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postmortem toxicology

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https://www.readbyqxmd.com/read/28803722/advantages-of-analyzing-postmortem-brain-samples-in-routine-forensic-drug-screening-case-series-of-three-non-natural-deaths-tested-positive-for-lysergic-acid-diethylamide-lsd
#1
Marie Mardal, Sys Stybe Johansen, Ragnar Thomsen, Kristian Linnet
Three case reports are presented, including autopsy findings and toxicological screening results, which were tested positive for the potent hallucinogenic drug lysergic acid diethylamide (LSD). LSD and its main metabolites were quantified in brain tissue and femoral blood, and furthermore hematoma and urine when available. LSD, its main metabolite 2-oxo-3-hydroxy-LSD (oxo-HO-LSD), and iso-LSD were quantified in biological samples according to a previously published procedure involving liquid-liquid extraction and ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS)...
July 30, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28767539/medicolegal-investigations-into-deaths-due-to-crush-asphyxia-after-tractor-side-rollovers
#2
Carlo Moreschi, Ugo Da Broi, Antonia Fanzutto, Sirio Cividino, Rino Gubiani, Gianfranco Pergher
Farm tractors are large, heavy, powerful vehicles with a high center of gravity. When driven carelessly on sloping, irregular, or slippery ground, tractors can overturn sideways and cause the death by crush asphyxia of the driver or passengers, especially if appropriate safety equipment is not fitted or used. The aim of this review is to focus on the diagnostic difficulties with which coroners and forensic pathologists have to cope when a confirmation of crush asphyxia after tractor side rollover is required by judicial authorities...
August 1, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28737525/death-by-snow-a-fatal-forensic-case-of-cocaine-leakage-in-a-drug-mule-on-postmortem-computed-and-magnetic-resonance-tomography-compared-with-autopsy
#3
Patricia Mildred Flach, Dominic Gascho, René Fader, Rosita Martinez, Michael J Thali, Lars C Ebert
This forensic case presents unique postmortem imaging of a "drug mule" with fatal intoxication due to cocaine leakage on postmortem computed and magnetic resonance (MR) tomography compared with autopsy.Imaging by postmortem computed and MR tomography was performed before autopsy, histology, and toxicology were commissioned. Forensic imaging revealed 91 hyperdense, uniformly shaped body packs with signs of leakage, which was confirmed by autopsy. Postmortem MR imaging displayed the rarely described hypointense appearance of the body packs in T1- and T2-weighted sequences...
July 22, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28735777/heroin-and-fentanyl-overdoses-in-kentucky-epidemiology-and-surveillance
#4
Svetla Slavova, Julia F Costich, Terry L Bunn, Huong Luu, Michael Singleton, Sarah L Hargrove, Jeremy S Triplett, Dana Quesinberry, William Ralston, Van Ingram
BACKGROUND: The study aims to describe recent changes in Kentucky's drug overdose trends related to increased heroin and fentanyl involvement, and to discuss future directions for improved drug overdose surveillance. METHODS: The study used multiple data sources (death certificates, postmortem toxicology results, emergency department [ED] records, law enforcement drug submissions, and prescription drug monitoring records) to describe temporal, geographic, and demographic changes in drug overdoses in Kentucky...
June 27, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28690283/postmortem-computed-tomographic-analysis-of-death-caused-by-oral-drug-intoxication
#5
Akihito Usui, Yusuke Kawasumi, Kiyotaka Usui, Yuya Ishizuka, Kaito Takahashi, Masato Funayama, Haruo Saito
Traditional autopsy has changed little in the past century. In Japan, the rate of forensic autopsy in cases of unusual death is very low. Therefore, multi-slice computed tomography (CT) has been used to obtain imaging data instead of or in addition to autopsy in suspicious forensic cases. In our institute, postmortem multi-slice CT has been performed since 2009, and by 2014 there were over 1,000 cases. Our extensive experience with postmortem CT shows that in many cases of death by drug overdose, stomach contents exhibit high X-ray absorption...
July 2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28681657/fatal-poisoning-by-terbufos-following-occupational-exposure
#6
Yue Liang, Fang Tong, Lin Zhang, Wenhe Li, Weisheng Huang, Yiwu Zhou
CONTEXT: Terbufos (TBF) is a class Ia (extremely hazardous) organophosphate pesticide (OP) and its distribution in industrialized countries has been severely restricted. Thus, acute occupational poisoning is rather uncommon. However, it still occurs in rural areas of some developing countries, where the sale of TBF is not controlled and its use is thus not properly regulated. We report a case of a 43-year-old female farmer who died after applying TBF granules. CASE: The patient died within 3 h after applying 20 bags of 5% TBF granules (900 g per bag)...
July 6, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28643397/experimental-study-on-the-postmortem-redistribution-of-the-substituted-phenethylamine-25b-nbome
#7
Kaori Shintani-Ishida, Kanju Saka, Mami Nakamura, Ken-Ichi Yoshida, Hiroshi Ikegaya
2-(4-Bromo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25B-NBOMe) is a substituted phenethylamine, which has become highly prevalent worldwide since 2014. Recently, in an autopsy case involving fatal 25B-NBOMe intoxication, we found the postmortem increase of 25B-NBOMe concentration in the cardiac blood approximately 2 days after death. The aim of this study was to investigate the distribution of 25B-NBOMe and reproduce the postmortem redistribution using a rat model. Sprague-Dawley rats were killed 30 min after intraperitoneal injection of 25B-NBOMe (0...
June 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28641536/overview-of-forensic-toxicology-yesterday-today-and-in-the-future
#8
Heesun Chung, Sanggil Choe
BACKGROUND: The scope of forensic toxicology has been tremendously expanded over the past 50 years. From two general sections forensic toxicology can be further classified into 8-9 sections. METHODS: The most outstanding improvement in forensic toxicology is the changes brought by instrumental development. The field of forensic toxicology was revolutionized by the development of immunoassay and bench-top GC-MS in the 1980's and LC-MS-MS in 2000's. Detection of trace amounts of analytes has allowed the use of new specimens such as hair and oral fluids, along with blood and urine...
June 22, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28633314/qualitative-identification-of-fentanyl-analogs-and-other-opioids-in-postmortem-cases-by-uhplc-ion-trap-msn
#9
Elisa N Shoff, M Elizabeth Zaney, Joseph H Kahl, George W Hime, Diane M Boland
Since 2013, the Miami-Dade County Medical Examiner Department has experienced an increase in the number of opioid-related deaths. The majority of cases coincided with the introduction of fentanyl into the local heroin supply. From 2014 to 2015, Miami-Dade County experienced a near 600% increase in fentanyl-related deaths, followed by an additional 200% increase in 2016. In 2015, two novel fentanyl analogs were identified in medical examiner cases: beta-hydroxythiofentanyl and acetyl fentanyl. In 2016, four additional fentanyl analogs emerged: para-fluoroisobutyryl fentanyl, butyryl fentanyl, furanyl fentanyl and carfentanil, as well as the synthetic opioid U-47700...
June 13, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28631318/bupropion-overdose-resulted-in-a-pharmacobezoar-in-a-fatal-bupropion-wellbutrin-%C3%A2-sustained-release-overdose-postmortem-distribution-of-bupropion-and-its-major-metabolites
#10
Gregory Schmit, Evy De Boosere, Jessica Vanhaebost, Arnaud Capron
Bupropion (BUP) overdose commonly causes generalized seizures and central nervous system depression. The case of a 28-year-old woman who died from a massive lethal overdose with sustained-release bupropion (Wellbutrin(®) 300 mg) is herein presented. The autopsy revealed the presence of a pharmacobezoar consisting of at least 40 tablets in the stomach. Determination of bupropion and its active metabolites (hydroxybupropion, threobupropion, erythrobupropion) was achieved by a liquid chromatographic mass spectrometry (LC-MS/MS) method...
June 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28610598/forensic-toxicology-analysis-of-self-poisoning-suicidal-deaths-in-tehran-iran-trends-between-2011-2015
#11
Roya Kordrostami, Maryam Akhgari, Maryam Ameri, Masoud Ghadipasha, Kamran Aghakhani
BACKGROUND: Suicide ranks among the top ten causes of death in all age groups all over the world. There are many methods for committing suicide including self-poisoning, firearm and hanging. The aim of the present study was to provide an overview of self-poisoning related suicidal deaths with special focus on forensic toxicology analysis results in Tehran, Iran from 2011 to 2015. METHODS: All suspicious cases with the the history of self-poisoning were investigated to define the cause and manner of death under the supervision of forensic medicine practitioners...
June 13, 2017: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
https://www.readbyqxmd.com/read/28575422/fatalities-involving-carfentanil-and-furanyl-fentanyl-two-case-reports
#12
Dina M Swanson, Laura S Hair, Selly R Strauch Rivers, Brianna C Smyth, Sara C Brogan, Alexis D Ventoso, Samantha L Vaccaro, Julia M Pearson
Carfentanil is a fentanyl analog frequently used in large animal veterinary medicine. Recently, carfentanil has been discovered in postmortem and antemortem cases throughout the United States in the heroin supply either alone or mixed with heroin and/or other fentanyl analogs. The potency of carfentanil is ~10,000 times greater than morphine and 100 times greater than fentanyl. In two recent cases, carfentanil was identified and ruled to be the cause of death, either alone or in combination with other drugs...
May 31, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28457508/an-experimental-study-of-postmortem-decomposition-of-methomyl-in-blood
#13
Yuka Kawakami, Chiaki Fuke, Maki Fukasawa, Kenji Ninomiya, Yoko Ihama, Tetsuji Miyazaki
Methomyl (S-methyl-1-N-[(methylcarbamoyl)oxy]thioacetimidate) is a carbamate pesticide. It has been noted that in some cases of methomyl poisoning, methomyl is either not detected or detected only in low concentrations in the blood of the victims. However, in such cases, methomyl is detected at higher concentrations in the vitreous humor than in the blood. This indicates that methomyl in the blood is possibly decomposed after death. However, the reasons for this phenomenon have been unclear. We have previously reported that methomyl is decomposed to dimethyl disulfide (DMDS) in the livers and kidneys of pigs but not in their blood...
March 2017: Legal Medicine
https://www.readbyqxmd.com/read/28425102/fatal-overdose-of-gamma-hydroxybutyrate-acid-after-ingestion-of-1-4-butanediol
#14
Erwan Le Garff, Vadim Mesli, Raphael Cornez, Christophe Demarly, Gilles Tournel, Valery Hédouin
We report a case of fatal intoxication from 1,4-butanediol (1,4-BD), which was ingested by a young and "naïve" gamma-hydroxybutyrate (GHB) consumer during a party with the co-ingestion of alcohol, cannabis, and methylene-dioxy-methamphetamine. The following drug concentrations were found using gas chromatography coupled with mass spectrometry on autopsy samples and on a cup and a glass found at the scene: 20,350 mg/L (bottle) for 1,4-BD; 1020 mg/L (femoral blood), 3380 mg/L (cardiac blood), 47,280 mg/L (gastric content), and 570 mg/L (vitreous humor) for GHB...
April 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28406883/characteristics-of-fentanyl-overdose-massachusetts-2014-2016
#15
Nicholas J Somerville, Julie O'Donnell, R Matthew Gladden, Jon E Zibbell, Traci C Green, Morgan Younkin, Sarah Ruiz, Hermik Babakhanlou-Chase, Miranda Chan, Barry P Callis, Janet Kuramoto-Crawford, Henry M Nields, Alexander Y Walley
Opioid overdose deaths in Massachusetts increased 150% from 2012 to 2015 (1). The proportion of opioid overdose deaths in the state involving fentanyl, a synthetic, short-acting opioid with 50-100 times the potency of morphine, increased from 32% during 2013-2014 to 74% in the first half of 2016 (1-3). In April 2015, the Drug Enforcement Agency (DEA) and CDC reported an increase in law enforcement fentanyl seizures in Massachusetts, much of which was believed to be illicitly manufactured fentanyl (IMF) (4)...
April 14, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28378323/trends-in-officer-involved-firearm-deaths-in-oklahoma-from-2000-to-2015
#16
Kyla M Jorgenson, Andrea L Wiens, Eric A Pfeifer, Joshua Lanter
The purpose of this study was to collect data and disseminate trends in officer-involved firearm deaths in Oklahoma from 2000 to 2015. The Oklahoma Office of the Chief Medical Examiner (OCME) database was searched for civilian decedents with gunshot wounds inflicted by law enforcement officers and officer decedents with gunshot wounds inflicted by civilians. Five decedents were law enforcement officers, while 274 decedents were civilians. The number of civilian decedents throughout the study followed a quadratic trend...
April 4, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28369523/desomorphine-screening-using-commercial-enzyme-linked-immunosorbent-assays
#17
Jessica Winborn, Sarah Kerrigan
Desomorphine ("Krokodil") is a semi-synthetic opioid that has drawn attention as a recreational drug, particularly in Russia, neighboring former Soviet Republics, Eastern and Central Europe. It has no accepted medicinal uses and is currently a schedule I drug in the United States. In clandestine environments, desomorphine is synthesized from codeine using red phosphorous, hydroiodic acid and gasoline. Residual starting materials in illicit preparations have been associated with severe dermatological effects and extensive tissue necrosis...
June 1, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28340233/increase-in-drug-overdose-deaths-involving-fentanyl-rhode-island-january-2012-march-2014
#18
Melissa C Mercado, Steven A Sumner, M Bridget Spelke, Michele K Bohm, David E Sugerman, Christina Stanley
Objective.:  This study identified sociodemographic, substance use, and multiple opioid prescriber and dispenser risk factors among drug overdose decedents in Rhode Island, in response to an increase in overdose deaths (ODs) involving fentanyl. Methods.:  This cross-sectional investigation comprised all ODs reviewed by Rhode Island's Office of the State Medical Examiners (OSME) during January 2012 to March 2014. Data for 536 decedents were abstracted from OSME's charts, death certificates, toxicology reports, and Prescription Monitoring Program (PMP) databases...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28315148/a-case-of-cardiac-tamponade-due-to-an-isolated-abscess-in-the-ascending-aorta-of-a-pregnant-woman-with-a-history-of-intravenous-substance-abuse
#19
Brandy Shattuck, John Livingstone
We describe the case of a 23-year-old white female, 10-12 weeks pregnant, with a history of intravenous drug use and a recently diagnosed pneumonia, who was found deceased in her bed after a night of sleep. Although postmortem serum toxicology tested positive for alprazolam, tetrahydrocannabinol, and morphine, the ultimate cause of death was determined to be cardiac tamponade secondary to an isolated abscess in the ascending aorta. The patient had several risk factors for aortic rupture and cardiac tamponade including intravenous drug use, pneumonia, and pregnancy...
June 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28261784/fatal-folic-acid-toxicity-in-humans
#20
Gerard Pradeep Devnath, Senthil Kumaran, R Rajiv, Kusa Kumar Shaha, Ashok Nagaraj
Folic acid is B-9 vitamin. Folic acid is prescribed commonly for pregnant women to prevent neural tube defects in the fetus, patients under chemotherapy, pernicious anemia and to reduce the risk of stroke and cardiovascular disease. Acute or chronic ingestion of a large dose of folic acid generally manifests as neurological complications, which are reversible. In this present case, a 23-year-old pregnant woman committed suicide by consuming folic acid tablets and succumbed to death within 36 h. Postmortem toxicological analysis detected folic acid in viscera...
March 6, 2017: Journal of Forensic Sciences
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