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Abady MM, Jeong JS, Kwon HJ. Dried blood spot sampling coupled with liquid chromatography-tandem mass for simultaneous quantitative analysis of multiple cardiovascular drugs. J Chromatogr B Analyt Technol Biomed Life Sci 2024; 1242:124215. [PMID: 38917652 DOI: 10.1016/j.jchromb.2024.124215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/10/2024] [Accepted: 06/20/2024] [Indexed: 06/27/2024]
Abstract
Dried Blood Spots (DBS) revolutionize therapeutic drug monitoring using LC-MS for the precise quantification of cardiovascular drugs (CDs), enabling personalized treatment adapted to patient-specific pharmacokinetics with minimal invasiveness. This study aims to achieve simultaneous quantification of eight CDs in DBS, overcoming physicochemical challenges. A two-step protein precipitation method was used for simple and precise sample preparation. The drugs were analyzed using LC-MS/MS in ESI positive-ion mode, showing high sensitivity and linearity, with a correlation coefficient (r2) exceeding 0.999, after being separated on a reversed-phase chromatography by gradient elution of DW-acetonitrile containing 0.1 % formic acid + 2 mM ammonium formate. The validation results indicate good selectivity, with no observed matrix effect and carry-over. The intra- and inter-day accuracy and precision were within 6 % for most drugs, except for digoxin and deslanoside at low therapeutic levels where the variation was within 20 %. Stability tests confirmed suitable DBS handling and storage conditions, indicating drug stability for at least 30 days at room temperature. The analysis of whole spot has demonstrated remarkable precision and reliability in all target drugs. The analysis of 3 mm internal diameter discs, punched in and out of DBS, presumed to contain 3 µL of blood, showed acceptable accuracy for most drugs, with less polar drugs like digoxin and deslanoside showing lower accuracy, indicating a need for further correction due to non-uniform drug distribution. Consequently, the developed LC-MS/MS method enables the quantification of multiple CDs in a single DBS analysis, while suggesting the potential for accuracy-based analysis.
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Affiliation(s)
- Mariam M Abady
- Organic Metrology Group, Division of Chemical and Material Metrology, Korea Research Institute of Standards and Science, Yuseong-gu, Daejeon 34113, Republic of Korea; Department of Bio-Analytical Science, University of Science and Technology, 217 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea; Department of Nutrition and Food Science, National Research Centre, Dokki, Cairo 12622, Egypt
| | - Ji-Seon Jeong
- Organic Metrology Group, Division of Chemical and Material Metrology, Korea Research Institute of Standards and Science, Yuseong-gu, Daejeon 34113, Republic of Korea; Department of Bio-Analytical Science, University of Science and Technology, 217 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea
| | - Ha-Jeong Kwon
- Organic Metrology Group, Division of Chemical and Material Metrology, Korea Research Institute of Standards and Science, Yuseong-gu, Daejeon 34113, Republic of Korea.
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2
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Fernández-López L, Rodríguez S, Cánovas-Cabanes A, Teruel-Fernández FJ, Almela P, del Rincón JPH, Navarro-Zaragoza J, Falcón M. Identification of Benzodiazepine Use Based on Dried Blood Stains Analysis. Pharmaceuticals (Basel) 2024; 17:799. [PMID: 38931466 PMCID: PMC11206677 DOI: 10.3390/ph17060799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/07/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Biological matrices are typically used in forensic toxicological or pharmacological analysis: mainly blood, vitreous humor or urine. However, there are many cases in which crimes are a consequence of drug intoxication or drug abuse and they are not closed because over the months or years the samples become altered or decomposed. A dried blood stains test (DBS-MS) has recently been proposed to be used in drug toxicology when blood is found at a crime scene. This test could help an investigator to reveal what a person had consumed before the perpetration of the crime. In order to check the possibilities of this test, we analyzed several dried blood stains located on a cotton fabric. Therefore, the aim of this study was to determine if the analysis of a dried blood spot located on a cotton fabric could be an alternate source of obtaining toxicological results, particularly regarding benzodiazepines. We splashed blood stains on cotton fabric with different concentrations of the following benzodiazepines: alprazolam, bromazepam, clonazepam, diazepam and lorazepam, which were dried for 96 h and subsequently quantified by high-performance liquid chromatography coupled mass spectrometry (HPLC-MS). Our results show that it is possible to identify several benzodiazepines contained in a cotton fabric blood stain; consequently, this method may add another sample option to the toxicological analysis of biological vestiges found at a crime scene.
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Affiliation(s)
- Lucía Fernández-López
- Department of Pharmacology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain; (L.F.-L.); (P.A.)
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
| | - Sandra Rodríguez
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
- Forensic and Legal Medicine, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain
| | - Alberto Cánovas-Cabanes
- Department of Pharmacology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain; (L.F.-L.); (P.A.)
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
| | - Francisco-Javier Teruel-Fernández
- Department of Pharmacology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain; (L.F.-L.); (P.A.)
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
| | - Pilar Almela
- Department of Pharmacology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain; (L.F.-L.); (P.A.)
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
| | - Juan-Pedro Hernández del Rincón
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
- Forensic and Legal Medicine, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain
| | - Javier Navarro-Zaragoza
- Department of Pharmacology, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain; (L.F.-L.); (P.A.)
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
| | - María Falcón
- IMIB-Arrixaca, Instituto Murciano de Investigación Biosanitaria, 30120 Murcia, Spain (J.-P.H.d.R.); (M.F.)
- Forensic and Legal Medicine, Faculty of Medicine, University of Murcia, 30120 Murcia, Spain
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3
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Świądro-Piętoń M, Dudek D, Wietecha-Posłuszny R. Direct Immersion-Solid Phase Microextraction for Therapeutic Drug Monitoring of Patients with Mood Disorders. Molecules 2024; 29:676. [PMID: 38338419 PMCID: PMC10856736 DOI: 10.3390/molecules29030676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
This article discusses a new method for monitoring drug concentrations in blood samples from patients with mood disorders. The method uses solid-phase microextraction to extract analytes directly from blood samples. It has been adapted to identify the most commonly used drugs in mood disorders, including amitriptyline, citalopram, fluoxetine, paroxetine, sertraline, trazodone, duloxetine, venlafaxine, lamotrigine, quetiapine, olanzapine, and mirtazapine. The analysis is carried out using high-performance liquid chromatography coupled with mass spectroscopy. The proposed DI-SPME/LC-MS method allows for a simple and quick screening analysis while minimizing the volume of the tested sample and solvent, in line with the principles of green analytical chemistry. The method was used to analyze 38 blood samples taken from patients with mood disorders, and drug concentrations were determined and compared with therapeutic and toxic dose ranges. This allowed for better control of the course of treatment.
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Affiliation(s)
- Magdalena Świądro-Piętoń
- Laboratory for Forensic Chemistry, Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, 2, Gronostajowa St., 30-387 Kraków, Poland;
| | - Dominika Dudek
- Department of Adult Psychiatry, Medical College, Jagiellonian University, 21a, Mikołaja Kopernika St., 31-387 Kraków, Poland;
| | - Renata Wietecha-Posłuszny
- Laboratory for Forensic Chemistry, Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, 2, Gronostajowa St., 30-387 Kraków, Poland;
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Sakr MF, El-Khalek AMA, Mohammad NS, Abouhashem NS, Gaballah MH, Ragab HM. Estimation of postmortem interval using histological and oxidative biomarkers in human bone marrow. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00753-9. [PMID: 37987965 DOI: 10.1007/s12024-023-00753-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2023] [Indexed: 11/22/2023]
Abstract
In forensic medicine, estimating the postmortem interval (PMI) is of great importance for the timeline and the reconstruction of the events surrounding death. Bone marrow (BM) is one of the largest organs in the body, with good resistance to autolysis and contamination. Therefore, the present study aims to correlate different postmortem intervals and bone marrow antioxidant enzyme levels using an Enzyme-linked immunosorbent assay (ELISA). In addition, detection of the changes in the histological structure of human bone marrow in relation to the time passed since death. BM samples from 20 forensic autopsy cadavers were obtained from cases referred to the Department of Forensic Medicine in the Ministry of Justice, Dakahlia Governorate, processed for histopathological examination as well as estimation of reduced glutathione (GSH), glutathione peroxidase (GPX), and glutathione reductase (GRX) using ELISA. Results of ELISA analysis showed a significant decrease in the level of antioxidant enzymes with increasing PMI; regarding histopathological examination, from 6 to > 18 h PMI, the changes in morphology after death were gradual, progressive, and regular, indicating great value in PMI determination. Also, 18 h of PMI showed loss of cellular details, absence of fat cells, and necrosis of BM with the nucleus dispersed as eosinophilic debris. Estimation of antioxidant enzymes level in human bone marrow using ELISA and detection of the changes in the histological structure of human bone marrow in relation to time passed since the death, either separately or in combination, can be used to estimate PMI accurately.
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Affiliation(s)
| | - Amal Mohamad Abd El-Khalek
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nanies Sameeh Mohammad
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nehal S Abouhashem
- Department of Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Hosnia M Ragab
- Department of Public Health and Community Medicine, Zagazig University, Zagazig, Egypt
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Baillargeon K, Brooks JC, Miljanic PR, Mace CR. Patterned Dried Blood Spot Cards for the Improved Sampling of Whole Blood. ACS MEASUREMENT SCIENCE AU 2022; 2:31-38. [PMID: 35211698 PMCID: PMC8855418 DOI: 10.1021/acsmeasuresciau.1c00031] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Indexed: 06/12/2023]
Abstract
Dried blood spot (DBS) cards perform many functions for sampling blood that is intended for subsequent laboratory analysis, which include: (i) obviating the need for a phlebotomist by using fingersticks, (ii) enhancing the stability of analytes at ambient or elevated environmental conditions, and (iii) simplifying the transportation of samples without a cold chain. However, a significant drawback of standard DBS cards is the potential for sampling bias due to unrestricted filling caused by the hematocrit of blood, which often limits quantitative or reproducible measurements. Alternative microsampling technologies have minimized or eliminated this bias by restricting blood distribution, but these approaches deviate from clinical protocols and present a barrier to broad adoption. Herein, we describe a patterned dried blood spot (pDBS) card that uses wax barriers to control the flow and restrict the distribution of blood to provide enhanced sampling. These patterned cards reproducibly fill four replicate extraction zones independent of the hematocrit effect. We demonstrate a 3-fold improvement in accuracy for the quantitation of hemoglobin using pDBS cards compared to unpatterned cards. Patterned cards also facilitate the near quantitative recovery (ca. 95%) of sodium with no evidence of a statistically significant difference between dried and liquid blood samples. Similarly, the recovery of select amino acids was conserved in comparison to a recent report with improved intercard precision. We anticipate that this approach presents a viable method for preparing and storing samples of blood in limited resource settings while maintaining current clinical protocols for processing and analyzing dried blood spots.
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Sakr MF, Abd el-khalek AM, Mohammad NS, Abouhashem NS, Gaballah MH, Ragab HM. Estimation of Postmortem Interval Using Histological and Biochemical Changes in Human Bone Marrow. SSRN ELECTRONIC JOURNAL 2022. [DOI: 10.2139/ssrn.4197257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Optimized and Validated DBS/MAE/LC–MS Method for Rapid Determination of Date-Rape Drugs and Cocaine in Human Blood Samples—A New Tool in Forensic Analysis. SEPARATIONS 2021. [DOI: 10.3390/separations8120249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this work was to develop a new method for the determination of selected substances from the date-rape drugs group: ketamine, benzodiazepines and cocaine. The method is based on the dried blood spot method which seems to be a suitable tool in the analysis of tested substances. The extraction process based on microwave-assisted extraction was optimized to enable optimal conditions for the isolation of a wide range of analytes from blood samples collected on DBS cards. The extraction with ethyl acetate with a buffer of pH = 9 carried out at a temperature of 50 °C for 15 min ensured high extraction efficiency of the tested analytes. The optimized method was validated. Limits of detection (LOD = 4.38–21.1 ng/mL) and quantification (LOQ = 14.6–70.4 ng/mL), inter- and intra-day precision (CV = 1.37–13.4% and 3.39–14.8%, respectively), recovery (RE = 93.0–112.4%) and matrix effect (ME = 98.4–101.6%) were determined. The validation results indicate the possibility of using the proposed method in the analysis of real blood samples collected from victims of sexual assault.
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Arginine, as a Key Indicator for Real-Time Stability Monitoring of Quality Control in the Newborn Screening Test Using Dried Blood Spot. SEPARATIONS 2021. [DOI: 10.3390/separations8110201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Dried blood spots (DBS) have advantages such as minimizing blood collection volume and the distress to neonate. DBS have been used for tandem mass spectrometry (MS/MS)-based newborn screening tests (NST) of amino acid (AA) and acylcarnitine. The Newborn Screening Quality Assurance Program (NSQAP) have been provided quality control (QC) materials for MS/MS, as DBS cards. The NSQAP is generally provided within 14 months of the shelf life and the recommended storage condition is at −10 °C to −30 °C. Previously, several accelerated degradation studies had been performed to determine the transportation stability and short-term stability of AAs and acylcarnitines in DBS. However, the experimental condition is markedly different to the storage condition. We performed long-term monitoring for the real-time stability of seven AAs and 14 acylcarnitines from three levels of 2012 NSQAP QC materials across a time period of 788 days. Arginine suddenly yielded a catastrophic degeneration pattern, which started around D300. When comparing this with previous accelerated degradation studies, methionine, tyrosine, citrulline, and acetylcarnitine did not show a remarkable measurand drift for the real-time stability, except for arginine. Our study showed that arginine would require intensive QC monitoring in routine practice, and should be used for the assessment of the stability in long-term storage of DBS samples for biobanking.
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The Double Face of Ketamine-The Possibility of Its Identification in Blood and Beverages. Molecules 2021; 26:molecules26040813. [PMID: 33557268 PMCID: PMC7915646 DOI: 10.3390/molecules26040813] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to develop and validate a high-sensitivity methodology for identifying one of the most used drugs—ketamine. Ketamine is used medicinally to treat depression, alcoholism, and heroin addiction. Moreover, ketamine is the main ingredient used in so-called “date-rape” pills (DRP). This study presents a novel methodology for the simultaneous determination of ketamine based on the Dried Blood Spot (DBS) method, in combination with capillary electrophoresis coupled with a mass spectrometer (CE-TOF-MS). Then, 6-mm circles were punched out from DBS collected on Whatman DMPK-C paper and extracted using microwave-assisted extraction (MAE). The assay was linear in the range of 25–300 ng/mL. Values of limits of detection (LOD = 6.0 ng/mL) and quantification (LOQ = 19.8 ng/mL) were determined based on the signal to noise ratio. Intra-day precision at each determined concentration level was in the range of 6.1–11.1%, and inter-day between 7.9–13.1%. The obtained precision was under 15.0% (for medium and high concentrations) and lower than 20.0% (for low concentrations), which are in accordance with acceptance criteria. Therefore, the DBS/MAE/CE-TOF-MS method was successfully checked for analysis of ketamine in matrices other than blood, i.e., rose wine and orange juice. Moreover, it is possible to identify ketamine in the presence of flunitrazepam, which is the other most popular ingredient used in DRP. Based on this information, the selectivity of the proposed methodology for identifying ketamine in the presence of other components of rape pills was checked.
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Verstraete J, Boffel L, Stove C. Dried blood microsample-assisted determination of vitamins: Recent developments and challenges. Trends Analyt Chem 2020. [DOI: 10.1016/j.trac.2020.116057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Świądro M, Stelmaszczyk P, Wietecha-Posłuszny R, Dudek D. Development of a new method for drug detection based on a combination of the dried blood spot method and capillary electrophoresis. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1157:122339. [PMID: 32877802 DOI: 10.1016/j.jchromb.2020.122339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 08/05/2020] [Accepted: 08/18/2020] [Indexed: 12/18/2022]
Abstract
The aim of this study was to develop a new approach to sample preparation of biological material based on a combination of the Dried Blood Spot (DBS) method and capillary electrophoresis coupled with mass spectrometry (CE-MS) for the analysis of blood samples collected in vivo or post-mortem. The proposed approach allowed the identification of typical drugs from different groups, such as tricyclic antidepressants (amitriptyline, imipramine), selective serotonin reuptake inhibitors (citalopram), benzodiazepines (tetrazepam) and hypnotics (zolpidem). In this study, a blood sample was spotted on FTA DMPK C cards, then dried, and 6-mm discs were cut out. The sample preparation procedure involved microwave-assisted extraction (MAE). Various extraction agents, temperatures and durations of extraction were examined in order to achieve the highest efficiency of the process. The method was subjected to a validation procedure. Limits of detection (LOD = 1.76 - 14.7 ng/mL) and quantification (LOQ = 5.25 - 49.0 ng/mL), inter- (CV = 1.31 - 9.43%) and intra- (CV = 3.26 - 18.52%) day precision of the determinations, recovery (RE = 85.0-105.4%) and matrix effect on ionization of analytes (ME = 98.6-105.5%) were determined. Furthermore, the developed DBS/MAE/CM-MS method was selective and analytes present in the blood applied on DBS cards were found to be stable after 7 and after 14 days. Moreover, the developed method was successfully applied to the analysis of both post-mortem samples and blood samples taken from patients treated with the analyzed drugs.
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Affiliation(s)
- Magdalena Świądro
- Laboratory for Forensic Chemistry, Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, 2, Gronostajowa St., 30-387 Kraków, Poland
| | - Paweł Stelmaszczyk
- Laboratory for Forensic Chemistry, Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, 2, Gronostajowa St., 30-387 Kraków, Poland
| | - Renata Wietecha-Posłuszny
- Laboratory for Forensic Chemistry, Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, 2, Gronostajowa St., 30-387 Kraków, Poland.
| | - Dominika Dudek
- Department of Adult Psychiatry, Jagiellonian University Medical College, 21a, Mikołaja Kopernika St., 31-000 Kraków, Poland
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Wójtowicz A, Wietecha-Posłuszny R, Snamina M. Contemporary trends in drug analysis of vitreous humor: A critical review. Trends Analyt Chem 2020. [DOI: 10.1016/j.trac.2020.115935] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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13
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Fast and efficient analyses of the post-mortem human blood and bone marrow using DI-SPME/LC-TOFMS method for forensic medicine purposes. Talanta 2020; 209:120533. [DOI: 10.1016/j.talanta.2019.120533] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 02/06/2023]
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Alsous MM, Hawwa AF, McElnay JC. Hematocrit, blood volume, and surface area of dried blood spots - a quantitative model. Drug Test Anal 2020; 12:555-560. [PMID: 32061031 DOI: 10.1002/dta.2776] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 12/30/2022]
Abstract
The use of the dried blood spot (DBS) sampling technique has extended the scope of clinical research, particularly in children. The effects of different hematocrit levels (25-55%) and different blood volumes (7.5-30 μL) on the surface area of the blood spots were investigated using ImageJ® software. Variation in hematocrit levels between patients and inaccuracies in blood volumes applied to Guthrie cards can have a marked effect on analyte concentrations measured in DBS samples. The current study presents a validated model that links blood volume and hematocrit to the surface area of the blood spot. The final model showed that both factors affect the blood spot surface area, however, the positive effect of blood volume is higher than the negative effect of hematocrit. The measurement of surface area could be added as an additional quality control step in clinical studies that have adopted fixed volume DBS sampling for the quantification of the analytes. This approach can be used in estimating the hematocrit if this is not known for a patient or estimating the volume in spots that are visually different in size from the norm, i.e. technical error.
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Affiliation(s)
- Mervat M Alsous
- Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast, UK.,Faculty of Pharmacy, Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan.,Faculty of Pharmacy, Department of Pharmacy Practice, Yarmouk University, Irbid, Jordan
| | - Ahmed F Hawwa
- Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast, UK.,University Hospital Southampton NHS Foundation Trust, Tremona Rd, Southampton SO16 6YD, UK
| | - James C McElnay
- Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast, UK
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