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Hahn M, Dreimann M, Matschke J, Lohner L, Püschel K. Ja, vom Lebensretter zur Gefahr – „Out of position“ macht den Unterschied. Rechtsmedizin (Berl) 2022. [DOI: 10.1007/s00194-022-00582-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Lohner L, Nigbur L, Klasen C, Witzel I, Garland J, Ondruschka B, Anders S. Vaginal injuries after consensual sexual intercourse - a survey among office-based gynecologists in Hamburg, Germany. Forensic Sci Med Pathol 2022; 18:352-358. [PMID: 35716294 PMCID: PMC9587115 DOI: 10.1007/s12024-022-00488-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 12/14/2022]
Abstract
Studies on the occurrence of injuries following consensual sexual intercourse (CSI) among patients treated by office-based gynecologists are lacking. This survey aimed to assess the presence and medical relevance of vaginal injuries after CSI in gynecological office-based practice, associated risk factors, and their significance for forensic medical assessment practice. All office-based gynecologists in Hamburg, Germany (n = 316), were asked to fill in a one-page questionnaire via a fax survey. The questionnaire covered various aspects such as having observed CSI-related injuries, injury severity, risk factors, and concomitant factors (bleeding, need for surgical care, hospitalization). Response rate was 43.2% (n = 115). Overall, 83.5% of office-based gynecologists reported having observed vaginal injuries after CSI at least once and 59.1% repeatedly. Regarding maximum injury severity, 52.1% observed mucosal erosions, 32.3% mucosa penetrating injuries, and 14.6% injuries penetrating the vagina. Having observed bleeding was reported by 56.3%, 28.1% had to perform surgical suture care, and hospital admission was initiated by 20.8%. Menopause (37.5%), use of objects (19.8%), alcohol, and/or drug use (16.7%) were reported as the most frequently observed associated risk factors. Vaginal injuries after CSI have been observed by the majority of office-based gynecologists in Hamburg involving a wide spectrum of severity, including the necessity of surgical care and hospital admission. Complementing published work in clinical and emergency medicine, these findings are highly relevant to the forensic evaluation of injuries in an allegation of sexual assault, as the severity of a vaginal injury in this setting does not necessarily support a conclusion on the issue of consent.
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Affiliation(s)
- L. Lohner
- grid.13648.380000 0001 2180 3484Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Germany
| | - L. Nigbur
- grid.13648.380000 0001 2180 3484Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Germany
| | - C. Klasen
- grid.13648.380000 0001 2180 3484Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - I. Witzel
- grid.13648.380000 0001 2180 3484Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J. Garland
- Forensic and Scientific Services, Coopers Plains, Brisbane, Australia
| | - B. Ondruschka
- grid.13648.380000 0001 2180 3484Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Germany
| | - S. Anders
- grid.13648.380000 0001 2180 3484Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Germany
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von Stillfried S, Freeborn B, Windeck S, Boor P, Böcker J, Schmidt J, Tholen P, Röhrig R, Majeed R, Wienströer J, Bremer J, Weis J, Knüchel R, Breitbach A, Bülow RD, Cacchi C, Wucherpfennig S, Märkl B, Claus R, Dhillon C, Schaller T, Sipos E, Spring O, Braun G, Römmele C, Kling E, Kröncke T, Wittmann M, Hirschbühl K, Heppner FL, Meinhardt J, Radbruch H, Streit S, Horst D, Elezkurtaj S, Quaas A, Göbel H, Friemann J, Hansen T, Titze U, Lorenzen J, Reuter T, Woloszyn J, Baretton G, Hilsenbeck J, Meinhardt M, Pablik J, Sommer L, Holotiuk O, Meinel M, Esposito I, Crudele G, Seidl M, Mahlke N, Hartmann A, Haller F, Eichhorn P, Lange F, Amann KU, Coras R, Ingenwerth M, Rawitzer J, Schmid KW, Theegarten D, Gradhand E, Smith K, Wild P, Birngruber CG, Schilling O, Werner M, Acker T, Gattenlöhner S, Franz J, Metz I, Stadelmann C, Stork L, Thomas C, Zechel S, Ströbel P, Fathke C, Harder A, Wickenhauser C, Glatzel M, Matschke J, Krasemann S, Dietz E, Edler C, Fitzek A, Fröb D, Heinemann A, Heinrich F, Klein A, Kniep I, Lohner L, Möbius D, Ondruschka B, Püschel K, Schädler J, Schröder AS, Sperhake JP, Aepfelbacher M, Fischer N, Lütgehetmann M, Pfefferle S, Jonigk D, Werlein C, Domke LM, Hartmann L, Klein I, Schirmacher P, Schwab C, Röcken C, Langer D, Roth W, Strobl S, Rudelius M, Delbridge C, Kasajima A, Kuhn PH, Slotta-Huspenina J, Weichert W, Weirich G, Stock K, Barth P, Schnepper A, Wardelmann E, Evert K, Evert M, Büttner A, Manhart J, Nigbur S, Bösmüller H, Fend F, Granai M, Klingel K, Warm V, Steinestel K, Umathum VG, Rosenwald A, Vogt N, Kurz F. [Update on collaborative autopsy-based research in German pathology, neuropathology, and forensic medicine]. Pathologie (Heidelb) 2022; 43:101-105. [PMID: 36114379 PMCID: PMC9483541 DOI: 10.1007/s00292-022-01117-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Autopsies are a valuable tool for understanding disease, including COVID-19. MATERIALS AND METHODS The German Registry of COVID-19 Autopsies (DeRegCOVID), established in April 2020, serves as the electronic backbone of the National Autopsy Network (NATON), launched in early 2022 following DEFEAT PANDEMIcs. RESULTS The NATON consortium's interconnected, collaborative autopsy research is enabled by an unprecedented collaboration of 138 individuals at more than 35 German university and non-university autopsy centers through which pathology, neuropathology, and forensic medicine autopsy data including data on biomaterials are collected in DeRegCOVID and tissue-based research and methods development are conducted. More than 145 publications have now emerged from participating autopsy centers, highlighting various basic science and clinical aspects of COVID-19, such as thromboembolic events, organ tropism, SARS-CoV‑2 detection methods, and infectivity of SARS-CoV-2 at autopsy. CONCLUSIONS Participating centers have demonstrated the high value of autopsy and autopsy-derived data and biomaterials to modern medicine. The planned long-term continuation and further development of the registry and network, as well as the open and participatory design, will allow the involvement of all interested partners.
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Affiliation(s)
- Saskia von Stillfried
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Benita Freeborn
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Svenja Windeck
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Peter Boor
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland ,Medizinische Klinik II (Nephrologie und Immunologie), Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland ,Elektronenmikroskopische Einrichtung, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
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Lohner L, Fröb D, Edler C, Schröder AS, Dietz E, Ondruschka B. [SARS-CoV-2-associated deaths in adult persons up to 50 years of age]. Rechtsmedizin (Berl) 2021; 31:418-426. [PMID: 33867689 PMCID: PMC8042458 DOI: 10.1007/s00194-021-00483-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Several evaluations of deaths in persons of advanced age associated with SARS-CoV‑2 can be found in the international literature. The aim of this work was the evaluation of deaths associated with SARS-CoV‑2 of persons of younger or middle age (up to 50 years) at the Institute of Legal Medicine in Hamburg, Germany, with presentation of frequency, comorbidities and disease courses. MATERIAL AND METHODS A total of 735 SARS-CoV-2-associated cases of decedents with registered addresses in Hamburg were evaluated in 2020 at the Institute of Legal Medicine in Hamburg, Germany, using various examination methods. The selection and performance of the respective methods was based on the consent given by the relatives. In addition, more autopsies of decedents with a registered address outside Hamburg and positive SARS-CoV‑2 detection were performed. RESULTS AND CONCLUSION Of the 735 decedents 9 with a registered Hamburg address and 3 of the deaths studied with an external registered address (n = 12; 7 men and 5 women) were aged 50 years or younger, with an average age of 39.8 years. Essentially, there were cardiovascular, neurological, and malignant pre-existing diseases, as well as obesity. The SARS-CoV‑2 was detected post-mortem for the first time in two cases; these were found to have a virus-independent cause of death. Of the individuals 7 died from COVID-19 pneumonia, 3 individuals from the consequences of the necessary intensive medical treatment.Several studies have demonstrated an association between obesity and severe SARS-CoV-2-related disease progression, particularly in younger patients and this was confirmed in the legal medicine study population.
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Affiliation(s)
- L. Lohner
- Institut für Rechtsmedizin Hamburg, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - D. Fröb
- Institut für Rechtsmedizin Hamburg, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - C. Edler
- Institut für Rechtsmedizin Hamburg, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - A. S. Schröder
- Institut für Rechtsmedizin Hamburg, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - E. Dietz
- Institut für Rechtsmedizin Hamburg, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
| | - B. Ondruschka
- Institut für Rechtsmedizin Hamburg, Universitätsklinikum Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Deutschland
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Lohner L, Süße A, Polac M, Kühne OC, Anders S. Nichtakzidentelle gewaltbedingte Verletzungen in chirurgischen Notaufnahmen in Hamburg. Rechtsmedizin (Berl) 2021. [DOI: 10.1007/s00194-021-00458-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lohner L, Sperhake JP, Püschel K, Burandt EC, Heinemann A, Anders S. Vaginal laceration leading to air embolism during consensual sexual intercourse. Int J Legal Med 2020; 135:341-346. [PMID: 33033843 DOI: 10.1007/s00414-020-02433-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/30/2020] [Indexed: 11/24/2022]
Abstract
Vaginal injuries with clinical complications apart from local bleeding following sexual intercourse are thought to be rare events that have recently fostered a discussion on the topic. We report a case of a vaginal laceration resulting in death caused by air embolism in a non-pregnant woman during consensual sexual intercourse with digital and penile penetration. Hysterectomy and a preexisting vaginal injury were additional risk factors present in this case. Besides case history and autopsy findings, histological examination of the vaginal lesion and postmortem computer tomography (PMCT) helped in diagnosing the cause of death and underlying pathophysiological mechanisms.
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Affiliation(s)
- L Lohner
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - J-P Sperhake
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E-C Burandt
- Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Heinemann
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Anders
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Lohner L, Sperhake JP, Püschel K, Schröder AS. Autoerotic Deaths in Hamburg, Germany: Autoerotic accident or death from internal cause in an autoerotic setting? A retrospective study from 2004-2018. Forensic Sci Int 2020; 313:110340. [PMID: 32497993 DOI: 10.1016/j.forsciint.2020.110340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/10/2020] [Accepted: 05/12/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Autoerotic deaths are rare events. The death scene is often bizarre and the death unexpected, thus often requiring forensic autopsies. Our analysis will provide an overview of the expected range of causes and manners of death in cases of autoerotic deaths. METHODS A retrospective analysis was carried out on all scientific and forensic autopsies and postmortem examinations performed at the Department of Legal Medicine in Hamburg, Germany, over the period of 2004-2018. RESULTS 25 cases of autoerotic fatalities were identified over this 15-year-period or one to two cases per year, respectively. Autopsies were carried out on 23 of these cases. 16 (64%) of the cases involved autoerotic accidents and 7 (28%) from internal causes of death during an autoerotic act. Two cases had not undergone an autopsy. On average, those who were involved in autoerotic accidents had been younger in age (average age: 37 years) than the individuals who died from internal disease (average age: 61 years). Only one woman was involved. The most common cause of death in autoerotic accidents was strangulation (hanging: 8 cases, ligature strangulation: 1 case), followed by smothering of the respiratory tract (4 cases). Fatal intoxication was diagnosed in three of the cases. Fatalities with natural cause of death solely involved cardiovascular causes of death. CONCLUSIONS Autoerotic deaths involved a wide range of natural and non-natural causes of death. The reconstruction of such unusual cases and detection of non-natural fatalities requires thorough investigation of the scene of death as well as a postmortem external and internal examination including a chemical toxicological and blood alcohol analysis.
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Affiliation(s)
- L Lohner
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld, 34, 22529, Hamburg, Germany.
| | - J P Sperhake
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld, 34, 22529, Hamburg, Germany
| | - K Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld, 34, 22529, Hamburg, Germany
| | - A S Schröder
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld, 34, 22529, Hamburg, Germany
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Van Aken CME, Meyer L, Lohner L, Anders S, Püschel K, Schmalfeldt B, Witzel I. Auftreten genitaler Verletzungen bei Frauen nach Sexualdelikten – unizentrische Analyse zur Bedeutung der gynäkologischen Untersuchungen. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- CME Van Aken
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie, Hamburg, Deutschland
| | - L Meyer
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie, Hamburg, Deutschland
| | - L Lohner
- Universitätsklinikum Hamburg-Eppendorf, Institut für Rechtsmedizin, Hamburg, Deutschland
| | - S Anders
- Universitätsklinikum Hamburg-Eppendorf, Institut für Rechtsmedizin, Hamburg, Deutschland
| | - K Püschel
- Universitätsklinikum Hamburg-Eppendorf, Institut für Rechtsmedizin, Hamburg, Deutschland
| | - B Schmalfeldt
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie, Hamburg, Deutschland
| | - I Witzel
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie, Hamburg, Deutschland
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Mezey G, Kótai E, Nagy T, Lohner L, Manuba A, Gyulai J, Deline V, Evans C, Blattner R. A comparison of techniques for depth profiling oxygen in silicon. ACTA ACUST UNITED AC 1979. [DOI: 10.1016/0029-554x(79)90016-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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