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The objective of this study was to determine the presence of alcohol and drugs in drivers severely injured in traffic crashes in six European countries. Data were collected from 2492 seriously injured drivers of cars and vans in Belgium, Denmark, Finland, Italy, Lithuania, and the Netherlands, between 2007 and 2010. Toxicological analysis was performed with chromatographic techniques on whole blood for 23 substances. The percentage of drivers positive for at least one psychoactive substance ranged between 28% (Lithuania) and 53% (Belgium). Alcohol (≥0.1 g/L) was the most common finding with the highest percentage in Belgium (42.5%). Among the alcohol-positive drivers, 90.5% had a blood alcohol count (BAC) ≥0.5 g/L and 65.7% had a BAC ≥1.3 g/L. Benzodiazepines (0.0-10.2%) and medicinal opioids (0.5-7.8%) were the most prevailing medicinal drugs, but half of the concentrations were lower than therapeutic. Cannabis (0.5-7.6%) was the most prevailing illicit drug. Alcohol was found in combination with drugs in 2.3-13.2% of the drivers. Drug combinations were found in 0.5-4.3% of the drivers. This study confirms the high prevalence of psychoactive substances in injured drivers, but we observed large differences between the participating countries. Alcohol was the most common finding, followed by cannabis and benzodiazepines. Notable are the many drivers having a BAC ≥ 1.3 g/L. The majority of the substances were found in combination with another psychoactive substance, mostly alcohol. The high prevalence of high BACs and combinations (compared to roadside surveys) suggest that those drivers are most at risk and that preventive actions should target them preferentially.

Motor vehicle accidental injuries are a frequent cause of death among young children and adolescents. The goal of this study was to compare patterns of injury between three capitals (Budapest, Vilnius, and Tallinn). Information on 190 fatal traffic accidents (69 pedestrians, 14 bicyclists, and 107 motor vehicle occupants) between 2002 and 2006 was collected from databases of medico-legal autopsies. The role of victims in accidents, the location of injuries, cause of death, survival period, and blood alcohol levels were evaluated. One-hundred and forty-one (74%) victims had a passive role in traffic as pedestrians, passengers in cars, or public transport. In victims who died at the scene, the rate of head injury was higher than in cases who received medical treatment (odds ratio = 2.58, CI = 1.2-5.55, p = 0.0127). These results underline the importance of postmortem studies to examine the pathomechanism of fatal traffic accidental injuries and to provide information for the prevention of road traffic accidents against children and adolescents. Language: en

The data presents the first comprehensive autosomal STR analysis in the Lithuanian population for the purpose to compile an autosomal STR DNA database of natives from Lithuania, evaluate autosomal STR diversity, introduce population reference data for forensic and population genetic issues. Autosomal STR data were collected from the blood samples of 300 unrelated individuals distributed throughout the country. The amplification of 15 autosomal STRs was performed in one multiplex PCR by the use of AmpFlSTR ® Identifiler ® PCR Amplification Kit for human identity and parentage testing. Statistical analyses were carried out to determine the basic parameters of population genetics and forensic efficiency for 15 autosomal STRs. The results indicated that autosomal STR profiles enable to achieve high-resolution essential for forensic DNA casework.

Evaluation of the pathomorphological characteristics of cases involving natural and sudden cardiovascular death is essential for the determination of the cause of death. The main purpose of this study is to investigate sudden unexpected cardiovascular death and to study how different geographical climatic influences may affect cardiac mortality in three capitals: Budapest, Vilnius and Tallinn. There were 8482 (5753 male, 2729 female) cardiovascular deaths between 2005 and 2009. The highest rate was observed in the age group between 71 and 80 years (35.17%) and 51–60 years (24.45%). The highest number of cardiovascular deaths occur in January (805/9.49%) and December (770/9.07%). Seasonal distribution was observed, with winter prevalence in Tallinn (279/3.20%) and spring prevalence in Vilnius (760/8.90%). Though in Vilnius and Budapest a great number of deaths occurred in winter and spring, any correlation with other factors (e.g. age, gender, BAC) was not statistically significant. Based on our results we can conclude that environmental–geographical parameters may affect natural cardiovascular death. Examination of pathological patterns and predisposing environmental parameters may help to improve prevention strategies.

The manuscript presents the European Guidelines on medico-legal Methods of Ascertainment and Criteria of Evaluation in cases of suspected subjective "Medical Responsibility and/or Liability" developed by an international working group under the patronage of the European Academy of Legal Medicine. It includes a step-by-step illustrated explanation of approved Flow Charts, articulated in 18 sequential steps and comprehensive of both Methods of Ascertainment and Evaluation Criteria.

This chapter presents the European Guidelines on Medico-Legal Methods of Ascertainment and Criteria of Evaluation in cases of suspected subjective “Medical Responsibility and/or Liability” developed under the patronage of the European Academy of Legal Medicine (EALM). It includes a step-by-step illustrated explanation of approved Flow Charts, articulated on 18 sequential steps, comprehensive of both Methods of Ascertainment and Evaluation Criteria. This document is adopted as European Guideline on the issue by the EALM.

This chapter includes three subchapters, specifically devoted to Lithuania, Latvia and Estonia. Lithuania: this subchapter begins with an overview of the judicial and normative situation regarding medical liability in Lithuania, discussing judicial/extra-judicial institutions and operative roles within that context. The second section of the subchapter describes the ascertainment methodology for living persons and cadavers in Lithuania, while the third section examines the evaluation criteria. The subchapter ends with a discussion on the future perspectives for medical liability in Lithuania. Latvia: the first section of the subchapter contains an overview of the legislation governing the medical practitioner’s liability and is followed by a description of the extra-legal activity in Latvia. The main section of the subchapter outlines the ascertainment methodology for living persons and cadavers in Latvia, while the fourth section examines the evaluation criteriology currently in effect. The subchapter ends with a discussion on the future perspectives for medical liability in Latvia. Estonia: this subchapter begins with a judicial and normative overview of medical liability in Estonia, while the second section outlines the judicial/extra-judicial institutions and operative roles. The third section details the ascertainment methodology, in Estonia, for living persons and cadavers, while the penultimate section focuses on the evaluation criteria. This subchapter ends with a discussion on the future perspectives for medical liability in Estonia.

Objective: To determine the presence of alcohol and drugs in drivers severely injured in traffic crashes in 6 European countries. Methods: Data were collected from 2492 seriously injured drivers of cars and vans in Belgium, Denmark, Finland, Italy, Lithuania and The Netherlands, between 2007 and 2010. Toxicological analysis was performed with chromatographic techniques on whole blood for 23 substances Results: The percentage of drivers positive for at least one psychoactive substance ranged between 28 (Lithuania) and 53% (Belgium). Alcohol (≥0.1 g/L) was the most common finding with the highest percentage in Belgium (42.5%). Among the alcohol-positive drivers, 90.5% had a BAC ≥0.5 g/L and 65.7% had a BAC ≥1.3 g/L (between 58.2% (NL) and 76.5% (FI)). Benzodiazepines (0.0-10.2%) and medicinal opioids (0.5-7.8%) were the most prevailing medicinal drugs, but half of the concentrations were lower than therapeutic. Cannabis (0.5-7.6%) was the most prevailing illicit drug. Alcohol was found in combination with drugs in 2.3-13.2% of the drivers. Drug combinations were found in 0.5-4.3% of the drivers. Conclusion: This study confirms the high prevalence of psychoactive substances in injured drivers, but we observed large differences between the participating countries. Alcohol was the most common finding, followed by cannabis and benzodiazepines. Notable are the many drivers having a BAC ≥ 1.3 g/L. The majority of the substances were found in combination with another psychoactive substance, mostly alcohol. The high prevalence of high BACs and combinations (compared to roadside surveys) suggest that those drivers are most at risk and that preventive actions should target them preferentially.

Motor vehicle accidental injuries are a frequent cause of death among young children and adolescents. The goal of this study was to compare patterns of injury between three capitals (Budapest, Vilnius, and Tallinn). Information on 190 fatal traffic accidents (69 pedestrians, 14 bicyclists, and 107 motor vehicle occupants) between 2002 and 2006 was collected from databases of medico-legal autopsies. The role of victims in accidents, the location of injuries, cause of death, survival period, and blood alcohol levels were evaluated. One-hundred and forty-one (74%) victims had a passive role in traffic as pedestrians, passengers in cars, or public transport. In victims who died at the scene, the rate of head injury was higher than in cases who received medical treatment (odds ratio = 2.58, CI = 1.2-5.55, p = 0.0127). These results underline the importance of postmortem studies to examine the pathomechanism of fatal traffic accidental injuries and to provide information for the prevention of road traffic accidents against children and adolescents.

Aiming to identify the injuring tool characteristics and the tool itself morphologic, experimental-comparative investigations of the skin wound, rib and cartilage injuries taken during the autopsy are performed. During 1995-2004, 489 investigations were performed for this purpose. In 418 cases, knives were submitted for identification of the specific injuring tool (in total-835 knives). In 205 cases the investigation included not only skin wounds, but also the injured rib cartilages. Identification investigations were performed by investigating both the skin wounds morphologic characteristics and dynamic traces-trails in the rib cartilage tissue left by the micro relief of the knife blade edge. In the case of the investigated and experimental skin wounds characteristics coincidence the experimental and comparative dynamic traces investigation was performed when the traces were suitable for the tool identification purposes. In the case of the investigated and experimental skin wounds, dynamic traces coincidence, the totality of the coincided characteristics was considered individual. In those cases, the conclusion included the fact that the injury had been made by a particular knife. According to our data during 1995-2004 in 23 cases-15.9% (5.5% out of the total investigated cases), the knife identification was based on the skin wound characteristics and dynamic traces in the rib cartilage tissue. In our opinion, the dynamic traces in the rib cartilage tissue investigations supplement the identification field and are valuable in the tool identification. In 11 (2.6% out of the total investigated cases) cases knives were identified only by the skin wounds morphologic characteristics, the ribs being not injured or dynamic traces being not suitable for the tool identification.

The new approach is given in this work combines autosomal and Y-chromosomal short tandem repeats (STRs) data in paternity testing with father/son pairs taking into account mutation events. Our results show that Y-STRs can identify nonpaternity cases with high accuracy but need to be validated with autosomal STR to establish paternity. Autosomal and Y-STR mutations give disputing questions in paternity testing as well.

s / Forensic Science International 169S (2007) S50–S54 S51 promotions within their organizations, and to achieve their personal goals. The success of these programs is attributed to their novel presentation, the high level of student support, the availability and accessibility of the courses and a quality of interaction with professors and instructors that often exceeds that of a traditional classroom setting. DOI: 10.1016/j.forsciint.2007.04.149 CPE-POL-SERV-FO-02 Forensic medicine in Lithuania: Challenges and trends Marija Caplinskiene, Alvydas Pauliukevicius Institute of Forensic Medicine, Mykolas Romeris University, Vilnius, Lithuania Issues: To describe the forensic medicine tendencies and current trends in Lithuania in the European context, future perspectives, framework and network of cooperation in the Baltic and other regions. New challenges appear for forensic medicine in Lithuania related to global processes of integration, free migration, quick technical development and other sequels which made influences in all spheres of social life including criminality. Some defenses become a global problem—drugs trafficking, terrorism, disaster victim identification (DVI), missing person investigation (MPI), etc. The applications of the newest biotechnologies while creating modern methods of medical—biological expertise, estimation of cause and time of death by applying specificcomplex investigations, looking for new methods and modeling became the main issue. Forensic medicine and science is a vital instrument for the detection of crime and the administration of justice, as it is not always recognized. The forensic medicine institutions play a critical role in the delivery of forensic services to the criminal justice system. The direct attention should be taken to different level of forensic service institutions in the region with special emphasis to New Member States of the European Union. All documents of the European Council of Legal Medicine (ECLM) are on basis as recommendations. The importance is to apply for the mandatory resolution of the EC to develop the forensic science and legal medicine institutions as in the needed basic level which has to be recognized as priority. Identification of needs and the implementation of advanced technology measures to ensure that the criminal justice system could have an uninterrupted access to the full range of forensic services of the required quality standards. The need for better management of the technology transfer process to facilitate exploitation of academic research with potential for application to crime prevention and detection technologies. Various measures have to improve the handling of expert evidence in court, including better provision of training for expert witnesses, lawyers and judges. It’s critically important to promote communication between the scientific and legal professions and to provide for ongoing scientific scrutiny of expert evidence. Conclusions: Development of these trends of scientific activities will be useful for development of cooperation between the different scientific research institutions in the Baltic and other regions, preparing and submitting common international projects, preparing highly qualified specialists, educating scientific-pedagogical staff. The framework and network of cooperation have to be foreseen as the degree of progress varies, the gaps should be reduced. The areas where considerable efforts are still required are notably those related to the use of additional funds. The emphasis to different level of forensic service is the critical issue to be discussed.

The objective of this study was to determine the presence of alcohol and drugs in drivers severely injured in traffic crashes in six European countries. Data were collected from 2492 seriously injured drivers of cars and vans in Belgium, Denmark, Finland, Italy, Lithuania, and the Netherlands, between 2007 and 2010. Toxicological analysis was performed with chromatographic techniques on whole blood for 23 substances. The percentage of drivers positive for at least one psychoactive substance ranged between 28% (Lithuania) and 53% (Belgium). Alcohol (≥0.1 g/L) was the most common finding with the highest percentage in Belgium (42.5%). Among the alcohol-positive drivers, 90.5% had a blood alcohol count (BAC) ≥0.5 g/L and 65.7% had a BAC ≥1.3 g/L. Benzodiazepines (0.0-10.2%) and medicinal opioids (0.5-7.8%) were the most prevailing medicinal drugs, but half of the concentrations were lower than therapeutic. Cannabis (0.5-7.6%) was the most prevailing illicit drug. Alcohol was found in combination with drugs in 2.3-13.2% of the drivers. Drug combinations were found in 0.5-4.3% of the drivers. This study confirms the high prevalence of psychoactive substances in injured drivers, but we observed large differences between the participating countries. Alcohol was the most common finding, followed by cannabis and benzodiazepines. Notable are the many drivers having a BAC ≥ 1.3 g/L. The majority of the substances were found in combination with another psychoactive substance, mostly alcohol. The high prevalence of high BACs and combinations (compared to roadside surveys) suggest that those drivers are most at risk and that preventive actions should target them preferentially.