Acute poisonings and sudden deaths in Crete: a five-year review (1991-1996).

Fatal and non-fatal acute poisonings and other sudden deaths examined in the Toxicology Laboratory of University Hospital of Iraklion, Crete, from 1991 to 1996 mainly involved the abuse of drugs (heroin, flunitrazepam and other psychoactive substances), accidental poisonings or suicide attempts with pesticides (carbamates, organophosphates, paraquat), other chemicals (cyanide salts, paint thinner, chlorine), traffic accidents, drownings and violent deaths (gunshots). Many of the cases were related to poisonous gases or volatiles (carbon monoxide, methylbromide). Fatalities due to alcohol and methylene-dioxy-ethyl amphetamine were also examined. Amphetamine and alcohol-related deaths due to drowning were more recent. A significant number of cases were related to the accidental ingestion of alcohol, drugs or suicide attempts by children. Some of the cases were treated successfully in various Cretan hospitals, while others had fatal outcomes due to late hospital admission.

Conversion of atrial fibrillation to sinus rhythm using acute intravenous procainamide infusion.

The efficacy and safety of intravenous procainamide in the conversion of atrial fibrillation was investigated. A total of 114 patients without severe heart failure were randomized to receive either intravenous procainamide (1 g over 30 minutes, followed by an infusion of 2 mg/min over 1 hour) or placebo in a double-blind trial. Digoxin (0.5 mg intravenously) was administered to all patients who had not previously been receiving digoxin. Treatment was considered successful if sinus rhythm was restored within 1 hour after starting the infusion. Conversion to sinus rhythm was achieved in 29 (50.9%) of the 57 patients treated with procainamide and in 16 (28.1%) of the 57 who received placebo (P approximately 0.012). When the duration of the atrial fibrillation was < or = 48 hours, conversion to sinus rhythm was achieved in 29 (69%) of the 42 patients receiving procainamide and in 16 (38.1%) of those receiving placebo (P approximately 0.004). None of the patients with atrial fibrillation lasting > or = 48 hours converted to sinus rhythm in either group. Another factor that played a role in the restoration of sinus rhythm was the size of the left atrium: the smaller the left atrium, the larger the success rate. The results of the study suggest that intravenous procainamide is an effective and safe means for the rapid termination of atrial fibrillation of recent onset and that its success rate is inversely related to the size of the left atrium. However, the drug is ineffective in the conversion of atrial fibrillation lasting more than 48 hours.

Death following intentional methyl bromide poisoning: toxicological data and literature review.

A case of fatal poisoning due to ingestion-inhalation of methyl bromide (MeBr) is presented. In previously reported fatalities due to MeBr inhalation, only inorganic bromide levels in biological specimens were reported. Intact MeBr has not been isolated from human tissues following exposure. In the present case, MeBr was detected, confirmed and quantitated in various biological samples by headspace gas chromatography, and the clinical manifestations and autopsy findings are described. Postmortem MeBr peripheral blood concentration was 3.3 micrograms/mL and in subclavian blood was 3.8 micrograms/mL. Lung, brain, adrenal gland, kidney, liver and testis MeBr was 2.9, 3.5, 3.4, 2.6, 1.9 and 2.8 micrograms/g respectively; MeBr in bile was 1.2 micrograms/mL. Inorganic bromide concentrations were 530, 30, 310 and 130 micrograms/g in blood, brain, kidney and adrenal gland respectively.

A narrow-bore HPLC method for the identification and quantitation of free, conjugated, and bound polyamines.

A modified sensitive high-pressure liquid chromatography (HPLC) method, using a narrow-bore column (2.1 x 200 mm, C-18, 5-microns particle size) with a methanol:water gradient (55-84%, v/v), is described for direct analysis of benzoylated free (S), soluble-conjugated (SH), and insoluble-bound (PH) polyamines in plant tissues. Regression curves for each fraction of polyamines allow a precise quantitative determination of putrescine, cadaverine, spermidine, spermine, and agmatine in all fractions (S, SH, PH) of a crude extract. A comparison of the results to the corresponding values for dansylated polyamines separated by thin-layer chromatography and quantitated by fluorometry is also presented. S, SH, and PH polyamines as benzoylated derivatives from leaves of Vitis vinifera L. cv Dogridge were characterized and quantitatively determined with this improved sensitive HPLC method.