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postmortem toxicology

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https://www.readbyqxmd.com/read/29772071/to-test-or-not-to-test-the-value-of-toxicology-in-a-delayed-overdose-death
#1
Erin E Walsh, Elisa N Shoff, Mary Elizabeth Zaney, George W Hime, Fintan Garavan, Diane M Boland
A case demonstrating the necessity of thorough death investigation processes where toxicology plays an active role is presented. A 33-year-old white man presented to the emergency room in respiratory distress after an overdose episode where he was revived on the scene by fire rescue. His condition continued to deteriorate and he expired 6 days after the initial incident. No admission specimens were available for testing; however, there were specimens drawn 4 and 5 days after the incident. Drug paraphernalia from the scene was obtained by the laboratory through collaboration with local law enforcement...
May 17, 2018: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/29768651/cannabinoid-hyperemesis-syndrome-reports-of-fatal-cases
#2
Mahra Nourbakhsh, Angela Miller, Jeff Gofton, Graham Jones, Bamidele Adeagbo
Cannabinoid hyperemesis syndrome (CHS) is one of the more clinically challenging effects of cannabis consumption. It is characterized by cyclic attacks of nausea and vomiting in chronic cannabinoid users and learned behavior of compulsive hot bathing. The deaths of a 27-year-old female, a 27-year-old male, and a 31-year-old male with a history of CHS are reported. The decedents had a history of cyclical nausea and vomiting, chronic cannabinoid use and negative laboratory, radiological and endoscopic findings...
May 16, 2018: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/29762694/comparative-study-of-postmortem-concentrations-of-antidepressants-in-several-different-matrices
#3
Åse Marit Leere Øiestad, Ritva Karinen, Sidsel Rogde, Stian Nilsen, Kari-Beate Boye Eldor, Gerd-Wenche Brochmann, Marianne Arnestad, Elisabeth Leere Øiestad, Mariana Dadalto Peres, Lena Kristoffersen, Vigdis Vindenes
Peripheral blood (PB) is considered to be the golden standard for measuring postmortem drug concentrations. In several cases, PB is however not available, but information regarding drug findings might still be crucial in order to determine the cause of death. Antidepressants are frequently detected in postmortem samples from forensic toxicology cases, but the literature investigating concentrations in other matrices than peripheral and heart blood is limited.We here describe a study for comparison of concentrations for a large number of different drugs in six different matrices...
May 14, 2018: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29750250/analysis-of-fentanyl-and-18-novel-fentanyl-analogs-and-metabolites-by-lc-ms-ms-and-report-of-fatalities-associated-with-methoxyacetylfentanyl-and-cyclopropylfentanyl
#4
Melissa F Fogarty, Donna M Papsun, Barry K Logan
Methoxyacetylfentanyl and cyclopropylfentanyl are two of the newest illicit opioids that are infiltrating the heroin market. Methoxyacetylfentanyl and cyclopropylfentanyl were reported by the Drug Enforcement Administration (DEA) in their third quarter report of 2017 to have been chemically identified seven and five times, respectively, from drug evidence analyzed by the DEA's lab system; Q3 was the first time cyclopropylfentanyl was identified by the DEA's lab system, while methoxyacetylfentanyl was reported one time in Q2 2017...
May 10, 2018: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29704853/postmortem-blood-alcohol-content-among-late-middle-aged-and-older-suicide-decedents-associations-with-suicide-precipitating-risk-factors-means-and-other-drug-toxicology
#5
Namkee G Choi, Diana M DiNitto, Atami O Sagna, C Nathan Marti
BACKGROUND: This study examined blood alcohol content (BAC) among suicide decedents aged 50+ and its associations with suicide precipitating/risk factors, means, and other drug toxicology. METHODS: The National Violent Death Reporting System, 2005-2015, provided data (N = 56,118 for all suicide decedents and N = 29,115 with alcohol test results). We used logistic regression models, with BAC > 0.0 (BAC positive) and BAC > = 0.08 (intoxication) as the dependent variables...
April 10, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29679838/medico-legal-investigation-in-an-explicable-case-of-congenital-central-hypoventilation-syndrome-due-to-a-rare-variant-of-the-phox2b-gene
#6
Francesco Ventura, Rosario Barranco, Tiziana Bachetti, Paolo Nozza, Ezio Fulcheri, Antonella Palmieri, Isabella Ceccherini
The heterozygous PHOX2B gene mutation is related to congenital central hypoventilation syndrome (CCHS). It is characterized by defective autonomous nervous system development leading to inadequate breathing response to hypoxia and hypercapnia, leading to hypoventilation especially during non-REM sleep, but also during waking in the more severe cases. Herein we report a case of sudden death in a 28-day-old child. The mother reported the infant was found lying on her own bed in the prone position. The infant was wearing a romper and lying in her crib without any blanket or other objects...
April 17, 2018: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/29657389/hepato-nephropathology-associated-with-inclusion-body-hepatitis-complicated-with-citrinin-mycotoxicosis-in-a-broiler-farm
#7
Asok Kumar Mariappan, Palanivelu Munusamy, Shyma K Latheef, Shambu Dayal Singh, Kuldeep Dhama
Aim: Mortality in a broiler chicken farm was investigated for identifying the cause of mortality. Materials and Methods: A broiler farm with a population of 16000 succumbed to a disease outbreak. Clinical signs, vaccination history and mortality, were recorded. Necropsy examination and microscopic examination were carried out along with toxicological and molecular studies. Results: The clinical signs in the affected broiler birds were of non-specific nature with a total mortality of 26...
February 2018: Veterinary World
https://www.readbyqxmd.com/read/29579279/distribution-of-eight-qt-prolonging-drugs-and-their-main-metabolites-between-postmortem-cardiac-tissue-and-blood-reveals-potential-pitfalls-in-toxicological-interpretation
#8
Christian R Mikkelsen, Jakob R Jornil, Ljubica V Andersen, Jytte Banner, Jørgen B Hasselstrøm
Femoral blood concentrations are usually used in postmortem toxicology to assess possible toxic effects of drugs. This includes QT-prolongation and other cardiac dysrhythmia, which could have been the cause of death. However, blood concentration is only a surrogate for the active site concentration, and therefore cardiac tissue concentration may provide a more accurate toxicological interpretation. Thus, cardiac tissue and femoral and cardiac blood concentrations were examined for eight frequently used QT-prolonging drugs (QTD) and their metabolites in a mentally ill population...
March 20, 2018: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29573426/ionic-liquid-based-liquid-liquid-microextraction-for-benzodiazepine-analysis-in-postmortem-blood-samples
#9
Marieke De Boeck, Wim Dehaen, Jan Tytgat, Eva Cuypers
Sample preparation is rapidly improving to fulfill the need for faster and more environmentally friendly alternatives. In this respect, ionic liquid-based dispersive liquid-liquid microextraction (IL-DLLME) is an interesting technique. However, it has not yet been evaluated for the analysis of postmortem samples, which are frequently analyzed in forensic toxicology. This study investigates the applicability of IL-DLLME coupled to liquid chromatography-tandem mass spectrometry (LC-MS/MS), for the analysis of benzodiazepines in postmortem blood of 11 forensic cases...
March 24, 2018: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/29570893/comparison-of-dispensed-medications-and-forensic-toxicological-findings-to-assess-pharmacotherapy-in-the-swedish-population-2006-to-2013
#10
Jonas Forsman, Heidi Taipale, Thomas Masterman, Jari Tiihonen, Antti Tanskanen
PURPOSE: To investigate person-level agreement between medication exposure as predicted using the PRE2DUP (a prescription-based design to estimate continuous drug use) method and postmortem toxicological findings, in the Swedish population during the years 2006 to 2013. METHODS: Using the Swedish National Board of Forensic Medicine's toxicology database and the Swedish National Board of Health and Welfare's registries on causes of death, dispensed medications, and in-patient care, forensic-toxicological findings were compared with prescription-based estimates of drug use for 27 medications...
March 23, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29566235/case-reports-of-fatalities-involving-tianeptine-in-the-united-states
#11
Erica L Bakota, Warren C Samms, Teresa R Gray, Deanna A Oleske, Merrill O Hines
Tianeptine is a tricyclic anti-depressant that is also known to have opioid receptor activity. We present two fatal cases of tianeptine intoxication in Texas in which tianeptine was used recreationally. The first case involved a 28-year-old white male found alone on the floor of his locked residence. He had a history of drug abuse but no other toxicological findings. The second case involved a 30-year-old white male found on the floor of the bathroom in his home. Drug paraphernalia and bags labeled as tianeptine powder were found at both scenes...
March 16, 2018: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29560840/older-women-who-died-by-suicide-suicide-means-sociodemographic-and-psychiatric-risk-factors-and-other-precipitating-circumstances
#12
Namkee G Choi, Diana M DiNitto, Atami O Sagna, C Nathan Marti
BACKGROUND: US suicide rates among older women have substantially increased over the past decade. We examined potential differences in sociodemographic and risk/precipitating factors among older female suicide decedents who died by drug overdose versus firearms, hanging/suffocation, and other means, and postmortem toxicology results by suicide means. METHODS: Data are from the 2005 to 2015 US National Violent Death Reporting System (N = 12,401 female decedents aged 50 years and over)...
March 21, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29558687/cathinone-stability-in-authentic-urine-specimens
#13
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
https://www.readbyqxmd.com/read/29554591/prevalence-of-gabapentin-in-drug-overdose-postmortem-toxicology-testing-results
#14
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
https://www.readbyqxmd.com/read/29554274/dibutylone-bk-dmbdb-intoxications-quantitative-confirmations-and-metabolism-in-authentic-biological-specimens
#15
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
https://www.readbyqxmd.com/read/29496137/brain-donation-at-autopsy-clinical-characterization-and-toxicologic-analyses
#16
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
https://www.readbyqxmd.com/read/29495066/the-effects-of-storage-and-additives-on-postmortem-hba1c-measurements
#17
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
https://www.readbyqxmd.com/read/29480184/ozone-atmospheric-pollution-and-alzheimer-s-disease-from-epidemiological-facts-to-molecular-mechanisms
#18
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
https://www.readbyqxmd.com/read/29461269/coronary-artery-abnormalities-as-the-cause-of-sudden-cardiac-death-a-20-year-review
#19
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...
June 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29384483/occlusive-mycotic-tracheobronchitis-and-systemic-alphaherpesvirus-coinfection-in-a-free-living-striped-dolphin-stenella-coeruleoalba-in-italy
#20
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
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