The use of rapid diagnostic test of procalcitonin serum levels for the postmortem diagnosis of sepsis

Because serum Procalcitonin is reported to be a valid postmortem marker of sepsis, this prospective study was carried out to determine whether the semi-quantitative PCT-Q((R))-Test (B.R.A.H.M.S., Germany) is a reliable indicator of postmortem Procalcitonin (PCT) serum levels, thus enabling a quick "tableside" diagnosis of sepsis. Postmortem PCT-levels of 70 forensic and 78 clinical-pathological autopsy cases (n=148) were examined using the B.R.A.H.M.S-PCT-Q-Test during autopsy. 27 cases were categorized as the cases of sepsis according to the ACCP/SCCM Consensus Conference criteria. 121 cases were assigned to the non-sepsis group. Among the 148 cases, 18 samples could not be analyzed by the reason of strong hemolysis. Using a cut-off point of 2 ng/ml, 20 cases of sepsis were identified (true positive) whereas 3 cases of sepsis were not detected (false negative). In the non-sepsis group (107 cases) 6 cases showed a positive testing (false positive). When applied within 48 h postmortem, the PCT-Q-Test showed a sensitivity of 86.96% and a specificity of 94.39% (at cut-off 2 ng/ml). Likelihood ratios and positive predictive values proved to be lower in the forensic autopsy group (PPV: 59.3% in forensic case vs. 85.1% in clinicopathological cases; NPV: 98.73% in forensic cases vs. 95.2% in clinicopathological cases). The PPVs using a cut-off point of 10 ng/ml were 100% in both groups independent of sepsis prevalences. The results show, that a high NPV for prevalences ranging from 3% to 30% can be reached using a 2 ng/ml cut-off point, whereas a cut-off of 10 ng/ml ensures a high PPV for the respective prevalences in the absence of exclusion criteria. The study provides strong evidence that the introduction of rapid diagnostic test (RDTs) of postmortem PCT serum levels may be useful in achieving rapid distinction between sepsis and non-sepsis-related causes of death, especially in conjunction with the medical case history and further autopsy results. In addition, the use of RDTs enables clinicians to conduct an evidence-based validation of clinical diagnosis, thus facilitating future clinical decision-making.     

Comparison of the validity of three dental methods for the estimation of age at death

The aim of the present study was to compare the accuracy, precision, and bias of two macroscopic and one histological age at death estimation methods on human teeth. The sample was comprised of 67 permanent teeth, obtained from 37 individuals aged 20-91 years. Age was predicted according to the methods proposed by Lamendin et al. (LAM), Bang and Ramm (BR), and the quantification of tooth cementum annulations (TCA). TCA was found to be most accurate in all age groups. Its mean absolute error of the estimated age was about half as high as the mean absolute error for both LAM and BR. BR achieved approximately the same mean absolute error as TCA for old adults only. LAM displayed the highest precision in the young and the old age group whereas TCA was more precise in the middle age group. TCA was found to be the most precise method when the precision was calculated for all ages. Considering the bias, all methods displayed a tendency to overestimate age in young and to underestimate it in old specimens. The exception to this rule was TCA, which provided unbiased estimates for young adults. The higher accuracy and precision recommends favouring TCA over LAM and BR, provided that the required know-how and equipment are available.     

反规避措施——美国反倾销反补贴法律机制的新发展

<正> 1988年贸易与竞争混合法(下称1988年贸易法)对反倾销和反补贴税法作了广泛的修正,但就大部分而言,这些修正并不重要.然而,其中有一个修正案的适用却值得认真研究.在众多的反倾销和反补贴修正案中,反规避条款可能给反倾销反补贴法律机制——美国进口救济的中流砥柱——注入了润滑剂,甚至强化了这些法律的适     

走向九十年代——世界经济的挑战与东盟国家的反应

东南亚国家的经济成绩尽管原有的社会主义集团已经发生了变化,但是在东南亚地区仍然能够从市场导向型经济地区(包括东盟国家、即:文莱、印度尼西亚、马来西亚、菲律宾、新加坡和泰国)区分出非市场经济地区,即:缅甸、柬埔寨老挝、越南。第一表列示自1981年以来东南亚各国的经济增长率。     

新加坡贸易的新形势

英国现在加入欧洲经济共同体,人们的意见一致认为新加坡将不会遭到这个新经济组织的严重打击     

关于恩格斯法学观点的几个问题——纪念恩格斯诞生一百六十周年

<正> 恩格斯是马克思的亲密战友、杰出的革命家、伟大的思想家和卓越的学者。他毕生从事革命改造社会的斗争事业。他对辩证唯物主义和历史唯物主义的规律和范畴的论证,有着巨大的功绩。他"第一个说明了无产阶级不只是一个受苦的阶级……,无产阶级的     

加强劳动纪律的法律手段

<正> 在生产中加强劳动纪律和稳定干部的问题,始终是共产党和苏联政府一贯注意的中心。列宁在1918年写道:"必须把我们已经夺得的东西,把我们颁布过的法令,确定了的法规,讨论过的问题,拟订了的计划草案固定下来——必须把这些东西固定为不可动摇的日常劳动纪律。这是一个最困难而又最容易收效的任务,因为只有解决这个任务,我们才能树立起社会主义的秩序"。在加强自觉的劳动纪律中,劳动法令起了很大的作用。它巩固了人们对于遵守劳动纪律     

波兰及其他东欧社会主义国家的犯罪预防

<正> 背景犯罪作为一种社会现象,不论其规模大小和表现形式如何,总是影响社会进步的一种破坏性因素。就社会范围而言,犯罪按该词最广泛的意义是指触犯现行的刑律即不遵守为维护整体利益和个人利益而制订的禁令。这种行为     

再论完善经济立法

<正> 经济立法以及它和其他法律部门的区别。在1936年的苏联宪法里溲有经济法的术语。由此或许可以得出结论说,苏联溲有经济法,而只有民法、劳动法、土地法,家庭法等等。但是根据党和政府的决议,经济立法是存在的,而且在发展着,它非常复杂,非常广泛,并且应当完善。我们认为,在实践中广泛使用的"经济的"这一概念是十分确定的。在党和国家最重要的文件里,谈及社会主义经济中各经济组织、企业之间发生的合同和争议时就是说的经济立法、经济关系、经济合同和经济争议。