Evaluation of the diagnostic performance of an oral fluid screening test device for substance abuse at traffic controls.

INTRODUCTION: The aim of this study was to evaluate the analytical performance of the Kite Biotechnology Oral fluid (OF) screening test device, which is used for roadside screening of cannabis, opiates, amphetamines, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), cocaine and benzodiazepines by comparing samples with matched plasma samples, analysed via liquid chromatography-tandem mass spectrometry (LC-MS/MS) for confirmation. METHODS: OF and plasma samples were obtained simultaneously from a total of 100 subjects. OF samples were analysed by OF screening test based on immunochromatography. The OF screening test cut-off values were 50 ng/mL for amphetamines (d-amphetamine) and methamphetamine/MDMA (d-methamphetamine), 30 ng/mL for cocaine (benzoylecgonine), 40 ng/mL for opiates (morphine), 20 ng/mL for benzodiazepines (nordazepam), and 25 ng/mL for cannabis (Δ9-tetrahydrocannabinol). LC-MS/MS method validation was performed according to the CLSI C62-A recommendations with the following parameters: matrix effect, lower limit of quantification (LLOQ), linearity, intra-day and inter-day precision and accuracy. RESULTS: The overall specificity, accuracy and negative predictive values (NPV) were acceptable and met the DRUID standard of >80%. The OF screening test device showed good sensitivity for cocaine, amphetamines and opiates, whereas it indicated poor sensitivity for methamphetamine/MDMA (66.7%) and failed to detect cannabis and benzodiazepines. CONCLUSION: The present study is the first report to evaluate the Kite Biotechnology OF screening test device. The diagnostic performance of the OF screening test device was acceptable for opiates, cocaine and amphetamines, but it was insufficient for methamphetamine/MDMA, benzodiazepines and cannabis because of sensitivity issues.

Proinflammatory cytokine levels in hyperthyroidism.

BACKGROUND: Among suspected causes of the osteoporosis frequently seen in untreated thyrotoxicosis are the osteotrophic cytokines. We studied serum levels of osteotrophic cytokines including interlukin (IL)-1, IL-6, IL-8 and tumour necrosis factor alpha (TNF-alpha) in patients with various hyperthyroid states. METHODS: Serum cytokines were detected in 4 groups of SUBJECTS: 14 patients with Graves' disease, 9 patients with toxic nodular goitre, 27 patients with toxic multinodular goitre and 30 euthyroid control subjects. The levels of IL-1-beta, IL-6, IL-8 and TNF-alpha in the serum were determined by the IMMULITE autoanalyzer, using a chemoilluminesence method. RESULTS: Compared with euthyroid control subjects, patients with hyperthyroidism had significantly elevated serum levels of IL-8 (506.8 pg/mL v. 7.0 pg/mL, p < 0.001) and TNR-alpha (18.6 pg/mL v. 8.7 pg/mL, p < 0.05). Levels of IL-1-beta (12.2 pg/mL v. 5.0 pg/mL) and IL-6 (30.3 pg/mL v. 5.3 pg/mL) were also higher in controls, but the differences were not statistically significant. Levels of the cytokines were similar in 14 patients with diffuse goitre compared with 36 patients having nodular goitre. Cytokine levels in 20 premenopausal and 20 postmenopausal women with hyperthyroidism were also similar. INTERPRETATION: We conclude that increased circulating cytokine concentrations observed in patients with hyperthyroidism may derive from the activation of humoral reactions in sites other than the thyroid.