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Introduction: Severe COVID-19 is associated with an important increase of von Willebrand factor and mild lowering of ADAMTS13 activity that may, in the presence of a strong inflammatory reaction, increase the risk of acute thrombotic thrombocytopenic purpura (TTP). Although acute episodes of immune-mediated TTP associated with COVID-19 or SARS-CoV-2 vaccination have been reported, data about clinical evolution of hereditary TTP (hTTP) during the pandemic are scarce., Method: We conducted a survey among adult patients of the International Hereditary TTP Registry about SARS-CoV-2 vaccination, COVID-19, and occurrence of acute hTTP episodes., Results: Of 122 adult hTTP patients invited to participate, 86 (70.5%) responded. Sixty-five had been vaccinated (75.6%), of which 14 had received in addition a booster, resulting in 139 individual vaccine shots. Although vaccinations in patients on plasma prophylaxis were done within 1 week of the last plasma infusion, all 23 patients treated with plasma on demand were vaccinated without prior plasma infusions. One patient on uninterrupted weekly plasma infusions presented within 3 days from his second vaccination with neurological symptoms and computed tomography scan 9 days later showed subacute ischemic/hemorrhagic frontal lobe infarction. A second male patient developed acute myocarditis after his second dose of mRNA-1273 vaccine. Twelve (14%) patients had COVID-19, associated with an acute hTTP episode in three of them: one patient had a transient ischemic attack, one a stroke, and a pregnant woman was hospitalized to intensify plasma treatment., Discussion: The risk of an acute episode triggered by COVID-19 seems higher than following vaccination in hTTP patients, who can be safely vaccinated against SARS-CoV-2., (© 2022 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).)

Hereditary thrombotic thrombocytopenic purpura (hTTP) is a rare thrombotic microangiopathy characterized by severe congenital ADAMTS13 deficiency and recurring acute episodes causing morbidity and premature death. Information on the annual incidence and severity of acute episodes in patients with hTTP is largely lacking. This study reports prospective data on 87 patients from the Hereditary TTP Registry (clinicaltrials.gov #NCT01257269) for survival, frequency, and severity of acute episodes from enrollment until December 2019. The 87 patients, followed up for a median of 4.2 years (range, 0.01-15 years), had a median age at overt disease onset and at clinical diagnosis of 4.6 years and 18 years (range, 0.0-70 years for both), respectively. Forty-three patients received regular plasma prophylaxis, whereas 22 did not, and treatment changed over time or was unknown in the remaining 22. Forty-three patients experienced 131 acute episodes, of which 91 (69%) occurred in patients receiving regular prophylaxis. This resulted in an annual incidence of acute episodes of 0.36 (95% confidence interval [CI], 0.29-0.44) with regular plasma treatment and of 0.41 (95% CI, 0.30-0.56) without regular plasma treatment. More than one-third of acute episodes (n = 51) were documented in children <10 years of age at enrollment and were often triggered by infections. Their annual incidence of acute episodes was significantly higher than in patients aged >40 years (1.18 [95% CI, 0.88-1.55] vs 0.14 [95% CI, 0.08-0.23]). The prophylactic plasma infusion regimens used were insufficient to prevent acute episodes in many patients. Such regimens are burdensome, and caregivers, patients, and their guardians are reluctant to start regular plasma infusions, from which children particularly would benefit., (© 2021 by The American Society of Hematology.)

A new method for the determination of Pd by ion chromatography and spectrophotometric detection has been developed. The technique is based on the separation of palladium as PdCl4(2-) by anion exchange and on the detection, at a wavelength of 407 nm, of metal as PdI4(2-) after a post-column reaction with KI. The column used was an IonPac AS4 with HCl and HClO4 eluents. The eluent concentration and composition of post-column reagent were optimised in order to obtain the best separation and sensitivity for Pd. In order to reduce the detection limit, an on-line preconcentration step, has been optimised. The method, as developed, was suitable for palladium determination within a 300 ng/l D.L. value. The method applied to a BCR reference material (CRM 277, estuarine sediment) gave satisfactory results in agreement with the certified value within a D.L. value of 1.3 microg/l for the real sample.

A new method for palladium and platinum direct determination in environmental samples is proposed by coupling ion chromatography with quadrupole inductively coupled plasma MS. In order to optimise Pd and Pt separation and to minimise interference from matrix in real samples, several anionic and cationic stationary phases have been compared at different mobile phase compositions. In particular, the effect of acidity and of the addition of oxalic acid to the eluent on separation and detection performance has been studied, and the anion-exchange column AG11 turned out to be more suitable. After chromatographic and mass spectrometer parameter optimisation, several potential interferences and the main quality parameters of the method, according to the Eurachem-CITAC recommendations, were evaluated: the detection limit for Pt was 5 ng l(-1) while the value for Pd was 230 ng l(-1). The method was successfully employed in the determination of platinum group elements in urban road dust and atmospheric particulates and the complete absence of matrix spectral interferences was demonstrated.

Liquid chromatographic methods, based on reversed-phase (RP) and anion-exchange mechanisms, have been developed for chloral hydrate determination. Both methods are preceeded by derivatization of chloral hydrate. For RP separations, different reagents [namely dansylhydrazine and o-(4-nitrobenzyl)hydroxylamine] have been studied, but the best results have been achieved using 1,2-benzenedithiol with UV detection at 220 nm. The anion-exchange method is based on derivatization with NaOH to form sodium formate that is then analyzed by anion-exchange, with suppressed conductivity detection. Derivatization conditions were optimized in order to reach the best yield of reaction. The optimization of the procedure allowed to determine chloral hydrate with detection limits as low as 0.2 microg/l with good linearity and reproducibility. The anion-exchange method was also applied for chloral hydrate determination in a drinking water sample. A preconcentration procedure has also been studied.