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Urine Drug Screens

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https://www.readbyqxmd.com/read/29330240/structured-management-of-chronic-nonmalignant-pain-with-opioids-in-a-rural-primary-care-office
#1
Kevin S McCann, Shawndra Barker, Raymond Cousins, Adam Franks, Clinton McDaniel, Stephen Petrany, Eric Riley
INTRODUCTION: The use of opioid medication for nonmalignant chronic pain (NMCP) increased dramatically during the last 20 years. There have been regulatory changes implemented to reduce the risk of harm to both patients and society. Much of the burden of monitoring these patients is falling on primary care physicians (PCPs), who do not have the time or resources to handle what is entailed in a best-practice approach to NMCP. METHODS: A retrospective study was conducted with all patients on opioid medication for NMCP who were enrolled onto an individual PCP's practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29314750/phase-i-metabolism-of-the-recently-emerged-synthetic-cannabinoid-cumyl-pegaclone-and-detection-in-human-urine-samples
#2
Lukas Mogler, Maurice Wilde, Laura M Huppertz, Georg Weinfurtner, Florian Franz, Volker Auwärter
Indole, indazole or azaindole based synthetic cannabinoids (SCs), bearing a cumyl substituent are a widespread, recreationally used subgroup of new psychoactive substances (NPS). The latest cumyl-derivative, CUMYL-PEGACLONE, emerged in December 2016 on the German drug market. The substance features a novel γ-carboline core structure, which is most likely synthesized to bypass generic legislative approaches to control SCs by prohibiting distinct core structures. Using liquid chromatography tandem mass spectrometry and liquid chromatography high resolution mass spectrometry techniques, the main in vivo phase I metabolites of this new substance were detected...
January 3, 2018: Drug Testing and Analysis
https://www.readbyqxmd.com/read/29314710/different-in-vitro-and-in-vivo-tools-for-elucidating-the-human-metabolism-of-alpha-cathinone-derived-drugs-of-abuse
#3
Sascha K Manier, Lilian H J Richter, Jan Schäper, Hans H Maurer, Markus R Meyer
In vitro and in vivo experiments are widely used for studying the metabolism of new psychoactive substances (NPS). The availability of such data is required for toxicological risk assessments and development of urine screening approaches. This study investigated the in vitro metabolism of the five pyrrolidinophenone-derived NPS alpha-pyrrolidinobutyrophenone (alpha-PBP), alpha-pyrrolidinopentiothiophenone (alpha-PVT), alpha-pyrrolidinohexanophenone (alpha-PHP), alpha-pyrrolidinoenanthophenone (alpha-PEP, PV8), and alpha-pyrrolidinooctanophenone (alpha-POP, PV9)...
January 4, 2018: Drug Testing and Analysis
https://www.readbyqxmd.com/read/29314410/methods-to-reduce-false-reporting-of-substance-abstinence-in-clinical-research
#4
Sandra J Japuntich, Kimberly A Arditte Hall, Celina M Joos, Ann M Rasmusson, Suzanne L Pineles
OBJECTIVES: Substance use may influence study results in human subjects research. This study aims to report the concordance between self-report and biochemical assessments of substance use and test the effect of methods to reduce false reports of abstinence in trauma-exposed women participating in a research study. METHODS: In this pilot study, substance use was assessed during telephone prescreening and via self-report and biochemical verification (i.e., urine toxicology and alcohol breathalyzer tests) at an in-person evaluation...
January 4, 2018: International Journal of Methods in Psychiatric Research
https://www.readbyqxmd.com/read/29304922/the-appropriate-use-of-opioids-in-the-treatment-of-refractory-restless-legs-syndrome
#5
Michael H Silber, Philip M Becker, Mark J Buchfuhrer, Christopher J Earley, William G Ondo, Arthur S Walters, John W Winkelman
Restless legs syndrome (RLS) is a distinct disorder, differing from chronic pain in many ways. Refractory RLS is characterized by unresponsiveness to dopamine agonists or alpha-2-delta ligands due to inadequate efficacy, augmentation, or adverse effects. This may result in severely impaired quality of life, profound insomnia, and suicidal depression. Opioid therapy is a mainstay in the management of these patients. This article summarizes the basic science and clinical evidence in support of their use, including the positive result of a large controlled multicenter study of 306 subjects, and outlines an approach to their use in clinical practice...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29296031/dextromethorphan-in-cough-syrup-the-poor-man-s-psychosis
#6
Bridgette Martinak, Ramy A Bolis, Jeffrey Ryne Black, Rachel E Fargason, Badari Birur
Dextromethorphan (3-methoxy-N-methylmorphinan), also known as "DXM" and "the poor man's PCP," is a synthetically produced drug that is available in more than 140 over-the-counter cough and cold preparations. Dextromethorphan (DXM) has overtaken codeine as the most widely used cough suppressant due to its availability, efficacy, and safety profile at directed doses. However, DXM is subject to abuse. When consumed at inappropriately high doses (over 1500 mg/day), DXM can induce a state of psychosis characterized by Phencyclidine (PCP)-like psychological symptoms, including delusions, hallucinations, and paranoia...
September 15, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/29290509/ambient-mass-spectrometry-for-rapid-diagnosis-of-psychoactive-drugs-overdose-in-an-unstable-patient
#7
Chi-Wei Lee, Yu-Ying Chao, Jentaie Shiea, Jheng-Heng Shen, Hei-Hwa Lee, Bai-Hsiun Chen
A 25-year-old man suffered from consciousness change was sent to our emergency department by friends who reported that they were not sure what had happened to him. Physical examination revealed bilateral pupils dilatation, lethargy, slurred speech, and ataxia. Computer-aided tomographic scan of the brain revealed no definite evidence of intracranial lesions. Routine laboratory tests revealed total physiological turmoil. Despite immediate commencement of aggressive treatment, the patient's condition deteriorated long before the traditional drug screen provided an answer for the identities of the multiple drugs overdose...
December 20, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29287664/a-sequential-multiple-assignment-randomized-trial-for-cocaine-cessation-and-relapse-prevention-tailoring-treatment-to-the-individual
#8
Joy M Schmitz, Angela L Stotts, Anka Vujanovic, Michael Weaver, Jin Yoon, Jessica Vincent, Charles Green
Drug addiction is a chronic, devastating, but treatable disorder. A core principle of drug addiction treatment states that no single treatment is appropriate for everyone (NIDA, 2012); treatments need to adjust based on patient characteristics and response in order to be maximally effective. For cocaine use disorders (CUD), specifically, the most potent intervention currently available for initiating abstinence is behavior therapy using contingency management (CM) procedures, with early cessation being a robust predictor of future abstinence...
December 26, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29250236/post-ictal-transient-atrial-fibrillation-as-a-rare-manifestation-of-grand-mal-seizure
#9
Gulshan Man Singh Dangol, David A Hoffman
Atrial fibrillation (AF) most frequently occurs as a consequence of multiple etiologies including valvular disease, coronary artery disease, hyperthyroidism, alcohol ingestion, and pulmonary embolism. However, on rare occasion transient AF may be a result of generalized tonic-clonic seizures (GTCS). A 33-year-old-man presented to the emergency department following GTCS in AF with rapid ventricular response. He had no previous documented history. Diagnostic evaluation including electrolytes, thyroid function, cardiac enzymes, serum and urine drug screen, and two-dimensional echocardiogram were unremarkable...
August 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29248810/fast-screening-tests-for-the-simultaneous-detection-of-11-drugs-of-abuse-in-urine-specimens-a-forensic-epidemiology-study-of-28-298-cases-in-tunisia
#10
B Moslah, M Araoud, M A Nouioui, S Najjar, D Amira, A Hedhili
Forensic investigation performed on people suspected to be drug abusers covering all Tunisian cities was conducted by monitoring an epidemiological study of human urine samples surveying positive rates of consumption for drugs of abuse. The forensic investigations were conducted on a total of 28,298 arrested individuals suspected to be drug addicts during five years (January 2010-December 2015). An immunoassay screening tests to detect elevated levels of drugs classes in urine samples was performed. These screening assays provide a preliminary qualitative test result...
December 8, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29241263/systematic-review-of-oral-therapy-for-the-treatment-of-symptoms-of-bladder-pain-syndrome-the-brazilian-guidelines
#11
Thaís Guimarães Dos Santos, Isabela Albuquerque Severo de Miranda, Christiana Campani Nygaard, Lucas Schreiner, Rodrigo de Aquino Castro, Jorge Milhen Haddad
Interstitial cystitis (IC), including bladder pain syndrome (BPS), is a chronic and debilitating disease that mainly affects women. It is characterized by pelvic pain associated with urinary urgency, frequency, nocturia and negative urine culture, with normal cytology. In 2009, the Society for Urodynamics and Female Urology (SUFU) defined the term IC/BPS as "an unpleasant sensation (pain, pressure, and discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms for more than 6 weeks duration, in the absence of infection or other identifiable causes...
December 14, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29240853/the-evaluation-of-medical-inpatients-who-are-admitted-on-long-term-opioid-therapy-for-chronic-pain
#12
Hilary Mosher, Shoshana J Herzig, Itai Danovitch, Christina Boutsicaris, Sameer Hassamal, Karl Wittnebel, Azadeh Dashti, Teryl Nuckols
Individuals who are on long-term opioid therapy (LTOT) for chronic noncancer pain are frequently admitted to the hospital with acute pain, exacerbations of chronic pain, or comorbidities. Consequently, hospitalists find themselves faced with complex treatment decisions in the context of uncertainty about the effectiveness of LTOT as well as concerns about risks of overdose, opioid use disorders, and adverse events. Our multidisciplinary team sought to synthesize guideline recommendations and primary literature relevant to assessing medical inpatients on LTOT, with the objective of assisting practitioners in balancing effective pain treatment and opioid risk reduction...
December 6, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29237039/development-of-a-brief-version-of-the-current-opioid-misuse-measure-comm-the-comm-9
#13
Stacey A McCaffrey, Ryan A Black, Albert J Villapiano, Robert N Jamison, Stephen F Butler
Objective: The Current Opioid Misuse Measure (COMM) is a commonly used self-report instrument to identify and monitor aberrant opioid-related behavior in chronic pain patients on opioid therapy. However, the length of the COMM may limit its clinical utility. Additionally, this paper-and-pencil screener requires hand scoring, which increases paperwork and staff burden. Therefore, the current study presents development of the "COMM-9," a brief electronically administered form of the COMM...
December 11, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29226017/buprenorphine-for-medication-assisted-treatment-of-opioid-use-disorder-in-pregnancy-relationship-to-neonatal-opioid-withdrawal-syndrome
#14
Niraj R Chavan, Kristin B Ashford, Amanda T Wiggins, Michelle R Lofwall, Agatha S Critchfield
Objective  To examine the relationship between antepartum buprenorphine dose for medication-assisted treatment (MAT) of opioid use disorder (OUD) and incident neonatal opioid withdrawal syndrome (NOWS). Study Design  We performed a prospective cohort study of pregnant women with a singleton gestation diagnosed with OUD and receiving buprenorphine for MAT at a tertiary care academic institution from July 2015 to January 2017. We divided the study cohort into two groups-pregnancies with versus without NOWS...
October 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29220642/substance-use-patterns-associated-with-recent-exposure-to-fentanyl-among-people-who-inject-drugs-in-vancouver-canada-a-cross-sectional-urine-toxicology-screening-study
#15
Kanna Hayashi, M-J Milloy, Mark Lysyshyn, Kora DeBeck, Ekaterina Nosova, Evan Wood, Thomas Kerr
INTRODUCTION: Vancouver, Canada is experiencing an opioid overdose crisis where fentanyl, a potent, synthetic opioid contaminating the illicit drug supply, has been detected in the majority of fatal overdose cases. Despite its growing presence throughout North America, few studies have characterized exposure to fentanyl among people who use illicit drugs (PWUD). We sought to identify the prevalence and correlates of fentanyl exposure among PWUD in Vancouver. METHODS: Data were derived from cohort studies of PWUD in Vancouver...
December 5, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29220610/predictors-of-alcohol-use-during-pregnancy-among-women-attending-midwife-obstetric-units-in-the-cape-metropole-south-africa
#16
Petal Petersen-Williams, Catherine Mathews, Esmé Jordaan, Charles D H Parry
INTRODUCTION: Little is known about the nature and extent of substance use among pregnant women in Cape Town (South Africa) despite the very high levels of substance use and related consequences such as FASD in this part of the country. The aim of the study was to determine predictors of alcohol use among pregnant women. METHODS: A cross-sectional survey was conducted among pregnant women attending 11 Midwife Obstetric Units (MOUs) in greater Cape Town. A two-stage cluster survey design was used...
December 8, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/29216523/use-of-synthetic-stimulants-and-hallucinogens-in-a-cohort-of-electronic-dance-music-festival-attendees
#17
Amanda L A Mohr, Melissa Friscia, Jillian K Yeakel, Barry K Logan
Novel psychoactive substances (NPS), often characterized as unregulated psychoactive compounds designed to circumvent existing legislation, have become mainstream on the illicit drug market. Because of their physical and mind-altering properties, NPS may be deliberately or inadvertently ingested at electronic dance music (EDM) festivals to enhance the attendees' appreciation of the music and overall experience. Their widespread use at EDM festivals have been well documented and several adverse events and fatalities associated with NPS ingestion have been reported in the United States...
November 21, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29212847/attempted-replication-of-snps-in-rankl-and-opg-with-musculoskeletal-adverse-events-during-aromatase-inhibitor-treatment-for-breast-cancer
#18
Jacqueline M Dempsey, Jingyue Xi, N Lynn Henry, James M Rae, Daniel L Hertz
Aromatase inhibitor (AI) therapy is highly efficacious in the treatment of estrogen receptor-positive breast cancer, however in a subset of patients AI use is discontinued due to drug-induced musculoskeletal adverse events (MS-AE). Several studies have investigated the role of germline single nucleotide polymorphisms on patients' risk of MS-AE's, however no associations have yet to be validated for translation into clinical practice. This study attempted to replicate SNPs in RANKL (rs7984870) and OPG (rs2073618) on the risk of AI-induced MS-AEs, and screen for secondary associations with MS-AE related treatment discontinuation and serum and urine markers of bone health...
December 6, 2017: Physiological Genomics
https://www.readbyqxmd.com/read/29200659/electrochemical-detection-of-urinary-micrornas-via-sulfonamide-bound-antisense-hybridisation
#19
Daniel A Smith, Lucy J Newbury, Guido Drago, Timothy Bowen, James E Redman
Altered serum and plasma microRNA (miRNA) expression profiles have been observed in numerous human diseases, with a number of studies describing circulating miRNA biomarkers for cancer diagnosis, prognosis and response to treatment, and recruitment to clinical trials for miRNA-based drug therapy already underway. Electrochemical detection of biomarkers in urine has several significant advantages over circulating biomarker analysis including safety, cost, speed and ease of conversion to the point of care environment...
December 2017: Sensors and Actuators. B, Chemical
https://www.readbyqxmd.com/read/29194289/lack-of-detection-of-new-amphetamine-like-drugs-using-conventional-urinary-immunoassays
#20
A Begeman, E J F Franssen
BACKGROUND: The number of reports of serious adverse effects and intoxication after the use of the new drug 4-fluoroamphetamine (4-FA) increases. At the Emergency Department of the OLVG-Oost Hospital in Amsterdam an on-site drug test, the Triage® TOX Drug Screen, is available to assist in a rapid diagnosis. In less urgent cases, an EMIT® II Plus immunoassay is used to determine semi-quantitatively the presence of drugs of abuse. The antibodies in these immunoassays are designed to detect classic drugs of abuse and its urinary metabolites...
November 29, 2017: Therapeutic Drug Monitoring
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