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Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

EIC Assistant
Francesco Busardò

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada

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Via L. Temolo 4, 20126 Milano

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Giuseppe Agosta

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Chiara Riva
Biomedia srl
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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da M. Pellegrini

New psychoactive substances: a descriptive review
New psychoactive substances: a descriptive review
<p>New psychoactive substances (NPS) are psychotropic drugs, that are used as alternatives to the classical scheduled drugs of abuse and are not under control of the United Nations&rsquo; 1961 Narcotic Drugs/1971 Psychotropic Substances conventions. NPS is a umbrella generic term including new synthetic and natural drugs such as synthetic cannabinoids, synthetic opioids, hallucinogens, synthetic cathinones and other stimulants. Many NPS were originally developed as therapeutic drug candidates and/or as pharmacological tools to investigate endogenous systems, although none of them were clinically tested. Due to the absence of experimental and clinical data of on NPS, pharmacological and toxicological data are rarely available. Therefore, NPS use may induce unknown and unexpected effects, including acute and chronic toxic effects, as reported in numerous cases of intoxication and deaths in Europe and worldwide. The rapid emergence of a large number of NPS on the global drug market poses a significant risk to public health and a challenge to drug policy. The present manuscript provides an updated review of the large number of new/novel/emerging psychoactive substances and their associated psychopathological consequences.</p>
Biochimica Clinica ; 46(4) 283-291
Rassegne - Reviews
Farmacotossicologia e metodologie di analisi dell’acido gamma-idrossibutirrico nel laboratorio clinico e forense
Pharmacotoxicology and analytical issues of gamma-hydroxybutyric acid in clinical and forensic laboratory
<p>Gamma-hydroxybutyric acid (GHB) can be considered both an endogenous metabolite and a precursor of the neurotransmitter gamma-aminobutyric acid (GABA) acting within the central nervous system as a neuromodulator.<br />Pharmacologically, GHB is classified as a central nervous system depressant and its mechanism of action involves interaction and binding with GABA-B receptors.<br />With the generic name of sodium oxybate, the sodium salt of GHB, is sold as a pharmaceutical product under the trade name of Xyrem&reg; when prescribed for the treatment of people with narcolepsy and with the name of Alcover&reg; when used to relieve alcohol withdrawal syndrome and treat alcohol dependence.<br />Between the end of the 90s of the twentieth century and the beginning of the twenty-first one, the abuse of GHB became increasingly widespread in the recreational field. The substance, often consumed in combination with alcohol, cannabis, ecstasy (3,4-Methylenedioxymethamphetamine, MDMA), ketamine, has been converted in one of the most used &quot;club drugs&quot;, becoming one of the most serious health issues in the emergency department of many European and extra-European Countries because of the initial difficult clinical management of the growing number of cases of intoxication. At the same time, there was an increase of cases of sexual assaults of victims who were unaware they had been given GHB as odourless and colourless sedative substance.<br />In this narrative review, the three different aspects of GHB as endogenous neuromodulator, as prescription drug and as substance of abuse are illustrated. The main methods for qualitative and quantitative analysis in conventional and non-conventional biological matrices for clinical and forensic purposes are also described.</p>
Biochimica Clinica ; 44(4) 335-350
Rassegne - Reviews
Il laboratorio clinico nelle indagini tossicologiche
The role of clinical laboratory in toxicological investigations
<p>Clinical toxicology laboratory activities are carried out both for clinical purposes, providing support to the diagnosis and treatment of intoxicated patients, and for medico-legal aspects, providing data with value of judicial proof. The new Italian law (no. 41, March 23, 2016) considers vehicular homicide and road traffic injuries criminal offences to be severely punished, especially if the driver is under the influence of alcohol or psychotropic substances. Since toxicology results have an impact on administrative and legal decisions, analytical reliability and traceability of data, including the implementation of a chain of custody of samples, are crucial. Forensic toxicological analyses use conventional matrices (blood and urine) and alternative matrices (hair, saliva, sweat). To assess the current use of illicit drugs, blood is the matrix of choice because substance concentrations correlate with subject&rsquo;s physical and mental status at the time of collection. On the other hand, urine testing is simple, rapid and non-invasive. A positive result indicates that the substance assumption was from several hours to a few days prior to sampling. The hair matrix is suitable to identify past use or abuse and segmental hair analysis allows the reconstruction of the history of abuse. Analytical methods for alcohol and drugs of abuse include qualitative screening tests and quantitative confirmatory tests. A negative result of the screening test does not require further investigation, while a positive result cannot assume forensic value without confirmatory analysis. The use of mass spectrometry in combination with chromatographic or electrophoretic separation techniques for confirmatory tests has found the consensus of the international scientific community.</p>
Biochimica Clinica ; 41(3) 216-227
Rassegne - Reviews
“Smart drugs”, le nuove droghe sul web: due casi di intossicazione acuta
“Smart drugs”, the new drugs on the web: two cases of acute intoxication
<p>New psychoactive substances that&nbsp;in some cases are not subjected to any legal restriction recently overwhelmed web market. They were historically&nbsp;defined &ldquo;smart drugs&rdquo;: substances either natural or synthetic with alleged psychoactive effects as well as effects on&nbsp;sexual performance. We present here two intoxication cases: the first concernes a male subject hospitalized for deep&nbsp;unconsciousness, who took in yohimbine and kawaine, two psychoactive alkaloids present in herbal preparations of&nbsp;Pausinystalia yohimbe and Piper methysticum, sold on the sexy shop websites; the second concernes a female with&nbsp;a previous history of drug poliabuse, hospitalized for dysphoric syndrome/hallucinations, who took in benzydamine,&nbsp;a local anesthetic and analgesic drug, contained in an antibacterial gynecological powder that in oral mis-overdosage&nbsp;acts as a deliriant and central nervous system stimulant.</p>
Biochimica Clinica ; 38(3) 268-271
Casi clinici - Case report
Determinazione di sostanze farmacologicamente attive lecite e illecite nel latte materno mediante cromatografia liquida - spettrometria di massa tandem
Liquid chromatography-mass tandem spectrometry assay (LC-MS/MS) for licit and illicit drugs in breast milk
Biochimica Clinica ; 35(4) 285