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Biomedical subjects

Manfred Risse

Publications and source records attributed to Manfred Risse.

6 recordsLinked to original sources

Munchausen syndrome by proxy (MSBP): an extreme form of child abuse with a special forensic challenge.

Munchausen syndrome by proxy (MSBP) is a special form of child abuse in which an adult repeatedly produces symptoms of illness in a person under his/her care. In most cases the perpetrators are mothers who repeatedly and in different ways produce or feign symptoms of illness in their children in order to obtain medical treatment for them. MSBP is thus a special form of child abuse that is also of importance in the field of forensic medicine and a particular challenge to the medicolegal expert. We report two cases of poisoning with different substances (clozapine and clonidine) detected by toxicological investigations at our Department of Legal Medicine. The relevance of the problem for the medicolegal expert and the importance of an interdisciplinary co-operation are pointed out.

Antipsychotic Agents↗

Postmortem in situ diagnosis of pacemakers and electrodes to detect dysfunction.

Cardiac pacemakers usually are very reliable, but sometimes malfunctions of the system occur. We conceived and developed a method to judge the functionality of pacemaker systems in deceased patients. The idea was to verify the hypothesis that more dysfunctions of implanted pacemaker systems go undetected than are detected and corrected. With the aid of a pre-amplifier and a digital storage oscilloscope, pacemaker pulse signals are derived from the surface of the thorax. The derived pulse shape offers information on the functionality of pacemakers and electrodes. Additionally the lead impedance is measured with a test pacemaker and its corresponding hand-held programmer. Synchronization properties can also be assessed with an external test pacemaker. So far 262 pacemakers have been investigated yielding an anomaly rate of 15%, comprising life threatening to annoying malfunctions. These results emphasize the forensic relevance and give reason for a discussion about the natural cause of death in these cases.

Electrodes, Implanted↗

Simultaneous screening and detection of drugs in small blood samples and bloodstains.

A gas chromatography-mass spectrometry (GC-MS) method is described for the screening and detection of morphine, codeine, cocaine, benzoylecgonine, methylecgonine, cocaethylene, delta-9-tetrahydrocannabinol (THC), 11-nor-9-carboxy-THC (THC-COOH), 11-hydroxy-THC (11-OH-THC), amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxymetamphetamine (MDMA) and N-methyl-1-(3,4-methylenedioxyphenyl)-2-butanamine (MBDB) in small blood samples and bloodstains using solid phase SPE columns and a pipetting robot (Gilson Aspec XL). The detection limits are in the order of 1.62-4.10 ng/50 microl spot (amphetamines), 0.15-0.82 ng/50 microl spot (cannabinoids), 1.67-4.70 ng/50 microl spot (cocaine and derivatives) and 4.53-4.91 ng/50 microl spot (opiates) and the correlation factors are between 0.9957 and 0.9999. The method has proven useful in forensic cases with only small sample volumes or bloodstains.

Adult↗

Studies of interferences of apomorphine and its metabolites or decomposition products with immunochemical screening tests for legal and illicit drugs after therapeutic doses of apomorphine.

This study deals with the question of whether apomorphine (CAS 314-19-2; e.g. in Ixense) and its metabolites or decomposition products interfere with the specificity of immunochemical screening tests (immunoassays) for legal and illicit drugs. It was the result of the investigations that after the therapeutic use of apomorphine no relevant false-positive screening findings were observed with the CEDIA (cloned enzyme donor immuno assay) and FPIA (fluorescence polarisation immuno assay) tests, which are commonly encountered in drug-screening programs, when using recommended cut-off values for urine.

Apomorphine↗

[Cadaver mix-up--an avoidable problem?].

Depending on local conditions it may happen from time to time that no officer involved in the previous investigation is present during the forensic autopsy. In this case, the post mortem examiner often has to rely solely on written documentation concerning the identity of the deceased. The authors report a case where the body had already been mixed up with another body by the undertaker prior to the inspection by the police. In spite of clear distinguishing characteristics in the written documentation, this led to the wrong body being autopsied. For the post mortem examiner, the only safe way to identify a body seems to be the presence of persons who had known the deceased or of police officers as acknowledging witnesses. If these conditions are not given, other means of safe information on the identity are called for, for example a "police body card" similar to an evidence card.

Adult↗

[Death in the neonatal period and infancy. History of medicine and forensic criminal aspects].

From antiquity up to the present time the history of medicine contains innumerable examples of the different attitude of human beings in dealing with the death of children. This is paradigmatically described for the death of neonates and infants, with special consideration of the sudden infant death syndrome (SIDS) and selected forensic-criminalistic aspects. Against the historical background of forensic postmortem examination and forensic paidopathology the development of the autopsy is also outlined.

Autopsy↗