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A Journal on Forensic Medicine
Minerva Medicolegale 2007 December;127(4):255-9
Glucose postmortem comparative study in pericardial, spinal and synovial fluids
Arroyo A. 1, Coronas C. 2
1 Legal Medicine Institute Cataluña Barcelona, Spain
2 Indurkern Pharmaceutical Industry Barcelona, Spain
Aim. Thanatochemistry is a complementary procedure in forensic practice. Alterations are known to take place during the postmortem period, particularly in blood, and results have to be carefully considered. Since contamination does not occur in other fluids as fast as in blood these fluids are usually examined too. Vitreous humour, pericardial fluid (PF), cerebrospinal fluid (CSF) are specimens analyzed to get information about metabolic or toxicological disorders. The aims of this study are to measure glucose levels in PF, CSF and synovial fluid (SF), to compare the values obtained and correlate them with antemortem hyperglycemia using 62 cadavers from forensic autopsies performed in the town of Hospitalet de Llobregat (Spain).
Methods. A cross observational analytic study was designed. Samples were obtained by direct aspiration of the fluids and analyzed right after the extraction from the cadavers. The analysis was performed using an Accutrend GC (Boerhinger, Mannheim) reflectometer. The computerized data-processing system SPSS Windows was used for the statistical analysis.
Results. PF glucose levels were significantly higher than CSF and SF glucose levels . No differences were found either between SF and CSF values or concerning the cause of death (natural or violent) and cardiopulmonary resuscitation (presence or absence), when these variables were included in the analysis.
Conclusion. As established by other authors, CSF and SF can be good specimens for assessing antemortem hyperglycemia. Unfortunately, the study sample was too small for us to be able to reach a conclusion in this sense. CSF is easily obtained during necropsy practice, as described in the methods. Other variables or influences need to be controlled to explain the elevated glucose level in PF.