Forensic science international
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Synthetic cannabinoids have caused a large number of emergency presentations to hospitals for adverse cardiovascular events including numerous deaths, particularly for the more potent analogs acting on the CB1 receptor. While smoked cannabis use is often associated with significant changes in heart rate and cardiac output, amongst other physiological changes, it has been rarely considered in the forensic literature as a significant contributory or causal factor in sudden unexpected death. A review of case reports of admissions to hospitals for cardiovascular events was undertaken together with a review of epidemiological studies, and case reports of sudden death attributed, at least in part, to use of this drug. ⋯ At least 13 deaths from a cardiovascular mechanism have been reported from use of this drug which is very likely to be an under-estimate of the true incidence of its contribution to sudden death. In addition, many cases of stroke and vascular arteritis have also been reported with the latter often involving a limb amputation. While it is a drug with widespread usage among the community with relatively few deaths when faced with a circumstance of very recent use (within a few hours), a positive blood concentration of THC and a possible cardiac-related or cerebrovascular cause of death this drug should be considered, at least, a contributory cause of death in cases of sudden or unexpected death.
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Highly potent cannabis concentrates obtained by butane or by supercritical carbon dioxide-extraction are gaining popularity. These extracts called butane hash oil (BHO) with Δ9-tetrahydrocannabinolic acid A (THCA) contents above 60% are consumed by flash vaporization on a glowing titanium nail, followed by inhalation of the resulting vapor through a water pipe in a single puff - a technique referred to as "dabbing". We herein investigated the decarboxylation rate of THCA during artificial smoking of cannabis plant material and simulated dabbing, and the lung availability of Δ9-tetrahydrocannabinol (THC) which we define as the recovery of THC in the smoke and vapor condensates. ⋯ Lung availability ranged from 12% for mixed cannabis material with a rather low THC content, to approximately 19-27% for marijuana flowers, similar for THC in marijuana as for CBD in CBD-rich marijuana. In reality, when smoking a joint, further losses in recovery must be assumed by additional sidestream smoke. The rather high lung availability of THC via dabbing can explain the increased psychoactive and adverse effects associated with this new trend of cannabis consumption.
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Synthetic models, also called "surrogates", are commonly used in wound ballistics in order to simulate human tissues. Despite several surrogates are worldwide accepted and used; some of them have not been yet fully validated and their limits for forensic reconstructions have not been deeply investigated yet. In this work we present a homicide/suicide case involving three gunshots to the head with bullets retained in the skull or beneath the scalp. ⋯ Although the results highlighted general similarities in terms of injury characteristics, some of the experimental shots overpenetrated. Furthermore, the bullets recovered in the synthetic models did not show the same quality of deformations as the questioned bullets. This lack of bullet deformation in the synthetic models might be mainly attributed to the physical difference between real bones and polyurethane surrogate.
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Being sudden cardiac death (SCD) and acute myocardial infarction (AMI) frequent occurrences in forensic medicine, extensive research has been published about the use of cardiac troponin T (cTnT) as a potential specific postmortem biochemical marker. However, cTnT has produced uncertain results, leading to the lack of a standardized application in routine postmortem examinations. The present systematic review focuses on the determination of whether cTnT may be considered as a suitable marker for the postmortem diagnosis of AMI and SCD, analysing the literature according to the following criteria: only human experiments, published from 1st January 2001 to 12th April 2018, available in English, on the following databases: (1). ⋯ CPR seems to have no influence on cTnT values. The postmortem cut-offs differ from clinical ones, and at present no consensus has been reached concerning the postmortem ranges. Further research needs to be carried out in order to establish a common accepted cut-off value for forensic use.
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In this report we describe a first suicide case in Serbia related to ingestion of Taxus baccata leaves. A 30-year old woman was found dead, and the green plant material in a plastic bag was found near her bed. ⋯ Using gas chromatography-mass spectrometry (GC-MS), 3,5-dimethoxyphenol (3,5-DMP) as toxicological evidence for the ingestion of yew leaves, was detected in biological samples. As the autopsy showed unspecific findings, and also the routine toxicological examination, based upon 3,5-DMP identification, the cause of death was determined to be suicide, caused by yew poisoning.