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Publications (10 of 163) Show all publications
Lynøe, N. & Eriksson, A. (2025). High-altitude retinopathy: a potential model for retinal haemorrhages in suspected shaken baby syndrome [Letter to the editor]. Eye (London. 1987), Article ID 111383.
Open this publication in new window or tab >>High-altitude retinopathy: a potential model for retinal haemorrhages in suspected shaken baby syndrome
2025 (English)In: Eye (London. 1987), ISSN 0950-222X, E-ISSN 1476-5454, article id 111383Article in journal, Letter (Refereed) Epub ahead of print
Place, publisher, year, edition, pages
Springer Nature, 2025
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-238711 (URN)10.1038/s41433-025-03824-z (DOI)001480556200001 ()40316782 (PubMedID)2-s2.0-105004174372 (Scopus ID)
Available from: 2025-05-22 Created: 2025-05-22 Last updated: 2025-05-22
Lynøe, N. & Eriksson, A. (2025). Policy critique: The conflation of shaken baby syndrome and abusive head trauma: a measure with several negative effects. Forensic Science International: Synergy, 10, Article ID 100585.
Open this publication in new window or tab >>Policy critique: The conflation of shaken baby syndrome and abusive head trauma: a measure with several negative effects
2025 (English)In: Forensic Science International: Synergy, E-ISSN 2589-871X, Vol. 10, article id 100585Article in journal, Editorial material (Other academic) Published
Abstract [en]

The amalgamizing of shaken baby syndrome (SBS) with the much broader and heterogeneous abusive head trauma (AHT) diagnosis is problematized. We suggest that the reason why American Academy of Pediatrics (AAP) took this step in 2009 was a response to another theory being presented and discussed from 2001 and onwards. This theory had completely different legal consequences as it suggested that the medical findings on which the SBS diagnosis were based, i.e. “the triad” (subdural hemorrhages/SDH, retinal hemorrhages/RH, and encephalopathy) were non-traumatic. If such an explanation was accepted, this would reveal not only that serious legal abuses had occurred in the past and that the pediatricians should be held responsible for this, but also that it would in the future be more difficult to protect the child by claiming abuse in cases of unclear diagnosis. We present also other steps, taken by other pediatric organizations, having similar effects upon the current SBS controversy. We suggest that these value-based considerations were the underlying reasons why SBS was integrated in the AHT concept, and why competing theories and evidence-based criticism is ignored, allowing to always interpret triad findings as the result of abuse. If the ethical principle to protect the child is more important to AAP than the scientific ambition to develop evidence-based diagnostic procedures, we encourage AAP to be honest and admit this prioritization. Or at least to admit that in this ethical dilemma, AAP finds that the least bad choice is First of all, protect the child! despite the price is that many infants and its siblings may be separated on wrong grounds from their family, and that caregivers might be falsely accused and convicted of child abuse.

Place, publisher, year, edition, pages
Elsevier, 2025
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-237768 (URN)10.1016/j.fsisyn.2025.100585 (DOI)40276491 (PubMedID)2-s2.0-105002335396 (Scopus ID)
Available from: 2025-04-28 Created: 2025-04-28 Last updated: 2025-04-28Bibliographically approved
Lynøe, N., Juth, N. & Eriksson, A. (2025). The disservice of publishing preliminary results based on a premature hypothesis – Semmelweis’ ordeal revisited. Medicine, Health care and Philosophy
Open this publication in new window or tab >>The disservice of publishing preliminary results based on a premature hypothesis – Semmelweis’ ordeal revisited
2025 (English)In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633Article in journal (Refereed) Epub ahead of print
Abstract [en]

In an interesting article, Dr Zuzana Parusniková claimed: (i) that Semmelweis’ colleagues did not recognise the importance of his animal experiments, (ii) that the resistance to Semmelweis’ hypothesis and results was due mainly to applying mono-causality and (iii) Semmelweis inability to communicate, (iv) that the New Vienna Medical School applied evidence-based medicine, and (v) that the philosophy of Karl Popper is the best interpretation of Semmelweis’ scientific approach. Here, we present some factual aspects of Semmelweis’ text from 1861 and discuss Dr Parusniková’s claims against this backdrop. We conclude that Semmelweis might intentionally have abstained from communicating his hypothesis and results between 1847 and 1849 – including the results from his animal experiments – as he thought that they would eventually be understood and accepted. Semmelweis’ hypothesis was that cadaveric matters and decaying particles were the cause of childbed fever and increased maternal mortality. This hypothesis might have been controversial, but we claim that the major reason for the resistance was eminence-based and induced by the publication of preliminary and suboptimal results, based on a premature version of his hypothesis. If the New Vienna Medical School had been influenced by evidence-based medicine, we believe that Semmelweis’ empirical results would have been accepted - as they were based on an almost randomised controlled trial - and if the results had not been associated with his hypothesis but instead had focused on a black box procedure. We agree that the philosophy of Popper might be appropriate when analysing Semmelweis’ scientific approach when abandoning low-level theories. However, to understand the resistance against Semmelweis’ hypothesis and results, it is not sufficient to refer to a Pickwickian discussion; a Kuhnian framework is more adequate.

Place, publisher, year, edition, pages
Springer Netherlands, 2025
Keywords
Evidence-based medicine, Historical controversy, Karl Popper, Kuhn, Premature hypothesis, Premature results Thomas, Theory impregnated observations
National Category
Philosophy
Identifiers
urn:nbn:se:umu:diva-236292 (URN)10.1007/s11019-025-10257-8 (DOI)001420085000001 ()39946019 (PubMedID)2-s2.0-85218839366 (Scopus ID)
Available from: 2025-03-17 Created: 2025-03-17 Last updated: 2025-03-17
Eriksson, A. & Bäckstrom, B. (2024). Forensic medicine in Sweden. In: Jason Payne-James; Roger W. Byard (Ed.), Encyclopedia of forensic and legal medicine: (pp. V2:857-V2:862). Elsevier
Open this publication in new window or tab >>Forensic medicine in Sweden
2024 (English)In: Encyclopedia of forensic and legal medicine / [ed] Jason Payne-James; Roger W. Byard, Elsevier, 2024, p. V2:857-V2:862Chapter in book (Refereed)
Abstract [en]

This chapter presents the organization of forensic medicine in Sweden, which covers both medico-legal autopsies (forensic pathology) and examination of living persons (clinical forensic medicine). A national body, the National Board of Forensic Medicine, is responsible for all medico-legal autopsies and most issued certificates of medical evidence in clinical forensic medicine. In Sweden, forensic medicine is a recognized medical specialty, tasked to deliver impartial and evidence-based medical expert opinions to the legal system, and the only medical specialty which does not involve medical care or “patients.”

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Certificate of medical evidence, Examination of living persons, Medical age assessment, Medico-legal autopsies, National Board of Forensic Medicine, Organization of forensic medicine in Sweden, Other actors in forensic medicine, Specialist training of forensic pathologists, The forensic pathologist as a medico-legal expert, Undergraduate training in forensic medicine
National Category
Forensic Science
Identifiers
urn:nbn:se:umu:diva-237571 (URN)10.1016/B978-0-443-21441-7.00140-0 (DOI)2-s2.0-105001899594 (Scopus ID)9780443214424 (ISBN)9780443214417 (ISBN)
Available from: 2025-04-14 Created: 2025-04-14 Last updated: 2025-04-14
Lynøe, N. & Eriksson, A. (2024). Prolonged unexplained event might change an "unreliable perpetrator" into a "reliable resuscitator". Medical Hypotheses, 189, Article ID 111383.
Open this publication in new window or tab >>Prolonged unexplained event might change an "unreliable perpetrator" into a "reliable resuscitator"
2024 (English)In: Medical Hypotheses, ISSN 0306-9877, E-ISSN 1532-2777, Vol. 189, article id 111383Article in journal (Refereed) Published
Abstract [en]

During the 1980′s a sudden life-lessness attack in a very young infant was described as “near-SIDS”, and a caregiver who observed and tried to revive the infant was considered to be reliable and honourable. If, after the later acceptance of the traditional shaken baby theory, bilateral thin subdural hemorrhages (SDH) and retinal hemorrhages (RH) are detected after a lifelessness attack such a reliable caregiver has by default been transformed into an unreliable perpetrator of violent shaking. In 2016, the term “near-SIDS” was – via “apparent life-threatening event” (ALTE) − replaced by “brief resolved unexplained event” (BRUE). We suggest that such a life-threatening event is not always brief, and not always resolved. Based on a neglected hypoxia theory from 2004 we suggest as a hypothesis that a prolonged episode of apnea can result in brain hypoxia, brain edema, SDH, RH and increased intracranial pressure. The new hypothesis includes two new concepts: Prolonged Non-fatal Unexplained Event (PNUE) and Prolonged Fatal Unexplained Event (PFUE) which together with the hypoxia theory might explain why these two separate diagnoses have been conflated into one, viz. shaken baby syndrome (SBS). We suggest a study design that might corroborate or falsify the hypothesis, and if our hypothesis is corroborated, current “unreliable perpetrators” could be re-established as reliable resuscitators.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Brief Resolved Unexplained Event (BRUE), Hypoxia theory, Prolonged Fatal Unexplained Event (PFUE), Prolonged Non-fatal Unexplained Event (PNUE), Shaken Baby Syndrome theory
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-225939 (URN)10.1016/j.mehy.2024.111383 (DOI)001250628600001 ()2-s2.0-85194935460 (Scopus ID)
Available from: 2024-06-12 Created: 2024-06-12 Last updated: 2025-04-24Bibliographically approved
Tuiskunen-Bäck, A., Flygare, C., Eriksson, A. & Johansson, A. (2023). Acute myocarditis caused by Francisella tularensis: a case report. SN Comprehensive Clinical Medicine, 5(1), Article ID 105.
Open this publication in new window or tab >>Acute myocarditis caused by Francisella tularensis: a case report
2023 (English)In: SN Comprehensive Clinical Medicine, E-ISSN 2523-8973, Vol. 5, no 1, article id 105Article in journal (Other academic) Published
Abstract [en]

Myocarditis is an inflammatory disease of the myocardium with either focal or diffuse involvement and usually gives rise to chest pain, dyspnea, palpitations, and fatigue. In severe cases, arrythmias, syncope, and cardiogenic shock may occur. Acute myocarditis is most commonly caused by a variety of viruses with cardiotropic properties. Rare causes of myocarditis include bacterial infections. We, herein, describe a case of acute myocarditis caused by the intracellular bacterium Francisella tularensis. A young and previously healthy male in Northern Sweden was referred to the emergency department due to intense upper-chest pain and dyspnea. ECG exhibited minimal ST-segment elevations and laboratory parameters revealed pathological levels of high-sensitivity cardiac troponin and C-reactive protein. Radiological imaging showed increased metabolism in enlarged lymph nodes in the chest and signs that could be compatible with increased metabolism in the left ventricular of the heart. The combination of acute myocarditis and enlarged lymph nodes was believed to be caused by the intracellular bacterium Francisella tularensis, endemic in the Northern Sweden, and was verified with positive serology. The patient showed full recovery after antimicrobial treatment. As this is the fifth published case of myocarditis associated with Francisella tularensis, we suggest considering tularemia in acute myocarditis in tularemia-endemic area.

National Category
Microbiology in the medical area Cardiology and Cardiovascular Disease Infectious Medicine
Identifiers
urn:nbn:se:umu:diva-223356 (URN)10.1007/s42399-023-01436-w (DOI)
Available from: 2024-04-15 Created: 2024-04-15 Last updated: 2025-02-10Bibliographically approved
Lynoe, N. & Eriksson, A. (2023). An overview of the scientific controversy regarding the diagnostic accuracy of Shaken baby syndrome. Medicine and Law Journal, 42(4), 763-780
Open this publication in new window or tab >>An overview of the scientific controversy regarding the diagnostic accuracy of Shaken baby syndrome
2023 (English)In: Medicine and Law Journal, ISSN 0723-1393, Vol. 42, no 4, p. 763-780Article in journal (Refereed) Published
Abstract [en]

The process used to diagnose Shaken Baby Syndrome (SBS), a subgroup of Abusive Head Trauma (AHT) without signs of relevant trauma, is not reliable and remains uncertain. There is insufficient scientific evidence for any doctor or medical expert to conclude that if a child has three medical findings, the “triad”, then the infant must have been shaken or abused. All studies showing a ‘strong’ association between the triad and the diagnostic accuracy of the SBS diagnosis rely on circular reasoning., There is insufficient scientific evidence that the isolated triad can predict traumatic shaking, as there is a high risk of bias. There is an ongoing scientific controversy within the area. The aim of the present article is to facilitate a better understanding of this scientific controversy for those who are not themselves medical scientists -, such as lawyers, prosecutors, and judges. The legal and medical consequences of the current scientific controversy is that an incorrect diagnosis may delay the correct diagnosis, harm the infant and its family, and jeopardis e rule of law.

Place, publisher, year, edition, pages
New York: William S. Hein & Co., Inc., 2023
Keywords
Shaken Baby Syndrome (SBS), Abusive Head Trauma (AHT), Scientific Controversy, Insufficient Scientific Evidence, Circular Reasoning
National Category
Pediatrics Forensic Science
Research subject
Pediatrics; Forensic Medicine
Identifiers
urn:nbn:se:umu:diva-222459 (URN)2-s2.0-85218769772 (Scopus ID)
Available from: 2024-04-02 Created: 2024-04-02 Last updated: 2025-03-31Bibliographically approved
Gustafsson, T., Bäckstrom, B., Ottosson, A., Rietz, A., Michard, J.-F., Loisel, J., . . . Eriksson, A. (2023). Authors' response [Letter to the editor]. Journal of Forensic Sciences, 68(3), 1086-1088
Open this publication in new window or tab >>Authors' response
Show others...
2023 (English)In: Journal of Forensic Sciences, ISSN 0022-1198, E-ISSN 1556-4029, Vol. 68, no 3, p. 1086-1088Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2023
National Category
Forensic Science
Identifiers
urn:nbn:se:umu:diva-206359 (URN)10.1111/1556-4029.15228 (DOI)000957077000001 ()36946495 (PubMedID)2-s2.0-85150913110 (Scopus ID)
Note

Original article: Beer, T, Bäckström, B, Ottosson, A, Rietz, A, Michard, J-F, Loisel, J, et al. The utility of histology in assessing the cause of death in medico-legal autopsies in selected trauma deaths: Suspension-, immersion-, fire-, and traffic-related. J Forensic Sci. 2023; 68: 509– 517. DOI: 10.1111/1556-4029.15193

Commentary: Wingren, C.J., Persson, S. and Thiblin, I. (2023), Commentary on: Beer T, Bäckström B, Ottosson A, Rietz A, Michard J-F, Loisel J, et al. The utility of histology in assessing the cause of death in medico-legal autopsies in selected trauma deaths: Suspension-, immersion-, fire-, and traffic-related. J Forensic Sci, 68: 1084-1085. DOI: 10.1111/1556-4029.15227

Available from: 2023-04-26 Created: 2023-04-26 Last updated: 2023-06-19Bibliographically approved
Beer, T., Eriksson, A. & Wingren, C. J. (2023). Cardiac enlargement in a medicolegal autopsy setting. American Journal of Forensic Medicine and Pathology, 44(4), 267-272
Open this publication in new window or tab >>Cardiac enlargement in a medicolegal autopsy setting
2023 (English)In: American Journal of Forensic Medicine and Pathology, ISSN 0195-7910, E-ISSN 1533-404X, Vol. 44, no 4, p. 267-272Article in journal (Refereed) Published
Abstract [en]

A key element for diagnosing cardiac enlargement in an autopsy setting is relevant heart weight references. However, most available references are to a large extent not representative of a medicolegal autopsy population, implying that reference weights are likely lower than those in the relevant population.To establish more applicable heart weight references in a medicolegal autopsy population, we designed a heart weight model that accounts for undiagnosed cardiac enlargement using data from 11,897 nontraumatic Swedish medicolegal autopsy cases autopsied between 2010 and 2019. The model was validated in 296 nonobese young adult suicidal hanging cases.For a decedent of average height (174 cm), the evidence that a heart weight was enlarged reached weak support at approximately 430 g, substantial support at approximately 480 g, and strong support at 520 g. The modeled prevalence of cardiac enlargement was very high among elderly and obese decedents.We believe that our model is more applicable in a medicolegal setting than those previously published. The presented quantification of the degree of uncertainty regarding diagnosis can help the pathologist in diagnosing cardiac enlargement. To facilitate the use of this model, we also made it available through a simple online tool (https://formedum.shinyapps.io/HeartWeightCalc/).

Place, publisher, year, edition, pages
Wolters Kluwer, 2023
Keywords
heart weight, autopsy, cardiac enlargement, forensic pathology, Bayesian analysis, forensic medicine, cause of death
National Category
Forensic Science
Identifiers
urn:nbn:se:umu:diva-217051 (URN)10.1097/PAF.0000000000000883 (DOI)001208558600017 ()37819124 (PubMedID)2-s2.0-85178498181 (Scopus ID)
Available from: 2023-11-25 Created: 2023-11-25 Last updated: 2025-04-24Bibliographically approved
Lynoe, N. & Eriksson, A. (2023). Disguised incorporation bias and meta‐analysis of diagnostic accuracy studies. Acta Paediatrica, 113(3), 503-505
Open this publication in new window or tab >>Disguised incorporation bias and meta‐analysis of diagnostic accuracy studies
2023 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 113, no 3, p. 503-505Article in journal, Editorial material (Refereed) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2023
National Category
Pediatrics Forensic Science
Research subject
Forensic Medicine
Identifiers
urn:nbn:se:umu:diva-233339 (URN)10.1111/apa.17076 (DOI)001127980900001 ()38115697 (PubMedID)2-s2.0-85180253850 (Scopus ID)
Available from: 2024-12-30 Created: 2024-12-30 Last updated: 2025-01-10Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7026-5061

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