Transvaginal Ultrasound Accuracy in the Hydrosalpinx Diagnosis: A Systematic Review and Meta-Analysis.

Hydrosalpinx is a condition with a crucial prognostic role in reproduction, and its diagnosis by a non-invasive technique such as ultrasound is key in achieving an adequate reproductive assessment while avoiding unnecessary laparoscopies. The aim of the present systematic review and meta-analysis is to synthetize and report the current evidence on transvaginal sonography (TVS) accuracy to diagnose hydrosalpinx. Articles on the topic published between January 1990 and December 2022 were searched in five electronic databases. Data from the six selected studies, comprising 4144 adnexal masses in 3974 women, 118 of which were hydrosalpinxes, were analyzed as follows: overall, TVS had a pooled estimated sensitivity for hydrosalpinx of 84% (95% confidence interval (CI) = 76-89%), specificity of 99% (95% CI = 98-100%), positive likelihood ratio of 80.7 (95% CI = 33.7-193.0), and negative likelihood ratio of 0.16 (95% CI = 0.11-0.25) and DOR of 496 (95% CI = 178-1381). The mean prevalence of hydrosalpinx was 4%. The quality of the studies and their risk of bias were assessed using QUADAS-2, evidencing an overall acceptable quality of the selected articles. We concluded that TVS has a good specificity and sensitivity for diagnosing hydrosalpinx.

Development of sensitive and rapid analytical methodology for food analysis of 18 mycotoxins included in a total diet study.

A rapid and sensitive method for the determination of 18 mycotoxins in 24 different food matrices has been developed and validated. With the exception of beverages and oil samples, a simple extraction with acetonitrile:water 80:20 (0.1% formic acid) was applied. Fruit juice, wine and beer samples were simply diluted with water containing 0.1% formic acid. Oil samples were partitioned with acetonitrile/hexane in order to remove fats. Analyses were made by ultra-high performance liquid chromatography (UHPLC) coupled to tandem mass spectrometry with triple quadrupole. Validation was carried out in all selected matrices using blank samples spiked at two analyte concentrations. Extraction recoveries between 70 and 120% and relative standard deviations lower than 20% were obtained for the wide majority of analyte-matrix combinations. Matrix-matched calibration was used for a correct quantification in order to compensate for matrix effects. Limits of quantification were lower than maximum permitted levels for every regulated mycotoxin-matrix combination. The acquisition of three SRM transitions per compound allowed the unequivocal confirmation of positive samples, supported by the accomplishment of ion intensity ratios and retention time when compared with reference standards. The developed methodology was applied to the analysis of 240 samples within a total diet study performed at Comunidad Valenciana (Spain). The most frequently found mycotoxins were deoxynivalenol, fumonisin B1, ochratoxin A and zearalenone at low µg kg(-1) levels, mainly in bread, breakfast cereals and beer.

Liquid chromatography coupled to tandem mass spectrometry for the residue determination of ethylenethiourea (ETU) and propylenethiourea (PTU) in water.

Ethylenethiourea (ETU) and propylenethiourea (PTU) are the main degradation products of dithiocarbamates fungicides, which are widely used in agriculture from several years ago. Their determination in water at low concentrations (e.g. sub-ppb levels) is highly problematic due to their polar character and low molecular size. In the present study, two analytical methodologies have been developed and compared for the selective and sensitive determination of ETU and PTU in various types of waters. Both approaches are based on liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) with electrospray ionization, using triple quadrupole analyzer. Whereas the first methodology used an on-line solid-phase extraction (SPE) step in order to reach the adequate sensitivity, the second one avoided sample treatment and was based on direct injection into an ultra high performance liquid chromatography (UHPLC-MS/MS) system, making use of a new-generation instrument in order to reach sub-ppb analyte levels in water. Strong matrix effects (typically leading to signal enhancement) were observed for most of the evaluated waters, especially when applying the on-line SPE method, surely due to the higher amount of sample injected into the system. The use of the own analyte (ETU-d4)) as isotope-labelled internal standard (ILIS) allowed to compensate these effects and to achieve an accurate ETU quantification at low concentrations. Moreover, three simultaneous transitions, operating in selected reaction monitoring mode, were acquired for both ETU and ETU-d4. This fact together with the evaluation of their relative intensity ratios assured the reliable identification of the analyte in the water samples. The two optimized methodologies were validated by analysis of six different samples (two drinking water, two groundwater and two surface water), spiked at two levels (0.1 and 1.0 µg/L), and analyzed each in quintuplicate. Satisfactory accuracy and precision, with recoveries ranging from 73 to 104% and RSDs lower than 20%, were obtained for ETU. Limits of detection for ETU were found to be 0.058 µg/L and 0.027 µg/L with direct injection and with the on-line methodology, respectively. No satisfactory recoveries were obtained, in general, for PTU despite using its own deuterium-labelled molecule for matrix effects correction. Notable differences in the chemical behaviour between PTU and PTU-d6 were observed, which lead to significant variation in their chromatographic retention time and ionization efficiency. Thus, no satisfactory correction of matrix effects could be reached illustrating that the use of deuterated ILIS can be problematic in some particular cases. Despite the poor correction, a semi-quantitative analysis would be feasible for PTU at sub-ppb levels in water. To the best of our knowledge, this is the first article reporting the use of LC-MS/MS for the trace level determination of these problematic analytes in water.

Determination of eight nitrosamines in water at the ng L(-1) levels by liquid chromatography coupled to atmospheric pressure chemical ionization tandem mass spectrometry.

In this work, we have developed a sensitive method for detection and quantification of eight N-nitrosamines, N-nitrosodimethylamine (NDMA), N-nitrosomorpholine (NMor), N-nitrosomethylethylamine (NMEA), N-nitrosopirrolidine (NPyr), N-nitrosodiethylamine (NDEA), N-nitrosopiperidine (NPip), N-nitroso-n-dipropylamine (NDPA) and N-nitrosodi-n-butylamine (NDBA) in drinking water. The method is based on liquid chromatography coupled to tandem mass spectrometry, using atmospheric pressure chemical ionization (APCI) in positive mode with a triple quadrupole analyzer (QqQ). The simultaneous acquisition of two MS/MS transitions in selected reaction monitoring mode (SRM) for each compound, together with the evaluation of their relative intensity, allowed the simultaneous quantification and reliable identification in water at ppt levels. Empirical formula of the product ions selected was confirmed by UHPLC-(Q)TOF MS accurate mass measurements from reference standards. Prior to LC-MS/MS QqQ analysis, a preconcentration step by off-line SPE using coconut charcoal EPA 521 cartridges (by passing 500 mL of water sample) was necessary to improve the sensitivity and to meet regulation requirements. For accurate quantification, two isotope labelled nitrosamines (NDMA-d(6) and NDPA-d(14)) were added as surrogate internal standards to the samples. The optimized method was validated at two concentration levels (10 and 100 ng L(-1)) in drinking water samples, obtaining satisfactory recoveries (between 90 and 120%) and precision (RSD<20%). Limits of detection were found to be in the range of 1-8 ng L(-1). The described methodology has been applied to different types of water samples: chlorinated from drinking water and wastewater treatment plants (DWTP and WWTP, respectively), wastewaters subjected to ozonation and tap waters.

Determination of sub-ppb epichlorohydrin levels in water by on-line solid-phase extraction liquid chromatography/tandem mass spectrometry.

A new sensitive and selective method based on on-line solid-phase extraction (SPE) coupled to liquid chromatography/electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS) using a triple quadrupole mass spectrometer has been developed for the determination of epichlorohydrin (ECH) in different types of water samples. ECH is not easily determined directly by ESI-MS as it is not readily ionized, and it has a low molecular mass and high polarity. Thus, prior derivatization of ECH was necessary, employing 3,5-difluorobenzylamine as a derivatizing agent with Fe(III) as a catalyst. In order to achieve accurate quantification, correcting for matrix effects, losses in the derivatization process and instrumental deviations, isotope labelled ECH (ECH-d(5)) was added as an internal standard (IS) to the water samples. The method was validated based on European SANCO guidelines using drinking and other types of treated water spiked at two concentration levels (0.1 and 1.0 microg/L), the lower level having been established as the limit of quantification (LOQ) of the method. Satisfactory accuracy (recoveries between 70 and 103%), precision (RSD <20%) and linearity (from 0.05 to 50 microg/L, r >0.99) were obtained. The limit of detection (LOD) was set up at 0.03 microg/L. The method was applied to different water samples (drinking water and water samples collected from a municipal treatment water plant). In order to enhance confidence, five selected reaction monitoring (SRM) transitions were acquired, thus obtaining a simultaneous reliable quantification and identification of ECH in water, even at sub-ppb levels.