RESUMO
We evaluated the Triage panel for drugs of abuse, a visual method that simultaneously detects seven distinct drug classes in a single aliquot of urine, by use of 1214 urine specimens obtained from children and adolescent patients whose clinical findings warranted a toxicology evaluation. A total of 295 positive results were confirmed by gas chromatography-mass spectrometry. Additional toxicology investigations were not performed on specimens with negative results unless the clinical findings did not correspond with the urine Triage results. The positive predictive value of the test was found to be > 85% for detection of barbiturates, cannabinoid metabolite, cocaine metabolite, and opiates; for the benzodiazepines the positive predictive value was 77%. Positive predictive values were 53% for amphetamines and 40% for phencyclidine, although only five specimens were available for evaluation of the latter drug. Correlation between clinical findings of patients and results from the Triage test were good except for ingestion of sympathomimetic amines (because of selectivity of the antibodies used in the test for amphetamines) and in patients receiving either antianxiety or antidepressant drugs (some members of these classes of drugs or their metabolites appeared to cross-react with the benzodiazepine test). The primary advantages of the Triage test were the rapid turnaround time, the ease with which a specimen could be processed, and the ability to use rapidly provided information as part of a differential diagnosis.
Assuntos
Adolescente , Comportamento Infantil , Detecção do Abuso de Substâncias/métodos , Transtornos Relacionados ao Uso de Substâncias/urina , Fatores Etários , Anfetaminas , Barbitúricos , Benzodiazepinas , Canabinoides , Criança , Pré-Escolar , Cromatografia Gasosa , Reações Cruzadas , Diagnóstico Diferencial , Humanos , Espectrometria de Massas , Entorpecentes , Valor Preditivo dos TestesRESUMO
The selenium in the diet of persons in arsenic-endemic areas, high levels of arsenic in the drinking water, was evaluated. The methodology used was that of 24-hr dietary recall. Daily selenium intakes of two rural towns in northern Mexico were found to be similar, approximating 72.9 and 60.6 micrograms. These values were similar to those of a previously arsenic-exposed area from California, Edison community. The Edison participants had a daily selenium intake of 61.8 micrograms. The possible negative effect of selenium to produce differences in reported geographical variation in disease could not be substantiated in this study. Other nutrient intakes, protein and energy were also found similar for communities. Differences were noted in vitamin A intake where one-third the daily requirement was experienced by Mexican participants compared to two-thirds the requirement being satisfied by those participants from Edison.