Journal of forensic sciences
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Review Case Reports
Cardiac sarcoidosis--an occult cause of sudden death: a case report and literature review.
Sarcoidosis is a multi-systemic granulomatous disease of unknown cause. It commonly involves lymph nodes, lungs, eyes, and skin. Cardiac sarcoid may be isolated, or associated with systemic involvement. ⋯ The most common site of involvement is the interventricular septum base, which when involved may lead to heart block or arrhythmia. We report a case of sudden death in a 33-year-old male with a history of surgically repaired congenital heart disease. Although his congenital heart disease was originally postulated to be important in his death, autopsy examination revealed cardiac sarcoid with prominent involvement of the conduction system.
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Atypical gunshot wounds due to ricochet and intermediate targets have been well described in the literature. We represent a case of suicide with an atypical entrance wound and bullet without rifling marks due to 9 mm ammunition being loaded and fired from a 40 caliber semiautomatic pistol.
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This paper describes an epidemic of uncommon psychiatric symptoms among nine criminal defendants charged under California's new "Three Strikes and You're Out" law. The defendants were facing a minimum sentence of 25 years to life in prison. The defendants exhibited the following uncommon psychiatric symptoms: coprophagia (eating feces), eating cockroaches and many reported seeing little green men. ⋯ The authors created a database which included information on the defendants from court documents and from our interview with the defendants. We summarized the data and outcomes of the case. Also included is a brief review of the "Three Strikes Law" and a paradigm for how we ruled out relevant psychiatric diagnoses before we arrived at our opinion of malingering.
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Comparative Study
Postmortem amitriptyline pharmacokinetics in pigs after oral and intravenous routes of administration.
In this study we have evaluated the postmortem pharmacokinetics of amitriptyline (Ami) and metabolites in pigs after oral and intravenous administration, and the results are compared with previous studies in rats and humans. In addition a meticulous investigation of blood and tissue concentrations after postmortem intravenous infusion of Ami was undertaken. Of a total of 9 over-night fasted pigs, 3 were given 25 mg/Kg Ami orally, and another 3 pigs received an intravenous infusion lasting 1 h of 3.3 mg/Kg Ami prior to death. ⋯ Tissue/blood Ami concentration ratios were generally lower than previously reported in rats and approximating the levels reported in humans. The animals infused intravenously after death demonstrated high drug levels in blood samples from central vessels, heart, lungs as well as cerebrospinal fluid and vitreous humour. This implies that the presence of a lethal concentration of a drug in just one sample of heart blood can prove worthless in a case where agonal drug infusion may have occurred.
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Comparative Study
A comparison of ONTRAK TESTCUP, abuscreen ONTRAK, abuscreen ONLINE, and GC/MS urinalysis test results.
This study was designed to compare results obtained from two separate on-site drug testing kits (ONTRAK TESTCUP and Abuscreen ONTRAK) with those obtained from laboratory based immunoassay and GC/MS. Abuscreen ONLINE immunoassay was used to select 250 negative samples and 100 presumptive-positive samples each for cocaine/metabolites, opiates and cannabinoids. Presumptive-positive samples were selected if the immunoassay response was > or = 300 ng/mL for cocaine/metabolites (BZE), > or = 300 ng/mL for opiates or > or = 50 ng/mL for cannabinoids (THC-COOH). ⋯ The least agreement between ONTRAK and ONLINE results was found when testing samples that contained THC-COOH. The agreement was 89%, however, all discrepant samples contained GC/MS concentrations of THC-COOH less that the 50 ng/mL cutoff. With ONTRAK, a 100% agreement was obtained between expected and recorded results QC samples that contained morphine or THC-COOH and a 97.7% agreement was obtained between expected and recorded results on QC samples that contained BZE.