Vitreous humour glucose and lactate kinetics in a hospital forensic cohort
Anno: 2026
Rivista: LEGAL MEDICINE
Autori/autrici: Montanari, E.; Sabbatinelli, J.; Dervisevic, E.; Kalfoglu, E.; Montana, A.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/363896
Citazioni:
Vitreous humour glucose and lactate kinetics in a hospital forensic cohort / Montanari, E., Sabbatinelli, J., Dervisevic, E., Kalfoglu, E., Montana, A.. - In: LEGAL MEDICINE. - ISSN 1344-6223. - ELETTRONICO. - 86:(2026). [10.1016/j.legalmed.2026.102961]
Abstract:
Background The inverse relationship between vitreous humour (VH) glucose and lactate, classically used in the Traub formula, is widely applied in post-mortem biochemistry. Methods We analysed 127 VH samples from external examinations and forensic autopsies performed in a hospital forensic setting (P...MI 4–187 h; 58 septic and 69 non-septic deaths). Glucose was available in 78 cases, lactic acid in all 127. Cases were stratified by PMI window, septic status and storage condition. Spearman correlations and non-parametric comparisons were applied. Results Within the first 24 h post-mortem, glucose and lactic acid showed significant opposite correlations with PMI. Glucose reached a low-value floor of approximately 2 mg/dl by 25–48 h, after which no meaningful PMI-related decrease was observed. Lactic acid showed a different trajectory: septic and non-septic cases had similar baseline levels at ≤10 h, but diverged thereafter, with continued increase in septic cases through 25–48 h. This divergence emerged after glucose depletion, suggesting glucose-independent lactate accumulation. Glucose–lactate coupling was absent in septic cases and weak in non-septic cases. Conclusions VH glucose and lactic acid showed limited evidence of direct stoichiometric coupling in this hospital cohort. Glucose reflected PMI mainly within the first 24 h, whereas its interpretative value declined after reaching a post-mortem floor. Lactic acid showed a sepsis-associated post-mortem amplification not explained by glucose availability alone, possibly reflecting autolytic processes. These findings do not invalidate the Traub formula in its original diagnostic context, but caution against its uncritical application in heterogeneous forensic cohorts.
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Xenobiotic Sulforaphane in Head and Neck Cancer: Beyond the Nrf2 Pathway
Anno: 2026
Rivista: JOURNAL OF XENOBIOTICS
Autori/autrici: Polizzi, A; Rotondo, R; Donati Zeppa, S; Cecati, M; Smolik, M; Schiavoni, V; Montana, A; Pozzi, V; Sartini, D; Campagna, R; Isola, G
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/358437
Citazioni:
Xenobiotic Sulforaphane in Head and Neck Cancer: Beyond the Nrf2 Pathway / Polizzi, A., Rotondo, R., Donati Zeppa, S., Cecati, M., Smolik, M., Schiavoni, V., Montana, A., Pozzi, V., Sartini, D., Campagna, R., Isola, G.. - In: JOURNAL OF XENOBIOTICS. - ISSN 2039-4713. - STAMPA. - 16:3(2026). [10.3390/jox16030099]
Abstract:
Head and neck cancers (HNCs) represent a major global health burden and remain associated with substantial morbidity and limited therapeutic options, particularly in advanced or recurrent disease. Increasing interest has focused on naturally derived bioactive compounds with potential chemopreventive... and therapeutic properties. Sulforaphane, a dietary xenobiotic isothiocyanate derived from glucoraphanin in cruciferous vegetables, has attracted attention due to its ability to modulate redox balance, epigenetic regulation, and multiple oncogenic signaling pathways. This manuscript reviews current evidence regarding the biological effects of sulforaphane in HNCs. Particular attention is given to the molecular mechanisms underlying its modulation of the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway, a key regulator of cellular antioxidant and detoxification responses that can be activated by sulforaphane. Several studies indicate that sulforaphane can inhibit tumor growth through several mechanisms beyond Nrf2 activation, including induction of apoptosis, cell cycle arrest, epigenetic modulation, and suppression of oncogenic signaling pathways. In addition, sulforaphane has been shown to enhance the efficacy of conventional treatments, including chemotherapy, radiotherapy, and photodynamic therapy. Overall, the literature suggests that sulforaphane may represent a promising chemopreventive or therapeutic adjunct in HNC, although further clinical investigation is required to clarify its translational potential.
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Cisplatin as a Xenobiotic Agent: Molecular Mechanisms of Actions and Clinical Applications in Oncology
Anno: 2026
Rivista: JOURNAL OF XENOBIOTICS
Autori/autrici: Cecati, M; Pozzi, V; Pompei, V; Schiavoni, V; Fumarola, S; Romagnoli, A; Tossetta, G; Montana, A; Polizzi, A; Sartini, D; Campagna, R
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/352075
Citazioni:
Cisplatin as a Xenobiotic Agent: Molecular Mechanisms of Actions and Clinical Applications in Oncology / Cecati, M., Pozzi, V., Pompei, V., Schiavoni, V., Fumarola, S., Romagnoli, A., Tossetta, G., Montana, A., Polizzi, A., Sartini, D., Campagna, R.. - In: JOURNAL OF XENOBIOTICS. - ISSN 2039-4713. - STAMPA. - 16:1(2026). [10.3390/jox16010009]
Abstract:
Cisplatin, a platinum-based compound, is a cornerstone of modern chemotherapy and remains widely used against a variety of solid tumors, including testicular, ovarian, lung, bladder, and head and neck cancers. Its anticancer activity is primarily attributed to the formation of DNA crosslinks, which ...obstruct replication and repair, ultimately leading to apoptosis. However, the clinical value of cisplatin is constrained by two major challenges: its toxic profile and the development of resistance. Cisplatin toxicity arises from its interaction not only with tumor DNA but also with proteins and nucleic acids in healthy tissues, resulting in a range of adverse effects, including, but not limited to, nephrotoxicity, ototoxicity, neurotoxicity, and gastrointestinal injury. In pediatric patients, permanent hearing loss represents a particularly debilitating complication. On the other hand, tumor cells can evade cisplatin cytotoxicity through diverse mechanisms, including reduced intracellular drug accumulation, enhanced DNA repair, detoxification by thiol-containing molecules, and alterations in apoptotic signaling. These resistance pathways severely compromise treatment outcomes and often necessitate alternative or combination strategies. This review examines the chemical structure of cisplatin, the molecular mechanisms of cisplatin cytotoxicity and cisplatin-induced resistance, as well as the main applications in cancer management and the complications associated with its clinical use.
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Postmortem Oxycodone Toxicology: A Systematic Review and Meta-Analysis of Concentrations and Interpretative Markers
Anno: 2026
Rivista: MOLECULES
Autori/autrici: Fede, Maria Sofia; Pellegrini, Manuela; Minutillo, Adele; Likey, Alida; Montana, Angelo; Busardò, Francesco Paolo; Tini, Anastasio
Lingua: ENG
Classificazione IRIS: 1.2 Recensione in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/363732
Citazioni:
Postmortem Oxycodone Toxicology: A Systematic Review and Meta-Analysis of Concentrations and Interpretative Markers / Fede, M.S., Pellegrini, M., Minutillo, A., Likey, A., Montana, A., Busardò, F.P., Tini, A.. - In: MOLECULES. - ISSN 1420-3049. - ELETTRONICO. - 31:(2026). [10.3390/molecules31122051]
Abstract:
Background: Oxycodone is a widely prescribed semi-synthetic opioid central to pain management. However, establishing its role in death when detected in postmortem toxicology is challenging. Quantitative evidence to support forensic interpretation remains limited. Methods: A systematic review and met...a-analysis was conducted following PRISMA 2020 guidelines. PubMed and Scopus were searched through 3 March 2026, for studies reporting quantitative postmortem oxycodone concentrations in human biological matrices. Peripheral blood was predefined as the primary matrix for quantitative synthesis. Random-effects meta-analysis with restricted maximum likelihood estimation was performed on logarithmically transformed concentrations to compare fatal intoxications versus non-intoxication deaths and mono- versus mixed-intoxication cases. Pooled estimates were reported as geometric mean concentrations with 95% confidence and prediction intervals. Secondary analyses evaluated metabolite-to-parent ratios, alternative matrices, and postmortem interval (PMI). Results: Twenty-three studies comprising 4335 oxycodone-positive decedents were included in the qualitative synthesis, and 14 studies in the quantitative meta-analysis. Fatal intoxication cases (n = 1555) showed a pooled geometric mean peripheral blood oxycodone concentration of 0.37 mg/L (95% CI: 0.24–0.58; I2 = 93.5%), compared with 0.08 mg/L (95% CI: 0.04–0.15; I2 = 98.5%) in non-intoxication deaths (n = 1409). Mono-intoxication cases (n = 135) exhibited higher concentrations (0.52 mg/L; 95% CI: 0.22–1.21; I2 = 82.3%) than mixed-drug fatalities (n = 511; 0.29 mg/L; 95% CI: 0.13–0.65; I2 = 93.1%). Metabolite data indicated that noroxycodone and oxymorphone patterns may assist in distinguishing acute intake and metabolic variability. Alternative matrices, particularly vitreous humor and solid tissues provided complementary interpretative information, while PMI contributed concentration variability. Conclusions: The key quantitative findings of this meta-analysis indicate higher peripheral blood oxycodone levels in fatal intoxications than in non-intoxication deaths. However, substantial heterogeneity precludes the definition of absolute concentration cut-offs, emphasizing the need to approach postmortem oxycodone interpretation within a probabilistic forensic framework integrating circumstantial evidence, sampling time, metabolite ratios, and data from alternative biological matrices.
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Post-mortem sepsis diagnosis through vitreous humour biomarkers: A retrospective forensic cohort study
Anno: 2026
Rivista: FORENSIC SCIENCE INTERNATIONAL
Autori/autrici: Montanari, E.; Montana, A.; Alessandrini, F.; Sabbatinelli, J.; Sbriscia, M.; Busardo, F. P.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/363897
Citazioni:
Post-mortem sepsis diagnosis through vitreous humour biomarkers: A retrospective forensic cohort study / Montanari, E., Montana, A., Alessandrini, F., Sabbatinelli, J., Sbriscia, M., Busardo, F.P.. - In: FORENSIC SCIENCE INTERNATIONAL. - ISSN 0379-0738. - ELETTRONICO. - 386:(2026). [10.1016/j.forsciint.2026.112988]
Abstract:
Background: Sepsis remains a challenging post-mortem diagnosis due to the nonspecificity of autopsy findings. This study evaluates five sepsis biomarkers (urea, high-sensitivity C-reactive protein, procalcitonin, lactic acid, and glucose) detected in vitreous humour. Methods: In this retrospective s...tudy, 127 vitreous humour samples were analysed. Septic deaths were defined by clinical, radiological, and autopsy evidence, serving as reference standard for case/control group identification. Concentrations of urea, hs-CRP, PCT, lactic acid, and glucose were measured using ELISA and compared between septic/non-septic groups. Marker stability was tested across five post-mortem interval groups. A systematic literature review following PRISMA guidelines was conducted to contextualise the findings within the existing forensic evidence on sepsis biomarkers. Results: Urea and hs-CRP levels were significantly higher in septic cases (p < 0.001). hs-CRP demonstrated superior discriminatory ability (AUC = 0.729) and specificity (88.4%) compared to urea (AUC = 0.686), which showed higher sensitivity (85.7%) in ROC analyses. Combined analysis yielded an AUC of 0.781. All biomarkers except glucose and lactic acid remained stable during post-mortem up to 187 h. Conclusions: Vitreous humour represents a promising matrix for post-mortem sepsis diagnosis. Urea and hs-CRP in vitreous humour demonstrated both discriminatory ability and post-mortem stability, making them valuable forensic tools, particularly when conventional matrices are unavailable. However, as a proof-of-concept study conducted in a selected forensic cohort with documented post-mortem intervals, these findings require validation in broader forensic scenarios. The demonstrated stability of urea, hs-CRP and PCT up to 187 h suggests potential applicability when the exact post-mortem interval is unknown.
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The application of artificial intelligence in forensic pathology: a systematic literature review
Anno: 2025
Rivista: FRONTIERS IN MEDICINE
Autori/autrici: Orsini, Francesco; Cioffi, Andrea; Cipolloni, Luigi; Bibbò, Roberta; Montana, Angelo; De Simone, Stefania; Cecannecchia, Camilla
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/348877
Citazioni:
The application of artificial intelligence in forensic pathology: a systematic literature review / Orsini, F., Cioffi, A., Cipolloni, L., Bibbò, R., Montana, A., De Simone, S., Cecannecchia, C.. - In: FRONTIERS IN MEDICINE. - ISSN 2296-858X. - 12:(2025). [10.3389/fmed.2025.1583743]
Abstract:
Introduction: Recent advancements in Artificial Intelligence have shown immense potential across various domains of healthcare, including forensic pathology. This systematic review aims to evaluate the latest innovations brought by Artificial Intelligence in forensic pathology and provide insights i...nto future directions in this evolving field. Methods: A systematic literature search was conducted using databases for papers published from 1990 to 2025. The search strategy combined terms related to artificial intelligence, forensic odontology, forensic psychiatry and forensic medicine/pathology. Following PRISMA guidelines, 65 articles were initially identified, of which 18 met the inclusion criteria after applying exclusion criteria. Results: Artificial Intelligence applications demonstrated significant success across multiple forensic domains. In post-mortem analysis, deep learning achieved 70–94% accuracy in neurological forensics. Wound analysis systems showed high accuracy rates (87.99–98%) in gunshot wound classification. Artificial Intelligence-enhanced diatom testing for drowning cases achieved precision scores of 0.9 and recall scores of 0.95. Microbiome analysis applications reached accuracy rates up to 90% for individual identification and geographical origin determination. AI shows promise in forensic age estimation, psychiatric risk assessment, and insanity evaluations. Discussion: While Artificial Intelligence shows promise as a supportive tool in forensic pathology, several limitations persist, including small sample sizes and variable performance across different applications. Artificial Intelligence serves best as an enhancement rather than a replacement for human expertise. Future development should focus on larger datasets, specialized systems for different forensic applications, and improved interpretability of Artificial Intelligence decisions for legal contexts. The integration of Artificial Intelligence in forensic pathology represents a significant advancement, requiring careful balance between technological innovation and human expertise for optimal implementation.
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Myocardial Ischemia/Reperfusion Injury: Molecular Insights, Forensic Perspectives, and Therapeutic Horizons
Anno: 2025
Rivista: CELLS
Autori/autrici: Fede, Maria Sofia; Daziani, Gloria; Tavoletta, Francesco; Montana, Angelo; Compagnucci, Paolo; Goteri, Gaia; Neri, Margherita; Busardo', Francesco Paolo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/348881
Citazioni:
Myocardial Ischemia/Reperfusion Injury: Molecular Insights, Forensic Perspectives, and Therapeutic Horizons / Fede, M.S., Daziani, G., Tavoletta, F., Montana, A., Compagnucci, P., Goteri, G., Neri, M., Busardo', F.P.. - In: CELLS. - ISSN 2073-4409. - 14:19(2025). [10.3390/cells14191509]
Abstract:
Acute myocardial infarction (AMI) remains the leading cause of death worldwide, with myocardial ischemia/reperfusion injury (MIRI) emerging as a significant factor influencing patient outcomes despite timely reperfusion therapy. MIRI refers to paradoxical myocardial damage that occurs upon restorati...on of coronary blood flow and is driven by complex inflammatory, oxidative, and metabolic mechanisms, which can exacerbate infarct size (IS), contributing to adverse outcomes. This review explores the molecular and cellular pathophysiology of MIRI, emphasizing both its clinical and forensic relevance. The principal mechanisms discussed include oxidative stress and mitochondrial dysfunction, calcium overload and ion homeostasis imbalance, inflammatory responses, with particular focus on the NLRP3 inflammasome and cytokine pathways, and multiple forms of cell death (apoptosis, necroptosis, pyroptosis, and autophagy). Additionally, the authors present original immunohistochemical findings from autopsy cases of patients who suffered ST-segment elevation myocardial infarction (STEMI) and underwent percutaneous coronary intervention (PCI), but subsequently died. These findings underscore that successful reperfusion does not completely prevent delayed complications, like arrhythmias, ventricular fibrillation (VF), and sudden cardiac death (SCD), often caused by secondary MIRI-related mechanisms. Moreover, the case series highlight the diagnostic value of inflammatory markers for pathologists in identifying MIRI as a contributing factor in such fatalities. Finally, immunotherapeutic strategies—including IL-1 and IL-6 inhibitors such as Canakinumab and Tocilizumab—are reviewed for their potential to reduce cardiovascular events and mitigate the effects of MIRI. The review advocates for continued multidisciplinary research aimed at improving our understanding of MIRI, developing effective treatments, and informing forensic investigations of reperfusion-related deaths.
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A new approach to assess post-mortem interval: A machine learning-assisted label-free ATR-FTIR analysis of human vitreous humor
Anno: 2025
Rivista: SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY
Autori/autrici: Notarstefano, Valentina; Santoni, Chiara; Montanari, Eva; Busardo, Francesco Paolo; Montana, Angelo; Orilisi, Giulia; Mariani, Paolo; Giorgini, Elisabetta
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/337192
Citazioni:
A new approach to assess post-mortem interval: A machine learning-assisted label-free ATR-FTIR analysis of human vitreous humor / Notarstefano, V., Santoni, C., Montanari, E., Busardo, F.P., Montana, A., Orilisi, G., Mariani, P., Giorgini, E.. - In: SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY. - ISSN 1386-1425. - 327:(2025). [10.1016/j.saa.2024.125326]
Abstract:
A crucial issue in forensics is determining the post-mortem interval (PMI), the time between death and the finding of a body. Despite various methods already employed for its estimation, only approximate values are currently achievable. Vitreous humor (VH) is an avascular tissue between the lens and... the retina, mainly composed by a collagen fibers network, hyaluronic acid, and hyalocytes. Recently, it has received interest in forensic medicine, being easy to collect and susceptible to low microbiological contamination and putrefaction. Based on this evidence and thanks to the ability of Attenuated Total Reflectance – Fourier Transform InfraRed (ATR–FTIR) spectroscopy to perform fast analyses on a minimal sample amount, in this study, a new analytical approach to reliably estimate PMI is proposed combining ATR-FTIR analysis of VH human samples with multivariate statistical procedures, such as Principal Component Analysis (PCA) and Partial Least Squares-Discriminant Analysis (PLS-DA), for discriminant classification. Regression procedures, including Partial Least Squares Regression (PLSR), were performed: extremely positive results were obtained, and the most discriminant spectral features were highlighted (peaks at 1665, 1630, 1585, 1400, 1220, 1200, 1120, 854, 835, and 740 cm−1) and associated to PMI classes (average accuracy over 80 %). Specific and reliable markers able to correlate the macromolecular composition of VH with the PMI were identified, revealing a post-mortem protein degradation and amino acids deamination (decrease of proteins and increase of free amino acids and NH3), an increase of lactate, which diffuses from the retina to the VH, and changes in the hyaluronic acid component.
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Sudden Gastrointestinal Deaths of a Child due to a Fecaloma: a Multilevel Forensic Pathological Approach
Anno: 2025
Rivista: LA CLINICA TERAPEUTICA
Autori/autrici: V Lacasella, G; De Simone, S; Karaboue, M; Montana, A; Orsini, F; Dimauro, E; Cipolloni, L; Cioffi, A; Cecannecchia, C
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/348878
Citazioni:
Sudden Gastrointestinal Deaths of a Child due to a Fecaloma: a Multilevel Forensic Pathological Approach / V Lacasella, G., De Simone, S., Karaboue, M., Montana, A., Orsini, F., Dimauro, E., Cipolloni, L., Cioffi, A., Cecannecchia, C.. - In: LA CLINICA TERAPEUTICA. - ISSN 0009-9074. - 176:3(2025). [10.7417/CT.2025.5221]
Abstract:
Background.: Sudden gastrointestinal deaths refer to unexpected fatalities that occure due severe gastrointestinal conditions. They are rare, especially when compared to sudden deaths caused by cardiovascular, respiratory or neurological events. It is even more rare that a sudden death due to gastro...intestinal causes occurs in a child. Results. We presented a unique case of sudden death of a 9-year-old child with no pertinent medical history, presenting abdominal pain and diarrhea and deceased shortly after the onset of symptoms. The autopsy showed a severe intestinal obstruction due to a rectosigmoid fecaloma. In addition, the immunohistochemical evaluation revealed an inflammation of the intestine. Conclusion. In case of sudden deaths, forensic pathological investigation is essential to determine the cause of death. Diagnosis can only be made through a rigorous and multi-level post-mortem approach in which immunostochemical investigation can also make an important contribution.
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γ-H2AX: A useful tool to detect DNA damage in sudden cardiac death heart tissues, an experimental study
Anno: 2025
Rivista: TISSUE & CELL
Autori/autrici: Tossetta, Giovanni; Fantone, Sonia; Compagnucci, Paolo; Marzioni, Daniela; Montanari, Eva; Neri, Margherita; Busardo', Francesco Paolo; Montana, Angelo
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/348880
Citazioni:
γ-H2AX: A useful tool to detect DNA damage in sudden cardiac death heart tissues, an experimental study / Tossetta, G., Fantone, S., Compagnucci, P., Marzioni, D., Montanari, E., Neri, M., Busardo', F.P., Montana, A.. - In: TISSUE & CELL. - ISSN 1532-3072. - 96:(2025). [10.1016/j.tice.2025.103042]
Abstract:
Sudden cardiac death (SCD) is defined as death due to cardiovascular or unidentifiable causes that occurs within an hour of the onset of symptoms. Several lines of evidence suggest that oxidative stress, which is due to an increased production/accumulation of reactive oxygen species (ROS) in cells, ...may be associated with SCD. ROS can induce DNA damage leading to DNA double-strand break (DSB) that, if not repaired, can lead to cell death. In presence of a DNA DSB, H2AX (a histone H2A variant) is phosphorylated to form γ-H2AX, which binds the DNA DSBs and recruits DNA repair proteins. If DNA damage is excessive and cannot be repaired, cells undergo apoptosis. In the present study, we sought to evaluate the myocardial immunohistochemical expression of γ-H2AX in samples from patients suffering SCD as well as from healthy controls, in order to assess its potential role as a SCD biomarker
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Application of Aquaporins as Markers in Forensic Pathology: A Systematic Review of the Literature
Anno: 2024
Rivista: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
Autori/autrici: Alfieri, Letizia; Montana, Angelo; Frisoni, Paolo; D'Errico, Stefano; Neri, Margherita
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327895
Citazioni:
Application of Aquaporins as Markers in Forensic Pathology: A Systematic Review of the Literature / Alfieri, L., Montana, A., Frisoni, P., D'Errico, S., Neri, M.. - In: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES. - ISSN 1422-0067. - 25:5(2024). [10.3390/ijms25052664]
Abstract:
The study of aquaporins (AQPs) in various forensic fields has offered a promising horizon in response to the need to have reliable elements for the identification of the manner of death and for the individuation of forensic markers for the timing of lesions and vitality of injury. In the literature,... various tissues have been studied; the most investigated are the lungs, brain, kidneys, skin, and blood vessels. A systematic literature review on PubMed following PRISMA 2020 guidelines enabled the identification of 96 articles. In all, 34 of these were enrolled to identify Aquaporin-like (AQP-like) forensic markers. The analysis of the literature demonstrated that the most significant markers among the AQPs are as follows: for the brain, AQP4, which is very important in brain trauma and hypoxic damage; AQP3 in the skin lesions caused by various mechanisms; and AQP5 in the diagnosis of drowning. Other applications are in organ damage due to drug abuse and thrombus dating. The focus of this review is to collect all the data present in the literature about the forensic application of AQPs as forensic markers in the most important fields of application. In the current use, the individuation, validation, and application of markers in forensic investigation are very useful in real forensic applications in cases evaluated in court.
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The main causes of orthopedics and traumatology litigation in Italy: state of the art and review of the literature
Anno: 2024
Rivista: MINERVA ORTHOPEDICS
Autori/autrici: Basile, Giuseppe; Calori, Giorgio M.; Bianco Prevot, Luca; Fozzato, Stefania; Ragona, Monica; Chiodi, Benedetto; Montanari, Eva; Amadei, Federico; Leigheb, Massimiliano; Montana, Angelo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/348875
Citazioni:
The main causes of orthopedics and traumatology litigation in Italy: state of the art and review of the literature / Basile, G., Calori, G.M., Bianco Prevot, L., Fozzato, S., Ragona, M., Chiodi, B., Montanari, E., Amadei, F., Leigheb, M., Montana, A.. - In: MINERVA ORTHOPEDICS. - ISSN 2784-8469. - 75:2(2024), pp. 153-162. [10.23736/S2784-8469.23.04377-8]
Abstract:
The current situation is complex and not homogeneous, given the increase in litigation and the different legal framework at international level. This work wants to assess the situation in Italy, with the aim of helping to identify the various critical issues and possibly formulate effective correcti...ve actions. A risk management policy was introduced in Italy about 20 years ago. In the region of Lombardy, resolution 46/SAN 2004 and subsequent amendments structured and implemented a detailed litigation analysis process, aimed at clinical governance. The inspiring principle is the availability of true data to be able to intervene with effective corrective actions. The main objective is to better protect the patient, but in compliance with the economic sustainability of the treatment and the whole Health Care System. Data relating to litigation in the field of professional liability of specialists in orthopedics and traumatology will be considered in this contribution. We analyzed the data processed by Lombardy Region, in 22 years of litigations.
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Sudden Intrauterine Unexplained Death (SIUD) and Oxidative Stress: Placental Immunohistochemical Markers
Anno: 2024
Rivista: CELLS
Autori/autrici: Montana, A.; Alfieri, L.; Marino, R.; Greco, P.; Taliento, C.; Fulcheri, E.; Neri, M
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/348873
Citazioni:
Sudden Intrauterine Unexplained Death (SIUD) and Oxidative Stress: Placental Immunohistochemical Markers / Montana, A., Alfieri, L., Marino, R., Greco, P., Taliento, C., Fulcheri, E., Neri, M.. - In: CELLS. - ISSN 2073-4409. - 13:16(2024). [10.3390/cells13161347]
Abstract:
Background: Intrauterine fetal death and perinatal death represent one of the most relevant medical scientific problems since, in many cases, even after extensive investigation, the causes remain unknown. The considerable increase in medical legal litigation in the obstetrical field that has witness...ed in recent years, especially in cases of stillborn births, has simultaneously involved the figure of the forensic pathologist in scientific research aimed at clarifying the pathophysiological processes underlying stillbirth. Methods: our study aims to analyze cases of sudden intrauterine unexplained death syndrome (SIUD) to evaluate the role of oxidative stress in the complex pathogenetic process of stillbirth. In particular, the immunohistochemical expression of specific oxidative stress markers (NOX2, NT, iNOS, 8-HODG, IL-6) was evaluated in tissue samples of placentas of SIUDs belonging to the extensive case series (20 cases), collected from autopsy cases of the University of Ferrara and Politecnica delle Marche between 2017 and 2023. Results: The study demonstrated the involvement of oxidative stress in intrauterine fetal deaths in the placenta of the cases examined. In SIUD, the most expressed oxidative stress markers were NOX2 and 8-HODG. Conclusions: The study contributes to investigating the role of oxidative stress in modulating different pathways in unexplained intrauterine fetal death (SIUD) tissues
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Macroscopic and Microscopic Cerebral Findings in Drug and Alcohol Abusers: The Point of View of the Forensic Pathologist
Anno: 2024
Rivista: BIOMEDICINES
Autori/autrici: Montana, A; Alfieri, L; Neri, M; Piano, D; Renier, E; Marti, M; Palpacelli, M; Basile, G; Tossetta, G; Busardo', Francesco Paolo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/348872
Citazioni:
Macroscopic and Microscopic Cerebral Findings in Drug and Alcohol Abusers: The Point of View of the Forensic Pathologist / Montana, A., Alfieri, L., Neri, M., Piano, D., Renier, E., Marti, M., Palpacelli, M., Basile, G., Tossetta, G., Busardo', F.P.. - In: BIOMEDICINES. - ISSN 2227-9059. - 12:3(2024). [10.3390/biomedicines12030681]
Abstract:
Drug abuse still represents a significant challenge for forensic pathologists; it must always be considered during the autopsy examination when the brain morphological alterations observed are not characteristic of any known disease of the central nervous system (CNS). Nonetheless, no specific brain... lesions had been found to characterize the precise drug that caused the poisoning. In fact, a broad spectrum of changes affecting the CNS are seen in drug abusers. Thus, forensic pathology plays a key role in identifying the encephalic morphological alterations underlying the death. The aim of this review is to present an updated overview of the literature regarding the correlation between the main substances of abuse and the morphological alterations of the CNS to help the forensic pathologist to discriminate drug-induced alterations of the brain. The authors used the PRISMA criteriology to perform the bibliographic search for the present review. Among the articles identified according to the selected search criteria, 116 articles were chosen which allow us to define a picture of the main macroscopic and microscopic alterations of the brain in drug abuse.
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Diagnostic Methods in Forensic Pathology: Autoptic Findings and Immunohistochemical Study in Cases of Sudden Death Due to a Colloid Cyst of the Third Ventricle
Anno: 2024
Rivista: DIAGNOSTICS
Autori/autrici: Montana, Angelo; Busardò, Francesco Paolo; Tossetta, Giovanni; Goteri, Gaia; Castaldo, Pasqualina; Basile, Giuseppe; Bambagiotti, Giulia
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327671
Citazioni:
Diagnostic Methods in Forensic Pathology: Autoptic Findings and Immunohistochemical Study in Cases of Sudden Death Due to a Colloid Cyst of the Third Ventricle / Montana, A., Busardò, F.P., Tossetta, G., Goteri, G., Castaldo, P., Basile, G., Bambagiotti, G.. - In: DIAGNOSTICS. - ISSN 2075-4418. - 14:1(2024). [10.3390/diagnostics14010100]
Abstract:
The colloid cyst is a non-malignant tumor growth made of a gelatinous material covered by a membrane of epithelial tissue. It is usually located posterior to the foramen of Monro, in the anterior aspect of the third ventricle of the brain. Due to its location, it can cause obstructive hydrocephalus,... increased intracranial pressure, and sudden cardiac death, catecholamine-mediated, through hypothalamus compression. All the mechanisms are still controversial, but the role of catecholamine has been confirmed with histological findings that highlighted myocardial injury (coagulative myocytolysis and contraction band necrosis, CBN). This study presents a case of sudden death in a previously healthy 22-year-old male due to a colloid cyst of the third ventricle. A complete autopsy was performed, highlighting in the brain an abundant quantity of cerebrospinal fluid (CSF) and a 2 cm pale grayish-green rounded cyst formation partially filling and distending the third ventricle. The diagnosis was confirmed through immunohistochemical investigation: positivity for Periodic acid-Schiff (PAS) staining and CK7 expression. In cases such as the one reported here, a combined approach of autopsy, histology, and immunohistochemistry is mandatory in order to identify the neoformation's location and morpho-structural characteristics for a correct differential diagnosis, as well as to identify the cause of death.
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Forensic perspectives on postmortem CIED interrogation: A systematic review and meta-analysis
Anno: 2024
Rivista: FORENSIC SCIENCE INTERNATIONAL
Autori/autrici: Fede, M. S.; Compagnucci, P.; Montana, A.; Dello Russo, Antonio.; Giorgetti, Raffaele; Busardo, F. P.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/348874
Citazioni:
Forensic perspectives on postmortem CIED interrogation: A systematic review and meta-analysis / Fede, M.S., Compagnucci, P., Montana, A., Dello Russo, Antonio., Giorgetti, R., Busardo, F.P.. - In: FORENSIC SCIENCE INTERNATIONAL. - ISSN 0379-0738. - 359:(2024). [10.1016/j.forsciint.2024.112001]
Abstract:
Background: Cardiac implantable electronic devices (CIED) are a heterogeneous group of medical devices with increasingly sophisticated diagnostic capabilities, which could be exploited in forensic investigations. However, current guidelines are lacking clear recommendations on the topic. The first a...im of this systematic review is to provide an updated assessment of the role of postmortem CIED interrogation, and to give practical recommendations, which can be used in daily practice. Secondly, the authors aim to determine the rates of postmortem CIED interrogation and autopsy investigations, the type of final rhythm detected close to death (with a focus on the significance of documented arrhythmias), as well as the role of postmortem CIED interrogation in the determination of final cause/time of death, and any potentially fatal device malfunctions. Methods: A systematic search in MEDLINE and Scopus aiming to identify reports concerning postmortem human CIED interrogation was performed, including a systematic screening of reference lists. Case reports, letters to the editors, commentaries, review articles or guidelines were excluded, along with studies related to cardiac devices other than CIED. All data were pooled and analyzed using fixed-effects meta-analysis models, and the I2 statistic was used to assess heterogeneity. Results: A total of 25 articles were included in the systematic review, enrolling 3194 decedent CIED carriers. Ten studies (40%) had a 100% autopsy rate, whereas in further 6 studies autopsy findings were variably reported; CIED interrogation was available from 22 studies (88%), and it was never performed prior to autopsy. The overall rate of successful postmortem CIED interrogation was 89%, with high heterogeneity among studies, mainly due to device deactivation/battery discharge. Twenty-four percent of CIED carriers experienced sudden cardiac death (SCD), whereas non-sudden cardiac and non-cardiac death (NSCD, NCD) were reported in 37% and 30% of decedents, respectively. Ventricular tachyarrhythmias were recorded in 34% of overall successfully interrogated CIED, and in 62% of decedents who experienced a SCD; of all ventricular tachyarrhythmias recorded, 40% was found in NSCD or NCD. A clear interpretation of the etiological role of recorded arrhythmias in the causation of death required integration with autopsy findings. Overall, potentially fatal device malfunctions were detected in 12% of cases. Conclusions: Postmortem CIED interrogation is a valuable tool for the determination of the cause of death, and may complement autopsy. Forensic pathologists need to know the potential utility, pitfalls, and limitations of this diagnostic examination to make this tool as much reliable as possible.
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The physiological and pathological cause in the definition of the compensation for traumatic knee pathology: forensic medicine perspective
Anno: 2023
Rivista: GAZZETTA MEDICA ITALIANA. ARCHIVIO PER LE SCIENZE MEDICHE
Autori/autrici: Basile, Giuseppe; Fozzato, Stefania; Bianco Prevot, Luca; Passeri, Alberto; Accetta, Riccardo; Amadei, Federico; Gallina, Mario; Montana, Angelo; Leigheb, Massimiliano
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/349356
Citazioni:
The physiological and pathological cause in the definition of the compensation for traumatic knee pathology: forensic medicine perspective / Basile, G., Fozzato, S., Bianco Prevot, L., Passeri, A., Accetta, R., Amadei, F., Gallina, M., Montana, A., Leigheb, M.. - In: GAZZETTA MEDICA ITALIANA. ARCHIVIO PER LE SCIENZE MEDICHE. - ISSN 0393-3660. - 182:11(2023), pp. 841-849. [10.23736/s0393-3660.23.05307-x]
Abstract:
In defining compensation for traumatic knee pathology, a correct medico-legal evaluation judgment must consider a complete anamnestic reconstruction not separated from the biomechanical context of the accident dynamics and of the harmful efficacy, a deep knowledge of the relationship of the legal co...ntract, objective semiotic investigations and a careful interpretation of the instrumental investigations carried out by the insured. Alongside the borderline cases, in which diagnostic imaging may be sufficient to demonstrate the pre-existence of the lesion, there are numerous situations in which the iconographic data may be misleading if not subjected to accurate medico-legal analysis. The authors note that the definition of risk must include the deterioration of natural and non-pathological organ-tissue structures, and the physical conditions relating to the physiological or paraphysiological sphere which may have had a merely potential role in contributing to the lesion do not preclude compensation.
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Synthetic Cathinones and Neurotoxicity Risks: A Systematic Review
Anno: 2023
Rivista: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
Autori/autrici: Daziani, Gloria; Lo Faro, Alfredo Fabrizio; Montana, Vincenzo; Goteri, Gaia; Pesaresi, Mauro; Bambagiotti, Giulia; Montanari, Eva; Giorgetti, Raffaele; Montana, Angelo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/317013
Citazioni:
Synthetic Cathinones and Neurotoxicity Risks: A Systematic Review / Daziani, G., Lo Faro, A.F., Montana, V., Goteri, G., Pesaresi, M., Bambagiotti, G., Montanari, E., Giorgetti, R., Montana, A.. - In: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES. - ISSN 1422-0067. - 24:7(2023). [10.3390/ijms24076230]
Abstract:
According to the EU Early Warning System (EWS), synthetic cathinones (SCs) are the second largest new psychoactive substances (NPS) class, with 162 synthetic cathinones monitored by the EU EWS. They have a similar structure to cathinone, principally found in Catha Edulis; they have a phenethylamine ...related structure but also exhibit amphetamine-like stimulant effects. Illegal laboratories regularly develop new substances and place them on the market. For this reason, during the last decade this class of substances has presented a great challenge for public health and forensic toxicologists. Acting on different systems and with various mechanisms of action, the spectrum of side effects caused by the intake of these drugs of abuse is very broad. To date, most studies have focused on the substances' cardiac effects, and very few on their associated neurotoxicity. Specifically, synthetic cathinones appear to be involved in different neurological events, including increased alertness, mild agitation, severe psychosis, hyperthermia and death. A systematic literature search in PubMed and Scopus databases according to PRISMA guidelines was performed. A total of 515 studies published from 2005 to 2022 (350 articles from PubMed and 165 from Scopus) were initially screened for eligibility. The papers excluded, according to the criteria described in the Method Section (n = 401) and after full text analyses (n = 82), were 483 in total. The remaining 76 were included in the present review, as they met fully the inclusion criteria. The present work provides a comprehensive review on neurotoxic mechanisms of synthetic cathinones highlighting intoxication cases and fatalities in humans, as well as the toxic effects on animals (in particular rats, mice and zebrafish larvae). The reviewed studies showed brain-related adverse effects, including encephalopathy, coma and convulsions, and sympathomimetic and hallucinogenic toxidromes, together with the risk of developing excited/agitated delirium syndrome and serotonin syndrome.
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New Psychoactive Substances Intoxications and Fatalities during the COVID-19 Epidemic
Anno: 2023
Rivista: BIOLOGY
Autori/autrici: Lo Faro, Alfredo Fabrizio; Berardinelli, Diletta; Cassano, Tommaso; Dendramis, Gregory; Montanari, Eva; Montana, Angelo; Berretta, Paolo; Zaami, Simona; Busardo', Francesco Paolo; Huestis, Marilyn Ann
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/322044
Citazioni:
New Psychoactive Substances Intoxications and Fatalities during the COVID-19 Epidemic / Lo Faro, A.F., Berardinelli, D., Cassano, T., Dendramis, G., Montanari, E., Montana, A., Berretta, P., Zaami, S., Busardo', F.P., Huestis, M.A.. - In: BIOLOGY. - ISSN 2079-7737. - 12:2(2023). [10.3390/biology12020273]
Abstract:
In January 2020, the World Health Organization (WHO) issued a Public Health Emergency of International Concern, declaring the COVID-19 outbreak a pandemic in March 2020. Stringent measures decreased consumption of some drugs, moving the illicit market to alternative substances, such as New Psychoact...ive Substances (NPS). A systematic literature search was performed, using scientific databases such as PubMed, Scopus, Web of Science and institutional and government websites, to identify reported intoxications and fatalities from NPS during the COVID-19 pandemic. The search terms were: COVID-19, SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, coronavirus disease 2019, intox*, fatal*, new psychoactive substance, novel psychoactive substance, smart drugs, new psychoactive substance, novel synthetic opioid, synthetic opioid, synthetic cathinone, bath salts, legal highs, nitazene, bath salt, legal high, synthetic cannabinoid, phenethylamine, phencyclidine, piperazine, novel benzodiazepine, benzodiazepine analogue, designer benzodiazepines, tryptamine and psychostimulant. From January 2020 to March 2022, 215 NPS exposures were reported in Europe, UK, Japan and USA. Single NPS class intoxications accounted for 25, while mixed NPS class intoxications represented only 3 cases. A total of 130 NPS single class fatalities and 56 fatalities involving mixed NPS classes were published during the pandemic. Synthetic opioids were the NPS class most abused, followed by synthetic cathinones and synthetic cannabinoids. Notably, designer benzodiazepines were frequently found in combination with fentalogues. Considering the stress to communities and healthcare systems generated by the pandemic, NPS-related information may be underestimated. However, we could not define the exact impacts of COVID-19 on processing of toxicological data, autopsy and death investigations
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Molecular Insights of New Psychoactive Substances (NPS) 2.0
Anno: 2023
Rivista: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
Autori/autrici: Di Trana, Annagiulia; Montana, Angelo; Lo Faro, Alfredo Fabrizio; Busardo, Francesco Paolo; Pichini, Simona
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327872
Citazioni:
Molecular Insights of New Psychoactive Substances (NPS) 2.0 / Di Trana, A., Montana, A., Lo Faro, A.F., Busardo, F.P., Pichini, S.. - In: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES. - ISSN 1422-0067. - 24:24(2023). [10.3390/ijms242417492]
Abstract:
The New Psychoactive Substances (NPS) phenomenon represents an ever-changing global issue, with a number of new molecules entering the illicit market every year in response to international banning laws [...].

End-of-life in the operational functioning of public healthcare: ethical and legal issues
Anno: 2023
Rivista: ACTA BIOMEDICA
Autori/autrici: Basile, Giuseppe; De Nina, Angelo; Montana, Angelo; Negro, Francesca; Straccamore, Marco; Napoletano, Gabriele; Marinelli, Enrico
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327897
Citazioni:
End-of-life in the operational functioning of public healthcare: ethical and legal issues / Basile, G., De Nina, A., Montana, A., Negro, F., Straccamore, M., Napoletano, G., Marinelli, E.. - In: ACTA BIOMEDICA. - ISSN 2531-6745. - 94:2(2023). [10.23750/abm.v94i2.14207]
Abstract:
Background and aim: The article aims to outline the current scenario relative to the medical role in end-of-life issues. In order to do this, historical-legal references have been drawn upon relating to technical, legal and scientific thought and doctrine, as it has come down to us in the medical fi...eld through the evolution of ethical and philosophical frameworks. Methods: The authors have conducted a thorough analysis of end-of-life legislative initiatives, in Italy and across the EU, and court rulings to outline possible ways to harmonize and reconcile the current medical ethics frameworks with the needs and rights of all, especially the most vulnerable among us. To that end, the necessary operational choices and adjustments have not yet been made by our legal system, from a technical, as well as moral, standpoint. Results: An operational proposal has therefore been laid out to protect both healthcare providers and patients, in a relationship that goes beyond treatment in the strict sense, which prioritizes mutual needs as an integral part of a common, essential path. Conclusions: In order for doctors to consider themselves complete, they should in fact deal not only with life, but also with death.
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β'-Phenylfentanyl Metabolism in Primary Human Hepatocyte Incubations: Identification of Potential Biomarkers of Exposure in Clinical and Forensic Toxicology
Anno: 2022
Rivista: JOURNAL OF ANALYTICAL TOXICOLOGY
Autori/autrici: Brunetti, Pietro; Lo Faro, Alfredo F; Di Trana, Annagiulia; Montana, Angelo; Basile, Giuseppe; Carlier, Jeremy; Busardò, Francesco P
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/310687
Citazioni:
β'-Phenylfentanyl Metabolism in Primary Human Hepatocyte Incubations: Identification of Potential Biomarkers of Exposure in Clinical and Forensic Toxicology / Brunetti, P., Lo Faro, A.F., Di Trana, A., Montana, A., Basile, G., Carlier, J., Busardò, F.P.. - In: JOURNAL OF ANALYTICAL TOXICOLOGY. - ISSN 0146-4760. - 46:9(2022), pp. e207-e217. [10.1093/jat/bkac065]
Abstract:
From 2014 onwards, illicit fentanyl and analogues have caused numerous intoxications and fatalities worldwide, impacting the demographics of opioid-related overdoses. The identification of cases involving fentanyl analogues is crucial in clinical and forensic settings to treat patients, elucidate in...toxications, address drug use disorders and tackle drug trends. However, in analytical toxicology, the concentration of fentanyl analogues in biological matrices is low, making their detection challenging. Therefore, the identification of specific metabolite biomarkers is often required to document consumption. beta '-Phenylfentanyl (N-phenyl-N-[1-(2-phenylethyl)-4-piperidinyl]-benzenepropanamide) is a fentanyl analogue that was first detected in Sweden in 2017 and has recently reemerged onto the American illicit drug market. There is little data available on beta '-phenylfentanyl effects and toxicokinetics and its metabolism is yet to be studied. We aimed to investigate beta '-phenylfentanyl human metabolism to identify potential biomarkers of use. To assist in beta '-phenylfentanyl metabolite identification, a list of putative reactions was generated using in silico predictions with GLORYx freeware. beta '-phenylfentanyl was incubated with cryopreserved 10-donor-pooled human hepatocytes, analyses were performed by liquid chromatography-high-resolution tandem mass spectrometry (LC-HRMS-MS) and data were processed using a partially automated targeted/untargeted approach with Compound Discoverer. We identified 26 metabolites produced by N-dealkylation, oxidation, hydroxylation, O-glucuronidation, O-methylation and combinations thereof. We suggest beta '-phenylnorfentanyl (N-phenyl-N-4-piperidinyl-benzenepropanamide) and further metabolites 1-oxo-N-phenyl-N-4-piperidinyl-benzenepropanamide and 1-hydroxy-N-phenyl-N-4-piperidinyl-benzenepropanamide as major biomarkers of beta '-phenylfentanyl use. In silico predictions were mostly wrong, and beta '-phenylfentanyl metabolic fate substantially differed from that of a closely related analogue incubated in the same conditions, highlighting the value of the experimental assessment of new psychoactive substance human metabolism. In vivo data are necessary to confirm the present results. However, the present results may be necessary to help analytical toxicologists identify beta '-phenylfentanyl-positive cases to provide authentic samples.
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Synthetic cathinones and cardiotoxicity risks
Anno: 2022
Rivista: LA CLINICA TERAPEUTICA
Autori/autrici: Lo Faro, A. F.; Berretta, P.; Montana, A.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/310448
Citazioni:
Synthetic cathinones and cardiotoxicity risks / Lo Faro, A.F., Berretta, P., Montana, A.. - In: LA CLINICA TERAPEUTICA. - ISSN 1972-6007. - 173:6(2022), pp. 524-525. [10.7417/CT.2022.2475]
Abstract:
: Recently, there has been a worldwide rise in the popularity and abuse of synthetic cathinones. The spectrum of side effects caused by the intake of these drugs of abuse is very wide since they act on different systems with various mechanisms of action, they appear to be involved in different cardi...ac events, including myocardial infarction and sudden cardiac death due to fatal arrhythmias. Overall, khat users have a higher risk of death, recurrent myocardial ischemia, cardiogenic shock, ventricular arrhythmia, and stroke compared with non-khat user.
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Anaphylactic Death: A New Forensic Workflow for Diagnosis
Anno: 2021
Rivista: HEALTHCARE
Autori/autrici: Esposito, Massimiliano; Montana, Angelo; Liberto, Aldo; Filetti, Veronica; Nunno, Nunzio Di; Amico, Francesco; Salerno, Monica; Loreto, Carla; Sessa, Francesco
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/318934
Citazioni:
Anaphylactic Death: A New Forensic Workflow for Diagnosis / Esposito, M., Montana, A., Liberto, A., Filetti, V., Nunno, N.D., Amico, F., Salerno, M., Loreto, C., Sessa, F.. - In: HEALTHCARE. - ISSN 2227-9032. - 9:2(2021). [10.3390/healthcare9020117]
Abstract:
Anaphylaxis is a life-threatening or fatal clinical emergency characterized by rapid onset, and death may be sudden. The margin of certainty about the diagnosis of anaphylactic death is not well established. The application of immunohistochemical techniques combined with the evaluation of blood tryp...tase concentrations opened up a new field of investigation into anaphylactic death. The present study investigated eleven autopsy cases of anaphylactic death, carried out between 2005 and 2017, by the Departments of Forensic Pathology of the Universities of Foggia and Catania (Italy). An analysis of the medical records was carried out in all autopsies. Seven autopsies were carried out on males and four on females. Of the eleven cases, one showed a history of asthma, one of food ingestion, two of oral administration of medications, six did not refer any allergy history, and one subject was unknown. All cases (100%) showed pulmonary congestion and edema; 7/11 (64%) of the cases had pharyngeal/laryngeal edema and mucus plugging in the airway; only one case (9%) had a skin reaction that was found during external examination. Serum tryptase concentration was measured in ten cases, and the mean value was 133.5 mu g/L +/- 177.9. The immunohistochemical examination using an anti-tryptase antibody on samples from the lungs, pharynx/larynx, and skin site of medication injection showed that all cases (100%) were strongly immunopositive for anti-tryptase antibody staining on lung samples; three cases (30%) were strongly immunopositive for anti-tryptase antibody staining on pharyngeal/laryngeal samples; and eight cases (80%) were strongly immunopositive for anti-tryptase antibody staining on skin samples. We conclude that a typical clinical history, blood tryptase level >40 mu g/L, and strongly positive anti-tryptase antibody staining in the immunohistochemical investigation may represent reliable parameters in the determination of anaphylactic death with the accuracy needed for forensic purposes.
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Multidisciplinary Approach to Suspected Sudden Death Caused by Arteriovenous Malformation Rupture: A Case Report
Anno: 2021
Rivista: MEDICINA
Autori/autrici: Patanè, Federico Giuseppe; Esposito, Massimiliano; Musumeci, Andrea Giovanni; Palermo, Monica; Torrisi, Marco; Salerno, Monica; Montana, Angelo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/318938
Citazioni:
Multidisciplinary Approach to Suspected Sudden Death Caused by Arteriovenous Malformation Rupture: A Case Report / Patanè, F.G., Esposito, M., Musumeci, A.G., Palermo, M., Torrisi, M., Salerno, M., Montana, A.. - In: MEDICINA. - ISSN 1010-660X. - 57:7(2021), p. 644. [10.3390/medicina57070644]
Abstract:
Arteriovenous malformations (AVMs) are rare congenital conditions with a prevalence of less than 1% and are mostly asymptomatic. However, these malformations can suddenly cause intense pain or bleeding, leading to life-threatening medical problems. This report presents a case of an unexpected death ...in a 37-year-old previously healthy woman due to an intra-cerebellum arteriovenous malformation rupture identified during autopsy. While infective processes where preliminarily excluded, a Post Mortem Computed Tomography (PMCT) identified a tetra ventricular hemorrhage and intra-cerebellum hemorrhage. Toxicological examination was negative for most substances of abuse. During autopsy an intense hemorrhagic infiltrate in the subarachnoid space was observed. After formalin fixation of the brain the cerebellum showed hemorrhagic infarction on fourth ventricle sides, as well as several small reddish infarctions across the entire cerebellum parenchyma. Histological examination of the brain and cerebellum showed a suffusion of erythrocytes in the sub-arachnoid region. Evidence of an arterio-venous malformation, with several intertwine vessels of variable diameter, surrounded by hemorrhagic evidence. The autopsy played a crucial role in identifying the location and the possibly affected vessel, as well as defining the cause of death. It is necessary to have a greater number of autopsies to make an epidemiological contribution. Furthermore, it is crucial to create a multicenter data network with other authors from other departments to improve information about epidemiological, clinical, diagnostic and therapeutic data. Most brain AVMs as cause of death are often undiscovered.
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A Rare Case of Suicide by Ingestion of Phorate: A Case Report and a Review of the Literature
Anno: 2021
Rivista: HEALTHCARE
Autori/autrici: Montana, Angelo; Rapisarda, Venerando; Esposito, Massimiliano; Amico, Francesco; Cocimano, Giuseppe; Nunno, Nunzio Di; Ledda, Caterina; Salerno, Monica
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/318935
Citazioni:
A Rare Case of Suicide by Ingestion of Phorate: A Case Report and a Review of the Literature / Montana, A., Rapisarda, V., Esposito, M., Amico, F., Cocimano, G., Nunno, N.D., Ledda, C., Salerno, M.. - In: HEALTHCARE. - ISSN 2227-9032. - 9:2(2021). [10.3390/healthcare9020131]
Abstract:
Phorate is a systemic organophosphorus pesticide (OP) that acts by inhibiting cholinesterases. Recent studies have reported that long-term low/moderate exposure to OP could be correlated with impaired cardiovascular and pulmonary function and other neurological effects. A 70-year-old farmer died aft...er an intention ingestion of a granular powder mixed with water. He was employed on a farm for over 50 years producing fruit and vegetables, and for about 20 years, he had also applied pesticides. In the last 15 years, he used phorate predominantly. The Phorate concentration detected in gastric contents was 3.29 mu g/mL. Chronic exposure to phorate is experimentally studied by histopathological changes observed in the kidney. In the light of current literature, our case confirms that there is an association between renal damage and chronic exposure to phorate in a subject exposed for years to the pesticide. Autopsies and toxicological analyses play a key role in the reconstruction of the dynamics, including the cause of the death.
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Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review
Anno: 2021
Rivista: HEALTHCARE
Autori/autrici: Albano, Gd; Amico, F; Cocimano, G; Liberto, A; Maglietta, F; Esposito, M; Rosi, Gl; Di Nunno, N; Salerno, M; Montana, A
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/318932
Citazioni:
Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review / Albano, G.d., Amico, F., Cocimano, G., Liberto, A., Maglietta, F., Esposito, M., Rosi, G.l., Di Nunno, N., Salerno, M., Montana, A.. - In: HEALTHCARE. - ISSN 2227-9032. - 9:1(2021). [10.3390/healthcare9010097]
Abstract:
Anabolic-androgenic steroids (AASs) are a large group of molecules including endogenously produced androgens, such as testosterone, as well as synthetically manufactured derivatives. AAS use is widespread due to their ability to improve muscle growth for aesthetic purposes and athletes' perform...ance, minimizing androgenic effects. AAS use is very popular and 1-3% of US inhabitants have been estimated to be AAS users. However, AASs have side effects, involving all organs, tissues and body functions, especially long-term toxicity involving the cardiovascular system and the reproductive system, thereby, their abuse is considered a public health issue. The aim of the proposed review is to highlight the most recent evidence regarding the mechanisms of action of AASs and their unwanted effects on organs and lifestyle, as well as suggesting that AAS misuse and abuse lead to adverse effects in all body tissues and organs. Oxidative stress, apoptosis, and protein synthesis alteration are common mechanisms involved in AAS-related damage in the whole body. The cardiovascular system and the reproductive system are the most frequently involved apparatuses. Epidemiology as well as the molecular and pathological mechanisms involved in the neuropsychiatric side-effects of AAS abuse are still unclear, further research is needed in this field. In addition, diagnostically reliable tests for AAS abuse should be standardized. In this regard, to prevent the use of AASs, public health measures in all settings are crucial. These measures consist of improved knowledge among healthcare workers, proper doping screening tests, educational interventions, and updated legislation.
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Management of the corpse with suspect, probable or confirmed COVID-19 respiratory infection - Italian interim recommendations for personnel potentially exposed to material from corpses, including body fluids, in morgue structures and during autopsy practice
Anno: 2020
Rivista: PATHOLOGICA
Autori/autrici: Fineschi, Vittorio; Aprile, Anna; Aquila, Isabella; Arcangeli, Mauro; Asmundo, Alessio; Bacci, Mauro; Cingolani, Mariano; Cipolloni, Luigi; D'Errico, Stefano; De Casamassimi, Ilaria; Di Mizio, Giulio; Di Paolo, Marco; Focardi, Martina; Frati, Paola; Gabbrielli, Mario; La Russa, Raffaele; Maiese, Aniello; Manetti, Federico; Martelloni, Massimo; Mazzeo, Elena; Montana, Angelo; Neri, Margherita; Padovano, Martina; Pinchi, Vilma; Pomara, Cristoforo; Ricci, Pietrantonio; Salerno, Monica; Santurro, Alessandro; Scopetti, Matteo; Testi, Roberto; Turillazzi, Emanuela; Vacchiano, Giuseppe; Crivelli, Filippo; Bonoldi, Emanuela; Facchetti, Fabio; Nebuloni, Manuela; Sapino, Anna
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327898
Citazioni:
Management of the corpse with suspect, probable or confirmed COVID-19 respiratory infection - Italian interim recommendations for personnel potentially exposed to material from corpses, including body fluids, in morgue structures and during autopsy practice / Fineschi, V., Aprile, A., Aquila, I., Arcangeli, M., Asmundo, A., Bacci, M., Cingolani, M., Cipolloni, L., D'Errico, S., De Casamassimi, I., Di Mizio, G., Di Paolo, M., Focardi, M., Frati, P., Gabbrielli, M., La Russa, R., Maiese, A., Manetti, F., Martelloni, M., Mazzeo, E., et al.. - In: PATHOLOGICA. - ISSN 1591-951X. - 112:2(2020), pp. 64-77. [10.32074/1591-951X-13-20]

Risk Management and Recommendations for the Prevention of Fatal Foreign Body Aspiration: Four Cases Aged 1.5 to 3 Years and Mini-Review of the Literature
Anno: 2020
Rivista: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
Autori/autrici: Montana, Angelo; Salerno, Monica; Feola, Alessandro; Asmundo, Alessio; Di Nunno, Nunzio; Casella, Filomena; Manno, Emilpaolo; Colosimo, Federica; Serra, Raffaele; Di Mizio, Giulio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/318937
Citazioni:
Risk Management and Recommendations for the Prevention of Fatal Foreign Body Aspiration: Four Cases Aged 1.5 to 3 Years and Mini-Review of the Literature / Montana, A., Salerno, M., Feola, A., Asmundo, A., Di Nunno, N., Casella, F., Manno, E., Colosimo, F., Serra, R., Di Mizio, G.. - In: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH. - ISSN 1660-4601. - 17:13(2020). [10.3390/ijerph17134700]
Abstract:
Background: Foreign body aspiration (FBA) is a significant public health concern among the pediatric population, and fatalities are dramatic for families. It typically involves organic foreign bodies (mainly food) aspirated by children under three years old, usually at home or school. This review ai...med to focus on the preventive measures around four actual cases of fatal foreign body aspiration, emphasizing the correct execution of the Heimlich maneuver and cardiopulmonary resuscitation, supervised mealtimes, and high-risk foods. (2) Methods: Four fatal cases of foreign body aspiration in children are presented here. The children were in a free environment, such as school, home, and the countryside, and were in the presence of teachers, parents, and a grandmother who did not supervise the children adequately. A literature review was performed via the MEDLINE database using the key terms: "foreign body aspiration," "infant choking, 1.5 to 3 years," "food and foreign body aspiration," "common household," "prevention of foreign body aspiration," "guidelines," "recommendations," "training of caregivers (parents, educators)," "resuscitation," "Heimlich maneuver," and "disengagement of the upper airways." We focused on the prevention of foreign body aspiration. (3) Results: a complete postmortem examination was performed. In three cases, the foreign bodies were food (mozzarella cheese, pear, or raw bean), while in one case, the foreign body was a pebble. (4) Conclusions: This review aimed to discuss recent scientific literature and provide a perspective on the benefits of a dedicated approach to the management of fatal foreign body aspiration in children by caregivers who usually have no experience with the best ways of supervising children in a safe environment, especially regarding the correct execution of resuscitation maneuvers, such as the Heimlich maneuver. Recommendation updates could improve healthcare quality in a pediatric setting and reduce medico-legal implications.
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No Autopsies on COVID-19 Deaths: A Missed Opportunity and the Lockdown of Science
Anno: 2020
Rivista: JOURNAL OF CLINICAL MEDICINE
Autori/autrici: Salerno, Monica; Sessa, Francesco; Piscopo, Amalia; Montana, Angelo; Torrisi, Marco; Patanè, Federico; Murabito, Paolo; Volti, Giovanni Li; Pomara, Cristoforo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/318940
Citazioni:
No Autopsies on COVID-19 Deaths: A Missed Opportunity and the Lockdown of Science / Salerno, M., Sessa, F., Piscopo, A., Montana, A., Torrisi, M., Patanè, F., Murabito, P., Volti, G.L., Pomara, C.. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 9:5(2020). [10.3390/jcm9051472]
Abstract:
Background: The current outbreak of COVID-19 infection, which started in Wuhan, Hubei province, China, in December 2019, is an ongoing challenge and a significant threat to public health requiring surveillance, prompt diagnosis, and research efforts to understand a new, emergent, and unknown pathoge...n and to develop effective therapies. Despite the increasing number of published studies on COVID-19, in all the examined studies the lack of a well-defined pathophysiology of death among patients who died following COVID-19 infection is evident. Autopsy should be considered mandatory to define the exact cause of death, thus providing useful clinical and epidemiologic information as well as pathophysiological insights to further provide therapeutic tools. Methods: A literature review was performed on PubMed database, using the key terms: "COVID-19", "nCov 19", and "Sars Cov 2". 9709 articles were retrieved; by excluding all duplicated articles, additional criteria were then applied: articles or abstracts in English and articles containing one of the following words: "death", "died", "comorbidity", "cause of death", "biopsy", "autopsy", or "pathological". Results: A total of 50 articles met the inclusion criteria. However, only 7 of these studies reported autopsy-based data. Discussion: The analysis of the main data from the selected studies concerns the complete analysis of 12,954 patients, of whom 2269 died (with a mortality rate of 17.52%). Laboratory confirmation of COVID-19 infection was obtained in all cases and comorbidities were fully reported in 46 studies. The most common comorbidities were: cardiovascular diseases (hypertension and coronary artery disease), metabolic disorders (diabetes, overweight, or obesity), respiratory disorders (chronic obstructive pulmonary disease), and cancer. The most common reported complications were: acute respiratory distress syndrome (ARDS), acute kidney injury, cardiac injury, liver insufficiency, and septic shock. Only 7 papers reported histological investigations. Nevertheless, only two complete autopsies are described and the cause of death was listed as COVID-19 in only one of them. The lack of postmortem investigation did not allow a definition of the exact cause of death to determine the pathways of this infection. Based on the few histopathological findings reported in the analyzed studies, it seems to be a clear alteration of the coagulation system: frequently prothrombotic activity with consequent thromboembolism was described in COVID-19 patients. As a scientific community, we are called on to face this global threat, and to defeat it with all the available tools necessary. Despite the improvement and reinforcement of any method of study in every field of medicine and science, encouraging the autopsy practice as a tool of investigation could also therefore, help physicians to define an effective treatment to reduce mortality.
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Sudden Cardiac Death in Anabolic-Androgenic Steroid Users: A Literature Review
Anno: 2020
Rivista: MEDICINA
Autori/autrici: Torrisi, Marco; Pennisi, Giuliana; Russo, Ilenia; Amico, Francesco; Esposito, Massimiliano; Liberto, Aldo; Cocimano, Giuseppe; Salerno, Monica; Li Rosi, Giuseppe; Di Nunno, Nunzio; Montana, Angelo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/318931
Citazioni:
Sudden Cardiac Death in Anabolic-Androgenic Steroid Users: A Literature Review / Torrisi, M., Pennisi, G., Russo, I., Amico, F., Esposito, M., Liberto, A., Cocimano, G., Salerno, M., Li Rosi, G., Di Nunno, N., Montana, A.. - In: MEDICINA. - ISSN 1010-660X. - 56:11(2020), pp. 1-19. [10.3390/medicina56110587]
Abstract:
Background and objectives: Anabolic-androgenic steroids (AASs) are a group of synthetic molecules derived from testosterone and its related precursors. AASs are widely used illicitly by adolescents and athletes, especially by bodybuilders, both for aesthetic uses and as performance enhancers to incr...ease muscle growth and lean body mass. When used illicitly they can damage health and cause disorders affecting several functions. Sudden cardiac death (SCD) is the most common medical cause of death in athletes. SCD in athletes has also been associated with the use of performance-enhancing drugs. This review aimed to focus on deaths related to AAS abuse to investigate the cardiac pathophysiological mechanism that underlies this type of death, which still needs to be fully investigated. Materials and Methods: This review was conducted using PubMed Central and Google Scholar databases, until 21 July 2020, using the following key terms: "((Sudden cardiac death) OR (Sudden death)) AND ((androgenic anabolic steroid) OR (androgenic anabolic steroids) OR (anabolic-androgenic steroids) OR (anabolic-androgenic steroid))". Thirteen articles met the inclusion and exclusion criteria, for a total of 33 reported cases. Results: Of the 33 cases, 31 (93.9%) were males while only 2 (61%) were females. Mean age was 29.79 and, among sportsmen, the most represented sports activity was bodybuilding. In all cases there was a history of AAS abuse or a physical phenotype suggesting AAS use; the total usage period was unspecified in most cases. In 24 cases the results of the toxicological analysis were reported. The most detected AASs were nandrolone, testosterone, and stanozolol. The most frequently reported macroscopic alterations were cardiomegaly and left ventricular hypertrophy, while the histological alterations were foci of fibrosis and necrosis of the myocardial tissue. Conclusions: Four principal mechanisms responsible for SCD have been proposed in AAS abusers: the atherogenic model, the thrombosis model, the model of vasospasm induced by the release of nitric oxide, and the direct myocardial injury model. Hypertrophy, fibrosis, and necrosis represent a substrate for arrhythmias, especially when combined with exercise. Indeed, AAS use has been shown to change physiological cardiac remodeling of athletes to pathophysiological cardiac hypertrophy with an increased risk of life-threatening arrhythmias.
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Nandrolone Decanoate: Use, Abuse and Side Effects
Anno: 2020
Rivista: MEDICINA
Autori/autrici: Patanè, Federico Giuseppe; Liberto, Aldo; Maria Maglitto, Andreana Nicoletta; Malandrino, Pasquale; Esposito, Massimiliano; Amico, Francesco; Cocimano, Giuseppe; Rosi, Giuseppe Li; Condorelli, Dario; Nunno, Nunzio Di; Montana, Angelo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/318933
Citazioni:
Nandrolone Decanoate: Use, Abuse and Side Effects / Patanè, F.G., Liberto, A., Maria Maglitto, A.N., Malandrino, P., Esposito, M., Amico, F., Cocimano, G., Rosi, G.L., Condorelli, D., Nunno, N.D., Montana, A.. - In: MEDICINA. - ISSN 1010-660X. - 56:11(2020), pp. 1-24. [10.3390/medicina56110606]
Abstract:
Background and Objectives: Androgens play a significant role in the development of male reproductive organs. The clinical use of synthetic testosterone derivatives, such as nandrolone, is focused on maximizing the anabolic effects and minimizing the androgenic ones. Class II anabolic androgenic ster...oids (AAS), including nandrolone, are rapidly becoming a widespread group of drugs used both clinically and illicitly. The illicit use of AAS is diffused among adolescent and bodybuilders because of their anabolic proprieties and their capacity to increase tolerance to exercise. This systematic review aims to focus on side effects related to illicit AAS abuse, evaluating the scientific literature in order to underline the most frequent side effects on AAS abusers' bodies. Materials and Methods: A systematic review of the scientific literature was performed using the PubMed database and the keywords "nandrolone decanoate". The inclusion criteria for articles or abstracts were English language and the presence of the following words: "abuse" or "adverse effects". After applying the exclusion and inclusion criteria, from a total of 766 articles, only 148 were considered eligible for the study. Results: The most reported adverse effects (found in more than 5% of the studies) were endocrine effects (18 studies, 42%), such as virilization, gynecomastia, hormonal disorders, dyslipidemia, genital alterations, and infertility; cardiovascular dysfunctions (six studies, 14%) such as vascular damage, coagulation disorders, and arteriosus hypertension; skin disorders (five studies, 12%) such as pricking, acne, and skin spots; psychiatric and mood disorders (four studies, 9%) such as aggressiveness, sleep disorders and anxiety; musculoskeletal disorders (two studies, 5%), excretory disorders (two studies, 5%), and gastrointestinal disorders (two studies, 5%). Conclusions: Based on the result of our study, the most common adverse effects secondary to the abuse of nandrolone decanoate (ND) involve the endocrine, cardiovascular, skin, and psychiatric systems. These data could prove useful to healthcare professionals in both sports and clinical settings.
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More than Pneumonia: Distinctive Features of SARS-Cov-2 Infection. From Autopsy Findings to Clinical Implications: A Systematic Review
Anno: 2020
Rivista: MICROORGANISMS
Autori/autrici: D'Errico, Stefano; Zanon, Martina; Montanaro, Martina; Radaelli, Davide; Sessa, Francesco; Di Mizio, Giulio; Montana, Angelo; Corrao, Salvatore; Salerno, Monica; Pomara, Cristoforo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/318936
Citazioni:
More than Pneumonia: Distinctive Features of SARS-Cov-2 Infection. From Autopsy Findings to Clinical Implications: A Systematic Review / D'Errico, S., Zanon, M., Montanaro, M., Radaelli, D., Sessa, F., Di Mizio, G., Montana, A., Corrao, S., Salerno, M., Pomara, C.. - In: MICROORGANISMS. - ISSN 2076-2607. - 8:11(2020), pp. 1-18. [10.3390/microorganisms8111642]
Abstract:
Despite safety recommendations for the management of corpses with COVID-19 infection and the high number of deaths worldwide, the post-mortem investigation rate is extremely low as well as the scientific contributions describing the pathological features. The first results of post-mortem investigati...ons provided interesting findings and contributed to promoting unexplored therapeutic approaches and new frontiers of research. A systematic review is provided with the aim of summarizing all autopsy studies up to February 2020 in which a complete post-mortem investigation in patients with COVID-19 disease was performed, focusing on histopathological features. We included case reports, case series, retrospective and prospective studies, letters to the editor, and reviews. A total of 28 studies fulfilled the inclusion criteria, producing a pooled dataset of 407 full autopsies. Analyzing the medical history data, only 12 subjects had died without any comorbidities (for 15 cases the data were not available). The post-mortem investigation highlighted that acute respiratory distress syndrome (ARDS) and multiple organ failure represent the main clinical features of COVID-19 disease, often leading to pulmonary thromboembolism and superimposed bronchopneumonia. The discussed data showed a strict relationship among the inflammatory processes, diffuse alveolar, and endothelial damage. In light of these results, the full autopsy can be considered as the gold standard to investigate unknown infections or pathogens resulting in death.
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Correlation between Blood and Oral Fluid Psychoactive Drug Concentrations and Cognitive Impairment in Driving under the Influence of Drugs
Anno: 2018
Rivista: CURRENT NEUROPHARMACOLOGY
Autori/autrici: Busardo, Francesco Paolo; Pichini, Simona; Pellegrini, Manuela; Montana, Angelo; Lo Faro, Alfredo Fabrizio; Zaami, Simona; Graziano, Silvia
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/310710
Citazioni:
Correlation between Blood and Oral Fluid Psychoactive Drug Concentrations and Cognitive Impairment in Driving under the Influence of Drugs / Busardo, F.P., Pichini, S., Pellegrini, M., Montana, A., Lo Faro, A.F., Zaami, S., Graziano, S.. - In: CURRENT NEUROPHARMACOLOGY. - ISSN 1570-159X. - 16:1(2018), pp. 84-96. [10.2174/1570159X15666170828162057]
Abstract:
Background: The effects of drugs on driving performance should be checked with drug concentration in the brain and at the same time with the evaluation of both the behavioural and neurophysiological effects. The best accessible indicator of this information is the concentration of the drug and/or me...tabolites in blood and, to a certain extent, oral fluid. We sought to review international studies on correlation between blood and oral fluid drug concentrations, neurological correlates and cognitive impairment in driving under the influence of drugs.Methods: Relevant scientific articles were identified from PubMed, Cochrane Central, Scopus, Web of Science, Science Direct, EMBASE up to April 2017.Results: Up to 2010, no epidemiological studies were available on this matter and International scientists suggested that even minimal amounts of parent drugs in blood and oral fluid could affect driving impairment. More recently, epidemiological data, systematic reviews and meta-analysis on drugged drivers allowed the suggestion of impairment concentration limits for the most common illicit drugs. These values were obtained comparing driving disability induced by psychotropic drugs with that of established blood alcohol limits. Differently from ethyl alcohol where both detection methods and concentration limits have been well established even with inhomogeneity of ranges within different countries, in case of drugs of abuse no official cut-offs have yet been established, nor any standardized analytical protocols.Conclusion: Multiple aspects of driving performance can be differently affected by illicit drugs, and even if for few of them some dose/concentration dependent impairment has been reported, a wider knowledge on concentration/impairment relationship is still missing.
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Correlation between blood and oral fluid psychoactive drug concentrations and cognitive impairment in driving under the influence of drugs
Anno: 2018
Rivista: CURRENT NEUROPHARMACOLOGY
Autori/autrici: Busardò, Francesco Paolo; Pichini, Simona; Pellegrini, Manuela; Faro, Alfredo Fabrizio Lo; Zaami, Simona; Graziano, Silvia; Montana, Angelo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/265666
Citazioni:
Correlation between blood and oral fluid psychoactive drug concentrations and cognitive impairment in driving under the influence of drugs / Busardò, F.P., Pichini, S., Pellegrini, M., Faro, A.F.L., Zaami, S., Graziano, S., Montana, A.. - In: CURRENT NEUROPHARMACOLOGY. - ISSN 1570-159X. - 16:1(2018), pp. 84-96. [10.2174/1570159X15666170828162057]

A fatal accidental subarachnoid injection of lidocaine and levobupivacaine during a lumbar paravertebral block
Anno: 2015
Rivista: FORENSIC SCIENCE INTERNATIONAL
Autori/autrici: Busardo', F; Tritapepe, L; Indorato, F; Zaami, S; Romano, G; Montana, A
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/265633
Citazioni:
A fatal accidental subarachnoid injection of lidocaine and levobupivacaine during a lumbar paravertebral block / Busardo', F., Tritapepe, L., Indorato, F., Zaami, S., Romano, G., Montana, A.. - In: FORENSIC SCIENCE INTERNATIONAL. - ISSN 0379-0738. - ELETTRONICO. - 256:(2015), pp. 17-20. [10.1016/j.forsciint.2015.07.017]

Assessment of the stability of exogenous gamma hydroxybutyric acid (GHB) in stored blood and urine specimens
Anno: 2015
Rivista: EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES
Autori/autrici: Busardo', F; Zaami, S; Baglio, G; Indorato, F; Montana, A; Giarratana, N; Kyriakou, C; Marinelli, E; Romano, G
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/265571
Citazioni:
Assessment of the stability of exogenous gamma hydroxybutyric acid (GHB) in stored blood and urine specimens / Busardo', F., Zaami, S., Baglio, G., Indorato, F., Montana, A., Giarratana, N., Kyriakou, C., Marinelli, E., Romano, G.. - In: EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES. - ISSN 2284-0729. - ELETTRONICO. - 19:21(2015), pp. 4187-4194.

Post mortem concentrations of endogenous gamma hydroxybutyric acid (GHB) and in vitro formation in stored blood and urine samples
Anno: 2014
Rivista: FORENSIC SCIENCE INTERNATIONAL
Autori/autrici: Busardo', F; Bertol, E; Vaiano, F; Baglio, G; Montana, A; Barbera, N; Zaami, S; Romano, G
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/265660
Citazioni:
Post mortem concentrations of endogenous gamma hydroxybutyric acid (GHB) and in vitro formation in stored blood and urine samples / Busardo', F., Bertol, E., Vaiano, F., Baglio, G., Montana, A., Barbera, N., Zaami, S., Romano, G.. - In: FORENSIC SCIENCE INTERNATIONAL. - ISSN 0379-0738. - STAMPA. - 243:(2014), pp. 144-148. [10.1016/j.forsciint.2014.07.019]