Diagnóstico de situación del puerperio reciente y la prestación de anticoncepción en pacientes con screening de drogas positivo en un hospital regional, entre junio 2015 a agosto 2016 / Situation diagnosis of recent puerperio and contraception patients with positive drug screening, in a regional hospital, between june 2015 and august 2016

El consumo de sustancias ilícitas y de alcohol durante el embarazo constituye un problema de salud pública grave, que incide en el aumento de la morbi-mortalidad materno-fetal, el síndrome de abstinencia neonatal e institucionalización de los menores. El puerperio de estas mujeres presenta otros desafíos, siendo uno de ellos el control de su fertilidad posterior dado la menor adherencia al uso de métodos de anticoncepción (MAC) versus la población general. OBJETIVO: Conocer sobre la indicación de métodos anticonceptivos en puérperas con consumo problemático de drogas durante el embarazo, atendidas en el Hospital Dr.Gustavo Fricke, de Viña del Mar. MÉTODO: Se realizó un estudio observacional retrospectivo de los registros médicos de todas las pacientes con test de drogas positivo en orina de la Unidad de Puerperio del Servicio de Ginecología y Obstetricia cuyo parto ocurrió entre Junio del 2015 y Agosto del 2016...

The consumption of illicit substances and alcohol during pregnancy is a serious public health problem, given the increase in maternal-fetal morbidity and mortality, neonatal abstinence syndrome and institutionalization of minors. In turn, the postpartum period of these women presents other challenges, one of which is the control of their subsequent fertility given the lower adherence to the use of contraception methods (MAC) versus the general population. OBJECTIVE: Get to know the indication of contraceptive methods in postpartum women with problematic drug use during pregnancy, treated at the Dr. Gustavo Fricke Hospital, in Viña del Mar. METHOD: A retrospective observational study of the medical records of all patients with a positive urine drug test was performed at the Puerperium Unit of the Gynecology and Obstetrics Service whose delivery occurred between June 2015 and August 2016...

Validación de un método para cuantificar ácido-11-nor-9-carboxi-delta 9-tetrahidrocannabinol en orina por cromatografía gaseosa-espectrometría de masas previa extracción en fase sólida / Validation of a method for quantify 11-nor-9-carboxy-delta 9-tetrahydrocannabinol in human urine using solid phase extraction and gas chromatography-mass spectrometry

El cannabis es una de las drogas ilegales más usadas a nivel mundial. Su consumo se relaciona con diferentes hechos en el ámbito forense, laboral, deportivo y clínico. Para su detección se utilizan métodos con diferentes fundamentos y alcances (inmunológicos, cromatográficos). En este trabajo se describe un método preciso, reproducible y validado, para la cuantificación del principal metabolito urinario del Δ9-tetrahidrocannabinol, el ácido-11-nor-9-carboxi- Δ 9-tetrahidrocannabinol (THC-COOH), por cromatografía gaseosa-espectrometría de masas (GC-MS). Se efectuó una extracción en fase sólida (SPE) a partir de la orina, previa hidrólisis alcalina. Se utilizó el análogo deuterado (THC-COOH D3) como estándar interno. El análisis por GC-MS se realizó en modo SIM. La curva de calibración fue lineal en el rango de trabajo (10-100 ng/ml, r > 0,999) y el límite de cuantificación fue de 10 ng/ml. La recuperación absoluta estuvo comprendida entre el 91,0 y 99,0 %. La precisión intra e inter ensayo fue de 1,06 a 1,26 y 3,59 a 9,80 %, respectivamente. El método fue aplicado a muestras reales, positivas por test inmunológico, resultando ser muy útil y fiable en el análisis de rutina de THC-COOH en orina humana con fines toxicológicos.

Cannabis is one of the most widely used illegal drug in the world. Its consumption is related to different forensic, work, sports and clinical events. In order to determinate the presence of cannabis, different methods with distinct fundamentals and scopes (immunoassay and chromatography) are applied. This report described an accurate, reproducible, and validated gas chromatography-mass spectrometry (GC-MS) method for the quantitation of 11-nor-9-carboxy- Δ9-tetrahydrocannabinol (THCCOOH), the major metabolite of Δ9-tetrahydrocannabinol in urine. A solid phase extraction (SPE), previous alkaline hydrolysis, was performed on the urine sample. Its deuterated analog (THC-COOH D3) was used as internal standard. The GC-MS analysis made by selected ion monitoring (SIM). Calibration curve was linear over the specified range (10 -100 ng/ml; r > 0.999) and limit of quantitation was 10 ng/ml. Absolute recoveries ranged from 91.0 to 99.0. Intra-assay and inter assay precision ranged from 1.06 to 1.26 and 3.59 to 9.80 %, respectively. The method has been applied to real samples, positive to immunological screening test, resulting to be very useful and reliable in routine analysis of THC-COOH in human urine for toxicological purposes.

Validación de un método rápido en orina por lC/MS/MS para la búsqueda de compuestos empleados en sumisión química y su aplicación a muestras reales / Validation of a fast screening method in urine by lC/MS/MS for compounds used in drug-facilitated crime (DFC) and its application to real samples

La Oficina de Naciones Unidas contra la Droga y el Delito (UNODC) en 2011 señala que "El delito facilitado por drogas (DFD) es una expresión general que abarca la violación y otras agresiones sexuales, el robo con violencia o intimidación, la extorsión de dinero y los malos tratos deliberados de ancianos o niños bajo la influencia de sustancias sicotrópicas". En este trabajo se validó un método cualitativo y rápido a partir de muestras de orina por LC/MS/MS para 39 compuestos comprendidos en los listados de sumisión química. El objetivo fue alcanzar un límite de detección un 50 % por debajo de la concentración propuesta como "Límites mínimos de funcionamiento exigidos (MRPL)" por la UNODC, para poder ser aplicado a muestras reales.

The United Nations Office on Drugs and Crime (UNODC) in 2011, states that "The Drug-facilitated crime (DFC) is a general term that includes rape or other sexual assault, robbery, money extortion, as well as the deliberate maltreatment of the elderly or children under the influence of psychotropic substances". In this work we validated a qualitative and fast method from urine samples by LC/MS/MS for 39 compounds included in the Drug-facilitated crime lists. The aim was to reach a detection limit of 50% below the proposed concentration as "minimum required performance limits (MRPL)" by UNODC in order to be applied in real samples.

Prevalência do uso de drogas psicotrópicas em unidades da polícia militar / Prevalence of psychotropic drug use in military police units

Este trabalho objetivou verificar a prevalência do uso de drogas psicoativas (anfetamina, metanfetamina, canabinoides, cocaína, opioides e benzodiazepínicos) entre policiais militares do Estado de Goiás. Os dados foram obtidos a partir de amostras de urina cedidas voluntariamente pelos policiais participantes da pesquisa, os quais foram esclarecidos em relação à metodologia do estudo e assinaram o TCLE. As amostras foram submetidas à análise de triagem por imunocromatografia (Multi-DrugOneStep Test®) e, aquelas positivas, foram confirmadas por cromatografia em fase gasosa acoplada à espectrometria de massa. Os dados foram analisados por estatística descritiva. Os resultados apontaram a presença das seguintes drogas: anfetaminas (0,33%); canabinoides (0,67%); benzodiazepínicos (1,34%); 97,66% foram resultados negativos. A distribuição dos casos positivos foi: benzodiazepínicos (57,1%); canabinoides (28,6%) e anfetaminas (14,3%). Conclui-se que os achados de substâncias psicoativas na amostra de policiais militares voluntários chama a atenção sobre a necessidade da implantação de testes de drogas no efetivo da polícia militar e de políticas públicas preventivas, que visem evitar as consequências do consumo abusivo de psicotrópicos.

The present study aimed to verify the prevalence of psychoactive drug use (amphetamines, methamphetamines, cannabinoids, cocaine, opioids and benzodiazepines) among military police officers in the state of Goiás. Data were obtained from urine samples voluntarily provided by the officers participating in the study, who were informed of the study methods and signed a free and informed consent form. The samples were subject to screening analysis by immunochromatography (Multi-DrugOneStep Test®), with positive tests confirmed by gas chromatography– mass spectrometry (GC-MS) and data analyzed by descriptive statistics. The results indicated the presence of the following drugs: amphetamines (0.33%), cannabinoids (0.67%) and benzodiazepines (1.34%); 97.66% showed negative results. The positive cases were distributed as follows: benzodiazepines (57.1%); cannabinoids (28.6%) and amphetamines (14.3%). In conclusion, the detection of psychoactive substances in voluntary sampling of military police officers indicates the need to implement drug testing among active military officers and preventive public policies aimed at eliminating the abusive consumption of psychotropic drugs.

Drug abuse among workers in Brazilian regions

OBJETIVO: No Brasil, desde 1992, inúmeras empresas comerciais e industriais vêm adotando programas de controle do uso de drogas de abuso no ambiente de trabalho. Nenhuma medida disciplinar ou demissionária é tomada sem antes se tentar a reabilitação do funcionário. O objetivo do estudo é apresentar o perfil do uso de drogas de abuso entre trabalhadores de diferentes empresas brasileiras. MÉTODOS: Amostras de urina de 12.700 indivíduos provenientes das cinco regiões geográficas brasileiras foram analisadas visando à detecção das principais drogas de abuso utilizadas no País: cocaína, maconha e anfetamina. A técnica de enzimaimunoensaio (EMIT) foi usada como análise de triagem para as substâncias pesquisadas. A confirmação dos resultados foi realizada pela espectrometria de massa associada à cromatografia em fase gasosa (GC/MS). A distribuição das amostras de acordo com as regiões geográficas foi: 72,0 por cento foram coletadas na região Sudeste, 13,8 por cento no Nordeste, 7,9 por cento originaram-se na região Sul, 5,7 por cento no Centro-Oeste e 0,6 por cento na região Norte. RESULTADOS: Os resultados obtidos foram: 1,8 por cento de todas as amostras analisadas foram positivas para a presença de drogas de abuso, sendo que 0,5 por cento eram provenientes da região Sul, 1,1 por cento da região Nordeste, 1,2 por cento do Centro-Oeste, 1,3 por cento da região Norte e 2,2 por cento do Sudeste. A freqüência com que as diferentes drogas foram encontradas foi: 59,9 por cento para maconha, 17,7 por cento para cocaína, 14,6 por cento para anfetamina e 7,7 por cento para drogas em associação. CONCLUSÕES: A distribuição das drogas de abuso detectadas apresentou variações regionais. A maconha foi encontrada nas amostras de todas as regiões; a cocaína estava presente somente em amostras oriundas das regiões Centro-Oeste e Sudeste. A anfetamina foi detectada nas amostras provenientes do Nordeste, Centro-Oeste e Sudeste.

Self-reported drug use and urinalysis results.

The study examined the consistency between retrospective self-reported drug use and urinalysis data among 281 male opioid dependent subjects attending out patient clinic of National Drug Dependence Treatment Centre from January 2001 to December 2001 at All India Institute of Medical Sciences, New Delhi. Preliminary analysis indicated that there was moderate to high concordance between the two measures among different drug types. On an average 85% of urine test results matched with self-report. Subject's over-reported drug use as indicated by the low positive predictive value. In contrast, subjects were more accurate when they were reporting no drug use as suggested by the high negative predictive value. The study suggests that urine analysis is a critical variable in substance abuse treatment programs. Clinicians should be cautious while prescribing agonist drug due to frequent over-reporting of drug use by patients in our setting. This will make the substance abuse program more meaningful.

Relacao entre requerimemnto analítico de determinacao de drogas de abuso por imunoensaio e a concordancia nos achados / Relationship between analytical rerquest of drugs abuse determination by immunoassay and the agreement in the discoveries

Las drogas de abuso son sustancias toxicas naturales o sintéticas de uso no terapéutico, relacionadas con la autoadministración inadecuada. El uso abusivo de sustancias psicotrópicas conduce a daños orgánicos motivados por la dependencia físicas y quimica, que conlleva a la autodestrucción del individuo y a la destructuración familiar y social. Este trabajo tiene por objetivo, estudiar la presencia de drogas de abusdo en muestras de orina, de individuos de distintos segmentos sociales entre 15 a 60 años y de ambos sexos. Se investigo la presencia de Marihuana en 124 muestras, Cocaína en 106. Anfetaminas en 95, Benzodiacepinas en 17 y Opiáceos en 21. Se utilizó la técnica semicuantitativa de inmunoensayo de Fluorescencia Polarizada (FPIA). Hubo una prevalencia de positividad a la Marihuana, Anfetamina y Cocaína de 14,51 por ciento; 6,32 por ciento y 0,94 por ciento respectivamente, siendo para hombres entre 15 a 30 años de 11,30 por ciento

Consumo reciente de alcohol y drogas en accidentes del trabajo / Recent use of alcohol and drugs in victims of work related accidents

Background: Twenty to twenty two percent of work related accidents have a direct or indirect relationship with recent alcohol use. Aim: To detect recent alcohol or drug use in patients who required hospitalization for severe work related accidents. Patients and methods: Blood and urine samples were obtained from patients admitted to a hospital within 6 hours of an accident severe enough to require hospitalization. Blood alcohol and urinary metabolites of cocaine, marijuana, amphetamines and benzodiazepines were measured. Patient identity was kept confidential throughout the study. Once patients were stabilized, they were interviewed by a psychologist that was blind to laboratory results. Results: Two hundred thirty men and 18 women were studied and 29 percent (30 percent of men and 17 percent of women) had recent use of alcohol or drugs. The most common substances were alcohol in 15 percent and benzodiazepines in 13 percent. Use of alcohol or drugs was found in 21 percent of professionals, in 33 percent of other occupational levels, half of agricultural workers and 25 percent of commerce workers. Only two of 60 positive cases, admitted substance use during the interview. Most of negative cases admitted the use of alcohol or other drugs during the month prior to the accident. Conclusions: Recent use of alcohol and drugs is frequent among severe work related accident victims. Probably, a high proportion of these subjects are problem drinkers. The combination of alcohol and benzodiazepines is an additional risk factor

Screening for urinary amphetamine in truck drivers and drug addicts.

Sixty-two urine samples from truck drivers and drug addicts were analysed by TDx (Abbott Laboratories) for amphetamines. Eighteen samples were found to be positive while the rest were negative. The eighteen samples were simultaneously determined for amphetamines by EMIT (Syva Company). Sixteen samples were found to be positive and 2 of negative samples had amphetamines levels of 0.48-0.85 micrograms/mL. When the same samples were subjected to qualitative screening and some were found false negative as follows: 7 cases in Color Test by using test solution kits amphetamine in urine (the Department of Medical Science, Ministry of Public Health), 8 cases by Albuscreen Ontrax for amphetamine (Roche Diagnostic System), 5 cases by amphetamine Double Antibody 125I-RIA (Diagnostic Products Corporation-DPC) and 3 cases by the method of Ten-One (DPC) respectively. But when forty four samples which gave negative results by TDx were subjected to Testing by EMIT and Ontrax. The results of both EMIT and Ontrax were negative. Some of forty four samples were false positive by the Color Test solution kit amphetamines in urine and amphetamine Double Antibody 125I-RIA. Reliability of results reported not only depends on the methodology or principle but also the sensitivity of the method.