Isabella Mercurio

Drugs and psychoactive substances in the Tiber River

Wastewater analysis is a direct and objective method used to measure human consumption of illicit drugs. In the last few years these have become a new class of environmental contaminants. The aim of our study was the identification of drugs in Tiber River waters. We collected 20 water samples from May to June 2012, at six points of the river: at the source, near Perugia, near Rome and at the mouth. Samples were analysed using gas chromatography with a mass detector. Basic analytes were extracted using the method of Varian Certify. For acidic analytes we proceed to direct extraction using organic solvents. The most detected drug was ecstasy. We also identified traces of methadone, morphine, heroine, methylamphetamine and tetrahydrocannabinol (THC). The highest concentration of cocaine was found near Perugia with a peak in the weekend (4744 ng/ml). Psychoactive substances had constant concentrations in the week. Ecstasy (MDMA) was the most detected drug. The most interesting finding was the increased concentration of cocaine and heroin in waters near Perugia showing the alarming phenomenon of weekend use of these substances.

A 10 year post-mortem analysis of keratin matrix in Perugia (Italy): focus on cocaine involvement in several types of death

Abstract The use of keratin matrix, in detecting drug consumption, offers compelling advantages compared to other conventional biological matrices used for these types of investigation, and provides important information to surveys which are characterised by a general underestimation, especially in Italy. In our study we collected and analysed 424 hair samples from corpses autopsied in Perugia from January 2001 to December 2011 in order to detect traces of drugs and especially of cocaine, and evaluate their involvement in several types of death. Hair samples were analysed by gas chromatography–mass spectrometry in the Laboratory of Forensic Toxicology of the Department of Legal Medicine of the University of Perugia: 232 samples derived from cases of overdose deaths; 192 were connected to different causes of death. The average concentration of cocaine in the keratin matrix samples was of 3.74 ng/mg in people who died from overdose, 3.09 ng/mg in people who died from other causes. In 232 cases of overdose deaths, 135 were positive for cocaine (accounting for 58.18% of total); in 192 deaths from other causes, 39 were positive for cocaine (accounting for 20.31% of the total). Our study demonstrated the crucial role of cocaine in overdose deaths and in other deaths, as is well known in other research.

Hair testing for cocaine in living men: an epidemiological study on hair samples collected for various medico-legal purposes

Abstract The collection and analysis of hair samples offers higher chances of identifying people addicted to drugs than urine samples. In our study we propose hair analysis as a useful epidemiological indicator to identify the extent of cocaine use in different medico-legal situations: currently the epidemiological trends of substance abuse are estimated indirectly, mainly through large-scale surveys or through medical and crime statistics that may be too generic. We conducted a cross-sectional study, analysing hair samples, collected for various medico-legal purposes, from living men belonging to different categories, in order to complete a previous study conducted in 2016. Of 104 samples collected for different purposes, 55 were positive for drugs (52.88% of total) and, in this group, positivity for cocaine was found in 28 cases (26.92% of total), with a mean concentration of 4.58 ng/mg of hair, and a mean concentration of 0.75 ng/mg of hair of its major metabolite (benzoylecgonine). This datum is in line with the Italian Superior Health Institute reports, which declared a reduction in the use of cannabis and benzodiazepines, but a notable increase in cocaine use. Despite its limitations, this study adds further information to the previous one conducted in the same context, and furnishes an interesting picture of the phenomenon of cocaine addiction in Italy.

Serum tryptase, Immunoglobuline E assay and circumstantial data are fundamental tools for the post-mortem diagnosis of food anaphylaxis: a case report and literature review

Introduction. The most recent literature suggests that postmortem diagnosis of anaphylaxis remains a significant challenge for pathologists. Even with autopsy examination, the diagnosis of anaphylactic shock is difficult due to the complexity of the pathogenetic factors and the lack of pathognomonic data. Case presentation. The authors present a case of death for anaphylactic shock after food ingestion. Laboratory examinations carried out on blood taken from femoral arteries, approximately 5 hours after death, showed a value of 120 ng/ L of tryptase (n.v. <11.4 ng/ L) . Examination aimed at detecting IgE confirmed the existence of milk proteins allergy. Autopsy findings were suggestive of sudden death of cardiovascular origin, characterized by multi-organ congestion, petechiae and tracheal and bronchial foam. Conclusions. The combination of autopsy findings with serum tryptase and immunoglobuline E assay, histological preparations and anamnestic-circumstantial data provided the necessary elements for the postmortem diagnosis of anaphylactic shock caused by milk proteins ingestion.

Caravaggio’s Judith and Holofernes: a forensic approach

Sir, Michelangelo Merisi was born in September 1571 in Caravaggio, near Milan and was always known by the name of his hometown. Caravaggio moved to Rome in the early 1590s. His paintings were characterized by their extreme realism and dramatic contrasts of light and shade. Several works were realized as religious works commissioned by important exponents of clergy (BBC, 2017). In this group of works should be included the two paintings about Judith and Holofernes, adapted from the Book of Judith. The Book of Judith is one of the three books in the Septuagint, and later Bibles, named for a woman: Judith, Esther, and Ruth. There is also one story named for a woman, the Story of Susanna, found in an addition to the Book of Daniel. Of the four women – Esther, Ruth, Susanna, and Judith – Judith is by far the most autonomous, politically engaged, and spiritually accomplished (Kevin et al., 2010). The Book of Judith is the story of a Jewish heroine living during the period of the Second Temple when the Jewish community had returned from the Babylonian captivity and reestablished temple worship in Jerusalem. The story is famous for Judith’s pursuit and beheading of the King’s general, Holofernes (Kevin et al., 2010). In 1599 Caravaggio painted the first “Judith Beheading Holofernes” (Fig. 1), an impressive canvas that tells the Biblical story of Judith, who saved her people by seducing and beheading the Assyrian general Holofernes, which was a common theme in the 16th century (Carvaggio.org, 2017).

Suicide by a rifle with a muzzle brake: a particular entrance wound

Abstract The authors describe a case in which a 21-year-old male committed suicide using a rifle equipped with a muzzle brake, placed in contact with his head. A muzzle brake for firearms is a device positioned at the mouth of a weapon, which dissipates the gases, that are generated subsequent to the gun being discharged. Generally, when a gun is pressed against an anatomical region, where the skin lies on the bone surface without interposition of other soft parts, the entrance wound consists of many lacerated branches, originating from a central lack of tissue. In this case report, the use of a rifle with a muzzle brake generated an unexpected wound, circular in shape, with a diameter of 0.8 cm. This lesion was surrounded by a bruised area, circular in shape, and an abrasion collar of the height of 0.5 cm. In addition, a muzzle imprint mark consisting of intradermal bruises, composed of a narrow red line concentrically encircling the entrance hole, was found. In order to analyze in detail if this particular entrance wound could be associated with a weapon equipped with the muzzle brake, ballistic tests – with weapons compatible with that used by the victim – were performed.