Development and optimization of an HPLC analysis of citalopram and its four nonchiral impurities using experimental design methodology.

In this study, the RP-HPLC method was investigated for the separation of citalopram and its four impurities by use of statistical experimental design. Initially, the influence of different experimental conditions (buffer pH, flow rate, and column temperature) on the chromatographic behavior of citalopram and its four impurities was investigated by use of partial least squares regression (PLSR) and multilayer perceptron (MLP) artificial neural networks (ANNs) trained by back-propagation. The developed models and the corresponding response surface plots were used to select the optimal HPLC conditions, buffer pH 7.0, flow rate 1.0 mL/ min, and column temperature 25 degrees C, for an efficient separation of citalopram and its four impurities. The elaborated HPLC method was found to be linear, specific, sensitive, precise, accurate, and robust. Retention times of citalopram and its impurities, obtained with the developed HPLC method, and the computed molecular parameters of the examined compounds were used in a quantitative structure retention relationship (QSRR) study. The PLSR and ANN algorithms were applied for the development of the QSRR methods. The MLP-two layers-ANN-QSRR model with root mean square error of prediction 0.105 and r(2) (observed versus predicted) 0.978 was selected. Since many different reaction conditions are applied for the synthesis of citalopram, different impurities and degradation products can be formed. Therefore, the developed QSRR model can be extended to the prediction of the retention times with the other citalopram impurities, degradation products, and metabolites.

Obstacles in the diagnostics and therapy of heparin-induced thrombocytopenia.

An immune-mediated, severe, acquired prothrombotic disorder, heparin-induced thrombocytopenia type II (HIT II) occurs in 0.5-5% of patients exposed to unfractionated heparin longer than 5-7 days. Arterial and venous thromboses are induced by HIT II in about 35-50% of patients. Typical death rate for HIT is about 29%, while 21% of HIT patients result in amputation of a limb. The trend towards the occurrence of HIT due to the administration of low molecular weight heparins (LMWH) taking ever conspicuous place in the standard venous thromboembolism (VTE) prophylaxis has been more frequently observed recently. It is considered that LMWH may cause HIT II in about 0.25-1%. The need for further modification of HIPA assays with LMWH has been imposed in the HIT laboratory diagnostics, heretofore overburdened with complexity. There are several constantly opposing problems arising in HIT laboratory diagnostics, one of which is that in a certain number of patients immunologic assays detect nonpathogenic antibodies (mainly IgM or IgA heparin-PF4 antibodies) while, on the other hand, the occurrence of HIT pathogenetically mediated by minor antigens (neutrophil-activating peptide 2 or interleukin 8) may be neglected in certain cases. The following factors play an important role in the interpretation of each laboratory HIT assays performed: 1. correlation with HIT clinical probability test, the best known of which is 4T'score, 2. the interpretation of the laboratory findings dependent on the time of the thrombocytopenia onset, as well as 3. the sensitivity and specificity of each test respectively. The HIT diagnostics in the presence of other comorbid states which may also induce thrombocytopenia, more precisely known as pseudo HIT (cancer, sepsis, disseminated intravascular coagulation, pulmonary embolism, antiphospholipid syndrome, etc), represents a specific clinical problem.