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postmortem toxicology

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https://www.readbyqxmd.com/read/29133010/three-fatalities-associated-with-the-synthetic-cannabinoids-5f-adb-5f-pb-22-and-ab-chminaca
#1
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...
November 7, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29127890/the-role-of-ethyl-glucuronide-in-supporting-medico-legal-investigations-analysis-of-this-biomarker-in-different-postmortem-specimens-from-21-selected-autopsy-cases
#2
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
https://www.readbyqxmd.com/read/29076627/forensic-toxicology-perspectives-of-methadone-associated-deaths-in-tehran-iran-a-seven-year-overview
#3
Maryam Akhgari, Noushin Amini-Shirazi, Fariba Sardari Iravani
Methadone has a long history of pain relief and successful substitute for maintenance treatment in heroin and narcotic addiction. The aim of the study was to assess the trends of methadone-associated deaths in Tehran, Iran, in 2009-2015, from a forensic toxicology point of view. All methadone-associated deaths during this 7-year study period were evaluated according to demographic parameters and forensic toxicology analysis results. Results showed that 1274 cases of methadone-associated deaths were investigated during the study period...
October 27, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29051136/using-google-glass-in-nonsurgical-medical-settings-systematic-review
#4
Bryn Dougherty, Sherif M Badawy
BACKGROUND: Wearable technologies provide users hands-free access to computer functions and are becoming increasingly popular on both the consumer market and in various industries. The medical industry has pioneered research and implementation of head-mounted wearable devices, such as Google Glass. Most of this research has focused on surgical interventions; however, other medical fields have begun to explore the potential of this technology to support both patients and clinicians. OBJECTIVE: Our aim was to systematically evaluate the feasibility, usability, and acceptability of using Google Glass in nonsurgical medical settings and to determine the benefits, limitations, and future directions of its application...
October 19, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29036543/pilot-reported-beta-blockers-identified-by-forensic-toxicology-analysis-of-postmortem-specimens
#5
Dennis V Canfield, Kurt M Dubowski, James M Whinnery, Estrella M Forster
Introduction: This study compared beta-blockers reported by pilots with the medications found by postmortem toxicology analysis of specimens received from fatal aviation accidents between 1999 and 2015. Several studies have compared drugs using the standard approach: Compare the drug found by toxicology analysis with the drug reported by the pilot. This study uniquely examined first the pilot-reported medication and then compared it to that detected by toxicology analysis. This study will serve two purposes: (i) to determine the capability of a toxicology laboratory to detect reported medications, and (ii) to identify pilots with medications below detectable limits...
September 25, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29033634/sudden-unexpected-death-in-epilepsy-a-retrospective-autopsy-study-of-112-epileptic-patients
#6
İpek Esen Melez, Murat Nihat Arslan, Deniz Oğuzhan Melez, Ahmet Necati Şanli, Sermet Koç
INTRODUCTION: Sudden unexpected deaths comprise the most important and worthy investigation case profiles in both neurology and forensic medicine. Epilepsy, which is one of the neuropathological causes of sudden unexpected deaths, is an important disorder having mysterious aspects. The aim of this study is to make common the points of view between neurology and forensic medicine experts and to discuss the features of the findings together with the related clinical hypotheses, leading to the differential diagnosis of sudden unexpected death in epilepsy (SUDEP) by presenting autopsy findings and available medical data of patients who had a prior diagnosis of epilepsy...
September 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/29017087/detection-of-butane-gas-inhalation-at-16days-after-hypoxic-encephalopathy-a-case-report
#7
Takako Sato, Hiroshi Nishioka, Kento Tsuboi, Munehiro Katagi, Akihiro Miki, Takashi Saito, Shuntaro Abe, Masakatsu Nomura, Misa Kitagawa, Hitoshi Tsuchihashi, Koichi Suzuki
In Japan, there are increasing reports of death by poisoning following butane abuse. To determine the specific cause of death in such cases, it is important to confirm the presence of fuel gas components in the body, although careful analysis is required because of their volatile properties. In most reported cases, the subject died suddenly during or immediately after butane aspiration. Thus, the butane concentration in the samples from the deceased should be relatively high. Herein, we present a case of an 18-year-old man found with cardiopulmonary arrest, who then exhibited hypoxic encephalopathy for 16days in a hospital...
October 3, 2017: Legal Medicine
https://www.readbyqxmd.com/read/28985320/multiple-drug-toxicity-involving-novel-psychoactive-substances-3-fluorophenmetrazine-and-u-47700
#8
Kayla N Ellefsen, Elizabeth A Taylor, Paul Simmons, Vickie Willoughby, Brad J Hall
3-Fluorophenmetrazine (3-FPM) is a stimulant-like novel psychoactive substance (NPS) and fluorinated analog of phenmetrazine that has recently appeared on the recreational drug market, with limited published information. Likewise, the synthetic opioid U-47700 has gained popularity among recreational drug users and is frequently detected in postmortem casework. We present the case history, autopsy and toxicological findings of a fatality involving the designer drugs 3-FPM and U-47700 for the first time in the literature...
July 20, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28977581/stability-of-synthetic-cathinones-in-blood
#9
Lindsay Glicksberg, Sarah Kerrigan
The synthetic cathinones are powerful psychostimulants that have been associated with impairment, intoxication and fatal overdose. Forensic laboratories must be able to identify these new drugs as part of antemortem and postmortem toxicology investigations. Preliminary reports have indicated that some of the synthetic cathinones are unstable in biological matrices. It is important to understand drug stability in biological evidence so that analytical findings can be interpreted appropriately. The objective of this study was to systematically evaluate the concentration, temperature and analyte-dependent stability of synthetic cathinones in preserved blood using liquid-chromatography/quadrupole-time of flight-mass spectrometry (LC/Q-TOF-MS)...
August 31, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28977432/quantification-of-loperamide-by-gas-chromatography-mass-spectrometry
#10
Rachel Beck, Daniel S Atherton, Susan Kloda, Daniel W Dye, C Andrew Robinson
Due to reported pharmacological activity similar to classical opioids at supratherapeutic concentrations, abuse of the anti-diarrheal medication loperamide (Imodium AD™) has become a target in the opioid epidemic. While this phenomenon is not new, published quantitative analytical methods use liquid chromatography tandem mass spectrometry. Described here is an 11 min method for quantification of loperamide in postmortem whole blood by gas chromatography mass spectrometry. Validation studies performed followed SWGTOX guidelines and included: accuracy, specificity, limit of detection (LOD), regression model analysis, stability, and matrix recovery enhancement and/or suppression...
August 31, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28917762/full-validation-of-a-method-for-the-determination-of-drugs-of-abuse-in-non-mineralized-dental-biofilm-using-liquid-chromatography-tandem-mass-spectrometry-and-application-to-postmortem-samples
#11
Kerstin Henkel, Markus J Altenburger, Volker Auwärter, Merja A Neukamm
Alternative matrices play a major role in postmortem forensic toxicology, especially if common matrices (like body fluids or hair) are not available. Incorporation of illicit and medicinal drugs into non-mineralized dental biofilm (plaque) seems likely but has not been investigated so far. Analysis of plaque could therefore extend the spectrum of potentially used matrices in postmortem toxicology. For this reason, a rapid, simple and sensitive method for the extraction, determination and quantification of ten drugs of abuse from plaque using liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed and fully validated...
January 1, 2018: Talanta
https://www.readbyqxmd.com/read/28852820/assessment-of-simpler-calibration-models-in-the-development-and-validation-of-a-fast-postmortem-multi-analyte-lc-qtof-quantitation-method-in-whole-blood-with-simultaneous-screening-capabilities-using-swath-acquisition
#12
Marco P Elmiger, Michael Poetzsch, Andrea E Steuer, Thomas Kraemer
In postmortem toxicology, fast methods can provide a triage to avoid unnecessary autopsies. Usually, this requires multiple qualitative and quantitative analytical methods. The aim of the present study was to develop a postmortem LC-QTOF method for simultaneous screening and quantitation using easy sample preparation and reduced alternative calibration models. Hence, a method for 24 highly relevant substances in forensic toxicology was fully validated using the following calibration models: one-point external, one-point internal via corresponding deuterated standards, multi-point external daily calibration, and multi-point external weekly calibration...
August 29, 2017: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/28830124/postmortem-fluid-and-tissue-concentrations-of-thc-11-oh-thc-and-thc-cooh
#13
Sunday R Saenz, Russell J Lewis, Mike K Angier, Jarrad R Wagner
Marijuana is the most commonly abused illicit drug worldwide. Marijuana is used for its euphoric and relaxing properties. However, marijuana use has been shown to result in impaired memory, cognitive skills and psychomotor function. The Federal Aviation Administration's Civil Aerospace Medical Institute conducts toxicological analysis on aviation fatalities. Due to severe trauma associated with aviation accidents, blood is not always available; therefore, the laboratory must rely on specimens other than blood for toxicological analysis in ~30-40% of cases...
July 1, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28830120/detection-of-carfentanil-by-lc-ms-ms-and-reports-of-associated-fatalities-in-the-usa
#14
Kevin G Shanks, George S Behonick
Carfentanil is a mu (μ) opioid receptor agonist and is estimated to be ~10,000 times more potent than morphine in animal (non-human) models. It is not approved for human use and is only used to immobilize large exotic animals in veterinary medicine. In mid-2016, carfentanil emerged as a contaminant in street heroin in the USA and was central to a large number of emergency department visits and deaths. We describe an analytical method for the detection and quantification of carfentanil in whole blood specimens via a protein precipitation extraction with acetonitrile and liquid chromatography with triple quadrupole mass spectrometry...
July 1, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28803722/advantages-of-analyzing-postmortem-brain-samples-in-routine-forensic-drug-screening-case-series-of-three-non-natural-deaths-tested-positive-for-lysergic-acid-diethylamide-lsd
#15
Marie Mardal, Sys Stybe Johansen, Ragnar Thomsen, Kristian Linnet
Three case reports are presented, including autopsy findings and toxicological screening results, which were tested positive for the potent hallucinogenic drug lysergic acid diethylamide (LSD). LSD and its main metabolites were quantified in brain tissue and femoral blood, and furthermore hematoma and urine when available. LSD, its main metabolite 2-oxo-3-hydroxy-LSD (oxo-HO-LSD), and iso-LSD were quantified in biological samples according to a previously published procedure involving liquid-liquid extraction and ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS)...
September 2017: Forensic Science International
https://www.readbyqxmd.com/read/28767539/medicolegal-investigations-into-deaths-due-to-crush-asphyxia-after-tractor-side-rollovers
#16
Carlo Moreschi, Ugo Da Broi, Antonia Fanzutto, Sirio Cividino, Rino Gubiani, Gianfranco Pergher
Farm tractors are large, heavy, powerful vehicles with a high center of gravity. When driven carelessly on sloping, irregular, or slippery ground, tractors can overturn sideways and cause the death by crush asphyxia of the driver or passengers, especially if appropriate safety equipment is not fitted or used. The aim of this review is to focus on the diagnostic difficulties with which coroners and forensic pathologists have to cope when a confirmation of crush asphyxia after tractor side rollover is required by judicial authorities...
December 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28737525/death-by-snow-a-fatal-forensic-case-of-cocaine-leakage-in-a-drug-mule-on-postmortem-computed-and-magnetic-resonance-tomography-compared-with-autopsy
#17
Patricia Mildred Flach, Dominic Gascho, René Fader, Rosita Martinez, Michael J Thali, Lars C Ebert
This forensic case presents unique postmortem imaging of a "drug mule" with fatal intoxication due to cocaine leakage on postmortem computed and magnetic resonance (MR) tomography compared with autopsy.Imaging by postmortem computed and MR tomography was performed before autopsy, histology, and toxicology were commissioned. Forensic imaging revealed 91 hyperdense, uniformly shaped body packs with signs of leakage, which was confirmed by autopsy. Postmortem MR imaging displayed the rarely described hypointense appearance of the body packs in T1- and T2-weighted sequences...
December 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28735777/heroin-and-fentanyl-overdoses-in-kentucky-epidemiology-and-surveillance
#18
Svetla Slavova, Julia F Costich, Terry L Bunn, Huong Luu, Michael Singleton, Sarah L Hargrove, Jeremy S Triplett, Dana Quesinberry, William Ralston, Van Ingram
BACKGROUND: The study aims to describe recent changes in Kentucky's drug overdose trends related to increased heroin and fentanyl involvement, and to discuss future directions for improved drug overdose surveillance. METHODS: The study used multiple data sources (death certificates, postmortem toxicology results, emergency department [ED] records, law enforcement drug submissions, and prescription drug monitoring records) to describe temporal, geographic, and demographic changes in drug overdoses in Kentucky...
June 27, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28690283/postmortem-computed-tomographic-analysis-of-death-caused-by-oral-drug-intoxication
#19
Akihito Usui, Yusuke Kawasumi, Kiyotaka Usui, Yuya Ishizuka, Kaito Takahashi, Masato Funayama, Haruo Saito
Traditional autopsy has changed little in the past century. In Japan, the rate of forensic autopsy in cases of unusual death is very low. Therefore, multi-slice computed tomography (CT) has been used to obtain imaging data instead of or in addition to autopsy in suspicious forensic cases. In our institute, postmortem multi-slice CT has been performed since 2009, and by 2014 there were over 1,000 cases. Our extensive experience with postmortem CT shows that in many cases of death by drug overdose, stomach contents exhibit high X-ray absorption...
July 2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28681657/fatal-poisoning-by-terbufos-following-occupational-exposure
#20
Yue Liang, Fang Tong, Lin Zhang, Wenhe Li, Weisheng Huang, Yiwu Zhou
CONTEXT: Terbufos (TBF) is a class Ia (extremely hazardous) organophosphate pesticide (OP) and its distribution in industrialized countries has been severely restricted. Thus, acute occupational poisoning is rather uncommon. However, it still occurs in rural areas of some developing countries, where the sale of TBF is not controlled and its use is thus not properly regulated. We report a case of a 43-year-old female farmer who died after applying TBF granules. CASE: The patient died within 3 h after applying 20 bags of 5% TBF granules (900 g per bag)...
July 6, 2017: Clinical Toxicology
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