Toxicologie Analytique et Clinique最新文献

{"title":"Oral fluid analysis by LC-MS/MS: Comparison between drivers tested in random checks and after an electro/trance festival","authors":"Denis Dubois-Chabert , Amélie Poly , Ludovic Romeuf , Cécile Moreau , Camille Chatenay , Guillaume Hoizey , Charline Bottinelli","doi":"10.1016/j.toxac.2025.01.069","DOIUrl":"10.1016/j.toxac.2025.01.069","url":null,"abstract":"<div><h3>Aim</h3><div>To compare substances consumed by 2 populations of drivers – electro/trance festival (teknival) goers and drivers tested on random checks – by analyzing oral fluid samples collected on FLOQswabs™ devices.</div><div>To assess trends in new psychoactive substance (NPS) consumption during electro/trance music events such as teknival.</div></div><div><h3>Method</h3><div>Following driving checks during a teknival in the summer of 2024, our laboratory received 68 FLOQswabs™ samples for confirmatory analysis under French regulations. The first qualitative analysis, performed by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS), targeted amphetamine, methamphetamine, MDA, MDMA, MDEA, morphine, 6-monoacteylmorphine (6-MAM), cocaine, benzoylecgonine (BZE) and delta-9-tetrahydrocannabinol (THC). The previously reported protocol was implemented, according to the legal thresholds (Romeuf, Toxac, 2023, 35, 124–132). With the same injection, cannabidiol (CBD) and hexahydrocannabinol (HHC) were also targeted. In a second injection, unknown NPS screening was carried out by LC-MS/MS. The same methodology was applied to a representative population of 68 oral fluid samples collected on the same device during classic random checks for driving under influence of drugs.</div></div><div><h3>Results</h3><div>Sixty-six teknival samples were positive for at least one substance listed in the regulations, as were 64 from the random checks. Concerning cannabinoids, THC and CBD were more often detected in control samples (80.9% and 42.6%, respectively) than in teknival samples (61.8% and 26.5%). Morphine and 6-MAM were detected in only 1 control sample. Cocaine was systematically associated with its metabolite, BZE, with higher prevalence in teknival samples (44.1%) than in control samples (27.9%). Likewise, amphetamines, and particularly MDMA, were detected in 42.6% of teknival samples but in only 13.0% of control samples. On NPS analysis, ketamine was the most frequently detected substance in both populations, with higher prevalence in teknival samples (61.8%) than in controls (19.1%). In 98.0% of cases, ketamine was associated with at least one other substance. Few NPSs were found in the control population, with only diphenidine and HHC detected, in 1 case each; conversely, in the teknival population, dimethyltryptamine (DMT) and LSD were detected in 17.6% and 11.7% of cases, respectively. X-MMC and the benzofuran x-APB were identified in 2 cases each.</div></div><div><h3>Conclusion</h3><div>As expected, almost all swabs were positive for least at one substance, as confirmation is only required when the first oral fluid test by immunoassay is positive.</div><div>In both study populations, THC was the most frequently consumed substance. Cocaine and MDMA were consumed more frequently in the teknival context. Ketamine, which was detected in both populations, is one of the substances most commonly used in partying, particularly in combin","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Pages S45-S46"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529297","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":"Bladder wash as an alternative specimen for post-mortem toxicology: Feedback from 63 authentic samples","authors":"Théo Willeman , Bérénice Royez , Jeremy Borges , Coralie Boudin , François Paysant , Françoise Stanke-Labesque , Hélène Eysseric-Guerin , Virginie Scolan","doi":"10.1016/j.toxac.2025.01.060","DOIUrl":"10.1016/j.toxac.2025.01.060","url":null,"abstract":"<div><h3>Aim</h3><div>In post-mortem toxicology, analysis of different biological matrices is crucial to confirm what has been identified in blood. Nevertheless, conventional matrices can be difficult to analyze with standard extraction protocol or missing. The concept of bladder washing has been introduced in 2022 at the TIAFT annual meeting <span><span>[1]</span></span>. The evaluation was carried out after emptying bladder and then rewashing it. But real-life conditions can be difficult with putrefied, polytraumatized or carbonized corpses. The first bladder wash was performed in Grenoble in November 2022 by forensic pathologist team and is now performed routinely. The authors aim to describe bladder wash sampling technique and present a critical evaluation in current post-mortem toxicology practice.</div></div><div><h3>Method</h3><div>Bladder wash was achieved when bladder was empty, with a 5<!--> <!-->mL wash of 0.9% NaCl solution during the forensic autopsy.</div><div>This study included authentic bladder washes from November 2022 to November 2024. Toxicological analysis were performed on request of police officers or prosecutors. The analysis was carried out in LC-MS/MS, LC-HRMS for screenings of drugs of abuses and medications and GC-FID for volatiles.</div><div>Sample preparation for screening consisted in a phospholipid removal using Ostro® plates. Targeted LC-MS/MS screenings were carried out on an Acquity UPLC HSS C18 column (2.1<!--> <!-->×<!--> <!-->100<!--> <!-->mm) and a Xevo TQ-XS mass spectrometer (Waters). Targeted LC-HRMS screenings were carried out on an Accucore Phenyl-Hexyl column (2.1<!--> <!-->×<!--> <!-->100<!--> <!-->mm) and an Exploris 120 (Thermo Scientific) mass spectrometer.</div><div>To evaluate the efficiency of the wash, creatininuria and proteinuria assays were carried out on an Atellica system (Siemens Healthineers®) using automated enzymatic and colorimetric techniques.</div></div><div><h3>Results</h3><div>This study included 63 authentic bladder washes. Mean bladder wash volume was 2,3<!--> <!-->mL. Subjects were aged from 1 month to 92 years with mean body mass index of 26.6. Mean post-mortem interval was 2.5 days.</div><div>No substance was identified in 8 washes. Among the substances identified, psychotropic drugs (lithium, cyamemaine, venlafaxine, diazepam, vortioxetine, valproic acid, pregabaline…), drugs of abuse (cocaine, MDMA, THC-COOH, oxycodone, methadone, morphine…), cardiotropic and antidiabetic medications (amlodipine, sotalol, irbesartan, amiodarone, ramiprilat, metformine, sitagliptine, gliclazide…), anesthesic drugs (sufentanil, midazolam, laudanosine, etomidate, propofol, ketamine) or metabolites (ethylglucuronide, cotinine, acetone) were correctly detected in bladder wash.</div><div>Between blood and bladder wash results, a concordance of 76.2% was observed in this study, including ethanol. In 15.9% cases, bladder wash was negative and only ethanol was identified in blood. Therefore, ethanol","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Page S40"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529142","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":"From Lab to action: The role of a General Hospital Toxicology Lab in multidisciplinary responses to Flakka's regional emergence","authors":"Nik De Brabanter,&nbsp;Pauline Herroelen,&nbsp;Eva Dewandelaere,&nbsp;Saartje Gijbels,&nbsp;Cindy Maeren,&nbsp;Lisa Van Langendonck,&nbsp;Hilde Vanpoucke,&nbsp;Inge De Cuyper,&nbsp;Dieter De Smet,&nbsp;Ansofie Decavele","doi":"10.1016/j.toxac.2025.01.010","DOIUrl":"10.1016/j.toxac.2025.01.010","url":null,"abstract":"<div><div>In November 2022 an intoxicated patient was admitted to the AZ Delta General Hospital emergency department declaring he smoked Flakka. Initially appearing as an isolated case, it quickly became clear that this was the beginning of a regional emergence. In the following weeks, several patients presented with symptoms ranging from excited delirium syndrome and psychosis to coma, all linked to the use of Flakka. This surge necessitated a coordinated response at multiple levels: hospital, regional, and national.</div><div>To address this, our toxicology lab rapidly developed an LC-MS/MS method to selectively detect the cathinones alpha-PVP, alpha-PHP and alpha-PHiP in urine and implemented in the routine tox screening. To date, this method has been used to identify over 100 alpha-PHiP positive patients and enabled correct monitoring of the situation.</div><div>In parallel, actions were initiated along multiple axes. In the hospital, close cooperation with e.g. the emergency department led to effective follow-up and the initiation of patient management plans.</div><div>On a regional level, regular consultations were established with local stakeholders: the city council, law enforcement and healthcare providers. The focus here was on ensuring the exchange of accurate and up-to-date information on the issue, as well as streamlining external communication.</div><div>The toxicology lab's findings were continuously reported to Belgian Early Warning System (BEWSD). This ensured that the data collected at the regional level induced national responses.</div><div>One and a half years after the first case, our laboratory results indicate that alpha-PHiP has disappeared from the regional drug market. Interdisciplinary collaboration and rapid, open communication have proven to be crucial in tackling and containing this surge. However, continued monitoring of the (regional) drug market for potential successors to alpha-PHiP remains essential. While the toxicology lab plays a key role in this effort, progress depends on the activation of a multidisciplinary network.</div></div>","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Pages S12-S13"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529153","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":"Pikachu : la nouvelle drogue du violeur ?","authors":"Pascal Kintz ,&nbsp;Nadia Arbouche","doi":"10.1016/j.toxac.2024.12.004","DOIUrl":"10.1016/j.toxac.2024.12.004","url":null,"abstract":"","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Pages 1-3"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527299","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":"Death following ingestion of cocaine capsules after 48 hours in police custody","authors":"Romain Pelletier ,&nbsp;Maxime Alexandre ,&nbsp;Pauline Guillot ,&nbsp;Valentin Coirier ,&nbsp;Isabelle Morel ,&nbsp;Renaud Bouvet ,&nbsp;Thomas Gicquel","doi":"10.1016/j.toxac.2025.01.067","DOIUrl":"10.1016/j.toxac.2025.01.067","url":null,"abstract":"<div><h3>Aim</h3><div>Poisonings among body-packers are well-documented in toxicological and forensic literature. Deaths due to ingestion of narcotic substances are common; however, the toxicological kinetics in such cases are rarely described. A 29-year-old man was admitted to the ICU for status epilepticus (Day 0), followed by recurrent cardiac arrests. His family revealed a history of cocaine capsule ingestion three days prior (Day 3). An abdominal CT scan revealed foreign bodies in the stomach. Given the severe cocaine intoxication and multi-organ failure, emergency gastrotomy was performed to remove the cocaine-containing contents from the stomach. Despite this intervention, the patient continued to experience recurrent cardiac arrests, leading to refractory shock and death on Day 2. The aim of this study is to describe the evolution of cocaine and its metabolites concentrations following the ingestion of cocaine capsules in relation with medical care.</div></div><div><h3>Method</h3><div>Cocaine and its two main metabolites, benzoylecgonine (BZE) and ecgonine methyl ester (EME), were quantified in blood using high-resolution mass spectrometry (LC-HRMS) (Q-Exactive®, ThermoScientific).</div></div><div><h3>Results</h3><div>We present the plasma kinetics of cocaine and its metabolites during hospitalization (Day 0, Day 1 and Day 2), along with the measurement of post-mortem blood concentrations taken at autopsy. The plasma concentrations of cocaine, BZE, and EME were respectively: Day 0: 18,680 ng/mL, 11,400 ng/mL, and 15,720 ng/mL; Day 1 (during gastrotomy): 43,928 ng/mL, 62,456 ng/mL, and 81,452 ng/mL; Day 2: 396 ng/mL, 34,532 ng/mL, and 35,480 ng/mL. Post-mortem blood concentrations of cocaine, BZE, and EME were 125 ng/mL, 6,897 ng/mL, and 10,329 ng/mL, respectively.</div></div><div><h3>Conclusion</h3><div>The death resulted from massive cocaine intoxication following ingestion. We observed extremely high concentrations of cocaine and its metabolites, peaking at the time of gastrotomy. Concentrations subsequently declined, but not enough to prevent from patient's death. Although a multidisciplinary approach has been required to manage high concentrations of drugs, resulting from ingestion of cocaine capsules, it was unfortunately not sufficient in this case to prevent from a fatal issue.</div></div>","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Pages S44-S45"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529148","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":"Mitragygine, seul alcaloïde d’intérêt du kratom ? A propos d’un cas","authors":"Richeval Camille ,&nbsp;Gish Alexandr ,&nbsp;Viard Marie Céline ,&nbsp;Gaulier Jean-Michel","doi":"10.1016/j.toxac.2025.01.051","DOIUrl":"10.1016/j.toxac.2025.01.051","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectif&lt;/h3&gt;&lt;div&gt;Dans la littérature, peu de publications rapportant des cas de consommation de kratom sont documentés de données analytiques dans des matrices biologiques variées (sang, urine, cheveux, ongles).&lt;/div&gt;&lt;div&gt;Dans cette situation, nous rapportons le cas d’une patiente, de 40 ans, admise aux urgences suite à l’apparition d’une crise d’angoisse, des palpitations, des sueurs, d’une sensation de chaud-froid, et des céphalées survenue après l’ingestion d’une tisane au kratom. À l’examen clinique, le bilan est normal : Glasgow 15, bilan hémodynamique stable. Elle tient un discours cohérent, sans céphalée, ni douleur thoracique, ni trouble fonctionnel digestif. Il lui est administré un comprimé de 25 mg d’Atarax®. Lors de l’entretien, la patiente, ayant des antécédents de dépendance à la codéine, déclare consommer régulièrement depuis 3 ans du kratom en tisane, et avoir augmenté la quantité journalière à 20 g depuis quelques mois. Des prélèvements sanguin et urinaire sont réalisés à son admission ; des cheveux et des ongles sont prélevés le lendemain. La patiente confie également un reliquat d’échantillon de kratom (poudre verte) consommé.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Méthode&lt;/h3&gt;&lt;div&gt;Ces échantillons sont analysés par CL-SMHR selon des méthodologies déjà publiées &lt;span&gt;&lt;span&gt;[1]&lt;/span&gt;&lt;/span&gt; intégrant l’usage de bibliothèques spectrales incluant des substances d’origine végétale &lt;span&gt;&lt;span&gt;[2]&lt;/span&gt;&lt;/span&gt;. Les cheveux sont analysés après une segmentation en 7 tronçons de 2 cm, sauf pour le dernier segment (12 cm). Les alcaloïdes et leurs métabolites identifiés sont recherchés in silico à l’aide du logiciel UNIFI™ combiné au réseau moléculaire, en renseignant les différentes voies métaboliques plausibles.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Résultats&lt;/h3&gt;&lt;div&gt;Le criblage toxicologique réalisé dans les prélèvements biologiques met en évidence des principes actifs de médicaments : paracétamol, hydroxyzine, doxylamine et leurs métabolites, ainsi que de l’éphédrine et de la diphénhydramine dans les cheveux et ongles.&lt;/div&gt;&lt;div&gt;L’analyse de la poudre de kratom permet d’identifier plusieurs composés : la mitragynine à une teneur de 1,9 % ainsi que d’autres alcaloïdes, la spéciolliatine, et la spéciogynine, deux stéréo-isomères de la mitragynine et la paynanthéine, un analogue déhydrogéné de la mitragynine. La concentration sanguine de mitragynine est de 42 ng/mL, dans les cheveux à 2460 et 1790 pg/mg respectivement pour le segment proximal et distal et dans les ongles à 659 pg/mg.&lt;/div&gt;&lt;div&gt;Ces alcaloïdes sont également identifiés dans tous les échantillons biologiques. L’exploitation des données permet de caractériser in vivo dans l’urine, de nombreux métabolites hydroxylés et déméthylés de la mitragynine et de ses analogues, générés in silico.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Le kratom est issu de la préparation des feuilles de Mitragyna speciosa de la famille des Rubiaceae, plante arborescente d’Asie du Sud-Est. Traditionnellement, le kratom était","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Page S35"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529150","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":"Protoxyde d’azote : accidentologie, agressions et décès : fini la perception d’innocuité !","authors":"Joëlle Micallef ,&nbsp;Cécile Moreau ,&nbsp;Christophe Bartoli ,&nbsp;Anne-Laure Pelissier ,&nbsp;Islam-Amine Larabi ,&nbsp;Jean-Michel Gaulier ,&nbsp;Caroline Victorri-Vigneau","doi":"10.1016/j.toxac.2025.01.047","DOIUrl":"10.1016/j.toxac.2025.01.047","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectif&lt;/h3&gt;&lt;div&gt;Le protoxyde d’azote (N&lt;sub&gt;2&lt;/sub&gt;O) est aujourd’hui l’une des substances les plus consommées. Dès 2019, le réseau français des Centres d’Évaluation et d’Information sur la Pharmacodépendance a alerté sur les conséquences néfastes de son usage, notamment les effets somatiques, principalement neurologiques, ainsi que les troubles de l’usage (addiction). Mais qu’en est-il des accidents et des décès associés à sa consommation ? Les données à ce sujet restent très limitées, car le N&lt;sub&gt;2&lt;/sub&gt;O étant un gaz difficilement identifiable, il n’est pas recherché dans les analyses de routine. Cela complique son implication directe dans les cas de décès ou d’accidents. Pourtant, on observe une forte médiatisation des accidents de la route ou d’engins motorisés à deux roues en lien avec la consommation de N&lt;sub&gt;2&lt;/sub&gt;O. Face à cette situation, il devient essentiel de disposer de données précises sur l’accidentologie et les agressions impliquant le N&lt;sub&gt;2&lt;/sub&gt;O.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Méthode&lt;/h3&gt;&lt;div&gt;Nous avons, par le biais des Sociétés Savantes, réunissant l’ensemble des experts concernés (SFMLEM, CNBAE et SFTA) interrogé les experts analystes, toxicologues et médecins légistes sur les cas pour lesquels ils ont été sollicités de 2018 à 2023, où l’exposition au protoxyde d’azote est fortement suspectée.&lt;/div&gt;&lt;div&gt;Pour chaque situation pour laquelle le protoxyde d’azote était mentionné, que ce soit chez une victime ou chez un sujet impliqué dans un accident, ainsi que toute autre situation (agression, décès hors accidentologie …), les experts renseignaient une fiche de notification avec des données sur le consommateur (sexe, âge, consommation de N&lt;sub&gt;2&lt;/sub&gt;O et d’autres substances stupéfiantes ou médicamenteuses habituelle et lors de la survenue), sur le type de complication (accidentologie en précisant si la personne consommatrice suspectée est possiblement à l’origine de l’accident ou victime de l’accident ou autres situations, agression, tentative de suicide …) ainsi que les éléments permettant d’impliquer le N&lt;sub&gt;2&lt;/sub&gt;O.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Résultats&lt;/h3&gt;&lt;div&gt;Au total, 27 cas concernant des sujets jeunes pour lesquels l’exposition au N&lt;sub&gt;2&lt;/sub&gt;O était suspectée ont été transmis, dont la moitié de décès, tous survenus à partir de 2020. La moitié des cas concerne l’accidentologie et l’autre moitié concerne d’autres situations dont les agressions sexuelles. Les éléments permettant d’impliquer le N&lt;sub&gt;2&lt;/sub&gt;O sont dans la majorité des cas la présence de cartouches, bouteilles ou ballons retrouvés dans les véhicules, des consommations ou notion de consommations rapportées par les sujets ou l’entourage. Sur les 16 cas où le N&lt;sub&gt;2&lt;/sub&gt;O a été recherché dans le sang périphérique ou central et/ou dans des fragments de poumons et/ou dans l’air recueilli au niveau pulmonaire en fonction des cas, il a été détecté dans 6 situations (dont 4 fois dans le sang périphérique).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Il existe des ","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Pages S32-S33"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528825","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":"Place du dosage capillaire du plomb dans l’identification d’une source d’exposition lors d’un cas d’intoxication","authors":"Jérôme Langrand ,&nbsp;Chloé Bruneau ,&nbsp;Hervé Laborde-Casterot ,&nbsp;Marie-Laure Island ,&nbsp;Martine Ropert-Bouchet","doi":"10.1016/j.toxac.2025.01.085","DOIUrl":"10.1016/j.toxac.2025.01.085","url":null,"abstract":"<div><h3>Objectifs</h3><div>Le dosage capillaire du plomb est souvent jugé peu pertinent sur le plan clinique en raison de la contamination externe importante, qui peut influencer les résultats. Toutefois, cet article présente un cas d’intoxication familiale sévère où l’analyse capillaire du plomb a permis de révéler une source de contamination méconnue, apportant ainsi des informations décisives.</div></div><div><h3>Méthodes</h3><div>Description de l’histoire clinique et des investigations analytiques cliniques et environnementales. Le plomb (Pb) a été mesuré par spectrométrie de masse à plasma à couplage inductif (ICP-MS), sur un ICAP-TQ de Thermo Scientific® (Plateforme AEM2, Université de Rennes 1/Laboratoire de Biochimie, CHU de Rennes).</div></div><div><h3>Résultats</h3><div>Une femme a été prise en charge pour une intoxication au plomb sévère. Les explorations ont montré que certains membres de la famille présentaient également des niveaux de contamination élevés. Aucun facteur professionnel, domestique ou environnemental évocateur n’a pu être identifié initialement. Des investigations environnementales approfondies, incluant des analyses de ratios isotopiques, n’ont pas permis de déterminer la source de la contamination. Cependant, une analyse capillaire a montré une augmentation soudaine des niveaux de plomb dans les cheveux, remontant à la fin de l’été précédent l’intoxication, avec une concentration capillaire maximale de 10,07<!--> <!-->μg/g de cheveu. Un interrogatoire détaillé a alors révélé une source de contamination jusque-là ignorée : le meulage et la pose de carrelages traditionnels de type « zellige » à cette même période. L’analyse des zelliges a montré de fortes concentrations de plomb dans leur partie émaillée. La contamination avait été majorée chez certains membres de la famille par une onychophagie importante. L’évolution des niveaux de plomb était cohérente avec cette exposition et a permis de déclencher une alerte sanitaire concernant le risque associé à ces carrelages à la mode, qui représentent une source potentiellement conséquente de contamination à l’échelon national.</div></div><div><h3>Conclusion</h3><div>Le dosage du plomb capillaire est mal corrélé avec la plombémie, en particulier lorsque celle-ci est modérément élevée (&lt; 120<!--> <!-->μg/L) [ATSDR, <em>Toxicological Profile for Lead</em>, août 2020]. La contamination externe importante rend cette technique le plus souvent inutilisable pour l’interprétation clinique. Toutefois, dans cette situation particulière, l’analyse capillaire a été déterminante pour identifier la source de la contamination, que les tests isotopiques seuls n’avaient pas permis de faire. Bien que le dosage du plomb capillaire soit le plus souvent peu utilisable en clinique en raison des risques de contamination externe, il peut apporter des informations chronologiques décisives dans certaines situations spécifiques pour identifier la source de la contamination.</div></div>","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Page S55"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528831","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":"Dent versus mèche de cheveux. Quelle matrice utiliser pour documenter une exposition répétée ? À propos d’un cas impliquant l’aripiprazole","authors":"Pascal Kintz ,&nbsp;Alice Ameline ,&nbsp;Laurie Gheddar ,&nbsp;Jean-Sébastien Raul","doi":"10.1016/j.toxac.2024.05.002","DOIUrl":"10.1016/j.toxac.2024.05.002","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Ces dernières années, les progrès en termes de sensibilité des instruments analytiques ont été tels qu’il est désormais possible d’identifier des xénobiotiques à l’état de traces dans des matrices alternatives, comme la salive, la sueur ou les cheveux. Parfois, d’autres prélèvements recueillis sur une scène de crime, comme les dents, peuvent faire l’objet d’investigations analytiques car ils sont les seuls éléments à disposition des enquêteurs. Pour évaluer un intérêt toxicologique, les auteurs présentent une comparaison de concentrations entre les cheveux et une dent d’un sujet sous traitement au long cours par aripiprazole (5&lt;!--&gt; &lt;!--&gt;mg/j). La dent a été prélevée lors de l’extraction classique d’une dent de sagesse. Après avoir recueilli le consentement d’un sujet masculin de 19 ans, une mèche de cheveux blonds a été coupée. Après avoir enlevé le matériel organique autour de la dent, celle-ci a été pulvérisée au broyeur à boulet, puis 20&lt;!--&gt; &lt;!--&gt;mg ont été incubés dans un tampon à pH 8,4 pendant une nuit, avant d’être extrait par un mélange de solvants organiques. Après décontamination par le dichlorométhane et segmentation en 3&lt;!--&gt; &lt;!--&gt;×&lt;!--&gt; &lt;!--&gt;3&lt;!--&gt; &lt;!--&gt;cm, les cheveux ont été traités de la même façon. L’analyse a été réalisée par LC/MS-MS. L’aripiprazole est identifié par 2 transitions (m/z 450,2&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;287,1 et 450,2&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;98,0). L’aripiprazole dans la dent est à 1,4&lt;!--&gt; &lt;!--&gt;pg/mg et à 3,5 ; 3,9 et 2,6&lt;!--&gt; &lt;!--&gt;ng/mg dans les cheveux, soit une différence d’un facteur&lt;!--&gt; &lt;!--&gt;×&lt;!--&gt; &lt;!--&gt;1000. Bien qu’il puisse y avoir un intérêt d’identifier des xénobiotiques dans les dents, en particulier quand elles constituent l’unique prélèvement disponible, ce tissu n’est pas aussi intéressant que les cheveux pour mettre en évidence une exposition à long terme. La préparation (pulvérisation) est fastidieuse et les concentrations retrouvées sont généralement faibles selon la littérature scientifique. Enfin, la fenêtre de détection d’un xénobiotique dans une dent demeure inconnue.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;In recent years, remarkable advances in sensitive analytical techniques have enabled the analysis of drugs in unconventional biological specimens such as oral fluid, sweat or hair. However, other matrices, including tooth, deserve attention as they can be the unique remain on a crime scene. The authors present here the comparison between tooth and hair specimens collected from a long-term subject under aripiprazole therapy (5&lt;!--&gt; &lt;!--&gt;mg per day). Tooth was collected during a standard consultation for removal of wisdom tooth. At the same time, after oral consent, a strand of hair (blonde in colour) was collected from a 19-year-old man. After careful elimination of organic material, the tooth was pulverized in a ball mill and 20&lt;!--&gt; &lt;!--&gt;mg were incubated under alkaline conditions (pH 8.4) followed by a mixture of organic solvents. After decontamination by dichloromethane, the hair was segmente","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Pages 82-87"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141397760","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":"Usefulness of microsampling devices in pharmacology and toxicology","authors":"Florian Hakim ,&nbsp;Maude Marillier ,&nbsp;Jenny Becam ,&nbsp;Charline Bottinelli ,&nbsp;Coralie Boudin ,&nbsp;Estelle Flament ,&nbsp;Laurie Gheddar ,&nbsp;Alexandr Gish ,&nbsp;Angéline Kernalleguen ,&nbsp;Edouard Lecarpentier ,&nbsp;Romain Pelletier ,&nbsp;Jean-Joseph Sabiani ,&nbsp;Anissa Zergui ,&nbsp;Alice Ameline ,&nbsp;Nicolas Fabresse","doi":"10.1016/j.toxac.2024.12.001","DOIUrl":"10.1016/j.toxac.2024.12.001","url":null,"abstract":"<div><div>Microsampling devices, such as dried blood spot (DBS) cards, offer significant advantages such as easy collection and low sample volume. However, their use poses challenges, including the effect of blood volume on analyses and the risk of contamination. The analytical validation of these methods requires a thorough evaluation of specific parameters, which can increase the number of required analyses compared to conventional methods. In the field of therapeutic drug monitoring, microsampling methods like DBS facilitate the collection of valuable information on drug interactions and patient metabolic capacities, thereby enhancing therapy efficacy and safety. Similarly, toxicological screening techniques benefit from the advantages of microsampling for faster and more comprehensive analysis. DBS analysis for doping detection offers advantages such as rapid and minimally invasive sample collection, as well as analyte stability at room temperature. However, it is subject to constraints related to sample preparation and volume. Recent advances in DBS technology have improved the detection and quantification of a wide range of drugs and psychoactive substances in clinical and forensic toxicology, offering more effective and stable methods despite some limitations related to sample collection and analysis. Finally, the application of DBS technology to environmental analysis enables the measurement of chemical concentration or presence in the human body, providing valuable information for assessing environmental exposures and contributing to the prevention of environmental health risks, particularly concerning trace elements, organic chemicals, and environmental exposure biomarkers such as tobacco smoke.</div></div>","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"37 1","pages":"Pages 20-38"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527187","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}