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  • 1.
    Aalberg, L
    et al.
    National Bureau of Investigation, Finland.
    Andersson, K
    Swedish National Laboratory of Forensic Science.
    Bertler, C
    Swedish National Laboratory of Forensic Science.
    Cole, MD
    University of Strathclyde, Glasgow.
    Finnon, Y
    University of Strathclyde, Glasgow.
    Huizer, H
    Netherlands Forensic Institute.
    Jalava, K
    National Bureau of Investigation, Finland.
    Kaa, E
    Aarhus Universitet.
    Lock, E
    Université de Lausanne.
    Lopes, A
    Laboratorio Policia Cientifica, Lisbon, Portugal.
    Poortman-van der Maar, A
    Netherlands Forensic Institute.
    Sippola, E
    National Bureau of Investigation, Finland.
    Dahlén, Johan
    Swedish National Laboratory of Forensic Science.
    Development of a harmonised method for the profiling of amphetamines: II. Stability of impurities in organic solvents2005Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 149, nr 03-Feb, s. 231-241Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The present study focused on the stability of 22 amphetamine impurities dissolved in six organic solvents: isooctane, toluene, ethanol, dichloromethane, ethyl acetate, and diethyl ether. The aim was to find the most inert, and thereby most suitable, solvent for amphetamine profiling. Mixtures of the impurities were prepared in the different solvents, and changes in the concentrations of the individual compounds over-time were monitored by gas chromatographic analysis after 0, 4, 12, 24, 48, and 96 h. Isooctane and toluene provided the most inert conditions, although, a few of the impurities were insufficiently stable in these two solvents. The present experiments were performed as a part of the development of a harmonised method for profiling of amphetamine. The results can be used to support the choice of organic solvents for sample preparation. They also provide information about the stability of the impurities that are found in profiles of illicit amphetamine. This is essential due to the fact, that unstable compounds can have a negative influence on the comparison of profiles.

  • 2.
    Aalberg, Laura
    et al.
    National Bureau of Investigation, P.O. Box 285, FIN-01301 Vantaa, Finland.
    Andersson, Kjell
    Swedish National Laboratory of Forensic Science, SKL, SE-581 94 Linköping, Sweden.
    Bertler, Christina
    Swedish National Laboratory of Forensic Science, SKL, SE-581 94 Linköping, Sweden.
    Borén, Hans
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för fysik, kemi och biologi, Organisk Analytisk Kemi.
    Cole, Michael D.
    Forensic Science Unit, University of Strathclyde, 204 George Street, Glasgow, UK.
    Dahlén, Johan
    Swedish National Laboratory of Forensic Science, SKL, SE-581 94 Linköping, Sweden.
    Finnon, Yvonne
    Forensic Science Unit, University of Strathclyde, 204 George Street, Glasgow, UK.
    Huizer, Henk
    Netherlands Forensic Institute, Volmerlaan 17, 2288 GD Rijswijk, The Netherlands.
    Jalava, Kajsa
    National Bureau of Investigation, P.O. Box 285, FIN-01301 Vantaa, Finland.
    Kaa, Elisabet
    Department of Forensic Medicine, University of Aarhus, Skovagervej 2, DK-8240 Risskov, Denmark.
    Lock, Eric
    Netherlands Forensic Institute, Volmerlaan 17, 2288 GD Rijswijk, The Netherlands/Institut de Police Scientifique, University of Lausanne, Batiment de Chimie, CH-1015 Lausanne-Dorigny, Switzerland.
    Lopes, Alvaro
    Laboratorio de Policia Cientifica, Policia Judiciaria, Rua Gomes Freire 174, 1169-007 Lisbon, Portugal.
    Poortman-van-der Meer, Anneke
    Department of Forensic Medicine, University of Aarhus, Skovagervej 2, DK-8240 Risskov, Denmark.
    Sippola, Erkki
    National Bureau of Investigation, P.O. Box 285, FIN-01301 Vantaa, Finland.
    Development of a harmonised method for the profiling of amphetamines: I. Synthesis of standards and compilation of analytical data2005Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 149, nr 2-3, s. 219-229Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Reference material was synthesised for 21 substances that are frequently present as synthetic impurities, i.e. by-products, in illicitly produced amphetamine. Each of these substances is a typical by-product for at least one of the three approaches most often used to synthesise amphetamine, namely, the Leuckart, the reductive amination of benzyl methyl ketone, and the nitrostyrene routes. A large body of data on the substances was recorded, including the following: mass spectra, ultraviolet spectra, Fourier transform infrared spectra, infrared spectra in gas phase, and 1H NMR and 13C NMR spectra. © 2004 Elsevier Ireland Ltd. All rights reserved.

  • 3.
    Ahlner, Johan
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Swedish National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    Holmgren, Anita
    Swedish National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    Jones, A Wayne
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Swedish National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    Demographics and post-mortem toxicology findings in deaths among people arrested multiple times for use of illicit drugs and/or impaired driving2016Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 265, s. 138-143Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Multiple arrests for use of illicit drugs and/or impaired driving strongly suggests the existence of a personality disorder and/or a substance abuse problem. Methods: This retrospective study (1993-2010) used a national forensic toxicology database (TOXBASE), and we identified 3943 individuals with two or more arrests for use of illicit drugs and/or impaired driving. These individuals had subsequently died from a fatal drug poisoning or some other cause of death, such as trauma. Results: Of the 3943 repeat offenders 1807 (46%) died from a fatal drug overdose and 2136 (54%) died from other causes (p amp;lt; 0.001). The repeat offenders were predominantly male (90% vs 10%) and mean age of drug poisoning deaths was 5 y younger (mean 35 y) than other causes of death (mean 40 y). Significantly more repeat offenders (46%) died from drug overdose compared with all other forensic autopsies (14%) (p amp;lt; 0.001). Four or more drugs were identified in femoral blood in 44% of deaths from poisoning (drug overdose) compared with 18% of deaths by other causes (p amp;lt; 0.001). The manner of death was considered accidental in 54% of deaths among repeat offenders compared with 28% for other suspicious deaths (p amp;lt; 0.001). The psychoactive substances most commonly identified in autopsy blood from repeat offenders were ethanol, morphine (from heroin), diazepam, amphetamines, cannabis, and various opioids. Conclusions: This study shows that people arrested multiple times for use of illicit drugs and/or impaired driving are more likely to die by accidentally overdosing with drugs. Lives might be saved if repeat offenders were sentenced to treatment and rehabilitation for their drug abuse problem instead of conventional penalties for drug-related crimes. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

  • 4.
    Andersson, Kjell
    et al.
    Swedish National Laboratory of Forensic Science.
    Jalava, Kaisa
    National Bureau of Investigation, Finland.
    Lock, Eric
    University of Lausanne.
    Finnon, Yvonne
    University of Strathclyde, Glasgow.
    Huizer, Henk
    Netherlands Forensic Institute.
    Kaa, Elisabet
    University of Aarhus.
    Lopes, Alvaro
    Policia Judiciaria, Lisbon, Portugal.
    Poortman-Van der Meer, Anneke
    Netherlands Forensic Institute.
    Cole, Michael D.
    University of Strathclyde, Glasgow.
    Dahlén, Johan
    Swedish National Laboratory of Forensic Science.
    Sippola, Erkki
    National Bureau of Investigation, Finland.
    Development of a harmonised method for the profiling of amphetamines : III. Development of the gas chromatographic method2007Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 169, nr 1, s. 50-63Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study focused on gas chromatographic analysis of target compounds found in illicit amphetamine synthesised by the Leuckart reaction, reductive amination of benzyl methyl ketone, and the nitrostyrene route. The analytical method was investigated and optimised with respect to introduction of amphetamine samples into the gas chromatograph and separation and detection of the target substances. Sample introduction using split and splitless injection was tested at different injector temperatures, and their ability to transfer the target compounds to the GC column was evaluated using cold on column injection as a reference. Taking the results from both techniques into consideration a temperature of 250 °C was considered to be the best compromise. The most efficient separation was achieved with a DB-35MS capillary column (35% diphenyl 65% dimethyl silicone; 30 m × 0.25 mm, df 0.25 μm) and an oven temperature program that started at 90 °C (1 min) and was increased by 8 °C/min to 300 °C (10 min). Reproducibility, repeatability, linearity, and limits of determination for the flame ionisation detector (FID), nitrogen phosphorous detector (NPD), and mass spectrometry (MS) in scan mode and selected ion monitoring (SIM) mode were evaluated. In addition, selectivity was studied applying FID and MS in both scan and SIM mode. It was found that reproducibility, repeatability, and limits of determination were similar for FID, NPD, and MS in scan mode. Moreover, the linearity was better when applying FID or NPD whereas the selectivity was better when utilising the MS. Finally, the introduction of target compounds to the GC column when applying injection volumes of 0.2 μl, 1 μl, 2 μl, and 4 μl with splitless injection respectively 1 μl with split injection (split ratio, 1:40) were compared. It was demonstrated that splitless injections of 1 μl, 2 μl, and 4 μl could be employed in the developed method, while split injection and splitless injections of 0.2 μl should be avoided.

  • 5.
    Andersson, Kjell
    et al.
    Swedish National Laboratory of Forensic Science.
    Jalava, Kaisa
    National Bureau of Investigation, Finland.
    Lock, Eric
    University of Lausanne.
    Huizer, Henk
    Netherlands Forensic Institute.
    Kaa, Elisabet
    University of Aarhus.
    Lopes, Alvaro
    Policia Judiciaria, Lisbon, Portugal.
    Poortman-van der Meer, Anneke
    Netherlands Forensic Institute.
    Cole, Michael D.
    University of Strathclyde, Glasgow.
    Dahlén, Johan
    Swedish National Laboratory of Forensic Science.
    Sippola, Erkki
    National Bureau of Investigation, Finland.
    Development of a harmonised method for the profiling of amphetamines: IV. Optimisation of sample preparation2007Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 169, nr 1, s. 64-76Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The suitability of liquid–liquid extraction (LLE) and solid-phase extraction (SPE) for the preparation of impurity extracts intended for gas chromatographic profiling analyses of amphetamine were evaluated. Both techniques were optimised with respect to the extraction of selected target compounds by use of full factorial designs in which the variables affecting the performance were evaluated. Test samples consisted of amphetamine synthesised by the Leuckart reaction, by reductive amination of benzyl methyl ketone and by the nitrostyrene route. The performance of LLE and SPE were comparable in terms of repeatability and recovery of the target compounds. LLE was considered the better choice for the present harmonised amphetamine profiling method due to the lack of information on the long-term stability of SPE columns.

  • 6.
    Andersson, Kjell
    et al.
    Swedish National Laboratory for Forensic Science.
    Lock, Eric
    Institut de Police Scientifique, University of Lausanne.
    Jalava, Kaisa
    National Bureau of Investigation, Finland.
    Huizer, Henk
    Netherlands Forensic Institute.
    Jonson, Sten
    Swedish National Laboratory for Forensic Science.
    Kaa, Elisabet
    University of Aarhus.
    Lopes, Alvaro
    Policia Judiciaria, Lisbon, Portugal.
    Poortman-Van der Meer, Anneke
    Netherlands Forensic Institute.
    Sippola, Erkki
    National Bureau of Investigation, Finland.
    Dujourdy, Laurence
    Institut de Police Scientifique, University of Lausanne.
    Dahlén, Johan
    Swedish National Laboratory for Forensic Science.
    Development of a harmonised method for the profiling of amphetamines VI: Evaluation of methods for comparison of amphetamine2007Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 169, nr 1, s. 86-99Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Amphetamine samples were analysed by gas chromatography–mass spectrometry (GC–MS), and the peak areas of 33 target compounds were transformed by applying various pretreatment techniques. The objective was to optimise the ability of a number of distance metrics to establish links between samples of amphetamine originating from the same batch (henceforth refered to as linked distances). Furthermore, partial least squares discriminant analysis (PLS-DA) was used to evaluate the effects of various pretreatment methods on separation of amphetamine batches synthesised by the Leuckart reaction, reductive amination of benzyl methyl ketone, and the nitrostyrene route. The most efficient way to pretreat GC–MS data varied for the different distance metrics, although best results were obtained when data were normalised to the sum of peak areas, and either the fourth root or a logarithm was applied to the normalised data. When pretreating normalised data by fourth root transformation, Pearson correlation was the distance metric that was most successful at finding linked samples. Normalisation and the use of fourth root also represented the best method of pretreating data when employing PLS-DA to separate samples synthesised by different routes. To achieve a faster and more user-friendly procedure for evaluating chromatograms, experiments were performed in which the number of target compounds used to compare samples was reduced. The effect of each compound that was removed was studied by applying PLS-DA and by using Pearson correlation to calculate linked distances as well as unlinked distances (between samples from different batches of amphetamine). Considering both links between samples from the same batch and separation of samples synthesised by different routes, the best results were obtained with the data set comprising 26 compounds. Finally, it was found that the profiling method developed in this work was superior to an existing technique with respect to separating linked and unlinked distances.

  • 7.
    Bastami, Salumeh
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet.
    Haage, Pernilla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet. National Board of Forensic Medicine, Department of Forensic Genetics and Forensic Toxicology, Linköping, Sweden.
    Kronstrand, Robert
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet. National Board of Forensic Medicine, Department of Forensic Genetics and Forensic Toxicology, Linköping, Sweden.
    Kugelberg, Fredrik
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet. National Board of Forensic Medicine, Department of Forensic Genetics and Forensic Toxicology, Linköping, Sweden.
    Zackrisson, Anna-Lena
    National Board of Forensic Medicine, Department of Forensic Genetics and Forensic Toxicology, Linköping, Sweden.
    Uppugunduri, Srinivas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk kemi.
    Pharmacogenetic aspects of tramadol pharmacokinetics and pharmacodynamics after a single oral dose2014Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 238, s. 125-132Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The major purpose of this study was to elucidate if genotyping can facilitate interpretations of tramadol (TRA) in forensic case work, with special regard to the estimation of the time of drug intake and drug related symptoms (DRS). The association between genetic polymorphisms in CYP2D6, OPRM1 and ABCB1 and pharmacokinetic and pharmacodynamic properties of TRA was studied. Nineteen healthy volunteers were randomized into two groups receiving a single dose of either 50 or 100 mg of orally administrated TRA. Blood samples were collected prior to dosing and up to 72 h after drug intake. The subjects were asked to report DRS during the experimental day. We found a positive correlation between the metabolic ratio of O-desmethyltramadol (ODT) to TRA and the time after drug intake for both CYP2D6 intermediate metabolizers and extensive metabolizers. For the only poor metabolizer with detectable ODT levels the metabolic ratio was almost constant. Significant associations were found between the area under the concentration-time curve (AUC) and three of the investigated ABCB1 single nucleotide polymorphisms for TRA, but not for ODT and only in the 50 mg dosage group. There was great interindividual variation in DRS, some subjects exhibited no symptoms at all whereas one subject both fainted and vomited after a single therapeutic dose. However, no associations could be found between DRS and investigated polymorphisms. We conclude that the metabolic ratio of ODT/TRA may be used for estimation of the time of drug intake, but only when the CYP2D6 genotype is known and taken into consideration. The influence of genetic polymorphisms in ABCB1 and OPRM1 requires further study.

  • 8.
    Bendroth, Peter
    et al.
    Department of Forensic Medicine, Lund, Sweden.
    Kronstrand, Robert
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rättsgenetik. Linköpings universitet, Hälsouniversitetet.
    Helander, Anders
    Department of Clinical Neuroscience, Alcohol Laboratory, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.
    Greby, Jesper
    Department of Forensic Medicine, Lund, Sweden.
    Stephanson, Nikolai
    Department of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
    Krantz, Peter
    Department of Forensic Medicine, Lund, Sweden.
    Comparison of ethyl glucuronide in hair with phosphatidylethanol in whole blood as post-mortem markers of alcohol abuse2008Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 176, nr 1, s. 76-81Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Ethyl glucuronide (EtG) is a direct metabolite of ethanol and has been used as a marker of alcohol abuse in both urine and hair. This study investigated the value of EtG testing in post-mortem hair for diagnostic improvement of alcohol abuse in forensic medicine. Material from 70 consecutive medico-legal autopsies was collected in accordance with the recommendations on ethics by the Swedish National Board of Forensic Medicine. A method for determination of EtG in hair samples was developed using ultra performance liquid chromatography/electrospray tandem mass spectrometry (UPLC/ESI-MS/MS; LOQ, 2.5 pg/mg). The result of the EtG analysis was compared with the findings of phosphatidylethanol (PEth) in femoral whole blood, as measured by high performance liquid chromatography with an evaporative light-scattering detector (HPLC–ELSD; LOQ, 0.22 μmol/l). Evaluation of liver histology and anamnestic evidence of alcohol abuse of the deceased were taken in consideration for the interpretation. Measurable levels of EtG were present in 49 of the 70 autopsy cases whereas PEth was present in 36. Thirty-nine cases had EtG levels above the cutoff limit (≥30 pg/mg) compared with 29 for PEth (≥0.7 μmol/l). Fifteen cases had EtG as exclusive indicator for alcohol abuse compared with four cases for PEth. These findings suggest that measurements of EtG in hair may provide improved diagnostic information on alcohol abuse, due to a long retrospective time-window for detection and stability of EtG in hair in the decaying cadaver. However, an EtG level below the cutoff does not completely exclude previous alcohol abuse.

  • 9. Bergström, J
    et al.
    Helander, A
    Jones, A Wayne
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Klinisk kemi.
    Ethyl glucuronide concentrations in two successive urinary voids from drinking drivers: Relationship to creatinine content and blood and urine ethanol concentrations2003Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 133, nr 1-2, s. 86-94Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The concentrations of alcohol in blood (BAC) and two successive urine voids (UAC) from 100 drunk drivers were compared with the concentration of ethyl glucuronide (EtG), a minor metabolite of ethanol in urine, and the urinary creatinine content as an indicator of dilution. The subjects consisted of 87 men with mean age 42.2 ▒ 14.2 years (▒standard deviation, S.D.) and 13 women with mean age 42.5 ▒ 14.4 years. Ethanol was measured in blood and urine by headspace gas chromatography (GC) and EtG was determined in urine by liquid chromatography-mass spectrometry (LC-MS). The mean UAC was 2.53 ▒ 1.15g/l for first void compared with 2.35 ▒ 1.17g/l for second void, decreasing by 0.18 ▒ 0.24g/l on average (P < 0.001 in paired t-test). The ratios of UAC/BAC were 1.35 ▒ 0.25 for first void and 1.20 ▒ 0.16 for second void and the difference of 0.15 ▒ 0.27 was statistically significant (P < 0.001). The UAC/BAC ratio was not correlated with creatinine content of the urine specimens, whereas the concentration of urinary EtG was positively correlated with creatinine (r=0.64 for first void and r=0.62 for second void). The UAC was not correlated with urinary EtG directly (r=-0.03 for first void and r=0.08 for second void) but after adjusting for the relative dilution of the specimens (EtG/creatinine ratio) statistically significant positive correlations were obtained (r=0.58 for first void and r=0.57 for second void). The dilution of the urine, as reflected in creatinine content, is important to consider when EtG measurements are interpreted. The excretion of EtG in urine, like glucuronide conjugates of other drugs, is influenced by diuresis. EtG represents a sensitive and specific marker of acute alcohol ingestion with applications in clinical and forensic medicine. ⌐ 2003 Elsevier Science Ireland Ltd. All rights reserved.

  • 10.
    Bonzon, Jerome
    et al.
    University of Bern, Switzerland.
    Schoen, Corinna A.
    University of Bern, Switzerland.
    Schwendener, Nicole
    University of Bern, Switzerland.
    Zech, Wolf-Dieter
    University of Bern, Switzerland.
    Kara, Levent
    Triemli Hospital, Switzerland.
    Persson, Anders
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Diagnostikcentrum, Röntgenkliniken i Linköping. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Jackowski, Christian
    University of Bern, Switzerland.
    Rigor mortis at the myocardium investigated by post-mortem magnetic resonance imaging2015Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 257, s. 93-97Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Post-mortem cardiac MR exams present with different contraction appearances of the left ventricle in cardiac short axis images. It was hypothesized that the grade of post-mortem contraction may be related to the post-mortem interval (PMI) or cause of death and a phenomenon caused by internal rigor mortis that may give further insights in the circumstances of death. Method and materials: The cardiac contraction grade was investigated in 71 post-mortem cardiac MR exams (mean age at death 52 y, range 12-89 y; 48 males, 23 females). In cardiac short axis images the left ventricular lumen volume as well as the left ventricular myocardial volume were assessed by manual segmentation. The quotient of both (LVQ) represents the grade of myocardial contraction. LVQ was correlated to the PMI, sex, age, cardiac weight, body mass and height, cause of death and pericardial tamponade when present. In cardiac causes of death a separate correlation was investigated for acute myocardial infarction cases and arrhythmic deaths. Results: LVQ values ranged from 1.99 (maximum dilatation) to 42.91 (maximum contraction) with a mean of 15.13. LVQ decreased slightly with increasing PMI, however without significant correlation. Pericardial tamponade positively correlated with higher LVQ values. Variables such as sex, age, body mass and height, cardiac weight and cause of death did not correlate with LVQ values. There was no difference in LVQ values for myocardial infarction without tamponade and arrhythmic deaths. Conclusion: Based on the observation in our investigated cases, the phenomenon of post-mortem myocardial contraction cannot be explained by the influence of the investigated variables, except for pericardial tamponade cases. Further research addressing post-mortem myocardial contraction has to focus on other, less obvious factors, which may influence the early post-mortem phase too. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

  • 11.
    Bovens, Michael
    et al.
    Zurich Forensic Science Institute, Switzerland.
    Ahrens, Björn
    Federal Criminal Police Office, Wiesbaden, Germany.
    Alberink, Ivo
    Netherlands Forensic Institute, The Hague, Netherlands.
    Nordgaard, Anders
    Linköpings universitet, Institutionen för datavetenskap, Statistik och maskininlärning. Linköpings universitet, Filosofiska fakulteten.
    Salonen, Tuomas
    University of Helsinki, Faculty of Science, Department of Mathematics and Statistics.
    Huhtala, Sami
    National Bureau of Investigation, Helsinki, Finland.
    Chemometrics in forensic chemistry — Part I: Implications to the forensic workflow2019Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 301, s. 82-90Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The forensic literature shows a clear trend towards increasing use of chemometrics (i.e. multivariate analysis and other statistical methods). This can be seen in different disciplines such as drug profiling, arson debris analysis, spectral imaging, glass analysis, age determination, and more. In particular, current chemometric applications cover low-dimensional (e.g. drug impurity profiles) and high-dimensional data (e.g. Infrared and Raman spectra) and are therefore useful in many forensic disciplines. There is a dominant and increasing need in forensic chemistry for reliable and structured processing and interpretation of analytical data. This is especially true when classification (grouping) or profiling (batch comparison) is of interest.

    Chemometrics can provide additional information in complex crime cases and enhance productivity by improving the processes of data handling and interpretation in various applications. However, the use of chemometrics in everyday work tasks is often considered demanding by forensic scientists and, consequently, they are only reluctantly used. This article and following planned contributions are dedicated to those forensic chemists, interested in applying chemometrics but for any reasons are limited in the proper application of statistical tools — usually made for professionals — or the direct support of statisticians. Without claiming to be comprehensive, the literature reviewed revealed a sufficient overview towards the preferably used data handling and chemometric methods used to answer the forensic question. With this basis, a software tool will be designed (part of the EU project STEFA-G02) and handed out to forensic chemist with all necessary elements of data handling and evaluation.

    Because practical casework is less and less accompanied from the beginning to the end out of the same hand, more and more interfaces are built in through specialization of individuals. This article presents key influencing elements in the forensic workflow related to the most meaningful chemometric application and evaluation.

  • 12.
    Bulut, Ozgur
    et al.
    Hitit University, Turkey.
    Petaros, Anja
    Rijeka University, Croatia.
    Hizliol, Ismail
    Turkish Police Forens Lab, Turkey.
    Wärmländer, Sebastian
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Affärsrätt. Linköpings universitet, Filosofiska fakulteten. University of Calif Los Angeles, CA USA; Stockholm University, Sweden.
    Hekimoglu, Baki
    Yildirim Beyazit Training and Research Hospital, Turkey.
    Sexual dimorphism in frontal bone roundness quantified by a novel 3D-based and landmark-free method2016Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 261, nr UNSP 162.e1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In this study we present a novel and landmark-free method for quantifying shape differences between male and female frontal bones. CT scans were recorded for 80 male and 80 female Turkish hospital patients, age 25-40. The frontal bones were first isolated from the 3D models by digital cutting along the bordering sutures, and then aligned to a CAD-based sphere. This allowed us to quantify the amount of frontal bone overlapping with the sphere (on average 43.2 +/- 6.5% for males and 33.9 +/- 6.6% for females, the difference is significant at p &lt; 0.0001), and to identify areas of shape difference and deviation from the sphere surface in male and female bones. The larger proportion of spherical frontal bone surface in males challenges the common description of the female forehead as "rounder. Based on the overlap data, we developed discriminant functions able to correctly classify 77.5% of the frontal bone models as male/female. This demonstrates that 3D-based and landmark-free approaches to statistical shape analysis may become a viable alternative to the currently dominating landmark-based approaches for shape investigation. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

  • 13.
    Christophersen, A. S.
    et al.
    National Institute of Forensic Toxicology, Sentrum, Oslo, Norway.
    Ceder, G.
    Department of Forensic Chemistry, National Board of Forensic Medicine, Linköping, Sweden.
    Kristinsson, J.
    Department of Pharmacology, University of Iceland, Reykjavik, Iceland.
    Lillsunde, P.
    National Public Health Institute, Helsinki, Finland.
    Steentoft, A.
    Institute of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark.
    Drugged driving in the Nordic countries: a comparative study between five countries1999Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 106, nr 3, s. 173-190Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to compare whether the high incidence of drugged driving in Norway was different to that in the other Nordic countries. All blood samples received by Nordic forensic institutes during one week in 1996, from drivers suspected by the police of driving under the influence (Denmark: n=255, Finland: n=270, Iceland: n=40, Sweden: n=86, Norway: n=149), were analysed for alcohol and drugs (benzodiazepines, cannabinoids, amphetamines, cocaine, opiates and a number of antidepressant drugs) independent of the primary suspicion, and using the same analytical cut-off levels at the different institutes. The primary suspicion was directed towards drugs in more than 40% of the Norwegian cases, drugs were detected in more than 70% of these samples. In only 0–3% of the cases from Denmark, Finland and Iceland, were drugs suspected, while the corresponding frequency for Sweden was 17%. However, evidential breath analyses were used for about three-quarters of the Swedish drivers suspected to be influenced by alcohol. Blood alcohol concentrations (BAC’s) below the legal limits were found in 32, 18 and 2% of the Norwegian, Icelandic and Finnish cases, respectively (BAC<0.05%), in 10% of the Danish cases (BAC<0.08%) and in 20% of the Swedish cases (BAC<0.02%). Drugs were most frequently found in the Norwegian and Swedish cases with no alcohol (80–83%). Similar frequencies of drugs in samples with BAC’s above the legal limits (19–22%), were obtained for all countries. Benzodiazepines, tetrahydrocannabinol and amphetamine represented the most commonly detected drugs. Our results show that differences between Norway and other Nordic countries with regard to drugs and driving, are connected to the selection criteria made by the police and with more focus on drugged driving in Norway.

  • 14.
    Cooper, Gail A A
    et al.
    Forensic Medicine and Science, University of Glasgow, Glasgow Scotland.
    Kronstrand, Robert
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet. Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.
    Kintz, Pascal
    X-Pertise Consulting, Oberhausbergen, France.
    Society of Hair Testing guidelines for drug testing in hair2012Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 218, nr 1-3, s. 20-24Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    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.

  • 15.
    Cooper, Gail
    et al.
    Forensic Medicine and Science, University of Glasgow, Scotland, United Kingdom.
    Moeller, Manfred
    Saarland University Hospital, Homburg/SAAR, Germany.
    Kronstrand, Robert
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Rättsgenetik. Linköpings universitet, Hälsouniversitetet.
    Current status of accreditation for drug testing in hair2008Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 176, nr 1, s. 9-12Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    At the annual meeting of the Society of Hair Testing in Vadstena, Sweden in 2006, a committee was appointed to address the issue of guidelines for hair testing and to assess the current status of accreditation amongst laboratories offering drug testing in hair.

    A short questionnaire was circulated amongst the membership and interested parties. Fifty-two responses were received from hair testing laboratories providing details on the amount and type of hair tests they offered and the status of accreditation within their facilities.

    Although the vast majority of laboratories follow current guidelines (83%), only nine laboratories were accredited to ISO/IEC 17025 for hair testing. A significant number of laboratories reporting that they were in the process of developing quality systems with a view to accrediting their methods within 2–3 years. This study provides an insight into the status of accreditation in hair testing laboratories and supports the need for guidelines to encourage best practice.

  • 16. Dahlen, J.
    et al.
    Vriesman, T.
    Forensic Science Unit, University of Strathclyde, 204 George Street, Glasgow G1 1XW, United Kingdom.
    Simultaneous analysis of ?-hydroxybutyric acid, ?-butyrolactone, and 1,4-butanediol by micellar electrokinetic chromatography2002Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 125, nr 2-3, s. 113-119Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A micellar electrokinetic chromatography (MEKC) method was optimised for simultaneous analysis of ?-hydroxybutyric acid (GHB), ?-butyrolactone (GBL), and 1,4-butanediol (BD). Best conditions for separation and baseline stability were achieved using a carrier electrolyte comprising 30.0mM sodium barbital and 150.0mM sodium dodecyl sulphate (SDS) at pH 10.2. Calibration functions were linear, giving correlation coefficients (r2) >0.998 for the three target compounds. Limits of detection (LOD) defined as three times the noise, were 5.1mg/l, 0.34 and 0.25g/l for GHB, GBL and BD, respectively. The repeatability of migration times and peak areas, expressed as the R.S.D. (n=9) was better than 0.41 and 3.05%, respectively. Some casework samples were analysed using the optimised conditions. Copyright © 2002 Elsevier Science Ireland Ltd.

  • 17.
    Dahlén, Johan
    et al.
    Swedish National Laboratory of Forensic Science – SKL.
    Lundquist, Per
    Swedish National Laboratory of Forensic Science – SKL.
    Jonsson, Malin
    Swedish National Laboratory of Forensic Science – SKL.
    Spontaneous formation of gamma-hydroxybutyric acid from gamma-butyrolactone in tap water solutions2011Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 210, nr 1-3, s. 247-256Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The spontaneous conversion of g-butyrolactone (GBL) to g-hydroxybutyric acid (GHB) in seven different Swedish tap waters was investigated. The waters used in the study were selected to represent the diversity among Swedish tap waters as well as possible, which was enabled by principal component analysis (PCA) of a number of water quality parameters. GBL solutions (5, 25 and 50% v/v) were prepared in each of the tap waters and in deionized water and the formation of GHB was followed over time. The GHB quantifications were made using a CZE method, employing a carrier electrolyte consisting of 25 mM benzoic acid, 54 mM tris(hydroxymethyl) aminomethane (Tris) and 1.7 mM tetradecyltrimethylammonium bromide (TTAB), which was developed as a part of the current study. Data evaluation showed that the formation of GHB was largely dependent on the type of tap water. For example, there was a negative correlation between the kinetics of the GHB formation and the alkalinity of the tap waters (r(2) = 0.990). This could be explained by a faster decrease in pH in the waters with low buffering capacity (i.e. low alkalinity), which catalysed the hydrolysis of GBL. Equilibrium was reached after 40-250 days depending on the initial GBL concentration and the type of tap water. The level of the equilibrium appeared to be dependent on the initial GBL concentration and ranged from 26 to 37%. Gained knowledge on the levels of the GHB/GBL equilibrium and the kinetics of the formation of GHB in tap water solutions of GBL, including the influence of the tap water quality, may be useful information for casework with the GHB/GBL problem in focus. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

  • 18. Druid, H.
    et al.
    Holmgren, P.
    Ahlner, Johan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi.
    Flunitrazepam: An evaluation of use, abuse and toxicity2001Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 122, nr 2-3, s. 136-141Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The benzodiazepine flunitrazepam is extensively prescribed to patients with insomnia in many countries, but has also become popular among alcohol- and drug abusers. Several reports indicate that it is used as a date rape drug and suggest that it may precipitate violent behavior. Furthermore, flunitrazepam is involved in many fatal intoxications in Sweden. This study was designed and conducted to explore the negative consequences of flunitrazepam abuse in Sweden, and to assess the trends in its use and abuse. The occurrence of flunitrazepam in cases referred to the Department of Forensic Chemistry in Linköping, Sweden 1992-1998, was investigated in detail. The detections were studied separately for different groups, medicolegal death investigations, drug abuse cases, driving under influence cases, and other medicolegal cases. These data were further compared with the sales, and seizures by the Swedish Customs and the Swedish Police. During 1992-1998, 641 fatalities occurred, where the cause of death was attributed to intoxication with flunitrazepam solely (130) or in combination with other drugs, or concomittant conditions (511). In 78% of all driving under influence cases, where flunitrazepam was detected, the analyses also disclosed the presence of illicit drugs. A similar association was seen in drug abuse cases. The seizures reported by the Swedish Customs revealed a substantial and increasing illegal trade. Cases, where flunitrazepam seemingly induced violent behavior were identified, and one of these is described in some detail. It is concluded that the abuse pattern and the toxicity of flunitrazepam should be kept in mind by forensic investigators and that this panorama also should be considered when decisions about the registration and classification of flunitrazepam are made in different countries. Copyright © 2001 Elsevier Science Ireland Ltd.

  • 19.
    Druid, H
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Rättsmedicin.
    Holmgren, P
    Carlsson, B
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Klinisk kemi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk kemi.
    Ahlner, Johan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk farmakologi.
    Cytochrome P450 2D6 (CYPP2D6) genotyping on postmortem blood as a supplementary tool for interpretation of forensic toxicological results.  1999Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 99, s. 25-34Artikkel i tidsskrift (Fagfellevurdert)
  • 20.
    Druid, Henrik
    et al.
    Department of Forensic Medicine, Karolinska Institutet, Stockholm, Sweden.
    Strandberg, Joakim J.
    Department of Forensic Medicine, Karolinska Institutet, Stockholm, Sweden.
    Alkass, Kanar
    Department of Forensic Medicine, Karolinska Institutet, Stockholm, Sweden.
    Nyström, Ingrid
    Department of Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.
    Kugelberg, Fredrik
    Department of Forensic Medicine, Karolinska Institutet, Stockholm, Sweden.
    Kronstrand, Robert
    Department of Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.
    Evaluation of the role of abstinence in heroin overdose deaths using segmental hair analysis2007Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 168, nr 2-3, s. 223-226Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In the body heroin is rapidly metabolized to 6-acetylmorphine and morphine. Victims of lethal heroin overdose often present with fairly low blood concentrations of morphine. Reduced tolerance due to abstinence has been proposed to account for this finding. The aim of the present study was to examine the role of abstinence in drug-related deaths by comparing recent and past exposure to opioids using segmental hair analysis with the postmortem blood morphine concentrations in deceased heroin users. The study included 60 deceased drug addicts in the Stockholm area, Sweden. In 32 cases, death was not related to heroin intake. In 18 of the 28 heroin fatalities, opioids were absent in the most recent hair segment, suggesting a reduced tolerance to opioids. However, the blood morphine levels were similar to those found in the 10 subjects that showed continuous opioid use. Hair and blood analysis disclosed an extensive use of additional drugs that directly or indirectly may influence the opioid system. The results suggest that abstinence is not a critical factor for heroin overdose death. Obviously tolerant subjects die after intake of similar doses. Other factors, particularly polydrug use, seem to be more causally important for these deaths.

  • 21.
    Edston, Erik
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Rättsmedicin.
    van Hage-Hamsten, M
    Mast cell tryptase and hemolysis after trauma2003Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 131, nr 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: We have previously found increased mast cell tryptase in accidental deaths due to trauma, indicating that mast cell degranulation had occurred. The present study was designed to confirm the previous observation and to determine if tryptase release after trauma is acute or delayed. Furthermore, the importance of hemolysis and direct trauma to the mast cells was investigated. Materials and methods: Mast cell tryptase was measured in post-mortem blood from the femoral vein in 27 cases of death from trauma and in 27 control cases by means of a commercially available immunoassay. The trauma cases were further classified into groups with single versus multiple trauma, and groups with short survival time (i.e. death at the scene of the accident) versus longer survival time (death in hospital). In five multi-trauma deaths, blood was sampled locally from the sites of crush injury. Results: The mean value of tryptase in femoral vein blood was 35.6▒34.6╡g/l in the entire trauma group and 14.7▒6.5╡g/l in the controls (P<0.005). In bloody liquid sampled from crush injuries, tryptase was substantially elevated in all cases, with a mean of 227▒146╡g/l. In cases with short survival time, tryptase was significantly higher than in those who died after several hours or days in hospital (P<0.001). No statistically significant difference was seen between multi- and single-trauma cases. A correlation between hemolysis in the samples and elevated tryptase was found only in the trauma cases (P<0.05), but experimentally induced hemolysis in vitro was not found to influence the measurements. Conclusion: Mast cell tryptase becomes elevated in trauma deaths and this seems to be ascribable either to direct mechanical injury to tissue mast cells and/or to cell lysis. In patients initially surviving severe injuries, the effects of massive release of histamine and other mast cell mediators might be of importance for treatment strategies and prognosis.

  • 22.
    Guerrieri, Davide
    et al.
    National Board Forens Med, Department Forens Genet and Forens Toxicol, S-58758 Linkoping, Sweden.
    Rapp, Emma
    National Board Forens Med, Department Forens Genet and Forens Toxicol, S-58758 Linkoping, Sweden.
    Roman, Markus
    National Board Forens Med, Department Forens Genet and Forens Toxicol, S-58758 Linkoping, Sweden.
    Thelander, Gunilla
    National Board Forens Med, Department Forens Genet and Forens Toxicol, S-58758 Linkoping, Sweden.
    Kronstrand, Robert
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. National Board Forens Med, Department Forens Genet and Forens Toxicol, S-58758 Linkoping, Sweden.
    Acrylfentanyl: Another new psychoactive drug with fatal consequences2017Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 277, s. E21-E29Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The European Nordic Countries are the most exposed to opioid-related deaths. Between April and October 2016, a series of forty lethal intoxications occurred in Sweden, in which the presence of the synthetic opioid acrylfentanyl was determined to be the main - or a contributing - cause of death. In the reported cases, the blood concentration of acrylfentanyl - mostly detected in combination with other drugs - ranged from 0.01 ng/g to 5 ng/g; victims were predominantly males (34 males and 6 females), and their age varied between 18 and 53 years. We further describe five cases, representative of the different drug administration route (nasal spray, tablets) and intentions (accidental or voluntary intoxication). Moreover, we address nine cases of non-lethal intoxication, in single (8 cases) or polydrug scenario (1 case). We discuss the present characteristics of the Swedish drug market for fentanyl-analogs in general and acrylfentanyl in particular, reporting a structural difficulty to effectively counteracting the appearance of unscheduled substances due to the constant turnover of new molecules on the recreational drug market. (C) 2017 Published by Elsevier Ireland Ltd.

  • 23.
    Hedlund, Jonatan
    et al.
    National Board Forens Med, Sweden; Karolinska Institute, Sweden.
    Ahlner, Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet.
    Kristiansson, Marianne
    National Board Forens Med, Sweden; Karolinska Institute, Sweden.
    Sturup, Joakim
    National Board Forens Med, Sweden; Karolinska Institute, Sweden.
    A population-based study on toxicological findings in Swedish homicide victims and offenders from 2007 to 20092014Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 244, s. 25-29Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and objectives: Previous research on the toxicology of homicide has shown that about half of offenders and victims have psychoactive substances in their blood. The purpose of this study was to examine this topic in a Swedish setting. Methods: Toxicological data were sought in a database for all victims (n = 273) and perpetrators (n = 257) of homicide in Sweden from 2007 to 2009. Sufficient tests were identified for 97.1% of all victims (n = 265) and 46.7% of all offenders (n = 120). Additional information was obtained from court records and police reports. Results: A majority of individuals involved in homicides displayed positive toxicology (57.0% of victims and 62.5% of offenders). The most commonly detected substances, in both victims and offenders, were ethanol (44.9% vs. 40.8%) and benzodiazepines (8.3% vs. 19.2%). The difference between offenders and victims concerning benzodiazepines was statistically significant (OR 2.6; p = 0.002). Perpetrators of homicide-suicide had a lower prevalence of positive toxicology (30.8%) than other homicide offenders (66.4%; p = 0.04) and victims in unsolved cases more often exhibited positive drug toxicology compared to victims in solved cases (36.1% vs. 8.3%; p less than 0.001). Conclusions: The results of the study support the notion that substance abuse is firmly linked to committing homicide and to becoming a victim thereof.

  • 24.
    Hedlund, Jonatan
    et al.
    National Board Forens Med, Sweden; Karolinska Institute, Sweden.
    Ahlner, Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet.
    Kristiansson, Marianne
    National Board Forens Med, Sweden; Karolinska Institute, Sweden.
    Sturup, Joakim
    National Board Forens Med, Sweden; Karolinska Institute, Sweden.
    Correction: A population-based study on toxicological findings in Swedish homicide victims and offenders from 2007 to 2009 (vol 244, pg 25, 2014)2014Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 245, s. 161-161Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    n/a

  • 25.
    Holmgren, Per
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Holmgren, A
    Nationall Board of Forensic Medicine.
    Ahlner, Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Alcohol and drugs in drivers fatally injured in traffic accidents in Sweden during the years 2000-20022005Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 151, nr 1, s. 11-17Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    During the years 2000-2002, alcohol, pharmaceuticals and illicit drugs were analysed in blood samples from fatally injured drivers in Sweden. The total number of drivers was 920 and in 855 of these, corresponding to 93%, a toxicological investigation was performed. About 85% of the drivers were men and 15% were women. All but three women (96%) were car drivers while the corresponding figure for men was about 78% and about 13% were motorcyclists. The number of positive cases increased from 38.9% in year 2000 to 45.9% in year 2002 and alcohol was the most common drug with frequencies of 19.8%, 25.0% and 21.8% for the studied years 2000, 2001 and 2002, respectively. The median blood alcohol concentration ranged from 1.6 to 2.0 mg/mL for men and from 1.2 to 1.8 mg/mL for women. There was a decrease in cases where alcohol was the only drug detected, from 52 out of 58 cases (90%) in year 2000 to 41 out of 61 cases (67%) in 2002. At the same time there was an increase, from 5.4% to 10.0% of illicit drugs, mainly amphetamine, and the cases with multiple drug intake increased from 10% to 26%. The prevalence of pharmaceuticals as the only drug or drugs detected decreased from 14.0% to 10.4% and in the majority of these cases the drug concentrations were within the therapeutic range.

  • 26.
    Holmgren, Per
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Norden-Pettersson, Lotta
    National Board of Forensic Medicine.
    Ahlner, Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Caffeine fatalities - four case reports2004Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 139, nr 1, s. 71-73Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Four cases of fatal intoxications with caffeine are described. Caffeine is widely available in beverages and in different OTC-products, in many of them in combinations with other drugs like ephedrine. Caffeine is not as harmless as one might believe. An overdose of caffeine alone, intentional or not, might be deadly. It seems to be warranted to include caffeine in the drug-screening of forensic autopsy cases. It is not motivated from a medical point of view to sell pure caffeine over the counter.

  • 27.
    Holmlund, Gunilla
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet. National Board of Forensic Medicine, Linköping, Sweden.
    Nilsson, Helena
    National Board of Forensic Medicine, Linköping, Sweden.
    Karlsson, Andreas
    National Board of Forensic Medicine, Linköping, Sweden.
    Lindblom, Bertil
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet. National Board of Forensic Medicine, Linköping, Sweden.
    Y-chromosome STR haplotypes in Sweden2006Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 160, nr 1, s. 66-79Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A total of 708 men, with Swedish names, from different parts of Sweden have been typed for the Y-chromosome minimal haplotype STR markers DYS19, DYS389I, DYS389II, DYS390, DYS391, DYS392, DYS393 and DYS385. Of these, 403 men were of geographically undefined Swedish origin and the rest, 305, from seven defined geographical regions. PCR-products were detected by ABI377 using sequenced allelic ladders. An evaluation of the 708 chromosomes revealed 423 different haplotypes. Only 100 of the haplotypes were found more than once. The over all haplotype diversity was 0.994. The haplotype 14, 12, 28, 23, 10, 11, 13, 14-14 has the highest frequency of 5.79% and is significantly Swedish, when compared to other European populations.

  • 28.
    Johansson, Anna
    et al.
    National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    Lindstedt, Daniel
    National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    Roman, Markus
    National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    Thelander, Gunilla
    National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    Nielsen, Elisabet I.
    Uppsala University, Sweden.
    Lennborn, Ulrica
    Uppsala University, Sweden.
    Sandler, Hakan
    National Board Forens Med, Sweden; Uppsala University, Sweden.
    Rubertsson, Sten
    Uppsala University, Sweden.
    Ahlner, Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    Kronstrand, Robert
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    Kugelberg, Fredrik
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    A non-fatal intoxication and seven deaths involving the dissociative drug 3-MeO-PCP2017Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 275, s. 76-82Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: 3-methoxyphencyclidine (3-MeO-PCP) appeared on the illicit drug market in 2011 and is an analogue of phencyclidine, which exhibits anesthetic, analgesic and hallucinogenic properties. In this paper, we report data from a non-fatal intoxication and seven deaths involving 3-MeO-PCP in Sweden during the period March 2014 until June 2016. Case descriptions: The non-fatal intoxication case, a 19-year-old male with drug problems and a medical history of depression, was found awake but tachycardic, hypertensive, tachypnoeic and catatonic at home. After being hospitalized, his condition worsened as he developed a fever and lactic acidosis concomitant with psychomotor agitation and hallucinations. After 22 h of intensive care, the patient had made a complete recovery. During his hospitalization, a total of four blood samples were collected at different time points. The seven autopsy cases, six males and one female, were all in their twenties to thirties with psychiatric problems and/or an ongoing drug abuse. Methods: 3-MeO-PCP was identified with liquid chromatography (LC)/time-of-flight technology and quantified using LC-tandem mass spectrometry. Results: In the clinical case, the concentration of 3-MeO-PCP was 0.14 mu g/g at admission, 0.08 mu g/g 2.5 h after admission, 0.06 mu g/g 5 h after admission and 0.04 mu g/g 17 h after admission. The half-life of 3-MeO-PCP was estimated to 11 h. In the autopsy cases, femoral blood concentrations ranged from 0.05 mu g/g to 0.38 mu g/g. 3-MeO-PCP was the sole finding in the case with the highest concentration and the cause of death was established as intoxication with 3-MeO-PCP. In the remaining six autopsy cases, other medications and drugs of abuse were present as well. Conclusion: Despite being scheduled in January 2015, 3-MeO-PCP continues to be abused in Sweden. Exposure to 3-MeO-PCP may cause severe adverse events and even death, especially if the user does not receive life-supporting treatment. (C) 2017 Elsevier B. V. All rights reserved.

  • 29.
    Jones, A Wayne
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för klinisk kemi.
    Driving under the influence of chlormethiazole2005Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 153, nr 2-3, s. 213-217Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article describes a case of driving under the influence of the sedative-hypnotic-anticonvulsant drug chlormethiazole. The suspect, who was a physician, was driving dangerously on a busy highway and caused a traffic collision. When apprehended by the police, the man had bloodshot and glazed eyes and pupil size was enlarged. He could not answer the questions properly and his gait was unsteady. A roadside breath-alcohol screening test was positive but an evidential breath-alcohol test conducted about one hour later was below the legal limit for driving of 0.10 mg/L (10 μg/100 mL or 0.021 g/210 L). Because of the special circumstances of the traffic crash and the man's appearance and behaviour, the police suspected that drugs other than alcohol were involved and obtained a venous blood sample for toxicological analysis. The blood contained 0.23 mg/g alcohol, which is above the legal limit for driving in Sweden 0.20 mg/g (20 mg/100 mL or 0.020 g/100 mL), and codeine was also present at a therapeutic concentration of 0.02 mg/L. The conflict between the clinical signs of impairment and the toxicology report prompted a reanalysis of the blood sample with major focus on sedative-hypnotic drugs. Analysis by capillary GC-NPD identified chlormethiazole at a concentration of 5 mg/L, the highest so far encountered in traffic cases in Sweden. In 13 other impaired driving cases over 10 years the mean (median) and range of concentrations of chlormethiazole were 1.6 mg/L (1.6 mg/L) and 0.3-3.3 mg/L. This case report underscores the need to consider clinical observations and the person's behaviour in relation to the toxicology report when interpreting and testifying in drug-impaired driving cases. © 2005 Elsevier Ireland Ltd. All rights reserved.

  • 30.
    Jones, A Wayne
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning.
    Evidence-based survey of the elimination rates of ethanol from blood with applications in forensic casework2010Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 200, nr 01-MarArtikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Reliable information about the elimination rate of alcohol (ethanol) from blood is often needed in forensic science and legal medicine when alcohol-related crimes, such as drunken driving or drug-related sexual assault are investigated. A blood sample for forensic analysis might not be taken until several hours after an offence was committed. The courts usually want to know the suspects blood-alcohol concentration (BAC) at some earlier time, such as the time of driving. Making these back calculations or retrograde extrapolations of BAC in criminal cases has many proponents and critics. Ethanol is eliminated from the body mainly by oxidative metabolism in the liver by Class I isoenzymes of alcohol dehydrogenase (ADH). Ethanol is an example of a drug for which the Michaelis-Menten pharmacokinetic model applies and the Michaelis constant (k(m)) for Class I ADH is at a BAC of 2-10 mg/100 mL. This means that the enzyme is saturated with substrate after the first few drinks and that zero-order kinetics is adequate to describe the declining phase of the BAC profile in most forensic situations (BAC greater than 20 mg/100 mL). After drinking on an empty stomach, the elimination rate of ethanol from blood falls within the range 10-15 mg/100 mL/h. In non-fasted subjects the rate of elimination tends to be in the range 15-20 mg/100 mL/h. In alcoholics during detoxification, because activity of microsomal enzyme (CYP2E1) is boosted, the ethanol elimination rate might be 25-35 mg/100 mL/h. The slope of the BAC declining phase is slightly steeper in women compared with men, which seems to be related to gender differences in liver weight in relation to lean body mass. The present evidence-based review suggests that the physiological range of ethanol elimination rates from blood is from 10 to 35 mg/100 mL/h. In moderate drinkers 15 mg/100 mL/h remains a good average value for the population, whereas in apprehended drivers 19 mg/100 mL/h is more appropriate, since many of these individuals are binge drinkers or alcoholics. In preparing this article, a large number of peer-reviewed publications were scrutinized. Only those meeting certain standards in experimental design, dose of alcohol and blood-sampling protocol were used. The results presented can hopefully serve as best-practice guidelines when questions arise in criminal and civil litigation about the elimination rate of ethanol from blood in humans.

  • 31.
    Jones, A Wayne
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Klinisk kemi.
    Impact factors of forensic science and toxicology journals: What do the numbers really mean?2003Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 133, nr 1-2Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article presents review and opinion about the use and abuse of journal impact factors for judging the importance and prestige of scientific journals in the field of forensic science and toxicology. The application of impact factors for evaluating the published work of individual scientists is also discussed. The impact factor of a particular journal is calculated by dividing the number of current year citations to a journal's articles that were published in the previous 2 years by the total number of citable items (articles and reviews) published in the same 2-year period. Journal impact factors differ from discipline to discipline and range from 0 for a journal whose articles are not cited in the previous 2 years to 46 for a journal where the average recent article is cited 46 times per year. The impact factor reflects the citation rate of the average article in a journal and not a specific article. Many parameters influence the citation rate of a particular journal's articles and, therefore, its impact factor. These include the visibility and size of the circulation of the journal including availability of electronic formats and options for on-line search and retrieval. Other things to consider are editorial standards especially rapid and effective peer-reviewing and a short time lag between acceptance and appearance in print. The number of self-citations and citation density (the ratio of references to articles) and also the inclusion of many review articles containing hundreds of references to recently published articles will boost the impact factor. Judging the importance of a scientist's work based on the average or median impact factor of the journals used to publish articles is not recommended. Instead an article-by-article citation count should be done, but this involves much more time and effort. Moreover, some weighting factor is necessary to allow for the number of co-authors on each article and the relative positioning of the individual names should also be considered. Authors should submit their research results and manuscripts to journals that are easily available and are read by their peers (the most interested audience) and pay less attention to journal impact factors. To assess the true usefulness of a person's contributions to forensic science and toxicology one needs to look beyond impact factor and citation counts. For example, one might consider whether the articles contained new ideas or innovations that proved useful in routine forensic casework or are widely relied upon in courts of law as proof source. ⌐ 2003 Elsevier Science Ireland Ltd. All rights reserved.

  • 32.
    Jones, A Wayne
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för klinisk kemi.
    The distribution of forensic journals, reflections on authorship practices, peer-review and role of the impact factor2007Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 165, nr 2-3, s. 115-128Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article presents information about journals specializing in the forensic sciences and legal medicine, their development and distribution and their current status as reflected in the journal impact factor. The first scientific journal devoted to spreading information and reporting new developments in social and legal medicine seemingly originated in Germany about 150 years ago. The official journal of the American Academy of Forensic Sciences (Journal of Forensic Sciences, JFS) was founded in 1956 and has enjoyed 50 years of scholarly publishing. The two leading European journals specializing in forensics are Forensic Science International (FSI) and International Journal of Legal Medicine (IJLM). Besides the size of the circulation, the readership numbers, the quality of the editorial staff and the peer-reviewers, the number of submitted and accepted manuscripts, considerable interest has focused on the journal's impact factor as a measure of prestige. The 2006 impact factor of a certain journal is derived by counting the number of citations in 2006 to all material published in the journal in the previous 2 years (2004 and 2005) and dividing this total by the number of citable items (articles and reviews) published in the same 2 years. Impact factors for several thousand scientific journals are compiled and published by a company called Thomson Institute for Scientific Information (Thomson ISI) and are available on-line via the database Journal Citation Reports. Forensic journals are grouped within the subject category Medicine, Legal, which currently comprises nine journals a few of which are seemingly unrelated to mainstream forensics. The top-ranked forensic journal in terms of its impact factor was IJLM with a score of just over 2.0 in 2004. This means that the average article published in 2003 and 2002 was cited twice per year in the 2-year window after publication. Impact factors of forensic journals are fairly low in comparison with many other disciplines, probably because of the small size of the field, fewer active researchers and less pressure to publish. The relatively low impact factors of forensic journals should be less of a concern than ensuring that manuscripts receive a rigorous and preferably an open peer-review prior to acceptance for publication. The information, conclusions and opinions published in forensic science journals might one day be proffered as evidence in criminal or civil litigation. © 2006 Elsevier Ireland Ltd. All rights reserved.

  • 33.
    Jones, A Wayne
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Klinisk kemi.
    Andersson, L
    Comparison of ethanol concentrations in venous blood and end-expired breath during a controlled drinking study2003Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 132, nr 1, s. 18-25Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Concentration-time profiles of ethanol were determined for venous whole blood and end-expired breath during a controlled drinking experiment in which healthy men (n=9) and women (n=9) drank 0.40-0.65g ethanol per kg body weight in 20-30min. Specimens of blood and breath were obtained for analysis of ethanol starting at 50-60min post-dosing and then every 30-60min for 3-6h. This protocol furnished 130 blood-breath pairs for statistical evaluation. Blood-ethanol concentration (BAC, mg/g) was determined by headspace gas chromatography and breath-ethanol concentration (BrAC, mg/2l) was determined with a quantitative infrared analyzer (Intoxilyzer 5000S), which is the instrument currently used in Sweden for legal purposes. In 18 instances the Intoxilyzer 5000S gave readings of 0.00mg/2l whereas the actual BAC was 0.08mg/g on average (range 0.04-0.15mg/g). The remaining 112 blood- and breath-alcohol measurements were highly correlated (r=0.97) and the regression relationship was BAC=0.10+0.91BrAC and the residual standard deviation (S.D.) was 0.042mg/g (8.4%). The slope (0.91▒0.0217) differed significantly from unity being 9% low and the intercept (0.10▒0.0101) deviated from zero (t=10.2, P0.05). The mean rate of ethanol disappearance from blood was 0.157▒0.021mg/(g per hour), which was very close to the elimination rate from breath of 0.161▒0.021mg/(2l per hour) (P>0.05). Breath-test results obtained with Intoxilyzer 5000S (mg/2l) were generally less than the coexisting concentrations of ethanol in venous blood (mg/g), which gives an advantage to the suspect who provides breath compared with blood in cases close to a threshold alcohol limit. ⌐ 2002 Elsevier Science Ireland Ltd. All rights reserved.

  • 34.
    Jones, A Wayne
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet.
    Harding, Patrick
    Wisconsin State Lab Hyg, WI USA .
    Driving under the influence with blood alcohol concentrations over 0.4 g%2013Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 231, nr 1-3, s. 349-353Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to evaluate the characteristics of traffic offenders with unusually high blood-alcohol concentrations (BAC greater than 0.4 g%) when arrested. The BAC that kills one person might be easily tolerated by another, depending on, among other things, the persons age, pattern of drinking, and the development of tolerance. The archives of two forensic laboratories, one in Sweden and the other in Wisconsin (USA), were searched to find traffic offenders with BACs greater than 0.4 g%. The results were compared in relation to the persons age and gender, mean BAC and the weekday and time of day of the arrest. The mean age (+/- standard deviation) of N = 158 Swedish offenders was 45 +/- 9.0 y, which was not significantly different from the 43 +/- 9.4 y in N = 233 Wisconsin drivers (p greater than 0.05). Overall there were more men (78%) than women (22%) arrested with BACs greater than 0.4 g%, although the proportion of women in Wisconsin (35%) was higher than in Sweden (9%) (p less than 0.001). The mean (median) and highest BAC did not differ between jurisdictions; 0.429 g% (0.422) and 0.546 g% in Sweden and 0.428 g% (0.421 g%) and 0.526 g% in Wisconsin. In Sweden 40% of the arrests occurred on Fridays and Saturdays, whereas in Wisconsin the arrests of people with such high BACs were more evenly distributed throughout the week. Forty eight percent of the arrests in Sweden were made between 12 noon and 6 pm compared with 37% in Wisconsin. Neither the mean age of offenders nor their mean BAC seemed to depend on the weekday or time of day of the arrest. Attempting to drive with a BAC above 0.4 g% verifies the development of an appreciable tolerance to ethanol-induced cognitive and psychomotor impairment. Reaching such a high BAC probably requires continuous heavy drinking over several days as opposed to an evenings binge drinking.

  • 35.
    Jones, A Wayne
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning.
    Holmgren, A
    National Board for Forensic Medicine.
    Ahlner, Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Concentrations of free-morphine in peripheral blood after recent use of heroin in overdose deaths and in apprehended drivers2012Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 215, nr 1-3, s. 18-24Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The concentration of free-morphine was determined in peripheral (femoral) blood from heroin-related deaths and compared with the concentration in venous blood from impaired drivers. The presence of 6-MAM in blood or urine served as a biomarker for recent use of heroin. Males dominated over females (p andlt; 0.001) in both the autopsy cases (88%) and the drivers (91%), although their mean age was about the same 33-35 y (p andgt; 0.05). Concentrations of free-morphine in blood were not associated with age of heroin users in Sweden (p andgt; 0.05). The median concentration of free-morphine was higher in autopsy cases (0.24 mg/L, N = 766) compared with apprehended drivers with 6-MAM in blood (0.15 mg/L, N = 124, p andlt; 0.05), and appreciably higher than in drivers with 6-MAM in urine but not in blood (0.03 mg/L, N = 1823, p andlt; 0.001). The free-morphine concentration was above 0.20 mg/L in 65% of autopsy cases, 36% of drivers with 6-MAM in blood but only 1.4% of drivers with 6-MAM in urine. Poly-drug deaths had about the same concentrations of free-morphine in blood (0.24 mg/L, N = 703) as heroin-only deaths (0.25 mg/L, N = 63). The concentration of morphine in drug overdose deaths (median 0.25 mg/L, N = 669) was about the same as in traumatic deaths among heroin users (0.23 mg/L, N = 97). However, the concentration of morphine was lower when the deceased had consumed alcohol (0.18 mg/L, N = 104) compared with taking a benzodiazepine (0.32 mg/L, N = 94). The concentration distributions of free-morphine in blood in heroin-related deaths overlapped with the concentrations in impaired drivers, which makes the interpretation of toxicology results difficult without knowledge about tolerance to opiates in any individual case.

  • 36.
    Jones, A Wayne
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för klinisk kemi.
    Holmgren, A
    Holmgren, P
    High concentrations of diazepam and nordiazepam in blood of impaired drivers: Association with age, gender and spectrum of other drugs present2004Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 146, nr 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A zero-concentration limit for controlled scheduled drugs in the blood of motorists was introduced in Sweden in 1999 and the annual number of arrests for driving under the influence of drugs (DUID) has since increased eight-fold. However, for prescription drugs that might cause impairment (e.g. benzodiazepines) additional proof is needed to justify prosecution, such as whether the medication was being misused. Over a 2-year period, we found 94 cases of DUID in which the concentrations of diazepam in blood was 1.1 μg/g or more. Diazepam (D) and nordiazepam (ND) were determined in whole blood by capillary gas chromatography with a limit of quantitation of 0.05 μg/g for each compound. The mean (median) and maximum concentrations of D were 2.0 μg/g (1.7 μg/g) and 7.8 μg/g and the corresponding ND concentrations were 1.5 μg/g (1.0 μg/g) and 7.6 μg/g, respectively. The concentration of D in blood exceeded 2 μg/g in 21% of cases and was over 3.0 μg/g in 11% of cases. D and ND were the only drugs present in eight cases (seven men and one women) and in another five cases ethanol was present at concentrations ranging from 0.81 to 1.98 mg/g. Polydrug use was very common in these DUID suspects and D and ND coexisted with amphetamine in 20% of cases, tetrahydrocannabinol in 18% of cases and with both these illicit drugs in 12% of cases. The next most prevalent drug combination was D, ND and morphine (mostly derived from heroin), seen in 13% of cases. Other psychoactive prescription drugs were identified in blood including alprazolam, flunitrazepam, oxazepam, zolpidem and zopiclone. This case series of DUID suspects demonstrate the high frequency of polydrug use showing preference for illicit drugs like amphetamine, cannabis and heroin, in that order. Furthermore, Swedish traffic delinquents frequently overdose with prescription drugs as exemplified here by unusually high concentrations of D and its active metabolite ND.

  • 37.
    Jones, A Wayne
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi.
    Holmgren, A.
    Department of Forensic Genetics and Forensic Toxicology National Board of Forensic Medicine, Linköping.
    Kugelberg, Fredrik
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi.
    Concentrations of cocaine and its major metabolite benzoylecgonine in blood samples from apprehended drivers in Sweden2008Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 177, nr 2-3, s. 133-139Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cocaine and its major metabolite benzoylecgonine (BZE) were determined in blood samples from people arrested in Sweden for driving under the influence of drugs (DUID) over a 5-year period (2000-2004). Venous blood or urine if available, was subjected to a broad toxicological screening analysis for cannabis, cocaine metabolite, amphetamines, opiates and the major benzodiazepines. Verification and quantitative analysis of cocaine and BZE in blood was done by gas chromatography-mass spectrometry (GC-MS) at limits of quantitation (LOQ) of 0.02 mg/L for both substances. Over the study period 26,567 blood samples were analyzed and cocaine and/or BZE were verified in 795 cases (3%). The motorists using cocaine were predominantly men (>96%) with an average age of 28.3 ± 7.1 years (±standard deviation, S.D.). The concentration of cocaine was below LOQ in 574 cases although BZE was determined at mean, median and highest concentrations of 0.19 mg/L, 0.12 mg/L and 1.3 mg/L, respectively. In 221 cases, cocaine and BZE were together in the blood samples at mean and (median) concentrations of 0.076 mg/L (0.05 mg/L) and 0.859 mg/L (0.70 mg/L), respectively. The concentrations of BZE were always higher than the parent drug, mean BZE/cocaine ratio 14.2 (median 10.9) range 1-55. Cocaine and BZE were the only psychoactive substances reported in N = 61 cases at mean (median) and highest concentrations of 0.095 (0.07) and 0.5 mg/L for cocaine and 1.01 (0.70) and 3.1 mg/L for BZE. Typical signs of drug influence noted by the arresting police officers included bloodshot and glossy eyes, agitation, difficulty in sitting still and incoherent speech. © 2007 Elsevier Ireland Ltd. All rights reserved.

  • 38.
    Jones, A Wayne
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning.
    Holmgren, Anita
    National Board for Forensic Medicine.
    Age and gender differences in blood-alcohol concentration in apprehended drivers in relation to the amounts of alcohol consumed2009Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 188, nr 01-Mar, s. 40-45Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article reports the age, gender, and blood-alcohol concentration (BAC) of people apprehended in Sweden for driving under the influence of alcohol (DUIA) over an 8-year period (2000-2007). Duplicate determinations of ethanol were made in venous blood by headspace gas chromatography and results were reported positive at a cut-off concentration of 0.1 g/L (10 mg/100 ml or 0.01 g%). The mean, median and highest BAC was 1.74 g/L, 1.70 g/L and 5.18 g/L, respectively. The vast majority of offenders were men (89.5%) with a mean age of 39.0 +/- 14.6 y (+/- SD). The women (10.5%) were a few years older 41.8 +/- 13.6 y (p less than 0.001). The mean BAC in the men (1.73 +/- 0.85 g/L) did not differ significantly (p greater than 0.05) from women (1.77 +/- 0.87 g/L). The youngest offenders aged 15-20 y (N = 3513) had a mean BAC of 1.30 +/- 0.60 g/L (median 1.32), which was significantly less (p less than 0.001) than people aged 40-50 y (N = 6644): mean 1.90 g/L (median 2.0 g/L). In 95 individuals (89 men and 6 women) the BAC exceeded 4.0 g/L, which is a level considered to cause death by acute alcohol poisoning. The Widmark formula was used to calculate that a man (80 kg) with a BAC of 1.7 g/L has 95 g ethanol (similar to 12 units of alcohol) in the body compared with 61 g (similar to 8 units) for a woman (60 kg). This study verifies that the average drunken driver in Sweden is typically a binge drinker and education programs and treatment for alcohol-use disorder might be a more appropriate sanction than the more conventional penalties for alcohol-impaired driving. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

  • 39.
    Jones, A Wayne
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning.
    Holmgren, Anita
    National Board for Forens Medicine, Sweden .
    Concentrations of zolpidem and zopiclone in venous blood samples from impaired drivers compared with femoral blood from forensic autopsies2012Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 222, nr 1-3, s. 118-123Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The concentrations of zolpidem and zopiclone were determined in peripheral blood samples in two forensic materials collected over a 10-year period (2001-2010). The z-hypnotics were determined in venous blood from living subjects (impaired drivers) and in femoral blood from deceased persons (forensic autopsies), with the latter classified as intoxication or other causes of death. The z-hypnotics were determined in blood by capillary column gas chromatography (GC) with a nitrogen-phosphorous (N-P) detector after solvent extraction with n-butyl acetate. The analytical limit of quantitation (LOQ) was 0.02 mg/L for zopiclone and 0.05 mg/L for zolpidem and these have remained unchanged throughout the study. When death was attributed to drug intoxication (N = 918), the median concentration of zopiclone in blood was 0.20 mg/L compared with 0.06 mg/L for other causes of death (N = 1215) and 0.07 mg/L in traffic offenders (N = 691) (p andlt; 0.001). Likewise, a higher median concentration (0.30 mg/L) was found in intoxication deaths involving zolpidem (N = 357) compared with 0.13 mg/L for other causes of death (N = 397) or 0.19 mg/L in impaired drivers (N = 837) (p andlt; 0.001). Median concentration in blood of both z-hypnotics were appreciably higher in intoxication deaths when no other substances were identified; 0 70 mg/L (N = 12) for zopiclone and 1.35 mg/L (N = 12) for zolpidem. The median concentrations of z-hypnotics in blood decreased as the number of co-ingested substances increased for intoxication deaths but not other causes of death. The most prevalent co-ingested substances were ethanol in autopsy cases and diazepam in the motorists. This large compilation of forensic cases should prove useful when toxicologists are required to interpret concentrations of z-hypnotics in blood samples in relation to cause of death.

  • 40.
    Jones, A Wayne
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten.
    Holmgren, Anita
    Swedish National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    Ahlner, Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Swedish National Board Forens Med, Department Forens Genet and Forens Toxicol, Linkoping, Sweden.
    Post-mortem concentrations of drugs determined in femoral blood in single-drug fatalities compared with multi-drug poisoning deaths2016Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 267, s. 96-103Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Reference concentrations of drugs in post-mortem femoral blood furnishes useful information when poisoning (intoxication) deaths are investigated. However, few publications compare the concentrations of drugs in single-drug fatalities with multi-drug intoxications. This article attempts to fill this gap in knowledge. Methods: We searched a national forensic toxicology database (TOXBASE) and found N = 13,963 deaths attributed by pathologists to intoxication by drugs (poisoning). The manner of death, whether accidental, suicidal or undetermined intent, was also available. To compare drug concentrations in living and deceased persons, we used information from people arrested for driving under the influence of drugs (DUID). Results: The percentage of drug intoxication deaths classified as undetermined intent decreased and accidental overdose deaths increased during the study period. In 2010 manner of death was considered accidental, suicidal or undetermined, in 41%, 30% and 28% of victims, respectively. Most of the deceased had taken multiple drugs (mean three drugs/case) and four or more drugs were identified in 35% of deaths. In single-drug fatalities ethanol (1585), morphine (114), citalopram (28), propoxyphene (51), flunitrazepam (70), propiomazine (46), tramadol (20) and zopiclone (15) were most prevalent. Alprazolam and diazepam were common findings in multi-drug deaths, although these benzodiazepines were rarely encountered in mono-drug intoxication deaths. Median blood concentrations were appreciably higher (2-10 fold) in single-drug fatalities compared with multi-drug deaths. The blood concentrations in DUID suspects were mostly lower than in the multi-drug poisoning deaths. Conclusion: This compilation of femoral blood concentrations of drugs in poisoning deaths provides a useful reference material, because we have distinguished between mono-drug intoxication deaths and poisoning with multiple-drugs. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

  • 41.
    Jones, A Wayne
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Klinisk kemi.
    Holmgren, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk farmakologi.
    Urine/blood ratios of ethanol in deaths attributed to acute alcohol poisoning and chronic alcoholism2003Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 135, nr 3, s. 206-212Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The concentrations of ethanol were determined in femoral venous blood (BAC) and urine (UAC) and the UAC/BAC ratios were evaluated for a large case series of forensic autopsies in which the primary cause of death was either acute alcohol poisoning (N=628) or chronic alcoholism (N=647). In alcohol poisoning deaths both UAC and BAC were higher by about 2g/l compared with chronic alcoholism deaths. In acute alcohol poisoning deaths the minimum BAC was 0.74g/l and the distribution of UAC/BAC ratios agreed well with the shape of a Gaussian curve with mean-standard deviation (S.D.) and median (2.5th and 97.5th centiles) of 1.18-0.182 and 1.18 (0.87 and 1.53), respectively. In alcoholism deaths, when the BAC was above 0.74g/l (N=457) the mean-S.D. and median (2.5th and 97.5th centiles) UAC/BAC ratios were 1.30-0.29 and 1.26 (0.87 and 2.1), respectively. When the BAC was below 0.74g/l (N=190), the mean and median UAC/BAC ratios were considerably higher, being 2.24 and 1.58, respectively. BAC and UAC were highly correlated in acute alcohol poisoning deaths (r=0.84, residual S.D.=0.47g/l) and in chronic alcoholism deaths (r=0.95, residual S.D.=0.41g/l). For both causes of death (N=1275), the correlation between BAC and UAC was r=0.95 and the residual S.D. was 0.46g/l. The lower UAC/BAC ratio observed in acute alcohol poisoning deaths (mean and median 1.18:1) suggests that these individuals died before absorption and distribution of ethanol in all body fluids were complete. The higher UAC/BAC ratio in chronic alcoholism (median 1.30:1) is closer to the value expected for complete absorption and distribution of ethanol in all body fluids.

  • 42.
    Jones, A Wayne
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning.
    Kugelberg, Fredrik
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Holmgren, Anita
    National Board for Forensic Medicine.
    Ahlner, Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Five-year update on the occurrence of alcohol and other drugs in blood samples from drivers killed in road-traffic crashes in Sweden2009Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 186, nr 01-Mar, s. 56-62Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    According to statistics provided by the Swedish National Road Administration (Vagverket). a total of 1403 drivers were killed in road-traffic crashes in Sweden between 2003 and 2007. Forensic autopsies were performed in similar to 97% of all deaths and specimens of blood and urine were sent for toxicological analysis. In 60% of cases (N = 835) the toxicology results were negative and 83% of these victims were men. The blood-alcohol concentration (BAC) was above the legal limit for driving (greater than0.2 g/L) in 22% of cases (N = 315) at mean, median and highest concentrations of 1.7 g/L, 1.7 g/L and 4.9 g/L, respectively. The proportions of male to female drivers with BAC greater than 0.2 g/L were 93% vs 7% compared with 83% vs 17% for those with drugs other than alcohol in blood. Drivers with a punishable BAC were over-represented in single vehicle crashes compared with multiple vehicle crashes (67% vs 33%). The opposite held for drivers who had taken a prescription drug (39% vs 61%) and also for drug-negative cases (31% vs 69%). Drugs other than alcohol were identified in 253 cases (18%); illicit drugs only in 39 cases (2.8%), both licit and illicit in 28 cases (2.0%) and in 186 cases (13.3%) one or more therapeutic drugs were present. Amphetamine was the most common illicit drug identified at mean, median and highest concentrations of 1.5 mg/L, 1.1 mg/L and 5.0 mg/L, respectively (N = 39). Blood specimens contained a wide spectrum of pharmaceutical products (mean 2.4 drugs/person), comprising sedative-hypno tics (N = 93), opiates/opioids (N = 69) as well non-scheduled substances, such as paracetamol (N = 78) and antidepressants (N = 93). The concentrations of these substances in blood were mostly in the therapeutic range. Despite an appreciable increase (12-fold) in number of arrests made by the police for drug-impaired driving after a zero-tolerance law was introduced (July 1999), alcohol still remains the psychoactive substance most frequently identified in the blood of drivers killed in road-traffic crashes. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

  • 43.
    Jones, A Wayne
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi.
    Kugelberg, Fredrik
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi.
    Holmgren, Anita
    Department of Forensic Genetics and Forensic Toxicology National Board of Forensic Medicine, Linköping.
    Ahlner, Johan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi.
    Occurrence of ethanol and other drugs in blood and urine specimens from female victims of alleged sexual assault2008Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 181, nr 1-3, s. 40-46Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Results of toxicological analysis of blood and urine specimens from 1806 female victims of alleged non-consensual sexual activity are reported. After making contact with the police authorities, the victims were examined by a physician for injuries and biological specimens were taken for forensic toxicology and other purposes (e.g. DNA). Urine if available or otherwise on an aliquot of blood after protein precipitation was screened for the presence of drugs by enzyme immunoassay methods (EMIT/CEDIA). All positive results from screening were verified by more specific methods, involving isotope dilution gas chromatography-mass spectrometry (GC-MS) for illicit drugs. A large number of prescription drugs were analyzed in blood by capillary column gas chromatography with a nitrogen-phosphorous (N-P) detector. Ethanol was determined in blood and urine by headspace gas chromatography and concentrations less than 0.1 g/L were reported as negative. The number of reported cases of alleged sexual assault was highest during the warmer summer months and the mean age of victims was 24 years (median 20 years), with ∼60% being between 15 and 25 years. In 559 cases (31%) ethanol and drugs were negative. In 772 cases (43% of total) ethanol was the only drug identified in blood or urine. In 215 cases (12%) ethanol occurred together with at least one other drug. The mean, median and highest concentrations of ethanol in blood (N = 806) were 1.24 g/L, 1.19 g/L and 3.7 g/L, respectively. The age of victims and their blood-alcohol concentration (BAC) were positively correlated (r = 0.365, p < 0.001). Because BAC decreases at a rate of 0.10-0.25 g/(L h), owing to metabolism the concentration in blood at time of sampling is often appreciably less than when the crime was committed several hours earlier. Licit or illicit drugs were identified in blood or urine in N = 262 cases (15%). Amphetamine and tetrahydrocannabinol were the most common illicit drugs at mean (median) concentrations in blood of 0.22 mg/L (0.1 mg/L) and 0.0012 mg/L (0.0006 mg/L), respectively. Among prescription drugs, sedative-hypnotics such as diazepam and zopiclone were common findings along with SSRI antidepressants and various opiate analgesics. Interpreting the analytical results in terms of voluntary vs. surreptitious administration of drugs and the degree of incapacitation in the victim as well as ability to give informed consent for sexual activity is fraught with difficulties. © 2008 Elsevier Ireland Ltd. All rights reserved.

  • 44.
    Jones, Wayne
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten.
    Letter: Evidential breath alcohol analysis and the venous blood-to-breath ratio in FORENSIC SCIENCE INTERNATIONAL, vol 262, issue , pp E37-E392016Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 262, s. E37-E39Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    n/a

  • 45.
    Jornil, J
    et al.
    Aarhus University, Denmark .
    Nielsen, T S.
    Aarhus University, Denmark .
    Rosendal, I
    Aarhus University, Denmark .
    Ahlner, Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Zackrisson, Anna Lena
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Boel, L W T.
    Aarhus University, Denmark .
    Brock, B
    Aarhus University, Denmark .
    A poor metabolizer of both CYP2C19 and CYP2D6 identified by mechanistic pharmacokinetic simulation in a fatal drug poisoning case involving venlafaxine2013Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 226, nr 1-3, s. E26-E31Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We present a fatal drug poisoning case involving venlafaxine (VEN). The deceased took his medication regularly (including 150 mg VEN twice daily), and nothing in the case or autopsy findings pointed towards suicide. The toxicological assessment concluded that the cause of death was most likely due to a poisoning with a combination of VEN, oxycodone and ethanol, and the manner of death was considered to be an accident. The blood concentration of VEN was high (4.5 mg/kg), and the ratio of the VEN metabolite O-desmethylvenlafaxine (ODV) to VEN was exceptionally low (0.006). Mechanistic pharmacokinetic simulations suggested that the low metabolite ratio was the result of combined poor metabolizer (PM) status of cytochrome P450 (CYP) 2C19 and CYP2D6. This hypothesis was confirmed by genetic analysis. Simulations revealed that it was likely that the combined missing CYP2D6 and CYP2C19 activity would cause higher concentrations of VEN, but the simulations also suggested that there could be additional reasons to explain the high VEN concentration found in this case. Thus, it seems likely that the potentially toxic VEN concentration was caused by reduced metabolic capacity. The simulations combined with genotyping were considered very useful in this fatal drug poisoning case.

  • 46.
    Jönsson, Anna
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk farmakologi. National Board of Forensic Medicine, Linköping, Sweden.
    Holmgren, Per
    National Board of Forensic Medicine, Linköping, Sweden.
    Druid, Henrik
    KI, Stockholm.
    Ahlner, Johan
    National Board of Forensic Medicine, Linköping, Sweden.
    Cause of death and drug use pattern in deceased drug addicts in Sweden, 2002-20032007Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 169, nr 2-3, s. 101-107Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Compared with their contemporaries, individuals abusing illicit drugs suffer a higher risk of premature death. In Sweden, a simple protocol for registration of fatalities among abusers of alcohol, pharmaceuticals, illicit drugs, or other substances, has been used by the forensic pathologists since 2001. This routine was introduced to allow for an evaluation of the cause and manner of death, and patterns of abuse among different groups of abusers. We explored the data on drug abusers (i.e. abusers of illicit drugs) subjected to a forensic autopsy 2002-2003. The Swedish forensic pathologists examined 10,273 dead victims during the study period and 7% (743/10,273) of the cases were classified as drug abusers. Toxicological analyses were carried out in 99% (736/743) and illicit drugs were detected in 70% (514/736) of these. On average, 3.8 substances (legal or illegal) were found per case. The most common substances were ethanol and morphine, detected in 43 and 35% of the cases, respectively. When exploring the importance of the different substances for the cause of death, we found that the detection of some substances, such as fentanyl and morphine, strongly indicated a poisoning, whereas certain other substances, such as benzodiazepines more often were incidental findings. In total, 50% (372/743) died of poisoning, whereas only 22% (161/743) died of natural causes. Death was considered to be directly or indirectly due to drug abuse in 47% (346/743), whereas evidence of drug abuse was an incidental finding in 21% (153/743) or based on case history alone in 33% (244/743). We believe that this strategy to prospectively categorize deaths among drug addicts constitutes a simple means of standardizing the surveillance of the death toll among drug addicts that could allow for comparisons over time and between countries. © 2006 Elsevier Ireland Ltd. All rights reserved.

  • 47.
    Jönsson, Anna K
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk farmakologi.
    Soderberg, Carl
    Karolinska Institute, Sweden .
    Arne Espnes, Ketil
    St Olavs University Hospital, Norway .
    Ahlner, Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet.
    Eriksson, Anders
    Umeå University, Sweden .
    Reis, Margareta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet.
    Druid, Henrik
    Karolinska Institute, Sweden .
    Sedative and hypnotic drugs-Fatal and non-fatal reference blood concentrations2014Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 236, s. 138-145Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In postmortem investigations of fatal intoxications it is often challenging to determine which drug/s caused the death. To improve the interpretation of postmortem blood concentrations of sedative and hypnotic drugs and/or clonazepam, all medico-legal autopsies in Sweden - where these drugs had been detected in femoral vein blood during 1992-2006 - were identified in the databases of the National Board of Forensic Medicine. For each drug, concentrations in postmortem control cases - where the cause of death was not intoxication and where incapacitation by drugs could be excluded - were compiled as well as the levels found in living subjects; drugged driving cases and therapeutic drug monitoring cases. Subsequently, fatal intoxications were assessed with regards to the primary substances contributing to death, and blood levels were compiled for single and multiple drug intoxications. The postmortem femoral blood levels are reported for 16 sedative and hypnotic drugs, based on findings in 3560 autopsy cases. The cases were classified as single substance intoxications (N = 498), multiple substance intoxications (N = 1555) and postmortem controls (N = 1507). Each autopsy case could be represented more than once in the group of multiple intoxications and among the postmortem controls if more than one of the included substances were detected. The concentration ranges for all groups are provided. Overlap in concentrations between fatal intoxications and reference groups was seen for most substances. However, the concentrations found in single and multiple intoxications were significantly higher than concentrations found in postmortem controls for all substances except alprazolam and triazolam. Concentrations observed among drugged drivers were similar to the concentrations observed among the therapeutic drug monitoring cases. Flunitrazepam was the substance with the highest number of single intoxications, when related to sales. In summary, this study provides reference drug concentrations primarily to be used for improving interpretation of postmortem drug levels in obscure cases, but which also may assist in drug safety work and in pharmacovigilance efforts.

  • 48.
    Karlsson, AO
    et al.
    National Board of Forensic Medicine.
    Holmlund, Gunilla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Identification of mammal species using species-specific DNA pyrosequencing2007Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 173, nr 1, s. 16-20Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In forensic casework it is highly relevant to be able to deduce the species origin of an unknown biological sample. For such a purpose we have designed and developed an assay for species identification based on DNA sequencing of two short mitochondrial DNA amplicons. In short, partial 12S rRNA and partial 16S rRNA fragments (similar to 100 bp) are amplified by PCR followed by direct sequencing using pyrosequencing technique. Due to properties of the chosen targets, the same PCR conditions and primers were used irrespective of the true species of an unknown sample. A total of 28 different mammals present in the European fauna were sequenced both for the partial 12S rRNA and the partial 16S rRNA sequences for accuracy verification. Together the two sequences showed to have a high divergence factor, discriminating almost all mammals. Furthermore, the human reference nucleotide sequences were always at least nine nucleotides different compared to the other sequenced species both at the partial 12S rRNA and the partial 16S rRNA sequences.

  • 49.
    Karlsson, T.
    et al.
    Dept. Forensic Med. Stockholm N., Stockholm, Box 1352, S-171 26, Solna, Sweden.
    Stahling, S.
    Experimental blowgun injuries, ballistic aspects of modern blowguns2000Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 112, nr 1, s. 59-64Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Slender thin arrows blown through modern blowguns can cause serious injuries. In this paper we present some data regarding the terminal ballistics of such an arrow when blown by a young male who had no previous experience with the weapon. The penetration depth into wood was similar to that of an arrow fired from a pistol-crossbow. Further, the blowgun arrow could pass through more than 7 mm of porcine bone. The velocities at a distance of 2 m from the blowgun of three different types of arrows having weights of 1-1.6 g and diameters between 1 and 5 mm were between 22 and 32 m/s, giving an energy of 0.3 to 0.6 J. When blown from a blowgun, these slender modern arrows can thus penetrate human skin and even the cranial bone of a child and cause serious injury. Copyright (C) 2000 Elsevier Science Ireland Ltd.

  • 50.
    Karlsson Tillman, Andreas
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Holmlund, Gunilla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Egeland, Thore
    Ullevaal University Hospital.
    Mostad, Petter
    University of Oslo.
    DNA-testing for immigration cases: The risk of erroneous conclusions2007Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 172, nr 03-Feb, s. 144-149Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Making the correct decision based on results from DNA analyses and other information in family reunification cases can be complicated for a number of reasons. These include stratified populations, cultural differences in family constellations, families with different population origin, and complicated family relations giving complex pedigrees. The aim of this study was to analyze the risk of erroneous conclusions in immigration cases and to propose alternative procedures to current methods to reduce the risk of making such errors. A simulation model was used to study different issues. For simplicity, we focus on cases which can be formulated as questions about paternity. We present an overview of error rates (of falsely included men as the true father and of falsely excluded true fathers) for fairly standard computations, and we show how these are affected by different factors For example, adding more DNA markers to a case will decrease the error rates, as will the inclusion of more children. We found that using inappropriate population frequency databases had just minor effects on the error rates, but the likelihood ratios varied from an underestimation of 100 times up to an overestimation of 100,000 times To reduce the risk of falsely including a man related to the true father we propose a more refined prior including five hypotheses instead of the two normally used. Simulations showed that this method gave reduced error rates compared with standard computations, even when the prior does not exactly correspond to reality.

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