Winter 2014

new art laboratories

Inside Diagnostics

ADULTERATIONHow adulteration can be detected in a urine sample

COLON CANCERA proper prophylaxis can be crucial

SCARLET FEVERA clear diagnosis helps to prevent

the late effects

Rapid Tests

Laboratory Diagnostics

Laboratory Service

Consulting & Service

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ForwordDear Readers,

I am very pleased to take over the responsibilities of being the new Editor in Chief of our Inside Diagnostics magazine. It was a real pleasure for me to work on this issue and I hope it is the first of many. It is enjoyable and very rewarding to be part of such a motivated and dedicated team.

In this issue, we focused on the topic of the colon cancer: What is it? What are the symptoms? How can it be detected? In order to answer this last question, we will analyse our wide range of tests including Clostridium, FOB and HBHP rapid tests. In addition, we also offer you a unique article highlighting the various methods of adulteration to manipulate

the results of a drug test. This article will help raise awareness about how individuals can have a significant influence on their results.

Finally, I want to remind you that Inside Diagnostics is your magazine. We want to offer you content and quality articles that meet your expectations and interests. Please, send us your suggestions, feedback, ideas and topics so that we can develop them in future issues.

Now, last but not least, I wish you a good read and hope you discover something new and interesting in this issue.

Kind regards, Nicolas Kennof

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Inside Diagnostics

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Contents

Flag

ThemesColon Cancer ..................................................... 4Drug Substitution .............................................. 6 Adulteration ...................................................... 8Scarlet Fever .................................................... 10Hair Analysis .................................................... 11

nvm Inside Donation Campaign ......................................... 12 Christmas Donation 2013 ................................ 12 Medica 2013 .................................................... 13 Short News & Conference Calender ................ 14

COLON CANCER | Page 4Colorectal cancer is the most common cancer in Germany. Every year, approx-imately 70,000 people are diagnosed with colorectal cancer and 30,000 peo-ple die from it. Read more on page 4

Inside Diagnostics nal von minden GmbH Customer Magazine Contact: nal von minden GmbH Nicolas Kennof Friedenstraße 3293053 Regensburg

Chief Editor: Nicolas Kennof

Editors: Torsten Winkler, Kristina Sambs, Raffaela Seiband, Christopher Beiderbeck, Anne Kaiser, Andrea Kreuzer, Franziska Stöckinger, Jodie Baker, Martina Kastenmaierinside-diagnostics@nal-vonminden.com

Layout: Martina Kastenmaier, Kasia Orlowska

Inside Diagnostics Contents

• Colorectal cancer in one of the most common malignant diseases in Western countries. In Germany alone there are 66,000 new cases every year.

• Regular screening can detect cancer at an early stage and significantly improve the chances of recovery. A checkup should be conducted once a year.

• The NADAL ® FOB plus rapid test is quick and easy to perform. Your doctor only needs a stool sample. A specific diet is not necessary before carrying out the test.

• It is strongly recommended to take the test if certain risk factors apply to you, or your state of health gives reason to be suspicious of a bowel disease.

• Unfortunately, the test is not provided by regu-lar health insurance, but it can be carried out on request, and at an additional cost. The test is just a few Euros and it could be crucial for you!

• Talk to your doctor, they will be happy to give you more information and advice regarding colorectal cancer precaution!

Colorectal CancerPrevention

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Oncology Colon Cancer

"Anyone who loves their partner will send them to take pre-ventive examination" – The German actor Sky Du Mont and his wife Mirja and Vitali Klitschko and his Natalia collabora-te in an effective advertising campaign "Liebe" (German for Love) of the Felix-Burda Foundation. Since March is the awa-reness month for colon cancer, the Inside Diagnostics Team wanted to present the most important topics regarding colon cancer and colorectal cancer screening. Why do we want to do this? In this particular area, precaution is more important than anything else. The chances of recovery and the therapy approach depend on an early detection of the cancer. Nowa-days there are different ways to test for colon cancer. The term ‚colon cancer‘ in medicine refers to colorectal carcinoma, which usually occurs in the colon or the rectum. If the anus or the rectum are infected, it is a rectal carcinoma, however if any part of the colon is concerned, it is a colon carcinoma. Situation in Europe

The Medical Journal warns of the gap between Western and Eastern Europe. While the rates of colon cancer throughout

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Europe have epidemic proportions, the cure rate only rises in Western Europe. Obesity, excessive alcohol consumption and especially smoking, are the main causes of this disease, and are to blame for the rising number of new cases. In Wes-tern Europe, colorectal cancer is the second leading cause of deaths through cancer after lung cancer. In Germany, every 33rd death is caused by colorectal cancer. The relatively good economic situation in Eastern Europe has elevated the can-cer rate drastically in this region. As they are less medically advanced than Western Europe, the chances of curing the di-sease are not as good.

The United States have already found a new way to reach their patients. There, patients are now advised by telephone. The success speaks for itself. 34% of the called party could perform a colonoscopy in the next 9 months. In Germany, however, this still does not work. For medical advice the patients have to go to their physician on their own and cannot avoid the face to face conversation.

RS, FS, TW

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Rapid tests for colorectal cancer screening - an alternative to colonoscopy

FOB (plus)

A simple stool test examines whether there is blood in the sam-ple that is not visible. The doctor will give the collection tube for the sample to the patient with a case for storage and a print-ed manual. The patient should then bring back the tube with the sample in the following 3 days. Then in the doctor‘s office, the tube is converted by snapping off the tip so it then takes the form of a pipette. 3 drops of the sample are added to the test cassette, and the result will be available in just a few minutes.

Hb/Hp Complex

This immunological stool test works just like the FOBPlus test.

Similarities:

• Immunological Tests, that detect human hemoglobin (Hb) in the colonic region (= free of hemoglobin) with a high sensitivity.

• A specific diet is not required

Differences:

• Additionally the NADAL ® Hb / Hp makes it possible to detect bleeding in higher intestinal passages. It shows not only free hemoglobin but also hemoglobin, which is bound to haptoglobin. This hemoglobin-haptogobin com-plex has a higher survival rate within the digestive tract than hemoglobin alone; hence the test is more sensitive for hidden bleeding.

• The sensitivity is increased by approximately 25% by loo-king at those 2 parameters, opposed to just one.

Among cancer related deaths, colorectal cancer is statistically still in second place. This fact could be changed and minimized drastically with the consistent implementation of appropria-te preventive examinations. The chances of recovery are very good if there is an early diagnosis. Therefore, it is highly ad-visable, to have an examination at the age of 50 and from then on every 5 years. The use of a FOB or a Hb / Hp rapid tests offers a non-invasive, reliable, fast and easy method to detect hidden bleedings, which can be a hint for pathological chan-ges in the intestinal tract. Positive rapid test results can then be further evaluated with a colonoscopy and possible precur-sors of malignant tumors (adenomas / polyps) can be directly removed.

Oncology Colon Cancer

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Quick Guide FOB Immunological stool test

There are two treatment targets of drug substitution: abstinence or slow dose reduction.

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Rapid Tests Substitution

Drug substitution therapy or drug substitution is used for the treatment of those addicted to opiates, mostly heroin addicts. For many of those affected, it is the only way to break the cy-cle of addiction, intoxication and social descent. Overcoming heroin addiction it is especially difficult due to severe physi-cal withdrawal symptoms. During drug substitution therapy, drugs which would normally be consumed are substituted by other substances. These replacement substances are still addictive and are thus subject to the laws governing the use and traffic of drugs, yet they can decisively improve the life of drug addicts.

These substitute drugs are administered in exact doses and contain no impurities. They are taken orally and there is no risk of HIV or hepatitis infection through contaminated drug injection equipment. Moreover, orally administered drugs give no kick. The patient does not become intoxicated and his/her consciousness remains clear. This is especially impor-tant in order to enable the affected to live a normal daily life and participate in a working life. The affected will also be re-lieved of the pressure of drug procurement, prostitution and drug-related crime.

Methadone is most frequently used in drug substitution ther-apy. Buprenorphine and less often dihydrocodeine/ codeine are increasingly used.

There are two treatment targets of drug substitution: long lasting freedom from drugs (abstinence) through a slow dose reduction of the prescribed amount or damage limitation through continuous drug substitution. Both aims are equal and are not mutually exclusive. Continuous drug substitution can be compared with insulin treatment of diabetics, as drug addiction has in general many similarities to other chronic dis-eases.

The History of Drug SubstitutionContinuous Addiction Therapy Saves Lives

The History of Drug Substitution Therapy

The Americans Doyle and Nyswander are regarded as “found-ers” of drug substitution with their inpatient program of methadone maintenance. They introduced this on the under-standing that certain substances have the same effect as opi-ates without causing a state of intoxication.

The initially strictly inpatient programs with methadone achieved good results, striving for lifelong maintenance of addiction under controlled conditions as means to complete abstinence. Since the beginning of the 1970s some German doctors have tried to include methadone substitution as an offer in their practices. This led to many heated and contro-versial discussions. Opponents of drug substitution state that addictive substances are only substituted by others, thus only furthering addiction.

Till 1991: Criminal Prosecution of Doctors Providing Drug Substitution Treatment

Initially, there were criminal prosecutions against doctors providing drug substitution treatment. The treatment was de-scribed as medically contradictory and even as a bodily harm. Doctors were accused of belittling opiate addiction. Drug sub-stitution treatments could be punished by revocation of a li-cense to practice medicine and by imprisonment. Addiction was often understood not as a disease but as a self-inflicted condition and a painful detoxification was supposed to deter from a resumption of drug consumption.

In 1988 a text with the name “Report of a mother” written by Dorothea Klieber, who had fought for the right to drug substi-tution for years, caused a sensation. Her son, who had been a heroin addict for 14 years, committed suicide after his very successful methadone treatment was abruptly ended, when his doctor had been taken into custody. 14 years later Doro-thea Klieber obtained a Federal Cross of Merit as recognition for her extraordinary commitment to methadone treatment.

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Rapid Tests Substitution

Turning Point: Legal Basis of Drug Substitution

In 1991 the Federal Committee of Doctors and Health Insur-ance Companies surprised the public with new drug substi-tution regulations with the result that after long debates, the way of drug substitution therapy was eventually paved. Finally, in the year 1992, a legal framework for drug substitu-tion was created which explicitly, though not unrestrictedly, allowed the use of drug substitutes. To begin with, only the dispensing of three day take-home doses was allowed, and in 1997 dispensing seven day take-home doses were allowed, in order to increase one’s own responsibility. Prior to that, a comprehensive control of drug taking had been demanded.

Methadone was authorised as a substitution drug only in 1994. Buprenorphine was authorized in 2000. However, precise le-gal guidelines for the procedure of drug substitution therapy were introduced only in 2000. This was achieved through a law that determined fundamental regulations for the dispens-ing surgery or clinic in the prescription of narcotics (BtMVV).

Nowadays, drug substitution is a recognised form of therapy for opiate-addicted patients and is evidently the most success-ful type of treatment. Germany is, judging by the estimated number of opiate addicts, one of the countries with the high-est proportion of drug substitution patients within Europe.

Foundation of Successful Drug Substitution

On top of physical symptoms an opiate addiction is almost al-ways accompanied by other complex problems, such as debts, unemployment, social exclusion and involvement in drug relat-ed crime.

Therefore, social support and psychosocial counseling of pa-tients are especially important for a successful drug substi-tution therapy. Otherwise, the patient who fails to deal with daily problems can relapse into opiate addiction, in order to forget about his/her problems. A good relationship of trust with the doctor providing substitution treatment, social con-tacts outside the drug world and steady assistance are also essential to help the patients find a way back to a life without drugs.

Treatment costs are carried by health insurance companies in Germany. Drug substitution treatment is open to all opiate addicts who have been opiate-addicted for at least 2 years. KS

At the beginning of treatment, the taking of a substitution drug is taken under supervision at the doctor’s office or at the pharmacy, authorised by the doctor providing substitu-tion treatment.

Regular urine tests should be used to confirm that there is no additional drug consumption, and to monitor the substitute drug, to ensure it is being taken as prescribed. If a patient is stably adapted to a substitution drug, there is a possibility of dispensing a take-home substitution drug after six months of therapy. The frequency of appointments with a doctor will then be reduced to once weekly.

Possible Problems in the Course of Therapy

Parallel consumption, i.e. an additional taking of other psy-chotropic substances, principally benzodiazepines, alcohol and cocaine but also antidepressants, is one of the biggest problems of drug addicts in and outside the drug substitution program especially regarding a lethal overdose.

Moreover, it can lead to the misuse of substitution drugs, i.e. the substitution drug is injected to cause an intoxicating ef-fect. Especially if a patient feels overstrained while dealing with daily life or if the old contacts with the drug milieu are still strong, it can lead to misuse or disruption of treatment. These are, however, the consequences of drug addiction and not the consequences of drug substitution therapy.

The Number of Doctors Providing Drug Substitution Treat-ment is Declining

Every doctor with an additional qualification can offer metha-done treatment. Yet mere conversations with a family doctor are not sufficient to solve complex problems of a drug addict. Therefore, collaboration with advice centres is advisable.

However, fewer and fewer doctors provide drug substitution treatment. Especially in the countryside considerable supply gaps and long travel routes constitute a big obstacle concern-ing regulations on take-home substitution drugs. There is a lack of incentives for taking on this responsible task and strict regulations act as a deterrent for many doctors. There is a need for political actions in this field in order not to avoid the success story of drug substitution to be compromised.

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Many patients, in one way or another, attempt to manipulate a drug test in order to influence the result in their favour. In practice, there are multiple possibilities to falsify a urine result and thus escape the associated consequences.

In Vivo Manipulation

Firstly, the composition and concentration of the urine can be influenced by extensive drinking (about half an hour to several hours before).

This leads to the dilution of the urine, thus a low creatinine va-lue occurs and possibly causes a lightening of the urine colour. These undesirable (from the tester‘s point of view) effects can conceal the intake of vitamin B and creatinine in a high con-centration. On the other hand, there are studies that show that the intake of various of drugs can suppress the detection of others in urine.

Such manipulation of test results is difficult to detect and can only be revealed after a detailed investigation into the patient’s medication and diet.

In Vitro manipulation

During and after the dilution of the given sample, the additi-on of other substances or the replacement of urine are a few other possibilities for manipulation.

pH Value

The normal pH value of urine lies between 4.5 and 8. Values of pH which are less than 3 or more than 11 are abnormal, and indicate that a falsification is present. By measuring the distortion of the pH in the sample, substances such as sodium hypochlorite, vinegar, eye drops, sodium bicarbonate, drain cleaners, soft drinks or hydrogen peroxide can be detected.

Creatinine

The daily excretion of creatinine, in relation to body muscle mass, is constant. Therefore the DOT guidelines confirm that in samples with a Creatinine rate of under 20mg/dl, dilution has more than likely occurred. Although age, gender, diet, mu-scle mass and the local population density can affect a sam-ple, Creatinine levels below 20mg/dl must be considered as diluted.

Glutaraldehyde

A colourless, liquid, chemical compound included with a sharp, unpleasant smell like disinfectant. The glutaraldehy-de is not a normal component of urine and its presence is an indicator that that the sample has been manipulated. This is because many commercially available adulterants contain glutaraldehyde.

Drug Test AdulterationHow do I determine the Adulteration of a Urine Sample?

Rapid Tests Adulteration

AK

Drug Test AdulterationHow do I determine the Adulteration of a Urine Sample?

Nitrate Salts

Positive test results for nitrates in urine samples are usually caused by gram negative bacteria through the conversion of nitrates in the body (as a dietary ingredient). This causes nit-rates to occur in the urine.

In the absence of infection, the urine is negative. The salts do not have an effect on the result of the rapid test, however it will have a negative impact on chromatographic confirmatory analysis in the laboratory. The nitrite test indicates an addition of nitrite.

Pyridinium chlorochromate (PCC)

Publications have shown that an additional distortion of urine is Pyridinium chlorochromate (PCC). This can be determined by measuring the chromate in the sample. In positive urine samples, about 58 to 100% of the THC carboxylic acid is lost when treated with PCC: for this reason, PCC is highly used in manipulating urine samples.

Bizarre!*

On the internet you can find all sorts. In the United States the ‘Whizzinator’ can be found – a deceptively real looking artificial penis. It can be filled with clean urine and drained using pressure without suspicion. It even comes in an array of colours!

Rapid Tests Verfälschung

Page 9www.istockphoto.com © xrender

Sample Manipulation In-vitro Where appropriate, these cab be recognised by

Sample dilution through the addition of water or other li-quids (yellow liquid, apple juice, lemonade etc.)

Dilution of urine can be detected through the change of co-lour, pH value, Creatinine value and temperature.

Sample exchange where the actual urine is replaced with foreign urine. Aids used help disguise the foreign urine (e.g. artificial penis*)

The sample will be the same temperature as body tempe-rature.

Temperature strips can be used and applied to the urine cup.

Manipulation of the Urine Sample with; Substances such as bleaches, oxidants and disinfectants. These can alter the chemical components which can lead to a strong pH shift between acid and alkali.

Colour, Creatinine value, pH value, temperature, odor

The following information is a summative table to explain the most commons method of adulteration and methods to detect or eliminate them.

For the prevention or detection of possible adulteration we suggest using the following products;

Product-Nr. 630925 Urine-Control-Stick 7, Tubes of 25 test strips.

Parameter: Creatinine, pH, Glutaraldehyde, specific gravity, nit-rate, bleach und Pyridinium chlorochromate

Product-Nr. 124004, Temperature Strips 32°C - 37°C

Product-Nr. 630001, Creatinine Semi-quantitative, Packs of 50 test Strips

Scarlet fever is an insidious disease: it is contagious from the very beginning and for a long period of time, and external symptoms of the disease are usually not sufficient for the di-agnosis. A rapid diagnosis is crucial to fight the disease with a timely use of antibiotics for ten days straight, even if the symptoms subside for a short term.

It is common that most cases of scarlet fever occur in nursery and school age. Infants under six months cannot be infected with scarlet fever as they have an immune protection from the mother. Adults, however, are not immune to the disease. Approximately 25% of the 50,000 cases of scarlet fever in Ger-many affect adults.

A vaccination against this bacterial infection does not exist. Everyone who has had scarlet fever is then immune to the bacteria strain that causes the disease. Since there are many different strains of bacteria known as group A-Streptococci (Lancefield group A), it is possible to get the disease multiple times. Most infections occur during the months of October to March. The most common antibiotic for scarlet fever is peni-cillin, but in cases of intolerance, it is also possible to prescribe macrolide antibiotics or an antibiotic from the group cephalo-sporins.

Scarlet fever is transmitted by mucus or saliva of an infected person. Anyone who carries the pathogen is contagious, even in the incubation period. The first symptoms are not visible for the first few days of infection and the risk of infection per-sists for two to three weeks. When the infection is treated with antibiotics, however, the infection is usually gone within 24 hours of taking the drug.

In the 19th Century scarlet fever was the leading cause of death in childhood. This is no longer the case, but an untreated infection can, in some cases, still result in death. What should not be underestimated are the possible late effects that may occur up until several weeks after the apparent recovery.

Streptococcus A, the causative agent of scarlet fever, secretes a kind of poison. This causes blood vessels to become perme-able and red blood cells come out. This can cause vomiting, di-

arrhoea, circulatory failure and myocarditis. In addition to the toxic course there is also the septic course. Here, the infection spreads through the blood throughout the body, which can lead to meningitis or purulent sinuses.

Rheumatic fever, joint pain, lung and heart muscle inflamma-tion are potential late effects of scarlet fever. The antibodies are directed against healthy tissue. Similarly, the kidneys can be irreversibly damaged by severe inflammation. There is also a chance of blood poisoning due to the pronounced suppura-tion of the pharynx.

Scarlet Fever is also dangerous because diagnosis can be dif-ficult. If the patient has the typical red, swollen tongue and a rough, red rash, the diagnosis is easier. Otherwise, the symp-toms are very similar to many other bacterial or viral infec-tions (e.g., acute respiratory infections, infectious mononucle-osis, etc.), which means that diagnosis can often be unclear. In some cases, people infected with Streptococcal A did not show any symptoms.

There are two methods for diagnosis: the first would be the use of a rapid test; the second to grow a culture from a throat swab. The swab has the disadvantage that a result takes 14-18 hours, where a rapid test will give results within a few min-utes, and are still very reliable.

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Scarlet feverLate effects of Scarlet fever should not be underestimated. An early and definite diagnosis can help to prevent that.

AK

Infectiology Scharlet Fever

www.istockphoto.com © GlobalP, lattesmile

The faster scarlet fever is detected, the lower the risk of late effects. The NADAL ® Strep A - test is an immuno-logical rapid test for the qualitative detection of strep-tococcal antigens of Group A in throat swab and is ideal for diagnosis in clinics, hospitals and laboratories. The test can be evaluated after only five minutes. If you are interested in this or other tests from our NADAL® range please visit our website www.nal-vonminden.com or call us on: 0808 234 1237

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Hair AnalysisThe "Elephant" of the sample materialsAn elephant never forgets. This is similar to what happens in the human hair. Abuse of substances can be detected by hair analysis over a much longer period than is the case with blood, saliva, or urine analysis. That is why a hair analysis is best suited to prove consumption or abstinence from alcohol, drugs and medication for a longer period of time with just one analysis.

Detection times in hair

The exact time window for the analysis depends on the length of hairs provided for the sample. With an average growth rate of head hair of about 1 cm per month, for example, using a 12 cm long sample, it is possible to detect the consumption be-havior of an entire year. Also body hair such as armpit, chest or pubic hair is suitable for analysis, although the determination of the detection period is more complicated due to the pro-longed telogen phase (resting phase). The detection of chronic or excessive alcohol abuse is possible in hair through the direct alcohol marker ethylglucuronide (EtG). Similar to drug analysis, 1 cm of hair cover the period of one month.

Storage of Substances

As long as the consumed substances or their breakdown products are in the circulatory system, they will be stored in the roots of the hair. They remain there permanently stored in the hair matrix. Even chemical treatment such as dye-ing or the use of hair growth medium has no effect on the outcome of the analysis. The following table gives an over-view of the growth rate of the various types of body hair: (Source: Statista 2009: Kunsch / Kunsch):

Due to the exposed position of the hair, it is possible that it gets contaminated with other substances. For example, the hair of a person who is not using drugs, but has contact with drug users; there is a chance that the hair gets contaminated with cannabis smoke or cocaine dust. To exclude a false posi-tive laboratory result through such an external contamination, the sample material is washed several times before extraction begins. If there is doubt, positive results must be reexamined and and the last washing liquid should be checked for sub-stances.

Source: www.abstinenztest.de

Rapid Tests Hair Analysis

Part of the body Growth in mm per week

Beard 2.8

Head 2.5

Arm pit 2.1

Arms 1.5

Legs 1.4

Eye brows 1.1

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nvm Service Donation

Christmas Donation 2013The nal von minden GmbH supports Mentor

NK

Christmas is always a good time to share, so we took this op-portunity to donate to a foundation that shares our vision and values. This is why we choose to support Mentor, an organisa-tion whose vision is a world where children and young people are empowered to make healthy decisions and avoid drug use.

Under the patronage of Queen Silvia of Sweden, their work through the “Rebound” project helps to raise the awareness of young people regarding substance abuse. The foundation takes an integral approach in this matter and uses resilience philosophy in cooperation with the University of Heidelberg in Germany and the University of San Diego in the USA. The main aim is to support the development of young people´s resistance against drugs, helping them to make independent and responsible decisions on the risks surrounding drugs on the basis of the comprehensive knowledge.

At the same time Mentor strengthens the development of young people on three levels:

• to learn oneself, develop self-confidence, and take own responsibility

• to understand how to adapt to a group and to build rela-tionships

• to understand their environment and have insight and an action in its future

“Rebound” is a current programme also supported by the EU, which targets schools and youth organisations. Social learning is encouraged through school development, school courses, e-learning and mentoring. The programme is directed not only at risk groups but at all young people and also includes teacher prevention.

If you are interested in Mentor and Rebound, please visit their websites www.my-rebound.de and www.mentorfoundation.org. For the healthy, self-confident and undisturbed develop-ment of all children and young people!

Donation campaignCzech Orphanage gets donation

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With a lot of commitment, nal von Minden supports many different research and science based projects. But we‘re also concerned about the future generations. Special attention is given to children in serious need, who have fallen into obliv-ion. We are proud of being able to make a contribution that makes life for some boys and girls a little happier. Our dona-tion went to an orphanage with an adjoining school in Bychory in Czech Republic. The orphanage has been chosen personally, by our business partners, using a customer survey.

We decided to give a money donation, so the orphanage has the opportunity to decide what the children actually need the most. Hana, a member of our Czech salesteam, insisted on presenting the donation in person, to get an impression of the institution and have the chance to visit the children person-ally.

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nvm Service Beratungsstellen

MEDICA 2013Trade fair participation of nal von minden GmbH

THE COMPLETED STANDThe result is quite impressive.

DILIGENT EFFORTS With combined forces

the stand is taking shape.

TEAM STAND CONSTRUCTIONAll in a good mood and motivated - our team stand construction is just awesome!

DAY 1 OF MEDICA Even on the first day, the stand was busy.

Again this year nal von minden represented itself with a booth stand at Medica. Here we were able to showcase our latest products and wide range of offers to our customers. Thanks to the outstanding teamwork and the commitment of our em-ployees, it was again possible to create a highly professional and customerfriendly trade fair participation. We wish to ex-tend our particular thanks to our collegues from Moers, who gave us great support and motivation! We are really looking forward to the Medica 2014!

nal von mindenShort News

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THE RISE OF TROPICAL DISEASES

Globalisation, cheap air travel and the desire for adventure are only a few examples of why more and more people are travelling across countries and continents. Yet while people continue to set foot in foreign lands, they are forgetting the risk of bringing home an ‘unwanted souvenir’ – a tropical dis-ease.

Tropical diseases are diseases that are prevalent in tropical regions and not usually present in the western world. Howev-er, their presence is increasing as travellers continue to bring them back to their home countries without realising. Some examples of these diseases include Malaria, Dengue and Lep-tospira. In the UK, over 1,000 cases of Malaria get diagnosed every year because of increased globetrotting.

People at the highest risk are those who visit family in tropical areas and presume they are safe because they grew up in this area. However, according to the Liverpool School of Tropical Medicine, people lose immunity after 2 – 3 years of leaving their home country and so their intolerance will increase over time.

Initial diagnosis of tropical diseases can be difficult because they often display symptoms similar to more common, do-mestic illnesses. In addition symptoms can sometimes only appear weeks after returning home and so the thought that the disease was contracted internationally is not considered. Therefore it is important to stay safe and book a vaccination before starting your next adventure.

GBL/GHB

Also known as ‘coma in a bottle’ or liquid ecstasy, GBL/GHB is the newest addition to the ‘Party Drugs’ group – a set of recreational drugs popular in the clubbing and party scene. Other members of this group include Ketamine, MDMA and Methampthtamine.

GBL (gammahydroxybutrate) is a substance that breaks down into GHB (gammabutyrolactone) once entering the body. Both substances can cause feelings of euphoria and are easy to con-sume due to their lack in colour, odour and taste. Therefore the drug is often added to drinks and can be drunk with ease. According to one English newspaper, a small bottle can be purchased online for only £23.50. With each of these bottles containing roughly 60 doses of the drug each, this works out at approximately 50p a go!

However these benefits can also lead to very dangerous, if not fatal, results. Most notably GBL/GHB can cause drowsi-ness which may lead to a user becoming unconscious, and entering a coma or death. This risk increases when consumed with alcohol. Another dangerous impact of GBL/GHB is that the lack of taste and smell means that someone may consume

it without realising. This has lead to reported cases of sexual assault because the consumer becomes unconscious or fully unaware of the situation surrounding them.

It is still unclear how many fatalities the drug has caused. This is because its presence only stays in the body for roughly 12 hours and so it is difficult to tell if the drug was related to a death. However in the UK, it is estimated that GBL/GHB kills on average 6 people a year. However drug rehab centers and charities are expecting this number to rise while GBH/GBL re-mains a ‘legal high’.

Inside Diagnostics Short News

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Analytika in Munich01.04.2014 - 04.04.2014 • Munich, DE19th Addiction Treatment Days in Tübingen 02.04.2014 - 04.04.2014 • Tübingen, DE DGIM - 120th Congress of the German Society for Internal Medicine 26.04.2014 - 29.04.2014 • Wiesbaden, DE

MAYMesse Africa Health06.05.2014-09.05.2014 • Johannesburg, DE

24th European Congress of Clinical Microbiology and Infectious Diseases10.05.2013-13.05.2014 • Barcelona, ES

JUNE19th Addiction Treatment Days in Hamburg10.06.2014-13.06.2014 • Hamburg, DE

44th Meeting of Oberr. Forensic Scientists together with the 23th Spring Meeting of the Dt. Ges f Forensic Medicine - Southern Region 13.06.2014-14.06.2014 • Basel, CH

Spring Issue 2014 Theme Overview

Page 15

In the next issue, read about Chlamydia, the Krokodil, interpreting results of rapid tests using Instrumentation, and much more...

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Conference Calendar 2014

Inside Diagnostics Conference Calendar

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