Afdeling for Retspatologi
Frederik V's Vej 11, København Ø
Survive: Let the Dead Help the Living
A notable excess mortality is seen among mentally ill persons. This excess mortality is associated with somatic conditions caused by medical treatment and sequelae from the patients' inopportune way of life. The project "Survive: Let the Dead Help the Living" is a prospective, nationwide autopsy-based study.
Autopsies of mentally ill persons may help uncover a range of conditions critical to their survival by allowing studies that would otherwise have been impossible to perform. For obvious reasons, the tissue of living persons cannot be studied as thoroughly as the tissue of deceased persons. Direct observation of the individual organ and subsequent tissue microscopy, forensic chemistry and molecular biology testing may provide important, detailed information that may be a substantial supplement to the many other methods used when testing and examining living persons.
The overall hypothesis of the SURVIVE project is that optimized molecular biology autopsy of deceased mentally ill persons may reveal the importance of 1) somatic disease and organ changes, 2) metabolic syndrome, 3) use and abuse of alcohol, pharmaceuticals and euphoriants, 4) factors of importance for the metabolism (ADME) of pharmaceuticals and 5) acquired and/or congenital genetic variation in SDC.
We are therefore convinced that this project will contribute both through formation of hypotheses and hypothesis testing, primarily in the field of applied research. We also believe that this will raise the hope of rapid and direct implementation and anchoring of these new methods in current diagnostic treatment routines and preventive measures for the benefit of those living with mental illness.
More specifically, a prospective anchoring of the project will be achieved through the implementation of an optimized autopsy algorithm for continued and improved monitoring of this type of deaths which will, in turn, be instrumental in improving the diagnostic measures, disease control and management of mentally ill persons in the future.
Within the forensic setting, we will optimize the following diagnostic tools: CT scans, MR scans, histomorphometric analyses, metabolic and genetic analysis.
Scientific work in the area of sudden death in infancy including sudden infant death syndrome (SIDS) with focus in part from the need to acquire skills in the field of forensic pathology such as autopsy techniques, organ examinations and histology including histochemical, genetic and molecular biological studies with interleukin detection, development of methods for isolating mRNA from formalin- fixed, paraffin-embedded tissue, functional studies on tenoblasts from SIDS cases and genetic tests on purified DNA from blood.
In recent years the focus has been on the adult group of sudden death patients – including sudden cardiac death and the increased morbidity, co-morbidity and excess mortality among mentally ill persons. In order to meet the standard for evidence-based medicine in forensic pathology, these studies have required increased focus on the implementation of international pathology standards, especially for heart examination in forensic pathology, tissue sampling techniques and storage of relevant tissue.
Undervisnings- og vejledningsområder
Medical students: Forensic Medicine, every semester since 1999
Medical students: 2nd part A, 2nd semester and 6th semester in pathology (1995-1997)
Medical students: 1st part A, 2nd semester in anatomy (1995-1997)
Nursing students: Pathology, Demonstration of section (1995-1997)
Occupational therapists: Rheumatology: Pathogenesis, Clinic and Therapy, 3rd year, Aarhus School of Occupational Therapy in 1989, 1990, 1994 and 1995
General practitioners: Postgraduate course held by Novo Nordisk, 1993
Specialists and nurses: Clinical Forensic Medicine, Center for Voldtægtsofre (Centre for Rape Victims) and the Regional Departments of Forensic Medicine, Aarhus, every second year since 1999
Continuing education courses under the Danish Society of Forensic Science (DSFS): Homicide, Suicide and Clinical Forensic Medicine
Speciality-specific courses: Forensic Medicine: Course organizer and lecturer in Clinical Forensic Medicine every second year from 2008, and for pathologists and forensic pathologists in Research Training in 2011 and 2013.
Police and legal experts:In-service training on the forensic medicine examination of sexually abused children, Danish National Police College, biannually since 2004.
PhD course at the University of Copenhagen (course organizer and lecturer) – Sudden Cardiac Death
Nordic Forensic Medicine Congress 2012 – Aarhus – co-organizer
Occupational therapists: Examiner, oral exam (tentamen) in Rheumatology, 3rd year, Aarhus, School of Occupational Therapy, 1989
Medical students: Examiner, Forensic Medicine, FHS, AU, since 1999 oral exams and as from 2004 written exams
Medical students: External examiner in Pathological Anatomy and Forensic Medicine, since 2002
Students of dentistry: External examiner in Pathological Anatomy, since 2006
Drafting of training and information material
1. Chlamydial Histopathology. In: Chlamydial Infections of the Genital and Respiratory Tract and Allied Conditions. 1991, eds. P.A. Mårdh, P. Saikku
2. Pathological Criteria in the Nordic Study of Sudden Infant Death; Lung Pathology. In: Sudden Infant Death Syndrome, New Trends in the Nineties, ed. TO. Rognum, 1995, Scandinavian University Press, Oslo.
3. Histopathological Methods in Renal Toxicology. In: Renal Toxicology, ed. P.L. Petralia, 1995, CRC Press INC, Boca Raton, USA.
4. Chapter on sexual assault on children for Manual on Forensic Medicine (Lærebog i Retsmedicin) AV. Charles, JB Lundemose; ed. JL. Thomsen, FADL, 1.ed. 2004, 2. ed. 2008 and 3. ed. 2013
5. Truth and Consequence (Sandhed og konsekvens) – Training and information material for the municipal primary and lower secondary schools of Denmark: Interactive training material on rape and the consequences hereof. Targeting children/teenagers aged 12-18 years. Published May 2005, ISBN 87-988678-1-4
6. Web: www.sandhedogkonsekvens.dk (in Danish)
7. Description of objectives and logbook, DSFS: www.forensic.dk
8. The DSFS webpage www.forensic.dk
9. Description of objectives and portfolio for training positions for the introductory
and the main training programmes of forensic medicine, 2008 and their revision in 2012
Project manager: Survive - Let the Dead Help the Living, a national and cross-disciplinary project on excess mortality in the mentally ill. Includes the effect of pharmacological as well as non-pharmacological factors. Comprises seven sub-projects, including five PhD projects.
PhD project supervisor
Main supervisor for the PhD project: Hyperthermic and Oxidative Stress in Sudden Infant Death. Investigation of Human Fibroblasts Cultures and Evaluation of Infant Death in a Forensic Setting. Defended and approved 2011 at FHS, AU.
Co-supervisor on the project of MSc in Psychology: Adolescent Sexual Assault: Informing Prevention”, defended and approved 2010 at the Faculty of Social Sciences, AU.
Main supervisor on the PhD project: Hypoxic Changes and Neurotropic Viruses of Sudden Infant Death. Enrolled 2008 at FHS, AU
Main supervisor on the PhD project: Sudden Unexpected Death – Cardiac Disease with Genetic Background", enrolled 2009 at FHS, AU
Co-supervisor on the PhD project:Newer Strategies Toward Myocarditis – Evaluation and Development of Diagnostic and Prognostic Markers, enrolled in May 2001 at Faculty of Health Science and Technology, Aalborg University.
Research methodology assignments for 9th semester students of medicine
False Notification in Clinical Forensic Medicine.Pathomimia in Clinical Forensic Medicine. Assault on Women of Non-Danish Origin.Sexual Assault as Onset. Negative Cardiovascular Sequelae of Abuse of Anabolic Steroids. Congenital Heart Malformation in Infants.. The Police Certificate and how to Complete it..
Supervisor for persons seeking speciality training in forensic medicine
Mentally ill and sudden death