebriation, multiplicity of injuries, and degree of coronary heart disease did not significantly affect the amount of internal (pleural) bleeding. Also, post-mortem delay to autopsy did not correlated to the amount of extravasated blood, indicating that post-mortem bleeding is of no importance in these days.
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| 2. |
- Ahlm, Kristin, et al.
(författare)
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Driver's alcohol and passenger's death in motor vehicle crashes
- 2006
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Ingår i: Traffic Injury Prevention. - : Taylor & Francis. - 1538-9588 .- 1538-957X. ; 7:3, s. 219-223
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Previous studies on alcohol involvement associated with fatal injury in traffic crashes have focused on the drivers, but the passenger's view is not well known. This study (1) analyzes the relationship between passenger's death and alcohol inebriation of the driver and (2) estimates the role of alcohol as the cause of a crash by examining who was at fault, sober, or inebriated.METHOD: The study includes all motor vehicle passengers (n = 420) who died in crashes in Sweden 1993 through 1996 and were medicolegally autopsied. Autopsy reports from the Departments of Forensic Medicine, including toxicological analyses, and police reports were studied. Presence of alcohol among drivers was based on blood and breath tests.RESULTS: One-fifth of the fatally injured passengers and one-fifth of the tested drivers were under the influence of alcohol. The youngest drivers had the highest prevalence of drunken driving. Drivers at fault were alcohol positive in 21% of these crashes and drivers were not at fault in 2% of these crashes. In 53% of the crashes where both the passenger and driver were alcohol positive, the passenger had a lower alcohol concentration than the driver. Children (<16 years) comprised 15% of the killed passengers. Notably, the children were riding with a driver who was under influence of alcohol in 13% of these crashes. Alcohol involvement was not tested in half of the surviving drivers.CONCLUSIONS: The data show that 20% of both passengers and drivers were under the influence of alcohol. Increased testing of surviving drivers regarding alcohol and other drugs is recommended.
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| 3. |
- Ahlm, Kristin, et al.
(författare)
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Unnatural deaths in reindeer-herding Sami families in Sweden, 1961-2001
- 2010
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Ingår i: International Journal of Circumpolar Health. - 1239-9736 .- 2242-3982. ; 69:2, s. 129-137
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Unnatural deaths among Indigenous populations, including the Swedish Sami, occur more often than among the general population. To find prevention strategies, we explored the circumstances of the unnatural deaths of members of reindeer-herding Sami families.STUDY DESIGN: The number of deaths from among a cohort of 7,482 members of reindeer-herding Sami families were retrieved from the National Board of Health and Welfare for the years 1961- 2001.METHODS: An evaluation of the information from autopsy records at the National Board of Forensic Medicine, police reports, and available medical records identified 158 unnatural deaths. These were then analysed in detail.RESULTS: Transport-related deaths and suicides were the most common unnatural deaths among Swedish reindeer-herding Sami family members. Suicides contributed to 23% of all deaths, road traffic accidents to 16%, and snowmobile fatalities to 11%. The accidents generally reflected an "outdoor lifestyle" and the working conditions were characterized by the use of off-road vehicles such as snowmobiles. Half of the number of victims tested positive for alcohol and alcohol abuse was documented in 15% of all victims.CONCLUSIONS: The results indicate that alcohol is an important factor in preventing unnatural deaths among reindeer-herding Sami, together with increased safety of both on-road and off-road transportation.
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| 4. |
- Beer, Torfinn, 1992-
(författare)
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An epidemiological perspective on heart and lung weight in cardiac and intoxication deaths
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main purpose of a medico-legal autopsy is to determine the cause and manner of death. A forensic pathologist makes assessments of this using several sources of information, one of which is the discrepancy between measured organ weight and reference values. Of particular interest is the heart weight in heart disease and the weight of the lungs in fatal intoxications. In this thesis, a linear model of lung weight was created, but the model could at best explain only 13% of the variation in combined lung weight (Paper I). Unsurprisingly, this meant that the model was a poor definition of “normal” lung weight and could not be used to identify intoxication cases (Paper II). A ratio of lung weight to heart weight (LWHW ratio) also failed to differentiate intoxication cases from controls. The poor performance of these methods could plausibly have been due to fatal intoxications with only some substances being associated with increased lung weight, but an analysis showed that many common intoxicants were associated with heavier lungs than hanging deaths (Paper III). To establish heart weight references more applicable in a medico-legal autopsy population, a model of heart weight accounting for undiagnosed cardiac hypertrophy was created (Paper IV). The model showed that for a decedent of average the evidence that a was hypertrophic reached, substantial support at around 470 g.In conclusion, a definition of “heavy lungs” remains elusive. However, it seems to be a finding compatible with fatal intoxications with many substances and the low predictive value found may be due to study design. The heart weight model presented allows pathologists to assess the evidence of cardiac hypertrophy more easily than previously published models.
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| 5. |
- Beer, Torfinn, et al.
(författare)
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Cardiac enlargement in a medicolegal autopsy setting
- 2023
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Ingår i: American Journal of Forensic Medicine and Pathology. - : Wolters Kluwer. - 0195-7910 .- 1533-404X. ; 44:4, s. 267-272
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Tidskriftsartikel (refereegranskat)abstract
- A key element for diagnosing cardiac enlargement in an autopsy setting is relevant heart weight references. However, most available references are to a large extent not representative of a medicolegal autopsy population, implying that reference weights are likely lower than those in the relevant population.To establish more applicable heart weight references in a medicolegal autopsy population, we designed a heart weight model that accounts for undiagnosed cardiac enlargement using data from 11,897 nontraumatic Swedish medicolegal autopsy cases autopsied between 2010 and 2019. The model was validated in 296 nonobese young adult suicidal hanging cases.For a decedent of average height (174 cm), the evidence that a heart weight was enlarged reached weak support at approximately 430 g, substantial support at approximately 480 g, and strong support at 520 g. The modeled prevalence of cardiac enlargement was very high among elderly and obese decedents.We believe that our model is more applicable in a medicolegal setting than those previously published. The presented quantification of the degree of uncertainty regarding diagnosis can help the pathologist in diagnosing cardiac enlargement. To facilitate the use of this model, we also made it available through a simple online tool (https://formedum.shinyapps.io/HeartWeightCalc/).
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| 6. |
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| 7. |
- Beer, Torfinn, et al.
(författare)
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Increased lung weight in fatal intoxications is not unique to opioid drugs
- 2023
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Ingår i: Journal of Forensic Sciences. - : John Wiley & Sons. - 0022-1198 .- 1556-4029. ; 68:2, s. 518-523
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Tidskriftsartikel (refereegranskat)abstract
- Fatal intoxications with opioids are known to be associated with an increased lung weight, as well as with brain and pulmonary edema and urinary retention. However, there is evidence to suggest that fatal intoxications with non-opioid substances are also associated with increased lung weight; however, the latter aspect has not been comprehensively analyzed. To determine to what extent opioid and non-opioid substances are associated with increased lung and brain weight, we studied these organs in cases where the cause of death was attributed to intoxication with a single agent. Using data from cases autopsied at the National Board of Forensic Medicine (NBFM) in Sweden from 2009 through 2019 where the cause of death was attributed to a single substance, we created models of combined lung weight and brain weight. The models used age and sex as predictors as well as nested varying effects for the specific intoxicant and category of intoxicant. Suicidal hanging with negative toxicology cases served as controls. The population majority was male among both intoxications (68%) and controls (83%). The most common single substance group was opioids. All tested substances were associated with heavier lungs than controls, with the largest effect in the opioid group. Our findings show that several substances are associated with increased lung weight and that among intoxication deaths there is no difference in expected brain weight between substances. Hence, heavy lungs, without a reasonable explanation, should prompt a broad toxicological screening.
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| 8. |
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| 9. |
- Behndig, Anders, et al.
(författare)
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Evaluation of surgical performance with intracameral mydriatics in phacoemulsification surgery.
- 2004
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Ingår i: Acta Ophthalmologica Scandinavica. - : Wiley. - 1395-3907 .- 1600-0420. ; 82:2, s. 144-147
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate surgical performance using intracameral mydriatics (ICM) in phacoemulsification surgery in a series of consecutive cases. METHODS: In a series of 198 consecutive procedures 50-200 microl of cyclopentolate 0.1%, phenylephrine 1.5% and lidocaine 1% was given intracamerally for mydriasis and anaesthesia. The previous 198 cases, dilated with topical mydriatics, were studied for comparison. Several pre- intra- and postoperative parameters were registered, and the subjective surgical performance was graded after each procedure. In 41 consecutive cases, the change in pulse and oxygen saturation induced by the ICM injection was registered. RESULTS: No increase in operation time or complication rates was seen with ICM, compared to when standard topical mydriatics were used. The subjective surgical performance was ranked as equally good for both groups. CONCLUSION: From this clinical evaluation, our impression is that ICM performs well in routine phacoemulsification surgery.
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| 10. |
- Bergman, Sofia, 1991-, et al.
(författare)
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Flow directions of low-energy ions in and around the diamagnetic cavity of comet 67P
- 2021
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Ingår i: Monthly notices of the Royal Astronomical Society. - : Oxford University Press. - 0035-8711 .- 1365-2966. ; 507:4, s. 4900-4913
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Tidskriftsartikel (refereegranskat)abstract
- The flow direction of low-energy ions around comet 67P/Churyumov–Gerasimenko has previously been difficult to constrain due to the influence of the spacecraft potential. The Ion Composition Analyzer of the Rosetta Plasma Consortium (RPC-ICA) on Rosetta measured the distribution function of positive ions with energies down to just a few eV/q throughout the escort phase ofthe mission. Unfortunately, the substantial negative spacecraft potential distorted the directional information of the low-energy data. In this work, we present the flow directions of low-energy ions around comet 67P, corrected for the spacecraft potential using Particle-In-Cell simulation results. We focus on the region in and around the diamagnetic cavity, where low-energy ions are especially important for the dynamics. We separate between slightly accelerated ‘burst’ features and a more constant ‘band’ of low-energy ions visible in the data. The ‘bursts’ are flowing radially outwards from the nucleus with an antisunward component while the ‘band’ is predominantly streaming back towards the comet. This provides evidence of counter-streaming ions, which has implications for the overall expansion velocity of the ions. The backstreaming ions are present also at times when the diamagnetic cavity was not detected, indicating that the process accelerating the ions back towards the comet is not connected to the cavity boundary.
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