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Toxicology Screen (toxicology + screen)

Distribution by Scientific Domains
Medical Sciences80%

Selected Abstracts

Marijuana Use in Potential Liver Transplant Candidates

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 2 2009
D. N. Ranney
Concern exists that liver transplant center substance abuse policies may have an inappropriate and disproportionate impact on marijuana users. Our hypothesis is that patients with chronic liver disease who were marijuana users will have inferior survival. This is a retrospective (1999,2007) cohort study. The primary outcome measure is time-dependent, adjusted patient survival from the time of liver transplant evaluation. The primary exposure variable is a positive cannabinoid toxicology screen during the liver transplant evaluation period. Overall, 155 patients qualified as marijuana users while 1334 patients were marijuana non-users. Marijuana users were significantly (p < 0.05) younger (48.3 vs. 52.1), more likely to be male (78.1% vs. 63.0%), have hepatitis C (63.9% vs. 40.6%) and were less likely to receive a transplant (21.8% vs. 14.8%). Marijuana users were more likely to use tobacco, narcotics, benzodiazepines, amphetamines, cocaine or barbiturates (p < 0.05). Unadjusted survival rates were similar between cohorts. Upon multivariate analysis, MELD score, hepatitis C and transplantation were significantly associated with survival, while marijuana use was not (HR 1.09, 95% CI 0.78,1.54). We conclude that patients who did and did not use marijuana had similar survival rates. Current substance abuse policies do not seen to systematically expose marijuana users to additional risk of mortality. [source]

Strategy for increasing detection rates of drug and alcohol abuse in paediatric emergency departments

ACTA PAEDIATRICA, Issue 10 2009
E Kozer
Abstract Aim:, To determine whether implementation of criteria for performing a toxicology screen and increasing staff awareness improve detection of substance abuse among adolescents presenting to the emergency department. Methods:, Patients 12 to 18 years of age presenting to one of three emergency departments in Israel were included in a prospective cohort study. In the ,study' hospital, a set of criteria for urine toxicology screen and measurements of ethanol serum level were implemented. No specific interventions were implemented in the two other hospitals. The main outcome measure was the rate of substance abuse detection. Results:, The number of adolescents seen in the participating centres was 3200 at the study hospital, and 3493 and 2792 at the two other hospitals. High blood ethanol concentrations were found in 49 patients at the study hospital compared with 30 and 19 patients at the two other hospitals (p < 0.001). Illicit drugs were detected in 13, 4 and 1 patients, respectively (p = 0.002). Conclusions:, Introducing structured guidelines for ordering toxicological screening increases the detection of alcohol and drug of abuse among adolescents presenting to paediatric emergency departments. [source]

A Case of Fatal Aconitine Poisoning by Monkshood Ingestion,

JOURNAL OF FORENSIC SCIENCES, Issue 2 2008
Ravi Pullela B.Sc.
Abstract:, Accidental aconitine poisoning is extremely rare in North America. This report describes the confirmation of a case of accidental aconitine poisoning using a liquid chromatography,tandem mass spectrometry (LC-MS/MS) method. The case involved a 25-year-old man who died suddenly following a recreational outing with friends where he consumed a number of wild berries and plants including one that was later identified as Monkshood (Aconitum napellus). Postmortem blood and urine samples were available for analysis. All routine urine and blood toxicology screens were negative. The LC-MS/MS method allowed sensitive quantification of aconitine, the main toxin in A. napellus, and showed 3.6 and 149 ,g/L in blood and urine, respectively. These concentrations were similar to that reported in other aconitine-related deaths. This case illustrates the dangers of consuming unidentified plants, and documents concentrations of aconitine in blood and urine in a fatal case of A. napallus -related poisoning. [source]

Treatment of Cannabis Use Disorders: A Review of the Literature

THE AMERICAN JOURNAL ON ADDICTIONS, Issue 5 2007
Benjamin R. Nordstrom MD
Cannabis is the most widely used illicit drug in the United States. Despite the fact that there are large numbers of people with cannabis dependence, relatively little attention has been paid to the treatment of this condition. This article seeks to critically review the existing literature about the various psychosocial and pharmacologic treatments of cannabis dependence. We begin with a discussion of the early treatment literature which draws primarily from anecdotal experience and open, uncontrolled trials and proceed through two recent, large, randomized controlled trials of psychotherapies for the treatment of cannabis dependence. We conclude that while a number of psychotherapies have been found to be effective in treating this disorder, with the exception of adding vouchers to reinforce negative urine toxicology screens, no form of psychotherapy has been found to be more effective than any other. In addition, we review the only two clinical pharmacotherapy trials for cannabis dependence as well as the pre-clinical laboratory pharmacotherapy trials in cannabis dependent individuals. We also review pertinent dual-diagnosis pharmacotherapy trials and discuss potential future directions in treatment research for the pharmacotherapy of cannabis dependence. [source]