Mentally disordered offenders in Sweden.

This article reviews the laws in Sweden concerning mentally disordered offenders. It also contains some figures on the relationship between mentally disordered offenders and other offenders sentenced to prison. The rules in Sweden are very different from other countries in that the responsibility concept has been abolished and thus there is no acquittal on a psychiatric basis.     

Surveillance of human immunodeficiency virus (HIV) antibodies in medicolegal autopsies in Finland--monitoring early changes in HIV-seropositivity among risk groups and average population.

In order to cooperate with voluntary screening programs aimed at the surveillance of the HIV epidemic in Finland, we have studied medicolegal autopsies for HIV antibodies since 1986 using an enzyme immunoassay on postmortem sera. The investigation covered 47.4% and 39.2%, respectively, of all deaths under the age of 65 years in the metropolitan areas of Helsinki and Turku--two cities on the densely populated southern coast of Finland from which most HIV infections have thus far been detected. Nine HIV-positive cases (0.12%) were detected among the 7305 medicolegal autopsies tested in 1986 to 1990. This figure is higher than the prevalence of 0.01 to 0.03% in voluntary screening programs for the general population would suggest. Seven of our cases had previously tested positive, and two were previously unknown cases, indicating that people at high risk are clustered in the medicolegal autopsy series. Of the six cases in an early stage of infection, three committed suicide suggesting the importance of HIV-screening in suicide cases in tracing symptomless HIV carriers. Five of the cases were detected in 1990, a year when the number of new HIV infections had more than doubled compared to the previous two years. This suggests that testing of medicolegal autopsies as surrogate tests for the population gives useful information even in low-prevalence areas like Finland. Such testing has none of the ethical problems of many other back-up surveys, and may be particularly sensitive to early changes in epidemiology.     

Dissecting intramural haematoma of the coronary artery with intimal tears.

A dissecting intramural haematoma of the coronary artery is an infrequent cause of sudden and unexpected death. Most cases are women and in a significant number of these women, the haematoma occurred at term to 80 days postpartum. Because the intimal rupture and communication with the lumen were not found in most of the cases, the site of rupture has been considered to be a vasa vasorum. The authors report on a case of one woman who was at a later postpartum period (106 days). The microscopic finding of the dissected coronary artery revealed two intimal tears in a section. The case showed that the dissecting intramural haematoma of the coronary artery is caused not only by the rupture of the vasa vasorum but also by the rupture of the intima.     

Should Abused Women's Reports of Partner Substance Abuse Be Accepted as Valid?

Current research suggests that a husband's substance abuse is correlated with severity of physical abuse and the woman's decision to leave a violent situation. Often, only the battered woman's report of abuse is available. This study compares women's reports of their partners' substance use/abuse with their partners' report using a brief measure of polydrug and alcohol abuse, the Substance Abuse Subtle Screening Inventory (SASSI) and the Conflict Tactics Scale (CTS). Data were analyzed for 25 recovery couples and 25 nonrecovery couples. The correlations for all 50 couples between the male's reported use and the female's report of her partner's use on the SASSI and the CTS were significant on all but one of the CTS scales. They ranged on SASSI from .73 to .33 and from .31 to .06 on the CTS. This suggests that the SASSI and possibly the CTS could be used as valuable tools for assessing women's reports of their partner's substance use/abuse.     

Identification based on medical findings

1. The indications such as the place of finding, the identification of clothes or other personal items, represent only the first step towards the identification of a corpse. 2. An identification based on medical data, other than dental, is often possible, more often than it is believed. 3. The forensic pathologist plays a double role in the case of such an identification: a) in the phase of the inquiry, he must contact the investigators and the families to explain his wishes and the different possibilities of identification. b) he must use the gathered information in the appropriate way. 4. It would be desirable to compose some statistical tables of the various medical elements useful for the identification (mutilations, surgical operations, etc...). We present six cases of identification in our practice.