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PubMed1990

Home collection of urine specimens--boric acid bottles or Dipslides?

Sterile mid stream specimens of urine (MSSU) were obtained from 84 children in a hospital outpatient department. All 84 children collected urine at home by one of two Dipslide methods and by collection into boric acid within 24 hours of the hospital collected MSSU. The samples collected at home were posted to the hospital. Thirty six of the Dipslides (43%) and nine of the boric acid samples (10%) were not sterile but none had a pure growth of a single organism of greater than 10(5) organisms/ml. In addition, 17 of the Dipslides (20%) were returned with one or both media detached and therefore could not be relied upon to exclude urinary tract infection. In a second part to the study, 95 urines which showed a significant growth in primary culture were also cultured after storage in boric acid. Inhibition was noted in nine samples after storage in boric acid, seven of which were in underfilled bottles. Transport of specimens in boric acid produced less contamination than Dipslides but may inhibit growth in a small number of specimens. Technical failures with Dipslides were disappointingly high.

Adolescent↗
PubMed1975

The investigation of ovarian function by measurement of urinary oestrogen and pregnanediol excretion.

Urinary oestrogen and pregnanediol excretion was measued daily ("daily monitoring") for a complete cycle in 20 normally menstruating women, in one patient with an anovulatory cycle and for 28 days in a patient with secondary amenorrhoea. The measurements were also performed on urine specimens collected at weekly intervals for 4 to 6 weeks ("weekly tracking") from 506 patients with evidence of abnormal ovarian function. These included 9 patients with primary amenorrhoea, 132 patients with secondary amenorrheoa, 138 patients with oligomenorrhoea and 227 patients with evidence of ovarian dysfunction and cycle lengths of 25 to 42 days. The results were subjected to statistical analysis. In the normal cycles, ovulation could be identified on the criteria of a rising pregnanediol value reaching or exceeding 2-0 mg. per 24 hours for a period of 7 days or more. Valid conclusions on the overall mean oestrogen and pregnanediol values for a complete cycle could be made from the results of weekly tracking, irrespective of which day the tracking commenced. Correlations were obtained by comparing the mean and maximum urinary oestrogen values and the variability of the values with the evidence of ovarian function indicated by the clinical classifications of the patients, the duration of the disorders and the subsequent occurrence of uterine bleeding. Mean oestrogen values of 10 mug. per 24 hours or less were associated with lack of ovarian function. For values higher than this a discriminant function based on both the mean oestrogen value and the variability of the oestrogen values was useful in predicting onset of spontaneous menstruation. A single urine specimen collected 4 to 8 days before onset of menstruation showing a raised pregnanediol value of 2-0 mg. per 24 hours or more provided a valid test for ovulation in women with regular cycles, and a single urine specimen giving an oestrogen value of 10 mug per 24 hours or less gave a valid indication of absent ovarian function in women with amenorrhoea for two years or more. In all other circumstances serial sampling at weekly intervals provided a valid assessment of ovarian activity. Application of these principles allows the greatest amount of information on ovarian function to be obtained with the greatest economy of effort.

Amenorrhea↗
PubMed1997

A sensitive GC-MS procedure for the analysis of flunitrazepam and its metabolites in urine.

Analysis of urine specimens collected from individuals ingesting 2 and 4 mg flunitrazepam (FN) showed positive results by OnLine and OnTrak immunoassays for up to 60 h. Gas chromatographic-mass spectrometric (GC-MS) analysis of these specimens for FN, 3-OH-FN, 7-amino-FN, 7-amino-3-OH-FN, desmethyl-FN, and 3-OH-desmethyl-FN after glucuronidase treatment showed only low levels of 7-amino-FN with almost none of the other metabolites. These levels were far below the expected results based on the immunoassay data. This study reports on a GC-MS procedure for FN and the previously listed metabolites. The method is based on acid hydrolysis of the urine specimens, which converts FN and all its metabolites described previously to one of four amino-benzophenone derivatives (1-4) with oxazepam-d5 as the internal standard. Under the experimental conditions, the internal standard is converted to 2-amino-5-chloro-benzophenone-d5. The limit of detection for 7-amino-FN and 7-amino-desmethyl-FN and their 3-OH derivatives was less than 1 ng/mL. Analysis of urine specimens collected for 72-h postingestion of 1, 2, or 4 mg FN showed appreciable levels of benzophenone 3 (product of 7-amino-FN and 7-amino-3-OH-FN) and lower levels of benzophenone 4 (product of 7-amino-desmethyl-FN and 7-amino-3-OH-desmethyl-FN) with no detectable levels of benzophenones 1 and 2. The method makes it possible to confirm the presence of FN metabolites in urine at least 72-h postingestion of small doses of the drug.

Anti-Anxiety Agents↗
PubMed2004

Passive cannabis smoke exposure and oral fluid testing.

Oral fluid testing for Delta(9)-tetrahydrocannabinol (THC) provides a convenient means of detection of recent cannabis usage. In this study, the risk of positive oral fluid tests from passive cannabis smoke exposure was investigated by housing four cannabis-free volunteers in a small, unventilated, and sealed room with an approximate volume of 36 m(3). Five active cannabis smokers were also present in the room, and each smoked a single cannabis cigarette (1.75% THC). Cannabis smoking occurred over the first 20 min of the study session. All subjects remained in the room for approximately 4 h. Oral fluid specimens were collected with the Intercept DOA Oral Specimen Collection Device. Three urine specimens were collected (0, 20, and 245 min). In addition, three air samples were collected for measurement of THC content. All oral fluid specimens were screened by enzyme immunoassay (EIA) for cannabinoids (cutoff concentration = 3 ng/mL) and tested by gas chromatography-tandem mass spectrometry (GC-MS-MS) for THC (LOQ/LOD = 0.75 ng/mL). All urine specimens were screened by EIA for cannabinoids (cutoff concentration = 50 ng/mL) and tested by GC-MS-MS for THCCOOH (LOQ/LOD = 1 ng/mL). Air samples were measured for THC by GC-MS (LOD = 1 ng/L). A total of eight oral fluid specimens (collected 20 to 50 min following initiation of smoking) from the four passive subjects screened and confirmed positive for THC at concentrations ranging from 3.6 to 26.4 ng/mL. Two additional specimens from one passive subject, collected at 50 and 65 min, screened negative but contained THC in concentrations of 4.2 and 1.1 ng/mL, respectively. All subsequent specimens for passive participants tested negative by EIA and GC-MS-MS for the remainder of the 4-h session. In contrast, oral fluid specimens collected from the five cannabis smokers generally screened and confirmed positive for THC throughout the session at concentrations substantially higher than observed for passive subjects. Urine specimens from active cannabis smokers also screened and confirmed positive at conventional cutoff concentrations. A biphasic pattern of decline for THC was observed in oral fluid specimens collected from cannabis smokers, whereas a linear decline was seen for passive subjects suggesting that initial oral fluid contamination is cleared rapidly and is followed by THC sequestration in the oral mucosa. It is concluded that the risk of positive oral fluid tests from passive cannabis smoke inhalation is limited to a period of approximately 30 min following exposure.

Adult↗
PubMed2000

Monitoring opiate use in substance abuse treatment patients with sweat and urine drug testing.

Although urine testing remains the standard for drug use monitoring, sweat testing for drugs of abuse is increasing, especially in criminal justice programs. One reason for this increase is sweat testing may widen the detection window compared to urine testing. Drug metabolites are rapidly excreted in urine limiting the window of detection of a single use to a few days. In contrast, sweat collection devices can be worn for longer periods of time. This study was designed to compare the efficacy of sweat testing versus urine testing for detecting drug use. Paired sweat patches that were applied and removed weekly on Tuesdays were compared to 3-5 consecutive urine specimens collected Mondays, Wednesdays, and Fridays (355 matched sweat and urine specimen sets) from 44 patients in a methadone-maintenance outpatient treatment program. All patches (N = 925) were extracted in 2.5 mL of solvent and analyzed by ELISA immunoassay for opiates (cutoff concentration 10 ng/mL). A subset (N = 389) of patches was analyzed by gas chromatography-mass spectrometry (GC-MS). Urine specimens (N = 1886) were subjected to qualitative analysis by EMIT (cutoff 300 ng/mL). Results were evaluated to (1) determine the identity and relative amounts of opiates in sweat; (2) assess replicability in duplicate patches; (3) compare ELISA and GC-MS results for opiates in sweat; and (4) compare the detection of opiate use by sweat and urine testing. Opiates were detected in 38.5% of the sweat patches with the ELISA screen. GC-MS analysis confirmed 83.4% of the screen-positive sweat patches for heroin, 6-acetylmorphine, morphine, and/or codeine (cutoff concentration 5 ng/mL) and 90.2% of the screen-negative patches. The sensitivity, specificity, and efficiency of ELISA opiate results as compared to GC-MS results in sweat were 96.7%, 72.2%, and 89.5%, respectively. Heroin and/or 6-acetylmorphine were detected in 78.1% of the GC-MS-positive sweat patches. Median concentrations of heroin, 6-acetylmorphine, morphine, and codeine in the positive sweat samples were 10.5, 13.6, 15.9, and 13.0 ng/mL, respectively. Agreement in paired sweat patch test results was 90.6% by ELISA analysis. For the purposes of this comparison of ELISA sweat patch to EMIT urine screening for opiates, the more commonly used urine test was considered to be the reference method. The sensitivity, specificity, and efficiency of sweat patch results to urine results for opiates were 68.6%, 86.1%, and 78.6%, respectively. There were 13.5% false-negative and 7.9% false-positive sweat results as compared to urine tests. Analysis of sweat patches provides an alternate method for objectively monitoring drug use and provides an advantage over urine drug testing by extending drug detection times to one week or longer. In addition, identification of heroin and/or 6-acetylmorphine in sweat patches confirmed the use of heroin in 78.1% of the positive cases and differentiated illicit heroin use from possible ingestion of codeine or opiate-containing foods. However, the percentage of false-negative results, at least in this treatment population, indicates that weekly sweat testing may be less sensitive than thrice weekly urine testing in detecting opiate use.

Adolescent↗
PubMed1995

Simultaneous determination of pseudouridine, neopterine and creatinine in urine by ion-pair high-performance liquid chromatography with in-series ultraviolet and fluorescence detection.

A simple, fast and precise method for the simultaneous determination of neopterine (Npt), pseudouridine (Psu) and creatinine (Cre) in urine by using ion-pair HPLC has been developed. The urine specimen is subjected to a microcolumn clean-up step, providing a ten-fold sample dilution, and is then injected into the column. The eluate is forced through the respective cells of a fluorescence and then a UV detector, which are connected in series. Neopterine is monitored by fluorescence emission at 438 nm (excitation wavelength 353 nm) while Psu and Cre are monitored by UV absorption at 235 nm. This allows the determination of Npt/Cre and Psu/Cre concentration ratios in a single run on the same sample, and the use of urine specimens collected randomly instead of 24 hourly collections. The method has been applied to urine specimens from 19 healthy, male donors (mean Npt/Cre (mumol/mol) and Psu/Cre (mumol/mmol) values of 41.7 and 16.8, respectively) and 23 healthy, female donors (mean Npt/Cre (mumol/mol) and Psu/Cre (mumol/mol) values of 67.4 and 18.5, respectively). The within-run S(r) for Npt/Cre and Psu/Cre concentration ratios ranged between 3.3 and 4.6%.

Adult↗
PubMed1995

Response of EMIT amphetamine immunoassays to urinary desoxyephedrine following Vicks inhaler use.

The cross-reactivity of l-methamphetamine (l-desoxyephedrine) to the EMIT-d.a.u. class (EC) and EMIT-d.a.u. monoclonal amphetamine/methamphetamine (EM) assays was evaluated in urine specimens collected from six subjects using Vicks inhalers. The subjects were five men and a woman ranging from 27 to 47 years old. Four subjects used the inhaler as recommended by the manufacturer for five consecutive days; two subjects used double this dosage for three consecutive days. All urine voids were collected, totaling 132 specimens. All specimens were analyzed by the EC and EM assays. Specimens yielding a positive response were then analyzed by chiral and achiral gas chromatography/mass spectrometry (GC/MS). No specimen was positive by the EM assay, whereas 17 specimens yielded positive EC results. One subject for form the "as recommended" group had six positive specimens with maximum l-desoxyephedrine of 872 ng/ml. Both subjects using twice the recommended dosage had positive specimens, maximum l-desoxyephedrine of 1,560 ng/ml. No positive specimen contained > 200 ng/ml l-amphetamine.

Administration, Inhalation↗
PubMed1990

Casual urine concentrations of sodium, potassium, and creatine in population studies of blood pressure.

The relationships between blood pressure and the concentrations of urinary sodium, potassium and creatinine have been examined using casual urine specimens collected from a random sample of 1,556 men aged 40-59. Partial correlations with systolic blood pressure after adjustment for age, body mass index (BMI), alcohol consumption, and town showed that sodium was not significantly associated with BP, but potassium [r = -0.09 (P less than 0.001)] and creatinine [r = -0.07 (P less than 0.01)] were negatively associated. The sodium/creatinine ratio [r = 0.10 (P less than 0.001)] and sodium/potassium ratio [r = 0.11 (P less than 0.001)] were positively correlated with SBP. Comparable results were found throughout for diastolic pressure. Multiple regression analysis suggested that it was creatinine rather than sodium that was the important component of the sodium/creatinine ratio, and raised the possibility that potassium may play a part in this association because of the strong correlation between potassium and creatinine. Similarly, potassium appeared to be the more important component of the sodium/potassium ratio. The regression coefficients for sodium, potassium, and the sodium/potassium ratio in this study of casual urine samples were found to be similar in direction and magnitude to two large studies using 24 hour urine collections. We suggest that causal specimens may be useful for estimating sodium and potassium intake in population studies.

Adult↗