97 results on '"Pelletti G."'
Search Results
2. Prevalence of drug and polydrug abuse in drunk drivers. Possible implications in the driving license regranting system
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Snenghi R, Pelletti G, Frigo AC, Nalesso A, Favretto D, Montisci M, Ferrara SD, and Snenghi R, Pelletti G, Frigo AC, Nalesso A, Favretto D, Montisci M, Ferrara SD
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Forensic Toxicology, Polydrug Abuse - Published
- 2017
3. Qualitative and Quantitative study of false starts on bones through micro-CT. Preliminary results
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Pelletti G, Giraudo C, Viero A, De Matteis M, Visentin S, Ferrara SD, Montisci M, and Pelletti G, Giraudo C, Viero A, De Matteis M, Visentin S, Ferrara SD, Montisci M
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Forensic Radiology, False Starts, Micro-computed tomography - Published
- 2017
4. Characterisation of sharp force trauma and thermal injuries on human bone samples: a forensic MicroCT study
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Pelletti G, Cecchetto G, Miotto D, Viel G, Fais P, Montisci M, Ferrara SD, Giraudo C, and Pelletti G, Cecchetto G, Miotto D, Viel G, Fais P, Montisci M, Ferrara SD, Giraudo C
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Forensic Pathology, Forensic Radiology, Saw Marks, Mirco-CT - Published
- 2017
5. Hair analysis for the detection and quantification of letrozole after single and repeated use
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Favretto, D., primary, Pelletti, G., additional, Snenghi, R., additional, Pertile, R., additional, El Mazloum, R., additional, Tucci, M., additional, Visentin, S., additional, and Vogliardi, S., additional
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- 2019
- Full Text
- View/download PDF
6. Morphometric analysis of saw marks on human bones throug micro-CT
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Pelletti G, Visentin S, Giraudo C, Miotto D, Viel G, Boscolo Berto R, Viero A, Montisci M, Cecchetto G, Ferrara SD, FAIS, PAOLO, Pelletti G, Visentin S, Giraudo C, Miotto D, Viel G, Boscolo-Berto R, Viero A, Montisci M, Fais P, Cecchetto G, and Ferrara SD
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Saw marks, micro-CT, Morphometric analysis - Abstract
Introduction: The analysis of saw mark characteristics on bones can provide useful information about the type of saw used to produce the injury/mark. This study aims at testing micro-computed tomography (micro-CT) analysis of false start saw marks produced on human bones by different types of saws in order to correlate the metrical characteristics of the saw with those of the mark. Material and Methods: This study was performed on 40 human defleshed metacarpal, metatarsal and phalanx bones, collected from individuals who donated their body to the University of Padua for research purposes. The saw marks examined in this study were generated using 5 new saws, including: 3 saws with alternating set and different teeth per inch (TPI; 5, 8 and 10, respectively) and 2 saws with wavy set and different TPI (18 and 24, respectively). All marks were inflicted manually by the same operator, holding the saw perpendicularly to the long axis of the bone, applying a single unidirectional stroke with an excursion of 15 cm in length, in order to simulate a false start. Each bone sample was scanned by a Skyscan 1172 HR micro-CT (Skyscan, Aartselaar, Belgium) with the following parameters: 14 μm isotropic voxel size, 51 Kv, 194 uA, exposition time 6050 ms, rotation step 0.7, frame averaging 2, 1280 x 1024 pixel Field of View. Reconstructions were performed by N-Recon Software (Skyscan, Aartslaar Belgium), subsequently, the bitmap files were converted in DICOM using the DICOM Converter® Software. Osirix (Open Source Software, Version 7.0.1) was used to perform all the measurements and elaborate the multiplanar (MPR) and 3D volumetric reconstructions. For each bone sample, on the MPR images, the following features were assessed: number of isolated marks on each bone, shape of the mark on the sagittal plane (rectangular or triangular), maximal depth and height measured on the sagittal plane and presence of metal residues. Results: All saw marks were detected by micro-CT. Marks produced by saws with 5, 8 and 10 TPI showed two incisions with different shapes and dimensions, which were in some cases in continuity one with the other. Saw marks produced by saws with 18 and 24 TPI showed a single mark with rectangular shape and different dimensions. Metallic residues were observed in several cases. Conclusions: The preliminary results of the study suggest that micro-CT could be a useful tool for the analysis of saw marks produced on human bones. The possibility to assess the morphometric features of each lesion indicates that this technique might provide accurate and precise information about the characteristics of the type of saw used. However, further studies including a wider number of samples and using a higher variety of cutting weapons need to be performed to fully assess the potentiality of the presented radiological technique.
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- 2016
7. Micro-CT features of saw and cut marks on human bones before and after exposure to fire. A preliminary study
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Pelletti G, Visentin S, De Matteis M, Giraudo C, Amagliani A, Miotto D, Montisci M, Ferrara SD., and Pelletti G, Visentin S, De Matteis M, Giraudo C, Amagliani A, Miotto D, Montisci M, Ferrara SD.
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Saw Marks, micro-computed tomography, burned bones - Published
- 2016
8. Underlying substance abuse in drunk drivers. Lack of a uniform toxicological protocol in assessing fitness to drive
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Nalesso A, Snenghi R, Favretto D, Amagliani A, Frigo AC, Pelletti G, Ferrara SD, and Nalesso A, Snenghi R, Favretto D, Amagliani A, Frigo AC, Pelletti G, Ferrara SD
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Polydrug Abuse, Drunk Drivers, Regranting - Published
- 2016
9. Crime scene and body alterations caused by arthropods: implications in death investigation
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Viero, A., primary, Montisci, M., additional, Pelletti, G., additional, and Vanin, S., additional
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- 2018
- Full Text
- View/download PDF
10. Deliberate Self-Poisoning: Real-Time Characterization of Suicidal Habits and Toxidromes in the Food and Drug Administration Adverse Event Reporting System
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Michele Fusaroli, Guido Pelletti, Valentina Giunchi, Chiara Pugliese, Mattia Bartolucci, Elena Narmine Necibi, Emanuel Raschi, Fabrizio De Ponti, Susi Pelotti, Elisabetta Poluzzi, Fusaroli M., Pelletti G., Giunchi V., Pugliese C., Bartolucci M., Necibi E.N., Raschi E., De Ponti F., Pelotti S., and Poluzzi E.
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Pharmacology ,drugs safety ,FAERS ,Deliberate self poisoning ,Pharmacology (medical) ,Toxicology ,suicide - Abstract
IntroductionDeliberate self-poisoning (DSP) using drugs is the preferred method of suicide at a global level. Its investigation is hampered by limited sample sizes and data reliability. We investigate the role of the US FDA Adverse Event Reporting System (FAERS), a consolidated pharmacovigilance database, in outlining DSP habits and toxidromes.MethodsWe retrieved cases of 'intentional overdose' and 'poisoning deliberate' from the FAERS (January 2004-December 2021). Using descriptive and disproportionality analyses, we estimated temporal trends, potential risk factors, toxidromes, case-fatality rates and lethal doses (LDs) for the most frequently reported drugs.ResultsWe retrieved 42,103 DSP cases (17% fatal). Most cases were submitted in winter. Reports of DSP involved younger people, psychiatric conditions, and alcohol use, compared with non-DSP, and fatality was higher in men and older patients. Suspected drugs were mainly antidepressants, analgesics, and antipsychotics. Multiple drug intake was recorded in more than 50% of the reports, especially analgesics, psychotropics, and cardiovascular agents. The most frequently reported drugs were paracetamol, promethazine, amlodipine, quetiapine, and metformin. We estimated LD25 for paracetamol (150 g).ConclusionWorldwide coverage of the FAERS complements existing knowledge about DSP and may drive tailored prevention measures to timely address the DSP phenomenon and prevent intentional suicides.
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- 2023
11. Intravascular large <scp>B‐cell</scp> lymphoma affecting multiple cranial nerves: A histopathological study
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Andrea Porzionato, Martina Contran, Veronica Macchi, Luisa Barzon, Aron Emmi, Guido Pelletti, Angelo Arminio, Raffaele De Caro, Porzionato A., Pelletti G., Barzon L., Contran M., Emmi A., Arminio A., Macchi V., and De Caro R.
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Male ,Pathology ,medicine.medical_specialty ,Cerebellum ,nerve palsy ,Hypoglossal nucleus ,cranial nerves ,Motor Neuron ,Solitary tract nucleus ,Pathology and Forensic Medicine ,medicine ,cranial nerve ,Diplopia ,neurolymphomatosi ,Intravascular large B-cell lymphoma ,business.industry ,intravascular large B-cell lymphoma ,Cranial nerves ,General Medicine ,Middle Aged ,medicine.disease ,neurolymphomatosis ,medicine.anatomical_structure ,Medulla oblongata ,Autopsy ,Lymphoma, Large B-Cell, Diffuse ,Neurology (clinical) ,medicine.symptom ,Cuneate nucleus ,business ,Human - Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a rare form of lymphomas with poor prognosis, characterized by atypical lymphocytes selectively growing within the lumen of small or medium-sized vessels. Here, we report a case of intracerebral IVLBCL in a 54-year-old man who died three months after symptom onset. The diagnosis was made by postmortem pathological examination, based on the identification of multiple ischemic lesions, with small or medium-sized vessels filled with malignant B-cells, in the cerebral hemispheres, cerebellum, midbrain, and medulla oblongata, including the external cuneate nucleus and trigeminal spinal tract nucleus. Apart from necrotic lesions, specific histopathological search for occluded vessels in the other brain stem structures permitted identification of significant involvement of the cuneate nucleus, solitary tract nucleus, hypoglossal nucleus, and inferior olivary complex. Small vessels affected by IVLBCL were also found in the trunks of the oculomotor, trigeminal, glossopharyngeal, vagal, and hypoglossal nerves. These histopathological findings were consistent with some cranial nerve symptoms/signs ascertained during hospitalization, such as diplopia, dysphonia, and asymmetry/hypomotility of the palatal veil. The case study presented here reports novel insights on radiological, anatomical, and clinical correlations of the IVLBCL, including the possible involvement of nuclei and trunks of multiple cranial nerves. The reported findings may help clinicians in the early identification of this rapidly progressive disease that can be easily misdiagnosed, through integrated neuroradiological, neurological and neuropathological approaches.
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- 2021
12. Morphological characterization using scanning electron microscopy of fly artifacts deposited by Calliphora vomitoria (Diptera: Calliphoridae) on household materials
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Desiree Martini, Laura Ingrà, Paolo Fais, Arianna Giorgetti, Maria Carla Mazzotti, Mirella Falconi, Guido Pelletti, Pelletti G., Martini D., Ingra L., Mazzotti M.C., Giorgetti A., Falconi M., and Fais P.
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Morphology (linguistics) ,Scanning electron microscope ,Analytical chemistry ,01 natural sciences ,Calliphora ,Pathology and Forensic Medicine ,Forensic pathology ,03 medical and health sciences ,0302 clinical medicine ,Calliphoridae ,Animals ,Humans ,030216 legal & forensic medicine ,Texture (crystalline) ,biology ,Chemistry ,Diptera ,010401 analytical chemistry ,Bloodstain pattern analysi ,biology.organism_classification ,0104 chemical sciences ,Amorphous solid ,Fly artifact ,Polyester ,Blood Stains ,Ultrastructure ,Microscopy, Electron, Scanning ,Artifacts ,Bloodstain pattern analysis ,Scanning electron microscopy ,Crime scene - Abstract
Insects found at a crime scene can produce traces referred to as fly artifacts (FA) due to their movement over the corpse and the manner in which they feed upon it. These can be detrimental for carrying out criminal investigations. Confusing a FA with a genuine bloodspot can lead to misinterpretations, also taking into consideration that FA may contain a human DNA profile. The aim of the present study was to employ scanning electron microscopy (SEM) for the analysis of FA produced by Calliphora vomitoria on hard surfaces and fabrics that are commonly present at crime scenes. FA and control bloodstains were produced under experimental conditions on metal, glass, plaster, cotton, and polyester. After macroscopic analysis, FA were examined at standard low (20–40 ×), medium low (300–600 ×), and high ultrastructural (1200 ×) magnification through a SEM Stereoscan 360, Leica, Cambridge. SEM analysis enabled the identification of distinctive features of FA on hard surfaces, namely, amorphous crystals, micro-crystals with a morphology similar to those of uric or micro-crystals with a comparable morphology to cholesterol, absent in controls. Moreover, red blood cells (RBC) were absent in FA but were always present in controls. On cotton, for both FA and controls, the drop was almost completely absorbed and thus indistinguishable from the underlying fabric texture. On polyester, FA showed amorphous/crystal-like deposits and no RBC, as observed on hard surfaces, except for those showing a completely flat surface. SEM analysis appeared to be suitable for differential diagnosis between FA and genuine bloodstains on hard surfaces, although the results may be inconclusive on tested fabrics.
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- 2022
13. A DNA-based method for distinction of fly artifacts from human bloodstains
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Alessandra Iuvaro, Arianna Giorgetti, Guido Pelletti, Elena Giovannini, Denise Gianfreda, Susi Pelotti, Carla Bini, Bini C., Giorgetti A., Iuvaro A., Giovannini E., Gianfreda D., Pelletti G., and Pelotti S.
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Mitochondrial DNA ,genetic structures ,Human dna ,Forensic genetics ,Biology ,Pathology and Forensic Medicine ,Crime scene ,Animals ,Humans ,A-DNA ,Bloodstain pattern analysis ,Species identification ,Artifact (error) ,Fly artifacts ,Human blood ,mtDNA ,Diptera ,fungi ,Bloodstain pattern analysi ,Reproducibility of Results ,Forensic genetic ,DNA ,Feeding Behavior ,Fly artifact ,Blood Stains ,Evolutionary biology ,Mitochondrial cytochrome ,Original Article ,Artifacts ,COI sequence - Abstract
Fly artifacts resulting from insect activity could act as confounding factors on a crime scene and interfere with bloodstain pattern analysis interpretation. Several techniques have been proposed to distinguish fly artifacts from human bloodstains based on morphological approach and immunological assay, but a DNA-based method has not been developed so far. Even if in forensic genetic investigations the detection of human DNA is generally the primary goal, fly artifacts can provide useful information on the dynamics of crime events. The present study provides a molecular method to detect fly DNA from artifacts deposited by Calliphora vomitoria after feeding on human blood through the analysis of the mitochondrial cytochrome oxidase gene subunit I (COI). Fly artifacts originated from digestive process and of different morphology spanning from red and brownish/light brown, circular and elliptical stains to artifacts with sperm-like tail or a tear-shaped body were collected. The COI amplification was successfully obtained in 94% of fly artifact samples. The method showed high sensitivity and reproducibility, and no human DNA contamination was observed, offering specificity for use in confirmatory test. This molecular approach permits the distinction of fly artifacts from genuine bloodstains and the identification of fly’s species through the COI region sequencing by protocols usually applied in forensic genetic laboratories. Supplementary Information The online version contains supplementary material available at 10.1007/s00414-021-02643-7.
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- 2021
14. Sudden Unexpected Death after a mild trauma: The complex forensic interpretation of cardiac and genetic findings
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Susi Pelotti, Simone Gavelli, Guido Pelletti, Alberto Foà, Cesare Rossi, Valentina Agostini, Ornella Leone, Pelletti G., Leone O., Gavelli S., Rossi C., Foa A., Agostini V., and Pelotti S.
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medicine.medical_specialty ,Heart disease ,business.industry ,RYR2 variation ,Cardiomyopathy ,Dilated cardiomyopathy ,Autopsy ,medicine.disease ,Catecholaminergic polymorphic ventricular tachycardia ,Ryanodine receptor 2 ,Pathology and Forensic Medicine ,Sudden cardiac death ,Dilated cardiopathy, Molecular autopsy ,Internal medicine ,medicine ,Cardiology ,Next-generation sequencing ,Medical genetics ,business ,Law - Abstract
A 55-year-old man affected by a psychotic disorder suddenly died during a quarrel with his father. The autopsy excluded traumatic causes of death, and the cardiac examination identified a severe cardiomegaly with biventricular dilatation of very likely multifactorial origin. Toxicological and pharmacogenetic analyses excluded a fatal intoxication and identified the presence of the antipsychotic drug fluphenazine in the therapeutic range in a normal metabolizer. The screening for genetic variations highlighted a novel heterozygous single-nucleotide variant in the exon 36: c 0.4750C>A (p.Pro1584Thr) of the Ryanodine Receptor Type 2 (RYR2) gene. The mutation detected can be classified as Likely Pathogenic according to the American College of Medical Genetics and Genomics (ACMG) criteria. RYR2 variation has been associated to catecholaminergic polymorphic ventricular tachycardia (CPVT), a disease currently recognized as one of the most malignant cardiac channelopathies, expressed mostly in young patients, normally in the absence of structural heart disease. The victim late middle age, compared to juvenile onset of CPVT reported in literature, his clinical history, his structurally altered heart, circumstances at death and the absence of phenotype-related variations of dilated cardiomyopathy genes, suggested that the fatal arrhythmia could have been caused by an acquired form of dilated cardiopathy/cardiomyopathy. However, the contribution of the genetic variant to death cannot be completely ruled out, since the significance of a VUS or of a novel variant depends on the data available at the time of investigation, and should be periodically evaluated. We discuss the contribution of the structural alteration and of the variant detected, as well as the role of the molecular autopsy in forensic examination, which can make a significant contribution for inferring both cause and manner of death.
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- 2021
15. The use of fly artifacts in a crime scene: Is there any application for forensic toxicology?
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Elena Giovannini, Arianna Giorgetti, Paolo Fais, Guido Pelletti, Rossella Barone, Susi Pelotti, Jennifer P. Pascali, Giorgetti A., Pelletti G., Fais P., Giovannini E., Barone R., Pelotti S., and Pascali J.P.
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6-MAM ,human bloodstains ,Pathology and Forensic Medicine ,Heroin ,chemistry.chemical_compound ,Trace evidence ,Tandem Mass Spectrometry ,Genetics ,Crime scene ,Medicine ,Heroin users ,forensic toxicology ,Putrefaction ,liquid chromatography-mass spectrometry ,codeine ,Morphine Derivatives ,fly artifacts ,business.industry ,Codeine ,human bloodstain ,Forensic toxicology ,Pattern recognition ,chemistry ,benzoylecgonine ,fly artifact ,Benzoylecgonine ,crime scene investigation ,Crime ,Artificial intelligence ,Artifacts ,business ,Chromatography, Liquid ,medicine.drug - Abstract
Fly artifacts (FA) are bloodstains resulting from insect activity at a crime scene, usually by feeding on human blood. Whether these artifactual stains might be useful for forensic toxicological investigations in cases of absence of conventional and unconventional matrices, for example, in cases concealment of the body or of extensive putrefaction, has not yet been investigated. The purpose of this study is to understand if FA trace evidence permits toxicological analysis when traditional matrices are not available. To this aim, FA experimentally produced by Calliphora vomitoria feeding on human blood of a cocaine and heroin user were collected from absorptive and non-absorptive material. FA material was analyzed by a new simple and fast LC-MS/MS method. Results were evaluated in terms of presence of the drug and relative amount of the detected molecules. From a qualitative point of view, the analysis of FA revealed all the substances originally detected in post-mortem blood in both cases. The ratios of cocaine/benzoylecgonine, codeine/morphine, and 6-monoacetylmorphine/morphine recovered in FA from cotton-textile materials and from non-absorptive surfaces were consistent with data resulted from original post-mortem blood. The preliminary study herein reported demonstrated that FA are extremely informative in case of cocaine and heroin users and merit further research in order to be applied in real caseworks.
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- 2021
16. Importance of dashboard camera (Dash Cam) analysis in fatal vehicle–pedestrian crash reconstruction
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Arianna Giorgetti, Alessio Giusti, Marco Garagnani, Elena Giovannini, Guido Pelletti, Paolo Fais, Susi Pelotti, Jennifer P. Pascali, Giovannini E., Giorgetti A., Pelletti G., Giusti A., Garagnani M., Pascali J.P., Pelotti S., and Fais P.
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Computer science ,Vehicle pedestrian crash ,Video Recording ,Case Report ,Dash Cam ,Pedestrian ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Aeronautics ,Traffic crash ,0502 economics and business ,Dash ,Humans ,030216 legal & forensic medicine ,Articulated vehicle ,Forensic Pathology ,Pedestrians ,050210 logistics & transportation ,Privacy right ,05 social sciences ,Digital video ,Accidents, Traffic ,General Medicine ,Manner of death ,Motor Vehicles ,Dashboard ,Motor Vehicle ,Forensic pathology ,Human - Abstract
The reconstruction of dynamic of traffic injuries remains a challenge in forensic pathology and is often based on circumstantial data. Dash Cams are digital video recorders which can be located inside a vehicle and continuously record the view through the windscreen, thus providing objective evidence. Here we present the case of a traffic crash in which a pedestrian was hit by an articulated lorry. The analysis of a video recorded from a Dash Cam retrieved inside the vehicle during the death scene investigation (DSI) was crucial in the reconstruction of the manner of death. Indeed, the death, which was initially assumed to be accidental, was finally deemed as a suicide on the basis of the video recording, which showed an intentional and sudden rush of the victim to the middle of the roadway. Advantages and disadvantages of the use of Dash Cams will be discussed, focusing on the profound differences in the related national and international regulations. Based on the present case, in traffic crashes, the search for Dash Cams during the DSI may be recommended and the video recordings should be analyzed in the setting of a multidisciplinary and multimodal evaluation of the case, for a proper reconstruction of the facts. Supplementary Information The online version contains supplementary material available at 10.1007/s12024-021-00382-0.
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- 2021
17. Molecular mechanisms of action of novel psychoactive substances (Nps). A new threat for young drug users with forensic-toxicological implications
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Giorgia Franchetti, Giovanni Cecchetto, Guido Pelletti, Paolo Fais, Andrea Gabbin, Arianna Giorgetti, Jennifer P. Pascali, Guido Viel, Giorgetti A., Pascali J.P., Fais P., Pelletti G., Gabbin A., Franchetti G., Cecchetto G., and Viel G.
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0301 basic medicine ,Hallucinogen ,Drug ,media_common.quotation_subject ,Science ,Neurotransmitter systems ,toxicodynamic ,Review ,Mechanism of action ,Bioinformatics ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Study Eligibility Criteria ,Synthetic cannabinoids ,Medicine ,Health risk ,Ecology, Evolution, Behavior and Systematics ,media_common ,Mass spectrometry ,business.industry ,Toxicody-namic ,Forensic toxicology ,Paleontology ,030104 developmental biology ,Action (philosophy) ,Space and Planetary Science ,New psychoactive substances (NPS) ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Novel psychoactive substances (NPS) represent a severe health risk for drug users. Even though the phenomenon has been growing since the early 2000s, the mechanisms of action of NPS at the receptors and beyond them are still scarcely understood. The aim of the present study was to provide a systematic review of the updated knowledge regarding the molecular mechanisms underlying the toxicity of synthetic opioids, cannabinoids, cathinones, and stimulants. The study was conducted on the PubMed database. Study eligibility criteria included relevance to the topic, English language, and time of publication (2010–2020). A combined Mesh and free-text protocols search was performed. Study selection was performed on the title/abstract and, in doubtful cases, on the full texts of papers. Of the 580 records identified through PubMed searching and reference checking, 307 were excluded by title/abstract and 78 additional papers were excluded after full-text reading, leaving a total of 155 included papers. Molecular mechanisms of synthetic opioids, synthetic cannabinoids, stimulants, psychedelics, and hallucinogens were reviewed and mostly involved both a receptor-mediated and non-receptor mediated cellular modulation with multiple neurotransmitters interactions. The molecular mechanisms underlying the action of NPS are more complex than expected, with a wide range of overlap among activated receptors and neurotransmitter systems. The peculiar action profile of single compounds does not necessarily reflect that of the structural class to which they belong, accounting for possible unexpected toxic reactions.
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- 2021
18. Integrated multidisciplinary approach in a case of occupation related planned complex suicide-peticide
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Chiara Palazzo, Paolo Fais, Guido Pelletti, Susi Pelotti, Jennifer P. Pascali, Federica Fersini, Maria Carla Mazzotti, Palazzo C., Pascali J.P., Pelletti G., Mazzotti M.C., Fersini F., Pelotti S., and Fais P.
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Forensic pathology ,medicine.medical_specialty ,01 natural sciences ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Dogs ,Multidisciplinary approach ,Dog ,Medicine ,Animals ,Humans ,Psychiatric drugs ,030216 legal & forensic medicine ,Occupations ,Psychiatry ,business.industry ,Illicit Drugs ,Mentally ill ,Mental Disorders ,010401 analytical chemistry ,Forensic toxicology ,Pets ,Middle Aged ,0104 chemical sciences ,Pet ,Suicide ,Issues, ethics and legal aspects ,Licit drug ,Female ,business ,Homicide - Abstract
The combined event of a suicide and the killing of a pet has been hardly explored in forensic literature, but it is not rare at all. In the reported case the dead corpse of a 60-year old mentally ill woman and the carcass of a dog were found on the bed of a private apartment. In light of death scene investigation, necroscopic examination and toxicological analyses death was attributed to licit drug intoxication and self-strangulation after lethal poisoning of the dog. Due to the presence of two lethal means (cervical noose and drugs), acting in chronological order, the event was classified as a secondary complex suicide. Moreover, the woman, although mentally ill, was a psychiatrist. Thus, her professional background, namely the easy access to psychiatric drugs together with her knowledge of drug composition and properties lead to suppose an occupation related suicide. The comprehensive analysis of all the available information, including death scene investigation, occupational, necroscopic and toxicological data, resulted of the utmost importance for a proper reconstruction of the events and are recommended in complex cases such as occupation related planned complex suicides combined to the killing of pets.
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- 2020
19. 'Light cannabis' consumption in a sample of young adults: Preliminary pharmacokinetic data and psychomotor impairment evaluation
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Rossella Barone, Arianna Giorgetti, Francesca Rossi, Susi Pelotti, Marco Garagnani, Guido Pelletti, Paolo Fais, Pelletti G., Barone R., Giorgetti A., Garagnani M., Rossi F., Fais P., and Pelotti S.
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media_common.quotation_subject ,Pharmacokinetic ,Cannabidiol (CBD) ,01 natural sciences ,Pathology and Forensic Medicine ,03 medical and health sciences ,Psychomotor Performances ,0302 clinical medicine ,Human use ,Pharmacokinetics ,Δ9-tetrahydrocannabinol (Δ9-THC) ,Medicine ,030216 legal & forensic medicine ,Young adult ,media_common ,Psychomotor learning ,biology ,Light cannabi ,business.industry ,010401 analytical chemistry ,Psychomotor impairment ,biology.organism_classification ,0104 chemical sciences ,Blood ,Cannabis ,business ,Law ,Cannabidiol ,Vigilance (psychology) ,Demography ,medicine.drug - Abstract
Introduction: In 2019, the Italian Supreme Court established that hemp cannot be commercialized for human use, when the “psychotropic effect” of the product or its “offensiveness” can be demonstrated. The aim of the present study is to assess Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) blood concentrations after smoking cannabis with a low percentage of Δ9-THC, also referred as “light cannabis”, and its effects on young adults’ vigilance, cognitive and motor skills. Materials and methods: Eighteen young adults consumed three light cannabis cigarettes containing 400 mg of inflorescences each, with a percentage of 0.41% of Δ9-THC and of 12.41% of CBD. Blood samples were collected before the experiment (t0), after each light cannabis cigarette (t1→t3), 60 (t4) and 120 (t5) minutes after the beginning of the experiment. Five performance tasks and a subjective scale were employed for measuring cognitive and psychomotor performances the day before the experiment (TT0) and after the third cigarette (TT1). Results: Mean (SD) concentrations (ng/ml) were 1.0 (0.8) in t1, 1.2 (0.9) in t2, 1.0 (0.8) in t3, 0.6 (0.4) in t4 and 0.3 (0.3) in t5 for Δ9-THC; 10.5 (10.3) in t1, 10.3 (13.2) in t2, 15.1 (14.8) in t3, 9.9 (9.2) in t4 and 5.7 (5.7) in t5 for CBD. No significant differences were observed between TT0 and TT1 for all performed psychomotor performance task. None of the subjects declared to feel “high” after the experiment. Discussion: All study participants reported that a higher number of cigarettes, corresponding in this study to 1200 mg of herbal product, could hardly be consumed by smoking in a recreational setting. Δ9-THC and CBD concentrations showed a high inter-subject variability, and the average concentrations were lower than those previously reported. Toxicological results showed a decrease of Δ9-THC and CBD after the third light cannabis cigarette, and a Δ9-THC /CBD ratio always
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- 2021
20. Prevalence of therapeutic drugs in blood of drivers involved in traffic crashes in the area of Bologna, Italy
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Guido Pelletti, Tim Reyns, Francesca Rossi, Marco Garagnani, Rossella Barone, Alain Verstraete, Susi Pelotti, and Pelletti G, Verstraete AG, Reyns T, Barone R, Rossi F, Garagnani M, Pelotti S.
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Adult ,Male ,medicine.medical_specialty ,Population ,Poison control ,01 natural sciences ,Suicide prevention ,Occupational safety and health ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Age Distribution ,Environmental health ,Injury prevention ,Epidemiology ,Prevalence ,Medicine ,Humans ,030216 legal & forensic medicine ,Sex Distribution ,education ,Driving Under the Influence ,Driving under the influence ,education.field_of_study ,Psychotropic Drugs ,business.industry ,Illicit Drugs ,010401 analytical chemistry ,celebrities ,Psychoactive medicinal drugsEpidemiologyDriversRoad traffic crashesDriving under the influence ,Accidents, Traffic ,Human factors and ergonomics ,Middle Aged ,0104 chemical sciences ,celebrities.reason_for_arrest ,Analgesics, Opioid ,Substance Abuse Detection ,Italy ,Blood Alcohol Content ,Female ,business ,human activities ,Law - Abstract
Introduction Psychoactive medicines, such as benzodiazepines and Z-drugs (BdZ), antidepressants and antipsychotics (AA) and medical opioids (MO), have an impairing effect on driving ability. In previous epidemiological studies performed on impaired and/or injured drivers, not all relevant psychoactive substances were included in the toxicological assessment, and their prevalence may be underestimated. This study aims to assess the prevalence of a large set of psychoactive substances (n = 53) in Italian drivers involved in a road traffic crash and in predefined population subgroups. Materials and methods The toxicological analyses were performed on the whole blood of 1026 drivers involved in a road traffic crash in the area of Bologna, Italy, from January 2017 to March 2018. Analyses were performed using GC-FID (alcohol), GC MS (illicit drugs) and LC/HRMS (psychoactive drugs). The population was divided into subgroups according to gender, age and crash time. Descriptive statistics were used in order to assess differences among sub-groups. Results The highest prevalence was found for alcohol (17.3%), followed by medicinal drugs (13.6%) and illicit drugs (5.5%). The prevalence of BdZ, AA and MO were 7.3%, 7.2% and 3.1%, respectively. The frequency of BDZ and AA was significantly higher in female drivers and showed higher prevalence at increasing age. The presence of medicinal drugs was significantly higher during the week and in crashes occurring during the day. Conclusion Results for alcohol and illicit drugs partially overlap with those reported in previous European and Italian studies, but the prevalence of BdZ was much higher. We also found a high prevalence of AA, which are rarely investigated in epidemiological studies performed on drivers, but may cause impairment of the ability to drive, especially when taken in combination with alcohol or other drugs. The pattern of medication use differs from that involving drugs of abuse, since it is mainly observed in female subjects and older drivers and does not follow the same weekly trend observed for alcohol and other illicit drugs.
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- 2019
21. Scanning electron microscopy in the identification of fly artifacts
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Desiree Martini, Alberto Amadasi, Laura Ingrà, Mirella Falconi, Susi Pelotti, Maria Carla Mazzotti, Guido Pelletti, Paolo Fais, Chiara Palazzo, Pelletti G., Mazzotti M.C., Fais P., Martini D., Ingra L., Amadasi A., Palazzo C., Falconi M., and Pelotti S.
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Scanning electron microscope ,Sarcophagidae ,Sarcophaga carnaria ,01 natural sciences ,Pathology and Forensic Medicine ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Animals ,Humans ,030216 legal & forensic medicine ,biology ,Chemistry ,010401 analytical chemistry ,Bloodstain pattern analysi ,Sem analysis ,biology.organism_classification ,Blood Physiological Phenomena ,0104 chemical sciences ,Fly artifact ,Blood Stains ,Microscopy, Electron, Scanning ,Artifacts ,Bloodstain pattern analysis ,Scanning electron microscopy ,Biomedical engineering ,Crime scene - Abstract
Bloodstain pattern analysis has a key role in crime scene reconstruction; however, it can be hampered by diverse confounding factors, such as insect activity which may lead to the production of small artifactual bloodstains, commonly referred to as fly artifacts (FA). Although several techniques aimed at distinguishing human bloodstains and FA have been developed, actually, no standardized and reproducible methodology is available. The aim of our study was to test the use of scanning electron microscopy (SEM) to distinguish human bloodstains from FA produced by Sarcophaga carnaria. FA and bloodstains have been produced on five different deposition surfaces under experimental conditions. After visual analysis, bloodstains and FA were analyzed at standard low (× 40–× 300) and high (× 600–× 1200) magnification through a Philips SEM 515. Although differential diagnosis between bloodstains and FA resulted often inconclusive at visual analysis, SEM analysis allowed the identification of additional key distinctive morphological features. In particular, on the surface of FA, small crystal-like and/or amorphous material deposits were observed. Such deposits were absent on bloodstains which, on the other hand, displayed red blood cells stacked in “rouleaux.” Basing on these results and under our experimental conditions, SEM analysis resulted suitable to perform a differential diagnosis between bloodstains and FA produced from the insect activity of Sarcophaga carnaria.
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- 2018
22. Validation and preliminary application of a GC-MS method for the determination of putrescine and cadaverine in the human brain: a promising technique for PMI estimation
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Susi Pelotti, Paolo Fais, Rafael Boscolo-Berto, Marco Garagnani, Annalisa Morotti, Francesca Rossi, Guido Pelletti, Rossella Barone, Raffaella Roffi, and Pelletti G, Garagnani M, Barone R, Boscolo-Berto R, Rossi F, Morotti A, Roffi R, Fais P, Pelotti S.
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Accuracy and precision ,Correlation coefficient ,Gas chromatography mass spectrometry ,Liquid-Liquid Extraction ,CAD ,Post mortem interval ,01 natural sciences ,Gas Chromatography-Mass Spectrometry ,Pathology and Forensic Medicine ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Limit of Detection ,Cadaverine ,medicine ,Putrescine ,Humans ,030216 legal & forensic medicine ,Forensic Pathology ,Mathematics ,Post-mortem interval ,Biogenic polyamine ,Forensic biochemistry and toxicology ,business.industry ,010401 analytical chemistry ,Forensic toxicology ,Brain ,Reproducibility of Results ,Pattern recognition ,Human brain ,Biogenic polyamines ,2734 ,0104 chemical sciences ,medicine.anatomical_structure ,chemistry ,Postmortem Changes ,Artificial intelligence ,Gas chromatography–mass spectrometry ,business ,Law ,Biomarkers - Abstract
Introduction Among the several techniques proposed for the estimation of the Post Mortem Interval (PMI), the analysis of odorous amines has been applied in the past, with conflicting results. The aims of this study are: (i) to develop and validate a GC–MS method for the determination of putrescine (PUT) and cadaverine (CAD) in the human brain (validation study) and (ii) to study the relation of PUT and CAD concentration in the human brain and the PMI (decomposition study). Materials and methods Validation study. Analysis has been performed through GC–MS after a liquid-liquid extraction and a single step-derivatization for the identification and quantification of odorous amines in brain cortex samples. The standard protocol used in forensic toxicology, slightly modified for endogenous compounds according to recent guidelines, was used for validation. Decomposition study. Three uninjured human brains were sampled during the autopsy of three fatal traumatic cases. Along a 120-hour period of decomposition under experimental conditions, each brain was sampled along predetermined time intervals. Results Validation study. Both PUT and CAD validation parameters were within the acceptable values defined by the Scientific Working Group for Forensic Toxicology (SWGTOX), with better selectivity, linearity, accuracy and precision values for PUT. Decomposition study. A significant relationship between PUT and CAD levels and PMI has been demonstrated through statistical analysis with a correlation coefficient of 0.98 for PUT and 0.93 for CAD (p Conclusion Although further experimental studies on a wider number of samples are necessary, the results of this study suggest a possible role of polyamine levels in brain cortex for the estimation of PMI.
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- 2018
23. Application of aquatic decomposition scores for the determination of the Post Mortem Submersion Interval on human bodies recovered from the Northern Adriatic Sea
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Chiara Palazzo, Arianna Giorgetti, Guido Pelletti, Rafael Boscolo-Berto, Susi Pelotti, Paolo Fais, Filippo Pirani, Rosa Maria Gaudio, Adriano Tagliabracci, Palazzo C., Pelletti G., Fais P., Giorgetti A., Boscolo-Berto R., Gaudio R.M., Pirani F., Tagliabracci A., and Pelotti S.
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Adult ,Male ,Mediterranean climate ,Adolescent ,Oceans and Seas ,Submersion (coastal management) ,Warm season ,Pathology and Forensic Medicine ,Aquatic decomposition score ,Young Adult ,Northern Adriatic Sea ,Prediction model ,Immersion ,Linear regression ,Cadaver ,medicine ,Humans ,Forensic Pathology ,Marine environment ,Aged ,Retrospective Studies ,Cold season ,Post Mortem Submersion Interval ,Temperature ,Middle Aged ,Seasonality ,medicine.disease ,Fresh water ,Water temperature ,Postmortem Changes ,Female ,Regression Analysis ,Environmental science ,Physical geography ,Law - Abstract
Purpose The decomposition process of human bodies in marine environment is not well understood, and it is influenced by external variables related to the geographical area where the body is submerged. We report the application of two decomposition scores, the Heaton’s score and the van Daalen’s score, on a casuistry of human bodies recovered from the Northern Adriatic Sea. The aims of this study are to verify whether the marine environment of a Mediterranean climate area may affect the applicability of both scores and to develop a prediction model that can be applied on bodies recovered in salt water. Methods A retrospective study was performed on 61 human bodies recovered between 2005 and 2019 from coastal water of the Northern Adriatic Sea nearby the Italian regions Emilia-Romagna and Marche. For each of the 61 cases included, the Total Aquatic Decomposition Score (TADS) was calculated with the Heaton’s score and the Van Daalen’s score. The prediction model was assessed through multiple regression analyses, and the determination coefficients (r2) between TADS and PMSI (expressed in days) and between TADS and Accumulate Degrees Days (ADD) were studied. The prediction model was applied to the entire case sample, to bodies recovered during the warm season and to bodies recovered during the cold season. Results All bodies were recovered floating, and a very poor scavenging activity was observed. The regression analyses showed a strong correlation between the TADS and the total case sample using both scores and both independent variables (PMSI and ADD). The determination coefficients were greater than 0.95 also when considering the total case sample. Discussion The proposed prediction models are not significantly influenced by seasonality, contrarily to what observed on bodies recovered in fresh water in the same climate area. However, the ADD model, which also consider the water temperature, should be preferred for higher decomposition stages. This study helps increase the accuracy of PMSI estimation in bodies recovered from a marine environment of the Northern Adriatic Sea.
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- 2021
24. Deaths related to nitrogen inhalation: Analytical challenges
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Gianni Guadagnini, Guido Pelletti, Rossella Barone, Marco Garagnani, Paolo Fais, Francesca Rossi, Arianna Giorgetti, Susi Pelotti, Giorgetti A., Pelletti G., Barone R., Garagnani M., Rossi F., Guadagnini G., Fais P., and Pelotti S.
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Adult ,Male ,medicine.medical_specialty ,Nitrogen ,Autopsy ,01 natural sciences ,Vial ,Gas Chromatography-Mass Spectrometry ,Pathology and Forensic Medicine ,Asphyxia ,03 medical and health sciences ,0302 clinical medicine ,Administration, Inhalation ,Suicide, Completed ,medicine ,Biological fluids ,Humans ,GC–MS ,030216 legal & forensic medicine ,Nitrogen inhalation ,Cause of death ,Peak area ,Inhalation ,business.industry ,010401 analytical chemistry ,Forensic toxicology ,Carbon Dioxide ,0104 chemical sciences ,Oxygen ,Case-Control Studies ,Emergency medicine ,Asphyxiant ga ,medicine.symptom ,business ,Law - Abstract
Dinitrogen (N2) has been increasingly connected to suicidal deaths. The analysis of N2 in post-mortem cases still represents a major challenge in forensic toxicology and circumstantial data has so far played a major role for the determination of the cause of death. In this paper, after presenting a review of cases of N2 intoxication described in forensic literature, we report the application of two approaches in order to quantify an excess of N2 in post-mortem whole blood collected from a case of suicide by nitrogen inhalation. N2 analyses were performed by GC–MS on the suicidal case and on controls taken from 10 autopsy cases with similar PMI (5 traumatic deaths and 5 deaths by asphyxia). The percentage of N2 was estimated by building a five-point N2 peak area calibration curve (0, 15.6 %, 62.4 % 78.1 %, 100 %) and through an external QC, assessing linearity, accuracy and precision, LLOQ, specificity and stability of N2 in the sample vial. Percentage of N2 of the case was significantly higher than the post-mortem controls (p < 0.05). The N2/O2 ratio of the case and controls was also calculated as an additional indicator, and was significantly higher in the case (p < 0.05). The strengths and the limitation of both methods are reported in the paper. Toxicological confirmation for N2 are rarely performed when the cause of death is evident, probably due to the lack of validated methods and the complexity of the interpretation of N2 concentration in biological fluids. The presented methods can be rapidly and profitably applied with instrumentation normally available in forensic laboratories.
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- 2020
25. Optimization of cloned enzyme donor immunoassay cut-offs for drugs of abuse in post-mortem whole blood
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Rossella Barone, Marco Garagnani, Francesca Rossi, Susi Pelotti, Paolo Fais, Raffaella Roffi, Guido Pelletti, Pelletti G., Rossi F., Garagnani M., Barone R., Roffi R., Fais P., and Pelotti S.
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Drugs of abuse ,Post-mortem ,Sensitivity and Specificity ,Gas Chromatography-Mass Spectrometry ,Pathology and Forensic Medicine ,Immunoenzyme Techniques ,Forensic Toxicology ,chemistry.chemical_compound ,Cocaine ,False positive paradox ,Humans ,Medicine ,Amphetamine ,Whole blood ,Immunoassay ,Chromatography ,Receiver operating characteristic ,medicine.diagnostic_test ,Cannabinoids ,Illicit Drugs ,business.industry ,Opiate Alkaloids ,Amphetamines ,Cut-off ,CEDIA ,Substance Abuse Detection ,chemistry ,Benzoylecgonine ,business ,Law ,Methadone ,medicine.drug - Abstract
Introduction Immunoassay (IA) tests are not widely applied in post-mortem samples, since they are based on technologies requiring relatively non-viscous specimens, and compounds originating from the degradation of proteins and lipids during the post-mortem interval can alter the efficiency of the test. However, since the extraction techniques for IA tests are normally rapid and low-cost, IA could be used as near-body drug-screening for the classes of drugs most commonly found in Italy and Europe. In this study, semi-quantitative results on post-mortem whole blood samples obtained through CEDIA analysis (cannabinoids, cocaine, amphetamine compounds, opiates and methadone), were compared with results of confirmatory analysis obtained using GC–MS. Screening cut-offs for all drugs were retrospectively optimized. Methods Post-mortem whole blood samples from autopsy cases of suspected fatal intoxication were collected over 3 years. Samples were initially analyzed through CEDIA (CEDIA, ILab 650, Werfen). Confirmatory analyses were then performed by GC–MS (QP 2010 Plus, Shimadzu). Screening cut-offs were retrospectively optimized using Receiver Operating Characteristic (ROC) analysis. Results CEDIA results were available for 125 samples. Two-hundred-eighty-nine (289) positive screening results were found. Among these, 162 positive confirmation results were obtained. Optimized screening cut-offs were as follows: 6.5 ng/ml for THC; 4.2 ng/ml for THC-COOH; 12.0 ng/ml for cocaine; 6.6 ng/ml for benzoylecgonine; 6.4 ng/ml for opiates; 2.0 ng/ml for methadone. Analysis of ROC-curves showed a satisfying degree of separation in all tests except for amphetamine compounds, with areas under the curve (AUC) between 0.915 (THC) and 0.999 (for benzoylecgonine and methadone). Discussion The results of the study showed that CEDIA screening at the optimized cut-offs exhibits a very high sensitivity and good specificity and positive predictive value (PPV) for cannabinoids, cocaine and metabolites, opiates and methadone. A high number of false positives (n = 19) for amphetamine compounds was observed at the optimized cut-off, resulting in a very low PPV, which is also influenced by the very low number of TP (n = 4). Conclusion The results of the study show that the CEDIA is a valuable screening test on post-mortem whole blood for cannabinoids, cocaine and metabolites, opiates and methadone, but it is not recommended for amphetamine compounds, due to the high number of false positives. The strengths of the study are the large sample size, the inclusion of post-mortem cases only and the high level of sensitivity and specificity obtained at the optimized cut-offs.
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- 2020
26. Postmortem submersion interval in human bodies recovered from fresh water in an area of Mediterranean climate. Application and comparison of preexisting models
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Federica Fersini, Paolo Fais, Chiara Palazzo, Rafael Boscolo-Berto, Guido Pelletti, Rosa Maria Gaudio, Susi Pelotti, Palazzo C., Pelletti G., Fais P., Boscolo-Berto R., Fersini F., Gaudio R.M., and Pelotti S.
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Adult ,Male ,Mediterranean climate ,Italian river ,Correlation coefficient ,Climate ,Fresh Water ,Context (language use) ,Biology ,Mediterranean area ,01 natural sciences ,NO ,Pathology and Forensic Medicine ,Submersion (mathematics) ,Aquatic decomposition score ,03 medical and health sciences ,0302 clinical medicine ,Retrospective Studie ,Models ,Immersion ,Linear regression ,Statistics ,Cadaver ,Temperate climate ,Humans ,030216 legal & forensic medicine ,Retrospective Studies ,Models, Statistical ,Italian rivers ,Postmortem submersion interval ,Female ,Italy ,Temperature ,Postmortem Changes ,010401 analytical chemistry ,Regression analysis ,Statistical ,0104 chemical sciences ,Fresh water ,Law ,Human - Abstract
Purpose The methods developed in recent years for the assessment of the Postmortem Submersion Interval (PMSI) have proven to be promising, but are strictly related to specific geographical areas or climates. The aim of this study is to assess the suitability of two of the most recent total aquatic decomposition scores (TADS) for the determination of the PMSI in bodies recovered from fresh water in an area of Mediterranean climate in the last 15 years. To do this, the correlation coefficient (r2) between PMSI and Accumulate Degrees Days (ADD) or PMSI and days was studied. Methods The correlation between PMSI (expressed in days or in ADD) and the TADS was evaluated considering: (a) bodies recovered during the entire period; (b) bodies recovered during the cold season; (c) bodies recovered during the warm season. A linear regression analysis was set comparing the statistical significance of a model plotting TADS versus ADD, and another model plotting TADS versus PMSI (expressed in days) for both scores. Results Scores were scarcely applicable when considering the entire casuistry, as regression models showed low r2 values, but both scores showed high correlations after dividing the cases into 2 groups. In fact, after performing the seasonal partition, we observed a strong correlation between PMSI and TADS, using either of the scores. Conclusion This study helps increase the accuracy, reliability, and validity of PMI estimation in bodies recovered from freshwater in an area of temperate climate, such as Northern Italy, supporting the need to establish regionally-specific equations for estimating PMI in a forensic context.
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- 2020
27. Alcohol and illicit drugs in drivers involved in road traffic crashes in Italy. An 8-year retrospective study
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Susi Pelotti, Alessio Giusti, Guido Pelletti, Marco Garagnani, Francesca Rossi, Rossella Barone, Paolo Fais, Raffaella Roffi, Mattia Marzi, and Barone R, Pelletti G, Garagnani M, Giusti A, Marzi M, Rossi F, Roffi R, Fais P, Pelotti S
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Adult ,Male ,medicine.medical_specialty ,Substance-Related Disorders ,Blood concentration ,01 natural sciences ,Pathology and Forensic Medicine ,03 medical and health sciences ,Age Distribution ,0302 clinical medicine ,Epidemiology ,medicine ,Humans ,030216 legal & forensic medicine ,Sex Distribution ,Tetrahydrocannabinol ,Amphetamine ,Driving Under the Influence ,Driving under the influence ,Retrospective Studies ,Road crash ,Illicit Drugs ,business.industry ,Incidence (epidemiology) ,010401 analytical chemistry ,celebrities ,Accidents, Traffic ,MDMA ,Middle Aged ,Methamphetamine ,medicine.disease ,0104 chemical sciences ,Substance Abuse Detection ,celebrities.reason_for_arrest ,Substance abuse ,Italy ,Blood Alcohol Content ,Female ,Drug ,Alcohol ,business ,human activities ,Law ,Demography ,medicine.drug - Abstract
his study aims to investigate the prevalence of alcohol and drugs of abuse in Italian drivers involved in road traffic crashes between 2011 and 2018. Toxicological analyses were performed on the whole blood of 7593 injured drivers. Alcohol and illicit drugs, namely tetrahydrocannabinol (THC; cut-off 2ng/ml), cocaine (cut-off 10ng/ml), illicit opiates (cut-off 10ng/ml) and amphetamines (amphetamine, methamphetamine, MDMA, MDA; cut-off 20ng/ml) were investigated. The age and gender of the driver, the time of the crash (weekend/weekday and day/night), the road crash year and Blood Alcohol Concentration (BAC) were also considered. The 16.2% of samples tested positive for alcohol, 2.5% for cocaine, followed by opiates (2.0%), cannabinoids (1.5%), and amphetamines (0.5%). The overall prevalence of alcohol and drugs was lower than those reported in previous epidemiological studies of the DRUID project. The year 2011 showed the highest prevalence of drug-positive cases (24.1%), while the lowest prevalence was found in 2016 (16.8%), after the update of the Road Traffic Law (RTL) that increased punishments for driving under the influence. A progressive increase in the number of alcohol-positive female drivers was observed from 2011 to 2018, and the highest prevalence was found in the 26-35-year-old age range. Illicit drugs showed the highest overall prevalence in drivers
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- 2019
28. Motorcycle injuries: a systematic review for forensic evaluation.
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Giovannini E, Santelli S, Pelletti G, Bonasoni MP, Lacchè E, Pelotti S, and Fais P
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- Humans, Forensic Medicine, Craniocerebral Trauma, Motorcycles, Accidents, Traffic, Wounds and Injuries
- Abstract
The intricate interplay of exposure and speed leave motorcyclists vulnerable, leading to high mortality rates. During the collision, the driver and the passenger are usually projected away from the motorcycle, with variable trajectories or final positions. Injuries resulting from the crash can exhibit distinct and specific characteristics depending on the circumstances of the occurrence.The aim of this study is to provide a systematic review of the literature on injuries sustained by motorcyclists involved in road accidents describing and analyzing elements that are useful for forensic assessment.The literature search was performed using PubMed, Scopus and Web of Science from January 1970 to June 2023. Eligible studies have investigated issues of interest to forensic medicine about during traffic accidents involving motorcycle. A total of 142 studies met the inclusion criteria and were classified and analyzed based on the anatomical regions of the body affected (head, neck, thoraco-abdominal, pelvis, and limb injuries). Moreover, also the strategies for preventing lesions and assessing injuries in the reconstruction of motorcycle accidents were examined and discussed.This review highlights that, beyond injuries commonly associated with motorcycle accidents, such as head injuries, there are also unique lesions linked to the specific dynamics of accidents. These include factors like the seating position of the passenger or impact with the helmet or motorbike components. The forensic assessment of injury distribution could serve as support in reconstructing the sequence of events leading to the crash and defining the cause of death in trauma fatalities., (© 2024. The Author(s).)
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- 2024
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29. Prevalence of alcohol-impaired driving: a systematic review with a gender-driven approach and meta-analysis of gender differences.
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Pelletti G, Boscolo-Berto R, Anniballi L, Giorgetti A, Pirani F, Cavallaro M, Giorgini L, Fais P, Pascali JP, and Pelotti S
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Background: A growing number of studies investigated the factors that contribute to driving under the influence (DUI) of alcohol in relation to gender. However, a gendered approach of the scientific evidence is missing in the literature. To fill this gap, a gender-driven systematic review on real case studies of the last two decades was performed. In addition to the gender of the drivers involved, major independent variables such as the period of recruitment, the type of drivers recruited, and the geographical area where the study was conducted, were examined. Afterwards, a meta-analysis was performed comparing alcohol-positive rates (APR) between male and female drivers in three subgroups of drivers: those involved in road traffic accidents, those randomly tested on the road, and volunteers., Methods: Three databases were searched for eligible studies in October 2023. Real-case studies reporting APR in man and women convicted for DUI of alcohol worldwide were included. Univariate analysis by ANOVA with post-hoc tests identified the independent variables with a significant impact on the dependent variable APR, according to a relationship subsequently investigated by standard multiple linear regression. The meta-analysis of random effects estimates was performed to investigate the change in overall effect size (measured by Cohen's d standardized mean difference test) and 95% confidence interval (CI)., Results: Among papers addressing driver gender, univariate analysis of independent variables revealed a higher Alcohol Positive Rate (APR) in men, particularly in drivers involved in crashes, with a noticeable decrease over time. Analyzing the gender of drivers involved in crashes, the meta-analysis showed that men had a significantly higher APR (30.7%; 95%CI 26.8-35.0) compared to women (13.2%; 95%CI 10.7-16.1). However, in drivers randomly tested, there was no significant difference in APR between genders (2.1% for men and 1.4% for women), while in volunteers, there was a statistically significant difference in APR with 3.4% (95%CI 1.5-7.6) for men and 1.1% (95%CI 0.5-2.7) for women., Conclusion: Despite a progressive decrease in the epidemiological prevalence of alcohol-related DUI over time, this phenomenon remains at worryingly high levels among drivers involved in road traffic accidents in both genders, with a higher prevalence in men. It's important for policymakers, professionals, and scientists to consider gender when planning research, analysis, interventions, and policies related to psychoactive substances, such as alcohol or other licit drugs. Forensic sciences can play a vital role in this regard, enabling a thorough analysis of gender gaps in different populations., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2024
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30. Pediatric motor vehicle crashes injuries: A systematic review for forensic evaluation.
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Giovannini E, Santelli S, Pelletti G, Bonasoni MP, Cornacchia A, Pelotti S, and Fais P
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- Adolescent, Child, Child, Preschool, Humans, Infant, Child Restraint Systems, Forensic Medicine, Accidents, Traffic, Wounds and Injuries
- Abstract
Children involved in car crashes can experience either direct trauma or inertial injuries resulting from interactions with external objects, such as other vehicles, or with the restraint system. Furthermore, improper use of restraint systems can lead to additional severe injuries. Recent reports from international institutions underscored the persistent prevalence of inadequate restraint systems utilization and this widespread issue increases children's vulnerability and risk of injuries.The aim of this study is to provide a systematic review of the literature on injuries sustained in children involved in road accidents describing and analyzing elements useful for forensic assessment.The literature search was performed using PubMed, Scopus and Web of Science from January 1970 to March 2023. Eligible studies have investigated issues of interest to forensic medicine about traffic accidents involving pediatric passengers. A total of 69 studies satisfied the inclusion criteria and were categorized and analyzed according to the anatomical regions of the body affected (head, neck, thoraco-abdominal, and limb injuries), and the assessment of lesions in reconstruction of the accident was examined and discussed.The review highlights that in motor vehicle accidents involving children, the forensic evaluation of both the cause of death and accident dynamics needs to consider several factors, such as the child's age, the type of restraint system employed, and the specific passenger seat occupied. Considering the complexity of the factors that can be involved in this road accident, it is crucial that there is a comprehensive exchange of information between the judge and the medical expert., (© 2024. The Author(s).)
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- 2024
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31. Validation and application of a method for the quantification of 137 drugs of abuse and new psychoactive substances in hair.
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Barone R, Pelletti G, Giorgetti A, Mohamed S, Pascali JP, Sablone S, Introna F, and Pelotti S
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- Humans, Substance Abuse Detection methods, Analgesics, Opioid analysis, Hair chemistry, Substance-Related Disorders, Illicit Drugs analysis, Cannabinoids analysis
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Introduction: In the dynamic universe of new psychoactive substances (NPS), the identification of multiple and chemically diverse compounds remains a challenge for forensic laboratories. Since hair analysis represents a gold-standard to assess the prevalence of NPS, which are commonly detected together with classical drugs of abuse (DoA), our study aimed at developing a wide-screen method to detect and quantify 127 NPS and 15 DoA on hair., Materials and Methods: A multi-analyte ultra-high performance liquid chromatography mass spectrometry method for the identification and quantification of 127 NPS (phenethylamines, arylcyclohexylamines, synthetic opioids, tryptamines, synthetic cannabinoids, synthetic cathinones, designer benzodiazepines) and 15 DoA in hair samples was developed. A full validation was performed according to the European medicines Agency (EMA) guidelines, by assessing selectivity, linearity, accuracy, precision, limit of quantification (LOQ), limit of detection (LOD), matrix effect and recovery. As a proof of the applicability, the method was applied to 22 authentic hair samples collected for forensic purposes., Results: Successful validation was achieved, by meeting the required technical parameters, for 137 compounds (122 NPS and 15 DoA), with LOQ set at 4 pg/mg for 129 compounds, at 10 pg/mg for 6 and at 40 pg/mg for 2. The method was not considered validated for 5 NPS, as LLOQ resulted too high for a forensic analysis (80 pg/mg). Among authentic forensic samples, 17 tested positive for DoA, and 10 to NPS, most samples showing positivity for both. Detected NPS were ketamine and norketamine, 5-MMPA, ritalinic acid, methoxyacetyl fentanyl, methylone and RCS-4., Conclusion: The present methodology represents an easy, low cost, wide-panel method for the quantification of 122 NPS and 15 DoA, for a total of 137 analytes, in hair samples. The method can be profitably applied by forensic laboratories. Similar multi-analyte methods on the hair matrix might be useful in the future to study the prevalence of NPS and the co-occurrence of NPS-DoA abuse., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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32. Bicycle injuries: A systematic review for forensic evaluation.
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Giovannini E, Santelli S, Pelletti G, Bonasoni MP, Innocenti M, Pelotti S, and Fais P
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- Humans, Wounds and Injuries epidemiology, Bicycling injuries, Accidents, Traffic
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Bicycles are employed as means of transportation across various age groups, from young students to the elderly, for work, education, health, and leisure trips. Despite not achieving high speeds, bicyclists remain vulnerable to severe and even fatal injuries when they are involved in traffic accidents. Although the rising awareness of ecological issues and traffic law enforcement mean that cyclists are increasingly susceptible to road traffic crashes and injuries. Injuries resulting from a traffic accident involving cyclists can show distinct and specific characteristics depending on the manner of occurrence. The aim of this study is to provide a systematic review of the literature on injuries sustained in cyclists involved in road accidents describing and analysing elements useful for forensic assessment. The literature search was performed using PubMed, Scopus, and Web of Science from January 1970 to March 2023. Eligible studies have investigated issues of interest to forensic medicine about traffic accidents involving bicycles. A total of 128 studies satisfied the inclusion criteria and were categorized and analyzed according to the anatomical regions of the body affected (head, neck, thoraco-abdominal, and limb injuries), and the assessment of lesions in reconstruction of the bicycle accident was examined and discussed. This review highlights that injuries resulting from a traffic accident involving cyclists can show distinct and specific characteristics depending on the manner of occurrence and the energy levels involved in the crash. The assessment of injuries offers valuable insights that integrated with circumstantial and engineering data perform the reconstruction of accident dynamics., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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33. Reliability in distinguishing murder from accidental event with current forensic criteria in traumatic head injury.
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Pirani F, Bonasoni MP, Cornacchia A, Lacchè E, Giorgetti A, Pelotti S, and Pelletti G
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- Humans, Male, Middle Aged, Autopsy, Forensic Pathology methods, Brain Injuries, Traumatic diagnosis, Accidental Injuries diagnosis, Craniocerebral Trauma diagnosis, Cause of Death, Accidents, Reproducibility of Results, Homicide
- Abstract
Discovering a body displaying signs of multiple head trauma requires a thorough examination by the forensic pathologist, and a multidisciplinary approach is recommended. However, determining the manner of death is not always possible. We present a case in which the body of a 60-year-old man was discovered lying face down on the floor of his apartment, partially unclothed, surrounded by blood and vomit, and presenting numerous head injuries. The autopsy concluded that the cause of death was a result of post-traumatic brain injury. Nevertheless, applying current criteria made it challenging to ascertain whether the trauma stemmed from an accidental event or an assault., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
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- 2024
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34. Forensic value of soft tissue detachments from the hyoid bone in death due to strangulation asphyxia.
- Author
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Balzo GD, Pelletti G, Raniero D, Farinelli A, Uberti A, Vermiglio E, Molteni G, Nocini R, Gobbo S, Taus F, Eccher A, Luchini C, and Brunelli M
- Abstract
Background: There are no unequivocal histopathological findings for the diagnosis of fatal asphyxia due to neck compression. From the observation of a series of asphyxiation cases, we noted, during microscopic analysis, a high frequency of "detachment" of soft tissues from the hyoid bone. This specifically refers to the presence of an optical space between the surface of the hyoid bone and soft tissues., Objectives: We aimed to evaluate the detachment of soft tissues from the hyoid bone as specific histological evidence of death due to strangulation asphyxia., Material and Methods: Ten blocks were taken from deaths due to external mechanical compression of the neck (strangulation asphyxia, group A), 22 blocks were taken from deaths for other causes without trauma to the neck (group B), and 38 blocks were obtained from living subjects that have undergone laryngectomies (group C). The presence/absence of detachments were compared between the 3 groups (A, B and C) using Fisher's exact test., Results: The detachment of soft tissues from the hyoid bone was observed in 5 cases (50%) in group A, 6 cases (27.2%) in group B, and 17 cases (44.3%) in group C. The sensitivity and specificity of the presence of the detachment in group A were 0.5 (95% confidence interval (95% CI): 0.38-0.62) and 0.57 (95% CI: 0.45-0.69), respectively. The comparison between the 3 groups and the presence/absence of soft tissue detachment showed no statistically significant differences between the groups (p = 0.329), clarifying that soft tissue detachment is a nonspecific variable for all 3 situations., Conclusions: Detachment of soft tissues has poor value as a single element to favor the diagnosis of asphyxia due to violent compression of the neck and should be interpreted as an artifactual finding, unrelated to the neck injury or injury vitality.
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- 2024
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35. Diagnostic challenges and forensic implications in a case of infantile fatal myocarditis.
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Grimaldi F, Bonasoni MP, Pelletti G, Gabrielli L, and Pelotti S
- Subjects
- Infant, Child, Humans, Child, Preschool, Autopsy methods, Heart, Myocarditis pathology, Sudden Infant Death etiology
- Abstract
We present the case of a 23-month-old child who died less than 24 h after the onset of cardiac symptoms, despite being admitted to the hospital 72 h earlier. Autopsy revealed no significant macroscopic changes, and histologic examination revealed focal lymphocytic myocarditis with myocyte disruption, diffuse alveolar damage in the exudative phase, and generalized lymphocytic immune activation in other organs. Ante-mortem and post-mortem microbiological exams did not clearly prove a causative role of infectious agents. The peculiarity of this case was characterized by the contrast between the severe clinical features and the mild cardiac histological findings. This discrepancy, coupled with the suspicion of a viral causative role based on both ante-mortem and post-mortem microbiological examinations, presented significant challenges in reaching an etiological diagnosis. This case also confirms that the diagnosis of myocarditis in children cannot be made solely on the basis of histological cut-offs or microbiological results. Using abductive reasoning, various diagnostic hypotheses were formulated and evaluated to arrive at the final diagnosis of fatal myocarditis of viral or post-viral origin. Data from post-mortem examination are often the only source of information that is available to the experts, especially in cases of sudden infant death syndrome. In such cases, the forensic pathologists should accurately evaluate findings that may appear to indicate a different etiology, and, in the absence of clinical or radiological data, interpret post-mortem data in a logically correct manner. The autopsy is the first essential step to evaluate the cause of death and must be integrated with the results of ante- and post-mortem diagnostic tests in a holistic approach, which is crucial to allow forensic pathologists to provide an appropriate and relevant opinion., (© 2023. The Author(s).)
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- 2024
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36. On tackling abuse of older people: The forensic challenges in fatal cases investigation.
- Author
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Giorgetti A, Pelletti G, Fiorentini C, Mazzotti MC, Fais P, and Pelotti S
- Subjects
- Humans, Female, Aged, Autopsy, Risk Factors, Family, Elder Abuse
- Abstract
The World Health Organization recently presented the priorities for tackling abuse of older people in a coordinated and strategic way. However, data on the forensic scenario is still lacking. In this context, the aim of the present work was to provide a comprehensive literature review of this inherently complex phenomenon in the post-mortem setting, in order to better characterize it from a forensic point of view. A comprehensive literature search was performed in three electronic databases following the PRISMA guidelines. Sociodemographic and medical data of victims and perpetrators, post-mortem data, types of abuse and risk factors were extracted from non-aggregated data. Forty-eight papers dealing with abuse in the post-mortem setting were included, with a predominance of case reports and case series. The review showed that neglect was the most common type of abuse and victims are predominantly older women who are abused in a domestic setting by trusted family member. To generate more and better data, expanded research in the forensic field requires standardized methods and the raise of professional awareness about abuse of older people., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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37. An unusual case of corpse concealment driven by emotional distress.
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Giovannini E, Franchetti G, Ridolfi M, Berardi D, Pelletti G, Gualandi A, Giraudo C, Cecchetto G, and Fais P
- Subjects
- Humans, Female, Cadaver, Autopsy, Emotions, Homicide, Psychological Distress
- Abstract
Corpse concealment involves hiding a body for criminal purposes for many different reasons, such as destroy evidence of a murder or avoid the discovery of the victim. Although defendants could argue that they did not conceal the corpse with any criminal intent, but rather to spare themselves or others from emotional distress or to honor the wishes of the deceased. However, these arguments are often challenging to substantiate, and defendants may encounter significant legal obstacles when attempting to justify their actions. Herein, we report a case involving the concealment of a woman's corpse by her father. Autopsy and histological investigations were significantly limited due to the advanced decomposition of the body. Nevertheless, by integrating these data with radiological findings obtained from total body CT and micro-CT of the larynx-hyoid complex, hanging was deemed the cause of death. Additionally, the psychological evaluation of the father indicated that the act of concealment was motivated by emotions rather than criminal intent., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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38. Optimizing screening cutoffs for drugs of abuse in hair using immunoassay for forensic applications.
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Giorgetti A, Pascali JP, Pelletti G, Garagnani M, Roffi R, Grech M, and Fais P
- Abstract
Background: In forensic toxicology, positive immunoassay (IA) test results do not hold forensic validity and need to be confirmed with mass spectrometry (MS). On the other hand, a negative result is a strong indication that the drug and/or the drug metabolites are not present in the sample and that confirmatory analyses are not necessary. Consequently, a negative IA result must have forensic validity since it can be admitted in court during a trial., Objectives: Screening cutoffs for the analysis of hair samples using immunoassays (IAs) were retrospectively optimized based on the Society of Hair Testing (SoHT) confirmation cutoffs and the utility of the test for forensic applications was discussed., Material and Methods: Hair samples taken from 150 patients with a history of drug addiction were analyzed with ILab 650, Werfen (Milan, Italy) using DRI® reagents. Confirmatory analyses were subsequently performed using the ACQUITY UPLC® System, Waters Corporation (Milford, USA). Screening cutoffs were retrospectively optimized using receiver operating characteristic (ROC) analysis., Results: A total of 162 single positive results were obtained for confirmatory analysis (10 for amphetamines/methamphetamines, 11 for MDMA, 37 for cocaine, 40 for THC, 33 for methadone, and 31 for opiates). The optimized screening cutoffs were 0.27 IA ng/mg for amphetamines, 0.51 IA ng/mg for MDMA, 0.59 IA ng/mg for cocaine, 0.14 IA ng/mg for cannabinoids, 0.63 IA ng/mg for methadone, and 0.26 IA ng/mg for opiates. An area under the curve (AUC) greater than 0.95 was obtained with very high sensitivity and specificity for all drugs., Conclusions: The presented screening method proved to be a useful technique on hair samples for the classes of drugs most commonly found in Italy and Europe and can be applied to forensic analysis.
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- 2024
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39. Fetal and Infant Effects of Maternal Opioid Use during Pregnancy: A Literature Review including Clinical, Toxicological, Pharmacogenomic, and Epigenetic Aspects for Forensic Evaluation.
- Author
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Giovannini E, Bonasoni MP, Pascali JP, Bini C, Pelletti G, Gualandi A, Dal Lago G, Mercati A, Mariotti B, Pasini GP, Poll IA, and Fais P
- Abstract
The two primary classes of opioid substances are morphine and its synthetic derivative, heroin. Opioids can cross the placental barrier, reaching fetal circulation. Therefore, at any gestational age, the fetus is highly exposed to pharmacologically active opioid metabolites and their associated adverse effects. This review aimed to investigate all the studies reported in a timeframe of forty years about prenatal and postnatal outcomes of opioid exposition during pregnancy. Clinical and toxicological aspects, as well as pharmacogenetic and epigenetic research focusing on fetal and infant effects of opioid use during pregnancy together with their medico-legal implications are exposed and discussed.
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- 2024
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40. ADB-HEXINACA-a novel synthetic cannabinoid with a hexyl substituent: phase I metabolism in authentic urine samples, a case report and prevalence on the German market.
- Author
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Giorgetti A, Zschiesche A, Groth O, Haschimi B, Scheu M, Pelletti G, Fais P, Musshoff F, and Auwärter V
- Abstract
Synthetic cannabinoid receptor agonists (SCRAs) are one of the largest groups of new psychoactive substances (NPS). Yet, another novel analog started spreading on the NPS market around 2021. Soon after, the substance could be analytically characterized in herbal material as ADB-HEXINACA, an SCRA containing a hexyl-substituted tail on the indazole core. Here, we present suitable urinary markers to prove the consumption of this analog, a case report of acute polydrug intoxication and data on its prevalence in Germany. Anticipated phase I metabolites were detected in 12 authentic urine samples that were collected for abstinence control and analyzed by ultra-performance liquid chromatography coupled to a time-of-flight mass spectrometer (UPLC-qToF-MS). The results of in vivo samples were confirmed by analysis of in vitro incubates with pooled human liver microsomes (pHLMs). Forensic samples were used to assess the prevalence of ADB-HEXINACA. Thirty-two phase I metabolites were detected in the authentic urine samples. The main metabolites resulted from amide hydrolysis in combination with either monohydroxylation or ketone formation at the hexyl moiety (M15 and M26), the monitoring of which is recommended as a proof of consumption. ADB-HEXINACA was detected in 3.5% of SCRA positive urine samples collected for abstinence control in Freiburg up to December 2022 and in 5.5% of the SCRA positive blood/serum samples. The hexyl substituent of ADB-HEXINACA allows for the detection of specific urinary biomarkers suggested as analytical targets to confirm its prior intake. ADB-HEXINACA had a rather low prevalence in Germany, alternating months of higher prevalence with periods of total absence., (© 2024 The Authors. Drug Testing and Analysis published by John Wiley & Sons Ltd.)
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- 2024
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41. Homicide, suicide, or accident? Complex differential diagnosis. A case series.
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Santelli S, Berti L, Giovannini E, Pelletti G, Pelotti S, and Fais P
- Subjects
- Humans, Diagnosis, Differential, Accidents, Autopsy, Cause of Death, Homicide, Mental Disorders
- Abstract
Distinguishing between homicides, suicides, and accidental deaths remains a challenging task. The examination of actual cases, which involve a multitude of variables, significantly contributes to our understanding of these matters. In this context, we present three distinct cases that required the involvement of various specialists to conduct a thorough analysis of the manner of death. In the first case, the integration of on-site inspection, autopsy, radiological, and kinematic data enabled the identification of a homicidal death. In the second case, the combination of circumstantial evidence, autopsy findings, toxicological analysis, and meteorological data revealed an atypical accidental death resulting from an attempted suicide. In the third case, radiological findings, supplemented with criteria from forensic science, indicated an accidental manner of death. In all reported cases, a multidisciplinary approach played a pivotal role in the differential diagnosis of the manner of death., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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42. Homicide or suicide? A probabilistic approach for the evaluation of the manner of death in sharp force fatalities.
- Author
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Irmici M, D'Aleo M, Pelletti G, Pirani F, Giorgetti A, Fais P, and Pelotti S
- Subjects
- Humans, Homicide, Forensic Pathology, Data Collection, Age Distribution, Cause of Death, Suicide
- Abstract
The role of forensic science can be defined as providing relevant opinions to assist investigators and courts of law in answering questions. The Likelihood Ratio (LR) provides a quantitative and logical approach to communicating the strength of expert evidence. We reviewed existing forensic literature on sharp force fatalities, focusing on studies reporting the manner of death and the frequency of some characteristics that are traditionally assessed. Four studies were included, resulting in a database of 173 suicides and 354 homicides. The LR of each of the characteristic under both hypotheses (suicide and homicide) was obtained. Subsequently, the LR was computed in six fatalities with known manner of death, three suicides and three homicides, by multiplying the corresponding LR of each individual characteristic. LR ranged from 115 to 140,250 in suicidal cases and from 9 to 2728 in homicidal cases. Compared to other fields of forensic science where LR is used extensively, the values obtained in our cases of sharp force fatalities is low. However, in forensic pathology there is evidence that is outside the expert's opinion, and it is for the trier of fact, such as the judge or jury, to draw conclusions. Nevertheless, the LR serves as a tool for interpreting and weighing evidence while maintaining the distinct roles of the trier of fact and the expert. To comprehensively apply the LR in the field of sharp force deaths, it will be necessary to standardize the methodology of investigation and data collection in descriptive studies., (© 2023 The Authors. Journal of Forensic Sciences published by Wiley Periodicals LLC on behalf of American Academy of Forensic Sciences.)
- Published
- 2024
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43. External hair contamination from cannabis and "light cannabis" delivered by smoking and vaping: An in vitro study.
- Author
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Giorgetti A, Fais P, Pascali JP, Mohamed S, Rossi F, Garagnani M, and Pelletti G
- Abstract
External contamination of hair by cannabis smoking requires a careful evaluation in forensic toxicology. Medical and recreational cannabis are increasingly consumed by e-cigarettes, which give rise to side-stream vapor. Moreover, products containing low Δ9-tetrahydrocannabinol (Δ9-THC) and rich in cannabidiol (CBD) started spreading legally. The goal of the present study was to assess whether hair analysis could allow to distinguish the type of delivered product, with low or high Δ9-THC, and the delivering mode, by smoking or vaping. Contamination of blank hair was mimicked by in vitro exposure to low- (0.4%) and high-Δ9-THC (9.7%) products delivered by smoking and vaping within a small confined system. Cannabis vaping extracts were prepared to deliver identical target Δ9-THC doses. Eighty samples were analyzed by ultrahigh-performance liquid chromatography mass spectrometry and quantified for Δ9-THC and CBD. After contamination by cannabis smoking, THC levels were in line with past in vitro and in vivo studies. Samples exposed to cannabis (169.30 ng/mg) showed significantly higher Δ9-THC than hair exposed to "light cannabis" (35.54 ng/mg), and the opposite was seen for the CBD/Δ9-THC ratio. Hair contaminated by vaping or smoking did not show a statistically different Δ9-THC content. Under our in vitro conditions, hair analysis might allow to discriminate whether external contamination is determined by products containing low or high Δ9-THC, but not the delivering mode. More research is needed in real-life conditions, to see whether the same also applies to the interpretation of forensic casework., (© 2023 The Authors. Drug Testing and Analysis published by John Wiley & Sons Ltd.)
- Published
- 2023
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44. Fatal coronary perforation during percutaneous coronary intervention: The medico-legal interest in establishing the correlation between in vivo imaging and post-mortem histopathology.
- Author
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Pelletti G, Fiorentini C, Pirani F, Fais P, and Pelotti S
- Abstract
A 64-year-old man diagnosed with chronic coronary syndrome (CCS) underwent elective percutaneous coronary intervention (PCI) to place a stent in a branch of the first diagonal artery. Fifteen minutes after the procedure, the patient suffered a cardiac arrest, which was subsequently determined to be caused by cardiac tamponade identified through ultrasound examination. Despite an hour of cardiopulmonary resuscitation, the patient died and a forensic investigation was requested by the public prosecutor. On review of the coronary angiography images, an extravasation of contrast was noted, which was classified as a type II perforation according to the Ellis classification. Autopsy revealed a hemorrhagic suffusion area on the anterior surface of the left ventricle with suspected epicardial discontinuity. Histopathological examination confirmed a complete rupture of the vessel wall in the distal section of the branch where the stent was placed, accompanied by adjacent hemorrhagic and fibrin-platelet material. The diagnosis of coronary perforation is typically made through imaging and histological confirmation is rarely obtained. In the present case, the correlation between in vivo imaging and post-mortem histopathology not only facilitated the precise localization of the coronary perforation but also had significant medico-legal implications in the assessment of presumed medical liability., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2023
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45. Determination of ethyl glucuronide in hair and self-reported alcohol consumption in university students.
- Author
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Pascali JP, Giorgetti A, Pelletti G, Morini L, Mohamed S, Barbaresi M, Cecchi R, Pelotti S, and Fais P
- Abstract
Young individuals constitute an intriguing population, as their drinking habits are notably shaped by their perception of their peers' alcohol consumption. Nonetheless, excessive alcohol intake can have detrimental effects on academic performance, interpersonal relationships, and the risk and severity of accidents. This study reported the first data involving students enrolled from three universities on a voluntary basis for alcohol consumption evaluation. Alcohol consumption was assessed through questionnaires and EtG quantification in hair (hEtG) carried out by liquid chromatography-mass spectrometry (LC-MS/MS) analysis after a solid-phase extraction (SPE) purification step. The results of our study demonstrated that 77.1% of samples tested negative for hEtG or displayed hEtG ≤ 5 pg/mg. Particularly, the student population was not characterized by samples with hEtG indicative of chronic excessive consumption (hEtG ≥ 30 pg/mg). No significant association was identified between biological sex, among the degree course/the year attended, nor in relation to BMI or smoking/coffee consumption. Among the obtained results, it was worth noting that the comparison of self-reporting abstinence from tobacco and coffee accounted for 65.3% and 16.7%, respectively, while only 2.8% of the total declared abstinence from alcohol. The current study has uncovered a significant level of interest among students in this analysis and its interpretation. This suggests that implementing public health promotion activities within a university setting could be beneficial., (© 2023. The Author(s).)
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- 2023
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46. Authors' Reply to Cappello et al. Comment on: "Deliberate Self-Poisoning: Real-Time Characterization of Suicidal Habits and Toxidromes in the Food and Drug Administration Adverse Event Reporting System".
- Author
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Fusaroli M, Pelletti G, Giunchi V, Raschi E, De Ponti F, Pelotti S, and Poluzzi E
- Subjects
- United States, Humans, United States Food and Drug Administration, Suicidal Ideation, Suicide, Attempted
- Published
- 2023
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47. Insights in opiates toxicity: impairment of human vascular mesenchymal stromal cells.
- Author
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Mazzotti MC, Teti G, Giorgetti A, Carano F, Pelletti G, Pascali JP, Falconi M, Pelotti S, and Fais P
- Subjects
- Humans, Cellular Senescence physiology, Reactive Oxygen Species metabolism, Reactive Oxygen Species pharmacology, Morphine Derivatives pharmacology, Opiate Alkaloids pharmacology, Mesenchymal Stem Cells metabolism
- Abstract
The most common pulmonary findings in opiate-related fatalities are congestion and oedema, as well as acute and/or chronic alveolar haemorrhage, the cause of which is thought to be a damage to the capillary endothelium related to ischemia. Human vascular mesenchymal stromal cells (vMSCs) play a fundamental role in tissue regeneration and repair after endothelial cell injury, and they express opioid receptors. The aim of this study was to assess the effect of in vitro morphine exposure on the physiological activity and maintenance of human vMSCs. vMSCs were obtained from abdominal aorta fragments collected during surgery repair and were exposed to incremental doses (0.1 mM, 0.4 mM, 0.8 mM and 1 mM) of morphine sulphate for 7 days. The effect was investigated through cell viability assessment, proliferation assay, reactive oxygen species (ROS) detection assay, senescence-associated β-galactosidase assay, senescent-related markers (p21
WAF1/CIP1 and p16INK4 ) and the apoptosis-related marker caspase 3. Moreover, an ultrastructural analysis by transmission electron microscopy and in vitro vascular differentiation were evaluated. Results showed a decrease of the cellular metabolic activity, a pro-oxidant and pro-senescence effect, an increase in intracellular ROS and the activation of the apoptosis signalling, as well as ultrastructural modifications and impairment of vascular differentiation after morphine treatment of vMSC. Although confirmation studies are required on real fatal opiate intoxications, the approach based on morphological and immunofluorescence methodologies may have a high potential also as a useful tool or as a complementary method in forensic pathology. The application of these techniques in the future may lead to the identification of new markers and morphological parameters useful as complementary investigations for drug-related deaths., (© 2023. The Author(s).)- Published
- 2023
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48. A Genome-Wide Analysis of a Sudden Cardiac Death Cohort: Identifying Novel Target Variants in the Era of Molecular Autopsy.
- Author
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Beccacece L, Abondio P, Giorgetti A, Bini C, Pelletti G, Luiselli D, and Pelotti S
- Subjects
- Humans, Autopsy, Death, Sudden, Cardiac etiology
- Abstract
Sudden cardiac death (SCD) is an unexpected natural death due to cardiac causes, usually happening within one hour of symptom manifestation or in individuals in good health up to 24 h before the event. Genomic screening has been increasingly applied as a useful approach to detecting the genetic variants that potentially contribute to SCD and helping the evaluation of SCD cases in the post-mortem setting. Our aim was to identify the genetic markers associated with SCD, which might enable its target screening and prevention. In this scope, a case-control analysis through the post-mortem genome-wide screening of 30 autopsy cases was performed. We identified a high number of novel genetic variants associated with SCD, of which 25 polymorphisms were consistent with a previous link to cardiovascular diseases. We ascertained that many genes have been already linked to cardiovascular system functioning and diseases and that the metabolisms most implicated in SCD are the lipid, cholesterol, arachidonic acid, and drug metabolisms, suggesting their roles as potential risk factors. Overall, the genetic variants pinpointed herein might be useful markers of SCD, but the novelty of these results requires further investigations.
- Published
- 2023
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49. Routine Photography of Injuries: A Comparison Between Smartphone Cameras and Digital Single-Lens Camera-A Pilot Study.
- Author
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Giorgetti A, Pascali JP, Pelletti G, Silvestri A, Giovannini E, Pelotti S, and Fais P
- Subjects
- Humans, Pilot Projects, Autopsy, Smartphone, Photography methods
- Abstract
Abstract: Ten lesions were photographed with an entry-level (HUAWEI P smart 2019), a midrange (Samsung Galaxy S8) and a high range (Apple Iphone XR) smartphone camera and with a digital single-lens camera (DSLC). Images were independently rated by 3 pathologists, based on comparison to the real lesion and "visual impact." Difference of perceptual lightness coordinates between smartphones and the criterion standard (DSLC) was calculated.The highest ranking for adherence to reality was obtained with DSLC, while the highest ranking for visual impact was obtained with the Iphone. The color representation better reflecting the criterion standard (DSLC) was obtained for the entry-level smartphone.All the devices allow to assess the general features (ie, the color, the shape, and the main characteristics) of an injury during a forensic autopsy. However, results might be different when photos are obtained in suboptimal, such as low-light, conditions. Moreover, images acquired through a smartphone camera might be unsuitable for later image exploitation, such as enlargement of a portion of the image to magnification of a detail, which seemed not relevant when the photo was shot. Only a raw image, acquired using a dedicated camera and deactivating images manipulation software, might allow the preservation of the true data., Competing Interests: The authors report no conflict of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2023
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50. The Evaluation of CYP2D6, CYP2C9, CYP2C19 , and CYP2B6 Phenoconversion in Post-Mortem Casework: The Challenge of Forensic Toxicogenetics.
- Author
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Giorgetti A, Amurri S, Fazio G, Bini C, Anniballi L, Pirani F, Pelletti G, and Pelotti S
- Abstract
In toxicogenetics, an integrative approach including the prediction of phenotype based on post-mortem genotyping of drug-metabolising enzymes might help explain the cause of death (CoD) and manner of death (MoD). The use of concomitant drugs, however, might lead to phenoconversion, a mismatch between the phenotype based on the genotype and the metabolic profile actually observed after phenoconversion. The aim of our study was to evaluate the phenoconversion of CYP2D6, CYP2C9, CYP2C19 , and CYP2B6 drug-metabolising enzymes in a series of autopsy cases tested positive for drugs that are substrates, inducers, or inhibitors of these enzymes. Our results showed a high rate of phenoconversion for all enzymes and a statistically significant higher frequency of poor and intermediate metabolisers for CYP2D6, CYP2C9 , and CYP2C19 after phenoconversion. No association was found between phenotypes and CoD or MoD, suggesting that, although phenoconversion might be useful for a forensic toxicogenetics approach, more research is needed to overcome the challenges arising from the post-mortem setting.
- Published
- 2023
- Full Text
- View/download PDF
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