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1.
Forensic Sci Int ; 330: 111033, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34883302

RESUMO

During a Disaster Victims Identification (DVI) mission, international protocols rely on interdisciplinary work, especially between specialists from forensic imaging and anthropology. In case of air crashes or explosions, DVI units may face thousands of fragmented human remains (FHRs). The physical re-association of FHRs and the identification process is very complex and challenging, and relies upon expensive and destructive DNA analysis. A virtual re-association (VRA) of these fragments, using Multidetector Computed Tomography (MDCT), could be a helpful tool in forensic anthropology analysis, as it could assist in reducing the number of DNA samples. However, there is no standardized protocol for including such an approach into a DVI procedure. The aim of this study was to summarize and analyze existing techniques through a systematic review and to develop a protocol for virtual re-association of FHRs, adapted to the DVI context. A keyword-based literature search was conducted, focusing on the VRA methods using MDCT imaging and 3D surface scan methodology. Reviews and primary articles, published between 2005 and 2020 in the fields of forensic anthropology, paleoanthropology, archeology, and fracture reduction surgery were sorted out. A total of 45 publications were selected and analyzed based on their content and relevance. The results show that research on the re-association of FHRs increased significantly during the last five years. Seven steps regarding the MDCT-based method for the virtual re-association of FHRs could be identified: acquisition of 3D-images, segmentation of the MDCT-data, post-processing and surface generation, identification of intact and fracture surfaces, identification and registration of matching fragments, and validation of the re-association. The literature is surprisingly sparse regarding the FHRs re-association as a forensic tool, and mainly consists in case reports, whereas validated methods were presented in archeology and surgery publications. However, we were able to adapt the MDCT-based approach for the virtual re-association of the FHRs and propose an innovative protocol for DVI missions. This protocol includes the needed details, from the acquisition of MDCT imaging to the virtual re-association of 3D models and its validation. Each step has to be fully tested, adapted and validated in future studies.


Assuntos
Restos Mortais , Vítimas de Desastres , Medicina Legal , DNA , Antropologia Forense , Humanos
2.
Int J Legal Med ; 134(5): 1875-1895, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32440888

RESUMO

Taphonomy is the study of decaying organisms over time and their process of fossilization. Taphonomy, originally a branch of palaeontology and anthropology, was developed to understand the ecology of a decomposition site, how site ecology changes upon the introduction of plant or animal remains and, in turn, how site ecology affects the decomposition of these materials. In recent years, these goals were incorporated by forensic science to understand the decomposition of human cadavers, to provide a basis on which to estimate postmortem and/or postburial interval, to assist in the determination of cause and circumstances of death, and to aid in the location of clandestine graves. These goals are achieved through the study of the factors that influence cadaver decomposition (e.g. temperature, moisture, insect activity). These studies have also provided insight into the belowground ecology of cadaver breakdown and allowed to develop useful protocols for mass disaster managements in humanitarian medicine. From the results obtained, new scientific disciplines have arisen, gathered under the word "taphonomics" such as the study of microorganisms living below/on a cadaver (thanatogeomicrobiology), and join the more classical forensic sciences such as anthropology, botany or entomology. Taking into account the specificities of the study object (human cadaver), primordial requirements are needed in terms of security (physical and environmental) as well as ethical and legal concerns which are studied in the Swiss context. The present review aims to present in a first part the concept of human forensic taphonomy facilities (HFTF, also colloquially named "body farm") leading to an enrichment of forensic sciences with new "taphonomics". The second part is focused on the mandatory points that must be addressed for a HFTF approach, especially because it requires a specific place to undertake this research which must be performed in conformity with a country's human ethics and laws.


Assuntos
Ciências Forenses/ética , Ciências Forenses/legislação & jurisprudência , Ciências Forenses/métodos , Instalações Privadas , Animais , Cadáver , Ciências Forenses/tendências , Humanos , Mudanças Depois da Morte , Suíça
3.
Forensic Sci Int ; 306: 110063, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31790891

RESUMO

Diagnosis of carbon monoxide (CO) poisonings has always been a challenging task due to the susceptibility to alterations of the optical state and degradation of blood samples during sampling, transport and storage, which highly affects the analysis with spectrophotometric methods. Methodological improvements are then required urgently because of increased reports of cases with discrepancies between results of the measured biomarker carboxyhemoglobin (COHb) and reported symptoms. Total blood CO (TBCO) measured chromatographically was thus proposed in a previous study as alternative biomarker to COHb. This approach was investigated in this study by comparing the two biomarkers and assessing the effects of various storage parameters (temperature, preservative, time, tube headspace (HS) volume, initial saturation level, freeze- and thaw- and reopening-cycles) over a period of one month. Results show that while for TBCO, concentrations are relatively stable over the observation period regardless of parameters such as temperature, time and HS volume, for COHb, concentrations are altered significantly during storage. Therefore, the use of TBCO as alternative biomarker for CO poisonings has been proposed, since it provides more valid results and is more stable even under non-optimal storage conditions. Additionally, it can be used to predict COHb in cases where sample degradation hinders optical measurement. Furthermore, a correction formula for COHb and TBCO is provided to be used in laboratories or circumstances where optimal storage or analysis is not possible, to obtain more accurate results.


Assuntos
Intoxicação por Monóxido de Carbono/diagnóstico , Monóxido de Carbono/sangue , Carboxihemoglobina/análise , Medicina Legal/métodos , Biomarcadores/sangue , Cromatografia Gasosa , Interpretação Estatística de Dados , Humanos , Oximetria , Manejo de Espécimes , Espectrofotometria
4.
J Anat ; 235(5): 863-872, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31297814

RESUMO

Human cadavers constitute very useful educational tools to teach anatomy in medical scholarship and related disciplines such as physiology, for example. However, as biological material, human body is subjected to decay. Thanatopraxy cares such as embalming have been developed to slow down and inhibit this decay, but the formula used for the preservation fluids are mainly formaldehyde (FA)-based. Very recently, other formulas were developed in order to replace FA, and to avoid its toxicity leading to important environmental and professional exposure concerns. However, these alternative FA-free fluids are still not validated or commercialized, and their efficiency is still under discussion. In this context, the use of FA-releasing substances, already used in the cosmetics industry, may offer interesting alternatives in order to reduce professional exposures to FA. Simultaneously, the preservation of the body is still guaranteed by FA generated over time from FA-releasers. The aim of this review is to revaluate the use of FA in thanatopraxy cares, to present its benefits and disadvantages, and finally to propose an alternative to reduce FA professional exposure during thanatopraxy cares thanks to FA-releasers use.


Assuntos
Embalsamamento/métodos , Formaldeído/efeitos adversos , Hipersensibilidade Respiratória/prevenção & controle , Cadáver , Humanos
5.
Int J Legal Med ; 133(6): 1809-1818, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30734118

RESUMO

An increasing number of suicidal asphyxiation with a plastic bag with inert gases, and in particular helium (He), have been reported from numerous countries over the last decade. These cases are differently managed and lead to different and variable interpretations. Based on the 12 last cases analysed in the laboratory and on the review of the most recent literature about this topic, updated autopsy guidelines for sampling have been proposed regarding to the samples choice and analytical challenges required by the gaseous state of this substance. Biological samples from airways (lungs lobe) followed by brain and cardiac blood are the best matrices to take during the autopsy to diagnose He exposure. Gaseous samples from trachea, pulmonary bronchi, gastric and cardiac areas are also recommended as alternative samples. The anatomical site of sampling must be carefully detailed, and to this end, forensic imaging constitutes a beneficial tool. Even if He detection is sufficient to conclude to He exposure, He concentrations in samples may be related to He exposure conditions (duration, breathing rate, etc.). A quantification in biological samples could be helpful to document more precisely the case. He concentrations in gaseous samples are reported up to 6.0 µmol/mL (tracheal gas), 2.4 µmol/mL (pulmonary gas), 0.64 µmol/mL (cardiac gas) and 12 µmol/mL (gastric gas). He concentrations in solid/liquid samples are reported up to 28 µmol/g (lungs) and 0.03 µmol/g (cardiac blood). The other matrices usually sampled during autopsy such as urine, peripheral blood, liver, fat matter and kidney appear as not relevant.


Assuntos
Toxicologia Forense/métodos , Hélio/análise , Asfixia , Química Encefálica , Brônquios/química , Cromatografia Gasosa-Espectrometria de Massas , Ventrículos do Coração/química , Hélio/intoxicação , Humanos , Abuso de Inalantes , Pulmão/química , Intoxicação/diagnóstico , Manejo de Espécimes , Estômago/química , Suicídio , Traqueia/química
6.
J Forensic Leg Med ; 58: 14-19, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29679839

RESUMO

Xenon is a rare, mostly inert, noble gas that has applications in a wide range of fields, including medicine. Xenon acts on the human body as a useful organ-protective and anesthetic agent and has also been previously studied for potential applications in fields such as optics, aerospace and medical imaging. Recently, it was discovered that xenon can boost erythropoietin production, and it has been used as a performance-enhancing agent in international sports competitions such as the Sochi Olympic Games. Therefore, screening methods to detect the misuse of xenon by analysis of biological samples and to monitor anesthesia kinetics and efficiency are being investigated. The aim of this study was to develop and validate an analytical method to detect xenon in blood samples using gas chromatography coupled to tandem mass spectrometry (GC-MS/MS). Preliminary studies were conducted to determine the best parameters for chromatography and mass spectrometry for xenon. The analysis was performed using the multiple reaction monitoring (MRM) mode using the transitions m/z 129 â†’ 129, 131 â†’ 131 for xenon and 84 â†’ 84, 86 â†’ 86 for krypton, which was chosen as the internal standard. The LOD of GC-MS/MS was found to be 52 pmol on-column. Calibration lines and controls were made to obtain an accuracy profile at a range of 2.08-104 nmol with a ß-expectation tolerance interval set at 80% and the acceptability limit set at ±30%. From the accuracy profile, the LOQ of 15 nmol on-column for the range of 2.08-104 nmol was obtained. The method was validated according to the guidelines of the French Society of Pharmaceutical Sciences and Techniques. The detection method was finally validated using blood from test persons subjected to a 15% or 30% xenon mixture with pure oxygen and air for 45 min. Even though the probes were already used for other projects, it was still possible to detect xenon.


Assuntos
Anestésicos Inalatórios/sangue , Dopagem Esportivo , Detecção do Abuso de Substâncias/métodos , Xenônio/sangue , Cromatografia Gasosa , Humanos , Limite de Detecção , Espectrometria de Massas em Tandem
7.
Forensic Sci Int ; 283: 21-28, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29245041

RESUMO

Hemoglobin is the protein in red blood cells that carries and distributes oxygen to the body. Methemoglobinemia is a blood disorder in which an abnormal amount of methemoglobin (MetHb), a form of hemoglobin (Hb), is produced from either inadequate MetHb reductase activity or too much MetHb production or by exposure to oxidizing agents. This could lead to anoxia and death if it is not treated. However, this parameter has not been investigated as a valid post-mortem indicator because random MetHb levels have been observed in various studies: MetHb increases can be observed due to autoxidation during storage, and MetHb decreases can be observed due to MetHb reductase or microbial activity in post-mortem samples. MetHb variations can also come from the blood state and can interfere in the optical measurements of MetHb. We have studied the post-mortem MetHb concentrations according to various storage conditions. Based on our results, both the post-mortem delay and the delay before analysis should be reduced whenever possible to avoid changes in MetHb. If the analysis is delayed for a short period of time (two weeks), the blood sample taken at autopsy should not be frozen but collected in EDTA preservative and stored under refrigeration (4-6°C) until analysis. If the analysis is delayed for a longer period (more than two weeks), the blood sample should be frozen with cryoprotectant at -80°C or -196°C.


Assuntos
Artefatos , Metemoglobina/química , Mudanças Depois da Morte , Manejo de Espécimes/métodos , Criopreservação , Ácido Edético , Medicina Legal , Humanos
8.
J Forensic Leg Med ; 52: 35-39, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28850861

RESUMO

Death due to inhalation of aliphatic hydrocarbons such as butane and propane is a particularly serious problem worldwide, resulting in several fatal cases of sniffing these volatile substances in order to "get high". Despite the number of cases published, there is not a unique approach to case management of fatal sniffing. In this paper we illustrate the volatile lipophilic substances management in a case of a prisoner died after sniffing a butane-propane gas mixture from prefilled camping stove gas canisters, discussing the comprehensive approach of the crime scene, the autopsy, histology and toxicology. A large set of accurate values of both butane and propane was obtained by gas chromatography-mass spectrometry analyzing the following post-mortem biological samples: peripheral blood, heart blood, vitreous humor, liver, lung, heart, brain/cerebral cortex, fat tissue, kidney, and allowed an in depth discussion about the cause of death. A key role is played by following the proper sampling approach during autopsy.


Assuntos
Butanos/análise , Butanos/intoxicação , Abuso de Inalantes , Propano/análise , Propano/intoxicação , Tecido Adiposo/química , Tecido Adiposo/patologia , Adulto , Análise Química do Sangue , Química Encefálica , Patologia Legal , Toxicologia Forense , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Rim/química , Rim/patologia , Fígado/química , Fígado/patologia , Pulmão/química , Pulmão/patologia , Masculino , Miocárdio/química , Miocárdio/patologia , Púrpura/patologia , Mucosa Respiratória/patologia , Corpo Vítreo/química , Corpo Vítreo/patologia
9.
Int J Legal Med ; 131(5): 1271-1281, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28616692

RESUMO

In forensic casework, non-invasive and minimally-invasive methods for postmortem examinations are extremely valuable. Whole body postmortem computed tomography (PMCT) is often used to provide visualization of the internal characteristics of a body prior to more invasive procedures and has also been used to locate gas reservoirs inside the body to assist in determining cause of death. Preliminary studies have demonstrated that exploiting the volatile organic compounds (VOCs) located in these gas reservoirs by comprehensive two-dimensional gas chromatography-high-resolution time-of-flight mass spectrometry (GC×GC-HRTOF-MS) may assist in providing information regarding the postmortem interval. The aim of the current study was to further develop the procedures related to solid-phase microextraction (SPME) and GC×GC-HRTOF-MS analysis of gas reservoirs collected from deceased individuals. SPME fiber extraction parameters, internal standard approach, and sample stability were investigated. Altering the SPME parameters increased the selectivity and sensitivity for the VOC profile, and the use of a mixed deuterated internal standard contributed to data quality. Samples were found to be stable up to 6 weeks but were recommended to be analyzed within 4 weeks due to higher variation observed beyond this point. In addition, 29 VOC markers of interest were identified, and heart and/or abdominal cavity samples were suggested as a possible standardized sampling location for future studies. The data presented in this study will contribute to the long-term goal of producing a routine, accredited method for minimally-invasive VOC analysis in postmortem examinations.


Assuntos
Mudanças Depois da Morte , Microextração em Fase Sólida , Compostos Orgânicos Voláteis/análise , Cavidade Abdominal , Adulto , Idoso , Idoso de 80 Anos ou mais , Patologia Legal/métodos , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Masculino , Pessoa de Meia-Idade , Miocárdio/química , Músculos Peitorais/química , Cavidade Torácica/química
10.
Diving Hyperb Med ; 47(2): 75-81, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28641319

RESUMO

INTRODUCTION: Important developments in the diagnosis of scuba diving fatalities have been made thanks to forensic imaging tool improvements. Multi-detector computed tomography (MDCT) permits reliable interpretation of the overall gaseous distribution in the cadaver. However, due to post-mortem delay, the radiological interpretation is often doubtful because the distinction between gas related to the dive and post-mortem decomposition artifactual gases becomes less obvious. METHODS: We present six cases of fatal scuba diving showing gas in the heart and other vasculature. Carbon dioxide (CO2) in cardiac gas measured by gas chromatography coupled to thermal conductivity detection were employed to distinguish decomposition from embolism based on the detection of decomposition gases (hydrogen, hydrogen sulfide and methane) and to confirm arterial gas embolism (AGE) or post-mortem offgasing diagnoses. A Radiological Alteration Index (RAI) was calculated from the scan. RESULTS: Based on the dive history, the intra-cadaveric gas was diagnosed as deriving from decomposition (one case, minimal RAI of 61), post-mortem decompression artifacts (two cases, intermediate RAI between 60 and 85) and barotrauma/AGE (three cases, maximal RAI between 85 and 100), illustrating a large distribution inside the bodies. CONCLUSION: MDCT scans should be interpreted simultaneously with compositional analysis of intra-cadaveric gases. Intra-cadaveric gas sampling and analysis may become useful tools for understanding and diagnosing scuba diving fatalities. In cases with short post-mortem delays, the CO2 concentration of the cardiac gas provides relevant information about the circumstances and cause of death when this parameter is interpreted in combination with the diving profile.


Assuntos
Barotrauma/diagnóstico , Doença da Descompressão/diagnóstico , Mergulho/efeitos adversos , Afogamento/diagnóstico , Gases/análise , Tomografia Computadorizada Multidetectores , Mudanças Depois da Morte , Adulto , Idoso , Ar , Artefatos , Autopsia , Barotrauma/complicações , Dióxido de Carbono/análise , Cromatografia Gasosa , Descompressão/efeitos adversos , Afogamento/etiologia , Embolia Aérea/complicações , Embolia Aérea/diagnóstico , Artéria Femoral , Veia Femoral , Coração/diagnóstico por imagem , Humanos , Hidrogênio/análise , Veias Jugulares , Masculino , Pessoa de Meia-Idade , Nitrogênio , Oxigênio/análise , Veia Subclávia , Condutividade Térmica
11.
Forensic Sci Res ; 2(2): 100-106, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-30483626

RESUMO

This case reports on a 68-year-old man who was found dead in hospital next to his bed. Before this, he had been treated with intravenous antibiotics for pneumonia. The body was found with a peripheral venous catheter connected to a nasal cannula delivering oxygen (O2) from the wall. Extensive medico-legal examinations were performed, including post-mortem computed tomography (CT), complete conventional autopsy, histological and immunohistochemistry analysis, toxicological analysis and post-mortem chemistry. Additionally, CT-guided gas sampling was performed at multiple sites to collect samples for gas analysis. During the external examination, massive subcutaneous emphysema was visible over the entire surface of the body. The CT scan revealed the presence of gas throughout the vascular system, and in the subcutaneous and muscular tissues. The autopsy confirmed the presence of lobar pneumonia and multiple gas bubbles in the vascular system. The gas analysis results showed a subnormal concentration of oxygen, confirming the suspected pure O2 embolism. Moreover, the carbon dioxide (CO2) concentration in the gas sample from the heart was elevated to a level similar to those found in scuba diving fatalities. This could come from degassing of dissolved CO2 that accumulated and was trapped in the cardiac cavity. Based on the results of the different exams performed, and especially the gas analysis results, it was concluded that the cause of death was O2 embolism.

12.
Forensic Sci Int ; 274: 33-37, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27932047

RESUMO

Treatment with atypical antipsychotic agents and tetracyclic antidepressants has been associated with impaired glycemic control. Reported complications have included new-onset diabetes mellitus, life-threatening diabetic ketoacidosis and, rarely, death. The study presented herein focuses on biochemical investigations of glucose metabolism in a series of medico-legal cases that revealed the presence of atypical antipsychotic agents (clozapine, olanzapine, quetiapine and risperidone) or mirtazapine at toxicology. Two different approaches were used. In one, 55 forensic autopsy cases (characterized by the presence of clozapine, olanzapine, quetiapine, risperidone and mirtazapine toxicologically identified) were retrospectively selected. In the second approach, 20 forensic autopsy cases that had a cause of death attributed to diabetic ketoacidosis were retrospectively selected. The combination of the results obtained from the first and second approaches allowed only one case of possibly drug-induced glucose metabolism disturbance (in one individual treated with mirtazapine who was not known to suffer from diabetes mellitus) to be identified. Though our results could raise the question of the benefit of systematizing postmortem biochemical investigation in situations of sudden death involving individuals treated with psychotropic drugs, the study stresses the importance of investigating all potentially relevant data (including the overall knowledge of medication history) in order to formulate appropriate hypotheses concerning the cause and pathogenesis of death.


Assuntos
Antipsicóticos/efeitos adversos , Glucose/metabolismo , Adulto , Idoso , Antipsicóticos/análise , Bile/química , Química Encefálica , Diabetes Mellitus , Cetoacidose Diabética , Feminino , Conteúdo Gastrointestinal/química , Cabelo/química , Humanos , Fígado/química , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/química , Líquido Pericárdico/química , Estudos Retrospectivos , Corpo Vítreo/química , Adulto Jovem
13.
Forensic Sci Int ; 274: 27-32, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27932048

RESUMO

Fatal cases of potassium overdoses have traditionally been considered indemonstrable due postmortem biochemical investigation limits (mainly potassium determination in postmortem serum and vitreous humor). Nevertheless, some authors have expressed a divergent opinion over the years based on the results of their own investigations. In this study, we investigated left vitreous, right vitreous, postmortem serum from peripheral blood, postmortem serum from cardiac blood, urine, pericardial and cerebrospinal fluid potassium concentrations in 21 forensic autopsy cases. One of these was a case of accidental, fatal intravenous potassium injection in a hospitalized patient. The other twenty cases were subjects with various causes of death unrelated to potassium administration and comparable postmortem intervals. Our aim was to assess whether postmortem biochemical investigations performed in several biological samples may be useful in diagnosing exogenous potassium administration. No statistically significant differences were observed between the measured concentrations in the fatal case of potassium intravenous administration and the control cases in any of the tested samples. Potassium concentrations in the investigated case of exogenous potassium injection were within the range of those measured in the control cases, irrespective of the tested biological sample. Our findings corroborate the conclusions of former authors who highlighted that circumstantial evidence provides the greatest diagnostic contribution in situations of suspected potassium poisoning. This is due to the objective limitations demonstrated by postmortem biochemical investigations in such cases, even when potassium measurements are carried out in several biological samples of satisfying quality and within a relatively short postmortem interval.


Assuntos
Potássio/análise , Potássio/intoxicação , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Injeções Intravenosas , Masculino , Erros de Medicação , Pessoa de Meia-Idade , Líquido Pericárdico/química , Intoxicação/diagnóstico , Corpo Vítreo/química , Adulto Jovem
14.
Sci Rep ; 6: 25599, 2016 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-27228348

RESUMO

Therapeutic cannabis administration is increasingly used in Western countries due to its positive role in several pathologies. Dronabinol or tetrahydrocannabinol (THC) pills, ethanolic cannabis tinctures, oromucosal sprays or table vaporizing devices are available but other cannabinoids forms can be used. Inspired by the illegal practice of dabbing of butane hashish oil (BHO), cannabinoids from cannabis were extracted with butane gas, and the resulting concentrate (BHO) was atomized with specific vaporizing devices. The efficiency of "cannavaping," defined as the "vaping" of liquid refills for e-cigarettes enriched with cannabinoids, including BHO, was studied as an alternative route of administration for therapeutic cannabinoids. The results showed that illegal cannavaping would be subjected to marginal development due to the poor solubility of BHO in commercial liquid refills (especially those with high glycerin content). This prevents the manufacture of liquid refills with high BHO concentrations adopted by most recreational users of cannabis to feel the psychoactive effects more rapidly and extensively. Conversely, "therapeutic cannavaping" could be an efficient route for cannabinoids administration because less concentrated cannabinoids-enriched liquid refills are required. However, the electronic device marketed for therapeutic cannavaping should be carefully designed to minimize potential overheating and contaminant generation.


Assuntos
Cannabis/química , Sistemas Eletrônicos de Liberação de Nicotina/métodos , Fumar Maconha , Maconha Medicinal/uso terapêutico , Vaping/métodos , Butanos/administração & dosagem , Butanos/uso terapêutico , Canabinoides/administração & dosagem , Canabinoides/uso terapêutico , Dronabinol/administração & dosagem , Dronabinol/uso terapêutico , Sistemas Eletrônicos de Liberação de Nicotina/instrumentação , Estudos de Viabilidade , Humanos , Maconha Medicinal/administração & dosagem , Reprodutibilidade dos Testes , Vaping/instrumentação
15.
Therapie ; 71(1): 97-105, 107-14, 2016 Feb.
Artigo em Inglês, Francês | MEDLINE | ID: mdl-27080635

RESUMO

The healthcare sector is currently facing a new paradigm, the explosion of "big data". Coupled with advances in computer technology, the field of "big data" appears promising, allowing us to better understand the natural history of diseases, to follow-up new technologies (devices, drugs) implementation and to participate in precision medicine, etc. Data sources are multiple (medical and administrative data, electronic medical records, data from rapidly developing technologies such as DNA sequencing, connected devices, etc.) and heterogeneous while their use requires complex methods for accurate analysis. Moreover, faced with this new paradigm, we must determine who could (or should) have access to which data, how to combine collective interest and protection of personal data and how to finance in the long-term both operating costs and databases interrogation. This article analyses the opportunities and challenges related to the use of open and/or "big data", from the viewpoint of pharmacologists and representatives of the pharmaceutical and medical device industry.


Assuntos
Acesso à Informação , Bases de Dados Factuais , Registros Eletrônicos de Saúde , Pesquisadores , Humanos
16.
Int J Environ Res Public Health ; 12(8): 9988-10008, 2015 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-26308021

RESUMO

The emergence of electronic cigarettes (e-cigs) has given cannabis smokers a new method of inhaling cannabinoids. E-cigs differ from traditional marijuana cigarettes in several respects. First, it is assumed that vaporizing cannabinoids at lower temperatures is safer because it produces smaller amounts of toxic substances than the hot combustion of a marijuana cigarette. Recreational cannabis users can discretely "vape" deodorized cannabis extracts with minimal annoyance to the people around them and less chance of detection. There are nevertheless several drawbacks worth mentioning: although manufacturing commercial (or homemade) cannabinoid-enriched electronic liquids (e-liquids) requires lengthy, complex processing, some are readily on the Internet despite their lack of quality control, expiry date, and conditions of preservation and, above all, any toxicological and clinical assessment. Besides these safety problems, the regulatory situation surrounding e-liquids is often unclear. More simply ground cannabis flowering heads or concentrated, oily THC extracts (such as butane honey oil or BHO) can be vaped in specially designed, pen-sized marijuana vaporizers. Analysis of a commercial e-liquid rich in cannabidiol showed that it contained a smaller dose of active ingredient than advertised; testing our laboratory-made, purified BHO, however, confirmed that it could be vaped in an e-cig to deliver a psychoactive dose of THC. The health consequences specific to vaping these cannabis preparations remain largely unknown and speculative due to the absence of comprehensive, robust scientific studies. The most significant health concerns involve the vaping of cannabinoids by children and teenagers. E-cigs could provide an alternative gateway to cannabis use for young people. Furthermore, vaping cannabinoids could lead to environmental and passive contamination.


Assuntos
Canabinoides/análise , Sistemas Eletrônicos de Liberação de Nicotina/efeitos adversos , Sistemas Eletrônicos de Liberação de Nicotina/tendências , Fumar Maconha/efeitos adversos , Fumar Maconha/tendências , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Humanos , Fumar Maconha/epidemiologia , Nebulizadores e Vaporizadores/estatística & dados numéricos , Nebulizadores e Vaporizadores/tendências
17.
Int J Environ Res Public Health ; 12(5): 4796-815, 2015 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-25941845

RESUMO

We analyzed 42 models from 14 brands of refill liquids for e-cigarettes for the presence of micro-organisms, diethylene glycol, ethylene glycol, hydrocarbons, ethanol, aldehydes, tobacco-specific nitrosamines, and solvents. All the liquids under scrutiny complied with norms for the absence of yeast, mold, aerobic microbes, Staphylococcus aureus, and Pseudomonas aeruginosa. Diethylene glycol, ethylene glycol and ethanol were detected, but remained within limits authorized for food and pharmaceutical products. Terpenic compounds and aldehydes were found in the products, in particular formaldehyde and acrolein. No sample contained nitrosamines at levels above the limit of detection (1 µg/g). Residual solvents such as 1,3-butadiene, cyclohexane and acetone, to name a few, were found in some products. None of the products under scrutiny were totally exempt of potentially toxic compounds. However, for products other than nicotine, the oral acute toxicity of the e-liquids tested seems to be of minor concern. However, a minority of liquids, especially those with flavorings, showed particularly high ranges of chemicals, causing concerns about their potential toxicity in case of chronic oral exposure.


Assuntos
Microbiologia do Ar , Poluentes Atmosféricos/análise , Sistemas Eletrônicos de Liberação de Nicotina , Compostos Orgânicos/análise , Solventes/análise
18.
J Anal Toxicol ; 39(1): 52-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25336379

RESUMO

The aim of our study was to present a new headspace-gas chromatography-mass spectrometry (HS-GC-MS) method applicable to the routine determination of hydrogen sulfide (H(2)S) concentrations in biological and gaseous samples. The primary analytical drawback of the GC/MS methods for H(2)S measurement discussed in the literature was the absence of a specific H(2)S internal standard required to perform quantification. Although a deuterated hydrogen sulfide (D(2)S) standard is currently available, this standard is not often used because this standard is expensive and is only available in the gas phase. As an alternative approach, D(2)S can be generated in situ by reacting deuterated chloride with sodium sulfide; however, this technique can lead to low recovery yield and potential isotopic fractionation. Therefore, N(2)O was chosen for use as an internal standard. This method allows precise measurements of H(2)S concentrations in biological and gaseous samples. Therefore, a full validation using accuracy profile based on the ß-expectation tolerance interval is presented. Finally, this method was applied to quantify H(2)S in an actual case of H(2)S fatal intoxication.


Assuntos
Sulfeto de Hidrogênio/análise , Músculo Esquelético/química , Adulto , Autopsia , Calibragem , Fracionamento Químico , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Sulfeto de Hidrogênio/intoxicação , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Manejo de Espécimes , Sulfetos/química
19.
Anal Chim Acta ; 810: 43-4, 2014 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-24439504

RESUMO

Saffaj et al. recently criticized our method of monitoring carbon dioxide in human postmortem cardiac gas samples using Headspace-Gas Chromatography-Mass Spectrometry. According to the authors, their demonstration, based on the latest SFSTP guidelines (established after 2007) fitted for the validation of drug monitoring bioanalytical methods, has put in evidence potential errors. However, our validation approach was built using SFSTP guidelines established before 2007. We justify the use of these guidelines because of the post-mortem context of the study (and not clinical) and the gaseous state of the sample (and not solid or liquid). Using these guidelines, our validation remains correct.


Assuntos
Aorta Torácica/química , Dióxido de Carbono/análise , Patologia Legal/métodos , Cromatografia Gasosa-Espectrometria de Massas/métodos , Átrios do Coração/química , Humanos
20.
J Anal Toxicol ; 38(2): 73-9, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24327620

RESUMO

Propane can be responsible for several types of lethal intoxication and explosions. Quantifying it would be very helpful to determine in some cases the cause of death. Some gas chromatography-mass spectrometry (GC-MS) methods of propane measurements do already exist. The main drawback of these GC-MS methods described in the literature is the absence of a specific propane internal standard necessary for accurate quantitative analysis. The main outcome of the following study was to provide an innovative Headspace-GC-MS method (HS-GC-MS) applicable to the routine determination of propane concentration in forensic toxicology laboratories. To date, no stable isotope of propane is commercially available. The development of an in situ generation of standards is thus presented. An internal-labeled standard gas (C3DH7) is generated in situ by the stoichiometric formation of propane by the reaction of deuterated water (D2O) with Grignard reagent propylmagnesium chloride (C3H7MgCl). The method aims to use this internal standard to quantify propane concentrations and, therefore, to obtain precise measurements. Consequently, a complete validation with an accuracy profile according to two different guidelines, the French Society of Pharmaceutical Sciences and Techniques (SFSTP) and the Gesellschaft für toxikologische und Forensische Chemie (GTFCh), is presented.


Assuntos
Toxicologia Forense/métodos , Cromatografia Gasosa-Espectrometria de Massas , Propano/análise , Autopsia , Calibragem , Causas de Morte , Cromatografia Gasosa-Espectrometria de Massas/normas , Gases , Humanos , Exposição por Inalação/efeitos adversos , Limite de Detecção , Intoxicação/diagnóstico , Intoxicação/metabolismo , Intoxicação/mortalidade , Valor Preditivo dos Testes , Propano/metabolismo , Propano/intoxicação , Padrões de Referência , Reprodutibilidade dos Testes
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