Forensic science international
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Chemical dependency is a disease that can affect all professions. Among the health care professionals, anesthesiologists represent a specific group. Numerous factors have been proposed to explain the high incidence of drug abuse among anesthesiologists. ⋯ Fentanyl derivatives are analyzed by GC-MS/MS. The following cases are included in this paper: Case 1: 50-year-old anesthetist, positive for fentanyl (644 pg/mg); Case 2: 42-year-old anesthetist, positive for fentanyl (101 pg/mg) and sufentanil (2 pg/mg); Case 3: 40-year-old anesthetist, positive for codeine (210 pg/mg), alfentanil (30 pg/mg) and midazolam (160 pg/mg); Case 4: 46-year-old nurse, found dead, positive for alfentanil (2 pg/mg) and fentanyl (8 pg/mg). In these cases, the combination of an alternative specimen (hair) and hyphenated analytical techniques (tandem mass spectrometry) appears to be a pre-requisite.
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In recent years, there has been an increase in cocaine-related deaths at the Department of Legal Medicine and Public Health of Pavia, probably reflecting the rising trend in cocaine use in Western Europe. Deaths from cocaine alone have increased from 6 cases in 1979-1991 (1.5% of drug-of-abuse deaths) to 13 in 1992-2002 (3.2%) and comparing the same periods, heroin-related deaths (HRDs) involving cocaine more than doubled from 8 (1.9%) to 22 (5.4%). In an attempt to investigate the role of cocaine in HRDs, acute narcotic death cases testing positive for cocaine use (blood cocaine or metabolite concentration >0.01 mg/l, COC+) were examined. ⋯ However, ethanol results suggested that a pharmacokinetic interaction is prevalent (inhibition of heroin metabolism, as suggested by the increased FM/TM ratio, resulting in reduced urinary and biliary excretion). In the case of cocaine, a pharmacodynamic interaction seems to prevail, as the FM/TM ratio remains unchanged and UM and BM are not lower in the COC+ group. The hypothesis of a pharmacodynamic interaction of cocaine with heroin could not be confirmed owing to the paucity of data and the many uncontrolled variables involved.
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Steamer accidents, through contact with the bucket wheel, are very seldom today. No publication of such a kind of fatal accident could be found in literature. We present the case of a fatal steamer accident, in which the findings of a blunt traumatization of a person by the ship was completely documented by post-mortem combined multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) examinations. ⋯ Furthermore, algological analysis detected diatoms in the lung tissue and blood from the left heart. Therefore, the cause of death was considered being a combination of fatal hemorrhage, caused by the aortic rupture, and drowning. We conclude that virtual autopsy using combined post-mortem MSCT and MRI is a useful tool for documentation, visualisation and analysis of the findings of blunt force trauma and drowning with a large potential in forensic medicine.
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The objective of this study was to investigate characteristic injuries of pedestrians and bicyclists (unprotected) compared to motor vehicle occupants' (protected) in fatal traffic accidents. Cases of 664 fatal traffic accidents (371 pedestrians, 45 bicyclists, and 248 motor vehicle occupants) were collected from 1999 to 2001 using the database of the Forensic Institute in Budapest. Autopsy reports were analyzed. ⋯ Thoracic damages, such as traumatic aortic rupture, hemothorax, and abdominal damages, like liver rupture were dominant in motor vehicle occupants. Considering existing natural diseases, coronary artery disease was the only one with higher occurrence among motor vehicle occupants 24 (9.7%) compared with pedestrians and bicyclist 36 (8.6%). These results underline the importance of preventive strategies in transportation, pointing out that different methods are necessary to reduce fatal injuries of various traffic participants.
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Comparative Study
Comparison of injuries caused by the pistols Tokarev, Makarov and Glock 19 at firing distances of 10, 15 and 25cm.
Firings at cloth targets and at human skin from autopsy material were performed from the pistols 7.62 mm Tokarev (TT), 9 mm Makarov (PM) and 9 x 19 mm Glock 19 with common ammunition. The differences were in the soot deposit pattern, the degree of scorching of the synthetic fibres on the edges of the entrance hole and in the findings of the soot and the gunpowder particles. The results were similar on the cloth and on the skin targets. ⋯ The gunpowder particles could be found in the epidermis and deeper in both layers of the dermis at all distances fired from the TT and the Glock 19. In the case of firings from the PM, at the distance 10 cm some of the gunpowder particles had penetrated into the dermis and most of them were in the upper layer of the dermis. At the firing distance of 15 and 25 cm, the gunpowder particles were only on and in the stratum corneum.