Paraphenylenediamine (PPD) is commonly used in several industries (dyeing furs, photochemical processes, tyre vulcanisation industries, oxidisable hair dye, etc.). Its allergic effect is well established and many studies are devoted to the subject, but PPD systemic poisoning is not understood. Several acute PPD poisoning cases (accidental or intentional) had been reported, in particular, from Africa and Asia where it is traditionally used mixed with Henna to colour palms of hands and soles of feet and to dye hair. We examine here an eleven-year (1992-2002) retrospective of PPD poisoning reported to the Poison Control Centre of Morocco. It revealed 374 cases with a female predominance (77%). The majority of poisoning was intentional (78.1%) and the group most prone to PPD poisoning were the young population (15.1-25 and 25.1-35 years-old-age groups) accounting for 54.3% and 15.2%, respectively. 21.1% of poisoning cases were fatal, and the source/route of poisoning was by ingestion in the largest number of cases (93%). 50% of poisoning were from the south of Morocco, where phytotherapy knowledge is very developed. The largest number of cases was recorded in 2001 (20.1%). The prevention and treatment of PPD poisoning by public enlightenment is mandatory in the effort to reduce poisoning by this agent.
A 27-year-old man was carrying in his digestive tract 99 packages each containing about 10 g of a 86% cocaine powder. The courier died by acute cocaine intoxication due to inflation and rupture of four packages during a flight from Bogotá to Rome. At the autopsy, the external examination was unremarkable. The internal examination showed edema and generalized congestion of the organs.
Toxicological analyses were performed by gas chromatographymass spectrometry after solid phase extraction using Bond Elut Certify columns and derivatization with BSTFA/TMCS. High levels of cocaine and benzoylecgonine were found in blood (4.0 μg/mL and 17.0 μg/mL), urine (152.0 μg/mL and 512.0 μg/mL), bile (99.8 μg/mL and 54.0 μg/mL), vitreous humor (7.1 μg/mL and 5.8 μg/mL), brain (7.5 μg/mL and 3.5 μg/mL), and hair (55.5 ng/mg and 27.7 ng/mg). The presence of the cocaine and its metabolite in the hair suggested that the man was a cocaine user.
Lormetazepam is a benzodiazepine widely used as a hypnotic for management of insomnia. It is considered to be a safe drug when not combined with alcohol or other psychoactive substances. Indeed, we could neither fi nd its toxic nor lethal concentrations in the literature. In the present article, we report a fatal case in which lormetazepam and its metabolite lorazepam were the only drugs found in body fl uids. The concentration measured in blood was more than 100 times higher than the therapeutic one. Therefore, we concluded that the death was due to the drug and that the measured levels could be regarded as lethal
A man was found dead in a hotel located near Rome (Italy). The man was still holding a syringe attached to a butterfly needle inserted in his left forearm vein. The syringe contained a cloudy pinkish fluid. In the hotel room the Police found a broken propofol glass vial plus four sealed ones, an opened NaCl plastic vial and six more still sealed, and a number of packed smaller disposable syringes and needles. An opened plastic bottle containing a white crystalline powder labeled as potassium cyanide was also found. Systematic toxicological analysis (STA), carried out on blood, urine and bile, evidenced only the presence of propofol in blood and bile. So the validated L-L extraction protocol and the GC/MS-TOF method for the confirmation of propofol in the biological fluids optimized in our laboratory was applied to blood, urine and bile. The concentration of propofol resulted to be 0.432 μg/mL in blood and 0.786 μg/mL in bile. The quantitative determination of cyanide in blood was carried out by microdiffusion technique coupled to spectrophotometric detection obtaining a cyanide concentration of 5.3 μg/mL. The quantitative determination was then confirmed by GC/NPD and the concentration of cyanide resulted to be 5.5 μg/mL in blood and 1.7 μg/mL in bile. Data emerging from autopsy findings, histopathological exams and the concentrations of cyanide suggested that death might be due to poisoning caused by cyanide, however, respiratory depression caused by propofol could not be excluded.
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