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1/5. Ecstasy (MDMA) deaths in new york city: a case series and review of the literature.

    MDMA ("ecstasy") has gained renewed popularity as a drug of abuse. To access the epidemiology and causes of death of MDMA-positive fatalities, all deaths investigated by the OCME that tested positive for MDMA (22 deaths) between January 1997 and June 2000 were reviewed. There were three deaths in each 1997 and 1998, eleven in 1999, and five in the first part of 2000. Of these 22 deaths, 13 were due to acute drug intoxications, 7 due to mechanical injury (blunt trauma, gunshot wounds), and 2 due to a combination of natural disease and acute drug intoxication. Evidence of recent opiate and/or cocaine use was found in 7 of the acute intoxication deaths and in none of the traumatic or combination natural/intoxication deaths. The race of all decedents was White between the ages of 17-41 years, and 18 of 22 were men.
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ranking = 1
keywords = intoxication
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2/5. Hospital treatment of addicts arrested for intoxication in finland.

    In the present study the treatment of addicts as performed by the Finnish police was investigated. The intention was to evaluate how the treatment procedure functioned in meeting the need for medical care and safety of the addict. The series was collected from the police district of Helsinki, the Finnish capital, and comprised all addicts arrested and transported to hospital during 1969. The series totalled 859 cases, which is about 2% of all addicts arrested in Helsinki during 1969. The reasons for transportation to hospital were: external injuries (60%) and the addict's complaints of an injury or illness (17%). Of all subjects, 44 were admitted to a hospital ward and of these, 2 died later on the ward. Furthermore, 7 addicts had died at the police station, on the way to hospital, or at the out-patients' department. Thus the number of deaths totalled 9. On investigating the cases of death in detail it was found that omission of or delay in the transport to hospital may have been of decisive influence on the addict's death in 4 cases. It was estimated that, had the police not transported any of the addicts to hospital, the number of deaths would have been about 20. When the cost of hospital treatment and transport to hospital is used as an evaluation factor the effort of the activity covered by the present study is 98 500 Fmk (U.S. $ 23 200). The output is the number of lives saved, i.e. 11. The efficiency of the activity is thus the saving of one life at the cost of about 9000 Fmk (about 2 100 U.S. $). The social characteristics of the addict were not found to have had a decisive bearing on the question of transportation to hospital. Differences between the various points of activity were observed in the relative numbers of the addicts arrested and transported to hospital.
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ranking = 1
keywords = intoxication
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3/5. methanol intoxication in multiple trauma.

    Management of inflicted or self-inflicted trauma to accomplish homicide or suicide is no novelty in the practice of medicine. However, it takes an astute clinician to recognize serious poisoning in the midst of life-threatening injuries. We describe two cases where homicide and suicide attempts were accompanied with the ingestion of methanol. Both patients recovered with proper management of the injuries as well as early recognition and treatment of the methanol poisoning.
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ranking = 1
keywords = intoxication
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4/5. Unexpected amantadine intoxication in the death of a trauma patient.

    We present a case of amantadine intoxication that developed unexpectedly in a hospitalized patient with craniocerebral trauma. The intoxication confused the clinical situation and contributed to the patient's deterioration and death. After excluding overdosage as the cause of the intoxication, we concluded that the excessive blood drug levels (39 mg/L) resulted from tubulointerstitial nephritis--induced renal failure. This case represents an example of an adverse drug reaction that resulted in an unusual drug intoxication and illustrates why toxicological analyses are important for investigation of deaths in hospitalized patients.
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ranking = 2
keywords = intoxication
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5/5. Responsibility for crime and injury when drunk.

    The aim of this paper is to highlight the complexity in the connection between alcohol intoxication and responsibility for crime from a multidisciplinary approach comprising medical, legal and criminological perspectives. There is no doubt that there is a connection between violent behaviour and alcohol intoxication. However, several investigations show that alcohol heightens aggressiveness only when the drunken person is provoked. A case which may serve as a model when discussing legal responsibility for acts carried out when drunk is outlined. Ethical considerations are discussed and exemplified concerning the motive, as well as the principles, of punishing an intoxicated perpetrator. However, there are no definite solutions concerning what is right or wrong, and each reader will have his own opinion, which may well differ from that of the author.
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ranking = 0.5
keywords = intoxication
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