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Urine toxicology

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https://www.readbyqxmd.com/read/29150198/comparative-effectiveness-of-extended-release-naltrexone-versus-buprenorphine-naloxone-for-opioid-relapse-prevention-x-bot-a-multicentre-open-label-randomised-controlled-trial
#1
Joshua D Lee, Edward V Nunes, Patricia Novo, Ken Bachrach, Genie L Bailey, Snehal Bhatt, Sarah Farkas, Marc Fishman, Phoebe Gauthier, Candace C Hodgkins, Jacquie King, Robert Lindblad, David Liu, Abigail G Matthews, Jeanine May, K Michelle Peavy, Stephen Ross, Dagmar Salazar, Paul Schkolnik, Dikla Shmueli-Blumberg, Don Stablein, Geetha Subramaniam, John Rotrosen
BACKGROUND: Extended-release naltrexone (XR-NTX), an opioid antagonist, and sublingual buprenorphine-naloxone (BUP-NX), a partial opioid agonist, are pharmacologically and conceptually distinct interventions to prevent opioid relapse. We aimed to estimate the difference in opioid relapse-free survival between XR-NTX and BUP-NX. METHODS: We initiated this 24 week, open-label, randomised controlled, comparative effectiveness trial at eight US community-based inpatient services and followed up participants as outpatients...
November 14, 2017: Lancet
https://www.readbyqxmd.com/read/29149155/lower-cutoffs-for-lc-ms-ms-urine-drug-testing-indicates-better-patient-compliance
#2
Kevin Krock, Amadeo Pesce, Dennis Ritz, Richard Thomas, Agnes Cua, Ryan Rogers, Phil Lipnick, Kristen Kilbourn
BACKGROUND: Urine drug testing is used by health care providers to determine a patient's compliance to their prescribed regimen and to detect non-prescribed medications and illicit drugs. However, the cutoff levels used by clinical labs are often arbitrarily set and may not reflect the urine drug concentrations of compliant patients. OBJECTIVES: Our aim was to test the hypothesis that commonly used cutoffs for many prescribed and illicit drugs were set too high, and methods using these cutoffs may yield a considerable number of false-negative results...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29145707/relationship-between-testosterone-in-serum-saliva-and-urine-during-treatment-with-intramuscular-testosterone-undecanoate-in-gender-dysphoria-and-male-hypogonadism
#3
Y Lood, E Aardal-Eriksson, C Webe, J Ahlner, B Ekman, J Wahlberg
Long-term testosterone replacement therapy is mainly monitored by trough levels of serum testosterone (S-T), while urinary testosterone (U-T) is used by forensic toxicology to evaluate testosterone doping. Testosterone in saliva (Sal-T) may provide additional information and simplify the sample collection. We aimed to investigate the relationships between testosterone measured in saliva, serum and urine during standard treatment with 1,000 mg testosterone undecanoate (TU) every 12th week during 1 year. This was an observational study...
November 16, 2017: Andrology
https://www.readbyqxmd.com/read/29140478/comparison-of-cocaine-crack-biomarkers-concentrations-in-oral-fluid-urine-and-plasma-simultaneously-collected-from-drug-users
#4
Taís Regina Fiorentin, Juliana Nichterwitz Scherer, Marcelo Caetano Alexandre Marcelo, Tanara Rosângela Vieira Sousa, Flavio Pechansky, Marco Flôres Ferrão, Renata Pereira Limberger
The use of oral fluid (OF) as an alternative specimen for drug analysis has become very popular in forensic toxicology. Many clinical studies have evaluated the correlations between concentrations of cocaine and its metabolites in OF and other matrices, but results have shown high variability. In addition, there are no data available regarding the correlations between biomarkers of crack-cocaine use in different matrices. This study evaluated the relationship between concentrations of cocaine/crack-cocaine biomarkers in OF, urine and plasma samples collected from cocaine users...
November 13, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29135039/a-novel-fast-method-for-aqueous-derivatization-of-thc-oh-thc-and-thc-cooh-in-human-whole-blood-and-urine-samples-for-routine-forensic-analyses
#5
Fabio Stefanelli, Federica Giorgia Pesci, Mario Giusiani, Silvio Chericoni
A novel aqueous in situ derivatization procedure with propyl chloroformate (PCF) for the simultaneous, quantitative analysis of Δ(9) -tetrahydrocannabinol (THC), 11-hydroxy-Δ(9) -tetrahydrocannabinol (OH-THC) and 11-nor-Δ(9) -tetrahydrocannabinol-carboxylic acid (THC-COOH) in human blood and urine is proposed. Unlike current methods based on the silylating agent (BSTFA) added in an anhydrous environment, this new proposed method allows to add the derivatizing agent (propyl chloroformate, PCF) directly to the deproteinized blood and recover the derivatives by liquid-liquid extraction...
November 14, 2017: Biomedical Chromatography: BMC
https://www.readbyqxmd.com/read/29115703/moderators-of-response-to-sertraline-versus-placebo-among-recently-abstinent-cocaine-dependent-patients-a-retrospective-analysis-of-two-clinical-trials
#6
Maryam Bashiri, Michael J Mancino, Virginia A Stanick, Jeff Thostenson, Thomas R Kosten, Alison H Oliveto
BACKGROUND AND OBJECTIVES: Moderators of treatment response to serotonin reuptake inhibitor sertraline (SRT) for cocaine dependence were assessed in two randomized, double blind, placebo-controlled clinical trials. METHODS: Generalized estimating equation modeling was performed on data from cocaine-dependent volunteers randomized to receive SRT or placebo (N = 126) who completed >2-week drug-free residential portions of the 12-week trials, in which subsequent outpatient treatment (weeks 3-12) included weekly cognitive behavioral therapy and thrice-weekly supervised urine toxicology...
November 8, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/29097239/studies-on-the-environmental-fate-ecotoxicology-and-toxicology-of-2-methyl-1-3-propanediol
#7
REVIEW
J Fowles, C Lewis, E Rushton
2-methyl 1,3-propandiol (MPD) is a low molecular weight, colorless glycol used in polymer and coating applications. The log Kow of -0.6 suggests partitioning to aqueous phases with a low concern for possible bioaccumulation. MPD was found to be inherently biodegradable. Ecotoxicological results in several aquatic and terrestrial species found no significant hazard potential. MPD is rapidly absorbed via the oral and dermal routes, metabolized to 3-hydroxybutyrate, and excreted in urine with a half-life of 3...
October 28, 2017: Regulatory Toxicology and Pharmacology: RTP
https://www.readbyqxmd.com/read/29078043/doping-control-analysis-at-the-rio-2016-olympic-and-paralympic-games
#8
Henrique Marcelo Gualberto Pereira, Vinicius Figueiredo Sardela, Monica Costa Padilha, Luciana Mirotti, Alessandro Casilli, Fabio Azamor de Oliveira, Gustavo de Albuquerque Cavalcanti, Lucas Martins Lisandro Rodrigues, Amanda Lessa Dutra de Araujo, Rachel Santos Levy, Pedro Antonio Castelo Teixeira, Felipe Alves Gomes de Oliveira, Ana Carolina Giordani Duarte, Ana Carolina Dudenhoeffer Carneiro, Joseph Albert Medeiros Evaristo, Gustavo Ramalho Cardoso Dos Santos, Giovanni Carlo Verissimo da Costa, Fernando de Lima Castro, Fabio Cesar Sousa Nogueira, Fernanda Bertão Scalco, Luciana Pizzatti, Francisco Radler de Aquino Neto
This paper summarizes the results obtained from the doping control analyses performed during the Summer XXXI Olympic Games (from 03 to 21 August 2016) and XV Paralympic Games (from 07 to 18 September 2016). The analyses of all doping control samples were performed at the Brazilian Doping Control Laboratory (LBCD), a World Anti-Doping Agency (WADA)-accredited laboratory located in Rio de Janeiro, Brazil. A new facility at Rio de Janeiro Federal University (UFRJ) was built and fully operated by over seven hundred professionals, including Brazilian and international scientists, administrative staff and volunteers...
October 27, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/29073142/elevation-in-and-persistence-of-multiple-urinary-biomarkers-indicative-of-oxidative-dna-stress-and-inflammation-toxicological-implications-of-maleic-acid-consumption-using-a-rat-model
#9
Charlene Wu, Hsin-Chang Chen, Shu-Ting Chen, Su-Yin Chiang, Kuen-Yuh Wu
Maleic acid (MA), an intermediate reagent used in many industrial products, instigated public health concerns in Taiwan when it was used to adulterate an array of starch-based delicacies to improve texture and storage time. Established studies reported that exposure to high concentrations of MA induce renal injury; little is known whether oxidative stress is induced at a relative low dose. This study aims to investigate the effect of oral single dose exposure of MA on the status of oxidative stress and inflammation...
2017: PloS One
https://www.readbyqxmd.com/read/29067261/active-cocaine-use-does-not-increase-the-likelihood-of-hyperglycemic-crisis
#10
Katherine L Modzelewski, Denis V Rybin, Janice M Weinberg, Sara M Alexanian, Marie E McDonnell, Devin W Steenkamp
OBJECTIVE: Hyperglycemic crisis encompasses a group of diabetes emergencies characterized by insulin deficiency with high morbidity and mortality. Cocaine use is increasingly prevalent in the United States and may be associated with increased risk of diabetic ketoacidosis. The objective was to determine if active cocaine use at hospital admission could be considered a risk factor for development of hyperglycemic crisis. METHODS: A retrospective case-control analysis was performed on 950 inpatients with hyperglycemia at an urban academic hospital...
September 2017: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29066336/safety-investigation-on-total-steroid-saponins-extracts-from-dioscorea-zingiberensis-c-h-wright-sub-acute-and-chronic-toxicity-studies-on-dogs
#11
Xinxin Zhang, Ming Jin, Nigatu Tadesse, Liang Xian, Hui Zhang, Sicen Wang, Jun Dang, Yan Zhang, Zengjun Guo, Yoichiro Ito
Sub-acute and chronic toxic effects of total steroidal saponins (TSSN) extracts from Dioscorea zingiberensis C.H. Wright on various internal organs and biochemical indicators have never been studied before and this study is the first of its kind to demonstrate sub-acute and chronic toxicities of TSSN on dogs. Administration of TSSN extracts at doses up to 3000 mg/Kg daily for 14 days, no biochemical and organ changes were observed on the experimental groups of dogs. Further, chronic toxicity study through oral administration of TSSN extracts at the gradual doses of 50, 250 and 500 mg/Kg for 90 days followed by a 2-week recovery assay revealed absence of significant architectural and morphological changes in internal organs which were confirmed through histopathological examination and merely no significant alteration in the biochemical indicators including hematologic and urine analysis and electrocardiogram compared to the control dogs...
October 21, 2017: Regulatory Toxicology and Pharmacology: RTP
https://www.readbyqxmd.com/read/29055888/prenatal-exposure-to-glycol-ethers-and-cryptorchidism-and-hypospadias-a-nested-case-control-study
#12
Charline Warembourg, Jérémie Botton, Nathalie Lelong, Florence Rouget, Babak Khoshnood, Florent Le Gléau, Christine Monfort, Laurence Labat, Fabrice Pierre, Barbara Heude, Rémy Slama, Luc Multigner, Marie-Aline Charles, Sylvaine Cordier, Ronan Garlantézec
OBJECTIVES: Glycol ethers (GE) are oxygenated solvents frequently found in occupational and consumer products. Some of them are well-known testicular and developmental animal toxicants. This study aims to evaluate the risk of male genital anomalies in association with prenatal exposure to GE using urinary biomarkers of exposure. METHODS: We conducted a case-control study nested in two joint mother-child cohorts (5303 pregnant women). Cases of cryptorchidism and hypospadias were identified at birth and confirmed during a 2-year follow-up period (n=14 cryptorchidism and n=15 hypospadias)...
October 21, 2017: Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29046744/clinical-and-epidemiological-characteristics-of-patients-with-acute-drug-intoxication-admitted-to-icu
#13
Jose Orsini, Nanda Din, Ershad Elahi, Anthony Gomez, Salil Rajayer, Ryan Malik, Elie Jean
Background: Drug overdose continues to be the most common cause of acute poisoning worldwide. There has been a substantial increase in drug overdose incidence and prevalence over the past decade, probably as a result of the emergence of new synthetic designer drugs. The purpose of this study is to describe the clinical and epidemiological characteristics of patients with acute drug intoxication admitted to the Intensive Care Unit (ICU). Methods: A single center, prospective, observational study was conducted among all adult patients with clinical signs suggestive of acute drug intoxication admitted from the Emergency Department (ED) to ICU during a 6-month period (September to March)...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29045066/fatality-involving-ocfentanil-documented-by-identification-of-metabolites
#14
Nathalie Allibe, Camille Richeval, Mélodie Phanithavong, Amandine Faure, Delphine Allorge, François Paysant, Françoise Stanke-Labesque, Hélène Eysseric-Guerin, Jean-Michel Gaulier
New psychoactive substances (NPS) use has rapidly increased over the last decade, and in the last 4 years producers increasingly appear to be targeting non-controlled synthetic opioids, involving fentanyl derivatives such as ocfentanil (OcF). Identification of metabolites is of major importance in the context of NPS use as it could improve detection window in biological matrices in clinical and forensic intoxication cases. Hence, this work aims to report a fatality involving OcF documented by the identification of metabolites...
October 16, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/29040568/u-47700-a-not-so-new-opioid
#15
Timothy P Rohrig, Samuel A Miller, Tyson R Baird
U-47700 was developed by the Upjohn Co. in the 1970s as part of their search for a selective μ-opioid agonist with similar potency as morphine. U-47700 has re-emerged recently in the illicit drug market and is easily and cheaply obtained via the internet as well as on the street, many times falsely sold as another drug. Several fatalities from U-47700 have been reported in scientific literature, often in combination with other intoxicants. This case report describes the first death in south-central Kansas resulting solely from U-47700 intoxication: a 26-year-old white male found dead in his bedroom with apparent drug paraphernalia...
October 11, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29036502/three-cases-of-fatal-acrylfentanyl-toxicity-in-the-united-states-and-a-review-of-literature
#16
Daniel C Butler, Kevin Shanks, George S Behonick, Dustin Smith, Susan E Presnell, Lee Marie Tormos
Fentanyl analogs pose a unique challenge for forensic pathologists and toxicologists. The extreme potency of these analogs results in minute blood, urine and vitreous concentrations that are technically difficult to identify. This in addition to their absence from standard drug screening may potentiate a setting of apparent drug overdose without an immediately identifiable source. The following case series illustrates three such encounters with acrylfentanyl, an analog whose presence has not yet been reported in the scientific literature in the United States...
September 28, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29024987/development-and-validation-of-an-eight-item-brief-form-of-the-soapp-r-soapp-8
#17
Ryan A Black, Stacey A McCaffrey, Albert J Villapiano, Robert N Jamison, Stephen F Butler
Objective: Although the Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R) has become a widely used screener for aberrant opioid-related behavior in adults, the length of the instrument may limit its utility. The purpose of the current study was to develop a short form of the SOAPP-R by retaining as few items as possible while maximizing predictive accuracy. Methods: Participants (N = 555), recruited from pain clinics, completed the 24-item SOAPP-R and participated in a five-month follow-up visit to evaluate aberrant drug-related behaviors...
August 11, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29022692/paper-spray-ionization-coupled-to-high-resolution-tandem-mass-spectrometry-for-comprehensive-urine-drug-testing-in-comparison-to-liquid-chromatography-coupled-techniques-after-urine-precipitation-or-dried-urine-spot-workup
#18
Julian A Michely, Markus R Meyer, Hans H Maurer
Screening procedures using high resolution (HR)-mass spectrometry (MS) are getting more and more important, e.g., for drug testing or adherence monitoring. Approaches usually include time-consuming sample preparation and compound separation by liquid chromatography (LC). The paper spray ionization (PSI) technique coupled to MS might overcome these steps by direct analysis of complex mixtures without extraction and separation. In recent years, this technology proved its potential for quantification and/or qualitative screening in biofluids...
November 7, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28987305/unintentional-marijuana-exposure-presenting-as-altered-mental-status-in-the-pediatric-emergency-department-a-case-series
#19
Anita A Thomas, Suzan Mazor
BACKGROUND: Unintentional tetrahydrocannabinol (THC) exposure in pediatric patients can present as altered mental status. Altered mental status in a pediatric patient often leads to invasive diagnostic testing. CASE REPORT: The following cases describe 3 pediatric patients in Washington state who presented to a tertiary care children's hospital emergency department (ED) with altered mental status, later found to have urine toxicology screening positive for inactive THC metabolite (positive THC toxicology screen)...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28987302/ricin-poisoning-after-oral-ingestion-of-castor-beans-a-case-report-and-review-of-the-literature-and-laboratory-testing
#20
Oscar F Lopez Nunez, Anthony F Pizon, Kenichi Tamama
BACKGROUND: Ricin is a protein toxin derived from the castor bean plant Ricinus communis. Several cases secondary to its consumption have been published and, more recently, its use as a potential bioterrorism agent has also been reported. Oral absorption of ricin is highly erratic, leading to a wide spectrum of symptoms. In addition, conventional urine drug screening tests will not be able to detect this compound, posing a diagnostic challenge. CASE REPORT: A male teenager intended to die by ingesting 200 castor beans after mixing and blending them with juice...
November 2017: Journal of Emergency Medicine
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