Il laboratorio di tossicologia forense nell’ambito della diagnostica medico-legale

Nadia De Giovanni*, Nadia Fucci
*Laboratorio di Tossicologia Forense - Istituto di Medicina Legale – Università Cattolica del Sacro Cuore, Roma

Biochimica Clinica: 2006; 30(2): 98-105 [Article in italian]

ABSTRACT. The role of the toxicology laboratory in legal medicine. The forensic toxicological laboratory is a highly specialistic laboratory which interests include the determination of use/abuse of drugs, workplace and roadside controls, therapeutical programs in rehabilitation, doping problems. The laboratory must guarantee the reliability and the high quality of its performances, using sophisticated instrumentations and highly qualified researchers. This paper describes the laboratory organization discussing the analytical process from the choice of biological sample and adequate procedures to the supply of analytical data and interpretation of results.

Costruzione di un Sistema di Qualità per il laboratorio chimico-tossicologico

Anna Pia Colucci*, Roberto Gagliano-Candela
*Dipartimento Medicina Interna Medicina Pubblica, Università degli Studi di Bari

Biochimica Clinica: 2006; 30(2): 106-111 [Article in italian]

ABSTRACT. Building up a quality system for the chemical-toxicological laboratory. Reliable analytic measurements are needed when human health care is concerned; the control of analytical data quality is an absolutely necessary requisite for a rigorous control of reliability. In such a process it is necessary to guarantee homogeneity, both in the definition and evaluation of quality parameters, in agreement with the most recent suggestions at European level, and in the interpretation of results, in consideration of the scopes of testing. Therefore, in the present work, we suggest the procedures for building up a quality system for the laboratory of toxicological analytical chemistry, aimed to guarantee the “analytical quality assurance”, even through the use of appropriate parameters for quality verification (representativness, accuracy of value, recovery, detection limit, LOD, LOQ, selectivity, specificity, robustness, uncertainty of measurement).

Stragi del sabato sera: esperienza di collaborazione tra Polizia Stradale e Sezione FarmacoTossicologica della Medicina di Laboratorio dell'Ospedale "Infermi" di Rimini

Mirella Filocamo
Servizio di Medicina di Laboratorio Ospedale "Infermi" Rimini

Biochimica Clinica: 2006; 30(2): 112-114 [Article in italian]

ABSTRACT. Saturday night slaughters: experience of cooperation between the Traffic Police and the Laboratory Medicine Pharmaco-Toxicological section of the “Infermi” Hospital, in Rimini. We report about the experience of the Pharmaco-Toxicological section of the Laboratyory Medicine of the Infermi hospital in Rimini, in cooperating with the traffic Police in a project aimed at reducing the frequency of car accidents in the week-end nights, a phenomenon called “Saturday night slaughters”. To such an aim, a mobile laboratory has been installed on a suitable motor-vehicle, and operative protocols of analytical accuracy, and quality have been standardized. in order to protect the citizens’ rights.

Ecstasy

Sergio Pellegrino
Settore di Tossicologia, Laboratorio di Analisi, ASO Ordine Mauriziano, Torino

Biochimica Clinica: 2006; 30(2): 115-119 [Article in italian]

ABSTRACT. The ecstasy. The 3,4-metyhylendioxyamfetmine (MDMA or ecstasy), active principles belonging to the toxicological class of phenylethylamines, structurally correlated to adrenaline, is used as a drug of abuse for recreation purposes. Taken by oral way as tablets, it acts producing pharmacologic excitant effects on the brain structures and superior functions. The MDAM is easily synthetized in large amounts in illicit laboratories starting from safrol, a low cost chemical compound easily available on the market. Ecstasy assumption causes improvement of tone and humour, of resistance against fatigue, and of performance: the addict is induced towards a routine consumption and psychic and physic dependence. Toxic effects show with arising anxious states, and prolonged abuse determines degeneration of serotoninergic neurons. The lethal dose depends on the tolerance of the addict, and death comes within a clinical picture including fever, convulsions, coma and cerebral haemorrhages. The main metabolites are 3,4-methylendioxyamfetamine (MDA), and 4-hydroxi-3-metoxyamfetamine (HMMA), in plasma and urine, respectively. Plasma concentrations of MDMA are well correlated with saliva and sweat concentrations, this allowing their assay in “non-conventional” matrices

Le sostanze stupefacenti sequestrate sul mercato clandestino romano nell’anno 2005

Federica Umani Ronchi
Dipartimento di Medicina Legale dell’Università degli Studi di Roma “La Sapienza”

Biochimica Clinica: 2006; 30(2): 120-125 [Article in italian]

ABSTRACT. Drugs of abuse confiscated on the illicit market in Rome in 2005. The statistical data collected during 776 sequestrations of drugs of abuse on the illicit market in Rome in the year 2005 have been elaborated. The kind of drugs, their diffusion, and their trends during the months of the year and the days of the week have been considered in our study. Cocaine and Cannabis-based mixtures, followed by heroin, were the most frequently confiscated substances. For such substances, the percentage of the active principle most frequently found in the materials has been determined. As far as possible, our data have been compared with those given by the European Observatory on Drugs of abuse and Drug Addicts, and with those coming from the Central Department for Services against Drugs of Abuse.

Le sostanze doping negli integratori alimentari: sviluppo di un metodo lc/ms/ms per la loro determinazione

Marialinda Felli*, Marcello Chiarotti
*Istituto di Medicina Legale – Università Cattolica del Sacro Cuore Roma

Biochimica Clinica: 2006; 30(2): 126-131 [Article in italian]

ABSTRACT. Doping subtances in nutritional supplements: development of an LC/MS/MS method for their determination. Several doping cases have been reported in sports competition world wide during official doping tests. In some cases athletes claimed to have inadvertently absorbed the drugs, by the ingestion of products sold as nutritional supplements that contained prohibited substances. Most of dietary supplements do not contain doping agents, but studies have demonstrated that some of these products may contain undeclared substances prohibited by the International Olympic Committee/World Anti-Doping Agency. In some “non-hormonal” nutritional supplements banned substances such as ephedrine, caffeine, steroids and pro-hormones were found. The development of specific method for the screening of prohibited substances in these products is of primary importance for athletes’ health. This study describes a qualitative LC/MS/MS method for the determination of several anabolic steroids in nutritional supplements.

Determinazione delle isoforme della transferrina mediante elettroforesi capillare

Simona Martello
Università Cattolica del Sacro Cuore - Istituto di Medicina Legale - Roma

Biochimica Clinica: 2006; 30(2): 132-136 [Article in italian]

ABSTRACT. Determination of carbohidrate deficient transferrin isoforms by capillary electrophoresis. Carbohydrate-deficient transferrin (CDT) is the most specific marker of chronic or sustained alcohol abuse. This marker is commonly used as a diagnostic tool in many areas: employment, traffic safety and forensic medicine. For this reason in the last years the development of specific method for CDT determination has been a target. Capillary electrophoresis (CE) has been confirmed a convenient tool for rapid and accurate CDT analysis. Commercial kits have been simplified the CDT determination by capillary electrophoresis and now they are used for routine diagnostic. In this work it is reported the experience of CDT analysis using CE. It was also reported the limit of CDT determination in serum for forensic purposes and the comparison with immunoassays.

Valutazione di un metodo nefelometrico applicato su BNII della Dade Behring per la determinazione della transferrina carboidrato carente

Gianluigi Devoto*, Giorgio Albalustri, Rinaldo Arsenio, Franca Deiana, Marco Musso
*Laboratorio Analisi, Ospedale di Lavagna, Genova

Biochimica Clinica: 2006; 30(2): 137-141 [Article in italian]

ABSTRACT. We compared a Dade Behring N Latex CDT assay with Bio-rad %CDT TIA assay and with Bio-rad % CDT HPLC used in our laboratory such as screening and confirm test respectively. Serum samples of Normal patients (N°120), well-definied alcoholics in pharmacological treatment (N°12), patients affected by Hepatic conditions not alcohol related (N°30), Patients undergoing mandatory control for legal situation (N° 84), were assayed with these three methods. The results show a good correlation between HPLC e N LATEX CDT (r=0,96; p<0,001) , a good concordance in terms of positive-negative samples with a reduce need for confirmation tests, with a reduce of costs and an improvement of laboratory organization.

Determinazione della benzoilecgonina su siero e su sangue cadaverico. Studio di applicazione di tecnica immunoenzimatica (Emit® II Plus)

Marzia Bernini*, Daniela Ruffini, Manuela Licata, Patrizia Verri, Francesco De Ferrari
*Dipartimento di Specialità Chirurgiche, Scienze Radiologiche e Medico Forensi – Cattedra di Medicina Legale – Università degli Studi di Brescia

Biochimica Clinica: 2006; 30(2): 142-147 [Article in italian]

ABSTRACT. Direct detection of Benzoylecgonine in serum and post-mortem blood by Emit® II Plus Cocaine Metabolites immunoassay. An EMIT® II PLUS Cocaine Metabolites Assay for urine testing was applied on VIVA-Twin™ Dade-Behring analyzer, for the detection of the cocaine metabolite Benzoylecgonine in human serum and post-mortem blood. The aim of our study came from the need to realize a reliable screening method on serum and post-mortem blood, instead of using a RIA method, to determine cocaine and metabolites. In this work we realized a first calibration curve, entirely on serum, and then a second calibration curve on EMIT® Calibrator/Control Level 0,2,3, commercial reagents and, finally, we analyzed real samples on both of them, previously tested with RIA and confirmed with GC/MS method. On that serum calibration curve, we analyzed post-mortem blood samples too, previously deproteined with acetone, and tested with GC/MS method. The results of the modified EMIT immunoassay system presented here were good on both the series examined, with a valid correspondence (absence of false negative), but we found a certain difficulty in identify an advisable cut-off. The method in any case seems to be useful for screening of cocaine in serum and post-mortem blood samples, in alternative to RIA method.

Analisi tossicologica dei capelli: stato dell’arte e considerazioni operative

F. Umani Ronchi
Dipartimento di Medicina Legale Università di Roma “La Sapienza”

Biochimica Clinica: 2006; 30(2): 148-154 [Article in italian]

ABSTRACT. Toxicological hair assay: state of the art and considerations. A review of the literature concerning toxicological hair assay has been performed, by carefully examining the contents of 48 reports published in the relevant national and international bibliography

Modello organizzativo e ruolo del laboratorio tossicologico ad alta produttività per la gestione della farmacodipendenza del territorio metropolitano A.S.L. Napoli 1

Luigi Vrenna*, Daniela Giardiello, Agnese Morani, Patrizia Padulano, Immacolata Amoroso, Rita Fiore,Claudio Balsamo, Paola Cortese, Gennaro Meucci, Antonella D’Aniello, Lucia Lombardi, Patrizia Frassi, Gabriella Frigeri, Maria Attaianese
*Laboratorio di Patologia Clinica, Polo Tossicologico di Riferimento Territoriale P.S.I. “S.M.Loreto Crispi ASL Napoli 1;

Biochimica Clinica: 2006; 30(2): 155-168 [Article in italian]

ABSTRACT. The laboratories for toxicology and related diseases were created at the end of 1996 within the city area of the Napoli 1 A.S.L. and, so far, have gained an important experience. Their aims is to control drug abuse, monitor the use of metadone and buprenorphine and diagnose and monitor alcoholism through the screening of urinary and serum samples. Confirmation results are obtained by chromatographic techniques. Based on the above experiences and in order to provide a better service, we attempted to improve the reliability of the results, speed up the diagnostic procedures, comply with privacy laws, control costs, elaborate analytical results, monitor the geographic area, and observe the custody chain - which is expecially needed in the presence of forensic issues - by implementing an organization model. This organization descends from a long lasting experience supported by several administrative deliberations, which allowed the current model to be widely adopted. We have been trying to improve this model in order to satisfy the requests of the addicted subjects. In addition, we aimed at realizing projects focused on specific objectives either diagnostic or rehabilitative, always within a legal framework.

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