RESUMEN
Collective sex venues such as sex clubs are strategic sites to promote sexual health among sexual and gender minority individuals. We present qualitative findings from a multiple-method study on the acceptability of sexual-health services at collective sex venues in New York City (NYC) among attendees who identified as men, transgender, or gender non-conforming. In a survey used for sample selection (n = 342), most respondents (82.7%) agreed that "having outreach workers at sex venues is a good thing." Interviewees (n = 30) appreciated how on-site services could promote sexual health in their community. They felt peer workers should be familiar with collective sex venues and share demographic characteristics with attendees. Some participants felt workers should keep some boundaries from attendees, while others felt they could be fully integrated in the environment, suggesting that either peer outreach or popular-opinion leader types of interventions could be feasible.
Asunto(s)
Infecciones por VIH , Minorías Sexuales y de Género , Infecciones por VIH/prevención & control , Servicios de Salud , Homosexualidad Masculina , Humanos , Masculino , Ciudad de Nueva York , Conducta SexualRESUMEN
BACKGROUND: High-resolution mass spectrometry (HRMS) has the potential to supplement other drug screening platforms used in toxicology laboratories. HRMS offers high analytical specificity, which can be further enhanced by incorporating a fragment ion for each analyte. The ability to obtain precursor ions and fragment ions using elevated collision energies (MS(E)) can help improve the specificity of HRMS methods. METHODS: We developed a broad-spectrum screening method on an ultraperformance liquid chromatography TOF mass spectrometer (UPLC-TOF-MS) using the MS(E) mode. A diverse set of patient samples were subjected to a simple dilute, hydrolyze, and shoot protocol and analyzed in a blind manner. Data were processed with 3 sets of criteria with increasing stringency, and the results were compared with the reference laboratory results. RESULTS: A combination of retention time match (±0.2 min), a protonated analyte, and fragment ion mass accuracy of ±5 ppm produced zero false-positive results. Using these criteria, we confirmed 92% (253/275) of true positives. The positive confirmation rate increased to 98% (270/275) when the requirement for a fragment ion was dropped, but also produced 53 false positives. A total of 136 additional positive drug findings not identified by the reference methods were identified with the UPLC-TOF-MS. CONCLUSIONS: MS(E) provides a unique way to incorporate fragment ion information without the need of precursor ion selection. A primary limitation of requiring a fragment ion for positive identification was that certain drug classes required high-energy collisions, which formed many fragment ions of low abundance that were not readily detected.
Asunto(s)
Cromatografía Liquida/métodos , Monitoreo de Drogas/métodos , Espectrometría de Masas/métodos , Voluntarios Sanos , Humanos , Límite de DetecciónRESUMEN
The presented case highlights a rare instance of relapsing polychondritis (RP) manifesting as seronegative limbic encephalitis, an uncommon neurological complication. A 70-year-old female patient with a history of RP-related inflammation, along with neuropsychiatric symptoms, was diagnosed through multidisciplinary collaboration. Swift administration of steroid therapy, followed by azathioprine, led to remarkable physical and cognitive recovery. This case emphasises the importance of a multidisciplinary approach in diagnosing and treating complex autoimmune disorders with neurological manifestations.
Asunto(s)
Encefalitis Límbica , Policondritis Recurrente , Femenino , Humanos , Anciano , Encefalitis Límbica/etiología , Encefalitis Límbica/complicaciones , Policondritis Recurrente/complicaciones , Policondritis Recurrente/diagnóstico , AzatioprinaRESUMEN
During the reproducibility validation for a time-of-flight (TOF) high-resolution mass spectrometry (HRMS) method set up to detect 61 drugs of abuse commonly encountered in the toxicology laboratory, it was noticed that, a number of compounds were not identified correctly during the between run analysis; the most difficult compounds to identify were norpropoxyphene, morphine, norbuprenorphine, nortriptyline, EDDP and tramadol. In subsequent patient comparison studies, screening a panel of 338 analytes, the TOF-HRMS method correctly identified 211 analytes over two runs, but did not identify 127. A total of 11 false positive results were identified by manual review of the data to be the result of confirmation ion signal-to-noise ratio(s)â¯<â¯3, although one false positive that was difficult to resolve (i.e., identification of maprotiline as amitriptyline) was due to similar fragment ions and retention times. The TOF-HRMS method showed reasonable agreement with LC-MS/MS results, but there were a number of discrepant results. Additionally, the TOF-HRMS did detect five compounds missed by the LC-MS/MS methods. This extensive validation effort highlights the difficulty of analysis for certain compounds that are likely to require additional follow up prior to reporting a positive result, especially at low and high concentrations, regardless of the type of instrumentation involved.