Recent trends in barbiturate detection in medicolegal deaths
TL;DR: A study of 51 cases where barbiturates were detected in post-mortem blood samples from 2000 to 2019 at Forensic Science South Australia, Adelaide, Australia as discussed by the authors showed that the cause of death was drug toxicity in only 27 (53%) (M:F = 19:8; age range 19-74yrs, mean 46yrs).
About: This article is published in Legal Medicine.The article was published on 2021-06-07. It has received 2 citations till now.
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TL;DR: In this article , a review aimed to summarize findings in studies that have investigated mental health and suicide in veterinarians and veterinary students and highlight measures that could be implemented as options for mental health promotion and suicide prevention.
Abstract: Veterinarians are commonly exposed to occupational stressors, including excessive workload and financial constraints. These stressors can lead to psychological distress, which typically results in mental health disorders such as depression, anxiety, and burnout and can even culminate in suicide attempts or suicide deaths. Risk factors associated with poor mental health and high rates of suicide in veterinary practitioners include continuous exposure to challenging scenarios, such as interpersonal conflicts, performing euthanasia, and easy access to lethal means of suicide, such as opioids and anesthetics. The previous studies highlight the urgent need for a better understanding of predisposing factors, mental health-related improvements in the professional environment, and the subsequent establishment of primary mental health-related care policies. Effective ways to promote mental health and prevent suicide may include social support, resilience, developing coping skills, promoting a healthy work environment, and discouraging perfectionist behaviors. This review aimed to summarize findings in studies that have investigated mental health and suicide in veterinarians and veterinary students and highlight measures that could be implemented as options for mental health promotion and suicide prevention.
Keywords: burnout, depression, mental health, occupational stress, veterinarians.
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TL;DR: Copyright (©) 1999–2012 R Foundation for Statistical Computing; permission is granted to make and distribute verbatim copies of this manual provided the copyright notice and permission notice are preserved on all copies.
Abstract: Copyright (©) 1999–2012 R Foundation for Statistical Computing. Permission is granted to make and distribute verbatim copies of this manual provided the copyright notice and this permission notice are preserved on all copies. Permission is granted to copy and distribute modified versions of this manual under the conditions for verbatim copying, provided that the entire resulting derived work is distributed under the terms of a permission notice identical to this one. Permission is granted to copy and distribute translations of this manual into another language, under the above conditions for modified versions, except that this permission notice may be stated in a translation approved by the R Core Team.
272,030 citations
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TL;DR: In case of intoxications, the concentration of the ingested substances and/or metabolites in blood plasma better predicts the clinical severity of the case when compared to the assumed amount and time of ingestion.
Abstract: Introduction
In order to assess the significance of drug levels measured in intensive care medicine, clinical and forensic toxicology, as well as for therapeutic drug monitoring, it is essential that a comprehensive collection of data is readily available. Therefore, it makes sense to offer a carefully referenced compilation of therapeutic and toxic plasma concentration ranges, as well as half-lives, of a large number of drugs and other xenobiotics for quick and comprehensive information.
541 citations
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TL;DR: Mental illness is an important comorbidity for physicians who complete a suicide but postmortem toxicology data shows low rates of medication treatment, and inadequate treatment and increased problems related to job stress may be potentially modifiable risk factors to reduce suicidal death among physicians.
221 citations
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TL;DR: Comparing methods used for suicide by doctors with those used by the general population found that self-poisoning with drugs was more common in the doctors than in general population suicides, and a large proportion of suicides in anaesthetists involved anaesthetic agents.
Abstract: Medical practitioners have a relatively high rate of suicide. Death entry data for doctors who died by suicide or undetermined cause between 1979 and 1995 in England and Wales were used to compare methods used for suicide by doctors with those used by the general population. Methods used were analysed according to gender, occupational status and speciality, to assess the extent to which access to dangerous means influences the pattern of suicide. Self-poisoning with drugs was more common in the doctors than in general population suicides (57% vs. 26.6%; OR=3.65, 95% CI 2.85-4. 68), including in retired doctors. Barbiturates were the most frequent drugs used. Half of the anaesthetists who died used anaesthetic agents. Self-cutting was also more frequently used as a method of suicide. The finding that the greater proportion of suicide deaths in doctors were by self-poisoning may reflect the fact that doctors have ready access to drugs, and have knowledge of which drugs and doses are likely to cause death. The specific finding that a large proportion of suicides in anaesthetists involved anaesthetic agents supports this explanation. Availability of method may be a factor contributing to the relatively high suicide rate of doctors. This fact might influence clinical management of doctors who are known to be depressed or suicidal.
111 citations
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TL;DR: To examine the morbidity and mortality associated with self‐poisoning with different drug classes, a large number of patients were diagnosed with at least some form of psychotic illness or substance abuse.
Abstract: OBJECTIVE: To examine the morbidity and mortality associated with self-poisoning with different drug classes. DESIGN: Prospective cohort study with limited follow-up. Retrospective analysis of coronial data. SETTING: Primary and tertiary referral toxicology centre covering Newcastle and Lake Macquarie, Australia, 1987-1992. RESULTS: There were 1969 admissions after ingestion of 3724 substances (2424 prescription drugs and 1300 non-prescription items). The coroner investigated 83 drug-related deaths. Only 12 of these people presented to hospital and, for most of these, death was inevitable at presentation. The most frequently ingested substances were benzodiazepines, alcohol, paracetamol, antidepressants, neuroleptics and anticonvulsants. Since 1980, the percentage of self-poisonings involving benzodiazepines has fallen, while it has risen for those involving antidepressants. Over 50% of deaths were due to tricyclic antidepressants or opioid analgesics. CONCLUSIONS: As death usually occurs out of hospital, interventions to decrease mortality from self-poisoning must focus on prevention, and targeting drugs that are frequently taken or frequently lethal in overdose. Consideration should be given to the use of antidepressants that are safer in overdose. The use of antidepressants, barbiturates or chloral hydrate as sedatives should be discouraged. Language: en
107 citations