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Mario Thevis - One of the best experts on this subject based on the ideXlab platform.
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post mortem vitreous humour as potential specimen for detection of Insulin analogues by lc ms ms
Forensic Science International, 2013Co-Authors: Ilkka Ojanpera, Larisa Vinogradova, Antti Sajantila, Andreas Thomas, Wilhelm Schanzer, Mario ThevisAbstract:A B S T R A C T Differentiation of Insulin analogues is required in forensic and clinical toxicology as well as in sports doping control. Immunoassay results provide only weak evidence for exogenous administration of Insulin, as concentrations cannot be reliably interpreted and specific information on the Insulin species remains unknown. In post-mortem blood, Insulin degrades rapidly. In this study, improved methodology consisting of precipitation of proteins, immunoaffinity purification and liquid chromatography coupled to high resolution/high accuracy mass spectrometry were applied to post-mortem vitreous humour. Ten successive cases with a post-mortem interval from four to ten days were investigated for Insulin analogues. The cause of death in these cases was connected with diabetes and its complications, as well as with chronic cardiovascular disease, alcoholism and cancer. In all cases, the manner of death was natural (disease). Insulin was positively detected in post-mortem vitreous humour in three cases out of ten by mass spectrometry. In two cases, the method revealed the long-acting Insulin glargine (Lantus) metabolite M2 (DesB31-32 Lantus), and human Insulin was detected in one case. The findings were in agreement with the documented history of Insulin Medication. No other obvious reason could be found for the failure of detecting Insulins in the other cases than Insulin degradation during the lengthy postmortem interval. Vitreous humour is still a most prospective specimen for detection of Insulin analogues post-mortem.
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Post-mortem vitreous humour as potential specimen for detection of Insulin analogues by LC-MS/MS.
Forensic science international, 2013Co-Authors: Ilkka Ojanpera, Larisa Vinogradova, Antti Sajantila, Andreas Thomas, Wilhelm Schanzer, Mario ThevisAbstract:Differentiation of Insulin analogues is required in forensic and clinical toxicology as well as in sports doping control. Immunoassay results provide only weak evidence for exogenous administration of Insulin, as concentrations cannot be reliably interpreted and specific information on the Insulin species remains unknown. In post-mortem blood, Insulin degrades rapidly. In this study, improved methodology consisting of precipitation of proteins, immunoaffinity purification and liquid chromatography coupled to high resolution/high accuracy mass spectrometry were applied to post-mortem vitreous humour. Ten successive cases with a post-mortem interval from four to ten days were investigated for Insulin analogues. The cause of death in these cases was connected with diabetes and its complications, as well as with chronic cardiovascular disease, alcoholism and cancer. In all cases, the manner of death was natural (disease). Insulin was positively detected in post-mortem vitreous humour in three cases out of ten by mass spectrometry. In two cases, the method revealed the long-acting Insulin glargine (Lantus) metabolite M2 (DesB31-32 Lantus), and human Insulin was detected in one case. The findings were in agreement with the documented history of Insulin Medication. No other obvious reason could be found for the failure of detecting Insulins in the other cases than Insulin degradation during the lengthy post-mortem interval. Vitreous humour is still a most prospective specimen for detection of Insulin analogues post-mortem.
Antti Sajantila - One of the best experts on this subject based on the ideXlab platform.
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post mortem vitreous humour as potential specimen for detection of Insulin analogues by lc ms ms
Forensic Science International, 2013Co-Authors: Ilkka Ojanpera, Larisa Vinogradova, Antti Sajantila, Andreas Thomas, Wilhelm Schanzer, Mario ThevisAbstract:A B S T R A C T Differentiation of Insulin analogues is required in forensic and clinical toxicology as well as in sports doping control. Immunoassay results provide only weak evidence for exogenous administration of Insulin, as concentrations cannot be reliably interpreted and specific information on the Insulin species remains unknown. In post-mortem blood, Insulin degrades rapidly. In this study, improved methodology consisting of precipitation of proteins, immunoaffinity purification and liquid chromatography coupled to high resolution/high accuracy mass spectrometry were applied to post-mortem vitreous humour. Ten successive cases with a post-mortem interval from four to ten days were investigated for Insulin analogues. The cause of death in these cases was connected with diabetes and its complications, as well as with chronic cardiovascular disease, alcoholism and cancer. In all cases, the manner of death was natural (disease). Insulin was positively detected in post-mortem vitreous humour in three cases out of ten by mass spectrometry. In two cases, the method revealed the long-acting Insulin glargine (Lantus) metabolite M2 (DesB31-32 Lantus), and human Insulin was detected in one case. The findings were in agreement with the documented history of Insulin Medication. No other obvious reason could be found for the failure of detecting Insulins in the other cases than Insulin degradation during the lengthy postmortem interval. Vitreous humour is still a most prospective specimen for detection of Insulin analogues post-mortem.
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Post-mortem vitreous humour as potential specimen for detection of Insulin analogues by LC-MS/MS.
Forensic science international, 2013Co-Authors: Ilkka Ojanpera, Larisa Vinogradova, Antti Sajantila, Andreas Thomas, Wilhelm Schanzer, Mario ThevisAbstract:Differentiation of Insulin analogues is required in forensic and clinical toxicology as well as in sports doping control. Immunoassay results provide only weak evidence for exogenous administration of Insulin, as concentrations cannot be reliably interpreted and specific information on the Insulin species remains unknown. In post-mortem blood, Insulin degrades rapidly. In this study, improved methodology consisting of precipitation of proteins, immunoaffinity purification and liquid chromatography coupled to high resolution/high accuracy mass spectrometry were applied to post-mortem vitreous humour. Ten successive cases with a post-mortem interval from four to ten days were investigated for Insulin analogues. The cause of death in these cases was connected with diabetes and its complications, as well as with chronic cardiovascular disease, alcoholism and cancer. In all cases, the manner of death was natural (disease). Insulin was positively detected in post-mortem vitreous humour in three cases out of ten by mass spectrometry. In two cases, the method revealed the long-acting Insulin glargine (Lantus) metabolite M2 (DesB31-32 Lantus), and human Insulin was detected in one case. The findings were in agreement with the documented history of Insulin Medication. No other obvious reason could be found for the failure of detecting Insulins in the other cases than Insulin degradation during the lengthy post-mortem interval. Vitreous humour is still a most prospective specimen for detection of Insulin analogues post-mortem.
Ilkka Ojanpera - One of the best experts on this subject based on the ideXlab platform.
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post mortem vitreous humour as potential specimen for detection of Insulin analogues by lc ms ms
Forensic Science International, 2013Co-Authors: Ilkka Ojanpera, Larisa Vinogradova, Antti Sajantila, Andreas Thomas, Wilhelm Schanzer, Mario ThevisAbstract:A B S T R A C T Differentiation of Insulin analogues is required in forensic and clinical toxicology as well as in sports doping control. Immunoassay results provide only weak evidence for exogenous administration of Insulin, as concentrations cannot be reliably interpreted and specific information on the Insulin species remains unknown. In post-mortem blood, Insulin degrades rapidly. In this study, improved methodology consisting of precipitation of proteins, immunoaffinity purification and liquid chromatography coupled to high resolution/high accuracy mass spectrometry were applied to post-mortem vitreous humour. Ten successive cases with a post-mortem interval from four to ten days were investigated for Insulin analogues. The cause of death in these cases was connected with diabetes and its complications, as well as with chronic cardiovascular disease, alcoholism and cancer. In all cases, the manner of death was natural (disease). Insulin was positively detected in post-mortem vitreous humour in three cases out of ten by mass spectrometry. In two cases, the method revealed the long-acting Insulin glargine (Lantus) metabolite M2 (DesB31-32 Lantus), and human Insulin was detected in one case. The findings were in agreement with the documented history of Insulin Medication. No other obvious reason could be found for the failure of detecting Insulins in the other cases than Insulin degradation during the lengthy postmortem interval. Vitreous humour is still a most prospective specimen for detection of Insulin analogues post-mortem.
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Post-mortem vitreous humour as potential specimen for detection of Insulin analogues by LC-MS/MS.
Forensic science international, 2013Co-Authors: Ilkka Ojanpera, Larisa Vinogradova, Antti Sajantila, Andreas Thomas, Wilhelm Schanzer, Mario ThevisAbstract:Differentiation of Insulin analogues is required in forensic and clinical toxicology as well as in sports doping control. Immunoassay results provide only weak evidence for exogenous administration of Insulin, as concentrations cannot be reliably interpreted and specific information on the Insulin species remains unknown. In post-mortem blood, Insulin degrades rapidly. In this study, improved methodology consisting of precipitation of proteins, immunoaffinity purification and liquid chromatography coupled to high resolution/high accuracy mass spectrometry were applied to post-mortem vitreous humour. Ten successive cases with a post-mortem interval from four to ten days were investigated for Insulin analogues. The cause of death in these cases was connected with diabetes and its complications, as well as with chronic cardiovascular disease, alcoholism and cancer. In all cases, the manner of death was natural (disease). Insulin was positively detected in post-mortem vitreous humour in three cases out of ten by mass spectrometry. In two cases, the method revealed the long-acting Insulin glargine (Lantus) metabolite M2 (DesB31-32 Lantus), and human Insulin was detected in one case. The findings were in agreement with the documented history of Insulin Medication. No other obvious reason could be found for the failure of detecting Insulins in the other cases than Insulin degradation during the lengthy post-mortem interval. Vitreous humour is still a most prospective specimen for detection of Insulin analogues post-mortem.
Daniel B Hawcutt - One of the best experts on this subject based on the ideXlab platform.
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p44 type 2 diabetes mellitus in children non Insulin Medication where are we up to
Archives of Disease in Childhood, 2019Co-Authors: R Austin, P Paul, Daniel B HawcuttAbstract:Background Childhood type 2 diabetes mellitus (T2DM) is a relatively rare condition but is an important health concern as its prevalence continues to rise. Current management consists of lifestyle modification, metformin and Insulin. Several new pharmacological classes are currently used in adult medicine but are not yet available in paediatric care. In this review we will look at the current evidence for use of these newer Medications in the paediatric population. Methods A literature search (EMBASE, Medline, Pubmed, CINHAL) was performed for papers studying the use of non-Insulin Medications in children; including a separate search of ´clinicaltrials.gov´ to identify any ongoing trials in paediatric T2DM. Results Newer classes of Medications include incretin mimetics, dipeptidyl peptidase-4-inhibitors, sodium/glucose-cotransporter-2-inhibitors, and thiazolidinediones. There have been a small number of pharmacokinetic/pharmacodynamic studies carried out in small cohorts of paediatric participants, but larger long-term efficacy and safety trials are lacking. These studies and individual case-reports have shown good tolerability but are unable to identify any long-term effects associated with these Medications. Randomised controlled trials studying rosiglitazone and glimepiride use in children have been performed. However, safety concerns in adults and notable side-effects including weight gain, mean their future use is uncertain. Currently many relevant trials involving paediatric patients listed on ´clinicaltrials.gov´ are awaiting completion. Conclusion Medical management for T2DM in children remains limited. Ongoing studies are aiming to equip practitioners with wider treatment options in the future. However, there are concerns regarding the long-term safety of these Medications due to the increased risk of pancreatitis, gallbladder conditions and bladder malignancy in adult patients. Paediatric T2DM patients suffer from complications earlier and more severely compared with adults, making this is a pressing issue. Long-term surveillance studies to identify adverse effects and a framework for highlighting research gaps are required to enable improvements in paediatric T2DM management. Disclosure(s) Nothing to disclose
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P44 Type 2 diabetes mellitus in children: non-Insulin Medication, where are we up to?
Archives of Disease in Childhood, 2019Co-Authors: R Austin, P Paul, Daniel B HawcuttAbstract:Background Childhood type 2 diabetes mellitus (T2DM) is a relatively rare condition but is an important health concern as its prevalence continues to rise. Current management consists of lifestyle modification, metformin and Insulin. Several new pharmacological classes are currently used in adult medicine but are not yet available in paediatric care. In this review we will look at the current evidence for use of these newer Medications in the paediatric population. Methods A literature search (EMBASE, Medline, Pubmed, CINHAL) was performed for papers studying the use of non-Insulin Medications in children; including a separate search of ´clinicaltrials.gov´ to identify any ongoing trials in paediatric T2DM. Results Newer classes of Medications include incretin mimetics, dipeptidyl peptidase-4-inhibitors, sodium/glucose-cotransporter-2-inhibitors, and thiazolidinediones. There have been a small number of pharmacokinetic/pharmacodynamic studies carried out in small cohorts of paediatric participants, but larger long-term efficacy and safety trials are lacking. These studies and individual case-reports have shown good tolerability but are unable to identify any long-term effects associated with these Medications. Randomised controlled trials studying rosiglitazone and glimepiride use in children have been performed. However, safety concerns in adults and notable side-effects including weight gain, mean their future use is uncertain. Currently many relevant trials involving paediatric patients listed on ´clinicaltrials.gov´ are awaiting completion. Conclusion Medical management for T2DM in children remains limited. Ongoing studies are aiming to equip practitioners with wider treatment options in the future. However, there are concerns regarding the long-term safety of these Medications due to the increased risk of pancreatitis, gallbladder conditions and bladder malignancy in adult patients. Paediatric T2DM patients suffer from complications earlier and more severely compared with adults, making this is a pressing issue. Long-term surveillance studies to identify adverse effects and a framework for highlighting research gaps are required to enable improvements in paediatric T2DM management. Disclosure(s) Nothing to disclose
Larisa Vinogradova - One of the best experts on this subject based on the ideXlab platform.
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post mortem vitreous humour as potential specimen for detection of Insulin analogues by lc ms ms
Forensic Science International, 2013Co-Authors: Ilkka Ojanpera, Larisa Vinogradova, Antti Sajantila, Andreas Thomas, Wilhelm Schanzer, Mario ThevisAbstract:A B S T R A C T Differentiation of Insulin analogues is required in forensic and clinical toxicology as well as in sports doping control. Immunoassay results provide only weak evidence for exogenous administration of Insulin, as concentrations cannot be reliably interpreted and specific information on the Insulin species remains unknown. In post-mortem blood, Insulin degrades rapidly. In this study, improved methodology consisting of precipitation of proteins, immunoaffinity purification and liquid chromatography coupled to high resolution/high accuracy mass spectrometry were applied to post-mortem vitreous humour. Ten successive cases with a post-mortem interval from four to ten days were investigated for Insulin analogues. The cause of death in these cases was connected with diabetes and its complications, as well as with chronic cardiovascular disease, alcoholism and cancer. In all cases, the manner of death was natural (disease). Insulin was positively detected in post-mortem vitreous humour in three cases out of ten by mass spectrometry. In two cases, the method revealed the long-acting Insulin glargine (Lantus) metabolite M2 (DesB31-32 Lantus), and human Insulin was detected in one case. The findings were in agreement with the documented history of Insulin Medication. No other obvious reason could be found for the failure of detecting Insulins in the other cases than Insulin degradation during the lengthy postmortem interval. Vitreous humour is still a most prospective specimen for detection of Insulin analogues post-mortem.
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Post-mortem vitreous humour as potential specimen for detection of Insulin analogues by LC-MS/MS.
Forensic science international, 2013Co-Authors: Ilkka Ojanpera, Larisa Vinogradova, Antti Sajantila, Andreas Thomas, Wilhelm Schanzer, Mario ThevisAbstract:Differentiation of Insulin analogues is required in forensic and clinical toxicology as well as in sports doping control. Immunoassay results provide only weak evidence for exogenous administration of Insulin, as concentrations cannot be reliably interpreted and specific information on the Insulin species remains unknown. In post-mortem blood, Insulin degrades rapidly. In this study, improved methodology consisting of precipitation of proteins, immunoaffinity purification and liquid chromatography coupled to high resolution/high accuracy mass spectrometry were applied to post-mortem vitreous humour. Ten successive cases with a post-mortem interval from four to ten days were investigated for Insulin analogues. The cause of death in these cases was connected with diabetes and its complications, as well as with chronic cardiovascular disease, alcoholism and cancer. In all cases, the manner of death was natural (disease). Insulin was positively detected in post-mortem vitreous humour in three cases out of ten by mass spectrometry. In two cases, the method revealed the long-acting Insulin glargine (Lantus) metabolite M2 (DesB31-32 Lantus), and human Insulin was detected in one case. The findings were in agreement with the documented history of Insulin Medication. No other obvious reason could be found for the failure of detecting Insulins in the other cases than Insulin degradation during the lengthy post-mortem interval. Vitreous humour is still a most prospective specimen for detection of Insulin analogues post-mortem.