Meta-chlorobenzhydryl urea

Fentanyl has played a significant role in the opioid crisis, proving to be a persistent problem due to its analgesic effects and addictive nature. Consequently, fentanyl analogs have been identified as a rising threat in the illicit drug market, contributing to thousands of both fatal and nonfatal overdoses in the United States. A profile of the fentanyl and fentanyl analogs present in Washington D.C. was developed by analyzing syringe extracts obtained from needle-exchange programs in the city. Gas chromatography-mass spectrometry (GC-MS) with selected ion monitoring (SIM) acquisition provided a targeted analysis scheme to detect trace amounts of nine compounds: acetyl fentanyl, para-fluorofentanyl, fentanyl, methoxyacetyl fentanyl, meta-chlorofentanyl, carfentanil, valeryl fentanyl, beta-hydroxythiofentanyl, and furanyl fentanyl. In total, 332 syringe extracts were analyzed. The detected analytes and their percent prevalences were fentanyl (72.29 %), acetyl fentanyl (11.44 %), para-fluorofentanyl (6.63 %), and furanyl fentanyl (3.61 %). Tandem use was detected with combinations of fentanyl with acetyl fentanyl (12.08 %), fentanyl with para-fluorofentanyl (7.08 %), fentanyl with furanyl fentanyl (4.58 %), and fentanyl with acetyl fentanyl and para-fluorofentanyl (2.08 %). The identities of the analogs present, their relative potencies, and tandem use trends provides valuable information, especially for medical personnel who respond to opioid-related overdoses and deaths. Based on the fentanyl analog trends and tandem use of these compounds revealed in this study, it is recommended that Congress passes the permanent classification of fentanyl analogs as Schedule I drugs.

The survival of patients with high‐risk neuroblastoma has improved significantly with the use of intensive multimodality treatment regimens, including chemotherapy, surgery, radiation therapy, myeloablative chemotherapy followed by stem cell rescue, and immunotherapy. This report summarizes the current treatment strategies used in the COG and SIOP for children with neuroblastoma. The improved global collaboration and the adoption of a uniform International Neuroblastoma Risk Group Staging System will help facilitate comparison of homogeneous pretreatment cohorts across clinical trials. Future research strategies regarding the indications for and dosages of radiation therapy to the primary and metastatic sites, and the integration of meta‐iodobenzyl guanidine therapy into the multimodal treatment program, are discussed.