Brain homogenate stability for stimulant drugs.

Brain can be a useful specimen for toxicology testing as it is a protected and isolated organ with lower metabolic activity than other tissues, but there is currently no published data supporting the stability of stimulant drugs in prepared brain homogenates. Brain homogenates were evaluated to determine the stability of the following stimulant drugs: amphetamine, benzoylecgonine, bupropion, cocaethylene, cocaine, ephedrine, methylenedioxyamphetamine, methylenedioxymethamphetamine, methamphetamine, and phentermine. Four different homogenates were prepared at a 1:4 dilution with deionized water and fortified at 500 ng/mL of: cocaine without sodium fluoride, cocaine with 1% sodium fluoride, stimulant drugs other than cocaine without sodium fluoride, and stimulant drugs other than cocaine with 1% sodium fluoride.

Assessment of urine drug screen utility at autopsy to predict laboratory postmortem blood toxicology.

When faced with increasing drug-related deaths and decline in practicing forensic pathologists, the need to quickly identify toxicology-related deaths is evident in order to appropriately triage cases and expedite turnaround times. Lateral flow immunoassays conducted pre-autopsy offer quick urine drug screen (UDS) results in minutes and are used to inform the need for autopsy. Over 1000 medicolegal cases were reviewed to compare UDS results to laboratory enzyme-linked immunosorbent assay (ELISA) blood results to evaluate how well autopsy UDS predicted laboratory findings.

Novel participant-level meta-analytic evidence for AbSANT efficacy.

The current study employed interrupted time series (ITS) models to analyze all available (published and unpublished) Abstract Semantic Associative Network Training (AbSANT) data. AbSANT is a semantically focused anomia treatment that targets not only concrete but abstract words, unique among existing anomia treatments. However, evidence to date for the positive effects of AbSANT comes only from small-sample, single-subject design studies, limiting the strength of this evidence and the inferences that can be drawn from it.

Examination of acetone findings in suspected drug-facilitated sexual assaults: A case series.

Acetone presence in human biological specimens can result from exogenous administration or endogenous production, resulting from diabetes, dietary composition, alcoholism, and stress response. Victims of drug-facilitated sexual assaults (DFSA) are understood to experience enhanced stress. At the Harris County Institute of Forensic Sciences (HCIFS), DFSA drug testing includes analysis of volatile compounds, ethanol, methanol, isopropanol, and acetone, by headspace gas chromatography/flame ionization detection.

A Comparison of High Drug Concentrations in Impaired Driving and Postmortem Casework in Harris County, TX.

Drug-impaired driving is a growing public safety issue. Addressing impairment due to drugs other than ethanol can be challenging for forensic toxicologists as many factors need to be considered including the type of drug(s), drug-drug interaction, the dose(s) and the individual's physiological condition and drug use history. Interpretation of blood drug test results is additionally difficult as drug concentrations in impaired driving cases may overlap levels typically viewed as toxic.

Phenibut, a GABAB Agonist, Detected in a Fatality.

Phenibut, a GABAB agonist structurally similar to baclofen, is not approved for medical use in the United States, but is available through internet suppliers for recreational use. Calls to poison control centers for phenibut have increased over the last five years, and there are many case reports of severe acute intoxications and withdrawals requiring hospitalization. This case report describes the autopsy and toxicology findings of a 26-year-old male found dead at home with phenibut containers on scene.

Bilingual Abstract Semantic Associative Network Training (BAbSANT): A Polish-English case study.

Introduction: This article presents a novel approach to anomia therapy (i.e., BAbSANT: Bilingual Abstract Semantic Associative Network Training) for bilingual persons with aphasia (B-PWA) that capitalizes both on lexico-semantic theories in bilingualism and general theories of semantic organization and learning.

Telerehabilitation for Word Retrieval Deficits in Bilinguals With Aphasia: Effectiveness and Reliability as Compared to In-person Language Therapy.

Bilinguals with post-stroke aphasia (BWA) require treatment options that are sensitive to their particular bilingual background and deficits across languages. However, they may experience limited access to bilingual clinical resources due to reduced availability of bilingual practitioners, geographical constraints, and other difficulties. Telerehabilitation can improve access to bilingual clinical services for BWA and facilitate the delivery of specific language treatments at distance, but more evidence on its effectiveness and reliability is needed.

The Relationship between Language Control, Semantic Control and Nonverbal Control.

The purpose of this study was to examine the relationship between language control, semantic control, and nonverbal control in bilingual aphasia. Twelve bilingual adults with aphasia (BPWA) and 20 age-matched bilingual adults (AMBA) completed a language control task, semantic control task, and nonverbal control task, each designed to examine resistance to distractor interference. AMBA and BPWA exhibited significant effects of control on all tasks.

Abstract Semantic Associative Network Training: A Replication and Update of an Abstract Word Retrieval Therapy Program.

Purpose We report on a study that replicates previous treatment studies using Abstract Semantic Associative Network Training (AbSANT), which was developed to help persons with aphasia improve their ability to retrieve abstract words, as well as thematically related concrete words. We hypothesized that previous results would be replicated; that is, when abstract words are trained using this protocol, improvement would be observed for both abstract and concrete words in the same context-category, but when concrete words are trained, no improvement for abstract words would be observed. We then frame the results of this study with the results of previous studies that used AbSANT to provide better evidence for the utility of this therapeutic technique.

Is bilingualism protective for adults with aphasia?

The bilingual advantage proposes that bilingual individuals have enhanced cognitive control compared to their monolingual counterparts. Bilingualism has also been shown to contribute to cognitive reserve by offsetting the behavioral presentation of brain injury or neural degeneration. However, this effect has not been closely examined in individuals with post-stroke or post-TBI aphasia.

Development of a Free Online Interactive Naming Therapy for Bilingual Aphasia.

Purpose The purpose of this ongoing project was to provide speech-language pathologists who serve culturally and linguistically diverse populations with a freely available online tool for naming therapy in a variety of languages. The purpose of this clinical focus article was to report on this resource in an effort to make known its existence, its instructions for use, and the evidence-based practices from which it was developed. Method The website, http://bilingualnamingtherapy.

Case Reports of Fatalities Involving Tianeptine in the United States.

Tianeptine is a tricyclic anti-depressant that is also known to have opioid receptor activity. We present two fatal cases of tianeptine intoxication in Texas in which tianeptine was used recreationally. The first case involved a 28-year-old white male found alone on the floor of his locked residence.

A theoretical account of lexical and semantic naming deficits in bilingual aphasia.

Purpose: The purpose of this study was to examine premorbid language proficiency and lexical and semantic processing deficits in bilingual aphasia and develop a theoretical account of bilingual language processing.

Method: Nineteen Spanish-English patients with bilingual aphasia completed a language use questionnaire (LUQ) and were administered Spanish and English standardized language assessments. The authors analyzed the data to (a) identify patterns of lexical and semantic processing deficits and conceptualize a theoretical framework that accounts for language deficits, (b) determine LUQ measures that predict poststroke language deficits, and (c) evaluate the relationship between predictive LUQ measures and poststroke language deficits in order to identify impairment patterns.

Rehabilitation in bilingual aphasia: evidence for within- and between-language generalization.

Purpose: The goal of this study was to examine if there was a principled way to understand the nature of rehabilitation in bilingual aphasia such that patterns of acquisition and generalization are predictable and logical.

Method: Seventeen Spanish-English bilingual individuals with aphasia participated in the experiment. For each participant, three sets of stimuli were developed for each language: (a) English Set 1, (b) English Set 2 (semantically related to each item in English Set 1), (c) English Set 3 (unrelated control items), (d) Spanish Set 1 (translations of English Set 1), (e) Spanish Set 2 (translations of English Set 2; semantically related to each item in Spanish Set 1), and (f) Spanish Set 3 (translations of English Set 3; unrelated control items).

Physiological Regulation at 9 Months of Age in Infants Prenatally Exposed to Cigarettes.

The primary purpose of this study was to examine the association between prenatal cigarette exposure and physiological regulation at 9 months of age. Specifically, we explored the possibility that any association between prenatal cigarette exposure and infant physiological regulation was moderated by postnatal environmental tobacco smoke (ETS) exposure or infant gender. We evaluated whether male infants with prenatal cigarette exposure or infants who were also exposed to ETS after birth had the highest levels of physiological dysregulation.

Changes in smoking patterns during pregnancy.

This study examined trajectories of smoking during pregnancy among low-income smokers and differences on demographics, psychopathology, and smoking outcome expectancies among women with different smoking trajectories. The sample consisted of 215 urban pregnant smokers living in the United States. Results indicated four trajectories of smoking and significant changes over time within each trajectory.

Anger, hostility, and aggression as predictors of persistent smoking during pregnancy.

Objective: We examined the role of anger, hostility, and aggression, in addition to depression and stress, in predicting persistent smoking during pregnancy in a low-income sample.

Method: The sample consisted of 270 pregnant women (189 smokers, 81 nonsmokers) recruited into a prospective study of prenatal cigarette exposure in the first trimester. Persistent pregnancy smoking was defined as self-reporting daily smoking in at least two trimesters, a positive salivary cotinine level in at least two trimesters, or infant meconium positive for nicotine and/ or its metabolites.

Methadone, cocaine, opiates, and metabolite disposition in umbilical cord and correlations to maternal methadone dose and neonatal outcomes.

Objectives: The purpose was to explore methadone and 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) umbilical cord disposition, correlate with maternal methadone dose and neonatal outcomes, and evaluate the window of drug detection in umbilical cord of in utero illicit drug exposure.

Methods: Subjects comprised 19 opioid-dependent pregnant women from 2 clinical studies, one comparing methadone and buprenorphine pharmacotherapy for opioid-dependence treatment and the second examining monetary reinforcement schedules to maintain drug abstinence. Correlations were calculated for methadone and EDDP umbilical cord concentrations and maternal methadone dose, and neonatal outcomes.

Maternal methadone dose, placental methadone concentrations, and neonatal outcomes.

Background: Few investigations have used placenta as an alternative matrix to detect in utero drug exposure, despite its availability at the time of birth and the large amount of sample. Methadone-maintained opioid-dependent pregnant women provide a unique opportunity to examine the placental disposition of methadone and metabolite [2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP)], to explore their correlations with maternal methadone dose and neonatal outcomes, and to test the ability to detect in utero exposure to illicit drugs.

Methods: We calculated the correlations of placental methadone and EDDP concentrations and their correlations with maternal methadone doses and neonatal outcomes.

Prenatal methadone exposure, meconium biomarker concentrations and neonatal abstinence syndrome.

Aims: Methadone is standard pharmacotherapy for opioid-dependent pregnant women, yet the relationship between maternal methadone dose and neonatal abstinence syndrome (NAS) severity is still unclear. This research evaluated whether quantification of fetal methadone and drug exposure via meconium would reflect maternal dose and predict neonatal outcomes.

Design: Prospective clinical study.

Methadone disposition in oral fluid during pharmacotherapy for opioid-dependence.

Introduction: Oral fluid testing is widely used for detecting drug exposure, but data describing methadone and metabolites in oral fluid during pharmacotherapy for opioid-dependence are relatively limited.

Methods: 414 oral fluid specimens from 16 opioid-dependent pregnant women receiving daily methadone were analyzed for methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), and methadol by liquid chromatography-mass spectrometry.

Results: All oral fluid specimens contained methadone greater than 1 ng/mL; 88% were positive for EDDP and 12% for methadol.

High-throughput simultaneous analysis of buprenorphine, methadone, cocaine, opiates, nicotine, and metabolites in oral fluid by liquid chromatography tandem mass spectrometry.

A method for simultaneous determination of buprenorphine (BUP), norbuprenorphine (NBUP), methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), cocaine, benzoylecgonine (BE), ecgonine methyl ester (EME), anhydroecgonine methyl ester (AEME), morphine, codeine, 6-acetylmorphine (6AM), heroin, 6-acetylcodeine (6AC), nicotine, cotinine, and trans-3'-hydroxycotinine (OH-cotinine) by liquid chromatography tandem mass spectrometry in oral fluid (OF) was developed and extensively validated. Acetonitrile (800 μL) and OF (250 μL) were added to a 96-well Isolute-PPT+protein precipitation plate. Reverse-phase separation was achieved in 16 min and quantification was performed by multiple reaction monitoring.