Pupil function as an indicator for being under the influence of central nervous system-acting substances from a traffic-medicine perspective.

To evaluate an individual's ability to drive safely, objective measurement methods are required. The primary aim of this study was to assess the applicability and value of infrared pupillography as an objective measurement method to indicate possible influence of central nervous system-acting substances. We exposed healthy test subjects (n = 41), as well as persons who were under the influence of drugs and/or medication (n = 105), to different light stimuli and tested the pupillary light reflex using infrared technology. The synoptic examination of numerous parameters, and the possibility of examination under various conditions, made it possible to achieve highly significant differentiation between persons who were under the influence of drugs and/or medication and control persons. Infrared pupillography represents an objective method of measuring pupil function, providing a reliable indicator of previous consumption of drugs and/or medication. In order to increase legal certainty it would thus appear desirable to make infrared pupillography a routine part of police checks in the near future.

Consenting to cornea donation: influencing factors.

BACKGROUND: The purpose of the study was to determine factors influencing the decision of the next relative being asked for consent to cornea donation in a prospective, non-comparative case series. METHODS: Interviews with the relatives of 264 potential cornea donors to the eye bank of the Ludwig-Maximilians-Universität, Munich, were documented following a standardized protocol. The influence of sociological factors on the frequency of obtained consents was investigated by uni- and multivariate analysis. RESULTS: During a 9-month period, 214 relatives of 264 possible donors were interviewed for consent to cornea donation. In total, 144 consents (67%) and 70 refusals (33%) were obtained; 50 relatives could not be reached. Analysis showed a higher consent rate for donors with a university degree (72%) versus those without (68%). Consent was more often obtained from relatives of donors that were divorced (71%) than from unmarried ones (63%). Husband and wife (71%) consented more frequently to cornea donation than children of age (62%) or parents (58%). Examination of residential area postal codes indicated more frequent refusals from donors of rural (56% consent rate) than urban Munich populations (67% consent rate). The situation was the opposite concerning the residential area of the consenting relative. Postal codes of both the donor and the relative were statistically significant factors in a multiple logistic regression model. There was relatively high willingness to donate in suicides (70%), but not significantly different from other causes like natural deaths (70%) and traffic accidents (66%). CONCLUSIONS: Some socioeconomic factors such as - in particular - the permanent address of the potential donors and their relatives reflecting a different background and status play an important role in the willingness to donate. A better understanding of this decision making can help the physician to ask more empathically for consent and inform the public more specifically about the donation process.