Xylazine, an alpha-2 receptor agonist used in veterinary medicine for its sedative and muscle-relaxant effects, has been reported in forensic toxicology casework since the 1980s. It is not approved for human use, but it is used as an adulterant in heroin and illicit fentanyl. The prevalence and concentrations of xylazine in 2.5 years (January 2019-June 2021) of driving under the influence of drugs (DUID) and medico-legal death investigation (MDI) cases was investigated, including other drugs detected in combination with xylazine. Of over 170,000 cases screened for xylazine, 97% were classified as MDI. Over the course of the study period, the prevalence and geographical spread of xylazine increased. Overall, 2.8% of DUID and 2.1% of MDI cases screened positive for xylazine with concentrations of 5.1-450 ng/mL (mean = 36 ng/mL) and 5.0-11,000 ng/mL (mean = 41 ng/mL), respectively. Two MDI cases which had xylazine concentrations of 9,100 and 11,000 ng/mL were drug overdose suicides that did not involve any opioids. Opioids, primarily fentanyl and/or a fentanyl byproduct/metabolite were detected in 100% of DUID and all but two MDI cases. After opioids, stimulants, phyto-cannabinoids and benzodiazepines were the most common drug classes detected in conjunction with xylazine in both DUID and MDI casework. In summary, xylazine exposure continues to increase, mostly through the adulteration of illicit opioids. There is an extensive overlap in the concentrations between living and deceased individuals, making it difficult to interpret the role of the drug in MDI or DUID cases without other case information.
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http://dx.doi.org/10.1093/jat/bkac049 | DOI Listing |
J Assoc Physicians India
December 2024
Assistant Professor, Department of Respiratory Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Ambala, Haryana, India.
Inhaler therapy has become the mainstay of treatment in obstructive airway diseases. Although patients, and to a certain extent doctors also, were not initially comfortable with inhalation devices, they have now become the standard of care in chronic obstructive pulmonary disease (COPD) and asthma. However, the choice of inhaler device prescribed in different subsets of patients is still not clear.
View Article and Find Full Text PDFContinuous-variable measurement-device-independent quantum key distribution (CV-MDI QKD) can defend all detection-side attacks effectively. Therefore, the source side is the final battlefield for performing quantum hacking attacks. This paper investigates the practical security of a CV-MDI QKD system under a light-injection attack.
View Article and Find Full Text PDFInjury
September 2024
Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Inge Lehmanns Vej 6, 2100 Copenhagen, Denmark; Danish Air Ambulance, Brendstrupgårdsvej 7, 8200 Aarhus N, Denmark; Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark; Faculty of Health, Aarhus University, Vennelyst Blvd. 4, 8000 Aarhus, Denmark. Electronic address:
J Asthma
September 2024
Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Exp Clin Endocrinol Diabetes
August 2024
University of Ulm, Institute for Epidemiology and Medical Biometry, ZIBMT, Ulm, Germany.
Objective: This study investigated the onset and the choice of treatment in children with very early onset of type 1 diabetes mellitus (T1D).
Methods: The study included 5,763 patients from the German Diabetes Patient Follow-up registry with onset of T1D in the first 4 years of life from January 2010 - June 2022. The analysis included diabetes-specific parameters, anthropometric data, and mode of treatment at onset, within the first and second year of T1D.
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