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Sribanditmongkol P, Junkuy A, Homkham N, Worasuwannarak W, Hess JA. Autopsy study of alcohol-associated unnatural deaths in Thailand, 2007-2019. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:2056-2067. [PMID: 38226751 DOI: 10.1111/acer.15185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/06/2023] [Accepted: 08/23/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND To date, there have been no major studies of alcohol-associated unnatural deaths in Thailand or South East Asia. Thailand leads South East Asia in per capita alcohol consumption. The objectives of this study were to determine the incidence of alcohol-associated unnatural deaths in Thailand and their relation to post-mortem blood alcohol concentration (BAC); to investigate correlations between BAC and selected demographic variables; and to evaluate the incidence of co-use of alcohol and illicit substances. METHODS We conducted a retrospective register-based study of alcohol-investigated unnatural deaths in Thailand for the period 2007-2019. The core study sample (n = 77,006) was derived from a Thai government computerized database of unnatural-death autopsies. RESULTS Of the total autopsy sample 32.49% was alcohol positive (BAC ≥0.20 g/L). The rate at which male autopsy cases were alcohol positive (35.52%) was approximately twice that of female autopsy cases (16.62%), with males having significantly higher median BAC levels, 1.64 and 1.31 g/L, respectively. The incidence of female alcohol-positive cases with extremely high BACs (≥3.50 g/L) was comparable to that of male alcohol-positive autopsies. The rates at which victims of accidents, homicides, and suicides were alcohol positive were 42.44%, 38.81%, and 33.25%, respectively. Drowning fatalities had the highest rate of alcohol detection (49.12%) and the highest median BAC (2.47 g/L). The next highest rate (48.47%) was among road traffic fatalities (RTFs, BAC 1.92 g/L), which accounted for about one-half of all RTFs and one-third of all alcohol-positive autopsies. Of the total alcohol-positive population, 8.33% tested positive for illicit substances, most commonly methamphetamine/amphetamine. CONCLUSIONS BAC results for the majority of male and female alcohol-positive victims exceeded the generally accepted threshold for Heavy Episodic Drinking (0.8 g/L) and provided a rare BAC-documented (≥3.50 g/L) example of gender parity in the incidence of heavy alcohol consumption. The median BAC value for alcohol-positive RTFs (1.92 g/L) was about 10% higher than in studies in most other countries and about four times greater the Thai legal limit for motor-vehicle operation (0.50 g/L).
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Affiliation(s)
- Pongruk Sribanditmongkol
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Anongphan Junkuy
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nontiya Homkham
- Faculty of Public Health, Thammasat University, Khlong Luang, Thailand
| | - Wisarn Worasuwannarak
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jeffrey A Hess
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Pinto M, Eusébio E, Monteiro C. Development and Validation of an Analytical Method for Volatiles with Endogenous Production in Putrefaction and Submersion Situations. J Anal Toxicol 2021; 45:961-968. [PMID: 33031530 DOI: 10.1093/jat/bkaa154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 09/12/2020] [Accepted: 10/06/2020] [Indexed: 11/14/2022] Open
Abstract
A group of 16 volatile substances (ethyl acetate, 2-propanol, 1-propanol, methanol, acetone, ethanol, acetaldehyde, diethyl ether, methyl ethyl ketone, 1-butanol, 2-butanol, t-butanol, isobutanol, 2-methyl-1-butanol, 3-methyl-1-butanol and 1-pentanol) were qualitatively and quantitatively analyzed through a method developed for volatiles with endogenous production in putrefaction and submersion situations. The method was validated for blood, urine and vitreous humor, using a gas chromatograph (Varian 450-GC) with a flame ionization detector coupled to a headspace injector (HS-GC-FID). The vials were prepared by diluting 100 µL of the sample of interest in 1 mL of internal standard (acetonitrile 100 mg/L), using two capillary columns (VF-624ms and VF-5ms) with different polarities to ensure that all test compounds would be properly identified and undoubtedly distinguished from the rest. All volatiles were studied in a range of 50 to 2,000 mg/L in terms of selectivity/specificity, detection and quantification limits, linearity and calibration model, precision, accuracy, bias, robustness and stability according to the Scientific Working Group for Forensic Toxicology. Detection and quantification limits were between 1 to 8 mg/L and 4 to 24 mg/L, respectively, with coefficient of variation values under 10% in bias studies and in intermediate precision studies for most substances. The developed method was applied to real cases to test the method.
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Affiliation(s)
- Mélanie Pinto
- National Institute of Legal Medicine and Forensic Sciences, Forensic Chemistry and Toxicology Service, Centre Branch, Largo da Sé Nova, 3000-213 Coimbra, Portugal.,Chemistry Department of the Faculty of Sciences and Technologies, University of Coimbra, Largo da Sé Nova, 3000-213 Coimbra, Portugal
| | - Ermelinda Eusébio
- Chemistry Department of the Faculty of Sciences and Technologies, University of Coimbra, Largo da Sé Nova, 3000-213 Coimbra, Portugal
| | - Carla Monteiro
- National Institute of Legal Medicine and Forensic Sciences, Forensic Chemistry and Toxicology Service, Centre Branch, Largo da Sé Nova, 3000-213 Coimbra, Portugal
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Azarbakhsh H, Moftakhar L, Amiri S, Mirahmadizadeh A. Epidemiology of Suicide by Medication Overdose: A Population-based Study 2011-2019. Arch Med Res 2021; 53:304-311. [PMID: 34756732 DOI: 10.1016/j.arcmed.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/26/2021] [Accepted: 10/13/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUNDS The trend of suicide attempt by medication overdose has shown an increasing trend in recent years. The present study was conducted to investigate the epidemiology of suicide attempts and completed suicide by medication overdoses in Fars's province between 2011 and 2019. METHODS This cross-sectional study was performed on 40334 suicide attempts by medication overdose. First, fetal rate, and crude and aged-standardized mortality rate (ASR) were calculated. Then, χ2 test was used to calculate the trend of rates of suicide attempt and completed suicide, also to explore differences between qualitative and outcome variables. Finally, logistic regression analysis was performed to identify factors associated with suicide outcome. RESULTS The mean age of the participants was 26.66 ± 11.03 years. The highest ASR for suicide attempt by medication overdose was observed in the age range of 15-24 years. The rate of completed suicide by medication overdose was estimated as 1.22%. The odds of completed suicide were 2.7 times higher in men than in women, 2.7 times higher in people with a family history of suicide, and 1.7 times higher in people with a previous history of suicide. CONCLUSION The results of our study may help health policymakers to effectively prevent recurrence of suicide attempts through establishing effective strategies for timely identification and appropriate intervention among high-risk individuals with previous history of suicide.
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Affiliation(s)
| | - Leila Moftakhar
- Student Research Committee,Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sanaz Amiri
- Epidemiology in Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Mirahmadizadeh
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Jales JT, Barbosa TM, de Medeiros JR, de Lima LAS, de Lima KMG, Gama RA. Infrared spectroscopy and forensic entomology: Can this union work? A literature review. J Forensic Sci 2021; 66:2080-2091. [PMID: 34291458 DOI: 10.1111/1556-4029.14800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/11/2021] [Accepted: 06/01/2021] [Indexed: 12/01/2022]
Abstract
For more than two decades, infrared spectroscopy techniques combined with multivariate analysis have been efficiently applied in several entomological fields, such as Taxonomy and Toxicology. However, little is known about its use and applicability in Forensic entomology (FE) field, with vibrational techniques such as Near-infrared spectroscopy (NIRS) and Medium-infrared spectroscopy (MIRS) underutilized in forensic sciences. Thus, this work describes the potential of NIRS, MIRS, and other spectroscopic methodologies, for entomological analysis in FE, as well as discusses its future uses for criminal or civil investigations. After a thorough research on scientific journals database, a total of 33 publications were found in scientific journals, with direct or indirect application to FE, including experimental applications of NIRS and MIRS in taxonomic discrimination of species, larval age prediction, detection of toxic substances in insects from environments or crime scenes, and detection of internal or external infestations by live or dead insects in stored products. Besides, NIRS and MIRS combined with multivariate analysis were efficient, inexpensive, fast, and non-destructive analytical tools. However, more than 51% of the spectroscopic publications are concentrated in the stored products field, and so we discuss the need for expansion and more direct application in other FE areas. We hope the number of articles continues to increase, and as NIRS and MIRS technology progress, they advance in forensic research and routine use.
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Affiliation(s)
- Jessica T Jales
- Laboratory of Insect and Vectors, Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Biochemistry and Molecular Biology post-graduation program, Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Taciano M Barbosa
- Laboratory of Insect and Vectors, Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Parasitic biology post-graduation program, Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Jucélia R de Medeiros
- Laboratory of Insect and Vectors, Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Parasitic biology post-graduation program, Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Leomir A S de Lima
- Laboratory of Biological Chemistry and Chemometric, Department of Chemistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Kássio M G de Lima
- Laboratory of Biological Chemistry and Chemometric, Department of Chemistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Renata A Gama
- Laboratory of Insect and Vectors, Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Parasitic biology post-graduation program, Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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