Comprehensive analysis of vitamin D3 impurities in oily drug products using supercritical fluid chromatography-mass spectrometry.

Vitamin D3, an essential micronutrient, often requires supplementation via medicines or food supplements, which necessitate quality control (QC). This study presents the development of a method for detecting and quantifying seven impurities of vitamin D3 in oily drug products using supercritical fluid chromatography-mass spectrometry (SFC-MS). Targeted impurities include two esters of vitamin D3 and five non-esters including four that are isobaric to vitamin D3. Firstly, a screening study highlighted the Torus 1-AA column and acetonitrile modifier as adequate for the separation, followed by optimization of the SFC conditions. Secondly, make-up solvent composition and MS settings were optimized to reach high sensitivity. For both the separation and MS response, the screening design of experiments proved useful. Lastly, a fast saponification and liquid-liquid extraction method was developed, enabling efficient sample cleanup and impurities recovery from the complex oily matrix. The SFC-MS method suitability was assessed in two validation studies. The first study employed the ICH Q2 guideline for impurity limit test to demonstrate method specificity and establish a limit of detection (LOD) and a limit of quantification (LOQ) at 0.2% and 0.5%, respectively, for ester impurities. The second study conducted a comprehensive quantitative assessment for three non-ester impurities using a total error approach, determining method validity through accuracy profiles. The validated method exhibited reliable performance across impurity concentrations from 0.1% to 2.0%, with estimated LODs ranging from 2 to 7 ng/mL. This study further promotes SFC-MS as a valuable, versatile, and green tool for routine pharmaceutical QC.

Novel bioengineered collagen with Manuka honey and hydroxyapatite sheet for the treatment of lower extremity chronic wounds in an urban hospital wound care setting.

INTRODUCTION: A novel BCMH sheet has been shown to achieve improved wound closure rates in chronic and acute wounds when compared with SOC. OBJECTIVE: This retrospective evaluation assessed chronic wound closure rates with SOC or treatment with the BCMH sheet in an urban hospital wound clinic. METHODS: Forty-seven chronic wounds were treated with SOC or the BCMH sheet. The primary endpoint was time to closure. For wounds that did not close, investigations were conducted to determine the reason. RESULTS: Twenty wounds were treated with SOC, which varied in usage of multiple products and/or therapies, and 27 wounds were treated with the BCMH sheet. The average initial wound size was not statistically different between the groups. In both groups, most wounds that were treated did not close. For wounds that did close, the average time to closure was 2x faster in the BCMH group compared with the SOC group (7.4 weeks and 14.8 weeks, respectively; P < .05). CONCLUSIONS: This retrospective evaluation showed average time to wound closure to be significantly faster with BCMH compared with SOC in patients who maintained adherence with regular visits.

Chlorhexidine residues in sludge from municipal wastewater treatment plants: analytical determination and toxicity evaluation.

In this work, a procedure for the sensitive and selective determination of chlorhexidine in sludge from municipal sewage treatment plants (STPs) based on matrix solid-phase dispersion (MSPD) and liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) was optimized and validated. Analysis of sewage sludge samples, obtained from different STPs in Northwest Spain from 2018 to 2021, showed that chlorhexidine was ubiquitous in this environmental compartment with concentrations between 0.3 and 16 µg g-1. The toxicity of this pollutant was assessed in in vitro assays considering three different model organisms: Candida albicans, Escherichia coli, and Staphylococcus aureus. C. albicans was the most sensitive of the tested microorganisms to chlorhexidine with a lethal threshold concentration of 0.1 mg L-1. Thus, the lowest observed sludge residue was 3 times higher than the acute toxicity threshold measured for C. albicans. Moreover, E. coli and S. aureus were also affected at chlorhexidine concentrations around 1.8 mg L-1 and 0.5 mg L-1, respectively. So, chlorhexidine residues might affect the population of microorganisms existing in STPs. In addition, the potential phytotoxicity of the compound was evaluated with germination experiments using different model seeds. At the evaluated dose (10 µg g-1 dried soil), chlorhexidine did not affect the germination of Sorghum saccharatum, Lepidium sativum, or Sinapis alba seeds. Thus, amending agriculture soils with chlorhexidine containing sludge is unlikely to affect the germination of plants.

[Recommendations for the use of ranibizumab in diabetic macular edema at IMSS]. / Recomendaciones para el uso de ranibizumab en edema macular diabético en el IMSS.

Diabetic macular edema can occur at any stage of diabetic retinopathy. It represents the main cause of vision loss in diabetes type I and II with a prevalence of 3-10% in diabetic patients of the Instituto Mexicano del Seguro Social (IMSS). Our aim is to elaborate treatment guidelines and provide recommendations for the use of intravitreal ranibizumab for diabetic medical edema at IMSS. Nine retina specialists and 10 ophthalmologists from IMSS high specialty medical units gathered to discuss the bibliographic evidence for the safety and efficacy of ranibizumab for this disease, in order to create consensus on its use in the institution. Intravitreal ranibizumab injection should be used on patients presenting diffuse or cystic diabetic macular edema who have strict metabolic control and visual acuity between 20/30 and 20/200 ETDRS, as well as structural features, such as inferior foveal limit of 280 µm and ischemic areas no larger than 50% of the central foveal area. Treatment regime should consist of a loading charge of three monthly injections of ranibizumab 0.5 mg, followed by monthly follow-ups and treatment as needed according to anatomic and functional criteria. This consensus decision-making process on the criteria to treat and re-treat patients with this drug will result in better health outcomes than those currently observed among patients with diabetic macular edema at IMSS.

El edema macular diabético se presenta en cualquier etapa de la retinopatía diabética y representa la principal causa de pérdida de visión en las diabetes tipo I y II, con una prevalencia que va del 3 al 10% en pacientes diabéticos del Instituto Mexicano del Seguro Social (IMSS). El objetivo de este trabajo es elaborar una guía de tratamiento y recomendaciones para el uso de ranibizumab intravítreo en pacientes con edema macular diabético en el IMSS. Se llevó a cabo una reunión de expertos (9 retinólogos y 10 oftalmólogos) de las unidades médicas de alta especialidad del IMSS para realizar una revisión crítica de la eficacia y seguridad del ranibizumab para esta enfermedad y llegar a un consenso sobre el uso de este antiangiogénico en la institución. Las inyecciones de ranibizumab intravítreo se aplicarían a pacientes con edema macular diabético del tipo difuso o quístico, con un control metabólico estricto, agudeza visual en un rango de 20/30 a 20/200 ETDRS y criterios estructurales, como el límite foveal inferior a 280 µm y zonas isquémicas de no más del 50% de la zona central foveal. El esquema de tratamiento consistiría en una dosis de carga de tres inyecciones mensuales de ranibizumab de 0.5 mg y posteriormente seguimiento mensual y tratamiento por razón necesaria según criterios anatómicos y funcionales. El consenso sobre los criterios de tratamiento y retratamiento con este medicamento garantizará mejores resultados clínicos en pacientes con edema macular diabético en el IMSS.

Healthy effect of different proportions of marine ω-3 PUFAs EPA and DHA supplementation in Wistar rats: Lipidomic biomarkers of oxidative stress and inflammation.

Dietary intervention with ω-3 marine fatty acids may potentially modulate inflammation and oxidative stress markers related with CVD, metabolic syndrome and cancer. The aim of this study was to evaluate whether different proportions of ω-3 EPA and DHA intake provoke a modulation of the production of lipid mediators and then, an influence on different indexes of inflammation and oxidative stress in a controlled dietary animal experiment using Wistar rats. For such scope, a lipidomic SPE-LC-ESI-MS/MS approach previously developed was applied to determine lipid mediators profile in plasma samples. The effect of ω-3 fatty acids associated to different ratios EPA:DHA was compared with the effect exerted by ω-3 ALA supplementation from linseed oil and ω-6 LA from soybean oil. CRP showed a tendency to greater inflammatory status in all ω-3-fed animals. Interestingly, ratios 1:1 and 2:1 EPA:DHA evidenced a noteworthy healthy effect generating a less oxidative environment and modulating LOX and COX activities toward a decrease in the production of proinflammatory ARA eicosanoids and oxidative stress biomarkers from EPA and DHA. In addition, the ability of 1:1 and 2:1 fish oil diets to reduce lipid mediator levels was in concurrence with the protective effect exerted by decreasing inflammatory markers as ω-6/ω-3 ratio in plasma and membranes. It was also highlighted the effect of a higher DHA amount in the diet reducing the healthy benefits described in terms of inflammation and oxidative stress. Results support the antiinflammatory and antioxidative role of fish oils and, particularly, the effect of adequate proportions EPA:DHA.