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91.
Fatal Fentanyl Patch Misuse in a Hospitalized Patient with a Postmortem Increase in Fentanyl Blood Concentration 下载免费PDF全文
Philip W. Moore D.O. Robert B. Palmer Ph.D. Joseph Ward Donovan M.D. 《Journal of forensic sciences》2015,60(1):243-246
Opioid‐related mortality happens, even in healthcare settings. We describe serial postmortem fentanyl blood concentrations in a hospital inpatient who fatally abused transdermal fentanyl. This is a single‐patient case report. A 42‐year‐old man with lymphoma was started on transdermal fentanyl therapy while hospitalized for chronic abdominal pain. The patient was last seen awake 1.3 h prior to being found apneic and cyanotic. During the resuscitation attempt, a small square‐shaped film was removed from the patient's oropharynx. Femoral blood was collected 0.5 and 2 h postmortem, and the measured fentanyl concentration increased from 1.6 to 14 ng/mL. Study limitations include potential laboratory or collection errors and missing data. (i) Providers must be vigilant for signs of fentanyl patch abuse. (ii) Postmortem blood concentrations are not static postmortem, likely secondary to decreasing pH, increased aqueous solubility, and tissue redistribution, and are therefore unlikely to accurately represent antemortem blood concentrations. 相似文献
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In a companion paper to “Environmentalism in the USSR: The Opposition to the River Diversion Projects,” two geographers survey the current status of water transfer research after cancellation of the European and Siberian diversion projects and offer a different perspective on the debates leading to that cancellation. Implications of a demand-side approach to Centra! Asian water management problems are then assessed in light of (a) contradictory objectives of expanding irrigated hectarage and mitigating environmental deterioration in the Aral basin and (b) the problematic nature of projected water savings and costs involved in their realization. Journal of Economic Literature, Classification Numbers: 052, 124, 720. 相似文献
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Philip Longworth 《The Journal of peasant studies》2013,40(2):183-205
This paper examines the leadership of the Pugachev revolt, the vast peasant uprising which took place in Russia between 1773 and 1775. It is also concerned with certain general issues, particularly those concerning the raising and subsequent sustaining of large‐scale peasant movements in ‘pre‐industrial’ societies where peasant organisations beyond village level are lacking. The Pugachev revolt had peculiarities which are of intrinsic interest, but it also provides significant parallels and contrasts to other peasant uprisings (not only in seventeenth‐ and eighteenth‐century Russia) and generally serves to highlight the problems of the articulation of rural protest in backward societies. 相似文献
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