PubMed Health⌕ Search

Biomedical subjects

M Augsburger

Publications and source records attributed to M Augsburger.

15 recordsLinked to original sources
PubMed2001

[Cannabis and automobile driving].

Cannabis use has increased considerably during the last 15 years. One of the major problems dealing with cannabis use is driving under the influence of drugs. With the exception of ethyl alcohol, the majority of the epidemiological studies have shown that cannabis is the most frequently detected substance in people suspected of driving under the influence of drugs. Experimental studies are therefore needed to assess cannabis effects on driving capability. Many studies indicate that cannabis impairs psychomotor performance. This impairment becomes obvious when high doses of cannabis are taken, when ethyl alcohol or other drugs are simultaneously ingested, or when sustained attention is needed. Moreover, cannabis effects are qualitatively different from those observed after ethyl alcohol consumption. In forensic practice, cannabis impairment of driving performance must be related to cannabinoids blood concentrations. To facilitate the interpretation of cannabinoids blood levels, several models were set up recently. These models must be further improved in order to fit in with all circumstances of cannabis use.

Accidents, Traffic↗
PubMed2001

Performance of a new implantable cardiac assist centrifugal pump.

The AB-180 is a new implantable centrifugal pump with a low volume dome (10 ml) and a local heparin delivery system which avoids systemic heparinization. This study focuses on its hemodynamic performance. We analyzed 3 anesthetized calves (71.0 +/- 2.5 kg), equipped with arterial pressure (AP), and Swan-Ganz and left atrial pressure (LAP) catheters. The AB-180 pump was installed through a left thoracotomy, with a transmitral left ventricular (LV) inflow cannula inserted via the left appendage and an outflow tract sutured to the descending aorta. LAP, AP, and blood flow across the pump were recorded for various pump speed and in different preload conditions (right atrial pressure = 4, 7, and 10 mm Hg, respectively). The pump significantly unloaded the left heart cavities and was able to increase the mean AP. For an RAP of 10 mm Hg, running the pump at 4,500 rpm decreased the LAP from 11.0 +/- 0.8 mm Hg to 3.0 +/- 0.8 mm Hg (p < 0.001) and augmented the mean AP from 48.2 +/- 6.4 mm Hg to 80.8 +/- 12.1 mm Hg (p < 0.001). A maximal pump flow of 5.6 +/- 0.2 L/min was obtained under these conditions. In addition to the advantage of its particular design, the AB-180 can be considered as an efficient left ventricular assist device (LVAD). It significantly unloads the left heart cavities and ensures efficient systemic AP and blood flow.

Animals↗
PubMed2000

Salvia divinorum: an hallucinogenic mint which might become a new recreational drug in Switzerland.

Salvia divinorum Epling & Jativa is an hallucinogenic mint traditionally used for curing and divination by the Mazatec Indians of Oaxaca, Mexico. Young people from Mexican cities were reported to smoke dried leaves of S. divinorum as a marijuana substitute. Recently, two S. divinorum specimens were seized in a large-scale illicit in-door and out-door hemp plantation. Salvinorin A also called divinorin A, a trans-neoclerodane diterpene, was identified in several organic solvent extracts by gas chromatography-mass spectrometry. The botanical identity of the plant was confirmed by comparing it to an authentic herbarium specimen. More plants were then discovered in Swiss horticulturists greenhouses. All these data taken together suggest that many attempts exist in Switzerland to use S. divinorum as a recreational drug. This phenomenon may be enhanced because neither the magic mint, nor its active compound are banned substances listed in the Swiss narcotic law.

Diterpenes↗
PubMed1999

Fatal flecainide intoxication.

A fatal case attributed to flecainide acetate (Tambocor), a class Ic antiarrythmic drug, is presented. Flecainide was detected by GC/MS in gastric contents, blood and liver as well. The urine analysis revealed the presence of its dealkylated metabolite. Body fluids and tissue concentrations determined by GC/ECD were 7.7 mg/kg in femoral blood, 0.26 mg/kg in bile, 18 mg/kg in liver, 0.17 mg/kg in cerebrospinal fluid, 0.22 mg/kg in brain cortex and 28.9 mg/kg in urine. The total amount of flecainide in gastric contents was about 43 mg. Even taking into account the postmortem redistribution of flecainide, its blood level still remains in the toxic range.

Aged↗
PubMed1999

Fatal overdose of tramadol and alprazolam.

A 30-year-old woman, with history of depression, was found dead after the ingestion of an unknown quantity of Xanax (alprazolam), Tramal (tramadol) and alcohol. At the autopsy only a slight decomposition and a diffuse visceral congestion were noticed. Biological samples obtained at autopsy were analysed to detect the presence of alprazolam, tramadol and alcohol. Blood concentrations of alprazolam, alcohol and tramadol were 0.21 mg/l, 1.29 g/kg and 38.3 mg/l, respectively.

Adult↗
PubMed1999

Method for quantification of morphine and its 3- and 6- glucuronides, codeine, codeine glucuronide and 6-monoacetylmorphine in human blood by liquid chromatography-electrospray mass spectrometry for routine analysis in forensic toxicology.

Simultaneous determination of opiates and their glucuronides in body fluids has a great practical interest in the forensic assessment of heroin intoxication. A selective and sensitive method for quantification of morphine and its 3- and 6-glucuronides, codeine, codeine glucuronide and 6-monoacetylmorphine (6-MAM) based on liquid chromatography-electrospray ionisation mass spectrometry is described. The drugs were analysed in human autopsy whole blood after solid-phase extraction on a C8 cartridge. The separation was performed on an ODS column in acetonitrile (analysis time 15 min). For the quantitative analysis, deuterated analogues of each compound were used as internal standards. Selected-ion monitoring was applied where the molecular ion was chosen for quantification. The limits of quantification were 0.5 ng/ml for morphine and 6-MAM and 1 ng/ml for the 6-glucuronide of morphine, codeine-6-glucuronide and codeine and 5 ng/ml for the 3-glucuronide of morphine.

Calibration↗
PubMed1999

[Brief history of recent hemp cultivation in Switzerland and subsequent medico-legal problems resulting from hemp cultivation].

In March 1995, a decision about cultivation of cannabis was issued by the Swiss Federal Offices of Public Health, Police and Agriculture in order to satisfy the growing interest of farmers and other people in hemp farming. It pointed out that 1)... each hemp plant contains THC and must be therefore considered a drug, 2)... no permission is required for those who grow hemp without the intention to produce drugs ... meaning that the choice of the plant variety was not restricted to those which are characterized by a low THC concentration and grown in a few countries belonging to the European Union. Claiming that natural hemp must contain significant amounts of THC and thanks to the Swiss legislation, areas dedicated to hemp cultivation develop considerably. Most hemp plants which are submitted to our laboratories by the police for THC quantification belong to the drug-type. Nowadays, a great deal of goods (food and beverages, cosmetics, drugs) made of hemp are marketed in Switzerland. Strong suspicions exist however that several of these products could be used as a screen for the illegal market of cannabis. For instance, despite financial support from the state, fiber hemp cultivation remains unsuccessful. No advantage with regard to seed productivity, edible seed and essential oils qualities and yields have been found for drug hemp over fiber hemp by agricultural research stations up to now. Several clues about the possible illicit use of hemp goods rich in THC, especially hemp tea made of flower tops and "therapeutic" pillows filled with cannabis exist. Recently, two Federal edits were issued in order to restrict the selling of hemp seedlings and of hemp foods and beverages to those containing only low amounts of THC. However, the marketing of hemp plants used for decorating remains free partly explaining the recent success of these "beautiful" plants. Broadly speaking, the Swiss and European legislations about hemp have approached mutually during the last years.

Agriculture↗
PubMed1999

Exit association-mediated suicide: toxicologic and forensic aspects.

The Swiss German chapter of the Exit Association provides conditional assistance to individuals wishing to end their own lives. The Exit Association advocates death with dignity and fights for the right to freely choose the timing of one's own death. According to the Swiss criminal code (articles 114 and 115), altruistic assistance to suicide is not punishable. Active euthanasia is punished by imprisonment. An individual commits active euthanasia if he or she is driven by honorable motives (e.g., pity) and causes the death of another person wishing to die who seriously and insistently requests such action. Based on our information, the preparation for suicide and its completion relies on a well-defined protocol. First, the candidate's eligibility for Exit Association assistance is verified. The candidate then writes a farewell declaration that explicitly confirms the will to terminate his or her own life. A written report describes the events during the suicide procedure. Depending on the circumstances, the investigative judge requests a forensic autopsy and toxicologic analyses. The results of the forensic investigations conducted in the cases presented here are in agreement with the scenario described in the reports of the Exit Association, namely, suicide by massive ingestion of pentobarbital.

Aged↗
PubMed1999

Optimization of the pump driven venous return for minimally invasive open heart surgery.

Blood return into the cardiotomy reservoir is usually reduced when a cardiopulmonary bypass (CPB) is initiated through a peripheral access, even if the tip of the venous cannula is pushed into the right atrium. A centrifugal pump can be placed on the venous line to increase the negative pressure. Surgery involving the right atrium requires selective cannulation of both vena cavae. Because of the small diameter of the vena cava as compared to the right atrium, the benefit of the centrifugal pump may have limitations. We analyze the factors influencing the active venous return when the cannula is maintained into the vena cava. In 4 calves (83.0+/-14.9 Kg) a CPB was initiated through carotid and jugular access, with the tip of the venous cannula placed into the superior vena cava, before ventricular fibrillation was provoked. Venous drainage was progressively increased thanks to the centrifugal pump. Considering the negative pressure induced on the venous line, we analyzed the performance expressed in l/min of blood drained, of four one stage cannulae ("lighthouse" tip 24F, 28F or 32F, and percutaneous 28F). The performance of all cannulae were highly dependent on the central venous pressure (CVP) with better drainage for higher CVP. The size and type of cannula also significantly affected blood drainage. Active drainage was best with the percutaneous 28F cannula. This cannula was specially attractive at low CVP conditions.

Animals↗
PubMed1998

Car crash after massive ingestion of digoxin and midazolam.

In a case where a 32-year-old man lost control of his vehicle, urine and blood samples were taken 6 h after the crash for toxicological investigations. In the hospital, the driver admitted consumption of some drugs, in particular digoxin and midazolam just before the crash which corresponded to the results of blood analyses. Toxicological findings indicated the presence of digoxin at 12.9 ng/ml and midazolam at 7 ng/ml in the blood. These results suggested that at the moment of the crash digoxin and midazolam blood levels were in the range of toxic and therapeutic concentrations, respectively. Therefore the respective roles of the drugs in the impairment of the ability to drive at the moment of the crash is discussed.

Accidents, Traffic↗
PubMed1998

Comparison of different immunoassays and GC-MS screening of benzodiazepines in urine.

A total of 53 urine samples were tested by different immunoassay methods and by gas chromatography/mass spectrometry to determine repeatability of the different methods and to assess whether the immunoassays performed on samples obtained from elderly patients of the emergency section could be considered as reliable enough for identifying a benzodiazepine consumption. Repeatability was excellent for GC/MS and good for immunoassays. The specificity was not different for the three immunoassays (96%). The sensitivity varied from 36, 64 to 75% for OnLine, RIA Immunalysis and RIA DPC, respectively. An other difference between immunoassays and GC/MS was the ability of GC/MS to detect lorazepam and low concentrations of benzodiazepines whereas immunoassays did not.

Anti-Anxiety Agents↗
PubMed1998

2C-B: a new psychoactive phenylethylamine recently discovered in Ecstasy tablets sold on the Swiss black market.

This study sought to identify, by means of several analytical methods (GC-MS, HPLC-DAD, CE-DAD, FTIR, and NMR), 4-bromo-2,5-dimethoxyphenethylamine (2C-B), which was found in two sets of tablets obtained from the Swiss black market. Unequivocal identification of 2C-B was only achieved by a combination of mass spectrometric and NMR analysis. Quantitation of 2C-B was performed by HPLC-DAD and CE-DAD. The amounts of 2C-B found in the tablets (3-8 mg) were in the range of the minimum quantity required to induce the effects characteristic of this drug.

Chromatography, High Pressure Liquid↗
PubMed1997

[Ecstasy--the status in French-speaking Switzerland. Composition of seized drugs, analysis of biological specimens and short review of its pharmacological action and toxicity].

Methylenedioxy-N-methylamphetamine (MDMA, "Ecstasy") and other related phenylethylamines are nowadays used extensively in Western Switzerland at dance clubs and raves. There is a widely held belief among teenagers and misusers that ecstasy is safe. In the last years however, an increasing number of reports of MDMA-related deaths has been reported. Acute clinical toxicity problems following MDMA ingestion include hyperthermia, convulsions and arrhythmias. There is also growing concern that these phenylethylamines are neurotoxic and cause long-term damage to serotonineric nerve terminals in animal brains. Qualitative analyses by GC-MS of street samples of ecstasy showed that only a part of them contain MDMA or related phenylethylamines (MDA, MDEA, MBDB and 2C-B). Most of them were mixed with caffeine and an excipient (sugars or polyols [e.g. mannitol]). Amphetamine cut with caffeine and other drugs (e.g. testosterone), stimulants (e.g. pseudoephedrine) and other drugs unrelated to stimulants and phenylethylamines (e.g. LSD, chloroquine, vasodilators) were also detected. Quantitative determinations performed by HPLC-DAD or EC-DAD reveal huge fluctuations in the amount of active substance(s) per tablet. MDMA and related compounds display unique psychoactive properties, acting as a stimulant and inducing feelings of empathy. The effects of MDMA intake are very likely the results of the large release of serotonin (5-HT) in the synaptic cleft, of the inhibition of the re-uptake inactivation of 5-HT and of the inhibition of a key-enzyme involved in the biosynthesis of 5-HT. Forensic investigations performed at our institute showed significant blood levels of MDMA, MDEA and MDA in samples drawn from people suspected of driving under the influence of psychoactive drugs. Up to now, no death could be attributed to MDMA intoxication only because our analyses always revealed the additional presence of toxic amounts of other psychoactive drugs (e.g. opiates, cocaine). Our study shows that because of the variable composition of ecstasy tablets, unpredictable types and amounts of drugs may be taken by MDMA misusers. Moreover, there is considerable concern that traffic accidents may be caused by MDMA-abusers. MDMA intake could result in severe intoxication and even death, especially when combined with other types of drugs.

Chromatography, High Pressure Liquid↗
PubMed1997

Drugs and alcohol among suspected impaired drivers in Canton de Vaud (Switzerland).

Epidemiological and analytical laboratory records concerning living drivers suspected of driving under the influence of drug (DUID) during the 13 years period ranging from 1982 to 1994 were examined. This study included 641 records. 551 men (86%) and 90 women (14%). The average age of the drivers was 27 +/- 7 years (n = 636, minimum 18 and maximum 74) and the 18-30 interval age range was overrepresented (80%) in this population sample. A traffic accident had occurred in 254 (40%) of the records, 273 (43%) drivers were suspected of DUID during police controls and 95 (15%) drivers were suspected of DUID because of their erratic driving. One or more psychoactive drugs were found in 92.8% of the samples. In these records, cannabinoids were found in 57%, opiates in 36%, ethanol in 36%, benzodiazepines in 15%, cocaine in 11%, methadone in 10% and amphetamines in 4%. The majority (58%) of cases presented two or more drugs in biological samples, thus indicating a high incidence of potential interactions between drugs. This observation was specially relevant for methadone and methaqualone. We conclude that police suspicion about drivers under influence highly correlated with positive results for drug analyses in biological samples.

Adult↗