Monitoring of adherence to headache treatments by means of hair analysis

The aim of this study was to evaluate the potential of hair analysis to monitor medication adherence in headache patients undergoing chronic therapy. For this purpose, the following parameters were analyzed: the detection rate of 23 therapeutic drugs in headache patients' hair, the degree of agreement between the self-reported drug and the drug found in hair, and whether the levels found in hair reflected the drug intake reported by the patients

Hair analysis for detection of triptans occasionally used or overused by migraine patients-a pilot study

Purpose The aim of this study is to evaluate the detection rate of almotriptan, eletriptan, frovatriptan, sumatriptan, rizatriptan, and zolmitriptan in the hair of migraineurs taking these drugs; the degree of agreement between type of self-reported triptan and triptan found in hair; if the concentrations in hair were related to the reported cumulative doses of triptans; and whether hair analysis was able to distinguish occasional use from the overuse of these drugs. Methods Out of 300 headache patients consecutively enrolled, we included 147 migraine patients who reported to have taken at least one dose of one triptan in the previous 3 months; 51 % of the patients overused triptans. A detailed pharmacological history and a sample of hair were collected for each patient. Hair samples were analyzed by liquid chromatography-electrospray tandem mass spectrometry (LC-MS/MS) by a method that we developed. Results All the triptans could be detected in the hair of the patients. The agreement between type of self-reported triptan and type of triptan found in hair was from fair to good for frovatriptan and zolmitriptan and excellent for almotriptan, eletriptan, sumatriptan, and rizatriptan (P < 0.01, Cohen’s kappa). The correlation between the reported quantities of triptan and hair concentrations was statistically significant for almotriptan, eletriptan, rizatriptan, and sumatriptan (P < 0.01, Spearman’ s rank correlation coefficient). The accuracy of hair analysis in distinguishing occasionally users from overusers was high for almotriptan (ROC AUC = 0.9092), eletriptan (ROC AUC = 0.8721), rizatriptan (ROC AUC = 0.9724), and sumatriptan (ROC AUC = 0.9583). Conclusions Hair analysis can be a valuable system to discriminate occasional use from triptan overuse

Measurement uncertainty of blood ethanol concentration in drink-driving cases in an emergency laboratory

Introduction: The quality of blood ethanol concentration (BEC) determination is important because of its legal ramifications. Measurement uncertainty provides quantitative information about the quality and reliability of test results. In this study, we aim to calculate the measurement uncertainty for the ethanol test in our laboratory measured with a Synchron Systems Ethanol assay kit by employing an enzymatic rate method on the Beckman-Coulter Olympus AU400 auto analyzer (Beckman Coulter Inc, Melville, USA). Materials and methods: The measurement uncertainty values were calculated in accordance to the Nordtest guidelines. All vehicle drivers involved in a traffic accident were retrospectively inspected for the BEC test conducted during July to December 2016 in our emergency laboratory. Results: A 1034 vehicle drivers had their BEC tested. The results for 181 drivers were > 0.50 g/L and reported as positive. The serum ethanol concentration in those showing a positive result was 2.04 ± 1.01 g/L, over four times the legal limit. The median BEC in those showing a negative result was 0.03 (IQR: 0.03) g/L. The expanded uncertainty obtained was 19.74%. When measurement uncertainty values were added to the results of the 1034 drivers who were retrospectively screened, eight vehicle drivers had results with 95% confidence intervals that exceeded the legal limit 0.50 g/L. Conclusions: The BEC test results for vehicle drivers with values close to legal limits should be reported as the obtained ethanol concentration with corresponding measurement uncertainty