Andrea M Berzlanovich

• Prof. Dr.
• Leader of the Unit Forensic Gerontology at Medical University of Vienna

The cement line (CL) is a thin layer separating secondary osteons from interstitial bone and other osteons. It is assumed to play a significant role in bone fracture resistance, owing to its ability to deflect or arrest microcracks. Despite the possible role for bone quality, the CL is still one of the least understood microstructural features of b...

For a better understanding of living tissues and materials, it is essential to study the intricate spatial relationship between cells and their surrounding tissue on the nanoscale, with a need for 3D, high‐resolution imaging techniques. In the case of bone, focused ion beam‐scanning electron microscopy (FIB‐SEM) operated in the backscattered electr...

Osteocytes act as bone mechanosensors, regulators of osteoblast/osteoclast activity and mineral homeostasis, however, knowledge about their functional/morphological changes throughout life is limited. We used quantitative backscattered electron imaging (qBEI) to investigate osteocyte lacunae sections (OLS) as a 2D-surrogate characterizing the osteo...

The spatial distribution of mineralization density is an important signature of bone growth and remodeling processes, and its alterations are often related to disease. The extracellular matrix of some vertebrate mineralized tissues is known to be perfused by a lacunocanalicular network (LCN), a fluid-filled unmineralized structure that harbors oste...

The formation of the hard tissues that provide support and mobility to organisms is achieved through the interplay of inorganic crystals and an organic framework composed of collagen and a small percentage of non‐collagenous proteins. Despite their clinical relevance, the mechanisms governing mineralization of the extracellular matrix are still poo...

Quantitative backscattered electron imaging is an established method to map mineral content distributions in bone and to determine the bone mineralization density distribution (BMDD). The method we applied was initially validated for a scanning electron microscope (SEM) equipped with a tungsten hairpin cathode (thermionic electron emission) under s...

During bone remodeling, osteoblasts are known to deposit unmineralized collagenous tissue (osteoid), which mineralizes after some time lag. Some of the osteoblasts differentiate into osteocytes, forming a cell network within the lacunocanalicular network (LCN) of bone. To get more insight into the potential role of osteocytes in the mineralization...

During bone remodeling, osteoblasts are known to deposit unmineralized collagenous tissue (osteoid), which mineralizes after some time lag. Some of the osteoblasts differentiate into osteocytes, forming a cell network within the lacunocanalicular network (LCN) of bone. To get more insight into the potential role of osteocytes in the mineralization...

A popular hypothesis explains the mechanosensitivity of bone due to osteocytes sensing the load-induced flow of interstitial fluid squeezed through the lacunocanalicular network (LCN). However, the way in which the intricate structure of the LCN influences fluid flow through the network is largely unexplored. We therefore aimed to quantify fluid fl...

During human skeletal growth, bone is formed via different processes. Two of them are: new bone formation by depositing bone at the periosteal (outer) surface and bone remodeling corresponding to a local renewal of tissue. Since in remodeling formation is preceded by resorption, we hypothesize that modeling and remodeling could require radically di...

Examination of a person who has been a victim of a physical or sexual assault may be very important for upcoming legal proceedings. In the context of a clinical forensic examination, physical findings are recorded and biological trace material is gathered and secured. Ideally, all forensic findings are documented in a detailed report combined with...

The osteocyte lacunar-canalicular network (LCN) penetrates bone and houses the osteocytes and their processes. Despite its rather low volume fraction, the LCN represents an outstanding large surface that is possibly used by the osteocytes to interact with the surrounding mineralized bone matrix thereby contributing to mineral homeostasis. The aim o...

Violence may affect everyone, even elderly people, whether man or woman. As a result of reduced physical strength, older people are rather helpless when it comes to defending themselves, and frailty, illness, and care dependency entail an increased risk for serious health damage as a result of physical violence or trauma. Elderly people mostly have...

Background: The variables sex and gender are significantly related to health and disease of women and men. Aiming at quality research, biomedical publications need to account for the key variables sex and gender. Methods: All original articles published in the Wiener klinische Wochenschrift between 2013 and 2015 were extracted into a database. A...

During bone formation osteocytes get connected with each other via a dense network of canaliculi within the mineralized bone matrix. Important functions attributed to the osteocyte network include the control of bone remodeling and a contribution to mineral homeostasis. To detect structural clues of the formation and functionality of the network, t...

Previous surveys have asked local and regional samples of physicians about their demand for further education about elder abuse, and found majorities of respondents indicating such demand. We present results from the first nationally representative study of this topic. We focus on education about physical restraint and neglect of patients in need o...

Fig. S1 Example showing the advantages of the adaptive thresholding algorithm in the segmentation of lacunae and canaliculi: top, raw data image showing part of the Haversian canal at the bottom of the image and three lacunae with high fluorescence intensity. The two plots below compare the outcome of the applied adaptive thresholding algorithm wit...

Long-term antiresorptives use has been linked to atypical subtrochanteric and diaphyseal femoral fractures (AFF), the pathogenesis of which is still unknown. In the present case report we present the results of analysis of bone chips from a 74-year old female patient that had been on alendronate, ibandronate and denosumab treatment, and who sustain...

Osteocytes interconnect with each other forming an intricate cell network within the mineralized bone matrix. One important function of the osteocyte network is the mechano-regulation of bone remodeling, where a possible mechanism includes the fluid flow through the porosity housing the cell network - the osteocyte lacuno-canalicular network (OLCN)...

Dieses Kapitel beschäftigt sich mit der Gewalt gegen Pflegebedürftige. Das Erkennen von Gewalt im Handlungsfeld der ambulanten Pflege und Betreuung eröffnet die Möglichkeit, Hilfe und Unterstützung für die Opfer anzubieten und auch präventive Maßnahmen zur Vermeidung weiterer Gewalttätigkeiten einzuleiten.

Bei Verdacht auf körperliche und/oder sexualisierte Gewalt gegen Kinder und Jugendliche kann eine korrekte ärztliche Untersuchung dazu beitragen, die Lage der Betroffenen in einem späteren Straf- und/oder Zivilverfahren zu stärken und deren sekun däre Viktimisierung zu verhindern. Da diese Untersuchung nicht nur klinisch-kurativen, sondern auch for...

Death due to blunt trauma as a sequel of falls, as a cause of an increased life span is expected. The aim of this retrospective study was to examine the correlation between the height of fall and the frequency, the extensiveness, and the type of injuries of certain body regions and organs. The study included 201 cases of fatal falls, which consiste...

Raman microspectroscopy and quantitative backscattered electron imaging (qBEI) of bone are powerful tools to investigate bone material properties. Both methods provide information on the degree of bone matrix mineralization. However, a head-to-head comparison of these outcomes from identical bone areas has not been performed to date. In femoral mid...

An important determinant of mechanical properties of bone is Young's modulus and its variation in individual osteons of cortical bone tissue. Its mechanical behavior also depends on deformation rate owing to its visco- or poroelastic properties. We developed a method to measure dynamical mechanical properties of bulk bone tissue at osteonal level b...

Long-term exposure to increased Lead (Pb) concentrations is associated with several chronic diseases. The divalent cation Zinc (Zn) is essential for numerous enzymes. In a recent study we found remarkably elevated concentrations of Pb and Zn in the tidemark (TM), which is the mineralization front of human articular cartilage. Duplication or multipl...

Achtsamkeit (Mindfulness) ist ein zentraler Begriff in der buddhistischen Weisheitslehre, der in psychologischer Terminologie als ein spezifischer, trainierbarer Bewusstseinszustand beschrieben werden kann, der auf das direkte und nicht-wertende Gewahrsein dessen abzielt, was in jedem Augenblick geschieht (Hayes and Feldman, 2004, Sauer et al., 201...

Die Anwendung freiheitsentziehender Maßnahmen gegen den Willen Pflegebedürftiger ist eine spezielle Form von Gewalt in der Pflege. Dem ärztlichen und pflegerischen Personal ist oft nicht ausreichend bewusst, dass es sich dabei um schwerwiegende Eingriffe in die Menschenrechte mit Auswirkungen auf Würde, Lebensqualität und Gesundheit der zu Pflegend...

Physical restraint is used primarily for patients at risk of falling, those with motor unrest and agitated behavior, and those who manifest an intention of doing harm to themselves or are at risk of suicide. The use of freedom-restraining measures (FRM), and, in particular, the use of physical restraints against the patient's will, can be a serious...

ZUSAMMENFASSUNG Hintergrund: Gurtfixierungen werden vor allem bei zu Pfle-genden mit erhöhtem Sturzrisiko, motorischer Unruhe, agi-tiertem Verhalten sowie auch bei Selbstbeschädigungsab-sichten und Suizidgefahr eingesetzt. Die Anwendung von freiheitsentziehenden Maßnahmen (FEM), insbesondere das Anbringen von Gurten gegen den Willen der Betroffe-ne...

Male idiopathic osteoporosis (MIO) is a metabolic bone disease that is characterized by low bone mass, microstructural alterations, and increased fracture risk in otherwise healthy men. Although the detailed pathophysiology of MIO has yet to be clarified, evidence increasingly suggests an osteoblastic defect as the underlying cause. In this study w...

A highly specific accumulation of the toxic element lead was recently measured in the transition zone between non-calcified and calcified normal human articular cartilage. This transition zone, the so-called ‘tidemark’, is considered to be an active calcification front of great clinical importance. However, little is known about the mechanisms of a...

Suffocation using a soft cover is a specific form of smothering by oronasal occlusion. In this process, there are as a rule no morphological findings or only uncharacteristic ones. This form of asphyxia is therefore one of the diagnoses by exclusion in forensic medicine. When evaluating suspicious cases it is necessary to consider possible function...

During closed chest compression for cardiac arrest, any increase in coronary perfusion pressure accounts for a proportional increase in myocardial blood flow and therefore the resuscitability of the patient. The objectives of this study were to evaluate the safety, feasibility, and hemodynamic effects of phased chest and abdominal compression-decom...

In humans the toxic trace element lead (Pb) mainly accumulates in the skeletal tissue where it resides for a long period. Although Pb is known to play a role in bone and cartilage diseases, the distribution of Pb in these tissues is mostly unknown. Therefore synchrotron-radiation-induced micro x-ray fluorescence analysis (SR µ-XRF) in various geome...

The target of this paper was to quantify the amount of cognitive constriction in German-language suicide notes by studying quantitative psycholinguistic parameters of texts. This should give a better understanding of presuicidal events and encourage improvement in the field of suicide prevention and crisis intervention. The study is based on letter...

Nach dem Ende des Zweiten Weltkriegs stand aus betriebswirtschaftlicher Sicht zunächst insbesondere die Transformation von Verkäufermärkten in Käufermärkte im Fokus des Managements.1 Marketingseitig haben sich im Zuge dieser Entwicklung bis heute vielfältige, theoretisch-konzeptionelle und größtenteils empirisch fundierte Zugänge etabliert, die das...

Luftembolien stellen meist einen Nebenbefund dar, der besonders bei Obduktionen mit todesursächlichen Verletzungen an Kopf, Hals und Thorax zu beobachten ist. Dabei wird die Luftembolie als vitale Reaktion infolge von Venenverletzungen interpretiert. Sehr selten hat eine Luftembolie todesursächliche Bedeutung, z.B. im Zusammenhang mit medizinischen...

Im gerichtsmedizinischen Obduktionsgut werden gelegentlich Todesfälle von älteren pflegebedürftigen Heimbewohnern/Patienten im Zusammenhang mit nicht fach- bzw. sachgemäßen Fixierungsmaßnahmen beobachtet. Es wird über eine 91-jährige Bewohnerin eines Pflegeheims berichtet, bei der es trotz korrekt angelegtem Sitzgurt aufgrund ihrer Mobilität sowie...

Zusammenfassung Internationale Daten zeigen, dass die Suizidrate ab dem 65. Lebensjahr deutlich ansteigt. In Österreich stellen Suizide alter Menschen ein Drittel der gesamten Suizidinzidenz dar. Ziel dieser Studie war es alle innerhalb eines Dreijahreszeitraums am Department für Gerichtsmedizin Wien obduzierten Suizidfälle unter Berücksichtigung v...

The study of suicide notes has a long tradition. It is important to integrate this study into psychological autopsy and to make contact with the bereaved. For the first time, we present an Austrian-German study and its themes. A consecutive series of suicides, investigated at the Department for Forensic Medicine in Vienna from Mai 2002 until April...

Background The study of suicide notes has a long tradition. It is important to integrate this study into psychological autopsy and to make contact with the bereaved. For the first time, we present an Austrian-German study and its themes. Material and Methods A consecutive series of suicides, investigated at the Department for Forensic Medicine in V...

Aus betriebswirtschaftlicher Sicht stellt der japanische Silbermarkt kein homogenes, in sich abgeschlossenes und klar umrissenes Marktsegment dar. Das Konsumentenverhalten von Akteuren auf dem Silbermarkt und die kaufentscheidenden individuellen Prädispositionen werden durch lebensindividuelle, persönliche Erlebnisse und Erfahrungen mitgeprägt. Die...

Suicide notes provide direct information from suicide victims and often are written shortly before the suicide act. An important question is whether those who write such notes are representative for suicide victims who do not. A consecutive series of suicides investigated at the Department of Forensic Medicine in Vienna from April 2002 to March 200...

Background Suicide notes provide direct information from suicide victims and often are written shortly before the suicide act. An important question is whether those who write such notes are representative for suicide victims who do not. Methods A consecutive series of suicides investigated at the Department of Forensic Medicine in Vienna from Apri...

Determination of the spatial distribution of the toxic element lead (Pb) and other trace elements in normal articular cartilage and subchondral bone from adult humans with no history of work-related exposure to Pb. Four macroscopically normal femoral heads and three patellas were harvested from randomly selected forensic autopsies. All subjects die...

Our goal was to assess the prevalence of common causes of death and the demographic variables in a selected population of centenarians. The autopsy reports and medical histories of all individuals > or =100 years, dying unexpectedly out of hospital, were gathered from 42,398 consecutive autopsies, performed over a period of 18 years at the Institut...

The biomechanical properties of the zone of calcified cartilage (ZCC) in articulating joints are of clinical relevance due to the role ZCC plays in load transfer from cartilage to bone. To determine the micron-level mechanical properties and their correlation to mineral concentration in the ZCC, we combined nanoindentation (for micrometer level sti...

To assess the prevalence of food/foreign body asphyxia in the elderly Viennese population in order to reduce the incidence of these fatal events. This is an autopsy-based, retrospective study in Vienna, Austria. Participants included all nonhospitalized (n =200) cases of choking in 1984 to 2001, from a total 42,745 consecutive autopsies performed a...

In this survey, the textbooks on legal medicine which were published in the German-speaking countries from the 17th century up to now are briefly reviewed. The textbooks with the most impact on the further development of legal medicines were those published by Johann Ludwig Casper in Berlin and Eduard Ritter von Hofmann in Vienna in the 19th centur...

Despite the importance of autopsies for diagnosing disease and determining cause of death, autopsy rates are decreasing in many countries. Furthermore, autopsy rates are often not distributed randomly between different regions within countries. In this study we analyzed an apparent nonrandom spatial distribution of autopsy rates in Austria for the...

Background and objectiveDespite the importance of autopsies for diagnosing disease and determining cause of death, autopsy rates are decreasing in many countries. Furthermore, autopsy rates are often not distributed randomly between different regions within countries. In this study we analyzed an apparent nonrandom spatial distribution of autopsy r...

The so-called pinch-off syndrome is observed in up to 1% of all central venous catheters (CVCs), and is a valuable warning prior to fragmentation, which occurs in approximately 40% of the respective cases. As long-term indwelling CVCs are used with increasing frequency, this paper describes the necessity of pinch-off monitoring following the experi...

The aim of this study was to determine the causes of death in the very elderly. We reviewed 24,081 consecutive autopsies performed over 10 years (1989 to 1998) at the Institute of Forensic Medicine, Vienna, Austria. We focused on autopsies of people aged 85 years or older who died unexpectedly out of hospital. The mean age of the 1886 patients (561...

Bone and cartilage consist of different organic matrices, which can both be mineralized by the deposition of nano-sized calcium phosphate particles. We have studied these mineral particles in the mineralized cartilage layer between bone and different types of cartilage (bone/articular cartilage, bone/intervertebral disk, and bone/growth cartilage)...

The degree of mineralization of bone matrix is an important factor in determining the mechanical competence of bone. The remodeling and modeling activities of bone cells together with the time course of mineralization of newly formed bone matrix generate a characteristic bone mineralization density distribution (BMDD). In this study we investigated...

As a result of the increasing use of selective serotonin reuptake inhibitors (SSRI), the number of antidepressants (AD) prescribed in Vienna doubled from 1991 to 1997. In the same period, autopsies and chemical analyses performed at the Institute of Forensic Medicine, University of Vienna, revealed a total of 164 fatal intoxications by means of AD....

Wegen des zunehmenden Einsatzes der selektiven Serotoninwiederaufnahmehemmer (SSRI) verdoppelte sich die Zahl der verordneten Antidepressiva (AD) in Wien zwischen 1991 und 1997. Gleichzeitig wurden am Institut für Gerichtliche Medizin der Universität Wien 164 fatale Intoxikationen mit AD durch Autopsien und chemische Analysen nachgewiesen. Die von...

The breakage of two plates and one lag screw of Dynamic Hip Screws (AOR) was analyzed. Radiological examination showed technically inadequate internal fixation in one case and potentially unstable internal fixation in the other despite adequate reduction. In the case with breakage of a lag screw fracture reduction was unsuccessful and the fragments...

Knowledge of the structural development of the human vertebrae from non-weight-bearing before birth to weight-bearing after birth is still poor. We studied the mineralized tissue of the developing lumbar L4 vertebral body at ages 15 weeks postconception to 97 years from the tissue level (trabecular architecture) to the material level (micro- and na...

Objective: Spontaneous subarachnoid haemorrhage as a cause of out-of-hospital cardiac arrest is poorly evaluated. We analyse disease-specific and emergency care data in order to improve the recognition of subarachnoid haemorrhage as a cause of cardiac arrest. Design: We searched a registry of cardiac arrest patients admitted after primarily succ...

In vitro anatomic study investigating the degree of soft tissue disruption required to produce a subaxial cervical unilateral facet dislocation. To develop an understanding of the relative contributions to stability of the subaxial cervical soft tissues and to define an anatomic threshold of injury necessary to produce a unilateral cervical facet d...

Autopsies and toxicological analyses at the Institute of Forensic Medicine revealed 85 fatal intoxications with neuroleptics in Vienna from 1991 to 1997. A total of 17 cases were linked to a single neuroleptic (NL) alone, while 68 deaths were attributed to a combination of NLs with other drugs. The most frequently detected agent was prothipendyl (n...

A case report on fenestration of the extracranial vertebral artery found at forensic autopsy. To describe an extracranial vertebral artery fenestration involving the subaxial cervical region, assessed radiographically and angiographically at forensic autopsy, in a young man. Duplications or fenestrations of the extracranial course of the vertebral...

The elderly are living longer, and causes of death are shifting. At the same time, the autopsy rate is at, or near, its lowest in history, compounded by an even lower interest in geriatric autopsies. Thus, the prevalent cause of death in this age group remains poorly studied. For this reason we reviewed 24,081 consecutive autopsies performed in a t...

Inadequate pain management of cancer patients remains a striking problem despite impressive scientific progress in the knowledge of the pathophysiology, pathogenesis and therapy of pain. Our paper focuses on three topics: 1. physician-related barriers, 2. patient-related barriers, and 3. society- and tradition-related barriers as well as government...

Thirty-five fresh frozen cervical spine specimens underwent vertebral artery cannulization and angiography to determine the static influence of the four stages of subaxial flexion-distraction injuries as described by Allen et al on vertebral artery patency. To evaluate the degree of vertebral vessel deformation and potential injury in staged static...

The aetiology of atlanto-axial rotatory subluxation is obscure. Therefore, a post mortem investigation was designed in order to evaluate the C 1-2 rotation and translation mobility and to clear the borderline between mobility and instability and to clear the role of the atlanto-axial joints in atlanto-axial rotatory subluxation. C 1-2 specimen of 2...

Die Ätiologie der atlantoaxialen Rotationssubluxation ist unklar. Es wurde das natürliche Bewegungsausmaß von Rotation und sagittaler Translation zwischen Atlas und Axis bei Kindern untersucht, um die Grenze zwischen natürlicher Mobilität und Instabilität festzustellen. Es handelt sich um eine post mortem Untersuchung 2, 9 und 53 Monate alter Kinde...

Background Pulmonary embolism (PE) is a possible noncardiac cause of cardiac arrest. Mortality is very high, and often diagnosis is established only by autopsy. Methods In a retrospective study, we analyzed clinical presentation, diagnosis, therapy, and outcome of patients with cardiac arrest after PE admitted to the emergency department of an ur...

Although the WHO edited guidelines for pain treatment as early as 1986, practical management has frequently remained inadequate, especially in cancer patients. Traditional adherence to restrictions from the former Austrian Controlled Drug Act which have resulted in ongoing limitations in the prescription of opioids as well as complicated formal reg...