Assessment and Comparison of Vitreous Humor as an Alternative Matrix for Forensic Toxicology Screening by GC–MS

Metushi, Imir G.; Fitzgerald, Robert L.; McIntyre, Iain M.

doi:10.1093/jat/bkw009

Cited by 28 publications

(24 citation statements)

References 13 publications

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“…Our drug of abuse panel consists of amphetamine, benzodiazepines, buprenorphine, cannabinoids, cocaine metabolite, fentanyl, methadone, methamphetamine, opioids, and oxycodone. Where blood is unavailable, vitreous fluid or tissue specimens can be used for screening and quantitation . Tissues are sampled, diluted, and homogenized for analysis.…”

Section: Methodsmentioning

confidence: 99%

Opioid Deaths in Milwaukee County, Wisconsin 2013‐2017: The Primacy of Heroin and Fentanyl

Peterson

Schreiber

Fumo

et al. 2018

Journal of Forensic Sciences

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Heroin and fentanyl are the overwhelming and increasing cause of opioid deaths in Milwaukee County, Wisconsin. We reviewed all drug and opioid deaths from 2013 to 2017 to delineate the specific opioid drugs involved and changes in their incidence. From 2013 to 2017, 980 deaths were due to opioids, rising from 184 in 2013 to 337 in 2017. In 2017, opioid deaths exceeded combined non-natural deaths from homicide and suicide. Illicit heroin and fentanyl/analogs caused 84% of opioid deaths and 80% of drug deaths, with no increase in deaths due to oral prescription drugs such as oxycodone and hydrocodone. Any approach to decreasing this dramatic increase in opioid deaths should first focus on interdicting the supply and cheap availability of these illicit opioids. Fentanyl and its analogs represent the most deadly opioids and the greatest threat to human life in our population.

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Section: Methodsmentioning

confidence: 99%

Opioid Deaths in Milwaukee County, Wisconsin 2013‐2017: The Primacy of Heroin and Fentanyl

Peterson

Schreiber

Fumo

et al. 2018

Journal of Forensic Sciences

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“…VH is commonly used in postmortem toxicology for analysis of ethanol and other abused drugs, such as 6-acetylmorphine [85,86]. VH is a useful matrix because it is isolated within the eye globe, the retina, and the lens, which makes it less prone to putrefaction process and spread of bacterial from the gut [87].…”

Section: Vitreous Humormentioning

confidence: 99%

Interpreting γ-hydroxybutyrate concentrations for clinical and forensic purposes

Busardò

Jones

2018

Clinical Toxicology

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Introduction: c-Hydroxybutyric acid is an endogenous substance, a therapeutic agent, and a recreational drug of abuse. This psychoactive substance acts as a depressant of the central nervous system and is commonly encountered in clinical and forensic practice, including impaired drivers, poisoned patients, and drug-related intoxication deaths. Objective: The aim of this review is to assist clinical and forensic practitioners with the interpretation of c-hydroxybutyric acid concentrations in blood, urine, and alternative biological specimens from living and deceased persons. Methods: The information sources used to prepare this review were PubMed, Scopus, and Web-of-Science. These databases were searched using keywords c-hydroxybutyrate (GHB), blood, urine, alternative specimens, non-conventional biological matrices, saliva, oral fluid, sweat, hair, vitreous humor (VH), brain, cerebrospinal fluid (CSF), dried blood spots (DBS), breast milk, and various combinations thereof. The resulting 4228 references were screened to exclude duplicates, which left 1980 articles for further consideration. These publications were carefully evaluated by taking into account the main aims of the review and 143 scientific papers were considered relevant. Analytical methods: The analytical methods used to determine c-hydroxybutyric acid in blood and other biological specimens make use of gas-or liquid-chromatography coupled to mass spectrometry. These hyphenated techniques are accurate, precise, and specific for their intended purposes and the lower limit of quantitation in blood and other specimens is 0.5 mg/L or less. Human pharmacokinetics: GHB is rapidly absorbed from the gut and distributes into the total body water compartment. Only a small fraction of the dose (1-2%) is excreted unchanged in the urine. The plasma elimination half-life of c-hydroxybutyric acid is short, being only about 0.5-0.9 h, which requires timely sampling of blood and other biological specimens for clinical and forensic analysis. Endogenous concentrations of GHB in blood: GHB is both an endogenous metabolite and a drug of abuse, which complicates interpretation of the laboratory results of analysis. Moreover, the concentrations of GHB in blood and other specimens tend to increase after sampling, especially in autopsy cases. This requires the use of practical "cut-off" concentrations to avoid reporting false positive results. These cutoffs are different for different biological specimen types. Concentrations of GHB in clinical and forensic practice: As a recreational drug GHB is predominantly used by young males (94%) with a mean age of 27.1 years. The mean (median) and range of concentrations in blood from apprehended drivers was 90 mg/L (82 mg/L) and 8-600 mg/L, respectively. The concentration distributions in blood taken from living and deceased persons overlapped, although the mean (median) and range of concentrations were higher in intoxication deaths; 640 mg/ L (280 mg/L) and 30-9200 mg/L, respectively. Analysis of GHB in alternative specimens: All bi...

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“…En la autopsia el humor vítreo debe aspirarse cuidadosamente con una aguja hipodérmica fina, no se recomienda el uso de sistemas al vacío para la toma, ya que el exceso de presión podría propiciar el desprendimiento de células de la retina lo que interfiere en los valores de algunos analitos. La aguja debe insertarse en parte lateral externa del globo ocular, en dirección central, como se muestra en la Figura N°1, con el fin de evitar la aspiración de material de la retina, que presenta una composición química muy diferente de la del humor vítreo 9 . De preferencia debe recolectarse por separado el humor vítreo de ambos ojos y reportarse por separado.…”

Section: Humor Vítreounclassified

Bioquímica Postmortem. Revisión Bibliográfica

Martín¹,

Matamoros²

2019

Rev. cienc. forenses Honduras

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Justificación: Son diversas las ocasiones en las que el médico forense requiere auxiliarse de la bioquímica postmortem para obtener información que le permita determinar la causa de muerte, especialmente en aquellos casos cuyas patologías no presentan cambios morfológicos que indiquen cuáles fueron los cambios fisiopatológicos involucrados en el proceso de muerte. Se estima que su aplicación podría contribuir a resolver hasta el 10% de las muertes naturales que se estudian en la rutina forense, sin embargo, a pesar del enorme potencial de esta disciplina, la misma aún no ha sido ampliamente aplicada. Objetivo: Presentar algunas aplicaciones de la bioquímica postmortem, sus limitaciones; así como proporcionar un breve resumen de lo publicado recientemente sobre el tema. Metodología: Se realizó la búsqueda en pub med y google académico, utilizando los términos, bioquímica post mortem y tanatoquímia. Resultados: Se encontró que, pese a que la bioquímica postmortem es una disciplina que a pesar que data desde los años 40, son pocos los avances que se han realizado, debido a factores que limitan la interpretación de los resultados entre los que destacan la falta de valores de referencia y el escaso conocimiento de la dinámica del cambio postmortem de los metabolitos. Conclusiones: A pesar de las enormes aplicaciones que, desde la conceptualización teórica, la bioquímica postmortem pueda tener, su aplicación se ha visto limitada por diversos factores por lo que se requiere realizar más investigación.

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Assessment and Comparison of Vitreous Humor as an Alternative Matrix for Forensic Toxicology Screening by GC–MS

Cited by 28 publications

References 13 publications

Opioid Deaths in Milwaukee County, Wisconsin 2013‐2017: The Primacy of Heroin and Fentanyl

Opioid Deaths in Milwaukee County, Wisconsin 2013‐2017: The Primacy of Heroin and Fentanyl

Interpreting γ-hydroxybutyrate concentrations for clinical and forensic purposes

Bioquímica Postmortem. Revisión Bibliográfica

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