Pub Date : 2023-06-28DOI: 10.1007/s00194-023-00635-y
N. Eckardt, F. Schwarz, M. Hubig, G. Mall, H. Muggenthaler
Abstract Background Generally, disc changes are of degenerative origin and develop over a longer time span. Accidental incidents with isolated traumatic disc ruptures are rare events; however, occupants involved in low velocity accidents often claim a causal relationship between disc changes and accidents. In forensic casework the adequacy of the biomechanical load to cause traumatic disc rupture has to be assessed. Objective Based on patient data we addressed the following issues: – Do traumatic cervical disc rupture occur in low velocity accidents? – Are there always accompanying injuries in neuroradiological imaging? – What are the main injury mechanisms? Methods In this study we analyzed cases of traumatic disc ruptures without other severe injuries in patients who underwent surgical treatment between 2010 and 2021. The purpose was to identify cases with traumatic disc ruptures following low velocity scenarios. The sample contained 16 cases with the main diagnosis of traumatic cervical disc rupture. Results Falls caused traumatic disc rupture in 14 of the cases, while traffic accidents caused disc injury in 2 cases only. Radiological signs of acute trauma as well as sensorimotor deficits or pain were present in every case. Of the patients six did not sustain accompanying fractures. In the majority of cases a hyperextension mechanism was assumed, even though an exact reconstruction of the load was not possible in every case. Conclusion This study renders traumatic genesis of a disc rupture highly unlikely in patients involved in low velocity scenarios. Medical imaging without accompanying injuries or signs of acute trauma, e.g., in terms of bleeding, bony or ligamentous lesions, supports a non-accidental cause of disc changes. Nevertheless, expert opinions require case by case evaluation taking account of patient-specific and case-specific conditions.
{"title":"Traumatischer zervikaler Bandscheibenvorfall nach Niedriggeschwindigkeitsunfall?","authors":"N. Eckardt, F. Schwarz, M. Hubig, G. Mall, H. Muggenthaler","doi":"10.1007/s00194-023-00635-y","DOIUrl":"https://doi.org/10.1007/s00194-023-00635-y","url":null,"abstract":"Abstract Background Generally, disc changes are of degenerative origin and develop over a longer time span. Accidental incidents with isolated traumatic disc ruptures are rare events; however, occupants involved in low velocity accidents often claim a causal relationship between disc changes and accidents. In forensic casework the adequacy of the biomechanical load to cause traumatic disc rupture has to be assessed. Objective Based on patient data we addressed the following issues: – Do traumatic cervical disc rupture occur in low velocity accidents? – Are there always accompanying injuries in neuroradiological imaging? – What are the main injury mechanisms? Methods In this study we analyzed cases of traumatic disc ruptures without other severe injuries in patients who underwent surgical treatment between 2010 and 2021. The purpose was to identify cases with traumatic disc ruptures following low velocity scenarios. The sample contained 16 cases with the main diagnosis of traumatic cervical disc rupture. Results Falls caused traumatic disc rupture in 14 of the cases, while traffic accidents caused disc injury in 2 cases only. Radiological signs of acute trauma as well as sensorimotor deficits or pain were present in every case. Of the patients six did not sustain accompanying fractures. In the majority of cases a hyperextension mechanism was assumed, even though an exact reconstruction of the load was not possible in every case. Conclusion This study renders traumatic genesis of a disc rupture highly unlikely in patients involved in low velocity scenarios. Medical imaging without accompanying injuries or signs of acute trauma, e.g., in terms of bleeding, bony or ligamentous lesions, supports a non-accidental cause of disc changes. Nevertheless, expert opinions require case by case evaluation taking account of patient-specific and case-specific conditions.","PeriodicalId":54508,"journal":{"name":"Rechtsmedizin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135260226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-28DOI: 10.1007/s00194-023-00636-x
Angelina Autsch, Hannah Ihle, Sandra Kleemann, Juliane Sanft, Maria Hahnemann, Michael Hubig, Mike Philipp, Michael Bauer, Stefanie Deinhardt-Emmer, Nikolaus Gaßler, Gita Mall, Daniel Wittschieber
Abstract Background COVID-19 now exists for more than 3 years and has caused almost 7 million deaths worldwide. At the beginning of this study only little was known on the patients’ characteristics and comparative autopsy studies are still rare. Material and methods Between 11 March 2020 and 10 March 2021, 55 consecutive and complete autopsies of individuals who died in association with SARS-CoV‑2 infections were performed shortly after death (median PMI 6.8 h) by the same team. Clinical data were available in 45 of 55 cases. 1st vs. 2nd infection wave cases and male vs. female cases were compared. Results Thirty-five patients were male (63.6%) 20 were female (36.4%), average age 72.4 years. Seventeen cases (30.9%) could be assigned to the 1st and 38 cases (69.1%) to the 2nd infection wave. Forty-two of the decedents (76.4%) died due to COVID-19. Arterial hypertension, obesity, and cardiac hypertrophy were the most frequent detected comorbidities. Discussion The present study corroborates previous research data but also reveals new approaches for further comparative studies. Patient-specific personal and general ICU-related risk factors for the development of thromboembolisms oppose the effects of changes in anticoagulant medication.
{"title":"SARS-CoV-2-assoziierte Todesfälle innerhalb des ersten Jahres der COVID-19-Pandemie: eine Autopsiestudie","authors":"Angelina Autsch, Hannah Ihle, Sandra Kleemann, Juliane Sanft, Maria Hahnemann, Michael Hubig, Mike Philipp, Michael Bauer, Stefanie Deinhardt-Emmer, Nikolaus Gaßler, Gita Mall, Daniel Wittschieber","doi":"10.1007/s00194-023-00636-x","DOIUrl":"https://doi.org/10.1007/s00194-023-00636-x","url":null,"abstract":"Abstract Background COVID-19 now exists for more than 3 years and has caused almost 7 million deaths worldwide. At the beginning of this study only little was known on the patients’ characteristics and comparative autopsy studies are still rare. Material and methods Between 11 March 2020 and 10 March 2021, 55 consecutive and complete autopsies of individuals who died in association with SARS-CoV‑2 infections were performed shortly after death (median PMI 6.8 h) by the same team. Clinical data were available in 45 of 55 cases. 1st vs. 2nd infection wave cases and male vs. female cases were compared. Results Thirty-five patients were male (63.6%) 20 were female (36.4%), average age 72.4 years. Seventeen cases (30.9%) could be assigned to the 1st and 38 cases (69.1%) to the 2nd infection wave. Forty-two of the decedents (76.4%) died due to COVID-19. Arterial hypertension, obesity, and cardiac hypertrophy were the most frequent detected comorbidities. Discussion The present study corroborates previous research data but also reveals new approaches for further comparative studies. Patient-specific personal and general ICU-related risk factors for the development of thromboembolisms oppose the effects of changes in anticoagulant medication.","PeriodicalId":54508,"journal":{"name":"Rechtsmedizin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135210758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-22DOI: 10.1007/s00194-023-00632-1
Ines Ackermann, A. Müller, Severine Baisch, Sebastian N. Kunz
{"title":"Akzidentelle vs. vorgetäuschte Kettensägenverletzung am Unterschenkel","authors":"Ines Ackermann, A. Müller, Severine Baisch, Sebastian N. Kunz","doi":"10.1007/s00194-023-00632-1","DOIUrl":"https://doi.org/10.1007/s00194-023-00632-1","url":null,"abstract":"","PeriodicalId":54508,"journal":{"name":"Rechtsmedizin","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46072801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-04DOI: 10.1007/s00194-023-00629-w
T. Kern, C. Buschmann, J. Preuß-Wössner
{"title":"Suizid mit Schießkugelschreiber – ein Beitrag zur Notwendigkeit der Krematoriumsleichenschau","authors":"T. Kern, C. Buschmann, J. Preuß-Wössner","doi":"10.1007/s00194-023-00629-w","DOIUrl":"https://doi.org/10.1007/s00194-023-00629-w","url":null,"abstract":"","PeriodicalId":54508,"journal":{"name":"Rechtsmedizin","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42000154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1007/s00194-023-00626-z
F. Strassmann
{"title":"Mitteilungen der Deutschen Gesellschaft für Rechtsmedizin","authors":"F. Strassmann","doi":"10.1007/s00194-023-00626-z","DOIUrl":"https://doi.org/10.1007/s00194-023-00626-z","url":null,"abstract":"","PeriodicalId":54508,"journal":{"name":"Rechtsmedizin","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43716108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-13DOI: 10.1007/s00194-023-00627-y
C. Grove, Florian T. Fischer, Stefanie Lottner-Nau, O. Peschel, G. Bruch, P. Hofer
{"title":"Zwei tödliche Arbeitsunfälle durch Förderschneckenanlagen","authors":"C. Grove, Florian T. Fischer, Stefanie Lottner-Nau, O. Peschel, G. Bruch, P. Hofer","doi":"10.1007/s00194-023-00627-y","DOIUrl":"https://doi.org/10.1007/s00194-023-00627-y","url":null,"abstract":"","PeriodicalId":54508,"journal":{"name":"Rechtsmedizin","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51836304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-12DOI: 10.1007/s00194-023-00624-1
B. Schäffer, M. Graw
{"title":"Rechtsreport: Nach rechtzeitiger Aufklärung entscheidet der Patient selbst über den Zeitpunkt seiner Einwilligung","authors":"B. Schäffer, M. Graw","doi":"10.1007/s00194-023-00624-1","DOIUrl":"https://doi.org/10.1007/s00194-023-00624-1","url":null,"abstract":"","PeriodicalId":54508,"journal":{"name":"Rechtsmedizin","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42513188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-08DOI: 10.1007/s00194-023-00628-x
K. Maatz
{"title":"Rechtsmedizin zwischen Gesetzgebung und Rechtsprechung","authors":"K. Maatz","doi":"10.1007/s00194-023-00628-x","DOIUrl":"https://doi.org/10.1007/s00194-023-00628-x","url":null,"abstract":"","PeriodicalId":54508,"journal":{"name":"Rechtsmedizin","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42208352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-04DOI: 10.1007/s00194-023-00625-0
Cleo Walz, Ulrike Kullmer, Johannes Lecht, Thomas Riepert, Tanja Germerott, Clara-Sophie Schwarz
Zusammenfassung Hintergrund Kindliche Gewalterfahrungen können schwerwiegende Schädigungen hervorrufen. Durch frühzeitiges Erkennen von familiären Risikofaktoren können Hilfen zielgerichtet angeboten werden. Die Studie untersucht familiäre Risikofaktoren in Misshandlungsfällen, um die Ergebnisse für den präventiven Kinderschutz heranzuziehen. Methoden Es erfolgte eine retrospektive Auswertung von 368 rechtsmedizinischen Fallakten misshandelter Kinder (0 bis 14 Jahre) im Vergleich zu einer Kontrollgruppe von Kindern ohne Misshandlungsverdacht ( n = 336). Erhoben wurden demografische und soziale Faktoren, die psychische Gesundheit der leiblichen Eltern und die angeschuldigten Personen. Zudem wurden vorherige Kontakte der Familien zu Jugendämtern ausgewertet. Ergebnisse Ein junges Alter der Eltern und von der traditionellen Familienform abweichende Familienkonstellationen wurden als signifikante Risikofaktoren für Kindesmisshandlung identifiziert. Die Auswertung der Anzahl der Geschwister und der Position in der Geschwisterreihe ergab keine signifikanten Unterschiede. Bei niedrigen Erfassungsquoten (2–22 %) wurden auch für die Faktoren Drogenmissbrauch, Vorstrafen, Migrationshintergrund, psychische Gesundheit, Arbeitslosigkeit und Bildungsstatus der leiblichen Eltern keine signifikanten Unterschiede festgestellt. In über einem Drittel der Misshandlungsfälle waren die Familien bereits beim Jugendamt bekannt (36 %). Am häufigsten wurden Mutter (24 %), Vater (22 %) oder beide Elternteile (31 %) beschuldigt, die Misshandlung begangen zu haben. Schlussfolgerung Bei ärztlichen Untersuchungen von Kindern und misshandlungsverdächtigen Verletzungen sollte immer die soziale Anamnese erhoben und in die Beurteilung einbezogen werden, um bei erhöhtem Misshandlungsrisiko frühzeitig Hilfen aufzuzeigen.
有关暴力行为的背景通过对家庭风险因素的早期认识，可以有明确的目标地提供帮助。这项研究研究在行政错误情况下探索家庭风险因素以利用预防儿童保护的结果。368复机/ n = 336)回忆录:n n该研究的目标是人口以及社会因素、孩子的父母的心理健康和受教育的对象。这些父母以前与少管所的接触也被分析过。研究员发现，父母幼年时，加上家中不同的家庭观点，在某种程度上是虐待儿童的主要风险因素。对兄弟姐妹的数目和在兄弟姐妹中的地位进行了评估，发现两者没有显著的差别。低测算率(2—22%)在药物滥用、犯罪记录、移民背景、心理健康、失业以及亲子父母受教育程度等问题上也没有发现显著的差异。青少年在被虐待的个案中，超过三分之一的个案都是由社会团体知道的(占36%)。最常见的莫过于母亲(24%)、父亲(22%)以及父母双方(31%)受虐。应当将对儿童和可能遭受虐待的病患进行医治的结论纳入其评估之中，并将其纳入确认中，以便尽早确定在发生严重虐待的危险时能提供补救。
{"title":"Familial risk factors in cases of physical child maltreatment","authors":"Cleo Walz, Ulrike Kullmer, Johannes Lecht, Thomas Riepert, Tanja Germerott, Clara-Sophie Schwarz","doi":"10.1007/s00194-023-00625-0","DOIUrl":"https://doi.org/10.1007/s00194-023-00625-0","url":null,"abstract":"Zusammenfassung Hintergrund Kindliche Gewalterfahrungen können schwerwiegende Schädigungen hervorrufen. Durch frühzeitiges Erkennen von familiären Risikofaktoren können Hilfen zielgerichtet angeboten werden. Die Studie untersucht familiäre Risikofaktoren in Misshandlungsfällen, um die Ergebnisse für den präventiven Kinderschutz heranzuziehen. Methoden Es erfolgte eine retrospektive Auswertung von 368 rechtsmedizinischen Fallakten misshandelter Kinder (0 bis 14 Jahre) im Vergleich zu einer Kontrollgruppe von Kindern ohne Misshandlungsverdacht ( n = 336). Erhoben wurden demografische und soziale Faktoren, die psychische Gesundheit der leiblichen Eltern und die angeschuldigten Personen. Zudem wurden vorherige Kontakte der Familien zu Jugendämtern ausgewertet. Ergebnisse Ein junges Alter der Eltern und von der traditionellen Familienform abweichende Familienkonstellationen wurden als signifikante Risikofaktoren für Kindesmisshandlung identifiziert. Die Auswertung der Anzahl der Geschwister und der Position in der Geschwisterreihe ergab keine signifikanten Unterschiede. Bei niedrigen Erfassungsquoten (2–22 %) wurden auch für die Faktoren Drogenmissbrauch, Vorstrafen, Migrationshintergrund, psychische Gesundheit, Arbeitslosigkeit und Bildungsstatus der leiblichen Eltern keine signifikanten Unterschiede festgestellt. In über einem Drittel der Misshandlungsfälle waren die Familien bereits beim Jugendamt bekannt (36 %). Am häufigsten wurden Mutter (24 %), Vater (22 %) oder beide Elternteile (31 %) beschuldigt, die Misshandlung begangen zu haben. Schlussfolgerung Bei ärztlichen Untersuchungen von Kindern und misshandlungsverdächtigen Verletzungen sollte immer die soziale Anamnese erhoben und in die Beurteilung einbezogen werden, um bei erhöhtem Misshandlungsrisiko frühzeitig Hilfen aufzuzeigen.","PeriodicalId":54508,"journal":{"name":"Rechtsmedizin","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136315800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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