Detection of Synthetic Cannabinoid CUMYL-PEGACLONE in E-Cigarette Oil and Hair / 法医学杂志

OBJECTIVES@#To establish a combined high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) and gas chromatography-mass spectrometry (GC-MS) method to detect the synthetic cannabinoid CUMYL-PEGACLONE in e-cigarette oil and hair.@*METHODS@#HPLC-MS/MS and GC-MS were used to establish the detection method of CUMYL-PEGACLONE, and the hair of drug-involved persons and the seized e-cigarette oil were detected.@*RESULTS@#The main mass spectrometry characteristic ions m/z of CUMYL-PEGACLONE measured by GC-MS were 91, 179, 197, 254 and 372. CUMYL-PEGACLONE had a good linear relationship in the mass concentration range of 2-50 ng/mL, and the linear correlation coefficient (r) was greater than 0.99. The limit of detection (LOD) of CUMYL-PEGACLONE in hair was 0.01 ng/mg, and the limit of quantitation (LOQ) was 0.02 ng/mg. The LOD of CUMYL-PEGACLONE in e-cigarette oil was 1 ng/mg, and the LOQ was 2 ng/mg. The average recoveries of CUMYL-PEGACLONE under the attempt at high, intermediate and low levels in blank human hair and e-cigarette oil matrix were 98.2%-132.4% and 93.5%-110.6%, and the intraday and intraday precision were 1.2%-12.9% and 0.7%-2.9%. CUMYL-PEGACLONE was detected in the hair of 15 drug-involved persons. Except for 1 person who was lower than LOQ, the concentration of CUMYL-PEGACLONE in the hair of other 14 persons was 0.035-0.563 ng/mg. The mass fraction of CUMYL-PEGACLONE in 2 e-cigarette oil were 0.17% and 0.21%, respectively.@*CONCLUSIONS@#The established HPLC-MS/MS and GC-MS methods are applied to the detection of HPLC-MS/MS in drug-related cases, which provides strong evidence support for the handling authority to quickly investigate these cases, and also provides a reference for the identification of such substances in future.

Perfil de alcaloides de la hoja de coca en el fluido oral de un mascador de hoja de coca y un bebedor de té de coca: Estudio preliminar / Coca alkaloids profile in oral fluid from people chewing coca leaves and drinking coca tea: Preliminary study

Actualmente el fluido oral (FO) es aceptado como una matriz biológica alternativa para detectar drogas en toxicología clínica y forense. En países como Argentina donde el uso de hojas de coca (mascar hojas de coca o beber té de coca) es legal son necesarios procedimientos adecuados para logar una clara diferenciación entre los individuos que usan las hojas de coca de manera legal de aquéllos que usan cocaína en forma ilegal. Poca es la información que hay en la literatura sobre el perfil de los alcaloides de la hoja de coca en FO de personas que mascan hojas de coca o toman té de coca y hasta el presente trabajo no se hallaron datos sobre el perfil en FO de la higrina (HIG) y cuscohigrina (CUS). De este estudio preliminar participaron dos voluntarios. Los resultados mostraron que la CUS e HIG siguieron siendo positivas después que la cocaína (COC) y benzoilecgonina (BE) cayeron por debajo de los valores cut- off propuestos por las guías internacionales para FO en casos de screening (15 a 20 ng/ mL) y de confirmación (8 a 10 ng/mL) en el caso del mascador de coca. En el participante que tomó una taza de té de coca, en el último punto examinado (1 h) resultó ser positivo para la COC y BE y también para la CUS e HIG. El FO podría ser una muestra útil para confirmar el uso legal de la hoja de coca, aun cuando futuros estudios son necesarios para corroborar estos primeros datos.

Nowadays oral fluid (OF) is accepted as an alternative biological sample for detecting drugs in clinical and forensic toxicology. In countries like Argentina, where the use of coca leaves (coca leaves chewing and coca tea drinking) is legal, adequate procedures are required to allow a clear differentiation between people who use coca leaves (legal practice) and those who use cocaine (illicit practice). There is scarce literature regarding coca leaf alkaloids profile in OF from people who chew coca leaves and drink coca tea. Until now, coca leaf alkaloids profile of hygrine (HYG) and cuscohygrine (CUS) in OF were not described in the literature. The current preliminary study was performed with two healthy volunteers. In this research CUS and HYG have been found to be positive (detectable) even when cocaine (COC) and benzoylecgonine (BE) are dropped below the cut-off values proposed by international guidelines for screening (15 to 20 ng/mL), and confirmation (8 to 10 ng/mL) in OF. In addition, CUS and HYG were also found to be positive at the same time of the last detection of COC and BE after coca tea consumption. The OF would be a useful sample to confirm the legal use of coca leaf, even when more researches are therefore needed.

Medición de drogas ilícitas en aguas residuales: estudio piloto en México / Assessing illicit drugs in wastewater: a pilot study in Mexico

Resumen: Objetivo: Monitorear el consumo de drogas a través de la medición de sus metabolitos en aguas residuales. Material y métodos: Se obtuvieron muestras de 31 plantas de tratamiento de agua residual y de 95 sitios con poblaciones específicas (38 escuelas, 42 unidades de tratamiento de adicciones y 15 centros de readaptación social). Usando cromatografía líquida de ultra-alta resolución, se midieron nueve metabolitos de seis drogas. Resultados: Ocho de nueve metabolitos de drogas fueron identificados en aguas residuales. Los metabolitos de marihuana (THC-COOH), cocaína (benzoilecgonina) y metanfetamina fueron identificados en escuelas, centros de readaptación social y de tratamiento de adicciones. En Nuevo Laredo, Culiacán y Torreón se encontraron los consumos per cápita más elevados de cocaína, marihuana, anfetamina y metanfetamina. Conclusiones: El monitoreo del uso de drogas a través de aguas residuales es factible en México y podría constituir un sistema de vigilancia para identificar cambios de su consumo en el tiempo.

Abstract: Objective: Monitor drug use through wastewater metabolite measurement. Materials and methods: Wastewater samples were obtained from 31 wastewater treatment plants and 95 sites with specific populations (38 schools, 42 units of addiction treatment and 15 penitentiaries). Using ultra high liquid chromatography, we measured nine metabolites from six drugs. Results: Eight out of nine drug metabolites were identified in the samples. Marijuana (THC-COOH), cocaine (benzoylecgonine) and methamphetamine were identified in schools, centers of addiction treatment and penitentiaries. Nuevo Laredo, Culiacan and Torreon had the highest consumption of cocaine, marijuana, amphetamine and methamphetamine. Conclusions: Monitoring drug use through wastewater is feasible in Mexico and could constitute a surveillance system to identify changes in the time.

Rapid Identification of Four New Synthetic Cannabinoids in Whole Blood / 法医学杂志

Objective To establish accurate and rapid methods to identify four new synthetic cannabinoids （JWH-203, JWH-122, 5F-APINACA and AB-CHMINACA） in blood samples. Methods The whole blood samples were extracted by acetonitrile and methanol, screened by gas chromatography-mass spectrometry （GC-MS） then confirmed by liquid chromatography-tandem mass spectrometry （LC-MS/MS） method, and multiple reaction monitoring （MRM） mode was used for quantitative analysis. Results The GC-MS method needed 21 min to complete the analysis, while the LC-MS/MS method needed 5 min. The AB-CHMINACA, JWH-203, 5F-APINACA and JWH-122 all used quasi molecular ion peak as a parent ion. The precursor-product ion combinations were m/z 357.4→312.2, m/z 340.2→125.0, m/z 384.1→135.1 and m/z 356.4→169.2. The four synthetic cannabinoids in blood samples had good linearity in the 1-250 ng/mL mass concentration range （r>0.99）. The limits of detection （LODs） were in the range of 0.1-0.5 ng/mL, the recovery rate was 85.4%-95.2%, the RSD less than 10.0%, and the matrix effect was 80.3%-92.8%. Conclusion The GC-MS and LC-MS/MS chromatographic behaviors and mass spectrometry analysis information of four synthetic cannabinoids were obtained in this study, and the possible causes of differences in chromatographic behaviors were discussed preliminarily. Therefore this study has a suggestive effect on judging the development trend of synthetic cannabinoids. This method can be used for rapid identification of four synthetic cannabinoids in blood, which can provide reference for identification of new synthetic cannabinoids when they are proliferating at present.

Identification of New Designer Benzodiazepine Diclazepam in Drug Facilitated Sexual Assault / 法医学杂志

OBJECTIVES@#To identify the new designer drugs which are totally unknown and not in the routine testing list by the technologies such as high-resolution mass spectrometry in drug facilitated sexual assault, in order to solve the problem in actual cases.@*METHODS@#The milky fluid from an actual case was extracted and analyzed using LC-QE, ¹H-NMR and GC-MS, respectively. The accurate masses and cluster ions isotope patterns of unknown compound were obtained by LC-QE. The molecular formula was confirmed as C₁₆H₁₂C₂N₂O based on the protons number of ¹H-NMR. The isomers diclazepam and 4-chlorodiazepam were separated and detected with GC-MS.@*RESULTS@#The new designer benzodiazepine as diclazepam in the milky fluid was identified. The results provided direct evidence for the investigation and qualitative analysis of such cases.@*CONCLUSIONS@#The combined application of various methods, including LC-QE, ¹H-NMR and GC-MS, can be used to detect unknown new psychoactive substances.

The Role of Segmental Analysis of Clonazepam in Hair in Drug Facilitated Cases / 法医学杂志

OBJECTIVES@#To infer the frequency of dosage and medication history investigate of the victims in drug facilitated cases by the segmental analysis of clonazepam in hair.@*METHODS@#Freezing milling under liquid nitrogen environment combined with ultrasonic bath was used as sample pretreatment in this study, and liquid chromatography-tandem mass spectrometry was used for the segmental analysis of the hair samples collected from 6 victims in different cases. The concentrations of clonazepam and 7-aminoclonazepam were detected in each hair section.@*RESULTS@#Clonazepam and its metabolite 7-aminoclonazepam were detected in parts of hair sections from the 6 victims. The occurrence time of drug peak concentration was consistent with the intake timing provided by victims.@*CONCLUSIONS@#Segmental analysis of hair can provide the information of frequency of dosage and intake timing, which shows an unique evidential value in drug facilitated crimes.

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.

Testing for Drugs of Abuse - Part 2

This is the second article in this series. The first looked at some of the commonly encountered drugs of abuse; discussed the range of samples on offer; established why urine is the preferred matrix; and addressed methods of sample adulteration. Part 2 briefly discusses immunoassay technology; the means to comment on the integrity of a sample and issues regarding cut-points and interpretations. The necessity for confirmatory testing of positive test results is discussed and the use of a mass spectrometric method is recommended for this purpose

A continuidade do uso de anfetaminas por motoristas de caminhão no Estado de São Paulo, Brasil, a despeito da proibição de sua produção, prescrição e uso / Persistent amphetamine consumption by truck drivers in São Paulo State, Brazil, despite the ban on production, prescription, and use / El uso continuado de anfetaminas por parte de los conductores de camión en el estado de São Paulo, Brasil, a pesar de la prohibición de su producción, prescripción y uso

O uso de anfetaminas por motoristas de caminhão com fins ocupacionais é amplamente reconhecido, entretanto, no mês de outubro de 2011, sua produção e uso foram proibidos através de uma resolução da Agência Nacional de Vigilância Sanitária (ANVISA). O objetivo deste estudo foi identificar o uso de anfetaminas entre motoristas de caminhão após a implementação da referida resolução. Uma amostra de conveniência de 427 motoristas de caminhão foi abordada em rodovias do Estado de São Paulo, Brasil, durante o ano de 2012. Os participantes foram solicitados a responder um instrumento de pesquisa estruturado, assim como fornecer uma amostra de urina para avaliar o uso recente de anfetaminas através de análise toxicológica. Entre os motoristas avaliados, 7% fizeram uso recente de alguma substância ilícita, dos quais 2,7% usaram anfetaminas. Aparte a periculosidade associada ao uso de anfetaminas, assim como a despeito da resolução que o regulamenta, esse uso continua entre os motoristas de caminhão. Assim, sugere-se que as autoridades competentes fiscalizem a posse, assim como o uso de anfetaminas no contexto do trânsito.

Amphetamine use by truck drivers for occupational purposes is widely known. The production and consumption of amphetamines was banned by the Brazilian National Health Surveillance Agency (ANVISA) in October 2011. This study analyzes persistent amphetamine use by truck drivers since the ban was implemented. A convenience sample of 427 truck drivers was taken along highways in São Paulo State in 2012. Participants were asked to answer a structured questionnaire and provide a urine sample to screen for recent amphetamine consumption through toxicological analysis. Among the interviewed drivers, 7% had used some illicit drug recently and 2.7% had used amphetamines. Amphetamines are still consumed by truck drivers despite the risks and the recent ban. The authorities should thus monitor the possession and use of amphetamines by drivers in order to effectively enforce the ban.

El uso de anfetaminas con fines profesionales entre los conductores de camiones es ampliamente reconocido, sin embargo, en octubre de 2011, su producción y uso fueron prohibidos por una resolución de la Agencia Nacional de Vigilancia Sanitaria (ANVISA). El objetivo de este estudio fue identificar el uso de anfetaminas entre conductores de camión después de la implementación de esa resolución. Una muestra de conveniencia compuesta por 427 conductores de camiones fue abordada en las carreteras del estado de São Paulo, Brasil, en el año 2012. A los participantes se les pidió rellenar una encuesta estructurada, así como dar una muestra de orina para determinar el consumo reciente de anfetaminas, a través de análisis toxicológico. Entre los conductores evaluados, el 7% consumió recientemente algún estupefaciente, de los cuales un 2,7% había consumido anfetaminas. Aparte de los peligros asociados al uso de anfetaminas, y de la resolución que lo regula, ese uso sigue vigente entre los conductores de camión. Por lo tanto, se sugiere que las autoridades competentes supervisen la posesión, así como el consumo de anfetaminas, en el tráfico rodado.

Impacto de un programa de control en los consumos de antibióticos en pacientes quirúrgicos / Impact of a control program on the antimicrobial consumption by surgical patients

Introducción: los antimicrobianos son un recurso terapéutico esencial en pacientes quirúrgicos, los cuales frecuentemente son utilizados de forma inapropiada. Objetivo: demostrar los cambios en los patrones de consumo de antimicrobianos relacionados con un programa de control. Métodos: se realizó un estudio de intervención en los servicios quirúrgicos del Hospital Docente Clinicoquirúrgico Joaquín Albarrán desde mayo 2008 a diciembre 2010, el cual incluyó evaluaciones de calidad de prescripción y retroalimentación al equipo asistencial, sesiones educacionales, revisión de las políticas de uso de antimicrobianos y consulta con el comité de antibióticos. Se registran los consumos mensuales de antimicrobianos utilizados expresados en dosis prescritas por 1 000 días pacientes (DDP). Resultados: los antibióticos más utilizados fueron las cefalosporinas, metronidazol, ciprofloxacina, penicilinas y cotrimoxazol. Se destaca el mayor consumo de ceftriaxona (94,4 DDP) y cefazolina (88,3 DDP), con evidente disminución en los consumos de cefalosporinas de primera, tercera y cuarta generación, mientras que la cefuroxima incrementa los consumos desde 23,8 (2008) a 35,7 DDP (2010). La penicilina sódica (36,0 DDP), amoxicillina (7,2 DDP) y la amoxicillina con sulbactam (5,8 DDP) constituyen las penicilinas más utilizadas. Disminuyen los consumos de metronidazol de 312,4 a 75,7 DDP, de ciprofloxacina de 220,8 a 52,4 DDP, de cloranfenicol de 27,9 a 3,5 DDP y de cotrimoxazol de 99,4 a 26,6 DDP, en los años 2008 y 2010 respectivamente. Conclusión: es evidente que el programa de control implementado en los servicios quirúrgicos ha producido cambios en los patrones de consumo lo que evidencia mejora en la calidad de prescripción(AU)

Introduction: Antimicrobials is an essential therapeutic resource in surgical patients, but they are frequently used in an inappropriate way. Objective: To demonstrate the changes in the antimicrobial consumption patterns related with a control program. Methods: Intervention study conducted in the surgical services of Joaquin Albarrßn hospital in the period of May 2008 to December 2010. It included evaluations of quality of prescription and of feedback in the medical assistance team, educational sessions, checking of antimicrobial use policies and consultations with the antibiotic regulatory committee. The monthly antimicrobial consumption rates were registered and expressed as dose prescribed per 1000 patient-days. Results: The most frequently used antibiotics were cephalosporins, metronidazole, ciprofloxacin, penicillin and cotrimoxazole. The high consumption rates of ceftriaxone (94.4 DPD) and cefazoline (88. 3 DPD) was underlined along with the evident decrease in the consumption of first, third and fourth generation cephalosporins, whereas cefuroxime consumption increased from 23.8 (2008) to 35.7 (2010) DPD. Sodium penicillin (36.0 DPD), amoxicillin (7.2 DPD) and amoxicillin plus sulbactam (5.8 DPD) represented the most used penicillin. The consumption rate of metronidazole decreased from 312.4 to 75.7 DPD, that of ciprofloxacin from 220.8 to 52.4 DPD, chloramphenicol from 27.9 to 3.5 DDP and cotrimoxazole from 99.4 to 26.6 DDP in the years 2008 and 2010 respectively. Conclusions: It was evident that the control program implemented in the surgical services has brought about changes in the consumption patterns indicating improvement in the quality of prescribing patterns(AU)

Validación para Colombia de la escala CRAFFT para tamización de consumo de sustancias psicoactivas en adolescentes / Validation for Colombia of the CRAFFT substance abuse screening test in adolescents

Objetivos Evaluar las propiedades de la escala CRAFFT para el cribado de consumo de sustancias psicoactivas en adolescentes entre los 14 y 18 años y validar el criterio estándar de la escala. Métodos La validez de criterio se realizó comparando la escala CRAFFT contra el gold standard para la identificación del consumo: la entrevista clínica. Mediante el modelo de pruebas diagnósticas se calculó la sensibilidad, la especificidad y los valores predictivos. Resultados Se encontró una sensibilidad de 0,95, una especificidad de 0,83, un VPP de 0,85 y un VPN de 0,94 (χ²=187,87 y p<0,0005) para identificación de consumo disfuncional (uso frecuente, abuso y dependencia) con un puntaje >2. Conclusiones La escala presenta una alta utilidad para el cribado de consumo de sustancias psicoactivas. Con un puntaje igual o mayor a 2 se puede diferenciar el consumo funcional del consumo disfuncional.

Objectives Evaluate the properties of CRAFFT scale for substance abuse screening in adolescent population aged 14 to18. Methods The criteria was validated by comparing the CRAFFT scale to the gold standard for substance use identification (i.e. the clinical interview). The diagnostic test model was used for calculating the sensitivity, specificity and predictive values of the scale. Results The test revealed 0.95 sensitivity, 0.83 specificity, 0.85 PPV and 0.94 NPV (χ²=187.87 and p<0.0005) for identifying dysfunctional use (frequent use, abuse and dependence) with a score >2. Conclusions The scale was seen to have great usefulness for psychoactive substance use screening. A cut-off point of 2 differentiated functional from dysfunctional use.

Forensic onychology: An essential entity against crime.

Forensic Onychology (Greek word, Onuks = nail, Logia = study of) is the subject which deals with study of fingernails and toenails for better administration of justice in the court of law. Identification means determination of individuality of a person. Nails are important tissues for human identification. One of the major advantages of utilizing nail is that, in comparison with other tissues, sample size and sampling process can be considered relatively non invasive and non destructive and yet each nail retains a discrete record of detailed information on genetic inheritance, drug use, pathology, diet and location history as well as exposure to explosives residues or other pollutants. In contrast to soft tissues, nails survive relatively well in the decomposition environment. Furthermore, in contrast to other long lasting tissues (such as bone and teeth) nails are easy to decontaminate from external sources of DNA. Thus examination of nail is very useful in many ways against crime. In this paper, we discussed about structure and method of analysis of nail, utility of examination, drug use and nails and detection of DNA from nails.

Comparison of morphine and codeine concentration in urines of heroin abusers and codeine users / 法医学杂志

OBJECTIVE@#To compare morphine and codeine concentration in urines of heroin abusers and codeine users and to discuss the judgment index to distinguish between heroin abuser and codeine user.@*METHODS@#The urines of heroin abusers and codeine users were collected at different time periods. After protein precipitation, the urine samples were conducted for the qualitative and quantitative analysis of morphine and codeine by UPLC-MS/MS. And the results were all statistically analyzed.@*RESULTS@#Statistical analysis showed that morphine and codeine concentration in urines of heroin abusers and codeine users were both abnormal distributions. The probability of the heroin abuser would be more than 95% and less than 5% for the codeine user when the concentration of morphine in urine sample was more than 67 ng/mL. The probability of the codeine user would be more than 95% and less than 5% for the heroin abuser when the concentration of morphine in urine sample was less than 67 ng/mL.@*CONCLUSION@#The morphine concentration in urine could be used as a criterion to distinguish the heroin abuser from the codeine user, while the codeine concentration could not.

Mechanism of methamphetamine intoxication and its medical identification / 法医学杂志

Methamphetamine (MA) is a representative drug of amphetamine-type stimulants for central nervous system and has become one of the most dangerous drugs in the world recently. The present article reviews the pharmacological effects, distribution, metabolism, intoxication mechanism, the effects of MA on cardiovascular and central nervous systems of MA, and the current situation of forensic investigation on MA.

Screening and confirmation of psychotropic drugs in blood and urine by HPLC-LTQ Orbitrap MS / 法医学杂志

OBJECTIVE@#To establish a screening and confirmation method for psychotropic drugs and their metabolites in human blood and urine by HPLC-LTQ Orbitrap MS.@*METHODS@#The samples were pretreated with Sirocco protein precipitation plate, and then analyzed by HPLC-LTQ Orbitrap MS. The method was validated in terms of the limit of detection (LOD). An accurate mass database was created for psychotropic drugs screening.@*RESULTS@#The LOD for most of 56 determined compounds was < or = 0.1 ng/mL. The accurate mass database included the accurate mass information of 61 psychotropic drugs.@*CONCLUSION@#The method is accurate, rapid, sensitive and the database is suitable for psychotropic drugs screening and confirmation.

A ten-year assessment of anabolic steroid misuse among competitive athletes in Puerto Rico / Valoración por diez años del abuso de esteroides anabólicos entre los atletas de competencia de Puerto Rico

OBJECTIVE: Little is known about anabolic androgenic steroids (AAS) misuse in the Caribbean region in spite of increased popularity among athletes and adolescents. The present study examines the usage of AAS among competitive athletes in Puerto Rico. METHODS: Doping test results of competitive athletes obtained by random sampling out of competition during the 2000-2009 period were analysed. Doping tests were executed by the Centre for Sports, Health and Exercise Sciences (Albergue Olímpico, Salinas, Puerto Rico). A total of 550 athletes were monitored during 2000-2009. Information was collected with regard to competitive sport, gender and AAS compounds whenever a positive test result was encountered. RESULTS: From the total sample of monitored cases during the past decade, 5.4% showed adverse analytical findings. Anabolic androgenic steroids misuse was detected among male (62%) and female (38%) athletes. Weightlifting showed the greatest percentage of positive AAS doping test results (70% of total cases) and stanozolol was the most commonly misused exogenous androgen (60% of abused AAS whether alone or as part of a cocktail). Testosterone was the most common endogenous misused steroid (10% of misused compounds). CONCLUSION: In Puerto Rico, AAS misuse was detected across competitive sports for both genders. Although AAS misuse among Puerto Rican athletes shares some features that are consistent with the international sports community, it is imperative to address AAS misuse in the Caribbean region.

OBJETIVO: Poco se sabe acerca del abuso de los esteroides anabólicos androgénicos (EAA) en la región del Caribe, a pesar de su creciente popularidad entre atletas y adolescentes. El estudio presente examina el uso de EAA entre los atletas de competencia en Puerto Rico. MÉTODOS: Se analizaron los resultados de la prueba de dopaje practicada a atletas de competencia mediante un muestreo aleatorio realizado a partir de competencias celebradas durante el 2000-2009. Las pruebas de dopaje fueron realizadas por el Centro de Deportes, Salud y Ciencias del Ejercicio (Albergue Olímpico, Salinas, Puerto Rico). Se monitorearon un total de 550 atletas durante 2000-2009. Se recogió información en relación con los deportes de competencia, género, y compuestos de EAA, siempre que la prueba arrojara resultados positivos. RESULTADOS: De la muestra total de casos supervisados durante la década pasada, 5.4% mostraron resultados analíticos adversos. Se detectó un uso inapropiado de esteroides anabólicos androgénicos entre los atletas varones (62%) y hembras (38%). El levantamiento de pesas mostró el porcentaje más alto de resultados de dopaje positivos a EAA (70% del total de casos) y el estanozolol fue el andrógeno exógeno más comúnmente mal empleado (60% de los EAA usados inapropiadamente, bien solos o como parte de un cóctel). La testosterona fue el esteroide endógeno más comúnmente abusado (10% de los compuestos mal empleados). CONCLUSIÓN: En Puerto Rico, se detectó uso inapropiado de EAA en los deportes de competencia de ambos géneros. Aunque el abuso de EAA entre los atletas portorriqueños comparte algunas de las características correspondientes a la comunidad internacional de deportes, es absolutamente necesario profundizar en el problema del abuso de los EAA en el área del Caribe.

Calidad de prescripción de agentes antimicrobianos en pacientes hospitalizados en servicios clínicos / Quality of antimicrobials prescription in patient admitted in clinical services

Introducción: La resistencia microbiana es considerada un fenómeno emergente en todo el mundo y la calidad de la prescripción de los agentes antimicrobianos constituye un elemento esencial en su control. Objetivo: Determinar la calidad de prescripción de agentes antimicrobianos en pacientes hospitalizados en servicios clínicos. Métodos: Se realizó prevalencia puntual, en el Hospital Clinicoquirúrgico "Joaquín Albarrán" durante el período mayo 2008-febrero 2009, mediante evaluación de los pacientes ingresados durante un día de cada uno de los meses del período de estudio. Se utilizó un instrumento, que fue aplicado por 2 investigadores y en una segunda etapa fueron analizados por expertos en uso de agentes antimicrobianos, que determinaron aquellos con prescripción inadecuada. Se calculó la proporción de uso de agentes antimicrobianos y la proporción de prescripción inadecuada. Resultados: Fueron evaluados 1 175 pacientes de los cuales utilizaron agentes antimicrobianos 456 (38,80 por ciento), reportado de forma inadecuada en 66 pacientes (14,5 por ciento). La causa fundamental de prescripción inadecuada fue el uso cuando no estaba indicado o no era necesario (51 pacientes) y la duración incorrecta del tratamiento (40 pacientes). Identificamos deficiencias en la calidad de prescripción de agentes antimicrobianos en pacientes hospitalizados en servicios clínicos, para cuya solución se requieren intervenciones educacionales y organizacionales

Introduction: The microbial resistance is considered as a worldwide emerging phenomenon and the prescription quality of the antimicrobials is an essential element in its control. Objective: To determine the prescription quality of the antimicrobials in patients admitted in clinical services. Methods: A point prevalence in the "Joaquín Albarrán" Hospital from May, 2008 to February, 2009 was carry out by means of assessment of patients admitted for one day of each of months of the study period. A tool was used applied by two researchers and in a second stage were analyzed by experts in antimicrobials use, determining those with an inappropriate prescription. The use ratio of antimicrobials was estimated as well as the inappropriate prescription ratio. Results: A total of 1 175 patients were assessed, from which 456 used antimicrobials (38,80 percent) reported in an inappropriate way in 66 patients (14,5 percent). The leading cause of inappropriate prescription was its use when it was not prescribed or was not necessary (51 patients) and the wrong length of treatment (40 patients). It was possible to identify deficiencies in antimicrobials prescription quality in patients admitted in the clinical services being necessary educational and organizational interventions

Application of liquid chromatography-high resolution mass spectrometry in toxicological screening / 法医学杂志

Due to the diversity of toxicologically relevant substances, the uncertainty of target compounds and the specificity of samples, toxicological screening techniques have always been valued by the forensic toxicologists. Depending on its powerful separation ability, superhigh resolution and accurate mass measurement, combined with the two levels spectrum database matching and abundance ratio of isotope ion, the liquid chromatography-high resolution mass spectrometry (LC-HRMS) analyzers have increasingly advantage in screening and identification of chemical compound. This review focuses on the applications of LC-HRMS in screening and identification of drug-of-abuse, prescription drugs, pesticide and stimulant. The prospect of LC-HRMS in forensic toxicology analysis is also included.

Quantification of LSD in illicit samples by high performance liquid chromatography

In the present study, a method using high performance liquid chromatography to quantify LSD, in blotter papers seized in Minas Gerais, was optimized and validated. Linearity, precision, recovery, limits of detection and quantification, and selectivity were the parameters used to evaluate performance. The samples were extracted with methanol:water (1: 1) in an ultra-sound bath. The linearity between 0.05 and 20.00 μg/mL (0.5 and 200.0μg of LSD/blotter) was observed with satisfactory mean intra and inter assay precision (RSDr = 4.4% and RSD R = 6.4%, respectively) and with mean recoveries of 83.4% and 84.9% to the levels of 1.00 and 20.00 μg/mL (10 and 200μg LSD/blotter). The limits of detection and quantification were 0.01 and 0.05 μg/mL, respectively (0.1 and 0.5 μg of LSD/blotter). The samples of blotters (n =22) were analyzed and the mean value of 67.55 μg of LSD/blotter (RSD=27.5%) was found. Thus, the method used showed satisfactory analytical performance, and proved suitable as an analytical tool for LSD determination in illicit samples seized by police forces.

No presente trabalho, um método utilizando cromatografia líquida de alta eficiência foi otimizado e validado para quantificar o LSD em selos apreendidos em Minas Gerais. A linearidade, precisão, recuperação, limites de detecção e quantificação e seletividade foram os parâmetros de desempenho avaliados. As amostras foram extraídas com metanol: água (1:1) em banho de ultra-som. A linearidade entre 0,05 a 20,00 mg/mL (0,5 a 200 μg LSD/blotter) foi observada com precisão média, intra e inter ensaio, satisfatória (RSDr = 4,4% e RSD R = 6,4%, respectivamente) e com recuperações médias de 83,4% e 84,9% para os níveis de LSD de 1,00 e 20,00 mg/mL (10 e 200 μg LSD/selo). Os limites de detecção e quantificação encontrados foram de 0,01 e 0,05 mg/mL, respectivamente (0,1 e 0,5 μg LSD/selo). As amostras de selos (n = 22) foram analisadas e o valor médio encontrado foi de 67,55 μg de LSD/selo (RSD% = 27,5). Desta forma, o método analítico apresentou desempenho satisfatório, capaz de ser utilizado como instrumento de análise para a determinação do LSD em amostras ilícitas apreendidas pelas forças policiais.

Distribution of tramadol in acute poisoned rats / 法医学杂志

OBJECTIVE@#To develop a rapid and accurate gas chromatography method and investigate the distribution of tramadol in acute poisoned rats for information of samples selection and results evaluation in forensic identification.@*METHODS@#After an oral administration of tramadol at 1140 mg/kg (5 x LD50), concentrations of tramadol in rats' biological fluids and tissues were determined by gas chromatography.@*RESULTS@#The limit of detection of tramadol in blood and urine was 0.1 microg/mL and the limit of detection in liver was 0.1 microg/g. The intra-day precision and inter-day precision were within 3.1% and 5.5% respectively, and the recovery of tramadol in blood was more than 98%. The average levels of tramadol displayed in descending order of heart blood, liver, peripheral blood, urine, vitreous humor, kidney, lung, spleen, heart, brain respectively.@*CONCLUSION@#The established method could meet the requirements for toxicological analysis, and the results of the study suggest that blood, urine, liver, lung and kidney are suitable samples for forensic toxicological analysis in tramadol poisoning cases.