Drugs of abuse and alcohol in weekend drivers involved in car crashes in Belgium.

STUDY OBJECTIVE: To determine levels of alcohol and drugs of abuse in weekend drivers injured in car crashes. METHODS: This study was the first systematic drug and alcohol testing of blood and urine samples of drivers injured in weekend car crashes in Belgium. Five collaborating hospital in Flanders participated. All injured weekend drivers admitted to the emergency units from July 1, 1994, to June 30, 1995, were included in the study sample. Sampling times were from Friday at 8 PM to Monday at 8 AM. RESULTS: Of the 211 injured drivers, 47.9% had positive test results for screenings for drugs or alcohol; 35.5% only for alcohol, 6.6% only for drugs, and 5.7% had positive results for both alcohol and drugs. Of the 87 weekend drivers with positive alcohol test results, 8% had a blood alcohol concentration (BAC) level below 80 mg/dL, 25.3% had a concentration between 150 and 190 mg/dL, and 39% had a BAC of 200 mg/dL or greater. There seems to be a consistent association between the consequences of the weekend crashes and the use of alcohol, drugs, or both. More than 50% of those who had negative results for drugs and alcohol could leave the hospital within 24 hours after their car crash. For the majority of those with positive findings for alcohol only or for drugs and alcohol (respectively, 72% and 78%), hospitalization in a general hospital unit or ICU was necessary. CONCLUSION: The results suggest that testing drivers for use of alcohol alone is insufficient.

A 2,4-dichlorophenoxyacetic acid induced fatality.

This paper reports on a fatal intoxication by oral ingestion of the herbicide 2,4-dichlorophenoxyacetic acid (2,4-D). At admission, the victim was unconscious. His condition deteroriated rapidly with blood loss from his mouth and nose. Since the cause of this condition was not known, gastroscopy was performed and haemorrhagic mucosa was observed in the mouth, oesophagus and stomach. Gastric contents (removed by lavage), urine and blood were submitted for toxicological analysis. Unfortunately, within 3 h of admission (about 5 h following ingestion of the toxin) profound cardiogenic shock developed and the patient died. The identity of the toxic xenobiotic was revealed by gas chromatography-mass spectrometry. Analytical quantification of the herbicide was performed by acid extraction prior to gas chromatographic examination using electron capture detection. His blood level of 2,4-D was 192 mg l-1.

In vitro effects of tremorgenic mycotoxins.

Paxilline was isolated from Penicillium paxilli (NRRL 6110). It was studied together with penitrem B and verruculogen in the electrically stimulated guinea pig ileum. All three mycotoxins enhanced the electrically induced twitch contractions, without influencing the contractions provoked by exogenous acetylcholine. The effect of the mycotoxins could be greatly diminished by hyoscine. The possible mechanism of action of these substances in this in vitro model is discussed. The electrically stimulated guinea pig ileum could be useful in the detection and estimation of the biological activity of tremorgenic mycotoxins.

Fungal tremorgens: the mechanism of action of single nitrogen containing toxins--a hypothesis.

Tremorgenic mycotoxins are fungal secondary metabolites with a specific effect on the central nervous system (CNS). Except for a few toxins that are produced by Claviceps paspali, a plant parasitic fungus, most tremorgenic mycotoxins are synthesized by common saprophytic moulds of the genera Penicillium and Aspergillus. Since these compounds produce sustained tremor in the abscence of other neurotoxic effects, several authors have suggested that they are the causative agents of a number of naturally occurring incoordination syndromes in ruminants. The nature of the tremor produced by these compounds in laboratory animals is clinically indistinguishable from that occurring naturally. In particular, the most implicated tremorgenic mycotoxins are those that contain a single nitrogen atom in their molecules. Although individual compounds within this group are produced by unrelated fungal species, they all contain a similar biologically active chemical moiety. To date, their mechanism of action is unknown, and their role in neuropharmacology has not yet been defined. However, the presence of a GABA-like conformation within their active nucleus and the limited torsional flexibility of this moiety suggest that they are partial agonists of GABA (gamma-aminobutyric acid). A hypothetical mode of action of these toxins at the GABA receptor sites is presented and discussed.

Positive confirmation of identity of doping agents using gas chromatography-mass spectrometry with Fourier transform infrared spectrometry.

During the past two decades, the use of retention times in gas chromatography has been augmented by mass spectrometric data. By providing both the retention indices and spectrometric data, this technique has greatly improved gas chromatographic identification analysis. However, although gas chromatography-mass spectrometry has become pre-eminent, several drawbacks still remain. The mass spectral library often gives erroneous identifications when concentrations near the detection limit are analysed, when gas chromatographically interfering substances are present, or when structural isomers or compounds exhibiting identical retention behaviour are analysed. Linked with gas chromatography-mass spectrometry, Fourier transform infrared spectroscopy can be a powerful complementary technique in peak identification analysis. Some spectral data to illustrate this point are presented.

Quantitative determination of nitroglycerin by capillary gas chromatography-electron capture detection.

A rapid and sensitive capillary gas chromatographic method based on the one described by Noonan et al. [1] was used to evaluate the nitroglycerin content in serum samples of healthy volunteers, who had orally received a special preparation of the drug (Nisconitrine 6.5, Bio-Therabel). Concentrations were monitored up to 12 h after administration. In accordance with other literature data [2], no detectable amounts of the mother compound were found (limit of detection: 50 pg ml-1). Yet, significant amounts of the active metabolites, 1,2- and 1,3-dinitroglycerine could be demonstrated. Due to the low mass spectrometric response (electron impact ionization) of the different nitroglycerins, positive confirmation of the results with GC-MS was not possible. However, the concentrations reported here do agree with literature data [2], i.e. the ng ml-1 level.