Expert criteria of the degree of severity of the chemical trauma in acute poisonings by organophosphate insecticides

The article deals with quantitative assessment of severity of chemical trauma (according to life-threatening characteristics) in case of acute peroral poisoning with OPI (carbophos and chlorophos). Standard diagrams were plotted which help to assess the life threatening values of the given compounds depending on the initial blood poison level or recorded decrease in enzyme cholinesterase activity. Basic opportunity to assess severity of body lesions in case of poisoning with OPI according to character of specific clinical signs was evidenced.     

The forensic medical diagnosis of death-cup poisonings

Comparative analysis and evaluation of all modern methods used for medicolegal diagnosis of poisoning with Amanita phalloides are presented. Imperfection of methods used for laboratory diagnosis of such poisonings requires extensive experimental control using the designed method of liquid chromatography for amanitine and phalloidine assay in the cadaveric organs and tissues.     

Postmortem evaluation of barbiturate poisonings

The evaluation of barbiturate intoxication as the cause of death is often difficult when the concentration in body fluids and organs is not extremely high. The problem arises because of the great capacity of barbiturates to produce tolerance after chronic use, a property that is often unknown. Therefore, the most abused barbiturates were studied to assess whether chronic intake causes morphological liver changes or not. It was found that the chronic abuse of drugs containing seco-, cyclo-, brallo-, and/or pentobarbital produces hypertrophy of the smooth endoplasmic reticulum of hepatocytes corresponding to that of phenobarbital. Neither acute barbiturate overdose (without a history of abuse) nor chronic abuse of opiates causes similar liver changes. In conclusion, barbiturate tolerance can be evaluated postmortem by light microscopic examination of the liver.     

The clinico-morphological basis for a diagnosis of diffuse axonal brain damage in head trauma

The most typical neurologic signs and variants of computer-tomographic cerebral picture in diffuse axonal lesion of the brain are presented. Dynamics of pathomorphologic changes depending on duration of posttraumatic periods is detected.     

The trend in lethal poisonings with narcotic substances in Moscow

The analysis of the 1989-2005 records of the Moscow Bureau of Forensic-Medical Examinations, statistics on lethal narcotic poisonings by gender, age, education, social and family status has revealed that the trend to reduction of the number of narcotic substances (NS) poisonings stopped in 2003. There was a 238.4% rise in the above poisonings in 2004. The highest rise was in the age group of 21-25-year-olds (35.7%; CI = 0.34-0.37; p = 0.05) and 26-30-year-olds (29.6%; CI = 0.28-0.31; p = 0.05). Among lethal cases one-third were unemployed (35.8%; CI = 0.34-0.37; p = 0.05) and one-forth were workers (22.2%; CI = 0.20-0.24; p = 0.05). By the family status, most of the dead were unmarried (57%; CI = 0.55-0.59; p = 0.05). This study gives a complete and accurate picture of the structure of narcotic drug poisonings. Relevant preventive measures are proposed.     

The forensic medical aspects of the toxicokinetics of organophosphate insecticides

The article deals with analysis of toxicokinetics of organophosphorous compounds (malathion and trichlorfon) in blood and of its changes in critical situations (shock, coma). In these forms of viability disturbances provided for mass-transfer and accumulation of poisonous substances in gastrointestinal tract their kinetics was shown to decelerate substantially. Active detoxification therapy improves markedly the parameters of organophosphorous insecticide kinetics. The parameters of toxicokinetics were recommended for use as objective criteria in estimation of intoxication gravity and therapy efficacy.     

Regional indices of alcoholic poisonings and alcoholic psychoses

Interrelations of phenomena preconditioned by alcohol consumption were the starting prerequisite of the case study. The annual lethality rates due the to alcohol poisonings (AP) and alcoholic psychosis (APS) morbidity were investigated in 77 Russia's regions during 1991-1999, when the alcohol consumption used to be dynamic in the country--a sharp growth in 1991-1994, a drop in 1995-1998, and a new increase in 1999. The correlation of studied phenomena was observed only in 33 regions. The ratio of AP level to APS level varied in different regions and during different time periods from 50-fold AP prevalence to 65-fold APS prevalence. The distribution of APS indices was normal, while the distribution of AP deviated from the norm towards a higher dispersion. Two etalons were made use of, i.e. one for AP and the other for APS, to assess the differences between the AP and APS indices. APS differed from the appropriate etalon by far less versus AP. A list of regions with respect for deviations of APS and AP indices was compiled. A conclusion was made to the extent that consciously or unconsciously the postmortem diagnoses of AP were concealed in a majority of Russia's regions; APS were not registered in full either. However, the latter reflect better the alcohol-related situation in regions versus AP.     

Identification of atractyloside by LC-ESI-MS in alleged herbal poisonings

An LC-MS screening method was developed to detect the presence of atractyloside (ATR), the toxic principle of a commonly used medicinal plant in South Africa, Callilepis laureola, in biological matrices such as body fluids and human viscera.     

The morphofunctional changes in the internal organs in the modelling of poisonings by psilocybine-containing mushrooms]

Histological analysis of the viscera in experimental poisoning with psilocybin-containing mushrooms showed nonspecific changes in all examined organs, presenting as expressed hemocirculatory disorders and intracellular dystrophy. Quantitative histochemical analysis showed appreciable shifts in the activities of enzymes involved in the cytoplasmic and mitochondrial redox processes and of specific enzymes involved in nerve tissue metabolism. This may reflect some features in the direct effects of narcotic alkaloids contained in psilocybin-producing mushrooms.     

有机磷农药薄层色谱溴酚蓝显色法的改进

目的对有机磷农药薄层色谱溴酚蓝显色法进行改进,使该检验方法更完善。方法采用薄层色谱溴酚蓝—柠檬酸显色。结果显色背景呈纯正的浅黄色,并且颜色稳定。结论该方法操作简单、快速、检测灵敏度高。     

Tissue disposition of cocaine in man: a report of five fatal poisonings

The disposition of cocaine in five cases of fatal poisoning are presented. The highest concentrations of cocaine were found in urine, kidney, spleen, brain, lung and skeletal muscle. Cocaine concentrations in these organs far exceeded those in blood. Cocaine was detected in all other specimens tested including: bile, heart, liver, vitreous and adipose tissue. These results are in agreement with limited, previously reported, tissue data, and indicate that when urine is not available, kidney, spleen, brain and/or lung should be the specimen of choice for cocaine detection.     

The medical and scientific evidence in alleged tubocurarine poisonings. A review of the so-called Dr. X case

The problem of proving the presence or absence of a poison in a buried cadaver is the central theme of this presentation. Certain general questions are posed which may serve to guide those seeking to determine the cause of death in buried cadavers and allegedly due to a poison. Medicolegal and scientific evidence is presented from the court records of five deaths which were alleged homicides due to intravenous tubocurarine. As to the medical evidence: The prosecution claimed absence of adequate medical causes but full congruence with intravenous tubocurarine as the cause of death. The defense claimed and presented its evidence, including history, clinical picture, gross and microscopic pathological findings--for the deaths having occurred from competent natural causes in all but one case. In that one case the cause was undetermined. In two of the four cases evidence was presented for the mechanism of death and why they died at the time that they did. As to the forensic toxicological evidence: The prosecution claimed qualitative identification but with no particular quantitative detection or identification limits of tubocurarine in the remains based on results of combinations of HPLC followed by RIA and of some selected ion direct inlet mass spectrometry. The defense corroborated--along with a quantitative estimate--the presence of a substantial concentration of tubocurarine in the liver specimen of one case. However the chain of custody of this particular specimen was compromised for a period of several days between post-exhumation autopsy and submission to the prosecution toxicologists. With respect to all the other specimens examined by the defense, direct inlet mass spectrometry failed to show ions which are critical for establishing the identity of tubocurarine. The defense also presented results of experiments which showed that the tissues of the cases in question destroyed tubocurarine at such a rate that no reasonably conceivable administered amount could have survived the 10 years of burial of these cases. In each of the five cases exhumation and re-autopsy would have been found to be neither justified nor even indicated had an objective examination of the available record been made and supplemented by a similarly objective review of the literature and the simple stability experiments used by the defense. After an 8-month trial, the jury brought in a not guilty verdict on all counts after less than 2 h of deliberations.