2 citations found

1: Forensic Sci Int 2002 Nov 5;130(1):49-54 Related Articles, Links

Fatal versus non-fatal heroin "overdose": blood morphine concentrations with fatal outcome in comparison to those of intoxicated drivers.

Meissner C, Recker S, Reiter A, Friedrich HJ, Oehmichen M.

Department of Legal Medicine, Medical University of Luebeck, Kahlhorststrasse 31-35, D-23562, Luebeck, Germany

The study was performed to distinguish fatal from non-fatal blood concentrations of morphine. For this purpose, blood levels of free morphine and total morphine (free morphine plus morphine conjugates) in 207 cases of heroin-related deaths were compared to those in 27 drivers surviving opiate intoxication. The majority of both survivors and non-survivors were found to show a concomitant use of depressants including alcohol or stimulants. Blood morphine levels in both groups varied widely, with a large area of overlap between survivors (free morphine: 0-128ng/ml, total morphine: 10-2110ng/ml) and non-survivors (free morphine: 0-2800ng/ml, total morphine: 33-5000ng/ml). Five (18.5%) survivors and 87 (42.0%) non-survivors exhibit intoxication only by morphine. In these cases, too, both groups overlapped (survivors-free morphine: 28-93ng/ml, total morphine: 230-1451ng/ml; non-survivors-free morphine: 0-2800ng/ml, total morphine: 119-4660ng/ml). Although the blood levels of free or total morphine do not allow a reliable prediction of survival versus non-survival, the ratio of free/total morphine may be a criterion to distinguish lethal versus survived intoxication. The mean of the ratio of free to total morphine for all lethal cases (N=207) was 0.293, for those that survived (N=27) 0.135, in cases of intoxication only by morphine 0.250 (N=87) and 0.080 (N=5), respectively. Applying a cut-off of 0.12 for free/total morphine and performing ROC analyses, fatal outcome can be predicted in 80% of the cases correctly, whereas 16% of the survivors were classified as dead. Nevertheless, in this study, all cases with a blood concentration of 200ng/ml and more of free morphine displayed a fatal outcome.

PMID: 12427450 [PubMed - in process]

2: Forensic Sci Int 2002 Nov 5;130(1):44-48 Related Articles, Links
 
Suicide by sodium tetraoxoselenate(VI) poisoning.

Lech T.

Institute of Forensic Research, ul. Westerplatte 9, 31-033, Krakow, Poland

Selenium is one of the most toxic elements necessary for the life of mammals. Only a narrow range separates therapeutic (connected with a protective effect) and toxic doses. Selenium incorporated into animal or human tissues in larger amounts can exceed normal human levels and may be toxic (only elemental selenium and selenium sulphide are poorly absorbed). Acute poisonings with selenium or its compounds, especially fatal ones, occur extremely rarely in humans. Levels of selenium in four fatal cases are reviewed, and the levels in a fatal poisoning with sodium tetraoxoselenate(VI) are evaluated. Postmortem tissue selenium contents in the latter case were the following: brain, 1.45 and 1.60&mgr;g/g; stomach, 6.12 and 6.37&mgr;g/g; small intestine, 4.37 and 4.13&mgr;g/g; large intestine, 4.53 and 4.43&mgr;g/g; liver, 4.20 and 4.35&mgr;g/g; kidney, 3.35 and 3.60&mgr;g/g; lung, 1.80 and 1.60&mgr;g/g; blood, 1.43 and 1.41&mgr;g/ml measured by the use of ETA-AAS and fluorimetric methods, respectively.

PMID: 12427449 [PubMed - as supplied by publisher]