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Biomedical subjects

R O Bost

Publications and source records attributed to R O Bost.

18 recordsLinked to original sources
PubMed1996

Whole blood levels of dodecanoic acid, a routinely detectable forensic marker for a genetic disease often misdiagnosed as sudden infant death syndrome (SIDS): MCAD deficiency.

We investigated whether or not elevated whole blood dodecanoic acid concentration was due to a beta-oxidation defect in fatty acid metabolism previously reported. We prospectively analyzed blood from 55 consecutive sudden infant death syndrome (SIDS) cases for fatty acid concentrations by gas chromatograph. Three of 55 cases had elevated dodecanoic acid concentrations (> or = 18.4 mg/L). The three SIDS cases with elevated blood dodecanoic acid were confirmed to have medium chain acyl-CoA dehydrogenase (MCAD) deficiency by outside laboratories, indicating that elevated dodecanoic acid is highly specific and sensitive for predicting MCAD deficiency in SIDS victims. Dodecanoic acid was easily detected in routine toxicology for acid and neutral drugs done at autopsy. MCAD deficiency is an autosomal recessive genetic disease, carrying a 25% recurrence risk. Families should be notified that siblings, both presently living and yet to be born, should be screened for this deficiency because MCAD deficiency can be treated, and sudden, unexplained infant deaths of living and subsequent offspring can be prevented.

Acyl-CoA Dehydrogenase↗
PubMed1995

Fatal hydrofluoric acid ingestion: a suicide case report.

Numerous reports of poisonings due to various fluoride salts and also to hydrofluoric acid have appeared in the literature. Hydrofluoric acid, which is recognized as a strong acid, is expected to cause severe burns following acute exposure. This case is reported because the expected burns were not observed, but the laboratory analysis (a blood fluoride concentration of 13 mg/L) supported the ruling of death due to ingestion of hydrofluoric acid.

Administration, Oral↗
PubMed1993

Hair analysis--perspectives and limits of a proposed forensic method of proof: a review.

In the last few decades, a significant trend has been the self-administration of drugs to 'get high' or to achieve other desired pleasurable effects. This trend has produced major efforts to combat drug misuse or abuse. One such effort has been to utilize analytical toxicology to identify individuals who abuse drugs. Recognizing that individuals who abuse drugs might report for work in an impaired condition and create risk for themselves, for co-workers, or for others around them, many employers have established programs to deter drug use by their employees. These programs often include collection of a urine specimen and analysis of that specimen for drugs of abuse. Recently, some investigators have proposed that hair samples should be used in place of, or in addition to, urine samples for this purpose. Among the subjects which are relevant to utilizing hair as a specimen for detection of drugs of abuse and which will be covered in this review are the following: hair morphology and growth; which analyte--parent or metabolite(s); specimen collection and preparation; external contamination; comparison/standard specimens; segmental vs. whole hair analysis; and interpretation of results.

Forensic Medicine↗
PubMed1993

Alcohol in decomposed bodies: postmortem synthesis and distribution.

Blood alcohol (ethanol) concentrations in decomposed bodies can mean drinking during life and/or endogenous production after death. The correct interpretation is important in medicolegal cases. This retrospective study of 286 autopsied medical examiner cases was undertaken to evaluate alcohol concentrations and distribution in various fluids and tissues in decomposed bodies. Cases with alcohol present were classified as endogenous production, ingestion, or unable to determine based upon one or more of the following criteria: the presence of ethanol in only one of more than one body fluids, an atypical distribution of ethanol in body fluids, reliable scene or historical information, the presence of C3 alcohols in body fluids. Alcohol was classified as endogenously produced in 55 cases. The presence of alcohol was attributed to ingestion in 130 cases. No alcohol was detected in 39 cases. We were unable to determine the source of the remaining 62 alcohol concentrations. The highest blood alcohol concentration derived from endogenous production was 0.07% in the cases with other fluids negative. The mean blood alcohol concentration was 0.06% and ranged as high as 0.16% in cases having atypical ratios. Alcohol was found in blood and bile while urine and vitreous fluid were negative or had lower concentrations in cases with endogenous production. We conclude that for the majority of cases in which endogenous blood production of alcohol occurs the concentration in blood may be as high as 0.15%.

Alcohol Drinking↗
PubMed1988

Cyanide toxicity in burned patients.

The role of cyanide (CN) in smoke inhalation injury has been the subject of investigation for many years. Prospective evaluation of serum CN, thiocyanate (the primary metabolic product of CN), and carboxyhemoglobin (COHb) in patients suspected by history of having smoke inhalation injury was performed in 144 patients. Eight of 12 patients with "lethal" CN levels (greater than 1.0 mg/L) died. All had sublethal levels of COHb. A separate group of patients who were DOA following fatal burn injuries were also studied. Lethal CN levels were found in 12 of 14 victims with lethal COHb levels and in 14 of 20 victims with sublethal COHb levels. The results show that elevated CN levels are frequent in patients with smoke inhalation and suggest that cyanide toxicity is a contributor to severe inhalation injuries. In some cases, CN was the primary measured toxicant.

Acidosis↗
PubMed1988

3,4-Methylenedioxymethamphetamine (MDMA) and other amphetamine derivatives.

As various substances of abuse come under Drug Enforcement Administration (DEA) Schedule restrictions, slightly modified derivatives (designer drugs) replace them. A series of amphetamine derivatives are discussed in this presentation. Applicable analytical methods are presented. Details of cases handled by the office (hospital patients, driving while under the influence/driving under the influence of drugs [DWI/DUID], and medical examiner cases) are discussed.

3,4-Methylenedioxyamphetamine↗
PubMed1987

'Eve' and 'Ecstasy'. A report of five deaths associated with the use of MDEA and MDMA.

3,4-Methylenedioxymethamphetamine (MDMA, "Ecstasy"), a synthetic analogue of 3,4-methylenedioxyamphetamine, has been the center of recent debate over its potential for abuse vs its use as a psychotherapeutic agent. Following its emergency classification in Schedule 1 by the Drug Enforcement Administration in 1985, 3,4-methylenedioxyethamphetamine (MDEA, "Eve") has appeared as MDMA's legal replacement. MDMA is thought to be safe by recreational users and by psychotherapists who support its use. The details of five deaths associated with the use of MDMA and MDEA are reported. In three patients, MDMA or MDEA may have contributed to death by the induction of arrhythmias in individuals with underlying natural disease. In another patient, use of MDMA preceded an episode of bizarre and risky behavior that resulted in accidental death. In another patient, MDMA was thought to be the immediate cause of death. Death as a consequence of the use of these drugs appears to be rare, but it does occur; this outcome may be more common in individuals with underlying cardiac disease.

3,4-Methylenedioxyamphetamine↗
PubMed1985

Effects of alcohol and other drugs on traumatized patients.

During a six-month period, blood was drawn from 615 traumatized patients for alcohol determination and general toxicology screen. The patients were divided into four groups: alcohol only, other drugs only, alcohol and other drugs, and no alcohol or other drugs. Each group was analyzed for severity of injury, length of hospitalization, complications, and mortality. In 362 patients (58.9%) we found alcohol in the blood; 74% had alcohol levels greater than 100 mg/dL. Twenty patients (3.3%) had other drugs, while 34 patients (5.5%) had both alcohol and other drugs. There were no differences between the groups except that the patients with drugs only had a significantly higher incidence of shock, severity of injury, and mortality.

Accidents, Traffic↗
PubMed1978

Distribution of thioridazine and its metabolites in human tissues and fluids obtained postmortem.

Thioridazine and metabolites were measured in brain, liver, and kidney specimens, obtained postmortem from two subjects whose deaths were related to acute intoxication with thioridazine, by gas-liquid chromatography. Although the absolute concentration measured for thioridazine and metabolites differed in the two cases, the metabolic pattern for each tissue, expressed in terms of the percentage of total drug in each tissue, was quite similar. The brain, liver, and kidney metabolic patterns, however, are in sharp contrast to the plasma metabolite patterns observed for subjects on a therapeutic regimen of thioridazine. As this example demonstrates, postmortem specimens are a valuable (but seldom used) source of human pharmacological data.

Adolescent↗
PubMed1977

Carboxyhemoglobin concentrations in flash fire victims: report of six simultaneous fire fatalities without elevated carboxyhemoglobin.

Eight people died in a traffic accident involving a tractor-trailer and ten autos. The accident caused a series of flash fires from ruptured gas tanks. Complete autopsies established that six of the victims died exclusively from thermal trauma; none showed an elevated blood carboxyhemoglobin concentration. Flash fire victims are exceptions to the axiom that elevation of blood carboxyhemoglobin is a sine qua non for concluding that a decedent recovered from the scene of a conflagration was alive in the fire.

Accidents, Traffic↗
PubMed1976

Relative merits of some methods for amphetamine assay in biological fluids.

We describe principles and details that we use for amphetamine determination in blood and urine by photometric, thin-layer chromatographic, gas-chromatographic, and immunologic (EMIT and radioimmunoassay) procedures. Results, interferences, stabilities, and economic considerations are intercompared and recommendations are made.

Amphetamine↗
PubMedDate not supplied

Tissue distribution of ketamine: two case reports.

Two cases of death are reported; one involved an overdose of ketamine, the other involved a gunshot victim who was given ketamine during surgery. Distribution of ketamine through the body is reported for both cases.

Adult↗
PubMedDate not supplied

Tissue distribution of methamphetamine and amphetamine in premature infants.

An amphetamine-abusing mother who had taken methamphetamine 5 hours before beginning labor gave birth to twins who died 1 to 2 hours after birth; an autopsy and toxicological examination were performed. The results are consistent with previous findings of premature delivery and retarded intrauterine development. Tissue distribution shows a similar pattern to an earlier reported case, though drug concentrations are about 10 times higher.

Amphetamine↗
PubMedDate not supplied

A possible association between fluoxetine use and suicide.

Fluoxetine has been available for use as an antidepressant since early 1988. Numerous reports have indicated that it is at least as good as some of the tricyclic antidepressants and that it does not produce as serious toxicity as the tricyclics. Recently, however, case reports have suggested that it may produce suicidal tendencies in some patients. The present report provides data from a medical examiner's office regarding the number of cases in which fluoxetine has been detected and the proportion certified as suicides.

Adult↗
PubMedDate not supplied

Collection and handling of clinical blood samples to assure the accurate measurement of cocaine concentration.

The measurement of serum cocaine concentration is difficult because it is rapidly metabolized in vivo and in vitro. Previous investigators have used sodium fluoride (0.5-3.0%) in an attempt to stabilize its concentration in samples of whole blood, but these concentrations of sodium fluoride are not readily available outside the analytical laboratory. This study was performed to assess the stability of cocaine in whole blood when stabilized in a commonly available concentration of sodium fluoride (0.25%), with or without concomitant refrigeration. Whole blood was enriched with cocaine to a final concentration of 900 ng/mL and added to flasks containing sodium fluoride (0, 0.25, 0.5, and 1.0%) or 0.25% sodium fluoride plus potassium oxalate (gray-top Vacutainer tubes), after which it was stored at 4 degrees C or at room temperature. Whole blood cocaine concentrations were measured at 0, 24, and 48 h by gas chromatography. Sodium fluoride at all concentrations, with or without refrigeration and potassium oxalate, effectively inhibited cocaine degradation, with 86-91% of the drug present after 48 h. In contrast, substantial degradation of cocaine occurred in the samples stored without sodium fluoride, regardless of temperature. Thus, the use of commercial gray-top Vacutainer tubes effectively stabilizes cocaine in blood during procurement, transport, and short-term storage.

Chromatography, Gas↗
PubMedDate not supplied

Ethylene glycol analysis by gas chromatography.

A rapid, simple and specific gas chromatographic assay for ethylene glycol was developed. It requires a column packed with Carbopak B coated with 5% Carbowax 20-M. Linearly, accuracy, and precision data are reported.

Chromatography, Gas↗