Manual & exercise therapy for treatment of chronic abdominal pain and diarrhea, a case report.

A 34-year-old male with a 9+ year history of right sided abdominal pain, associated diarrhea and a diagnosis of irritable bowel syndrome was referred for physical therapy and chiropractic care at a multidisciplinary primary care clinic. Multiple evaluations by various providers resulted in multiple tests and numerous medications without substantial relief in symptoms. Five physical therapy visits and three sessions of chiropractic care resulted in 90% improvement in subjective pain report and 60-70% reduction in diarrhea frequency. At a 6 month follow up phone visit, his symptoms had continued to decrease. While limited as a case study, this report may illustrate a potential somatovisceral relationship and subsequent reduction in gastrointestinal symptoms that can be addressed with conservative care.

Evaluating the use of tricationic reagents for the detection of doubly charged anions in the positive mode by ESI-MS.

The analysis of anions remains an important task for many areas of science, and new sensitive analytical methods continue to be of great interest. In this study, we present the use of 17 tricationic reagents for use as gas-phase ion pairing agents for divalent anions. When the anion pairs with the tricationic reagent, an overall positive charge is retained and enables detection by ESI-MS in the positive mode. The 17 tricationic reagents were made from 1 of 4 core structures and 7 terminal charged groups. The effect of these structural elements on the detection sensitivity of the complex is examined empirically. A comparison of signal-to-noise ratios achieved in positive and negative modes also is presented.

Evaluation of dicationic reagents for their use in detection of anions using positive ion mode ESI-MS via gas phase ion association.

Twenty-three different dications were investigated for their effectiveness in pairing with singly charged anions, thereby allowing the electrospray ionization mass spectrometry (ESI-MS) detection of anions as positively charged complexes. Nitrate, iodide, cyanate, monochloroacetate, benzenesulfonate, and perfluoro-octanoate were chosen as representative test anions as they differ in mass, size-to-charge ratio, chaotropic nature, and overall complexity. Detection limits were found using direct injection of the anion into a carrier liquid containing the dication. Detection limits are given for all six anions with each of the 23 dications. Each anion was easily detected at the ppb (microg/L) and often the ppt (ng/L) levels using certain dicationic reagents. The ability of dicationic reagents to pair with anions and produce ESI-MS signals varied tremendously. Indeed, only a few dications can be considered broadly useful and able to produce sensitive results. Liquid chromatography (LC)-ESI-MS also was investigated and used to show how varying the dicationic reagent produced significantly different peak intensities. Also, the use of tandem mass spectrometry can lead to even greater sensitivity when using imidazolium based dications.

A general, positive ion mode ESI-MS approach for the analysis of singly charged inorganic and organic anions using a dicationic reagent.

Anion analysis continues to be of great importance to many scientific and technical fields. We propose here a general and sensitive method of detecting singly charged anions by ESI-MS and LC-ESI-MS as positive ions. This method utilizes a dicationic reagent to form a complex with the anion that retains an overall positive charge for analysis by MS. Nitrate, thiocyanate, perchlorate, perfluorooctanoic acid (PFOA), halogenated acetic acids, and various other inorganic and organic anions and are investigated. The use of tandem mass spectrometry to enhance the detection limits of some of the anions is demonstrated. Chaotropic anions provided the lowest detection limits, with PFOA detected at the hundreds of femtograms level. Indeed, this single approach provides the lowest reported detection limits for a variety of anions, especially PFOA, nitrate, monochloroacetic acid, dichloroacetic acid, and bromochloroacetic acid, among others. The integrated areas and signal-to-noise ratios for five ions during a chromatographic run in both the positive and negative ion modes are compared. The ability of this method to detect differences in related ions is shown for four arsenic species. Finally, a tap water sample is analyzed for the anions in this study using the dicationic reagent method.