Morphine Concentrations in Human Urine Following Poppy Seed Paste Consumption

WOS: 000456165500014PubMed ID: 30579243Papaver somniferum (opium poppy) is one of the world's oldest medicinal plants which are widely used for medicinal, nutritive and scientific purposes. Turkey is one of the major legal opium poppy producer countries in the world and the seed paste of the poppies is consumed in great deal, even more than 100 g per meal. The main objective of this study is to investigate the influence of poppy seed paste ingestion on urine tests for opiates whether or not could lead to opiate positive urine test results. For this purpose, a variety of poppies were used and the morphine content of white, yellow and blue-black poppies were determined as 1.9, 4.0 and 2.6 mg/kg, respectively. 100g of these seed pastes were consumed in the breakfast by ten healthy adults enrolled in the study over three days and urine samples were collected before and after the breakfast. Opiate screening analysis was carried out by enzyme immunoassay method and the results were evaluated by two different cut-off values (300 and 2000 ng/mL). Morphine confirmation analysis was made by GC-MS system and the chromatographic method was validated in terms of selectivity, extraction efficiency, linearity (25-2000 ng/ml), intra-assay precision, accuracy, limit of detection (LOD) and limit of quantitation (LOQ) (3 and 10 ng/ml), carryover, matrix effect, dilution integrity and stability. According to cut-off value 300 ng/ml, opiate concentrations were found positive up to 48 h. For cut-off value 2000 ng/mL; this time was up to 12 h in collected urine samples after consumption of three different colored poppy seed pastes. In all urine samples, thebaine was detected while the heroin abuse metabolite 6-acetyl morphine (6-AM) was not. Urine drug testing legislation was revised on 2016 in Turkey and opiate screening cut-off values increased from 300 to 2000 ng/mL. Overall results have shown that poppy seed paste as food consumption could lead to opiate positive urine test result even if increased cut off levels are used. It can also be deduced that thebaine can be taken as supportive biomarker for poppy seed paste consumption. Awareness of interpretation of urine test results and defining the procedures especially for forensic drug testing must be done in legal aspect to ensure justice for each individual (workplace, traffic, court etc.). (C) 2018 Published by Elsevier B.V

False positivity for marijuana in immunoassay analysis due to Efavirenz use. A case report

WOS: 000378754600011Cross-reaction is an important problem with immunoassays that may lead to interferences and potentially yield wrong results. This case study describes a false positive tetrahydrocannabinol (THC) screening with CEDIA immunoassay reagents after the use of efavirenz for anti-retroviral therapy. A 31-year-old HIV (+) probationer transsexual was admitted to Ege University Institute of Drug Abuse, Toxicology and Pharmaceutical Sciences Toxicology Laboratory due to marijuana abuse. He had been using 600 mg/day Efavirenz to overcome his disease. As the routine application in the laboratory, the urine specimens of the probationer were first screened for drugs of abuse using CEDIA reagents. The analysis results were all found to be positive. Subsequently, the urine specimens were also analyzed for their THC content with another urine screening immunoassay kit using DRI (Diagnostic Reagent Inc.) reagents. The results were found to be negative. In order to ensure a correct result, the confirmation of the analysis was performed with the gas chromatography-mass spectrometer for the urine samples and the results were found to be below the detection limit (LOD < 1.97 ng/mL), Additionally a hair sample belonging to probationer was obtained, analyzed with a fully validated method and the result was also found to be negative. Therefore, it was concluded that the result obtained with CEDIA reagents was false positive for THC which is, and was caused by Efavirenz use by the probationer. The results demonstrated that there is a strong need for the careful interpretation of the analysis results by an experienced forensic toxicologist to decrease the chances of obtaining wrong results

Effect of Telehealth System on Glycemic Control in Children and Adolescents with Type 1 Diabetes

Objective: A close diabetes team-patient relationship is required for establishing satisfactory metabolic control. The purpose of this study was to investigate the effect of a telehealth system on diabetes control. Methods: The study was carried out between June 2015 and January 2016 at the Gazi University Faculty of Medicine, Pediatric Endocrinology Department. The telehealth system was developed by the diabetes team. The demographic characteristics, frequency of use and hemoglobin A1c (HbA1c) changes of type 1 diabetic (T1DM) patients using this communication network were analysed. Results: Eighty two patients {[}43 (52.4\%) females, mean (+/- standard deviation) age 10.89 +/- 4 years] used the telehealth system. Fourteen (17.1 \%) of the cases were on pump therapy and 59 (72.0 \%) were counting carbohydrates. The individuals with diabetes or their families preferred WhatsApp communication. Whatsapp provided a means for instant messaging in most instances (57.3 \%), contact with diabetes education nurse (32.9\%) and consultation with the diabetes team about insulin doses and blood glucose regulation (42.7 \%). HbA1c values after six months were significantly lower in patients/parents calling frequently (p <0.001) compared with HbA1c values recorded at the beginning of the study. Conclusion: Increase in frequency of counselling by the diabetes team led to improved blood glucose control in T1DM patients. A telehealth system is useful for early detection of the need for changes in treatment and for intervention. It also promoted better self care