La violenza di genere: analisi della casistica autoptica di femminicidio e degli ammonimenti del Questore per stalking e per violenza domestica della citta metropolitana di Bologna

Il presente lavoro tratta il tema della violenza di genere, in particolare femminicidio, stalking e violenza domestica per la connessione tra questi intercorrente nell’escalation violenta. Spesso, i femminicidi sono preceduti da stalking o ripetuti episodi di violenza fisica prettamente consumata in ambito domestico e relazioni affettive pregresse/attuali. La prima parte del lavoro descrive ambito scientifico e giuridico, internazionale e nazionale, della violenza di genere, dimensione del fenomeno ed evoluzione normativa a tutela delle vittime, come richiesto dalla Convenzione di Istanbul. La seconda parte affronta aspetti medico-legali della violenza di genere (attività di patologia forense, genetica forense e tossicologia forense nei femminicidi, assistenza medico-legale alla vittima di maltrattamenti e violenza sessuale, valutazione medico-legale del danno alla persona per stalking). La terza parte presenta lo studio su casistica autoptica di femminicidi del 1950-2019 e provvedimenti di ammonimento del Questore per stalking e per violenza domestica del 2009-2020 nella provincia bolognese. Secondo i risultati il femminicidio è un fenomeno di “vecchia data”, in un quadro normativo-culturale che “tollerava” violenza a danno di vittime femminili. L’andamento del fenomeno è costante fino a oggi con modifiche di cause e mezzi del decesso. L’aumentata età media delle vittime richiama il crescente fenomeno dell’elder abuse. Negli ammonimenti per stalking e per violenza domestica analizzati prevalgono vittime di genere femminile e autori di genere maschile, in vicende affettive e familiari. Lo studio approfondito delle caratteristiche di autori e vittime di femminicidio, stalking e violenza domestica permette di individuare indicatori di rischio per implementare strategie di prevenzione mirate. Il punto di vista privilegiato medico-legale può assumere un ruolo centrale insieme alle altre figure coinvolte in prevenzione, repressione e contrasto alla violenza di genere. Solo un rigoroso approccio metodologico multidisciplinare può aiutare nella prevenzione. La ricerca in tale ambito è il punto di forza della gestione multidisciplinare della vittima.

Monitoring of New Psychoactive Substances in the hair of patients with a history of addiction. Evaluation of the public health impact.

Introduction. The term New Psychoactive Substances (NPS) encompasses a broad category of drugs which have become available on the market in recent years and whose illicit use for recreational purposes has recently exploded. The analysis of NPS usually requires mass spectrometry based techniques. The aim of our study was to define the preva-lence of NPS consumption in patients with a history of drug addiction followed by Public Services for Pathological Addictions, with the purpose of highlighting the effective presence of NPS within the area of Bologna and evaluating their association with classical drugs of abuse (DOA). Materials and methods. Sustained by literature, a multi-analyte UHPLC-MS/MS method for the identification of 127 NPS (phenethylamines, arylcyclohexylamines, synthetic opioids, tryptamines, synthetic cannabinoids, synthetic cathinones, designer benzodiazepines) and 15 classic drugs of abuse (DOA) in hair samples was developed and validated according to International Guidelines [112]. Samples pretreatment consisted of washing steps and overnight incubation at 45°C in an acid mixture of methanol and water. After cooling, supernatant were injected into the chromatographic system coupled with a tandem mass spectrometry detector. Results. Successful validation was achieved for almost all of the compounds. The method met all the required technical parameters. LOQ was set from 4 to 80 pg/mg The developed method was applied to 107 cases (85 males and 22 females) of clinical interest. Out of 85 hair samples resulting positive to classical drugs of abuse, NPS were found in twelve (8 male and 4 female). Conclusion. The present methodology represents an easy, low cost, wide-panel method for the de-tection of 127 NPS and 15 DOA in hair samples. Such multi-analyte methods facilitates the study of the prevalence of drugs abused that will enable the competent control authorities to obtain evi-dence-based reports regarding the critical spread of the threat represented by NPS.

Study of the urinary biomarkers of synthetic cannabinoid receptor agonists (SCRAs) for the forensic unequivocal proof of consumption: medico-legal implications for drug abuse prevention

Introduction. Synthetic cannabinoid receptor agonists (SCRAs) represent the widest group of New Psychoactive Substances (NPS) and, around 2021-2022, new compounds emerged on the market. The aims of the present research were to identify suitable urinary markers of Cumyl-CB-MEGACLONE, Cumyl-NB-MEGACLONE, Cumyl-NB-MINACA, 5F-EDMB-PICA, EDMB-PINACA and ADB-HEXINACA, to present data on their prevalence and to adapt the methodology from the University of Freiburg to the University of Bologna. Materials and methods. Human phase-I metabolites detected in 46 authentic urine samples were confirmed in vitro with pooled human liver microsomes (pHLM) assays, analyzed by liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-qToF-MS). Prevalence data were obtained from urines collected for abstinence control programs. The method to study SCRAs metabolism in use at the University of Freiburg was adapted to the local facilities, tested in vitro with 5F-EDMB-PICA and applied to the study of ADB-HEXINACA metabolism. Results. Metabolites built by mono, di- and tri-hydroxylation were recommended as specific urinary biomarkers to monitor the consumption of SCRAs bearing a cumyl moiety. Monohydroxylated and defluorinated metabolites were suitable proof of 5F-EDMB-PICA consumption. Products of monohydroxylation and amide or ester hydrolysis, coupled to monohydroxylation or ketone formation, were recognized as specific markers for EDMB-PINACA and ADB-HEXINACA. The LC-qToF-MS method was successfully adapted to the University of Bologna, as tested with 5F-EDMB-PICA in vitro metabolites. Prevalence data showed that 5F-EDMB-PINACA and EDMB-PINACA were more prevalent than ADB-HEXINACA, but for a limited period. Conclusion. Due to undetectability of parent compounds in urines and to shared metabolites among structurally related compounds, the identification of specific urinary biomarkers as unequivocal proofs of SCRAs consumption remains challenging for forensic laboratories. Urinary biomarkers are necessary to monitor SCRAs abuse and prevalence data could help in establishing tailored strategies to prevent their spreading, highlighting the role for legal medicine as a service to public health.