Forensic science international
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A new group of recreational drugs, popularly known as "bath salts", "plant feeders" or "plant food", has recently emerged in numerous countries. Although various products are labeled with warnings "not for human consumption" or "not tested for hazards or toxicity", they are intended to produce a high similar to that obtained with illegal stimulants, such as MDMA, methamphetamine or cocaine. The active compounds in "bath salts" are cathinone derivatives continuously developed and modified by drug designers to avoid detection or legal scrutiny. ⋯ This review surveys the current state of knowledge regarding the pharmacotoxicological properties of synthetic cathinones, the prevalence and pattern of their use. Special emphasis is given to the negative consequences of using these products including, among others, cardiovascular, psychiatric and neurologic symptoms, dehydration, rhambdomyolysis, renal and liver failure. Case reports on synthetic cathinones-related fatalities are also presented.
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Carbon monoxide (CO) may be the cause of more than half the fatal poisonings reported in many countries, with some of these cases under-reported or misdiagnosed by medical professionals. Therefore, an accurate and reliable analytical method to measure blood carboxyhemoglobin level (COHb%), in the 1% to lethal range, is essential for correct diagnosis. Herein a method was established, i.e. head-space gas chromatography-mass spectrometry (HS/GC/MS) that has numerous advantages over other techniques, such as UV spectrometry, for determination of COHb%. ⋯ Using a molecular sieve-packed column, CO levels in the air down to 0.01% and COHb% levels in small blood samples down to 0.2% could be quantitated rapidly and accurately. Furthermore, this method showed good reproducibility with a relative standard deviation for COHb% of <1%. Therefore, this technique provides an accurate and reliable method for determining CO and COHb% levels and may prove useful for investigation of deaths potentially related to CO exposure.
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Fatalities due to an extreme ambient temperature might present with poor or nonspecific pathologies; thus, the diagnosis of the cause of death in such cases is one of the most difficult tasks in forensic pathology. The present study investigated the molecular pathology of alveolar damage involving pulmonary edema with special regard to hyperthermia (heatstroke) and hypothermia (cold exposure) in forensic autopsy cases (total, n=122; within 48 h postmortem). Intrapulmonary mRNA and immunohistochemical expressions of matrix metalloproteinases (MMPs), intercellular adhesion molecule-1 (ICAM-1), claudin-5 (CLDN-5) and aquaporins (AQPs) were examined. ⋯ In immunostaining, only MMPs showed evident differences among the causes of death: MMP-9 was intensely positive in most cases of hyperthermia and hypothermia, but MMP-2 expression was evident only in hyperthermia. These findings suggest alveolar damage involving pulmonary edema, characteristic of fatal hyperthermia and hypothermia. Systematic analysis of gene expressions using real-time PCR might be a useful procedure in forensic death investigation.
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When it comes to firearm fatalities, the main goal of forensic analysis is to distinguish firearm suicides from homicides and accidents. Apart from the location of the entrance wound, wound path trajectory and gunshot residue, blood stain pattern analysis of gunshot-related backspatter on the hands of the victim can be an essential tool not only to determine which hand was holding the firearm, but also to reconstruct the position from which a weapon was fired. We present a case of a 90-year-old man, who was found dead in his house. ⋯ We could reconstruct that the man held the weapon in his right hand, using the left hand to stabilise the firearm and the right thumb to pull the trigger. A contact shot to the right temple led to central regulatory failure due to extensive brain injury. The manner of death was concluded to be a suicide.
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Previous studies have suggested that postmortem serum catecholamine levels reflect the magnitude of physical stress responses or toxic/hyperthermic neuronal dysfunction during the death process. The present study investigated postmortem adrenaline (Adr), noradrenaline (Nad), and dopamine (DA) levels in pericardial fluid (PCF) and cerebrospinal fluid (CSF) with regard to the cause of death, compared with right heart blood levels, in serial medicolegal autopsy cases with a postmortem time within 48 h (n=494). Correlations between PCF and CSF Adr levels, and those among right heart blood, PCF, and CSF DA levels were marked (r=0.66-0.83, p<0.0001), but were otherwise lower (r=0.22-0.44). ⋯ DA levels at each site were higher in injury and intoxication. In addition, higher levels were detected for Nad levels in sharp instrument injury, as well as Adr, Nad, and DA in carbon monoxide intoxication at each site, and for CSF Nad in psychotropic drug intoxication. These findings suggest that characteristic elevations in Adr, Nad, and DA levels in PCF and CSF are involved in systemic responses to fatal stress and toxic neuronal dysfunction, reflecting the magnitude of such responses in individual cases.