Pascal Kintz

Pascal Kintz
X-Pertise Consulting

PharmD, PhD

About

683
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Publications

Publications (683)
Article
Early November 2020 an Olympic gold medal winner returned during an out‐competition control an adverse analytical finding for dorzolamide, a diuretic mostly used to treat glaucoma. Estimated urine concentrations were 2.2 and 1.6 ng/ml in the A and B specimens, respectively. As the athlete denied any use of dorzolamide, a complex forensic investigat...
Article
The dead body of a 59-year-old man was found at his home by his father. The subject was naked in the corridor, wearing a black hood and a collar around the neck where a dog leash was attached. An empty syringe was discovered in the decedent’s rectal vein. The autopsy revealed marked asphyxia signs with no indication of violence or trauma. Femoral b...
Article
Full-text available
1-Benzofuran-5-ylpropan-2-amine or 5-APB is a new psychoactive substance (NPS) with empathic effects close to ecstasy (MDMA). Although 5-APB has been observed in fatality cases, the drug has not yet been reported in the context of hidden administration for behaviour impairment, also known as drug-facilitated crime. Such a situation was recently obs...
Article
Oral antidiabetics are the drugs used to control blood sugar in diabetic subjects. The greatest risk of using these drugs is hypoglycaemia, which can be fatal if managed inappropriately. The diagnosis of hypoglycemia may be simple in diabetic subjects but can become a challenge in subjects with no history of exposure to these drugs. The major inter...
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Résumé Contexte Les cas de soumission chimique impliquant la MDMA sont rares, probablement parce que la MDMA n’a pas d’effet sédatif. Les auteurs présentent un cas avec des concentrations de MDMA particulièrement élevées dans le sang et les cheveux. Cas Une femme de 34 ans est invitée à boire un verre chez son ancien compagnon. Alertée par le goû...
Article
Résumé Introduction La noyade demeure un diagnostic des plus complexes en médecine légale en l’absence de signe clinique ou paraclinique spécifique. La recherche des diatomées tient lieu de méthode de référence et le dosage du strontium sanguin constitue une technique complémentaire efficace en cas de noyade en eau de mer. L’objectif principal de...
Article
Résumé Le dépistage des antidiabétiques oraux, agents hypoglycémiants utilisés pour le traitement du diabète de type II, représente un défi dans la pratique médico-légale. En cas d’hypoglycémie d’origine douteuse, la recherche des antidiabétiques oraux permet de différencier les hypoglycémies factices (tentative de suicide, syndrome de Münchhausen...
Article
Résumé Il est désormais admis par la communauté scientifique que l’analyse des cheveux permet d’établir un calendrier rétrospectif d’une exposition à un xénobiotique, dont la masse moléculaire ne dépasserait pas 1200 daltons. Ce qui est vrai pour l’homme l’est également pour l’animal et c’est pourquoi, depuis quelques années, les instances officiel...
Article
The selective androgen receptor modulators are a recent class of anabolic agents, used to improve athletic performance. Among these molecules, there is (2 S)-N-(4-cyano-3-trifluoromethylphenyl)-3-(3-fluoro-4-chlorophenoxyl)2-hydroxy-2-methyl-propanamide, commonly known as S-23. This molecule appeared very recently on the doping market. As a result,...
Article
Résumé La prégabaline est indiquée en France dans le traitement de l’épilepsie, des douleurs neuropathiques et des troubles anxieux généralisés. Bien que récent, l’usage détourné de cette molécule, généralement en association avec d’autres composés psychoactifs, connaît un développement notable (hausse des demandes de prescription en détention, exi...
Article
Tizanidine, an imidazoline derivative close to clonidine, is a central alpha-2 adrenergic receptor agonist. Therapeutically, the drug is used as a muscle relaxant under the trade names Sirdalud™ or Zanaflex™. The drug is not prohibited by the World Anti-Doping Agency but, for therapeutic purposes, can only be obtained via a nominative temporary use...
Article
Objectif Établir les causes d’un décès fœtal est un problème complexe pour le médecin légiste. Au-delà du contexte médico-légal, l’expert doit notamment être en mesure d’apporter des réponses quant à la viabilité du fœtus au moment du décès, d’éliminer une mort fœtale in-utéro et de déterminer si la mort est en lien avec une cause fœtale, une cause...
Article
Full-text available
After observing a modification in behavior of his three dogs, an owner consulted a laboratory to determine if a drug could be involved. Hair strands of each animal were collected from the neck area and sent to the laboratory for anabolic steroid screening. Initial screening by liquid chromatography coupled to high-resolution mass spectrometry ident...
Article
Selective Androgen Receptors Modulators (SARMs) are a new class of doping drugs that emerged in sport since 2008. Easy access on the Internet also leads to their misuse by amateurs. It seems important for a laboratory of toxicology to develop a targeted screening of SARMs, given their health risks. A method has been developed and validated for the...
Article
Full-text available
A 43-year-old male, sport coach, presented him-self at the Emergency unit of a local hospital for epigastric pain, myalgia pain and severe headache. He claimed having used for some days a combination of GW1516 (cardarine), a peroxisome proliferator-activated receptor delta agonist (PPAR- δ) and MK2866 (ostarine), a selective androgen receptor modul...
Article
Selective androgen receptor modulators (SARMs) are a class of drugs presenting identical anabolic properties to anabolic steroids in addition to marked reduced androgenic effects. These drugs have emerged in the doping area within the early 2000’s. Ligandrol, ostarine, RAD-140 and andarine are the most popular agents belonging to this class. Accord...
Article
The identification and quantification of insulin and its analogues have always been a challenge in the forensic field. Murder, suicide attempts and induced hypoglycemia in the context of factitious disorders have been described with the use of synthetic analogues of human insulin. There is very few information in the literature about aspart insulin...
Article
Promazine is one of the oldest phenothiazine derivatives that have been proposed for the treatment of various psychiatric disorders. The drug is available as tablets, syrups and in injectable forms. Despite its prescription to millions of subjects, its detection in human hair has seldom been reported. The aim of the present work was to develop a sp...
Article
Résumé Dans le cadre d’une intoxication fatale au fentanyl, les auteurs ont voulu vérifier que la 4-ANPP (4-anilino N-phenethyl-piperidine) pouvait être retrouvée dans plusieurs matrices biologiques d’intérêt médico-judiciaire. En France, le fentanyl est utilisé en milieu hospitalier et son usage détourné est principalement limité au personnel soig...
Article
Objectifs Discuter de l’intérêt des traces papillaires latentes (TPL) pour la caractérisation de xénobiotiques. Présenter la stratégie du laboratoire dans deux études de faisabilité et évaluer les perspectives de cette nouvelle approche. Méthode Les TPL sont des traces invisibles à l’œil nu qui résultent d’un dépôt de sueur et de sébum présent sur...
Article
Objectifs En 2019, Salomone et al. [1] publiaient que la 4-anilino N-phenethyl-piperidine (4-ANPP), précurseur et métabolite de nombreux dérivés du fentanyl pouvait servir de marqueur d’exposition dans les cheveux à cette classe de molécules ultra-actives. Dans le cadre d’une intoxication fatale au fentanyl, les auteurs ont voulu vérifier que la 4-...
Article
Objectifs Les anabolisants androgéniques stéroïdiens sont des dérivés synthétiques de la testostérone, emblème des hormones mâles. Leur abus peut engendrer des effets secondaires graves (trouble cardiaque, toxicité hépatique, dérèglement hormonal) mais aussi une profonde modification du comportement, pouvant conduire à une altération de la libido m...
Article
Objectifs Présenter l’accumulation de difficultés pour évaluer si l’auteur d’un double homicide était, au moment des faits, sous influence de 25I-NBOMe, afin de savoir si le comportement de l’agresseur était la conséquence de l’usage de cette substance ou si, au contraire, il pouvait être lié à un événement psychotique. Méthode Deux jours avant No...
Article
Objectifs Présenter un cas d’empoisonnement par insuline asparte après injection à un enfant non diabétique, suivi d’une tentative de suicide de l’auteur (la mère) et décrire les résultats des analyses effectués par LC-HRMS et UHPLC- MS/MS sur les échantillons de sang des 2 protagonistes. Méthode L’identification et la quantification de l’insuline...
Article
Objectifs Identification de SARMs dans les cheveux d’une sportive après un résultat analytique anormal d’ostarine dans les urines. Méthode Au cours des dernières années, une nouvelle famille de produits dopants, appelée modulateurs sélectifs des récepteurs aux androgènes (SARMs), a émergé. Ces produits, utilisés pour améliorer les performances phy...
Article
Although it has been published during the last 15 years that hallucinogens derived from new psychoactive substances are increasingly abused, the old psychedelic agents are still used. Among these vegetal compounds, magic mushrooms are frequently mentioned. The major ingredient of the Psilocybe species is psilocybin, which is rapidly converted into...
Article
Tizanidine, an imidazoline derivative close to clonidine, is a central alpha‐2 adrenergic receptor agonist. Therapeutically, the drug is used as a muscle relaxant under the trade names Sirdalud™ or Zanaflex™. The drug is not prohibited by the World Anti‐Doping Agency, but, for therapeutic purposes, can only be obtained via a nominative temporary us...
Article
A 60-year-old man was found dead at home by his wife. The man was known to be a regular trainer in a fitness center and was described as a long-term user of anabolic steroids. The autopsy revealed heart failure with a cardiomegaly, a visceral congestion and a pulmonary edema. The local prosecutor ordered toxicological analyses but no anatomic patho...
Article
Full-text available
A 32-year-old male went to the police to claim he just killed his girlfriend by inflicting several stabs with a kitchen knife. He was very nervous and particularly aggressive. About 90 min after the assault, a blood specimen was collected with natrium fluoride as preservative. The blood was free of alcohol, pharmaceuticals and drugs of abuse, but t...
Article
Résumé Si la conquête de l’espace a marqué la fin du millénaire précédant, la découverte du monde aquatique est l’activité en plein essor depuis le début des années 2000. Au-delà de l’aspect économique du fait d’une richesse encore peu exploitée tant pour l’alimentation que pour les minerais, les mers et océans sont des lieux fascinants qui attiren...
Article
Full-text available
3-Methoxyphencyclidine (3-MeO-PCP) is a new psychoactive substance that belongs to the phencyclidines family, first identified in Europe in 2012. This drug presents a stronger binding to N-methyl-D-aspartate (NMDA) receptors when compared to phencyclidine, which results in more potent effects, even at low concentrations. Very few articles have been...
Article
A 21-year old male was arrested after killing a rival during a dramatic episode of violence, due to jealousy. The perpetrator was sent to prison, where he revealed, several months later, that he was using anabolic steroids at the time of the assault. The steroids were used to enhance his muscular mass. To document possible steroids abuse, a hair sp...
Article
A 59-year old male was found dead at home, with 2 empty vials of an oily preparation attributed to a manufacturer from East Europe. There was no label on the vial. The subject was a former weightlifter, also known as an anabolic steroids abuser. The local prosecutor ordered a body examination, which was unremarkable and allowed collecting femoral b...
Article
Résumé La scopolamine est le premier alcaloïde à avoir été commercialisé sous la forme d’un système transdermique. Ce dispositif, commercialisé sous la dénomination Scopoderm®, a été développé pour délivrer de façon constante de la scopolamine à travers la peau, soit environ 5 μg/heure, pour traiter le mal des transports, les nausées récurrentes et...
Article
Anabolic steroids are synthetic derivatives of testosterone, and their abuse can have numerous health consequences. Identification of this group of drugs has found applications in forensic toxicology, clinical situations, psychiatric disorders, and of course, anti-doping violations. Although anabolic steroids are generally tested in urine and very...
Article
Substandard/counterfeit drugs are a growing global problem. According to the World Health Organisation, counterfeit medicines are medicines that are mislabelled deliberately and fraudulently regarding their identity and/or source. In high income countries, drugs seized are mainly represented by performance and image enhancing drugs (PIEDs). The aim...
Article
Since the late 90s, hair testing for anabolic steroids in humans has found numerous forensic, clinical and anti‐doping applications. In most cases, analyses were performed on head hair, collected in the vertex regions. However, for various reasons (shaved subject, bald subject, religious belief, cosmetic treatment, aesthetic reason), hair collector...
Article
Mirtazapine is an antidepressant drug, used to treat depression, but also, in some specific conditions, to treat obsessive-compulsive disorder and anxiety. Although mirtazapine is not a hypnotic, it can make the subject feel drowsy. Children under the age of 18 should not take mirtazapine, but for some very special diseases, a physician can prescri...
Article
The aim of this study was to identify new markers of deschloro‐N‐ethyl‐ketamine (O‐PCE), a ketamine analogue that has been involved in acute intoxications with sever outcomes including death and whose metabolism has never been studied before. In vitro study after 2h incubation with pooled human liver microsomes (HLMs) cross‐checked by the analysis...
Article
The objective of this publication is to present the interest of collecting several keratinous specimens in order to document possible drug impairment at the time of the assault, when knowledge solely occurred 7 months after. A subject committed a murder and within minutes after the crime self-inflicted serious wounds. He was charged to the hospital...
Article
Background: As hair testing increases the window of drug detection and permits the differentiation of long-term use from a single exposure when performing segmental analyses (which also allows establishing the pattern of use), this matrix should be considered as a suitable complement to standard investigations in clinical, forensic, and sport toxi...
Article
Coca tea is a popular drink in some South American countries where it is reputed to have medicinal properties. This preparation is composed of natural cocaine alkaloids and therefore can be banned in some countries. During an anti-doping control in Peru, the urine of an athlete tested positive for benzoylecgonine, ecgonine methyl ester and cocaine...
Article
Among the hundred cannabinoids present in cannabis sativa indica, cannabidiol is a phytocannabinoid discovered in 1940, which can account for up to 40 % of the plant’s extract. Medically, it has been proposed to treat convulsions, inflammation, anxiety and nausea. Contrary to the hallucinogenic ingredient of the plant, delta-9-tetrahydrocannabinol,...
Article
Objectif Caractériser l’exposition au chloramphénicol, un antibiotique bactériostatique de la famille des phénicolés, dans des cheveux après consommation cachée. Introduction Le chloramphénicol est un médicament utilisé dans le passé pour traiter la méningite, la peste, le choléra et la fièvre typhoïde. Ce traitement présente des effets secondaire...
Article
Objectifs Discuter une possible mort toxique impliquant la DOC (2,5-dimethoxy-4–chloramphétamine) chez un individu décédé il y a 4 ans, dont le corps est en état de décomposition. Méthode Pendant une soirée festive à l’étranger, des individus sniffent une poudre présentée comme du LSD. Deux d’entre eux sont retrouvés morts le lendemain, dont un re...
Article
Objectif L’utilisation des produits de la performance dans le milieu des sports amateurs est en constante augmentation. Les auteurs présentent un cas de décès impliquant la prise d’agents anabolisants consommés de façon régulière par un homme pratiquant le bodybuilding. Description du cas Les auteurs rapportent le cas d’un homme de 61 ans découver...
Article
Objectifs Identifier les sources de contamination après un résultat analytique anormal dans les urines pour la métandiénone. Après un contrôle analytique anormal dans les urines, en cas de contestation, la charge de la preuve revient au sportif. Les auteurs rapportent le cas d’un athlète professionnel présentant un résultat anormal dans les urines...
Article
Objectifs Présenter les différentes preuves matérielles et biologiques dans une situation de maltraitance chimique du nourrisson et discuter de la pertinence des analyses. Si la maltraitance du nourrisson peut prendre plusieurs formes, incluant violence physique, privation de nourriture ou absence de soin, seule l’administration de xénobiotique(s),...
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Objectifs Présenter la stratégie d’interprétation des résultats d’analyse de cheveux, dans une expertise judiciaire où le magistrat s’interroge sur la sécurité d’un très jeune enfant. Il est largement décrit, dans la littérature scientifique, que les cheveux des enfants, plus fins et plus poreux que ceux des adultes, sont extrêmement propices aux c...
Article
Objectifs Présenter et discuter des résultats de cocaïne et de ses métabolites dans les urines après consommation par 5 sujets d’un Maté de coca contenant environ 4 mg de cocaïne par sachet. Le Maté de coca est une boisson populaire dans certains pays d’Amérique du Sud (Pérou, Bolivie, Equateur) où il est réputé pour avoir des vertus médicinales. D...
Article
Letrozole is a reversible aromatase inhibitor, used in the treatment of hormone-dependent woman cancer. No indication for medical use is available for men. In recent years, several cases of doping with letrozole have been observed, especially among high level athletes. Aromatase inhibitors reverse the harmful effects (feminizing) of the abuse of an...
Article
Gabapentin, a GABA analogue, is a drug with anticonvulsant properties, used to treat epilepsy in adults and to relieve pain in patients suffering from postherpetic neuralgia. The usual oral daily dose is 300-1800 mg, but may be increased to a maximum of 3600 mg in 1-3 divided doses. The most reported adverse effects of gabapentin are somnolence, di...
Article
Testing for drugs in hair raises several difficulties. Among them is the interpretation of the final concentration(s). In a post-mortem case, analyses revealed the presence of furosemide (12 ng/mL) in femoral blood, although it was not part of the victim's treatment. The prosecutor requested our laboratory to undertake an additional analysis in hai...
Article
For 40 years, hair tests have been presented as the best approach to document long‐term consumption of a drug. This unique property has found numerous applications in clinical, forensic, and occupational toxicology. However, since the beginning of its implementation in biology, external contamination, with an associated risk of false positive resul...
Article
Hair analysis is very useful for toxicological investigations since, by providing a wider detection window, it gives the possibility to perform a retrospective study on the historical consumption of a substance. Unfortunately, there are no data available for hair concentrations in metformin-related deaths. In this study, the authors present 2 cases...
Article
Cases of foreign body ingestion in the forensic literature are mainly described in children or psychiatric patients. Postmortem imaging can detect most foreign bodies, but its sensitivity depends, among other things, on the type of item and its location. In some cases, the ingestion of foreign bodies can remain unnoticed and have serious consequenc...
Article
During a party in another country, several adults sniffed a powder presented as being LSD. The next morning, two subjects, including a French citizen, were found dead. After a body examination that concluded death was due to respiratory and cardiac collapses, the French citizen's corpse was returned to France and buried. Four years later, the body...
Article
Résumé Souvent présentée comme une alternative moins nocive au tabac, la cigarette électronique, également appelée e-cigarette, vapoteuse ou vaporette, est un dispositif électronique générant un aérosol destiné à être inhalé et produisant une vapeur visuellement proche de la fumée produite par la combustion du tabac. Les liquides à vapoter, appelés...
Article
Ostarine, also known as S22 or MK2866 and enobosarm, is a selective androgen receptor modulator (SARM). It has high anabolic potency, in addition to limited androgenic effects. At this time, ostarine has no therapeutic use, but can be abused for performance‐enhancing purposes using the oral route, at dosages of 10 to 25 mg per day. As the drug can...
Article
A 23-month old boy was brought to a medical center by his mother, as she noticed that the father has gripped him around the neck and this had left marks. As a result of this, a child protection medical examination was requested. However, there was a significant chronology of mental health issues in the mother. Among the mother's medications, quetia...
Article
Diabetes mellitus is one of the most important public health challenges. Metformin (1,1‐dimethylbiguanide) represents the “gold standard” for the treatment of diabetes mellitus type 2. Despite its important role in reducing mortality and morbidity in the diabetic population, metformin is associated with an increased risk of stroke. To document expo...
Article
GW501516, also known as GW‐1516 or cardarine and endurobol, is a peroxisome proliferator‐activated receptor delta (PPAR‐δ) agonist. Activation of the receptor will increase fat‐burning capacity and muscle production, as it changes the body's fuel preference from glucose to lipids. GW501516 has no therapeutic use, but can be abused for performance‐e...
Article
Résumé Parmi la soixantaine de cannabinoïdes présents dans le cannabis sativa indica on trouve essentiellement des terpénophénols, parmi lesquels figure le delta-9-trans tétrahydrocannabinol (Δ9-THC) qui constitue le principal produit psychoactif chez l'homme. Depuis une dizaine d’années, avec l’émergence du e-commerce et la recherche pharmaceutiqu...
Article
Résumé L’objectif de cet article est de présenter deux approches, l’une basée sur les analyses biochimiques et l’autre sur le dosage des oligo-éléments dans les cheveux, afin d’explorer le statut nutritionnel d’enfants pour lesquels une dénutrition est suspectée à l’autopsie. Nous présentons le cas d’une fillette de 9 mois décédée au domicile. Le c...
Article
An athlete challenged the result from an in-competition doping test which returned with an adverse analytical finding for stanozolol, claiming it was due to supplement contamination. Her lawyer asked the laboratory to analyze several hair specimens simultaneously collected from 5 different anatomical regions, head, arm, leg, pubic and armpit, to do...
Article
An unexpected death of a 46-year-old woman presenting a type II diabetes was observed and the Prosecutor requested an autopsy followed by toxicological investigations. Autopsy findings (labial ecchymosis, multiviscera congestion, asphyxia syndrome, moderate cerebral edema) were in accordance with a possible hypoglycemia death. Toxicological analyse...
Article
Résumé L’usage de cathinones est un phénomène récent lié à l’émergence de nouvelles substances psychoactives. Certains groupes de la population peuvent être davantage exposés comme, par exemple, les hommes qui ont des activités sexuelles avec d’autres hommes sous l’influence de substances psychoactives. Cette pratique porte le nom de « chemsex ». L...
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Full-text available
For several years, the misuse of stimulant substances is increasingly observed both in the field of sport, to improve the functions of the body and therefore to be more performant, and also by non-athletes to make life more tolerable on a daily basis. Adrafinil, 2-((diphenylmethyl)sulfinyl)-N-hydroxyacetamide, is a drug designed for the treatment o...
Article
A 5‐week‐old infant was admitted to the pediatric emergency department with agitation and incessant crying. Investigations led to a diagnosis of rhabdomyolysis following coma due to severe bromazepam intoxication (blood concentration 656 μg/L). The infant was hospitalized and his condition rapidly improved. Ten days later, an inquiry was opened to...
Article
• Hair testing is a complementary approach to document doping agent(s) use • All prohibited substances but hormones should be detectable in hair • Interest and limitations of hair testing for doping agents are reviewed based on the authors' experience • Although a lot of data are available for drugs of abuse, controlled studies are missing for anab...
Article
Introduction: Chloramphenicol (2,2-dichloro-N-[1,3-dihydroxy-1-(4-nitrophenyl)porpan-2-yl]acetamide) is a bacteriostatic antibiotic of the phenicolated family, used in the past to treat meningitis, plague, cholera, or typhoid fever. Treatment with chloramphenicol can have life threatening side effects, the most serious of which is aplastic anemia,...
Article
The authors aim to report a case of surreptitious administration of a synthetic cannabinoid (SC) and the subsequent toxicological investigations to be able to document accurately the case for submission at a hearing. A dealer gave surreptitiously a substance to two juvenile migrants who experienced shakings and faintness. The laboratory received a...
Article
The retrospective calendar of an individual's drug use requires a multisectional analysis in which the length of hair, corresponding to the full temporal window available, is cut into shorter sections to measure drug use during shorter periods of time (generally 1 cm corresponds to ~1 month).