The Good, the Bad, and the Ugly

The urine drug screen commonly utilized in the emergency department is an immunoassay that uses antibodies to detect specific drugs or their metabolites. This allows for rapid screening for drugs of abuse, but it has many limitations.   Gas chromatography-mass spectrometry (GC-MS) is the confirmatory test, but it is more costly, time-consuming, and generally can only be performed by outside laboratories. This confirmatory test is generally not useful in the emergency department, but has a role in cases of pediatric exposures, research, or occupational drug testing.     One of the limitations of a urine drug screen are the false-positive results from the interference of other drugs with the immunoassay, many of which are from structural similarities. Diphenhydramine and quetiapine commonly cause a false-positive for tricyclic antidepressants (TCA).                                TCA, left; diphenhydramine, center; quetiapine, right.   The specificity for phencyclidine (PCP) immunoassays is generally poor and false-positives may result from dextromethorphan, venlafaxine, tramadol, ketamine, and diphenhydramine.                                   PCP, lef...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

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Publication date: Available online 26 May 2020Source: Artificial Intelligence in MedicineAuthor(s): Evangelos Triantaphyllou, Juri Yanase
Source: Artificial Intelligence in Medicine - Category: Bioinformatics Source Type: research
Authors: Formisano R PMID: 32454002 [PubMed - as supplied by publisher]
Source: Functional Neurology - Category: Neurology Tags: Funct Neurol Source Type: research
Authors: Garbarino MC Abstract Although rabies, or hydrophobia, is one of the so-called forgotten tropical diseases, it still kills thousands of people each year, especially children living in rural areas of Asia and Africa. This terrible disease was once a much-feared threat throughout Europe, whose terrifying symptoms were described in a vast body of literature that was based on both science and popular beliefs. One notable individual whose name is linked to the fight against this disease is Adelchi Negri, a brilliant but unfortunate pupil of Camillo Golgi. At the beginning of the 20th century, Negri observed pec...
Source: Functional Neurology - Category: Neurology Tags: Funct Neurol Source Type: research
Authors: Vetri L, Messina LM, Drago F, D'Aiuto F, Vanadia F, Brighina F, Raieli V Abstract The aim of this study was to assess admissions, for headache, to the emergency department (ED) of the Di Cristina Children's Hospital in Palermo over a decade. The total number of ED admissions for headache was retrospectively analysed considering two 24- month periods: 2009-2010 and 2017-2018. Total admissions to the ED decreased from 55,613 to 50,096 (-10%) between the two periods considered, while the number of admissions for headache increased by 63.56% (p
Source: Functional Neurology - Category: Neurology Tags: Funct Neurol Source Type: research
Authors: Negri M, Gorgora M, Nasser JA, Salles JI, Teixeira S, Arias-Carrión O, Junqueira J, Nicoliche E, Velasques B, Cagy M, Budde H, Basile LF, Orsini M, Friede R, Bastos VH, Ribeiro P Abstract Chronic deep brain stimulation (CDBS) is a surgical treatment that reduces the cardinal signs of Parkinson's disease (PD). Although CDBS has been in use for a long time, very little has been reported on its supposed effects on cognition, particularly in relation to implants in the subthalamic nucleus. The results of the rare studies that do exist are controversial, and in many cases the studies have several design ...
Source: Functional Neurology - Category: Neurology Tags: Funct Neurol Source Type: research
This study assesses the current practices of physicians in Lebanon routinely involved in ischemic stroke (IS) management. We conducted a prospective observational study of patients hospitalized at 8 different Lebanese hospitals in the period August 1, 2015 to July 31, 2016, with a diagnosis of acute stroke. Baseline characteristics and data on diagnostic studies, as well as treatments received during hospitalization and at discharge, were collected and analyzed. Two hundred and three strokes/transient ischemic attacks (TIAs) were recorded but only 173 patients (85%) with ischemic events were included in the study. The pati...
Source: Functional Neurology - Category: Neurology Tags: Funct Neurol Source Type: research
Authors: Goldhardt MG, Andreia A, Dorneles GP, da Silva IR, Pochmann D, Peres A, Rostirola Elsner V Abstract Our aim was to evaluate the impact of a single bout of exercise, consisting of a gait training session with body weight support (BWS), on histone acetylation status (global histone H4 and H3 acetylation levels), brain-derived neurotrophic factor (BDNF) levels, and oxidative stress markers in peripheral blood of individuals with chronic spinal cord injury (SCI). We also set out to compare these responses with those recorded after gait training performed using a walker and with no BWS. The subjects (nearly all...
Source: Functional Neurology - Category: Neurology Tags: Funct Neurol Source Type: research
Authors: de Sire A, Mauro A, Priano L, Baudo S, Bigoni M, Solaro C Abstract Multiple sclerosis (MS) is a chronic disease of the central nervous system, characterized by demyelinization and axonal loss resulting, in 66% of cases, in upper limb motor impairment. The effects of constraint-induced movement therapy (CIMT) have recently been investigated in MS patients. The aim of this randomized single-blind pilot study was to assess the effects of CIMT on upper limb activity, specifically smoothness of movement, in patients affected by progressive MS. Patients affected by MS, and reporting reduced use primarily of one ...
Source: Functional Neurology - Category: Neurology Tags: Funct Neurol Source Type: research
The objective of this psychometric study was to validate the Italian version of the BI in a population of patients with Parkinson's disease (PD). The study was conducted at three neurological and rehabilitation centres in Rome, Italy. The BI was administered to outpatients with PD. The reliability of the scale was assessed using Cronbach's alpha for internal consistency; the intra-class correlation coefficient (ICC) was used to measure its intra- and inter-rater reliability. Pearson's correlation coefficient was calculated to evaluate its validity, comparing it with the Parkinson's disease Questionnaire (PDQ-39), the Itali...
Source: Functional Neurology - Category: Neurology Tags: Funct Neurol Source Type: research
Authors: De Bartolo D, Spitoni GF, Iosa M, Morone G, Ciancarelli I, Paolucci S, Antonucci G Abstract In recent years, cognitive theories have increasingly influenced the approach to motor rehabilitation. The connection between different aspects of cognitive and motor function is increasingly documented, underlining the importance of developing rehabilitation projects that take cognitive aspects into account. The aim of this non-systematic review is to highlight the relationship between cognition and motion and, in the light of new rehabilitation technologies, to better define how aspects of cognition can affect mot...
Source: Functional Neurology - Category: Neurology Tags: Funct Neurol Source Type: research
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