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At least 289 records · Page 16Linked to original sources

PubMed1998

Tetrachloroethylene intoxication in an autoerotic fatality.

This case report describes an accidental death due to the inhalation of tetrachloroethylene during an autoerotic episode. Tetrachloroethylene was administered from a can of Fix-A-Flat tire repair. Analysis of tetrachloroethylene was performed using headspace gas chromatography and electron capture detection. The blood tetrachloroethylene concentration of 62 mg/L was consistent with acute tetrachloroethylene intoxication.

Administration, Inhalation↗

PubMed2006

Testosterone: use, misuse and abuse.

Testosterone is among the oldest drugs in medicine. It has a long efficacy and safety record for its prime role of androgen replacement therapy in men with androgen deficiency. Testosterone and synthetic analogue androgens have also been used in pharmacological androgen therapy (PAT) to produce androgenic effects on marrow, muscle or bone. Although PAT is increasingly being superseded by newer, more expensive drugs, androgens remain cost-effective in many older applications. Androgen misuse is the systematic over-prescribing for unproven medical indications. Misuse is increasingly evident for male ageing ("andropause") and some other clinical conditions. Further trials for new indications for androgens require reliable safety data, but rising costs may make it increasingly attractive to circumvent the need for evidence by promoting off-label mass marketing. Androgen abuse is the illicit self-administration of often massive doses of androgens for non-medical purposes - notably power sports and body building. In parallel with effective detection reducing androgen abuse in elite sports, more focus is needed on non-sporting cosmetic, recreational and occupational androgen abuse. Despite ongoing androgen misuse and abuse, testosterone remains under-prescribed for younger men with classical androgen deficiency that frequently remains undiagnosed.

Aging↗

PubMed2004

Urinary screening for methylphenidate (Ritalin) abuse: a comparison of liquid chromatography-tandem mass spectrometry, gas chromatography-mass spectrometry, and immunoassay methods.

OBJECTIVE: To develop a routine method for detecting methylphenidate (Ritalin) use among drug abusers using liquid chromatography-tandem mass spectrometry (LC/MS/MS). The new methodology was designed to replace less reliable and/or more expensive and time-consuming techniques (GC/MS and ELISA) currently employed in our laboratory, and to provide a combined one-step screening and confirmation LC/MS/MS method. DESIGN AND METHODS: Because methylphenidate abuse is very prevalent in Saskatchewan, there is a demand to provide high volume urine screening both to detect abuse, and to monitor compliance. Random urine samples sent for drugs of abuse testing, standards, and controls were diluted 1:100 in methanol. Diluted specimens were injected directly into an Agilent 1100 liquid chromatograph coupled to a Sciex API 2000 mass spectrometer. The method utilized selected reaction monitoring (SRM) as well as an electrospray ionization source (EIS) to detect both urinary methylphenidate and the more prevalent metabolite, ritalinic acid (RA). RESULTS: There appeared to be little or no sacrifice in sensitivity because the higher dilutions exhibited much less matrix effect. Limit of quantitation (LOQ) for methylphenidate was 100 nM and 500 nM for RA. Linear calibration curves from 100 to 1000 nM for Ritalin and 500 to 5000 nM for RA were acquired. Imprecision of spiked and true specimens did not exceed 10% and at the LOQ, it was less than 20%. CONCLUSIONS: A rapid, sensitive, reliable, and highly specific method by LC/MS/MS for detecting methylphenidate and its metabolite, RA, were developed. Both the cost and performance of the LC/MS/MS method were superior to GC/MS or ELISA, and it allows use of a single rapid procedure for both screening and confirmation.

Chromatography, Liquid↗

PubMed2004

An epidemiological study on alcohol/drugs related fatal traffic crash cases of deceased drivers in Hong Kong between 1996 and 2000.

This study is designed to evaluate the correlation between fatal vehicle crashes (FVC) and consumption of alcohol and/or drugs among drivers. Between 1996 and 2000 in Hong Kong, a total of 197 FVC cases of deceased drivers were investigated. The blood and/or urine samples of the victims were examined for the presence of alcohol and drugs. The 197 cases were then classified into two groups: single-vehicle crashes (SVC) and multiple-vehicle crashes (MVC). Out of the 106 cases for the latter group, alcohol and/or drugs were detected in 22 cases (21%) while the remaining 84 cases (79%) were regarded as no significant finding. As for the 91 cases in SVC group, 51 cases (56%) were positive for alcohol and/or drugs. The findings indicate that a driver consuming alcohol and/or drugs has a higher risk of being involved in a FVC. The most frequently detected drugs for SVC group (11 cases) were: 46% central nervous system (CNS) stimulants (including designer drugs like MDMA); 36% cannabis; 18% benzodiazepines and 9% ketamine. The detected drug for the only case in the MVC group was a CNS stimulant. The number of cases with ketamine, methamphetamine and MDMA detected has increased in recent years as these party drugs have gained popularity in Hong Kong.

Accidents, Traffic↗

PubMed1994

Hair analysis for buprenorphine and its dealkylated metabolite by RIA and confirmation by LC/ECD.

Hair samples were obtained from 14 subjects admitted 2 or 3 months previously to a detoxification center. All reported an history of intravenous heroin abuse. After decontamination by two dichloromethane washes, about 50 mg hair were pulverized in a ball mill and incubated at 56 degrees C overnight in 1 mL 0.1 HCl. After neutralization, buprenorphine analyzed by RIA was in the range of 0.01 to 0.47 ng/mg. To confirm buprenorphine, liquid chromatography was used. After neutralization, drugs were extracted with toluene at pH 8.5 during a 3-step extraction procedure. A portion of the reconstituted residue was injected into a Lichrosorb CN column, with a mobile phase of phosphate buffer (pH 4.0)-acetonitrile-1-heptane sulfonic acid-butylamine (85:17:2:0.01, v/v). Detection was achieved by coulometry, and the potential of the electrodes was 0.15 and 0.50 V, respectively. Linear calibration curves were obtained from 0.02 to 2.0 ng/mg with a correlation coefficient r > 0.99 for both drugs. The detection limit for the major metabolite was about 0.01 ng/mg and 0.02 ng/mg for buprenorphine, using a 50 mg hair sample. Recovery (at 0.2 ng/mg) was 54 and 62% for norbuprenorphine and buprenorphine, respectively. Drugs concentrations in hair were in the range 0.02-0.59 and not detected--0.15 ng/mg for buprenorphine and norbuprenorphine, respectively. Results suggest that a dose-response relationship exists between the concentration of buprenorphine in hair and the administered dose.

Adult↗

PubMed1994

Subcritical fluid extraction of opiates in hair of drug addicts.

Hair analysis is a useful complement to blood and urine analysis in forensic science, but current procedures are tedious and time consuming. Owing to the difficulty of having a sufficient amount of hair in order to perform the optimization of the extraction method, standard hair was made and the procedure is described. The spiking method is reproducible and linearity can be obtained. Subcritical fluid extraction of opiates from standard and drug addicts' hair was optimized (extraction phase composition, extraction time, etc.) and compared with other extraction techniques (basic and acid hydrolysis, organic solvent and enzymatic digestion) followed by solid-phase extraction. Recovery, coefficient of variation, linearity, detection limits and quantification limits for the subcritical fluid extraction of opiates in hair are described.

Codeine↗

PubMed1993

Punishing pregnant drug users: enhancing the flight from care.

One hundred forty-two low income women were interviewed postpartum to determine their attitudes regarding the potential effects of a punitive law on the behavior of substance-using pregnant women. The convenience sample was primarily black (85.2%) and single (81%) and 14.8% admitted use of illicit drugs during pregnancy. A goodness-of-fit chi-square analysis revealed that subjects believed a punitive law would be a significant deterrent to substance-using gravida seeking prenatal care, drug testing or drug treatment (P < 0.01). Comments indicated that substance-using pregnant women would 'go underground' to avoid detection and treatment for fear of incarceration and loss of their children.

Alcohol Drinking↗

PubMed1993

Experience of a laboratory service for drug screening in urine.

The use of a drug screening service has been investigated over a nine month period during which 1500 urine samples from 765 patients were analysed. Preliminary drug screening of urine samples was performed by EMIT immunoassays adapted for use on the Cobas Bio analyser; further identification and confirmation were carried out by Toxi-Lab thin-layer chromatography and capillary gas chromatography. A large number of positive results were obtained for benzodiazepines, cannabinoids, methadone and opiates (mainly dihydrocodeine). Only a limited number of urines gave positive results for amphetamine and related stimulants; cocaine metabolite was rarely detected in samples. The service proved to be of considerable value in the management of drug misusers, and for the identification of new substances taken by the local population.

Enzyme Multiplied Immunoassay Technique↗

PubMed1994

Drug detection and trauma cause--a case control study of fatal injuries.

Although drugs are frequently detected when studied in trauma series, the association between specific trauma types (such as gun shot wound) and drug use complicates interpretation of such reports. We carried out a case control study of trauma deaths with drug detection matched by cause with non-drug detection trauma fatality controls. We studied 117 case and control pairs identified from medical examiner's records. By multiple logistic regression analysis, younger adult age (OR 3.1; 95% CI 1.5 to 6.1) and black race (OR 2.3; 95% CI 1.1 to 5.0) were both strongly associated with drug detection. In contrast, neither gender, intent (homicide, suicide or unintentional), primary trauma site, nor ethanol detection were significantly associated with drug detection. Our findings suggest that case mix variables should be considered when interpreting the drug use rates in trauma.

Adolescent↗

PubMed1996

Stability of opiates in hair fibers after exposure to cosmetic treatment.

The stability of opiates in clipped natural human hair was investigated. Hair fibers were incubated with defined solutions of morphine, codeine and dihydrocodeine (pH 7.4) until saturated. Original opiate-positive hair samples collected from drug addicts also were examined. Commercially available bleaching as well as perming formulas (Poly Blonde Ultra, Poly Lock; Henkel, Düsseldorf, Germany) were applied in vitro to the hair strands of both groups under investigation. After these treatments, the drug concentration had decreased for both bleaching and permanent waving. In the spiked hair, only 2-18% of the starting solution could be found after bleaching. About 20-30% of the drug substances could still be detected after perming. In the authentic hair samples, the drug levels of the formerly opiate positive hair fibers had also been reduced but distinct tendencies could not be observed.

Bias↗

PubMed1994

Prenatal drug use in Minneapolis-St Paul, Minn. A 4-year trend.

OBJECTIVES: To determine the rates of maternal ingestion of cocaine, marijuana, and opiates in women from Minneapolis-St Paul, Minn, in 1993 and compare them with rates observed in 1989; and to compare outcomes of newborns born to those women with and without evidence of prenatal drug ingestion. STUDY DESIGN: The meconium from newborns of a representative cluster-based sample of women from Minneapolis-St Paul was analyzed for metabolites of cocaine, marijuana, and opiates. The newborns were consecutive births in four urban and suburban hospitals. Maternal demographic information and newborn outcome data were collected and matched to the meconium samples. The race, age, and socioeconomic status of the mothers whose newborns were screened were the same as the demographic characteristics of all women delivering babies in Minneapolis-St Paul in 1990 and 1991. SETTING: Metropolitan hospitals of Minneapolis-St Paul. MAIN RESULTS: Of the 1333 samples, 27 (2.0%) were cocaine positive, 35 (2.6%) were tetrahydrocannabinol positive, and 16 (1.2%) were opiate positive. There were 168 women (22.6%) reporting that they smoked. Detection of tetrahydrocannabinol and cocaine was more common in newborns of women of color, those receiving medical assistance, and those over age 23 years. Newborns with meconium samples positive for cocaine or tetrahydrocannabinol had slightly lower average birth weights but were no more likely to be premature or to require neonatal intensive care unit admission than newborns with no drugs detected in their meconium. Newborns of mothers who smoked throughout pregnancy had lower average birth weights and higher rates of prematurity and neonatal intensive care unit admissions. Standardized rates of cocaine detection in the four hospitals decreased from 4.0% in 1989 to 2.0% in 1993. CONCLUSIONS: Rates of perinatal cocaine detection have declined in the Twin Cities of Minneapolis-St Paul over the past 4 years. In this population, self-reported smoking was associated with more serious adverse outcomes of the newborns than was the detection of cocaine, marijuana, or opiates.

Adolescent↗

PubMed2005

Drugs in oral fluid Part II. Investigation of drugs in drivers.

As part of the European project, Impaired Motorists, Methods of Roadside Testing and Assessment for Licensing, otherwise known as IMMORTAL (Deliverable R4.2), the University of Glasgow was required to analyse 1396 oral fluid samples, collected from drivers, for a wide range of drugs. A previously described method to include 49 drugs and metabolites was used. To include cannabis in the study a separate extraction method was required because of interferences caused by the collection device. The study group included drivers who were stopped at random and participation was entirely voluntary. The results showed that out of the 1396 samples tested, 16.8% were positive for at least one drug. In the majority of positive cases (85%), monodrug use was found and the most commonly detected drug was 3,4-methylenedioxymethamphetamine. This study showed that a significant number of the driving population are positive for at least one drug.

Automobile Driving↗

PubMed1995

Intensive surveillance for cocaine use in obstetric patients.

OBJECTIVE: To determine the value of intensive surveillance for cocaine use in pregnancy and also determine the prevalence of cocaine use in our institution. METHODS: Among 124 consecutive new obstetrical clinic patients, urine specimens were collected anonymously at the first prenatal visit, in each subsequent trimester of pregnancy, and on labor and delivery. Corresponding newborn urine and meconium were also collected for these patients. 324 urine specimens and 49 meconium specimens were obtained. A local private group also collected first prenatal visit urine from an additional 104 patients. Urine specimens were analyzed for cocaine metabolites by fluorescent polarization immunoassay with confirmation of positive results by gas chromatography/mass spectrophotometry. RESULTS: One clinic patient had a positive cocaine screen. All other urine and meconium screens were negative. CONCLUSION: Intensive surveillance did not increase the detection rate for cocaine abuse in our obstetric population. We also found that the prevalence of cocaine abuse among obstetrical patients at our institution is low (< 1%). These data reconfirm that resource allocation for drug treatment centers should be based on prevalence data specific to an area or institution.

Cocaine↗

PubMed2000

Interpretation and enantiomer analysis of methamphetamine abusers' urine and illegally brewed methamphetamine crystals.

This study deals with the high-performance liquid chromatographic identification of methamphetamine (MAMP) and amphetamine (AMP) enantiomers (d- and l-forms) in five illicit MAMP crystals and in urine specimens from 30 Japanese MAMP abusers. The analysis revealed that two of the types of crystals have a different optical purity ratio (l/d) and the other three have a single crystal of either the d- or l-enantiomer. The l/d ratios of two types of crystals were 0.04 and 49.4, and no racemic form (l/d = 1.00) was found. The urinary analysis showed that nonmetabolized MAMP and its demethylated metabolite, AMP, were present in urine specimens of all addicts. The stereoisomeric profiles in urine can be classified roughly into five groups according to the detected amount and the l/d ratio of MAMP and AMP enantiomers collected at one time point. In the first group, only d-MAMP and d-AMP were detected (in 16 cases). In the second group, only l-MAMP and l-AMP were detected (in one case). In the third group, the amount of the l-enantiomer detected, for both MAMP and AMP, was less than that of the d-enantiomer, and the l/d ratio was between 0.004 and 0.54 for MAMP and between 0.01 and 0.07 for AMP (in five cases). In the fourth group, the l-enantiomer of MAMP and AMP was found to be more abundant than the d-enantiomer, and the l/d ratio was between 2.63 and 30.11 for MAMP and between 1.23 and 31.30 for AMP (in four cases). In the fifth group, the amount of l-MAMP detected was greater than that of d-MAMP, and less l-AMP than d-AMP was detected. The l/d ratios were between 1.13 and 8.82 for MAMP and between 0.17 and 0.82 for AMP (in four cases). These results might be suitable for identification and the forensic toxicological investigation of AMP analogues.

Adolescent↗

PubMed1996

Long-term detection and identification of metandienone and stanozolol abuse in athletes by gas chromatography-high-resolution mass spectrometry.

The misuse of anabolic androgenic steroids (AAS) in human sports is controlled by gas chromatography-mass spectrometric analysis of urine specimens obtained from athletes. The analysis is improved with modern high-resolution mass spectrometry (HRMS). The detection and identification of metabolites of stanozolol (I) [3'-hydroxystanozolol (II) and 4 beta-hydroxystanozolol (III)] and metandienone (IV) I17 beta-methyl-5 beta-androst-1-ene-3 alpha,17 alpha-diol (V) and 18-nor-17,17-dimethyl-5 beta-androsta-1,13-dien-3 alpha-ol (VI)] with GC-HRMS at 3000 resolution yielded a large increase in the number of positive specimens. A total of 116 anabolic steroid positives were found in this laboratory in 1995 via GC-MS and GC-HRMS screening of 6700 human urine specimens collected at national and international sporting events and at out-of-competition testing. Of the 116 positive cases, 41 were detected using conventional (quadrupole) GC-MS screening. The other 75 positives were identified via GC-HRMS screening. To confirm the HRMS screening result, the urine sample was reanalyzed using a specific sample workup procedure to selectively isolate the metabolites of the identified substance. II and III were selectively isolated via immunoaffinity chromatography (IAC) using an antibody which was prepared for methyltestosterone and shows high cross reactivity to II and III. V and VI were isolated using high-performance liquid chromatography (HPLC) fractionation.

Anabolic Agents↗

PubMed1992

Measurement of gestational cocaine exposure: sensitivity of infants' hair, meconium, and urine.

We studied the sensitivity of testing the newborn infant's hair, meconium, and urine in detecting gestational cocaine exposure. The infants were born to 59 women who were interviewed to determine their use of cocaine during pregnancy and whose hair was analyzed for the presence of cocaine. Regression analysis was used to evaluate the relationship between cocaine in newborn hair and in maternal hair. Radioimmunoassay of infants' hair and gas chromatography-mass spectrometry of meconium were more sensitive than immunoassay of urine (p less than 0.02), which failed to identify 60% of cocaine-exposed infants. The quantity of benzoylecgonine in the newborn infant's hair correlated best with the proximal-segment maternal hair, representing the last 12 weeks of antepartum hair growth (R = less than R less than 0.83). Approximately half (52%) of the variation in infants' hair was explained by variation in the proximal maternal hair segment. Correlation (R = 0.77) and explained variation (59%) improved slightly when premature infants (n = 9) were excluded. We conclude that analysis of the newborn infant's hair by radioimmunoassay or of meconium by gas chromatography-mass spectrometry is more sensitive than analysis by immunoassay of urine, and can detect fetal cocaine exposure that occurred during the last two trimesters of pregnancy.

Adult↗

PubMed2000

Detection and importance of laxative use in adolescents with anorexia nervosa.

OBJECTIVE: The frequency of laxative use in adolescents with anorexia nervosa is poorly described. This study of adolescents with anorexia nervosa examined self-report and biochemical screening methods for the detection of laxative use, the pattern of laxative use in this population over time, and the associated medical complications and psychopathology. METHOD: Forty-three consecutive patients with anorexia nervosa were studied. Initial assessment encompassed psychiatric history, medical examination, and administration of the Eating Disorders Examination, Child Behavior Checklist, and Youth Self-Report. Biochemical investigations, including random urinary laxative screening, were performed at assessment and follow-up. RESULTS: The frequency of laxative use from self-report alone was 12%; combined with urine screening it was 19%. The frequency of laxative use increased to 32% with prospective follow-up. Medical complications were associated with laxative use at follow-up. Laxative use was associated with longer duration of disease and with higher scores on the Eating Disorders Examination subscale Eating Concern. CONCLUSIONS: Laxative use is common among adolescents with anorexia nervosa, and the risk of associated medical complications increases over time. Biochemical screening will improve detection of laxative use. Longer duration of illness and greater Eating Concern scores are associated with increased risk of laxative use, and monitoring patients at increased risk is important.

Adolescent↗

PubMed1994

An examination of current and proposed drug-testing policies at US colleges and universities.

Administrators at 400 colleges and universities were surveyed for information regarding their schools' current or proposed policies for the urine drug testing of faculty, nonfaculty employees, and students. Three hundred seven schools (77%) responded regarding their testing policies for employees and applicants for employment, including faculty and nonfaculty; 332 (83%) responded with respect to students. Twenty-five schools reported testing one or more of these groups. None of the schools reported randomly testing applicants for either faculty or nonfaculty positions, and none tested all applicants for all positions. Fewer than 7% of the colleges and universities surveyed reported that they tested urine of employees and applicants for employment to detect drug use. In those institutions that carried out tests, the tests were most often directed toward particular types of workers. Student testing was limited to approximately 2% of the 332 responding institutions.

Adult↗