Valutazione dell'idoneità a mansioni lavorative a rischio in base alla n.99/CU del 30.10.2007 (G.U. n. 266 del 15.11.2007). Esperienza della Sezione di Medicina Legale dell'Universtà di Ferrara

Studio retrospettivo su dati laboratoristici di dosaggio sostanze stupefacenti e/o psicotrope su matrice urinaria, relativi agli accertamenti di assenza di tossicodipendenza o di assunzione sporadica di tali sostanze, finalizzati al riconoscimento dell'idoneità a mansioni a rischio

Valutazione dell'idoneità a mansioni lavorative a rischio in base alla n.99/CU del 30.10.2007 (G.U. n. 266 del 15.11.2007). Esperienza della Sezione di Medicina Legale dell'Universtà di Ferrara

Studio retrospettivo su dati laboratoristici di dosaggio sostanze stupefacenti e/o psicotrope su matrice urinaria, relativi agli accertamenti di assenza di tossicodipendenza o di assunzione sporadica di tali sostanze, finalizzati al riconoscimento dell'idoneità a mansioni a rischio

The active metabolite of warfarin (3′-hydroxywarfarin) and correlation with INR, warfarin and drug weekly dosage in patients under oral anticoagulant therapy: A pharmacogenetics study

Objectives: Warfarin oral anticoagulant therapy (OAT) requires regular and frequent drug adjustment monitored by INR. Interindividual variability, drug and diet interferences, and genetics (VKORC1 and CYP2C9) make the maintenance/reaching of stable INR a not so easy task. HPLC assessment of warfarin/enantiomers was suggested as a valid monitoring-tool along with INR, but definite results are still lacking. We evaluated possible correlations between INR, warfarin/3′-hydroxywarfarin, and drug weekly dosage aimed at searching novel alternatives to OAT monitoring. VKORC1/CYP2C9 pharmacogenetics investigation was performed to account for the known influence on warfarin homeostasis. Methods: 133 OAT patients were recruited and assessed for warfarin/3′-hydroxywarfarin serum levels (HPLC), INR, and VKORC1 and CYP2C9 genotypes. A subgroup of 52 patients were monitored in detail (5 consecutive controls; c0-c4) till the target INR was reached. Correlation analyses were performed in both groups Results: In the whole OAT group both warfarin and 3′-hydroxywarfarin correlate with INR at comparable degree (r2 = 0.0388 and 0.0362 respectively). Conversely, warfarin weekly dosage better correlates with warfarin than with 3′-hydroxywarfarin (r2 = 0.0975 and r2 = 0.0381 respectively), but considering together warfarin plus 3′-hydroxywarfarin the correlation strongly increased (r2 = 0.1114; p<0.0001). Interestingly, 3′-hydroxywarfarin reached a strong correlation at c4 respect to warfarin (r2 = 0.2157 and r2 = 0.0549; p = 0.0005 and p = 0.0944 respectively) seeming less affected by drug adjustments in the subgroup of 52 patients who started OAT. The multivariate analyses aimed at estimating the true contribution of 3′-hydroxywarfarin on INR value ascribed it the unique significant value (p = 0.0021) in spite of warfarin who lost association. The pharmacogenetics studies confirmed that patients carrying the VKORC1 variant-allele required lower warfarin maintenance dosage and that the combination of VKORC1 and CYP2C9 yielded a warfarin responsive index (WRI) inversely related to the number variant alleles Conclusion: Our results overall suggest that 3′-hydroxywarfarin monitoring could be of great advantage in INR monitoring respect to classical warfarin assessment showing significant contribution also in multivariate analysis. Therefore, additional active metabolites should be recognized and investigated as novel useful indicators

Clinical and analytical aspects of quetiapine ingestion: a case report

Clinical and analytical aspects of quetiapine ingestion: a case repor

Consumo di alcool e "specificità" della determinazione della transferrina carboidrato carente (CDT)

Consumo di alcool e specificità della determinazione della transferrina carboidrato carente (CDT

Gaschromatography-mass spectrometry (GC-MS) determination of quetiapine in two non-fatal poisoning: diagnosis of intoxication and drug elimination monitoring

References Gaschromatography-mass spectrometry (GC-MS) determination of quetiapine in two non-fatal poisoning: diagnosis of intoxication and drug elimination monitoring Background Quetiapine is a benzazepinic derivate and part of the family of atypical antipsychotics. Is currently marketed to treat schizophrenia and prescribed in association with other drugs acting in the CNS. After oral administration and gastrointestinal absorption is exstensively metabolised by the liver, primarily by cytochrome P450, but the mayor plasma metabolites are inactive, and less than 1% of the dose is excreted as unchanged drug in the urine and feces. We report two cases of quetiapine's non-fatal intoxication: Case 1: woman, 59 years old, admitted to Emergency after ingestion of 1,4 gr of quetiapine (Seroquel 25 mg, 56 tablets). Case 2: woman, 54 years old, admitted to Emergency after ingestion of an unknown quantity of quetiapine. In both cases the time elapsed between assumption and hospitalization was unknown and each patient has taken quetiapine for suicidal purposes. Blood, urine and gastric lavage were collected for each patient and sent to our laboratory. The collection continues until quetiapine's elimination from blood.

ETHYLENE GLYCOL POISONING IN CATS: WHAT ARE THE PROGNOSTIC INDICATORS?

The correct management of some poisoned patients may require admission to the Intensive Care Unit (ICU). We studied ICU usage in poisoned patients and the related features

Time-frame findings in patients starting OAT (n = 52).

<p>Time-frame findings in patients starting OAT (n = 52).</p

Correlation analysis between INR and warfarin / 3’-hydroxywarfarin in the two cohorts of patients investigated.

<p>Correlation analysis between INR and warfarin / 3’-hydroxywarfarin in the two cohorts of patients investigated.</p