CONCLUSIONS: Caffeine antagonizes adenosine receptors, stimulates ryanodine receptors, and elevates catecholamines. The onset of AKI is hypothesized to result from a combination of these mechanisms, resulting in tubular ischemia and injury, as well as renal artery constriction. The development of AKI was thought to be caused by the following factors: (1) disruption of the tubular oxygen supply-demand ratio and consequent ischemia due to adenosine receptor antagonism by caffeine, (2) tubular...

CONCLUSION: A dilated common bile duct in postmortem computed tomography might be used as an indication for a lethal opioid or opiate intoxication only in regard to the specific case circumstances or together with other indicative findings in a postmortem investigation.

Cocaine is the most common stimulant drug that causes death in Connecticut. Unlike opioid intoxication deaths, which largely correlate with dose/concentration, cocaine deaths occur more idiosyncratically, with mechanisms of death often related to underlying cardiovascular disease. We examined 78 sole acute cocaine and 306 sole acute fentanyl intoxication deaths to assess their association with cardiovascular disease. In the cocaine cohort, 87% (68/78) had atherosclerotic and/or hypertensive...

"2C," formally known as 4-bromo-2,5-dimethoxyphenethylamine, is an illicit drug that combines elements of ketamine, MDMA (ecstasy), methamphetamine, cocaine, and opioids. This report highlights the emergence of 2C compounds, a new class of illicit drugs recognized for their distinctive blend of hallucinogenic and stimulant properties. We present the case of a 22-year-old female who was admitted to the psychiatric emergency department with a history of bipolar I disorder and recent use of various...