Fatal diphenhydramine intoxication in infants

Diphenhydramine is an antihistamine available in numerous over-the-counter preparations. Often used for its sedative effects in adults, it can cause paradoxical central nervous system stimulation in children, with effects ranging from excitation to seizures and death. Reports of fatal intoxications in young children are rare. We present five cases of fatal intoxication in infants 6, 8, 9, 12, and 12 weeks old. Postmortem blood diphenhydramine levels in the cases were 1.6, 1.5, 1.6, 1.1 and 1.1 mg/L, respectively. Anatomic findings in each case were normal. In one case the child's father admitted giving the infant diphenhydramine in an attempt to induce the infant to sleep; in another case, a daycare provider admitted putting diphenhydramine in a baby bottle. Two cases remain unsolved; one case remains under investigation. The postmortem drug levels in these cases are lower than seen in adult fatalities. We review the literature on diphenhydramine toxicity, particularly as it pertains to small children, and discuss the rationale for treating these cases as fatal intoxications.     

Further studies on spot tests and microcrystal tests for identification of cocaine

The presence of cocaine in illicit drug samples is still being determined in some laboratories using spot tests and microcrystal tests. Seventeen chemical species were tested using three different spot tests (Wagner, Marquis, and cobalt thiocyanate followed by stannous chloride reactions) and two microcrystal tests (gold chloride and platinic chloride) to determine whether the results could be differentiated from the results of these tests on cocaine. The data obtained indicated that nine of the 17 compounds gave results similar to those from cocaine using the three spot tests, but that the results from microcrystal testing allowed for differentiation of all nine compounds from cocaine.     

Extraction of 1,2- and 1,4-dihydroxybenzene from water solutions

The results of extraction of 1,2- and 1,4-dihydroxybenzene from water solutions by the hydrophobic and hydrophilic organic solvents are described. The influence of an extragent nature and of a water-phase pH medium on an extraction degree is demonstrated. The repetition factor needed to extract a preset quantity of examined compounds is calculated.     

Legal regulation and management of fee for services in the state expert institutions

With due regard for the economic situation in regions, differences in the material-technical and personnel provision of each forensic-medical bureau (FMB), paying capacity of local residents and for other factors, a method for estimating the cost of forensic medical services was elaborated and offered for use. The formula of cost estimation for rendered services allow for basic wages (BW) and bonuses, sick-list and vacation payments, overhead charges (including FMB wear-and-tear), and BW assignment to off-budget funds (which constitute, in total, the self-cost of services) as well as the planned profit and road taxes.     

Forensic and medical aspects of lethality from thromboembolytic complications of trauma,diseases and certain pathological conditions

A total of 743 lethal outcomes of thromboembolytic complications of trauma, diseases and certain pathological conditions as observed in 1999-2001 and in the three quarters of 2002 were studied. The undertaken analysis confirmed two factors provoking the pathological thrombosis, i.e. 1. Pathological changes observed in the surface vascular wall preconditioned by mechanical damages, atherosclerotic process and aging; and 2. A slower blood flow due to an impaired blood circulation, a forced positioning and to hypodynamics. While deciding on a possibility of a direct cause-effect relation between past traumas, surgeries, poisonings and death of thromboembolism of the pulmonary arteries (TEPA), such relation can be mentioned only on rare occasions. It is more often the case that an indirect, mediated relationship is found, when TERA evolves due to an unfavorable combination of risk factors, i.e. a forced immobility, changing coagulated blood system, impaired blood vessels etc.     

Methods of making the plaster copies of skulls for the medical and criminalistic identification of individuals

A possibility was studied to use the plaster copies of skulls in the forensic medical identification of personality by applying the craniofacial method. No dependence was found between the plaster casts and the moulding types. Differences between the same craniometric sizes in the skull and in its cast are of an incidental nature. Such incidental deviation is related with an accuracy of determining the localization of craniometric points and with an instrumental precision of measuring devices. The necessity is substantiated that, while making a craniofacial examination, it is necessary to mark all anthropometric points in the skull cast, with the original being a control. The use of a plaster skull cast is possible in those cases, when the burial of the remains must be done in full.