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Comparative binding energy analysis of HIV-1 protease inhibitors: incorporation of solvent effects and validation as a powerful tool in receptor-based drug design.

A comparative binding energy (COMBINE) analysis (Ortiz et al. J. Med. Chem. 1995, 38, 2681-2691) has been performed on a training set of 33 HIV-1 protease inhibitors, and the resulting regression models have been validated using an additional external set of 16 inhibitors. This data set was originally reported by Holloway et al. (J. Med. Chem. 1995, 38, 305-317), who showed the usefulness of molecular mechanics interaction energies for predicting the activity of novel HIV-1 protease inhibitors within the framework of the MM2X force field and linear regression techniques. We first used the AMBER force field on the same set of three-dimensional structures to check up on any possible force-field dependencies. In agreement with the previous findings, the calculated raw ligand-receptor interaction energies were highly correlated with the inhibitory activities (r2 = 0.81), and the linear regression model relating both magnitudes had an acceptable predictive ability both in internal validation tests (q2 = 0.79, SDEPcv = 0.61) and when applied to the external set of 16 different inhibitors (SDEPex = 1.08). When the interaction energies were further analyzed using the COMBINE formalism, the resulting PLS model showed improved fitting properties (r2 = 0.89) and provided better estimations for the activity of the compounds in the external data set (SDEPex = 0.83). Computation of the electrostatic part of the ligand-receptor interactions by numerically solving the Poisson-Boltzmann equation did not improve the quality of the linear regression model. On the contrary, incorporation of the solvent-screened residue-based electrostatic interactions and two additional descriptors representing the electrostatic energy contributions to the partial desolvation of both the ligands and the receptor resulted in a COMBINE model that achieved a remarkable predictive ability, as assessed by both internal (q2 = 0.73, SDEPcv = 0.69) and external validation tests (SDEPex = 0.59). Finally, when all the inhibitors studied were merged into a single expanded set, a new model was obtained that explained 91% of the variance in biological activity (r2 = 0.91), with very high predictive ability (q2 = 0.81, SDEPcv = 0.66). In addition, the COMBINE analysis provided valuable information about the relative importance of the contributions to the activity of individual residues that can be fruitfully used to design better inhibitors. All in all, COMBINE analysis is validated as a powerful methodology for predicting binding affinities and pharmacological activities of congeneric ligands that bind to a common receptor.

Drug Design↗

External dynamic fixation in fractures of the humerus: can it still be considered treatment of second choice?

The authors report 40 patients affected with diaphyseal fracture of the humerus treated by dynamic axial fixator (FAD Orthofix). Minimum follow-up was 2 years. A clinical and radiographic retrospective study was conducted with the purpose of verifying the validity of external fixation as treatment of choice in diaphyseal fractures of the humerus. The results were evaluated considering healing time, extent and type of complications, long-term clinical, radiographic and functional findings. Results were: excellent: 35; good: 2; fair: 2; poor: 1. Complications were: nonunione: 1; reimplantation of FAD screws: 1; 4 infections of the screw holes, 3 realignments due to secondary displacement, 1 re-fracture after removal of the implant. There were no iatrogenic lesions of the radial nerve, or infections of the fracture site. The authors conclude that this semi-invasive, versatile and well-tolerated method, may be considered a valid alternative to conservative treatment, or to internal fixation even in cases of single trauma, despite limits related to the degree of collaboration of the patient, particularly with regard to debridement of the screw holes and periodical clinical and radiographic monitoring.

Adolescent↗

Validity and reliability of the classroom participation questionnaire with deaf and hard of hearing students in public schools.

The Classroom Participation Questionnaire (CPQ) was administered to 136 deaf or hard of hearing (D/HH) students attending general education classrooms in Grades 4-10. The CPQ is a student-rated measure that yields scores for Understanding Teachers, Understanding Students, Positive Affect, and Negative Affect. Validity and reliability of a long (28-item) and a short (16-item) form are reported. We provide evidence of (a) internal structure validity through an examination of the relationships between the subscales and an analysis of interitem reliability within each scale, (b) reliability over time by examining the scores of students over a 3-year period, and (c) external structure validity through an examination of the relationships of the CPQ with measures of teacher-rated academic competence and Stanford achievement scores. The results suggest that both the long and short form of the CPQ can be used to assess participation of D/HH students in general education classrooms.

Adolescent↗

Polygenic risk scores associate with asthma phenotypes and proteomic analyses implicate IL1R1 in two family-based studies.

Despite its high prevalence and the discovery of hundreds of genetic associations, the genetic determinants and heterogeneous manifestations of asthma remain incompletely understood. Incorporating polygenic risk scores (PRS) into asthma research offers a powerful approach to quantify inherited susceptibility, refine risk profiles, and advance mechanistic understanding of disease development. For this study, we leveraged whole-genome sequencing (WGS) data from two family-based cohorts of childhood asthma - the Genetics of Asthma in Costa Rica Study (GACRS) and the Childhood Asthma Management Program (CAMP) - to examine the transmission profiles of externally derived asthma PRS and their associations with clinical phenotypes in children with asthma. To further elucidate molecular mechanisms, we integrated large-scale external genome-wide association study (GWAS) summary statistics and genetic prediction models of protein abundance in a two-step proteome-wide association study (PWAS) of asthma. Our findings provide robust evidence supporting the validity of externally derived asthma PRS (asthma PRS association p-value p = 10-24 [GACRS and CAMP trios combined] for the Global Biobank Meta-analysis Initiative [GBMI]) and reveal consistent associations with spirometry measures and atopy markers across both studies, as 13 of 21 traits (62%) were significantly associated with the GBMI-PRS in the meta-analysis after multiple-testing correction. Moreover, the results of the integrative proteomic analysis implicate IL-1 signaling in the etiology of asthma, reinforcing the candidacy of IL1R1 antagonists for drug repurposing.

Journal Article↗

Validation of the CORE Diabetes Model against epidemiological and clinical studies.

OBJECTIVES: The aim of this study was to assess the validity of the CORE Diabetes Model by comparing results from model simulations with observed outcomes from published epidemiological and clinical studies in type 1 and type 2 diabetes. METHODS: A total of 66 second- (internal) and third- (external) order validation analyses were performed across a range of complications and outcomes simulated by the CORE Diabetes Model (amputation, cataract, hypoglycaemia, ketoacidosis, macular oedema, myocardial infarction, nephropathy, neuropathy, retinopathy, stroke and mortality). Published studies were reproduced in the model by recreating cohorts in terms of demographics, baseline risk factors and complications, treatment patterns and patient management strategies, and simulating the progress of the cohort to an equivalent time horizon. RESULTS: Correlation analysis on results from 66 validation simulations produced an R2 value of 0.9224 (perfect fit = 1). A correlation plot of published study data versus values simulated by the CORE Diabetes Model had a trend line with a gradient of 1.0187 (perfect fit = 1). Validation analyses in type 1 and type 2 diabetes were associated with R2 values of 0.9778 and 0.8861 respectively. Correlation of second-order validation analyses (model predictions versus observed outcomes in studies used to construct the model) produced an R2 value of 0.9574, and the value for third-order analyses (model predictions versus observed outcomes in studies not used to construct the model) was 0.9023. CONCLUSIONS: The CORE Diabetes Model provides an accurate representation of patient outcomes when compared to 66 studies of diabetes and its complications. Model flexibility ensures it can be used to compare diabetes management strategies in different cohorts across a variety of clinical settings.

Computer Simulation↗

Validation of the French version of the Dallas Pain Questionnaire in chronic low back pain patients.

OBJECTIVES: To translate and to validate the metrological properties of the Dallas Pain Questionnaire, an instrument designed to evaluate the impact of low back pain on four aspects of patients' lives: daily activities, work and leisure activities, anxiety/depression and social interest. METHODS: The Dallas Pain Questionnaire, originally in English, was translated into French. The metrological properties of the French version were investigated in a cohort of 59 patients with chronic low back pain due to degenerative disk disease. Duration of the pain was between three and 24 months. Treatment consisted of nonsteroidal antiinflammatory drugs and/or analgesics, local corticosteroid injections and a plaster lumbar corset. Patients were evaluated at baseline, after ten days (under the same treatment), and at completion of the treatment. RESULTS: Results were reproducible for all four areas of the questionnaire (CCI > 0.75). Internal structural validity was satisfactory for the four areas (Cronbach alpha test = 0.89 to 0.91). At baseline, the pain score on a visual analog scale was significantly correlated with the Dallas scores for daily activities, anxiety/depression and social interest (external structural validity). The daily activities, work/leisure and anxiety/depression scores were sensitive to change (P < 0.001, P < 0.001, and P = 0.003, respectively), whereas the social interest score was not (P = 0.11). CONCLUSION: The French version of the Dallas Pain Questionnaire is valid, reproducible, and sensitive to change in chronic low back pain patients.

Activities of Daily Living↗

External jugular vein cutdown approach, as a useful alternative, supports the choice of the cephalic vein for totally implantable access device placement.

BACKGROUND: Cephalic vein (CV) cut down for totally implantable venous access device (TIVAD) placement has been accepted as an alternative to the percutaneous subclavian vein approach. The aim of this retrospective study was to validate the external jugular vein (EJV) cut-down approach when the CV is not feasible. METHODS: Patients receiving a TIVAD from January 1995 to December 2003 were included in this study. Age, sex, surgical technique, disease, device used, length of the procedure, and morbidity were considered. RESULTS: A total of 427 TIVADs were placed in 425 patients: 253 men (59.5%) and 172 women (40.5%) aged 31 to 79 years. Of 425 patients, 5 were excluded; 420 underwent a CV cut down on the first attempt, and 391 (93.1%) procedures were successful. Among the final 29 patients, 20 (68.96%) underwent a TIVAD placement through the ipsilateral EJV cut-down approach. In the remaining nine patients (31.04%), TIVAD placement was performed through the ipsilateral internal jugular vein in four cases, via the ipsilateral axillary vein in three cases, and through the ipsilateral coracobrachial vein in the other cases. No immediate postoperative complications were detected in any of the patients. CONCLUSIONS: TIVAD placement by the CV cut-down approach is safe and fast, and its success rate is very high. By avoiding the immediate complications associated with the percutaneous approach, the EJV cut down has to be considered a valid, safe, and suitable alternative when the CV is not feasible.

Adult↗

[Development and psychometric testing of a patient questionnaire for medical rehabilitation (IRES-3)].

BACKGROUND: Re-analyses of extensive datasets as well as theoretical considerations have led to the conclusion that the patient questionnaire "Indicators of Rehabilitation Status" (IRES) should be revised in several respects. The new version IRES-3 was developed on the basis of a theoretical model of rehabilitation following the ICF (International Classification of Functioning, Disability and Health) as well as of elements of the earlier version IRES-2. In addition, we included the results of expert panels on the definition of treatment goals in medical rehabilitation. METHODS: The IRES-3 was tested in 453 patients in rehabilitation clinics of seven diagnostic areas. To compare the IRES-3 with other generic instruments, the SF-36 and the HADS were employed at the same time. For purposes of cross-validation, an external sample could be used. The dimensional structure was tested in confirmatory factor analyses. RESULTS: With rare exceptions, the tests showed good values for item difficulties, ceiling and floor effects, internal consistencies and test-retest-reliability. Convergent validity could be established for the IRES-3 when compared to relevant scales of the SF-36 and the HADS. Indices of sensitivity to change were comparable, if not somewhat superior to the effects on comparable scales of the SF-36. The assessment of the construct validity and the dimensional structure of the questionnaire led to the definition of eight dimensions which can be interpreted as somatic, emotional, functional, occupational, social, pain, coping, as well as health information and behaviour. The dimensional structure of the IRES-3 can be regarded as theoretically meaningful as well as empirically proven. STANDARDIZATION: For purposes of standardization, data were collected on a sample representative of the population aged 30-75 years in Germany. These data allow a norm-oriented interpretation of scales and dimensions of the IRES-3 for patients in rehabilitation. APPLICATION: The questionnaire is ready for application, including a computer programme for data entry and analysis.

Activities of Daily Living↗

Reliability and validity of a modified gait scoring system and its use in assessing tibial dyschondroplasia in broilers.

1. The gait scoring system for broilers developed by Kestin et al. (Veterinary Record, 131: 190-194, 1992) has been widely used to evaluate leg problems. The many factors and measures associated with this scale have empirically established its external (biological) validity. However, published test-retest (within-observer) reliabilities are poor, and inter-observer reliabilities are unknown. We evaluated several modifications to this scale aimed at improving its objectivity and reliability. 2. Eighteen naïve observers scored a standardised video of birds exhibiting varying degrees of lameness, either using Kestin et al.'s system, or our modified system. 3. Test-retest reliability (0.906) for Kestin et al.'s system was higher than previously reported. Inter-rater reliability was also good (0.892). The modified system offered significantly better test-retest (0.948) and inter-rater reliabilities (0.943), without incurring costs in terms of time taken or difficulty of use. The systems were consistent, assigning individual birds the same score on average. 4. It is concluded that the modified system offers the advantages of reduced error within and between studies. 5. In a second experiment, we used our modified scoring system to examine the relationship between tibial dyschondroplasia (TD) and gait score in 267 selected broilers. 6. Neither the presence nor severity of TD affected gait score, suggesting that, at least in this strain of broilers, other leg problems like slipped tendons or torsional deformities had more influence on gait impairment than did TD.

Animals↗

Classification of obsessive-compulsive disorder in childhood and adolescence.

OBJECTIVE: In child and adolescent psychiatry the validation of the diagnosis must be seen in the context of development. Comparing different diagnostic formulations DSM-IV and ICD-10-DCR in a clinical sample of children and adolescents suffering from obsessive-compulsive disorder (OCD) and their validation on external criteria represent such a heuristic approach. METHOD: We investigated 61 children seen consecutively in a specialized out-patient clinic for OCD. All of them were assessed by the International Diagnostic Checklists (IDCL). Diagnosis and diagnostic certainty were validated regarding age, age of onset and duration of illness. RESULTS: The agreement between the two diagnostic systems was low. The diagnostic stability of ICD-10-DCR was highly dependent on age, whereas that of the criteria DSM-IV did not depend on age and almost all subjects could be diagnosed definitely. CONCLUSION: This study suggests that the DSM-IV criteria are superior to that of ICD-10-DCR for diagnosing OCD in children and younger adolescents.

Adolescent↗

Strength and power assessment. Issues, controversies and challenges.

Athletic strength and power refer to the forces or torques generated during sporting activity. Their assessment can be used for strength diagnosis or talent identification, to monitor the effects of training interventions and to estimate the relative significance of strength and power to particular athletic pursuits. However, strength and power assessment is a difficult task. Reasons for this include: the fledgling status of research within the area, our limited understanding of the mechanisms underpinning strength and power performance and development, and limitations associated with various forms of dynamometry. This article describes a frame work for the collection of data which may ultimately lead to recommendations for the assessment of strength and power in sporting contexts. Such a framework will be evolutionary and depends upon synergistic improvements in our understanding of: the physiological mechanisms underpinning strength and power development; the effect that various training regimens have upon the development of strength and power; and factors influencing the validity and reliability of dynamometry. Currently, isometric, isoinertial and isokinetic dynamometry are employed in assessment. Each form has its supporters and detractors. Basically, proponents and critics of isokinetic and isometric dynamometry emphasis their apparently high internal and apparently low external [corrected] validity respectively. While the converse applies for isoinertial dynamometry. It appears that all 3 modalities can have acceptable reliability, however this should be established rather than assumed, as the reliability of each can be threatened by a number of considerations (e.g. instruction for isometric tasks, the impact of weight used during weighted jumping tasks, and the effects of gravity and feedback on isokinetic performance). While reliability is a seminal issue in assessment, it is not the only critical issue. Specifically, there has been little research into the correlation between strength and power measures and athletic performance. This work is central to the use of such indices in talent identification. To date, this work has generally been limited to heterogeneous rather than homogeneous groups. More work is required in this area. Furthermore, not all modes of assessment are sensitive or similarly sensitive to various training interventions. This suggests that these modalities are measuring different neuromuscular qualities. How these qualities relate to performance requires more work, and will determine the contexts in which various strength and power assessment modalities and protocols are used.(ABSTRACT TRUNCATED AT 400 WORDS)

Biomechanical Phenomena↗

Construct validity of the Diagnostic Inventory of Personality and Symptoms: external correlates.

This study extended knowledge of the construct validity of Vincent's Diagnostic Inventory of Personality and Symptoms (DIPS) by examining the relationships between the DIPS and the MMPI, the Millon Clinical Multiaxial Inventory, the Profile of Mood States, the Symptom Check List-90, and the California Psychological Inventory. Subjects were 300 predominantly male psychiatric inpatients. Correlational analyses revealed that the DIPS clinical scales were related most strongly to MMPI and MCMI clinical scales. Eleven of 14 DIPS clinical scales showed clinically significant correlations with similar scales of the external measures. The validities of the Stress-Adjustment Disorders and Psychological Factors Affecting Physical Condition scales were not ascertained directly.

Adult↗

Reliability and validity of the Japanese version of the Support Team Assessment Schedule (STAS-J).

OBJECTIVE: The aim of this project was to develop an appropriate and valid instrument for assessment by medical professionals in Japanese palliative care settings. METHODS: We developed a Japanese version of the Support Team Assessment Schedule (STAS-J), using a back translation method, and tested its reliability and validity. In the reliability study, 16 nurses and a physician who work in a palliative care unit evaluated 10 hypothetical cases twice at 3-month intervals. For the validity study, external researchers interviewed 50 patients with matignancy and their families and compared the results with ratings by the nurses in the palliative care unit. RESULTS: Our results with hypothetical cases were: interrater reliability weighted kappa = 0.53-0.77 and intrarater reliability weighted kappa = 0.64-0.85. In the validity study comparing nurse evaluations and the results of interviews with patients and families, complete agreement was 36-70%, and close agreement (+/-1) was 74-100%. As a whole, weighted kappa were low: between -0.07 and 0.51. Our results were similar to those in the United Kingdom and Canada. SIGNIFICANCE OF RESULTS: Although this research was conducted under methodologically limited conditions, we concluded that the STAS-J is a reliable tool and its validity is acceptable. The STAS-J should become a valuable tool, not only for daily clinical use, but also for research.

Adult↗

Concurrent and predictive validity of the psychopathy checklist: youth version across gender and ethnicity.

The concurrent and predictive validity of the Psychopathy Checklist: Youth Version (PCL:YV) were examined across gender and ethnicity using multiple outcome measures on a community-based sample of 130 adjudicated youths. The PCL:YV demonstrated concurrent validity with externalizing behavior problems but, it is important to note, was also associated with internalizing measures of negative affect. With a mean follow-up period of 3 years, the PCL:YV was found to predict general and violent recidivism in male, Native Canadian, and Caucasian youths. However, the PCL:YV demonstrated weaker concurrent and predictive validity with girls and failed to predict nonviolent recidivism in all subgroups. Implications of the findings for clinical practice are discussed.

Adolescent↗

Patient-assessed health outcome measures for diabetes: a structured review.

AIMS: To identify available disease-specific measures of health-related quality of life (HRQL) for diabetes and to review evidence for the reliability, validity and responsiveness of instruments. METHODS: Systematic searches were used to identify instruments. Instruments were assessed against predefined inclusion and exclusion criteria. Letters were sent to authors requesting details of further instrument evaluation. Information relating to instrument content, patients, reliability, validity and responsiveness to change was extracted from published papers. RESULTS: The search produced 252 references. Nine instruments met the inclusion criteria: Appraisal of Diabetes Scale (ADS), Audit of Diabetes-Dependent Quality of Life (ADDQoL), Diabetes Health Profile (DHP-1, DHP-18), Diabetes Impact Measurement Scales (DIMS), Diabetes Quality of Life Measure (DQOL), Diabetes-Specific Quality of Life Scale (DSQOLS), Questionnaire on Stress in Diabetic Patients-Revised (QSD-R), Diabetes-39 (D-39) and Well-being Enquiry for Diabetics (WED). The shortest instrument (ADS) has seven items and the longest (WED) has 50 items. The ADS and ADDQoL are single-index measures. The seven multidimensional instruments have dimensions covering psychological well-being and social functioning but vary in the remainder of their content. The DHP-1 and DSQOLS are specific to Type 1 diabetes patients. The DHP-18 is specific to Type 2 diabetes patients. The DIMS and DQOL have weaker evidence for reliability and internal construct validity. Patients contributed to the content of the ADDQoL, DHP-1/18, DQOL, DSQOLS, D-39, QSD-R and WED. The authors of the ADDQoL, DHP-1/18, DQOL, DSQOLS gave explicit consideration to content validity. The construct validity of instruments was assessed through comparisons with instruments measuring related constructs and clinical and sociodemographic variables. None of the instruments has been formally assessed for responsiveness to changes in health. CONCLUSIONS: Five of the diabetes-specific instruments have good evidence for reliability and internal and external construct validity: the ADDQoL, DHP-1/18, DSQOLS, D-39 and QSD-R. Instrument content should be assessed for relevance before application. The instruments should be evaluated concurrently for validity and responsiveness to important changes in health.

Diabetes Mellitus↗

Association of MPO Expression with the Immune Microenvironment in Breast Cancer: Insights from Bioinformatics and Single-Cell Analyses.

Breast cancer remains a major cause of cancer-related mortality, and exploratory computational workflows can help prioritize immune-associated markers for further investigation. Here, we used the cancer genome atlas breast invasive carcinoma (TCGA-BRCA) bulk transcriptomic data and the public single-cell dataset GSE161529 to examine associations between myeloperoxidase (MPO) expression, clinical outcomes, immune infiltration, methylation, upstream-regulator annotations, single-cell expression patterns, virtual knockdown sensitivity outputs, drug-gene interaction retrieval, and absorption, distribution, metabolism, excretion, and toxicity (ADMET) annotation. MPO expression was lower in breast cancer tissues than in adjacent non-tumor tissues. Higher MPO expression was associated with a longer progression-free interval, whereas its associations with overall survival and disease-specific survival were not statistically significant. Receiver operating characteristic (ROC) analysis suggested tumor-normal separation within the analyzed public dataset, but this should not be interpreted as clinical diagnostic validation. Immune deconvolution and enrichment analyses indicated that MPO expression mainly tracked with immune- and myeloid-related transcriptional features, rather than establishing tumor-intrinsic regulation of the immune microenvironment. At single-cell resolution, the MPO signal was sparse, with only 85 MPO-positive cells detected before k-nearest neighbor (KNN)-based neighborhood expansion. Detectable MPO signal and MPO-associated scores were interpreted cautiously because they may be influenced by sparse expression, cell-type annotation uncertainty, dropout, doublets, or ambient RNA. In silico virtual knockdown suggested candidate immune- and inflammatory-related transcriptional changes, but these results were considered exploratory and require validation. Drug-gene interaction database (DGIdb)-based drug-gene retrieval and ADMET annotation were used only as preliminary chemical annotations and were not interpreted as therapeutic evidence. Overall, this study provides a reproducible in silico workflow for generating hypotheses about MPO-associated immune/myeloid features in breast cancer, which require external cohort validation and experimental confirmation.

Humans↗

Unfolding of titin domains studied by molecular dynamics simulations.

Titin, a approximately 1 micron long protein found in striated muscle myofibrils, possesses unique elastic properties. The extensible behavior of titin has been demonstrated in atomic force microscopy and optical tweezer experiments to involve the reversible unfolding of individual immunoglobulin-like (Ig) domains. We have used steered molecular dynamics (SMD), a novel computer simulation method, to investigate the mechanical response of single titin Ig domains upon stress. Simulations of stretching Ig domains I1 and I27 have been performed in a solvent of explicit water molecules. The SMD approach provides a detailed structural and dynamic description of how Ig domains react to external forces. Validation of SMD results includes both qualitative and quantitative agreement with AFM recordings. Furthermore, combining SMD with single molecule experimental data leads to a comprehensive understanding of Ig domains' mechanical properties. A set of backbone hydrogen bonds that link the domains' terminal beta-strands play a key role in the mechanical resistance to external forces. Slight differences in architecture permit a mechanical unfolding intermediate for I27, but not for I1. Refolding simulations of I27 demonstrate a locking mechanism.

Amino Acid Sequence↗

Analysis of eighteen antidepressants, four atypical antipsychotics and active metabolites in serum by liquid chromatography: a simple tool for therapeutic drug monitoring.

Therapeutic drug monitoring necessitates efficient, fast and reliable analytical methods validated by external quality control. We therefore devised an isocratic reversed-phase HPLC method with ultraviolet detection and optimised this to quantify mirtazapine, reboxetine, moclobemide, venlafaxine, O-desmethylvenlafaxine, paroxetine, fluvoxamine, fluoxetine, norfluoxetine, sertraline, citalopram, amitriptyline, nortriptyline, imipramine, desipramine, doxepin, nordoxepin, clomipramine, norclomipramine, trimipramine, mianserine, maprotiline, normaprotiline, amisulpride, clozapine, norclozapine, quetiapine, risperidone and 9-OH-risperidone in human serum. After solid-phase extraction of the drugs and metabolites, the chromatographic separation was achieved on a Nucleosil 100-Protect 1 column with acetonitrile-potassium dihydrogenphosphate buffer as mobile phase. The method was validated for therapeutic and toxic serum ranges. A linear relationship (r>0.998) was obtained between the concentration and the detector signal. Recoveries were between 75 and 99% for the drugs and metabolites. The accuracy of the quality control samples, expressed as percent recovery, ranged from 91 to 118%; intra- and inter-assay-relative standard deviations were 0.9-10.2% and 0.9-9.7%, respectively. Additional external quality control is carried out since 3 years. This method is applicable to rapidly and effectively analyze serum or plasma samples for therapeutic drug monitoring of about 30 antidepressants and atypical antipsychotics.

Antidepressive Agents↗