Search Results (352)

Objectives: Acute drug poisoning represents a significant public health issue among the pediatric population. The aim of this study was to evaluate the characteristics of drug poisoning in children and adolescents in the Vojvodina region from 2018 to 2023. Methods: In a retrospective observational study, 82 patients with confirmed drug poisoning were included, and data was collected regarding demographic characteristics, clinical manifestations, types of drugs involved, and the therapeutic interventions administered. The severity of poisonings was evaluated using the Poisoning Severity Score, and toxicological analysis was performed using gas chromatography–mass spectrometry. Results: The results indicated that poisonings were most prevalent in adolescent girls (72%), with 78% of cases resulting from intentional poisoning, while unintentional poisoning was more common in children. Benzodiazepines, antipsychotics, and analgesics were the primary drugs causing these poisoning incidents. The majority of patients (78%) experienced mild clinical symptoms, whereas 9% of pediatric patients suffered from severe poisoning, related to complications such as aspiration pneumonia and acute renal failure. Addressing pediatric drug poisoning in Vojvodina requires an increased focus on preventive strategies, including parental education and appropriate psychosocial support for the youth. Conclusions: Through collaborative efforts among healthcare providers, educators, and policymakers, prevention, treatment, and support mechanisms can be enhanced to combat this pressing public health challenge. Full article

In recent years, an increasing amount of research has investigated the impact of chronic inflammation on the development and progression of both neurological and psychiatric disorders, including epilepsy, depression, schizophrenia, and bipolar disorder. Moreover, growing attention is being paid to how inflammatory processes contribute to disease mechanisms, influence symptom severity, and interact with pharmacological treatments in these conditions. Changes in the levels of inflammatory biomarkers, such as cytokines and C-reactive protein, may signal the early stages of neurological disorder development. Furthermore, specific biomarker profiles have been identified for individual diseases, and chronic treatment may affect their blood levels. Over the last two decades, significant progress in the study of inflammatory biomarkers in psychiatric disorders and epilepsy has been achieved, demonstrating an association between biomarkers with symptoms, a potential prognostic role, and possible use in personalising therapy. Furthermore, widely used methods for biomarker evaluation, such as immunoenzymatic assays and flow cytometry, remain essential tools for current research. Despite numerous indications of the importance of inflammation in psychiatry and neurology, the available studies are characterised by considerable heterogeneity in terms of both population selection and methodology. Based on the available data, inflammatory biomarkers represent a promising diagnostic and therapeutic tool for epilepsy and psychiatric disorders. Although existing studies suggest a correlation between inflammation and the symptoms of various disorders, inconsistent results highlight the need for further research to enable wider implementation of these findings in psychiatric and epilepsy practice. Advancing knowledge of inflammatory biomarkers is essential for improving treatment outcomes and promoting the development of targeted interventions. Full article

New psychoactive substances (NPSs) have emerged as a significant global public health challenge due to their ability to mimic traditional drugs. Among these, mephedrone has gained attention because of its widespread use and associated toxicities. This review provides a comprehensive analysis of the structure, pharmacokinetic properties, and metabolic pathways of mephedrone, highlighting its phase I and phase II metabolites as potential biomarkers for detection and forensic applications. A comprehensive literature search was performed without date restrictions. The search employed key terms such as “mephedrone metabolites”, “pharmacokinetics of mephedrone”, “phase I metabolites of mephedrone”, and “phase II metabolites of mephedrone”. Additionally, the reference lists of selected studies were screened to ensure a thorough review of the literature. Mephedrone is a chiral compound existing in two enantiomeric forms, exhibiting different affinities for monoamine transporters and distinct pharmacological profiles. In vivo animal studies indicate rapid absorption, significant tissue distribution, and the formation of multiple phase I metabolites (e.g., normephedrone, dihydromephedrone, 4-carboxymephedrone) that influence its neurochemical effects. Phase II metabolism involves conjugation reactions leading to metabolites such as N-succinyl-normephedrone and N-glutaryl-normephedrone, further complicating its metabolic profile. These findings underscore the importance of elucidating mephedrone’s metabolic pathways to improve detection methods, enhance our understanding of its toxicological risks, and inform future therapeutic strategies. Full article

Hypothermia-related deaths present significant diagnostic challenges due to non-specific and often inconsistent autopsy findings. This study investigated the histological and immunohistochemical alterations associated with primary and secondary hypothermia in an experimental Rattus norvegicus model, focusing on the effects of benzodiazepine and alcohol ingestion. Twenty-one male rats were divided into three groups: control (K), benzodiazepine-treated (B), and alcohol-treated (A). After two weeks of substance administration, hypothermia was induced and multiple organ samples were analyzed. Histologically, renal tissue showed hydropic and vacuolar degeneration, congestion, and acute tubular injury across all groups, with no significant differences in E-cadherin expression. Lung samples revealed congestion, emphysema, and hemorrhage, with more pronounced vascular congestion in the alcohol and benzodiazepine groups. Cardiac tissue exhibited vacuolar degeneration and protein denaturation, particularly in substance-exposed animals. The spleen showed preserved architecture but increased erythrocyte infiltration and significantly elevated myeloperoxidase (MPO)-positive granulocytes in the intoxicated groups. Liver samples demonstrated congestion, focal necrosis, and subcapsular hemorrhage, especially in the alcohol group. Immunohistochemical analysis revealed statistically significant differences in MPO expression in both lung and spleen tissues, with the highest levels observed in the benzodiazepine group. Similarly, CK7 and CK20 expression in the gastroesophageal junction was significantly elevated in both alcohol- and benzodiazepine-treated animals compared to the controls. In contrast, E-cadherin expression in the kidney did not differ significantly among the groups. These findings suggest that specific histological and immunohistochemical patterns, particularly involving pulmonary, cardiac, hepatic, and splenic tissues, may help differentiate primary hypothermia from substance-related secondary hypothermia. The study underscores the value of integrating toxicological, histological, and molecular analyses to enhance the forensic assessment of hypothermia-related fatalities. Future research should aim to validate these markers in human autopsy series and explore additional molecular indicators to refine diagnostic accuracy in forensic pathology. Full article

Cuscohygrine (CUS) and hygrine (HYG) are pyrrolidine alkaloids proposed as biomarkers of coca leaf consumption, a culturally accepted practice in some Latin American countries. Differentiating legal coca use from illicit cocaine consumption holds forensic importance. While LC-MS/MS is preferred, GC-MS remains widely used in Latin American toxicology labs due to accessibility. This study critically evaluates the analytical limitations of GC-MS for detecting CUS and HYG in biological matrices. Key parameters—injector temperature (180–290 °C), injection mode (split/splitless), solvent, liner condition, and matrix—were systematically studied. GC-MS showed significant limitations: low-abundance, non-specific fragments (m/z 42, 84, 98, 140) failed to meet the identification criteria in SIM mode. Thermal degradation of CUS to HYG and CUS-d6 to HYG-d3 was observed, especially with splitless injection and aged liners. Matrix effects produced signal enhancement ranging from +29% to +316%, meaning that analyte responses in biological samples were significantly higher than in neat standards, likely due to reduced degradation or adsorption. Although deuterated internal standards (CUS-d6) partially corrected signal variability and matrix enhancement, these corrections were not sufficient to overcome the fundamental limitations of GC-MS, including poor ion specificity and compound instability. These findings support the need for LC-MS/MS-based approaches for reliable alkaloid detection and question the suitability of GC-MS for CUS analysis in forensic toxicology contexts. Full article

Introduction: This study aimed to analyze exhaled breath condensate (EBC) for 8-oxoguanine (8-oxoGua), an oxidative stress biomarker among waterpipe (WP) smokers. Methods: In a within-subject pre-post exposure design, thirty waterpipe smokers completed two 45 min laboratory sessions. EBC was analyzed for 8-oxoGua before and after WP smoking. Median differences between time points (pre vs. post) were assessed using the Wilcoxon sign rank test, with significance defined as p < 0.05. Results: The analysis included 59 WP smoking sessions. Participants had a median age of 24 years (IQR: 21–25), with 62.1% being female. Most had a bachelor’s degree or less (62.1%), and over half were students (55.2%), while 34.5% were employed. The average age for first WP use was 18.6 years, with participants reporting a median of three WP smoking sessions per month. Results indicate a median increase in 8-oxoGua among participants from 5.4 ng/mL (IQR: 8.8) before the smoking session to 7.6 ng/mL after (IQR: 15.7; p < 0.001). Conclusions: This study is the first to examine 8-oxoGua in EBC. Findings provide strong evidence of WP smoking’s contribution to oxidative stress in the airways. It justifies the use of EBC to study the exposure to markers of oxidative stress with emerging tobacco use methods such as the waterpipe. Full article

Narcotics trafficking is a fundamental part of organized crime, posing significant and evolving challenges for forensic investigations. Addressing these challenges requires rapid, precise, and scientifically validated analytical methods for reliable identification of illicit substances. Over the past five years, forensic drug testing has advanced considerably, improving detection of traditional drugs—such as tetrahydrocannabinol, cocaine, heroin, amphetamine-type stimulants, and lysergic acid diethylamide—as well as emerging new psychoactive substances (NPS), including synthetic cannabinoids (e.g., 5F-MDMB-PICA), cathinones (e.g., α-PVP), potent opioids (e.g., carfentanil), designer psychedelics (e.g., 25I-NBOMe), benzodiazepines (e.g., flualprazolam), and dissociatives (e.g., 3-HO-PCP). Current technologies include colorimetric assays, ambient ionization mass spectrometry, and chromatographic methods coupled with various detectors, all enhancing accuracy and precision. Vibrational spectroscopy techniques, like Raman and Fourier transform infrared spectroscopy, have become essential for non-destructive identification. Additionally, new sensors with disposable electrodes and miniaturized transducers allow ultrasensitive on-site detection of drugs and metabolites. Advanced chemometric algorithms extract maximum information from complex data, enabling faster and more reliable identifications. An important emerging trend is the adoption of green analytical methods—including direct analysis, solvent-free extraction, miniaturized instruments, and eco-friendly chromatographic processes—that reduce environmental impact without sacrificing performance. This review provides a comprehensive overview of innovations over the last five years in forensic drug analysis based on the ScienceDirect database and highlights technological trends shaping the future of forensic toxicology. Full article

Forensic entomotoxicology is a subdiscipline that utilizes necrophagous insects as bioindicators for detecting drugs and toxicants in decomposed remains, particularly in cases where conventional biological matrices are no longer available. Toxic substances can profoundly alter insect development, physiology, and community succession, potentially impacting the accuracy of postmortem interval (PMI) estimation. This review systematically summarizes the effects of various xenobiotics, including pesticides, illicit drugs, sedatives, heavy metals, and antibiotics on larval growth, physiological traits, and gut microbial composition in forensically relevant flies. However, most studies to date have relied primarily on phenotypic observations, with limited insight into underlying molecular mechanisms. Significant interspecies and dose-dependent variability also exists in the absorption, metabolism, and physiological responses to xenobiotics. We highlight recent advances in multi-omics technologies that facilitate the identification of molecular biomarkers associated with xenobiotic exposure, particularly within the insect detoxification system. Key components such as cytochrome P450 monooxygenases (P450s), glutathione S-transferases (GSTs), and ATP-binding cassette (ABC) transporters play essential roles in xenobiotic metabolism and insecticide resistance. Additionally, the insect fat body serves as a central hub for detoxification, hormonal regulation, and energy metabolism. It integrates signals related to xenobiotic exposure and modulates larval development, making it a promising model for future mechanistic studies in insect toxicology. Altogether, this review offers a comprehensive and reliable framework for understanding the complex interactions between toxic substance exposure, insect ecology, and decomposition in forensic investigations. Full article

Objective: To systematically review the scientific literature on lysergic acid amide (LSA), focusing on its physical, neurobiological, and social effects, as well as its potential risks and therapeutic uses. Methods: A systematic review was conducted across PubMed, Google Scholar, and Web of Science up to December 2023, using keywords such as “ergine,” “lysergic acid amide,” and “legal high.” Studies were included if they reported original human data on the physical, neurobiological, psychological, or social effects of LSA; seventeen studies were included. Animal studies, in vitro research, and non-original articles were excluded. Two independent reviewers screened and selected the studies, with a third resolving discrepancies. Data were extracted using a standardized form. The review followed PRISMA guidelines and was prospectively registered on the Open Science Framework. Results: LSA is primarily consumed through preparations made from the seeds of Convolvulaceae plants. Reported effects include euphoria, hallucinations, nausea, and anxiety. Severe adverse outcomes, such as psychosis, hypertension, and hospitalization, have also been documented. Some evidence suggests its potential therapeutic application for cluster headaches. However, variability in dosing and misinformation on digital platforms heighten the risks associated with LSA use. Conclusions: LSA poses significant health risks, exacerbated by online misinformation and variability in its effects, and a lack of scientific studies. Further research is essential to clarify its pharmacological profile, establish guidelines for safe use, and raise public awareness about its dangers. Full article

In Italy, the law on road homicide (Law no. 41/2016) introduced specific provisions for drivers who cause severe injuries or death to a person due to the violation of the Highway Code. The use of alcohol or drugs while driving constitutes an aggravating circumstance of the offence and provides for a tightening of penalties. Our study aims to report on the analysis performed on blood samples collected between January 2018 and December 2024 from drivers convicted of road homicide and who tested positive for alcohol and/or drugs. The majority of the involved subjects were males belonging to the 18–30 and 41–50 age groups. Alcohol, cocaine and cannabinoids were the most detected substances and the most frequent polydrug combination was alcohol and cocaine. We also investigated other influencing factors in road traffic accidents as the day of the week and the time of the day in which fatal road traffic accident occurred, and the time elapsed between the road accident and the collection of biological samples. Our data, in line with the international scenario, strongly support that, in addition to the tightening of penalties, raising awareness plays a key role in preventing alcohol- and drug-related traffic accidents by increasing risk perception and encouraging safer driving behaviors. Full article

Several plants produce toxic and hallucinogenic metabolites, posing risks when misused due to a lack of botanical knowledge. Improper or accidental use of these plants poses a public health risk and has been associated with forensic cases involving poisoning, suicide, or drug-facilitated crimes. This review identified eight species of forensic interest that grow in southern Chile and analyzed their active compounds, mechanisms of toxicity, and documented clinical and legal cases. These selected species included both native and introduced taxa, whose main toxic agents are tropane alkaloids (atropine, scopolamine), piperidine (coniine), taxane pseudoalkaloids, and natural opiates (morphine, codeine). Most reported cases involved unintentional poisoning, mainly in children, highlighting the lack of regulation and awareness. This review revealed the need for improved forensic and clinical documentation of plant-based intoxications in Chile and greater public education regarding the toxicological risks posed by these botanical species. Full article

Improper emissions from industrial activities pose toxicological risks to groundwater safety. Based on an environmental forensic identification case involving livestock (sheep) damage caused by groundwater pollution in a pastoral area, we comprehensively evaluated groundwater quality risks, toxicological risks, and pollution sources using multivariate statistical methods, the Nemerow index method, and a non-carcinogenic health risk model. The potential specific pollutants in the region mainly included calcium, potassium, sodium, magnesium, manganese, fluoride, chloride, sulfate, ammonia nitrogen, total dissolved solids, and nitrate. An evaluation of the groundwater health risk factors showed that fluoride, nitrate, and manganese pose higher health risks (HQ > 1), as fluoride > nitrate > manganese. This suggests that these three pollutants were the primary causes of livestock damage. Identification of pollution sources using multivariate statistical analysis revealed that the main pollutants in the groundwater originate from two rare earth enterprises in the surrounding industrial park, followed by the emissions from animal husbandry. This study provides guidelines into comprehensive regional toxicological risk assessment and source tracing, offering an identification method for similar forensic environmental damage cases. Full article

Background: Amphetamine-type stimulants (ATS) in water pose significant public health and ecological risks, necessitating reliable and efficient detection methods. Current approaches often involve time-consuming pH adjustments and post-processing steps, limiting their practicality for high-throughput analysis. This study aimed to develop a streamlined method integrating pH regulation and adsorption into a single material to simplify sample preparation and enhance analytical efficiency. Methods: A novel Fe₃O₄/MWCNTs-OH/CaO composite adsorbent was synthesized via a one-pot grinding method, embedding pH adjustment and adsorption functionalities within a single material. This innovation enabled magnetic solid-phase extraction (MSPE) without pre-adjusting sample pH or post-desorption steps. The method was coupled with liquid chromatography–tandem mass spectrometry (LC-MS/MS) for ATS detection. Optimization included evaluating adsorption/desorption conditions and validating performance in real water matrices. Results: The method demonstrated exceptional linearity (R² > 0.98), low detection limits (0.020–0.060 ng/mL), and high accuracy with relative recoveries of 92.8–104.8%. Precision was robust, with intra-/inter-day relative standard deviations (RSDs) below 11.6%. Single-blind experiments confirmed practical applicability, yielding consistent recoveries (relative errors: 1–8%) for ATS-spiked samples at 0.8 and 8 ng/mL. Compared to existing techniques, the approach reduced processing time to ~5 min by eliminating external pH adjustments and post-concentration steps. Conclusions: This work presents a rapid, reliable, and user-friendly method for ATS detection in complex environmental matrices. The integration of pH regulation and adsorption into a single adsorbent significantly simplifies workflows while maintaining high sensitivity and precision. The technique holds promise for large-scale environmental monitoring and forensic toxicology, offering a practical solution for high-throughput analysis of emerging contaminants. Full article

Purpose: Suicide is a leading cause of death among children and adolescents worldwide. This study examined the prevalence and characteristics of suicides among children and adolescents (aged ≤ 19 years) over a 13-year period in the broader area of Athens, Greece. Key aspects analyzed included victim demographics, circumstances surrounding the incidents, and methods employed. Methods: A retrospective analysis was conducted on autopsy cases performed at the Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, from 1 January 2011, to 31 December 2023. Results: Out of 5819 autopsies conducted between 2011 and 2023, 371 were classified as suicides. Among these, 12 cases (representing 3.2% of suicides) involved children and adolescents aged ≤ 19 years and met the study’s inclusion criteria for detailed forensic analysis. The average age of the victims was 17.7 ± 2.1 years (range: 14–19), with males representing 58.3% of cases. Hanging was the most common method of suicide (9 cases, 75.0%), followed by firearm use, falls from height, and hydrogen sulfide inhalation (one case each). Death occurred in the home in 10 cases (83.3%), with 6 specifically taking place in the bedroom. Scars indicative of prior self-harming behavior were present in two cases (16.7%), while suicide notes were found in three cases (25.0%). Toxicological analysis revealed alcohol and cannabis use in one case, cannabis alone in one case, and alcohol alone in two cases. Four victims (33.3%) had a documented psychiatric diagnosis, with two of them under antidepressant treatment at the time of death. Conclusions: This study highlights the forensic value of autopsy-based investigations in unveiling hidden patterns of adolescent suicidality and informs targeted prevention strategies. Integrating medico-legal findings into public health responses may enhance early identification and intervention in vulnerable youth populations. Full article