First Synthesis of Ergotamine-13CD3 and Ergotaminine-13CD3 from Unlabeled Ergotamine

Ergot alkaloids (EAs) formed by Claviceps fungi are one of the most common food contaminants worldwide, affecting cereals such as rye, wheat, and barley. To accurately determine the level of contamination and to monitor EAs maximum levels set by the European Union, the six most common EAs (so-called priority EAs) and their corresponding epimers are quantified using high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS). The quantification of EAs in complex food matrices without appropriate internal standards is challenging but currently carried out in the standard method EN 17425:2021 due to their commercial unavailability. To address the need for isotopically labeled EAs, we focus on two semi-synthetic approaches for the synthesis of these reference standards. Therefore, we investigate the feasibility of the N6-demethylation of native ergotamine to yield norergotamine, which can subsequently be remethylated with an isotopically labeled methylating reagent, such as iodomethane (13CD3-I), to yield isotopically labeled ergotamine and its C8-epimer ergotaminine. Testing the isotopically labeled ergotamine/-inine against native ergotamine/-inine with HPLC coupled to high-resolution HR-MS/MS proved the structure of ergotamine-13CD3 and ergotaminine-13CD3. Thus, for the first time, we can describe their synthesis from unlabeled, native ergotamine. Furthermore, this approach is promising as a universal way to synthesize other isotopically labeled EAs.

Cerebral Venous Thrombosis: A Challenging Diagnosis; A New Nonenhanced Computed Tomography Standardized Semi-Quantitative Method

Cerebral venous sinus thrombosis (CVST) on non-contrast CT (NCCT) is often challenging to detect. We retrospectively selected 41 children and 36 adults with confirmed CVST and two age-matched control groups with comparable initial symptoms. We evaluated NCCT placing four small circular ROIs in standardized regions of the cerebral dural venous system. The mean and maximum HU values were considered from each ROI, and the relative percentage variations were calculated (mean % variation and maximum % variation). We compared the highest measured value to the remaining three HU values through an ad-hoc formula based on the assumption that the thrombosed sinus has higher attenuation compared with the healthy sinuses. Percentage variations were employed to reflect how the attenuation of the thrombosed sinus deviates from the unaffected counterparts. The attenuation of the affected sinus was increased in patients with CVST, and consequently both the mean % and maximum % variations were increased. A mean % variation value of 12.97 and a maximum % variation value of 10.14 were found to be useful to distinguish patients with CVST from healthy subjects, with high sensitivity and specificity. Increased densitometric values were present in the site of venous thrombosis. A systematic, blind evaluation of the brain venous system can assist radiologists in identifying patients who need or do not need further imaging.

A review of ASTM D7979 for the analysis of per- and polyfluorinated alkyl substances in non-potable water by co-solvation with methanol and using liquid chromatography-tandem mass spectrometry

Per- and polyfluorinated alkyl substances are large class of man-made compounds known in the media as "forever chemicals". In 2015, ASTM International published ASTM D7979, for the analysis of per- and polyfluorinated alkyl substances in non-potable water samples. This method extracts the substances by co-solvation with methanol and measures targeted compounds using liquid chromatography-tandem mass spectrometry. ASTM D7979 is a performance-based method that analyzes 31 compounds plus 14 isotopically labeled surrogates. The minimum reporting limit is approximately 10 ng/L with an analytical range of 10-200 ng/L for most compounds. Expected recovery of surrogates and spiked matrices is 70-130%. Samples containing high suspended solids can be analyzed with minimal interferences and potential loss of analyte. The method is consistent with ASTM and EPA's sustainable development goals by using reduced volumes of sample, solvent, and minimizing hazardous solvents and sample preparation materials while maintaining data quality and detection limits that are suitable for the intended use. This paper covers the rationale, outlines some of the challenges associated with analysis of per- and polyfluorinated alkyl substances, and describes the steps taken by the ASTM Committee D19 task group to develop, optimize, and validate this method.

Individual Burden of Psoriasis (I-BOP): Building and Validation of a New Scoring Tool for Patients with Psoriasis

Background

Psoriasis impacts independently of its severity on patients’ lifestyle and quality of life (QoL).

Aim

To build a tool for assessing the patient-reported psoriasis burden.

Methods

An expert group created a questionnaire using a standardized methodology building questionnaires assessing quality of life issues. The questionnaire was translated from French into a cultural and linguistically validated US English version.

Results

A conceptual questionnaire of 54 questions was created. The confirmatory analyses resulted in a 10-feature questionnaire divided into 4 internally consistent domains with a Cronbach’s alpha coefficient of 0.9. It was reproducible and highly reliable. It correlated well with the Dermatology Life Quality Index (DLQI), Perceived Stress Scale (PSS), and SF-12 mental and SF12 physical scores.

Conclusion

This tool allows for the first time to assess the burden of psoriasis patients. Its use may allow improving medical and nonmedical patient care, thus improving their daily life.

[Total laparoscopic hysterectomy with the coagulation of the uterine arteries at their origin]

INTRODUCTION

Hysterectomy is one of the most frequently performed gynecological operations worldwide. Due to patient perceived advantages of technical development laparoscopic hysterectomy has become a widely used method. The attitude of patients, surgeons and service providers to laparoscopic procedures is not uniform, but total laparoscopic hysterectomy has prevailed due to its advantages from other types of laparoscopic hysterectomies. Coagulation of the uterine arteries at their origin during the standardized method of total laparoscopic hysterectomy provides further benefits for this procedure.

AIM

Our aim was the presentation of our experience together with a review of the relevant literature.

METHOD

Operations were performed with the coagulation of the uterine arteries at their origin right at the beginning of the procedure. Inclusion criteria were the use of the standardized method, video documentation of the surgery, and pre- and postoperative haemostatus results.

RESULTS

Our results confirm that the procedure involves an acceptable operating time that is comparable to that of open abdominal and vaginal hysterectomies, minimal blood loss that is far less than that in open procedures, a much shorter duration of hospitalization and a low complication rate.

CONCLUSION

In skilled hands with proper knowledge of the anatomy the standardized method of total laparoscopic hysterectomy with the coagulation of the uterine arteries at their origin is a safe and reproducible technique which suitably utilizes the advantages of minimally invasive surgery. Orv. Hetil., 2017, 158(8), 298-303.