Fortschritte der Neurologie-Psychiatrie
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This report assesses the influence of alcohol- and drug- induced disorders on criminal recidivism. A sample of 185 delinquents was examined for their criminal responsibility in the department of forensic psychiatry in the years 1992 and 1993. Official criminal records were obtained in December 2001. 27.3 % of the delinquents with alcohol abuse, 47.3 % with drug abuse and 47.2 % with a family history of alcohol abuse recidivated with a crime. 50 % of the individuals with an own alcohol- and drug abuse together with a family history of alcohol abuse recidivated. 62.5 % of offenders with both, own drug abuse and an alcohol abuse in their family history re-offended. The co-occurrence of both, own drug abuse and a family history of alcohol abuse is highly correlated with criminal recidivism and should be considered in treatment and aftercare programs.
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Myopathies include a broad range of disorders. Diagnostic steps in muscle disorders should therefore be followed sequentially, in order not to miss important information and to avoid unnecessary and cost intensive diagnostic procedures. Specific care should be applied in taking patient's history to ascertain myopathy related complaints, triggers and concomitant diseases possibly being accompanied by a myopathy. ⋯ Metabolic myopathies might be detected by exercise testing. Electromyography, muscle imaging and, usually as the last diagnostic step, muscle biopsy represent further diagnostic tools in the assessment of myopathies. In some disorders molecular genetic techniques can be applied.
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Fortschr Neurol Psychiatr · Nov 2002
Review[The diagnosis of brain death: medical and legal aspects with special reference to the German Transplantation Law (TPG)].
The diagnosis of brain death following total and irreversible cessation of all cerebral functions is based on anthropological assumptions and conventions as well as on the exact medical diagnosis of total loss of brain function. The question whether individual life ends after cerebral function is irreversibly lost cannot be answered by medical definition alone. Clear and unrefutable legal definitions of death and the cessation of the rights of the individual must be provided before organs may be harvested from brain dead individuals. ⋯ The prerequisites for entering the diagnostic procedure to determine brain death are described. The clinical signs of total and irreversible cessation of brain function are listed, and the technical examinations to corroborate the clinical signs of brain death as accepted in Germany are delineated. In the perspective of the authors, individuals having suffered brain death still possess the protection of their personal human rights according to the German constitution since it cannot be conclusively demonstrated that total loss of brain function alone constitutes the cessation of life in the sense of the German constitution.