A5032255317- Prenatal Substance Exposure Effects
- Forensic Toxicology and Drug Analysis
- Pharmacogenetics and Drug Metabolism
- Pharmacological Effects and Toxicity Studies
- Cannabis and Cannabinoid Research
- Pharmaceutical studies and practices
- Opioid Use Disorder Treatment
- Neonatal Health and Biochemistry
- Epilepsy research and treatment
- Neuroscience of respiration and sleep
- Drug Transport and Resistance Mechanisms
- Analytical Methods in Pharmaceuticals
- Neurotransmitter Receptor Influence on Behavior
- Birth, Development, and Health
- Heavy Metal Exposure and Toxicity
- Anesthesia and Sedative Agents
- Poisoning and overdose treatments
- Metabolism and Genetic Disorders
- Statistical Methods in Clinical Trials
- Antibiotics Pharmacokinetics and Efficacy
- Colorectal Cancer Treatments and Studies
- Renal Transplantation Outcomes and Treatments
- Health Systems, Economic Evaluations, Quality of Life
- Pain Management and Opioid Use
- Alcohol Consumption and Health Effects
University of Utah
2015-2024
ARUP Laboratories (United States)
2015-2024
ARUP Institute for Clinical and Experimental Pathology
2014-2024
Maine Farmland Trust
2024
Intermountain Healthcare
2022
Community Link
2022
University of Utah Health Care
2022
Eunice Kennedy Shriver National Institute of Child Health and Human Development
2021
Medical College of Wisconsin
2020
Brigham and Women's Hospital
2019
<h3>Importance</h3> Warfarin use accounts for more medication-related emergency department visits among older patients than any other drug. Whether genotype-guided warfarin dosing can prevent these adverse events is unknown. <h3>Objective</h3> To determine whether improves the safety of initiation. <h3>Design, Setting, and Patients</h3> The randomized clinical Genetic Informatics Trial (GIFT) to Prevent Deep Vein Thrombosis included aged 65 years or initiating elective hip knee arthroplasty...
Well-characterized genes that affect warfarin metabolism (cytochrome P450 (CYP) 2C9) and sensitivity (vitamin K epoxide reductase complex 1 (VKORC1)) explain one-third of the variability in therapeutic dose before international normalized ratio (INR) is measured. To determine genotypic relevance after INR becomes available, we derived clinical pharmacogenetic refinement algorithms on basis values (on day 4 or 5 therapy), factors, genotype. After adjusting for INR, CYP2C9 VKORC1 genotypes...
Toxic elements ("heavy metals") are common to the environment and responsible for both intentional poisonings unintentional exposures that can lead adverse health effects potentially death. Dangerous be prevented by recognizing minimizing sources of toxic in our diet, water, workplace, homes. Laboratory testing is an important tool detecting managing element exposure; several analytical methods available. However, clinical value elemental dependent upon collecting appropriate specimen at...
A liquid chromatography-tandem mass spectrometry (LC-MS-MS) method for simultaneous analysis of six major opiates in urine, serum, plasma, whole blood, and meconium is described. The included are codeine, morphine, hydrocodone, hydromorphone, oxycodone, 6-acetylmorphine (6-AM). was compared to an in-house gas chromatography (GC)-MS LC-MS-MS performed by another laboratory. sample preparation time decreased eliminating the glucuronide hydrolysis derivatization required GC-MS analysis, as well...
Copper is an essential element and, under conditions of overload, a toxicant. A dramatic example copper toxicity Wilson disease (WD), treatable but often fatal condition that difficult to diagnose and monitor. method for direct measurement free concentrations in serum or plasma ultrafiltrate by inductively coupled mass spectrometry was developed validated assist with diagnosis monitoring WD. The shown be accurate (94%-109% recoveries), linear (0.5-800 microg/dL [0.08-126 micromol/L]),...
OBJECTIVE: To compare self-reported maternal marijuana use with quantitative biological sampling for a metabolite, 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid, in umbilical cord homogenate state legalized marijuana. METHODS: We conducted cross-sectional study of women approached at the time admission delivery live, singleton pregnancies 24 weeks gestation or greater two urban medical centers Colorado. Maternal was estimated by 1) report to health care provider on history and...
Importance Cannabis use is increasing among reproductive-age individuals and the risks associated with cannabis exposure during pregnancy remain uncertain. Objective To evaluate association between maternal adverse outcomes known to be related placental function. Design, Setting, Participants Ancillary analysis of nulliparous treated at 8 US medical centers stored urine samples abstracted outcome data available. in Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort were...
Summary By guiding initial warfarin dose, pharmacogenetic (PGx) algorithms may improve the safety of initiation. However, once international normalised ratio (INR) response is known, contribution PGx to dose refinements uncertain. This study sought develop and validate clinical dosing for refinement on days 6–11 after therapy An sample 2,022 patients at 13 medical centres three continents provided clinical, INR, genetic data treatment predict therapeutic dose. Independent derivation...
A single method for confirmation and quantitation of a panel commonly prescribed benzodiazepines metabolites, α-hydroxyalprazolam, α-hydroxyethylflurazepam, α-hydroxytriazolam, alprazolam, desalkylflurazepam, diazepam, lorazepam, midazolam, nordiazepam, oxazepam, temazepam, clonazepam, 7-aminoclonazepam, was developed three specimen types, urine, serum/plasma, meconium. Quantitation by liquid chromatography tandem-mass spectrometry (LC-MS-MS) using Waters Alliance-Quattro Micro system. The...
Sixty-seven drugs and metabolites were detected in serum or plasma using a fast (7.5 min) liquid chromatography time-of-flight mass spectrometry (LC–TOF-MS) method. This method was developed as blood drug screen, with emphasis on the detection of common abuse used to manage chronic pain. Qualitative may identify exposure, assure patient adherence prescribed therapy document abstinence from non-prescribed medications. Compound identification is based chromatographic retention time, mass,...
The AACC Academy, formerly the National Academy of Clinical Biochemistry, has developed a laboratory medicine practice guideline (LMPG)10 for using tests to monitor drug therapy in pain management patients. purpose this was compile evidence-based recommendations use and point-of-care (POC) urine relevant over-the-counter medications, prescribed nonprescribed drugs, illicit substances exact process preparing publishing LMPG is shown Table 1. View table: Table 1. Process...
Sirolimus is indicated for prophylaxis treatment to prevent solid organ rejection. Due intrapatient and interpatient variabilities in pharmacokinetics, risk of concentration-related toxicity, noncompliance, a high likelihood drug-drug interactions, therapeutic drug monitoring sirolimus essential. There are several methodologies used clinically monitor sirolimus, ranging from immunoassay tandem mass spectrometry, each with potential strengths limitations. The purpose our study was validate...
The major objective of this research was to propose a simplified approach for the evaluation medication adherence in chronic pain management patients, using liquid chromatography time-of-flight (TOF) mass spectrometry, performed parallel with select homogeneous enzyme immunoassays (HEIAs). We called it "hybrid" urine drug testing.The hybrid defined based on anticipated positivity rates, availability commercial reagents HEIAs, and assay performance, particularly analytical sensitivity...
Meconium drug testing is performed to detect potentially harmful exposures in a newborn. Interpretation of meconium results can be complicated based on the patterns and proportional concentrations drug(s) and/or metabolite(s) detected.The objective this study was analyze de-identified dataset from national reference laboratory (n = 76,631) subset data, wherein specimens originated at single academic medical center for which detailed chart review possible 3635). using 11 immunoassay-based...
Warfarin remains a difficult drug to manage due narrow therapeutic range and wide interindividual variability in dose requirements. The relationship between warfarin sensitivity CYP2C9 VKORC1 variants is strong, the basis for several proposed dosing algorithms. Here gene-based algorithm was compared with standard of care patients receiving prevent venous thromboembolism after joint replacement surgery. Participants (n = 229) were adults (≥18 years) undergoing elective total hip or knee...
A method for qualitative detection of 57 drugs and metabolites in umbilical cord tissue using liquid chromatography time-of-flight (TOF) mass spectrometry is described.Results from 32 deidentified positive specimens analyzed by an outside laboratory "screen with reflex to confirmation" testing were compared TOF results. In addition, paired corresponding chart review data 37 meconium test results TOF. Urine drug mother (n = 18) neonate 30) included if available. Cutoff concentrations,...
Summary We performed a randomised pilot trial of PerMIT, novel decision support tool for genotype-based warfarin initiation and maintenance dosing, to assess its efficacy improving management. prospectively studied 26 subjects compare PerMIT-guided management with routine anticoagulation service CYP2C9 VKORC1 genotype results 13 randomly assigned the PerMIT arm were recorded within 24 hours enrolment. To aid in INR interpretation, calculates estimated loading doses based on patient’s genetic...