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Your search keyword '"Palazzo, Chiara"' showing total 11 results
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11 results on '"Palazzo, Chiara"'

8. An Explorative Study of CYP2D6's Polymorphism in a Sample of Chronic Pain Patients.

Author

Fanelli, Andrea, Palazzo, Chiara, Balzani, Eleonora, Iuvaro, Alessandra, Pelotti, Susi, and Melotti, Rita Maria

Subjects
*CHRONIC pain, *CLINICAL trials, *DNA, *GENETIC polymorphisms, *RESEARCH, *GENOTYPES, *CYTOCHROME P-450
Abstract

Background A proper antalgic treatment is based on the use of titrated drugs to provide adequate relief and a good tolerability profile. Therapies have a variable effectiveness among subjects depending on medical and genetic conditions. CYP2D6 variations determine a different clinical response to most analgesic drugs commonly used in daily clinical practice by influencing the drugs' pharmacokinetics. This study was a monocentric clinical trial exploring the CYP2D6 variants in 100 patients with a diagnosis of chronic pain. Methods DNA was extracted to evaluate the genotype and to classify patients as normal-fast (gNMs-F), normal-slow (gNMs-S), ultrarapid (gUMs), intermediate (gIMs), and poor metabolizers (gPMs) using the Activity Score (AS). Information on therapies and general side effects experienced by patients was collected. Nongenetic co-factors were evaluated to examine the discrepancy between metabolic profile predicted from genotype (gPh) and metabolic profile (phenocopying). Results The distribution of our data underlined the prevalence of the gNMs-F (67%), whereas gNMs-S were 24%, gIMs 6%, gPMs 3%, and no gUMs were found, resulting in 33% of patients with reduced metabolic activity. In the analyzed population sample, 86% and 56% of patients, respectively, took at least one or two drugs inhibiting in vitro activity of the CYP2D6 enzyme. Conclusions Over one-third of the enrolled patients showed altered CYP2D6 enzymatic metabolic activity, with a risk of phenocopying potentially due to polypharmacology. Trial registration ClinicalTrials.gov ID: NCT03411759. [ABSTRACT FROM AUTHOR]

Published
2020
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11. Possible fatal hyperthermia involving drug abuse in a vehicle: case series

Author

Jennifer P. Pascali, Susi Pelotti, Paolo Fais, Chiara Palazzo, Maria Carla Mazzotti, Guido Viel, Massimo Montisci, Giovanni Cecchetto, Fais, Paolo, Pascali, Jennifer Paola, Mazzotti, Maria Carla, Viel, Guido, Palazzo, Chiara, Cecchetto, Giovanni, Montisci, Massimo, and Pelotti, Susi

Subjects
Hyperthermia, Adult, Male, medicine.medical_specialty, Hot Temperature, Fever, Substance-Related Disorders, Crime Scene Investigation, Heat Stroke, Poison control, Autopsy, 01 natural sciences, Drug abuse, Pathology and Forensic Medicine, 03 medical and health sciences, Forensic Toxicology, 0302 clinical medicine, Adult vehicular hyperthermia, Injury prevention, medicine, Humans, 030216 legal & forensic medicine, Stroke, business.industry, 010401 analytical chemistry, Forensic toxicology, Humidity, Environmental Exposure, Middle Aged, medicine.disease, Substance-Related Disorder, 0104 chemical sciences, Substance abuse, Substance Abuse Detection, Post-mortem Biochemistry, Emergency medicine, Drug intoxication, business, Law, Automobiles, Human
Abstract

Major interplaying causes of heat stroke (HS) and fatal hyperthermia are climate, physical activity, artificial extreme ambient temperatures, confinement in a small compartment, and effects of drugs and chemicals, combined with predispositions and complications. A common and unfortunate cause of HS is vehicular hyperthermia (VH) death. Hyperthermia in a vehicle is a type of environmental thermal disorder, involving victim's susceptibility, confinement with restraint, and possible influences of drugs and poisons, including exhaust gas containing complex fumes, carbon dioxide and monoxide. Whereas VH typically occurs when babies or young children are being left unattended in parked vehicles in direct sunlight, it has been reported only anecdotally for adult subjects. Three cases of adult fatal VH will be herein presented. In each presented case the corpse was found enclosed in a vehicle on spring/summer days. During crime scene investigation (CSI) psychoactive substances were found near to the corpses leading to the suspect of a suicidal fatal drug intoxication. Basing on this misleading suspect in Case 2 and 3 a forensic expert was not charged for the CSI and a fatal VH was not suspected nor properly investigated. Later, a comprehensive autopsy, including biochemical and toxicological analyses, excluded a death related to natural causes, fatal intoxications, ketoacidosis and traumas. On the other hand, the reconstruction of the temperature, the humidity, the heat index and the related risk of HS allowed the diagnosis of fatal VH in all the reported cases. In particular, death occurred because of the long-lasting stay into a hot parked vehicle which was facilitated from self-administration of psychoactive drugs with related neuro-depression. This case series confirms that a comprehensive CSI followed by an autopsy including histology, biochemical and toxicological analysis remains mandatory in cases of forensic interest, as well as when a corpse is found enclosed in a vehicle. Anyway, sometimes the diagnosis of heat-related fatalities remains a medley of investigative and medicolegal observations.

Published
2018

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