scholarly journals Rates of Fentanyl Positivity in Neonatal Urine Following Maternal Analgesia During Labor and Delivery

2020 ◽  
Vol 5 (4) ◽  
pp. 686-694
Author(s):  
Natasha Novikov ◽  
Stacy E F Melanson ◽  
Jaime R Ransohoff ◽  
Athena K Petrides
Keyword(s):  
Labor Analgesia ◽  
Labor And Delivery ◽  
Strongly Correlated ◽  
Test Results ◽  
Fetal Exposure ◽  
Chromatography Tandem Mass Spectrometry ◽  
Urine Toxicology ◽  
Liquid Chromatography Tandem Mass ◽  
Record Review ◽  
The Relationship

Abstract Background Fentanyl is commonly given as an analgesic during labor and delivery. The extent of transplacental drug transfer and fetal exposure is not well studied. We analyzed the relationship between neonatal urine fentanyl results and various peripartum factors. Methods A total of 96 neonates with urine toxicology screening between January 2017 and September 2018 were included in the study. Medical record review was used to obtain maternal, neonatal, and anesthesia parameters. A subset of 9 specimens were further tested for levels of fentanyl and norfentanyl by liquid chromatography-tandem mass spectrometry. Results In 29% (n = 24) of cases associated with fentanyl-containing labor analgesia, neonatal toxicology screens were positive for the presence of fentanyl. Positive test results strongly correlated with the cumulative dose and duration of labor analgesia (P < 0.001). The odds of positive neonatal fentanyl screen results increased 4-fold for every 5 hours of maternal exposure to labor analgesia. Importantly, however, neonatal outcomes for infants with positive and negative urine fentanyl screens were the same. Conclusions Our study establishes that maternal fentanyl analgesia is strongly associated with positive neonatal urine fentanyl screens and suggests that more judicious use of these laboratory tests may be warranted.

scholarly journals Blood Concentrations of Designer Benzodiazepines: Relation to Impairment and Findings in Forensic Cases

2020 ◽  
Vol 44 (8) ◽  
pp. 905-914 ◽  
Author(s):  
Gunhild Heide ◽  
Gudrun Høiseth ◽  
Gerrit Middelkoop ◽  
Åse Marit Leere Øiestad
Keyword(s):  
High Performance ◽  
Clinical Test ◽  
Concentration Data ◽  
Criminal Offenders ◽  
Blood Concentrations ◽  
Blood Samples ◽  
Chromatography Tandem Mass Spectrometry ◽  
Liquid Chromatography Tandem Mass ◽  
The Relationship ◽  
Designer Benzodiazepines

Abstract The use of designer benzodiazepines appears to be increasing in many countries, but data concerning blood concentrations are scarce, making interpretation of concentrations difficult. The aim of this study was to report blood concentrations of clonazolam, diclazepam, etizolam, flualprazolam, flubromazepam, flubromazolam and phenazepam and to investigate the relationship between blood concentrations and impairment. The concentration data are from blood samples collected from living cases (apprehended drivers and other drug offences) and medico-legal autopsies. The blood samples were analysed for the seven designer benzodiazepines mentioned above by ultra high performance liquid chromatography–tandem mass spectrometry. Positive cases from between 1 June 2016 and 30 September 2019 were included. Blood concentrations and the conclusion from a clinical test of impairment (when available) are reported. The presented seven benzodiazepines were detected in a total of 575 cases, where 554 of these cases concerned apprehended drivers or other criminal offenders. The number of findings and the median (range) concentrations were as follows: clonazolam, n = 22, 0.0041 mg/L (0.0017–0.053 mg/L); diclazepam, n = 334, 0.0096 mg/L (0.0016–0.25 mg/L); etizolam, n = 40, 0.054 mg/L (0.015–0.30 mg/L); flualprazolam, n = 10, 0.0080 mg/L (0.0033–0.056 mg/L); flubromazepam, n = 5, 0.037 mg/L (0.0070–0.70 mg/L); flubromazolam, n = 20, 0.0056 mg/L (0.0004–0.036 mg/L); and phenazepam, n = 138, 0.022 mg/L (0.0018–0.85 mg/L). A designer benzodiazepine was the only drug detected with relevance for impairment in 25 of the 554 living cases. The physician concluded with impairment in 19 of the 25 cases. Most of the concentrations in these cases were relatively similar to or higher than the median reported concentrations. The most frequent other drugs detected were amphetamine, tetrahydrocannabinol, clonazepam and methamphetamine. The presented blood concentrations can be helpful with the interpretation of cases involving one or more of these seven benzodiazepines. The results indicate that concentrations commonly observed in forensic cases are associated with impairment.

scholarly journals Pharmacokinetics of Shikimic Acid Following Intragastric and Intravenous Administrations in Rats

Pharmaceutics ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 824
Author(s):  
Keumhan Noh ◽  
Hyun-Moon Back ◽  
Beom Soo Shin ◽  
Wonku Kang
Keyword(s):  
Total Synthesis ◽  
Shikimic Acid ◽  
Internal Standard ◽  
Rat Plasma ◽  
Intragastric Administration ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Chromatography Tandem Mass Spectrometry ◽  
Liquid Chromatography Tandem Mass ◽  
Absolute Oral Bioavailability ◽  
The Relationship

Shikimic acid, a critical starting material for the semi-total synthesis of oseltamivir to treat and prevent influenza, exerts many pharmacological effects. However, the optimal bioanalytical method has not been adequately defined. We used liquid chromatography-tandem mass spectrometry to quantitate shikimic acid in rat plasma and studied its pharmacokinetics after intragastric and intravenous administration. Plasma was spiked with an internal standard, and the proteins were precipitated with acetonitrile, followed by solvent evaporation and reconstitution of the mobile phase. Shikimic acid was separated on a hydrophilic reverse-phase column and showed a mass transition ([M-H]−) at m/z 173.4→136.6. Shikimic acid exhibited bi-exponential decay after intravenous dosing, with a rapid distribution (5.57 h−1) up to 1 h followed by slow elimination (0.78 h−1). The steady state distribution and clearance volumes were 5.17 and 1.79 L/h/kg, respectively. After intragastric administration, the shikimic acid level peaked at about 3 h, and the material then disappeared mono-exponentially with a half-life of 1.3 h. A double peak phenomenon was observed. The absolute oral bioavailability was about 10% in rats. We explored the relationship between the pharmacokinetics and pharmacodynamics of shikimic acid.

scholarly journals Familial dysalbuminemic hyperthyroxinemia in a 4-year-old girl with hyperactivity, palpitations and advanced dental age: how gold standard assays may be misleading

2015 ◽  
Vol 28 (1-2) ◽  
Author(s):  
Abha Choudhary ◽  
Chutintorn Sriphrapradang ◽  
Samuel Refetoff ◽  
Zoltan Antal
Keyword(s):  
Clinical Symptoms ◽  
Equilibrium Dialysis ◽  
Elevated Serum ◽  
Signs And Symptoms ◽  
Test Results ◽  
Dental Age ◽  
Diagnostic Dilemma ◽  
Chromatography Tandem Mass Spectrometry ◽  
The Family ◽  
Liquid Chromatography Tandem Mass

AbstractHere we report the case of a young girl who had vague signs and symptoms potentially attributable to hyperthyroidism and was found to have autoimmune thyroiditis and hyperthyroxinemia. The elevated serum free thyroxine levels were persistent when measured by both standard assays and equilibrium dialysis/high-pressure liquid chromatography-tandem mass spectrometry. The clinical symptoms, with discordant thyroid test results, created a diagnostic dilemma that led initially to unnecessary additional evaluations. She was ultimately found to have familial dysalbuminemic hyperthyroxinemia (FDH) and required no therapy. This case highlights the inherent difficulties in evaluating children, who typically have vague signs and symptoms of thyroid dysfunction, when, in addition, they have an unrelated acquired (autoimmune) as well as a genetic (FDH) defect. The benefit of including testing for immediate members of the family is emphasized.

scholarly journals Salivary Cortisone to Estimate Cortisol Exposure and Sampling Frequency Required Based on Serum Cortisol Measurements

2018 ◽  
Vol 104 (3) ◽  
pp. 765-772 ◽  
Author(s):  
Robert F Harrison ◽  
Miguel Debono ◽  
Martin J Whitaker ◽  
Brian G Keevil ◽  
John Newell-Price ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Population Studies ◽  
Area Under The Curve ◽  
Serum Cortisol ◽  
Sampling Frequency ◽  
Linear Mixed Effects ◽  
Chromatography Tandem Mass Spectrometry ◽  
Liquid Chromatography Tandem Mass ◽  
Autonomous Cortisol Secretion ◽  
The Relationship

Abstract Context Population studies frequently measure cortisol as a marker of stress, and excess cortisol is associated with increased mortality. Cortisol has a circadian rhythm, and frequent blood sampling is impractical to assess cortisol exposure. We investigated measuring salivary cortisone and examined the sampling frequency required to determine cortisol exposure. Methods Serum and saliva with cortisol and cortisone were measured by liquid chromatography–tandem mass spectrometry in independent cohorts. The relationship between serum cortisol and salivary cortisone was analyzed in cohort 1 using a linear mixed effects model. The resulting fixed effects component was applied to cohort 2. Saliva cannot easily be collected when a patient is sleeping, so we determined the minimum sampling required to estimate cortisol exposure [estimated area under the curve (eAUC)] using 24-hour cortisol profiles (AUC24) and calculated the relative error (RE) for eAUC. Results More than 90% of variability in salivary cortisone could be accounted for by change in serum cortisol. A single serum cortisol measurement was a poor estimate of AUC24, especially in the morning or last thing at night (RE >68%); however, three equally spaced samples gave a median RE of 0% (interquartile range, −15.6% to 15.1%). In patients with adrenal incidentalomas, eAUC based on three serum cortisol samples showed a difference between those with autonomous cortisol secretion and those without (P = 0.03). Interpretation Accepting that most people sleep 7 to 8 hours, ∼8-hourly salivary cortisone measurements provide a noninvasive method of estimating 24-hour cortisol exposure for population studies.

Study on the relationship between rivaroxaban and factor Xa activity in blood based on HPLC-MS/MS

2021 ◽  
Vol 22 ◽  
Author(s):  
Hongchuan Liu ◽  
Zhixia Zhao ◽  
Yingkai Wang ◽  
Lihong Liu ◽  
Yuanhua Yang ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
High Performance ◽  
Plasma Concentrations ◽  
Factor Xa ◽  
Bleeding Risk ◽  
Tandem Mass ◽  
Chromatography Tandem Mass Spectrometry ◽  
Liquid Chromatography Tandem Mass ◽  
The Relationship

Objective: The aim of the study was to investigate a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method for the determination of rivaroxaban and evaluate the correlation between plasma concentration and anti-Xa activity in patients using oral rivaroxaban. Methods: In this study, the plasma concentration of rivaroxaban and anti-Xa factor activities was determined in 125 patients, and the relationship between the two variables was analysed by SPSS 21.0 software. Results: The results showed that the plasma concentrations of oral rivaroxaban patients were significantly correlated with the activity of the anti-Xa factor (Spearman’s r = 0.990, p <0.05). Conclusion: The plasma concentrations of rivaroxaban are a potentially useful monitoring indicator to assess the patient’s bleeding risk if testing for plasma anti-Xa activity is not available.

scholarly journals Endometriosis & Infertility

2020 ◽  
Vol 3 (2) ◽  
pp. 01-03
Author(s):  
Mohamed Gharib
Keyword(s):  
Implantation Rate ◽  
Oocyte Quality ◽  
Oocyte Donation ◽  
Eutopic Endometrium ◽  
Infertile Women ◽  
Chromatography Tandem Mass Spectrometry ◽  
Liquid Chromatography Tandem Mass ◽  
The Relationship ◽  
Infertile Patients

In 2010 stated that the relationship between infertility and endometriosis is strong, and the monthly fecundity fee for regular couples 15%-20% decreases to 2%-5% when the lady has endometriosis. The mechanisms with which endometriosis reasons infertility are not settled [1]. The possible mechanisms encompass altered folliculogenesis, impaired oocyte release or oocyte oviduct pickup, defects in luteal phase function, differences in the eutopic endometrium, poor oocyte quality, diminished fertilization and implantation rate, and anatomic pelvic alterations, immunological and endocrinological elements may additionally be evolved [2]. Studies on oocyte donation cycles have bolstered the role of oocyte quality in infertile patients with the disease [3]. Lee et al., (2018) determined that liquid chromatography-tandem mass spectrometry displayed considerably elevated peritoneal fluid (PF) sphingolipids in infertile female with severe endometriosis compared with infertile women without endometriosis. Functional research revealed that very-long-chain ceramides may also compromise oocyte maturation

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