Evaluation of the Urine Drug Abuse Screening Tests.

BACKGROUND: Substance use is an important public health problem and increasing all over the world. Different methods have been defined for drug abuse testing in medical laboratories. We aimed to compare two urine drug screening methods with liquid chromatography-tandem mass spectrometry (LC-MS/MS). METHODS: A total of 102 patients' urine samples were analyzed by test dip card and EMIT (enzyme multiplied im-munoassay technique). Randomly selected samples (n = 51; 50%) were also analyzed by LC-MS/MS as the reference method. RESULTS: The drug results of all patients analyzed with the test card and EMIT were compatible. Nine of 51 samples (18%) were negative according to all methods. The sensitivity and specificity percentages of AMP, COC, MDMA, OPI/MOP, and THC using test card were 70/96, 100/100, 47/100, 50/100, and 80/85, respectively. Similarly, the sensitivity and specificity percentages of AMP, COC, MDMA, OPI/MOP, and THC using EMIT were 76/97, 100/100, 57/100, 56/100, and 76/91, respectively. CONCLUSIONS: The performances of two immunochemical methods were similar for AMP, BZO, COC, MDMA, OPI/MOP, and THC whereas lower than LCMS/MS for AMP, MDMA, OPI/MOP, and THC. A sample that is positive according to any immunochemical method should be confirmed by definitive techniques such as LC-MS/MS.

Efficacy of transcranial magnetic stimulation in treatment-resistant depression.

BACKGROUND: The use of Transcranial Magnetic Stimulation (TMS) in the add-on treatment of patients with treatment-resistant depression (TRD) is becoming more common. This study aims to investigate the efficacy of TMS on depression and accompanying anxiety symptoms among patients with TRD. METHODS: The current study was conducted with 38 patients diagnosed with TRD. The patients were randomly divided into two groups and received 20 sessions of high-frequency (10Hz) TMS and 20 sessions of sham TMS to the left dorsolateral prefrontal cortex in a double-blind and cross-over fashion without a change in their pharmacotherapy. In the clinical evaluation, Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A) were carried out three times in total: before, crossover phase, and at the end of the treatment. RESULTS: A statistically significant decrease was found in the HAM-D and HAM-A in the group who were actively stimulated in the cross-over phase of the study. While there was a significant decrease in the HAM-A in the group who received sham stimulation, the decrease in the HAM-D was not statistically significant. Group comparisons revealed a statistically significant decrease in HAM-D in the group who were actively stimulated compared to the group receiving sham stimulation. At the end of the study, 63% of 38 patients responded to treatment, 15% partially responded, and 42% reached remission. DISCUSSION: This randomized, double-blind, sham-controlled, cross-over study revealed that TMS is superior to sham-TMS, provides clinically significant improvement when implemented besides pharmacotherapy among patients with treatment-resistant depression, and is beneficial for accompanying anxiety symptoms.