Clinica chimica acta; international journal of clinical chemistry
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Comparative Study
Signify ER Drug Screen Test evaluation: comparison to Triage Drug of Abuse Panel plus tricyclic antidepressants.
Signify ER Drug Screen Test (Signify ER) and Triage Drug of Abuse Panel plus TCA (Triage DOA Panel) rapid drug screening devices were compared at four laboratories. Both assay systems are point of care immunoassays, measuring phencyclidine, barbiturates, amphetamine, cocaine metabolite, methamphetamine, tricyclic antidepressants, opiates, marijuana metabolite, and benzodiazepines in human urine. The performance of these two assay systems, including a cutoff verification and cross-reactivity using spiked urine specimens and accuracy using clinical urine samples, was investigated. ⋯ Eighty-seven structurally related drugs and metabolites were found to cross-react with at least one of the nine tests of the Signify ER. Four hundred forty structurally unrelated compounds that can be found in human urine were shown not to cross-react with the Signify ER. In terms of operating characteristics, the Signify ER device is simpler since only a single pipetting step is required, and reaction completed within 8 min.
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Adrenal function is commonly assessed by measuring plasma cortisol following synthetic ACTH (synacthen) challenge. Generally little regard is given to plasma levels of corticosteroid-binding globulin (CBG). We have developed and validated an enzyme-linked immunosorbent assay (ELISA) for CBG and together with plasma cortisol calculated the "free cortisol index" as an additional parameter for assessing adrenal function. ⋯ We conclude that the measurement of both plasma CBG and total cortisol to derive the free cortisol index may provide an additional parameter in the interpretation of the short synacthen test and that there is a decline in plasma CBG over this test.