Summary. We preview the results of the first year in a Miscarriage Clinic set up in 1989 in an effort to improve the support and counselling of women who have a miscarriage. Of 381 patients referred, 79% attended. The only statistically significant difference between the women who attended and those who did not attend was in the proportion of women who had planned their pregnancies (65% versus 33%, P<0.01). Of the 300 patients who attended, 4% reported no grief reaction; 75% experienced a reaction which had resolved within one month and 21% experienced a reaction which had not resolved. No factor was identified which could predict the duration of the grief reaction. This audit demonstrates that there is a strong demand and need for this service for couples who experience a miscarriage.
4-Methylthioamphetamine (4-MTA) is a new drug of abuse, and owing to a number of deaths in the EU over a 2-year period, it has become a major cause for concern. Little is known about the metabolism, half-life or excretion pro®le of 4-MTA, in man. We used a canine model to study the excretion pro®le of 4-MTA.Urine samples were screened for 4-MTA with EMIT amphetamine immunoassay, followed by con®rmatory analysis using GC-MS. 4-MTA was detectable using EMITamphetamine immunoassay down to 1 mg mL À1 in drug-free urine samples to which 4-MTA was added. 4-MTA was detectable by EMIT up to 23 h after administration. Base extracted urine samples were subjected to¯ash derivatization using N-methylbis(tri¯uoroacetamide) and the resulting tri¯uoroacetylated compound yielded a well fragmented mass spectrum under the GC-MS conditions used. Quanti®cation of 4-MTA in the urine samples revealed 15, 11 and 20 mg mL À1 at 5Á5, 13Á5 and 23 h, respectively. 4-MTA is detectable by immunoassay at 1 mg mL À1 and can be detected in dogs up to 23 h after administration. EMIT positive screens can be checked using GC-MS incorporating derivatization to con®rm the presence of 4-MTA.
Since the early 1990s ring-substituted derivatives of amphetamine have been abused widely in the Republic of Ireland. The main ring-substituted amphetamines being abused include methylenedioxyamphetamine (MDA), methylenedioxymethamphetamine (MDMA) and methylenedioxyethamphetamine (MDEA). A newer illicit synthetic analogue, which has been seized to a lesser extent by Irish police, is N-methyl-1-(3,4-methylenedioxyphenyl)-2-butanamine (MBDB). The work presented here involved the determination of the type of ring-substituted amphetamines being abused by a group of recovering opiate abusers participating in a methadone maintenance programme in a Dublin Drug Rehabilitation Centre. Urine samples which tested positive for amphetamines and ring-substituted amphetamines via EMIT immunoassay were subjected to further analysis using GC-MS with MBTFA flash derivatization. It was found that the methylenedioxypropanamines were being abused, as was amphetamine itself. However, no abuse of methylenedioxybutanamines or thioamphetamines was observed.
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