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  • 1.
    Ahlm, Kristin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Björnstig, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Öström, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Alcohol and drugs in fatally and non-fatally injured motor vehicle drivers in northern Sweden2009Ingår i: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 41, nr 1, s. 129-136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Alcohol and drugs are important risk factors for traffic injuries, a major health problem worldwide. This prospective study investigated the epidemiology and the presence of alcohol and drugs in fatally and hospitalized non-fatally injured drivers of motor vehicles in northern Sweden. During a 2-year study period, blood from fatally and hospitalized non-fatally injured drivers was tested for alcohol and drugs. The study subjects were recruited from well-defined geographical areas with known demographics. Autopsy reports, medical journals, police reports, and toxicological analyses were evaluated. Of the fatally injured, 38% tested positive for alcohol and of the non-fatally 21% tested positive; 7% and 13%, respectively, tested positive for pharmaceuticals with a warning for impaired driving; 9% and 4%, respectively, tested positive for illicit drugs. The most frequently detected pharmaceuticals were benzodiazepines, opiates, and antidepressants. Tetrahydrocannabinol was the most frequently detected illicit substance. No fatally injured women had illegal blood alcohol concentration. The relative proportion of positively tested drivers has increased and was higher than in a similar study 14 years earlier. This finding indicates that alcohol and drugs merit more attention in future traffic safety work.

  • 2.
    Davies Forsman, Lina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Öström, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Svanström, Mikael
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Eriksson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Fatal bupivacaine overdose through intrathecally positioned epidural catheter2013Ingår i: Scandinavian Journal of Forensic Science, ISSN 1503-9552, Vol. 19, nr 1, s. 10-12Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We describe a fatality due to an intrathecally positioned epidural catheter and an infusion rate of bupivacaine set 10 times higher than planned. The undetected misplacement, despite safety routines, is discussed along with the toxicological findings and new information on the intrathecal distribution of bupivacaine. From a clinical point of view, the human factor, in combination with an indistinct decimal point on the pump, was considered as the reason for the unfortunate overdose. In continuous epidural infusion of local anesthetics, the importance of guidelines and informed staff in managing complications of epidural lumbar infusion as well as careful monitoring of the vital functions is essential. Guidelines are also vital during the procedure of insertion of epidural catheters. When using combined spinal and epidural anaesthesia, we believe that an epidural catheter should be inserted, and its position tested, prior to spinal anesthesia. The case also illustrates the need of innovative investigation techniques to confirm the suspicion of unusual manifestations of inadvertent drug effects. Segmental analysis, together with analyses in a control case, enabled us to elucidate the high and varying tissue concentrations in the central nervous system.

  • 3.
    Eriksson, Anders
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Georén, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Öström, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Work-place homicide by bow and arrow.2000Ingår i: Journal of forensic sciences, ISSN 0022-1198, Vol. 45, nr 4, s. 911-6Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Arrow wounds represent an unusual class of wounds rarely seen by most forensic pathologists. In this paper we present a case of homicide by bow and arrow and the characteristics of such injuries. The essential characteristics of the lesions obtained from conically-tapered field points and from hunting broadhead tips are described and discussed in relation to injuries caused by firearm bullets. In the present case, three arrows struck the victim, and the order in which the injuries were sustained are analyzed. We also discuss the possibilities of localizing the shooter relative to the victim by analysis of the trajectories.

  • 4.
    Eriksson, Anders
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Öström, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Traffic fatalities2009Ingår i: Wiley Encyclopedia of Forensic Science, Chichester,: John Wiley & Sons Ltd , 2009Kapitel i bok, del av antologi (Övrig (populärvetenskap, debatt, mm))
    Abstract [en]

    This A to Z encyclopedia provides a comprehensive, definitive, and up-to-date reference of the main areas of specialist and expert knowledge and skills used by those involved in all aspects of the forensic process, including, but not limited to, forensic scientists, doctors, practicing and academic lawyers, paralegals, police, crime scene investigators, analytical chemists, behavioral scientists and toxicologists.

    This five-volume set covers all topics which, either as part of an established forensic discipline or as a potentially useful emerging discipline, are of interest to those involved in the forensic process. This includes both the scientific methodology and the admissibility of evidence. The encyclopedia also provides case studies of landmark cases in the definition and practice of forensic science.

    Wiley Encyclopedia of Forensic Science presents all material on a level and in a style that makes it accessible to a wide range of readers. In particular, lawyers needing to better understand the key aspects of the science, and scientists who require a deeper insight into legal issues will find the encyclopedia an important resource, as will physical, biological and behavioral scientists who require background information on the most important aspects of each other’s areas of expertise.

     

  • 5.
    Eriksson, Anders
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Öström, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Spigset, Olav
    Thorson, Jan
    Fatal intoxications with selective serotonin reuptake inhibition: Do the different drugs differ in toxicity?1999Ingår i: 15th Triennial Meeting International Association of Forensic Sciences, 1999, s. 270-Konferensbidrag (Övrig (populärvetenskap, debatt, mm))
  • 6. Spigset, Olav
    et al.
    Öström, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Eriksson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Death resulting from asthma associated with sertraline2001Ingår i: The American journal of forensic medicine and pathology : official publication of the National Association of Medical Examiners, ISSN 0195-7910, Vol. 22, nr 4, s. 419-20Artikel i tidskrift (Refereegranskat)
  • 7.
    Stjernbrandt, Albin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Öström, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Eriksson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Björnstig, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Land Motor Vehicle-Related Drownings in Sweden2008Ingår i: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 9, nr 6, s. 539-543Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Knowledge regarding drownings related to land motor vehicle events is limited although reports of these events occur globally. This study elucidates crash and injury mechanisms in motor vehicle-related drownings in a Swedish population during 1992 through 2006 in order to suggest preventive countermeasures. Methods: The cases were identified in the National Board of Forensic Medicine database and crosschecked against the official statistics. All available autopsy reports, hospital records, and police records were analyzed. In addition, corresponding in-depth analyses performed by the Swedish Road Administration were reviewed and analyzed. Results: In total, 83 drownings occurred in 64 vehicles. The great majority of victims had no serious injuries (92% MAIS ≤ 2) and would probably have survived if they had not drowned. Most events took place in waters directly adjacent to a roadway (36%) or bridge (34%). The vehicles were most often (72%) found upside down, and most drownings occurred in shallow water (65% depth <2 m). One third (32%) of the drivers tested positive for alcohol (mean BAC of 2.0 g/L; range 0.16-2.6). The majority (69%) of the fatalities could possibly have been prevented if effective guardrails had been in place. Conclusions: Drownings in motor vehicles are not negligible events and in many cases they are preventable. Sufficient design and placement of guardrails can minimize these events, but further experimental investigation should be conducted to better understand these events and how to optimize vehicle design, rescue operations, and self-rescue.

  • 8.
    Wiklund, Urban
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik.
    Karlsson, Marcus
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik.
    Öström, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Messner, Torbjörn
    Influence of energy drinks and alcohol on post-exercise heart rate recovery and heart rate variability2009Ingår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 29, nr 1, s. 74-80Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Background: Media have anecdotally reported that drinking energy drinks in combination with alcohol and exercise could cause sudden cardiac death. This study investigated changes in the electrocardiogram (ECG) and heart rate variability after intake of an energy drink, taken in combination with alcohol and exercise.

    Methods: Ten healthy volunteers (five men and five women aged 19–30) performed maximal bicycle ergometer exercise for 30 min after: (i) intake of 0·75 l of an energy drink mixed with alcohol; (ii) intake of energy drink; and, (iii) no intake of any drink. ECG was continuously recorded for analysis of heart rate variability and heart rate recovery.

    Results: No subject developed any clinically significant arrhythmias. Post-exercise recovery in heart rate and heart rate variability was slower after the subjects consumed energy drink and alcohol before exercise, than after exercise alone.

    Conclusion: The healthy subjects developed blunted cardiac autonomic modulation after exercising when they had consumed energy drinks mixed with alcohol. Although they did not develop any significant arrhythmia, individuals predisposed to arrhythmia by congenital or other rhythm disorders could have an increased risk for malignant cardiac arrhythmia in similar situations.

  • 9.
    Öström, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Vehicle-related injuries: with emphasis on fatality prevention1993Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    According to WHO, Sweden should aim to reduce unintentional fatalities, particularly vehicle-related injuries, by 25% by the year 2000. The aim of this thesis was to analyze vehicle-related injuries and injury events, especially the contributory effects of alcohol and disease and the injury reducing capacity of helmets and airbags in order to point out some preventive measures.

    Alcohol: Alcohol is the main contributing factor in fatal traffic crashes. In a study on 121 traffic fatalities in Washtenaw County, Michigan, USA, different sources of data for alcohol involvement were compared. In police reports alcohol involvement was found in 51% of the fatalities, in autopsy reports in 63%, and in hospital emergency records in 91%. To avoid bias in the estimation of the fraction of alcohol-related fatalities, it is important to routinely investigate all severe and fatally injured cases in traffic crashes, ideally as soon as possible after the crash.

    In a study on traumatic car fatalities (n=597) in northern Sweden, 58% of the single vehicle (SV) drivers were inebriated (multi-vehicle, MV 10%), the mean blood alcohol concentration (BAC) was 1.9 g /l (MV 1.6 g/1), and liver steatosis was found in 37% of the cases (MV 2%). Increased BAC was associated with fatty liver, indicating chronic alcohol abuse. To reduce injuries among these types of victims, passive protection is of great importance.

    Disease: Autopsied drivers (n=126) in northern Sweden who had died from natural causes in traffic were studied. This fraction was 25% of all driver fatalities. Cardiovascular causes of death were found in 96% of the deceased. Neither the victims nor other occupants suffered severe traumatic injuries. A minority of the victims had experienced previous symtoms of disease. Further restriction of individuals with, for example, cardiovascular diseases would probably have no significant impact on traffic safety since at present the identification of high-risk individuals is difficult.

    Helmets: Head injuries in 948 injured bicyclists, including 105 fatalities, were analysed. Head/face injuries were found in 64% of the fatal and 38% of the nonfatal cases with a median age of 55 years and 18 years, respectively. Head trauma was mostly blunt with only a few severe face injuries. Of the nonfatal cases with head injuries, 48% might have had an injury reduction effect if a bicycle helmet had been used, compared with 67% of the fatalities with head injuries.

    A helmet with a hard shell, chin cover, accurate retention system, that reduces rotation and translation impact is recommended. To increase helmet use among bicyclists, a law is probably the most effective measure as has been shown for motorcyclists. However, head injuries were less frequent among snowmobile riders than among bicyclist and motorcyclist riders, and in most cases the snowmobile riders with head injuries but without helmet had broken other traffic laws, indicating that in this crash category there was a low compliance to compulsary laws.

    Airbags: In a field study of car crashes where an airbag deployed, the effectiveness of the bag, as well as injuries to the skin and eye from the deployment of the bag, is reported. In laboratory tests with airbag deployment on human volunteers, tethering was found to eliminate skin abrasion within a distance of 250-300 mm. At a distance of 225 mm, the folding technique had the optimal influence on abrasions followed by a marginal effect of tethering. However, injuries due to airbag deployment must be considered as negligible compared with the airbag's role in reduction of severe and fatal injuries.

  • 10.
    Öström, Mats
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Ahlm, Kristin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Eriksson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Brister i handläggningen av onaturliga dödsfall1999Ingår i: Svenska Läkaresällskapets Handlingar Hygiea, 1999Konferensbidrag (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    Enligt gällande svenska rättsregler förutsätts att i princip samtliga onaturliga dödsfall, inkluderande samtliga fall där misstanke finns om yttre våld, förgiftning, missbruk eller om fel eller försummelse inom sjukvården, ska anmälas till polis och genomgå rättsmedicinsk undersökning. Syftet med den föreliggande undersökningen var att närmare studera de dödsfall som inte genomgått rättsmedicinsk undersökning trots att så borde ha skett enligt gällande regelverk, och att belysa varför så inte blivit fallet.

  • 11.
    Öström, Mats
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Eriksson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Snowmobile fatalities aspects on preventive measures from a 25-year review.2002Ingår i: Accident; analysis and prevention, ISSN 0001-4575, Vol. 34, nr 4, s. 563-8Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    During October 1973 through May 1998, 157 snowmobile fatalities were autopsied in Northern Sweden, including 131 riders, 15 passengers, six occupants with unknown position and five victims pulled by a snowmobile. Most fatalities occurred during March and April (41%), on weekends/holidays (75%), between 18:00 and 02:00 h (59%), during darkness (63%), in clear weather (84%) and at leisure time (94%). The median age was 39 years and 92% were men. The most common causes of death were blunt trauma (53%) and drowning (38%). A total of 64% were inebriated by alcohol, with a mean blood alcohol concentration of 1.7 g/l. More inebriated victims were found during weekends/holidays than on weekdays (75 vs. 51%) and during nighttime than during daytime (92 vs. 52). Driving into water was the most common event (38%) followed by collisions with immobile objects (20%). Alcohol and speeding were the most common contributors to the crashes, while flotation snowmobile suit and helmet use were considered to be the most important injury prevention factors.

  • 12.
    Öström, Mats
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Eriksson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Snowmobilie fatalities in Sweden1999Ingår i: Proceeding annual meeting American Academy of Forensic Sciences, 1999Konferensbidrag (Övrig (populärvetenskap, debatt, mm))
1 - 12 av 12
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