Return of the lysergamides. Part VI: Analytical and behavioural characterization of 1‐cyclopropanoyl‐d‐lysergic acid diethylamide (1CP‐LSD)

Lysergic acid diethylamide (LSD) is a prototypical serotonergic psychedelic drug and the subject of many clinical investigations. In recent years, a range of lysergamides has emerged with the production of some being inspired by the existing scientific literature. Others, for example various 1‐acyl substituted lysergamides, did not exist before their appearance as research chemicals. 1‐Cylopropanoyl‐LSD (1CP‐LSD) has recently emerged as a new addition to the group of lysergamide‐based designer drugs and is believed to be psychoactive in humans. In this investigation, 1CP‐LSD was subjected to detailed analytical characterizations including various mass spectrometry (MS) platforms, gas and liquid chromatography, nuclear magnetic resonance spectroscopy, solid phase and GC condensed phase infrared spectroscopy. Analysis by GC–MS also revealed the detection of artificially induced degradation products. Incubation of 1CP‐LSD with human serum led to the formation of LSD, indicating that it may act as a prodrug for LSD in vivo, similar to other 1‐acyl substituted lysergamides. The analysis of blotters and pellets is also included. 1CP‐LSD also induces the head‐twitch response (HTR) in C57BL/6 J mice, indicating that it produces an LSD‐like behavioural profile. 1CP‐LSD induced the HTR with an ED₅₀ = 430.0 nmol/kg which was comparable to 1P‐LSD (ED₅₀ = 349.6 nmol/kg) investigated previously. Clinical studies are required to determine the potency and profile of the effects produced by 1CP‐LSD in humans.     

Left Ventricular Assist Device Endocarditis Caused by Vancomycin-Intermediate Staphylococcus aureus Successfully Treated with Ceftaroline: a Review of the Clinical Case and Overview of Vancomycin Resistance in Staphylococcus aureus

In this article, we describe a case of left ventricular assist device endocarditis caused by a vancomycin-intermediate Staphylococcus aureus strain that was successfully treated with ceftaroline. Left ventricular assist device infections are briefly reviewed, and the current knowledge regarding vancomycin resistance is discussed.     

Objective assessment of the combined effect of exomass-related- and motion artefacts in cone beam CT

Objectives:To assess quantitatively the combined effect of exomass-related- and motion artefacts on voxel value parameters in cone beam CT (CBCT).Methods:A cylindrical phantom was manufactured, containing 21 tubes filled with a radiopaque solution, allowing the inclusion of three titanium implants in the periphery to induce exomass-related artefacts. The phantom was mounted on a robot simulating 0.75-, 1.5-, and 3 mm movements (nodding/lateral rotation/tremor). CBCT images with/without exomass and with/without movements were acquired in duplicate in three units: Cranex 3Dx, Orthophos SL-3D, and X1 (with motion-artefact correction). A cylindrical volume of interest was defined in each tube and voxel value mean and standard deviation were assessed. For each CBCT volume, the 21 mean voxel values were averaged providing the overall mean voxel value (MVV), and the standard deviation (among the 21 values) was calculated providing overall voxel value inhomogeneity (VVI). The standard deviation from each of the 21 volumes-of-interest were averaged, providing overall image noise (IN). The effect of the diverse tested situations was inferred from a repeated-measures analysis of variance, followed by Sidak’s test (α = 0.05).Results:Overall, images acquired with exomass showed significantly (p ≤ 0.05) lower MVV, and higher VVI and IN. Motion artefacts aggravated exomass-related alterations. MVV and VVI were mostly affected by 3 mm nodding movements. Motion-artefact correction eliminated the deleterious effect of movement.Conclusions:CBCT voxel-value parameters are altered by exomass-related artefacts, and this finding is aggravated in the presence of motion artefacts. Motion-artefact correction effectively eliminated the deleterious impact of movement.     

Aortic root dimensions as a correlate for aortic regurgitation’s severity

The International Journal of Cardiovascular Imaging - To evaluate the prevalence of aortic regurgitation (AR) and associations between the individual aortic root components and AR severity in the...     

Standardized method to quantify the variation in voxel value distribution in patient-simulated CBCT data sets

Objectives:

To suggest a standardized method to assess the variation in voxel value distribution in patient-simulated CBCT data sets and the effect of time between exposures (TBE). Additionally, a measurement of reproducibility, Aarhus measurement of reproducibility (AMORe), is introduced, which could be used for quality assurance purposes.

Methods:

Six CBCT units were tested [Cranex^® 3D/CRAN (Soredex Oy, Tuusula, Finland); Scanora^® 3D/SCAN (Soredex Oy); NewTom™ 5G/NEW5 (QR srl, Verona, Italy); i-CAT/ICAT (Imaging Sciences International, Hatfield, PA); 3D Accuitomo FPD80/ACCU (Morita, Kyoto, Japan); and NewTom VG/NEWV (QR srl)]. Two sets of volumetric data of a wax-imbedded dry human skull (containing a titanium implant) were acquired by each CBCT unit at two sessions on separate days. Each session consisted 21 exposures: 1 “initial” followed by a 30-min interval (initial data set), 10 acquired with 30-min TBE (data sets 1–10) and 10 acquired with 15-min TBE (data sets 11–20). CBCT data were exported as digital imaging and communications in medicine files and converted to text files containing x, y and z positions and grey shade for each voxel. Subtractions were performed voxel-by-voxel in two set-ups: (1) between two consecutive data sets and (2) between any subsequent data set and data set 1. The mean grey shade variation for each voxel was calculated for each unit/session.

Results:

The largest mean grey shade variation was found in the subtraction set-up 2 (27–447 shades of grey, depending on the unit). Considering subtraction set-up 1, the highest variation was seen for NEW5, between data sets 1 and the initial.

Conclusions:

Discrepancies in voxel value distribution were found by comparing the initial examination of the day with the subsequent examinations. TBE had no predictable effect on the variation of CBCT-derived voxel values. AMORe ranged between 0 and 64.     

Immunogenicity and reactogenicity of combined versus separately administered DTPw-HBV and Hib vaccines given to healthy infants at 2, 4 and 6 months of age, with a booster at 18 months.

OBJECTIVES: To determine the immunogenicity and reactogenicity of a combined DTPw-HBV/Hib vaccine, in comparison with DTPw-HBV and Hib vaccines given as separate concomitant injections. METHODS: In an open, randomized study, healthy infants were injected with either DTPw-HBV/Hib vaccine or separate DTPw-HBV and Hib vaccines at 2, 4 and 6 months of age, with a booster at 18 months. RESULTS: Both vaccination regimens were immunogenic, with seropositivity rates of 100% after the booster vaccination for all vaccine components. Even as early as 2 months after the second dose of the primary vaccination, most patients had seroprotective antibody titers, the proportion of seropositive subjects approaching 100% for tetanus, hepatitis B, and Hib. Post-primary and post-booster geometric mean titers (GMTs) were well above seroprotective thresholds for each vaccine antigen in both groups, with no clinically relevant differences in the groups. The separate and combined administrations showed comparable reactogenicity profiles, and neither showed a significant increase in reactogenicity with successive doses. CONCLUSIONS: The results of this study support the combination of Hib and DTPw-HBV vaccination in routine infant immunization at 2, 4 and 6 months of age with a booster at 18 months. Maximum benefit is obtained from compliance with the full course, but substantial benefit is likely to be achieved even in partially compliant patients, provided they receive at least two doses. Furthermore, these results demonstrate the tolerability of a fourth (booster) administration, where the addition of the Hib vaccine to DTPw-HBV did not lead to an increase in the overall reactogenicity.