ABSTRACT
We present the case of a 17-year-old man, who died after 2,4-dinitrophenol (DNP) and clenbuterol consumption, which he likely took for physical enhancement. Forensic post-mortem examination revealed a yellowish skin colour and nonspecific signs of asphyxia. Analytical confirmation of the intoxication was obtained in blood and urine, with high levels of DNP and clenbuterol. Both of these substances are used by bodybuilders as DNP enhance lipolysis and clenbuterol has anabolic properties, but their toxicity is underestimated. DNP uncouples oxidative phosphorylation, leading to thermogenesis and even relatively small doses can cause fatal hyperthermia. Clenbuterol is a ß2 agonist that causes electrolyte disturbances (hypokalemia and hyperglycemia mostly) and death have been described through coronary vasospasm. Given the circumstances in which the body was found and toxicological results, we believe the cause of death to be fatal hyperthermia from DNP intake. These substances are illegal in many countries, but easily bought online. Through this availability, the last decades have seen an increase of fatal intoxications. Websites selling them are regularly closed by French public authorities and Interpol, but unfortunately it seems insufficient.
Subject(s)
2,4-Dinitrophenol/poisoning , Clenbuterol/poisoning , Drug Overdose , Forensic Toxicology , Hyperthermia/chemically induced , Adolescent , Fatal Outcome , Humans , MaleABSTRACT
Circumcision is defined as the partial or total excision of the prepuce. It is one of the most frequently performed surgical procedures around the world. This practice primarily involves minors. The aim of this study was to review the legal aspects of ritual circumcision in France. We report the cases of an 11-year-old and a 15-year-old boy examined in the forensic unit at the Hôtel-Dieu hospital in Paris, after their father complained to the Minors Protection Brigade of Paris following the discovery of their circumcision. The examination conducted in the forensic unit found that the two boys had undergone recent circumcision. The total incapacity of work (ITT) was assessed as 5 days for the 15-year-old boy and 1 day for the 11-year-old boy. Ritual "medicalized" circumcision is legal in France, and does not fall under article 222-1 of the Criminal Code (torture and acts of barbarism) or article 16-1 of the Civil Code (inviolability of the human body). Circumcision is treated as a "serious act" by several areas of jurisprudence, which means it is imperative to obtain the consent of both parents. Moreover, it must be performed in a hospital by knowledgeable staff.
