{"id":"https://openalex.org/W4241937434","doi":"https://doi.org/10.1373/clinchem.2019.304923","title":"Commentary","display_name":"Commentary","publication_year":2019,"publication_date":"2019-10-29","ids":{"openalex":"https://openalex.org/W4241937434","doi":"https://doi.org/10.1373/clinchem.2019.304923","pmid":"https://pubmed.ncbi.nlm.nih.gov/31662335"},"language":"en","primary_location":{"id":"doi:10.1373/clinchem.2019.304923","doi":"https://doi.org/10.1373/clinchem.2019.304923","is_oa":false,"landing_page_url":"https://doi.org/10.1373/clinchem.2019.304923","pdf_url":null,"source":{"id":"https://openalex.org/S139212996","display_name":"Clinical Chemistry","issn_l":"0009-9147","issn":["0009-9147","1530-8561"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320272","host_organization_name":"American Association for Clinical Chemistry","host_organization_lineage":["https://openalex.org/P4310320272"],"host_organization_lineage_names":["American Association for Clinical Chemistry"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical Chemistry","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":null,"display_name":"Feng Sheng","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2799810409","display_name":"Hospital of the University of Pennsylvania","ror":"https://ror.org/02917wp91","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2799810409","https://openalex.org/I4210143392"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Feng Sheng","raw_affiliation_strings":["Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA","institution_ids":["https://openalex.org/I2799810409"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5086683313","display_name":"Michael C. Milone","orcid":"https://orcid.org/0000-0002-1580-9844","observed_orcids":["https://orcid.org/0000-0002-1580-9844"]},"institutions":[{"id":"https://openalex.org/I2799810409","display_name":"Hospital of the University of Pennsylvania","ror":"https://ror.org/02917wp91","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2799810409","https://openalex.org/I4210143392"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Michael C Milone","raw_affiliation_strings":["Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA","institution_ids":["https://openalex.org/I2799810409"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5086683313"],"corresponding_institution_ids":["https://openalex.org/I2799810409"],"apc_list":{"value":4636,"currency":"USD","value_usd":4636},"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.33516812,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"65","issue":"11","first_page":"1361","last_page":"1361"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10800","display_name":"Forensic Toxicology and Drug Analysis","score":0.6859999895095825,"subfield":{"id":"https://openalex.org/subfields/3005","display_name":"Toxicology"},"field":{"id":"https://openalex.org/fields/30","display_name":"Pharmacology, Toxicology and Pharmaceutics"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T10800","display_name":"Forensic Toxicology and Drug Analysis","score":0.6859999895095825,"subfield":{"id":"https://openalex.org/subfields/3005","display_name":"Toxicology"},"field":{"id":"https://openalex.org/fields/30","display_name":"Pharmacology, Toxicology and Pharmaceutics"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T11635","display_name":"Poisoning and overdose treatments","score":0.21809999644756317,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10576","display_name":"Opioid Use Disorder Treatment","score":0.09109999984502792,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/loperamide","display_name":"loperamide","score":0.8550000190734863},{"id":"https://openalex.org/keywords/qt-interval-prolongation","display_name":"QT prolongation","score":0.6819999814033508},{"id":"https://openalex.org/keywords/cardiotoxicity","display_name":"cardiotoxicity","score":0.8069999814033508},{"id":"https://openalex.org/keywords/opioid-overdose","display_name":"opioid overdose","score":0.6110000014305115},{"id":"https://openalex.org/keywords/opioid-withdrawal","display_name":"opioid withdrawal","score":0.5479999780654907},{"id":"https://openalex.org/keywords/synthetic-opioids","display_name":"synthetic opioids","score":0.515999972820282},{"id":"https://openalex.org/keywords/emergency-department","display_name":"emergency department","score":0.593999981880188}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3332713842391968}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D004562","descriptor_name":"Electrocardiography","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013575","descriptor_name":"Syncope","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1373/clinchem.2019.304923","doi":"https://doi.org/10.1373/clinchem.2019.304923","is_oa":false,"landing_page_url":"https://doi.org/10.1373/clinchem.2019.304923","pdf_url":null,"source":{"id":"https://openalex.org/S139212996","display_name":"Clinical Chemistry","issn_l":"0009-9147","issn":["0009-9147","1530-8561"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320272","host_organization_name":"American Association for Clinical Chemistry","host_organization_lineage":["https://openalex.org/P4310320272"],"host_organization_lineage_names":["American Association for Clinical Chemistry"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical Chemistry","raw_type":"journal-article"},{"id":"pmid:31662335","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/31662335","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical chemistry","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":2,"referenced_works":["https://openalex.org/W2586852594","https://openalex.org/W2905823114"],"related_works":["https://openalex.org/W3038660031","https://openalex.org/W2803776673","https://openalex.org/W2905823114","https://openalex.org/W7170973452","https://openalex.org/W2950402629","https://openalex.org/W4380763396","https://openalex.org/W2613980613","https://openalex.org/W3138022222","https://openalex.org/W2344752595","https://openalex.org/W2555559827"],"abstract_inverted_index":{"This":[0,91],"case":[1,41,68,92],"of":[2,18,67,70,81,96,100,120,150,181,196,213],"a":[3,11,64,193,228],"patient":[4],"admitted":[5],"to":[6,46,58,63,74,86,124,206],"the":[7,19,25,29,34,56,79,94,148,178,184,202,211,225],"emergency":[8],"department":[9],"with":[10,44,78,201,231],"prolonged":[12],"QT":[13],"interval":[14],"caused":[15],"by":[16],"ingestion":[17],"over-the-counter":[20],"synthetic":[21],"opioid":[22,31,83],"loperamide":[23,71],"highlights":[24],"challenges":[26,95],"faced":[27],"in":[28,33,39,113,147,177,187,210,227],"current":[30],"epidemic":[32],"US.":[35],"Cardiotoxicity":[36],"as":[37],"observed":[38],"this":[40,52,60,116,160,166,188,217],"is":[42,118,163,170],"associated":[43],"exposure":[45],"excessively":[47],"large":[48],"dose":[49],"(1),":[50],"and":[51,76,85,112,142,199],"case,":[53,189],"although":[54],"not":[55],"first":[57],"describe":[59],"toxicity,":[61],"adds":[62],"growing":[65],"list":[66],"reports":[69],"toxicity":[72],"due":[73],"abuse":[75],"misuse":[77],"intent":[80],"self-treating":[82],"withdrawal":[84],"achieve":[87],"euphoric":[88],"effects":[89],"(2).":[90],"illustrates":[93],"evaluating":[97],"patients":[98],"suspected":[99,214],"drugs-of-abuse":[101],"intoxication.":[102],"Qualitative":[103],"immunoassays":[104],"for":[105,127,224],"commonly":[106],"abused":[107],"drugs":[108,138],"are":[109,133,204],"widely":[110],"available,":[111],"many":[114],"cases":[115],"testing":[117,162,169,209,219],"capable":[119],"providing":[121],"rapid":[122],"results":[123],"physicians":[125],"caring":[126],"these":[128,131],"patients.":[129,182],"However,":[130],"assays":[132],"generally":[134],"directed":[135],"toward":[136],"specific":[137],"or":[139],"their":[140],"metabolites,":[141],"they":[143],"cannot":[144],"be":[145,157,221],"comprehensive":[146,168],"detection":[149],"all":[151],"relevant":[152],"drugs.":[153],"Second-tier":[154],"screening":[155],"can":[156,220],"helpful":[158],"when":[159],"initial":[161],"negative;":[164],"however,":[165],"more":[167],"often":[171],"much":[172],"delayed,":[173],"hampering":[174],"its":[175],"utility":[176],"acute":[179],"management":[180],"As":[183],"authors":[185],"demonstrate":[186],"clinical":[190],"history,":[191],"including":[192],"patient's":[194],"self-report":[195],"substance":[197],"use,":[198],"consultation":[200],"laboratory":[203],"invaluable":[205],"guide":[207],"second-tier":[208],"evaluation":[212],"intoxications.":[215],"Otherwise,":[216],"secondary":[218],"like":[222],"searching":[223],"needle":[226],"proverbial":[229],"haystack,":[230],"low":[232],"yield":[233],"at":[234],"potentially":[235],"great":[236],"expense.":[237]},"counts_by_year":[],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2022-05-12T00:00:00"}