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Nowadays, it is vital to have new, complete, and rapid methods to screen and follow pharmacotoxicological and forensic cases. In this context, an important role is undoubtedly played by liquid chromatography-tandem mass spectrometry (LC-MS/MS) thanks to its advanced features. This instrument configuration can offer comprehensive and complete analysis and is a very potent analytical tool in the hands of analysts for the correct identification and quantification of analytes. The present review paper discusses the applications of LC-MS/MS in pharmacotoxicological cases because it is impossible to ignore the importance of this powerful instrument for the rapid development of pharmacological and forensic advanced research in recent years. On one hand, pharmacology is fundamental for drug monitoring and helping people to find the so-called "personal therapy" or "personalized therapy". On the other hand, toxicological and forensic LC-MS/MS represents the most critical instrument configuration applied to the screening and research of drugs and illicit drugs, giving critical support to law enforcement. Often the two areas are stackable, and for this reason, many methods include analytes attributable to both fields of application. In this manuscript, drugs and illicit drugs were divided in separate sections, with particular attention paid in the first section to therapeutic drug monitoring (TDM) and clinical approaches with a focus on central nervous system (CNS). The second section is focused on the methods developed in recent years for the determination of illicit drugs, often in combination with CNS drugs. All references considered herein cover the last 3 years, except for some specific and peculiar applications for which some more dated but still recent articles have been considered. [ABSTRACT FROM AUTHOR]

Hyperspectral imaging (HSI) collects and processes information from the entire electromagnetic spectrum to obtain the spectrum of each pixel in the image of a scene, with the aim of finding objects and identifying materials. It is a non-contact, non-destructive technology that can be used without modifying or altering the analysed target. Forensic analysis and crime scene investigations are two of the most investigated fields of application, being able to detect and analyse many types of evidence. In this paper we analysed the most commonly reported forensic science applications. The literature indicates that the fields in which HSI appears most promising are the analysis of blood traces, document forgery, gunshot residues and the identification of fingerprints. [ABSTRACT FROM AUTHOR]

Tryptamine intoxications and fatalities are increasing, although these novel psychoactive substances (NPS) are not controlled in most countries. There are few data on the metabolic pathways and enzymes involved in tryptamine biotransformation. 4-acetoxy-N,N-diisopropyltryptamine (4-AcO-DiPT) is a synthetic tryptamine related to 4-hydroxy-N,N-diisopropyltryptamine (4-OH-DiPT), 4-acetyloxy-N,N-dipropyltryptamine (4-AcO-DPT), and 4-acetoxy-N,N-dimethyltryptamine (4-AcO-DMT). The aim of this study was to determine the best 4-AcO-DiPT metabolites to identify 4-AcO-DiPT consumption through human hepatocyte metabolism and high-resolution mass spectrometry. 4-AcO-DiPT metabolites were predicted in silico with GLORYx freeware to assist in metabolite identification. 4-AcO-DiPT was incubated with 10-donor-pooled human hepatocytes and sample analysis was performed with reversed-phase liquid chromatography coupled with high-resolution tandem mass spectrometry (LC-HRMS/MS) in positive- and negative-ion modes. Software-assisted LC-HRMS/MS raw data mining was performed. A total of 47 phase I and II metabolites were predicted, and six metabolites were identified after 3 h incubation following ester hydrolysis, O-glucuronidation, O-sulfation, N-oxidation, and N-dealkylation. All second-generation metabolites were derived from the only first-generation metabolite detected after ester hydrolysis (4-OH-DiPT). The metabolite with the second-most-intense signal was 4-OH-iPT-sulfate followed by 4-OH-DiPT-glucuronide, indicating that glucuronidation and sulfation are common in this tryptamine's metabolic pathway. 4-OH-DiPT, 4-OH-iPT, and 4-OH-DiPT-N-oxide are suggested as optimal biomarkers to identify 4-AcO-DiPT consumption. [ABSTRACT FROM AUTHOR]

Hydrochloric acid (HCl) is a common reagent for neutralization of alkaline materials, in the synthesis of dyes and chemicals, and in metal refining. Ingestion of hydrochloric acid causes lesions, mainly in the esophagus and stomach. The severity of these injuries will vary with the concentration of the acid. Ingestion of concentrated HCl can lead to perforation of the bowel and be fatal. Most cases involve accidental ingestion by children or psychiatric patients, but it is used for suicide in adults. We describe a case of suicide by ingestion of about 250 mL of 33%-35% hydrochloric acid. The patient died a few hours after ingestion, and before health professionals could implement appropriate surgical therapy. Anatomically and pathologically, this case was characterized by severe esophageal damage and gastric perforation. [ABSTRACT FROM AUTHOR]

As suicide by ligature strangulation is rare, the correct medico-legal diagnosis may be difficult to establish if there is no clear supporting circumstantial evidence. We report an unusual case of suicide by strangulation with a double ligature. Investigation of the scene of death and pathological findings at autopsy are reported and discussed. We emphasise the importance of an external examination and an on-the-spot investigation. [ABSTRACT FROM AUTHOR]

The reported case is worthy of reporting because it shows the difficulties encountered in the medico-legal practice in determining of the death time. The Authors highlight the influence of the environmental factors on the thanatological processes and the importance of studying the climatic and microclimate conditions of the environment where the corpse is found. The thanatological phenomena, detected during the crime scene investigation, placed the death time 48-72 hours before the corpse was discovered, while the investigations of the Judicial Police assessed the murder was committed a week before. The anomalous development of the thanatological phenomena was explained as the consequence of the microclimatic conditions, which significantly slowed down the evolution of post-mortal processes, bringing the time of death to a time antecedent to that established. It can be asserted that the earlier the thanatological data are collected in relation to the time of death, the greater is the likelihood of the death time estimate to be correct, as the influence of the environmental factors is reduced. [ABSTRACT FROM AUTHOR]

Orbital fractures account for 10-25% of all facial fractures. The etiology of such injuries can be traced to: acts of violence (36%), motor vehicle accidents (32%), falls (18%), sports injuries (11%), occupational accidents (3%) and gunshot wounds (2%). In 30% of cases, or-bital fractures are associated with intraocular complications, 11-15% of which are serious ophthalmic emergencies that may cause reduced visual acuity. In this paper, we report the case of a motorcyclist who was treated for complex facial fractures (orbital, sphenoid, ethmoid and zygomaticomaxillary complex fractures involving the mastoid air cells and nasal conchae as well as the septum, nasal fractures and fractures in the pterygoid plates). After an initial diagnostic assessment, the doctors determined that the most critical damage was caused by the trauma inflicted to the left orbital walls. An open reduction was therefore carried out on this injury about a month later. The trauma had caused, on the one hand, a marked alteration of the patient's facial appearance, and on the other hand, at a functional level, the onset of diplopia. This article analyses the long-term effects of orbital fractures on the patients' physical fitness, considering the specific experience from the clinical case reported. [ABSTRACT FROM AUTHOR]

The case reported involved a 60-year-old man with psychiatric illness who was found dead at his home. He was almost naked and showed signs of death by violent asphyxiation, which led to the suspicion of homicide. Autopsy findings showed foreign material in the trachea and larynx. However, the partially digested content in his stomach, the study of the gastric content and the microscopic analysis of the airways made it possible to define this as accidental death due to inhalation of material from a diaper. Toxicological analysis detected the presence of phenytoin, valproic acid, and phenobarbital in his blood, with values within the therapeutic ranges. This is certainly a peculiar case, as particularly evident after careful review of the literature on deaths by asphyxiation in psychiatric patients. Furthermore, this study highlights the importance of a full autopsy and microscopic evaluation of any foreign bodies.