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Fernández-López L, Mancini R, Rotolo MC, Navarro-Zaragoza J, Hernández del Rincón JP, Falcón M. Carbamazepine Overdose after Psychiatric Conditions: A Case Study for Postmortem Analysis in Human Bone. TOXICS 2022; 10:toxics10060322. [PMID: 35736930 PMCID: PMC9228211 DOI: 10.3390/toxics10060322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 12/07/2022]
Abstract
Carbamazepine is the main option used as a preventive medication to treat bipolar disorder when there is no response to lithium. Carbamazepine toxicity is defined as serum levels greater than 12 μg/mL, with severe toxicity occurring over 40 μg/mL, reduced to 30 μg/mL when combined with pharmacological treatment, i.e., benzodiazepines or antidepressants. For these reasons, it is necessary to find a validated tool to determine carbamazepine levels in an autopsy to rule out suicide or to know if the death was a consequence of an adverse drug reaction (ADR), especially when only bones can be accessed. We have validated a tool to detect and quantify drug concentration in bone. Our results showed a peak for carbamazepine at minute 12 and a mass fragment of 193 m/z. This case study is the first time in the literature that carbamazepine has been detected and quantified in bone. These results demonstrate that carbamazepine can be detected in bone tissue from forensic cases, but almost more importantly, that the method proposed is valid, reliable, and trustworthy.
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Affiliation(s)
- Lucia Fernández-López
- Department of Pharmacology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain;
- Instituto Murciano de Investigación Biosanitaria IMIB-Arrixaca, 30120 Murcia, Spain;
| | - Rosanna Mancini
- National Centre on Drug Addiction and Doping, Istituto Superior di Sanitá, 00161 Rome, Italy; (R.M.); (M.-C.R.)
| | - Maria-Concetta Rotolo
- National Centre on Drug Addiction and Doping, Istituto Superior di Sanitá, 00161 Rome, Italy; (R.M.); (M.-C.R.)
| | - Javier Navarro-Zaragoza
- Department of Pharmacology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain;
- Instituto Murciano de Investigación Biosanitaria IMIB-Arrixaca, 30120 Murcia, Spain;
- Correspondence: ; Tel.: +34-868889286
| | | | - Maria Falcón
- Instituto Murciano de Investigación Biosanitaria IMIB-Arrixaca, 30120 Murcia, Spain;
- Forensic and Legal Medicine, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain;
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2
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Vandenbosch M, Pajk S, Van Den Bogaert W, Wuestenbergs J, Van de Voorde W, Cuypers E. Post Mortem Analysis of Opioids and Metabolites in Skeletal Tissue. J Anal Toxicol 2021; 46:783-790. [PMID: 34480794 PMCID: PMC9375233 DOI: 10.1093/jat/bkab095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/20/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022] Open
Abstract
Every year, thousands of suspicious deaths are accounted for by an overdose of opioids. Occasionally all traditional matrices are unavailable due to decomposition. Skeletal tissue may pose a valid alternative. However, reference data on postmortem concentrations in bone tissue and bone marrow (BM) is sparse. Therefore, a liquid chromatography--tandem mass spectrometry method was developed and fully validated for the analysis of four opioids and two metabolites (tramadol, O-desmethyltramadol, morphine, fentanyl, norfentanyl, codeine) in bone tissue and BM. Sample preparation was performed using solid phase extraction (BM), methanolic extraction (bone) and a protein precipitation (whole blood). All validation parameters were successfully fulfilled. This method was applied to analyze 22 forensic cases involving opioids. All six opioids were proven to be detectable and quantifiable in all specimens sampled. When tramadol blood concentrations were correlated with bone concentrations, a linear trend could be detected. The same was seen between tramadol blood and BM concentration. A similar linear trend was seen when correlating codeine blood concentration with bone and BM concentration. Although some variability was detected, the same linear trend was seen for morphine. For fentanyl and norfentanyl, the sample size was too small to draw conclusions, regarding correlation. As far as the authors know this is the first-time fentanyl and norfentanyl are quantified in skeletal tissue. In conclusion, due to the absence of reference data for drugs in skeletal tissue, these findings are a step forward toward a more thorough understanding of drug concentration found in postmortem skeletal tissue.
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Affiliation(s)
- Michiel Vandenbosch
- KU Leuven Toxicology and Pharmacology, Campus Gasthuisberg, Onderwijs en Navorsing 2, Herestraat 49, PO box 922, 3000 Leuven, Belgium.,Maastricht University, M4I Institute, Division of Imaging Mass Spectrometry, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands
| | - Stane Pajk
- KU Leuven Toxicology and Pharmacology, Campus Gasthuisberg, Onderwijs en Navorsing 2, Herestraat 49, PO box 922, 3000 Leuven, Belgium.,University of Ljubljana, Faculty of Pharmacy, Aškerčeva 7, SI-1000 Ljubljana, Slovenia
| | - Wouter Van Den Bogaert
- KU Leuven, Imaging and Pathology Department, Division Forensic Biomedical Sciences, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Joke Wuestenbergs
- KU Leuven, Imaging and Pathology Department, Division Forensic Biomedical Sciences, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Wim Van de Voorde
- KU Leuven, Imaging and Pathology Department, Division Forensic Biomedical Sciences, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Eva Cuypers
- KU Leuven Toxicology and Pharmacology, Campus Gasthuisberg, Onderwijs en Navorsing 2, Herestraat 49, PO box 922, 3000 Leuven, Belgium.,Maastricht University, M4I Institute, Division of Imaging Mass Spectrometry, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands
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3
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Iskierka M, Zawadzki M, Szpot P, Jurek T. Detection of Drugs in Postmortem Specimens of Blood, Vitreous Humor and Bone Marrow Aspirate. J Anal Toxicol 2021; 45:348-355. [PMID: 32672811 DOI: 10.1093/jat/bkaa083] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/21/2020] [Accepted: 07/01/2020] [Indexed: 11/12/2022] Open
Abstract
In case of basic biological materials (blood, urine, vitreous humor) being unavailable, bone marrow can be used for toxicological tests. The aim of the study was to assess the concentration of various xenobiotics in the bone marrow, as well as in the blood and the vitreous humor. The analysis was performed in the biological material originating from the autopsy (n = 120), using the LC-MS method and with liquid/liquid extraction at pH = 9. As many as 46 different xenobiotics were detected in the biological material, strong correlations between the concentration of a given xenobiotic in blood and bone marrow, as well as in the vitreous humor and bone marrow, were noted for most of them, with the exception of diazepam and 7-aminoclonazepam. The obtained results indicate the possibility of using bone marrow to determine the concentration of numerous xenobiotics in the situation of basic biological materials being unavailable, as well as using the results obtained in the future to better understand the pharmacokinetic processes and the effect of postmortem redistribution on medication and drug concentrations in the body of a deceased person.
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Affiliation(s)
- M Iskierka
- Department of Forensic Medicine, Wroclaw Medical University, J. Mikulicza-Radeckiego 4 50-367 Wrocław 71 784 14 58, Poland
| | - M Zawadzki
- Department of Forensic Medicine, Wroclaw Medical University, J. Mikulicza-Radeckiego 4 50-367 Wrocław 71 784 14 58, Poland
| | - P Szpot
- Department of Forensic Medicine, Wroclaw Medical University, J. Mikulicza-Radeckiego 4 50-367 Wrocław 71 784 14 58, Poland
| | - T Jurek
- Department of Forensic Medicine, Wroclaw Medical University, J. Mikulicza-Radeckiego 4 50-367 Wrocław 71 784 14 58, Poland
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4
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Mancini R, Fernadez-Lopez L, Falcon M, Pellegrini M, Luna A, Rotolo M. Postmortem Analysis of Benzodiazepines in Human Bone by Gas Chromatography-Mass Spectrometry. J Anal Toxicol 2021; 44:985-992. [PMID: 32453428 DOI: 10.1093/jat/bkaa020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 11/06/2019] [Accepted: 11/29/2019] [Indexed: 11/12/2022] Open
Abstract
A procedure based on gas chromatography-mass spectrometry was developed for the analysis of benzodiazepines (nordiazepam, oxazepam, lormetazepam, lorazepam, clonazepam, bromazepam and alprazolam) in postmortem human ribs. Powdered bone samples, including marrow remains inside, with the internal standard diazepam-d5 were subjected to enzymatic hydrolysis with 100 μL of β-glucoronidase and were incubated in sodium hydroxide for 1 h in a 70°C oven. Samples underwent liquid phase extraction and ethyl acetate was used as eluent. Chromatography was performed on a fused silica capillary column and the selected-ion-monitoring mode was used for analytes determination. The method was validated in the range 0.1-0.5 ng/mg (depending on the benzodiazepine) to 100 ng/mg with average values of recovery, matrix effect and process efficiency ranged from 83.2 to 94.3%, from 97.3 to 102.1% and from 80.5 to 91.2%, respectively. The intra- and inter-day accuracy was <15%. The procedure was tested in rib specimens obtained during routine autopsies from 20 cases where these benzodiazepines were found in blood. Benzodiazepines were detected in the combined bone and marrow samples in 60% of cases. Lorazepam was detected in bone in the range of 0.3-0.7 ng/mg, nordiazepam at 1.3-4.2 ng/mg and oxazepam at 1.1-1.2 ng/mg. To our knowledge, this protocol for the simultaneous analysis of these benzodiazepines is the first performed and validated using human ribs.
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Affiliation(s)
- Rosanna Mancini
- Istituto Superiore di Sanità, Analytical Pharmacotoxicology, Viale Regina Elena, 299, 00161 Roma, Italy
| | - Lucia Fernadez-Lopez
- University of Murcia, Department of Legal and Forensic Medicine, Calle Campus Universitario, 11, 30100 Murcia, Spain
| | - Maria Falcon
- University of Murcia, Department of Legal and Forensic Medicine, Calle Campus Universitario, 11, 30100 Murcia, Spain
| | - Manuela Pellegrini
- Istituto Superiore di Sanità, Analytical Pharmacotoxicology, Viale Regina Elena, 299, 00161 Roma, Italy
| | - Aurelio Luna
- University of Murcia, Department of Legal and Forensic Medicine, Calle Campus Universitario, 11, 30100 Murcia, Spain
| | - Maria Rotolo
- Istituto Superiore di Sanità, Analytical Pharmacotoxicology, Viale Regina Elena, 299, 00161 Roma, Italy
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5
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Postmortem analysis of quetiapine and pregabalin in human bone. Leg Med (Tokyo) 2020; 46:101717. [PMID: 32442861 DOI: 10.1016/j.legalmed.2020.101717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/11/2020] [Accepted: 05/06/2020] [Indexed: 11/23/2022]
Abstract
In this study quetiapine and pregabalin were analyzed in human bones. A method previously developed for the determination of antidepressants in human bone was tested for the analysis of these two substances. Bones were pulverized and subjected to the extraction protocol, and after undergoing solid-phase extraction, samples were analyzed using gas chromatography-mass spectrometry. The assay was validated in the range 0.3-500 ng/mg, mean analytical recovery was 76.9% for quetiapine and 90.9% for pregabalin, matrix effect was 83% for quetiapine and 91% for pregabalin and process efficiency was 63.8% for quetiapine and 82.7% for pregabalin. The intra- and inter-day precision was below 3% in all cases and the intra- and inter-assay accuracy values were in almost all cases better than 12%. The validated method was then applied to bone samples from forensic cases. Drugs were detected in bone in 2 of the 3 blood positive cases. The approximate concentrations in bone were 40 ng/mg for pregabalin and 7 ng/mg for quetiapine. To our knowledge, this is the first time these substances were detected in bones. With this study the number of substances with a validated protocol to be used in human bones in case of necessity is expanded.
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6
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Vandenbosch M, Rooseleers L, Van Den Bogaert W, Wuestenbergs J, Van de Voorde W, Cuypers E. Skeletal tissue, a viable option in forensic toxicology? A view into post mortem cases. Forensic Sci Int 2020; 309:110225. [PMID: 32146303 DOI: 10.1016/j.forsciint.2020.110225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 02/12/2020] [Accepted: 02/27/2020] [Indexed: 11/30/2022]
Abstract
Blood analysis is the golden standard in the field of forensic toxicology. However, when extended decomposition of the remains has occurred, alternative matrices are required. Skeletal tissue may provide an appropriate sample of choice since it is very resistant to putrefaction. However, today, the absence of reference data of drug concentrations in skeletal tissue poses a problem to meaningfully and reliably conduct toxicological testing on human skeletal material. The present study investigates the viability of skeletal tissue as an alternative matrix to evaluate xenobiotic consumption in legal cases. Blood, bone tissue and bone marrow of different forensic cases were screened for 415 compounds of forensic interest. Afterwards, methadone, clomipramine, citalopram and their respectively metabolites positive samples were quantified using fully validated methods. Sample preparation was carried out by SPE (whole blood and bone marrow), methanol extraction (bone sections) or protein precipitation (whole blood). All samples were analyzed using liquid chromatography coupled to a triple quad mass spectrometer. Multiple drugs were successfully identified in all sampled matrices. In bone (marrow) not as many substances were detected as in blood but it poses a valid alternative when blood is not available. Especially bone marrow showed big potential with a concordance of 80.5% with blood. Clomipramine, citalopram and their metabolites were proven to be detectable and quantifiable in all specimens sampled. Bone marrow showed the highest concentrations followed by blood and bone tissue. When citalopram blood concentrations were correlated with the bone concentrations, a linear trend could be detected. The same was seen between blood and bone marrow for citalopram concentrations. Methadone was also proven to be detectable in all specimens sampled. However, its metabolites EMDP and EDPP were absent or below the LOD in some samples. Overall, methadone concentrations were higher in bone marrow than in bone. With exception of one case, blood concentrations were higher than bone concentrations. For methadone, a linear trend could be found between blood and bone concentration. Comparing methadone concentrations in blood and bone marrow an exponential trend could be seen. In conclusion, these findings show the potential forensic value of bone and bone marrow as an alternative matrix. Aside to that, a standard protocol for the sample collection and processing is proposed.
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Affiliation(s)
- Michiel Vandenbosch
- KU Leuven Toxicology and Pharmacology, Campus Gasthuisberg, Onderwijs en Navorsing 2, Herestraat 49, PO Box 922, 3000 Leuven, Belgium
| | - Lukas Rooseleers
- KU Leuven Toxicology and Pharmacology, Campus Gasthuisberg, Onderwijs en Navorsing 2, Herestraat 49, PO Box 922, 3000 Leuven, Belgium
| | - Wouter Van Den Bogaert
- KU Leuven, Imaging and Pathology Department, Division Forensic Biomedical Sciences, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Joke Wuestenbergs
- KU Leuven, Imaging and Pathology Department, Division Forensic Biomedical Sciences, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Wim Van de Voorde
- KU Leuven, Imaging and Pathology Department, Division Forensic Biomedical Sciences, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000 Leuven, Belgium
| | - Eva Cuypers
- KU Leuven Toxicology and Pharmacology, Campus Gasthuisberg, Onderwijs en Navorsing 2, Herestraat 49, PO Box 922, 3000 Leuven, Belgium; Maastricht University, M4I Institute, Division of Imaging Mass Spectrometry, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands.
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7
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Cornthwaite HM, McDonald CS, Watterson JH. Analysis of Dextromethorphan and Three Metabolites in Decomposed Skeletal Tissues by UPLC-QToF-MS: Comparison of Acute and Repeated Drug Exposures. J Anal Toxicol 2019; 43:726-733. [PMID: 31504591 DOI: 10.1093/jat/bkz074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/31/2019] [Accepted: 06/06/2019] [Indexed: 11/14/2022] Open
Abstract
Ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-QToF-MS) analysis of dextromethorphan (DXM) and its metabolites-dextrorphan, 3-methoxymorphinan (3-MEM) and 3-hydroxymorphinan-in skeletal remains of rats exposed to DXM under different dosing patterns is described. Rats (n = 20) received DXM in one of four dosing patterns: acute (ACU1 or ACU2-100 or 200 mg/kg, i.p.; n = 5, respectively) or repeated (REP1 or REP2-3 doses of 25 or 50 mg/kg, i.p., 30 min apart; n = 5, respectively). Drug-free animals (n = 5) served as negative controls. Following euthanasia, the animals decomposed to skeleton outdoors. Bones were sorted by animal and skeletal element (vertebra, femur, pelvis, tibia, rib and skull), washed, air-dried and pulverized prior to dynamic methanolic drug extraction, filtration/pass-through extraction and analysis by UPLC-QToF-MS in positive electrospray ionization mode. Analyte levels (expressed as mass-normalized response ratios, RR/m) differed significantly between ACU1 and ACU2 (Mann-Whitney (MW), P < 0.05) in all skeletal elements for all analytes investigated, and between REP1 and REP2 in most skeletal elements for 3-MEM and 3-HOM, but in all skeletal elements for DXM. Between ACU1 and ACU2, and between REP1 and REP2, analyte level ratios (RRi/RRj) differed significantly (MW, P < 0.05) in 3/6 to 6/6 skeletal elements, depending on the ratios concerned, with no analyte level ratio differing significantly between both ACU1 vs ACU2 and REP1 vs REP2. Kruskal-Wallis (KW) analysis showed skeletal element to be a main effect for all analyte levels and analyte level ratios in all ACU and REP groups examined (P < 0.05). For data pooled only according to exposure pattern, KW analysis showed dose pattern to be a main effect for both analyte levels and analyte level ratios (P < 0.05). These data illustrate a dependence of these measures on dose, dose pattern and skeletal element, suggesting that some exposure patterns may be distinguished by toxicological analysis of bone.
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Affiliation(s)
- Heather M Cornthwaite
- Department of Chemistry and Biochemistry, Laurentian University, 935 Ramsey Lake Rd, Sudbury, Ontario P3E 2C6, Canada
| | - Claire S McDonald
- Department of Forensic Science, Laurentian University, 935 Ramsey Lake Rd, Sudbury, Ontario P3E 2C6, Canada
| | - James H Watterson
- Department of Chemistry and Biochemistry, Laurentian University, 935 Ramsey Lake Rd, Sudbury, Ontario P3E 2C6, Canada.,Department of Forensic Science, Laurentian University, 935 Ramsey Lake Rd, Sudbury, Ontario P3E 2C6, Canada
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8
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Fernandez-Lopez L, Pellegrini M, Rotolo MC, Luna A, Falcon M, Mancini R. Development and Validation of a Method for the Analysis of Bisoprolol and Atenolol in Human Bone. Molecules 2019; 24:E2400. [PMID: 31261852 PMCID: PMC6651798 DOI: 10.3390/molecules24132400] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 06/24/2019] [Indexed: 11/24/2022] Open
Abstract
A method based on gas chromatography-mass spectrometry (GC-MS) is described for the determination of bisoprolol and atenolol in human bone. After the addition of lobivolol as internal standard, pulverized samples were incubated in acetonitrile for 1 h under ultrasounds. After adjusting the pH of the samples to 6, they were centrifuged, and the supernatants were subjected to solid phase extraction. Elution was achieved by using 3 mL of 2% ammonium hydroxide in 80:20 dichloromethane:isopropanol solution. Eluted samples were evaporated and derivatized. Chromatography was performed on a fused silica capillary column and analytes were determined in the selected-ion-monitoring (SIM) mode. The assay was validated in the range 0.1-0.3 ng/mg (depending on the drug) to 150 ng/mg, the mean absolute recoveries were 60% for bisoprolol and 106% for atenolol, the matrix effect was 69% for bisoprolol and 70% for atenolol and process efficiency was 41% for bisoprolol and 80% for atenolol. The intra- and inter-assay accuracy values were always better than 12%. The validated method was then applied to bone samples from two real forensic cases in which toxicological analysis in blood were positive for atenolol in the first case (0.65 µg/mL) and bisoprolol in the second case (0.06 µg/mL). Atenolol was found in bone samples from the corresponding case at the approximate concentration of 148 ng/mg and bisoprolol was found at 8 ng/mg.
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Affiliation(s)
- Lucia Fernandez-Lopez
- Legal and Forensic Medicine, School of Medicine, University of Murcia,30100 Murcia, Spain
| | - Manuela Pellegrini
- National Centre on Drug Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Maria Concetta Rotolo
- National Centre on Drug Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Aurelio Luna
- Legal and Forensic Medicine, School of Medicine, University of Murcia,30100 Murcia, Spain
| | - Maria Falcon
- Legal and Forensic Medicine, School of Medicine, University of Murcia,30100 Murcia, Spain.
| | - Rosanna Mancini
- National Centre on Drug Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy
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9
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Fernandez-Lopez L, Pellegrini M, Rotolo MC, Luna Maldonado A, Falcon M, Mancini R. Development and validation of a method for analysing of duloxetine, venlafaxine and amitriptyline in human bone. Forensic Sci Int 2019; 299:154-160. [DOI: 10.1016/j.forsciint.2019.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/18/2019] [Accepted: 04/01/2019] [Indexed: 10/27/2022]
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10
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Vandenbosch M, Somers T, Cuypers E. Distribution of clomipramine, citalopram, midazolam, and metabolites in skeletal tissue after chronic dosing in rats. Drug Test Anal 2019; 11:1083-1093. [PMID: 30817095 DOI: 10.1002/dta.2578] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/13/2019] [Accepted: 02/22/2019] [Indexed: 11/07/2022]
Abstract
In recent years, the use of skeletal tissue as an alternative matrix in forensic toxicology has received new interest. In cases where extreme decomposition has taken place, analysis of skeletal tissue is often the only option left. In this article, a fully validated method is presented and the distribution of clomipramine, citalopram, midazolam, and metabolites after chronically administration is examined within skeletal tissue. Rats were chronically dosed with respectively clomipramine, citalopram, or midazolam. Extracts were quantitatively analyzed using liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS). Clomipramine, citalopram, and metabolites, respectively desmethylclomipramine and desmethylcitalopram are shown to be detectable in all bone types sampled. Midazolam and its metabolite α-OH-midazolam could not be detected. The absence of midazolam in extracts gives an indication that drugs with pKa values under physiological pH are badly or not incorporated in bone tissue. Bone and post-mortem blood concentrations were compared. A range of different bone types was compared and showed that the concentration is strongly dependent on the bone type. In concordance with previous publications, the humerus shows the highest drug levels. Skeletal tissue concentrations found ranged from 1.1 to 587.8 ng/g. Comparison of the same bone type between the different rats showed high variances. However, the drugs-metabolite ratio proved to have lower variances (<20%). Moreover, the drugs-metabolite ratio in the sampled bones is in close concordance to the ratios seen in blood within a rat. From this, we can assume that the drugs-metabolite ratio in skeletal tissue may prove to be more useful than absolute found concentration.
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Affiliation(s)
| | - Tomas Somers
- Toxicology and Pharmacology, KU Leuven, Leuven, Belgium
| | - Eva Cuypers
- Toxicology and Pharmacology, KU Leuven, Leuven, Belgium
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11
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Fernandez-Lopez L, Luna-Maldonado A, Falcon M, Mastrobattista L, Navarro-Zaragoza J, Mancini R. Development and validation of a gas chromatography–mass spectrometry method for opiates and cocaine in human bone. J Pharm Biomed Anal 2019; 164:636-641. [DOI: 10.1016/j.jpba.2018.11.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/25/2018] [Accepted: 11/05/2018] [Indexed: 10/27/2022]
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12
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The current state and future directions of skeletal toxicology: Forensic and humanitarian implications of a proposed model for the in vivo incorporation of drugs into the human skeleton. Forensic Sci Int 2018; 289:419-428. [DOI: 10.1016/j.forsciint.2018.06.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/04/2018] [Accepted: 06/17/2018] [Indexed: 11/19/2022]
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13
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Vandenbosch M, Somers T, Cuypers E. Distribution of Methadone and Metabolites in Skeletal Tissue. J Anal Toxicol 2018; 42:400-408. [DOI: 10.1093/jat/bky014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 02/08/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Michiel Vandenbosch
- Toxicology and Pharmacology, KU Leuven, Campus Gasthuisberg O&N2, Herestraat 49, PO Box 922, 3000 Leuven, Belgium
| | - Tomas Somers
- Toxicology and Pharmacology, KU Leuven, Campus Gasthuisberg O&N2, Herestraat 49, PO Box 922, 3000 Leuven, Belgium
| | - Eva Cuypers
- Toxicology and Pharmacology, KU Leuven, Campus Gasthuisberg O&N2, Herestraat 49, PO Box 922, 3000 Leuven, Belgium
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14
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Mella M, Schweitzer B, Mallet CR, Moore T, Botch-Jones S. Detection of Cocaine and Metabolites in Bone Following Decomposition Using 2D LC–MS-MS. J Anal Toxicol 2017; 42:265-275. [DOI: 10.1093/jat/bkx106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 12/07/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Malorie Mella
- Department of Anatomy and Neurobiology, Biomedical Forensic Sciences, Boston University School of Medicine, 72 E. Concord St, L805C, Boston, MA 02118, USA
| | - Brendan Schweitzer
- Department of Anatomy and Neurobiology, Biomedical Forensic Sciences, Boston University School of Medicine, 72 E. Concord St, L805C, Boston, MA 02118, USA
| | - Claude R Mallet
- Separation Technologies, Waters Corporation, 34 Maple Street, Milford, MA 01757, USA
| | - Tara Moore
- Department of Anatomy and Neurobiology, Forensic Anthropology, Boston University School of Medicine, 72 E. Concord St, L805C, Boston, MA 02118, USA
| | - Sabra Botch-Jones
- Department of Anatomy and Neurobiology, Biomedical Forensic Sciences, Boston University School of Medicine, 72 E. Concord St, L805C, Boston, MA 02118, USA
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15
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Morrison LM, Unger KA, Watterson JH. Analysis of Dextromethorphan and Dextrorphan in Skeletal Remains Following Differential Microclimate Exposure: Comparison of Acute vs. Repeated Drug Exposure. J Anal Toxicol 2017; 41:566-572. [DOI: 10.1093/jat/bkx040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 06/01/2017] [Indexed: 11/14/2022] Open
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16
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Unger KA, Watterson JH. Analysis of Dextromethorphan and Dextrorphan in Skeletal Remains Following Decomposition in Different Microclimate Conditions. J Anal Toxicol 2016; 40:669-676. [DOI: 10.1093/jat/bkw083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 05/30/2016] [Indexed: 01/26/2023] Open
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17
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Persona K, Madej K, Knihnicki P, Piekoszewski W. Analytical methodologies for the determination of benzodiazepines in biological samples. J Pharm Biomed Anal 2015; 113:239-64. [DOI: 10.1016/j.jpba.2015.02.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 02/05/2015] [Accepted: 02/09/2015] [Indexed: 10/24/2022]
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18
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Fraser CD, Cornthwaite HM, Watterson JH. Analysis of dextromethorphan and dextrorphan in decomposed skeletal tissues by microwave assisted extraction, microplate solid-phase extraction and gas chromatography- mass spectrometry (MAE-MPSPE-GCMS). Drug Test Anal 2014; 7:708-13. [DOI: 10.1002/dta.1754] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 10/23/2014] [Accepted: 10/24/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Candice D. Fraser
- Department of Forensic Science; Laurentian University; 935 Ramsey Lake Rd Sudbury Ontario P3L 1C6 Canada
| | - Heather M. Cornthwaite
- Department of Chemistry & Biochemistry; Laurentian University; 935 Ramsey Lake Rd Sudbury Ontario P3L 1C6 Canada
| | - James H. Watterson
- Department of Forensic Science; Laurentian University; 935 Ramsey Lake Rd Sudbury Ontario P3L 1C6 Canada
- Department of Chemistry & Biochemistry; Laurentian University; 935 Ramsey Lake Rd Sudbury Ontario P3L 1C6 Canada
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19
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Analysis of tramadol and O -desmethyltramadol in decomposed skeletal tissues following acute and repeated tramadol exposure by gas chromatography mass spectrometry. Forensic Sci Int 2014; 242:261-265. [DOI: 10.1016/j.forsciint.2014.07.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 06/28/2014] [Accepted: 07/11/2014] [Indexed: 11/21/2022]
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20
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Vardakou I, Athanaselis S, Pistos C, Papadodima S, Spiliopoulou C, Moraitis K. The clavicle bone as an alternative matrix in forensic toxicological analysis. J Forensic Leg Med 2014; 22:7-9. [DOI: 10.1016/j.jflm.2013.11.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 10/24/2013] [Accepted: 11/25/2013] [Indexed: 11/26/2022]
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21
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Postmortem bone marrow analysis in forensic science: Study of 73 cases and review of the literature. Forensic Sci Int 2014; 234:72-8. [DOI: 10.1016/j.forsciint.2013.10.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Revised: 06/01/2013] [Accepted: 10/28/2013] [Indexed: 12/19/2022]
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22
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Lodha A, Pandya A, Sutariya PG, Menon SK. A smart and rapid colorimetric method for the detection of codeine sulphate, using unmodified gold nanoprobe. RSC Adv 2014. [DOI: 10.1039/c4ra06269h] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Herein, we reported unique optical and electrochemical properties of citrate-stabilized gold nanoparticles (AuNPs) as a probe for smartphone-assisted, on-spot detection of codeine sulphate in toxicological screening with high sensitivity (0.9 μM).
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Affiliation(s)
- Anand Lodha
- Department of Forensic Science
- School of Sciences
- Gujarat University
- Ahmedabad, India
| | - Alok Pandya
- Institute of Life Sciences
- Ahmedabad University
- Ahmedabad, India
| | | | - Shobhana K. Menon
- Department of Forensic Science
- School of Sciences
- Gujarat University
- Ahmedabad, India
- Department of Chemistry
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23
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Discrimination Between Patterns of Drug Exposure by Toxicological Analysis of Decomposed Skeletal Tissues. Part II: Amitriptyline and Citalopram. J Anal Toxicol 2013; 37:565-72. [DOI: 10.1093/jat/bkt078] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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24
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Using bone marrow matrix to analyze meprobamate for forensic toxicological purposes. Int J Legal Med 2013; 127:915-21. [DOI: 10.1007/s00414-013-0833-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 01/29/2013] [Indexed: 11/27/2022]
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25
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Watterson JH, Donohue JP, Betit CC. Comparison of relative distribution of ketamine and norketamine in decomposed skeletal tissues following single and repeated exposures. J Anal Toxicol 2012; 36:429-33. [PMID: 22582220 DOI: 10.1093/jat/bks045] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Bone was analyzed for ketamine and norketamine to examine whether different patterns of drug exposure could be discriminated. Rats received (intraperitoneally) one 75 mg/kg dose (Acute-1 and Acute-2 groups), three 25-mg/kg doses 1 hour apart (Repeated group), or nine single daily ketamine doses of 75 mg/kg followed by a 24-h washout period (Chronic group). Following euthanasia, all animals decomposed to skeleton outdoors. Ground samples of recovered bone underwent methanolic extraction and analysis by gas chromatography-mass spectrometry after solid-phase extraction. Drug levels (mass normalized response ratios) were compared across bone types and exposure pattern. Bone type significantly influenced drug level for the Acute-1 and Repeated dose groups, and the drug/metabolite level ratio (DMLR) for the Acute-1 group. Mean ketamine and norketamine level and DMLR varied by up to 8-fold, 7-fold and 3-fold, respectively, in the Acute-1 group, and by up to 24-fold, 5-fold and 10-fold, respectively, in the Repeated group. Drug level and DMLR differed significantly between the Acute-1 and Repeated groups for most bone types. In the Chronic group, only 1/16 and 4/16 samples were positive for ketamine and norketamine, respectively. All Acute-2 samples were positive for ketamine and norketamine. The Acute-2 and Chronic groups differed significantly in ketamine and norketamine levels, and DMLR.
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Affiliation(s)
- James H Watterson
- Department of Forensic Science, Laurentian University, 935 Ramsey Lake Rd., Sudbury, Ontario, Canada.
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26
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Desrosiers NA, Watterson JH, Dean D, Wyman JF. Detection of Amitriptyline, Citalopram, and Metabolites in Porcine Bones Following Extended Outdoor Decomposition*. J Forensic Sci 2011; 57:544-9. [DOI: 10.1111/j.1556-4029.2011.01994.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Gas chromatography–tandem mass spectrometry assay for the quantification of four benzodiazepines and citalopram in eleven postmortem rabbit fluids and tissues, with application to animal and human samples. J Chromatogr B Analyt Technol Biomed Life Sci 2011; 879:2909-18. [DOI: 10.1016/j.jchromb.2011.08.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 08/15/2011] [Accepted: 08/18/2011] [Indexed: 11/18/2022]
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28
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Pathirana W, Gunasekera SM, Constantine GR, Perera S, Perera BM, Kamaladiwela R. Brain targeted transcranial administration of diazepam and shortening of sleep latency in healthy human volunteers. Indian J Pharm Sci 2011; 73:497-503. [PMID: 22923861 PMCID: PMC3425060 DOI: 10.4103/0250-474x.98985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 08/02/2011] [Accepted: 08/22/2011] [Indexed: 11/04/2022] Open
Abstract
Application of medicated oils on scalp had been practiced for centuries in the Ayurvedic system of medicine in diseases associated with the central nervous system. It is possible that the effectiveness of the therapy may be a result of targeted delivery of active compounds to the brain transcranially. Evidence also comes from two previous studies with positive results on brain targeted transcranial delivery of methadone base and diazepam on rat models. Possibility of transcranial drug delivery was investigated in healthy human volunteers using electroencephalography techniques by assessing the ability of transcranially administered diazepam in bringing about β activity in the electroencephalographic wave patterns and shortening of the sleep latency period. Non polar drug molecules dissolved in a non-aqueous sesame oil based vehicle is a significant feature in the transcranial dosage design. The study was under taken in two phases. In the Phase-I study scalp application of a single dose of 2 mg/3 ml of the oil was employed and in the Phase-II study repeat application of three doses 24 h apart were employed. Sleep latency changes were monitored with Multiple Sleep Latency Tests with 5 naps employing the standard electroencephalography, electroocculography and electromyography electrodes. Sleep onset was identified with the first epoch of any sleep stage non rapid eye movement 1, 2, 3, 4 or rapid eye movement using electroencephalography, electroocculography and electromyography criteria. In both phases of the study there was significant reduction in the sleep latencies. It was much more pronounced in the Phase-II study. None of the subjects however displayed beta activity in the electroencephalography. Sleep latency reduction following scalp application in both the phases are suggestive of transcranial migration of diazepam molecules to the receptor sites of the nerve tissue of the brain eliciting its pharmacological effect of sedation. Transcranial brain targeted dosage design is therefore feasible.
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Affiliation(s)
- W. Pathirana
- Department of Pharmacology and Pharmacy, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo 08, Sri Lanka
| | - S. M. Gunasekera
- Institute of Neurology, National Hospital of Sri Lanka, Colombo 10, Sri Lanka
| | - G. R. Constantine
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo 08, Sri Lanka
| | - Sanja Perera
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo 08, Sri Lanka
| | - B. M. Perera
- Faculty of Medicine, University of Colombo, Kynsey Road, Colombo 08, Sri Lanka
| | - R. Kamaladiwela
- M.S.J.Industries (Ceylon) Ltd, 126 Aluthmawatha Road, Colombo 15, Sri Lanka
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29
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Cartiser N, Bévalot F, Fanton L, Gaillard Y, Guitton J. State-of-the-art of bone marrow analysis in forensic toxicology: a review. Int J Legal Med 2011; 125:181-98. [PMID: 21061013 DOI: 10.1007/s00414-010-0525-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 10/20/2010] [Indexed: 10/18/2022]
Abstract
Although blood is the reference medium in the field of forensic toxicology, alternative matrices are required in case of limited, unavailable or unusable blood samples. The present review investigated the suitability of bone marrow (BM) as an alternative matrix to characterize xenobiotic consumption and its influence on the occurrence of death. Basic data on BM physiology are reported in order to highlight the specificities of this matrix and their analytical and toxicokinetic consequences. A review of case reports, animal and human studies involving BM sample analysis focuses on the various parameters of interpretation of toxicological results: analytic limits, sampling location, pharmacokinetics, blood/BM concentration correlation, stability and postmortem redistribution. Tables summarizing the analytical conditions and quantification of 45 compounds from BM samples provide a useful tool for toxicologists. A specific section devoted to ethanol shows that, despite successful quantification, interpretation is highly dependent on postmortem interval. In conclusion, BM is an interesting alternative matrix, and further experimental data and validated assays are required to confirm its great potential relevance in forensic toxicology.
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Affiliation(s)
- Nathalie Cartiser
- Université de Lyon, Université Claude Bernard Lyon 1, ISPB-Faculté de pharmacie, Laboratoire de Toxicologie, 8 avenue Rockefeller, 69373 Lyon cedex 08, France
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30
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Watterson JH, Desrosiers NA. Examination of the effect of dose-death interval on detection of meperidine exposure in decomposed skeletal tissues using microwave-assisted extraction. Forensic Sci Int 2011; 207:40-5. [DOI: 10.1016/j.forsciint.2010.08.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 08/19/2010] [Accepted: 08/24/2010] [Indexed: 10/19/2022]
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31
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Desrosiers NA, Watterson JH. The effects of burial on drug detection in skeletal tissues. Drug Test Anal 2010; 2:346-56. [DOI: 10.1002/dta.144] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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32
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Coulter C, Tuyay J, Taruc M, Moore C. Semi-quantitative analysis of drugs of abuse, including tetrahydrocannabinol in hair using aqueous extraction and immunoassay. Forensic Sci Int 2010; 196:70-3. [DOI: 10.1016/j.forsciint.2009.12.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 07/27/2009] [Indexed: 10/19/2022]
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33
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Lafreniere NM, Watterson JH. Detection of acute fentanyl exposure in fresh and decomposed skeletal tissues part II: The effect of dose–death interval. Forensic Sci Int 2010; 194:60-6. [DOI: 10.1016/j.forsciint.2009.10.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Revised: 09/20/2009] [Accepted: 10/08/2009] [Indexed: 11/25/2022]
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34
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Current Awareness in Drug Testing and Analysis. Drug Test Anal 2009. [DOI: 10.1002/dta.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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35
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Microwave-assisted extraction in toxicological screening of skeletal tissues. Forensic Sci Int 2009; 188:23-30. [DOI: 10.1016/j.forsciint.2009.03.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Revised: 01/23/2009] [Accepted: 03/08/2009] [Indexed: 11/20/2022]
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