PubMed Health⌕ Search

Biomedical subjects

P Leth

Publications and source records attributed to P Leth.

11 recordsLinked to original sources

Mobile autopsy teams in the investigation of war crimes in Kosovo 1999.

On request of the International Criminal Tribunal for the former Yugoslavia (ICTY), the Danish-Swedish forensic teams worked in Kosovo during the summer and the fall of 1999. The teams worked mainly as "mobile teams" at sites with few graves. Only two larger sites were examined. Most of the bodies were buried separately. A few "multiple burial" graves were examined, but no mass graves were encountered. The main purpose of the autopsies was to establish the cause and manner of death. Identification was of less importance, but a majority of the bodies had been identified prior to the autopsy. A total of 308 bodies, mainly males, were examined. The age varied greatly with a mean age of 47 years. The most common cause of death was gun shot wounds and the most common manner of death was homicide.

Adolescent↗

Homicidal hanging masquerading as suicide.

Homicidal hanging is rare and presents special problems for the forensic pathologist. We report a case of homicide by hanging masquerading as suicide, in which the forensic evidence was of crucial importance. The victim was a 61 years old man, who was found in his house suspended by a rope around his neck. The autopsy showed fresh bruises due to blunt trauma. Moreover, a voluminous subdural haematoma with brain swelling was found which indicated that the victim was unconscious at the time of the hanging. An obvious vital reaction consisting of cutaneous bleeding in the ligature mark supported the opinion that the deceased was alive and not dead at the time of the hanging. The estimation of the time of death was of great importance, as only one other person could have been present at the estimated time interval. This person was later sentenced to prison for manslaughter.

Adult↗

Suicide by self-incineration.

During a 10-year period (1980-1989), at least 43 cases of self-incineration with lethal outcome took place in Denmark. The incidence seems to be increasing: 11 cases took place in the first 5 years and 32 cases in the last 5 years. An even sex ratio as found (male:female = 23:20). The median age was 43 years, with a broad age range (20-87). Many incidents of self-incineration as a form of political protest were reported in the press especially during the 1960s and 1970s, and the press reports often inspired others to commit suicide in the same way. None of the cases in our investigation were politically motivated or reported in the press, and only one case could have been inspired by another similar case. Other investigations have shown that self-incineration is more common in some cultures than in others, and many have found that a religious motivation was common. In our investigation, all victims were of Danish origin, and a religious motive played no significant role. Most of the victims were suffering from mental illness, and a majority had tried to commit suicide before. None of the victims left a suicide note. The scene was most often at home and indoors--only a minority committed suicide in remote areas of the countryside. Most were found dead at the scene, and the cause of death was usually heat exposure. Only a minority had a lethal carboxy-hemoglobin (CO-Hb) concentration. It is concluded that close cooperation between police, fire experts, and the forensic pathologist is necessary to permit a correct classification of the mode of death in these cases.

Adult↗

The effect of the calcium antagonist, isradipine, on working capacity, pulmonary function, morbidity and survival rate in patients with severe chronic obstructive pulmonary disease (COPD): a randomized, double-blind, placebo-controlled study.

Beneficial effects of calcium antagonists on the pulmonary haemodynamics of patients with chronic obstructive pulmonary disease (COPD) have been observed in several studies. Such effects include a decrease in pulmonary vascular resistance, an increase in cardiac output, and an increase in oxygen delivery. The clinical implications of these effects are uncertain. The randomized, double-blind, placebo-controlled, long-term study described here is the first to investigate the clinical effects of a calcium antagonist on patients with COPD. The aim was to test the hypothesis that the calcium antagonist, isradipine, could increase working capacity and lung function, and decrease morbidity and mortality. Fifty-two patients with COPD were investigated. During a 22-month observation period no statistically significant differences between the isradipine group and the placebo group were found with regard to these parameters. It is concluded that the existing evidence does not justify the introduction of calcium antagonists as part of the routine treatment of COPD.

Aged↗

Characteristics of cirrhosis undiagnosed during life: a comparative analysis of 73 undiagnosed cases and 149 diagnosed cases of cirrhosis, detected in 4929 consecutive autopsies.

In 4929 consecutive autopsies performed during a period of 4 years, 222 cases (4.5%) of cirrhosis were found, of which 149 (3%) were detected while the patients were alive (diagnosed cirrhosis) and 73 (1.5%) were not detected while the patients were living (undiagnosed cirrhosis). Fifty-three of the 73 undiagnosed patients appeared to be completely without signs of cirrhosis (silent cirrhosis). In the diagnosed group, 70% of patients died from hepatic causes, in contrast to 16% in the undiagnosed group. At autopsy, the following complications of cirrhosis were found more frequently in the diagnosed group than in the undiagnosed group: ascites (41% vs. 8%), oesophageal varices (44% vs. 10%), splenomegaly (52% vs. 29%). The prevalence of hepatocellular carcinoma did not differ significantly in the two groups (12% vs. 8%). It is concluded that cirrhosis without obvious signs occurs relatively frequently, and that no sensitive non-invasive screening methods are available at present.

Adult↗

Ubiquitin: an immunohistochemical marker of Mallory bodies and alcoholic liver disease.

One hundred forty eight liver needle biopsies, comprising 88 consecutive biopsies from patients with clinically diagnosed or suspected alcoholic liver disease and 60 selected biopsies from non-alcoholics, were immunostained for the cell stress protein ubiquitin (Ub). Ub + cells were detected in all of 33 biopsies with alcoholic hepatitis (AH). Practically all Mallory bodies (MBs) showed intense Ub-staining. In addition, many cells revealed Ub + granules lying aggregated (pre-MBs) or dispersed in the cytoplasm of ballooned cells. The mean number of Ub + cells in 10 biopsies with AH was more than 30 times the number of MBs and more than 6 times the number of MBs + pre-MBs found in adjacent Haematoxylin-Eosin (HE) stained sections. Among 55 biopsies from alcoholic patients without AH (i.e. without MBs or pre-MBs in HE stained sections), Ub + cells occurred in eight (14.5%). Among the 60 selected biopsies from non-alcoholic patients with liver diseases in which hepatocyte ballooning and occasionally MBs are seen, a few Ub + cells were revealed in two out of ten with primary biliary cirrhosis (one of which also showed MBs) but none in biopsies with primary sclerosing cholangitis, long-standing large duct obstruction, or various hepatitides. Thus Ub-immunostaining appears to be a highly sensitive and specific method in the detection of MBs and MB precursor stages, making it a valuable tool in the study of alcoholic liver disease, and particularly a more objective method (compared to conventional staining methods) of diagnosing alcoholic hepatitis.

Biomarkers↗

Fatal residential fire accidents in the municipality of Copenhagen, 1991-1996.

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.

Accidents, Home↗