{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T12:44:11Z","timestamp":1767703451918,"version":"3.45.0"},"reference-count":19,"publisher":"BMJ","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[2008,7]]},"abstract":"<jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To establish the most frequent pathological findings encountered at postmortem examination during the investigation of a fatality with a history of cocaine abuse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Autopsied deaths investigated by the coroner for the Eastern district of London, between 2004 and 2007, in which the decedent had positive toxicology for cocaine were identified (n\u200a=\u200a28). The autopsy records and histology of tissue taken at autopsy were retrieved and reviewed. Pathological findings (gross and microscopic, including cardiac, pulmonary, gastrointestinal, hepatobiliary, renal and neurological) were collated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The main pathological findings at autopsy occurring in this cohort (comprising predominantly men, mean age 31 years), were cardiovascular: left ventricular hypertrophy (46%), multifocal myocardial fibrosis (21%), coronary artery disease (29%), cerebrovascular disease (36%) and pulmonary oedema (71%). Hepatic steatosis (29%) and gastrointestinal haemorrhage (18%), due mostly to gastric erosions\/ulceration, were also frequent findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>During a coroner\u2019s autopsy of a cocaine user, a thorough cardiac examination combined with cardiac tissue sampling for histology, are valuable investigations, which are most likely to help show pathology relevant to the cause of death.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jcp.2007.054569","type":"journal-article","created":{"date-parts":[[2008,6,27]],"date-time":"2008-06-27T13:25:08Z","timestamp":1214573108000},"page":"848-850","source":"Crossref","is-referenced-by-count":12,"title":["Autopsy pathology of cocaine users from the Eastern district of London: a retrospective cohort study"],"prefix":"10.1136","volume":"61","author":[{"given":"R","family":"Rajab","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Stearns","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Baithun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2008,6,27]]},"reference":[{"key":"2025112110372245000_61.7.848.1","unstructured":"Ghadse H Corkery J Schifano F . Drug-related deaths in the UK. Annual Report 2005. National Programme on Substance Abuse Deaths, International Centre for Drug Policy. St Georges\u2019s, University of London, UK, 2006."},{"key":"2025112110372245000_61.7.848.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchromb.2004.10.036"},{"key":"2025112110372245000_61.7.848.3","doi-asserted-by":"publisher","DOI":"10.1258\/0004563001899744"},{"key":"2025112110372245000_61.7.848.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchromb.2006.12.021"},{"key":"2025112110372245000_61.7.848.5","first-page":"3","article-title":"Myocarditis. A histopathologic definition and classification.","volume":"1","author":"Aretz","year":"1987","journal-title":"Am J Cardiovasc Pathol"},{"key":"2025112110372245000_61.7.848.6","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1520\/JFS13831J","article-title":"Myocardial hypertrophy and coronary artery disease in male cocaine users.","volume":"40","author":"Karch","year":"1995","journal-title":"J Forensic Sci"},{"key":"2025112110372245000_61.7.848.7","doi-asserted-by":"publisher","DOI":"10.1097\/01.smj.0000168701.08879.3f"},{"key":"2025112110372245000_61.7.848.8","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1161\/01.HYP.34.4.782","article-title":"State of the Art lecture. Risk mechanisms in hypertensive heart disease.","volume":"34","author":"Frohlich","year":"1999","journal-title":"Hypertension"},{"key":"2025112110372245000_61.7.848.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)64946-5"},{"key":"2025112110372245000_61.7.848.10","doi-asserted-by":"crossref","unstructured":"Sheaff M Hopster D . Post mortem technique handbook. London: Springer, 2001.","DOI":"10.1007\/978-1-4471-3677-4"},{"issue":"(6)","key":"2025112110372245000_61.7.848.11","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1097\/00132981-200506000-00015","article-title":"Acute cocaine toxicity.","volume":"26","author":"Harrigan","year":"2005","journal-title":"Emergency Medicine News"},{"key":"2025112110372245000_61.7.848.12","doi-asserted-by":"publisher","DOI":"10.1378\/chest.100.4.903"},{"key":"2025112110372245000_61.7.848.13","doi-asserted-by":"publisher","DOI":"10.1378\/chest.97.4.1009"},{"key":"2025112110372245000_61.7.848.14","first-page":"293","article-title":"Perforated ulcers related to smoking \u201ccrack\u201d cocaine.","volume":"58","author":"Kram","year":"1992","journal-title":"Am Surg"},{"key":"2025112110372245000_61.7.848.15","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1097\/00004836-199102000-00006","article-title":"Crack-related perforated gastropyloric ulcer.","volume":"13","author":"Abramson","year":"1991","journal-title":"J Clin Gastroenterol"},{"key":"2025112110372245000_61.7.848.16","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199811000-00011"},{"key":"2025112110372245000_61.7.848.17","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1002\/bjs.1800820154","article-title":"Ischaemic colitis induced by cocaine abuse.","volume":"82","author":"Sanjuanbenito Dehesa","year":"1995","journal-title":"Br J Surg"},{"key":"2025112110372245000_61.7.848.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0147-9563(97)90040-6"},{"key":"2025112110372245000_61.7.848.19","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1600-0773.1993.tb01331.x","article-title":"Clinical pharmacology and toxicology of cocaine.","volume":"72","author":"Benowitz","year":"1993","journal-title":"Pharmacol Toxicol"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.2007.054569","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T18:37:36Z","timestamp":1763750256000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.2007.054569"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,6,27]]},"references-count":19,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2008,6,27]]},"published-print":{"date-parts":[[2008,7]]}},"alternative-id":["10.1136\/jcp.2007.054569"],"URL":"https:\/\/doi.org\/10.1136\/jcp.2007.054569","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"type":"print","value":"0021-9746"},{"type":"electronic","value":"1472-4146"}],"subject":[],"published":{"date-parts":[[2008,6,27]]}}}