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3.
Forensic Sci Int ; 214(1-3): e26-9, 2012 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-21839594

RESUMO

Forensic pathologists are sometimes confronted with microscopic foreign bodies mixed in with soft tissues surrounding wounds and which are thus difficult to identify. This identification, however, could be primordial in investigating a crime and in determining the weapon used. A case of a fatal respiratory distress syndrome due to conjoining suicidal drug intoxication and laryngeal obstruction by a voluminous foreign body giant cell granuloma is presented. The classical histological examination showed exogenous particles in the vocal cord tumor with birefringent qualities. Their analysis with Fourier-Transform infrared (FTIR) spectrometry coupled with infrared microscope allows the determination of their chemical nature as polytetrafluoroethylene and to the diagnosis of teflonoma. This case report put the emphasis on the forensic interest of the FTIR imaging.


Assuntos
Granuloma de Corpo Estranho/diagnóstico , Doenças da Laringe/diagnóstico , Politetrafluoretileno/efeitos adversos , Espectroscopia de Infravermelho com Transformada de Fourier , Adulto , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/patologia , Antipsicóticos/envenenamento , Patologia Legal , Granuloma de Corpo Estranho/etiologia , Humanos , Doenças da Laringe/etiologia , Laringoestenose/etiologia , Laringoestenose/patologia , Laringe/patologia , Masculino , Microscopia , Fenotiazinas/envenenamento , Aspiração Respiratória/complicações , Síndrome do Desconforto Respiratório do Adulto/etiologia , Suicídio
4.
Sud Med Ekspert ; 51(5): 39-41, 2008.
Artigo em Russo | MEDLINE | ID: mdl-19048878

RESUMO

The method of clinoid dehydration of biological fluids along with pH measurement is shown to be suitable for the diagnosis of narcotic intoxication and poisoning with narcotic and potent agents. The data obtained by this and conventional methods are compared. Diagnostically significant signs of narcotic intoxication are deduced from the hemogram of a dry blood droplet and serum pH values.


Assuntos
Benzodiazepinas/envenenamento , Toxicologia Forense/métodos , Entorpecentes/envenenamento , Fenotiazinas/envenenamento , Benzodiazepinas/sangue , Benzodiazepinas/urina , Cadáver , Estudos de Casos e Controles , Causas de Morte , Desidratação , Humanos , Entorpecentes/sangue , Entorpecentes/urina , Fenotiazinas/sangue , Fenotiazinas/urina , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/mortalidade
6.
Przegl Lek ; 64(4-5): 304-7, 2007.
Artigo em Polonês | MEDLINE | ID: mdl-17724892

RESUMO

UNLABELLED: Two cases (woman and man) of the extended suicidal poisonings with carbamazepine and phenothiazine derivatives are presented. Drug's blood concentrations during poisoning were monitored. We examine correlation between patient's general status and the drug's blood concentrations, carbamazepine and phenothiazine derivatives interaction due to young, healthy people who received no earlier treatment. MATERIAL AND METHODS: blood samples for toxicological examinations were collected at 0, 12, 24 and 48 hours after admission. Carbamazepine was determined using FPIA method and phenothiazines derivatives by HPLC-DAD. The highest blood concentrations were for carbamazepine: 30.92 mg/l (woman) and 20.95 ng/ml (man); for phenothiazine derivatives: 927 ng/ml (woman) and 733 ng/ ml (man). CONCLUSIONS: In both cases severe central nervous depression was observed due to summed action of the drugs. Sex and individual differences in cytochromes activities should have influence to carbamazepine metabolism and faster elimination time in woman. In the case of phenothiazine derivatives faster elimination time in man was observed. The differences in elimination times between compared drugs confirm their different metabolic routes.


Assuntos
Carbamazepina/farmacocinética , Carbamazepina/envenenamento , Inativação Metabólica , Fenotiazinas/farmacocinética , Fenotiazinas/envenenamento , Adolescente , Adulto , Anticonvulsivantes/sangue , Anticonvulsivantes/urina , Carbamazepina/sangue , Carbamazepina/urina , Depressores do Sistema Nervoso Central/sangue , Depressores do Sistema Nervoso Central/farmacocinética , Depressores do Sistema Nervoso Central/envenenamento , Depressores do Sistema Nervoso Central/urina , Overdose de Drogas , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Fenotiazinas/sangue , Fenotiazinas/urina , Índice de Gravidade de Doença , Fatores Sexuais , Tentativa de Suicídio , Resultado do Tratamento
7.
J Emerg Med ; 31(1): 53-9, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16798156

RESUMO

Traditionally, pediatric phenothiazine exposures are considered dangerous even at low doses. The actual risk of exposure to 1-2 tablets is unclear. In an attempt to determine this risk, the authors performed a literature search, review of the American Association of Poison Control Center data, and evaluation of related resources (e.g., textbooks, bibliographies of relevant papers). This review reveals only sparse data from case reports regarding morbidity and mortality in the pediatric population despite years of clinical experience. Serious toxicity from exposure to low doses is rare and nearly always the result of chlorpromazine ingestion. Although the risk to the toddler ingesting 1-2 tablets seems to be extremely low, several factors should be considered when determining the need for triage to a health care facility.


Assuntos
Fenotiazinas/envenenamento , Administração Oral , Pré-Escolar , Overdose de Drogas , Tratamento de Emergência , Humanos
8.
Forensic Sci Int ; 137(1): 13-5, 2003 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-14550607

RESUMO

A case of fatal poisoning with cyamemazine is presented. The cyamemazine was identified in post-mortem blood using a specific gas chromatographic/mass spectrometry method. The autopsy blood concentration of cyamemazine was 1800 ng/ml. Chronic use of cyamemazine was demonstrated by the presence of the drug in hair. Two other drugs were also detected (bromazepam and trimeprazine). We think that this current blood concentration (1800 ng/ml) is a fatal blood concentration because of the negativity of the other parameters, but careful interpretation of analytical findings are important, the possibility that this death was a consequence of the toxicity of combined drugs could not be excluded. Not many therapeutics and toxic levels were previously reported in overdosage cases in which cyamemazine was involved. We consider that this concentration is only of guidance value for a fatal cyamemazine poisoning.


Assuntos
Antipsicóticos/envenenamento , Fenotiazinas/envenenamento , Ansiolíticos/análise , Antipruriginosos/análise , Antipsicóticos/análise , Bromazepam/análise , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Cabelo/química , Humanos , Pessoa de Meia-Idade , Fenotiazinas/análise , Trimeprazina/análise
9.
J Forensic Sci ; 45(1): 7-10, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10641912

RESUMO

To compare the characteristics of dextropropoxyphene (DXP) poisoning victims with those of victims of poisonings by antidepressants and sedatives, we examined all fatal poisonings due to DXP, antidepressants or sedatives among autopsies performed at one department of forensic medicine in Sweden during the six-year period from 1992 to 1997. In 202 cases, death was classified as fatal poisonings by DXP, antidepressants or sedatives. DXP caused death in 78 cases (39%), antidepressants in 49 (24%), and sedatives in 75 (37%). DXP as a single preparation was predominant in causing death. The second compound, flunitrazepam, caused death in 30 cases (15%). The victims of poisonings by DXP, antidepressants, or sedatives shared a similar history of alcohol/drug abuse, depression and somatic illness. They were mostly living alone at the time of death (>60%), the majority died at home (81%), and suicide was the most frequent manner of death (73%). Age seemed to be an important characteristic regarding the choice of drug. Younger people predominantly died of DXP (mean age 43 years, 95% confidence interval, CI 39-47), and elderly people of sedatives (mean age 59 years, CI 55-63). Antidepressants were found mainly in middle-aged victims (mean age 51 years, CI 48-54). The predominance of sedatives among the elderly might be explained by a very high prescription rate of such drugs in older age groups, but prescription rate could not explain the DXP predominance among younger people. We hypothesize that younger people are more prone to abuse therapeutic drugs for euphoric reasons than elderly people, and that because of its high toxicity, DXP leads to accidental deaths more often than sedatives.


Assuntos
Antidepressivos/envenenamento , Dextropropoxifeno/envenenamento , Hipnóticos e Sedativos/envenenamento , Entorpecentes/envenenamento , Envenenamento/mortalidade , Adulto , Fatores Etários , Idoso , Amitriptilina/envenenamento , Autopsia , Compostos Azabicíclicos , Clomipramina/envenenamento , Feminino , Flunitrazepam/envenenamento , Humanos , Masculino , Pessoa de Meia-Idade , Fenotiazinas/envenenamento , Piperazinas/envenenamento , Trimeprazina/envenenamento
10.
Eur J Gastroenterol Hepatol ; 11(4): 451-3, 1999 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10321765

RESUMO

Hepatotoxicity of cyamamezine, a phenothiazine structurally related to chlorpromazine, has been rarely documented. We report here a case of acute symptomatic hepatitis following a unique massive intake of cyamamezine in a suicide attempt and discuss the mechanisms of such injury.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/etiologia , Fenotiazinas/envenenamento , Doença Aguda , Adulto , Doença Hepática Induzida por Substâncias e Drogas/patologia , Feminino , Humanos , Fígado/patologia , Tentativa de Suicídio
12.
Anesteziol Reanimatol ; (3): 10-3, 1995.
Artigo em Russo | MEDLINE | ID: mdl-7653856

RESUMO

Efficacy of dobutrex was assessed in 75 patients with grave poisonings. In 45 of these poisoning with cardiotoxic agents was complicated by acute heart failure and in 30 poisoning with psychopharmacological agents involved secondary disorders of cardiac contractile function. A sharp reduction of cardiac contractile function and output were observed in all the cases. Treatment efficacy was assessed by monitoring the parameters of central hemodynamics and by phase analysis of left-ventricular systole by rheopolycardiography with recording by mingograf-82. The results indicated a rapid and effective correction of decreased cardiac contractility and increase of cardiac output. The dose-effective concentration of dobutrex in the blood needed for the treatment of acute heart failure was from 10 to 17.5 micrograms/kg/min. Arterial pressure, cardiac contractility, and cardiac output stabilized within 4 to 6 h. After poisoning with psychopharmacological agents cardiac contractility recovered in 3-3.5 h. The dose-effective concentration of dobutrex in the blood was 5 micrograms/kg/min. Dobutrex is a highly active cardiotonic agent for the treatment of critical states developing in the aforesaid poisonings.


Assuntos
Barbitúricos/envenenamento , Dobutamina/uso terapêutico , Fenotiazinas/envenenamento , Envenenamento/tratamento farmacológico , Psicotrópicos/envenenamento , Doença Aguda , Adolescente , Adulto , Hemodinâmica , Humanos , Pessoa de Meia-Idade , Contração Miocárdica , Envenenamento/fisiopatologia , Fatores de Tempo
13.
Sud Med Ekspert ; 37(4): 25-7, 1994.
Artigo em Russo | MEDLINE | ID: mdl-7892687

RESUMO

Ethacizin and its principal metabolite 2-carbethoxyaminophenothiazine may be isolated from cadaveric material by acetonitrile and subsequent ether extraction at pH 13.0. Detection of ethacizin from the hydrolysis product improves the sensitivity of detection.


Assuntos
Antiarrítmicos/análise , Fenotiazinas/análise , Adulto , Antiarrítmicos/envenenamento , Cromatografia em Camada Delgada/métodos , Feminino , Humanos , Fenotiazinas/envenenamento , Envenenamento/metabolismo , Espectrofotometria Ultravioleta , Triazinas/análise
14.
J Anal Toxicol ; 17(6): 386-8, 1993 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7903727

RESUMO

A fatality involving cyamemazine, a phenothiazine derivative, is presented. Cyamemazine was formally identified in postmortem blood using an HPLC-DAD screening procedure, and then quantified in some postmortem samples by means of a specific HPLC method. The blood concentration of cyamemazine was 9.8 micrograms/mL. Tissue distribution of cyamemazine is discussed in light of the existing literature.


Assuntos
Antipsicóticos/envenenamento , Fenotiazinas/envenenamento , Causas de Morte , Humanos , Masculino , Pessoa de Meia-Idade , Estrutura Molecular , Suicídio
18.
Z Gesamte Inn Med ; 42(7): 187-90, 1987 Apr 01.
Artigo em Alemão | MEDLINE | ID: mdl-3604351

RESUMO

Underlying literature and taking into consideration own experiences in the anticholinergic syndrome the following view is taken: Physostigmine salicylate is the remedy of choice for the treatment of the anticholinergic syndrome and altogether causes only slight side effects. While for differential-diagnostic reasons the application is recommended under hospital conditions, the pre-hospital application is to be estimated as problematical. The improvement of the clinical symptoms under the influence of physostigmine salicylate must not lead to the neglect of the control of the patient. A differentiated use of physostigmine salicylate is necessary, and it cannot be regarded as "universal antidote" in intoxications caused by central-nervous effective substances.


Assuntos
Fibras Colinérgicas/efeitos dos fármacos , Fisostigmina/análogos & derivados , Envenenamento/tratamento farmacológico , Adolescente , Relação Dose-Resposta a Droga , Feminino , Humanos , Nitrazepam/envenenamento , Fenotiazinas/envenenamento , Fisostigmina/efeitos adversos , Fisostigmina/uso terapêutico , Síndrome
19.
Ann Fr Anesth Reanim ; 6(2): 122-4, 1987.
Artigo em Francês | MEDLINE | ID: mdl-2884905

RESUMO

A case is reported of massive drug self-poisoning (more than 200 pills associated with slices of oranges) in which repeated gastric lavage failed to empty the stomach. An attempt to split up the amalgamated pills, adherent to the gastric mucosa, by fibre-optic gastroscopy failed and a gastrotomy was required. Endoscopy together with gastric lavage is indicated in certain situations to quickly empty the stomach and so shorten the course of the poisoning. Indications are the large number of pills swallowed, a poor result of the treatment, a worsening of the clinical condition despite treatment, and three positive gastric toxicological assays within the first 24 h.


Assuntos
Amitriptilina/envenenamento , Antipsicóticos/envenenamento , Lavagem Gástrica , Gastroscopia , Lorazepam/envenenamento , Fenotiazinas/envenenamento , Eletrocardiografia , Feminino , Bloqueio Cardíaco/etiologia , Humanos , Pessoa de Meia-Idade
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