Equipamiento e insumos para realizar determinación de concentración de inmunosupresores en sangre de pacientes trasplantados en Neuquén / Equipment and supplies for determining the concentration of immunosuppressants in blood of transplant patients in Neuquén

INTRODUCCION: El presente Informe estructurado ha sido elaborado para ser utilizado en el proceso de evaluación de incorporación de nuevas tecnologías en el subsector de servicios de salud público. OBJETIVOS: Los objetivos del son: -Simplificar el análisis de la solicitud de incorporación de tecnologías a través de la organización de la información en distintos dominios; -Facilitar la elaboración de los juicios valorativos; -Armonizar la elaboración de las recomendaciones. ELABORACIÓN DEL INFORME Y POSTERIOR TRAMITACIÓN: El mismo debe ser elaborado por el Comité Provincial para luego remitirse a la DPGTBM. El Comité Provincial deberá agotar las instancias para lograr una recomendación por consenso. El informe considera los siguientes dominios: -adecuación a los objetivos estratégicos y al plan de salud provincial, -balance entre las ventajas e inconvenientes de adoptar la nueva tecnología, -capacidad del Hospital de asumir la propuesta. Deben adjuntarse los formularios de declaración de conflictos de Interés. La DPGTBM puede requerir la participación en la decisión final acerca de la propuesta de las siguientes direcciones: -Calidad de gestión, -Provincial de Salud; -De Administración; -De Organizaciones de Establecimientos Asistenciales. TECNOLOGÍA SANITARIA SOLICITADA: Equipamiento e insumos para realizar determinación de concentración de inmunosupresores en sangre de pacientes trasplantados en Neuquén. COMENTARIOS SOBRE LAS ALTERNATIVAS EVALUADAS: 1-Recientemente fue solicitado al Comité de Biotecnologías la evaluación de la incorporación de un equipo Architect de Abott para el centro regional de hemoterapia en el Hospital Bouquet Roldan (HBR). Sin embargo el pedido fue desestimado inicialmente debido a que las determinaciones de serologías que el mismo realiza son actualmente realizadas, con efectividad comparable, por dos equipos (DaVinci de Biomerieux) cuyos reactivos son provistos en forma gratuita por el Plan Nacional de Hemoterapia. 2-No fueron incluidas alternativas relacionadas al método de espectrometría de masas ni al método de HPLC (Cromatografía líquida de alta resolución), que son de mucho mayor costo inicial, requieren alta capacitación del personal y están escasamente disponibles en el país (ningún centro público los posee en Argentina para este uso).

T-2 and HT-2 toxins in cereals and cereal-based products in South Korea.

A total of 214 samples, consisting of brown rice, barley, mixed grains, corn, wheat and wheat flour were analysed for T-2 and HT-2 toxins using high-performance liquid chromatography with fluorescence detection. Recovery and repeatability were 79.9%-107.5% and 4.9%-14.5% for T-2, and 74.0%-106.1% and 5.0%-17.9% for HT-2, respectively. T-2 toxin was detected in 11 (5.1%) of all samples. The highest incidence was found in corn (21.7%) followed by mixed grains and brown rice. Mean of all samples was 1.5-4.1 µg kg⁻¹, the maximum level being 41.5 µg kg⁻¹ in corn. HT-2 toxin was detected in 126 (58.9%) of all samples, and the mean values were 26.4-59.2 µg kg⁻¹. The estimated daily intakes for the sum of T-2 and HT-2 toxins were 2.56, 3.22, 2.53, 0.03, 0.01 and 2.45 ng (kg bw)⁻¹ day⁻¹ in brown rice, barley, mixed grains, corn, wheat and wheat flour, respectively.

Natural occurrence of ochratoxin A in wolfberry fruit wine marketed in China.

Wolfberry fruit wine (WFW) is widely used as a global functional food to improve the immune system and prevent human disease. A total of 36 bottled WFWs were randomly collected in China between 2005 and 2010. Samples were analysed for the presence of ochratoxin A (OTA) using immunoaffinity column (IAC) clean-up and high-performance liquid chromatography with fluorescence detection (HPLC-FLD). Positive results were confirmed by liquid chromatography-electrospray ionisation-tandem mass spectrometry (LC-ESI-MS/MS). The limit of detection (LOD), based on a signal-to-noise ratio of 3, was 0.05 ng mL⁻¹. Recoveries ranged from 78.3% to 94.7% and relative standard deviations from 1.1% to 4.3% within the spiking range of 0.2-20 ng mL⁻¹. OTA was detected in one sample, below the maximum allowable limit as established by the European community.

Ochratoxin A in wines from 2002 to 2008 harvest marketed in Rio de Janeiro, Brazil.

The occurrence of ochratoxin A (OTA) in wine from 2002 to 2008 harvest, traded in Rio de Janeiro State, was evaluated by analysing 43 national and 37 imported wines from Argentina (32) and Chile (5), adding up to 80 samples in total. OTA determination was performed using immunoaffinity columns and high-performance liquid chromatography. In 80 wine samples analysed, 25 (31.3%) were positive, presenting levels greater than 0.020 ng OTA mL⁻¹. It was not detected in imported wines. Within national wines, 58.1% of the samples were contaminated, with levels ranging from 0.020 to 0.050 ng mL⁻¹. The toxin was detected in 18 (69.2%) of 26 samples analysed of red table wine. Wines from 2008 harvest presented 84.6% of samples contaminated in 13 samples analysed. Despite the levels found in this study, they are below Brazilian tolerance limits. Nevertheless, the presence of OTA as found contributes to the human exposure to this toxin.

Occurrence of fumonisins and aflatoxins in cereals from markets of Hebei Province of China.

Fumonisins B1, B2 and B3 (FB1, FB2 and FB3) and aflatoxins B1 (AFB1), B2 (AFB2), G1 (AFG1) and G2 (AFG2) are both major mycotoxins of food concern, because of their wide range of concentration and possible co-occurrence. Therefore, a contamination survey in corn and wheat flour by liquid chromatography-tandem mass spectrometry was carried out. Quantification of fumonisins and aflatoxins was based on internal calibration (by the use of ¹³C34-fumonisin) and external calibration, respectively. Fumonisins were detected in 95% of corn samples and in 7% of wheat flour samples, with the mean level (FB1 + FB2 + FB3) of 441 µg kg⁻¹ and 0.09 µg kg⁻¹, respectively. Low levels of aflatoxins were detected in 37% of the samples with a mean level (B1 + B2 + G1 + G2) of 0.12 µg kg⁻¹. Fumonisins and aflatoxins were not detected in 29% of the samples analysed. Simultaneous occurrence of fumonisins and aflatoxins was observed in 12% of samples.

Receptor assay based on surface plasmon resonance for the assessment of the complex formation activity of cyclosporin A and its metabolites.

OBJECTIVE: A new automated receptor assay has been used to determine the complex formation activity of cyclosporin A (CsA) and its metabolites in whole blood. METHODS: CsA in vivo forms a complex with cyclophilin A and calcineurin leading to an inhibition of the calmodulin-dependent phosphatase activity of calcineurin. The equilibrium complex formation gives information about the potential immunosuppressive activity of CsA and its metabolites. To measure the amount of this complex the authors developed an automated receptor assay based on an optical biosensor (Biacore) with surface plasmon resonance (SPR) technology. RESULTS: In the range of 50-300 nM CsA, the intra-day coefficient of variation (CV) was 7.2%, and the inter-day CV was 10.1%. Measuring range of the assay was 10-500 nM with a detection limit of 5 nM and a processing time of 10 min. Recovery rate for sample pretreatment was 74 +/- 5%. 193 blood specimens from heart transplant recipients were analyzed with 3 different methods. The results determined with the receptor assay were correlated with those obtained by fluorescence polarization immunoassay (FPIA; r = 0.599) and high-performance liquid chromatography (HPLC; r = 0.615). CONCLUSION: The receptor assay determines the complex formation activity of CsA and its metabolites with high sensitivity and precision.