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Suicide is a major public health issue and the risk of attempting and committing suicide increases with age. We present the case of an elderly couple who decided to commit suicide together by self-poisoning using levamisole-adulterated cocaine. The choice of committing a double suicide, the method selected (self-poisoning), the drug self-administered (cocaine), and the route of administration (ingestion) are events rarely encountered in the forensic pathology practice, especially not in combination. In this article, we will review the literature regarding the frequency and features of these methods of suicide. An overview of the effects and mechanism of action of levamisole is also provided, highlighting the importance of including this substance and its metabolites in the routine toxicological analyses for cocaine deaths.

Acute administration of a neurosteroid 5beta-pregnan-3alpha-ol-20-one induced a greater impairment in motor performance of the selectively bred alcohol-sensitive (ANT) than alcohol-insensitive (AT) rats. This difference was not associated with the sensitivity of gamma-aminobutyrate type A (GABA(A)) receptors, as 5alpha-pregnan-3alpha-ol-20-one (allopregnanolone) decreased the autoradiographic signals of t-butylbicyclophosphoro[35S]thionate binding to GABA(A) receptor-associated ionophores more in the brain sections of AT than ANT rats. Nor was the difference associated with baseline levels of neuroactive progesterone metabolites, as 5alpha-pregnan-3,20-dione (5alpha-DHP) and 5alpha-pregnan-3alpha-ol-20-one were lower in the ANT rats. After ethanol (2 g/kg, i.p.) administration and the subsequent motor performance test, the increased brain concentrations of these metabolites were still lower in the ANT than AT rats, although especially in the cerebellum the relative increases were greater in the ANT than AT rats. The present data suggest that the mechanisms mediating neurosteroid-induced motor impairment are susceptible to genetic variation in rat lines selected for differences in ethanol intoxication.

Most of the cocaine - deaths are said to be related to cardiovascular complications. This paper addresses a rather infrequent complication of chronic cocaine use, represented by the aortic dissection. The case in point pertains to a 45-year-old, caucasian male, substance abuser who suffered an aortic dissection following the use of cocaine. Blood concentrations of cocaine and benzoylecgonine were considered not to be within a potentially toxic range.

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.Keywords: paraphenylenediamine, acute poisoning, takawt, Tamarix aphyla, Morocco African Journal of Traditional, Complementary and Alternative Medicines Vol. 3(1) 2006: 142-149

The identification of di(beta-phenylisopropyl)amine found as the main ingredient in several sets of amphetamine tablets sold on the illicit market in Rome, Italy, during 1999-2000 is described. The identification was achieved by examining the ultraviolet and nuclear magnetic resonance spectral properties as well as the chromatographic, gas chromatographic, and mass spectrometric data. The molecular structure of the ingredient showed a close analogy to the amphetamine and could very likely produce similar pharmacological activity. A preliminary test on the metabolic pathway of di(beta-phenylisopropyl)amine performed on rats, suggests its biotransformation to amphetamine.

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.

Recently, 3,4-methylenedioxyamphetamine derivatives have been encountered in the Italian illicit market, mainly in form of tablets. Among this class of substances small modifications of the molecule may result in a wide range of derivatives and analogs some of which are not yet listed as controlled substances in the Italian schedules. Due to the structural similarity some of these molecules have a gas chromatographic behavior and mass spectra that only slightly differ. In the present work, an analytical strategy is proposed to achieve the identification of analogs within this class of molecules. In seized material sent by the Court of Law of Rome to our laboratories a number of tablets engraved with different symbols (e.g., `Dollar', `Fido Dido' and `Bomb') were submitted to analysis in order to establish whether they contained drugs of abuse. The analytical techniques employed for this purpose were UV spectrophotometry and thin-layer chromatography which provided information suggesting that the tablets contained a methylenedioxyamphetamine. Gas chromatography with flame ionization detection indicated that the main ingredient differed from the molecules of the same class already known. Finally, capillary gas chromatographic–mass spectrometric analysis of the native molecules and their pentafluoropropionic acid derivatives, performed with both, electron impact and chemical ionization, allowed the identification, in each tablet, of three molecules: the N -methyl-1-(3,4-methylenedioxyphenyl)-2-butanamine (MDP-2-MB, MBDB), the 1-(3,4-methylenedioxyphenyl)-2-butanamine (MDP-2-B) and the N , N -dimethyl-1-(3,4-methylenedioxyphenyl)-2-butanamine (MDP-2-MMB).

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 chromatography-mass 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 microg/mL and 17.0 microg/mL), urine (152.0 microg/mL and 512.0 microg/mL), bile (99.8 microg/mL and 54.0 microg/mL), vitreous humor (7.1 microg/mL and 5.8 microg/mL), brain (7.5 microg/mL and 3.5 microg/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.

Losses due to plymerization of vapours collected from the atmosphere using a solid adsobent (activated carbon), that catalyses this polymerization were examined. The losses of styrene vapour sampled on activated carbon that occur when elution is delayed were studied. Tests performed using an adsorbent treated with an inhibitor of the polymerization reaction (catechol), which is effective only when the granules remain in contact with the eluate, are described.