Occurrence of HIV-antibodies among drug abuse-related fatalities in major European cities (up to December 31st, 1992)
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Cause of Death↗
Biomedical subjects
D Risser
Publications and source records attributed to D Risser.
Drug-related deaths between 1985 and 1992 examined at the Institute of Forensic Medicine in Vienna, Austria.
Considering the official figure on drug-related deaths in Austria, the problem of substance abuse has dramatically worsened over the last years. There is a distinct lack of comprehensive information concerning drug-related deaths in Austria, although deaths of drug users may be potentially important indicators of the extent of drug-related problems in the population. The results of examinations performed on 372 deceased substance abusers at the Institute of Forensic Medicine in Vienna between 1985 and 1992 are presented. Drug-related deaths are defined according to the official definition issued by the Austrian Federal Ministry of Internal Affairs. A distinction was made between injecting drug users and non-injecting drug users with respect to infectious diseases transmitted by sharing of paraphernalia. Between 1985 and 1992 there was a distinct increase in drug-related deaths. In approximately 30% an accidental single substance intoxication, mainly due to morphine, was found. A connection with a better quality of street drugs is assumed but not proven. In 207 corpses more than one drug, including alcohol, was detected. During the investigation there was an evident trend towards multi-substance abuse patterns. Furthermore, blood alcohol concentration, an additional risk factor for narcotic overdose, was strongly associated with higher age. The small number of examined drug injectors found positive for the human immunodeficiency virus type-1 (HIV-1) makes it difficult to draw any kind of conclusion regarding the HIV-I seroprevalence among injecting drug users in Vienna.
Adolescent↗
[Drug fatalities from the forensic medicine viewpoint. 10 years experiences of the Vienna Institute of Forensic Medicine].
The problem of illicit drug abuse has of course not spared Austria. In fact, considering only the increase in the official figures on drug-related deaths over the past few years, this problem has dramatically worsened in Austria. Drug-related deaths represent the most serious consequence of substance abuse, but according to the Pompidou Group classification such deaths are only one of eight indicators in assessing the extent of drug abuse in a community. We analyzed reports on all postmortems classified as drug-related deaths according to the official definition of the Austrian Federal Ministry of Internal Affairs undertaken at the Institute of Forensic Medicine in Vienna between 1984 and 1993. The annual number of drug-related deaths increased nearly ten-fold during the study period. In about a third of the cases accidental single substance overdosage (of mainly a morphine-containing drug) was the cause of death. In the majority of the corpses more than one drug, including alcohol, was detected. During the past 10 years there was an evident trend towards a multisubstance abuse pattern. Since the plateau reached in 1988, the incidence of HIV-1 infection among decreased drug injectors has decreased.
Adolescent↗
HIV-1- prevalence among drug deaths in major cities of central and northern Europe.
Since 1985, a number of Institutes of Forensic Medicine in Germany have cooperated in a multicenter study, to provide a constant monitoring of HIV-1-prevalence among drug related deaths. In 1990/91, the Institutes in Copenhagen, Stockholm, Vienna and Zürich also participated in this study. HIV-1-prevalence is decreasing in the German cities, whereas the epidemiological development is not uniform in the other major cities. Regional differences are obvious. In 1991, the prevalence rates were as follows: Berlin 15% (n = 220), Hamburg 4% (n = 179), Frankfurt 17% (n = 167), Munich 9% (n = 136), Stockholm 10% (n = 79), Copenhagen 14% (n = 130), Vienna 20% (n = 56), and Zürich 23% (n = 84).
Acquired Immunodeficiency Syndrome↗
[False positive radiographic findings in expert assessment of whiplash trauma of the cervical spine].
It is reported about a possible misdiagnosis after whiplash injuries. Calcifications of the nuchal ligament have been interpreted as fractures. The inappropriate radiological diagnosis has been corrected within the criminal procedure. Prolonged complaints as possible consequences of information about the false positive radiological diagnosis to the patient are discussed.
Accidents, Traffic↗
[Perception of stab injuries].
It is reported about two men with a stab wound to the back, who did not realize their injuries. In both cases the specific living circumstances are discussed as a reason of their perception-disorders.
Aged↗
[Sudden death caused by anorexia nervosa].
Two cases of sudden unexpected death at home (girl 16 year-old, woman 26 year-old) are reported. Both persons suffered from anorexia nervosa. Morphological investigation revealed heart atrophy as well as atrophy of other organs (striped muscle, spleen, mammary glands, ovaries, skin). Also lipofuscin accumulation (myocardium, liver, spleen) was noted. Especially conspicuous was serous (gelatinous) atrophy of fatty tissue. Anorexia nervosa is a common psychiatric disorder, therefore legal consequences--especially treatment without patient's consent--have to be considered. The legal situation in Austria is discussed. Concerning the 16 year-old girl the authors think that medical malpractice and carelessness of the parents were involved.
Adipose Tissue↗
[Pump-gun as a weapon. Type of injuries, prohibition of weapons].
Pumpguns are shotguns with pump action whose injuries and wound mechanisms have several special features: extremely high kinetic energy of the shot (2500 to 3500 J) frequent cases of "Krönlein shots" (exenteration of the brain) punchmark/imprint immediately adjacent to the entrance wound from the front of the pipe magazine exit wounds from buckshot may be similar to pellet entrance injuries from a distant shotgun discharge the use of various shotgun cartridges (plastic ammunition, slug bullet, various lead pellets) within the same weapon. The change in the Austrian gun law and the banning of the pumpgun in 1995 is also discussed in the article.
Adult↗