The clinical signs of poisoning differ from one another according to the length of exposure, the

Abstract

Karbonmonoksit CO renksiz, kokusuz, tam olarak yanmayan non irritatif özellikte bir gazdır. Yüksek seviyede solunduğunda letal etkiye sahiptir. Önemli bir halk sağlığı sorunu olan karbonmonoksit zehirlenmesi ülkemiz için özellikle kış aylarında görülen, oldukça sık rastlanan morbidite ve mortalite nedenidir. Literatürde CO intoksikasyonlarına madde bağımlılığının da eşlik ettiği bildirilmiştir. Tetrahidrokannabinol THC/esrar maddesinin kullanımı sıklığı sigara, alkol, kafein gibi bağımlılık yapıcı maddelerden sonra gelmektedir Bu çalışmamızda, kanlarında THC saptanan ve CO entoksikasyonu sonucu ölen olgular üzerinden, esrarın nöropsikiyatrik ve bilişsel yetenekler üzerinde oluşturduğu etkiler tartışılmıştır

Keywords

• Karbonmoksit
• tetrahidrokannabinol
• intoksikasyon
• otopsi
• adli toksikoloji

intoxications, which are currently seen more often than intoxications from other toxic substances, are

Abstract

Carbon monoxide CO is a colorless, odorless gas with the nonirritative feature that does not completely burn. A high level of respiration has a lethal effect. Carbon monoxide poisoning, which is a major public health problem, is the frequently encountered cause of morbidity and mortality in Turkey, especially in the winter months. It has also been reported in literature that CO intoxications go hand in hand with substance addiction. The use of tetrahydrocannabinol THC/marijuana often leads to the dependence on substances such as cigarette, alcohol and caffeine. In this study of cases where death resulted from CO intoxication and THC was determined in the blood, the effects created by the drug on the neuropsychiatric and cognitive capacity are discussed

Keywords

• Carbonmonoxide
• tetrahydrocannabinol
• intoxication
• autopsy
• forensic toxicology

References

1. Dogan KH, Ozbek S, Unver Dogan N, Karabulut AK. Late neurological syndrome that developed after carbon monox- ide intoxication: A case report. The Bulletin of Legal Medicine ;19 1 :63-6. Kandis H, Katirci Y, Cakır Z, Aslan S, Uzkeser M, Bilir O. Retrospective analysis of the cases with emergency service carbonmonoxide entoxication. Academic Emergency Medicine Journal 2007;5:21-5.
2. Oliu G, Nogue S, Miro O. Carbon monoxide poisoning: Pathophysiologic principles underlying good treatment. Emergencias 2010;22:451-9.
3. Albert RK, Slutsky AS, Ranier VM, Takala J, Torees A. Clini- cal Intensive Care. First Edition. Translation Editors: Kutay Akpir, Simru Tuğrul. Istanbul Medicine Publishing: Istan- bul:2009;679-83.
4. Malley W.J. Clinical Blood Gases: Evaluation and Interven- tion Second edition. Translation editor: Yalım Dikmen. Nobel Medicine Publishing: Istanbul;2010:181-2.
5. Harper A, Croft-Baker J. Carbon monoxide poisoning: Undetected by both patients and their doctors. Age Ageing ;33 2 :105-9. Goldfrank L, Flomenbaum N, Lewin N, Howland MA, Hoff- man R, Nelson L. Goldfrank’s toxicologic emergencies. Seventh edition. Carbon monoxide. Tomaszewski C. 2003; 97: 1478-91.
6. Gul M, Girisgin S, Ak A, Gokalp A. Carbonmonoxide Poison- ings and hyperbaric oxygen therapy. The Turkish Journal of Toxicology 2004;2 2 :27-32.
7. Koc S, Ozaslan A. Carbonmonoxide Poisonings. Forensic Medicine Book Volume 1 Ed: Soysal Z, Cakalır C , Istanbul Universty. Cerrahpasa Medical School Publishing, Istanbul, ;445-52. Ozen C, Sozen H. Forensic Medicine and Toxicology. Ser- met Printer, Istanbul, 1971;135-5.
8. Piantadosi CA. Carbon monoxide poisoning. Undersea Hy- perb Med 2004;31:167-77.

9. Nursel T, Semra A. Deaths due to carbonmonoxide poi- sonings autopsied in Bursa. J For Med 2005;19 2 :20-5.
10. Garg J, Krishnamoorthy P, Palaniswamy C, Khera S, Ah- mad H, Jain D, Aronow WS, Frishman WH. Cardiovascular abnormalities in carbon monoxide poisoning. Am J Ther 2014
11. Epub ahead of print . Prockop LD, Chichkova RI. Carbon monoxide intoxication: An updated review. J Neurol Sci 2007;262 1-2 :122-30.
12. Knight B. Simpson’s Forensic Medicine. Tenth edition. Hadder and Staughton, London,1991; 304-7.
13. Knight B. The Coroner’s Autopsy, a guide to non-criminal autopsies for the general pathologists. First edition. Churchill Livingstone, Edinburgh, 1983:239-43.
14. Irwin RS, Rippe J.M. Irwin and Rippe’s Intensive Care Medi- cine, Sixth Edition. Translation Editors: Melek Tulunay, Handan Cuhruk. Gunes Medicine Publishing: Ankara;2014:Skin 1:756
15. Kandis H, Katirci Y, Karapolat BS. Carbon monoxide poi- soning. Duzce Medical Journal 2009;11 3 :54-60.
16. Buyuk Y, Yazici Y.A, Uzun I, Cagdir AS. The facilitating role of alcohol in CO Intoxication: A case report. J For Med ;18 2 :7-11. Alici T, Ubay IT. Cannabinoids: A review of neurobiology and neuropsychopharmacology of rewarding and addictive ef- fects. Addiction Journal 2006;7:140-9.
17. Ogel, K, Taner, S, Yilmazcetin, C. Guide to Approach to Drug Use Disorders in Adolescents. Istanbul IQ Culture-Art Publishing, 2003.
18. Ogel K, Uguz K, Sir A. Between elementary and secondary youth in Turkey cannabis use prevalence. Addiction Journal ;4:15-9. Gok S. Forensic Medicine. 5th edition. Filiz Publishing, Is- tanbul,1988:158.
19. Aksoy ME, Polat O, Inanıcı MA, Yuksel U. 293 Retrospec- tive analysis of the carbon monoxide poisoning case. Clinical Development 1995;8 3 :3545-9.
20. Yeginaltay C. Carbon monoxide poisoning in terms of fo- rensics Unpublished thesis . Istanbul, 1981.
21. Plueckhohn VD, Cordner SM. Ethics, Legal Medicine and Forensic Pathology. Second edition. Plueckhohn Cordner. Melbourne;1991:267-9.
22. Weigend T. Traffic and Criminal Law. Project Responsible: Icel K.; prepared: Unver Y. Ankara: Seckin Publishing, 2006.
23. Uzbay IT. Addictive substances and their properties. Turk- ish Pharmacists’ Association, MISED. 2009;21-22:16-32.