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September 2014 CFTN

An AACC/CAP Educational Newsletter for Toxicology Laboratories

Read the September 2014 Issue
This issue features views from a medical examiner’s perspective on the future of virtual autopsy, information on a new extended-release opioid medication without acetaminophen, and study results on drug testing in multiple births. We look forward to your feedback or comments.

The Virtual Autopsy
Will it Make the Scalpel Obsolete?

By Jim Caruso, MD 

Some investigators have advocated that “virtopsy” should replace traditional autopsy. Others say that 3D imaging can be an important adjunct in select cases. Denver’s chief medical examiner discusses the advantages and drawbacks of multi-slice computerized tomography and magnetic resonance imaging in forensic pathology.

Zohydro ER
Medication Offers Extended-Release Hydrocodone without Acetaminophen

By David Kuntz, PhD, DABTF 

Amidst fears of the potential for abuse, Zohydro ER, a new extended-release hydrocodone, faced some initial difficulty winning FDA approval. This single-entity formulation is specifically intended for patients with severe pain who require daily, long-term opioid treatment. Although Zohydro’s sustained-release formulation is unique, laboratory procedures don’t differ from those already used for hydrocodone testing in plasma or urine and require no changes in methods.

Drug Tests in Multiple Births
Largest Study Examines Incidence of Mismatches in Meconium Test Results

By Kelly E. Wood, MD, Matthew D. Krasowski, MD, PhD, and Gwendolyn A. McMillin, PhD, DABCC 

Meconium drug-testing in twins and triplets doesn’t often result in mismatches. When they do occur, discrepancies can frequently be explained by medications administered to one infant but not the other, separate placentas, or low drug concentrations around screening test cutoffs. These authors compared multiple birth meconium test results from a four-year period in a large national reference laboratory dataset and in a smaller dataset from an academic medical center.