Medicolegal aspects of blood-urine toluene and urinary ortho-cresol concentrations in toluene exposure

Toluene is a widely used solvent in different industrial areas and has a depressant effect on the central nervous system. In medicolegal cases, for the possible influence of toluene on actions or conditions prior to death, a reliable indicator of exposure must be precisely investigated. We developed an appropriate method for toluene analysis and investigate the blood-urine toluene levels and urinary ortho-cresol levels in toluene-exposed workers. Blood and urine toluene levels from 50 male subjects were detected by Gas Chromatography-FID (GC-FID) using the head-space method, and urinary o-cresol levels, a metabolite of toluene, were analyzed by GC. The significance of difference of ocresol/creatinine levels was evaluated by the nonparametric statistics Kruskal-Wallis One Way Anova, and correlation and regression statistics were determined by Pearson Correlation of bivariant analysis. The toluene concentrations in blood ranged from 0.07 to 2.12 mg/g. Urinary o-cresol levels were not correlated significantly with blood or urine toluene levels. There was no significant difference for ortho-cresol/creatinine levels between the control and worker groups. It is concluded that for medicolegal purposes, urine toluene and urinary o-cresol levels are not reliable markers, and direct toluene analysis in blood must be preferrred in toluene exposure

The role of neutrophil gelatinase-associated lipocalin (NGAL) in the determination of contrast-induced nephropathy in patients undergoing coronary angiography

OBJECTIVE: Contrast-induced nephropathy (CIN) is the acute kidney injury developing following the administration of contrast agent after all other reasons are excluded. We aimed to determine the role of NGAL in the urine for early diagnosis of contrast-induced nephropathy, as the disorder is an important reason of acute renal failure in cases subject to cardiac catheterization clinical practice, and the frequency is increasing.MATERIAL and METHODS: One hundred cases undergoing elective coronary angiography between the dates of January 1st 2011 and March 1st 2011 were included in the study. Urine samples of the patients were taken maximum 4 hours after the coronary angiography to check the urinary NGAL level.RESULTS: The creatinine level had increased 25% in 8 patients at the 48th hour following angiography and this was accepted as CIN. Using a cutoff value of 100 ng/ml, urinary NGAL levels were found to elevated in these 8 patients, consisting of 6 females and 2 males. All them had hypertension (HT) by itself or with other accompanying diseases.CONCLUSION: The CIN diagnosis can be made with the conventional method of measuring the level of creatinine in the blood 48 hours after surgery but using the urinary NGAL method can fasten the diagnosis and treatment and also can shorten hospital stays