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1.
J Anal Toxicol ; 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32020200

RESUMO

Sampling and drug stability in oral fluid (OF) are crucial factors when interpreting forensic toxicological analysis, mainly because samples may not be analyzed immediately after collection, potentially altering drug concentrations. Therefore, the stability of some common drugs of abuse (morphine, codeine, 6-monoacetylmorphine, cocaine, benzoylecgonine, Δ9-tetrahydrocannabinol, cannabidiol, amphetamine, 3,4-methylenedioxymethamphetamine, ketamine) and the more commonly consumed new psychoactive substances in our environment (mephedrone, and N-(adamantan-1-yl)-1-(5-fluoropentyl)-1H-indazole-3-carboxamide 5F-AKB48 also known as 5F-APINACA) was investigated in an OF pool for the presence and absence of M3 Reagent Buffer® up to 1 year of storage. Fortified OF samples were stored at three different temperatures (room temperature, 4 and -20°C) to determine the best storage conditions over time. Control fortified OF samples were stored at -80°C for reference purposes. Compounds with concentration changes within ±15% of initial value were considered stable. The drugs were significantly more stable in M3 Reagent Buffer® than in neat OF samples in all storage conditions. All analytes were stable for 1 year at 4°C and -20°C in M3 Reagent Buffer®. Drugs stability in OF varied depending on the analyte, the presence of a stabilizer, the storage duration and temperature. When immediate sample analysis is not possible, we suggest to store OF samples at 4 or -20°C and test them within 2 weeks. Alternatively, OF samples may be stored at 4 or -20°C with M3 Reagent Buffer® to be tested within 1 year.

3.
J Pharm Biomed Anal ; 170: 63-67, 2019 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-30904741

RESUMO

A fast and sensitive ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method was developed and validated for the measurement of the most common drugs of abuse and some new psychoactive substances in oral fluid. The target compounds were 6-monoacetylmorphine, morphine, codeine, cocaine, benzoylecgonine, amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine, Δ-9-tetrahydrocannabinol, cannabidiol, mephedrone, ketamine and synthetic cannabinoid 5F-AKB48 (5F-APINACA). Oral fluid (OF) samples were 1/3 diluted with water and separated by reversed phase chromatography with gradient elution of 0.1% formic acid in water and 0.1% formic acid in acetonitrile and detected with tandem mass spectrometry operated in positive multiple reaction monitoring mode. The method was linear for all analytes under investigation from limit of quantification (LOQ, range: 0.5-5 ng/ml) to 250 ng/mL OF. Recovery of analytes under investigation and matrix effect were always higher than 90% (recovery range: 90.6-105.5% and matrix effect range 90.6-101.3%) whereas intra-assay and inter-assay precision and accuracy were always better than 15%. The developed method was successfully applied to ten OF specimens obtained from a proficiency test program and previously analyzed by gas-chromatography mass spectrometry. Analytes concentration between the two methods presented an excellent agreement (r2 = 0.952) with overlapping values demonstrating method feasibility for high throughput laboratories needing indisputable results for clinical and/or forensic purposes.


Assuntos
Líquidos Corporais/química , Boca/química , Psicotrópicos/química , Cromatografia Líquida de Alta Pressão , Humanos , Reprodutibilidade dos Testes , Detecção do Abuso de Substâncias , Espectrometria de Massas em Tandem/métodos
6.
Alcohol ; 67: 1-6, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29289821

RESUMO

This study aimed to objectively verify smoking and drinking behavior during pregnancy and to disclose self-misreporting through maternal hair analysis. A total of 153 women attending a university hospital in Barcelona (Spain) were selected and interviewed after delivery, on their smoking and drinking habits during pregnancy. A 9-cm hair strand was collected and analyzed by liquid chromatography tandem mass spectrometry for the presence of nicotine (NIC) and ethyl glucuronide (EtG) as biomarkers of tobacco and alcohol consumption, respectively. Concentrations of EtG <7 pg/mg hair and ≥30 pg/mg hair in the 0-3-cm hair segment have been used to assess, respectively, total abstinence and chronic excessive consumption in the previous 3 months, with repetitive moderate drinking lying in the interval 7-30 pg EtG per mg hair. Hair NIC less than 1 ng/mg hair indicates non-exposure to tobacco smoke while hair NIC indicates daily active smoking. In the interview, 28.1% of women declared to have smoked occasionally during gestation, while only 2.6% stated to have consumed alcohol on more than one occasion during pregnancy. Hair testing of smoking biomarkers disclosed that 7.2% of women remained active smokers during the whole pregnancy (hair NIC: 3.21-56.98 ng/mg hair), 16.3% were passive non-smokers or occasional smokers (hair NIC: 1.04-2.99 ng/mg hair), while 76.5% were not exposed to any cigarette smoke (hair NIC < limit of quantification - 0.91 ng/mg hair). Conversely, alcohol hair biomarkers showed that only 35.3% of women were totally abstinent during gestation (hair EtG: 3.89-6.73 pg/mg hair), while 62.7% drank a non-negligible amount of alcohol during pregnancy (hair EtG: 7.06-26.57 pg/mg hair), and 2% were chronic excessive drinkers (hair EtG: 35.33-47.52 pg/mg hair). Maternal hair analysis has shown to be significantly more sensitive than interviews in revealing an alarming misreported prevalence of alcohol use during pregnancy. These findings stress the need to use objective measures to assess alcohol exposure and to consider the inclusion of targeted actions to reduce alcohol consumption in maternal-child health policies.


Assuntos
Consumo de Bebidas Alcoólicas/metabolismo , Cabelo/química , Saúde Materna , Autorrelato/normas , Fumar/metabolismo , Consumo de Bebidas Alcoólicas/epidemiologia , Biomarcadores/química , Biomarcadores/metabolismo , Estudos de Coortes , Feminino , Humanos , Gravidez , Fumar/epidemiologia , Espanha/epidemiologia
8.
Curr Pharm Biotechnol ; 18(10): 834-839, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29173161

RESUMO

BACKGROUND: New psychoactive substances (NPS) are a heterogenic group of substances with different chemical structures and psychotropic effects. METHOD: Many pharmacotoxicological laboratories performing drug testing in conventional and nonconventional biological matrices for clinical and forensic purposes do not include screening procedures for NPS in their routine protocols. This is mainly due to the continued entry in the market of newly synthesized products, the low availability of reference standards, in particular of their metabolites, the low availability of immunochemical kits, etc. Moreover, many of the new compounds are very potent, and low doses ingested will lead to low concentrations in biological matrices, especially in hair. RESULTS: Hair analysis has become a powerful tool for detecting chronic drug use and has become a routine technique in forensic toxicology laboratories. CONCLUSION: The aim of this study was to set up analytical strategies to identify repeated consumption of NPS by hair analysis. Although UHPLC-MS/MS may represent the elective technique in studying NPS, a combination of both GC-MS and UHPLC-MS/MS techniques is useful in creating a complete toxicological image.


Assuntos
Toxicologia Forense/métodos , Cabelo/química , Psicotrópicos/análise , Detecção do Abuso de Substâncias/métodos , Cromatografia Líquida de Alta Pressão , Feminino , Toxicologia Forense/instrumentação , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Limite de Detecção , Masculino , Detecção do Abuso de Substâncias/instrumentação , Espectrometria de Massas em Tandem
9.
Int J Legal Med ; 131(6): 1543-1553, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28710651

RESUMO

The acute and chronic toxicity of several new psychoactive substances (NPS) is unknown, and only little information is available on the pharmacology and toxicology, toxicokinetics, and detectability in body samples of such new compounds. We here propose analytical methods to disclose acute and chronic use of two types of new psychostimulants: benzofurans and ethylphenidate and we applied them to a real case of a subject attending Emergency Department with signs of acute intoxication due to psychotropic drug(s). After a urinary immunoassay screening which gave a positivity to amphetamines, general unknown gas chromatography-mass spectrometry (GC-MS) urine analysis identified 5-(2-methylaminopropyl)benzofuran (5-MAPB), 5-(2-aminopropyl)benzofuran (5-APB), 5-(2-ethylaminopropyl)benzofuran (5-EAPB), ethylphenidate, and ritalinic acid. All these substances were confirmed and quantified not only in urine but also in serum samples at different times after hospitalization by GC-MS and ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS). Two subsequent 2-cm hair segments were also analyzed and tested positive for the above reported substances, evidencing repeated use. The matching quantitative results in all the analyzed biological matrices demonstrated that both analytical methodologies were suitable to correctly quantify NPS involved in the current intoxication. The objective assessment of acute and chronic intoxication by the above reported compounds demonstrate that the development of analytical methods aiming at the detection of a broad spectrum of compounds in conventional and non-conventional biological matrices is helpful when facing the new challenging threat of intoxications caused by NPS.


Assuntos
Benzofuranos/análise , Cabelo/química , Metilfenidato/análogos & derivados , Psicotrópicos/análise , Detecção do Abuso de Substâncias/métodos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Benzofuranos/efeitos adversos , Cromatografia Líquida de Alta Pressão , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Imunoensaio , Masculino , Metilfenidato/efeitos adversos , Metilfenidato/análise , Psicotrópicos/efeitos adversos , Espectrometria de Massas em Tandem , Adulto Jovem
10.
Curr Pharm Des ; 23(36): 5455-5467, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28641530

RESUMO

BACKGROUND: In the field of forensic toxicology, the quality of analytical methods is of great importance to ensure the reliability of results and to avoid unjustified legal consequences. A key to high quality analytical methods is a thorough method development. METHODS: The presented article will provide an overview on the process of developing methods for forensic applications. RESULTS: This includes the definition of the method's purpose (e.g. qualitative vs quantitative) and the analytes to be included, choosing an appropriate sample matrix, setting up separation and detection systems as well as establishing a versatile sample preparation. CONCLUSION: Method development is concluded by an optimization process after which the new method is subject to method validation.


Assuntos
Técnicas de Química Analítica/métodos , Toxicologia Forense/métodos , Técnicas de Química Analítica/tendências , Toxicologia Forense/tendências , Humanos , Espectrometria de Massas/métodos , Espectrometria de Massas/tendências , Projetos de Pesquisa/tendências
11.
Clin Chem Lab Med ; 55(10): 1555-1563, 2017 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-28207408

RESUMO

BACKGROUND: Cannabis has been used since ancient times to relieve neuropathic pain, to lower intraocular pressure, to increase appetite and finally to decrease nausea and vomiting. The combination of the psychoactive cannabis alkaloid Δ9-tetrahydrocannabinol (THC) with the non-psychotropic alkaloids cannabidiol (CBD) and cannabinol (CBN) demonstrated a higher activity than THC alone. The Italian National Institute of Health sought to establish conditions and indications on how to correctly use nationally produced cannabis to guarantee therapeutic continuity in individuals treated with medical cannabis. METHODS: The evaluation of cannabinoids concentration and stability in standardized preparations of cannabis tea and cannabis oil was conducted using an easy and fast ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) assay. RESULTS: Extraction efficiency of oil was significantly higher than that of water with respect to the different cannabinoids. This was especially observed in the case of the pharmacologically active THC, CBD and their acidic precursors. Fifteen minutes boiling was sufficient to achieve the highest concentrations of cannabinoids in the cannabis tea solutions. At ambient temperature, a significant THC and CBD decrease to 50% or less of the initial concentration was observed over 3 and 7 days, respectively. When refrigerated at 4 °C, similar decreasing profiles were observed for the two compounds. The cannabinoids profile in cannabis oil obtained after pre-heating the flowering tops at 145 °C for 30 min in a static oven resulted in a complete decarboxylation of cannabinoid acids CBDA and THCA-A. Nevertheless, it was apparent that heat not only decarboxylated acidic compounds, but also significantly increased the final concentrations of cannabinoids in oil. The stability of cannabinoids in oil samples was higher than that in tea samples since the maximum decrease (72% of initial concentration) was observed in THC coming from unheated flowering tops at ambient temperature. In the case of the other cannabinoids, at ambient and refrigerated temperatures, 80%-85% of the initial concentrations were measured up to 14 days after oil preparation. CONCLUSIONS: As the first and most important aim of the different cannabis preparations is to guarantee therapeutic continuity in treated individuals, a strictly standardized preparation protocol is necessary to assure the availability of a homogeneous product of defined stability.


Assuntos
Canabinoides/análise , Cromatografia Líquida de Alta Pressão , Óleos Vegetais/química , Espectrometria de Massas em Tandem , Chá/química , Canabinoides/isolamento & purificação , Canabinoides/normas , Cannabis/química , Cannabis/metabolismo , Cromatografia Líquida de Alta Pressão/normas , Padrões de Referência , Espectrometria de Massas em Tandem/normas , Temperatura Ambiente
12.
J Pharm Biomed Anal ; 137: 123-131, 2017 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-28110168

RESUMO

Gamma-hydroxybutyric acid (GHB) acts as a precursor and metabolite of the inhibitory central nervous system (CNS) neurotransmitter gamma-aminobutyric acid (GABA). Sodium salt of GHB has been used as a medication for narcolepsy and alcohol withdrawal. Moreover, GHB and its precursor gamma-butyrolactone (GBL), are illegal recreational drugs of abuse. A procedure based on ultra-high-performance liquid chromatography tandem mass spectrometry has been developed and validated in plasma, urine, cerebrospinal fluid and hair for acute and chronic exposure to GHB and in seized preparations coming from black market. In biological matrices, GHB was investigated together with its glucuronide (GHB-Gluc) as a potential marker of exposure, GABA as endogenous precursor and metabolite and GBL as eventual exogenous precursor. GBL was sought together with GHB in illegal preparations. Chromatographic separation was achieved at ambient temperature using a reverse-phase column and an isocratic elution with two solvents: 0.1% formic acid in water and pure methanol. Multiple reaction monitoring (MRM) was used. The method was linear for all analytes under investigation from limit of quantification (LOQ) to 500µgmL-1 plasma, urine and cerebrospinal fluid, from LOQ to 100ngmg-1 hair and from LOQ to 10mgmL-1 illicit preparations with good correlation coefficients (r2=0.99) for all substances. Recovery of analytes under investigation was always higher than 75% and intra-assay and inter-assay precision and accuracy were always better than 15%. The validated method was then successfully applied to real specimens from either forensic (one post-mortem urine sample taken from a GHB fatal intoxication case) or clinical cases (cerebrospinal fluid, plasma and hair samples collected from narcoleptic patients under sodium oxybate treatment). Finally, illicit preparations, seized by police forces were also checked for GHB amount and eventual presence of prodrug GBL.


Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Hidroxibutiratos/química , Espectrometria de Massas em Tandem/métodos , 4-Butirolactona/química , Líquido Cefalorraquidiano/química , Ciências Forenses/métodos , Cabelo/química , Humanos , Masculino , Metanol/química , Pessoa de Meia-Idade , Plasma/química , Oxibato de Sódio/química , Ácido gama-Aminobutírico/química
14.
Adicciones ; 28(3): 158-62, 2016 Jun 15.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27399225

RESUMO

This study presents the case of a 4-year-old healthy child admitted to the paediatric ward for suspected accidental intoxication due to ingestion of narcoleptic drugs (methylphenidate, sertraline and quetiapine), taken on a regular basis by his 8-year-old brother affected by Asperger syndrome.Intoxication can be objectively assessed by measurements of drugs and metabolites in biological matrices with short-term (blood and urine) or long-term (hair) detection windows. At the hospital, the child's blood and urine were analysed by immunoassay (confirmed by liquid chromatography-mass spectrometry), and sertraline and quetiapine and their metabolites were identified. The suspicion that the mother administered drugs chronically prompted the analysis of six, consecutive 2-cm segments of the child's hair, using ultra-high performance liquid chromatography-tandem mass spectrometry, thereby accounting for ingestion over the previous 12 months. Quetiapine was found in the first four segments with a mean concentration of 1.00 ng/mg ± 0.94 ng/mg hair while sertraline and its metabolite, desmethyl-sertraline, were found in all segments with a mean concentration of 2.65 ± 0.94 ng/mg and 1.50 ± 0.94 ng/mg hair, respectively. Hair analyses were negative for methylphenidate and its metabolite (ritalinic acid). Biological matrices testing for psychoactive drugs disclosed both acute and chronic intoxication with quetiapine and sertraline administered by the mother.


Assuntos
Cabelo/química , Psicotrópicos/análise , Psicotrópicos/envenenamento , Pré-Escolar , Humanos , Masculino
15.
J Hum Lact ; 32(3): 542-5, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27197576

RESUMO

BACKGROUND: The use of illegal drugs and tobacco is an exclusion criteria for accepting a nursing mother as a milk donor. The detection window for human milk testing is typically a few hours. Hair testing has been considered the gold standard to assess chronic exposure to these toxic substances. OBJECTIVE: The aim of this study was to determine the levels of illegal drugs, nicotine, and caffeine in breast milk and hair samples from donors to assess whether these substances were being used during the donation period and the months leading up to it. METHODS: Thirty-six samples of hair and breast milk were obtained from 36 donors. The tests performed identified nicotine, caffeine, morphine, cocaine, cannabis, amphetamines, codeine, methadone, and other substances derived therefrom. RESULTS: No illegal drugs were found in any of the samples analyzed. Nicotine and cotinine were found in 33.3% (12/36) of all hair samples. Among these 12 samples, 10 had cotinine concentrations consistent with cutoff values for unexposed nonsmokers, 1 had concentrations consistent with cutoff values for passive smokers, and 1 had concentrations consistent with cutoff values for active smokers. Caffeine was found in 77.7% of the hair samples and in 50% of the donor milk samples. The correlation for caffeine between donor milk and hair samples was r = 0.288, P = .0881. CONCLUSION: Donors do not use illegal drugs during either the donation period or the months leading up to it. They are occasionally exposed to tobacco smoke and almost all of them consume caffeine.


Assuntos
Cafeína/análise , Cabelo/química , Bancos de Leite , Leite Humano/química , Nicotina/análise , Detecção do Abuso de Substâncias , Adulto , Feminino , Humanos , Espanha , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Doadores de Tecidos
16.
J Pharm Biomed Anal ; 128: 53-60, 2016 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-27232151

RESUMO

A procedure based on ultra-high-pressure liquid chromatography tandem mass spectrometry has been developed for the determination of twenty three psychoactive drugs and metabolites in whole blood using dried blood spot (DBS). Chromatographic separation was achieved at ambient temperature using a reverse-phase column and a linear gradient elution with two solvents: 0.1% formic acid in acetonitrile and 5mM ammonium formate at pH 3. The mass spectrometer was operated in positive ion mode, using multiple reaction monitoring via positive electro-spray ionization. The method was linear from the limit of quantification (5ng/ml for all the analytes apart from 15ng/ml for Δ-9-tetrahydrocannabinol and metabolites) to 500ng/ml, and showed good correlation coefficients (r(2)=0.990) for all substances. Analytical recovery of analytes under investigation was always higher than 75% and intra-assay and inter-assay precision and accuracy always better than 15%. Using the validated method, ten DBS samples, collected at the hospital emergency department in cases of acute drug intoxication, were found positive to one or more psychoactive drugs. Our data support the potential of DBS sampling for non invasive monitoring of exposure/intoxication to psychoactive drugs.


Assuntos
Psicotrópicos/sangue , Psicotrópicos/química , Canabinol/sangue , Canabinol/química , Cromatografia Líquida de Alta Pressão/métodos , Teste em Amostras de Sangue Seco/métodos , Humanos , Reprodutibilidade dos Testes , Espectrometria de Massas em Tandem/métodos
17.
J Pharm Biomed Anal ; 118: 9-16, 2016 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-26512994

RESUMO

A procedure based on ultra-high-pressure liquid chromatography tandem mass spectrometry has been developed for the determination of 22 antidepressant and anxiolytic drugs ad metabolites in the three consecutive maternal hair segments representing the pregnancy trimesters and paired neonatal meconium samples. After hair washing with methyl alcohol and diethyl ether and subsequent addition of internal standards, hair samples were treated with 500 µl VMA-T M3 reagent for 1h at 100 °C. After cooling, 100 µl M3 extract were diluted with 400 µl water and a volume of 10 µl was injected into chromatographic system. Meconium samples were firstly treated with 1 ml methyl alcohol and the organic layer back-extracted twice with 1.5 ml of a mixture of ethylacetate:hexane (80:20, v/v). Chromatographic separation was achieved at ambient temperature using a reverse-phase column and a linear gradient elution with two solvents: 0.3% formic acid in acetonitrile and 5mM ammonium formate pH 3. The mass spectrometer was operated in positive ion mode, using multiple reaction monitoring via positive electrospray ionization. The method was linear from the limit of quantification (0.05-1 ng/mg hair and 5-25 ng/g meconium depending on analyte under investigation;) to 10 ng/mg hair and 1000 ng/g meconium, with an intra- and inter-assay imprecision and inaccuracy always less than 20% and an analytical recovery between 66.6% and 95.3%, depending on the considered analyte and biological matrix. Using the validated method, 7 mothers were found positive to one or more hair segments and 5 meconium samples were found positive to one or more antidepressant and anxiolytic drugs, assessing prenatal exposure to these drugs following maternal consumption in one or more pregnancy trimesters.


Assuntos
Ansiolíticos/análise , Antidepressivos/análise , Cabelo/química , Mecônio/química , Espectrometria de Massas em Tandem/métodos , Ansiolíticos/farmacologia , Antidepressivos/farmacologia , Cromatografia Líquida de Alta Pressão/métodos , Estudos de Coortes , Feminino , Cabelo/efeitos dos fármacos , Humanos , Recém-Nascido , Mecônio/efeitos dos fármacos , Gravidez
18.
J Antimicrob Chemother ; 71(4): 1027-30, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26679247

RESUMO

OBJECTIVES: To evaluate antiretroviral drug concentrations in mothers and infants enrolled under the Option B-Plus approach for the prevention of HIV mother-to-child transmission in Malawi and to assess the maternal virological response after 1 year of treatment. PATIENTS AND METHODS: Forty-seven women and 25 children were studied. Mothers were administered during pregnancy a combination of tenofovir, lamivudine and efavirenz and continued it during breastfeeding (up to 2 years) and thereafter. Drug concentrations were evaluated in mothers (plasma and breast milk) at 1 and 12 months post-partum and in infants (plasma) at 6 and 12 months of age. Drug concentrations were determined using an LC-MS/MS validated methodology. RESULTS: In breast milk, tenofovir concentrations were very low (breast milk/maternal plasma ratio = 0.08), while lamivudine was concentrated (breast milk/plasma ratio = 3) and efavirenz levels were 80% of those found in plasma. In infants, median levels at 6 months were 24 ng/mL tenofovir, 2.5 ng/mL lamivudine and 86.4 ng/mL efavirenz. At month 12, median levels were below the limit of quantification for the three drugs. No correlation was found between drug concentrations and laboratory parameters or indices of growth. HIV-RNA >1000 copies/mL was seen at month 1 in 15% of the women and at month 12 in 8.5%. Resistance was found in half of the women with detectable viral load. CONCLUSIONS: Breastfeeding infants under Option B-Plus are exposed to low concentrations of antiretroviral drugs. With this strategy, mothers had a good virological response 1 year after delivery.


Assuntos
Terapia Antirretroviral de Alta Atividade , Benzoxazinas/farmacocinética , Infecções por HIV/tratamento farmacológico , Infecções por HIV/transmissão , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Lamivudina/farmacocinética , Tenofovir/farmacocinética , Adulto , Contagem de Linfócito CD4 , Cromatografia Líquida , Feminino , Infecções por HIV/diagnóstico , Humanos , Lactente , Malaui , Gravidez , Complicações Infecciosas na Gravidez , Espectrometria de Massas em Tandem , Carga Viral , Adulto Jovem
19.
Drug Test Anal ; 8(8): 864-8, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26627903

RESUMO

In a prospective sample of 80 mother-infant dyads, we investigated whether drugs of abuse in maternal hair measured during the pregnancy trimesters were also present in neonatal meconium. Principal drugs of abuse were analyzed in the three consecutive maternal hair segments and meconium samples by ultra-performance liquid chromatography tandem mass spectrometry assay. Of the 80 mothers, 32 (40%) presented one or more hair shafts with at least one of the analyzed drugs of abuse and/or its metabolites. The drug of abuse with a higher prevalence in our study population was methamphetamine: 19 mothers had methamphetamine in one or more hair segments (59.4%). The second most detected drug of abuse was cocaine; nine mothers presented cocaine in one or more hair segments (28.1%). Nineteen pregnant women consumed at least one drug of abuse during the first trimester, ten continued consuming drugs of abuse during the second trimester; and nine consumed until the end of pregnancy. Five of the nine newborns from mothers who consumed drugs during the whole pregnancy showed drugs of abuse in meconium samples. Newborns from the 23 remaining mothers with one or two hair shafts positive to drugs of abuse did not present drugs in their meconium. Indeed from these results, it seems that discontinuous and/or sporadic consumption during pregnancy could produce a negligible transplacental passage and hence negative results in meconium. Furthermore, the role of placenta in the metabolism and excretion of drugs of abuse is still to be precisely investigated. Copyright © 2015 John Wiley & Sons, Ltd.


Assuntos
Cabelo/química , Exposição Materna , Mecônio/química , Detecção do Abuso de Substâncias/métodos , Adulto , Anestésicos Locais/análise , Estimulantes do Sistema Nervoso Central/análise , Cocaína/análise , Feminino , Humanos , Recém-Nascido , Metanfetamina/análise , Gravidez , Estudos Prospectivos , Adulto Jovem
20.
Clin Chem Lab Med ; 54(3): 427-35, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26351940

RESUMO

BACKGROUND: In recent years, fatty acid ethyl esters (FAEEs) and ethyl glucuronide (EtG) in meconium emerged as reliable, direct biological markers for establishing gestational ethanol exposure. We investigated whether EtG in maternal hair measured during the three trimesters of pregnancy correlated with EtG and FAEEs in neonatal meconium. METHODS: In a prospective sample of 80 mother-infant dyads from Barcelona (Spain), we measured EtG and FAEE in maternal hair segments and meconium samples using a validated UHPLC-MS/MS method. RESULTS: Fifty-eight (72.5%) women had EtG concentrations in the hair shafts >7 pg/mg in one or more pregnancy trimesters, and EtG and FAEEs in meconium samples were documented in 50 and 24 of their neonates, respectively. The best significant correlations (p<0.0001) were found between EtG concentration in the proximal 0-3 and 3-6 hair shaft segments corresponding to the last two pregnancy trimesters and EtG in neonatal meconium (ρ=0.609 and ρ=0.577, respectively). Using the combination of EtG in meconium ≥30 ng/g and a median of EtG >11 pg/mg in maternal hair during the second and third trimesters of pregnancy, prenatal ethanol exposure could be predicted with a sensitivity of 85.7% and specificity of 73.7%. CONCLUSIONS: This study provides evidence of proven fetal exposure to ethanol during the second and third trimesters of pregnancy by linking detection of ethanol biomarkers (EtG) in maternal hair segments and EtG in neonatal meconium.


Assuntos
Consumo de Bebidas Alcoólicas , Biomarcadores/química , Glucuronatos/análise , Cabelo/química , Mecônio/química , Adulto , Cromatografia Líquida , Feminino , Humanos , Recém-Nascido , Gravidez , Trimestres da Gravidez , Espectrometria de Massas em Tandem
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