196,058 research outputs found
Toxicological investigation of forensic cases related to the designer drug 3,4-methylenedioxypyrovalerone (MDPV): Detection, quantification and studies on human metabolism by GC-MS
No full text3,4-methylenedioxypyrovalerone (MDPV) is a synthetic cathinone belonging to the class of a-pyrrolidinophenones that become increasingly popular as a designer psychostimulant. Here, we report a comprehensive collection of MDPV exposure with quantitative serum level confirmation in Germany. During the years 2014-2016, we could proof consumption of MDPV in 23 cases where urine and blood samples were submitted to our laboratory by the police of Lower Saxony. Most of the samples underwent systematic toxicological analysis by gas chromatography-mass spectrometry (GC-MS), where MDPV could be detected in urine and/or serum samples. The determined concentrations of MDPV in serum showed a high variability, ranging from traces (< 10 ng/mL) up to 576 ng/mL with a mean concentration of 118 ng/mL and median of 47 ng/mL. The majority of MDPV users were men (87%) and the age ranged from 23 to 49 years (mean 35.9, median 37 years). For most of the analytically confirmed MDPV cases we could prove co-consumption of other psychotropic drugs with frequent occurrence of opiates and cannabinoids in 22% of the cases, followed by benzodiazepines and cocaine in 17%. Analysis of urine samples by GC-MS disclosed the presence of MDPV and its metabolites 2'-oxo-MDPV, demethylenyl-MDPV, demethylenyl-methyl-MDPV, demethylenyl-oxo-MDPV, demethylenyl-methyloxo- MDPV and demethylenyl-methyl-N, N-bisdealkyl-MDPV. The metabolite pattern substantiates previous suggestions for principle metabolic pathways of MDPV in humans. (C) 2017 Elsevier B.V. All rights reserved
Acute pulmonary injuries from chlorine-based swimming pool disinfectants in northern Germany
No full textCocaine-body-packing. Infrequent indication for laparotomy
No full textIntroduction. Body-packers or "mules" are drug smugglers who swallow cocaine-filled condoms in order to conceal them during air travel. Body pushers hide drug packages in the rectum or vagina. In a cooperative effort between the Frankfurt Airport Clinic and the GIZ-Nord (Goettingen University poison control center), we performed a retrospective study and developed an algorithm for the problem of "rupture of a cocaine-filled condom in a body-packer." Methods. In a retrospective analysis, the data of all cocaine body-packers and body pushers who were identified at Frankfurt International Airport from 1985 to 2001 were evaluated. Temporal development, demographic data, and surgical aspects were of special interest. Results. From 1985 to 2001 a total of 280 body pushers and 2880 body-packers were identified: 63 "mules" (2.2%) developed symptoms of severe cocaine intoxication following rupture of a condom. Emergency laparotomy was performed on 20 patients (i.e., 32% of all symptomatic body-packers) and the condoms were removed,while 43 body-packers (68%) died before surgical therapy could be initiated. All operated patients survived. Conclusion. Severe cocaine intoxication is life threatening. Patients die from complications caused by generalized vasoconstriction. If the reason for severe cocaine intoxication is the rupture of a cocaine-filled condom,the only possible therapy consists of immediate laparotomy for removal of the condoms
Acute pulmonary injuries from chlorine-based swimming pool disinfectants in northern Germany
No full textInfant botulism—an underestimated rarity?
No full textSäuglingsbotulismus ist eine neuroparalytische Erkrankung, die durch toxinbildende Clostridien verursacht wird. Das klinische Bild ist durch schlaffe Muskelparesen und Störungen des autonomen Nervensystems gekennzeichnet. Während in Deutschland nur einige wenige Fälle pro Jahr diagnostiziert werden, liegt die Häufigkeit in den USA mehr als 10-mal so hoch.
Es wird über 2 Fälle von Säuglingsbotulismus, bei einem 5 Monate alten Mädchen und einem 4 Monate alten Jungen, berichtet, die innerhalb von 5 Monaten in derselben Klinik behandelt wurden. Während das Mädchen typische Symptome wie Mydriasis, Ptosis, herabgesetzte Motorik und Darmatonie zeigte, waren die Symptome des später eingelieferten Jungen wesentlich unspezifischer. Auch durch die Erfahrung mit der ersten Patientin wurde die Botulismusdiagnostik bei dem Jungen frühzeitig eingeleitet und positiv befundet.
Einer der Gründe für die unterschiedliche Inzidenz für Säulingsbotulismus in Deutschland und den USA könnte auch in einer Unterdiagnostik hierzulande liegen. Gerade die frühzeitige Erkennung ist für Therapie und Prognose entscheidend
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