Quantitative analysis of multiple illicit drugs in preserved oral fluid by solid-phase extraction and liquid chromatography–tandem mass spectrometry

We present a validated method for the simultaneous analysis of basic drugs which comprises a sample clean-up step, using mixed-mode solid-phase extraction (SPE), followed by LC–MS/MS analysis. Deuterated analogues for all of the analytes of interest were used for quantitation. The applied HPLC gradient ensured the elution of all the drugs examined within 14 min and produced chromatographic peaks of acceptable symmetry. Selectivity of the method was achieved by a combination of retention time, and two precursor-product ion transitions for the non-deuterated analogues. Oral fluid was collected with the Intercept^®, a FDA approved sampling device that is used on a large scale in the US for workplace drug testing. However, this collection system contains some ingredients (stabilizers and preservatives) that can cause substantial interferences, e.g. ion suppression or enhancement during LC–MS/MS analysis, in the absence of suitable sample pre-treatment. The use of the SPE was demonstrated to be highly effective and led to significant decreases in the interferences. Extraction was found to be both reproducible and efficient with recoveries >76% for all of the analytes. Furthermore, the processed samples were demonstrated to be stable for 48 h, except for cocaine and benzoylecgonine, where a slight negative trend was observed, but did not compromise the quantitation. In all cases the method was linear over the range investigated (2–200 μg/L) with an excellent intra-assay and inter-assay precision (coefficients of variation <10% in most cases) for QC samples spiked at a concentration of 4, 12 and 100 μg/L. Limits of quantitation were estimated to be at 2 μg/L with limits of detection ranging from 0.2 to 0.5 μg/L, which meets the requirements of SAMHSA for oral fluid testing in the workplace. The method was subsequently applied to the analysis of Intercept^® samples collected at the roadside by the police, and to determine MDMA and MDA levels in oral fluid samples from a controlled study.     

Civil commitment by conservatorship: the workings of California's law

This article summarizes the conservatorship provisions of the California Civil Commitment Statute, the Lanterman-Petris-Short (LPS) Act and reviews the major findings from previous studies. By studying the hospital records of eighty-five gravely disabled patients affected by LPS, the authors address issues raised by these reports. The results indicate that the law's provisions work unevenly. Patients with acute and current disability received conservatorships more frequently than those who had been disabled in the past. There is some evidence that the process is used to confine threatening patients and does not function equally well for all diagnostic groups.     

'Nuisance' phone calls to women in England and Wales

Obscene or nuisance phone calls are particularly targeted towards women. Employing data from two sweeps of the British Crime Survey a decade apart (BCS 1982 and BCS 1992), this work attempts to measure the effects of individual socio-economic characteristics and victimization history of women in England and Wales on their likelihood of receiving at least one nuisance call. To make the logit modelling analysis more tangible, risks of nuisance calls are calculated from our models of five hypothetical women, single mother, professional, student, housewife and pensioner, with specific attributes taken from the set of explanatory variables.     

Pastoral counseling and the concept of malpractice

The discipline of pastoral counseling has developed to the point at which malpractice claims against pastoral counselors are a reality. The need for forensic psychiatrists to participate in such suits is likely to increase. In this article, we review the recent California case of Nally v. Grace Community Church. Kenneth Nally committed suicide while under the care of clergy. His parents claimed that the pastoral counselors negligently counseled their son and that this counseling led to his death. This case will serve as a point of departure for reviewing the developments and evolution of pastoral counseling as a discipline. Then we shall highlight the difficult problem of whether pastoral counseling ought to be classified as a religious or a secular activity, while pointing out that this dichotomous view does not accurately portray the activities and beliefs of pastoral counselors. Nevertheless, we underline the connection made between the definition of pastoral counseling and the assertion that pastors should be shielded from malpractice claims.     

Suicide by fire in a car trunk: a case with potential pitfalls

We present an unusual case in which an adult female committed suicide by fire while enclosed in the trunk of her vehicle. A finding of suicide was reached only because several key investigative facts were uncovered. Without these discoveries the case may still remain open as a suspicious death. Fire is rarely used as a mechanism of suicide in Western culture, and, as such, similar cases should be reported to advance our recognition of this phenomenon.     

Analysis of the impurities in the methamphetamine synthesized by three different methods from ephedrine and pseudoephedrine

Organic impurities of methamphetamine may show different patterns by synthesis. In the present study, we tried to find the impurities reflecting the conditions of synthesis by comparing impurity patterns of the methamphetamine samples synthesized by different methods. Sixteen methamphetamine samples were synthesized from ephedrine and pseudoephedrine by the three different manufacturing methods of Emde, Nagai and Moscow. The synthesized samples were extracted with ethyl acetate containing four internal standards, and the patterns of the organic impurities were investigated by GC-MS and GC-FID . Through the investigation, we found 10 peaks appearing in the latter part of GC chromatograms are characteristic to synthesis. The areas of the selected peaks were converted to the variables suitable for the statistical calculation, and the synthesized samples could be classified into four groups through the resultant cluster analysis.     

Examination of Y-STR mutations in sex chromosomal abnormality in forensic cases

The Y-STR typing was carried out on eight DNA samples (three from criminal cases) demonstrating Klinefelter's syndrome. STR types in the X chromosome were randomly distributed. However, some Y-STR markers were distributed within the normal range but restricted to only one or two specific alleles, that is, some specific haplotypes were found in Klinefelter's syndrome. In addition, a single nucleotide polymorphism in DYS390 (transversion of G to A at the 28th position downstream of tandem repeats) was detected in Klinefelter samples. This Y-STR polymorphism and restricted Y-STR alleles in Klinefelter's syndrome is not known, but it might be related to the genesis of Klinefelter's syndrome. We also found that extended standard haplotypes of these samples are extremely rare in the normal population, according to the Y-STR haplotype reference database (YHRD). The extended standard haplotype database in a Japanese population is also reported. In 100 unrelated Japanese, 89 haplotypes were observed, and the haplotype diversity was calculated to be 0.9866.