The PMMA epidemic in Norway: comparison of fatal and non-fatal intoxications

During a 6 month period (July 2010-January 2011) we observed 12 fatal intoxications and 22 non-fatal cases related to the drug paramethoxymethamphetamine (PMMA) in Norway (4.8 mill inhabitants). This toxic designer drug, also known as "Death", is occasionally found in street drugs offered as "ecstasy" or "amphetamine". The present study aimed to evaluate the cause of death, and to compare the PMMA blood concentrations in fatal and non-fatal cases. Methods for identification and quantification of PMMA are presented. The median age of fatalities was 30 years (range 15-50) with 67% males; in non-fatal cases 27 years (20-47) with 86% males. In the 12 fatalities, the median PMMA blood concentration was 1.92 mg/L (range 0.17-3.30), which is in the reported lethal range of 0.6-3.1 mg/L in peripheral blood and 1.2-15.8 mg/L in heart blood. In the 22 non-fatal cases, the median PMMA concentration was 0.07 mg/L (range 0.01-0.65). Poly-drug use was frequent both in fatal and non-fatal cases. The PMA concentrations ranging from 0.00 to 0.26 mg/L in both groups likely represented a PMMA metabolite. Three fatalities were attributed to PMMA only, six to PMMA and other psychostimulant drugs, and three to PMMA and CNS depressant drugs, with median PMMA concentrations of 3.05 mg/L (range 1.58-3.30), 2.56 (1.52-3.23) and 0.52 mg/L (0.17-1.24), respectively. Eight victims were found dead, while death was witnessed in four cases, with symptoms of acute respiratory distress, hyperthermia, cardiac arrest, convulsions, sudden collapse and/or multiple organ failure. In summary, all fatalities attributed to PMMA had high PMMA blood concentrations compared to non-fatal cases. Our sample size was too small to evaluate a possible impact of poly-drug use. A public warning is warranted against use and overdose with illegal "ecstasy" or "speed" drugs.     

Fixation of cells for analysis by laser microdissection--comparative studies in forensic trace material

This paper is focused on the preparation of samples for laser microdissection (LM) in forensic casework. In forensic genetics, it is essential to preserve and separate cellular traces during sample preparation, as they are usually gathered in very small amounts and are often contaminated with undesired cells. This is made possible by laser microdissection, a technique developed to cut cells or tissue of a certain type from a microscopical specimen by UV laser and catapult them directly into a PCR reactor. This method minimizes the risk of getting inconclusive, mixed DNA profiles due to contamination by foreign DNA and also supplies information about the cellular origin of a DNA profile. A method for optimized fixation and staining of spermatozoa for laser microdissection was established. Four different fixation methods combined with two staining methods were tested on two different microscope slides. Moreover, the effect of a blocker pen to contain the specimen on the slide was investigated.     

Literatur

Ohne Zusammenfassung     

Clinical observations of ghetto four-year-olds: Organization,involvement, interpersonal responsiveness,and psychosexual content of play

This study attempted to refine the assessment of the effectance of four-year-old children through observation of their play. Two scales were developed; the first scale defined organization, involvement, and interpersonal responsiveness in play, and the second operationally defined psychosexual content of play. The validity and reliability of both scales and the inter correlations among the four major variables were explored. The results confirmed the validity and reliability of the instruments as measures of the children's effectance and important indicators of a child's capacity as a learner at age four.This research was carried out at the Dr. Martin Luther King Family Center and was supported by the Kenneth F. Montgomery Charitable Foundation in collaboration with the State of Illinois Department of Mental Health. Additional support was provided by the National Institutes of Health, General Research Support Grant No. 1-So 1 FR 05 666-01.Received M.D. from Tulane University School of Medicine in 1957. Presently Associate Professor of Psychiatry at the University of Illinois College of Medicine. Research interests lie in cross-cultural personality development and in psychophysiologic studies of human sexual arousal.Received Ph.D. from the Illinois Institute of Technology in 1967. Presently Assistant Professor of Psychology at the Yale Child Study Center. Research has been mainly in the area of development and interference of effective learning in children.Graduated from the University of Cincinnati College of Medicine in 1954. Presently Associate Professor of Psychiatry at the University of Illinois College of Medicine. Primarily interested in the effects of poverty on personality and social organization.     

Schiavo's lessons for health attorneys when good law is all you have: reflections of the special guardian ad litem to Theresa Marie Schiavo

Rarely have all the branches of federal and state government converged upon a single issue, a single person as they did in the tragic and acrimonious case of Theresa Maria Schiavo. In late 2003, the Florida Legislature passed what become known as "Terri's Law" and in Spring of 2005, Congress and the President of the United States sought to directly intervene in the care of the severely brain damaged woman. During that period, the state and federal court systems, through the highest courts in both venues, ruled on Ms. Schiavo's life, resulting in the removal of an artificial feeding tube and her death during Easter week. The legal and medical issues in this complex, politically and emotionally charged case continue to raise important questions for health attorneys. In this Article, Professor Wolfson, who served as the legislatively mandated, court appointed special guardian ad litem for Theresa Schiavo in late 2003, provides a distinctive first-person overview of the Schiavo case.     

Using STR analysis to detect human DNA from exploded pipe bomb devices

This study investigated the possibility of recovering a bomb assembler's DNA from an exploded pipe bomb device. Metal and polyvinyl chloride (PVC) pipes were examined to determine if one surface type would allow better DNA recovery than the other. Ten subjects each handled components of one metal and one PVC pipe bomb. The bombs were exploded, the fragments were collected and swabbed using the double swab technique, and the samples were extracted, quantified, amplified, and genotyped using polymerase chain reaction/short tandem repeat (PCR/STR). Of the 20 bombs handled by the subjects, four bombs gave reportable results that matched the subject's known DNA profiles. An additional eight profiles, also matching the subject's known DNA profiles, were generated but were below the reportable threshold. There was no difference in the success rate of obtaining DNA profiles related to the use of either PVC or metal in the manufacture of the pipe bomb. The variables that appeared to have the greatest influence on the success of generating a DNA profile were the amount of fragmentation and subsequent recovery of the bomb fragments. It is suspected that successful DNA profiling could also be dependent upon the bomb assembler's propensity to slough skin cells on objects they handled.