Toxicological and histological analyses for a stillborn delivered by a mother under methadone maintenance therapy

Published on Jan 12, 2018in Forensic Toxicology4.096
路 DOI :10.1007/S11419-017-0402-9
Eva Montanari5
Estimated H-index: 5
(Marche Polytechnic University),
Maria Paola Bonasoni1
Estimated H-index: 1
+ 5 AuthorsAdriano Tagliabracci27
Estimated H-index: 27
(Marche Polytechnic University)
Sources
Abstract
Purpose Based on autopsy findings and toxicological results, it was ascertained whether chronic fetal exposure to methadone (MTD) could have caused intrauterine death of a fetus born to a mother under MTD maintenance therapy.
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#1Anthea B. Mahesan Paul (University of Oxford)H-Index: 5
#2Lary SimmsH-Index: 4
Last. Arnold M. Mahesan (EVMS: Eastern Virginia Medical School)H-Index: 3
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Methadone-related fatalities occur rarely in infants under 1 year, with five confirmed cases in the literature. The interpretation of pediatric postmortem toxicology relies on adult data; however, infants have crucial physiological differences that may impact interpretation of results. Retrospective case review included scene investigation, interviews, autopsy, and NIH/CDC Sudden Unexplained Infant Death Investigation Reporting Form. Methadone levels were confirmed by liquid chromatography/tande...
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#1Allison E. Serra (University of Pittsburgh)H-Index: 3
#2Lara S. Lemon (University of Pittsburgh)H-Index: 7
Last. Steve N. Caritis (University of Pittsburgh)H-Index: 77
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Background Opioid use disorder among pregnant women is associated with adverse perinatal outcomes and is increasing in the United States. The standard of care for pregnant women with opioid use disorder is opioid maintenance therapy including either methadone or buprenorphine, which can be initiated at any time during pregnancy. These medications are known to cross the placenta but their placental and fetal effects have not been well characterized. Delayed villous maturation, a placental finding...
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#2Ashley L. MannH-Index: 4
Last. Hendr茅e E. Jones (UNC: University of North Carolina at Chapel Hill)H-Index: 54
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Aims To assess the safety of buprenorphine compared with methadone to treat pregnant women with opioid use disorder. Methods We searched PubMed, Embase and the Cochrane Library from inception to February 2015 for randomized controlled trials (RCT) and observational cohort studies (OBS) that compared buprenorphine with methadone for treating opioid-dependent pregnant women. Two reviewers assessed independently the titles and abstracts of all search results and full texts of potentially eligible s...
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#2Angelo Groppi (UNIPV: University of Pavia)H-Index: 24
Last. Cristian Palmiere (American Board of Legal Medicine)H-Index: 24
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Voluntary methadone administration for the purpose of sedation eventually resulting in the infant's death is extremely infrequent, though it has been observed. In this report, we describe an autopsy case pertaining to a 32-month-old infant who was repeatedly exposed to methadone by his parents. Autopsy revealed a coarctation of the aorta with a focal stenosis located at the junction of the distal aortic arch and the descending aorta. Left ventricular hypertrophy was also observed. Both these fin...
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#1T. Yee Khong (Boston Children's Hospital)H-Index: 12
#2Eoghan E. MooneyH-Index: 15
Last. John Gillan (Rotunda Hospital)H-Index: 11
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Context.鈥擳he value of placental examination in investigations of adverse pregnancy outcomes may be compromised by sampling and definition differences between laboratories. Objective.鈥擳o establish an agreed-upon protocol for sampling the placenta, and for diagnostic criteria for placental lesions. Recommendations would cover reporting placentas in tertiary centers as well as in community hospitals and district general hospitals, and are also relevant to the scientific research community. Data Sou...
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#1Monia Lusetti (University of Modena and Reggio Emilia)H-Index: 4
#2Manuela Licata (University of Modena and Reggio Emilia)H-Index: 14
Last. Cristian Palmiere (UNIL: University of Lausanne)H-Index: 24
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Several classes of drugs have been associated with an increased risk of cardiovascular disease and occurrence of arrhythmias potentially involved in sudden deaths in chronic users even at therapeutic doses. The study presented herein focuses on pathological changes involving the heart possibly due to methadone use. 60 cases were included in the study in total and were divided into three groups (therapeutic methadone users: 20 cases, recreational methadone users: 20 cases, and sudden death group ...
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#1Parvaz MadadiH-Index: 22
#2Lauren E. Kelly (UWO: University of Western Ontario)H-Index: 17
Last. Gideon Koren (UWO: University of Western Ontario)H-Index: 1
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There is a paucity of data to aid in assessing whether postmortem methadone findings in breastfed infants are clinically and/or toxicologically significant. Two cases are reported in which methadone was detected in deceased neonates whose mothers were enrolled in methadone maintenance programs and were breastfeeding. In addition to a complete autopsy and toxicological testing for alcohol, prescription medications, and drugs of abuse, pharmacogenetic analysis was performed for variants in genes r...
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#1Karen Marie Dollerup Holm (UCPH: University of Copenhagen)H-Index: 6
#2Kristian Linnet (UCPH: University of Copenhagen)H-Index: 58
Knowledge concerning the distribution of methadone in postmortem human tissue and the effect of postmortem redistribution on methadone is today limited making the choice of a suitable substitute for femoral blood difficult when this is not available. Cardiac blood, femoral blood, muscle, and brain tissue concentrations of the enantiomers of methadone and its metabolite 2-ethyl-1,5-dimethyl-3,3-diphenylpyrrolinium were recorded for 155 postmortem cases. Brain and muscle tissue concentrations exce...
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#1Robert M. Ward (UofU: University of Utah)H-Index: 34
#2David R. Drover (Stanford University)H-Index: 31
Last. Kristin L Satterfield (UofU: University of Utah)H-Index: 2
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Background The lack of methadone pharmacokinetic data in children and neonates restrains dosing to achieve the target concentration in these populations. A minimum effective analgesic concentration of methadone in opioid naive adults is 0.058 mg.L鈭1, while no withdrawal symptoms were observed in neonates suffering opioid withdrawal if plasma concentrations of methadone were above 0.06 mg.L鈭1. The racemate of methadone which is commonly used in pediatric and anaesthetic care is metabolized to EDD...
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Abstract null null There are currently no vaccines or effective drugs to prevent the disorders caused by avian leukosis virus subgroup J (ALV-J). Hence, it is critical to identify potential biomarkers in ALV-J-infected chickens to prevent ALV-J-induced disorders. We hypothesized that ALV-J infection alters metabolic profile in chickens. In the present study, a nontargeted metabolomics approach based on liquid chromatography coupled with mass spectrometry (LC-MS) was used to find differential met...
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#1Eva Montanari (American Board of Legal Medicine)H-Index: 5
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