Sorted By Test Name - Mayo Medical Laboratories

FCOCB
90093
COKEM
84140
disorders, and thyroid abnormalities. The inhalation of dust during machining of cobalt alloyed metals can
lead to interstitial lung disease. Improperly handled (60)Co can cause radiation poisoning from exposure
to gamma radiation. Urine cobalt concentrations are likely to be increased above the reference value in
patients with metallic joint prosthesis. Prosthetic devices produced by Zimmer Company and Johnson &
Johnson typically are made of aluminum, vanadium, and titanium. Prosthetic devices produced by Depuy
Company, Dow Corning, Howmedica, LCS, PCA, Osteonics, Richards Company, Tricon, and Whiteside
typically are made of chromium, cobalt, and molybdenum. This list of products is incomplete, and these
products change occasionally; see prosthesis product information for each device for composition details.
Useful For: Detecting cobalt exposure Monitoring metallic prosthetic implant wear
Interpretation: Concentrations > or =2.0 mcg/g creatinine indicate excess exposure. There are no
Occupational Safety and Health Administration (OSHA) blood or urine criteria for occupational exposure
to cobalt. Prosthesis wear is known to result in increased circulating concentration of metal ions. In a
patient with a cobalt-based implant, modest increase (2-4 mcg/g creatinine) in urine cobalt concentration
is likely to be associated with a prosthetic device in good condition. Excessive exposure is indicated when
urine cobalt concentration is >5 mcg/g creatinine, consistent with prosthesis wear. Urine concentrations
>20 mcg/g creatinine in a patient with a cobalt-based implant suggest significant prosthesis wear.
Increased urine trace element concentrations in the absence of corroborating clinical information do not
independently predict prosthesis wear or failure.
Reference Values:
0.0-1.9 mcg/g Creatinine
Reference values apply to all ages.
Clinical References: 1. Keegan GM, Learmonth ID, Case CP: A systematic comparison of the
actual, potential, and theoretical health effects of cobalt and chromium from industry and surgical
implants. Crit Rev Toxicol 2008;38:645-674 2. Lhotka C, Szekes T, Stefan I, et al: Four-year study of
cobalt and chromium blood levels in patients managed with two different metal-on-metal total hip
replacements. J Orthop Res 2003;21:189-195 3. Lison D, De Boeck M, Verougstraete V, Kirsch-Volders
M: Update on the genotoxicity and carcinogenicity of cobalt compounds. Occup Environ Med
2001;58(10):619-625
Cocaine and Benzoylecgonine Screen and GC/MS Confirmation,
Blood-Forensic
Reference Values:
Test Performed by: Medtox Laboratories, Inc.
402 W. County Road D
St. Paul, MN 55112
Cocaine and Metabolites Confirmation, Meconium
Clinical Information: Cocaine is an alkaloid found in Erythroxylon coca, which grows principally in
the northern South American Andes and to a lesser extent in India, Africa, and Java.(1) Cocaine is a
powerfully addictive stimulant drug. Cocaine abuse has a long history and is rooted into the drug culture
in the United States,(2) and is 1 of the most common illicit drugs of abuse.(3,4) Cocaine is rapidly
metabolized primarily to benzoylecgonine, which is further metabolized to m-hydroxybenzoylecgonine
(m-HOBE).(1,5) Cocaine is frequently used with other drugs, most commonly ethanol, and the
simultaneous use of both drugs can be determined by the presence of the unique metabolite
cocaethylene.(4) Intrauterine drug exposure to cocaine has been associated with placental abruption,
premature labor, small for gestational age status, microcephaly, and congenital anomalies (eg, cardiac and
genitourinary abnormalities, necrotizing enterocolitis, and central nervous system stroke or
hemorrhage).(6) The disposition of drug in meconium, the first fecal material passed by the neonate, is not
well understood. The proposed mechanism is that the fetus excretes drug into bile and amniotic fluid.
Drug accumulates in meconium either by direct deposition from bile or through swallowing of amniotic
Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or MayoMedicalLaboratories.com Page 495