Postmortem tissue distribution of morphine and its metabolites in a series of heroin related deaths

The abuse of heroin (diamorphine) and heroin deaths are growing around the world. The interpretation of the toxicological results from suspected heroin deaths is notoriously difficult especially in cases where there may be limited samples. In order to help forensic practitioners with heroin interpretation we determined the concentration of morphine (M), morphine‐3‐glucuronide (M3G) and morphine‐6‐glucuronide (M6G) in blood (femoral and cardiac), brain (thalamus), liver (deep right lobe), bone marrow (sternum), skeletal muscle (psoas) and vitreous humor in 44 heroin related deaths. The presence of 6‐monoacetylmorphine (6‐MAM) in any of the postmortem samples was used as confirmation of heroin use. Quantitation was carried out using a validated LC‐MS/MS method with solid phase extraction. We also determined the presence of papaverine, noscapine and codeine in the samples, substances often found in illicit heroin and that may help determine illicit heroin use. The results of this study show that vitreous is the best sample to detect 6‐MAM (100% of cases), and thus heroin use. The results of the M, M3G and M6G quantitation in this study allow a degree of interpretation when samples are limited. However in some cases it may not be possible to determine heroin/morphine use as in 4 cases in muscle (3 cases in bone marrow) no morphine, morphine‐3‐glucuronide or morphine‐6‐glucuronide was detected, even though they were detected in other case samples. As always postmortem cases of suspected morphine/heroin intoxication should be interpreted with care and with as much case knowledge as possible

Synthesis of 3-Aryl-1-aminopropane Derivatives:Lithiation-Borylation-Ring-Opening of Azetidinium Ions

In situ generated 2-phenyl-azetidinium ylides react with boronic esters to form acyclic γ-dimethylamino tertiary boronic esters. The transformation is believed to involve the formation of a zwitterionic boronate, which subsequently undergoes ring-opening 1,2-migration, which is promoted by the relief of ring strain. Owing to the configurational instability of the initially formed ylides, which appear to be in equilibrium with the open-chain carbene form, the reaction is not stereospecific. The C–B bond of the γ-dimethylamino tertiary boronic esters can be transformed into a variety of functional groups (C–OH, C–vinyl, C–H, C–BF3), thus giving a diverse selection of 3-aryl-1-aminopropanes, which represent a privileged motif among drug molecules.</jats:p

Optical coherence tomography as a simple and non invasive tool for the diagnosis of oral disease: a case report

Introduction. Optical Coherence Tomography (OCT) is a new biomedical imaging modality that provides high reso- lution cross-sectional images of tissue. Conceptually, it has been compared with ultrasound scanning but it uses in- frared light and records reflections below the surface to produce a cross-sectional architectural image of the tissue. OCT has been applied in ophthalmology and recently in dermatology; several studies have shown the validity of the use of OCT in ex vivo oral lesions but, to date, it does not exist a bank of normative and pathological OCT data of the oral tissues to consent identification of cellular structures of normal and pathological processes. We report a case of fibroma, analyzing in vivo OCT use and comparing data with microscopic evaluation. Case report. A 44-year-old woman was referred to the Department Surgical, Oncological and Oral Sciences, Univer- sity of Palermo, with a neoformation on the apex region of the tongue, clinically compatible with the diagnosis of fi- broma or papilloma. Firstly, in vivo OCT analysis demonstrated the presence of a white area, due to the presence of hyper-reflective area for collagen storage that is strongly scattering. After, exeresis was performed and histological examination confirmed the diagnosis of fibroma. Conclusion. Optical coherence tomographic imaging can produce detailed cross-sectional images of tissue of oral cavity and it could be a new non-invasive approach that will help improve the diagnosis and the follow up of oral le- sions. The validity of OCT in ex vivo oral lesions is confirmed in literature, while in vivo OCT validity should be sup- ported by comparation of data of several oral disease: further researches are needed

Who delivers where? The effect of obstetric risk on facility delivery in East Africa.

OBJECTIVES: Skilled attendance at birth is key for the survival of pregnant women. This study investigates whether women at increased risk of maternal and newborn complications in four East African countries are more likely to deliver in a health facility than those at lower risk. METHODS: Demographic and Health Survey data for Kenya 2014, Rwanda 2014-15, Tanzania 2015-16 and Uganda 2011 were used to study women with a live birth in the three years preceding the survey. A three-level obstetric risk index was created using known risk factors. Generalised linear Poisson regression was used to investigate the association between obstetric risk and facility delivery. RESULTS: We analysed data from 13 119 women across the four countries of whom 42-45% were considered at medium risk and 12-17% at high risk, and the remainder were at low risk. In Rwanda, 93% of all women delivered in facilities but this was lower (59-66%) in the other three countries. There was no association between a woman's obstetric risk level and her place of delivery in any country; greater wealth and more education were, however, independently strongly associated with facility delivery. CONCLUSIONS: In four East African countries, women at higher obstetric risk were not more likely to deliver in a facility than those with lower risk. This calls for a renewed focus on antenatal risk screening and improved communication on birth planning to ensure women with an increased chance of maternal and newborn complications are supported to deliver in facilities with skilled care

A review of the analytical techniques for the detection of anabolic–androgenic steroids within biological matrices

Anabolic–androgenic steroids (AASs) and other image and performance enhancing drugs (IPEDs) are controlled by governments and sport institutions such as the World Anti-doping Agency (WADA). Although elite athletes and professional bodybuilders are the most visible AAS abusers, the introduction of the internet has increased the accessibility of AASs, with use being observed among recreational gym goers at increasing prevalence. Despite reported increase in use, routine analysis for these substances is uncommon, with many forensic laboratories opting to outsource AAS analysis. This review collates information regarding the extraction and analysis of AASs from various biological matrices with the considered purpose of providing a reference for the development of AAS methods to allow for routine detection by forensic laboratories

Oral squamous cell carcinoma as a complication of chronic graft-versus-host disease: a case report

Objectives. Chronic Graft-Versus-Host Disease (cGVHD) is an immunoregulatory disorder which occurs after allogeneic hematopoietic-cell transplantation (HCT) and often shares features of autoimmunity and immunodeficiency. GVHD related oral manifestations include severe oral pain, xerostemia, ulcerative lesions, and mucositis. Furthermore,a major late suggested complication of HSCT is the dramatically increased risk of secondary malignancies including oral cancer and oral cGVHD-releted inflammation may be considered a potential risk factor. Case report. A 51-year-old male patient referred in 1994 to our surgery for cGVHD oral lesions secondary to HCT for acute myelogenous leukemia developed in 1992. In 2010, an incisional biopsy in left retrocommissural region for an erosive lesion was performed and microscopic analysis revealed an intense lymphoplasmacytic inflammatory infiltrate. In 2011, clinical intraoral examination revealed white verrucous plaque lesion associated with ulcerations on the gingiva of the V sextant and on the lower labial mucosa; two incisional biopsies of oral mucosa and an incisional skin biopsy were performed. Microscopic analysis revealed a well differentiated SCC, a moderately differentiated SCC and a skin high grade dysplasia. Patient was surgically treated and is currently in follow up. Conclusions. Several authors suggest that cGVHD-related inflammation could be an important risk factor for carcinogenesis, also for oral cavity. Then it is recommended close follow-up to all patients treated with HCT, particularly when they develop graft-versus-host disease, and any suspicious oral lesions should be biopsied to rule out dysplasia or malignancy

Mung Bean nuclease mapping of RNAs 3' end

A method is described that allows an accurate mapping of 3' ends of RNAs. In this method a labeled DNA probe, containing the presumed 3' end of the RNA under analysis is allowed to anneals to the RNA itself. Mung-bean nuclease is then used to digest single strands of both RNA and DNA. Electrophoretic fractionation of "protected" undigested, labeled DNA is than performed using a sequence reaction of a known DNA as length marker. This procedure was applied to the analysis of both a polyA RNA (Interleukin 10 mRNA) and non polyA RNAs (sea urchin 18S and 26S rRNAs). This method might be potentially relevant for the evaluation of the role of posttrascriptional control of IL-10 in the pathogenesis of the immune and inflammatory mediated diseases associated to ageing. This might allow to develop new strategies to approach to the diagnosis and therapy of age related diseases

Paresthesia of the lip caused by a large osteoma of the mandible treated with a conservative approach: a case report.”

This study focused on a case of paresthesia of the right lip caused by an extensive osteoma of the mandible

The current status of pharmacotherapy for the treatment of Parkinson's disease: transition from single-target to multitarget therapy

Parkinson's disease (PD) is a neurodegenerative disorder characterized by degeneration of dopaminergic neurons. Motor features such as tremor, rigidity, bradykinesia and postural instability are common traits of PD. Current treatment options provide symptomatic relief to the condition but are unable to reverse disease progression. The conventional single-target therapeutic approach might not always induce the desired effect owing to the multifactorial nature of PD. Hence, multitarget strategies have been proposed to simultaneously target multiple proteins involved in the development of PD. Herein, we provide an overview of the pathogenesis of PD and the current pharmacotherapies. Furthermore, rationales and examples of multitarget approaches that have been tested in preclinical trials for the treatment of PD are also discussed