Drugs and toxins in clinical laboratory practice the ... - Clinical Chemistry

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by Horace K. Liang, Julius. G.K. Goepp, and Marc J. Bayer. On both days, the conference included two parallel breakout sessions with clinical toxicology.

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Cheinistiy 42:8(B) (1996)

Drugs and toxins in clinical laboratory practice the Nineteenth Arnold 0. Beckman Conference in Clinical Chemistry ROBERT

All substances are poisonous, there is none which is not a poison; it is the right dose that differentiates a poison. Paracelsus (1493?-1 541) The cause of toxic processes and the response to xenobiotics

REJ

Ames’s presentation does not appear in these proceedings; however, some aspects of his engaging presentation have appeared elsewhere [1]. The conference concluded with three presentations on the laboratory’s role in monitoring, diagnosis, and management in emergency toxicology. Various aspects of toxic syndromes and poison management were presented by Horace K. Liang, Julius G.K. Goepp, and Marc J. Bayer. On both days, the conference included two parallel breakout sessions with clinical toxicology case presentations by invited speakers and conference committee members. It was my pleasure to serve as chair of the Beckman Conference Organizing Committee for the Nineteenth Conference and as guest editor of these proceedings. I hope that this published record serves as an accurate account of the conference and further disseminates to all readers of Clinical Chemistry the information presented at the conference. I express my thanks to my fellow members of the Committee-Edward Ashwood, Ronald Elm, Martin Kroll, and Mario Werner-for their significant contributions in making this year’s meeting a success. The initial program for this conference was developed under the chairmanship of Roger Boeckx, whose early death has been reported in these pages [2]. The Committee has honored Roger by retaining him as posthumous program chair; the conference opened with a eulogy to Roger by Thomas Moyer. The generosity of the Arnold and Mabel Beckman Foundation makes possible this series of meetings and their proceedings. The clinical laboratory community owes a continuing debt of gratitude to Dr. Beckman’s foresight in establishing these annual conferences. The Organizing Committee thanks Cathy Sumners and Christine Donnell and members of the AACC Meetings Department and National Office for their outstanding organizational skills in making the 1996 conference a success.

have long been a focus of clinical laboratories. Toxicity has many manifestations and may have many causes. Individuals may be exposed to a variety of substances, either intentionally through use of therapeutic or abused drugs and xenobiotics such as tobacco and alcohol, or unintentionally as in many cases of poisoning or exposure to environmental toxins. The Nineteenth Arnold 0. Beckman Conference in Clinical Chemistry examined several key facets of toxicity and the central role that clinical laboratory measurements play in the management of toxicity syndromes in patients. The program commenced with an overview by Wayne Ray of methods utilized in clinical assessment studies of drugs. The first session included three presentations on specific systemic effects of cardiovascular, immunosuppressive, and antineoplastic drugs, which were reviewed by Frank Marcus, Leslie Shaw, and Bruce Chabner, respectively. The second session explored the epidemiology and legal aspects of illicit and abused drug use. Beatrice Rouse provided data obtained from a variety of surveillance studies that helped differentiate which illicit or abused drugs are most likely to be encountered in patients from differing geographical regions or demographic populations, and Thomas Chamberlain systematically reviewed the forensic role of the clinical chemist in court. Toxicity and chronic exposure opened the second day of the program. Noel Weiss outlined the epidemiology and mechanisms of action of long-term estrogen therapy, in contrast to short-term effects. Exposure to natural and synthetic toxins in the environment has been a global concern for the past three decades; Jay Silkworth and Bruce Ames reviewed the effects of diet and long-term exposure to environmental substances.

References 1. Ames BN, Gold LS, Willett WC. The causes and prevention of cancer. Proc NatI Acad Sd U S A 1995;92:5258-65. 2. Hicks J, Moyer T, Burtis C. Obituary. Clin Chem 1995;41:1550.

Wadsworth Center for Laboratories and Research, New York Stare Department of Health, School of Public Health-State University of New York at Albany, Albany, NY 1220 1-0509.

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