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Edston E.,National Board of Forensic Medicine
Forensic Science, Medicine, and Pathology | Year: 2013

Death in anaphylactic shock cannot be diagnosed by autopsy alone. Morphological diagnosis of anaphylactic death by counting mast cells in the lung and airways have failed to give consistent results. Previously it has been observed that eosinophils seem to accumulate in the spleen in anaphylaxis. The purpose of this study was to investigate if it is possible to safely diagnose anaphylactic deaths by counting eosinophils, mast cells, and basophils in the spleen. In 43 forensic autopsy cases specific antibodies to mast cells, eosinophil-, and basophil granulocytes were used on sections from lung and splenic tissue. The cells were counted in 20 × 40 fields in a Leica photo-microscope. Presumed deaths in anaphylaxis were compared with sudden deaths after intravenous injection of opiates, and sudden cardiac deaths (control group). The main result was that significant (p < 0.05)increases of both eosinophil granulocytes (mean 26.6 ± 17.8/SD/)and mast cells (3.2 ± 2.0/SD/) versus controls (eosinophils mean 7.0 ± 10.5 and mast cells mean 0.9 ± 1.1) were seen in splenic tissue in anaphylactic deaths. Comparing cases with high and low concentrations of mast cell tryptase in serum showed a similar increase in eosinophils and mast cells in the spleen in cases with elevated tryptase, but not in the lung. The numbers of pulmonary mast cells and eosinophils were not different in anaphylactic deaths compared with controls. It is concluded that by quantifying eosinophil granulocytes and mast cells in the spleen in combination with tryptase measurements in serum it is possible to diagnose anaphylaxis with a high degree of certainty. © 2013 Springer Science+Business Media New York.

O'Connor K.L.,U.S. National Institute of Standards and Technology | Tillmar A.O.,National Board of Forensic Medicine
Forensic Science International: Genetics | Year: 2012

Ideally for use in forensic analyses, genetic markers on the same chromosome should be more than 50 Mb in physical distance to ensure full recombination and thus independent inheritance. The forensic community has given attention to two STR markers, D12S391 and vWA, that are 6.3 megabases (Mb) apart on chromosome 12. Recent studies have shown no significant linkage disequilibrium between vWA and D12S391 in U.S. and worldwide populations, although genetic linkage has been identified. It is important to evaluate the impact of linkage effects on kinship analysis. In this study, we aimed to determine a more precise measurement of the recombination frequency between vWA and D12S391 based on a larger number of informative meiosis than has been studied previously. We estimated the recombination frequency (θ) to 0.089 (95% CI 0.044-0.158). Using pedigrees simulated under specific kinship scenarios where recombination was expected to affect the likelihood ratio (LR), we evaluated the impact on LR values of including or ignoring linkage between vWA and D12S391. For all pedigree scenarios considered, on average, LR values ignoring linkage were slightly underestimated than when linkage was considered. However, in the incest scenario considered, LR values could be overestimated up to 25-30 times when linkage was ignored. We demonstrate that the effect of ignoring linkage in the likelihood ratio calculation can be considerable. These results suggest that linkage should be considered during kinship analysis when vWA and D12S391 are tested for pedigrees where a recombination could impact the LR value. © 2012 Elsevier Ireland Ltd. All rights reserved.

Using a forensic toxicology database, the authors investigated cases of driving under the influence of drugs (DUID) if methamphetamine (MA) was identified in the blood samples (N = 9,310). The concentrations of MA and amphetamine (AM) in blood were determined after liquid-liquid extraction by gas chromatography-mass spectrometry at limits of quantitation of 0.03 mg/L for both stimulants. In 814 cases, AM was negative in blood and MA was positive at mean (median) and highest concentrations of 0.19 mg/L (0.11 mg/L) and 3.4 mg/L, respectively. Both amines were present in blood in 8,496 cases at concentrations of 0.54 mg/L (0.35 mg/L) and 10.4 mg/L for AM and 0.41 mg/L (0.22 mg/L) and 5.6 mg/L for MA. However, the correlation between AM and MA was low and insignificant (r = -0.13) in the whole material. The coefficient of correlation increased to r = 0.41 (P < 0.001) when the MA/AM concentration ratio was >1. When MA/AM ratios were selected at intervals of 1.0 (e.g., >3.0 and <4.0 up to >9.0 and <10.0), the correlation between AM and MA was r = 0.99 (P < 0.001). Such cases represent the use of MA without contamination from AM, and the mean (median) and highest concentrations of this secondary amine in blood of DUID suspects were 0.72 mg/L (0.56 mg/L) and 4.2 mg/L, respectively.

Cooper G.A.A.,University of Glasgow | Kronstrand R.,National Board of Forensic Medicine | Kintz P.,Linkoping University
Forensic Science International | Year: 2012

The Society of Hair Testing (SoHT) Guidelines for Drug Testing in Hair provide laboratories with recommended best practice guidelines whether they are currently offering drug testing in hair, or plan to offer a hair testing service in the future. The guidelines include reference to recommended sample collection and storage procedures, through sample preparation, pre-treatment and analysis and the use of cut-offs. © 2011.

Reis M.,National Board of Forensic Medicine | Kllen B.,Lund University
Psychological Medicine | Year: 2010

Background Concerns have been expressed about possible adverse effects of the use of antidepressant medication during pregnancy, including risk for neonatal pathology and the presence of congenital malformations. Method Data from the Swedish Medical Birth Register (MBR) from 1 July 1995 up to 2007 were used to identify women who reported the use of antidepressants in early pregnancy or were prescribed antidepressants during pregnancy by antenatal care: a total of 14 821 women with 15 017 infants. Maternal characteristics, maternal delivery diagnoses, infant neonatal diagnoses and the presence of congenital malformations were compared with all other women who gave birth, using the Mantel-Haenszel technique and with adjustments for certain characteristics. Results There was an association between antidepressant treatment and pre-existing diabetes and chronic hypertension but also with many pregnancy complications. Rates of induced delivery and caesarean section were increased. The preterm birth rate was increased but not that of intrauterine growth retardation. Neonatal complications were common, notably after tricyclic antidepressant (TCA) use. An increased risk of persistent pulmonary hypertension of the newborn (PPHN) was verified. The congenital malformation rate was increased after TCAs. An association between use of paroxetine and congenital heart defects was verified and a similar effect on hypospadias was seen. Conclusions Women using antidepressants during pregnancy and their newborns have increased pathology. It is not clear how much of this is due to drug use or underlying pathology. Use of TCAs was found to carry a higher risk than other antidepressants and paroxetine seems to be associated with a specific teratogenic property. © Cambridge University Press 2010.

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