Forensic Toxicology: A New Scientific Contribution

A special issue of Toxics (ISSN 2305-6304). This special issue belongs to the section "Drugs Toxicity".

Deadline for manuscript submissions: closed (31 August 2022) | Viewed by 52293

Special Issue Editors


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Guest Editor
Pro.Mi.Se. Department, University of Palermo, 90133 Palermo, Italy
Interests: legal medicine, forensic toxicology; DFSA, forensic pathology; victims of sexual abuse and violent crime; diagnostic and medico legal assessment; ethics in research
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Guest Editor
U.R.I.To.N—Unit of Research, Department of Health Science, University of Florence, 50121 Florence, Italy
Interests: forensic toxicology; DUID; DFSA; forensic pathology; legal medicine
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
State Forensic Medicine Service, Mykolas Romeris University, Vilnius, Lithuania
Interests: forensic medicine; forensic toxicology; forensic genetics; forensic pathology; legal medicine

Special Issue Information

Dear Colleagues,

Forensic toxicology currently faces the challenges of great analytical complexity and of increasingly sophisticated interpretative models of laboratory parameters; this implies a continued improvement in the investigative methodology, for the evaluation of xenobiotics both in living and in post-mortem samples. This Special Issue of Toxic explores all areas of scientific research concerning traditional and emerging substances of abuse, with their forensic and clinical implications, including both analytical approaches within different samples of human body, and their impact on human health and behavior, such as driving impairment and fitness to work. Interdisciplinary and integrated forensic toxicology research which meets these requirements are welcomed by this Special Issue.

Case studies concerning intoxication from substance abuse and overdoses of psychotropic drugs are welcome. Other topics of interest include translational, pharmacogenetic and pharmacogenomic research, relating to substances of abuse and psychotropic drugs, in living people and post-mortem forensic casuistry; driving under the influence of alcohol and other substances of abuse; drug-facilitated sexual assault; emerging studies of postmortem biochemistry; in-depth examinations of death from intentional poisoning; and suicidal and homicidal deaths induced by drugs and substances of abuse.

We look forward to receiving your contributions.

Dr. Antonina Argo
Dr. Elisabetta Bertol
Dr. Marija Čaplinskiene
Guest Editors

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Keywords

  • forensic toxicology
  • analytical data
  • abuse
  • psychotropic drugs
  • human
  • samples
  • pharmacogenetic
  • pharmacogenomic
  • poisoning

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Published Papers (6 papers)

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Research

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11 pages, 279 KiB  
Article
Dentistry and Drug Adverse Events: Between Responsibilities and Regulations
by Tommaso D’Anna, Antonina Argo, Stefania Zerbo, Diego D’Urso and Maria Sofia Rini
Toxics 2022, 10(11), 671; https://doi.org/10.3390/toxics10110671 - 7 Nov 2022
Viewed by 1707
Abstract
The purpose of this paper is to renew interest and attention to the medical history, prescription, and/or use of drugs during dental practice. The work analyzes the issue of the use of drugs in dentistry from both a clinical and a medical–legal point [...] Read more.
The purpose of this paper is to renew interest and attention to the medical history, prescription, and/or use of drugs during dental practice. The work analyzes the issue of the use of drugs in dentistry from both a clinical and a medical–legal point of view. The laws governing the matter were also taken into consideration, relating them to the roles of prescriber and user that the dentist can acquire. Analysis of various aspects of this matter demonstrates that it is necessary for dentists to know the drugs and medical substances, their characteristics and properties, related effects, and interactions in order to use them appropriately and adequately. Knowledge of interferences, reactions, and adverse events or complications helps to reduce errors and protect patients’ health. Furthermore, knowledge of the national and international reference standards relating to the use of drugs leads to a reduction in medico–legal questions. In conclusion, knowledge and adequate and appropriate use of drugs reduces the possibility of accidents, adverse events, medico–legal consequences, and disputes with patients. Documented and traceable choices allow the analysis and valuation of professional conduct. Authors perceived the topic of informed consent of patients as relevant to the adequate procedure of prescribing drugs related to dentistry practice; therefore, representative conditions of patients at risk should be illustrated in practice. Legal duties related to physician drug prescription and use must be considered and carefully checked. Full article
(This article belongs to the Special Issue Forensic Toxicology: A New Scientific Contribution)
8 pages, 861 KiB  
Article
Substance Use among Adolescents: A Retrospective Study (2017–2018) in the Toxicology Unit, University Hospital of Lille, France
by Sanaa M. Aly, Ahmed Omran, Jean-Michel Gaulier and Delphine Allorge
Toxics 2022, 10(10), 594; https://doi.org/10.3390/toxics10100594 - 7 Oct 2022
Cited by 1 | Viewed by 1945
Abstract
Research on adolescent substance use is of utmost importance. Using local toxicological data, both prevalence and pattern of substance use (SU) and substance-related death (SRD) can be assessed to design effective prevention programs. A retrospective study of toxicology investigations of all adolescents referred [...] Read more.
Research on adolescent substance use is of utmost importance. Using local toxicological data, both prevalence and pattern of substance use (SU) and substance-related death (SRD) can be assessed to design effective prevention programs. A retrospective study of toxicology investigations of all adolescents referred to the medico-legal section of the Toxicology Unit of the University Hospital of Lille, France, for a 2-year period from 2017 to 2018. In the total sample of 1961 cases, adolescents accounted for 3.3% of the cases (n = 65). Among the adolescents, 16.9% were aged 10–14 years and 83.1% were aged >14–19 years. About 69.2% were males. Less than 70% of all presented adolescents used substances. More than two-thirds (74%) of positive detections were male. Illicit substances (43%) were the most detected substance followed by alcohol (20%) and prescription substances (20%). Tetrahydrocannabinol (THC) was extremely common as it was found in 29% of all adolescents. Cocaine and amphetamines were detected in 13.8% of total tested adolescents. Polysubstance use was common between alcohol and THC and among males. About one-third of deaths were due to substance use. About 54% of SRD was associated with polysubstance detection. It is recommended that illicit substances, ethanol, and prescription substances are targeted for testing among adolescents in order to provide appropriate prevention. Full article
(This article belongs to the Special Issue Forensic Toxicology: A New Scientific Contribution)
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21 pages, 1422 KiB  
Article
Post-Mortem Analysis of Heroin Biomarkers, Morphine and Codeine in Stomach Wall Tissue in Heroin-Related Deaths
by Ahmed I. Al-Asmari, Hassan Alharbi and Torki A. Zughaibi
Toxics 2022, 10(8), 473; https://doi.org/10.3390/toxics10080473 - 14 Aug 2022
Cited by 3 | Viewed by 3990
Abstract
Toxicological analysis of some cases can be complicated by poor sample quality caused by decomposition. Although heroin-related deaths have been researched extensively, the interpretation of toxicology findings in these cases is challenging, especially in instances where blood samples are unavailable. Thus, it is [...] Read more.
Toxicological analysis of some cases can be complicated by poor sample quality caused by decomposition. Although heroin-related deaths have been researched extensively, the interpretation of toxicology findings in these cases is challenging, especially in instances where blood samples are unavailable. Thus, it is important to develop analytical methods for different sample types. In this study. a method for the quantification of 6-monoacetylmorphine, 6-acetylcodeine, morphine, and codeine in postmortem stomach wall tissue using liquid chromatography coupled with tandem mass spectrometry was developed and validated. All calibration curves prepared with the stomach wall tissue were linear and ranged from 0.5–1000 ng/g with determination coefficients of >0.99 and a lower limit of quantification of 1.0 ng/g. The coefficients of variation for within-run precision and between-run precision were <9%. Matrix effects of stomach wall tissues and their extraction recoveries were investigated and ranged from −19% to +17% and 76% to 80%, respectively. Among the 16 analyzed heroin-related death cases, 6-monoacetylmorphine, 6-acetylcodeine, morphine, and codeine were detected in 75%, 31%, 100%, and 94% of all stomach wall tissues with median concentrations of 90 ng/g, 20 ng/g, 140 ng/g, and 30 ng/g, respectively. This study provides new data on the distribution of 6-monoacetylmorphine, 6-Acetylcodeine, morphine, and codeine in postmortem stomach wall tissue and suggests the usefulness of alternative matrices for investigating heroin-related fatalities when blood samples are unavailable. In addition, the prevalence of 6-monoacetylmorphine in the stomach wall tissue was higher than that in the liver and kidney tissues. Full article
(This article belongs to the Special Issue Forensic Toxicology: A New Scientific Contribution)
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Review

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13 pages, 309 KiB  
Review
EtG Quantification in Hair and Different Reference Cut-Offs in Relation to Various Pathologies: A Scoping Review
by Valentina Triolo, Mario Spanò, Roberto Buscemi, Simona Gioè, Ginevra Malta, Marija Čaplinskiene, Fabio Vaiano, Elisabetta Bertol, Stefania Zerbo, Giuseppe Davide Albano and Antonina Argo
Toxics 2022, 10(11), 682; https://doi.org/10.3390/toxics10110682 - 11 Nov 2022
Cited by 10 | Viewed by 3095
Abstract
Ethyl glucuronide (EtG) is a non-volatile, non-oxidative, hydrophilic, and stable ethanol phase II metabolite. EtG is produced through ethanol glucuronidation by UDP-glucuronosyltransferase (UGT), a phase II enzyme. EtG can be extracted from different biological matrices, including keratin ones, such as hair or nails. [...] Read more.
Ethyl glucuronide (EtG) is a non-volatile, non-oxidative, hydrophilic, and stable ethanol phase II metabolite. EtG is produced through ethanol glucuronidation by UDP-glucuronosyltransferase (UGT), a phase II enzyme. EtG can be extracted from different biological matrices, including keratin ones, such as hair or nails. The purpose of this scoping review is to describe the relationship between EtG levels in hair and some of the most common and frequent pathological conditions and verify whether different reference cut-offs in relation to various pathologies have been identified in the scientific literature. In fact, in-depth knowledge of the influence of pathologies, such as diabetes mellitus, hepatic and renal dysfunction, on EtG production and its storage in keratin matrices would allow a more appropriate interpretation of obtained data and rule out false positives or false negatives. This scoping review is based on bibliographic research carried out on PubMed regarding the quantification of EtG in hair of subjects affected by different pathological conditions. According to the scientific literature, the main and most common pathologies that can affect the concentration of EtG in hair are liver and kidney diseases and diabetes. The EtG quantification analytical data should be interpreted carefully as they may have a great impact in both forensic and clinical contexts. Full article
(This article belongs to the Special Issue Forensic Toxicology: A New Scientific Contribution)
14 pages, 378 KiB  
Review
The Other Face of Insulin—Overdose and Its Effects
by Szymon Rzepczyk, Klaudia Dolińska-Kaczmarek, Aleksandra Uruska and Czesław Żaba
Toxics 2022, 10(3), 123; https://doi.org/10.3390/toxics10030123 - 3 Mar 2022
Cited by 15 | Viewed by 31484
Abstract
Insulin is the most effective glycemic-lowering drug, and for people suffering from type 1 diabetes it is a life-saving drug. Its self-dosing by patients may be associated with a higher risk of overdose, both accidental and deliberate. Insulin-induced hypoglycemia causes up to 100,000 [...] Read more.
Insulin is the most effective glycemic-lowering drug, and for people suffering from type 1 diabetes it is a life-saving drug. Its self-dosing by patients may be associated with a higher risk of overdose, both accidental and deliberate. Insulin-induced hypoglycemia causes up to 100,000 emergency department calls per year. Cases of suicide attempts using insulin have been described in the literature since its introduction into therapy, and one of the important factors in their occurrence is the very fact of chronic disease. Up to 90% of patients who go to toxicology wards overdose insulin consciously. Patients with diabetes are burdened with a 2–3 times higher risk of developing depression compared to the general population. For this reason, it is necessary to develop an effective system for detecting a predisposition to overdose, including the assessment of the first symptoms of depression in patients with diabetes. A key role is played by a risk-conscious therapeutic team, as well as education. Further post-mortem testing is also needed for material collection and storage, as well as standardization of analytical methods and interpretation of results, which would allow for more effective detection and analysis of intentional overdose—both by the patient and for criminal purposes. Full article
(This article belongs to the Special Issue Forensic Toxicology: A New Scientific Contribution)

Other

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19 pages, 975 KiB  
Systematic Review
Toxicological Findings of Self-Poisoning Suicidal Deaths: A Systematic Review by Countries
by Giuseppe Davide Albano, Ginevra Malta, Corinne La Spina, Arianna Rifiorito, Valeria Provenzano, Valentina Triolo, Fabio Vaiano, Elisabetta Bertol, Stefania Zerbo and Antonina Argo
Toxics 2022, 10(11), 654; https://doi.org/10.3390/toxics10110654 - 29 Oct 2022
Cited by 17 | Viewed by 8305
Abstract
The use of illicit and non-illicit substances is widespread in suicides. The toxicological data may help in understanding the mechanism of death. This systematic review aimed to analyze autopsies related to suicides by consuming poison, focusing on the correlation between substance use and [...] Read more.
The use of illicit and non-illicit substances is widespread in suicides. The toxicological data may help in understanding the mechanism of death. This systematic review aimed to analyze autopsies related to suicides by consuming poison, focusing on the correlation between substance use and the country of origin to create an alarm bell to indicate that suicide maybe attempted and prevent it. The systematic review was conducted according to the PRISMA guidelines, with the primary objective of identifying autopsies conducted in cases of suicide by consuming poison in specific geographic areas. Significant differences in substances were observed between low-income and Western countries that confirm previous literature data. In rural areas and Asian countries, most suicides by consuming poison involve the use of pesticides, such as organophosphates and carbamates. In Western countries, illicit drugs and medically prescribed drugs are the leading cause of suicide by self-poisoning. Future research should shed light on the correlation between social, medical, and demographic characteristics and the autopsy findings in suicides by self-poisoning to highlight the risk factors and implement tailored prevention programs worldwide. Performing a complete autopsy on a suspected suicide by self-poisoning could be essential in supporting worldwide public health measures and policy makers. Therefore, complete autopsies in such cases must be vigorously promoted. Full article
(This article belongs to the Special Issue Forensic Toxicology: A New Scientific Contribution)
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