scholarly journals Summary statistics for drug concentrations in post‐mortem femoral blood representing all causes of death

2019 ◽  
Vol 11 (9) ◽  
pp. 1326-1337 ◽  
Author(s):  
Raimo A. Ketola ◽  
Ilkka Ojanperä
Keyword(s):  
Causes Of Death ◽  
Summary Statistics ◽  
Post Mortem ◽  
Drug Concentrations ◽  
Femoral Blood

Flubromazolam: Detection in five post-mortem cases

2020 ◽  
Vol 60 (4) ◽  
pp. 266-269 ◽  
Author(s):  
Kemba Abdul ◽  
Laura Hikin ◽  
Paul Smith ◽  
Hassan Kurimbokus ◽  
Emily Ashong ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Central Nervous System ◽  
Nervous System ◽  
High Resolution Mass Spectrometry ◽  
Post Mortem ◽  
Stimulant Drugs ◽  
Drug Concentrations ◽  
Central Nervous System Depressant ◽  
Femoral Blood ◽  
Resolution Mass

Flubromazolam is a potent triazole benzodiazepine with moderately long-lasting central nervous system–depressant effects relative to other benzodiazepines such as commonly prescribed diazepam. Flubromazolam has been studied in the living. However, there are no published reports including measured drug concentrations in post-mortem cases. We report five cases in which flubromazolam was detected in a systematic screen using high-resolution mass spectrometry and then quantified in femoral blood. In none of the five cases was the cause of death directly attributed to flubromazolam toxicity, as there was a variety of both sedative and stimulant drugs also present. However, it is important that the drug concentrations that were measured are made available for future post-mortem forensic interpretation.

scholarly journals Summary statistics for drugs and alcohol concentration recovered in post-mortem femoral blood in Western Switzerland

2021 ◽  
pp. 110883
Author(s):  
Elodie Lefrancois ◽  
Naomi Reymond ◽  
Aurélien Thomas ◽  
Christelle Lardi ◽  
Tony Fracasso ◽  
...  
Keyword(s):  
Alcohol Concentration ◽  
Summary Statistics ◽  
Post Mortem ◽  
Drugs And Alcohol ◽  
Femoral Blood

scholarly journals Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy

2021 ◽  
Vol 10 (7) ◽  
pp. 1337
Author(s):  
Astrid Malézieux-Picard ◽  
Cecilia Ferrer Soler ◽  
David De Macedo Ferreira ◽  
Emilie Gaud-Luethi ◽  
Christine Serratrice ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Causes Of Death ◽  
Clinical Findings ◽  
Pathological Examination ◽  
Post Mortem ◽  
Hypoxemic Respiratory Failure ◽  
Hospitalized Elderly ◽  
Acute Decompensation ◽  
Clinical Chart ◽  
Full Body

Background: Mechanisms and causes of death in older patients with SARS-CoV-2 infection are still poorly understood. Methods: We conducted in a retrospective monocentric study, a clinical chart review and post-mortem examination of patients aged 75 years and older hospitalized in acute care and positive for SARS-CoV-2. Full body autopsy and correlation with clinical findings and suspected causes of death were done. Results: Autopsies were performed in 12 patients (median age 85 years; median of 4 comorbidities, mainly hypertension and cardiovascular disease). All cases showed exudative or proliferative phases of alveolar damage and/or a pattern of organizing pneumonia. Causes of death were concordant in 6 cases (50%), and undetected diagnoses were found in 6. Five patients died from hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19), five had another associated diagnosis and two died from alternative causes. Deaths that occurred in the second week were related to SARS-CoV-2 pneumonia whereas those occurring earlier were related mainly to heart failure and those occurring later to complications. Conclusions: Although COVID-19 hypoxemic respiratory failure was the most common cause of death, post-mortem pathological examination revealed that acute decompensation from chronic comorbidities during the first week of COVID-19 and complications in the third week contributed to mortality.

Post-Mortem Antipsychotic Drug Concentrations and Unexplained Deaths

1994 ◽  
Vol 165 (6) ◽  
pp. 787-791 ◽  
Author(s):  
Nedzara Jusic ◽  
Malcolm Lader
Keyword(s):  
Drug Treatment ◽  
Antipsychotic Drug ◽  
Drug Regimen ◽  
The Body ◽  
Electrolyte Balance ◽  
Post Mortem ◽  
Unexpected Death ◽  
Legal Cases ◽  
Drug Concentrations ◽  
Antipsychotic Drug Treatment

BackgroundThe relationship between antipsychotic drug treatment and sudden unexplained death remains unclear. The estimation of post-mortem blood drug concentrations should be helpful.MethodEight medico-legal cases were reviewed with respect to behaviour of patient, type and dosage of drug treatment, mode of death, post-mortem findings and drug concentrations.ResultsThe problems of evaluating such drug levels are discussed. Five of the eight patients had probably toxic concentrations of antipsychotic and/or antidepressants, which caused death, usually involving cardiac arrhythmias.ConclusionsIn cases of sudden unexpected death, a sample of blood from a peripheral vein should be obtained immediately death is pronounced or the body discovered, and sent for analysis. To minimise such fatalities, the patient should be monitored carefully, with ECG if feasible, and electrolyte balance checked. The drug regimen used should be kept simple and large doses of antipsychotics and/or antidepressants avoided wherever possible.

RIGOR MORTIS: PHYSIOLOGY

2021 ◽  
Vol 6 ◽  
Author(s):  
Heron Teixeira
Keyword(s):  
Body Weight ◽  
Causes Of Death ◽  
Natural Course ◽  
Important Task ◽  
Time Of Death ◽  
Post Mortem ◽  
Rigor Mortis ◽  
Intrinsic Factors ◽  
The Subject ◽  
Extrinsic And Intrinsic Factors

Introduction: Estimating the time of death is an important task in day-to-day forensic work and many factors for its designation are understood, one of which is rigor mortis. They can be altered by extrinsic and intrinsic factors, such as temperature location, humidity, heat, age, sex, length and body weight, and can be used as a parameter for approximate identification of the time of death. Objective: To carry out a brief review on the topic in order to promote a better understanding of the subject addressed and fully understand its physiology. Materials and Methods: Pubmed, Scielo and Medline databases were searched without date restrictions for articles published in English and Portuguese using the descriptors rigor mortis, autolysis and changes after death. Results: The theme presents consolidated researches regarding its natural course, being an important tool to estimate the time of death along other signs that appear after death, as well as to estimate some causes of death. Conclusion: Understanding the development of rigor mortis, helps to identify and distinguish processes that may have led to death and the post-mortem time.

Interpretation of melperone intoxication: post-mortem concentration distribution and interpretation of intoxication data

2021 ◽  
Vol 36 (3) ◽  
pp. 233-237
Author(s):  
Marek Dziadosz ◽  
Katarina Bolte ◽  
Wolfgang Rosenberger ◽  
Michael Klintschar ◽  
Jörg Teske
Keyword(s):  
Concentration Distribution ◽  
Method Development ◽  
Standard Addition ◽  
Lethal Concentration ◽  
Post Mortem ◽  
Tissue Samples ◽  
Expert Opinions ◽  
Lack Of Information ◽  
Reference Concentration ◽  
Femoral Blood

Abstract Objectives Since melperone abuse with lethal intoxication is common, expert opinions based on therapeutical and lethal concentration ranges can be considered as important. Because there is a lack of information about fatalities caused by melperone mono-intoxications and data on tissue samples with concentration distribution, the aim of this work is the examination of lethal concentration ranges of melperone and drug quantification in different matrices. Methods An LC-MS/MS method was applied for analyses performed in blood and tissue samples. Quantification based on standard addition and sample preparation on liquid–liquid extraction with 1-chlorobutane. An appropriate tissue homogenization was performed ahead of extraction with an IKA Ultra-Turrax-Tube-Drive®. A Luna 5 µm C18 (2) 100 Å, 150  × 2 mm analytical column was used for chromatographic separation and the elution was performed with two mobile phases consisted of A (H2O/methanol = 95/5, v/v) and B (H2O/methanol = 3/97, v/v) both with 10 mM ammonium acetate and 0.1% acetic acid. Results A multi-drug LC-MS/MS analytical method developed was applied successfully for melperone quantification in different post-mortem matrices. No analytical problems could be identified during method development and analyses of real samples. The melperone lethal concentration calculated in femoral blood of the drug mono-intoxication investigated was 10 mg/L. Melperone concentration distribution was presented for the first time. Conclusions The lethal reference concentration of melperone in femoral blood of 17.1 mg/L pointed out in different reference lists should be used with caution. Instead, a lower lethal melperone concentration should be considered. The post-mortem concentration distribution of the drug presented could be helpful in the interpretation of cases where no blood samples are available.

Notes upon the Incidence of Tuberculosis in Asylums

1906 ◽  
Vol 52 (216) ◽  
pp. 92-108
Author(s):  
George Greene
Keyword(s):  
General Population ◽  
Pulmonary Tuberculosis ◽  
Death Rate ◽  
Causes Of Death ◽  
Tubercle Bacillus ◽  
Post Mortem ◽  
True Proportion ◽  
Lunatic Asylums

It is the prevalent opinion that phthisis is the scourge of our English lunatic asylums, and that these institutions are, literally speaking, hotbeds for the growth and distribution of the tubercle bacillus. In the Irish asylums, where the death-rate from phthisis alone amounts to nearly 30 per cent. of all causes of death, there seems to be just grounds for this belief. In the English asylums, however, the mortality is much lower, and is but little, if any, greater than that amongst the general population. This can be verified by examination of the Registrar-General's Report, from which it appears that phthisis accounts approximately for one in twelve of all deaths. These figures probably represent less than the true proportion of deaths from phthisis, since post-mortem examinations in the majority of cases are not made, and thus, doubtless, many cases of pulmonary tuberculosis are overlooked.

Dental Plaque Concentrations of Methadone, Morphine and Their Metabolites in Opioid Replacement Therapy and in Post-Mortem Cases

2021 ◽  
Author(s):  
Kerstin Henkel ◽  
Miriam Klima ◽  
Volker Auwärter ◽  
Markus J Altenburger ◽  
Merja A Neukamm
Keyword(s):  
Oral Cavity ◽  
Replacement Therapy ◽  
Dental Plaque ◽  
Oral Intake ◽  
Study Groups ◽  
Post Mortem ◽  
Dental Biofilm ◽  
Intravenous Application ◽  
Drug Concentrations ◽  
Opioid Replacement Therapy

Abstract Non-mineralized dental biofilm (plaque) has potential as novel alternative matrix in forensic toxicology to prove drug use. The incorporation of illicit and medicinal drugs in dental plaque could take place through direct contact after oral or nasal intake, which can lead to high drug levels in the oral cavity, or indirectly via the secretion of drug-containing saliva, e.g. after intravenous application. Therefore, plaque samples from patients in opioid replacement therapy (ORT) and post-mortem plaque samples were analyzed and the drug concentrations were compared. The study comprised 26 plaque samples from ORT patients with different daily doses which were analyzed for methadone, morphine and their respective metabolites. Plaque samples were taken directly before the oral administration of the regular daily dose. Seventeen post-mortem plaque samples were analyzed, either from cases of lethal drug intoxications or after pain therapy with morphine. Plaque analysis was performed using LC-MS/MS after liquid extraction with acetonitrile. Plaque concentrations in ORT for methadone and its metabolite EDDP ranged from 42 to approx. 49,000 pg/mg (median 1,300 pg/mg) and from below 10 to 610 pg/mg (median 31 pg/mg), respectively. Morphine plaque concentrations in ORT ranged from 120 to 480 pg/mg (median 400 pg/mg). In lethal intoxication cases plaque concentrations were generally at least one order of magnitude higher than in the study groups with therapeutic substance use. This data will help to interpret drug findings in plaque. Additionally, the EDDP/methadone concentration ratio in plaque was lower after oral intake with contamination of the oral cavity (e.g. syrup) compared to cases with suspected intravenous application of methadone and could therefore indicate the drug administration route.

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