Bernardí Barceló Martín

Publications (3)3.81 Total impact

• Article: Rheumatoid factor interference in a tacrolimus immunoassay.

  Bernardí Barceló Martín, Pierre Marquet, Joana Maria Ferrer, Bartomeu Castanyer Puig, Antonia Barcelo Bennasar, Maria Riesco Prieto, Regina Fortuny Marqués
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  ABSTRACT: Recently, there has been an interest in the use of tacrolimus for the treatment of rheumatoid arthritis (RA). The role of rheumatoid factor (RF) as a cause of immunoassay interferences is well known. This study is the first to investigate the susceptibility of a tacrolimus immunoassay to interference by RF. Tacrolimus apparent concentrations were determined using the antibody conjugated magnetic immunoassay (ACMIA) run on the Dimension RxL Immunoassay System in 100 randomly selected samples previously submitted for routine diagnostic or monitoring of RA in patients not receiving tacrolimus. Fifty of them had an RF concentration exceeding 100 IU/L and 50 had an RF concentration below 20 IU/L. Samples with tacrolimus apparent whole-blood concentrations above 2.3 ng/mL (limit of quantification of the ACMIA assay alleged by the vendor) were considered as potential false positives. No positive tacrolimus result was found among the 50 samples with serum RF < 20 IU/mL. Among the 50 selected samples from patients with RF > 100 IU/mL (RF range 110-2650 IU/mL), 2 were positive for tacrolimus with ACMIA. In both cases, the pretreatment of these samples with an immunoglobulin blocking agent reduced the apparent tacrolimus concentrations to below the limit of detection. This was confirmed using the alternative and reference tacrolimus assays, both of which reported results below their respective limits of detection. The measured human anti-mouse antibodies levels were found to be elevated. These results show that certain patients with positive RF can have false-positive tacrolimus results using the tacrolimus ACMIA-Flex immunoassay on a Dimension RXL analyzer, which was not the case with 2 other techniques. The interference with the tacrolimus ACMIA results was suppressed after preincubation with an immunoglobulin blocking reagent.
  Therapeutic drug monitoring 12/2009; 31(6):743-5. · 2.43 Impact Factor
• Article: [Clinical value of estimated half-life in paracetamol poisoning as a complement to Rumack's nomogram].

  Bartomeu Castanyer-Puig, Bernardí Barceló-Martín, Jordi Puiguriguer-Ferrando, Marina Rovira-Illamola, Dolors Soy-Muner, Santiago Nogué-Xarau
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  ABSTRACT: Rumack's nomogram is usually used to indicate the treatment with N-acetilcysteine in the paracetamol poisoning, but it has several limitations. Paracetamol half-life elimination (t1/2) is approximately of 2 h with therapeutic doses and it increases to more than 4 h in patients with hepatotoxicity. The aim of this study was to determine the usefulness of estimated paracetamol t1/2 as greater than or inferior to 4 h by using a simple ratio in relation to the development of hepatotoxicity. 21 patients with paracetamol overdose were admitted to Son Dureta Hospital (Palma de Mallorca) and Clínic Hospital (Barcelona) over 13 months. The estimated t1/2 is calculated using the quotient between 2 plasma paracetamol concentrations separated by 2 or more hours. We found a significant difference (p < 0.005) between the group with hepatotoxicity (n = 3; t1/2 = 8,5 h; range: 3,6 - 8,7 h); and without hepatotoxicity (n = 18; t1/2 = 2,4 h; (range: 1,6 - 4,3 h). We observed an agreement between positive ratio and a t1/2 > 4 h, and negative ratio with t1/2 < 4 h, bearing in mind that the quotient is obtained through mathematical equations. Rumack's nomogram should be complemented with t1/2 estimation in all cases of paracetamol poisoning, especially with those patients for whom we are not able to determine the time of ingestion at presentation or if there has been a multiple-timepoint ingestion.
  Medicina Clínica 10/2007; 129(13):501-3. · 1.38 Impact Factor
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  Article: Valoración del riesgo de hepatotoxicidad en la intoxicación aguda por paracetamol cuando no es posible aplicar el nomograma de Rumack-Matthew

  J. Puiguriguer Ferrando, Bernardí Barceló Martín, Bartomeu Castanyer Puig, S. Nogué Xarau
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  ABSTRACT: The Rumack-Matthew nomogram is used to guide treatment with N-acetylcysteine (NAC) as an antidote for paracetamol intoxication, but this approach has limitations. The elimination half-life of paracetamol increases to over 4 hours in the presence of hepatic toxicity. The aim of this study is to describe the characteristics of a series of cases of paracetamol toxicity in which a nomogram could not be used; the patient&apos;s risk was assessed by means of the elimination half-life. Patients with paracetamol intoxication from a single or cumulative overdose who came to Hospital de Son Dureta de Palma de Mallorca and Hospital Clínic de Barcelona over a 5-year period (July 2005-July 2010) were included if the findings of at least 2 immunoassays for paracetamol concentration were available. Half-life was estimated by means of the ratio between 2 consecutive concentrations determined 2 hours apart. Of 11 patients with paracetamol intoxication for whom a Rumack-Matthew nomogram was not used, 3 had liver toxicity. Two of them were accidental intoxications caused by ingesting several doses of the drug. The third was an attempted suicide. In all cases, the elimination half-life exceeded 4 hours. We suggest that in cases of paracetamol intoxication the Rumack-Matthew nomogram be complemented by calculation of the elimination half-life, which will provide an indication of possible liver toxicity in these patients. This approach should be chosen at least when there are doubts about when paracetamol ingestion occurred or if intoxication is the result of several doses. El nomograma de Rumack se utiliza para indicar el tratamiento antidótico con N-acetil-cisteína (NAC) en la intoxicación por paracetamol (PCT), pero tiene varias limitaciones de uso. La semivida de eliminación (t1/2) del PCT se incrementa a más de cuatro horas en caso de hepatotoxicidad. El objetivo de este trabajo es describir las características de los pacientes intoxicados por PCT de una serie en los que la aplicación del nomograma de Rumack nunca fuera posible y valorar su riesgo de hepatotoxicidad a través de la estimación de la t1/2. Se incluyeron los pacientes con una sobredosificación o intoxicación por PCT que acudieron al Hospital de Son Dureta de Palma de Mallorca y al Hospital Clínic de Barcelona durante un periodo de 5 años (julio 2005-julio 2010) en los que se dispusiera de al menos 2 determinaciones de PCT. La estimación de la t1/2 se realizó mediante un cociente entre dos determinaciones consecutivas separadas por un intervalo de tiempo de 2 o más horas. De 11 pacientes intoxicados por PCT a los que no se les pudo aplicar el nomograma de Rumack, tres desarrollaron hepatotoxicidad, dos de ellos fueron intoxicaciones accidentales producidas por ingesta fraccionada del fármaco y el tercero una intoxicación con intencionalidad suicida. En todos ellos la estimación del cálculo de la t1/2 puso de manifiesto que era superior a 4 horas. Proponemos que se complemente al nomograma de Rumack con la estimación de la t1/2 en los casos de intoxicación por PCT, y que esta estimación de la t1/2 sea la que aporte la información sobre la posible hepatotoxicidad de la intoxicación. Esto debe hacerse al menos en los casos en que existan dudas o se desconozca el tiempo transcurrido de la ingesta, o la misma haya sido fraccionada.
  Emergencias: Revista de la Sociedad Española de Medicina de Urgencias y Emergencias, ISSN 1137-6821, Vol. 22, Nº. 5, 2010, pags. 365-368.