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  • 101. Segger, Dorte
    et al.
    Matthies, Andreas
    Saldeen, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Supplementation with Eskimo (R) Skin Care improves skin elasticity in women. A pilot study2008Inngår i: Journal of dermatological treatment (Print), ISSN 0954-6634, E-ISSN 1471-1753, Vol. 19, nr 5, s. 279-283Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To investigate the question of whether supplementation with an oral oil formulation rich in natural stable fish oil can alter skin elasticity, transepidermal water loss (TEWL), and skin roughness in healthy women. Methods: Twenty-four healthy women aged 40-60 years participated in a single-blind randomized trial for testing the effect of a proprietary oral supplement for skin nutrition (Eskimo Skin Care) on skin elasticity, TEWL, and skin roughness. Skin elasticity was measured by an optical cutometer, TEWL by a water-loss module based upon the vapour gradient principle, and skin roughness with a three-dimensional microtopography imaging system. Results: Skin elasticity increased by 10% after 3 months of treatment with the supplement, a statistically significant increase in comparison with the control group (p=0.0298). There was a trend, though not statistically significant, towards a positive influence on the skin's barrier function. No effect on the skin roughness was observed. Conclusion: Eskimo Skin Care, an oral preparation rich in natural stable fish oil, can improve skin elasticity.

  • 102.
    Semenas, Egidijus
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Nozari, Ala
    Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 02114 Boston, Massachusetts, USA.
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Rubertsson, Sten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Wiklund, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Modulation of nitric oxide expression with methylene blue does not improve outcome after hypovolemic cardiac arrest2011Inngår i: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 82, nr 10, s. 1344-1349Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim of the study: We recently reported that female sex protects against cerebral and cardiac injury after hypovolemiccardiac arrest (CA), independent of sex hormone effects. As female sex was also associated with a smaller increase in inducible and neuronal nitric oxide synthase (NOS), we hypothesised that nitric oxide inhibition with methylene blue (MB) improves the outcome, primarily in male animals. Methods: Twenty sexually immature piglets (10 males and 10 females) were bled to mean arterial blood pressure of 35 mmHg, and were subjected to 2 min of untreated CA followed by 8 min of open chest cardiopulmonary resuscitation (CPR). Volume resuscitation was started during CPR with intravenous administration of 3 ml kg(-1) hypertonic saline-dextran. Methyleneblue was then administered as bolus of 2.5 mg kg(-1) over 20 min, followed by 1.5 mg kg(-1) infusion over 40 min. Historical data from 21 animals were used as control (no MB). Hemodynamic parameters, myocardial injury (troponin I), and short-term survival (3-h) were evaluated. Histopathological evaluation of heart specimens was performed. Results: There were no differences between male and female animals in survival or resuscitation rate. After CA female pigletshad significantly greater systolic and mean arterial pressures, and had lower troponin I plasma concentrations compared to malepiglets, with or without MB. No difference was observed in histopathological analysis of heart specimens between sexes. Conclusions: After resuscitation from hypovolemic CA, female sex protects against cardiac injury, independent of sex hormones. Modulation of NO expression with MB does not improve survival or myocardial histological injury in either sex. 

  • 103. Sillivan, Stephanie E.
    et al.
    Whittard, John D.
    Jacobs, Michelle M.
    Ren, Yanhua
    Mazloom, Amin R.
    Caputi, Francesca F.
    Horvath, Monika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Keller, Eva
    Ma'ayan, Avi
    Pan, Ying-Xian
    Chiang, Lillian W.
    Hurd, Yasmin L.
    ELK1 Transcription Factor Linked to Dysregulated Striatal Mu Opioid Receptor Signaling Network and OPRM1 Polymorphism in Human Heroin Abusers2013Inngår i: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 74, nr 7, s. 511-519Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Abuse of heroin and prescription opiate medications has grown to disturbing levels. Opioids mediate their effects through mu opioid receptors (MOR), but minimal information exists regarding MOR-related striatal signaling relevant to the human condition. The striatum is a structure central to reward and habitual behavior and neurobiological changes in this region are thought to underlie the pathophysiology of addiction disorders. Methods: We examined molecular mechanisms related to MOR in postmortem human brain striatal specimens from a homogenous European Caucasian population of heroin abusers and control subjects and in an animal model of heroin self-administration. Expression of ets-like kinase 1 (ELK1) was examined in relation to polymorphism of the MOR gene OPRM1 and drug history. Results: A characteristic feature of heroin abusers was decreased expression of MOR and extracellular regulated kinase signaling networks, concomitant with dysregulation of the downstream transcription factor ELK1. Striatal ELK1 in heroin abusers associated with the polymorphism rs2075572 in OPRM1 in a genotype dose-dependent manner and correlated with documented history of heroin use, an effect reproduced in an animal model that emphasizes a direct relationship between repeated heroin exposure and ELK1 dysregulation. A central role of ELK1 was evidenced by an unbiased whole transcriptome microarray that revealed similar to 20% of downregulated genes in human heroin abusers are ELK1 targets. Using chromatin immune precipitation, we confirmed decreased ELK1 promoter occupancy of the target gene Use1. Conclusions: ELK1 is a potential key transcriptional regulatory factor in striatal disturbances associated with heroin abuse and relevant to genetic mutation of OPRM1.

  • 104.
    Smekal, David
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Hansen, Tomas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Sandler, Håkan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Rubertsson, Sten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Comparison of computed tomography and autopsy in detection of injuries after unsuccessful cardiopulmonary resuscitation2013Inngår i: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 84, nr 3, s. 357-360Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM:

    Computed tomography (CT) has been suggested as an aid or even a replacement for autopsy. The aim of this trial was to study the conformity of the two methods in finding injuries in non-surviving patients after unsuccessful cardiopulmonary resuscitation.

    METHODS:

    In this prospective study, 31 patients were submitted to a CT prior to autopsy after unsuccessful resuscitation attempts. Pathological findings were noted by both the radiologist and the pathologists in a specified protocol. The pathologists and radiologist were blinded from each other's results.

    RESULTS:

    CT and autopsy revealed rib fractures in 22 and 24 patients respectively (kappa=0.83). In 8 patients, CT revealed more rib fractures than autopsy; and in 12 patients, autopsy revealed more rib fractures than CT. In 7 patients, neither method showed any rib fractures. The mean difference between the two methods in detecting rib fractures was 0.16 (S.D.: ±3.174, limits of agreement: -6.19 to 6.51). The kappa value for sternal fractures was 0.49. A total of 260 pathological findings were noted by CT and 244 by autopsy. The average patient showed a median of 9 injuries (every fracture counted as one injury), independent of the method used in detecting the injuries.

    CONCLUSIONS:

    There was a strong concordance between the two methods in finding rib fractures but not sternal fractures and these results support the concept of CT as a valuable complement to autopsy in detecting rib fractures after unsuccessful cardiopulmonary resuscitation but not as a replacement. Other injuries did not show the same concordance.

  • 105.
    Smekal, David
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Lindgren, Erik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Sandler, Håkan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Johansson, Jakob
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Rubertsson, Sten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    CPR related injuries after manual or mechanical chest compressions with the LUCAS™ device: A multicentre study in victims after unsuccessful resuscitation2014Inngår i: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 85, nr 12, s. 1708-1712Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: The reported incidence of injuries due to cardiopulmonary resuscitation using manual chest compressions (manual CPR) varies greatly. Our aim was to elucidate the incidence of CPR-related injuries by manual chest compressions compared to mechanical chest compressions with the LUCAS device (mechanical CPR) in non-survivors after out-of-hospital cardiac arrest.METHODS: In this prospective multicentre trial, including 222 patients (83 manual CPR/139 mechanical CPR), autopsies were conducted after unsuccessful CPR and the results were evaluated according to a specified protocol.RESULTS: Among the patients included, 75.9% in the manual CPR group and 91.4% in the mechanical CPR group (p=0.002) displayed CPR-related injuries. Sternal fractures were present in 54.2% of the patients in the manual CPR group and in 58.3% in the mechanical CPR group (p=0.56). Of the patients in the manual CPR group, there were 64.6% with at least one rib fracture versus 78.8% in the mechanical CPR group (p=0.02). The median number of rib fractures among patients with rib fractures was 7 in the manual CPR group and 6 in the mechanical CPR group. No CPR-related injury was considered to be the cause of death.CONCLUSION: In patients with unsuccessful CPR after out-of-hospital cardiac arrest, rib fractures were more frequent after mechanical CPR but there was no difference in the incidence of sternal fractures. No injury was deemed fatal by the pathologist.

  • 106.
    Tamsen, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Homicide Injury Quantification: Measures of injury severity in homicide victims and associations with homicide characteristics2019Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Some previous studies have found that the amount and severity of injuries in homicide victims correlate with different homicide characteristics, such as the victim-offender relationship and drug influence of the offender. If such relationships exist, they may be used by homicide investigators as part of an offender profiling.

    Furthermore, injury severity may be helpful in understanding the nature of lethal violence. If the injuries change over time or differ between regions, this may say something about the underlying causes and thus help society to take preventive measures. However, measures of injury severity are often missing in homicide epidemiology. This may in part be due to a lack of standardized and accessible ways to quantify injuries in homicide victim.

    To address these issues, there is a need for methods to quantify injury severity in homicide victims. The aim of the current thesis was to investigate different types of injury measures and their applicability to homicide victims. The aim was also to use such measures to address research questions related to offender profiling.

    Starting off with injury scores used in trauma research and two scores developed specifically for homicide victims, these measures were applied to a general homicide population. Since there is no obvious “gold standard” for injury severity quantification on homicide victims, one had to be defined to validate the applied methods. Out of forensic experience and rational reasoning, the Sum of all AIS scores (SAIS) was proposed as a reference measure. The other scores were then evaluated through their correlations with the SAIS.

    In the following study, the injury severity in homicides from different time periods was measured. There were statistically significant increases over time with respect to excessive injuries and the number of lethal injuries per victim. These changes can reflect both a brutalization of homicidal violence, improved trauma care, or shifts in the methods by which people are killed.

    Next, the associations between injury severity and homicide characteristics were analysed. No relevant associations between injury severity and victim-offender relationship were found. Neither were there any connections between benzodiazepine influence in the offender and injury severity on the victim. Thus, the studies do not support the use of injury severity scores for offender profiling in a general homicide population.

    Delarbeid
    1. Homicide Injury Quantification: Correlations and Reliability of Injury Severity Scores Applied to Homicide Victims
    Åpne denne publikasjonen i ny fane eller vindu >>Homicide Injury Quantification: Correlations and Reliability of Injury Severity Scores Applied to Homicide Victims
    2015 (engelsk)Inngår i: Homicide Studies, ISSN 1088-7679, E-ISSN 1552-6720, Vol. 19, nr 1, s. 88-100Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    No generally accepted method exists for quantifying the degree of injury in homicide victims. This study explores six different injury severity scores with the goal to recommend a valid method that is reliable and easy to use. To investigate this issue, 103 homicides are examined regarding the correlations between these scores. This study concludes that the Homicide Injury Scale is valid, easy to use, and has a satisfactory inter-rater reliability.

    Emneord
    homicide, lethal violence, injury severity score, quantification
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-243424 (URN)10.1177/1088767914558142 (DOI)000346910300005 ()
    Tilgjengelig fra: 2015-02-17 Laget: 2015-02-09 Sist oppdatert: 2019-05-21bibliografisk kontrollert
    2. Quantifying Homicide Injuries:: A Swedish Time Trend Study Using the Homicide Injury Scale
    Åpne denne publikasjonen i ny fane eller vindu >>Quantifying Homicide Injuries:: A Swedish Time Trend Study Using the Homicide Injury Scale
    2017 (engelsk)Inngår i: Scandinavian Journal of Forensic Science, ISSN 2353-0707, Vol. 23, nr 2Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Studies report that the homicide rate has decreased considerably in most Western countries since the 1990s. However, few studies have examined the level of injury in homicides. The injury severity in homicide victims was studied in the Stockholm area using both the Homicide Injury Scale (HIS) and the number of lethal injuries per victim. Cases were included from four periods; 1976-78, 1986- 88, 1996-98, and 2006-08. The number of homicides with overkill according to the HIS was significantly higher in 1996-98 compared to 1976-78. Compared with 1976-78, the number of lethal injuries per victim was significantly higher both in 1986-88 and 1996-98. There are various possible reasons for the changes, including a brutalization of lethal violence or a more effective trauma care. More in-depth analysis of individual cases together with research on victims of attempted homicides is needed to explain these shifts in injury severity.

    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-383632 (URN)10.1515/sjfs-2017-0005 (DOI)
    Tilgjengelig fra: 2019-05-20 Laget: 2019-05-20 Sist oppdatert: 2019-09-03bibliografisk kontrollert
    3. Homicide injury severity in association with the victim-offender relationship
    Åpne denne publikasjonen i ny fane eller vindu >>Homicide injury severity in association with the victim-offender relationship
    2019 (engelsk)Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 300, s. 151-156Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    There are previous studies that have found associations between specific injury patterns and different victim-offender relationships (VORs) in homicides. We have used quantitative injury severity scores to further investigate this issue. The amount and severity of injuries were assessed in 178 Swedish homicide victims, retrospectively included from the years 2007-2009. We analyzed whether different injury measures could be used to predict the VOR. In addition to a deeper understanding of violent behavior, such associations may be of help to homicide investigators for offender profiling. The victims' injuries were assessed with eleven different methods. The cases with known VORs were divided into four categories: partner, relative, acquaintance, and stranger. The injury seventies were then compared between these categories. No relevant differences were found. Thus, the current study does not support the claim that the VOR can be predicted from the injury severity in a general homicide population. These findings are in contrast to the results of some previous studies but confirm those of others.

    Emneord
    Homicide, Injury score, Injury quantification, Offender profiling
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-383634 (URN)10.1016/j.forsciint.2019.05.012 (DOI)000470903500030 ()
    Tilgjengelig fra: 2019-05-20 Laget: 2019-05-20 Sist oppdatert: 2019-07-05bibliografisk kontrollert
    4. Homicide injury severity in association with benzodiazepine influence
    Åpne denne publikasjonen i ny fane eller vindu >>Homicide injury severity in association with benzodiazepine influence
    (engelsk)Manuskript (preprint) (Annet vitenskapelig)
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-383635 (URN)
    Merknad

    Submitted to Homicide Studies

    Tilgjengelig fra: 2019-05-20 Laget: 2019-05-20 Sist oppdatert: 2019-05-21
  • 107.
    Tamsen, Fredrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Logan, Fia Klötz
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Addendum to "Homicide Injury Quantification: Correlations and Reliability of Injury Severity Scores Applied to Homicide Victims."€ Volume 19, Issue 1, pp. 88-1002016Inngår i: Homicide Studies, ISSN 1088-7679, E-ISSN 1552-6720, Vol. 20, s. 342-343Artikkel i tidsskrift (Annet vitenskapelig)
  • 108.
    Tamsen, Fredrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Logan, Fia Klötz
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Homicide Injury Quantification: Correlations and Reliability of Injury Severity Scores Applied to Homicide Victims2015Inngår i: Homicide Studies, ISSN 1088-7679, E-ISSN 1552-6720, Vol. 19, nr 1, s. 88-100Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    No generally accepted method exists for quantifying the degree of injury in homicide victims. This study explores six different injury severity scores with the goal to recommend a valid method that is reliable and easy to use. To investigate this issue, 103 homicides are examined regarding the correlations between these scores. This study concludes that the Homicide Injury Scale is valid, easy to use, and has a satisfactory inter-rater reliability.

  • 109.
    Tamsen, Fredrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Sturup, Joakim
    Swedish Police Authority.
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Homicide injury severity in association with benzodiazepine influenceManuskript (preprint) (Annet vitenskapelig)
  • 110.
    Tamsen, Fredrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Sturup, Joakim
    Swedish Police Author, Stockholm, Stockholm Regio, Sweden;Swedish Natl Board Forens Med, Dept Forens Psychiat, Stockholm, Sweden.
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin. Swedish Natl Board Forens Med, Dept Forens Med, Stockholm, Sweden.
    Homicide injury severity in association with the victim-offender relationship2019Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 300, s. 151-156Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    There are previous studies that have found associations between specific injury patterns and different victim-offender relationships (VORs) in homicides. We have used quantitative injury severity scores to further investigate this issue. The amount and severity of injuries were assessed in 178 Swedish homicide victims, retrospectively included from the years 2007-2009. We analyzed whether different injury measures could be used to predict the VOR. In addition to a deeper understanding of violent behavior, such associations may be of help to homicide investigators for offender profiling. The victims' injuries were assessed with eleven different methods. The cases with known VORs were divided into four categories: partner, relative, acquaintance, and stranger. The injury seventies were then compared between these categories. No relevant differences were found. Thus, the current study does not support the claim that the VOR can be predicted from the injury severity in a general homicide population. These findings are in contrast to the results of some previous studies but confirm those of others.

  • 111.
    Tamsen, Fredrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Sturup, Joakim
    Karolinska Institute, Stockholm, Sweden.
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Quantifying Homicide Injuries:: A Swedish Time Trend Study Using the Homicide Injury Scale2017Inngår i: Scandinavian Journal of Forensic Science, ISSN 2353-0707, Vol. 23, nr 2Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Studies report that the homicide rate has decreased considerably in most Western countries since the 1990s. However, few studies have examined the level of injury in homicides. The injury severity in homicide victims was studied in the Stockholm area using both the Homicide Injury Scale (HIS) and the number of lethal injuries per victim. Cases were included from four periods; 1976-78, 1986- 88, 1996-98, and 2006-08. The number of homicides with overkill according to the HIS was significantly higher in 1996-98 compared to 1976-78. Compared with 1976-78, the number of lethal injuries per victim was significantly higher both in 1986-88 and 1996-98. There are various possible reasons for the changes, including a brutalization of lethal violence or a more effective trauma care. More in-depth analysis of individual cases together with research on victims of attempted homicides is needed to explain these shifts in injury severity.

  • 112.
    Tamsen, Fredrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Deaths during apprehensions of agitated persons: A review of proposed pathophysiological theories.2013Inngår i: Scandinavian Journal of Forensic Science, ISSN 1503-9552, Vol. 1, nr 1, s. 1-6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The pathophysiology of sudden death during apprehension remains largely unclear. The most frequently discussed mechanisms are excited delirium, positional asphyxia, metabolic acidosis, acute and chronic drug abuse, and autonomic instability. As in most areas of forensic medicine, much of the knowledge comes from case reports, which are of little use in understanding causality. Experimental studies of some aspects have been performed, and they show somewhat divergent results and interpretations. The aim of this review is to summarize the different proposed theories, and to point out important issues for further research.

  • 113.
    Thiblin, I
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Dödsfall vid polisingripande. Riskfaktorer och rekommendationer: PHS serie i polisiärt arbete2011Annet (Annet (populærvitenskap, debatt, mm))
  • 114.
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Diagnostik av barnmisshandel måste vara evidensbaserad2014Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, artikkel-id C9SMArtikkel i tidsskrift (Annet vitenskapelig)
  • 115.
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Narkotikarelaterad död2011Inngår i: Beroendemedicin / [ed] Johan Franck & Ingrid Nylander, Lund: Studentlitteratur, 2011, 1. uppl., s. 323-327Kapittel i bok, del av antologi (Fagfellevurdert)
  • 116.
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Specificitet för barnmisshandel en fråga om etiologi2015Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112Artikkel i tidsskrift (Annet vitenskapelig)
  • 117.
    Thiblin, Ingemar
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Fugelstad, Anna
    Felaktiga slutsatser om narkotikadödsfall2016Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, artikkel-id EC63Artikkel i tidsskrift (Annet vitenskapelig)
  • 118.
    Thiblin, Ingemar
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Garmo, Hans
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Garle, Mats
    Holmberg, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Endokrinkirurgi.
    Byberg, Liisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Ortopedi.
    Michaëlsson, Karl
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Ortopedi.
    Gedeborg, Rolf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Anabolic steroids and cardiovascular risk: A national population-based cohort study2015Inngår i: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 152, s. 87-92Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Non-therapeutic use of anabolic androgenic steroids (AAS) has been associated with various adverse effects; one of the most serious being direct cardiovascular effects with unknown long-term consequences. Therefore, large studies of the association between AAS and cardiovascular outcomes are warranted. We investigated cardiovascular morbidity and mortality in individuals who tested positive for AAS. Methods and results: Between 2002 and 2009, a total of 2013 men were enrolled in a cohort on the date of their first AAS test. Mortality and morbidity after cohort entry was retrieved from national registries. Of the 2013 individuals, 409(20%) tested positive for MS. These men had twice the cardiovascular morbidity and mortality rate as those with negative tests (adjusted hazard ratio (aHR) 2.0; 95% confidence interval (CI) 1.2-3.3). Compared to the Swedish population, all tested men had an increased risk of premature death from all causes (standardized mortality ratio for MS-positive: 19.3, 95% CI 12.4-30.0; for AAS-negative: 8.3,95% CI 6.1-11.0). Conclusion: Non-therapeutic exposure to MS appears to be an independent risk factor for cardiovascular morbidity and premature death.

  • 119.
    Thiblin, Ingemar
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Michard, Jean-Francois
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Rättsmedicin i teori och praktik: En guide för läkare och jurister2014 (oppl. 1)Bok (Fagfellevurdert)
    Abstract [sv]

    Rättsmedicin är en medicinsk vetenskap, men samtidigt väsentligt skild från den terapeutiskt inriktade kliniska medicinen. Syftet med rättsmedicin är sakkunnigverksamhet på vetenskaplig grund till gagn för rättsväsendet och rättssäkerheten. Rättsmedicin i teori och praktik belyser dessa skillnader i förhållningssätt och förmedlar principiella frågor och kunskaper på ett lättillgängligt sätt. Boken ger även praktisk handledning i att skriva rättsintyg och att göra skadetolkningar och bedömningar.

    I första delen av boken beskrivs läkarens roll i förhållande till rättsväsendet samtidigt som de vetenskapliga begreppen och tankemodellerna reds ut och kopplas till den kliniska verkligheten. Vanliga fallgropar och missräkningar förmedlas också. Den andra delen av boken är en handbok i hur man skriver rättsintyg och utlåtanden samt hur man bedömer och tolkar skador. Boken är rikligt försedd med fallbeskrivningar som på ett pedagogiskt sätt applicerar teorierna i praktiken.

    Målgruppen är främst blivande och praktiserande läkare och jurister. Även naturvetenskapligt orienterade experter som avger utlåtanden till rätten, till exempel kriminaltekniker, och de som i sin profession kommer i kontakt med rättsmedicinska bedömningar, till exempel socialtjänsten, har nytta av boken, liksom politiska beslutsfattare och personer med intresse för rättssäkerhetsfrågor.

  • 120.
    Thiblin, Ingemar
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Mobini-Far, Hamid
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Frisk, M.
    Sudden unexpected death in a female fitness athlete, with a possible connection to the use of anabolic androgenic steroids (AAS) and ephedrine2009Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 184, nr 1-3, s. e7-11Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The use of anabolic androgenic steroids (AAS) has been associated with different adverse effects, some of which potentially lethal. Most users of AAS are male, but the prevalence of such use appears to be increasing in females. Here we present a sudden unexpected death in a female fitness athlete with a possible connection to use of doping agents.

  • 121.
    Thiblin, Ingemar
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Wennström, Bo
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Juridiska fakulteten, Centrum för polisforskning. Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Juridiska fakulteten, Juridiska institutionen.
    Allen, Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Genomik. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik.
    Låt även försvararsidan få tillgång till rättsmedicinsk expertis: [Let the defence have access to forensic expertise, too]2012Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 109, nr 1-2, s. 39-39Artikkel i tidsskrift (Fagfellevurdert)
  • 122. Torabi, Fereidon
    et al.
    Mobini Far, Hamid Reza
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Danielsson, Bengt
    Khayyami, Masoud
    Development of a plasma panel test for detection of human myocardial proteins by capillary immunoassay2007Inngår i: Biosensors & bioelectronics, ISSN 0956-5663, E-ISSN 1873-4235, Vol. 22, nr 7, s. 1218-1223Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A chemiluminescence immunoassay for the detection of four heart marker proteins: myoglobin, creatine kinase mb [CKmb], troponin I [TnI], and fatty acid-binding protein [FABP], was designed. The immunoassay was based on enzyme-linked immunosorbent assay [ELISA] and antibodies immobilized in glass capillaries pre-treated with 3-aminopropyltriethoxysilane. The protein bound to the antibody was detected by using an anti-protein-horseradish peroxidase [HRP] conjugate. The reaction of the HRP with luminal and hydrogen peroxide-based substrate generated the chemiluminescence and a photodiode detector was used to measure the light intensity. The same assay protocol was used to detect all four proteins. Ultrasound waves were used to improve the silanization of glass and the antibody immobilization process. The optimization of the duration and intensity of the ultrasound was performed for the myoglobin assay. Ultrasound improved the silanization procedure and the capillaries gave an approximately 2.5 times greater ELISA response. Ultrasound also improved the sensitivity by approximately 100% when monoclonal antibody was immobilized on a glass capillary. Calibration curves corresponding to analyte concentrations ranging from 2.4 to 2400 ng/ml in plasma samples were recorded. The detection limits were in the region of 1.2 myoglobin, 0.6 CKmb, 5.6 TnI, and 4 ng/ml FABP in plasma with a coefficient of variation of 3–9.9%.

  • 123. Tøllefsen, Ingvild Maria
    et al.
    Helweg-Larsen, Karin
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Hem, Erlend
    Kastrup, Marianne C
    Nyberg, Ullakarin
    Rogde, Sidsel
    Zahl, Per-Henrik
    Østevold, Gunvor
    Ekeberg, Øivind
    Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia.2015Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, nr 11, artikkel-id e009120Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Valid mortality statistics are important for healthcare planning and research. Suicides and accidents often present a challenge in the classification of the manner of death. The aim of this study was to analyse the reliability of the national suicide statistics by comparing the classification of suicide in the Scandinavian cause of death registers with a reclassification by 8 persons with different medical expertise (psychiatry, forensic pathology and public health) from each of the 3 Scandinavian countries.

    METHODS: The cause of death registers in Norway, Sweden and Denmark retrieved available information on a sample of 600 deaths in 2008 from each country. 200 were classified in the registers as suicides, 200 as accidents or undetermined and 200 as natural deaths. The reclassification comprised an assessment of the manner and cause of death as well as the level of certainty.

    RESULTS: In total, 81%, 88% and 90% of deaths registered as suicide in the official mortality statistics were confirmed by experts using the Swedish, Norwegian and Danish data sets, respectively. About 3% of deaths classified as accidents or natural deaths in the cause of death registers were reclassified as suicides. However, after a second reclassification based on additional information, 9% of the natural deaths and accidents were reclassified as suicides in the Norwegian data set, and 21% of the undetermined deaths were reclassified as suicides in the Swedish data set. In total, the levels of certainty of the experts were 87% of suicides in the Norwegian data set, 77% in the Swedish data set and 92% in Danish data set; the uncertainty was highest in poisoning suicides.

    CONCLUSIONS: A high percentage of reported suicides were confirmed as being suicides. Few accidents and natural deaths were reclassified as suicides. Hence, reclassification did not increase the overall official suicide statistics of the 3 Scandinavian countries.

  • 124.
    Tøllefsen, Ingvild Maria
    et al.
    Oslo Univ Hosp Ullevaal, Dept Acute Med, Box 4950, N-0424 Oslo, Norway.;Univ Oslo, Inst Basic Med Sci, Dept Behav Sci Med, Fac Med, Box 1072, N-0316 Oslo, Norway.;Oslo Univ Hosp Ullevaal, Dept Acute Med, Div Med, Box 4950, N-0424 Oslo, Norway..
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Helweg-Larsen, Karin
    Univ Copenhagen, Dept Social Med & Publ Hlth Res, Norregade 10, DK-1165 Copenhagen K, Denmark..
    Hem, Erlend
    Univ Oslo, Inst Basic Med Sci, Dept Behav Sci Med, Fac Med, Box 1072, N-0316 Oslo, Norway.;Oslo Univ Hosp Ullevaal, Div Mental Hlth & Addict, Box 4950, N-0424 Oslo, Norway..
    Kastrup, Marianne
    Amalievej 23, DK-1875 Frederiksberg, Denmark..
    Nyberg, Ullakarin
    Karolinska Inst, Stockholm Ctr Psychiat Res & Educ, Dept Clin Neurosci, Stockholm, Sweden.;Norra Stocholms Psychiat, St Gorans Sjukhus, S-11281 Stockholm, Sweden..
    Rogde, Sidsel
    Norwegian Inst Publ Hlth, Box 4404, N-0403 Oslo, Norway.;Univ Oslo, Inst Clin Med, Box 1072, N-0316 Oslo, Norway..
    Zahl, Per-Henrik
    Norwegian Inst Publ Hlth, Box 4404, N-0403 Oslo, Norway..
    Ostevold, Gunvor
    Norwegian Inst Publ Hlth, Box 4404, N-0403 Oslo, Norway..
    Ekeberg, Oivind
    Univ Oslo, Inst Basic Med Sci, Dept Behav Sci Med, Fac Med, Box 1072, N-0316 Oslo, Norway.;Oslo Univ Hosp Ullevaal, Div Mental Hlth & Addict, Box 4950, N-0424 Oslo, Norway..
    Accidents and undetermined deaths: re-evaluation of nationwide samples from the Scandinavian countries2016Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 16, artikkel-id 449Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: National mortality statistics should be comparable between countries that use the World Health Organization's International Classification of Diseases. Distinguishing between manners of death, especially suicides and accidents, is a challenge. Knowledge about accidents is important in prevention of both accidents and suicides. The aim of the present study was to assess the reliability of classifying deaths as accidents and undetermined manner of deaths in the three Scandinavian countries and to compare cross-national differences. Methods: The cause of death registers in Norway, Sweden and Denmark provided data from 2008 for samples of 600 deaths from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of deaths and 200 as natural deaths. The information given to the eight experts was identical to the information used by the Cause of Death Register. This included death certificates, and if available external post-mortem examinations, forensic autopsy reports and police reports. Results: In total, 69 % (Sweden and Norway) and 78 % (Denmark) of deaths registered in the official mortality statistics as accidents were confirmed by the experts. In the majority of the cases where disagreement was seen, the experts reclassified accidents to undetermined manner of death, in 26, 25 and 19 % of cases, respectively. Few cases were reclassified as suicides or natural deaths. Among the extracted accidents, the experts agreed least with the official mortality statistics concerning drowning and poisoning accidents. They also reported most uncertainty in these categories of accidents. In a second re-evaluation, where more information was made available, the Norwegian psychiatrist and forensic pathologist increased their agreement with the official mortality statistics from 76 to 87 %, and from 85 to 88 %, respectively, regarding the Norwegian and Swedish datasets. Among the extracted undetermined deaths in the Swedish dataset, the two experts reclassified 22 and 51 %, respectively, to accidents. Conclusion: There was moderate agreement in reclassification of accidents between the official mortality statistics and the experts. In the majority of cases where there was disagreement, accidents were reclassified as undetermined manner of death, and only a small proportion as suicides.

  • 125.
    Ågren, Greta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Lund, Irene
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Lundeberg, Thomas
    Tail skin temperatures reflect coping styles in rats2009Inngår i: Physiology and Behavior, ISSN 0031-9384, E-ISSN 1873-507X, Vol. 96, nr 2, s. 374-82Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study was carried out to elucidate the predictive value of tail skin temperatures (TSTs) assessed in naïve rats as a non-invasive pre-experimental method of classification of coping style. Male Lewis rats were classified according to tail skin temperatures (TST), and relative size within cage-groups. TSTs were monitored over two-hour periods following exposure to physical and emotional stressors. Bodyweight-shifts associated to the experiments were analysed. Six organs of neuroendocrine relevance to allostasis were weighed. Challenge-specific TST-profiles were size-related and consistent with proactive or reactive coping. Pro-active (A) rats showed a more pronounced TST-response to unknown conspecifics, but reactive (B) rats to environmental novelties. B-rats showed challenge-specific weight-losses while A-rats gained more after experiments. Second size males showed rapidly decreased TSTs (vasoconstriction) after nociceptive stimulation. Males that showed the highest basal TSTs and weight-loss in emotionality tests had lost a first rank position during a pre-experimental period, suggesting long-lasting effects of social defeat. Pre-experimental growth correlated positively to adiposisity post-experimentally, but negatively to testes relative weight in B-rats. Scaling effects explained heart-size in B-rats and pituitary-size in A-rats. The overall patterns that emerged, in factor analyses including organ sizes, were consistent with pro-active coping in A-rats and reactive in B-rats. Our results, controlling for rank-effects, suggest that non-invasively assessed TSTs may predict individual stress-coping phenotypes pre-experimentally in rats housed in groups.

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