Akutes Leberversagen

Acute liver failure is a rare dynamic disease with a high spontaneous mortality. It is defined as acute (<26 weeks) severe liver insufficiency (INR?>1.5) with hepatic encephalopathy in the absence of chronic liver disease. The most important prognostic parameters in acute liver failure are the etiology as well as the stage of hepatic encephalopathy. Multiorgan failure, infections as well as advanced cerebral edema are the most frequent causes of death in patients with acute liver failure. Management of acute liver failure always requires intensive care surveillance with close monitoring. In case of complications an early and aggressive therapy is recommended. This includes a fluid and blood glucose monitoring, tracheal intubation and mannitol in cases of cerebral edema, a substitution of coagulation factors only in case of hemorrhage, early antibiotics for infections, early renal replacement therapy, N-acetyl cysteine for stage I/II hepatic encephalopathy as well as etiology-specific therapeutic measures. Liver transplantation is the last step therapy.     

Ruptur einer zerebralen arterioven?sen Malformation

Arteriovenous malformations are vascular anomalies characterised by the presence of an arteriovenous shunt in the absence of a normally structured capillary bed. The prevalence of manifestations in the brain is given in specialist literature with a high level of variability. Brain hemorrhages resulting from a lesion of a cerebral arteriovenous malformation and leading to sudden unexpected death are relatively seldom in forensic autopsy material. The forensic significance of this syndrome may be illustrated by the example of a 16-year-old female who was found dead in the bathroom of her parents?? home for reasons which were initially unexplained.     

Synthetische Cannabinoide

In recent years a flood of new psychoactive substances offered as “legal highs” appeared on the drugs market worldwide. In some parts of the world amphetamine-type stimulants are predominant but in Germany synthetic cannabinoids represent the bigger problem. The high dynamics which are maintained by the “cat and mouse game” of scheduling substances and the producers circumventing the regulations by adding new, chemically modified substances, poses a great challenge for both forensic science and toxicology.     

Endokrinologie der humanen Plazenta

The placenta, a fetal organ at the feto-maternal interface, produces an amazing array of hormones, known to be produced in fact only in the hypothalamus or pituitary gland. Its special anatomy and its functional role as a barrier between fetal and maternal blood circulations enable a selective action of placental hormones either on the mother or the developing fetus. Knowledge concerning placental hormones has increased over the past decades, but some questions still remain. One of these questions is the relevance of hormone substitution in case of a placental insufficiency, as is usually done for other endocrine organs.