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Gitto L, Mir M, Arunkumar P. Evaluating the Reliability of Dipstick Drug Screens on Vitreous and Postmortem Blood as a Triage Modality in Forensic Pathology. Acad Forensic Pathol 2023; 13:92-100. [PMID: 38298544 PMCID: PMC10825466 DOI: 10.1177/19253621231190415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/02/2023] [Indexed: 02/02/2024]
Abstract
Dipstick drug screens are cheap, easy to use, and quick presumptive tests to detect common drugs of abuse. Dipsticks are designed for drug detection in urine. There is no literature regarding their potential use on fluids different from urine. The study aimed to determine the performance of dipstick screening tests on postmortem vitreous and blood specimens compared to urine dipsticks and final confirmatory toxicology analyses on blood. The study population included cases in which a complete toxicology analysis was performed. Each subject was screened for three substances: cocaine, fentanyl, and opiates. Dipstick results were checked by visual inspection. Results were compared with urine screening tests and quantitative, confirmatory toxicological analyses by gas chromatography/mass spectrometry on postmortem blood samples as the gold standards for screening and confirmatory analysis, respectively. There was a high number of false-negative results for opiates. Cocaine dipsticks in blood showed the highest reliability. Fentanyl dipsticks in vitreous showed a high number of false-negative results. Both vitreous and blood dipstick screening tests for all substances performed well on negative cases. When both blood and vitreous screening tests are negative, the chance that the confirmatory toxicology analysis will be positive is very low.
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Affiliation(s)
- Lorenzo Gitto
- Lorenzo Gitto MD, Cook County Office of the
Medical Examiners, 2121 W Harrison St., Chicago, IL 60612,
;
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2
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Al-Asmari AI, Alharbi H, Al-Zahrani AE, Zughaibi TA. Heroin-Related Fatalities in Jeddah, Saudi Arabia, between 2008 and 2018. TOXICS 2023; 11:248. [PMID: 36977013 PMCID: PMC10099738 DOI: 10.3390/toxics11030248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
To date, epidemiological studies have not evaluated heroin-related deaths in the Middle East and North African regions, especially Saudi Arabia. All heroin-related postmortem cases reported at the Jeddah Poison Control Center (JPCC) over a 10-year period (21 January 2008 to 31 July 2018) were reviewed. In addition, liquid chromatography electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS) was utilized to determine the 6-monoacetylmorphine (6-MAM), 6-acetylcodeine (6-AC), morphine (MOR), and codeine contents in unhydrolyzed postmortem specimens. Ninety-seven heroin-related deaths were assessed in this study, and they represented 2% of the total postmortem cases at the JPCC (median age, 38; 98% male). In the blood, urine, vitreous humor, and bile samples, the median morphine concentrations were 280 ng/mL, 1400 ng/mL, 90 ng/mL, and 2200 ng/mL, respectively; 6-MAM was detected in 60%, 100%, 99%, and 59% of the samples, respectively; and 6-AC was detected in 24%, 68%, 50%, and 30% of the samples, respectively. The highest number of deaths (33% of total cases) was observed in the 21-30 age group. In addition, 61% of cases were classified as "rapid deaths," while 24% were classified as "delayed deaths." The majority (76%) of deaths were accidental; 7% were from suicide; 5% were from homicide; and 11% were undetermined. This is the first epidemiological study to investigate heroin-related fatalities in Saudi Arabia and the Middle East and North African region. The rate of heroin-related deaths in Jeddah remained stable but increased slightly at the end of the study period. Most patients were heroin-dependent abusers and from the middle-aged group. The availability of urine, vitreous humor, and bile specimens provided valuable information regarding the opioids that were administered and the survival time following heroin injection.
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Affiliation(s)
- Ahmed I. Al-Asmari
- Laboratory Department, Ministry of Health, King Abdul-Aziz Hospital, Jeddah 21442, Saudi Arabia
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Hassan Alharbi
- Poison Control and Forensic Chemistry Center, Ministry of Health, Jeddah 21176, Saudi Arabia
| | | | - Torki A. Zughaibi
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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3
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Al-Asmari AI, Alharbi H, Zughaibi TA. Post-Mortem Analysis of Heroin Biomarkers, Morphine and Codeine in Stomach Wall Tissue in Heroin-Related Deaths. TOXICS 2022; 10:473. [PMID: 36006152 PMCID: PMC9413540 DOI: 10.3390/toxics10080473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/07/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
Toxicological analysis of some cases can be complicated by poor sample quality caused by decomposition. Although heroin-related deaths have been researched extensively, the interpretation of toxicology findings in these cases is challenging, especially in instances where blood samples are unavailable. Thus, it is important to develop analytical methods for different sample types. In this study. a method for the quantification of 6-monoacetylmorphine, 6-acetylcodeine, morphine, and codeine in postmortem stomach wall tissue using liquid chromatography coupled with tandem mass spectrometry was developed and validated. All calibration curves prepared with the stomach wall tissue were linear and ranged from 0.5−1000 ng/g with determination coefficients of >0.99 and a lower limit of quantification of 1.0 ng/g. The coefficients of variation for within-run precision and between-run precision were <9%. Matrix effects of stomach wall tissues and their extraction recoveries were investigated and ranged from −19% to +17% and 76% to 80%, respectively. Among the 16 analyzed heroin-related death cases, 6-monoacetylmorphine, 6-acetylcodeine, morphine, and codeine were detected in 75%, 31%, 100%, and 94% of all stomach wall tissues with median concentrations of 90 ng/g, 20 ng/g, 140 ng/g, and 30 ng/g, respectively. This study provides new data on the distribution of 6-monoacetylmorphine, 6-Acetylcodeine, morphine, and codeine in postmortem stomach wall tissue and suggests the usefulness of alternative matrices for investigating heroin-related fatalities when blood samples are unavailable. In addition, the prevalence of 6-monoacetylmorphine in the stomach wall tissue was higher than that in the liver and kidney tissues.
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Affiliation(s)
- Ahmed I. Al-Asmari
- Laboratory Department, Ministry of Health, King Abdul-Aziz Hospital, P.O. Box 6470, Jeddah 21442, Saudi Arabia
- King Fahd Medical Research Center, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia
| | - Hassan Alharbi
- Poison Control and Forensic Chemistry Center, Ministry of Health, P.O. Box 21543, Jeddah 21176, Saudi Arabia
| | - Torki A. Zughaibi
- King Fahd Medical Research Center, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia
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Morphine Accumulates in the Retina Following Chronic Systemic Administration. Pharmaceuticals (Basel) 2022; 15:ph15050527. [PMID: 35631353 PMCID: PMC9146690 DOI: 10.3390/ph15050527] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
Opioid transport into the central nervous system is crucial for the analgesic efficacy of opioid drugs. Thus, the pharmacokinetics of opioid analgesics such as morphine have been extensively studied in systemic circulation and the brain. While opioid metabolites are routinely detected in the vitreous fluid of the eye during postmortem toxicological analyses, the pharmacokinetics of morphine within the retina of the eye remains largely unexplored. In this study, we measured morphine in mouse retina following systemic exposure. We showed that morphine deposits and persists in the retina long after levels have dropped in the serum. Moreover, we found that morphine concentrations (ng/mg tissue) in the retina exceeded brain morphine concentrations at all time points tested. Perhaps most intriguingly, these data indicate that following chronic systemic exposure, morphine accumulates in the retina, but not in the brain or serum. These results suggest that morphine can accumulate in the retina following chronic use, which could contribute to the deleterious effects of chronic opioid use on both image-forming and non-image-forming visual functions.
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5
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Lappas NT, Lappas CM. Heroin. Forensic Toxicol 2022. [DOI: 10.1016/b978-0-12-819286-3.00024-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lappas NT, Lappas CM. Analytical Samples. Forensic Toxicol 2022. [DOI: 10.1016/b978-0-12-819286-3.00012-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dawidowska J, Krzyżanowska M, Markuszewski MJ, Kaliszan M. The Application of Metabolomics in Forensic Science with Focus on Forensic Toxicology and Time-of-Death Estimation. Metabolites 2021; 11:metabo11120801. [PMID: 34940558 PMCID: PMC8708813 DOI: 10.3390/metabo11120801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/22/2021] [Accepted: 11/22/2021] [Indexed: 12/21/2022] Open
Abstract
Recently, the diagnostic methods used by scientists in forensic examinations have enormously expanded. Metabolomics provides an important contribution to analytical method development. The main purpose of this review was to investigate and summarize the most recent applications of metabolomics in forensic science. The primary research method was an extensive review of available international literature in PubMed. The keywords “forensic” and “metabolomics” were used as search criteria for the PubMed database scan. Most authors emphasized the analysis of different biological sample types using chromatography methods. The presented review is a summary of recently published implementations of metabolomics in forensic science and types of biological material used and techniques applied. Possible opportunities for valuable metabolomics’ applications are discussed to emphasize the essential necessities resulting in numerous nontargeted metabolomics’ assays.
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Affiliation(s)
- Joanna Dawidowska
- Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (J.D.); (M.J.M.)
- Department of Forensic Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Marta Krzyżanowska
- Department of Forensic Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Michał Jan Markuszewski
- Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (J.D.); (M.J.M.)
| | - Michał Kaliszan
- Department of Forensic Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
- Correspondence: ; Tel.: +48-58-3491255
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Havig SM, Vindenes V, Øiestad ÅML, Rogde S, Thaulow CH. Methadone, Buprenorphine, Oxycodone, Fentanyl, and Tramadol in Multiple Postmortem Matrices. J Anal Toxicol 2021; 46:600-610. [PMID: 34115841 PMCID: PMC9282245 DOI: 10.1093/jat/bkab071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/11/2021] [Accepted: 06/11/2021] [Indexed: 11/28/2022] Open
Abstract
Peripheral blood (PB) concentrations are generally preferred for postmortem toxicological interpretation, but some autopsy cases may lack blood for sampling due to decomposition or large traumas, etc. In such cases, other tissues or bodily fluids must be sampled; however, limited information exists on postmortem concentrations in matrices other than blood. Pericardial fluid (PF), muscle and vitreous humor (VH) have been suggested as alternatives to blood, but only a few studies have investigated the detection of opioids in these matrices. In this study, we aimed to investigate the detection of methadone, buprenorphine, oxycodone, fentanyl and tramadol in postmortem samples of PF, skeletal muscle and VH, in addition to PB and cardiac blood and if drug concentrations in these alternative matrices were comparable to those in PB and thereby useful for interpretation. In most of the 54 included cases, only one opioid was detected. Methadone, oxycodone, fentanyl and tramadol were detected in all of the alternative matrices in almost all cases, while buprenorphine was detected less often. For methadone, the concentrations in the alternative matrices, except in VH, were relatively similar to those in PB. Larger variations in concentrations were found for buprenorphine, oxycodone and tramadol. Quantitative analyses appeared useful for fentanyl, in all of the alternative matrices, but only four cases were included. Toxicological analyses of opioids in these alternative postmortem matrices can be useful for detection, but quantitative results must be interpreted with caution.
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Affiliation(s)
| | - Vigdis Vindenes
- Department of Forensic Sciences, Oslo University Hospital.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo
| | | | - Sidsel Rogde
- Department of Forensic Sciences, Oslo University Hospital
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9
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Nassibou S, Richeval C, Wiart JF, Hakim F, Allorge D, Gaulier JM. In Heroin-Related Fatalities, Testing for 6-Acetylmorphine in Vitreous Humor Seems to Be of Higher Sensitivity than in Blood or Urine. J Anal Toxicol 2021; 44:e9-e10. [PMID: 32860697 DOI: 10.1093/jat/bkaa116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/06/2020] [Accepted: 08/22/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Shanti Nassibou
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000, Lille, France
| | - Camille Richeval
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000, Lille, France.,University of Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | | | - Florian Hakim
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000, Lille, France.,University of Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | - Delphine Allorge
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000, Lille, France.,University of Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | - Jean-Michel Gaulier
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000, Lille, France.,University of Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
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Application of microextraction techniques in alternative biological matrices with focus on forensic toxicology: a review. Bioanalysis 2020; 13:45-64. [PMID: 33326299 DOI: 10.4155/bio-2020-0241] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The interest in alternative biological matrices (e.g., hair and saliva) for forensic toxicology analysis has increased, and recent developments in sample preparation have targeted rapid, cheap, efficient and eco-friendly methods, including microextraction techniques. For this review, we have gathered information about these two hot topics. We discuss the composition, incorporation of analytes and advantages and disadvantages of different biological matrices, and also present the operation principles of the most reported microextraction procedures and their application in forensic toxicology. The outcome of this review may encourage future forensic researches into alternative samples and microextraction techniques.
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11
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Al‐Asmari AI. Postmortem Fluid Concentrations of Heroin Biomarkers and Their Metabolites. J Forensic Sci 2019; 65:570-579. [DOI: 10.1111/1556-4029.14200] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/06/2019] [Accepted: 09/06/2019] [Indexed: 11/28/2022]
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12
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Nedahl M, Johansen SS, Linnet K. Brain-blood ratio of morphine in heroin and morphine autopsy cases. Forensic Sci Int 2019; 301:388-393. [DOI: 10.1016/j.forsciint.2019.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/23/2019] [Accepted: 06/05/2019] [Indexed: 11/16/2022]
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13
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Metabolism and metabolomics of opiates: A long way of forensic implications to unravel. J Forensic Leg Med 2019; 61:128-140. [DOI: 10.1016/j.jflm.2018.12.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 12/15/2018] [Accepted: 12/17/2018] [Indexed: 12/27/2022]
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14
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Maskell PD, Wilson NE, Seetohul LN, Crichton ML, Beer LJ, Drummond G, De Paoli G. Postmortem tissue distribution of morphine and its metabolites in a series of heroin-related deaths. Drug Test Anal 2018; 11:292-304. [DOI: 10.1002/dta.2492] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/20/2018] [Accepted: 08/20/2018] [Indexed: 02/02/2023]
Affiliation(s)
- Peter D. Maskell
- School of Science, Engineering and Technology; Abertay University; Dundee DD11HG UK
| | | | - L. Nitin Seetohul
- School of Science and Technology; Nottingham Trent University; Nottingham UK
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15
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Thaulow CH, Øiestad ÅML, Rogde S, Andersen JM, Høiseth G, Handal M, Mørland J, Vindenes V. Can measurements of heroin metabolites in post-mortem matrices other than peripheral blood indicate if death was rapid or delayed? Forensic Sci Int 2018; 290:121-128. [DOI: 10.1016/j.forsciint.2018.06.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
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16
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Thaulow CH, Øiestad ÅML, Rogde S, Karinen R, Brochmann GW, Andersen JM, Høiseth G, Handal M, Mørland J, Arnestad M, Øiestad EL, Strand DH, Vindenes V. Metabolites of Heroin in Several Different Post-mortem Matrices. J Anal Toxicol 2018; 42:311-320. [DOI: 10.1093/jat/bky002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Cecilie Hasselø Thaulow
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Åse Marit Leere Øiestad
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Sidsel Rogde
- Department of Forensic Sciences, Section of Forensic Pathology and Clinical Forensic Medicine, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, N-0318 OSLO, Norway
| | - Ritva Karinen
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Gerd Wenche Brochmann
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Jannike Mørch Andersen
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Gudrun Høiseth
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Marte Handal
- Department of Mental Disorders, Norwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 OSLO, Norway
| | - Jørg Mørland
- Norwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 OSLO, Norway
- Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, N-0318 OSLO, Norway
| | - Marianne Arnestad
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Elisabeth Leere Øiestad
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
- School of Pharmacy, University of Oslo, PO Box 1068 Blindern, N-0316 Oslo, Norway
| | - Dag Helge Strand
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Vigdis Vindenes
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, N-0318 OSLO, Norway
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Visentin S, Bevilacqua G, Giraudo C, Dengo C, Nalesso A, Montisci M. Death by heroin intoxication in a body pusher with an innovative packaging technique: case report and review of the literature. Forensic Sci Int 2017; 280:8-14. [DOI: 10.1016/j.forsciint.2017.08.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 08/29/2017] [Indexed: 11/29/2022]
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18
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Love SA, Lelinski J, Kloss J, Middleton O, Apple FS. Heroin-related Deaths from the Hennepin County Medical Examiner's Office from 2004 Through 2015. J Forensic Sci 2017; 63:191-194. [DOI: 10.1111/1556-4029.13511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/06/2017] [Accepted: 03/07/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Sara A. Love
- Department of Laboratory Medicine & Pathology; Hennepin County Medical Center; 701 Park Avenue Minneapolis MN
- Department of Laboratory Medicine & Pathology; University of Minnesota; 420 Delaware Street SE Minneapolis MN
| | - Jessica Lelinski
- Hennepin County Medical Examiner; 530 Chicago Avenue Minneapolis MN
| | - Julie Kloss
- Department of Laboratory Medicine & Pathology; Hennepin County Medical Center; 701 Park Avenue Minneapolis MN
| | - Owen Middleton
- Hennepin County Medical Examiner; 530 Chicago Avenue Minneapolis MN
| | - Fred S. Apple
- Department of Laboratory Medicine & Pathology; Hennepin County Medical Center; 701 Park Avenue Minneapolis MN
- Department of Laboratory Medicine & Pathology; University of Minnesota; 420 Delaware Street SE Minneapolis MN
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Abstract
This paper is the thirty-seventh consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2014 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (endogenous opioids and receptors), and the roles of these opioid peptides and receptors in pain and analgesia (pain and analgesia); stress and social status (human studies); tolerance and dependence (opioid mediation of other analgesic responses); learning and memory (stress and social status); eating and drinking (stress-induced analgesia); alcohol and drugs of abuse (emotional responses in opioid-mediated behaviors); sexual activity and hormones, pregnancy, development and endocrinology (opioid involvement in stress response regulation); mental illness and mood (tolerance and dependence); seizures and neurologic disorders (learning and memory); electrical-related activity and neurophysiology (opiates and conditioned place preferences (CPP)); general activity and locomotion (eating and drinking); gastrointestinal, renal and hepatic functions (alcohol and drugs of abuse); cardiovascular responses (opiates and ethanol); respiration and thermoregulation (opiates and THC); and immunological responses (opiates and stimulants). This paper is the thirty-seventh consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2014 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (endogenous opioids and receptors), and the roles of these opioid peptides and receptors in pain and analgesia (pain and analgesia); stress and social status (human studies); tolerance and dependence (opioid mediation of other analgesic responses); learning and memory (stress and social status); eating and drinking (stress-induced analgesia); alcohol and drugs of abuse (emotional responses in opioid-mediated behaviors); sexual activity and hormones, pregnancy, development and endocrinology (opioid involvement in stress response regulation); mental illness and mood (tolerance and dependence); seizures and neurologic disorders (learning and memory); electrical-related activity and neurophysiology (opiates and conditioned place preferences (CPP)); general activity and locomotion (eating and drinking); gastrointestinal, renal and hepatic functions (alcohol and drugs of abuse); cardiovascular responses (opiates and ethanol); respiration and thermoregulation (opiates and THC); and immunological responses (opiates and stimulants).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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21
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Pearson J, Poklis J, Poklis A, Wolf C, Mainland M, Hair L, Devers K, Chrostowski L, Arbefeville E, Merves M. Postmortem Toxicology Findings of Acetyl Fentanyl, Fentanyl, and Morphine in Heroin Fatalities in Tampa, Florida. Acad Forensic Pathol 2015; 5:676-689. [PMID: 29034049 DOI: 10.23907/2015.072] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In the last two years, an epidemic of 40 fatal heroin overdose cases has occurred in the Tampa area of Florida. Of these cases, 14 involved fentanyl and acetyl fentanyl. Victim demographics, case histories, toxicology findings, and causes and manners of death for all 40 deaths are presented. In 26 deaths in which acetyl fentanyl or fentanyl were not involved, free and total peripheral blood morphine concentrations were consistent with fatal heroin intoxications, averaging 0.16 mg/L and 0.35 mg/L, respectively. In the heroin cases with fentanyl present (n=7), the average free morphine concentration was 0.040 mg/L, the average total morphine concentration was 0.080 mg/L, and the average fentanyl concentration was 0.012 mg/L. In the cases with heroin, fentanyl, and acetyl fentanyl (n=3), the average free morphine concentration was 0.010 mg/L, the average total morphine concentration was 0.030 mg/L, the average fentanyl concentration was 0.018 mg/L, and the average acetyl fentanyl concentration was 0.008 mg/L. In the cases involving only acetyl fentanyl (without heroin or fentanyl, n=4), the average acetyl fentanyl concentration was 0.47 mg/L and the average acetyl norfentanyl concentration was 0.053 mg/L. The presented cases, with associated drug concentrations, case histories, demographics, and causes and manners of death may help provide assistance with the interpretation of the postmortem findings. Based on case circumstances, autopsy results, and toxicology results, it is evident that fentanyl and/or acetyl fentanyl, when present, contributed to the cause of death.
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Affiliation(s)
| | - Justin Poklis
- Department of Pharmacology and Toxicology, Virginia Commonwealth University
| | - Alphonse Poklis
- Department of Pharmacology and Toxicology, Department of Pathology, and Department of Forensic Science, Virginia Commonwealth University
| | - Carl Wolf
- Department of Pathology, and Department of Forensic Science, Virginia Commonwealth University
| | | | - Laura Hair
- Hillsborough County Medical Examiner Department
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22
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Baillif-Couniou V, Kintz P, Sastre C, Pok PRP, Chèze M, Pépin G, Leonetti G, Pelissier-Alicot AL. Hair testing in postmortem diagnosis of substance abuse: An unusual case of slow-release oral morphine abuse in an adolescent. J Forensic Leg Med 2015; 36:172-6. [DOI: 10.1016/j.jflm.2015.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 08/24/2015] [Accepted: 08/27/2015] [Indexed: 10/23/2022]
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23
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Bévalot F, Cartiser N, Bottinelli C, Fanton L, Guitton J. Vitreous humor analysis for the detection of xenobiotics in forensic toxicology: a review. Forensic Toxicol 2015; 34:12-40. [PMID: 26793276 PMCID: PMC4705140 DOI: 10.1007/s11419-015-0294-5] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 09/21/2015] [Indexed: 01/10/2023]
Abstract
Vitreous humor (VH) is a gelatinous substance contained in the posterior chamber of the eye, playing a mechanical role in the eyeball. It has been the subject of numerous studies in various forensic applications, primarily for the assessment of postmortem interval and for postmortem chemical analysis. Since most of the xenobiotics present in the bloodstream are detected in VH after crossing the selective blood-retinal barrier, VH is an alternative matrix useful for forensic toxicology. VH analysis offers particular advantages over other biological matrices: it is less prone to postmortem redistribution, is easy to collect, has relatively few interfering compounds for the analytical process, and shows sample stability over time after death. The present study is an overview of VH physiology, drug transport and elimination. Collection, storage, analytical techniques and interpretation of results from qualitative and quantitative points of view are dealt with. The distribution of xenobiotics in VH samples is thus discussed and illustrated by a table reporting the concentrations of 106 drugs from more than 300 case reports. For this purpose, a survey was conducted of publications found in the MEDLINE database from 1969 through April 30, 2015.
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Affiliation(s)
- Fabien Bévalot
- Laboratoire LAT LUMTOX, 71 Avenue Rockefeller, 69003 Lyon, France.,Institut de Médecine Légale, Université de Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, 8 Avenue Rockefeller, 69373 Lyon Cedex 08, France
| | - Nathalie Cartiser
- Laboratoire de Toxicologie, ISPB-Faculté de Pharmacie, Université de Lyon, Université Claude Bernard Lyon 1, 8 Avenue Rockefeller, 69373 Lyon Cedex 08, France
| | | | - Laurent Fanton
- Département de Médecine Légale, Hôpital Edouard-Herriot, Hospices Civils de Lyon, Place D'Arsonval, 69437 Lyon Cedex 03, France.,CREATIS CNRS UMR 5220, INSERM U1044, Université de Lyon, Université Claude Bernard Lyon 1, INSA Lyon, 7 Avenue Jean Capelle, 69621 Villeurbanne Cedex, France
| | - Jérôme Guitton
- Laboratoire de Toxicologie, ISPB-Faculté de Pharmacie, Université de Lyon, Université Claude Bernard Lyon 1, 8 Avenue Rockefeller, 69373 Lyon Cedex 08, France.,Laboratoire de Pharmacologie-Toxicologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 165 Chemin Grand Revoyet, 69495 Pierre Bénite Cedex, France
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Langford AM, Bolton JR, Carlin MG, Palmer R. Post-mortem toxicology: A pilot study to evaluate the use of a Bayesian network to assess the likelihood of fatality. J Forensic Leg Med 2015; 33:82-90. [DOI: 10.1016/j.jflm.2015.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 04/22/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022]
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25
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Postmortem redistribution of the heroin metabolites morphine and morphine-3-glucuronide in rabbits over 24 h. Int J Legal Med 2015; 130:519-31. [DOI: 10.1007/s00414-015-1185-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 03/24/2015] [Indexed: 10/23/2022]
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26
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Bévalot F, Cartiser N, Bottinelli C, Fanton L, Guitton J. Correlation of bile and vitreous humor concentrations with blood drug concentrations for forensic interpretation: a comparative study between animal experimental and human postmortem data. Forensic Toxicol 2014. [DOI: 10.1007/s11419-014-0261-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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27
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Monteil-Ganiere C, Gaulier JM, Chopineaux D, Barrios L, Pineau A, Dailly É, Clément R. Fatal anoxia due to rachacha consumption: Two cases reported. Forensic Sci Int 2014; 245:e1-5. [DOI: 10.1016/j.forsciint.2014.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 09/13/2014] [Accepted: 09/16/2014] [Indexed: 11/30/2022]
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28
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Pharmacokinetic interactions between ethanol and heroin: A study on post-mortem cases. Forensic Sci Int 2014; 242:127-134. [DOI: 10.1016/j.forsciint.2014.06.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 06/20/2014] [Accepted: 06/27/2014] [Indexed: 12/22/2022]
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29
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Bévalot F, Bottinelli C, Cartiser N, Fanton L, Guitton J. Quantification of Five Compounds with Heterogeneous Physicochemical Properties (Morphine, 6-Monoacetylmorphine, Cyamemazine, Meprobamate and Caffeine) in 11 Fluids and Tissues, Using Automated Solid-Phase Extraction and Gas Chromatography–Tandem Mass Spectrometry. J Anal Toxicol 2014; 38:256-64. [DOI: 10.1093/jat/bku029] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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