Hemorrhagic stroke caused by xylometazoline poisoning.

An increase in the use of over-the-counter medications has been observed in recent years. This also concerns xylometazoline, approved for the treatment of allergic rhinitis or upper respiratory tract infections. We present the fatal case of a 40 year-old-woman with a massive hemorrhagic stroke. Initial toxicology tests of biological material collected during autopsy revealed the presence of xylometazoline. No other significant toxicology findings were noted. LC-MS/MS method has been developed to determine xylometazoline concentration, which was 18.6 ng/mL in blood and 498.9 ng/mL in urine. The macroscopically detected hemorrhagic focus was confirmed by histopathological which confirmed hemorrhagic infarcts in the brain tissue, especially in the subarachnoid area. No other pathological changes were found. Based on findings from autopsy and toxicological analyses, the direct cause of death was concluded to be hemorrhagic stroke resulting from xylometazoline intoxication. Although xylometazoline products are regarded as relatively safe and are available over the counter, the risk of adverse effects, in particular stroke leading to death, should be considered. If adverse effects are observed, it is reasonable to measure the concentration of the drug in blood and urine. With such data, it will be possible to assess the actual exposure to this xenobiotic and draw firmer conclusions.

Suicidal intoxication with mercury chloride.

PURPOSE: Poisoning with elemental metals and metallic compounds was much more frequent in the past, and was related, among other things, to lifestyle and the lack of appropriate toxicological diagnostics. One example is mercury, which is being gradually eliminated but still has many different applications as a pure metal or in the form of various compounds. The paper presents a case of suicidal poisoning with mercury chloride (corrosive sublimate). METHODS: Forensic and toxicological tests including inductively coupled plasma mass spectrometry (ICP-MS) were at the Department of Forensic Medicine, PMU in Szczecin. RESULTS: The patient before death had a range of symptoms such as epigastric pain, vomiting of the stomach contents, central cyanosis with tachycardia, tremors, severe shortness of breath with wheezing, difficulty swallowing, slurred speech, rales in the lungs, and diarrhea. The concentration of mercury measured by ICP-MS was 191 mg/L for a blood sample collected antemortem, and 147 mg/L for a blood sample collected at autopsy. Both concentrations of mercury are regarded as lethal. The post-mortem examination revealed signs of extensive thrombotic necrosis in some internal organs. CONCLUSIONS: Mercuric chloride has an estimated human fatal dose of between 1 and 4 g. It can produce a range of toxic effects, including corrosive injury, severe gastrointestinal disturbances, acute renal failure, circulatory collapse, and eventual death. The presented case of fatal poisoning with mercury chloride, due to the type of agent used, is now interesting in toxicological practice.

Dynamic Model of a Humanoid Exoskeleton of a Lower Limb with Hydraulic Actuators.

Exoskeletons are the mechanical systems whose operation is carried out in close cooperation with the human body. In this paper, the authors describe a mathematical model of the hydraulic exoskeleton of a lower limb. The coordinates of characteristic points of the exoskeleton in the sagittal plane as a function of user height are presented. The mathematical models, kinematics, and kinetics equations were determined. The masses of the actuators and their dimensions were selected based on catalog data. The force distribution in the wearable system during the squat is shown. The proposed models allowed us to determine the trajectory of individual points of the exoskeleton and to determine the forces in hydraulic cylinders that are necessary to perform a specific displacement. The simulation results show that the joint moments depend linearly on actuator forces. The dynamics equations of the wearable system are non-linear. The inertia of the system depends on the junction variables and it proves that there are dynamic couplings between the individual axes of the exoskeleton.

Fatal Intoxication with α-PVP, a Synthetic Cathinone Derivative.

This study presents the fatal case of a young man who was admitted to the ICAU due to sudden cardiac arrest. An interview revealed that the patient had taken some unspecified crystals. From the moment of admission, his condition deteriorated dramatically as a result of increasing circulatory insufficiency. After a few hours, sudden cardiac arrest occurred again and the patient was pronounced dead. In the course of a medicolegal autopsy, samples of biological material were preserved for toxicology tests and histopathological examination. The analysis of samples using the LC-MS/MS technique revealed the presence of α-PVP in the following concentrations: blood-174 ng/mL, urine-401 ng/mL, brain-292 ng/g, liver-190 ng/g, kidney-122 ng/g, gastric contents-606 ng/g. The study also presents findings from the parallel histopathological examination. Based on these findings, cardiac arrest secondary to intoxication with alpha-PVP was determined as the direct cause of the patient's death.

[A rare case of exposure to natural psychoactive substances, and difficulties with medicolegal assessment]. / Rzadki przypadek ekspozycji na naturalne srodki psychoaktywne i trudnosci w opiniowaniu sadowo-lekarskim.

An unusual case of exposure to natural psychoactive substances deriving from Datura stramonium (jimsonweed, thorn-apple) is presented in this article. It may be of interest in this case that a hallucinogenic substance was intentionally administered by a third party. An initial assessment in this criminal case was questionable, and resulted from a lack of consideration of toxicological exposure and its possible aftermath. The above-mentioned case demonstrates the necessity of considering all toxicological aspects of the case, even though initial findings seemed to indicate something else.

[Overdosing of popular medicines available without a prescription, a new trend among teenagers]. / Naduzywanie popularnych leków dostepnych bez recepty nowym trendem wsród mlodziezy.

INTRODUCTION: For last several years popularity of substances which improve concentration or/and cause hallucinations has considerably increased. There is a conviction that most frequent addictions among teenagers are cigarettes, alcohol or drugs of abuse. A very dangerous phenomenon has been ignored, becoming more common among scholars and students - usage of medicines available without doctor's prescription (over the counter drugs - OTC). Popularity and fame of these specifics comes from side effects observed especially when overdosed. MATERIAL AND METHODS: In years 2007-2012 in Clinical Toxicology Laboratory of Medical Pomeranian University 4304 toxicological analyses was conducted with specified direction on drugs analysis (39% of all analyses made in that period). In some cases, especially of young people, a doctor ordering the analysis pointed as possible cause of intoxication "recreational usage" of OTC drugs. Those suspicions were confirmed by toxicological examinations. CONCLUSIONS: It seems that dominating character feature of people who abuse psychoactive substances is emotional immaturity. Maturation process can be impaired or completely inhibited by abusing psychoactive substances. This is processes are considered which enhance immaturity of person's personality - so called defense mechanisms.

Death caused by addictive inhalation of nitrous oxide.

Intoxications with nitrous oxide have been, and still are, a rarity in forensic medicine. Apart from accidental overdose during hospital procedures, intoxication with this gas is the result of voluntary inhalation. We report the fatal case of a 32-year-old male who died during inhalation of nitrous oxide from whipped dairy cream cans and hint on the role of the internet in creating new behaviors among drug addicts. We rely on the autopsy report from the Department of Forensic Medicine, Pomeranian Medical University in Szczecin, on laboratory tests, and court files. Neither the autopsy nor the toxicologic and histopathologic tests disclosed the exact cause of death. However, circumstances in which the body was discovered were indicative that death resulted from cardiorespiratory failure. The present case is interesting with regard to its rarity, diagnostic difficulties and potential harm from nitrous oxide used by the food industry.

[Carbon monoxide as an external cause of fatality]. / Tlenek wegla przyczyna zewnetrzna wypadku przy pracy.

INTRODUCTION: Carbon monoxide intoxications mainly occur as a result of fires in houses and failures of heating systems. Case of fatal accident involving a charcoal factory worker is described in this paper. MATERIAL AND METHODS: Authors based on a medico-legal autopsy protocol and material collected in prosecutor files. Medico-legal autopsy of a 46 year old male was performed in the forensic medicine department. Interlocutory proceedings indicated that the immediate cause of death was a head-crush caused by a hydraulic cover. Previously self-ignition in the factory was noted. RESULTS: Autopsy revealed crushes of cervical spine involving the medulla. Where there were no sings of carbon monoxide intoxication. Due to unusual circumstances of the accident (self-ignition was detected by a carbon monoxide sensor and was treated by steam) additional toxicological test of autopsy material was performed. Twenty percent of carboxyhemoglobin was detected in blood collected from the heart cavity. In our opinion carbon monoxide may have been responsible for the accident. CONCLUSIONS: Relatively low carboxyhemoglobin concentration in the blood is known to be an important cause of central nervous system abnormalities. Exposure to carbon monoxide may also result in an impaired response to danger. Sometimes carbon monoxide exposure does not lead to fatal intoxication, but may lead to a fatal accident. Regardless of a well noted immediate cause of death, a specific toxicological test must be involved in each medico-legal procedure, if exposition to various chemical substances is suspected.

[Lawsuit experiment as an important element in expert's work regarding carbon monoxide poisoning cases]. / Eksperyment procesowy jako istotny element w opiniowaniu zatrucia tlenkiem wiegla.

INTRODUCTION: Giving an opinion in the field of carbon monoxide intoxications is still problematic. MATERIAL AND METHODS: In the paper we present a case of the sudden death of a young female in the garage. In such a situation there were serious suspicions of a violent cause of the death. According to eye-witness relation an experiment to evaluate momentary carbon monoxide concentration in the garage was conducted. The toxicokinetic and biologic effects of carbon monoxide were taken under consideration. RESULTS: It was revealed that under the given parameters it was impossible there to reach a lethal carbon monoxide concentration.

[Concentration of selected microelements in blood serum of rats exposed to the action of psilocin and phenylethylamine]. / Stezenia wybranych biopierwiastków w surowicy krwi szczurów narazonych na dzialanie psylocyny i fenyloetyloaminy.

Natural hallucinogens (including Psilocybe mushrooms) became popular in Europe since the nineties. They have been in the focus of clinicians interest for years because of their biological effects. Mechanism of action of these hallucinogens, both Psilocin and Psilocibin, is based on the physiological structure similarity to human neurotransmitters as serotonin and catecholamines. One of the previous works indicated the possibility of the cardiotoxic action of the Psilocibin mushroom, effecting in anoxemic heart laesure. To verify the hypothesis of the Psilocibin-like myocardial damage wide experimental programme was designed. In the present work we introduce some results concerning magnesium, calcium, natrium, kalium and chloride plasma concentration in rats subjected subchronicly to psilocin and phenylethylamine. Basing on the obtained results, it can be stated that subchronic intoxication with natural hallucinogens may disturb magnesium balance without significantly effecting other microelements.