Furosemide is included in the World Anti-Doping Agency’s (WADA) list of prohibited substances because it can be used by athletes to mask the presence of performance-enhancing drugs in urine and/or excrete water for rapid weight loss. But how effective is furosemide in masking prohibited substances in urine? Based on the pharmacology and the available literature, we conclude that the masking effect of furosemide is limited. Furosemide is a doping agent that is mainly relevant for sports with weight categories. Conflict of interest and financial support: none declared.
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As in many other countries worldwide, the coronavirus pandemic prompted the implementation of an “intelligent lockdown” in the spring of 2020 in the Netherlands, including the closure of nightlife venues and cancellation of festivals. Such restrictions and social distancing could particularly affect people who use alcohol or other drugs in recreational settings and give rise to new challenges and additional needs in the field of addiction prevention and care. To monitor changes in substance use and provide services with practical directions for tailored prevention, an anonymous web survey was set up, targeting a convenience sample aged 16 years or older through various social media and other online channels. Between May and October 2020, a total of 6,070 participants completed the survey, mainly adolescents and young adults (16–24 years old). These data were used to explore and describe changing patterns in substance use. Overall results showed declined current use compared to “pre-corona,” but mask underlying variation in changing patterns, including discontinued (tobacco 10.4%, alcohol 11.3%, cannabis 16.3%, other drugs 30.4%), decreased (tobacco 23.0%, alcohol 29.1%, cannabis 17.4%, other drugs 20.7%), unchanged (tobacco 30.3%, alcohol 21.2%, cannabis 22.3%, other drugs 17.3%), increased (tobacco 29.6%, alcohol 32.1%, cannabis 32.9%, other drugs 25.3%), and (re)commenced use (tobacco 6.7%, alcohol 6.3%, cannabis 11.1%, other drugs 6.2%). Especially the use of drugs like ecstasy and nitrous oxide was discontinued or decreased due to the lack of social occasions for use. Increased use was associated with coping motives for all substance types. As measures combatting the coronavirus may need to be practiced for some time to come, possibly leading to prolonged changes in substance use with lingering “post-corona” consequences, timely and ongoing monitoring of changing patterns of substance use is vital for informing prevention services within this field.
MULTIFILE
Aims: Prescribing errors among junior doctors are common in clinical practice because many lack prescribing competence after graduation. This is in part due to inadequate education in clinical pharmacology and therapeutics (CP&T) in the undergraduate medical curriculum. To support CP&T education, it is important to determine which drugs medical undergraduates should be able to prescribe safely and effectively without direct supervision by the time they graduate. Currently, there is no such list with broad-based consensus. Therefore, the aim was to reach consensus on a list of essential drugs for undergraduate medical education in the Netherlands. Methods: A two-round modified Delphi study was conducted among pharmacists, medical specialists, junior doctors and pharmacotherapy teachers from all eight Dutch academic hospitals. Participants were asked to indicate whether it was essential that medical graduates could prescribe specific drugs included on a preliminary list. Drugs for which ≥80% of all respondents agreed or strongly agreed were included in the final list. Results: In all, 42 (65%) participants completed the two Delphi rounds. A total of 132 drugs (39%) from the preliminary list and two (3%) newly proposed drugs were included. Conclusions: This is the first Delphi consensus study to identify the drugs that Dutch junior doctors should be able to prescribe safely and effectively without direct supervision. This list can be used to harmonize and support the teaching and assessment of CP&T. Moreover, this study shows that a Delphi method is suitable to reach consensus on such a list, and could be used for a European list.
MULTIFILE
Every year in the Netherlands around 10.000 people are diagnosed with non-small cell lung cancer, commonly at advanced stages. In 1 to 2% of patients, a chromosomal translocation of the ROS1 gene drives oncogenesis. Since a few years, ROS1+ cancer can be treated effectively by targeted therapy with the tyrosine kinase inhibitor (TKI) crizotinib, which binds to the ROS1 protein, impairs the kinase activity and thereby inhibits tumor growth. Despite the successful treatment with crizotinib, most patients eventually show disease progression due to development of resistance. The available TKI-drugs for ROS1+ lung cancer make it possible to sequentially change medication as the disease progresses, but this is largely a ‘trial and error’ approach. Patients and their doctors ask for better prediction which TKI will work best after resistance occurs. The ROS1 patient foundation ‘Stichting Merels Wereld’ raises awareness and brings researchers together to close the knowledge gap on ROS1-driven oncogenesis and increase the options for treatment. As ROS1+ lung cancer is rare, research into resistance mechanisms and the availability of cell line models are limited. Medical Life Sciences & Diagnostics can help to improve treatment by developing new models which mimic the situation in resistant tumor cells. In the current proposal we will develop novel TKI-resistant cell lines that allow screening for improved personalized treatment with TKIs. Knowledge of specific mutations occurring after resistance will help to predict more accurately what the next step in patient treatment could be. This project is part of a long-term collaboration between the ROS1 patient foundation ‘Stichting Merels Wereld’, the departments of Pulmonary Oncology and Pathology of the UMCG and the Institute for Life Science & Technology of the Hanzehogeschool. The company Vivomicx will join our consortium, adding expertise on drug screening in complex cell systems.
Terrorisme en drugs vormen een risico voor Nederlandse zeehavens en de zich daar bevindende schepen. De douane voert onder water inspecties uit ter bestrijding van dat risico. Deze inspecties met behulp van duikers zijn kostbaar en tijdrovend voor douane en koopvaardij. De Topsector Logistiek heeft het bedrijfsleven en de douane opgeroepen samen te werken bij de ontwikkelingen van nieuwe concepten. Binnen het voorliggende KIEM Logistiek projectvoorstel beoogt NHL Hogeschool een boundary research uit te voeren voor een innovatieve onder water dome ter oplossing van het gesignaleerde praktijkprobleem bij onder water inspecties. Dit onderzoek vormt een samenwerking tussen onderzoekers en studenten van NHL Hogeschool, het bedrijfsleven en de douane. Doel is een onder water dome daadwerkelijk te ontwikkelen binnen een aansluitend Raak project.
Van “wereldkampioen drugs” tot “narcostaat”, een greep uit de recente betitelingen van ons land als het gaat om de drugshandel. Nederlandse criminelen behoren wat betreft de productie van synthetische drugs tot de mondiale top. Een narcostaat wordt vooral gekenmerkt door een bloeiende, parallelle (synthetische) drugseconomie gepaard gaande met corruptie, infiltratie van de gevestigde orde en straffeloosheid. Het heeft ver strekkende gevolgen, veel verder dan alleen de schade voor de eindgebruiker, met recente voorbeelden als de moorden op de advocaat, de broer en de adviseur van de kroongetuige in het strafproces rondom hoofdverdachte R. Taghi, een recordaantal drugsuithalers in de afgelopen maand in de Rotterdamse haven waarbij tonnen aan cocaïne werd gevonden met een straatwaarde van meer dan 300 miljoen euro. De zogeheten “Enschedese kwartetmoord” laat zien hoe ook de handel in hennep tot extreem gewelddadige escalaties in Nederland leidt. Naast dat er door hennepkwekerijen jaarlijks 200 miljoen euro illegaal aan energie wordt afgetapt, leidt dit jaarlijks minimaal tot 65 woningbranden. Met de ontwikkeling van zogeheten e-nose technologie, te vergelijken met een elektronische speurhond, is de afgelopen jaren door enkele samenwerkende projectpartners een oplossing ontwikkeld voor de detectie van gevaarlijke stoffen. In eerste verkenningen is aangetoond dat deze technologie, in potentie, ook ingezet kan worden voor het opsporen van drugslaboratoria en kwekerijen. Naast dat dit doorontwikkeling vergt van elektrochemische sensoren en applicatietechnologie, is er in de praktijk vraag naar onderzoek inzake juridische kaders, de ontwikkeling van handelingskaders en werkinstructies en ontwikkeling van training en opleiding voor de inbedding binnen relevantie publieke organisaties. Een consortium bestaande uit hogeschool Saxion, publieke organisaties (waaronder Politie, OM, NVWA en Veiligheidsregio Twente) en private partijen wil deze (door)ontwikkeling gezamenlijk oppakken. De nieuwe werkmethoden zullen niet alleen in het laboratorium, maar ook in de opsporingspraktijk worden getest en gevalideerd.
