RESUMEN
The Royal Canadian Mounted Police Forensic Science and Identification Services was looking for a confirmatory method for lysergic acid diethylamide (LSD). As a result, an ultra-performance liquid chromatography-tandem mass spectrometry method was validated for the confirmation and quantitation of LSD, iso-LSD, N-demethyl-LSD (nor-LSD), and 2-oxo-3-hydroxy-LSD (O-H-LSD). Relative retention time and ion ratios were used as identification parameters. Limits of detection (LOD) in blood were 5 pg/mL for LSD and iso-LSD and 10 pg/mL for nor-LSD and O-H-LSD. In urine, the LOD was 10 pg/mL for all analytes. Limits of quantitation (LOQ) in blood and urine were 20 pg/mL for LSD and iso-LSD and 50 pg/mL for nor-LSD and O-H-LSD. The method was linear, accurate, and precise from 10 to 2000 pg/mL in blood and 20 to 2000 pg/mL in urine for LSD and iso-LSD and from 20 to 2000 pg/mL in blood and 50 to 2000 pg/mL in urine for nor-LSD and O-H-LSD with a coefficient of determination (R(2)) > or = 0.99. The method was applied to blinded biological control samples and biological samples taken from a suspected LSD user. This is the first reported detection of O-H-LSD in blood from a suspected LSD user.
Asunto(s)
Dietilamida del Ácido Lisérgico/análisis , Espectrometría de Masa por Ionización de Electrospray/métodos , Espectrometría de Masas en Tándem/métodos , Cromatografía Líquida de Alta Presión , Medicina Legal/métodos , Humanos , Isomerismo , Dietilamida del Ácido Lisérgico/análogos & derivados , Masculino , Reproducibilidad de los Resultados , Detección de Abuso de Sustancias/métodos , Adulto JovenRESUMEN
OBJECTIVE: To assess the effect of community prescribing of an antibiotic for acute respiratory infection on the prevalence of antibiotic resistant bacteria in an individual child. STUDY DESIGN: Observational cohort study with follow-up at two and 12 weeks. SETTING: General practices in Oxfordshire. PARTICIPANTS: 119 children with acute respiratory tract infection, of whom 71 received a beta lactam antibiotic. MAIN OUTCOME MEASURES: Antibiotic resistance was assessed by the geometric mean minimum inhibitory concentration (MIC) for ampicillin and presence of the ICEHin1056 resistance element in up to four isolates of Haemophilus species recovered from throat swabs at recruitment, two weeks, and 12 weeks. RESULTS: Prescribing amoxicillin to a child in general practice more than triples the mean minimum inhibitory concentration for ampicillin (9.2 microg/ml v 2.7 microg/ml, P=0.005) and doubles the risk of isolation of Haemophilus isolates possessing homologues of ICEHin1056 (67% v 36%; relative risk 1.9, 95% confidence interval 1.2 to 2.9) two weeks later. Although this increase is transient (by 12 weeks ampicillin resistance had fallen close to baseline), it is in the context of recovery of the element from 35% of children with Haemophilus isolates at recruitment and from 83% (76% to 89%) at some point in the study. CONCLUSION: The short term effect of amoxicillin prescribed in primary care is transitory in the individual child but sufficient to sustain a high level of antibiotic resistance in the population.
Asunto(s)
Antibacterianos/uso terapéutico , Medicina Familiar y Comunitaria/estadística & datos numéricos , Infecciones por Haemophilus/tratamiento farmacológico , Pautas de la Práctica en Medicina/estadística & datos numéricos , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Amoxicilina/uso terapéutico , Ampicilina/uso terapéutico , Niño , Preescolar , Estudios de Cohortes , Prescripciones de Medicamentos/estadística & datos numéricos , Humanos , Lactante , Pruebas de Sensibilidad Microbiana , Reacción en Cadena de la Polimerasa/métodos , Estudios Prospectivos , Proteínas del Envoltorio Viral/análisis , Resistencia betalactámicaRESUMEN
In this analysis report, racial minorities are cast as "problems to be solved" instead of victims of an unjust system. Yet, as 19th century, an African American freedom fighter put it nearly a century ago, "There is no Negro problem, the problem is whether the American people have loyalty, honor, patriotism enough, to live up to their own constitution." White privilege is more than a set of attitudes or individual opinions. It is an overarching, comprehensive framework of policies, practices, institutions and cultural norms that undergird every aspect of US society. Too often, discussion of racial discrimination focuses solely on the effects on those who are oppressed as if there are no oppressors or beneficiaries.