Versicherungsmedizin / herausgegeben von Verband der Lebensversicherungs-Unternehmen e.V. und Verband der Privaten Krankenversicherung e.V
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Gunshot residues on the hand are an important evidence of shooting. Different methods for sampling gunshot residues from the hands are presented and critically analyzed. The topographic methods-adhesive film and polyvinyl alcohol technique (PVAL)-have serious advantages over the cumulative methods like tape-lift or cotton swab. ⋯ Therefore PVAL is mostly applied post mortem. PVAL shows the distribution of gunshot residues also on bloody hands and is a powerful instrument for the reconstruction of the firing position. But the final differentiation between homicide, suicide or accident is not only based on gunshot residues, but requires a complex analysis of all findings in a case (scene, blood traces, autopsy, shot range).
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Versicherungsmedizin · Jun 1997
Review[Fat embolism--a too infrequently determined pathoanatomic diagnosis].
In 1993, pulmonary fat embolism occurred in 92 cases (17%) out of 527 clinical autopsies. It was found in 62% of patients who had suffered bone fractures, in 9% with soft tissue surgery and in 53% after resuscitation; non-traumatic fat embolism was present in 6% of the cases. ⋯ A retrospective analysis of the clinical data revealed no specific symptoms: a so called fat embolism syndrome had not been discovered clinically in any of the cases with histologically proven fat embolism. The significance of pulmonary fat embolism as a cause of death with regard to histological and clinical findings is discussed.
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For the evidence of causality of an accident for a cervical injury without any contact with the interior, it is necessary to provide a interdisciplinary expert's opinion. According to the state of experts knowledge for reconstruction of accidents a slight cervical injury can be precluded if the alteration of speed of the pushed car ist less than 15 km/h. Medical diagnoses are only valid if they have been proved by objective results. A diagnose based only on a subjective information is to be considered as a suspicious diagnose.
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Versicherungsmedizin · Jun 1996
Review[Microalbuminuria in diabetes mellitus--illness or symptom?].
Microalbuminuria (MA) is a term used for urinary albumin excretion between 20 and 200 micrograms/min. or 30-300 mg/24 h. This definition is not used by all authors. In addition, various methods may influence the results. ⋯ They reduce albumin excretion by 50%. In a single study (yet) with type 1 diabetes mortality also was reduced by 40-50%. This would imply that the excess mortality could be halved in patients undergoing this treatment.