Samoubojstvo fentanilom

Fentanyl is a potent, short-acting narcotic analgesic widely used as surgical anaesthetic. This article presents a case in which fentanyl was self-injected by a 41-year old nurse, an employee at the hospital emergency department, who was found dead at home. She had no known history of drug and alcohol abuse. Two syringes, one empty and one filled with a clear liquid, were found near the body, while a needle was stuck into her hand. Toxicological analysis showed fentanyl poisoning. Fentanyl overdose was declared the cause of death and the manner of death was classified as suicide. To our knowledge, death due to the intravenous injection of fentanyl has not previously been reported in Croatia.Fentanil je snažan narkotik u velikoj mjeri upotrebljavan kao anestetik pri kirurškim zahvatima. U ovom radu prikazan je slučaj samoubojstva upotrebom fentanila. 41-godišnja medicinska sestra, zaposlena u hitnoj službi pronađena je mrtva u svom stanu. Nije bilo podataka o njezinu zaživotnom uživanju alkohola niti drugih sredstava ovisnosti. Dvije šprice, jedna prazna i druga ispunjena prozirnom tekućinom, pronađene su kraj njezina tijela, dok je igla bila ubodena u njezinu ruku. Toksikološka analiza dala je pozitivan rezultat na fentanil. Uzrok smrti bio je predoziranje fentanilom u svrhu samoubojstva. Prema našim saznanjima, ovo je prvi dokazani slučaj samoubojstva u Hrvatskoj koji je počinjen fentanilom

Kobna intoksikacija alkoholom i heroinom

Drug abuse with alcohol consumption have been on the rise in Split-Dalmatian County for a while now. This article reports two separate cases with three deaths due to fatal combinations of heroin and alcohol. The first case of poisoning is related to a young couple, a 30-year-old man and a 28-year-old woman, who were found dead in a car, surrounded by cans of a variety alcoholic drinks. Two needles were found beside the bodies as well. The victims were registered drug abusers who had been in withdrawal programs. The second case was a 29-year-old man who was found dead in a house. Three fresh injection marks were visible on his right arm, and two needles were near his body. He was not known as a drug addict, but he had tried to commit suicide recently. Carboxyhaemoglobin was found in blood samples of both victims from the first case. The concentration was 25 % and that could contribute to their death. In both described cases blood alcohol concentration was higher then 1.60 g kg-1. Toxicology tests were positive for heroin, meconin, acetaminophen, 6-acetylmorphine, codeine, noscapine and papaverine. Ethanol, being a respiratory depressant, combined with morphine drastically increases the risk of rapid death due to respiration failure.U posljednje vrijeme u Splitsko-dalmatinskoj županiji konzumiranje opojnih droga uz alkohol je u porastu. Ovim radom prikazali smo dva slučaja s tri smrtno stradale osobe koje su bile kobne žrtve kombinacije alkohola i heroina. U prvom slučaju, mladi par, u dobi od 30 i 28 godina, pronađen je u automobilu okružen limenkama raznih alkoholnih pića. Dvije šprice nađene su kraj tijela. Žrtve su bili registrirani ovisnici i na programima odvikavanja u organiziranim tretmanima. Drugi slučaj bio je 29-godišnji muškarac pronađen mrtav u napuštenoj kući. Na njegovoj desnoj ruci primijećene su tri svježe ubodne rane, a dvije šprice pronađene su kraj tijela. Nije bio poznat kao ovisnik o drogama, ali je nedavno pokušao samoubojstvo. Karboksihemoglobin nađen je u uzorcima krvi obiju žrtava iz prvog slučaja. Koncentracija je bila 25 %, što je moglo pridonijeti njihovoj smrti. U oba opisana slučaja maseni udjel alkohola u krvi bilo je veći od 1.60 g kg-1. Toksikološke analize bile su pozitivne na heroin, mekonin, acetaminofen, monoacetil morfin, kodein, noskapin i papaverin. Alkohol, i sam kao depresor respiracije, zajedno s heroinskom smjesom značajno povisuje rizik od nagle smrti kao posljedice zatajenja disanja

Discovering the 60 years old secret: identification of the World War II mass grave victims from the island of Daksa near Dubrovnik, Croatia

Aim To describe the organization, field work, forensic anthropological examination, and DNA analysis conducted to identify the victims from a World War II mass grave found on the Dalmatian island of Daksa near Dubrovnik (Croatia) in 2009. Methods Excavation of the site was performed according to standard archeological procedures. Basic anthropological examination was made to determine the minimum number of victims, sex, age at death, and height. The bones with pathological and traumatic changes were identified. DNA was extracted from powdered bones and relatives’ blood samples. Y-chromosome and autosomal short tandem repeats (STR) were used to establish the relationship of the remains with the putative family members. Results The remains were found to belong to at least 53 distinctive victims. All were male, mostly with gunshot wounds to the head. DNA analysis and cross-matching of the samples with relatives resulted in 14 positive identifications using the Y-chromosomal STRs and 4 positive identifications using the autosomal STRs. Conclusions This study showed that even in cases of more than 50-year-old, highly degraded human remains from mass graves, Y-chromosomal and autosomal STRs analysis can contribute to identification of the victims

Suicide and Emo Youth Subculture – A Case Analysis

Depression and suicide present a serious health problem especially for teenagers as they are increasingly diagnosed with mood disorders of different severity, possibly leading to suicidal activity. Reported here is a misfortunate young girl who committed suicide by jumping from high altitude. She left a suicide note which, together with her behavior in the death-preceding period, pointed to her apparently belonging to an Emo subculture. Although few and scarce, most existing articles and reports on Emo subculture found that its members like to focus on negative things, dark premonitions and deprivation of enjoyment, like self harm and suicide but no scientific information are available about the characteristics, trends and possible suicidal tendencies of children and adolescents who belong to this subgroup. It is for the future researches to answer whether this type of behavior and music preference are causal factors for increased suicidal vulnerability, or personal characteristics and anamnesis, upbringing and mental health status are actual sources of the problem

Utjecaj alkohola i droge kod fatalnih utapanja u moru

The aim of the study is to investigate the influence of alcohol and drug consumption in all types of sea drowning lethal cases occurred in Split-Dalmatian County from September 2001 to August 2006, autopsied (89) and toxicologicaly analyzed (62). The autopsy reports of the Department of Forensic Medicine, Split University Hospital and School of Medicine were reviewed. Alcohol was regarded as a contributive death factor if the blood concentration was positive (BAC > 0.5 g/kg). Most of the victims were middle-aged to elderly males. The predominating cause of drowning fatalities was by accident. In 15 cases the concentration of alcohol in blood was positive. No victims were intoxicated by any kind of drug at the time of their death. It can be concluded from the above said that the majority of drowning deaths in Split-Dalmatian County were not drug related. Alcohol, which was the only type of drug detected, plays a minor role in such deaths.Cilj ove studije je ispitati utjecaj konzumacije alkohola i opojnih droga na sve oblike utapanja u moru u Splitsko-Dalmatinskoj županiji, u periodu od rujna 2001. do kolovoza 2006. godine, a koji su bili obducirani (89) i toksikološki obradeni (62). Kao izvor podataka korišteni su obdukcijski zapisnici i kemijskotoksikološki nalazi Klinickog odjela za sudsku medicinu, Klinicke bolnice Split. Alkohol kao rizican faktor, doprinosio je utapanju, ako je njegova koncentracija bila pozitivna, tj. ako je koncentracija bila veca od 0,5 g/kg. Žrtve utapanja bili su vecinom muškarci srednje životne dobi. Dominantan uzrok smrtnog utapanja bio je nesretan slucaj. U 15 slucajeva koncentracija alkohola u krvi bila je pozitivna. Nijedna žrtva nije bila pod utjecajem lijekova, droga niti drugih sredstava ovisnosti. Iz navedenog se može zakljuciti da nijedna žrtava utapanja u Splitsko-Dalmatinskoj županiji, u ispitivanom periodu, nije bila pod utjecajem droga. Kod malog broja žrtava koncentracija alkohola bila je pozitivna, a u navedenim smrtnim slucajevima imala je malu ulogu

Analiza droga u nekrofilnim muhama i ljudskim tkivima

Necrophagous insects may provide useful information about the time, place and cause of death. In addition, they can serve as reliable alternative specimens for toxicological analysis in cases where human tissue and fluids, normally taken during autopsies, are not available, due to decomposition of the corpse. This paper reports the results of drug analysis of the larvae of two fly families, Calliphoridae and Sarcophagidae, collected from the body of a middle-aged man who had committed suicide approximately three weeks before his corpse was found. Multiple samples of decomposed human tissue, of the blowfly, and of the larval flesh were analysed using gas chromatography/mass spectrometry (GC/MS), and amphetamine was detected in all samples. While the screening results were beyond doubt, the quantitative analysis was less clear, and further research is needed in this area.Insekti strvinari mogu pružiti korisne informacije o vremenu, mjestu i uzroku smrti. Dodatno, oni mogu poslužiti kao pouzdani zamjenski uzorci za toksikološke analize u slučajevima kada ljudska tkiva i tekućine, koji se uobičajeno uzimaju tijekom obdukcije, ne postoje zbog raspadanja trupla. Ovaj rad prikazuje rezultate analize droga u uzorcima ličinki dviju porodica muha (Diptera: Calliphoridae i Sarcophagidae), prikupljenima s tijela muškarca srednje životne dobi koji je počinio samoubojstvo otprilike 3 tjedna prije pronalaska njegova mrtvog tijela. Višestruki uzorci raspadajućeg ljudskog tkiva i ličinki muha analizirani su uporabom plinske kromatografije uz detekciju spektrometrijom masa (GC/MS) i u svima su otkriveni amfetamini. Dok su rezultati preliminarne kvalitativne analize bili izvan svake sumnje, kvantitativni su rezultati bili manje jasni te se preporučuje daljnje istraživanje u ovom području

Polimorfizmi gena ABCB1, CYP2B6 i CYP3A4 ne utječu na metadonsku terapiju održavanja u bolesnika s HCV-om

The aim of this study was to determine the influence of ABCB1, CYP2B6, and CYP3A4 genetic polymorphisms on methadone metabolism in patients with hepatitis C virus (HCV) undergoing methadone maintenance treatment (MMT).The study included 35 participants undergoing MMT, who were divided in three groups: HCV-positive (N=12), HCVnegative (N=16), and HCV clinical remission (CR) (N=7). The concentrations of methadone and its main metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) were determined with gas chromatography-mass spectrometry. The patients were genotyped for ABCB1 rs1045642, CYP2B6 rs3745274, CYP3A4 rs2242480, and CYP3A4 rs2740574 polymorphisms. Differences between single nucleotide polymorphism (SNP) genotypes and methadone-to-EDDP ratio were analysed with one-way ANOVA, which showed no significant difference between the genes (p=0.3772 for ABCB1 rs1045642, p=0.6909 for CYP2B6 rs3745274, and p=0.6533 for CYP3A4 rs2242480). None of the four analysed SNP genotypes correlated with methadone-to-EDDP concentration ratio. A major influence on it in hepatitis C-positive patients turned out to be the stage of liver damage.Cilj ovoga istraživanja bio je utvrditi utjecaj polimorfizama gena ABCB1, CYP2B6 i CYP3A4 na metabolizam metadona u bolesnika/ovisnika s pozitivnim nalazom virusa hepatitisa C (HCV) na metadonskoj terapiji održavanja. Istraživanje je provedeno na uzorku od 35 sudionika na metadonskoj terapiji održavanja, podijeljenih u sljedeće skupine: HCV pozitivni (N=12), HCV negativni (N=16) i oni s kliničkom remisijom HCV-a (CR) (N=7). Koncentracije metadona i njegova glavnog metabolita 2-etiliden-1,5-dimetil-3,3-difenilpirolidina (EDDP) utvrđene su plinskom kromatografijom – masenom spektrometrijom. U sudionika su analizirani genski polimorfizmi ABCB1 rs1045642, CYP2B6 rs3745274, CYP3A4 rs2242480 i CYP3A4 rs2740574. Jednosmjerna analiza varijance (engl. one-way ANOVA) nije pokazala statistički značajne razlike između genotipova jednonukleotidnih polimorfizama (engl. single-nucleotide polymorphism, krat. SNP) u omjeru koncentracije metadona i EDDP-a (p=0,3772 za ABCB1 rs1045642; p=0,6909 za CYP2B6 rs3745274 F=0,374 i p=0,6533 za CYP3A4 rs2242480). Nijedan od četiriju analiziranih SNP genotipova nije korelirao s omjerom koncentracije metadona i EDDP-a. U bolesnika/ovisnika koji su bili pozitivni na HCV na taj je omjer ponajviše utjecao stupanj oštećenja jetre

Nove psihoaktivne tvari u uzorcima urina prikupljenima tijekom Ultra Europe festivala u Splitu

We believe that analysing pooled urine samples for recreational drugs used at mass events can provide useful information about trends in drug use. An opportunity arose with the Ultra Europe music festival, which is attended by more than 150,000 people from over 150 countries every year. We analysed 30 pooled urine samples collected from portable chemical toilets located at or close to the Ultra Europe music festival venue in Split, Croatia in 2016–2018 to detect the presence of classic and new psychoactive substances (NPS). Four urine samples collected in 2016 were from a toilet without added chemicals (otherwise used to kill the smell) while the remaining samples were collected from toilets with added chemicals. Samples were qualitatively analysed with gas chromatography-mass spectrometry (GC/MS) using the fullscan mode. Data were compared with the Wiley mass spectral library of designer drugs and our in-house library containing about 1000 compounds and metabolites. We identified forty-six different substances and metabolites, 26 of which were classic substances/metabolites, mostly from the stimulants group, while 20 were NPS. In the NPS group, most of them were phenethylamines and cathinones. The variety of substances was the highest on the first day of the festival regardless of the year, but 2018 showed a significant drop compared to the previous two years. The results of our study revealed a stable trend of classic drug consumption, while NPS trend changed from one year to another.Analiza uzoraka urina prikupljenih iz prijenosnih kemijskih zahoda korisna je u otkrivanju droga za rekreaciju koje su se koristile tijekom Ultra Europe glazbenoga festivala. Zbog prisutnosti više od 150 000 ljudi iz više od 150 svjetskih zemalja, moguće je dobiti više informacija o svjetskom trendu NPS-a. Analiza uzoraka urina koji su se prikupljali od 2016. do 2018. tijekom glazbenoga festivala Ultra Europe u Splitu provedena je radi otkrivanja prisutnosti novih psihoaktivnih tvari (NPS). Analizirano je trideset uzoraka urina prikupljenih iz prijenosnih kemijskih zahoda smještenih na mjestu festivala ili blizu njega. U 2016. godini prikupljeno je osam uzoraka urina iz dvaju zahoda koji su bili smješteni na dvama različitim mjestima, i to jedan s dodanim kemikalijama, a drugi bez njih. U 2017. godini prikupljeno je deset uzoraka urina iz triju zahoda na trima mjestima, svi iz zahoda s dodanim kemikalijama. U 2018. godini prikupljeno je dvanaest uzoraka urina iz devet prijenosnih kemijskih zahoda na četirima mjestima, svi s dodatkom kemikalija. Uzorci su kvalitativno analizirani tehnikom plinske kromatografije-spektrometrije masa (GC/MS) korištenjem načina ukupnog skeniranja. Podatci su uspoređeni s bazom spektara masa Wiley (DD2015), kao i s vlastitom bibliotekom koja sadržava oko 1000 spojeva i metabolita. U analiziranim uzorcima pronađeno je 46 različitih tvari i metabolita, od kojih 26 klasičnih tvari/metabolita, uglavnom iz skupine stimulansa, te 20 tvari iz skupine novih psihoaktivnih tvari (NPS). U skupini NPS-a najviše ih je bilo iz skupina fenetilamina i katinona. U svakoj promatranoj godini, prvoga festivalskog dana otkriveno je više tvari nego u ostalim danima. Suprotno 2016. i 2017. godini, u 2018. godini broj otkrivenih tvari bio je znatno manji. Rezultati našeg istraživanja pokazali su stabilnost konzumacije klasičnih droga, ali su se trendovi NPS-a mijenjali

Rapid Extraction of Human DNA Containing Humic Acid

The identification process of dead bodies or human remains is nowadays conducted in numerous fields of forensic science, archeology and other judicial cases. A particular problem is the isolation and DNA typing of human remains found in mass graves, due to the degradation process, as well as post mortal DNA contamination with bacteria, fungi, humic acids, metals, etc. In this study, the influence of humic acid (HA) on the DNA extraction and typing is investigated. If present in the amplification reaction mix, humic acid inhibited DNA amplification, but the addition of 50 mg PVPP (polyvinil-polypyrrolidone) to the reaction mixture before extraction appeared to be optimal in overcoming this inhibition

Medical Laboratory Diagnostics

Medicinsko-laboratorijska dijagnostika sastavni je dio moderne medicine. Danas se više od 70% odluka u kliničkom liječenju oslanja na rezultate pretraga učinjenih od strane medicinsko-dijagnostičkih laboratorija. S obzirom na brz razvoj molekularne medicine, personalizirane medicine, kao i metoda i tehnologija koje se koriste u laboratorijskoj medicini, od ključne je važnosti kontinuirano stručno i znanstveno usavršavanje stručnjaka iz područja medicinsko-laboratorijske djelatnosti. To se postiže obrazovanjem na diplomskoj i poslijediplomskoj razini. Zapošljavanjem visokoobrazovanih stručnjaka, obrazovanih za rad u sustavu zdravstva i zdravstvene zaštite iz područja medicinsko-laboratorijske dijagnostike, unaprjeđuje se sustav analize bioloških uzoraka te značajno doprinosi procesu prevencije, otkrivanja i liječenja bolesti.Medical laboratory diagnostics is an integral segment of modern medicine. Today, more than 70% of decisions in clinical treatment rely on the results of tests performed by medical-diagnostic laboratories. Considering the rapid development of molecular medicine, personalized medicine, as well as the methods and technologies used in laboratory medicine, the continuous professional and scientific training of experts in the field of medical-laboratory activities is of crucial importance. This is achieved through education at the graduate and postgraduate level. By employing highly educated experts, trained to work in the health and health care system in the field of medical-laboratory diagnostics, the system of analysis of biological samples is improved and significantly contributes to the process of prevention, detection and treatment of diseases