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Pereira Dos Santos B, Birk L, Schwarz P, Sebben VC, Sgaravatti ÂM, de Gouveia GC, Petry AUS, de Menezes FP, Gonzaga AP, Schlickmann PF, Arbo MD, de Oliveira TF, Eller S. A validated dilute-and-shoot LC-MS/MS urine screening for the analysis of 95 illicit drugs and medicines: insights from clinical and forensic Brazilian cases. J Anal Toxicol 2024:bkae005. [PMID: 38334744 DOI: 10.1093/jat/bkae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/16/2023] [Accepted: 02/05/2024] [Indexed: 02/10/2024] Open
Abstract
Urine toxicological analysis is a relevant tool in both clinical and forensic scenarios, enabling the diagnosis of acute poisonings, elucidation of deaths, verification of substance use in the workplace, and identification of drug-facilitated crimes. For these analyses, the dilute-and-shoot technique associated with liquid chromatography coupled with tandem mass spectrometry (LC-MS-MS) is a promising alternative since it has demonstrated satisfactory results and broad applicability. This study developed and validated a comprehensive LC-MS-MS screening method to analyze 95 illicit drugs and medicines in urine samples and application to clinical and forensic Brazilian cases. The dilute-and-shoot protocol was defined through multivariate optimization studies and was set using 100 µL of sample and 300 µL of solvent. The total chromatographic run time was 7.5 minutes. The method was validated following the recommendations of the ANSI/ASB Standard 036 Guideline. The lower limits of quantification varied from 20 to 100 ng/mL. Within-run and between-run precision CVs% were lower than 20%, and bias was within ± 20%. Only four of the 95 analytes presented significant ionization suppression or enhancement (> 25%). As proof of applicability, 839 urine samples from in vivo and postmortem cases were analyzed. In total, 90.9% of the analyzed samples were positive for at least one substance, and 78 of the 95 analytes were detected. The most prevalent substances were lidocaine (40.2%), acetaminophen (38.0%), and benzoylecgonine (31.5%). The developed method proved to be an efficient and simplified alternative for analyzing 95 therapeutic and illicit drugs in urine samples. Additionally, the results obtained from sample analysis are essential to understanding the profile of Brazilian substance use, serving as a valuable database for the promotion of health and safety public policies.
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Affiliation(s)
- Bruno Pereira Dos Santos
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
- Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, 90010-150, Brazil
| | - Letícia Birk
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - Patrícia Schwarz
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | | | - Ângela Malysz Sgaravatti
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
- General Institute of Expertise of Rio Grande do Sul, Porto Alegre, RS, 90230-010, Brazil
| | - Giovanna Cristiano de Gouveia
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - Adriana Ubirajara Silva Petry
- Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
- Division of Postmortem Inspection, Associação Hospitalar Vila Nova, Porto Alegre, RS, 91750-040, Brazil
| | - Francisco Paz de Menezes
- Division of Postmortem Inspection, Associação Hospitalar Vila Nova, Porto Alegre, RS, 91750-040, Brazil
| | - Alexsandro Pinto Gonzaga
- Division of Postmortem Inspection, Associação Hospitalar Vila Nova, Porto Alegre, RS, 91750-040, Brazil
| | - Paula Flores Schlickmann
- Division of Postmortem Inspection, Associação Hospitalar Vila Nova, Porto Alegre, RS, 91750-040, Brazil
| | - Marcelo Dutra Arbo
- Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, 90010-150, Brazil
| | - Tiago Franco de Oliveira
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - Sarah Eller
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
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Ossanes DS, Birk L, Petry AUS, de Menezes FP, Gonzaga AP, Schlickmann PF, Eller S, de Oliveira TF. Cork sheet as an efficient biosorbent for forensic toxicology: Application to vitreous humor analysis. J Anal Toxicol 2023; 47:580-587. [PMID: 37506044 DOI: 10.1093/jat/bkad045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/05/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
There is an increasing number of people affected worldwide by mental health disorders, such as depression and anxiety. One of the main courses of treatment, along with psychotherapy, is the use of psychoactive medications, like antidepressants and benzodiazepines. Also, the unprescribed use of these substances is a concerning public health issue. Hence, the analysis of psychotropic medications is mandatory in postmortem toxicology and various biological samples can be used for this detection, among them the vitreous humor (VH) stands out. Also, there is a demand for more sustainable and more efficient extraction methodologies according to green chemistry. An example is solid phase microextraction techniques (SPME), which use a solid sorbent and small solvent amounts. Biosorbents are substances of natural origin with sorptive properties, and they have been successfully used in SPME in environmental toxicology for water analysis, mainly. This study aimed to develop a sustainable, fast, cheap and simple SPME methodology using cork sheet strips as a biosorbent, to extract antidepressants, benzodiazepines and others from VH samples by liquid chromatography coupled to tandem mass spectrometry. The extraction was conducted in a 96-well plate using 200 µL of VH and optimization of relevant parameters for extraction was performed. For solvent optimization, two simplex-centroid experiments were planned for extraction and desorption and to evaluate time and pH, a Doehlert design experiment was performed. The analytical method for the determination and quantification of 17 substances was validated. The quantification limits were 5 ng/mL for all analytes and the calibration curves were linear between 5 and 30 ng/mL. This study was able to develop an efficient, cheap, simple and fast microextraction method for 17 analytes in VH, using strips of cork sheet for extraction and a 96-well plate as a container. Furthermore, this approach system could be automated for routine toxicology laboratories.
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Affiliation(s)
- Daniela Souza Ossanes
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS 90050-170, Brazil
| | - Letícia Birk
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS 90050-170, Brazil
| | - Adriana Ubirajara Silva Petry
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS 90050-170, Brazil
- Division of Postmortem Inspection, Associação Hospitalar Vila Nova, Porto Alegre, RS 91750-040, Brazil
- Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS 90050-170, Brazil
| | - Francisco Paz de Menezes
- Division of Postmortem Inspection, Associação Hospitalar Vila Nova, Porto Alegre, RS 91750-040, Brazil
| | - Alexsandro Pinto Gonzaga
- Division of Postmortem Inspection, Associação Hospitalar Vila Nova, Porto Alegre, RS 91750-040, Brazil
| | - Paula Flores Schlickmann
- Division of Postmortem Inspection, Associação Hospitalar Vila Nova, Porto Alegre, RS 91750-040, Brazil
| | - Sarah Eller
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS 90050-170, Brazil
| | - Tiago Franco de Oliveira
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS 90050-170, Brazil
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Alves RDCS, Petry AUS, Marçal JMB, Hochhegger B, Damin AS, Roehe AV. Asymmetric parasitic twins - Heteropagus. ACTA ACUST UNITED AC 2020; 66:1526-1529. [PMID: 33295404 DOI: 10.1590/1806-9282.66.11.1526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/07/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Asymmetric or heteropagus conjoined twins is a rare occurrence, with an incidence of one case in 1-2 million. Conjoined twins are classified according to their symmetry, place of fusion, and grade of duplication. METHODS We report here an extremely rare presentation of parasitic twins not described before. We describe macro and micro anatomic alterations and discuss the aspects of this peculiar presentation and the importance of prenatal diagnosis. RESULTS The case of a twenty-three-year-old patient, with monochorionic, monoamniotic asymmetrically-conjoined twin pregnancy, discovered at 29 weeks of gestational age. We believe that this report calls attention to this presentation and the importance of prenatal care and management. The twins were delivered vaginally without life. The twins' combined weight was 1.300 gr. They were bonded in the left cervical region. CONCLUSION This report may help to find strategies for clinical decisions in future cases. Antepartum diagnosis is important to the management, preoperative planning, and outcomes. Prenatal imaging exams like echocardiography, CT, MRI, and ultrasonography are feasible and can provide relevant information about malformation severity and prognosis.
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Affiliation(s)
- Rita de Cássia S Alves
- Docente, Departamento de Métodos Diagnósticos, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Adriana Ubirajara Silva Petry
- Docente, Departamento de Métodos Diagnósticos, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Josenel Maria Barcelos Marçal
- Docente, Departamento de Métodos Diagnósticos, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Bruno Hochhegger
- Docente, Departamento de Métodos Diagnósticos, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Andréa Souto Damin
- Docente, Departamento de Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
| | - Adriana Vial Roehe
- Docente, Departamento de Métodos Diagnósticos, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
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