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postmortem toxicology

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https://www.readbyqxmd.com/read/27915431/time-dependent-postmortem-redistribution-of-morphine-and-its-metabolites-in-blood-and-alternative-matrices-application-of-ct-guided-biopsy-sampling
#1
Sandra N Staeheli, Dominic Gascho, Lars C Ebert, Thomas Kraemer, Andrea E Steuer
Interpretation of postmortem morphine concentrations in forensic toxicology provides several pitfalls such as missing information on tolerance, analyte stability, or postmortem redistribution (PMR). Recently, it had been shown that computed tomography (CT)-guided collection of biopsies using a robotic arm (virtobot) provides a valuable strategy for systematic studies on time-dependent PMR. Using this technique, time-dependent PMR of morphine and its metabolites was investigated in 12 cases. At admission to the institute (t1), femoral and heart blood (right ventricle) as well as biopsies from the right lung, the right kidney, liver, spleen, and muscle tissue were collected...
December 3, 2016: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27881618/simultaneous-screening-and-quantification-of-basic-neutral-and-acidic-drugs-in-blood-using-uplc-qtof-ms
#2
Sergei Bidny, Kim Gago, Phuong Chung, Desdemona Albertyn, Daniel Pasin
An analytical method using ultra performance liquid chromatography (UPLC) quadrupole time-of-flight mass spectrometry (QTOF-MS) was developed and validated for the targeted toxicological screening and quantification of commonly used pharmaceuticals and drugs of abuse in postmortem blood using 100 µL sample. It screens for more than 185 drugs and metabolites and quantifies more than 90 drugs. The selected compounds include classes of pharmaceuticals and drugs of abuse such as: antidepressants, antipsychotics, analgesics (including narcotic analgesics), anti-inflammatory drugs, benzodiazepines, beta-blockers, amphetamines, new psychoactive substances (NPS), cocaine and metabolites...
November 22, 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27874190/the-value-of-outsourcing-selected-cases-in-a-medical-examiner-population-a-10-year-experience
#3
Brandi C McCleskey, Stephanie D Reilly, Dan Atherton
Due to increasing caseloads and inadequate staffing, the burden on Coroner/Medical Examiner Offices to comply with recommended autopsy limits for forensic pathologists (FPs) has been difficult. Since 2006, pathologists at the University of Alabama at Birmingham have performed select autopsies for the Alabama Department of Forensic Sciences. Each case was reviewed by a state FP and scene investigator to determine appropriateness for referral. All referred cases received full postmortem examination including microscopic examination and collection of toxicological samples, and toxicology was ordered by the referring FP as appropriate...
November 22, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27864951/evaluation-of-the-role-of-toxicological-data-in-discriminating-between-h2-s-femoral-blood-concentration-secondary-to-lethal-poisoning-and-endogenous-h2-s-putrefactive-production
#4
Nunziata Barbera, Angelo Montana, Francesca Indorato, Nadia Arbouche, Guido Romano
Hydrogen sulfide is a colorless gas and has a strong odor of rotten eggs. It is absorbed by the upper respiratory tract mucosa, and it causes histotoxic hypoxemia and respiratory depression by exerting an inhibitory effect on cytochrome oxidase. To evaluate the role of toxicological data in distinguishing between the H2 S blood concentration secondary to lethal poisoning and the endogenous H2 S produced during putrefaction, we compared the postmortem H2 S concentrations of six fatal H2 S poisoning cases (8...
November 16, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27864947/determining-the-toxicological-significance-of-pregabalin-in-fatalities
#5
Simon P Elliott, Timothy Burke, Christopher Smith
Pregabalin has become more widely prescribed and abused in recent years but is still not always included in laboratory analysis. An LC-MS-MS method has been developed and applied to measure pregabalin in 93 postmortem cases, including drug-related deaths, alternative causes of death, and fatalities where pregabalin was likely to have contributed to death. Other drugs or alcohol was detected, and the most common drug types (in decreasing frequency) were antidepressants, opioids, benzodiazepines, opiates, alcohol, antipsychotics, cocaine, cardiac drugs, amphetamines, cannabis, anticonvulsants, and antihistamines...
November 16, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27863698/striatal-h3k27-acetylation-linked-to-glutamatergic-gene-dysregulation-in-human-heroin-abusers-holds-promise-as-therapeutic-target
#6
Gabor Egervari, Joseph Landry, James Callens, John F Fullard, Panos Roussos, Eva Keller, Yasmin L Hurd
BACKGROUND: Opiate abuse and overdose reached epidemic levels in the United States. However, despite significant advances in animal and in vitro models, little knowledge has been directly accrued regarding the neurobiology of the opiate-addicted human brain. METHODS: We used postmortem human brain specimens from a homogeneous European Caucasian population of heroin users for transcriptional and epigenetic profiling, as well as direct assessment of chromatin accessibility in the striatum, a brain region central to reward and emotion...
September 28, 2016: Biological Psychiatry
https://www.readbyqxmd.com/read/27842791/forensic-toxicology-an-introduction
#7
REVIEW
Michael P Smith, Martin H Bluth
This article presents an overview of forensic toxicology. The authors describe the three components that make up forensic toxicology: workplace drug testing, postmortem toxicology, and human performance toxicology. Also discussed are the specimens that are tested, the methods used, and how the results are interpreted in this particular discipline.
December 2016: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/27834143/distribution-of-synthetic-cannabinoids-jwh-210-rcs-4-and-%C3%A2-9-tetrahydrocannabinol-after-intravenous-administration-to-pigs
#8
Nadine Schaefer, Mattias Kettner, Matthias W Laschke, Julia Schlote, Andreas H Ewald, Michael D Menger, Hans H Maurer, Peter H Schmidt
Synthetic cannabinoids (SCs) have become an increasing issue in forensic toxicology. Controlled human studies evaluating pharmacokinetic data of SCs are lacking and only few animal studies have been published. Thus, an interpretation of analytical results found in intoxicated or poisoned individuals is difficult. Therefore, the distribution of two selected SCs, namely 4-ethylnaphthalen-1-yl-(1-pentylindol-3-yl)methanone (JWH-210) and 2-(4-methoxyphenyl)-1-(1-pentyl-indol-3-yl)methanone (RCS-4) as well as ∆9-tetrahydrocannabinol (THC) as reference were examined in pigs...
November 11, 2016: Current Neuropharmacology
https://www.readbyqxmd.com/read/27798077/a-fatality-related-to-the-synthetic-opioid-u-47700-postmortem-concentration-distribution
#9
Iain M McIntyre, Ray D Gary, Sandra Joseph, Robert Stabley
In this case report, we present an evaluation of the distribution of postmortem concentrations of 3,4-dichloro-N-[2-(dimethylamino)cyclohexyl]-N-methylbenzamide (U-47700) in a fatality attributed principally to the drug. A man who had a history of drug abuse was found unresponsive and not breathing on his bed. Drug paraphernalia, indicating drug insufflation, was located in the decedent's room. Toxicology screening tests in peripheral blood initially identified U-47700 using an alkaline drug screen with gas chromatography-mass spectrometry (GC-MS) following solid-phase extraction...
October 26, 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27789047/self-induced-illegal-abortion-with-rivanol-%C3%A2-a-medicolegal-toxicological-case-report
#10
Sarah C Koelzer, Hannelore Held, Stefan W Toennes, Marcel A Verhoff, Cora Wunder
Approximately during the 30th week of pregnancy, a woman gave birth to a still-born child in a hospital. After first citing an extraneous cause for the premature still-birth, the woman later admitted to having self-induced the abortion by injecting the antiseptic Rivanol(®) (active agent: ethacridine lactate) through her abdominal wall into the amniotic cavity. The investigating authorities ordered an autopsy of the fetus along with additional toxicological investigations. To the naked eye, no obvious cause of death was apparent...
August 27, 2016: Forensic Science International
https://www.readbyqxmd.com/read/27788407/determination-of-clozapine-and-five-antidepressants-in-human-plasma-serum-and-whole-blood-by-gas-chromatography-mass-spectrometry-a-simple-tool-for-clinical-and-postmortem-toxicological-analysis
#11
Vassiliki A Boumba, George Rallis, Petros Petrikis, Theodore Vougiouklakis, Venetsanos Mavreas
In this study, we describe a simple and rapid method for the determination of the antipsychotic drug clozapine and five commonly co-administered antidepressants - bupropion, mirtazapine, sertraline, clomipramine and citalopram - in serum, plasma and whole blood. Sample preparation includes solid phase extraction of analytes and determination of drug concentrations by gas chromatography-mass spectrometry without any derivatization steps. The method was fully validated according to international criteria and can be successfully applied for routine analyses...
October 21, 2016: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/27702938/illicit-fentanyl-related-fatalities-in-florida-toxicological-findings
#12
Dayong Lee, Chris W Chronister, Wilson A Broussard, Suzanne R Utley-Bobak, Daniel L Schultz, Russell S Vega, Bruce A Goldberger
Fentanyl induces pharmacological effects and abuse liability comparable to other prescription opioids and heroin. A surge in fentanyl-related fatalities has been periodically reported throughout the USA. The University of Florida Forensic Toxicology Laboratory observed a significant increase in fentanyl-related deaths starting in mid-2014. The present report evaluated toxicological findings, demographics of the decedents and circumstances of death in the postmortem cases that were submitted to the laboratory for toxicological analysis from July 2014 to January 2015 and that were tested for fentanyl in biological specimens...
October 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27685872/clinical-pharmacology-in-denmark-in-2016-40-years-with-the-danish-society-of-clinical-pharmacology-and-20-years-as-a-medical-speciality
#13
REVIEW
Kim Brøsen, Stig Ejdrup Andersen, Jeanett Borregaard, Hanne Rolighed Christensen, Palle Mark Christensen, Kim Peder Dalhoff, Per Damkier, Jesper Hallas, Jens Heisterberg, Niels Jessen, Gesche Jürgens, Jens Peter Konnerup Kampmann, Britt Elmedal Laursen, Torben Laursen, Lars Peter Nielsen, Birgitte Klindt Poulsen, Henrik Enghusen Poulsen, Ljubica Vukelic Andersen, Thomas Senderovitz, Jesper Sonne
The Danish Society of Clinical Pharmacology was founded in 1976, and mainly thanks to the persistent efforts of the society, clinical pharmacology became an independent medical speciality in Denmark in 1996. Since then, clinical pharmacology has gone from strength to strength. In the Danish healthcare system, clinical pharmacology has established itself as an indispensible part of the efforts to promote the rational, safe and economic use of drugs. Clinical pharmacologists are active in drug committees both in hospitals and in the primary sector...
December 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27685474/nitrobenzodiazepines-postmortem-brain-and-blood-reference-concentrations
#14
Louise Skov, Karen Marie Dollerup Holm, Kristian Linnet
Reference concentrations are needed to evaluate postmortem toxicology results and usually femoral blood is the specimen of choice. However, brain tissue has been suggested as a viable alternative specimen, since postmortem blood concentrations can be difficult to interpret due to postmortem redistribution, among other factors. Here we present reference concentrations of postmortem brain and femoral blood of the nitrobenzodiazepines clonazepam, flunitrazepam, and nitrazepam that are of particular interest since they commonly are converted to their corresponding 7-aminometabolites in the postmortem situation...
September 12, 2016: Forensic Science International
https://www.readbyqxmd.com/read/27660664/pharmacokinetics-of-heroin-and-its-metabolites-in-vitreous-humor-and-blood-in-a-living-pig-model
#15
André Gottås, Marianne Arnestad, Per Steinar Halvorsen, Liliana C Bachs, Gudrun Høiseth
Vitreous humor (VH) is an alternative matrix for drug analysis in forensic toxicology. However, little is known about the distribution of xenobiotics, such as opioids, into VH in living organisms. The aim of this study was to simultaneously measure heroin and metabolite concentrations in blood and VH after injection of heroin in a living pig model. Six pigs were under non-opioid anesthesia during the surgical operation and experiment. Ocular microdialysis was used to acquire dialysate from VH, and a venous catheter was used for blood sampling...
2016: Forensic Toxicology
https://www.readbyqxmd.com/read/27650310/an-acute-ocfentanil-fatality-a-case-report-with-postmortem-concentrations
#16
F E Dussy, S Hangartner, C Hamberg, C Berchtold, U Scherer, G Schlotterbeck, D Wyler, T A Briellmann
A 24-year-old man known to consume illegal drugs was found dead in his apartment. A reclosable plastic zipper bag containing several hundred milligrams of a brown powder was found close to the dead body and the first assumption of the investigators was death due to heroin intoxication. Therefore, a legal autopsy was ordered. The following toxicological analysis revealed ocfentanil in urine and in the brown powder. Four different approaches for the determination of the ocfentanil concentrations in peripheral whole blood are described...
September 20, 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27638923/sudden-neurologic-death-masquerading-as-out-of-hospital-sudden-cardiac-death
#17
Anthony S Kim, Ellen Moffatt, Philip C Ursell, Orrin Devinsky, Jeffrey Olgin, Zian H Tseng
OBJECTIVE: To characterize the frequency of and risk factors for out-of-hospital sudden neurologic deaths. METHODS: During the initial 25 months (February 1, 2011-March 1, 2013) of the San Francisco Postmortem Systematic Investigation of Sudden Cardiac Death Study, we captured incident WHO criteria sudden cardiac deaths (SCDs) through active surveillance of consecutive out-of-hospital deaths, which must be reported to the medical examiner by law. All cases were referred for full autopsy with detailed examination of the heart and cranial vault, toxicology, and histology...
October 18, 2016: Neurology
https://www.readbyqxmd.com/read/27635251/quantitative-analysis-of-benzodiazepines-in-vitreous-humor-by-high-performance-liquid-chromatography
#18
Elham Bazmi, Behnam Behnoush, Maryam Akhgari, Leila Bahmanabadi
OBJECTIVE: Benzodiazepines are frequently screened drugs in emergency toxicology, drugs of abuse testing, and in forensic cases. As the variations of benzodiazepines concentrations in biological samples during bleeding, postmortem changes, and redistribution could be biasing forensic medicine examinations, hence selecting a suitable sample and a validated accurate method is essential for the quantitative analysis of these main drug categories. The aim of this study was to develop a valid method for the determination of four benzodiazepines (flurazepam, lorazepam, alprazolam, and diazepam) in vitreous humor using liquid-liquid extraction and high-performance liquid chromatography...
2016: SAGE Open Medicine
https://www.readbyqxmd.com/read/27590036/analysis-of-novel-synthetic-opioids-u-47700-u-50488-and-furanyl-fentanyl-by-lc-ms-ms-in-postmortem-casework
#19
Amanda L A Mohr, Melissa Friscia, Donna Papsun, Sherri L Kacinko, David Buzby, Barry K Logan
Following series of synthetic cannabinoid and synthetic cathinone derivatives, the illicit drug market has begun to see increased incidence of synthetic opioids including fentanyl and its derivatives, and other chemically unrelated opioid agonists including AH-7921 and MT-45. Among the most frequently encountered compounds in postmortem casework have been furanyl fentanyl (N-(1-(2-phenylethyl)-4-piperidinyl)-N-phenylfuran-2-carboxamide, Fu-F) and U-47700 (trans-3,4-dichloro-N-(2-(dimethylamino)cyclohexyl)-N-methylbenzamide)...
September 1, 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27550995/stability-of-26-sedative-hypnotics-in-six-toxicological-matrices-at-different-storage-conditions
#20
Dani C Mata
Forensic laboratories are challenged with backlogs that produce turnaround times that vary from days to months. Therefore, drug stability is important for interpretation in both antemortem (blood and urine) and postmortem (blood, brain, liver, stomach contents) cases. In this study, 23 benzodiazepines (2-hydroxyethylflurazepam, 7-aminoclonazepam, 7-aminoflunitrazepam, α-hydroxyalprazolam, α-hydroxytriazolam, alprazolam, bromazepam, chlordiazepoxide, clonazepam, demoxepam, desalkylflurazepam, diazepam, estazolam, flunitrazepam, flurazepam, lorazepam, midazolam, nitrazepam, nordiazepam, oxazepam, phenazepam, temazepam and triazolam) and three sedative hypnotics (zaleplon, zopiclone and zolpidem) were spiked into the six matrices at two different concentrations for each drug...
October 2016: Journal of Analytical Toxicology
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