Varia

Certain minor projects are also running in parallel, and are typically related to some extent to the major projects. Epidemiological studies using the Swedish forensic pathology database and forensic toxicology database are carried out, aiming at improving diagnostics in forensic medicine casework, but also to provide other agencies with certain results that may have impact on their work and responsibilities.

One important issue is the surveillance of drug-related deaths, for which we have developed a three-step protocol for rapid evaluation allowing for early reporting. We believe this is an important asset to the monitoring of the drug abuse situation, given the high numbers of opioid toxicity deaths.

Experimental studies include characterization of patterns of postmortem changes in normal tissues and in tissues with certain pathologies using both histochemical stainings and immunohistochemistry protocols. Preliminary studies have revealed that degradation and putrefaction can produce changes in normal tissue that resembles certain pathological conditions, and that various pathological changes can gradually disappear. Certain immunohistochemistry markers are promising to assist in reaching a correct diagnosis.

Methods for segmental hair analysis of drugs have been developed at the department of forensic toxicology in Linköping. These have been particularly useful in order to determine previous opioid exposures in individuals who have died of acute opioid intoxication, since the degree of tolerance, as estimated from the hair analysis, apparently is a critical factor for the fatal outcome. The possibility of development of pharmacodynamic tolerance to the effects of pharmaceutical drugs has not been explored much, and hence a justified line of research is to develop methods for hair analysis of certain groups of pharmaceuticals that are regularly encountered in fatal intoxications. Such studies may assist in the interpretation of postmortem femoral blood drug concentrations.

Studies on the diagnosis of hypothermia have been launched with the aim to evaluate biomarkers and to study the pathophysiological mechanisms. To this end both a mice model of hypothermia and postmortem human tissues are studies. In particular we are interested in the reactivity pattern of the podocytes in the kidney and the activation of platelets in the spleen.

Finally, a large project regarding diagnosis of infections in deceased subjects, still at the planning stage, will tentatively be launched during 2021. This will include development of methods to identify infections that otherwise may go undetected by conventional postmortem examinations.

PI: Henrik Druid, henrik.druid@ki.se