Antidepressants in suicide: differences in fatality and drug utilisation.

All forensic autopsy cases in southern Sweden in 1986-89 in which antidepressant drugs were found in the blood were assessed and the findings related to the sales of antidepressants as expressed as defined daily doses per 1,000 inhabitants per day. There was a total of 272 antidepressant-positive cases, which were divided in three groups: 1. suicide or possible suicide caused by antidepressant drugs, 2. suicide or possible suicide caused by other means (including other drugs and other toxic agents), and 3. other deaths. Amitriptyline was the agent most commonly involved in suicide or possible suicide caused by antidepressants, and it was also the most commonly sold antidepressant. When corrected for sales, trimipramine was most frequently involved as the causal agent. Conversely, despite frequent sales, lofepramine appeared only rarely to be involved. This may be related to lower toxicity of lofepramine, reduced lofepramine absorption at overdose and/or to differences in the administration of various antidepressant drugs to patients with differing degrees of risk of suicide.

Occurrence of Erysipelothrix rhusiopathiae on pork and in pig slurry, and the distribution of specific antibodies in abattoir workers.

Strains of Erysipelothrix rhusiopathiae isolated at 19 pig farms serving a certain abattoir, and on pork and in workers of this abattoir were studied. Mouse-pathogenic E. rhusiopathiae was found in pig slurry from two farms (11%). The strains belonged to serotypes 7 and 16 (both from the same farm) or were untypable. In pig slurry from the abattoir lairage only serotype 2 strains were found and all were pathogenic to mice. Mouse-pathogenic E. rhusiopathiae strains of serotype 2 were also recovered from 25 pork lions (25%). A mouse-pathogenic E. rhusiopathiae (serotype 2) strain was isolated from one of the 16 hand infections of slaughterhouse workers. The E. rhusiopathiae strains were phenotypically grouped by the API 50 CH system. Variations were demonstrated for the different serotypes. In 20 of 138 workers antibodies against E. rhusiopathiae were found; 14 had increased levels of IgG antibodies, seven had increased levels of IgM antibodies and one had an increased level of both.

Animal consumption of antibiotics and chemotherapeutic drugs in Sweden during 1980, 1982 and 1984.

The total animal consumption of antibiotic and chemotherapeutic drugs in Sweden during 1980, 1982 and 1984 has been studied. The study also included coccidiostatic, antiparasitic and antimycotic drugs. The total animal consumption during the years mentioned was 66.1, 68.8 and 72.6 tons of active substance, respectively, and the amount of antibacterial drugs for therapy was 28.7 (43.4%), 29.1 (42.5%) and 34.1 (47.0%) tons, respectively. Tetracycline, penicillin, sulphonamide and aminoglycoside were the four major groups of antibiotics used for therapy of bacterial infections in animals. The consumption was related to the metabolic bodyweights of animals which were the potential consumers. A comparison was also made with the corresponding human consumption during 1980. The data on antibiotic consumption can be divided by county and compared to the animal population and disease situation in each county. This study thus offers a good base for further investigations on different aspects of the use of antibiotics.

Head and neck injuries.

A survey of cranial, intracranial and neck injuries caused by blunt trauma to the head is presented. The different types of fractures to the skull (impression fractures, linear fractures and ring fractures) are discussed as well as the injury mechanisms. Brain injuries are discussed under the heading of focal brain injury (i.e. brain laceration, cortical contusion, hemorrhages of the meninges and traumatic intracerebral hemorrhages). The different types of neck injuries, including atlanto-occipital dislocation, are listed and the stability of the different fractures are discussed. Facial injury is not included.

A device which allows dictation of the autopsy report during the autopsy.

We describe a device for the simultaneous recording of the autopsy findings during the autopsy, thereby offering a convenient way of obtaining correct and timely autopsy reports.

Rotational cerebral injuries near the superior margin of the brain.

Traumatic lesions near the superior margin of the brain frequently are caused by an anterior or posterior blow to the head. The injuries consist of disruptions of one or a few (with subdural bleeding) or of numerous or all (with instant death or immediate unconsciousness and later death because of simultaneous brain stem injuries) parasagittal bridging veins. Cerebral injuries close beneath the superior margin of the brain occur either alone or together with disruptions of parasagittal bridging veins. These injuries consist mainly of subcortical, perivascular or larger, hemorrhages and of injuries to the white matter. No extensive complete necrosis occurs. The lesions are most frequently found in the posterior part of the superior frontal gyrus and the central gyri and often are combined with brain stem injuries. By reconstruction of trauma events the injuries seem to be caused by a rotational acceleration of the head. By model experiments and simulations it is shown that a rotational acceleration of the skull leads to an "inner deformation" of the brain tissue. This deformation may be the explanation of the subcortical injuries, which are therefore designated rotational cerebral injuries (RC-injuries).