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Intensity of Psychoactive Substance Use Affects the Occurrence of Prodromal Symptoms of Psychosis

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This synthetic cathinone is classified as a forbidden substance in Poland. This substance takes mainly the form of powder and crystals 5. Witnesses called an ambulance, but after a resuscitative action, the doctor declared the man dead. The man was addicted to drugs. The autopsy revealed cerebral edema and congestion, subconjunctival and subpleural petechial hemorrhages, pulmonary edema and congestion, low-grade atherosclerosis, liver enlargement, traces of rescue operations, fluidity and stagnation of blood in internal organs. The histological examination showed high-grade cerebral edema, brainstem edema, cerebellar edema and hyperemia, diffuse cardiac scarring, recent ischemic foci of myocardial fibers, cardiomyocyte hypertrophy, focal pulmonary edema and hyperemia, nodular goiter, hyperemia and chronic interstitial nephritis, chronic non-specific portal space inflammation in the liver, splenic congestion, pancreatic autolysis and fibrosis, increased congestion and colitis, erosive hemorrhagic gastritis and adrenal congestion. For toxicological analysis, samples of blood collected from the heart, femoral vein and dural venous sinuses , vitreous humor, cerebrospinal fluid, cerebral cortex, brainstem, cerebellum, bile, liver, kidney, heart, pancreas, spleen, thyroid, lung, adipose tissue, stomach and intestine were collected during the autopsy. Mephedrone-d 3 at a concentration of 0. All the remaining reagents used in the analyses were of high purity grade high-performance liquid chromatography HPLC and mass spectrometry grade. Together with the analyzed samples, calibration samples were prepared. Calibration samples were obtained through the addition of the appropriate volumes of the working solutions to 0. The liquid—liquid extraction procedure was used to prepare biological samples. Then, to each sample, 2. The dry residues were dissolved in 0. The extraction procedure was the same as described earlier. This diluted sample extract was transferred to the glass insert and vial and then analyzed using gas chromatography—mass spectrometry GC—MS. The mobile phase was composed of Solvent A 0. The flow rate was 0. Samples were ionized in the ESI mode with positive ionization. Tandem MS conditions are presented in Table I. The obtained mass spectra in the positive electron impact ionization EI mode were compared with the spectra from the Cayman Chemical EI mass spectra library Cayman Chemical. The results obtained were processed with the use of the Xcalibur v. This transformation is a well-known feature of the cathinones. We expected a similar instrument response for drug and metabolite because of the similar chemical structure of both compounds. However, this is a significant limitation of this study, so the metabolite concentrations should be interpreted cautiously. Lidocaine was also detected in some materials. The analyses did not reveal any alcohol, classic drugs and other NPSs. New redistribution assessment coefficients are being sought. In previously published studies, the distribution of other cathinone derivatives in vitreous humor relative to the blood has been highly variable The parent drug-to-metabolite ratio has been calculated for all the fluids and tissues. However, the concentrations in the liver were significantly higher than in the adipose tissue. The detection of relevant metabolites in addition to the parent drug may be useful for other researchers and scientists working in the field of clinical and forensic toxicology. The presented case also shows that the evaluation of toxicological results along with histopathological alterations and circumstantial information is fundamental in determining the correct cause of death. Supplementary data are available at Journal of Analytical Toxicology online. This article does not contain any studies with human participants or animals performed by any of the authors. Polish Sanitary Inspector Warning. Adamowicz P. Legal Medicine , 42 , Google Scholar. Zawadzki M. Journal of Forensic and Legal Medicine , 85 , Kemenes K. Journal of Analytical Toxicology , 47 , — Matsuta S. Forensic Toxicology , 36 , — Paul M. Journal of Mass Spectrometry , 50 , — McIntyre I. Forensic Sciences Research , 1 , 33 — Journal of Analytical Toxicology , 27 , — Glicksberg L. Simmler L. British Journal of Pharmacology , , — Fujita Y. Journal of Analytical Toxicology , 42 , e1 — e5. Zaitsu K. Forensic Toxicology , 32 , 1 — 8. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign in through your institution. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Case History. Supplementary data. Data availability. Ethical approval. Author contributions. Journal Article. Paulina Wachholz , Paulina Wachholz. Email: d Oxford Academic. Toxicology Laboratory ToxLab. Natalia Pawlas. Revision received:. Editorial decision:. Corrected and typeset:. Select Format Select format. Permissions Icon Permissions. Table I. Open in new tab. Retention time min. Collision energy v. Figure 1. Open in new tab Download slide. Figure 2. Table II. Femoral blood 2, Figure 3. Google Scholar Crossref. Search ADS. Published by Oxford University Press. Issue Section:. Download all slides. Views 3, More metrics information. Total Views 3, Email alerts Article activity alert. Advance article alerts. New issue alert. Receive exclusive offers and updates from Oxford Academic. Citing articles via Web of Science 3. The rise of bromazolam in postmortem cases from Travis County, TX, and surrounding areas: to More from Oxford Academic. Biological Sciences. Clinical Medicine. Medical Toxicology. Medicine and Health. Science and Mathematics. Toxicology Non-medical. Authoring Open access Purchasing Institutional account management Rights and permissions. Get help with access Accessibility Contact us Advertising Media enquiries.

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