IVAN DIEB MIZIARA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de MedicinaLegal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina - Docente
LIM/40 - Laboratório de Imunohematologia e Hematologia Forense, Hospital das Clínicas, Faculdade de Medicina
LIM/40 - Laboratório de Imunohematologia e Hematologia Forense, Hospital das Clínicas, Faculdade de Medicina
7 resultados
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- Determination of cocaine and its derivatives in hair samples by liquid phase microextraction (LPME) and gas chromatography-mass spectrometry (GC-MS)(2017) PEGO, A. M. F.; ROVERI, F. L.; KUNINARI, R. Y.; LEYTON, V.; MIZIARA, I. D.; YONAMINE, M.Hair testing is a recognized approach when it comes to accessing historical drug use. According to the World Drug Report of United Nations Office on Drugs and Crime (UNODC) 2015, Brazil is the largest cocaine (COC) market in South America. New analytical methodologies to detect crack/cocaine analytes in hair samples are highly desirable. Here, a method consisting of a liquid-phase microextraction (LPME) as a clean-up step, followed by gas chromatography-mass spectrometry (GC-MS) analysis has been proposed. The new validated method consisted of a washing step; an overnight incubation with methanol and a quick derivatization with butylchloroformate. Once derivatized, the samples were then submitted to the LPME procedure. Limits of detection (LoD) and quantitation (LoQ) obtained were of 0.1 and 0.5 ng/ mg for COC 0.4 and 0.5 ng/mg for anhydroecgonine methyl ester (AEME); 0.03 and 0.05 for cocaethylene (CE), respectively and 0.05 ng/mg for both LoD and LoQ for benzoylecgonine (BZE). All calibration curves were linear over the scope applied, from LoQ up to 20 ng/mg, with a r(2) > 0.99. Precision and accuracy assays showed acceptable % RSD values, according to international guidelines. Twelve postmortem head hair samples stemming from the Institute of Legal Medicine of Sao Paulo (IML-SP) have been analyzed, from which seven have shown to be positive for COC (0.75-> 20 ng/mg) and BZE (0.1-> 20 ng/mg). Apart from COC's main metabolite, four samples were also positive for CE (0.1-3.9 ng/mg) and three samples for AEME (0.5-4.9 ng/mg). To conclude, the LPME technique together with GC-MS analysis have shown promising results and were able to meet the demand of the laboratory of analyzing postmortem hair samples to look for all four analytes.
- Alcohol use among fatally injured victims in SAo Paulo, Brazil: bridging the gap between research and health services in developing countries(2017) ANDREUCCETTI, Gabriel; LEYTON, Vilma; LEMOS, Nikolas P.; MIZIARA, Ivan Dieb; YE, Yu; TAKITANE, Juliana; MUNOZ, Daniel Romero; REINGOLD, Arthur L.; CHERPITEL, Cheryl J.; CARVALHO, Heraclito Barbosa deBackground and aimsMost studies reporting alcohol use among fatally injured victims are subject to bias, particularly those related to sample selection and to absence of injury context data. We developed a research method to estimate the prevalence of alcohol consumption and test correlates of alcohol use prior to fatal injuries. Design, Setting and ParticipantsCross-sectional study based on a probability sample of fatally injured adult victims (n=365) autopsied in SAo Paulo, Brazil. Victims were sampled within systematically selected 8-hour sampling blocks, generating a representative sample of fatal injuries occurring during all hours of the day for each day of the week between June 2014 and December 2015. MeasurementsThe presence of alcohol and blood alcohol concentration (BAC) were the primary outcomes evaluated according to victims' socio-demographic, injury context data (type, day, time and injury place) and criminal history characteristics. FindingsAlcohol was detected in 30.1% [95% confidence interval (CI)=25.6-35.1)] of the victims, with a mean blood alcohol level (BAC) level of 0.11%w/v (95% CI=0.09-0.13) among alcohol-positive cases. Black and mixed race victims presented a higher mean BAC than white victims (P=0.03). Fewer than one in every six suicides tested positive for alcohol, while almost half of traffic-related casualties were alcohol-positive. Having suffered traffic-related injuries, particularly those involving vehicle crashes, and injuries occurring during weekends and at night were associated significantly with alcohol use before injury (P<0.05). ConclusionsNearly one-third of fatal injuries in SAo Paulo between June 2014 and December 2015 were alcohol-related, with traffic accidents showing a greater association with alcohol use than other injuries. The sampling methodology tested here, including the possibility of adding injury context data to improve population-based estimates of alcohol use before fatal injury, appears to be a reliable and lower-cost strategy for avoiding biases common in death investigations.
- Cocaine toxicological findings in cases of violent death in Sao Paulo city - Brazil(2018) PEGO, Ana Miguel Fonseca; OLIVEIRA, Sarah Carobini Werner de Souza Eller Franco de; OLIVEIRA, Tiago Franco de; LEYTON, Vilma; MIZIARA, Ivan; YONAMINE, MauricioViolence is a dreadful phenomenon spread throughout the world, resulting in unfortunate events that can ultimately cause death. It is known that some countries play a much worrying role in this scenario than others. Brazil is one of them. The present work has focused on identifying the use of cocaine in 105 postmortem cases arriving at the Institute of Legal Medicine of Sao Paulo (IML-SP), the largest Brazilian city. Both blood and hair samples have been analyzed through ultra-performance liquid chromatography coupled to electrospray ionization tandem mass spectrometry (UPLC-ESI-MS/MS) in order to distinguish between recent or chronic cocaine use. The purpose of this work was to evaluate the proportion of cocaine use amongst violent individuals whose violence has ultimately led to their death. In order to do so, two previous methods, validated in-house, based on methanolic extraction for hair and protein precipitation for blood, have been used for this purpose and the final residue was analyzed through UPLC-ESI-MS/MS system. When looking at the demographics from the 105 postmortem cases analyzed, the results have shown the most critical age range to be between 18 and 25 years old and the least frequent between 37 and 45 years old. Gender wise, a rather extreme difference was found as 97 of the individuals were men and finally, considering the manner of death, the four-category criteria established appear to be fairly similar with 34 cases related to general violence and risk behavior, 26 to drug abuse suspicion, 23 to homicide resulting from opposition to police intervention and 22 to possible suicide.
- Introducing a new research method for evaluating alcohol and other drug use among fatally injured victims in Latin America(2017) ANDREUCCETTI, Gabriel; LEYTON, Vilma; MIZIARA, Ivan Dieb; LEMOS, Nikolas P.; MUNOZ, Daniel Romero; CHERPITEL, Cheryl J.; CARVALHO, Heraclito Barbosa
- SNPs from BCHE and DRD3 genes associated to cocaine abuse amongst violent individuals from Sao Paulo, Brazil(2020) PEGO, A.M.F.; LEYTON, V.; MIZIARA, I.D.; BORTOLIN, R.H.; FREITAS, R.C.C.; HIRATA, M.; TOMAZ, P.R.X.; SANTOS, J.R.; SANTOS, P.C.J.L.; YONAMINE, M.Violence and drug abuse are highly destructive phenomena found world-wide, especially in Brazil. They seem to rise proportionally to one another and possibly related. Additionally, genetics may also play a role in drug abuse. This study has focused on identifying the use of cocaine within postmortem cases arriving at the Institute of Legal Medicine of Sao Paulo as well as the presence of certain single nucleotide polymorphisms (SNPs) to better understand one's susceptibility to abuse the drug. Both hair and blood samples have been extracted through a simple methanol overnight incubation or a rapid dilute-and-shoot method, respectively. The samples were then analyzed using an UPLC-ESI-MS/MS and genotyped through RT-PCR. Statistical analyses were performed via SPSS software. From 105 postmortem cases, 53% and 51% of the cases shown to be positive for cocaine in hair and blood, respectively. Genetic wise, a significant difference has been observed for SNP rs4263329 from the BCHE gene with higher frequencies of the genotypes A/G and G/G seen in cocaine users (OR = 8.91; 95%CI = 1.58–50.21; p = 0.01). Likewise, also SNP rs6280 from the DRD3 gene presented a significant association, with both genotypes T/C and C/C being more frequent in users (OR = 4.96; 95% CI = 1.07–23.02; p = 0.04). To conclude, a rather high proportion of cocaine has been found, which may suggest a connotation between the use of the drug and risky/violent behaviors. Additionally, significant associations were also found within two SNPs related to cocaine use, however, due to several inherent limitations, these must be confirmed. © 2020 Elsevier B.V.
- Alcohol use among fatally injured victims in Sao Paulo, Brazil: bridging the gap between research and health services in developing countries (vol 112, pg 596, 2017)(2017) ANDREUCCETTI, Gabriel; LEYTON, Vilma; LEMOS, Nikolas P.; MIZIARA, Ivan Dieb; YE, Yu; TAKITANE, Juliana; MUNOZ, Daniel Romero; REINGOLD, Arthur L.; CHERPITEL, Cheryl J.; CARVALHO, Heraclito Barbosa de
- Alcohol in combination with illicit drugs among fatal injuries in Sao Paulo, Brazil: An epidemiological study on the association between acute substance use and injury(2018) ANDREUCCETTI, G.; CHERPITEL, C. J.; CARVALHO, H. B.; LEYTON, V; MIZIARA, I. D.; MUNOZ, D. R.; REINGOLD, A. L.; LEMOS, N. P.Injury deaths have a major impact on public health systems, particularly in the Latin American region; however, little is known about how different drugs, in combination or not with alcohol, interact with each injury type. We tested an epidemiological protocol for investigating alcohol and other drug acute use among fatally injured victims taking into account the injury context for all injury causes in Sao Paulo, Brazil. Blood alcohol and drug content were fully screened and confirmed following a probability sample selection of decedents (n = 365) during 19 consecutive months (2014-2015). Drug concentrations, including benzodiazepines, cannabis, cocaine, and opioids were determined by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography tandem mass spectrometry (LC-MS/MS). Toxicology data were interpreted in combination with injury context retrieved from police records regarding cause, place of injury, and victims' criminal history. More than half of all fatally injured victims studied were under the influence of at least one substance (55.3%). Alcohol was the leading substance consumed before a fatal injury event (30.1%), followed by cocaine (21.9%) and cannabis (14%). Illicit drug use (cocaine and cannabis) comprised more than two thirds of all drug-related deaths. Alcohol-positive deaths are over-represented among road traffic injuries, while drug-positive deaths are more prevalent among intentional injuries. Victims who had previous criminal convictions were significantly more likely to have used illicit drugs compared to those who did not have a criminal background. We estimated that one in every two fatal injuries in the city of Sao Paulo is associated with acute substance use by the victim. The health burden attributed to alcohol- and drug-related fatal injury events has reached significant higher levels in Latin American cities such as Sao Paulo compared globally.