Toxicologie Analytique et Clinique最新文献

{"title":"Thirty years of progresses in hair testing science, where do we go?","authors":"Carmen Jurado","doi":"10.1016/j.toxac.2025.01.052","DOIUrl":"10.1016/j.toxac.2025.01.052","url":null,"abstract":"<div><h3>Objective</h3><div>Describe the evolution and challenges faced within hair testing and discuss progress to a foreseeable future.</div></div><div><h3>Introduction</h3><div>Hair testing science has progressed rapidly during the past 30 years; mainly due to advances in instrumentation, expanded substance detection and applications. At the same time, it has faced many challenges, both in acceptance (in the early times) and interpretation issues. As society and technology are progressing, the future of this science is heading in several promising directions including the artificial intelligence and machine learning, which could automate much of the analysis and interpretation of the results.</div></div><div><h3>Results and discussion</h3><div>The evolution of hair analysis is closely related to advances in analytical instrumentation. Thirty years ago, the vast majority of labs performing hair analysis applied GC-MS, while more sensitive techniques were used in a minority. Over the years, the scenario has been changing and currently most laboratories use LC-MS/MS; even some labs use imaging mass spectrometry (MALDI-TOF) on a single hair. This is demonstrated by the Proficiency Test organized by the Society of Hair Testing. In 2001, 93% of the participants used GC-MS and 7% LC-MS; just the opposite happened in 2023, when 3% used GC-MS and 97% LC-MS/MS. The development of advanced analytical techniques allowed the detection of more drugs and their metabolites. Initially hair analysis focused on a limited number of substances (e.g. opiates, cocaine and later with cannabis). With the introduction of high-resolution techniques in the routine, hair testing now includes a wider array of drugs, including alcohol markers (ethyl-glucuronide), or new psychoactive substances (NPS). In addition, advances in understanding drug metabolism have allowed for the detection of specific metabolites, providing insights into usage patterns and the timing of drug use. The number of applications of these analyses has been growing over the years and it includes different fields: forensic investigations, workplace drug testing, driver's license regranting, child custody, clinical settings, doping control, etc. In the last years, the application of more sensitive and accurate methodologies allowed the detection of traces of a drug even after a single use. Thus, the spectrum of applications was expanded to cases of drug facilitated crimes. The major challenge of hair testing has been and (even in some circumstances) continues to be the external contamination and the risk of reporting false positive results. A lot of research has been done to solve this issue. An initial approach was the introduction of cut-off values, then extensive and/or sequential washes, the analysis of endogenous and minor metabolites. Lately metabolic concentration ratios are being applied. Some key trends and potential directions for the future of hair testing could be related to: (a) technological","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Page S36"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remerciements aux relecteurs","authors":"","doi":"10.1016/S2352-0078(25)00117-9","DOIUrl":"10.1016/S2352-0078(25)00117-9","url":null,"abstract":"","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Page 115"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bénéfices de la spectrométrie de masse haute résolution (LC-HR/MS) pour le dépistage des substances psychoactives (SPA) chez les patients en addictologie","authors":"Vanessa Biering ,&nbsp;Aurélie Aquizerate ,&nbsp;Morgan Helesbeux ,&nbsp;Malcolm Barrangou-Poueys-Darlas ,&nbsp;Audrey Verholleman ,&nbsp;Matthieu Gregoire ,&nbsp;Caroline Victorri-Vigneau ,&nbsp;Melanie Duval ,&nbsp;Edouard Le Carpentier","doi":"10.1016/j.toxac.2025.01.084","DOIUrl":"10.1016/j.toxac.2025.01.084","url":null,"abstract":"<div><h3>Objectifs</h3><div>Comparer les performances et l’intérêt clinique de la spectrométrie de masse haute résolution (LC-HR/MS) et d’une méthode d’immuno-analyse pour le dépistage urinaire des substances psychoactives (SPA) chez les patients hospitalisés en addictologie.</div></div><div><h3>Méthodes</h3><div>Un prélèvement urinaire était réalisé en début d’hospitalisation et analysé par méthode immuno-analyse (c503 CobasPro®, Roche Diagnostic®) et LC-HR/MS (Orbitrap exploris 120, Thermofisher®). Chaque SPA déclarée, ainsi que les médicaments prescrits ou non, étaient comparés aux résultats des analyses et les éventuelles discordances entre les deux méthodes d’analyses ainsi que la détection de substances non déclarées ont été étudiées afin d’évaluer la pertinence analytique de la LC-HR/MS. Une performance supérieure de celle-ci était définie soit par une nouvelle détection d’une substance non détectée ou non recherchée en immuno-analyse, la correction d’une erreur d’identification de l’immuno-analyse, la non détection d’une substance recherchée ou non en immuno-analyse pour laquelle une limite d’identification en LC-HR/MS était renseignée. La pertinence clinique des résultats obtenus avec la méthode en LC-HR/MS par rapport à ceux de l’immuno-analyse a été évaluée avec les cliniciens du service d’addictologie lors de réunions trimestrielles une fois le patient sorti d’hospitalisation et le dossier anonymisé.</div></div><div><h3>Résultats</h3><div>Dans cette étude observationnelle monocentrique prospective, 154 patients hospitalisés pour des troubles addictifs liés à un usage de SPA ont été inclus. Le prélèvement urinaire a été réalisé en moyenne 1,6<!--> <!-->jours<!--> <!-->±<!--> <!-->1 jour après le début d’hospitalisation. Concernant les molécules « hors prescription » (substances illicites et médicaments mésusés), la LC-HR/MS a montré une performance supérieure pour plus de la moitié des substances déclarées par le patient. Elle a essentiellement permis de détecter parmi ces molécules « hors prescription », des substances non recherchées en immuno-analyse et/ou non déclarées, notamment des analgésiques, des antidépresseurs, ainsi que des anti-histaminiques. De surcroît, la LC-HR/MS a permis de détecter une substance qui n’avait pas été détectée par l’immuno-analyse (principalement cocaïne et méthadone) pour plus d’une consommation déclarée sur dix. La LC-HR/MS a également montré une performance supérieure dans la détection de médicaments prescrits pour 71 % des cas qui concernaient, pour quasiment la totalité de ces cas, des substances non recherchées en immuno-analyse. Concernant l’impact clinique, les résultats obtenus par LC-HR/MS ont été jugés utiles par les cliniciens et auraient modifié la prise en charge pour un quart des patients. Dans la plupart des cas il s’agissait de molécules détectées et non déclarées par le patient. De plus, la LC-HR/MS a également permis de corriger un résultat d’amphétamine rendu faussement positif.</div","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Pages S54-S55"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update from the EU Early Warning System on new psychoactive substances","authors":"Thomas Néfau,&nbsp;Joanna De Morais,&nbsp;Simon Brandt,&nbsp;Ana Gallegos,&nbsp;Michael Evans-Brown,&nbsp;Gregorio Planchuelo,&nbsp;Roumen Sedefov","doi":"10.1016/j.toxac.2025.01.028","DOIUrl":"10.1016/j.toxac.2025.01.028","url":null,"abstract":"<div><h3>Aim</h3><div>The European Union Early Warning System on New Psychoactive Substances (EU EWS), operated by the EU Drug Agency (EUDA) is operational since 1997. It was the first regional early warning system to be established to monitor new psychoactive substances (NPS) and has been recognised as a model for national, regional and international early warning systems.</div></div><div><h3>Method</h3><div>The EU EWS rapidly detects, assesses and responds to health and social threats caused by NPS. Data collected and analysed include event based data on seizures by law enforcement, collected samples and serious adverse events linked to NPS. These data are complemented by annual reports, which include aggregated data on seizures and from poisonings.</div></div><div><h3>Results</h3><div>By September 2024, the EUDA was monitoring more than 980 NPS, 26 of which were first reported in 2023. The availability of NPS in Europe has reached a historic high, with more than 41 tons seized in 2023. This increase has been driven by a large increase in seizures of synthetic cathinones, in particular 3-CMC and 2-MMC, mostly trafficked from India. New threats continue to appear, including emergence of semi-synthetic cannabinoids (SSCs) and nitazenes. Since May 2022, 18 SSCs have been identified in Europe, underscoring the market's rapid evolution. They are sold openly in a broad range of consumer product forms, including vapes and edibles. While the available information on harms is limited, an outbreak of poisonings caused by edibles containing SSCs was reported by Hungary. Since 2022, there has been an increase in reports of nitazenes detections and poisonings in parts of Europe, and particularly in Estonia and Latvia. In addition, localised outbreaks of poisonings caused by nitazenes were reported by France and Ireland. The data also suggests an increase in the detection of fake medicines containing nitazene opioids.</div></div><div><h3>Conclusion</h3><div>Currently, the NPS market is characterised by complexity and increased integration with the market for established controlled drugs. The market is resilient and highly dynamic making it difficult to disrupt. Forensic and toxicological information sources are critically important for but there remains a need for investment in forensic, analytical and toxicological capacity. As of July 2024, the EUDA has a new mandate to implement and coordinate a network of laboratories with the aim of improving the detection capacity and knowledge of NPS, as well as the implementation of a European Drug Alert System (EDAS) for the detection and reporting of drug-related risks. The NPS market is still very dynamic in the EU and these new mechanisms (EUDA Laboratory network and EDAS) are aimed to further strengthen national and EU preparedness and response to NPS.</div></div>","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Page S22"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the post-mortem toxicological toolbox: A focus on vitreous humour metabolomics","authors":"Leen Jacobs","doi":"10.1016/j.toxac.2025.01.015","DOIUrl":"10.1016/j.toxac.2025.01.015","url":null,"abstract":"<div><h3>Aim</h3><div>Development of a tailored sample preparation protocol for untargeted metabolic and lipidomic profiling of post-mortem vitreous humour, and exploration of its metabolomic landscape for forensic applications.</div></div><div><h3>Introduction</h3><div>Traditional post-mortem toxicology primarily focuses on intoxications and relies heavily on the measurement of xenobiotics and their subsequent interpretation. However, to resolve broader forensic inquiries, an additional analytical approach is needed in toxicological investigations. Thanatometabolomics, the systematic analysis of small endogenous metabolites (e.g. lipids, amino acids) in post-mortem biofluids, represents an emerging concept aimed at addressing critical challenges, such as accurately determining the post-mortem interval and elucidating biochemical events preceding death. Although blood remains the gold standard in traditional forensic toxicology, it has notable limitations, including microbial degradation and post-mortem redistribution of compounds, which introduces variability dependent on sampling conditions. Vitreous humour, a more metabolite-stable post-mortem biofluid, offers a promising alternative matrix for thanatometabolomic research. However, a thorough review of the literature reveals a significant lack of established protocols for untargeted metabolomic analysis of vitreous humour, hindering progress in advancing the field of post-mortem toxicology.</div></div><div><h3>Method</h3><div>Three dilution series derived from three established sample preparation procedures: Folch biphasic extraction (CHCl₃: MeOH: H₂O, 8: 4: 3, v/v/v), Bligh-Dyer biphasic extraction (CHCl₃: MeOH: H₂O, 2: 2: 1.8, v/v/v) and a methanol single-phase extraction were evaluated. Additionally, the metabolite recoveries in each sample preparation were assessed through re-extraction of the remaining protein residue. Data acquisition was then performed with four in-house metabolomic platforms, employing liquid chromatography coupled to Quadrupole-Time of Flight high-resolution mass spectrometry. Finally, data preprocessing was conducted with MS-DIAL.</div></div><div><h3>Results</h3><div>The results of this study showed that low concentrations of lipids in vitreous humour necessitate large sample volumes, while polar metabolites are present in higher concentrations, allowing for smaller sample volumes. A diverse array of metabolites was identified, predominantly associated with pathways involved in energy metabolism (e.g. organic acids, carnitine), amino acid metabolism (e.g. tryptophan, lysine, tyrosine), oxidative stress regulation (e.g. methionine, glutathione), and nucleotide metabolism (e.g. hypoxanthine, cytidine, uridine). The lipid fraction was primarily composed of phospholipids, fatty acids, and sphingomyelins, supporting key functions such as energy production, intercellular communication, and the maintenance of structural integrity.","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Page S15"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a quantitative screening method by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) from a dried blood spot (DBS)","authors":"Robin Tiphaine,&nbsp;Hubert Chloé,&nbsp;Larabi Islam Amine,&nbsp;Alvarez Jean-Claude","doi":"10.1016/j.toxac.2025.01.022","DOIUrl":"10.1016/j.toxac.2025.01.022","url":null,"abstract":"<div><h3>Aim</h3><div>To develop and validate a quantitative screening method for a panel of 300 compounds by LC-MS/MS using a DBS.</div></div><div><h3>Method</h3><div>A drop of blood (10<!--> <!-->μL) is applied to HemaXis DB 10 filter paper (HMX-DB-10) and left to dry for 3<!--> <!-->hours. The compounds of interest are then extracted by a two-step liquid-liquid extraction: first with 2<!--> <!-->mL of a hexane/ethyl acetate mixture (50/50) in an alkaline environment (pH 9.7), followed by 2<!--> <!-->mL of a chloroform/isopropanol mixture (80/20). After evaporation of the supernatants, the residue is reconstituted with 80<!--> <!-->μL of a mixture of 2<!--> <!-->mM ammonium formate (0.1% formic acid) and acetonitrile (50/50). In all, 10<!--> <!-->μL is then injected into the system. Separation is performed on a HypersilGold PFP column (100<!--> <!-->×<!--> <!-->2.1<!--> <!-->mm, 1.9<!--> <!-->μm) using a gradient mode with 2<!--> <!-->mM formate buffer (0.1% formic acid) and acetonitrile. Detection is performed in MRM mode using a triple quadrupole mass spectrometer (TSQ Altis, ThermoFisher®).</div></div><div><h3>Results</h3><div>The method was validated for several panels of compounds, including traditional drugs of abuse (cocaine and its metabolites, 13 amphetamines, 28 opioids), NPS (12 synthetic benzodiazepines, 29 cathinones, 26 synthetic cannabinoids, 26 new synthetic opioids, other NPS), as well as several drug classes (30 benzodiazepines, 37 antipsychotics, 30 antidepressants, 12 antiepileptics, 18 β-blockers, 8 anesthetics, 8 sartans, etc.). The limits of quantification (LOQ) ranged from 5<!--> <!-->ng/mL (86% of compounds) to 10<!--> <!-->ng/mL (14% of compounds), with bias and CV ≤<!--> <!-->20%. Linearity was validated over a range of 5–10 to 500<!--> <!-->ng/mL with satisfactory performance in terms of accuracy and precision (bias and CV ≤<!--> <!-->15%). Analysis of a 200<!--> <!-->ng/mL quality control showed accuracy (bias<!--> <!-->+<!--> <!-->precision ≤<!--> <!-->15%). No carry-over effect was observed in blanks injected after the high point (500<!--> <!-->ng/mL). Selectivity was verified using negative blood samples, with no significant interferences. Patient samples were quantified, and results were compared to those obtained by the routine blood screening LC-MS/MS method used in the laboratory. The concentrations obtained were similar between the two techniques. Studies on stability, recovery, and reproducibility are on going.</div></div><div><h3>Conclusion</h3><div>The use of DBS for toxicological analyses or pharmacological therapeutic drug monitoring (TDM) is gaining popularity. This is due to several advantages: a simplified sampling procedure, a small sample volume, and good analyte stability on this type of substrate.</div><div>The adoption of DBS could also improve patient compliance, thanks to the simplicity of the collection (which can be done by the patient themselves), easy transport (by post), and storage witho","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Page S19"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing fitness to drive – proposal for a laboratory testing workflow tailored to the individual's case","authors":"Katleen Van Uytfanghe ,&nbsp;Hanne Van Beveren ,&nbsp;Christophe P. Stove ,&nbsp;Evy De Boosere","doi":"10.1016/j.toxac.2025.01.016","DOIUrl":"10.1016/j.toxac.2025.01.016","url":null,"abstract":"<div><h3>Aim</h3><div>Violating the law on driving under the influence can lead to a forfeiture of the right to drive. Either before or after this temporary forfeiture the individual can be subject to an assessment of the fitness to drive. In Belgium, the latter can be executed by medical doctors. For what concerns the analytical tests executed during the assessments, there are no common procedures. This leads to differences in which tests are performed and in the associated costs for the individuals. Here we propose an analytical workflow, as followed in Ghent, which is tailored to the individual case.</div></div><div><h3>Method</h3><div>The individual is invited by the doctor for a medical assessment. During this assessment, the individual is questioned on his drinking behavior and on the use of drugs-of-abuse. Based on the background information that initially led to the invitation for the assessment and on the answers to the questions, a list of potential substances is drafted for which biological specimens will be tested. The biological specimens collected are urine, dried blood (collected via fingerprick) and a hair sample (maximum 5<!--> <!-->cm is evaluated). If sample collection is not possible or refused, this is noted in the files. Samples are subject to different types of analysis: all urine samples are subject to a Nal Von Minden test and a screening based on liquid-chromatography high resolution mass-spectrometry (HRMS). If one of the screening methods indicates the presence of carboxy-THC, benzoylecgonine, amphetamines an/or opiates, the concentration is determined via other, independent, targeted MS-based methods. All dried whole blood samples are analyzed for their phosphatidylethanol 16: 0/18: 1 concentration (PEth). Hair samples are only tested for ethylglucuronide (hEtG) if PEth concentrations are below 270<!--> <!-->ng/mL. Testing of hair for drugs-of-abuse is not performed when the urine tested positive for drugs of abuse. Hair testing for drugs (of abuse) is pursued in case of a negative urine test and if there are elements pointing at a (suspected) history of drug use.</div></div><div><h3>Results</h3><div>This workflow was evaluated based on 365 cases. In 56% of these, PEth and hEtG results were not in full agreement, which could be due to the differences in the window of detection. PEth has a shorter window of detection (several weeks) than hEtG (several months, depending on the length of the hair)–hence, if a subject recently changed drinking behavior, this would only be reflected in the PEth level. For example: 3 subjects with a PEth value &lt;<!--> <!-->20<!--> <!-->ng/mL had hEtG ≥<!--> <!-->30<!--> <!-->pg/mg. Based on the value of PEth these may have been considered fit to drive, but the hEtG level revealed excessive alcohol use in the months prior to testing.</div><div>A total of 163 samples was positive in the Nal Von Minden test. For the most commonly used drugs-of-abuse, this positive screening results could be ","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Page S16"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La soumission chimique en dehors des agressions sexuelles","authors":"Alice Ameline,&nbsp;Laurie Gheddar,&nbsp;Nadia Arbouche,&nbsp;Pascal Kintz","doi":"10.1016/j.toxac.2025.01.039","DOIUrl":"10.1016/j.toxac.2025.01.039","url":null,"abstract":"<div><h3>Objectifs</h3><div>Discuter différents contextes de soumission chimique hors agressions sexuelles et présenter des cas judiciarisés, essentiellement devant un tribunal correctionnel.</div></div><div><h3>Méthodes</h3><div>Au laboratoire de toxicologie de l’IML de Strasbourg, l’approche analytique consiste à analyser des prélèvements sanguins et urinaires, collectés le plus rapidement possible après les faits, ainsi que des cheveux lorsque cela est possible. Une méthode dédiée, suivant les recommandations de la SFTA, a été développée en chromatographie liquide couplée à la spectrométrie de masse en tandem. Les mêmes extraits sont également analysés en spectrométrie de masse haute résolution afin de compléter le panel des molécules recherchées. Au cours des 8 dernières années, de nombreuses affaires de soumission chimique ont été investiguées au laboratoire. Les cas les plus marquants, hors agression sexuelle, ont été extraits, incluant vol, maltraitance aux agents chimiques, violence physique, séquestration, etc.</div></div><div><h3>Résultats</h3><div>Cas (1) un homme de 41 ans, en voyage au Panama, est drogué, kidnappé et volé sous l’influence d’une substance l’ayant fait perdre la mémoire et entraînée de sévères maux de tête et une vision floue. L’analyse de ses cheveux a permis l’identification de scopolamine à 15 pg/mg dans le segment correspondant à la période des faits. Cas (2) un joueur de tennis de 25 ans est décédé dans un accident de voiture, dont il aurait perdu le contrôle, quelques heures après une compétition dans laquelle il a déclaré forfait suite à une perte d’équilibre et un épuisement. Les analyses toxicologiques ont mis en évidence la présence de lorazépam dans son sang. Le père de son adversaire a avoué avoir mis un comprimé de lorazépam dans la bouteille d’eau du joueur, afin de faciliter la victoire de son fils. Il a également été reconnu coupable de soumission chimique à l’encontre de plusieurs adversaires de ses deux enfants au cours des 3 années précédentes. Cas (3) une enfant de 3 ans est admise aux urgences pour incoordination motrice et élocution difficile, repérés par l’infirmière scolaire. L’examen clinique est sans particularité, mais l’analyse de ses cheveux met en évidence la présence d’alprazolam à 482 pg/mg. La mère de l’enfant a reconnu donner de temps en temps de l’alprazolam à sa fille un peu « turbulente » pour la calmer. On parle alors d’enfant chimiquement battu. Cas (4) un homme de 56 ans est pris en charge aux urgences pour des difficultés respiratoires et une incoordination motrice. L’homme aurait mangé une soupe et bu trois verres de vin lors du dernier repas, servis par son épouse. Le criblage toxicologique a mis en évidence la présence de lévomépromazine à 82 ng/mL, associée à une alcoolémie à 0,51 g/L. Son épouse a reconnu avoir drogué son mari afin de « calmer ses ardeurs nocturnes ».</div></div><div><h3>Discussion</h3><div>À l’instar des produits utilisés dans le cas des agressions sexuell","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Page S28"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dépistage automatisé de l’intoxication à l’éthylène glycol – 10 ans d’expérience dans un laboratoire hospitalier","authors":"Marine Deville,&nbsp;Corinne Charlier","doi":"10.1016/j.toxac.2025.01.086","DOIUrl":"10.1016/j.toxac.2025.01.086","url":null,"abstract":"<div><h3>Objectifs</h3><div>Le diagnostic d’une intoxication à l’éthylène glycol nécessite de détecter ce composé (ou ses métabolites) dans les échantillons biologiques. La technique de référence, réalisée en chromatographie gazeuse couplée à la spectrométrie de masse (GC-MS) est difficilement applicable en urgence. Depuis 10<!--> <!-->ans, notre laboratoire utilise une méthode de dépistage installée sur les automates du laboratoire central. Notre objectif est de comparer les résultats de cette méthode à ceux obtenus par confirmation chromatographique.</div></div><div><h3>Méthodes</h3><div>Le principe du test repose sur une oxydation de l’éthylène glycol par la glycérol déshydrogénase. Initialement installée sur un Cobas 8000 (Roche), la trousse a été transférée sur un Alinity (Abbott) en 2019. Le seuil de positivité est de 50<!--> <!-->mg/L. La confirmation chromatographique est systématiquement réalisée par GC-MS avec une limite de quantification inférieure à 50<!--> <!-->mg/L.</div></div><div><h3>Résultats</h3><div>Au cours de ces 10 années, 331 échantillons de patients ont été analysés par les deux méthodes. Parmi ceux-ci, 247 se sont révélés négatifs (vrais négatifs). À l’inverse, 29 échantillons (correspondant à 9 patients distincts) se sont révélés positifs par les deux méthodes (vrais positifs), avec une tendance à la surestimation du résultat quantitatif par la méthode de dépistage.</div><div>51 échantillons ont été catégorisés comme positifs (&gt;<!--> <!-->50<!--> <!-->mg/L) avec la méthode de dépistage, mais non confirmés en chromatographie (faux positifs). Parmi ces 51 échantillons, 29 (57 %) étaient quantifiés entre 50 et 100<!--> <!-->mg/L. Le risque de résultats faussement positifs à proximité de la limite de quantification inférieure est élevé. Il est annoncé aux cliniciens au moyen d’un commentaire accompagnant chaque résultat.</div><div>Deux échantillons faussement positifs ont fourni une valeur de concentration particulièrement élevée (508 et 525<!--> <!-->mg/L), ils ont pu être exclus par l’anamnèse (overdose aux opiacés dans un cas, et décompensation cardiaque dans l’autre). Les 20 autres résultats faussement positifs correspondaient à 12 patients, avec plusieurs répétitions du dosage pour 2 d’entre eux, et la plupart de ces faux positifs ont été observés chez des patients éthyliques chroniques.</div><div>Les résultats faussement positifs au-delà de 100<!--> <!-->mg/L ont été observés, pour la plupart (91 %), après le transfert sur Alinity.</div><div>Inversement, seuls 4 échantillons présentaient un dépistage négatif (faux négatifs), alors que la technique chromatographique a fourni des résultats légèrement positifs (72, 96, 102 et 119<!--> <!-->mg/L). Le risque de résultat faussement négatif est très faible (1 %), voire presque nul, les 4 cas observés ne semblant pas concorder avec l’anamnèse.</div></div><div><h3>Conclusion</h3><div>L’intoxication à l’éthylène glycol, bien que rare, est une urgence médicale. Contrairement à","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Page S56"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methylone intoxication in a strangulation death: Suicide, homicide or overdose?","authors":"Sandrine Brault ,&nbsp;Hugo Arbues ,&nbsp;Camille Lochon ,&nbsp;Véronique Dumestre-Toulet","doi":"10.1016/j.toxac.2025.01.065","DOIUrl":"10.1016/j.toxac.2025.01.065","url":null,"abstract":"<div><h3>Aim</h3><div>Methylone (MDMC, BK-MDMA) is a synthetic cathinone with entactogenic and euphoric properties which, according to the literature and the DRAMES survey in France, is rarely found in toxic deaths today. We present here a case of potentially lethal intoxication, with measurement of blood, urine, tissues and hair methylone concentrations. A 45-year-old woman who had been missing for 5 days after a swinger's party and a violent argument with her partner was found dead in a semi-seated position, hanging by the handle of her backpack from the branch of a tree. According to the investigation, alcohol and MDMA were consumed during the evening. The Prosecutor's Office request an autopsy and toxicological analyses as part of the investigation into the cause of death.</div></div><div><h3>Method</h3><div>Analyses are carried out using the laboratory's usual techniques (GC/FID, GC-MS, LC-MS/MS), including the detection and determination of blood alcohol, narcotics, drugs including psychotropic drugs and synthetic products. A specific LC-MS/MS method was used to perform determination for methylone with methylone-D3 as internal standard, on all available specimen.</div></div><div><h3>Results</h3><div>Macroscopic autopsy data favoured violent death following strangulation by cervical hanging, with a possible toxic contribution, and did not rule out the intervention of a third party. Toxicological analyses identified ethanol (2.2<!--> <!-->g/L), THC (0.5<!--> <!-->μg/L) and THC COOH (1<!--> <!-->μg/L), benzoylecgonine (27<!--> <!-->μg/L), and amphetamine in blood. Methylone was identified in all samples at the following concentrations: 1450<!--> <!-->μg/L (heart blood), 1341<!--> <!-->μg/L (peripheral blood), 7494<!--> <!-->μg/L (urine), 4937<!--> <!-->μg/L (bile), 2.4<!--> <!-->mg/Kg (brain), 2.5<!--> <!-->mg/Kg (lung), 1.5<!--> <!-->mg/Kg (kidney), 3.5<!--> <!-->mg/Kg (liver) and 1.3<!--> <!-->mg/Kg (heart). To check whether the subject was a chronic consumer, a hair analysis was also carried out. 3 segments of 4<!--> <!-->cm were taken. Methylone was quantified at concentrations of 10,000; 3,350 and 2,360 pg/mg respectively. THC, CBD, amphetamine, MDMA, cocaine and metabolites were also identified in the 3 segments.</div><div>Cathinones can be sold instead of MDMA, because they have similar properties, are euphoric and increase sociability. Only a few data are published in the literature on methylone. Concentrations of 60 to 3300<!--> <!-->μg/L (mean: 835<!--> <!-->μg/L) in heart blood, 500 to 3300<!--> <!-->μg/L (mean: 1174<!--> <!-->μg/L) in peripheral blood, 420 to 1800<!--> <!-->μg/L in bile, 0.16 to 2.3<!--> <!-->mg/Kg in kidney and 0.14 to 1.8<!--> <!-->mg/Kg in liver, are described in several fatality cases in 2012 (Pearson, J Anal Toxicol, 2012, 36, 444–451; Cawrse, J Anal Toxicol, 2012, 36, 434–439) and from 6 to 98 pg/mg in hair tested positive (Salomone, J Anal Toxicol, 2017, 41, 376–381). The concentrations measured in our case ","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Pages S43-S44"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}