RESUMO
The recreational use of nitrous oxide is widespread. Nitrous oxide for recreational use is usually obtained from anesthesia tanks or whipped-cream machine chargers or cans. Twenty previously described deaths associated with recreational nitrous-oxide use describe anesthesia tanks and whipped-cream machine dispensors as a source. Five deaths associated with nitrous oxide use are presented; two involving whipped-cream cannisters as the source, two involving anesthesia tanks, and one involving a racing fuel tank as a source of nitrous oxide. Autopsy findings in our cases were subtle or negative, but usually suggestive of asphyxia. Through a laboratory simulation, we have confirmed that nitrous oxide displaces oxygen in a closed space, which probably leads to asphyxia. A review of the literature, neuropharmacology, and pathophysiology of nitrous oxide use is also presented.
Assuntos
Asfixia/etiologia , Causas de Morte , Óxido Nitroso , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Adolescente , Adulto , Aerossóis , Asfixia/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Óxido Nitroso/metabolismo , Oxigênio/metabolismoRESUMO
Discovery of a concealed body often leads to the assumption that the manner of death was homicide. However, in cases where death has resulted from illicit drug use or drug abuse, the body may be concealed to protect persons involved in drug abuse or drug marketing.
Assuntos
Cocaína/intoxicação , Homicídio/legislação & jurisprudência , Mudanças Depois da Morte , Adulto , Feminino , Humanos , MasculinoRESUMO
A procedure has been developed for the simultaneous determination of heroin, morphine, and hydromorphone from postmortem tissues by reversed phase high performance liquid chromatography (HPLC) using electrochemical detection. This method permits the direct determination of unmetabolized heroin from antemortem or postmortem urine as evidence of illegal drug use. Presumptive confirmation of heroin was based on the ability to hydrolyze the HPLC heroin fraction to morphine. Heroin was also confirmed in urine by gas chromatographic/mass spectroscopic (GC/MS) analysis of the HPLC fraction. Analysis of postmortem blood, gastric contents, urine, and injection site tissues have revealed the presence of morphine and hydromorphone, while heroin has only been identified in urine.
Assuntos
Líquidos Corporais/análise , Heroína/análise , Hidromorfona/análise , Morfina/análise , Cromatografia Líquida de Alta Pressão/métodos , Medicina Legal/métodos , Heroína/urina , Humanos , Concentração de Íons de HidrogênioRESUMO
A gas chromatographic method suitable for determination of blood iodide in concentrations reported for burn patients treated with iodophors is described. The iodide is reacted with methyl isobutyl ketone to form an iodoketone, extracted into hexane containing an internal standard, and analyzed by gas chromatography using a packed column and an electron capture detector.
Assuntos
Iodetos/sangue , Coleta de Amostras Sanguíneas , Queimaduras/sangue , Queimaduras/tratamento farmacológico , Cromatografia Gasosa , Humanos , Iodóforos/uso terapêuticoRESUMO
Increased serum iodide concentrations secondary to iodine absorption through wounds treated with povidone-iodine dressings is described. Hyperchloremic acidosis and a disparity between serum chloride concentrations determined by two different methods suggested the presence of an unidentified halide. Cardiovascular instability and renal failure occurred concurrent with systemic iodide accumulation. Measurement of serum iodide concentration should be performed when povidone-iodine is used topically in patients with impaired renal function.
Assuntos
Iodetos/sangue , Povidona-Iodo/uso terapêutico , Povidona/análogos & derivados , Úlcera por Pressão/sangue , Infecção da Ferida Cirúrgica/sangue , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Povidona-Iodo/efeitos adversos , Úlcera por Pressão/tratamento farmacológico , Infecção da Ferida Cirúrgica/tratamento farmacológicoAssuntos
Equilíbrio Ácido-Base/efeitos dos fármacos , Homeostase/efeitos dos fármacos , Iodetos/toxicidade , Rim/fisiologia , Fígado/fisiologia , Animais , Aspartato Aminotransferases/sangue , Nitrogênio da Ureia Sanguínea , Dióxido de Carbono/sangue , Cloretos/farmacologia , Feminino , Concentração de Íons de Hidrogênio , Iodetos/análise , Iodetos/sangue , Rim/análise , Rim/patologia , Fígado/análise , Fígado/patologia , Masculino , Proteinúria , Ratos , Fatores de TempoRESUMO
Providone-iodine is used as a topical antimicrobial in burn patients. Although absorption of iodine has been thought to be negligible, several patients have recently been noted with substantial elevations of serum free iodide. Unexplained abnormalities occurred in several of these patients, renal failure, metabolic acidosis, and elevation of serum glutamic oxaloacetic transaminase. It is conceivable that the large iodide loads noted were at least in part responsible for these abnormalities.