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postmortem toxicology

Lindsay Glicksberg, Sumandeep Rana, Sarah Kerrigan
PURPOSE: Synthetic cathinones are encountered in a variety of antemortem and postmortem forensic toxicology investigations. Earlier experimental studies using fortified urine have evaluated analyte, temperature and pH-dependent variables associated with their stability. The purpose of this study was to compare experimental findings with those obtained using authentic urine from cathinone users. METHODS: In this report we compare cathinone concentrations in 180 authentic unpreserved urine specimens, following known periods of refrigerated storage...
March 8, 2018: Forensic Science International
Svetla Slavova, Alison Miller, Terry L Bunn, Jessica R White, David Kirschke, Tom Light, Daniel Christy, Gary Thompson, Ruth Winecker
BACKGROUND: The goal of this study was to establish and compare baseline data on the prevalence of gabapentin identified through postmortem toxicology testing among drug overdose decedents in several geographically diverse states/jurisdictions with differing levels of drug overdose fatality burdens in 2015. METHODS: Death certificates and postmortem toxicology result reports from five U.S. jurisdictions were used to identify residents who died from drug overdoses in year 2015 and to calculate prevalence rates of gabapentin in postmortem toxicology by jurisdiction...
March 10, 2018: Drug and Alcohol Dependence
Alex J Krotulski, Amanda L A Mohr, Donna M Papsun, Barry K Logan
The number of emerging novel stimulants modified based on beta-keto variations of amphetamine-like substances continues to rise. Dibutylone reports described in the medical and toxicological literature are limited, therefore little information is available in terms of quantitative confirmation or metabolism. During this study, authentic human specimens, including blood, urine, vitreous humor, oral fluid and liver were quantitatively and qualitatively analyzed for the presence of dibutylone and butylone, with paired case history and demographic information...
March 15, 2018: Journal of Analytical Toxicology
Michelle I Mighdoll, Thomas M Hyde
The study of postmortem human brain tissue is central to the advancement of neurobiologic studies of psychiatric and neurologic illnesses, particularly the study of brain-specific isoforms and molecules. Due to tissue demands, especially pertaining to brain regions strongly implicated in the pathophysiology of neuropsychiatric disorders, the success and future of this research depend on the availability of high-quality brain specimens from large numbers of subjects, including nonpsychiatric controls, both of which may be obtained from brain banks...
2018: Handbook of Clinical Neurology
Jeffrey E Fournier, Victoria Northrup, Donaldo D Canales, Christa Moore, Jennifer L Shea
HbA1c is used in forensic toxicology to identify undiagnosed diabetes mellitus (DM) and those with poor glycemic control prior to death. HbA1c is typically measured in whole blood collected in tubes containing ethylenediaminetetraacetic acid (EDTA). The effect of other additives, including sodium fluoride (NaF), is unclear. Furthermore, the assessment of short- and long-term stability of HbA1c has produced conflicting results. In this study, we collected paired postmortem blood samples in EDTA and NaF tubes (n = 142) to assess their comparability for HbA1c measurement...
March 1, 2018: Journal of Forensic Sciences
Marine L Croze, Luc Zimmer
Atmospheric pollution is a well-known environmental hazard, especially in developing countries where millions of people are exposed to airborne pollutant levels above safety standards. Accordingly, several epidemiological and animal studies confirmed its role in respiratory and cardiovascular pathologies and identified a strong link between ambient air pollution exposure and adverse health outcomes such as hospitalization and mortality. More recently, the potential deleterious effect of air pollution inhalation on the central nervous system was also investigated and mounting evidence supports a link between air pollution exposure and neurodegenerative pathologies, especially Alzheimer's disease (AD)...
2018: Journal of Alzheimer's Disease: JAD
Bernard Pawlowicz, John Fernandes, Vidhya Nair
In this case series, we delve into the database of medicolegal cases of the Forensic Pathology Department at Hamilton Health Sciences in Hamilton Ontario from the last 20 years (1996-2017), and review cases of sudden cardiac death due to coronary artery abnormalities. We found 17 cases that fit the criteria, which gave us an incidence of 1.34 per 1000 cases. These cases were further audited for age, sex, type of coronary artery abnormality, symptoms before demise, circumstances of death, presence of significant atherosclerotic disease, and toxicology...
February 15, 2018: American Journal of Forensic Medicine and Pathology
Carla Grattarola, Federica Giorda, Barbara Iulini, Alessandra Pautasso, Marco Ballardini, Simona Zoppi, Letizia Marsili, Simone Peletto, Loretta Masoero, Katia Varello, Fulvio Garibaldi, Frine E Scaglione, Giovanni Di Guardo, Alessandro Dondo, Maria Goria, Laura Serracca, Walter Mignone, Cristina Casalone
A juvenile female striped dolphin Stenella coeruleoalba live stranded on 4 March 2016 at Alassio, western Ligurian Sea coast, Italy. The dolphin died shortly after stranding, and a complete postmortem examination was performed. Necropsy revealed severe tracheal occlusion and unilateral bronchial stenosis with luminal accumulation of abundant green-yellow mucous-gelatinous material. Histological features suggestive of tracheobronchial aspergillosis were observed. Cultures of lung tissue and tracheo-bronchial exudate isolated Aspergillus fumigatus, identified by a Microseq D2 LSUrDNA fungal sequencing kit...
January 31, 2018: Diseases of Aquatic Organisms
Hui Yan, Hang Chen, Zhengdong Li, Min Shen, Xianyi Zhuo, Hejian Wu, Ping Xiang
Phosphine is an insecticide for the fumigation of grains, animal feed, and leaf-stored tobacco, and it was used as a rodenticide in bulk grain stores. Phosphine poisoning may occur after accidental inhalation of phosphine, sometimes leading to death. Analysis of phosphine and its metabolites in postmortem specimens from seven fatal cases was conducted in this study, as well as postmortem specimens collected from rabbits exposed to phosphine. The total phosphine in postmortem specimens was analyzed by headspace gas chromatography coupled with mass spectrometry...
January 25, 2018: Journal of Analytical Toxicology
Josiah McKenna, Rachel Jett, Kevin Shanks, Nicholas E Manicke
Immunoassays and high-performance liquid chromatography (HPLC) coupled with mass spectrometry (MS) are both widely used methods for drug screening in toxicology. We investigated an alternative approach for rapid drug screening: paper spray MS (PS-MS). In paper spray, the biofluid sample is spotted onto a paper substrate. Upon application of a spray solvent and an electric potential, extraction and ionization occur directly from the paper without any need for additional sample preparation. We developed two paper spray high-resolution MS/MS targeted drug screening assays using a quadrupole-orbitrap mass spectrometer, one the positive ion mode and one in the negative ion mode...
January 25, 2018: Journal of Analytical Toxicology
A Pouliopoulos, E Tsakelidou, A Krokos, H G Gika, G Theodoridis, N Raikos
The aim of the study was to develop a LC-MS-MS method able to detect and quantify a number of frequently prescribed antipsychotic and antidepressant drugs for toxicological purposes. Separation of compounds was performed on a C-18 RP column by Ultra High-Pressure Chromatography over a 11 min run. A modified single step QuEChERS protocol consisted essentially by the addition of acetonitrile, potassium carbonate and magnesium sulfate in 100 μL of sample, vortexing, centrifugation and evaporation has been selected...
January 24, 2018: Journal of Analytical Toxicology
Malorie Mella, Brendan Schweitzer, Claude R Mallet, Tara Moore, Sabra Botch-Jones
Introduction: In forensic toxicology, challenges exist with quantification analysis of cocaine and metabolites in postmortem samples following extensive decomposition. Alternative matrices, such as bone could prove useful when other specimens are not available. Detection and quantification of drugs in complex matrices require time-consuming extraction processes. The objective of this study was to develop a robust extraction and clean-up methodology to efficiently extract cocaine, and its metabolites, in bone and reach target limits of detection using multidimensional chromatography...
December 28, 2017: Journal of Analytical Toxicology
Brian Waters, Kenji Hara, Natsuki Ikematsu, Mio Takayama, Aya Matsusue, Masayuki Kashiwagi, Shin-Ichi Kubo
Suvorexant (Belsomra®) is a relatively new insomnia medication that has been available in USA and Japan since 2014. It is a dual orexin receptor antagonist that promotes sleep by inhibiting the binding of orexin neurons to the OX1R and OX2R receptors. In this report, we describe the detection and quantitation of suvorexant from the postmortem specimens of three separate autopsy cases handled by our department. Suvorexant was identified by fast gas chromatography/mass spectrometry during routine screening, and quantitated by a fully validated liquid chromatography-tandem mass spectroscopy method...
December 28, 2017: Journal of Analytical Toxicology
M Z Zhang, B X Li, R Zhao, D W Guan, G H Zhang, X Wu, B L Zhu, R B Li
OBJECTIVES: To analyse the cases of sudden death due to hyperthyroid heart disease, and explore the general information of deaths and the forensic pathological characteristics to provide reference evidence for forensic identification of such cases. METHODS: Six cases of sudden death due to hyperthyroid heart disease between 2001 and 2016 were selected from School of Forensic Medicine, China Medical University. The general information (gender and age), clinical manifestations, medical history, anatomical and histopathological findings, biochemical parameters and cause of death were analysed retrospectively...
October 2017: Fa Yi Xue za Zhi
Clémence Delteil, Lucile Tuchtan, Julia Torrents, Caroline Capuani, Marie-Dominique Piercecchi-Marti
The aim of postmortem medicolegal examination in pediatric death is primarily to establish the circumstances and causes of death and to exclude child abuse. In France, pediatric death is systematically documented by medicolegal or medical autopsy. In case of medicolegal autopsy, the complementary examinations, requested and financed by justice, are rarely limited to a histopathological examination. However in medical autopsies other tools are available to the pathologist as toxicology, biochemistry and molecular biology...
January 2018: Journal of Forensic and Legal Medicine
Nadine Schaefer, Daniel Moj, Thorsten Lehr, Peter H Schmidt, Frank Ramsthaler
In forensic medicine, expert opinion is often required concerning dose and time of intake of a substance, especially in the context of fatal intoxications. In the present case, a 98-year-old man died 4 days after admission to a hospital due to a femur neck fracture following a domestic fall in his retirement home. As he had obtained high morphine doses in the context of palliative therapy and a confusion of his supplemental magnesium tablets with a diuretic by the care retirement home was suspected by the relatives, a comprehensive postmortem examination was performed...
March 2018: International Journal of Legal Medicine
Anthea B Mahesan Paul, Lary Simms, Saeideh Amini, Abraham Ebenezer Paul
Synthetic cannabinoids (SCs) are commonly abused by adolescents with reported past year (2013) use in high school students between 3 and 10%. Standard adolescent postmortem toxicology does not include routine SC analysis, and thus, the true burden of fatalities related to SCs is unknown. A retrospective case review of two cases included scene investigation, interviews, autopsy, and toxicology. SCs were confirmed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Review of the eight adolescent SC-associated fatalities in the literature revealed five of eight cases had no other discernible cause of death on autopsy...
December 1, 2017: Journal of Forensic Sciences
Laura R Monzon, Sue Pearring, Caitlin Miller, Jay R Vargas
The analytical value of vitreous humor as a specimen in postmortem forensic toxicology has been known for some time. Numerous medical examiner laboratories outsource the analysis of this important specimen for electrolyte and glucose measurements. This can be both time-consuming and costly. The utility of the i-STAT®1 medical device to measure electrolytes and glucose in whole blood samples has been demonstrated for over two decades in a clinical setting through single-use disposable cartridges that introduce samples to the i-STAT®1...
November 24, 2017: Journal of Analytical Toxicology
V Angerer, S Jacobi, F Franz, V Auwärter, J Pietsch
The use of synthetic cannabinoids (SC) has been widespread in certain groups of drug users for many years. In the scientific literature many intoxication cases and a number of fatalities after the use of synthetic cannabinoids were reported. In this paper three death cases are described with involvement of the synthetic cannabinoids 5F-PB-22, AB-CHMINACA, and 5F-ADB. The three cases occurred in the eastern region of Germany, which is known as a region of high methamphetamine abuse. All decedents were male, between 25 and 41 years old, and had a known history of drug use...
December 2017: Forensic Science International
Anna Laura Santunione, Patrizia Verri, Filippo Marchesi, Cecilia Rustichelli, Federica Palazzoli, Daniele Vandelli, Manuela Licata, Enrico Silingardi
Ethanol determination in postmortem blood is one of the most frequently requested analyses in legal medicine and forensic toxicology. Ethyl glucuronide is a non-oxidative ethanol metabolite. It is also a useful marker of ante-mortem alcohol ingestion when ethanol itself has been completely eliminated from the body and could be considered in autopsy cases to obtain more reliable indications. The aim of the present study was to investigate the ethyl glucuronide distribution in postmortem specimens from autopsy cases found to be positive for ethanol...
November 1, 2017: Journal of Forensic and Legal Medicine
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