Browse the latest forensic toxicology articles or search the collection.
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Can a Sedation Trial Tell Whether Lower Midazolam Use Caused Less Delirium?
A randomized trial can compare entire treatment regimens. Explaining why those regimens differ requires an additional step. A surgical intensive-care study illustrates this distinction with opioid analgesia, midazolam use and delirium. What the trial randomized Investigators assigned 105 mechanically ventilated patients to midazolam alone, midazolam with fentanyl, or midazolam with remifentanil. Both opioid groups received…
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Can a Normal First Potassium Result Rule Out Retained Extended-Release Tablets?
A blood concentration reflects what was measured in the sample at a particular time. With an extended-release ingestion, imaging and endoscopy can answer a separate question about material still in the stomach. What the case documented The initial serum potassium was 3.9 mmol/L after a reported ingestion of extended-release potassium chloride alongside clonazepam and ethanol.…
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Can One Case Separate the Effect of CBD Cigarettes From Other Care?
A clinical case can show that a person’s circumstances improved after several changes in care. It gives less leverage for identifying which change produced the improvement. A published report on low-THC CBD cigarettes illustrates that problem. What changed together The case involved a patient with schizophrenia and cannabis and cocaine use disorders. The team introduced…
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Does Lower Alcohol Craving Mean Fewer Drinks Per Drinking Day?
Craving and drinking are separate endpoints. A person may report less urge to drink while consuming a similar number of drinks on the days they drink. An eight-week randomized pilot study tested these outcomes separately. What the pilot compared Researchers randomized 44 participants with moderate to severe alcohol use disorder to full-spectrum CBD, broad-spectrum CBD…
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What Can a Caregiver Survey Establish About Children’s Access to CBD Products?
Caregiver beliefs about safety, storage practices and verified child exposures answer different questions. McNally and colleagues used a survey to learn what caregivers reported about CBD products in the household. Who answered and what was measured The investigators recruited through adult and pediatric emergency departments and a pediatric outpatient clinic at one academic medical center.…
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What Is Cannabinoid Immunoassay Cross-Reactivity? Delta-8, Delta-10, and HHC
Cross-reactivity occurs when a cannabinoid screening immunoassay responds to a substance other than its primary calibration target.
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How should diazepam’s frequency be read in a coronial series of drug-related deaths?
A drug can appear frequently in a set of fatal cases without having acted alone in those deaths. A New South Wales coronial study illustrates why the case definition and the number of contributors matter.
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Can an overdose death code identify zolpidem as the specific drug involved?
Death certificate coding can support surveillance across many years. The amount of detail in the underlying code determines which drug-specific claims those data can support.
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What is counted when hospital data report benzodiazepine poisonings?
An administrative dataset can show which poisonings hospitals reported during a period. It takes a different dataset to determine how many unique people were poisoned or what happened outside the hospital system.
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How much weight should a reviewer give a treatment response after suspected withdrawal catatonia?
Two reports supplied a before-and-after record Majumder and Layek reported catatonia following cessation of long-term benzodiazepine use in two patients. One stopped clonazepam and developed symptoms within two days. The other stopped lorazepam and was assessed after a different course of symptoms over about a week. Both improved after a benzodiazepine was reintroduced, with changes…
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What does an akathisia score establish in a synthetic cathinone case report?
The case distinguished restlessness from its possible causes Albert and colleagues described a hospitalized patient with a history of synthetic cathinone use and pronounced restlessness. The patient reported difficulty remaining seated or standing still and an ongoing urge to move. The authors identified akathisia and reported that its signs were present at admission, when the…
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What did a guideline review establish about observation time after flexible bronchoscopy?
A reference to two hours in a guideline discussion can be mistaken for a required observation period. A systematic review of flexible bronchoscopy guidelines tracked what documents discussed and what they supported with a recommendation.
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What did co-dispensing mean in a study of opioids and benzodiazepines during pregnancy?
Two pharmacy claims can show that a person had overlapping prescribed supplies during pregnancy. The study definition matters if someone uses that evidence to infer exposure on a particular day.
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Which benzodiazepine dose belongs in a status epilepticus timeline?
Separate the first dose from the total A retrospective study followed 196 adults treated for status epilepticus at one emergency department. Researchers distinguished the first benzodiazepine dose from the total administered. Only 34 patients, about 17%, received a first dose meeting the study’s criteria. Some patients had also received benzodiazepines before reaching the hospital. The…
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What does time within an anesthesia monitor target mean in a proposed organ-impairment trial?
An anesthesia protocol can define successful control as time spent within a numerical monitor range. The endpoint addresses a specific aspect of anesthetic management and has to be read alongside separate safety observations.
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When does the clock start in a trial of total endoscopy procedure time?
Two studies can both use the phrase procedure time while starting and stopping the clock at different points. An endoscopy trial protocol defined its primary clock to include the time after the examination as well as the examination itself.
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Why did a Veterans study separate suicide from unintended overdose deaths?
A study of mortality and psychoactive prescriptions examined two outcomes independently. That distinction matters when interpreting a medication history alongside an official determination of manner of death.
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What does an as-needed ICU sedation protocol tell us about a medication administration record?
An ICU may target the same sedation score using intermittent boluses or a continuous infusion. A protocol comparison makes clear why the label on the order should be separated from the drugs and amounts actually administered.
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Does a zolpidem delirium signal in three reporting databases establish incidence?
Spontaneous adverse-event systems can reveal recurring reports across countries. The count of those reports has no corresponding count of every exposed patient, so it cannot directly supply a rate of delirium among people who took zolpidem.
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What did a baclofen feasibility protocol propose to measure during GHB withdrawal?
A protocol can explain what investigators planned to test without supplying a treatment result. A 2016 GHB and GBL withdrawal paper describes how researchers planned to study baclofen as an adjunct. The planned comparisons Lingford-Hughes and colleagues planned separate enrollment for scheduled outpatient detoxification and unplanned inpatient withdrawal. The protocol proposed comparing baclofen with placebo…