Verkehrsmedizin

Mußhoff, Frank; Heß, Cornelius; Madea, Burkhard; Wehner, Heinz‐Dieter; Huckenbeck, W.; Gabriel, Peter; Pollak, Stefan

doi:10.1007/978-3-662-43500-7_9

Cited by 6 publications

(2 citation statements)

References 12 publications

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“…We found a negative correlation between alcohol intoxication and HbA 1c value ( r s = −0.1, P < 0.05), as deceased in the acute alcohol intoxication group were relatively younger. The effects may be also caused by alcohol-induced hypoglycaemia [ 41 ]. In the whole study group 54.6% of the deceased ethanol was determined in blood.…”

Section: Discussionmentioning

confidence: 99%

Glycated haemoglobin (HbA_1c) for postmortem diagnosis of diabetes

Lepik

Tõnisson

Kuudeberg

et al. 2018

Forensic Sciences Research

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The study was conducted at the Estonian Forensic Science Institute in 2008–2014 as continuous part of our previous study of alcohol and premature death in Estonian men. Autopsy data from 504 cases of male deaths (ages 19–79) were collected and blood and urine samples for glycated haemoglobin (HbA1c), liver enzymes and alcohol concentration were analysed. The aim of our research was to find undiagnosed diabetes and diabetes risk cases postmortem on the basis of increased values of HbA1c. HbA1c was within the reference value 4.8%–5.9% (29–42 mmol/mol), in 88.1% (n = 444) of cases, below reference value in 2.4% (n = 12), in the risk group of diabetes, HbA1c 6.0%–6.4% (42–46 mmol/mol) was within 5.8% (n = 29), and HbA1c result of ≥6.5% (48 mmol/mol) manifested in 3.8% (n = 19) of cases. The higher the age, the more cases with HbA1c value ≥6.0% (42 mmol/mol) occurred. In the group of external causes of death (n = 348), the HbA1c value of ≥6.5% (48 mmol/mol) HbA1c occurred in four cases. The HbA1c value was ≥6.5% (48 mmol/mol) in 78.9% of 156 cases when the cause of death was disease, of which 58% were cardiovascular diseases. The prevalence of diabetes and diabetes risk was found lower compared to population-based study, as majority of the deceased were young and middle-aged males and no females were included. In the case of poisoning with narcotic substances, HbA1c was within the reference range. A negative correlation occurred between alcohol intoxication and HbA1c value. A positive correlation between ALT and HbA1c was found – the higher stage of liver damage correlated with the higher HbA1c level.

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Section: Discussionmentioning

confidence: 99%

Glycated haemoglobin (HbA_1c) for postmortem diagnosis of diabetes

Lepik

Tõnisson

Kuudeberg

et al. 2018

Forensic Sciences Research

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“…9 Cocaine intoxications often play a role in criminal offenses, particularly traffic offenses (driving under the influence of drugs, DUID), and in the assessment of criminal responsibility. 10,11 In blood, cocaine exhibits a relatively short half-life, so that it is particularly difficult to assess the influence at the time of the offense on the basis of toxicological findings in the blood. In this regard, the in vitro degradation occurring between blood collection and analysis poses a further challenge.…”

Section: Introductionmentioning

confidence: 99%

Chiral pharmacokinetics of tetramisole stereoisomers—Enantioselective quantification of levamisole and dexamisole in serum samples from users of adulterated cocaine

Losacker

Hundertmark

Zoerntlein

et al. 2022

Drug Testing and Analysis

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Phenyltetrahydroimidazothiazole (PTHIT, tetramisole) is the most frequently used adulterant of cocaine and exists in the two enantiomeric forms levamsiole (S) and dexamisole (R). Existing studies show diverse fractions of samples containing enantiopure levamsiole, levamisole-enriched mixtures, and racemic tetramisole as adulterant. However, blood samples have never been enantioselectively tested for PTHIT. Because enantiomers are usually metabolized stereoselectively, chiral analysis of blood samples can help estimate the time of drug use, provided that a racemic substance is ingested. Therefore, an enantioselective liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed using a chiral column. Validation of the method was carried out for methanolic substance samples as well as serum samples and showed satisfactory selectivity, sensitivity, linearity (0.05-100 ng/mL), precision, and accuracy; 151 cocaine samples seized in Germany between 2018 and 2021 were analyzed. Most (94%, n = 48) of the 51 PTHIT-positive samples contained racemic tetramsiole, whereas there were two samples containing levamisole-enriched mixtures and one sample containing nearly enantiopure levamisole. Furthermore, 157 cocaine and/or benzoylecgonine-positive forensic serum samples were tested with cocaine-positive samples showing the highest frequency of PTHIT detection (43%). All positive samples contained either dexamisole alone or (R)/ (S)-concentration ratios >1 (1.05-70.6). Finally, a self-administration study was conducted with three subjects taking 10 mg of racemic tetramisole each. Although peak concentrations and corresponding times did not differ significantly between the enantiomers, dexamisole showed significantly longer apparent elimination half-lives (7.02-10.0 h) than levamisole (2.87-4.77 h). The resulting steadily increasing (R)/(S)-ratios can therefore be helpful in estimating the time of cocaine consumption.

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Forensic toxicological analyses for aptitude testing

Mußhoff¹,

Madea

2016

Rechtsmedizin

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Diese Fortbildungseinheit steht Ihnen als e.CME und e.Tutorial in der Springer Medizin e.Akademie zur Verfügung. -e.CME: kostenfreie Teilnahme im Rahmen des jeweiligen Zeitschriftenabonnements -e.Tutorial: Teilnahme im Rahmen des e.Med-Abonnements ZertifizierungDiese Fortbildungseinheit ist mit 3 CMEPunkten zertifiziert von der Landesärzte-kammer Hessen und der Nordrheinischen Akademie für Ärztliche Fort-und Weiterbildung und damit auch für andere Ärzte-kammern anerkennungsfähig. Hinweis für Leser aus ÖsterreichGemäß dem Diplom-Fortbildungs-Programm (DFP) der Österreichischen Ärzte-kammer werden die in der e.Akademie erworbenen CME-Punkte hierfür 1:1 als fachspezifische Fortbildung anerkannt.

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Verkehrsmedizin

Cited by 6 publications

References 12 publications

Glycated haemoglobin (HbA_1c) for postmortem diagnosis of diabetes

Glycated haemoglobin (HbA_1c) for postmortem diagnosis of diabetes

Chiral pharmacokinetics of tetramisole stereoisomers—Enantioselective quantification of levamisole and dexamisole in serum samples from users of adulterated cocaine

Forensic toxicological analyses for aptitude testing

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Verkehrsmedizin

Cited by 6 publications

References 12 publications

Glycated haemoglobin (HbA1c) for postmortem diagnosis of diabetes

Glycated haemoglobin (HbA1c) for postmortem diagnosis of diabetes

Chiral pharmacokinetics of tetramisole stereoisomers—Enantioselective quantification of levamisole and dexamisole in serum samples from users of adulterated cocaine

Forensic toxicological analyses for aptitude testing

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Glycated haemoglobin (HbA_1c) for postmortem diagnosis of diabetes

Glycated haemoglobin (HbA_1c) for postmortem diagnosis of diabetes