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Editor-in-chief
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

Publisher
Biomedia srl
Via L. Temolo 4, 20126 Milano

Responsible Editor
Giuseppe Agosta

Editorial Secretary
Chiara Riva
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282
email: biochimica.clinica@sibioc.it

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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da S Pichini

Sistema Nazionale di Allerta Precoce, una piattaforma web per il contrasto alla diffusione delle Nuove Sostanze Psicoattive
The National Early Warning System, a web-based platform to prevent the spread of New Psychoactive Substances
MR. Varì \| S. Zaami \| R. Pacifici \| S. Pichini \| P. Berretta \| M. Sciotti \| R. Tittarelli \| N. La Maida \| A. Tini \| E. Marinelli \| E. Buscaglia \| E. Brambilla \| G. Scaravaggi \| CA. Locatelli \| FP. Busardò \| M. Cavallo \| S. Graziano \|
<p>Introduction: the abuse of New Psychoactive Substances (NPS) has been a major issue since the 1990s, due to the significant impact this phenomenon has on the society and public health. The Italian legislation, in line with the European legislation, is aimed to limit the NPS use in the Country through different intervention strategies.<br />Methods: the Department for Anti-Drug Policies (DPA) of the Presidency of the Council of Ministers, has activated in Italy the National Early Warning System (SNAP) on NSP reporting, aimed at the early detection of potentially health-threatening phenomena related to the appearance of NPSs in the market. A second aim of the SNAP is the promotion of the technical-analytical expertise of laboratories for the detection of these substances.<br />Since June 2016, the DPA, where the National Focal Point (NFP) for the verification of the phenomenon of drug dependence is established, has entrusted the coordination of SNAP with the National Centre for Addiction and Doping (NCAD) of the “Istituto Superiore di Sanità”. The Centre works with several partners, including the Pavia Poison Control Centre for clinical toxicology, the Unit of Forensic Toxicology of Sapienza University of Rome for bio-toxicological aspects, and the Central Directorate for Anti-Drug Services for national coordination of seizures operated by law enforcement agencies. To implement this network of collaboration, the NCAD has developed and activated a strategic 'web application' that simplifies the collection of information across the Country, optimizing incoming/outgoing reports between all the involved authorities.<br />Results: the analysis of the information collected on NPS during 2020 through the SNAP platform, highlighted the circulation of 47 NSPs in Europe, including two synthetic cannabinoids with potential public health risks and the emergence of NPS belonging to the class of benzodiazepines and the benzimidazole family.<br />Conclusions: The SNAP is an important tool for identifying and notifying the spread of NSPs in our Country very rapidly.</p>
Biochimica Clinica ; 45(3) 267-280 Contributi Scientifici - Scientific Papers

Documento di consenso Gruppo di Studio di Farmacotossicologia Clinica e Doping SIBioC e Gruppo Tossicologi Forensi (GTFI). Modalità per lo svolgimento di indagini di laboratorio per la determinazione delle sostanze d’abuso
Consensus document of the Study Group on Clinical Pharmacotoxicology and Doping of Italian Society ofClinical Biochemistry and Italian Forensic Toxicologists Group (GTFI) – for laboratories involved in thedetermination of substances of abuse
D. Favretto \| S. Pichini \| P. Bucchioni \| R. Pacifici \|
<p>The greatest workload for the laboratories performing pharmacotoxicological tests remains the routine activity for detection and measurement, in different biological matrices, of psychotropic substances such as opiates, cocaine, cannabinoids, amphetamines, methadone, buprenorphine and ethyl alcohol. In addition to the investigations requested for clinical reasons, the requests to the pharmacotoxicological laboratories may also include medico-legal investigations, whose variety and complexity contributed to the adoption of personalized and extremely diverse operating modalities implemented in the Italian laboratories. The purpose of this document is to provide the Laboratories of the National Health Service in Italy that are planning to carry out or that already perform determination of drugs of abuse for medico-legal purposes, with recommendations at national level that take into account the “good laboratory practices” recognized at the international level in order to perform accurate and precise analytical tests so that they can meet the requirements necessary to provide a high quality and legally unassailable service.</p>
Biochimica Clinica ; 43(4) 449-452 Documenti SIBioC - SIBioC Documents

Droghe e alcol: tempo di armonizzazione
Alcohol and drugs: time for harmonization
S. Pichini \| R. Pacifici \|

Biochimica Clinica ; 39(2) 092-093 Editoriale - Editorial

“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
M.C. Rotolo \| M. Pellegrini \| R. Solimini \| S. Pichini \| R. Pacifici \|
<p>New psychoactive substances that in some cases are not subjected to any legal restriction recently overwhelmed web market. They were historically defined “smart drugs”: substances either natural or synthetic with alleged psychoactive effects as well as effects on sexual performance. We present here two intoxication cases: the first concernes a male subject hospitalized for deep unconsciousness, who took in yohimbine and kawaine, two psychoactive alkaloids present in herbal preparations of Pausinystalia yohimbe and Piper methysticum, sold on the sexy shop websites; the second concernes a female with a previous history of drug poliabuse, hospitalized for dysphoric syndrome/hallucinations, who took in benzydamine, a local anesthetic and analgesic drug, contained in an antibacterial gynecological powder that in oral mis-overdosage acts as a deliriant and central nervous system stimulant.</p>
Biochimica Clinica ; 38(3) 268-271 Casi clinici - Case report

Considerazioni sulle matrici biologiche idonee alla valutazione dell’“attualità d’uso di sostanze illecite” ai fini degli articoli 186 e 187 del nuovo Codice della Strada
Thoughts on biological matrices suitable for the assessment of "current use of illicit drugs" according to articles 186 and 187 of new Rules of the Road
R. Pacifici \| P. Gori \| L. Martucci \| S. Pichini \|
<p>Data on detection times of drugs of abuse in different biological matrices are based on pharmacokinetic studies in healthy volunteers during controlled clinical trials. The detection times mainly depend on the dose, route of administration, frequency of consumption (acute or chronic), detection limit of the assay employed for substance determination and matrix being analyzed (blood, saliva, urine, hair). Literature data agree that biologic effects drugs of abuse exert on the body match the presence of such substances and/or their metabolites in blood and/or saliva. Only after hepatic metabolism and renal excretion processes substances and/or their metabolites appear in urine, the last compartment from which substances are eliminated from the body. Hair analysis provides information on consumption of drugs of abuse in months prior to cutting of hair lock. These findings have relevance for the purposes of articles 186 and 187 of new Rules of the Road. Whereas in the case of alcohol, the law specifies in detail the biological matrix and the type of equipment to be used for the determination, for drugs of abuse it is unclear on what matrix is more appropriate to evaluate the presence of a substance of abuse and/or its metabolites in order to establish or better confirm driving under the influence of these substances. In this contribution, based on pharmacokinetic and pharmacodynamic considerations, we aim to reaffirm the most suitable biological matrices to determine the "current use of illicit drugs".</p>
Biochimica Clinica ; 38(1) 27-31 Opinioni - Opinions

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
E. Marchei \| M. Pellegrini \| MC. Rotolo \| I. Palmi \| O. Garcia-Algar \| D. Escuder \| C.R. Pallas \| S Pichini \| R. Pacifici \|

Biochimica Clinica ; 35(4) 285 CONTRIBUTI SCIENTIFICI - CONTRIBUTI SCIENTIFICI