[High incidence of autopsies in hospitals. Forensic medicine has become a society profession].
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Biomedical subjects
Publications and source records attributed to M Gregersen.
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Reports in the literature concerning isolated traumatic lesions of the conductive system of the heart following blunt injury to the thorax are rare. A 69-year-old woman who was a front-seat passenger developed disturbances of conduction with atrial fibrillation after blunt injury to the thorax. She died 7 days later. Autopsy and subsequent histological investigation of the conductive system of the heart showed isolated contusion in the right atrium close to the atrio-ventricular node.
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BACKGROUND: The death rate for fatal fire accidents in Denmark has doubled since 1951, mostly due to an increase in the number of fire accidents associated with smoking. The most common cause of residential fire deaths in Denmark today is smoking, often combined with alcohol intoxication or handicap. METHODS: This was a case-control study of fatal fire accidents in private homes in the municipality of Copenhagen from 1991 to 1996. The fatal fire accidents were identified from a police register, and the two non-fatal fire accidents registered immediately before and after each fatal fire were selected as a control group. Information about the circumstances surrounding the fires was derived from the police reports. Multivariate logistic regression analysis was used to estimate the risk associated with each variable after adjusting for confounders. The analysis was performed on the basis of the theoretical model in which the variables were part of a causal network. RESULTS: The following five variables seemed to be of most importance: (1) localization of the victim close to the source of ignition (OR = 11), (2) physical handicaps (OR = 5), (3) chronic alcoholism (OR = 7), (4) clothing fires (OR = 24), and (5) alarm being given by a person not present at the scene of fire (OR = 33). Preventive measures are discussed in the light of the results.
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A case of fracture of the hyoid bone and the thyroid cartilage is reported as a complication to resuscitation. This gave rise to many forensic as well as police investigations and stresses the importance of detailed information at medicolegal autopsies as regards the resuscitation carried out.
Sudden death in patients with mitral valve prolapse is a rare complication with a possible arrhythmic mechanism. We made a detailed postmortem examination of the conduction system in three patients with MVP who died suddenly. One patient who died in cardiac failure had a normal conduction system. The two other patients with no cardiac symptoms prior to death had both accessory atrioventricular pathways. These findings suggest a higher incidence than hitherto known of accessory bypass tracts in patients with MVP who die suddenly, and support the presumption of an arrhythmic cause of death.
A number of rare inherited metabolic disorders are known to lead to death in infancy. Deficiency of medium-chain acyl CoA dehydrogenase has, on clinical grounds, been related particularly to sudden infant death syndrome. The contribution of this disorder to the etiology of sudden infant death syndrome is still a matter of controversy. The present study investigated 120 well-defined cases of sudden infant death syndrome in order to detect the frequency of the most common disease-causing point mutation in the gene coding for medium-chain acyl-CoA dehydrogenase (G985) compared with the frequency in the general population. A highly specific polymerase chain reaction assay was applied on dried blood spots. No over-representation of homo- or heterozygosity for G985 appears to exist in such a strictly defined population, for which reason it may be more relevant to look at a broader spectrum of clinical presentations of inherited metabolic disorders and examine a wider range of sudden death in infancy.