Asunto(s)
Enfermedades Gastrointestinales/tratamiento farmacológico , Fallo Hepático Agudo/inducido químicamente , Trasplante de Hígado , Extractos Vegetales/efectos adversos , Acetilcisteína/uso terapéutico , Antiinflamatorios no Esteroideos/efectos adversos , Antiinflamatorios no Esteroideos/farmacología , Causalidad , Dipirona/efectos adversos , Dipirona/farmacología , Resultado Fatal , Femenino , Depuradores de Radicales Libres/uso terapéutico , Glucocorticoides/uso terapéutico , Hepatocitos/efectos de los fármacos , Humanos , Técnicas In Vitro , Fallo Hepático Agudo/terapia , Persona de Mediana Edad , Monocitos/efectos de los fármacos , Extractos Vegetales/farmacología , Prednisolona/uso terapéuticoRESUMEN
INTRODUCTION: Heat shock protein 70 (HSP70) expression could be discussed as an adaption that promotes repair and counteracts cell damage. Myoglobin is released upon muscle damage of several pathways. The purpose of the present study was to determine whether the expression of HSP70 in kidney, heart and brain and of myoglobin in the kidney were associated with the cause of death and the survival times after lethal intoxications with three of the drugs most widely used in our local area (Saxony, Germany) as well as after fatal traumatic brain injury (TBI). METHODS: We retrospectively collected kidney, heart and brain samples of 50 autopsy cases with toxicological proved lethal intoxication (main drugs methamphetamine, morphine, alcohol), 14 TBI cases and 15 fatalities with acute myocardial injury in age- and gender-matched compilations. RESULTS: Our main findings suggest that HSP70 is associated with hyperthermal and other stress factors of most cell populations. HSP70 expressions in kidney and heart muscle are useful for a differentiation between fatal intoxications and cases without toxicological influence (p < 0.05). There were significant differences in the cerebral expression patterns between methamphetamine- and morphine-associated deaths compared to alcohol fatalities (p < 0.05). An intensive staining of HSP70 in the pericontusional zone and the hippocampus after TBI (especially neuronal and vascular) was shown even after short survival times and may be useful as an additional marker in questions of vitality or wound age. A relevant myoglobin decoration of renal tubules was only shown for methamphetamine abuse in the study presented. CONCLUSION: In sum, the immunohistochemical characteristics presented can be supportive for determining final death circumstances and minimal trauma survival times but are not isolated usefully for the detection of drug- or trauma-induced hyperthermia.
Asunto(s)
Lesiones Traumáticas del Encéfalo/patología , Fiebre/patología , Proteínas HSP70 de Choque Térmico/metabolismo , Lesiones Cardíacas/patología , Mioglobina/metabolismo , Trastornos Relacionados con Sustancias/patología , Adulto , Anciano , Anciano de 80 o más Años , Autopsia , Biomarcadores/metabolismo , Encéfalo/patología , Lesiones Traumáticas del Encéfalo/complicaciones , Lesiones Traumáticas del Encéfalo/mortalidad , Etanol/toxicidad , Femenino , Fiebre/etiología , Alemania , Lesiones Cardíacas/complicaciones , Lesiones Cardíacas/mortalidad , Humanos , Inmunohistoquímica , Riñón/patología , Masculino , Metanfetamina/toxicidad , Persona de Mediana Edad , Morfina/toxicidad , Miocardio/patología , Estudios Retrospectivos , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/mortalidad , Adulto JovenRESUMEN
The authors describe the evaluation of an automated rapid emergency drug profiling system (REMEDi HS), which is designed for clinical toxicology and therapeutic drug monitoring, in a severe case of dimethoate poisoning. Successful qualitative and quantitative determination of dimethoate in diluted serum samples was achieved. The authors found that dimethoate serum concentrations were properly measured with the REMEDi method and well correlated with gas chromatography-mass spectrometry. The results provide evidence that besides screening and rapid estimation of drug concentrations in human fluids, this system is a suitable tool in cases of symptomatic dimethoate poisoning.