Biomedical subjects

Terry Lee

Publications and source records attributed to Terry Lee.

4 recordsLinked to original sources

PubMed2005

Analysis for identification in amnesty bin samples from dance venues.

The analysis of unknown substances discarded in amnesty bins, first described by Ramsey et al, from a large central London club and 7 smaller clubs in Manchester, UK are described. The contents of the bins were collected between July 2003 and March 2004. Solid dosage formulations were identified using the TICTAC database, chemical tests, and GC-MS screening. Drugs that could not be readily identified were subjected to other analytical techniques. The goal was to document the current range of drugs available on the dance scene and compare the findings between the London club, which had been the subject of a previous survey, and Manchester clubs. More than 1000 tablets, capsules, and powder doses were discarded in the amnesty bins. Tablets containing only MDMA (ecstasy) were found to be >94% and >84% of the total in London and Manchester, respectively. Although the quantities of tablets and powders recovered were different between London and Manchester, the proportions of the drugs were remarkably similar. The most common drugs found in powders in London and Manchester respectively were cocaine (29%, 40%), amphetamine (25%, 26%), ketamine (19%, 20%), and MDMA (19%, 11%).

Adolescent↗

PubMed2004

Determination of total mycophenolic acid and its glucuronide metabolite using liquid chromatography with ultraviolet detection and unbound mycophenolic acid using tandem mass spectrometry.

Two simple, sensitive and reproducible methods for determination of total mycophenolic acid (MPA) and its glucuronide metabolite (MPAG) as well as unbound MPA (fMPA) was developed by the use of HPLC-UV and LC-MS/MS methods, respectively. For the total MPA/MPAG method, the analytes were extracted using Isolute C(2) solid-phase extraction (SPE) cartridges and analyzed at 254 nm over a Zorbax Rx C(8) column (150 mm x 4.6 mm, 5 microm). The mobile phase was a gradient mixture of methanol and water (containing 0.1% (v/v) phosphoric acid). The total run time was 18 min and the extraction recovery was 77% for MPA and 84% for MPAG. The method was precise and accurate with a lower limit of quantification (LLOQ) of 0.5 mg/l for MPA and 5.0 mg/l for MPAG. For the fMPA method, plasma was subjected to ultrafiltration followed by SPE using C(18) cartridges. Analytical column was the same as the HPLC-UV method and the mobile phase was a gradient composition of methanol:0.05% formic acid with a flow rate of 0.6 ml/min for the first 3 min and 0.7 ml for the last 4 min. The chromatographic method separated MPA from its metabolites MPAG and Acyl-MPAG. Mass transitions in negative ionization mode for MPA and the internal standard, indomethacin were m/z: 319-->190.9 and m/z: 356-->312.2, respectively. The assay was linear in the concentration range of 1-1000 microg/l for fMPA with a LLOQ of 1 microg/l and an accuracy of >95%. The two methods reported have an adequate degree of robustness and dynamic concentration range for the measurement of MPA, MPAG and fMPA for therapeutic drug monitoring purposes or pharmacokinetics investigations.

Chromatography, High Pressure Liquid↗

PubMed2003

Temporal approach to hematological test usage in a major teaching hospital.

In the era of slowly increasing laboratory budgets, identifying usage patterns can be an important first step in decreasing unnecessary laboratory testing. From January 1, 1998, through December 27, 2002, we studied inpatient laboratory utilization at the University of Alberta Hospital, a large Canadian teaching hospital (665 inpatient beds with an almost 100% continuous occupancy rate). The daily numbers of complete blood cell count (CBC), CBC with differential (CBCD), international normalized ratio, activated partial thromboplastin time, vitamin B12, and red cell folate (FOL) tests were correlated with regularly occurring hospital events, such as weekends, statutory holidays, and resident changeover dates. Testing for hematological monitoring (CBC, CBCD) at our institution has been increasing at an average of 2% to 6% per year with a recent (2001 onward) rate of increase in hematological diagnostic testing (vitamin B12 and FOL) of close to 10%. As expected, laboratory usage was statistically significantly higher on weekdays compared with weekends. During the weekdays, ordering frequencies on Monday and Friday were shown to be statistically significantly higher than on the other days. A nadir occurred on Thursday and on the weekend. This finding was postulated to be due to a combination of attending physician unfamiliarity and defensive testing. Resident changeovers did not contribute to an increase in Monday laboratory testing, as was initially thought, nor did holidays. We believe that we can use our findings to decrease laboratory use. First, weekend or midweek use might become the appropriate standard for frequency of testing. Second, we must alert attending physicians (and residents who are soon to be attending physicians) about their subliminal need to increase testing during changeovers.

Hematologic Tests↗

PubMedDate not supplied

Effects of a restrictive blood transfusion policy on outcomes in children with burn injury.

A restrictive blood transfusion policy decreases blood utilization and improves outcomes in critically ill adults, but the impact of a restrictive blood transfusion policy in critically ill children is unclear. The study purpose was to compare the effects of a restrictive with a traditional blood transfusion policy in children with major burn injury. A retrospective review of all blood transfusions administered in a pediatric burn center during a 5-year period was conducted. Children in the traditional group (January 1, 2000, to June 30, 2002), were transfused at a hemoglobin level of less than 10 g/dl. Children in the restrictive group (January 1, 2003, to June 30, 2005, 6 months after the adoption of a restrictive protocol) were transfused at a hemoglobin level of less than 7 g/dl. Patient groups were compared for demographics, ventilator requirements, blood transfusion number, transfusion costs, and outcomes. Of the 1140 patients studied, 266 (24%) received a total of 2577 units of blood. There was no difference in age, TBSA burn, sex, inhalation injury, or mortality between groups. Patients in the traditional group received more blood than the restrictive group (12.3 +/- 1.8 vs 7.2 +/- 1.2 units/patient, P < .001). The mean cost of blood per patient was $2781 for the traditional group and $1489 for the restrictive group. A restrictive transfusion policy in children with burn injury decreases the amount of blood transfused, does not adversely impact patient outcome, and results in significant cost savings to the institution.

Blood Transfusion↗