WorldWideScience

Sample records for individualized pharmaceutical treatment

  1. On radiation treatment of pharmaceutical products

    International Nuclear Information System (INIS)

    Zukov, V.; Mende, V.

    1976-01-01

    The progress made in the GDR over the past decade in the field of radiosterilization of products of the medical industry, has naturally raised the question of radiosterilization in pharmaceutics. However, because of the diversity and complicated nature of pharmaceutical products and, consequently, longer periods of time required for preliminary studies, their radiosterilization has not yet been applied on an industrial scale, in contrast to the situation in the medical industry. The studies carried out so far have been mainly concerned with ascertaining the permissibility and effectiveness of radiosterilization of individual products under particular conditions rather than with laying down a broad theoretical basis. Accordingly, the present paper does not describe results of special studies but presents a brief rewiev of some studies on radiation treatment of pharmaceutical products undertaken in the GDR. (author)

  2. Pharmaceutical wastewater treatment: a physicochemical study

    International Nuclear Information System (INIS)

    Saleem, M.

    2007-01-01

    A physicochemical study for the treatment of pharmaceutical wastewater was performed. Objective of the laboratory investigation was to study the removal of color, Total Dissolved Solids (TDS), Biochemical Oxygen Demand (BOD), Chemical Oxygen Demand (COD), turbidity and phenol and bring them up to the allowable limits for reuse purposes. Efficiency of coagulation, flocculation, sedimentation, sand filtration followed by activated carbon adsorption was determined. It was found that tested coagulants (alum, ferric chloride, and ferrous sulphate) are not much effective and required high dosage for the removal; of TSS, BOD, COD and turbidity. Alum was found to be more effective among tested coagulants and reduce TSS, BOD, COD and turbidity 79.6%, 34.8, 48.6% and 69.2% respectively. Sand filtration further reduced the studied parameters 97.7%, 95.7%, 93.9% and 76.9% respectively. As the concentration of phenol in the studied pharmaceutical wastewater was 100 mg/l, granular activated carbon was used to remove phenol up to the allowable limit for reuse purpose. Activated carbon adsorption further reduces phenol, TDS, TSS, BOD, and COD up to 99.9%, 99.1%, 21.4%, 81.3% and 71.1% respectively. High removal of color observed after activated carbon adsorption. It was concluded that the suggested treatment scheme is suitable to bring the effluent quality up to the water quality standards. (author)

  3. PHARMACEUTICAL AEROSOLS FOR THE TREATMENT AND PREVENTION OF TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Shumaila N Muhammad Hanif

    2012-09-01

    Full Text Available Historically, pharmaceutical aerosols have been employed for the treatment of obstructive airway diseases, such as asthma and chronic obstructive pulmonary disease, but in the past decades their use has been expanded to treat lung infections associated with cystic fibrosis and other respiratory diseases. Tuberculosis (TB is acquired after inhalation of aerosol droplets containing the bacilli from the cough of infected individuals. Even though TB affects other organs, the lungs are the primary site of infection, which makes the pulmonary route an ideal alternative route to administer vaccines or drug treatments. Optimization of formulations and delivery systems for anti-TB vaccines and drugs, as well as the proper selection of the animal model to evaluate those is of paramount importance if novel vaccines or drug treatments are to be successful. Pharmaceutical aerosols for patient use are generated from metered dose inhalers, nebulizers and dry powder inhalers. In addition to the advantages of providing more efficient delivery of the drug, low cost and portability, pharmaceutical dry powder aerosols are more stable than inhalable liquid dosage forms and do not require refrigeration. Methods to manufacture dry powders in respirable sizes include micronization, spray drying and other proprietary technologies. Inhalable dry powders are characterized in terms of their drug content, particle size and dispersibility to ensure deposition in the appropriate lung region and effective aerosolization from the device. These methods will be illustrated as they were applied for the manufacture and characterization of powders containing anti-tubercular agents and vaccines for pulmonary administration. The influence of formulation, selection of animal model, method of aerosol generation and administration on the efficacy demonstrated in a given study will be illustrated by the evaluation of pharmaceutical aerosols of anti-TB drugs and vaccines in guinea pigs by

  4. Pharmaceutical Formulation Facilities as Sources of Opioids and Other Pharmaceuticals to Wastewater Treatment Plant Effluents

    Science.gov (United States)

    2010-01-01

    Facilities involved in the manufacture of pharmaceutical products are an under-investigated source of pharmaceuticals to the environment. Between 2004 and 2009, 35 to 38 effluent samples were collected from each of three wastewater treatment plants (WWTPs) in New York and analyzed for seven pharmaceuticals including opioids and muscle relaxants. Two WWTPs (NY2 and NY3) receive substantial flows (>20% of plant flow) from pharmaceutical formulation facilities (PFF) and one (NY1) receives no PFF flow. Samples of effluents from 23 WWTPs across the United States were analyzed once for these pharmaceuticals as part of a national survey. Maximum pharmaceutical effluent concentrations for the national survey and NY1 effluent samples were generally effluent had median concentrations ranging from 3.4 to >400 μg/L. Maximum concentrations of oxycodone (1700 μg/L) and metaxalone (3800 μg/L) in samples from NY3 effluent exceeded 1000 μg/L. Three pharmaceuticals (butalbital, carisoprodol, and oxycodone) in samples of NY2 effluent had median concentrations ranging from 2 to 11 μg/L. These findings suggest that current manufacturing practices at these PFFs can result in pharmaceuticals concentrations from 10 to 1000 times higher than those typically found in WWTP effluents. PMID:20521847

  5. Electrochemical treatment of pharmaceutical and industrial wastewater by anodic oxidation

    International Nuclear Information System (INIS)

    Menapace, H. M.; Fellerer, M.; Treschnitzer, M.

    2009-01-01

    In modern medicine pharmaceuticals play a decisive role: because of an increased life expectancy and intensive care medicine an increasing amount of pharmaceuticals is produced. thus these substances are consumed in a mass of tons per year in industrialized countries. Wastewater effluents from sewage treatment plants (STP) are important point sources for residues of pharmaceuticals and complexing agents in the aquatic environment. For this reason a research project, which started in December 2006, was established to eliminate pharmaceutical substances and complexing agents found in wastewater as micropollutants. (Author)

  6. Individual capacity-building approaches in a global pharmaceutical systems strengthening program: a selected review.

    Science.gov (United States)

    Konduri, Niranjan; Rauscher, Megan; Wang, Shiou-Chu Judy; Malpica-Llanos, Tanya

    2017-01-01

    Medicines use related challenges such as inadequate adherence, high levels of antimicrobial resistance and preventable adverse drug reactions have underscored the need to incorporate pharmaceutical services to help achieve desired treatment outcomes, and protect patients from inappropriate use of medicines. This situation is further constrained by insufficient numbers of pharmaceutical personnel and inappropriate skill mix. Studies have addressed individual capacity building approaches of logistics, supply chain or disease specific interventions but few have documented those involving such pharmacy assistants/professionals, or health workers/professionals charged with improving access and provision of pharmaceutical services. We examined how different training modalities have been employed and adapted to meet country-specific context and needs by a global pharmaceutical systems strengthening program in collaboration with a country's Ministry of Health and local stakeholders. Structured, content analysis of training approaches from twelve selected countries and a survey among conveniently selected trainees in Bangladesh and Ethiopia. Case-based learning, practice and feedback, and repetitive interventions such as post-training action plan, supportive supervision and mentoring approaches are effective, evidence-based training techniques. In Ethiopia and Bangladesh, over 94% of respondents indicated that they have improved or developed skills or competencies as a result of the program's training activities. Supportive supervision structures and mentorship have been institutionalized with appropriate management structures. National authorities have been sensitized to secure funding from domestic resources or from the global fund grants for post-training follow-up initiatives. The Pharmaceutical Leadership Development Program is an effective, case-based training modality that motivates staff to develop quality-improvement interventions and solve specific challenges

  7. Pharmaceutical Compounds in Wastewater: Wetland Treatment as a Potential Solution

    OpenAIRE

    White, John R.; Belmont, Marco A.; Metcalfe, Chris D.

    2006-01-01

    Pharmaceutical compounds are being released into the aquatic environment through wastewater discharge around the globe. While there is limited removal of these compounds within wastewater treatment plants, wetland treatment might prove to be an effective means to reduce the discharge of the compounds into the environment. Wetlands can promote removal of these pharmaceutical compounds through a number of mechanisms including photolysis, plant uptake, microbial degradation, and sorption to the ...

  8. Effluent treatment plant for pharmaceutical unit at Bahipheru - case study

    International Nuclear Information System (INIS)

    Hayat, A.

    1997-01-01

    This project has been awarded to environ (Pvt) Ltd., on turnkey basis, and is an integrated waste treatment facility for pharmaceuticals companies, manufacturing paracetamole, aspirin and various pharmaceuticals intermediates, from phenol as basic raw material. A highly toxic waste water, containing high concentrations of phenolics and sulfate ions is generated at this plant and has to be treatment before final disposal into an irrigation channel. (author)

  9. Pharmaceutical Compounds in Wastewater: Wetland Treatment as a Potential Solution

    Directory of Open Access Journals (Sweden)

    John R. White

    2006-01-01

    Full Text Available Pharmaceutical compounds are being released into the aquatic environment through wastewater discharge around the globe. While there is limited removal of these compounds within wastewater treatment plants, wetland treatment might prove to be an effective means to reduce the discharge of the compounds into the environment. Wetlands can promote removal of these pharmaceutical compounds through a number of mechanisms including photolysis, plant uptake, microbial degradation, and sorption to the soil. We review relevant laboratory research on these various mechanisms and provide data on the few studies that have examined wetland removal. There is a need to document the degree to which various pharmaceutical compounds are removed in full-scale treatment wetlands, as there is a paucity of data on overall pharmaceutical removal rates.

  10. Preference for pharmaceutical formulation and treatment process attributes

    Directory of Open Access Journals (Sweden)

    Stewart KD

    2016-07-01

    Full Text Available Katie D Stewart,1 Joseph A Johnston,2 Louis S Matza,1 Sarah E Curtis,2 Henry A Havel,3 Stephanie A Sweetana,3 Heather L Gelhorn1 1Outcomes Research, Evidera, Bethesda, MD, USA; 2Global Patient Outcomes & Real World Evidence, 3Small Molecule Design and Development, Eli Lilly & Company, Indianapolis, IN, USA Purpose: Pharmaceutical formulation and treatment process attributes, such as dose frequency and route of administration, can have an impact on quality of life, treatment adherence, and disease outcomes. The aim of this literature review was to examine studies on preferences for pharmaceutical treatment process attributes, focusing on research in diabetes, oncology, osteoporosis, and autoimmune disorders.Methods: The literature search focused on identifying studies reporting preferences for attributes of the pharmaceutical treatment process. Studies were required to use formal quantitative preference assessment methods, such as utility valuation, conjoint analysis, or contingent valuation. Searches were conducted using Medline, EMBASE, Cochrane Library, Health Economic Evaluation Database, and National Health Service Economic Evaluation Database (January 1993–October 2013.Results: A total of 42 studies met inclusion criteria: 19 diabetes, nine oncology, five osteoporosis, and nine autoimmune. Across these conditions, treatments associated with shorter treatment duration, less frequent administration, greater flexibility, and less invasive routes of administration were preferred over more burdensome or complex treatments. While efficacy and safety often had greater relative importance than treatment process, treatment process also had a quantifiable impact on preference. In some instances, particularly in diabetes and autoimmune disorders, treatment process attributes had greater relative importance than some or all efficacy and safety attributes. Some studies suggested that relative importance of treatment process depends on disease (eg

  11. Influence of radiation treatment on pharmaceuticals. A study of the relevant literature

    International Nuclear Information System (INIS)

    Dahlhelm, H.; Boess, C.

    2002-01-01

    The present communication provides a quick overview of the behaviour of individual substances when treated with ionizing radiation while making reference to the respective original literature. The choosen form of an encyclopaedia enables the user to find information at a glance. It is based on parts I - XII of our review of literature on the influence of radiation treatment on pharmaceutical products and adjuvants/excipients we started in 1978. (orig.)

  12. The behaviour, fate and removal of pharmaceuticals in biological nutrient removal sewage treatment

    OpenAIRE

    Popple, Tina

    2013-01-01

    Pharmaceuticals that are intended for human use are frequently detected in the aquatic environment. This is predominantly from the excretion of pharmaceuticals by patients, in their urine and faeces, which subsequently enter sewage treatment plants. Sewage treatment provides a final opportunity for pharmaceutical removal, prior to discharge into the environment, however, removal is often incomplete. Once in the environment, pharmaceuticals have the potential to cause effects on aquatic organi...

  13. Combination of ozonation and photocatalysis for pharmaceutical wastewater treatment

    Science.gov (United States)

    Ratnawati, Enjarlis, Slamet

    2017-11-01

    The chemical oxygen demand (COD) and phenol removal from pharmaceutical wastewater were investigated using configuration of two circulation batch reactors in a series with ozonation and photocatalytic processes. The ozonation is conducted with O3/granulated activated carbon (O3/GAC), whereas photocatalysis with TiO2 that immobilized on pumice stone (PS-TiO2). The effect of circulation flow rate (10; 12; 15 L/min) and the amount PS-TiO2 (200 g, 250 g, 300 g) were examined. Wastewater of 20 L was circulated pass through the pipe that injected with O3 by the ozone generator, and subsequently flow through two GAC columns, and finally, go through photoreactor that contains photocatalyst PS-TiO2 which equipped with mercury lamp as a photon source. At a time interval, COD and phenol concentration were measured to assess the performance of the process. FESEM imaging confirmed that TiO2 was successfully impregnated on PS, as corroborated by EDX spectra. Meanwhile, degradation process indicated that the combined ozonation and photocatalytic processes (O3/GAC-TiO2) is more efficient compared to the ozonation and photocatalysis alone. For combination process with the circulation flow rate of 10 L/min and 300 g of PS-TiO2,the influent COD of around 1000 ppm are effectively degraded to a final effluent COD of 290 ppm (71% removal) and initial phenol concentration of 4.75 ppm down to 0 ppm for 4 h which this condition fulfill the discharge standards quality. Therefore, this portable prototype reactor is effective that can be used in the pharmaceutical wastewater treatment. For the future, this process condition will be developed for orientation on the industrial applications (portable equipment) since pharmaceutical industries produce wastewater relatively in the small amount.

  14. Treatment of Antibiotic Pharmaceutical Wastewater Using a Rotating Biological Contactor

    Directory of Open Access Journals (Sweden)

    Rongjun Su

    2015-01-01

    Full Text Available Rotating biological contactors (RBC are effective for treating wastewater, while they are rarely reported to be used for treating antibiotic pharmaceutical wastewater (APW. The current study investigates treatment of APW using an RBC. The effects of influent concentration, number of stages, and temperature on the remediation of APW were studied. The results indicated, even at low ambient temperature, 45% COD and 40% NH4+-N removal efficiencies. Moreover, the BOD5 removal efficiency was 85%. Microscopic observations illustrated that there were various active microorganisms displayed in the biofilms and their distribution changed from stage to stage. Compared with activated sludge, the biofilms in this study have higher content of dry matter and are easier to dehydrate and settle. Compared with current commercial incineration processes or advanced oxidation processes, RBC can greatly reduce the treatment cost. This research shows RBC is effective for such an inherently biorecalcitrant wastewater even at low ambient temperature.

  15. Pharmaceutical pricing in Japan: market evidence for rheumatoid arthritis treatment.

    Science.gov (United States)

    Mahlich, Jörg; Kamae, Isao; Sruamsiri, Rosarin

    2018-06-01

    Drug price setting is one of the key challenges faced by the Japanese health care system. This study aims to identify the determinants of drug price in Japan using the example of the rheumatoid arthritis (RA) treatment market. In order to compare prices across different products, we calculated prices per defined daily dose using WHO methodology. Price determinants were calculated both at launch and over time using IMS quarterly data on medicines approved for RA treatment in Japan from 2012 to 2015. Pharmaceutical pricing was modeled as a function of clinical and economic variables using regression analysis. For prices at the launch we found that differences in efficacy are not reflected in price differentials. We also report that the number of products within a molecule class had a negative effect on prices while originator drugs maintained higher prices. Although the existing pricing rules in Japan are very comprehensive they do not necessarily capture differences in product characteristics. The findings here support the notion that competitive forces are weak in highly regulated markets such as Japan.

  16. Combined aerobic and physicochemical treatment of pharmaceutical industry sludge

    International Nuclear Information System (INIS)

    Asia, Q.I.; Ademoroti, A.M.C.

    2005-01-01

    Composite samples of sludge obtained from a pharmaceutical factory were analysed for their pollution characteristics. The samples were then treated by integrated aerobic biological and physicochemical methods. The analysis revealed that the BOD and COD of the sludge liquor were high, as well as were the levels of solids concentration, nitrogen, phosphorus and bacterial count. These showed that sludge from this industry had a high pollution potential, and therefore needed treatment before disposal or reuse in other applications. Percentage solids reduction achieved were in the range of 26.1 to 29% of total soluble solids, 26.1 to 33% of suspended solids, and 43 to 52% of volatile solids, BOD and COD reductions were in the range of 96.1 to 98.2% and 96.8 to 98.4% respectively. Ammonia nitrogen reductions in this sludge were about 85.2 to 93.3%. Total nitrogen and phosphorus were also found to be appreciably reduced by the combined aerobic and physicochemical treatment methods. (author)

  17. [New pharmaceuticals in treatment of chronic dust bronchitis].

    Science.gov (United States)

    Kosarev, V V; Vakurova, N V; Babanov, S A

    2007-01-01

    The study was dedicated to the assessment of the therapeutic possibilities provided by erespal (fenspirid) as a new class of pharmaceuticals inhibiting the inflammatory process, in patients with chronic dust bronchitis.

  18. Behaviour of pharmaceuticals and psychotic drugs in conventional and advanced wastewater treatments

    International Nuclear Information System (INIS)

    Cortacans Torre, J. A.; Castillo Gonzalez, I. del; Hernandez Lehmann, A.; Hernandez Munoz, A.; Rodriguez Barrera, X.

    2009-01-01

    The occurrence of various pharmaceuticals and psychotic drugs in wastewater and their removal rates in a conventional wastewater treatment plant has been investigated. The psychoactive drugs are poorly removed in the biological step. However, most pharmaceuticals except of carbamazepine, are significantly biodegraded depending the removal degree on the type of compound and on the sludge retention time of the biological treatment. Also, the removal efficiency of conventional tertiary treatments and ultrafiltration and nano filtration membranes using two pilot plants was examined. the effects of retaining pharmaceuticals with ultrafiltration and nano filtration membranes do not greatly differ despite the difference in their pore size. (Author) 25 refs.

  19. On the Margins of Pharmaceutical Citizenship: Not Taking HIV Medication in the "Treatment Revolution" Era.

    Science.gov (United States)

    Persson, Asha; Newman, Christy E; Mao, Limin; de Wit, John

    2016-09-01

    With the expanding pharmaceuticalization of public health, anthropologists have begun to examine how biomedicine's promissory discourses of normalization and demarginalization give rise to new practices of and criteria for citizenship. Much of this work focuses on the biomedicine-citizenship nexus in less-developed, resource-poor contexts. But how do we understand this relationship in resource-rich settings where medicines are readily available, often affordable, and a highly commonplace response to illness? In particular, what does it mean to not use pharmaceuticals for a treatable infectious disease in this context? We are interested in these questions in relation to the recent push for early and universal treatment for HIV infection in Australia for the twin purposes of individual and community health. Drawing on Ecks's concept of pharmaceutical citizenship, we examine the implications for citizenship among people with HIV who refuse or delay recommended medication. We find that moral and normative expectations emerging in the new HIV "treatment revolution" have the capacity to both demarginalize and marginalize people with HIV. © 2016 by the American Anthropological Association.

  20. Occurrence and reduction of pharmaceuticals in the water phase at Swedish wastewater treatment plants

    DEFF Research Database (Denmark)

    Falås, Per; Andersen, Henrik Rasmus; Ledin, Anna

    2012-01-01

    During the last decade, several screening programs for pharmaceuticals at Swedish wastewater treatment plants (WWTPs) have been conducted by research institutes, county councils, and wastewater treatment companies. In this study, influent and effluent concentrations compiled from these screening...... programs were used to assess the occurrence and reduction of non-antibiotic pharmaceuticals for human usage. The study is limited to full-scale WWTPs with biological treatment. Based on the data compiled, a total of 70 non-antibiotic pharmaceuticals have been detected, at concentrations ranging from a few...... WWTPs were identified. Further comparison based on the biological treatment showed lower reduction degrees for several pharmaceuticals in trickling filter plants compared to activated sludge plants with nitrogen removal....

  1. Occurrence of pharmaceuticals in a municipal wastewater treatment plant: mass balance and removal processes.

    Science.gov (United States)

    Gao, Pin; Ding, Yunjie; Li, Hui; Xagoraraki, Irene

    2012-06-01

    Occurrence and removal efficiencies of fifteen pharmaceuticals were investigated in a conventional municipal wastewater treatment plant in Michigan. Concentrations of these pharmaceuticals were determined in both wastewater and sludge phases by a high-performance liquid chromatograph coupled to a tandem mass spectrometer. Detailed mass balance analysis was conducted during the whole treatment process to evaluate the contributing processes for pharmaceutical removal. Among the pharmaceuticals studied, demeclocycline, sulfamerazine, erythromycin and tylosin were not detected in the wastewater treatment plant influent. Other target pharmaceuticals detected in wastewater were also found in the corresponding sludge phase. The removal efficiencies of chlortetracycline, tetracycline, sulfamerazine, acetaminophen and caffeine were >99%, while doxycycline, oxytetracycline, sulfadiazine and lincomycin exhibited relatively lower removal efficiencies (e.g., <50%). For sulfamethoxazole, the removal efficiency was approximately 90%. Carbamazepine manifested a net increase of mass, i.e. 41% more than the input from the influent. Based on the mass balance analysis, biotransformation is believed to be the predominant process responsible for the removal of pharmaceuticals (22% to 99%), whereas contribution of sorption to sludge was relatively insignificant (7%) for the investigated pharmaceuticals. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Probabilistic environmental risk characterization of pharmaceuticals in sewage treatment plant discharges.

    Science.gov (United States)

    Christensen, Anne Munch; Markussen, Bo; Baun, Anders; Halling-Sørensen, Bent

    2009-10-01

    The occurrence of pharmaceuticals in different water bodies and the findings of effects on aquatic organisms in ecotoxicity tests have raised concerns about environmental risks of pharmaceuticals in receiving waters. Due to the fact that the amount of ecotoxicological studies has increased significantly during the last decade, probabilistic approaches for risk characterization of these compounds may be feasible. This approach was evaluated by applying it to 22 human-used pharmaceuticals covering both pharmaceuticals with a high volume and high ecotoxicity, using ecotoxicological effect data from laboratory studies and comparing these to monitoring data on the effluents from sewage treatment plants in Europe and pharmaceutical sales quantities. We found that for 19 of the 22 selected pharmaceuticals the existing data were sufficient for probabilistic risk characterizations. The subsequently modeled ratios between monitored concentrations and low-effect concentrations were mostly above a factor of 100. Compared to the current paradigm for EU environmental risk assessment where a safety factor of 10 or 100 might have been used it seems that for the modeled compounds there's a low environmental risk. However, similarly calculated ratios for five pharmaceuticals (propranolol, ibuprofen, furosemide, ofloxacin, and ciprofloxacin) were below 100, while ibuprofen and ciprofloxacin are considered to be of high concern due to lack of ecotoxicity studies. This paper shows that by applying probabilistic approaches, existing data can be used to execute a comprehensive study on probability of impacts, thereby contributing to a more comprehensive environmental risk assessment of pharmaceuticals.

  3. Occurrence and fate of pharmaceuticals in wastewater treatment plants and rivers in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Sim, Won-Jin; Lee, Ji-Woo [Department of Civil and Environmental Engineering, Pusan National University, Jangjeon-dong, Geumjeong-gu, Busan 609-735 (Korea, Republic of); Oh, Jeong-Eun, E-mail: jeoh@pusan.ac.k [Department of Civil and Environmental Engineering, Pusan National University, Jangjeon-dong, Geumjeong-gu, Busan 609-735 (Korea, Republic of)

    2010-05-15

    We measured 25 pharmaceuticals in ten municipal wastewater treatment plants (WWTPs), one hospital WWTP and five rivers in Korea. In the municipal WWTP influents, acetaminophen, acetylsalicylic acid and caffeine showed relatively high concentrations. The occurrence of pharmaceuticals in the wastewater seems to be influenced by production and consumption of pharmaceuticals. The hospital WWTP influent showed higher total concentrations of pharmaceuticals than the municipal WWTPs, and caffeine, ciprofloxacin and acetaminophen were dominant. In the rivers, caffeine was dominant, and the distribution of pharmaceuticals was related to the inflow of the wastewater. In the municipal WWTPs, the concentrations of acetaminophen, caffeine, acetylsalicylic acid, ibuprofen and gemfibrozil decreased by over 99%. The decrease of these pharmaceuticals occurred mainly during the biological processes. In the physico-chemical processes, the decrease of pharmaceuticals was insignificant except for some cases. In the hospital WWTP, ciprofloxacin, acetylsalicylic acid, acetaminophen and carbamazepine showed the decrease rates of over 80%. - We investigated distribution and fate of pharmaceuticals in rivers and WWTPs including various biological and physico-chemical processes.

  4. Occurrence and fate of pharmaceuticals in wastewater treatment plants and rivers in Korea

    International Nuclear Information System (INIS)

    Sim, Won-Jin; Lee, Ji-Woo; Oh, Jeong-Eun

    2010-01-01

    We measured 25 pharmaceuticals in ten municipal wastewater treatment plants (WWTPs), one hospital WWTP and five rivers in Korea. In the municipal WWTP influents, acetaminophen, acetylsalicylic acid and caffeine showed relatively high concentrations. The occurrence of pharmaceuticals in the wastewater seems to be influenced by production and consumption of pharmaceuticals. The hospital WWTP influent showed higher total concentrations of pharmaceuticals than the municipal WWTPs, and caffeine, ciprofloxacin and acetaminophen were dominant. In the rivers, caffeine was dominant, and the distribution of pharmaceuticals was related to the inflow of the wastewater. In the municipal WWTPs, the concentrations of acetaminophen, caffeine, acetylsalicylic acid, ibuprofen and gemfibrozil decreased by over 99%. The decrease of these pharmaceuticals occurred mainly during the biological processes. In the physico-chemical processes, the decrease of pharmaceuticals was insignificant except for some cases. In the hospital WWTP, ciprofloxacin, acetylsalicylic acid, acetaminophen and carbamazepine showed the decrease rates of over 80%. - We investigated distribution and fate of pharmaceuticals in rivers and WWTPs including various biological and physico-chemical processes.

  5. Effects of pharmaceutical promotion on adherence to the treatment guidelines for depression.

    Science.gov (United States)

    Donohue, Julie M; Berndt, Ernst R; Rosenthal, Meredith; Epstein, Arnold M; Frank, Richard G

    2004-12-01

    We sought to examine the impact of direct-to-consumer advertising (DTCA) and pharmaceutical promotion to physicians on the likelihood that (1) an individual diagnosed with depression received antidepressant medication and that (2) antidepressant medication was used for the appropriate duration. A quasiexperimental design was used to examine treatment patterns of 30,621 depressed individuals whose insurance claims were included in the MarketScan database from 1997 through 2000. The main explanatory variables were spending on DTCA, detailing to physicians, and free samples for 6 antidepressant medications. Individuals diagnosed with depression during periods when class-level antidepressant DTCA spending was highest (cumulative spending more than US 18.5 million dollars) had 32% higher relative odds of initiating medication therapy compared with those diagnosed during periods when DTCA spending was lowest (P < 0.0001). Free samples of medications dispensed to physicians had no effect on odds of initiating antidepressant use. Class-level DTCA spending on antidepressants had a small positive effect on the duration of antidepressant use, whereas DTCA spending for the specific medication taken by an individual had no effect on treatment duration. Detailing spending at the class or product level had no significant effect on duration of treatment with an antidepressant medication. Our results suggest that DTCA of antidepressants was associated with an increase in the number of people diagnosed with depression who initiated medication therapy. DTCA was associated with a small increase in the number of individuals treated with antidepressants who received the appropriate duration of therapy. Promotion to physicians was not associated with either the initiation of treatment with an antidepressant or with the duration of therapy.

  6. Tracking acidic pharmaceuticals, caffeine, and triclosan through the wastewater treatment process.

    Science.gov (United States)

    Thomas, Paul M; Foster, Gregory D

    2005-01-01

    Pharmaceuticals are a class of emerging contaminants whose fate in the wastewater treatment process has received increasing attention in past years. Acidic pharmaceuticals (ibuprofen, naproxen, mefenamic acid, ketoprofen, and diclofenac), caffeine, and the antibacterial triclosan were quantified at four different steps of wastewater treatment from three urban wastewater treatment plants. The compounds were extracted from wastewater samples on Waters Oasis hydrophilic-lipophilic balance solid-phase extraction columns, silylated, and analyzed by gas chromatography-mass spectrometry. For the chemicals studied, it was found that the majority of the influent load was removed during secondary treatment (51-99%), yielding expected surface water concentrations of 13 to 56 ng/L.

  7. A Comparison Study of the Removal of Selected Pharmaceuticals in Waters by Chemical Oxidation Treatments

    OpenAIRE

    F. Javier Benitez; Juan Luis Acero; Francisco J. Real; Gloria Roldan; Francisco Casas

    2011-01-01

    The degradation of selected pharmaceuticals in some water matrices was studied by using several chemical treatments. The pharmaceuticals selected were the beta-blocker metoprolol, the nonsteroidal anti-inflammatory naproxen, the antibiotic amoxicillin, and the analgesic phenacetin; and their degradations were conducted by using UV radiation alone, ozone, Fenton-s reagent, Fenton-like system, photo-Fenton system, and combinations of UV radiation and ozone with H2O2, TiO2, ...

  8. Ozonation for source treatment of pharmaceuticals in hospital wastewater - ozone lifetime and required ozone dose

    DEFF Research Database (Denmark)

    Hansen, Kamilla Marie Speht; Spiliotopoulou, Aikaterini; Chhetri, Ravi Kumar

    2016-01-01

    Ozonation aimed at removing pharmaceuticals was studied in an effluent from an experimental pilot system using staged moving bed biofilm reactor (MBBR) tanks for the optimal biological treatment of wastewater from a medical care unit of Aarhus University Hospital. Dissolved organic carbon (DOC......) and pH in samples varied considerably, and the effect of these two parameters on ozone lifetime and the efficiency of ozone in removing pharmaceuticals were determined. The pH in the effluent varied from 5.0 to 9.0 resulting in approximately a doubling of the required ozone dose at the highest p......H for each pharmaceutical. DOC varied from 6 to 20 mg-DOC/L. The ozone required for removing each pharmaceutical, varied linearly with DOC and thus, ozone doses normalized to DOC (specific ozone dose) agreed between water samples (typically within 15%). At neutral pH the specific ozone dose required...

  9. Tracing pharmaceuticals in a municipal plant for integrated wastewater and organic solid waste treatment

    Energy Technology Data Exchange (ETDEWEB)

    Jelic, Aleksandra [Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Jordi Girona 18-26, 08034 Barcelona (Spain); Fatone, Francesco; Di Fabio, Silvia [Department of Biotechnology, University of Verona, Strada Le Grazie 15, I-37134, Verona (Italy); Interuniversity Consortium ' Chemistry for the Environment' (INCA), Via delle Industrie, I-30135, Marghera-Venice (Italy); Petrovic, Mira, E-mail: mpetrovic@icra.cat [Catalan Institution for Research and Advanced Studies (ICREA), Passeig Lluis Companys 23, 80010 Barcelona (Spain); Catalan Institute for Water Research (ICRA), H2O Building, Scientific and Technological Park of the University of Girona, 101-E-17003 Girona (Spain); Cecchi, Franco [Department of Biotechnology, University of Verona, Strada Le Grazie 15, I-37134, Verona (Italy); Interuniversity Consortium ' Chemistry for the Environment' (INCA), Via delle Industrie, I-30135, Marghera-Venice (Italy); Barcelo, Damia [Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Jordi Girona 18-26, 08034 Barcelona (Spain); Catalan Institute for Water Research (ICRA), H2O Building, Scientific and Technological Park of the University of Girona, 101-E-17003 Girona (Spain)

    2012-09-01

    The occurrence and removal of 42 pharmaceuticals, belonging to different therapeutic groups (analgesics and anti-inflammatory drugs, anti-ulcer agent, psychiatric drugs, antiepileptic drug, antibiotics, ss-blockers, diuretics, lipid regulator and cholesterol lowering statin drugs and anti-histamines), were studied in the wastewater and sewage sludge trains of a full scale integrated treatment plant. The plant employs a biological nutrient removal (BNR) process for the treatment of municipal wastewater, and a single-stage mesophilic anaerobic co-digestion for the treatment of wasted activated sludge mixed with the organic fraction of municipal solid waste (OFMSW), followed by a short-cut nitrification-denitrification of the anaerobic supernatant in a sequential batch reactor. Influent and effluent wastewater, as well as thickened, digested and treated sludge were sampled and analyzed for the selected pharmaceuticals in order to study their presence and fate during the treatment. Twenty three compounds were detected in influent and effluent wastewater and eleven in sludge. Infiltration of groundwater in the sewer system led to a dilution of raw sewage, resulting in lower concentrations in wastewater (up to 0.7 {mu}g/L in influent) and sludge (70 ng/g d.w.). Due to the dilution, overall risk quotient for the mixture of pharmaceuticals detected in effluent wastewater was less than one, indicating no direct risk for the aquatic environment. A wide range of removal efficiencies during the treatment was observed, i.e. < 20% to 90%. The influent concentrations of the target pharmaceuticals, as polar compounds, were undoubtedly mostly affected by BNR process in the wastewater train, and less by anaerobic-co-digestion. Mass balance calculations showed that less than 2% of the total mass load of the studied pharmaceuticals was removed by sorption. Experimentally estimated distribution coefficients (< 500 L/kg) also indicated that the selected pharmaceuticals preferably remain

  10. Tracing pharmaceuticals in a municipal plant for integrated wastewater and organic solid waste treatment

    International Nuclear Information System (INIS)

    Jelic, Aleksandra; Fatone, Francesco; Di Fabio, Silvia; Petrovic, Mira; Cecchi, Franco; Barcelo, Damia

    2012-01-01

    The occurrence and removal of 42 pharmaceuticals, belonging to different therapeutic groups (analgesics and anti-inflammatory drugs, anti-ulcer agent, psychiatric drugs, antiepileptic drug, antibiotics, ß-blockers, diuretics, lipid regulator and cholesterol lowering statin drugs and anti-histamines), were studied in the wastewater and sewage sludge trains of a full scale integrated treatment plant. The plant employs a biological nutrient removal (BNR) process for the treatment of municipal wastewater, and a single-stage mesophilic anaerobic co-digestion for the treatment of wasted activated sludge mixed with the organic fraction of municipal solid waste (OFMSW), followed by a short-cut nitrification–denitrification of the anaerobic supernatant in a sequential batch reactor. Influent and effluent wastewater, as well as thickened, digested and treated sludge were sampled and analyzed for the selected pharmaceuticals in order to study their presence and fate during the treatment. Twenty three compounds were detected in influent and effluent wastewater and eleven in sludge. Infiltration of groundwater in the sewer system led to a dilution of raw sewage, resulting in lower concentrations in wastewater (up to 0.7 μg/L in influent) and sludge (70 ng/g d.w.). Due to the dilution, overall risk quotient for the mixture of pharmaceuticals detected in effluent wastewater was less than one, indicating no direct risk for the aquatic environment. A wide range of removal efficiencies during the treatment was observed, i.e. < 20% to 90%. The influent concentrations of the target pharmaceuticals, as polar compounds, were undoubtedly mostly affected by BNR process in the wastewater train, and less by anaerobic-co-digestion. Mass balance calculations showed that less than 2% of the total mass load of the studied pharmaceuticals was removed by sorption. Experimentally estimated distribution coefficients (< 500 L/kg) also indicated that the selected pharmaceuticals preferably remain

  11. Effect of redox conditions on pharmaceutical loss during biological wastewater treatment using sequencing batch reactors

    Energy Technology Data Exchange (ETDEWEB)

    Stadler, Lauren B., E-mail: lstadler@umich.edu [Department of Civil and Environmental Engineering, University of Michigan, 1351 Beal Avenue, EWRE, Ann Arbor, MI 48109 (United States); Su, Lijuan, E-mail: lijuansu@buffalo.edu [Department of Chemistry, University at Buffalo, State University of New York, Buffalo, NY 14260 (United States); Moline, Christopher J., E-mail: christopher.moline@hdrinc.com [Department of Civil and Environmental Engineering, University of Michigan, 1351 Beal Avenue, EWRE, Ann Arbor, MI 48109 (United States); Ernstoff, Alexi S., E-mail: alexer@dtu.dk [Department of Civil and Environmental Engineering, University of Michigan, 1351 Beal Avenue, EWRE, Ann Arbor, MI 48109 (United States); Aga, Diana S., E-mail: dianaaga@buffalo.edu [Department of Chemistry, University at Buffalo, State University of New York, Buffalo, NY 14260 (United States); Love, Nancy G., E-mail: nglove@umich.edu [Department of Civil and Environmental Engineering, University of Michigan, 1351 Beal Avenue, EWRE, Ann Arbor, MI 48109 (United States)

    2015-01-23

    Highlights: • Pharmaceutical fate was studied in SBRs operated at different redox conditions. • Stable carbon oxidation and nitrification occurred under microaerobic conditions. • Losses of atenolol and trimethoprim were highest under fully aerobic conditions. • Loss of sulfamethoxazole was highest under microaerobic conditions. • Deconjugation occurred during treatment to form sulfamethoxazole and desvenlafaxine. - Abstract: We lack a clear understanding of how wastewater treatment plant (WWTP) process parameters, such as redox environment, impact pharmaceutical fate. WWTPs increasingly install more advanced aeration control systems to save energy and achieve better nutrient removal performance. The impact of redox condition, and specifically the use of microaerobic (low dissolved oxygen) treatment, is poorly understood. In this study, the fate of a mixture of pharmaceuticals and several of their transformation products present in the primary effluent of a local WWTP was assessed in sequencing batch reactors operated under different redox conditions: fully aerobic, anoxic/aerobic, and microaerobic (DO concentration ≈0.3 mg/L). Among the pharmaceuticals that were tracked during this study (atenolol, trimethoprim, sulfamethoxazole, desvenlafaxine, venlafaxine, and phenytoin), overall loss varied between them and between redox environments. Losses of atenolol and trimethoprim were highest in the aerobic reactor; sulfamethoxazole loss was highest in the microaerobic reactors; and phenytoin was recalcitrant in all reactors. Transformation products of sulfamethoxazole and desvenlafaxine resulted in the reformation of their parent compounds during treatment. The results suggest that transformation products must be accounted for when assessing removal efficiencies and that redox environment influences the degree of pharmaceutical loss.

  12. Effect of redox conditions on pharmaceutical loss during biological wastewater treatment using sequencing batch reactors

    International Nuclear Information System (INIS)

    Stadler, Lauren B.; Su, Lijuan; Moline, Christopher J.; Ernstoff, Alexi S.; Aga, Diana S.; Love, Nancy G.

    2015-01-01

    Highlights: • Pharmaceutical fate was studied in SBRs operated at different redox conditions. • Stable carbon oxidation and nitrification occurred under microaerobic conditions. • Losses of atenolol and trimethoprim were highest under fully aerobic conditions. • Loss of sulfamethoxazole was highest under microaerobic conditions. • Deconjugation occurred during treatment to form sulfamethoxazole and desvenlafaxine. - Abstract: We lack a clear understanding of how wastewater treatment plant (WWTP) process parameters, such as redox environment, impact pharmaceutical fate. WWTPs increasingly install more advanced aeration control systems to save energy and achieve better nutrient removal performance. The impact of redox condition, and specifically the use of microaerobic (low dissolved oxygen) treatment, is poorly understood. In this study, the fate of a mixture of pharmaceuticals and several of their transformation products present in the primary effluent of a local WWTP was assessed in sequencing batch reactors operated under different redox conditions: fully aerobic, anoxic/aerobic, and microaerobic (DO concentration ≈0.3 mg/L). Among the pharmaceuticals that were tracked during this study (atenolol, trimethoprim, sulfamethoxazole, desvenlafaxine, venlafaxine, and phenytoin), overall loss varied between them and between redox environments. Losses of atenolol and trimethoprim were highest in the aerobic reactor; sulfamethoxazole loss was highest in the microaerobic reactors; and phenytoin was recalcitrant in all reactors. Transformation products of sulfamethoxazole and desvenlafaxine resulted in the reformation of their parent compounds during treatment. The results suggest that transformation products must be accounted for when assessing removal efficiencies and that redox environment influences the degree of pharmaceutical loss

  13. Pharmaceutical wastewater treatment by internal micro-electrolysis--coagulation, biological treatment and activated carbon adsorption.

    Science.gov (United States)

    Wang, Kangle; Liu, Suiqing; Zhang, Qiang; He, Yiliang

    2009-12-01

    Treatment of pharmaceutical wastewater by the combined process of internal micro-electrolysis and coagulation, biological treatment and activated carbon adsorption was studied. Internal micro-electrolysis and coagulation served as the pretreatment for the wastewater before biological treatment to reduce the contaminants' toxicity to microbes and improve the biodegradability of wastewater to guarantee the smooth operation of the biological process. Biological treatment was the main body of the whole process which took an unparalleled role in removing COD (chemical oxygen demand). Activated carbon adsorption was adopted as the post-treatment process to further remove the remaining non-biodegradable particles. Results showed that the removal rates of COD and S2- (sulphide ion) by pretreatment were 66.9% and 98.9%, respectively, and the biodegradability, as measured by the ratio of biodegradable COD to initial COD, of the wastewater was greatly improved from 0.16 +/- 0.02 to 0.41 +/- 0.02. The overall removal rate of COD in the wastewater achieved by this combined treatment process was up to 96%, and the effluent COD met the Chinese tertiary discharge standard (GB 8978-1996).

  14. Influence of radiation treatment on pharmaceuticals and adjuvants: A literature study. Pt. 9. Supplement

    International Nuclear Information System (INIS)

    Lindemann, L.; Schuettler, C.; Boegl, K.W.

    1993-01-01

    Sterilization of medical aid articles (e.g. catheters, one-way syringes) with ionizing radiation is a successful practice in many countries. During recent years, the results from numerous experiments of radiosterillization of pharmaceuticals and adjuvants have likewise been published. Experience has shown that radiation treatment, in many cases, is leading to transformations of the irradiated substances. In the present part IX of the bibliographic study on the influence of radiation treatment on pharmaceuticals and adjuvants the results of experiments on ca. 80 substances from 36 different sources have been evaluated. In all parts of the study results of about 560 experiments on 360 substances from 176 different sources are present. (orig.)

  15. Transformation of pharmaceuticals during oxidation/disinfection processes in drinking water treatment.

    Science.gov (United States)

    Postigo, Cristina; Richardson, Susan D

    2014-08-30

    Pharmaceuticals are emerging contaminants of concern and are widespread in the environment. While the levels of these substances in finished drinking waters are generally considered too low for human health concern, there are now concerns about their disinfection by-products (DBPs) that can form during drinking water treatment, which in some cases have been proven to be more toxic than the parent compounds. The present manuscript reviews the transformation products of pharmaceuticals generated in water during different disinfection processes, i.e. chlorination, ozonation, chloramination, chlorine dioxide, UV, and UV/hydrogen peroxide, and the main reaction pathways taking place. Most of the findings considered for this review come from controlled laboratory studies involving reactions of pharmaceuticals with these oxidants used in drinking water treatment. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Two-year survey of specific hospital wastewater treatment and its impact on pharmaceutical discharges.

    Science.gov (United States)

    Wiest, Laure; Chonova, Teofana; Bergé, Alexandre; Baudot, Robert; Bessueille-Barbier, Frédérique; Ayouni-Derouiche, Linda; Vulliet, Emmanuelle

    2018-04-01

    It is well known that pharmaceuticals are not completely removed by conventional activated sludge wastewater treatment plants. Hospital effluents are of major concern, as they present high concentrations of pharmaceutically active compounds. Despite this, these specific effluents are usually co-treated with domestic wastewaters. Separate treatment has been recommended. However, there is a lack of information concerning the efficiency of separate hospital wastewater treatment by activated sludge, especially on the removal of pharmaceuticals. In this context, this article presents the results of a 2-year monitoring of conventional parameters, surfactants, gadolinium, and 13 pharmaceuticals on the specific study site SIPIBEL. This site allows the characterization of urban and hospital wastewaters and their separate treatment using the same process. Flow proportional sampling, solid-phase extraction, and liquid chromatography coupled with tandem mass spectrometry were used in order to obtain accurate data and limits of quantification consistent with ultra-trace detection. Thanks to these consolidated data, an in-depth characterization of urban and hospital wastewaters was realized, as well as a comparison of treatment efficiency between both effluents. Higher concentrations of organic carbon, AOX, phosphates, gadolinium, paracetamol, ketoprofen, and antibiotics were observed in hospital wastewaters compared to urban wastewaters. Globally higher removals were observed in the hospital wastewater treatment plant, and some parameters were shown to be of high importance regarding removal efficiencies: hydraulic retention time, redox conditions, and ambient temperature. Eleven pharmaceuticals were still quantified at relevant concentrations in hospital and urban wastewaters after treatment (e.g., up to 1 μg/L for sulfamethoxazole). However, as the urban flow was about 37 times higher than the hospital flow, the hospital contribution appeared relatively low compared to

  17. Future wastewater solutions: removal of pharmaceuticals in conventional wastewater treatment plants

    DEFF Research Database (Denmark)

    Jensen, Thomas

    Residues of pharmaceuticals, personal care products and industrial chemicals find their way into the environment mainly through incomplete removal in the conventional urban wastewater treatment plants (WWTPs) and appear as micro-pollutants at pg L-1 to μg L-1 concentrations. WWTPs were designed...

  18. The role of direct-to-consumer pharmaceutical advertisements and individual differences in getting people to talk to physicians.

    Science.gov (United States)

    Krezmien, Elyse; Wanzer, Melissa Bekelja; Servoss, Timothy; LaBelle, Sara

    2011-09-01

    In this study, 384 respondents provided quantitative and descriptive information about direct-to-consumer (DTC) pharmaceutical advertisements and factors related to message reception and drug adoption. The authors applied M. Booth-Butterfield's ( 2008 ) Standard Model to explain how DTC advertising is used in getting individuals to talk to their doctors about pharmaceutical drugs. The researchers predicted that individuals who talked with their physicians about a pharmaceutical drug (referred to as talkers) would differ from those who did not talk with their physicians (referred to as nontalkers) in a number of meaningful ways. Findings from this data set indicate that individuals who talked with their physician about a specific medication were more likely to be female, older, higher in need for cognition, and reported higher physician satisfaction. Total number of channels (TV, radio, newspaper, magazines, and the Internet) was negatively associated with talking to a physician about a specific medication, as was exposure to DTC advertisement on television. The authors offer explanations for these findings along with descriptive accounts of how talkers and nontalkers differed in their recall of DTC advertisement information. Copyright © Taylor & Francis Group, LLC

  19. Recent research data on the removal of pharmaceuticals from sewage treatment plants (STP

    Directory of Open Access Journals (Sweden)

    José Luiz Tambosi

    2010-01-01

    Full Text Available Pharmaceutical compounds have been detected in sewage treatment plant (STP effluents, surface waters and, less frequently, in groundwater and drinking water, all over the world. Different sources are responsible for their appearance in the aquatic environment, however, it is widely accepted that the main sources of this type of pollutant are STP effluents. The adverse effects of pharmaceuticals in the environment include aquatic toxicity, development of resistance in pathogenic bacteria, genotoxicity and endocrine disruption. Thus, the discharge of these compounds to the environment in STP effluents should be minimized.

  20. A study on monitoring of pharmaceuticals and personal care products (PPCPs) in livestock wastewater and treatment by radiation techniques

    Energy Technology Data Exchange (ETDEWEB)

    Myung, Seung Woon [KAERI, Daejeon (Korea, Republic of)

    2010-05-15

    In this study, and effective monitoring and the investigation of treatment efficiency of pharmaceuticals from the influent and effluent of livestock wastewater treatment plant (WWTPs) and by-product with radiation processing by LC/ESI-MS/MS was performed. Thirteen pharmaceuticals including antibiotics, growth promoters and disinfectants were assayed from twelve WWTPs in South Korea. The established method could be used to determine low concentration levels of pharmaceuticals in environmental samples. From few influents of live-stock WWTPs, chlortetracycline and acetaminophen were detected with the highest concentration among the monitoring pharmaceuticals. And also lincomycin, sufathiazole, sulfamethazine, trimethoprim, acetyl salicylic acid, tylosin, glutaraldehyde and formaldehyde were detected from the influents of WWTPs

  1. A study on monitoring of pharmaceuticals and personal care products (PPCPs) in livestock wastewater and treatment by radiation techniques

    International Nuclear Information System (INIS)

    Myung, Seung Woon

    2010-05-01

    In this study, and effective monitoring and the investigation of treatment efficiency of pharmaceuticals from the influent and effluent of livestock wastewater treatment plant (WWTPs) and by-product with radiation processing by LC/ESI-MS/MS was performed. Thirteen pharmaceuticals including antibiotics, growth promoters and disinfectants were assayed from twelve WWTPs in South Korea. The established method could be used to determine low concentration levels of pharmaceuticals in environmental samples. From few influents of live-stock WWTPs, chlortetracycline and acetaminophen were detected with the highest concentration among the monitoring pharmaceuticals. And also lincomycin, sufathiazole, sulfamethazine, trimethoprim, acetyl salicylic acid, tylosin, glutaraldehyde and formaldehyde were detected from the influents of WWTPs

  2. Pharmaceutical Innovation in the Treatment of Schizophrenia and Mental Disorders Compared with Other Diseases.

    Science.gov (United States)

    MacEwan, Joanna P; Seabury, Seth; Aigbogun, Myrlene Sanon; Kamat, Siddhesh; van Eijndhoven, Emma; Francois, Clement; Henderson, Crystal; Citrome, Leslie

    2016-01-01

    The objectives of this study were to assess the level of private and public investment in research and development of treatments for schizophrenia and other mental disorders compared to other diseases in order to present data on the economic burden and pharmaceutical innovation by disease area, and to compare the level of investment relative to burden across different diseases. The levels of investment and pharmaceutical innovation relative to burden across different diseases were assessed. Disease burden and prevalence for mental disorders (schizophrenia, bipolar disorder, and major depressive disorder); cancer; rheumatoid arthritis; chronic obstructive pulmonary disorder; diabetes; cardiovascular disease; and neurological disorders (dementia and epilepsy) were estimated from literature sources. Pharmaceutical treatment innovation was measured by the total number of drug launches and the number of drugs launched categorized by innovativeness. Research and development expenditures were estimated using published information on annual public and domestic private research and development expenditures by disease area. Lastly, investment relative to disease burden was measured among the set of disease classes for which all three measures were available: schizophrenia, bipolar disorder, major depressive disorder, cancer, rheumatoid arthritis, chronic obstructive pulmonary disease, diabetes, cardiovascular disease, and neurology (dementia and epilepsy combined). The level of investment and pharmaceutical innovation in mental disorders was comparatively low, especially relative to the burden of disease. For mental disorders, investment was $3.1 per $1,000 burden invested in research and development for schizophrenia, $1.8 for major depressive disorder, and $0.4 for bipolar disorder relative to cancer ($75.5), chronic obstructive pulmonary disease ($9.4), diabetes ($7.6), cardiovascular disease ($6.3), or rheumatoid arthritis ($5.3). Pharmaceutical innovation was also low

  3. Validation Aspects of Water Treatment Systems for Pharmaceutical ...

    African Journals Online (AJOL)

    The goal of conducting validation is to demonstrate that a process, when operated within established limits, produces a product of consistent and specified quality with a high degree of assurance. Validation of water treatment systems is necessary to obtain water with all desired quality attributes. This also provides a ...

  4. VETERINARY PHARMACEUTICALS: POTENTIAL ENVIRONMENTAL IMPACT AND TREATMENT STRATEGIES

    Science.gov (United States)

    In the late 1970s it was recognized that there were increasing occurrences of antibiotic-resistant organisms in Europe and the US. Even in the early stages, concerns were raised that large-scale treatment of farm animals for infectious disease as well as growth enhancement may be...

  5. PHARMACEUTICAL CARE IN THE TREATMENT OF PATIENTS WITH INFECTIONS OF THE LOWER URINARY TRACT

    OpenAIRE

    Moroz V.A.

    2013-01-01

    In order to monitor changes in the recommendations for drug treatment of lower urinary tract infections (UTI) and pharmaceutical care of patients analyzed resolution and related publications of American Urological Association at the end of 2012. Marked improvement of detail factors of chronicity UTI and allocation of roles pharmacist to prevent its recurrence. In the arsenal of treatments for uncomplicated disease (about 80%) left Co-trimoxazole, but exclude the scheme of its single administr...

  6. Low removal of acidic and hydrophilic pharmaceutical products by various types of municipal wastewater treatment plants

    Directory of Open Access Journals (Sweden)

    Christian Gagnon

    2012-03-01

    Full Text Available Pharmaceutical substances represent a risk for aquatic environments and their potential impacts on the receiving environment are poorly understood. Municipal effluents are important sources of contaminants including common pharmaceuticals like anti-inflammatory and anti-convulsive substances. The removal of pharmaceuticals, particularly those highly soluble can represent a great challenge to conventional wastewater treatment processes. Hydrophilic drugs (e.g. acidic drugs have properties that can highly influence removal efficiencies of treatment plants. The performance of different wastewater treatment processes for the removal of specific pharmaceutical products that are expected to be poorly removed was investigated. The obtained results were compared to inherent properties of the studied substances. Clofibric acid, carbamazepine, diclofenac, ibuprofen and naproxen were largely found in physicochemical primary-treated effluents at concentrations ranging from 77 to 2384 ng/L. This treatment type showed removal yields lower than 30%. On the other hand, biological treatments with activated sludge under aerobic conditions resulted in much better removal rates (>50% for 5 of the 8 studied substances. Interestingly, this latter type of process showed evidence of selectivity with respect to the size (R2=0.7388, solubility (R2=0.6812, and partitioning (R2=0.9999 of the removed substances; the smallest and least sorbed substances seemed to be removed at better rates, while the persistent carbamazepine (392 ng/L and diclofenac (66 ng/L were poorly removed (<10% after biological treatment. In the case of treatment by aerated lagoons, the most abundant substances were the highly soluble hydroxy-ibuprofen (350-3321 ng/L, followed by naproxen (42-413 n/L and carbamazepine (254-386 ng/L. In order to assess the impacts of all these contaminants of various properties on the environment and human health, we need to better understand the chemical and physical

  7. Concentrations of prioritized pharmaceuticals in effluents from 50 large wastewater treatment plants in the US and implications for risk estimation

    International Nuclear Information System (INIS)

    Kostich, Mitchell S.; Batt, Angela L.; Lazorchak, James M.

    2014-01-01

    We measured concentrations of 56 active pharmaceutical ingredients (APIs) in effluent samples from 50 large wastewater treatment plants across the US. Hydrochlorothiazide was found in every sample. Metoprolol, atenolol, and carbamazepine were found in over 90% of the samples. Valsartan had the highest concentration (5300 ng/L), and also had the highest average concentration (1600 ng/L) across all 50 samples. Estimates of potential risks to healthy human adults were greatest for six anti-hypertensive APIs (lisinopril, hydrochlorothiazide, valsartan, atenolol, enalaprilat, and metoprolol), but nevertheless suggest risks of exposure to individual APIs as well as their mixtures are generally very low. Estimates of potential risks to aquatic life were also low for most APIs, but suggest more detailed study of potential ecological impacts from four analytes (sertraline, propranolol, desmethylsertraline, and valsartan). -- Highlights: • Report concentrations of 56 pharmaceuticals in effluents from 50 wastewater plants. • Model and measurements agree that potential risks to healthy adult humans are low. • Model and measurements agree some uncertainties remain about risks to aquatic life. -- Measurements of pharmaceuticals in municipal effluent suggest risks of exposure to healthy human adults are low, but suggest the need for study of potential impacts on aquatic life

  8. Assessment of satisfaction with pharmaceutical services in patients receiving antiretroviral therapy in outpatient HIV treatment setting.

    Science.gov (United States)

    Agu, Kenneth Anene; Oqua, Dorothy; Agada, Peter; Ohiaeri, Samuel I; Adesina, Afusat; Abdulkareem, Mohammed Habeeb; King, Rosalyn C; Wutoh, Anthony K

    2014-06-01

    The patient's perception and satisfaction are increasingly considered as a useful factor in the assessment of competency of health care providers and quality of care. However, these patient focused assessments are largely ignored when assessing health care outcomes. The study assessed the perception and satisfaction of patients receiving antiretroviral therapy (ART) with pharmaceutical services received in outpatient HIV treatment settings. Seventeen HIV treatment centres in Nigeria. This cross-sectional survey included 2,700 patients randomly selected from 26,319 HIV patients on ART, who received pharmaceutical services in the study setting. A study-specific Likert-type instrument was administered to the participants at point of exit from the pharmacy. Midpoint of the 5-point scale was computed and scores above it were regarded as positive while below as negative. Chi-square was used for inferential statistics. All reported p values were 2-sided at 95 % confidence interval (CI). Patient satisfaction with pharmaceutical services. Of 2,700 patients sampled, data from 1,617 (59.9 %) were valid for analysis; 62.3 % were aged 26-40 years and 65.4 % were females. The participants had received pharmaceutical services for a mean duration of 25.2 (95 % CI 24.3-26.1) months. Perception of participants regarding the appearance of pharmacy was positive while that regarding the pharmacists' efforts to solve patients' medication related problems was negative. The participants' rating of satisfaction with the waiting time to access pharmaceutical services was negative; the satisfaction decreases with increasing waiting time. However, the satisfaction with the overall quality of pharmaceutical services received was rated as positive; 90.0 % reported that they got the kind of pharmaceutical services they wanted; 98.2 % would come back to the pharmacy if they were to seek help again and would recommend services to others. The level of satisfaction was found to be associated with

  9. Transformation of pharmaceuticals during oxidation/disinfection processes in drinking water treatment

    International Nuclear Information System (INIS)

    Postigo, Cristina; Richardson, Susan D.

    2014-01-01

    Graphical abstract: - Highlights: • Review of transformation pathways of pharmaceuticals during disinfection processes. • DBPs are formed with chlorine, chloramine, ozone, chlorine dioxide, UV, or UV/H 2 O 2 . • Chlorine reacts with amine and reduced sulfur groups and activated aromatic systems. • Chlorine dioxide and ozone react with electron-rich functional groups. • Potential health effects are noted for some pharmacuetical DBPs when available. - Abstract: Pharmaceuticals are emerging contaminants of concern and are widespread in the environment. While the levels of these substances in finished drinking waters are generally considered too low for human health concern, there are now concerns about their disinfection by-products (DBPs) that can form during drinking water treatment, which in some cases have been proven to be more toxic than the parent compounds. The present manuscript reviews the transformation products of pharmaceuticals generated in water during different disinfection processes, i.e. chlorination, ozonation, chloramination, chlorine dioxide, UV, and UV/hydrogen peroxide, and the main reaction pathways taking place. Most of the findings considered for this review come from controlled laboratory studies involving reactions of pharmaceuticals with these oxidants used in drinking water treatment

  10. Transformation of pharmaceuticals during oxidation/disinfection processes in drinking water treatment

    Energy Technology Data Exchange (ETDEWEB)

    Postigo, Cristina [Institute for Environmental Assessment and Water Research (IDAEA)—Spanish National Research Council (CID-CSIC), Barcelona (Spain); Richardson, Susan D., E-mail: richardson.susan@sc.edu [Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC (United States)

    2014-08-30

    Graphical abstract: - Highlights: • Review of transformation pathways of pharmaceuticals during disinfection processes. • DBPs are formed with chlorine, chloramine, ozone, chlorine dioxide, UV, or UV/H{sub 2}O{sub 2}. • Chlorine reacts with amine and reduced sulfur groups and activated aromatic systems. • Chlorine dioxide and ozone react with electron-rich functional groups. • Potential health effects are noted for some pharmacuetical DBPs when available. - Abstract: Pharmaceuticals are emerging contaminants of concern and are widespread in the environment. While the levels of these substances in finished drinking waters are generally considered too low for human health concern, there are now concerns about their disinfection by-products (DBPs) that can form during drinking water treatment, which in some cases have been proven to be more toxic than the parent compounds. The present manuscript reviews the transformation products of pharmaceuticals generated in water during different disinfection processes, i.e. chlorination, ozonation, chloramination, chlorine dioxide, UV, and UV/hydrogen peroxide, and the main reaction pathways taking place. Most of the findings considered for this review come from controlled laboratory studies involving reactions of pharmaceuticals with these oxidants used in drinking water treatment.

  11. PHARMACEUTICAL CARE IN THE TREATMENT OF PATIENTS WITH INFECTIONS OF THE LOWER URINARY TRACT

    Directory of Open Access Journals (Sweden)

    Moroz V.A.

    2013-06-01

    Full Text Available In order to monitor changes in the recommendations for drug treatment of lower urinary tract infections (UTI and pharmaceutical care of patients analyzed resolution and related publications of American Urological Association at the end of 2012. Marked improvement of detail factors of chronicity UTI and allocation of roles pharmacist to prevent its recurrence. In the arsenal of treatments for uncomplicated disease (about 80% left Co-trimoxazole, but exclude the scheme of its single administration. In complicated UTI the use of recommended combinations of antibiotics extended to 14 days, introduced the scheme extended use of Co-trimoxazole or fluoroquinolones in bacterial prostatitis and epididymitis. Formulated the principles of pharmaceutical care of patients with UTI and stated that this pathology are results from the interaction of several biomedical factors that must be considered for the rational choice of treatment strategy. Implementation of pharmaceutical care of patients with UTI is an important component of the treatment success and prevention of disease recurrence.

  12. Potential of Hibiscus Sabdariffa and Jatropha Curcas as Natural Coagulants in the Treatment of Pharmaceutical Wastewater

    Directory of Open Access Journals (Sweden)

    Sibartie Sheena

    2018-01-01

    Full Text Available Pharmaceutical wastewater is one of the most difficult wastewater to treat due to the presence of pharmaceutical compounds resulting in high concentration of organic matter, high turbidity and Chemical Oxygen Demand (COD. Chemical-based coagulation is a common method used to treat wastewater. However, the issue that has been raised with the use of chemical coagulants is their presence in water after treatment that can cause risks to the human health such as Alzheimer and cancer. Natural coagulants can be used as a safe alternative to these chemicals instead. Therefore, the objective of this experiment was to study the effect of H. Sabdariffa and J. Curcas as natural coagulants, separately and as a combination, on the treatment of pharmaceutical wastewater. Jar test experiment were carried out where beakers of 0.5L wastewater were mixed with the coagulants. The pH of the wastewater was varied from 2 to 12 while the coagulant dosage was varied from 40 to 200 mg/L. It was found that H. Sabdariffa works best at pH 4 and at a coagulant dosage of 190 mg/L with a highest turbidity removal of 35.8% and a decrease of COD by 29%. J. Curcas was found to perform best at pH 3 and with a coagulant dosage of 200 mg/L with a highest turbidity removal of 51% and a decrease of COD by 32%. When J. Curcas and H. Sabdariffa were used in combination, the optimum composition was found to be 80% J. Curcas and 20% H. Sabdariffa by weight with a maximum turbidity removal of 46.8% and a decrease in COD by 46%. In comparison between the two natural coagulants, J. Curcas is found to be a better and more suited coagulative agent for the treatment of pharmaceutical wastewater. The same experiment was carried with alum at pH 6 and coagulant dosage of 750 mg/L and a turbidity removal of 48% and a decrease in COD by 38% were recorded. In comparison with alum, J. Curcas was a better coagulant in treating the pharmaceutical wastewater. This shows that natural coagulants can be

  13. Toxicity and Treatment of Pharmaceutical and Personal Care Products Using Exotic Plants - A Laboratory Scale Experiment

    DEFF Research Database (Denmark)

    Ramírez Vargas, Carlos Andrés; Paredes, Diego; Cubillos, Janneth

    Pharmaceuticals and personal care products (PPCPs) detected in the environment belong to a large and diverse group of organic substances (analgesics, antibiotics, anticonvulsants, soaps, lotions, toothpaste, etc.). PPCPs reach aquatic ecosystems through point and diffuse discharges (unused....../expired products, excretion of people and animals, application of fertilizers, direct delivery of veterinary products etc. Santos et al., 2010). Conventional technologies for water treatment (potable and sewage) fail to remove efficiently these compounds (Dordio et al., 2010), hence it is desirable to implement...

  14. Factors to consider in developing individual pharmaceutical product quality risk profiles useful to government procurement agencies.

    Science.gov (United States)

    Xu, Wei; Boehm, Garth; Zheng, Qiang

    2016-01-01

    Governments that procure pharmaceutical products from an Essential Medicine List (EML) bear special responsibility for the quality of these products. In this article we examine the possibility of developing a pharmaceutical product quality risk assessment scheme for use by government procurement officials. We use the Chinese EML as a basis, and US recall data is examined as it is publically available.This is justified as the article is only concerned with inherent product quality risks. After establishing a link between Chinese essential medicines and those available in the US, we examine US recall data to separate product specific recalls. We conclude that, in addition to existing manufacturing based risks, there are two other product specific risks that stand out from all others, degradation and dissolution failure. Methodology for relative product risk for degradation is needed to be developed and further work is required to better understand dissolution failures which largely occur with modified-release solid oral products. We conclude that a product specific quality risk profile would be enhanced by including a risk assessment for degradation for all products, and in the case of solid oral products, dissolution.

  15. Pharmaceutical grey water footprint: Accounting, influence of wastewater treatment plants and implications of the reuse.

    Science.gov (United States)

    Martínez-Alcalá, Isabel; Pellicer-Martínez, Francisco; Fernández-López, Carmen

    2018-05-15

    Emerging pollutants, including pharmaceutical compounds, are producing water pollution problems around the world. Some pharmaceutical pollutants, which mainly reach ecosystems within wastewater discharges, are persistent in the water cycle and can also reach the food chain. This work addresses this issue, accounting the grey component of the water footprint (GWF P ) for four of the most common pharmaceutical compounds (carbamazepine (CBZ), diclofenac (DCF), ketoprofen (KTP) and naproxen (NPX)). In addition, the GWF C for the main conventional pollutants is also accounted (nitrate, phosphates and organic matter). The case study is the Murcia Region of southeastern Spain, where wastewater treatment plants (WWTPs) purify 99.1% of the wastewater discharges and there is an important direct reuse of the treated wastewater in irrigation. Thus, the influence of WWTPs and reuse on the GWF is analysed. The results reveal that GWF P , only taking into account pharmaceutical pollutants, has a value of 301 m 3 inhabitant -1 year -1 ; considering only conventional pollutants (GWF C ), this value increases to 4718 m 3 inhabitant -1 year -1 . So, the difference between these values is such that in other areas with consumption habits similar to those of the Murcia Region, and without wastewater purification, conventional pollutants may well establish the value of the GWF. On average, the WWTPs reduce the GWF C by 90% and the GWF P by 26%. These different reductions of the pollutant concentrations in the treated effluents show that the GWF is not only due to conventional pollutants, and other contaminants can became critical, such as the pharmaceutical pollutants. The reuse further reduces the value of the GWF for the Murcia Region, by around 43.6%. However, the reuse of treated wastewater is controversial, considering the pharmaceutical contaminants and their possible consequences in the food chain. In these cases, the GWF of pharmaceutical pollutants can be used to provide a

  16. Rejection of pharmaceuticals in nanofiltration and reverse osmosis membrane drinking water treatment.

    Science.gov (United States)

    Radjenović, J; Petrović, M; Ventura, F; Barceló, D

    2008-08-01

    This paper investigates the removal of a broad range of pharmaceuticals during nanofiltration (NF) and reverse osmosis (RO) applied in a full-scale drinking water treatment plant (DWTP) using groundwater. Pharmaceutical residues detected in groundwater used as feed water in all five sampling campaigns were analgesics and anti-inflammatory drugs such as ketoprofen, diclofenac, acetaminophen and propyphenazone, beta-blockers sotalol and metoprolol, an antiepileptic drug carbamazepine, the antibiotic sulfamethoxazole, a lipid regulator gemfibrozil and a diuretic hydrochlorothiazide. The highest concentrations in groundwater were recorded for hydrochlorothiazide (58.6-2548ngL(-1)), ketoprofen (85%). Deteriorations in retentions on NF and RO membranes were observed for acetaminophen (44.8-73 %), gemfibrozil (50-70 %) and mefenamic acid (30-50%). Furthermore, since several pharmaceutical residues were detected in the brine stream of NF and RO processes at concentrations of several hundreds nanogram per litre, its disposal to a near-by river can represent a possible risk implication of this type of treatment.

  17. Occurrence of antibiotics in pharmaceutical industrial wastewater, wastewater treatment plant and sea waters in Tunisia.

    Science.gov (United States)

    Tahrani, Leyla; Van Loco, Joris; Ben Mansour, Hedi; Reyns, Tim

    2016-04-01

    Antibiotics are among the most commonly used group of pharmaceuticals in human medicine. They can therefore reach surface and groundwater bodies through different routes, such as wastewater treatment plant effluents, surface runoff, or infiltration of water used for agricultural purposes. It is well known that antibiotics pose a significant risk to environmental and human health, even at low concentrations. The aim of the present study was to evaluate the presence of aminoglycosides and phenicol antibiotics in municipal wastewaters, sea water and pharmaceutical effluents in Tunisia. All analysed water samples contained detectable levels of aminoglycoside and phenicol antibiotics. The highest concentrations in wastewater influents were observed for neomycin and kanamycin B (16.4 ng mL(-1) and 7.5 ng mL(-1), respectively). Chloramphenicol was found in wastewater influents up to 3 ng mL(-1). It was observed that the waste water treatment plants were not efficient in completely removing these antibiotics. Chloramphenicol and florfenicol were found in sea water samples near aquaculture sites at levels up to, respectively, 15.6 ng mL(-1) and 18.4 ng mL(-1). Also aminoglycoside antibiotics were found near aquaculture sites with the highest concentration of 3.4 ng mL(-1) for streptomycin. In pharmaceutical effluents, only gentamycin was found at concentrations up to 19 ng mL(-1) over a sampling period of four months.

  18. Effect of redox conditions on pharmaceutical loss during biological wastewater treatment using sequencing batch reactors

    DEFF Research Database (Denmark)

    Stadler, Lauren B.; Su, Lijuan; Moline, Christopher J.

    2015-01-01

    We lack a clear understanding of how wastewater treatment plant (WWTP) process parameters, such as redox environment, impact pharmaceutical fate. WWTPs increasingly install more advanced aeration control systems to save energy and achieve better nutrient removal performance. The impact of redox...... under different redox conditions: fully aerobic, anoxic/aerobic, and microaerobic (DO concentration ≈0.3 mg/L). Among the pharmaceuticals that were tracked during this study (atenolol, trimethoprim, sulfamethoxazole, desvenlafaxine, venlafaxine, and phenytoin), overall loss varied between them...... and between redox environments. Losses of atenolol and trimethoprim were highest in the aerobic reactor; sulfamethoxazole loss was highest in the microaerobic reactors; and phenytoin was recalcitrant in all reactors. Transformation products of sulfamethoxazole and desvenlafaxine resulted in the reformation...

  19. Individual and mixture effects of selected pharmaceuticals on larval development of the estuarine shrimp Palaemon longirostris.

    Science.gov (United States)

    González-Ortegón, Enrique; Blasco, Julian; Nieto, Elena; Hampel, Miriam; Le Vay, Lewis; Giménez, Luis

    2016-01-01

    Few ecotoxicological studies incorporate within the experimental design environmental variability and mixture effects when assessing the impact of pollutants on organisms. We have studied the combined effects of selected pharmaceutical compounds and environmental variability in terms of salinity and temperature on survival, development and body mass of larvae of the estuarine shrimp Palaemon longirostris. Drug residues found in coastal waters occur as mixture, and the evaluation of combined effects of simultaneously occurring compounds is indispensable for their environmental risk assessment. All larval stages of P. longirostris were exposed to the nonsteroidal anti-inflammatory drug (NSAID) diclofenac sodium (DS: 40 and 750 μg L(-1)), the lipid regulator clofibric acid (CA: 17 and 361 μg L(-1)) and the fungicide clotrimazole (CLZ: 0.14 and 4 μg L(-1)). We observed no effect on larval survival of P. longirostris with the tested pharmaceuticals. However, and in contrast to previous studies on larvae of the related marine species Palaemon serratus, CA affected development through an increase in intermoult duration and reduced growth without affecting larval body mass. These developmental effects in P. longirostris larvae were similar to those observed in the mixture of DS and CA confirming the toxic effects of CA. In the case of CLZ, its effects were similar to those observed previously in P. serratus: high doses affected development altering intermoult duration, tended to reduce the number of larval instars and decreased significantly the growth rate. This study suggests that an inter-specific life histories approach should be taken into account to assess the effect of emergent compounds in coastal waters. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Metagenomic analysis of an ecological wastewater treatment plant's microbial communities and their potential to metabolize pharmaceuticals.

    Science.gov (United States)

    Balcom, Ian N; Driscoll, Heather; Vincent, James; Leduc, Meagan

    2016-01-01

    Pharmaceuticals and other micropollutants have been detected in drinking water, groundwater, surface water, and soil around the world. Even in locations where wastewater treatment is required, they can be found in drinking water wells, municipal water supplies, and agricultural soils. It is clear conventional wastewater treatment technologies are not meeting the challenge of the mounting pressures on global freshwater supplies. Cost-effective ecological wastewater treatment technologies have been developed in response. To determine whether the removal of micropollutants in ecological wastewater treatment plants (WWTPs) is promoted by the plant-microbe interactions, as has been reported for other recalcitrant xenobiotics, biofilm microbial communities growing on the surfaces of plant roots were profiled by whole metagenome sequencing and compared to the microbial communities residing in the wastewater. In this study, the concentrations of pharmaceuticals and personal care products (PPCPs) were quantified in each treatment tank of the ecological WWTP treating human wastewater at a highway rest stop and visitor center in Vermont. The concentrations of detected PPCPs were substantially greater than values reported for conventional WWTPs likely due to onsite recirculation of wastewater. The greatest reductions in PPCPs concentrations were observed in the anoxic treatment tank where Bacilli dominated the biofilm community. Benzoate degradation was the most abundant xenobiotic metabolic category identified throughout the system. Collectively, the microbial communities residing in the wastewater were taxonomically and metabolically more diverse than the immersed plant root biofilm. However, greater heterogeneity and higher relative abundances of xenobiotic metabolism genes was observed for the root biofilm.

  1. Effects of Pharmaceuticals Used for Breast Cancer Treatment on Reproduction and Aromatase Activity in a Marine Fish

    Science.gov (United States)

    Laboratory experiments were conducted with the marine fish cunner (Tautogolabrus adspersus) to evaluate whether four pharmaceuticals used in breast cancer treatment have an impact on reproduction or aromatase activity. Tamoxifen binds to estrogen receptors, while anastrozole, let...

  2. Concentrations of prioritized pharmaceuticals in effluents from 50 large wastewater treatment plants in the US and implications for risk estimation

    Science.gov (United States)

    We measured the concentrations of 56 active pharmaceutical ingredients (APIs) and seven metabolites, including 50 prioritized APIs, in 24-hour composite effluent samples collected from 50 very large municipal wastewater treatment plants across the US. Hydrochlorothiazide was foun...

  3. Biotransformation of pharmaceuticals in surface water and during waste water treatment: identification and occurrence of transformation products

    NARCIS (Netherlands)

    Boix, C.; Ibáñez, M.; Sancho, J.V.; Parsons, J.R.; de Voogt, P.; Hernández, F.

    2016-01-01

    Venlafaxine, gemfibrozil, ibuprofen, irbesartan and ofloxacin are highly-consumed pharmaceuticals that show considerable removal efficiencies (between 40 and 98%) in wastewater treatment plants (WWTPs). Consequently, they are expected to generate transformation products (TPs) during wastewater

  4. Removal of pharmaceuticals from wastewater by biological processes, hydrodynamic cavitation and UV treatment.

    Science.gov (United States)

    Zupanc, Mojca; Kosjek, Tina; Petkovšek, Martin; Dular, Matevž; Kompare, Boris; Širok, Brane; Blažeka, Željko; Heath, Ester

    2013-07-01

    To augment the removal of pharmaceuticals different conventional and alternative wastewater treatment processes and their combinations were investigated. We tested the efficiency of (1) two distinct laboratory scale biological processes: suspended activated sludge and attached-growth biomass, (2) a combined hydrodynamic cavitation-hydrogen peroxide process and (3) UV treatment. Five pharmaceuticals were chosen including ibuprofen, naproxen, ketoprofen, carbamazepine and diclofenac, and an active metabolite of the lipid regulating agent clofibric acid. Biological treatment efficiency was evaluated using lab-scale suspended activated sludge and moving bed biofilm flow-through reactors, which were operated under identical conditions in respect to hydraulic retention time, working volume, concentration of added pharmaceuticals and synthetic wastewater composition. The suspended activated sludge process showed poor and inconsistent removal of clofibric acid, carbamazepine and diclofenac, while ibuprofen, naproxen and ketoprofen yielded over 74% removal. Moving bed biofilm reactors were filled with two different types of carriers i.e. Kaldnes K1 and Mutag BioChip™ and resulted in higher removal efficiencies for ibuprofen and diclofenac. Augmentation and consistency in the removal of diclofenac were observed in reactors using Mutag BioChip™ carriers (85%±10%) compared to reactors using Kaldnes carriers and suspended activated sludge (74%±22% and 48%±19%, respectively). To enhance the removal of pharmaceuticals hydrodynamic cavitation with hydrogen peroxide process was evaluated and optimal conditions for removal were established regarding the duration of cavitation, amount of added hydrogen peroxide and initial pressure, all of which influence the efficiency of the process. Optimal parameters resulted in removal efficiencies between 3-70%. Coupling the attached-growth biomass biological treatment, hydrodynamic cavitation/hydrogen peroxide process and UV treatment

  5. Analysis of the domestic pharmaceutical market drugs for the treatment of urolithiasis

    Directory of Open Access Journals (Sweden)

    V. L. Shevina

    2014-12-01

    Full Text Available Urolithiasis is a metabolic disease caused by various endogenous and (or exogenous factors, often is hereditary and is defined by the stone presence in the urinary system. Antibacterial therapies, herbal medicine, dietary restrictions, mineral water are used in the complex treatment of patients with urolithiasis after removal of concrement by different methods. The search for new and improvement of already known methods of treatment of urolithiasis remains relevant to date. Along with the use of synthetic drugs the use of herbal remedies that have diuretic, antispasmodic, bacteriostatic and many other effects is appropriate. An extremely valuable feature of herbal products is their ability to enhance excretion of urea and other nitrogenous waste products of metabolism, which is especially important in cases of severe renal failure of different aetiology. Note, however, that the range of herbal medicines used for the treatment of urolithiasis with symptoms of azotaemia is rather limited. The aim of our study was to investigate the range of medicines used to treat urolithiasis presented in the domestic pharmaceutical market by different countries, as well as to determine whether the Ukrainian medicines are available in the domestic market. Materials and Methods The analysis of products’ range was performed according to the State Register of Medicines of Ukraine and АТС classification system. The object of the study was the medicinal products, which are used for treatment of urolithiasis. Results The products were analysed according to three АТС groups: products that inhibit uric acid synthesis; other urologicals; solvents of urinary concrement. The study has shown that 21 products are registered in Ukraine (June 2014. It has been established that the market is distributed almost equally between domestic and foreign manufacturers i.e. 8 foreign and 7 domestic manufacturers are present in the pharmaceutical market. The next stage of research

  6. Occurrence and removal of antibiotics, hormones and several other pharmaceuticals in wastewater treatment plants of the largest industrial city of Korea.

    Science.gov (United States)

    Behera, Shishir Kumar; Kim, Hyeong Woo; Oh, Jeong-Eun; Park, Hung-Suck

    2011-09-15

    Occurrence and removal efficiencies of 20 pharmaceuticals and personal care products (PPCPs) including antibiotics, hormones, and several other miscellaneous pharmaceuticals (analgesics, antiepileptics, antilipidemics, antihypertensives, antiseptics, and stimulants) were investigated in five wastewater treatment plants (WWTPs) of Ulsan, the largest industrial city of Korea. The compounds were extracted from wastewater samples by solid-phase extraction (SPE) and analyzed by High-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS). The results showed that acetaminophen, atenolol and lincomycin were the main individual pollutants usually found in concentrations over 10 μg/L in the sewage influent. In the WWTPs, the concentrations of analgesic acetaminophen, stimulant caffeine, hormones estriol and estradiol decreased by over 99%. On the contrary, the antibiotic sulfamethazine, the antihypertensive metoprolol, and the antiepileptic carbamazepine exhibited removal efficiencies below 30%. Particularly, removal of antibiotics was observed to vary between -11.2 and 69%. In the primary treatment (physico-chemical processes), the removal of pharmaceuticals was insignificant (up to 28%) and removal of majority of the pharmaceuticals occurred during the secondary treatment (biological processes). The compounds lincomycin, carbamazepine, atenolol, metoprolol, and triclosan showed better removal in WWTPs employing modified activated sludge process with co-existence of anoxic-oxic condition. Further investigation into the design and operational aspects of the biological processes is warranted for the efficient removal of PPCPs, particularly antibiotics, to secure healthy water resource in the receiving downstream, thereby ensuring a sustainable water cycle management. Copyright © 2011. Published by Elsevier B.V.

  7. Trace Analysis of Pharmaceutical Residues in Wastewater Treatment Plants in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Aldo Pacheco Ferreira

    2014-05-01

    Full Text Available The occurrence and fate of trace-level contamination of pharmaceuticals in the aquatic environment has been recognized as one of the emerging issues in environmental chemistry. The effluents of wastewater treatment plants, usually directly emitted to the environment, often contain the anti-inflammatory drug diclofenac. Diclofenac was chosen because it is of high consumption; by background literature indicate toxic effects on biota and the lack of profile in sewage removal provided by the city. For this purpose, a survey on the presence of diclofenac in urban wastewater of Rio de Janeiro was carried out. It were evaluated diclofenac concentration in the affluent and effluent from wastewater treatment plant (WWTP Penha and Ilha do Governador, Rio de Janeiro, Brazil. Samples were collected along the line of treatment of each WWTP, and for clean up the samples were solid phase extraction (SPE, analysed by high performance liquid chromatography (HPLC, assisted by diode array detector (DAD techniques. The removal efficiency of pharmaceuticals in the wastewater treatment plants was roughly evaluated. Diclofenac was detected in all samples analysed wastewater (treated and raw, which confirms the low removal efficiency of conventional treatment systems, aerobes and anaerobes.

  8. Exploring the Use of Cost-Benefit Analysis to Compare Pharmaceutical Treatments for Menorrhagia.

    Science.gov (United States)

    Sanghera, Sabina; Frew, Emma; Gupta, Janesh Kumar; Kai, Joe; Roberts, Tracy Elizabeth

    2015-09-01

    The extra-welfarist theoretical framework tends to focus on health-related quality of life, whilst the welfarist framework captures a wider notion of well-being. EQ-5D and SF-6D are commonly used to value outcomes in chronic conditions with episodic symptoms, such as heavy menstrual bleeding (clinically termed menorrhagia). Because of their narrow-health focus and the condition's periodic nature these measures may be unsuitable. A viable alternative measure is willingness to pay (WTP) from the welfarist framework. We explore the use of WTP in a preliminary cost-benefit analysis comparing pharmaceutical treatments for menorrhagia. A cost-benefit analysis was carried out based on an outcome of WTP. The analysis is based in the UK primary care setting over a 24-month time period, with a partial societal perspective. Ninety-nine women completed a WTP exercise from the ex-ante (pre-treatment/condition) perspective. Maximum average WTP values were elicited for two pharmaceutical treatments, levonorgestrel-releasing intrauterine system (LNG-IUS) and oral treatment. Cost data were offset against WTP and the net present value derived for treatment. Qualitative information explaining the WTP values was also collected. Oral treatment was indicated to be the most cost-beneficial intervention costing £107 less than LNG-IUS and generating £7 more benefits. The mean incremental net present value for oral treatment compared with LNG-IUS was £113. The use of the WTP approach was acceptable as very few protests and non-responses were observed. The preliminary cost-benefit analysis results recommend oral treatment as the first-line treatment for menorrhagia. The WTP approach is a feasible alternative to the conventional EQ-5D/SF-6D approaches and offers advantages by capturing benefits beyond health, which is particularly relevant in menorrhagia.

  9. Concentrations of prioritized pharmaceuticals in effluents from 50 large wastewater treatment plants in the US and implications for risk estimation.

    Science.gov (United States)

    Kostich, Mitchell S; Batt, Angela L; Lazorchak, James M

    2014-01-01

    We measured concentrations of 56 active pharmaceutical ingredients (APIs) in effluent samples from 50 large wastewater treatment plants across the US. Hydrochlorothiazide was found in every sample. Metoprolol, atenolol, and carbamazepine were found in over 90% of the samples. Valsartan had the highest concentration (5300 ng/L), and also had the highest average concentration (1600 ng/L) across all 50 samples. Estimates of potential risks to healthy human adults were greatest for six anti-hypertensive APIs (lisinopril, hydrochlorothiazide, valsartan, atenolol, enalaprilat, and metoprolol), but nevertheless suggest risks of exposure to individual APIs as well as their mixtures are generally very low. Estimates of potential risks to aquatic life were also low for most APIs, but suggest more detailed study of potential ecological impacts from four analytes (sertraline, propranolol, desmethylsertraline, and valsartan). Published by Elsevier Ltd.

  10. Assessment of Nelumbo nucifera and Hydrilla verticillata in the treatment of pharmaceutical industry effluent from 24 Parganas, West Bengal

    Directory of Open Access Journals (Sweden)

    Shamba Chatterjee

    2014-10-01

    Full Text Available Modern day technologies employed in industrialization and unhygienic lifestyle of mankind has led to a severe environmental menace resulting in pollution of freshwater bodies. Pharmaceutical industry effluents cause eutrophication and provide adequate nutrients for growth of pathogenic bacteria. This study has been conducted with aquatic plants water lotus (Nelumbo nucifera and hydrilla (Hydrilla verticillata with an novel aim to treat pharmaceutical industry effluents showing the outcome of the experiments carried out with the effluents collected from rural areas of 24 Parganas, West Bengal, India. Determination of pH, solid suspend, BOD5, NH3-N, MPN and coliform test were used for this notioned purpose. Pharmaceutical waste effluent water treated with water lotus showed less pH, solid suspend, DO, BOD, NH3-N, MPN and coliform bacteria than hydrilla treatment when compared to the control. In conclusion, water lotus is found to be more efficient in treatment of pharmaceutical industry effluent waste water than hydrilla.

  11. Occurrence of pharmaceutical contaminants and screening of treatment alternatives for southeastern Louisiana.

    Science.gov (United States)

    Boyd, G R; Grimm, D A

    2001-12-01

    Recent studies conducted in Germany, Switzerland, Denmark, Brazil, Canada, the United States, and elsewhere indicate that low-level concentrations of pharmaceuticals and personal-care products (PPCPs) and their metabolites may be widespread contaminants in our aquatic environment. The persistence of pharmaceutical contaminants has been attributed to (1) human consumption of drugs and subsequent discharges from sewage treatment plants, and (2) veterinary use of drugs and nonpoint discharges from agricultural runoff. Contamination of water resources by these compounds, particularly endocrine disrupting chemicals (EDCs), is emerging as an international environmental concern. The long-term effects of continuous, low-level exposure to PPCPs is not well understood. Preliminary data for raw water samples collected from the Mississippi River and Lake Pontchartrain, Louisiana, are summarized. Three PPCP compounds (clofibric acid, naproxen, and estrone) were analyzed using solid-phase extraction, derivatization, and GC/MS. Batch experiments also were conducted to determine equilibrium capacity of activated carbon for clofibric acid. Preliminary results indicate the occurrence of the selected PPCP contaminants in raw water samples at or near method-detection limits. For batch equilibrium experiments, preliminary results indicate that activated carbon potentially can be used to remove clofibric acid from water. More research is needed to develop rapid and reliable methods for PPCP analysis and to determine the effectiveness of treatment processes for removal of PPCP contaminants in water.

  12. Comparison of Pharmaceutical, Psychological, and Exercise Treatments for Cancer-Related Fatigue: A Meta-analysis.

    Science.gov (United States)

    Mustian, Karen M; Alfano, Catherine M; Heckler, Charles; Kleckner, Amber S; Kleckner, Ian R; Leach, Corinne R; Mohr, David; Palesh, Oxana G; Peppone, Luke J; Piper, Barbara F; Scarpato, John; Smith, Tenbroeck; Sprod, Lisa K; Miller, Suzanne M

    2017-07-01

    Cancer-related fatigue (CRF) remains one of the most prevalent and troublesome adverse events experienced by patients with cancer during and after therapy. To perform a meta-analysis to establish and compare the mean weighted effect sizes (WESs) of the 4 most commonly recommended treatments for CRF-exercise, psychological, combined exercise and psychological, and pharmaceutical-and to identify independent variables associated with treatment effectiveness. PubMed, PsycINFO, CINAHL, EMBASE, and the Cochrane Library were searched from the inception of each database to May 31, 2016. Randomized clinical trials in adults with cancer were selected. Inclusion criteria consisted of CRF severity as an outcome and testing of exercise, psychological, exercise plus psychological, or pharmaceutical interventions. Studies were independently reviewed by 12 raters in 3 groups using a systematic and blinded process for reconciling disagreement. Effect sizes (Cohen d) were calculated and inversely weighted by SE. Severity of CRF was the primary outcome. Study quality was assessed using a modified 12-item version of the Physiotherapy Evidence-Based Database scale (range, 0-12, with 12 indicating best quality). From 17 033 references, 113 unique studies articles (11 525 unique participants; 78% female; mean age, 54 [range, 35-72] years) published from January 1, 1999, through May 31, 2016, had sufficient data. Studies were of good quality (mean Physiotherapy Evidence-Based Database scale score, 8.2; range, 5-12) with no evidence of publication bias. Exercise (WES, 0.30; 95% CI, 0.25-0.36; P psychological (WES, 0.27; 95% CI, 0.21-0.33; P psychological interventions (WES, 0.26; 95% CI, 0.13-0.38; P psychological mode, type of control condition, use of intention-to-treat analysis, and fatigue measures (WES range, -0.91 to 0.99). Results suggest that the effectiveness of behavioral interventions, specifically exercise and psychological interventions, is not attributable to

  13. Pilot-scale removal of pharmaceuticals in municipal wastewater: Comparison of granular and powdered activated carbon treatment at three wastewater treatment plants.

    Science.gov (United States)

    Kårelid, Victor; Larsson, Gen; Björlenius, Berndt

    2017-05-15

    Adsorption with activated carbon is widely suggested as an option for the removal of organic micropollutants including pharmaceutically active compounds (PhACs) in wastewater. In this study adsorption with granular activated carbon (GAC) and powdered activated carbon (PAC) was analyzed and compared in parallel operation at three Swedish wastewater treatment plants with the goal to achieve a 95% PhAC removal. Initially, mapping of the prevalence of over 100 substances was performed at each plant and due to low concentrations a final 22 were selected for further evaluation. These include carbamazepine, clarithromycin and diclofenac, which currently are discussed for regulation internationally. A number of commercially available activated carbon products were initially screened using effluent wastewater. Of these, a reduced set was selected based on adsorption characteristics and cost. Experiments designed with the selected carbons in pilot-scale showed that most products could indeed remove PhACs to the target level, both on total and individual basis. In a setup using internal recirculation the PAC system achieved a 95% removal applying a fresh dose of 15-20 mg/L, while carbon usage rates for the GAC application were much broader and ranged from carbon product. The performance of the PAC products generally gave better results for individual PhACs in regards to carbon availability. All carbon products showed a specific adsorption for a specific PhAC meaning that knowledge of the target pollutants must be acquired before successful design of a treatment system. In spite of different configurations and operating conditions of the different wastewater treatment plants no considerable differences regarding pharmaceutical removal were observed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Risk identification for quality on stage of pharmaceutical development of combined eye drops for glaucoma treatment

    Directory of Open Access Journals (Sweden)

    Олександр Миколайович Якубчук

    2015-12-01

    Full Text Available Aim: To identify the possible risks associated with critical quality attribute of combined eye drops for the treatment of glaucoma using of common risk evaluation methodologies for plannig a drug quality on the stage of pharmaceutical development. Methods: The paper used method of causal analysis. The maximal number of factors has been define to identify potential factors that provide most significant impact on the drug quality and Ishikawa diagram - graphical representation of causes and effects has been built.Results: Analysis allowed to organize the possible factors affecting the drug quality in the generalized categories: quality control methods, medicines and excipients, primary packaging, proper manufacturing conditions and the stage of the process. The most important factors that are carriers of the risk factors and may lead to negative effects have been identified for the generalized categories.Conclusions: Determined at the stage of pharmaceutical development potential critical quality attribute of AFI, excipients and primary packaging, critical parameters of the process, provide a better understanding, reduction and adoption of risk in subsequent stages of the life cycle of the drug

  15. The effects of radiation treatment on drugs and pharmaceutical additives. Pt. 5

    International Nuclear Information System (INIS)

    Schnell, R.; Boegl, W.

    1982-01-01

    The sterilization of medical instruments (e.g. catheters, one-way syringes) with ionizing radiation is successfully practiced in many countries. Simultaneously, the results of many experiments involving the sterilization of pharmaceuticals and aiding substances with radiation have been published during the past years. Experiences have shown that radiation treatment in many cases has brought about aberrations in the irradiated substances. In this bibliographic study (Part I-V), the results of 275 radiation tested pharmaceuticals are discussed and evaluated. The substances were treated with ionizing radiation in their pure form (solid substance or liquid), as aqueous or alcohol solution, as emulsion or in compound form, almost exclusively with gamma radiation from cobalt-60 sources. The radiation doses applied amounted from some krd to about 100 Mrd. The results of the original papers analyzed in this Part V are not summarized separately since the final Part VII of the study on the effects of irradiation of drugs and drug additives will contain a survey for all essential data discussed in Parts I to VI. (orig.) [de

  16. Treatment Heterogeneity and Individual Qualitative Interaction

    Science.gov (United States)

    2011-08-01

    dark- coloured individuals escape.” ~ Charles Darwin “What is food to one to some becomes Fierce poison” ~ Lucretius The quotations above...the evaluation of the plausibility and frequency of such IQIs. The ideas may also be useful in evaluating advertising claims. Consider the context

  17. Evaluation of Fenton's Reagent and Activated Persulfate for Treatment of a Pharmaceutical Waste Mixture in Groundwater

    DEFF Research Database (Denmark)

    Bennedsen, Lars Rønn; Søgaard, Erik Gydesen; Kakarla, Prasad

    2010-01-01

    Soil and groundwater beneath the Kærgård Plantage megasite in Denmark are contaminated with a complex mixture of pharmaceutical wastes, including sulfonamides, barbiturates, aniline, pyridine chlorinated solvents (DNAPL), benzene, toluene, mercury, and cyanide. Regulatory agencies in Denmark...... capacity of the aquifer sediments, pH dropped to within the range of 1 to 3 for all tests. Due to the presence of significant quantities of mercury and cyanide in the target treatment zone and the lowering of pH, batch and continuous-flow column reactors were used to measure mobilization of the mercury......, cyanide, chromium and other metals both within the aqueous and vapour phases. Except the alkaline activation, all the investigated techniques for activating persulfate were able to remove more than 80% of the primary contaminants. Optimization and more dosages led to 98-99% destruction of primary...

  18. Genders and Individual Treatment Progress in (Non-)Binary Trans Individuals.

    Science.gov (United States)

    Koehler, Andreas; Eyssel, Jana; Nieder, Timo O

    2018-01-01

    Health care for transgender and transsexual (ie, trans) individuals has long been based on a binary understanding of gender (ie, feminine vs masculine). However, the existence of non-binary or genderqueer (NBGQ) genders is increasingly recognized by academic and/or health care professionals. To gain insight into the individual health care experiences and needs of binary and NBGQ individuals to improve their health care outcomes and experience. Data were collected using an online survey study on experiences with trans health care. The non-clinical sample consisted of 415 trans individuals. An individual treatment progress score was calculated to report and compare participants' individual progress toward treatment completion and consider the individual treatment needs and definitions of completed treatment (ie, amount and types of different treatments needed to complete one's medical transition). Main outcome measures were (i) general and trans-related sociodemographic data and (ii) received and planned treatments. Participants reported binary (81.7%) and different NBGQ (18.3%) genders. The 2 groups differed significantly in basic demographic data (eg, mean age; P < .05). NBGQ participants reported significantly fewer received treatments compared with binary participants. For planned treatments, binary participants reported more treatments related to primary sex characteristics only. Binary participants required more treatments for a completed treatment than NBGQ participants (6.0 vs 4.0). There were no differences with regard to individual treatment progress score. Because traditional binary-focused treatment practice could have hindered NBGQ individuals from accessing trans health care or sufficiently articulating their needs, health care professionals are encouraged to provide a holistic and individual treatment approach and acknowledge genders outside the gender binary to address their needs appropriately. Because the study was made inclusive for non

  19. Improving the biological nitrogen removal process in pharmaceutical wastewater treatment plants: a case study.

    Science.gov (United States)

    Torrijos, M; Carrera, J; Lafuente, J

    2004-04-01

    The Biological Nitrogen Removal (BNR) process of some pharmaceutical wastewater treatment plants has important operational problems. This study shows that, in order to solve these problems, the design of industrial BNR processes should start by analysing three key parameters: the characteristics of the wastewater load, the determination of the maximum TKN removal rate and the detection of toxic or inhibitory compounds in the wastewater. A case study of this analysis in pharmaceutical wastewater is presented here. In this case, the conventional TKN analytical method does not make an accurate characterisation of the wastewater load because it measures a concentration of 100 mg TKN l(-1) whereas the real concentration, determined with a modified TKN analytical method, is 150-500 mg TKN l(-1). Also, the TKN removal of the treatment system is insufficient in some periods because it falls below legal requirements. This problem might be a consequence of the wrong characterisation of wastewater during the design process. The maximum TKN removal at 27 degrees C (24 mg N g VSS(-1) d(-1) or 197 mg N l(-1) d(-1)) was evaluated in a pilot-scale plant. This value is six times greater than the average NLR applied in the full-scale plant. Finally, some of the components of the wastewater, such as p-phenylenediamine, might have inhibitory or toxic effects on the biological process. P-phenylenediamine causes a large decrease in the nitrification rate. This effect was determined by respirometry. This methodology shows that the effect is mainly inhibitory with a contact time of 30 min and if the contact time is longer, 14 hours, a toxic effect is observed.

  20. Enhanced degradation of persistent pharmaceuticals found in wastewater treatment effluents using TiO2 nanobelt photocatalysts

    International Nuclear Information System (INIS)

    Liang, Robert; Hu, Anming; Li, Wenjuan; Zhou, Y. Norman

    2013-01-01

    Pharmaceuticals in wastewater effluents are a current and emerging global problem and the development of cost-effective methods to facilitate their removal is needed to mitigate this issue. Advanced oxidation processes (AOPs), in particular UV/TiO 2 , have potential for wastewater treatment. In this study, TiO 2 anatase phase nanobelts (30–100 nm in width and 10 μm in length) have been synthesized using a high temperature hydrothermal method as a means to photocatalyze the oxidation of pharmaceutical contaminants. We have investigated a model dye (malachite green), three pharmaceuticals and personal care products—naproxen, carbamazepine, and theophylline—that are difficult to oxidize without AOP processes. TiO 2 nanobelts were exposed to 365 nm UV illumination and the measured photocatalytic degradation rates and adsorption parameters of pharmaceuticals were explored using kinetic models. Furthermore we have determined the degree of pharmaceutical degradation as a function of solution pH, illumination time, temperature, and concentration of contaminant. In addition, the roles of active oxygen species—hydroxyl radial (OH·), positive holes (h + ), and hydrogen peroxide (H 2 O 2 )—involved were also investigated in the degradation process. These studies offer additional applications of hierarchical TiO 2 nanobelt membranes, including those harnessing sunlight for water treatment

  1. Enhanced degradation of persistent pharmaceuticals found in wastewater treatment effluents using TiO2 nanobelt photocatalysts

    Science.gov (United States)

    Liang, Robert; Hu, Anming; Li, Wenjuan; Zhou, Y. Norman

    2013-10-01

    Pharmaceuticals in wastewater effluents are a current and emerging global problem and the development of cost-effective methods to facilitate their removal is needed to mitigate this issue. Advanced oxidation processes (AOPs), in particular UV/TiO2, have potential for wastewater treatment. In this study, TiO2 anatase phase nanobelts (30-100 nm in width and 10 μm in length) have been synthesized using a high temperature hydrothermal method as a means to photocatalyze the oxidation of pharmaceutical contaminants. We have investigated a model dye (malachite green), three pharmaceuticals and personal care products—naproxen, carbamazepine, and theophylline—that are difficult to oxidize without AOP processes. TiO2 nanobelts were exposed to 365 nm UV illumination and the measured photocatalytic degradation rates and adsorption parameters of pharmaceuticals were explored using kinetic models. Furthermore we have determined the degree of pharmaceutical degradation as a function of solution pH, illumination time, temperature, and concentration of contaminant. In addition, the roles of active oxygen species—hydroxyl radial (OH·), positive holes (h+), and hydrogen peroxide (H2O2)—involved were also investigated in the degradation process. These studies offer additional applications of hierarchical TiO2 nanobelt membranes, including those harnessing sunlight for water treatment.

  2. Enhanced degradation of persistent pharmaceuticals found in wastewater treatment effluents using TiO{sub 2} nanobelt photocatalysts

    Energy Technology Data Exchange (ETDEWEB)

    Liang, Robert; Hu, Anming, E-mail: a2hu@uwaterloo.ca; Li, Wenjuan; Zhou, Y. Norman [University of Waterloo, Centre for Advanced Materials Joining, Department of Mechanical and Mechatronics Engineering (Canada)

    2013-10-15

    Pharmaceuticals in wastewater effluents are a current and emerging global problem and the development of cost-effective methods to facilitate their removal is needed to mitigate this issue. Advanced oxidation processes (AOPs), in particular UV/TiO{sub 2}, have potential for wastewater treatment. In this study, TiO{sub 2} anatase phase nanobelts (30-100 nm in width and 10 {mu}m in length) have been synthesized using a high temperature hydrothermal method as a means to photocatalyze the oxidation of pharmaceutical contaminants. We have investigated a model dye (malachite green), three pharmaceuticals and personal care products-naproxen, carbamazepine, and theophylline-that are difficult to oxidize without AOP processes. TiO{sub 2} nanobelts were exposed to 365 nm UV illumination and the measured photocatalytic degradation rates and adsorption parameters of pharmaceuticals were explored using kinetic models. Furthermore we have determined the degree of pharmaceutical degradation as a function of solution pH, illumination time, temperature, and concentration of contaminant. In addition, the roles of active oxygen species-hydroxyl radial (OH{center_dot}), positive holes (h{sup +}), and hydrogen peroxide (H{sub 2}O{sub 2})-involved were also investigated in the degradation process. These studies offer additional applications of hierarchical TiO{sub 2} nanobelt membranes, including those harnessing sunlight for water treatment.

  3. Metagenomic analysis of an ecological wastewater treatment plant?s microbial communities and their potential to metabolize pharmaceuticals

    OpenAIRE

    Balcom, Ian N.; Driscoll, Heather; Vincent, James; Leduc, Meagan

    2016-01-01

    Pharmaceuticals and other micropollutants have been detected in drinking water, groundwater, surface water, and soil around the world. Even in locations where wastewater treatment is required, they can be found in drinking water wells, municipal water supplies, and agricultural soils. It is clear conventional wastewater treatment technologies are not meeting the challenge of the mounting pressures on global freshwater supplies. Cost-effective ecological wastewater treatment technologies have ...

  4. The fate of pharmaceuticals, steroid hormones, phytoestrogens, UV-filters and pesticides during MBR treatment.

    Science.gov (United States)

    Wijekoon, Kaushalya C; Hai, Faisal I; Kang, Jinguo; Price, William E; Guo, Wenshan; Ngo, Hao H; Nghiem, Long D

    2013-09-01

    This study examined the relationship between molecular properties and the fate of trace organic contaminants (TrOCs) in the aqueous and solid phases during wastewater treatment by MBR. A set of 29 TrOCs was selected to represent pharmaceuticals, steroid hormones, phytoestrogens, UV-filters and pesticides that occur ubiquitously in municipal wastewater. Both adsorption and biodegradation/transformation were found responsible for the removal of TrOCs by MBR treatment. A connection between biodegradation and molecular structure could be observed while adsorption was the dominant removal mechanism for the hydrophobic (logD>3.2) compounds. Highly hydrophobic (logD>3.2) but readily biodegradable compounds did not accumulate in sludge. In contrast, recalcitrant compounds with a moderate hydrophobicity, such as carbamazepine, accumulated significantly in the solid phase. The results provide a framework to predict the removal and fate of TrOCs by MBR treatment. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  5. Perceived stigma and social support in treatment for pharmaceutical opioid dependence.

    Science.gov (United States)

    Cooper, Sasha; Campbell, Gabrielle; Larance, Briony; Murnion, Bridin; Nielsen, Suzanne

    2018-02-01

    The dramatic increase in pharmaceutical opioid (PO) use in high-income countries is a growing public health concern. Stigma and social support are important as they may influence treatment uptake and outcomes, yet few studies exist regarding perceived stigma and social support among people with PO dependence. The aims of the study are to: (i) compare characteristics of those with PO dependence from iatrogenic and non-iatrogenic causes; (ii) document perceived stigma and its correlates in people in treatment for PO dependence; and (iii) examine correlates of social support in people in treatment for PO dependence. This prospective cohort study included (n = 108) PO-dependent people referred from treatment services. Telephone interviews were conducted at baseline, 3, 12 and 24 months. Multivariate linear regression was used to examine correlations. Mean age was 41 (SD = 10.5). Half (n = 56, 52%) were female. Two in five met the criteria for iatrogenic dependence (n = 41, 38%), with iatrogenic dependence associated with chronic pain, and no history of injection or heroin use. One quarter of study subjects reported past month unsanctioned opioid use (n = 25, 23%). Being married/de facto or female was associated with higher levels of perceived stigma. Unsanctioned opioid use, iatrogenic dependence and mental health conditions were associated with lower social support. Stigma affects all people in treatment. Those who are married/de facto and female may benefit from interventions to address stigma. The association of low social support with poorer mental health and ongoing substance use indicate that treatment could focus more on this area. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  6. Behavior of pharmaceuticals and drugs of abuse in a drinking water treatment plant (DWTP) using combined conventional and ultrafiltration and reverse osmosis (UF/RO) treatments

    Energy Technology Data Exchange (ETDEWEB)

    Boleda, Ma Rosa [AGBAR-Aiguees de Barcelona, Gral Batet 5-7, 08028 Barcelona (Spain); Galceran, Ma Teresa [University of Barcelona, Department Analytical Chemistry, Av. Diagonal 647, 08028 Barcelona (Spain); Ventura, Francesc, E-mail: fventura@agbar.es [AGBAR-Aiguees de Barcelona, Gral Batet 5-7, 08028 Barcelona (Spain)

    2011-06-15

    The behavior along the potabilization process of 29 pharmaceuticals and 12 drugs of abuse identified from a total of 81 compounds at the intake of a drinking water treatment plant (DWTP) has been studied. The DWTP has a common treatment consisting of dioxychlorination, coagulation/flocculation and sand filtration and then water is splitted in two parallel treatment lines: conventional (ozonation and carbon filtration) and advanced (ultrafiltration and reverse osmosis) to be further blended, chlorinated and distributed. Full removals were reached for most of the compounds. Iopromide (up to 17.2 ng/L), nicotine (13.7 ng/L), benzoylecgonine (1.9 ng/L), cotinine (3.6 ng/L), acetaminophen (15.6 ng/L), erythromycin (2.0 ng/L) and caffeine (6.0 ng/L) with elimination efficiencies {>=}94%, were the sole compounds found in the treated water. The advanced treatment process showed a slightly better efficiency than the conventional treatment to eliminate pharmaceuticals and drugs of abuse. - Highlights: > The presence of pharmaceuticals and drugs of abuse in surface water was demonstrated. > Elimination in both potabilization processes reached levels >99% for most compounds. > Four pharmaceuticals and three drugs of abuse survived the potabilization process. - The efficiency of potabilization processes to eliminate or transform pharmaceuticals and illicit drugs is evaluated.

  7. Behavior of pharmaceuticals and drugs of abuse in a drinking water treatment plant (DWTP) using combined conventional and ultrafiltration and reverse osmosis (UF/RO) treatments

    International Nuclear Information System (INIS)

    Boleda, Ma Rosa; Galceran, Ma Teresa; Ventura, Francesc

    2011-01-01

    The behavior along the potabilization process of 29 pharmaceuticals and 12 drugs of abuse identified from a total of 81 compounds at the intake of a drinking water treatment plant (DWTP) has been studied. The DWTP has a common treatment consisting of dioxychlorination, coagulation/flocculation and sand filtration and then water is splitted in two parallel treatment lines: conventional (ozonation and carbon filtration) and advanced (ultrafiltration and reverse osmosis) to be further blended, chlorinated and distributed. Full removals were reached for most of the compounds. Iopromide (up to 17.2 ng/L), nicotine (13.7 ng/L), benzoylecgonine (1.9 ng/L), cotinine (3.6 ng/L), acetaminophen (15.6 ng/L), erythromycin (2.0 ng/L) and caffeine (6.0 ng/L) with elimination efficiencies ≥94%, were the sole compounds found in the treated water. The advanced treatment process showed a slightly better efficiency than the conventional treatment to eliminate pharmaceuticals and drugs of abuse. - Highlights: → The presence of pharmaceuticals and drugs of abuse in surface water was demonstrated. → Elimination in both potabilization processes reached levels >99% for most compounds. → Four pharmaceuticals and three drugs of abuse survived the potabilization process. - The efficiency of potabilization processes to eliminate or transform pharmaceuticals and illicit drugs is evaluated.

  8. Towards spatially smart abatement of human pharmaceuticals in surface waters: defining impact of sewage treatment plants on susceptible functions

    NARCIS (Netherlands)

    Gils, J.A.G.; Coppens, L.J.C.; Laak, ter T.L.; Raterman, B.W.; Wezel, van A.P.

    2015-01-01

    For human pharmaceuticals, sewage treatment plants (STPs) are a major point of entry to surface waters. The receiving waters provide vital functions. Modeling the impact of STPs on susceptible functions of the surface water system allows for a spatially smart implementation of abatement options at,

  9. Towards spatially smart abatement of human pharmaceuticals in surface waters : Defining impact of sewage treatment plants on susceptible functions

    NARCIS (Netherlands)

    Coppens, Lieke J C; van Gils, Jos A G; Ter Laak, Thomas L|info:eu-repo/dai/nl/304831026; Raterman, Bernard W; van Wezel, Annemarie P|info:eu-repo/dai/nl/141376074

    2015-01-01

    For human pharmaceuticals, sewage treatment plants (STPs) are a major point of entry to surface waters. The receiving waters provide vital functions. Modeling the impact of STPs on susceptible functions of the surface water system allows for a spatially smart implementation of abatement options at,

  10. The occurrence and removal of selected pharmaceutical compounds in a sewage treatment works utilising activated sludge treatment

    Energy Technology Data Exchange (ETDEWEB)

    Jones, O.A.H. [Institute of Environmental Policy, Imperial College, London SW7 2AZ (United Kingdom); Voulvoulis, N. [Institute of Environmental Policy, Imperial College, London SW7 2AZ (United Kingdom); Lester, J.N. [School of Water Sciences, Cranfield University, Cranfield, Bedfordshire MK43 0AL (United Kingdom)]. E-mail: j.lester@cranfield.ac.uk

    2007-02-15

    Pharmaceutical substances have been detected in sewage effluents as well as receiving waters in many parts of the world. In this study, the occurrence and removal of a number of drug compounds were studied within a large sewage treatment plant in the south of England. Samples were processed using solid phase extraction and analysed using gas chromatography-mass spectrometry (GC-MS). The results demonstrate that ibuprofen, paracetamol, salbutamol and mefenamic acid were present in both the influent and effluent of the works while propranolol-HCl was not found above the limit of quantification in any sample. Elimination rates were circa 90% for each compound but several hundred nanograms per litre were still present in the final effluent. - This report looks at the occurrence and removal rates of drugs in English wastewater.

  11. The occurrence and removal of selected pharmaceutical compounds in a sewage treatment works utilising activated sludge treatment

    International Nuclear Information System (INIS)

    Jones, O.A.H.; Voulvoulis, N.; Lester, J.N.

    2007-01-01

    Pharmaceutical substances have been detected in sewage effluents as well as receiving waters in many parts of the world. In this study, the occurrence and removal of a number of drug compounds were studied within a large sewage treatment plant in the south of England. Samples were processed using solid phase extraction and analysed using gas chromatography-mass spectrometry (GC-MS). The results demonstrate that ibuprofen, paracetamol, salbutamol and mefenamic acid were present in both the influent and effluent of the works while propranolol-HCl was not found above the limit of quantification in any sample. Elimination rates were circa 90% for each compound but several hundred nanograms per litre were still present in the final effluent. - This report looks at the occurrence and removal rates of drugs in English wastewater

  12. RISK-FACTORS, PATHOGENESIS, AND PHARMACEUTICAL APPROACHES FOR TREATMENT OF STEROID-INDUCED BONE INFARCTION OF FEMORAL HEAD.

    Science.gov (United States)

    Wang, Fei; Wang, Yang; Hu, Ningning; Miao, Xuman

    2016-01-01

    During first year of steroid usage, osteocyte necrosis and blood vessel blockage may occur, which subsequently may produce steroid-induced bone infarction (SIBI) resulting in painful movement of patient. For treatment of SIBI, pharmaceutical strategy is the basic approach. It involves the use of various pharmacologically active compounds including bisphosphonates, hyperbaric oxygen (HBO), coenzyme Q10, erythropoietin, antihyperlipidemics, anticoagulants, antioxidants, and tissue repair protein. Out of these, there is no pharmaceutical agent that may completely treat this disease because many factors are found to be responsible for SIBI development; therefore, there are multiple biomarkers of this disease. This situation argues for need of new therapeutic agents for SIEB1.

  13. Arrest—Individual Treatment with Cord Blood

    Directory of Open Access Journals (Sweden)

    A. Jensen

    2013-01-01

    Full Text Available Each year, thousands of children incur brain damage that results in lifelong sequelae. Therefore, based on experimental evidence, we explored the therapeutic potential of human cord blood, known to contain stem cells, to examine the functional neuroregeneration in a child with cerebral palsy after cardiac arrest. The boy, whose cord blood was stored at birth, was 2.5 years old and normally developed when global ischemic brain damage occurred resulting in a persistent vegetative state. Nine weeks later, he received autologous cord blood (91.7 mL, cryopreserved, 5.75×10e8 mononuclear cells intravenously. Active rehabilitation (physio- and ergotherapy was provided daily, follow-up at 2, 5, 12, 24, 30, and 40 months. At 2-months follow-up the boy’s motor control improved, spastic paresis was largely reduced, and eyesight was recovered, as did the electroencephalogram. He smiled when played with, was able to sit and to speak simple words. At 40 months, independent eating, walking in gait trainer, crawling, and moving from prone position to free sitting were possible, and there was significantly improved receptive and expressive speech competence (four-word sentences, 200 words. This remarkable functional neuroregeneration is difficult to explain by intense active rehabilitation alone and suggests that autologous cord blood transplantation may be an additional and causative treatment of pediatric cerebral palsy after brain damage.

  14. Performance enhancement in the workplace: why and when healthy individuals should disclose their reliance on pharmaceutical cognitive enhancers.

    Science.gov (United States)

    Garasic, Mirko D; Lavazza, Andrea

    2015-01-01

    The use of pharmaceuticals cognitive enhancers (PCE) has been stirring growing interest, not only in the scientific domain but also in the popular media, and has probably had some increase recently in academic, professional and military quarters. So this phenomenon is deemed as a normal procedure aimed at improving the performance of an individual as well as the overall standards of an organization. Although the vast majority of countries have some kind of restrictions to reduce the wide non-medical usage of PCE, these can be overcome quite easily. In arguing for our explicit claim that, in many contexts, the use of cognitive enhancers should be disclosed-as a moral and socially relevant duty-we maintain that PCE present typical, or at least not rare, properties. The features are the following: (a) the enhancer has acute and/or chronic effects. In the first case, shortly after taking the drug the performance is significantly better than average; in the second case, there is a growing or lasting effect, which, however, is poised to diminish when one stops taking the drug; (b) those effects are significant (there is a difference in the outcome considered between taking and not taking the drug) and sometimes dramatic; and (c) a third feature, not directly related to enhancers as such, is their varying safety, availability, and legal permissibility, which might either induce people to take them or refrain them from doing so. We will consider the issue of fairness due to "unenhanced" people as well as the potentially dysfunctional social consequences of an undisclosed PCE use.

  15. Characterization of Individuals Seeking Treatment for Caffeine Dependence

    OpenAIRE

    Juliano, Laura M.; Evatt, Daniel P.; Richards, Brian D.; Griffiths, Roland R.

    2012-01-01

    Previous investigations have identified individuals who meet criteria for DSM-IV-TR substance dependence as applied to caffeine, but there is little research on treatments for caffeine dependence. This study aimed to thoroughly characterize individuals who are seeking treatment for problematic caffeine use. Ninety-four individuals who identified as being psychologically or physically dependent on caffeine, or who had tried unsuccessfully to modify caffeine consumption participated in a face-t...

  16. The contribution of pharmaceutically active compounds from healthcare facilities to a receiving sewage treatment plant in Canada.

    Science.gov (United States)

    Kleywegt, Sonya; Pileggi, Vince; Lam, Yuet Ming; Elises, Alan; Puddicomb, Aaron; Purba, Gurminder; Di Caro, Joanne; Fletcher, Tim

    2016-04-01

    Concentrations and percent loadings of pharmaceutically active compounds (PhACs) and other emerging contaminants released from healthcare facilities (2 hospitals and a long-term care facility) to a sewage treatment plant (STP) in a large urban sewershed were evaluated. An additional hospital outside the sewershed was also monitored. Fourteen of the 24 steroids/hormones and 88 of the 117 PhACs and emerging contaminants were detected at least once. Commonly used substances, including cotinine, caffeine and its metabolite 1,7-dimethylxanthine, ibuprofen and naproxen (analgesics), venlafaxine (antidepressant), and N,N-diethyl-meta-toluamide (insect repellant), were detected in all samples at all sites. Concentrations detected in the large specialty hospital outside the sewershed were similar to those within the sewershed. Cytotoxic drugs (tamoxifen and cyclophosphamide) and x-ray contrast media (iopamidol and diatrizoic acid) were infrequently detected in hospital effluents. Analysis for antibiotics indicated that azithromycin, clarithromycin, ciprofloxacin, erythromycin, ofloxacin, and sulfamethoxazole were consistently detected in hospital wastewaters, as was triclosan (antibacterial agent). Fifteen compounds individually contributed greater than 1% to the total PhAC and emerging contaminant load to the STP from the 2 hospitals in the sewershed, and 9 compounds in the STP effluent exceeded ecotoxicological criteria. The present survey demonstrates that point source discharges from healthcare facilities in this sewershed make a small contribution to the overall PhAC and emerging contaminant loading compared with the total concentrations entering the receiving STP. © 2015 SETAC.

  17. Pharmaceutical concentration variability at sewage treatment plant outlets dominated by hydrology and other factors.

    Science.gov (United States)

    Brunsch, Andrea F; Ter Laak, Thomas L; Rijnaarts, Huub; Christoffels, Ekkehard

    2018-04-01

    A study was conducted in which the effluent at four small to medium sized sewage treatment plants (STP) in North Rhine-Westphalia, Germany was monitored for three pharmaceutical compounds (carbamazepine, diclofenac, metoprolol) over a period of four years. Grab sampling and auto sampling campaigns were accomplished with respect to various weather conditions in the catchment area. Flow volumes and hydraulic retention times (HRT) from various sampling dates which provide information on processes causing emission changes were additionally taken into account. Monitoring results showed that concentration scattering in the effluent is related to HRT in the sewage treatment plants. Dilution effects following rain events in the catchment area were analysed for the three investigated substances. Short-term emission changes explained by dilution only could be well determined by the mathematical relation between discharge and concentration, and for carbamazepine to be solely determined by the dilution effects at all HRTs. For metoprolol, a clear decrease in concentrations was observed at HRTs above 80 h, and a significant contribution of biodegradation was supported by independent biodegradation tests. For three out of the four STPs, a decrease in concentrations of diclofenac was observed at hydraulic retention times above 80 h, indicating removal, whereas the relationship between concentration and HRT of the other STP could be explained by dilution only. The study shows that emissions can vary with weather conditions, hampering the assessment of emissions and estimation of concentrations in surface waters from generic removal rates only. Furthermore, it illustrates the importance of HRT of rather stable substances in wastewater treatment. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Microwave enhanced Fenton-like process for the treatment of high concentration pharmaceutical wastewater

    International Nuclear Information System (INIS)

    Yang Yu; Wang Peng; Shi Shujie; Liu Yuan

    2009-01-01

    This paper explored a novel process for wastewater treatment, i.e. microwave enhanced Fenton-like process. This novel process was introduced to treat high concentration pharmaceutical wastewater with initial COD loading of 49,912.5 mg L -1 . Operating parameters were investigated and the optimal condition included as follows: microwave power was 300 W, radiation time was 6 min, initial pH was 4.42, H 2 O 2 dosage was 1300 mg L -1 and Fe 2 (SO 4 ) 3 dosage was 4900 mg L -1 , respectively. Within the present experimental condition used, the COD removal and UV 254 removal reached to 57.53% and 55.06%, respectively, and BOD 5 /COD was enhanced from 0.165 to 0.470. The variation of molecular weight distribution indicated that both macromolecular substances and micromolecular substances were eliminated quite well. The structure of flocs revealed that one ferric hydrated ion seemed to connect with another ferric hydrated ion and/or organic compound molecule to form large-scale particles by means of van der waals force and/or hydrogen bond. Subsequently, these particles aggregated to form flocs and settled down. Comparing with traditional Fenton-like reaction and conventional heating assisted Fenton-like reaction, microwave enhanced Fenton-like process displayed superior treatment efficiency. Microwave was in favor of improving the degradation efficiency, the settling quality of sludge, as well as reducing the yield of sludge and enhancing the biodegradability of effluent. Microwave enhanced Fenton-like process is believed to be a promising treatment technology for high concentration and biorefractory wastewater.

  19. Fate of pharmaceuticals and personal care products in wastewater treatment plants - Conception of a database and first results

    International Nuclear Information System (INIS)

    Miege, C.; Choubert, J.M.; Ribeiro, L.; Eusebe, M.; Coquery, M.

    2009-01-01

    We created a database in order to quantitatively assess the occurrence and removal efficiency of pharmaceuticals and personal care products (PPCPs) in wastewater treatment plants (WWTPs). From 117 scientific publications, we compiled 6641 data covering 184 PPCPs. Data included the concentrations of PPCPs in WWTP influents and effluents, their removal efficiency and their loads to the aquatic environment. The first outputs of our database allowed to identify the most investigated PPCPs in WWTPs and the most persistent ones, and to obtain reliable and quantitative values on their concentrations, frequency of detection and removal efficiency in WWTPs. We were also able to compare various processes and pointed out activated sludge with nitrogen treatment and membrane bioreactor as the most efficient ones. - By means of a database including information from 117 international scientific papers, we present quantitative conclusions on the concentrations, frequencies of detection and removals of pharmaceutical products in wastewater treatment plants.

  20. Fate and removal of pharmaceuticals and illicit drugs in conventional and membrane bioreactor wastewater treatment plants and by riverbank filtration.

    Science.gov (United States)

    Petrovic, Mira; de Alda, Maria Jose Lopez; Diaz-Cruz, Silvia; Postigo, Cristina; Radjenovic, Jelena; Gros, Meritxell; Barcelo, Damià

    2009-10-13

    Pharmaceutically active compounds (PhACs) and drugs of abuse (DAs) are two important groups of emerging environmental contaminants that have raised an increasing interest in the scientific community. A number of studies revealed their presence in the environment. This is mainly due to the fact that some compounds are not efficiently removed during wastewater treatment processes, being able to reach surface and groundwater and subsequently, drinking waters. This paper reviews the data regarding the levels of pharmaceuticals and illicit drugs detected in wastewaters and gives an overview of their removal by conventional treatment technologies (applying activated sludge) as well as advanced treatments such as membrane bioreactor. The paper also gives an overview of bank filtration practices at managed aquifer recharge sites and discusses the potential of this approach to mitigate the contamination by PhACs and DAs.

  1. Weak bones in diabetes mellitus - an update on pharmaceutical treatment options.

    Science.gov (United States)

    Lin, Daphne P L; Dass, Crispin R

    2018-01-01

    Diabetes mellitus is often associated with a number of complications such as nephropathy, neuropathy, retinopathy and foot ulcers. However, weak bone is a diabetic complication that is often overlooked. Although the exact mechanism for weak bones within diabetes mellitus is unclear, studies have shown that the mechanism does differ in both type I (T1DM) and type II diabetes (T2DM). This review, however, investigates the application of mesenchymal stem cells, recombinant human bone morphogenetic protein-2, teriparatide, insulin administration and the effectiveness of a peroxisome proliferator-activated receptor-ϒ modulator, netoglitazone in the context of diabetic weak bones. In T1DM, weak bones may be the result of defective osteoblast activity, the absence of insulin's anabolic effects on bone, the deregulation of the bone-pancreas negative feedback loop and advanced glycation end product (AGE) aggregation within the bone matrix as a result of hyperglycaemia. Interestingly, T2DM patients placed on insulin administration, thiazolidinediones, SGLT2 inhibitors and sulfonylureas have an associated increased fracture risk. T2DM patients are also observed to have high sclerostin levels that impair osteoblast gene transcription, AGE aggregation within bone, which compromises bone strength and a decrease in esRAGE concentration resulting in a negative association with vertebral fractures. Effective treatment options for weak bones in the context of diabetes are currently lacking. There is certainly scope for discovery and development of novel agents that could alleviate this complication in diabetes patients. © 2017 Royal Pharmaceutical Society.

  2. The fate of a nitrobenzene-degrading bacterium in pharmaceutical wastewater treatment sludge.

    Science.gov (United States)

    Ren, Yuan; Yang, Juan; Chen, Shaoyi

    2015-12-01

    This paper describes the fate of a nitrobenzene-degrading bacterium, Klebsiella oxytoca NBA-1, which was isolated from a pharmaceutical wastewater treatment facility. The 90-day survivability of strain NBA-1 after exposure to sludge under anaerobic and aerobic conditions was investigated. The bacterium was inoculated into sludge amended with glucose and p-chloronitrobenzene (p-CNB) to compare the bacterial community variations between the modified sludge and nitrobenzene amendment. The results showed that glucose had no obvious effect on nitrobenzene biodegradation in the co-metabolism process, regardless of the presence/absence of oxygen. When p-CNB was added under anaerobic conditions, the biodegradation rate of nitrobenzene remained unchanged although p-CNB inhibited the production of aniline. The diversity of the microbial community increased and NBA-1 continued to be one of the dominant strains. Under aerobic conditions, the degradation rate of both nitrobenzene and p-CNB was only 20% of that under anaerobic conditions. p-CNB had a toxic effect on the microorganisms in the sludge so that most of the DGGE (denaturing gradient gel electrophoresis) bands, including that of NBA-1, began to disappear under aerobic conditions after 90days of exposure. These data show that the bacterial community was stable under anaerobic conditions and the microorganisms, including NBA-1, were more resistant to the adverse environment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Medical nutrition therapy is the essential cornerstone for effective treatment of "refractory" severe hypertriglyceridemia regardless of pharmaceutical treatment: Evidence from a Lipid Management Program.

    Science.gov (United States)

    Rhodes, Katherine S; Weintraub, Martha; Marchlewicz, Elizabeth H; Rubenfire, Melvyn; Brook, Robert D

    2015-01-01

    Patients with refractory severe hypertriglyceridemia are at risk of pancreatitis and cardiovascular disease. The role of individualized nutrition therapy in these patients independent of pharmaceutical treatment has not been documented. To document the effect of nutrition intervention on severe hypertriglyceridemia regardless of medication status or prior nutrition counseling. Outcomes of new patients with triglycerides ≥ 500 mg/dL presenting to a Lipid Management Program over a 6-year period were tracked. Patients received comprehensive laboratory assessment, nutrition assessment, and initiation of an individualized diet intervention before seeing the lipidologist. Clinical and behavioral outcomes were recorded. In all, 168 patients (117 men; mean age, 49.03 ± 11.22 years; body mass index, 32.61 ± 5.85 kg/m(2); 110 (65.5%) on lipid-lowering medications) returned for assessment of nutrition intervention. Triglycerides were reduced from median (interquartile range) 961.5 (611.5-1785.3) to 493.0 (337-736.3) mg/dL (P severe hypertriglyceridemia independent of lipid-lowering medication(s) and prior nutrition counseling. Copyright © 2015 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  4. Active pharmaceutical ingredients entering the aquatic environment from wastewater treatment works: A cause for concern?

    Science.gov (United States)

    Comber, Sean; Gardner, Mike; Sörme, Pernilla; Leverett, Dean; Ellor, Brian

    2018-02-01

    This work reports on the variation in wastewater treatment works (WwTW) influent concentrations of a wide variety of active pharmaceutical ingredients (APIs), their removal efficiency, effluent concentrations and potential risks to the aquatic environment. The research is based on data generated from two large UK-wide WwTW monitoring programmes. Taking account of removal of parent compound from the aqueous phase during treatment in combination with estimates of dilution available it is possible to prioritise the APIs of greatest risk of exceeding estimates of predicted no effect concentrations (PNEC) in receiving waters for all WwTW in the UK. The majority of substances studied were removed to a high degree, although with significant variation, both within and between WwTW. Poorer removal (between influent and effluent) was observed for ethinyloestradiol, diclofenac, propranolol, the macrolide antibiotics, fluoxetine, tamoxifen and carbamazepine. All except the last two of these substances were present in effluents at concentrations higher than their respective estimated PNEC (based on measurement of effluents from 45 WwTW on 20 occasions). Based on available dilution data as many as 890 WwTW in the UK (approximately 13% of all WwTW) may cause exceedances of estimated riverine PNECs after mixing of their effluents with receiving waters. The overall degree of risk is driven by the toxicity value selected, which in itself is controlled by the availability of reliable and relevant ecotoxicological data and consequently the safety factors applied. The dataset and discussion, provides information to assist in the future management of these types of chemicals. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Assessing Instructional Modalities: Individualized Treatment Effects for Personalized Learning

    Science.gov (United States)

    Beemer, Joshua; Spoon, Kelly; Fan, Juanjuan; Stronach, Jeanne; Frazee, James P.; Bohonak, Andrew J.; Levine, Richard A.

    2018-01-01

    Estimating the efficacy of different instructional modalities, techniques, and interventions is challenging because teaching style covaries with instructor, and the typical student only takes a course once. We introduce the individualized treatment effect (ITE) from analyses of personalized medicine as a means to quantify individual student…

  6. Pharmaceutical and personal care products in domestic wastewater and their removal in anaerobic treatment systems: septic tank - upflow anaerobic filter

    OpenAIRE

    Arrubla, Juan Pablo; Cubillos, Janneth A.; Ramírez Vargas, Carlos Andrés; Arredondo, Jhon Alexander; Arias, Carlos A.; Paredes, Diego

    2016-01-01

    In several countries around the world, Pharmaceutical and Personal Care Products (PPCPs) exist in aquatic environments, a fact that increases the awareness within the scientific community with respect to their possible fate and environment effects. This research presents a preliminary monitoring of use, consumption and presence of PPCPs in wastewater from a treatment plant in a rural area of Pereira (Colombia). Domestic sewage is treated in a septic tank followed by an Up-Flow Anaerobic Filte...

  7. Behaviour of pharmaceuticals and psychotic drugs in conventional and advanced wastewater treatments; Comportamiento de medicamentos y psicofarmacos en tratamaientos de depuracion convencionales y terciarios

    Energy Technology Data Exchange (ETDEWEB)

    Cortacans Torre, J. A.; Castillo Gonzalez, I. del; Hernandez Lehmann, A.; Hernandez Munoz, A.; Rodriguez Barrera, X.

    2009-07-01

    The occurrence of various pharmaceuticals and psychotic drugs in wastewater and their removal rates in a conventional wastewater treatment plant has been investigated. The psychoactive drugs are poorly removed in the biological step. However, most pharmaceuticals except of carbamazepine, are significantly biodegraded depending the removal degree on the type of compound and on the sludge retention time of the biological treatment. Also, the removal efficiency of conventional tertiary treatments and ultrafiltration and nano filtration membranes using two pilot plants was examined. the effects of retaining pharmaceuticals with ultrafiltration and nano filtration membranes do not greatly differ despite the difference in their pore size. (Author) 25 refs.

  8. Treatment of chemical-pharmaceutical wastewater in packed bed anaerobic reactors

    Energy Technology Data Exchange (ETDEWEB)

    Nacheva, P.M.; Pena-Loera, B.; Moralez-Guzman, F. [Mexican Institute for Water Technology, Jiutepec (Mexico)

    2006-07-01

    Biological degradation in packed bed anaerobic mesophilic reactors with five different support materials was studied for the treatment of chemical-pharmaceutical wastewater with high COD (23-31 g/L), which contains toxic organic compounds. Experimental up-flow bio-filters were operated at different organic loads for a two-year period. Removals of 80-98% were obtained in the reactors with sand, anthracite and black tezontle, but at relatively low organic loads, less than 3.6 kg m{sup -3} d{sup -1}. The reactor with granular activated carbon (GAC) had a better performance; efficiencies higher than 95% were obtained at loads up to 17kg m{sup -3} d{sup -1} and higher than 80% with loads up to 26 kg m{sup -3} d{sup -1}. Second in performance was the reactor with red tezontle which allows COD removals higher than 80% with loads up to 6 kg m{sup -3} d{sup -1}. The use of GAC as support material allows greater biodegradation rates than the rest of the materials and it makes the process more resistant to organic load increases, inhibition effects and toxicity. Methanogenic activity was inhibited at loads higher than 21.9 kg m{sup -3} d{sup -1} in the GAC-reactor and at loads higher than 3.6 kg m{sup -3} d{sup -1} in the rest of the reactors. At loads lower than the previously mentioned, high methane production yield was obtained, 0.32-0.35 m{sup 33}CH4/kg CODremoved.

  9. Occurrence and removal of pharmaceutically active compounds in sewage treatment plants with different technologies

    Science.gov (United States)

    Ying, Guang-Guo; Kookana, Rai S.; Kolpin, Dana W.

    2009-01-01

    Occurrence of eight selected pharmaceutically active compounds (PhACs; caffeine, carbamazepine, triclosan, gemfibrozil, diclofenac, ibuprofen, ketoprofen and naproxen) were investigated in effluents from fifteen sewage treatment plants (STPs) across South Australia. In addition, a detailed investigation into the removal of these compounds was also carried out in four STPs with different technologies (Plant A: conventional activated sludge; plant B: two oxidation ditches; plant C: three bioreactors; and plant D: ten lagoons in series). The concentrations of these compounds in the effluents from the fifteen STPs showed substantial variations among the STPs, with their median concentrations ranging from 26 ng/L for caffeine to 710 ng/L for carbamazepine. Risk assessment based on the "worst case scenario" of the monitoring data from the present study suggested potential toxic risks to aquatic organisms posed by carbamazepine, triclosan and diclofenac associated with such effluent discharge. With the exception of carbamazepine and gemfibrozil, significant concentration decreases between influent and effluent were observed in the four STPs studied in more detail. Biodegradation was found to be the main mechanism for removing concentrations from the liquid waste stream for the PhACs within the four STPs, while adsorption onto sludge appeared to be a minor process for all target PhACs except for triclosan. Some compounds (e.g. gemfibrozil) exhibited variable removal efficiencies within the four STPs. Plant D (10 lagoons in series) was least efficient in the removal of the target PhACs; significant biodegradation of these compounds only occurred from the sixth or seventh lagoon.

  10. Removal of pharmaceuticals from wastewater by electrochemical oxidation using cylindrical flow reactor and optimization of treatment conditions.

    Science.gov (United States)

    Babu, B Ramesh; Venkatesan, P; Kanimozhi, R; Basha, C Ahmed

    2009-08-01

    This paper examines the use of electrooxidation for treatment of wastewater obtained from a pharmaceutical industry. The wastewater primarily contained Gentamicin and Dexamethasone. With NaCl as supporting electrolyte, the effluent was treated in a cylindrical flow reactor in continuous (single pass) mode under various current densities (2-5 A/dm2) and flow rates (10-40 L/h). By cyclic voltammetric (CV) analysis, the optimum condition for maximum redox reaction was determined. The efficiency of chemical oxygen demand (COD) reduction and power consumption were studied for different operating conditions. From the results it was observed that maximum COD reduction of about 85.56% was obtained at a flow rate of 10 L/h with an applied current density of 4 A/dm2. FT-IR spectra studies showed that during electrooxidation, the intensities of characteristic functional groups such as N-H, O-H were reduced and some new peaks also started to appear. Probable theory, reaction mechanism and modeling were proposed for the oxidation of pharmaceutical effluent. The experimental results demonstrated that electrooxidation treatment was very effective and capable of elevating the quality of treated wastewater to the reuse standard prescribed for pharmaceutical industries.

  11. Continuous-flow photocatalytic treatment of pharmaceutical micropollutants: Activity, inhibition, and deactivation of TiO2 photocatalysts in wastewater effluent

    KAUST Repository

    Carbonaro, Sean; Sugihara, Matthew N.; Strathmann, Timothy J.

    2013-01-01

    for the purpose of studying the activity, inhibition, and deactivation of immobilized TiO2 photocatalysts during water treatment applications. As a demonstration, degradation of four pharmaceutical micropollutants (iopromide, acetaminophen, sulfamethoxazole

  12. Pharmaceutical virtue.

    Science.gov (United States)

    Martin, Emily

    2006-06-01

    In the early history of psychopharmacology, the prospect of developing technologically sophisticated drugs to alleviate human ills was surrounded with a fervor that could be described as religious. This paper explores the subsequent history of the development of psychopharmacological agents, focusing on the ambivalent position of both the industry and its employees. Based on interviews with retired pharmaceutical employees who were active in the industry in the 1950s and 1960s when the major breakthroughs were made in the development of MAOIs and SSRIs, the paper explores the initial development of educational materials for use in sales campaigns. In addition, based on interviews with current employees in pharmaceutical sales and marketing, the paper describes the complex perspective of contemporary pharmaceutical employees who must live surrounded by the growing public vilification of the industry as rapacious and profit hungry and yet find ways to make their jobs meaningful and dignified. The paper will contribute to the understudied problem of how individuals function in positions that require them to be part of processes that on one description constitute a social evil, but on another, constitute a social good.

  13. Different compositions of pharmaceuticals in Dutch and Belgian rivers explained by consumption patterns and treatment efficiency

    NARCIS (Netherlands)

    Laak, ter T.L.; Kooij, P.J.F.; Tolkamp, H.; Hofman, J.

    2014-01-01

    In the current study, 43 pharmaceuticals and 18 transformation products were studied in the river Meuse at the Belgian-Dutch border and four tributaries of the river Meuse in the southern part of the Netherlands. The tributaries originate from Belgian, Dutch and mixed Dutch and Belgian catchments.

  14. Characteristics of Transgender Individuals Entering Substance Abuse Treatment

    Science.gov (United States)

    Heck, Nicholas C.; Sorensen, James L.

    2014-01-01

    Little is known about the needs or characteristics of transgender individuals in substance abuse treatment settings. Transgender (n=199) and non-transgender (cisgender, n=13440) individuals were compared on psychosocial factors related to treatment, health risk behaviors, medical and mental health status and utilization, and substance use behaviors within a database that documented individuals entering substance abuse treatment in San Francisco, CA from 2007–2009 using logistic and linear regression analyses (run separately by identified gender). Transgender men (assigned birth sex of female) differed from cisgender men across many psychosocial factors, including having more recent employment, less legal system involvement, greater incidence of living with a substance abuser, and greater family conflict, while transgender women (assigned birth sex of male) were less likely to have minor children than cisgender women. Transgender women reported greater needle use and HIV testing rates were greater among transgender women. Transgender men and women reported higher rates of physical health problems, mental health diagnoses, and psychiatric medications but there were no differences in service utilization. There were no differences in substance use behaviors except that transgender women were more likely to endorse primary methamphetamine use. Transgender individuals evidence unique strengths and challenges that could inform targeted services in substance abuse treatment. PMID:24561017

  15. Autistic Learning Disabilities and Individualizing Treatment for Autistic Spectrum Disorders.

    Science.gov (United States)

    Siegel, Bryna

    1999-01-01

    This article evaluates three early intervention approaches--applied behavior analysis, TEAACH (Treatment and Education of Autistic and Related Communication Handicapped Children), a structured classroom-based program, and relationship therapy/"floor time"--to identify which aspects of each approach complement individual learning styles…

  16. Occurrences and removal of pharmaceuticals and personal care products (PPCPs) in drinking water and water/sewage treatment plants: A review.

    Science.gov (United States)

    Yang, Yi; Ok, Yong Sik; Kim, Ki-Hyun; Kwon, Eilhann E; Tsang, Yiu Fai

    2017-10-15

    In recent years, many of micropollutants have been widely detected because of continuous input of pharmaceuticals and personal care products (PPCPs) into the environment and newly developed state-of-the-art analytical methods. PPCP residues are frequently detected in drinking water sources, sewage treatment plants (STPs), and water treatment plants (WTPs) due to their universal consumption, low human metabolic capability, and improper disposal. When partially metabolized PPCPs are transferred into STPs, they elicit negative effects on biological treatment processes; therefore, conventional STPs are insufficient when it comes to PPCP removal. Furthermore, the excreted metabolites may become secondary pollutants and can be further modified in receiving water bodies. Several advanced treatment systems, including membrane filtration, granular activated carbon, and advanced oxidation processes, have been used for the effective removal of individual PPCPs. This review covers the occurrence patterns of PPCPs in water environments and the techniques adopted for their treatment in STP/WTP unit processes operating in various countries. The aim of this review is to provide a comprehensive summary of the removal and fate of PPCPs in different treatment facilities as well as the optimum methods for their elimination in STP and WTP systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Advances in multidisciplinary individualized treatment of refractory hepatic alveolar echinococcosis

    Directory of Open Access Journals (Sweden)

    ABUDUAINI Abulizi

    2015-04-01

    Full Text Available Hepatic alveolar echinococcosis (HAE is a zoonotic parasitic disease that seriously threatens the population in western China and compromises patients′ quality of life. With the continuous improvement in radical resection rate in recent years, late-stage HAE patients that were incurable in the past now have the opportunity for radical resection. However, patients who are not suitable candidates for radical resection still suffer from various complications and poor quality of life. Therefore, HAE is still considered a refractory and complex disease. The simple empirical treatment model provided by traditional professional discussion is unable to satisfy the treatment of advanced refractory HAE as it is unable to integrate specialized, standardized clinical skills for diagnosis and treatment. Multidisciplinary individualized treatment (MDT organically integrates the advantages of the available treatment into a reasonable individualized comprehensive treatment regimen. This review summarizes the advances in MDT for HAE as the best option to increase long-term survival, and suggests MDT as the first-line treatment for late-stage refractory hepatic alveolar echinococcosis.

  18. Impact of a pharmaceutical care program on clinical evolution and antiretroviral treatment adherence: a 5-year study

    Directory of Open Access Journals (Sweden)

    Hernández Arroyo MJ

    2013-08-01

    Full Text Available María Jesús Hernández Arroyo,1 Salvador Enrique Cabrera Figueroa,2 Rosa Sepúlveda Correa,3 María de la Paz Valverde Merino,1 Alicia Iglesias Gómez,4 Alfonso Domínguez-Gil Hurlé5 On behalf of the Tormes Team 1Pharmacy Service, University Hospital of Salamanca, Salamanca, Spain; 2Pharmacy Institute, University Austral of Chile, Valdivia, Chile; 3Department of Statistics, University of Salamanca, Salamanca, Spain; 4Infectious Disease Service, University Hospital of Salamanca, Salamanca, Spain; 5Department of Pharmacy and Pharmaceutical Technology, University of Salamanca, Salamanca, Spain Background: Antiretroviral treatments (ART form the basis of adequate clinical control in human immunodeficiency virus-infected patients, and adherence plays a primary role in the grade and duration of the antiviral response. The objectives of this study are: (1 to determine the impact of the implementation of a pharmaceutical care program on improvement of ART adherence and on the immunovirological response of the patients; and (2 to detect possible correlations between different adherence evaluation measurements. Methods: A 60-month long retrospective study was conducted. Adherence measures used were: therapeutic drug monitoring, a simplified medication adherence questionnaire, and antiretroviral dispensation records (DR. The number of interviews and interventions related to adherence made for each patient in yearly periods was related to the changes in the adherence variable (measured with DR in these same yearly periods. The dates when the laboratory tests were drawn were grouped according to proximity with the study assessment periods (February–May, 2005–2010. Results: A total of 528 patients were included in the study. A significant relationship was observed between the simplified medication adherence questionnaire and DR over the 60-month study period (P < 0.01. Improvement was observed in the mean adherence level (P < 0.001, and there was a

  19. Identification of potential toxicity caused by O3 and ClO2 treatment of pharmaceuticals in wastewater

    DEFF Research Database (Denmark)

    Furuhagen, S. M.; Hörsing, Maritha; Ledin, Anna

    2011-01-01

    Chemical oxidation treatment is an effective innovative technology in wastewater treatment plants for removal of micro-pollutants in the effluent. In particular, ozonation (O3) and chlorine dioxide (ClO2) treatments are commonly used to degrade organic pollutants. By oxidation, the micro...... complemented by oxidative stress biomarkers to understand effect mechanisms in different test systems and species. All tests were complemented with chemical analysis to confirm to what degree the pharmaceuticals have been mineralized and degraded by oxidation. Early results with APIs in milli-Q water treated...... Carbamazepine by chemical oxidation were more harmful to aquatic organisms compared to the parent compound. The aim of our study is to evaluate the potential risk of oxidation treatment, using O3 and ClO2, due to formation of toxic transformation products. The ecotoxicological effects caused by the two...

  20. Characterization of individuals seeking treatment for caffeine dependence.

    Science.gov (United States)

    Juliano, Laura M; Evatt, Daniel P; Richards, Brian D; Griffiths, Roland R

    2012-12-01

    Previous investigations have identified individuals who meet criteria for Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) substance dependence as applied to caffeine, but there is little research on treatments for caffeine dependence. This study aimed to thoroughly characterize individuals who are seeking treatment for problematic caffeine use. Ninety-four individuals who identified as being psychologically or physically dependent on caffeine, or who had tried unsuccessfully to modify caffeine consumption participated in a face-to-face diagnostic clinical interview. They also completed measures concerning caffeine use and quitting history, reasons for seeking treatment, and standardized self-report measures of psychological functioning. Caffeine treatment seekers (mean age 41 years, 55% women) consumed an average of 548 mg caffeine per day. The primary source of caffeine was coffee for 50% of the sample and soft drinks for 37%. Eighty-eight percent reported prior serious attempts to modify caffeine use (mean 2.7 prior attempts), and 43% reported being advised by a medical professional to reduce or eliminate caffeine. Ninety-three percent met criteria for caffeine dependence when generic DSM-IV-TR substance dependence criteria were applied to caffeine use. The most commonly endorsed criteria were withdrawal (96%), persistent desire or unsuccessful efforts to control use (89%), and use despite knowledge of physical or psychological problems caused by caffeine (87%). The most common reasons for wanting to modify caffeine use were health-related (59%) and not wanting to be dependent on caffeine (35%). This investigation reveals that there are individuals with problematic caffeine use who are seeking treatment and suggests that there is a need for effective caffeine dependence treatments. 2013 APA, all rights reserved

  1. Fate and removal of typical pharmaceuticals and personal care products by three different treatment processes

    International Nuclear Information System (INIS)

    He, Yu-jie; Chen, Wei; Zheng, Xiao-ying; Wang, Xing-nan; Huang, Xi

    2013-01-01

    The presence and distribution of typical of pharmaceuticals and personal care products (PPCPs), which comprise two types of polycyclic musks (PCMs) including Galaxolide (HHCB) and Tonalide (AHTN) as well as six types of estrogens containing estrone (E1), 17β-estradiol (E2), estriol (E3), 17α-ethynylestradiol (EE2), diethylstilbestrol (DES), and bisphenol A (BPA), were investigated at two wastewater treatment plants (WWTPs) in Jiangsu, China. Only raw wastewater was treated in WWTP A while WWTP B was serving an urban-industrialized area. In the influent, the concentrations of EE2 (2193–4437 ng L −1 ), E2 (1126–1170 ng L −1 ), and DES (268–421 ng L −1 ) were generally higher than the previously reported values, whereas the concentrations of HHCB (306–316 ng L −1 ), E1 (29–129 ng L −1 ), E3 (53 ng L −1 ), and BPA (26–176 ng L −1 ) were much lower than those reported in other previous studies. In addition, AHTN was not detected in either WWTP and E3 was not found in WWTP B. The detected processes including anaerobic/oxic process (A/O), combined orbal oxidation ditch process (C-orbal OD) and anaerobic/anoxic/anoxic/oxic membrane biological reactor (A/A/A/O-MBR) showed higher removal efficiencies for HHCB (67–71%) and EE2 (87%) than those in other previous studies. Besides, the total hydraulic retention time (HRT) ranged between 6.7 and 20.0 h, sludge retention time (SRT) ranged between 8 and 23 d, and water temperature ranged from 24.8 to 28.2 °C. The removal efficiencies for estrogens in biological processes were related to the following factors: the level of hydrophobic estrogens, the type of removal process (C-orbal OD was consistently less efficient in removing estrogens than A/O and A/A/A/O-MBR), and a high SRT or HRT (A/A/A/O-MBR with higher SRT and HRT showed higher and more stable removal of hydrophobic estrogens). - Highlights: ► We investigated 8 kinds of PPCPs in each unit at 2 WWTPs with different processes. ► Agilent 1290

  2. The effect of hydraulic retention time in onsite wastewater treatment and removal of pharmaceuticals, hormones and phenolic utility substances.

    Science.gov (United States)

    Ejhed, H; Fång, J; Hansen, K; Graae, L; Rahmberg, M; Magnér, J; Dorgeloh, E; Plaza, G

    2018-03-15

    Micropollutants such as pharmaceuticals, hormones and phenolic utility chemicals in sewage water are considered to be an emerging problem because of increased use and observed adverse effects in the environment. The study provides knowledge on the removal efficiency of micropollutants with a range of physical and chemical properties in three commercially available onsite wastewater treatment facilities (OWTFs), tested on influent wastewater collected from 2500 person equivalents in Bildchen, Germany. A longer hydraulic retention time would in theory be expected to have a positive effect, and this study presents results for three different OWTFs in full-scale comparable tests under natural conditions. A range of 24 different pharmaceuticals, five phenols and three hormones were analyzed. Flow-proportional consecutive sampling was performed in order to determine the removal efficiency. Twenty-eight substances were detected in the effluent wastewater out of 32 substances included. Average effluent concentrations of Simvastatin, Estrone, Estradiol and Ethinylestradiol were above the indicative critical-effect concentration of pharmacological effect on fish in all facilities. Average effluent concentrations of both Diclofenac and Estradiol were higher than the Environmental Quality Standards applied in Sweden (190-240 times and 9-35 times respectively). The removal efficiency of micropollutants was high for substances with high logK ow , which enhance the adsorption and removal with sludge. Low removal was observed for substances with low logK ow and acidic characteristics, and for substances with stabilizing elements of the chemical structure. Facilities that use activated sludge processes removed hormones more efficiently than facilities using trickling filter treatment technique. Moreover, longer hydraulic retention time increased the removal of pharmaceuticals, hormones, turbidity and total nitrogen. Removal of Caffeine, Ibuprofen, Estrone, Naproxen and Estradiol

  3. Machine Learning for Treatment Assignment: Improving Individualized Risk Attribution.

    Science.gov (United States)

    Weiss, Jeremy; Kuusisto, Finn; Boyd, Kendrick; Liu, Jie; Page, David

    2015-01-01

    Clinical studies model the average treatment effect (ATE), but apply this population-level effect to future individuals. Due to recent developments of machine learning algorithms with useful statistical guarantees, we argue instead for modeling the individualized treatment effect (ITE), which has better applicability to new patients. We compare ATE-estimation using randomized and observational analysis methods against ITE-estimation using machine learning, and describe how the ITE theoretically generalizes to new population distributions, whereas the ATE may not. On a synthetic data set of statin use and myocardial infarction (MI), we show that a learned ITE model improves true ITE estimation and outperforms the ATE. We additionally argue that ITE models should be learned with a consistent, nonparametric algorithm from unweighted examples and show experiments in favor of our argument using our synthetic data model and a real data set of D-penicillamine use for primary biliary cirrhosis.

  4. Seeking psychological help: a comparison of individual and group treatment.

    Science.gov (United States)

    Shechtman, Zipora; Vogel, David; Maman, Neta

    2010-01-01

    The study examined public and self-stigma and their association with attitudes and intentions to seek psychological help in regard to both individual and group treatment as well as to various subgroups, including gender, ethnicity, educational orientation, level of religion, and age. Undergraduate students (N=307) in three universities in Israel participated in the study. Results partly confirmed the model for both individual and group therapy: Self-stigma was related to attitudes and intentions to seek help. However, public stigma was not related to self-stigma. Importantly, some differences were also found among the various subgroups, and the model, which takes into account the different subgroups, looks somewhat different for individual and group therapy.

  5. Individual treatment selection for patients with posttraumatic stress disorder.

    Science.gov (United States)

    Deisenhofer, Anne-Katharina; Delgadillo, Jaime; Rubel, Julian A; Böhnke, Jan R; Zimmermann, Dirk; Schwartz, Brian; Lutz, Wolfgang

    2018-04-16

    Trauma-focused cognitive behavioral therapy (Tf-CBT) and eye movement desensitization and reprocessing (EMDR) are two highly effective treatment options for posttraumatic stress disorder (PTSD). Yet, on an individual level, PTSD patients vary substantially in treatment response. The aim of the paper is to test the application of a treatment selection method based on a personalized advantage index (PAI). The study used clinical data for patients accessing treatment for PTSD in a primary care mental health service in the north of England. PTSD patients received either EMDR (N = 75) or Tf-CBT (N = 242). The Patient Health Questionnaire (PHQ-9) was used as an outcome measure for depressive symptoms associated with PTSD. Variables predicting differential treatment response were identified using an automated variable selection approach (genetic algorithm) and afterwards included in regression models, allowing the calculation of each patient's PAI. Age, employment status, gender, and functional impairment were identified as relevant variables for Tf-CBT. For EMDR, baseline depressive symptoms as well as prescribed antidepressant medication were selected as predictor variables. Fifty-six percent of the patients (n = 125) had a PAI equal or higher than one standard deviation. From those patients, 62 (50%) did not receive their model-predicted treatment and could have benefited from a treatment assignment based on the PAI. Using a PAI-based algorithm has the potential to improve clinical decision making and to enhance individual patient outcomes, although further replication is necessary before such an approach can be implemented in prospective studies. © 2018 Wiley Periodicals, Inc.

  6. Performance analysis and optimization of an advanced pharmaceutical wastewater treatment plant through a visual basic software tool (PWWT.VB).

    Science.gov (United States)

    Pal, Parimal; Thakura, Ritwik; Chakrabortty, Sankha

    2016-05-01

    A user-friendly, menu-driven simulation software tool has been developed for the first time to optimize and analyze the system performance of an advanced continuous membrane-integrated pharmaceutical wastewater treatment plant. The software allows pre-analysis and manipulation of input data which helps in optimization and shows the software performance visually on a graphical platform. Moreover, the software helps the user to "visualize" the effects of the operating parameters through its model-predicted output profiles. The software is based on a dynamic mathematical model, developed for a systematically integrated forward osmosis-nanofiltration process for removal of toxic organic compounds from pharmaceutical wastewater. The model-predicted values have been observed to corroborate well with the extensive experimental investigations which were found to be consistent under varying operating conditions like operating pressure, operating flow rate, and draw solute concentration. Low values of the relative error (RE = 0.09) and high values of Willmott-d-index (d will = 0.981) reflected a high degree of accuracy and reliability of the software. This software is likely to be a very efficient tool for system design or simulation of an advanced membrane-integrated treatment plant for hazardous wastewater.

  7. Treatment of real effluents from the pharmaceutical industry: A comparison between Fenton oxidation and conductive-diamond electro-oxidation.

    Science.gov (United States)

    Pérez, J F; Llanos, J; Sáez, C; López, C; Cañizares, P; Rodrigo, M A

    2017-06-15

    Wastewater produced in pharmaceutical manufacturing plants (PMPs), especially the one coming from organic-synthesis facilities, is characterized by its large variability due to the wide range of solvents and chemical reagents used in the different stages of the production of medicines. Normally, the toxicity of the organic compounds prevent the utilization of biological processes and more powerful treatments are needed becoming advanced oxidation processes (AOPs) a valid alternative. In this work, the efficiency in abatement of pollution by Fenton oxidation (FO) and conductive-diamond electro-oxidation (CDEO) are compared in the treatment of 60 real effluents coming from different processes carried out in a pharmaceutical facility, using standardized tests. In 80% of the samples, CDEO was found to be more efficient than FO and in the remaining 20%, coagulation was found to exhibit a great significance in the COD abatement mechanism during FO, pointing out the effectiveness of the oxidation promoted by the electrochemical technology. Mean oxidation state of carbon was found to be a relevant parameter to understand the behavior of the oxidation technologies. It varied inversely proportional to efficiency in FO and it showed practically no influence in the case of CDEO. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Irradiation treatment of pharmaceutical and personal care products (PPCPs) in water and wastewater: An overview

    International Nuclear Information System (INIS)

    Wang, Jianlong; Chu, Libing

    2016-01-01

    Pharmaceutical and personal care products (PPCPs), especially the pharmaceutically active compounds (PhACs) such as antibiotics and hormones have attracted great concerns worldwide for their persistence and potential threat to ecosystem and public health. This paper presents an overview on the ionizing irradiation-induced degradation of PPCPs in aqueous solution. Parameters that affect PPCPs degradation, such as the absorbed dose, solution pH, dose rate, water matrices and the presence of some inorganic ions and humic acid are evaluated. The mechanism and pathways of radiolytic degradation of PPCPs are reviewed. In many cases, PPCPs such as antibiotics and X-ray contrast agent could be removed completely by radiation, but a higher absorbed dose was needed for their mineralization and toxicity reduction. The combination of ionizing irradiation with other methods such as H 2 O 2 , ozonation and TiO 2 nanoparticles could improve the degradation efficacy and reduce the cost. Ionizing irradiation is a promising alternative for degradation of PPCPs in aqueous solution. - Highlights: • This paper presents an overview on radiation-induced degradation of PPCPs. • Parameters that affect PPCPs degradation were evaluated. • The mechanism and pathways of PPCPs degradation are reviewed. • Ionizing irradiation is a promising alternative for degradation of PPCPs in aqueous solution.

  9. Occurrence of pharmaceutical compounds in urban wastewater: Removal, mass load and environmental risk after a secondary treatment-A review

    Energy Technology Data Exchange (ETDEWEB)

    Verlicchi, P., E-mail: paola.verlicchi@unife.it [Dept. of Engineering, University of Ferrara, Via Saragat 1, I-44122 Ferrara (Italy); Terra and AcquaTech Technopoles, Via Borsari 46, I-44121 Ferrara (Italy); Al Aukidy, M., E-mail: mustafakether.alaukidi@unife.it [Dept. of Engineering, University of Ferrara, Via Saragat 1, I-44122 Ferrara (Italy); Zambello, E., E-mail: elena.zambello@unife.it [Dept. of Engineering, University of Ferrara, Via Saragat 1, I-44122 Ferrara (Italy); Terra and AcquaTech Technopoles, Via Borsari 46, I-44121 Ferrara (Italy)

    2012-07-01

    This review focuses on 118 pharmaceuticals, belonging to seventeen different therapeutic classes, detected in raw urban wastewater and effluent from an activated sludge system, a usual treatment adopted for urban wastewaters worldwide prior to final discharge into surface water bodies. Data pertaining to 244 conventional activated sludge systems and 20 membrane biological reactors are analysed and the observed ranges of variability of each selected compound in their influent and effluent reported, with particular reference to the substances detected most frequently and in higher concentrations. A snapshot of the ability of these systems to remove such compounds is provided by comparing their global removal efficiencies for each substance. Where possible, the study then evaluates the average daily mass load of the majority of detected pharmaceuticals exiting the secondary treatment step. The final part of the review provides an assessment of the environmental risk posed by their presence in the secondary effluent by means of the risk quotient that is the ratio between the average pharmaceutical concentration measured in the secondary effluent and the predicted no-effect concentration. Finally, mass load rankings of the compounds under review are compared with those based on their risk level. This analysis shows that the highest amounts discharged through secondary effluent pertain to one antihypertensive, and several beta-blockers and analgesics/anti-inflammatories, while the highest risk is posed by antibiotics and several psychiatric drugs and analgesics/anti-inflammatories. These results are reported with a view to aiding scientists and administrators in planning measures aiming to reduce the impact of treated urban wastewater discharge into surface water bodies. - Highlights: Black-Right-Pointing-Pointer The review refers to 118 pharmaceuticals occurring in raw and treated wastewaters. Black-Right-Pointing-Pointer Data from 264 municipal WWTPs with a CAS or an

  10. Individually dosed omalizumab: an effective treatment for severe peanut allergy.

    Science.gov (United States)

    Brandström, J; Vetander, M; Lilja, G; Johansson, S G O; Sundqvist, A-C; Kalm, F; Nilsson, C; Nopp, A

    2017-04-01

    Treatment with omalizumab has shown a positive effect on food allergies, but no dosages are established. Basophil allergen threshold sensitivity (CD-sens) can be used to objectively measure omalizumab treatment efficacy and correlates with the outcome of double-blind placebo-controlled food challenge to peanut. To evaluate whether individualized omalizumab treatment monitored by CD-sens could be an effective intervention for suppression of allergic reactions to peanut. Severely peanut allergic adolescents (n = 23) were treated with omalizumab for 8 weeks, and CD-sens was analysed before and after. Based on whether CD-sens was suppressed after 8 weeks, the patients either were subject to a peanut challenge or received eight more weeks with increased dose of omalizumab, followed by peanut challenge or another 8-week cycle of omalizumab. IgE and IgE-antibodies to peanut and its components were analysed before treatment. After individualized omalizumab treatment (8-24 weeks), all patients continued with an open peanut challenge with no (n = 18) or mild (n = 5) objective allergic symptoms. Patients (n = 15) needing an elevated omalizumab dose (ED) to suppress CD-sens had significantly higher CD-sens values at baseline 1.49 (0.44-20.5) compared to those (n = 8) who managed with normal dose (ND) 0.32 (0.24-5.5) (P omalizumab, monitored by CD-sens, is an effective and safe treatment for severe peanut allergy. The ratio of IgE-ab to storage protein Ara h 2/IgE as well as CD-sens to peanut may predict the need of a higher omalizumab dose. Clinical trials numbers: EudraCT; 2012-005625-78, ClinicalTrials.gov; NCT02402231. © 2016 John Wiley & Sons Ltd.

  11. Behavior of pharmaceuticals and drugs of abuse in a drinking water treatment plant (DWTP) using combined conventional and ultrafiltration and reverse osmosis (UF/RO) treatments.

    Science.gov (United States)

    Boleda, M A Rosa; Galceran, M A Teresa; Ventura, Francesc

    2011-06-01

    The behavior along the potabilization process of 29 pharmaceuticals and 12 drugs of abuse identified from a total of 81 compounds at the intake of a drinking water treatment plant (DWTP) has been studied. The DWTP has a common treatment consisting of dioxychlorination, coagulation/flocculation and sand filtration and then water is splitted in two parallel treatment lines: conventional (ozonation and carbon filtration) and advanced (ultrafiltration and reverse osmosis) to be further blended, chlorinated and distributed. Full removals were reached for most of the compounds. Iopromide (up to 17.2 ng/L), nicotine (13.7 ng/L), benzoylecgonine (1.9 ng/L), cotinine (3.6 ng/L), acetaminophen (15.6 ng/L), erythromycin (2.0 ng/L) and caffeine (6.0 ng/L) with elimination efficiencies ≥ 94%, were the sole compounds found in the treated water. The advanced treatment process showed a slightly better efficiency than the conventional treatment to eliminate pharmaceuticals and drugs of abuse. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Quantitative structure-property relationships for predicting sorption of pharmaceuticals to sewage sludge during waste water treatment processes.

    Science.gov (United States)

    Berthod, L; Whitley, D C; Roberts, G; Sharpe, A; Greenwood, R; Mills, G A

    2017-02-01

    Understanding the sorption of pharmaceuticals to sewage sludge during waste water treatment processes is important for understanding their environmental fate and in risk assessments. The degree of sorption is defined by the sludge/water partition coefficient (K d ). Experimental K d values (n=297) for active pharmaceutical ingredients (n=148) in primary and activated sludge were collected from literature. The compounds were classified by their charge at pH7.4 (44 uncharged, 60 positively and 28 negatively charged, and 16 zwitterions). Univariate models relating log K d to log K ow for each charge class showed weak correlations (maximum R 2 =0.51 for positively charged) with no overall correlation for the combined dataset (R 2 =0.04). Weaker correlations were found when relating log K d to log D ow . Three sets of molecular descriptors (Molecular Operating Environment, VolSurf and ParaSurf) encoding a range of physico-chemical properties were used to derive multivariate models using stepwise regression, partial least squares and Bayesian artificial neural networks (ANN). The best predictive performance was obtained with ANN, with R 2 =0.62-0.69 for these descriptors using the complete dataset. Use of more complex Vsurf and ParaSurf descriptors showed little improvement over Molecular Operating Environment descriptors. The most influential descriptors in the ANN models, identified by automatic relevance determination, highlighted the importance of hydrophobicity, charge and molecular shape effects in these sorbate-sorbent interactions. The heterogeneous nature of the different sewage sludges used to measure K d limited the predictability of sorption from physico-chemical properties of the pharmaceuticals alone. Standardization of test materials for the measurement of K d would improve comparability of data from different studies, in the long-term leading to better quality environmental risk assessments. Copyright © 2016 British Geological Survey, NERC. Published by

  13. National surveys: a way to manage treatment strategies in Parkinson's disease? Pharmaceutical prescribing patterns and patient experiences of symptom control and their impact on disease

    Directory of Open Access Journals (Sweden)

    Skogar Ö

    2013-07-01

    Full Text Available Örjan Skogar,1,2 Mats Nilsson,1 Carl-Johan Törnhage,3 Johan Lökk2 1Futurum Health Care Academy, Jönköping, 2Institution of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, 3Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden Background: The purpose of this study was to draw conclusions from patient-reported experiences in two national surveys from Scandinavia with the intention of comparing treatment strategies and increasing our knowledge of factors that affect the experiences of patients with Parkinson's disease (PD. Methods: A total of 2000 individuals in Sweden and 1300 in Norway were invited to complete postal surveys covering PD-related issues. Patient experiences of diagnostic procedures, symptom control, and follow-up in PD and the effects on symptom-related quality of life were collected. Pharmaceutical prescription data on anti-PD drugs and administrative data were collected from national registries. Results: The surveys were completed by 1553 (78% of the Swedish cohort and 1244 (96% of the Norwegian cohort. Only small differences were seen in disease duration and age distribution. Statistically as well as clinically significant differences in symptom control, diagnostic, and follow-up procedures, as well as in pharmacological treatment and impact on quality of life, were found between the national cohorts independent of disease duration. Conclusion: Information from separate national surveys has the potential to increase our knowledge of patient experiences in PD and can be used to compare, evaluate, educate, and guide health care staff and administrators in optimizing health care for patients with the disease. Keywords: parkinson's disease, diagnosis, follow-up, pharmaceutical prescription, quality of life, survey

  14. Natural soil mediated photo Fenton-like processes in treatment of pharmaceuticals: Batch and continuous approach.

    Science.gov (United States)

    Changotra, Rahil; Rajput, Himadri; Dhir, Amit

    2017-12-01

    This paper manifests the potential viability of soil as a cost-free catalyst in photo-Fenton-like processes for treating pharmaceuticals at large scale. Naturally available soil without any cost intensive modification was utilized as a catalyst to degrade pharmaceuticals, specifically ornidazole (ORZ) and ofloxacin (OFX). Soil was characterized and found enriched with various iron oxides like hematite, magnetite, goethite, pyrite and wustite, which contributes toward enhanced dissolution of Fe 3+ than Fe 2+ in the aqueous solution resulting in augmented rate of photo-Fenton reaction. The leached iron concentration in solution was detected during the course of experiments. The degradation of ORZ and OFX was assessed in solar induced batch experiments using H 2 O 2 as oxidant and 95% ORZ and 92% OFX removal was achieved. Elevated efficiencies were achieved due to Fe 2+ /Fe 3+ cycling, producing more hydroxyl radical leading to the existence of homogeneous and heterogeneous reactions simultaneously. The removal efficiency of solar photo-Fenton like process was also compared to photo-Fenton process with different irradiation sources (UV-A and UV-B) and were statistically analysed. Continuous-scale studies were conducted employing soil either in the form of soil beads or as a thin layer spread on the surface of baffled reactor. Soil beads were found to have satisfactory reusability and stability. 84 and 79% degradation of ORZ and OFX was achieved using soil as thin layer while with soil beads 71 and 68% degradation, respectively. HPLC and TOC study confirmed the efficient removal of both the compounds. Toxicity assessment demonstrates the inexistence of toxic intermediates during the reaction. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Application of CWPO to the treatment of pharmaceutical emerging pollutants in different water matrices with a ferromagnetic catalyst.

    Science.gov (United States)

    Munoz, Macarena; Mora, Francisco J; de Pedro, Zahara M; Alvarez-Torrellas, Silvia; Casas, Jose A; Rodriguez, Juan J

    2017-06-05

    CWPO has proved to be effective for the treatment of representative pharmaceuticals (sulfamethoxazole, atenolol, metronidazole, diltiazem, trimethoprim and ranitidine) in different water matrices (ultrapure water, surface water, WWTP effluent and hospital wastewater). Complete removal of the pollutants and the aromatic intermediates was achieved using the stoichiometric dose of H 2 O 2 , a catalyst (Fe 3 O 4 /γ-Al 2 O 3 ) load of 2gL -1 , pH 3 and temperature of 50-75°C. Accordingly, the ecotoxicity was reduced to negligible values. The degradation was faster when the pharmaceuticals were together, being the reaction time for the elimination of the most refractory species (metronidazole) shortened from 4h to 1h. The mineralization of the drugs was fairly different, being the most reactive species those containing several aromatic rings (X TOC ∼80%) and the most refractory that bearing an imidazolium ring (X TOC ∼35%). The water matrix affected the kinetics of the process but in all cases complete conversion of the drugs was reached within 1h. The presence of dissolved organic matter (surface water) seemed to promote drugs degradation while the occurrence of inorganic ions (real WTTP and hospital effluents) partially inhibited it due to scavenging effects. Remarkably, the process was successfully operated at the typical concentrations of main micropollutant sources (μgL -1 ). Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Treatment Needs and Adverse Events Related to Dental Treatment under General Anesthesia for Individuals with Autism

    Science.gov (United States)

    Rada, Robert E.

    2013-01-01

    Individuals with autism can be quite challenging to treat in a routine dental-office setting, especially when extensive dental treatment and disruptive behavioral issues exist. Individuals with autism may also be at higher risk for oral disease. Frequently, general anesthesia is the only method to facilitate completion of the needed dental…

  17. Life cycle environmental impacts of advanced wastewater treatment techniques for removal of pharmaceuticals and personal care products (PPCPs).

    Science.gov (United States)

    Zepon Tarpani, Raphael Ricardo; Azapagic, Adisa

    2018-06-01

    Pharmaceutical and personal care products (PPCPs) are of increasing interest because of their ecotoxicological properties and environmental impacts. Wastewater treatment plants (WWTPs) are the main pathway for their release into freshwaters due to the inefficiency of conventional WWTPs in removing many of these contaminants from effluents. Therefore, different advanced effluent treatment techniques have been proposed for their treatment. However, it is not known at present how effective these treatment methods are and whether on a life cycle basis they cause other environmental impacts which may outweigh the benefits of the treatment. In an effort to provide an insight into this question, this paper considers life cycle environmental impacts of the following advanced treatment techniques aimed at reducing freshwater ecotoxicity potential of PPCPs: granular activated carbon (GAC), nanofiltration (NF), solar photo-Fenton (SPF) and ozonation. The results suggest that on average NF has the lowest impacts for 13 out of 18 categories considered. GAC is the best alternative for five impacts, including metals and water depletion, but it has the highest marine eutrophication. SPF and ozonation are the least sustainable for eight impacts, including ecotoxicity and climate change. GAC and NF are also more efficient in treating heavy metals while avoiding generation of harmful by-products during the treatment, thus being more suitable for potable reuse of wastewater. However, releasing the effluent without advanced treatment to agricultural land achieves a much higher reduction of freshwater ecotoxicity than treating it by any of the advanced treatments and releasing to the environment. Therefore, the use of advanced effluent treatment for agricultural purposes is not recommended. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Environmental sustainability of the solar photo-Fenton process for wastewater treatment and pharmaceuticals mineralization at semi-industrial scale.

    Science.gov (United States)

    Foteinis, Spyros; Monteagudo, Jose Maria; Durán, Antonio; Chatzisymeon, Efthalia

    2018-01-15

    The environmental sustainability of a semi-industrial solar photo-Fenton reactor, treating real effluents emanating from a pharmaceutical laboratory, is assessed herein. The life cycle assessment/analysis (LCA) methodology was employed and real life cycle inventory (LCI) data was collected from a ferrioxalate-assisted homogeneous solar photo-Fenton wastewater treatment plant (WWTP), at Ciudad Real, Spain. Electricity was provided by photovoltaic (PV) panels in tandem with a battery bank, making the plant autonomous from the local grid. The effective treatment of 1m 3 of secondary-treated pharmaceutical wastewater, containing antipyrine, was used as a functional unit. The main environmental hotspot was identified to be the chemical reagents used to enhance treatment efficiency, mainly hydrogen peroxide (H 2 O 2 ) and to a smaller degree oxalic acid. On the other hand, land use, PV panels, battery units, compound parabolic collectors (CPC), tanks, pipes and pumps, as materials, had a low contribution, ranging from as little as 0.06% up to about 2% on the total CO 2eq emissions. Overall, the solar photo-Fenton process was found to be a sustainable technology for treating wastewater containing micropollutants at semi-industrial level, since the total environmental footprint was found to be 2.71kgCO 2 m -3 or 272mPtm -3 , using IPCC 2013 and ReCiPe impact assessment methods, respectively. A sensitivity analysis revealed that if the excess of solar power is fed back into the grid then the total environmental footprint is reduced. Depending on the amount of solar power fed back into the grid the process could have a near zero total environmental footprint. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. ORGANIZATIONAL, LEGAL, MEDICAL AND PHARMACEUTICAL APPROACHES TO OPTIMIZATION OF MEDICINES’ CIRCULATION FOR HYPERTONIA TREATMENT IN COUNTRYSIDE AREAS

    Directory of Open Access Journals (Sweden)

    Shapovalova V.O.

    2016-06-01

    this mechanism, it does not work within the budget funding. Thanks to the work of the Department on the final stage of the pilot project during the circulation of drugs and their reimbursement attracted 575 pharmacies of different ownership forms and 1253 pharmacy points, whose work is in the village carried out by medical points, general practice and family medicine. The conducted monitoring shows us that during the pilot project 72 doctors of the CHI issued more than 265.2 thousand recipes. Hypertension drugs at discount prices began to sell from pharmacies of Ukraine from 01.08.2012. Drugs released by prescription, which could only write some doctors, family doctor, cardiologist, internist and neurologist. To control this process created a single electronic register of doctors and patients. Reimbursement cost of drugs for the treatment of essential hypertension conducted from the state budget. During the implementation of these measures was made following. Order from 23.05.2012 N331 "On creation of working groups” Department organized a telephone hotline (057705-10-64 for providing citizens, patients, most doctors, physicians, pharmacists and others with advices on the introduction and implementation of pilot projects involving scientific department of medical and pharmaceutical law, general and clinical pharmacy of the Kharkiv Medical Academy of Postgraduate Education. Order of the Department of Healthcare of Kharkiv Regional State Administration from 10.09.2014 N560 "On approval of the register of pharmacies" approved list of pharmacies and their departments participating in the pilot project, which has 576 outlets realization of drugs. Conclusions. Proposed the organizational, legal, medical and pharmaceutical approaches to optimization of medicines’ circulation for the treatment of hypertonia in countryside areas. Studied the existing legislative and regulatory framework of Ukraine on providing ofor concessional patients with hypertension drugs. Analyzed

  20. Optimization of pharmaceutical wastewater treatment by solar/ferrioxalate photo-catalysis.

    Science.gov (United States)

    Monteagudo, J M; Durán, A; Culebradas, R; San Martín, I; Carnicer, A

    2013-10-15

    The degradation of a pharmaceutical wastewater using a ferrioxalate-assisted solar/photo-Fenton system has been studied. The photochemical reaction was carried out in a pilot plant consisting of a compound parabolic collector (CPC) solar reactor. An optimization study was performed combining a multivariate experimental design and Neuronal Networks that included the following variables: initial concentrations of H2O2, catalyst Fe (II) and oxalic acid (H2C2O4), temperature and solar power. Under optimal conditions, 84% TOC (Total Organic Carbon) removal was achieved in 115 min. Oxalic acid had a positive effect on mineralization when solar power was above 30 W m(-2). The minimum amount of H2O2 to degrade 1 mol of TOC was found to be 3.57 mol. Both the H2O2 conversion efficiency and the degree of mineralization were highest when the oxalic/Fe(II) initial molar relation was close to 3. HO radicals were the main oxidative intermediate species in the process, although hydroperoxyl radicals (HO(2)(·)) also played a role. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Advanced oxidation treatment and photochemical fate of selected antidepressant pharmaceuticals in solutions of Suwannee River humic acid

    Energy Technology Data Exchange (ETDEWEB)

    Santoke, Hanoz, E-mail: hsantoke@uci.edu [Urban Water Research Center, Department of Civil and Environmental Engineering, University of California, Irvine, Irvine, CA 92697-2175 (United States); Song, Weihua, E-mail: wsong@uci.edu [Urban Water Research Center, Department of Civil and Environmental Engineering, University of California, Irvine, Irvine, CA 92697-2175 (United States); Department of Environmental Science and Engineering, Fudan University, Shanghai, 200433 (China); Cooper, William J., E-mail: wcooper@uci.edu [Urban Water Research Center, Department of Civil and Environmental Engineering, University of California, Irvine, Irvine, CA 92697-2175 (United States); Peake, Barrie M., E-mail: bpeake@chemistry.otago.ac.nz [Chemistry Department, University of Otago, P.O. Box 56, Dunedin 9054 (New Zealand)

    2012-05-30

    Highlights: Black-Right-Pointing-Pointer We elucidate the photochemical degradation of three antidepressant pharmaceuticals. Black-Right-Pointing-Pointer Hydroxyl radical is the most significant contributor to the degradation. Black-Right-Pointing-Pointer Excited state dissolved organic matter also plays a significant role for duloxetine. Black-Right-Pointing-Pointer Tentative reaction byproducts are identified. - Abstract: Antidepressant pharmaceuticals have recently been detected at low concentrations in wastewater and surface water. This work reports studies of the direct and indirect photochemical fate and treatment by advanced oxidation of three antidepressant compounds (duloxetine, venlafaxine and bupropion) in solutions of humic acid in order to elucidate their behavior in the natural environment prior to reaching a water treatment facility and potentially entering a potable water supply. Humic acid solution was prepared by adding to distilled water a known amount of organic matter as a photosensitizer. All three antidepressants react very rapidly with hydroxyl radicals ({center_dot}OH) and hydrated electrons (e{sup -}{sub aq}) with rate constants of {approx}10{sup 8} to 10{sup 10} M{sup -1} s{sup -1}, but significantly slower with singlet oxygen ({sup 1}{Delta}O{sub 2}) ({approx}10{sup 3} to 10{sup 5} M{sup -1} s{sup -1}). The steady-state concentrations of {center_dot}OH and {sup 1}{Delta}O{sub 2}, in a sample of humic acid solution were measured and used with the second order rate constants to show that the hydroxyl radical was an order of magnitude more effective than the singlet oxygen in the solar-induced photochemical degradation of the antidepressants. Excited state dissolved organic matter also accounted for a substantial portion of degradation of duloxetine, decreasing its half-life by 27% under solar irradiation. Several reaction pathways and by-products arising from the photodegradation were identified using gamma-irradiation followed by LC

  2. Occurrence and fate of pharmaceutically active compounds in the largest municipal wastewater treatment plant in Southwest China: mass balance analysis and consumption back-calculated model.

    Science.gov (United States)

    Yan, Qing; Gao, Xu; Huang, Lei; Gan, Xiu-Mei; Zhang, Yi-Xin; Chen, You-Peng; Peng, Xu-Ya; Guo, Jin-Song

    2014-03-01

    The occurrence and fate of twenty-one pharmaceutically active compounds (PhACs) were investigated in different steps of the largest wastewater treatment plant (WWTP) in Southwest China. Concentrations of these PhACs were determined in both wastewater and sludge phases by a high-performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry. Results showed that 21 target PhACs were present in wastewater and 18 in sludge. The calculated total mass load of PhACs per capita to the influent, the receiving water and sludge were 4.95mgd(-1)person(-1), 889.94μgd(-1)person(-1) and 78.57μgd(-1)person(-1), respectively. The overall removal efficiency of the individual PhACs ranged from "negative removal" to almost complete removal. Mass balance analysis revealed that biodegradation is believed to be the predominant removal mechanism, and sorption onto sludge was a relevant removal pathway for quinolone antibiotics, azithromycin and simvastatin, accounting for 9.35-26.96% of the initial loadings. However, the sorption of the other selected PhACs was negligible. The overall pharmaceutical consumption in Chongqing, China, was back-calculated based on influent concentration by considering the pharmacokinetics of PhACs in humans. The back-estimated usage was in good agreement with usage of ofloxacin (agreement ratio: 72.5%). However, the back-estimated usage of PhACs requires further verification. Generally, the average influent mass loads and back-calculated annual per capita consumption of the selected antibiotics were comparable to or higher than those reported in developed countries, while the case of other target PhACs was opposite. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Assessing the environmental hazard of individual and combined pharmaceuticals: acute and chronic toxicity of fluoxetine and propranolol in the crustacean Daphnia magna.

    Science.gov (United States)

    Varano, Valentina; Fabbri, Elena; Pasteris, Andrea

    2017-08-01

    Pharmaceuticals are widespread emerging contaminants and, like all pollutants, are present in combination with others in the ecosystems. The aim of the present work was to evaluate the toxic response of the crustacean Daphnia magna exposed to individual and combined pharmaceuticals. Fluoxetine, a selective serotonin re-uptake inhibitor widely prescribed as antidepressant, and propranolol, a non-selective β-adrenergic receptor-blocking agent used to treat hypertension, were tested. Several experimental trials of an acute immobilization test and a chronic reproduction test were performed. Single chemicals were first tested separately. Toxicity of binary mixtures was then assessed using a fixed ratio experimental design. Five concentrations and 5 percentages of each substance in the mixture (0, 25, 50, 75, and 100%) were tested. The MIXTOX model was applied to analyze the experimental results. This tool is a stepwise statistical procedure that evaluates if and how observed data deviate from a reference model, either concentration addition (CA) or independent action (IA), and provides significance testing for synergism, antagonism, or more complex interactions. Acute EC50 values ranged from 6.4 to 7.8 mg/L for propranolol and from 6.4 to 9.1 mg/L for fluoxetine. Chronic EC50 values ranged from 0.59 to 1.00 mg/L for propranolol and from 0.23 to 0.24 mg/L for fluoxetine. Results showed a significant antagonism between chemicals in both the acute and the chronic mixture tests when CA was adopted as the reference model, while absence of interactive effects when IA was used.

  4. [Etiological analysis and individualized treatment of pharyngeal paraesthesia].

    Science.gov (United States)

    Lou, Zhengcai; Gong, Xuhong; Lou, Fangyi; He, Lanjuan; Zhu, Qiaoying

    2009-07-01

    To analyze the nosazontology of pharyngeal paraesthesia and investigate the treatment. Two hundred and twelve misdiagnosed pharyngeal paraesthesia patients were investigated by history inquiry, routine examination, 24-hour esophageal pH monitoring, barium X-ray of the oesophagus, anxieties-athymic private measuring scale, coefficient of variation of the R-R (CVR-R), bioavailable testosterone detection (Bio-T), erection experiment and questionnaire about man climacteric syndrome. The concomitant symptoms and positions of pharyngeal paresthesia were also studied. We adopted individuallized sequential multi-therapy for every patient according to the cause of disease. The cause of disease within 212 cases of pharyngeal paraesthesia included 62 psychic trauma, 32 endocrine system disease, 106 upper gastrointestinal disease, circulatory disease, 9 circulatory disease, 3 idiopathic. With individualized treatment, 110 cases had fully recovered, 63 cases excellence and 31 cases utility, and the efficiency rate was 96.23%. Pharyngeal paraesthesia can be caused by several factors. Thorough examination and comprehensive analysis should be applied to those incurable patient who has been treated for a long time. Short course of treatment and irrational drug use are the main causes of short-term recurrence and unsatisfactory curative effect.

  5. Systematic review: treatment pattern and clinical effectiveness and safety of pharmaceutical therapies for Crohn’s disease in Europe

    Directory of Open Access Journals (Sweden)

    Lelli F

    2016-10-01

    Full Text Available Filippo Lelli,1 Solomon Nuhoho,2 Xin Ying Lee,3 Weiwei Xu4 1EMEA Hemar, Janssen, Milan, Italy; 2Health Economics, Market Access and Reimbursement, Johnson & Johnson Middle East FZ LLC, Dubai, United Arab Emirates; 3EMEA Hemar, Janssen, Birkerød, Denmark; 4Pharmerit International, Rotterdam, the Netherlands Background: Although many clinical trials have been conducted in treatments of Crohn’s ­disease (CD, whether the trial results were representative of daily practice needs to be supported by studies conducted in real-world settings. Aim: This study aims to identify how CD is treated and what are the clinical effectiveness and safety of the pharmaceutical therapies of CD in real-world settings. Methods: A systematic literature review was conducted based on Medline®, Embase®, and Cochrane. All publications were assessed for title/abstract and full-text according to a predefined study protocol. Data were extracted and reported.Results: A total of 1,998 publications were identified. Fifty studies including six publications reporting treatment pattern and 44 studies reporting clinical effectiveness and safety of pharmaceutical therapies in CD management in Europe were included. 5-Aminosalicylic acid and corticosteroids were reported to be used among 14%–74% of CD patients. Immunomodulators were used by 14%–25% and 29%–31% of CD patients as an initial and follow-up treatment, respectively. Biological therapies were used by 25%–33% of CD patients. A trend toward an increasing use of immunomodulators and biological therapies in Europe has been reported in recent years. Approximately 50% of patients achieved remission on immunomodulator or biologic treatment, although a relapse rate of up to 23% has been reported.Conclusion: There is a trend of treatment shift to immunomodulators and biologics in CD management. Clinical effectiveness of immunomodulators and biologics has been demonstrated, though with a lack of sustainability of the

  6. Fate and proliferation of typical antibiotic resistance genes in five full-scale pharmaceutical wastewater treatment plants

    International Nuclear Information System (INIS)

    Wang, Jilu; Mao, Daqing; Mu, Quanhua; Luo, Yi

    2015-01-01

    This study investigated the characteristics of 10 subtypes of antibiotic resistance genes (ARGs) for sulfonamide, tetracycline, β-lactam and macrolide resistance and the class 1 integrase gene (intI1). In total, these genes were monitored in 24 samples across each stage of five full-scale pharmaceutical wastewater treatment plants (PWWTPs) using qualitative and real-time quantitative polymerase chain reactions (PCRs). The levels of typical ARG subtypes in the final effluents ranged from (2.08 ± 0.16) × 10 3 to (3.68 ± 0.27) × 10 6 copies/mL. The absolute abundance of ARGs in effluents accounted for only 0.6%–59.8% of influents of the five PWWTPs, while the majority of the ARGs were transported to the dewatered sludge with concentrations from (9.38 ± 0.73) × 10 7 to (4.30 ± 0.81) × 10 10 copies/g dry weight (dw). The total loads of ARGs discharged through dewatered sludge was 7–308 folds higher than that in the raw influents and 16–638 folds higher than that in the final effluents. The proliferation of ARGs mainly occurs in the biological treatment processes, such as conventional activated sludge, cyclic activated sludge system (CASS) and membrane bio-reactor (MBR), implying that significant replication of certain subtypes of ARGs may be attributable to microbial growth. High concentrations of antibiotic residues (ranging from 0.14 to 92.2 mg/L) were detected in the influents of selected wastewater treatment systems and they still remain high residues in the effluents. Partial correlation analysis showed significant correlations between the antibiotic concentrations and the associated relative abundance of ARG subtypes in the effluent. Although correlation does not prove causation, this study demonstrates that in addition to bacterial growth, the high antibiotic residues within the pharmaceutical WWTPs may influence the proliferation and fate of the associated ARG subtypes. - Highlights: • The ARGs in final discharges were 7–308 times higher than

  7. Fate and proliferation of typical antibiotic resistance genes in five full-scale pharmaceutical wastewater treatment plants

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jilu [College of Environmental Science and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Nankai University, Tianjin 300071 (China); Mao, Daqing, E-mail: mao@tju.edu.cn [School of Environmental Science and Engineering, Tianjin University, Tianjin 300072 (China); Mu, Quanhua [College of Environmental Science and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Nankai University, Tianjin 300071 (China); Luo, Yi, E-mail: luoy@nankai.edu.cn [College of Environmental Science and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Nankai University, Tianjin 300071 (China)

    2015-09-01

    This study investigated the characteristics of 10 subtypes of antibiotic resistance genes (ARGs) for sulfonamide, tetracycline, β-lactam and macrolide resistance and the class 1 integrase gene (intI1). In total, these genes were monitored in 24 samples across each stage of five full-scale pharmaceutical wastewater treatment plants (PWWTPs) using qualitative and real-time quantitative polymerase chain reactions (PCRs). The levels of typical ARG subtypes in the final effluents ranged from (2.08 ± 0.16) × 10{sup 3} to (3.68 ± 0.27) × 10{sup 6} copies/mL. The absolute abundance of ARGs in effluents accounted for only 0.6%–59.8% of influents of the five PWWTPs, while the majority of the ARGs were transported to the dewatered sludge with concentrations from (9.38 ± 0.73) × 10{sup 7} to (4.30 ± 0.81) × 10{sup 10} copies/g dry weight (dw). The total loads of ARGs discharged through dewatered sludge was 7–308 folds higher than that in the raw influents and 16–638 folds higher than that in the final effluents. The proliferation of ARGs mainly occurs in the biological treatment processes, such as conventional activated sludge, cyclic activated sludge system (CASS) and membrane bio-reactor (MBR), implying that significant replication of certain subtypes of ARGs may be attributable to microbial growth. High concentrations of antibiotic residues (ranging from 0.14 to 92.2 mg/L) were detected in the influents of selected wastewater treatment systems and they still remain high residues in the effluents. Partial correlation analysis showed significant correlations between the antibiotic concentrations and the associated relative abundance of ARG subtypes in the effluent. Although correlation does not prove causation, this study demonstrates that in addition to bacterial growth, the high antibiotic residues within the pharmaceutical WWTPs may influence the proliferation and fate of the associated ARG subtypes. - Highlights: • The ARGs in final discharges were 7

  8. Unemployment risk among individuals undergoing medical treatment for chronic diseases.

    Science.gov (United States)

    Nakaya, N; Nakamura, T; Tsuchiya, N; Tsuji, I; Hozawa, A; Tomita, H

    2016-03-01

    Chronic diseases increase the risk of unemployment even in non-disaster settings; therefore, in post-disaster settings, special attention needs to be paid to the employment status of those suffering from chronic diseases. To examine the association between chronic disease and the risk of unemployment in a disaster area. This cross-sectional study was conducted in Shichigahama Town, Miyagi, north-eastern Japan, where had been severely inundated by the 2011 tsunami. Logistic regression analyses were used to evaluate the association between undergoing medical treatment for a combination of chronic diseases (stroke, cancer, myocardial infarction and angina) and unemployment risk. Confounders such as psychological distress and levels of daily life activity were considered. Among the 2588 individuals studied, there was a statistically significant association between undergoing medical treatment for chronic disease and the risk of unemployment [odds ratio (OR) = 1.7, 95% confidence interval (CI) 1.02-2.7, P unemployment risk was observed only in participants with a higher degree of psychological distress and/or poorer levels of daily life activity. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Targeting Inflammation Through a Physical Active Lifestyle and Pharmaceuticals for the Treatment of Type 2 Diabetes

    DEFF Research Database (Denmark)

    Knudsen, Sine Haugaard; Pedersen, Bente Klarlund

    2015-01-01

    Evidence exists that interleukin (IL)-1β is involved in pancreatic β-cell damage, whereas TNF-α appears to be a key molecule in peripheral insulin resistance. Although increased plasma levels of IL-6 are seen in individuals with type 2 diabetes, mechanistic studies suggest that moderate acute ele....... While waiting for the outcome of long-term clinical pharmacological trials, it should be emphasized that physical activity represents a natural strong anti-inflammatory intervention with little or no side effects.......Evidence exists that interleukin (IL)-1β is involved in pancreatic β-cell damage, whereas TNF-α appears to be a key molecule in peripheral insulin resistance. Although increased plasma levels of IL-6 are seen in individuals with type 2 diabetes, mechanistic studies suggest that moderate acute...

  10. Determination of pharmaceutical residues and assessment of their removal efficiency at the Daugavgriva municipal wastewater treatment plant in Riga, Latvia.

    Science.gov (United States)

    Reinholds, I; Muter, O; Pugajeva, I; Rusko, J; Perkons, I; Bartkevics, V

    2017-01-01

    Pharmaceutical products (PPs) belong to emerging contaminants that may accumulate along with other chemical pollutants in wastewaters (WWs) entering industrial and/or urban wastewater treatment plants (WWTPs). In the present study, the technique of ultra-high-performance liquid chromatography coupled to Orbitrap high-resolution mass spectrometry (Orbitrap-HRMS) was applied for the analysis of 24 multi-class PPs in WW samples collected at different technological stages of Daugavgriva WWTP located in Riga, Latvia. Caffeine and acetaminophen levels in the range of 7,570-11,403 ng/L and 810-1,883 ng/L, respectively, were the predominant compounds among 19 PPs determined in the WW. The results indicate that aerobic digestion in biological ponds was insufficiently effective to degrade most of the PPs (reduction efficiency <0-50.0%) with the exception of four PPs that showed degradation efficiency varying from 55.0 to 99.9%. Tests of short-term chemical and enzymatic hydrolysis for PP degradation in WW samples were performed, and the results reflected the complexity of different degradation mechanisms and physicochemical transformations of PPs. The toxicological studies of WW impact on Daphnia magna indicated gradual reduction of the total toxicity through the treatment stages at the WWTP.

  11. Cost-effectiveness analysis of cetuximab in treatment of metastatic colorectal cancer in Iranian pharmaceutical market

    Directory of Open Access Journals (Sweden)

    Majid Davari

    2015-01-01

    Conclusions: The FOLFOX regimen + cetuximab provides lower costs per additional life years gained (more cost-effective compared with its alternatives in the treatment of patients with unresectable metastatic CRC. However, according to the WHO indicator, none of the cetuximab regimens could be considered as cost effective for the Iranian health care market.

  12. Pathways to treatment retention for individuals legally coerced to substance use treatment: the interaction of hope and treatment motivation.

    Science.gov (United States)

    Hampton, Ashley S; Conner, Bradley T; Albert, Dustin; Anglin, M Douglas; Urada, Darren; Longshore, Douglas

    2011-11-01

    Although several states have adopted policies diverting individuals convicted of non-violent drug offenses to substance use treatment, in lieu of incarceration or as a condition of probation, previous research has produced inconsistent findings on the effectiveness of such programs when comparing outcomes for legally coerced individuals to more voluntary entrants. Less studied in these populations is within group variation in treatment expectations and motivation influences, which have been shown to affect retention as well. As motivation has traditionally been viewed as contributing to treatment retention and higher levels of hope (the perception that goals can be met) are viewed as an asset in treatment, the role of these factors in predicting better retention between legally coerced and more voluntary clients were examined in a sample of 289 treatment admissions in California. Results found that motivation mediates the relationship between hope and retention for participants in general. Although the differences in mediation between the legally coerced and the non-legally coerced were not significant, when examining the groups separately, there was a significant mediation of the relationship between hope and retention by motivation only for those individuals who were not legally coerced into treatment (plead to different pathways to treatment retention, for individuals who were not legally coerced, higher levels of hope may play an important role in determining treatment retention. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. Stress degradation studies and development of stability-indicating TLC-densitometry method for determination of prednisolone acetate and chloramphenicol in their individual and combined pharmaceutical formulations

    Directory of Open Access Journals (Sweden)

    Musharraf Syed

    2012-01-01

    Full Text Available Abstract A rapid and reproducible stability indicating TLC method was developed for the determination of prednisolone acetate and chloramphenicol in presence of their degraded products. Uniform degradation conditions were maintained by refluxing sixteen reaction mixtures for two hours at 80°C using parallel synthesizer including acidic, alkaline and neutral hydrolysis, oxidation and wet heating degradation. Oxidation at room temperature, photochemical and dry heating degradation studies were also carried out. Separation was done on TLC glass plates, pre-coated with silica gel 60F-254 using chloroform: methanol (14:1 v/v. Spots at Rf 0.21 ± 0.02 and Rf 0.41 ± 0.03 were recognized as chloramphenicol and prednisolone acetate, respectively. Quantitative analysis was done through densitometric measurements at multiwavelength (243 nm, λmax of prednisolone acetate and 278 nm, λmax of chloramphenicol, simultaneously. The developed method was optimized and validated as per ICH guidelines. Method was found linear over the concentration range of 200-6000 ng/spot with the correlation coefficient (r2 ± S.D. of 0.9976 ± 3.5 and 0.9920 ± 2.5 for prednisolone acetate and chloramphenicol, respectively. The developed TLC method can be applied for routine analysis of prednisolone acetate and chloramphenicol in presence of their degraded products in their individual and combined pharmaceutical formulations.

  14. Fate and distribution of pharmaceuticals in wastewater and sewage sludge of the conventional activated sludge (CAS) and advanced membrane bioreactor (MBR) treatment.

    Science.gov (United States)

    Radjenović, Jelena; Petrović, Mira; Barceló, Damià

    2009-02-01

    In this paper we report on the performances of full-scale conventional activated sludge (CAS) treatment and two pilot-scale membrane bioreactors (MBRs) in eliminating various pharmaceutically active compounds (PhACs) belonging to different therapeutic groups and with diverse physico-chemical properties. Both aqueous and solid phases were analysed for the presence of 31 pharmaceuticals included in the analytical method. The most ubiquitous contaminants in the sewage water were analgesics and anti-inflammatory drugs ibuprofen (14.6-31.3 microg/L) and acetaminophen (7.1-11.4 microg/L), antibiotic ofloxacin (0.89-31.7 microg/L), lipid regulators gemfibrozil (2.0-5.9 microg/L) and bezafibrate (1.9-29.8 microg/L), beta-blocker atenolol (0.84-2.8 microg/L), hypoglycaemic agent glibenclamide (0.12-15.9 microg/L) and a diuretic hydrochlorothiazide (2.3-4.8 microg/L). Also, several pharmaceuticals such as ibuprofen, ketoprofen, diclofenac, ofloxacin and azithromycin were detected in sewage sludge at concentrations up to 741.1, 336.3, 380.7, 454.7 and 299.6 ng/g dry weight. Two pilot-scale MBRs exhibited enhanced elimination of several pharmaceutical residues poorly removed by the CAS treatment (e.g., mefenamic acid, indomethacin, diclofenac, propyphenazone, pravastatin, gemfibrozil), whereas in some cases more stable operation of one of the MBR reactors at prolonged SRT proved to be detrimental for the elimination of some compounds (e.g., beta-blockers, ranitidine, famotidine, erythromycin). Moreover, the anti-epileptic drug carbamazepine and diuretic hydrochlorothiazide by-passed all three treatments investigated. Furthermore, sorption to sewage sludge in the MBRs as well as in the entire treatment line of a full-scale WWTP is discussed for the encountered analytes. Among the pharmaceuticals encountered in sewage sludge, sorption to sludge could be a relevant removal pathway only for several compounds (i.e., mefenamic acid, propranolol, and loratidine). Especially in the

  15. Enhanced biodegradation of antibiotic combinations via the sequential treatment of the sludge resulting from pharmaceutical wastewater treatment using white-rot fungi Trametes versicolor and Bjerkandera adusta.

    Science.gov (United States)

    Aydin, Sevcan

    2016-07-01

    While anaerobic treatment is capable of treating pharmaceutical wastewater and removing antibiotics in liquid phases, solid phases may still contain significant amounts of antibiotics following this treatment. The main goal of this study was to evaluate the use of white-rot fungi to remove erythromycin, sulfamethoxazole, and tetracycline combinations from biosolids. The degradation potential of Trametes versicolor and Bjerkandera adusta was evaluated via the sequential treatment of anaerobic sludge. Polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) analyses were used to identify competition between the autochthonous microbial communities and white-rot fungi. Solid-phase treatment using white-rot fungi substantially reduced antibiotic concentrations and toxicity in sludge. According to PCR-DGGE results, there is an association between species of fungus and antibiotic type as a result of the different transformation pathways of fungal strains. Fungal post-treatment of sludge represents a promising method of removing antibiotic combinations, therefore holding a significant promise as an environmentally friendly means of degrading the antibiotics present in sludge.

  16. Analysis and occurrence of pharmaceuticals, estrogens, progestogens and polar pesticides in sewage treatment plant effluents, river water and drinking water in the Llobregat river basin (Barcelona, Spain)

    Science.gov (United States)

    Kuster, Marina; López de Alda, Maria José; Hernando, Maria Dolores; Petrovic, Mira; Martín-Alonso, Jordi; Barceló, Damià

    2008-08-01

    SummaryThis work investigated the presence of 21 emerging contaminants of various chemical groups (7 estrogens, 3 progestogens, 6 pharmaceuticals and personal care products (PPCPs), and 5 acidic pesticides) in the Llobregat river basin (NE Spain). Waters from the outlet of various sewage treatment plants (STP) and waterworks located along the river basin, as well as water samples from the river or its tributaries upstream and downstream of these plants were analysed in two pilot monitoring studies. Chemical analyses were performed by means of on-line or off-line solid-phase extraction followed by liquid chromatography-electrospray-tandem mass spectrometry. Methods detection limits (in ng/L) were ⩽0.85 for estrogens, ⩽3.94 for progestogens, ⩽30 for PPCPs, and ⩽0.99 for pesticides. Of the estrogens and progestogens analysed, only estrone-3-sulfate, estrone, estriol and progesterone were found to be present in the low nanogram per liter range in some of the samples investigated. Except for atenolol, all PPCPs studied (ibuprofen, diclofenac, clofibric acid, salicylic acid, and triclosan) could be identified at levels usually lower than 250 ng/L and up to 1200 ng/l (diclofenac). Of the various pesticides investigated (2,4-D, bentazone; MCPA, mecoprop and propanil) MCPA and 2,4-D were the most ubiquitous and abundant and bentazone the only one not detected. Individual concentrations were most often below 100 ng/L and never surpassed the EU limits.

  17. Heterogeneous photo-Fenton treatment for the reduction of pharmaceutical contamination in Madrid rivers and ecotoxicological evaluation by a miniaturized fern spores bioassay.

    Science.gov (United States)

    Rodríguez-Gil, José L; Catalá, Myriam; Alonso, Silvia González; Maroto, Raúl Romo; Valcárcel, Yolanda; Segura, Yolanda; Molina, Raúl; Melero, Juan A; Martínez, Fernando

    2010-06-01

    Fifty-six pharmaceuticals of various chemical groups, such as anti-inflammatory, antibacterial and cardiovascular drugs, were detected in four selected river waters receiving sewage effluents in the Community of Madrid (Spain). A promising approach for the degradation of those residues is the application of a photo-Fenton treatment. Several new bioassays using fern spores were employed for the evaluation of acute and chronic toxicity based on mitochondrial activity, DNA and chlorophyll quantifications of as-received river water and photo-Fenton-treated samples. photo-Fenton treatment provided a high degree of total organic carbon mineralization with up to 70% reduction for river water samples. In addition, the elimination of most of the studied pharmaceutical compounds was confirmed. A few compounds, however (salicylic acid, ofloxacin, caffeine, cotinine and nicotine), seemed more resistant, with after-treatment concentrations between 4 and 44ngL(-1). Nicotine showed the most refractory behaviour with concentrations ranging from 29 to 224ngL(-1) for treated samples. Photo-Fenton treatment yielded a significant decrease in acute and chronic toxicity, even though some residual toxicity remained after treatment. This fact seemed to be related to the presence of toxicants in the water matrix, probably of inorganic nature, rather than the toxic effect of the studied pharmaceutical compounds, as revealed by the effective removal of these compounds and high TOC mineralization of photo-Fenton treatments.

  18. Microbial community functional structure in response to antibiotics in pharmaceutical wastewater treatment systems.

    Science.gov (United States)

    Zhang, Yu; Xie, Jianping; Liu, Miaomiao; Tian, Zhe; He, Zhili; van Nostrand, Joy D; Ren, Liren; Zhou, Jizhong; Yang, Min

    2013-10-15

    It is widely demonstrated that antibiotics in the environment affect microbial community structure. However, direct evidence regarding the impacts of antibiotics on microbial functional structures in wastewater treatment systems is limited. Herein, a high-throughput functional gene array (GeoChip 3.0) in combination with quantitative PCR and clone libraries were used to evaluate the microbial functional structures in two biological wastewater treatment systems, which treat antibiotic production wastewater mainly containing oxytetracycline. Despite the bacteriostatic effects of antibiotics, the GeoChip detected almost all key functional gene categories, including carbon cycling, nitrogen cycling, etc., suggesting that these microbial communities were functionally diverse. Totally 749 carbon-degrading genes belonging to 40 groups (24 from bacteria and 16 from fungi) were detected. The abundance of several fungal carbon-degrading genes (e.g., glyoxal oxidase (glx), lignin peroxidase or ligninase (lip), manganese peroxidase (mnp), endochitinase, exoglucanase_genes) was significantly correlated with antibiotic concentrations (Mantel test; P functional genes have been enhanced by the presence of antibiotics. However, from the fact that the majority of carbon-degrading genes were derived from bacteria and diverse antibiotic resistance genes were detected in bacteria, it was assumed that many bacteria could survive in the environment by acquiring antibiotic resistance and may have maintained the position as a main player in nutrient removal. Variance partitioning analysis showed that antibiotics could explain 24.4% of variations in microbial functional structure of the treatment systems. This study provides insights into the impacts of antibiotics on microbial functional structure of a unique system receiving antibiotic production wastewater, and reveals the potential importance of the cooperation between fungi and bacteria with antibiotic resistance in maintaining the

  19. Is the phototransformation of pharmaceuticals a natural purification process that decreases ecological and human health risks?

    International Nuclear Information System (INIS)

    Wang, Xiao-Huan; Lin, Angela Yu-Chen

    2014-01-01

    Sunlight photodegradation has long been considered a significant process in lowering the concentrations of pharmaceuticals in surface waters and thus decreasing the ecological risk. For the first time, this study identified the significance of investigating the environmental photodegradation of a pharmaceutical residue mixture (rather than a single compound) and the associated toxicity of transformation byproducts in environmental waters, including rivers, hospital wastewaters, and effluents from wastewater treatment plants and pharmaceutical production facilities. Pharmaceuticals undergo phototransformation rather than mineralization (11–23% in 34 h). Pharmaceutical mixtures could possibly act as dissolved organic matter for each individual compound and subsequently affect the photolysis rates. The increased toxicity of irradiated pharmaceutical mixtures challenges the validity of the current understanding of sunlight photolysis. The implications of this work suggest that current knowledge concerning the occurrence, natural attenuation, ecotoxicity, and human health risks of pharmaceuticals is far from complete; photolysis is not necessarily a purification process. -- Highlights: • Pharmaceutical mixtures could possibly act as DOMs for each other. • Pharmaceuticals underwent merely phototransformation rather than mineralization. • Increased toxicity from photo byproducts associated with the pharmaceutical mixture. • Phototransformation does not necessary mitigate the risk to human and the ecosystem. -- Transformation byproducts associated with a pharmaceutical mixture could be more toxic, and phototransformation does not necessary mitigate the risk to humans and the ecosystem

  20. Combined electrocoagulation and TiO2 photoassisted treatment applied to wastewater effluents from pharmaceutical and cosmetic industries

    International Nuclear Information System (INIS)

    Boroski, Marcela; Rodrigues, Angela Claudia; Garcia, Juliana Carla; Sampaio, Luiz Carlos; Nozaki, Jorge; Hioka, Noboru

    2009-01-01

    The treated wastewater consists of refractory materials and high organic content of hydrolyzed peptone residues from pharmaceutical factory. The combination of electrocoagulation (EC) followed by heterogeneous photocatalysis (TiO 2 ) conditions was maximized. The EC: iron cathode/anode (12.50 cm x 2.50 cm x 0.10 cm), current density 763 A m -2 , 90 min and initial pH 6.0. As EC consequence, the majority of the dissolved organic and suspended material was removed (about 91% and 86% of the turbidity and chemical oxygen demand (COD), respectively). After EC, refractory residues still remained in the effluent. The subsequent photocatalysis: UV/TiO 2 /H 2 O 2 (mercury lamps), pH 3.0, 4 h irradiation, 0.25 g L -1 TiO 2 and 10 mmol L -1 H 2 O 2 shows high levels of inorganic and organic compounds eliminations. The obtained COD values: 1753 mg L -1 for the sample from the factory, 160 mg L -1 after EC and 50 mg L -1 after EC/photocatalyzed effluents pointed out that the combined treatment stresses this water purification

  1. Combined electrocoagulation and TiO{sub 2} photoassisted treatment applied to wastewater effluents from pharmaceutical and cosmetic industries

    Energy Technology Data Exchange (ETDEWEB)

    Boroski, Marcela; Rodrigues, Angela Claudia; Garcia, Juliana Carla; Sampaio, Luiz Carlos; Nozaki, Jorge [Departamento de Quimica, Universidade Estadual de Maringa, Avenida Colombo 5790, Maringa-PR 87020-900 (Brazil); Hioka, Noboru [Departamento de Quimica, Universidade Estadual de Maringa, Avenida Colombo 5790, Maringa-PR 87020-900 (Brazil)], E-mail: nhioka2@yahoo.com.br

    2009-02-15

    The treated wastewater consists of refractory materials and high organic content of hydrolyzed peptone residues from pharmaceutical factory. The combination of electrocoagulation (EC) followed by heterogeneous photocatalysis (TiO{sub 2}) conditions was maximized. The EC: iron cathode/anode (12.50 cm x 2.50 cm x 0.10 cm), current density 763 A m{sup -2}, 90 min and initial pH 6.0. As EC consequence, the majority of the dissolved organic and suspended material was removed (about 91% and 86% of the turbidity and chemical oxygen demand (COD), respectively). After EC, refractory residues still remained in the effluent. The subsequent photocatalysis: UV/TiO{sub 2}/H{sub 2}O{sub 2} (mercury lamps), pH 3.0, 4 h irradiation, 0.25 g L{sup -1} TiO{sub 2} and 10 mmol L{sup -1} H{sub 2}O{sub 2} shows high levels of inorganic and organic compounds eliminations. The obtained COD values: 1753 mg L{sup -1} for the sample from the factory, 160 mg L{sup -1} after EC and 50 mg L{sup -1} after EC/photocatalyzed effluents pointed out that the combined treatment stresses this water purification.

  2. Pharmaceuticals, hormones and bisphenol A in untreated source and finished drinking water in Ontario, Canada - Occurrence and treatment efficiency

    International Nuclear Information System (INIS)

    Kleywegt, Sonya; Pileggi, Vince; Yang, Paul; Hao Chunyan; Zhao Xiaoming; Rocks, Carline; Thach, Serei; Cheung, Patrick; Whitehead, Brian

    2011-01-01

    pharmaceuticals and hormones and bisphenol A in aquatic environment of Ontario, Canada were determined in a 16-month survey. → IDMS analysis ensured monitoring data are with high precision and accuracy. → Reported the first detection of two antibiotics roxithromycin and enrofloxacin in aquatic environmental samples. → Compared removal efficiency of carbamazepine, gemfibrozil, ibuprofen, and BPA in DWSs using granulated activated carbon and ultraviolet treatment processes.

  3. Pharmaceuticals, hormones and bisphenol A in untreated source and finished drinking water in Ontario, Canada - Occurrence and treatment efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Kleywegt, Sonya; Pileggi, Vince [Standards Development Branch, Ontario Ministry of the Environment, 40 St. Clair Avenue West, Toronto, Ontario, M4V 1M2 (Canada); Yang, Paul, E-mail: paul.yang@ontario.ca [Laboratory Services Branch, Ontario Ministry of the Environment, 125 Resources Road, Etobicoke, Ontario, M9P 3V6 (Canada); Hao Chunyan; Zhao Xiaoming [Laboratory Services Branch, Ontario Ministry of the Environment, 125 Resources Road, Etobicoke, Ontario, M9P 3V6 (Canada); Rocks, Carline [Environmental Monitoring and Reporting Branch, Ontario Ministry of the Environment, 125 Resources Road, Etobicoke, Ontario, M9P 3V6 (Canada); Thach, Serei [Laboratory Services Branch, Ontario Ministry of the Environment, 125 Resources Road, Etobicoke, Ontario, M9P 3V6 (Canada); Cheung, Patrick; Whitehead, Brian [Environmental Monitoring and Reporting Branch, Ontario Ministry of the Environment, 125 Resources Road, Etobicoke, Ontario, M9P 3V6 (Canada)

    2011-03-15

    selected pharmaceuticals and hormones and bisphenol A in aquatic environment of Ontario, Canada were determined in a 16-month survey. {yields} IDMS analysis ensured monitoring data are with high precision and accuracy. {yields} Reported the first detection of two antibiotics roxithromycin and enrofloxacin in aquatic environmental samples. {yields} Compared removal efficiency of carbamazepine, gemfibrozil, ibuprofen, and BPA in DWSs using granulated activated carbon and ultraviolet treatment processes.

  4. Perceptions of Oncologists, Healthcare Policy Makers, Patients and the General Population on the Value of Pharmaceutical Treatments in Oncology.

    Science.gov (United States)

    Sacristán, José A; Lizan, Luís; Comellas, Marta; Garrido, Pilar; Avendaño, Cristina; Cruz-Hernández, Juan J; Espinosa, Javier; Dilla, Tatiana

    2016-11-01

    The purpose of this study was to explore the main factors explaining the relative weight of the different attributes that determine the value of oncologic treatments from the different perspectives of healthcare policy makers (HCPM), oncologists, patients and the general population in Spain. Structured interviews were conducted to assess: (1) the importance of the attributes on treatment choice when comparing a new cancer drug with a standard cancer treatment; (2) the importance of survival, quality of life (QoL), costs and innovation in cancer; and (3) the most worrying side effects related to cancer drugs. A total of 188 individuals participated in the study. For all participants, when choosing treatments, the best rated characteristics were greater efficacy, greater safety, treatment adaptation to patients' individual requirements and the rapid reincorporation of patients to their daily activities. There were important differences among participants in their opinion about survival, QoL and cost. In general, oncologists, patients, and the general population gave greater value to gains in QoL than healthcare policy makers. Compared to other participants healthcare policy makers gave greater importance to the economic impact related to oncology treatments. Gains in QoL, survival, safety, cost and innovation are perceived differently by different groups of stakeholders. It is recommended to consider the perspective of different stakeholders in the assessment of a new cancer drugs to obtain more informed decisions when deciding on the most appropriate treatment to use. Eli Lilly & Co, Madrid (Spain).

  5. Year-long evaluation on the occurrence and fate of pharmaceuticals, personal care products, and endocrine disrupting chemicals in an urban drinking water treatment plant.

    Science.gov (United States)

    Padhye, Lokesh P; Yao, Hong; Kung'u, Francis T; Huang, Ching-Hua

    2014-03-15

    The occurrence and removal of thirty representative pharmaceutical and personal care products (PPCPs) and endocrine disrupting chemicals (EDCs) in an urban drinking water treatment plant (DWTP) were investigated for a period of one year to evaluate current system's treatment efficacy and assess occurrence of PPCPs and EDCs in finished drinking water. Results showed that the average total PPCPs and EDCs concentration in the surface water source was around 360 ng/L (median concentration = 340 ng/L) with 57% coefficient of variation (CV). The median concentrations of most of the individual PPCPs and EDCs in the surface water were below 15 ng/L except for N,N-diethyltoluamide (DEET) and nonylphenol, which were at 122 and 83 ng/L, respectively. The compounds DEET, nonylphenol, ibuprofen, triclosan, atrazine, tris(2-chloroethyl)-phosphate (TCEP), bisphenol-A, and caffeine (in the order of decreasing median concentration) were among twenty compounds detected at least once in the surface water, while all of the above detected compounds, except two, were also detected in the finished drinking water. The average total PPCPs and EDCs concentration in the finished drinking water was around 98 ng/L (median concentration = 96 ng/L) with 66% CV. The median concentrations of most detected PPCPs and EDCs in drinking water were below 5 ng/L except for DEET and nonylphenol, which were at 12 and 20 ng/L, respectively. There was a strong correlation (r = 0.97) between PPCPs and EDCs' concentrations in the source water and in the drinking water over the one-year study period when data points from two sampling events with unusual removals were excluded. Individual water treatment unit processes showed greater temporal variations of PPCPs and EDCs removal efficiencies than the overall treatment processes. The removal efficiencies also varied greatly among different PPCPs and EDCs. The average removal for total PPCPs and EDCs was 76 ± 18% at the DWTP, with ozonation

  6. Effect of operating conditions in soil aquifer treatment on the removals of pharmaceuticals and personal care products

    Energy Technology Data Exchange (ETDEWEB)

    He, Kai, E-mail: hekai@urban.env.kyoto-u.ac.jp; Echigo, Shinya; Itoh, Sadahiko

    2016-09-15

    Soil aquifer treatment (SAT) is an alternative advanced treatment for wastewater reclamation, and it has the potential to control micropollutants including pharmaceuticals and personal care products (PPCPs). However, the relationship of operating conditions in SAT and removals of micropollutants was not clear. In this study, the effects of operating conditions on the removals of PPCPs were evaluated by using lab-scale columns and plant pilot-scale reactors under different operating conditions. Firstly, weathered granite soil (WGS), standard sand (SAND) and Toyoura standard sand (TS) have different soil characteristics such as total organic carbon (TOC) and cation exchange capacity (CEC). In the columns with these packing materials, the removals of carboxylic analgesics and antilipidemics were effective regardless packing materials. The removals of antibiotics were more effective in WGS than in TS and SAND, indicating high TOC and CEC enhance the sorption in SAT. Secondly, with the extension of hydraulic retention time (HRT), the removals of sulfamethoxazole, acetaminophen, crotamiton, and antipyrine were improved in WGS columns, and adaptable biodegradation for moderately removable PPCPs was formed. Thirdly, the removal efficiencies of sulfamethoxazole and crotamiton were higher in the WGS column under vadose condition than in the WGS column under saturated condition, because of aerobic condition in WGS column under vadose condition. Though long HRT and vadose condition had positive influence on the removals of several PPCPs such as sulfamethoxazole, WGS column with an HRT of 7 days under saturated condition removed most PPCPs. - Highlights: • Soil organic matter and cation exchange capacity enhanced the removals of antibiotics in SAT. • A hydraulic retention time (HRT) of 7 days was sufficient for the removals of most PPCPs. • The removals of most selected PPCPs were similar under vadose and saturated conditions. • Vadose condition contributed to the

  7. An ecofriendly green liquid chromatographic method for simultaneous determination of nicotinamide and clindamycin phosphate in pharmaceutical gel for acne treatment

    Directory of Open Access Journals (Sweden)

    Fawzia Ibrahim

    2017-07-01

    Full Text Available A new green micellar liquid chromatographic method was developed and validated for the quantitative estimation of nicotinamide (NICO and clindamycin phosphate (CLD in bulk and pharmaceutical gel formulation. The analytes are well resolved in less than 6.0 minutes using micellar mobile phase consisting of 0.10M sodium dodecyl sulfate (SDS, 0.3% triethylamine, and 10% 2-propanol in 0.02M orthophosphoric acid at pH 3.0, running through an Eclipse XDB-C8 column (150 mm×4.6 mm, 5 μm particle size with flow rate 1.0 mL/min. The effluent was monitored with diode array detection at 210 nm. The retention times of NICO and CLD were 3.8 minutes and 5.6 minutes, respectively. The method was validated according to the International Conference on Harmonisation (ICH guidelines in terms of linearity, limit of detection, limit of quantification, accuracy, precision, robustness, and specificity to prove its reliability. Linear correlation was achieved by plotting the peak area of each drug against its concentration. It was found to be rectilinear in the ranges of 1.0–40.0 μg/mL and 0.5–15.0 μg/mL with limits of detection of 0.06 μg/mL and 0.03 μg/mL and limits of quantification of 0.19 μg/mL and 0.09 μg/mL for NICO and CLD, respectively. The method was successfully implemented for the simultaneous determination of the analytes in their bulk powder and combined gel formulation with high % recoveries. The ease of sample treatment facilitates and greatly expedites the treatment with reduced cost and improved accuracy of the procedure.

  8. Treatment of selected pharmaceuticals by ferrate(VI): performance, kinetic studies and identification of oxidation products.

    Science.gov (United States)

    Zhou, Zhengwei; Jiang, Jia-Qian

    2015-03-15

    The performance of ferrate(VI) in treating sulfamethoxazole (SMX), diclofenac (DCF), carbamazepine (CBZ) and bezafibrate (BZF) in test solutions containing the four compounds was investigated. A series of jar-test experiments was performed on a bench-scale at pH 6-9 and at a ferrate(VI) dose of 1-5 mg Fe/L. The results suggested that ferrate(VI) can effectively remove SMX, DCF and CBZ from the test solutions, with greater than 80% removal under optimum conditions. However, the removal efficiency of BZF was very low, less than 25% under the studied conditions. Increasing the dose of ferrate(VI) improved the treatment performance, while the influence of solution pH on ferrate(VI) performance varied among the different target compounds. Ferrate(VI) demonstrated the highest reactivity with SMX at pH 8 and pH 9 (20 °C), with apparent second-order rate constants of 360±17 M(-1) s(-1) and 1.26±0.02 M(-1) s(-1), respectively. However, BZF showed the lowest removal by ferrate(VI) with the smallest rate constants (less than 0.5 M(-1) s(-1)) at pH 8 and pH 9. Furthermore, a number of oxidation products (OPs) of SMX, DCF and CBZ during ferrate(VI) oxidation were detected by liquid chromatography and mass spectrometry (LC-MS), and their degradation pathways were tentatively proposed. No OPs of BZF were detected during ferrate(VI) oxidation. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Methods of Improving Water Treatment Systems for Individual Residential Houses

    Directory of Open Access Journals (Sweden)

    Pavlov Sergey

    2016-01-01

    Full Text Available One of hot topics for ecological management is sewage treatment today in places where there is no sewerage. The volume of country construction in territories, which are not connected to the public sewage system increasing nowadays. Therefore, problem of wastewater treatment take place. Currently, there are a lot of different designs of local waste treatment plants is offered to consumers. However, a large number of negative reviews indicate serious shortcomings in most of the local plants offered in the market. The purpose of this paper is the proposal of improvement of the most common local treatment plants in Russia.

  10. Ecotoxicological assessment of the pharmaceutical fluoxetine hydrochloride and the surfactant dodecyl sodium sulfate after their submission to ionizing radiation treatment

    International Nuclear Information System (INIS)

    Santos, Dymes Rafael Alves dos

    2011-01-01

    The use of pharmaceuticals and personal care products and the consequent and continuous input of this substances in the environment generates an increasing need to investigate the presence, behavior and the effects on aquatic biota, as well as new ways to treat effluents containing such substances. Fluoxetine hydrochloride is an active ingredient used in the treatment of depressive disorders and anxiety. As the surfactant sodium dodecyl sulfate is present in many cleaning and personal care products. The present study aimed on assessing the acute toxicity of fluoxetine hydrochloride, sodium dodecyl sulfate and the mixture of both to the aquatic organisms Hyalella azteca, Daphnia similis and Vibrio ficheri. Reducing the toxicity of fluoxetine and the mixture after treatment with ionizing radiation from industrial electron beam accelerator has also been the focus of this study. For Daphnia similis the average values of CE50-4 8h found for the non-irradiated drug, surfactant and mixture were 14.4 %, 9.62 % and 13.8 %, respectively. After irradiation of the substances, the dose 5 kGy proved itself to be the most effective dose for the treatment of the drug and the mixture as it was obtained the mean values for CE50 48h 84.60 % and > 90 %, respectively. For Hyalella azteca the acute toxicity tests were performed for water column with duration of 96 hours, the mean values for CE50 96h found for the drug, the surfactant and the mixture non-irradiated were 5.63 %, 19.29 %, 6.27 %, respectively. For the drug fluoxetine and the mixture irradiated with 5 kGy, it was obtained 69.57 % and 77.7 %, respectively. For Vibrio ficheri the acute toxicity tests for the untreated drug and the drug irradiated with 5 kGy it was obtained CE50 15min of 6.9 % and 32.88 % respectively. These results presented a reduction of the acute toxicity of the test-substances after irradiation. (author)

  11. Occurrence, fate and ecotoxicological assessment of pharmaceutically active compounds in wastewater and sludge from wastewater treatment plants in Chongqing, the Three Gorges Reservoir Area

    International Nuclear Information System (INIS)

    Yan, Qing; Gao, Xu; Chen, You-Peng; Peng, Xu-Ya; Zhang, Yi-Xin; Gan, Xiu-Mei; Zi, Cheng-Fang; Guo, Jin-Song

    2014-01-01

    The occurrence, removal and ecotoxicological assessment of 21 pharmaceutically active compounds (PhACs) including antibiotics, analgesics, antiepileptics, antilipidemics and antihypersensitives, were studied at four municipal wastewater treatment plants (WWTP) in Chongqing, the Three Gorges Reservoir Area. Individual treatment unit effluents, as well as primary and secondary sludge, were sampled and analyzed for the selected PhACs to evaluate their biodegradation, persistence and partitioning behaviors. PhACs were identified and quantified using high performance liquid chromatography/tandem mass spectrometry after solid-phase extraction. All the 21 analyzed PhACs were detected in wastewater and the target PhACs except acetaminophen, ibuprofen and gemfibrozil, were also found in sludge. The concentrations of the antibiotics and SVT were comparable to or even higher than those reported in developed countries, while the case of other target PhACs was opposite. The elimination of PhACs except acetaminophen was incomplete and a wide range of elimination efficiencies during the treatment were observed, i.e. from “negative removal” to 99.5%. The removal of PhACs was insignificant in primary and disinfection processes, and was mainly achieved during the biological treatment. Based on the mass balance analysis, biodegradation is believed to be the primary removal mechanism, whereas only about 1.5% of the total mass load of the target PhACs was removed by sorption. Experimentally estimated distribution coefficients ( 2 O) in effluent and sludge, as well as the mixture of the 21 detected PhACs in effluent, sludge and receiving water had a significant ecotoxicological risk to algae. Therefore, further control of PhACs in effluent and sludge is required before their discharge and application to prevent their introduction into the environment. - Highlights: • All the 21 analyzed PhACs were detected in wastewater and 18 in sludge. • The removal of PhACs was insignificant

  12. Occurrence, fate and ecotoxicological assessment of pharmaceutically active compounds in wastewater and sludge from wastewater treatment plants in Chongqing, the Three Gorges Reservoir Area

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Qing, E-mail: qyan2005@hotmail.com [Key Laboratory of the Three Gorges Reservoir Region' s Eco-Environments of Ministry of Education, Chongqing University, Chongqing 400045 (China); College of Geography Science and Tourism, Chongqing Normal University, Chongqing 400047 (China); Gao, Xu, E-mail: gaoxu@cqu.edu.cn [Key Laboratory of the Three Gorges Reservoir Region' s Eco-Environments of Ministry of Education, Chongqing University, Chongqing 400045 (China); Chen, You-Peng [Key Laboratory of the Three Gorges Reservoir Region' s Eco-Environments of Ministry of Education, Chongqing University, Chongqing 400045 (China); Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences, Chongqing 401122 (China); Peng, Xu-Ya; Zhang, Yi-Xin; Gan, Xiu-Mei; Zi, Cheng-Fang [Key Laboratory of the Three Gorges Reservoir Region' s Eco-Environments of Ministry of Education, Chongqing University, Chongqing 400045 (China); Guo, Jin-Song [Key Laboratory of the Three Gorges Reservoir Region' s Eco-Environments of Ministry of Education, Chongqing University, Chongqing 400045 (China); Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences, Chongqing 401122 (China)

    2014-02-01

    The occurrence, removal and ecotoxicological assessment of 21 pharmaceutically active compounds (PhACs) including antibiotics, analgesics, antiepileptics, antilipidemics and antihypersensitives, were studied at four municipal wastewater treatment plants (WWTP) in Chongqing, the Three Gorges Reservoir Area. Individual treatment unit effluents, as well as primary and secondary sludge, were sampled and analyzed for the selected PhACs to evaluate their biodegradation, persistence and partitioning behaviors. PhACs were identified and quantified using high performance liquid chromatography/tandem mass spectrometry after solid-phase extraction. All the 21 analyzed PhACs were detected in wastewater and the target PhACs except acetaminophen, ibuprofen and gemfibrozil, were also found in sludge. The concentrations of the antibiotics and SVT were comparable to or even higher than those reported in developed countries, while the case of other target PhACs was opposite. The elimination of PhACs except acetaminophen was incomplete and a wide range of elimination efficiencies during the treatment were observed, i.e. from “negative removal” to 99.5%. The removal of PhACs was insignificant in primary and disinfection processes, and was mainly achieved during the biological treatment. Based on the mass balance analysis, biodegradation is believed to be the primary removal mechanism, whereas only about 1.5% of the total mass load of the target PhACs was removed by sorption. Experimentally estimated distribution coefficients (< 500 L/kg, with a few exceptions) also indicate that biodegradation/transformation was responsible for the removal of the target PhACs. Ecotoxicological assessment indicated that the environment concentrations of single compounds (including sulfadiazine, sulfamethoxazole, ofloxacin, azithromycin and erythromycin-H{sub 2}O) in effluent and sludge, as well as the mixture of the 21 detected PhACs in effluent, sludge and receiving water had a significant

  13. Enzyme replacement therapy in Fabry disease, towards individualized treatment

    NARCIS (Netherlands)

    Arends, M.

    2017-01-01

    Fabry disease is a very heterogeneous disorder for which expensive enzyme replacement therapy is available since more than 15 years. Because of the variety of symptoms and disease course, individual choices need to be made to improve the appropriate use of therapy. Supported by ZONWM, we have been

  14. On the role of salts for the treatment of wastewaters containing pharmaceuticals by electrochemical oxidation using a boron doped diamond anode

    International Nuclear Information System (INIS)

    Lan, Yandi; Coetsier, Clémence; Causserand, Christel; Groenen Serrano, Karine

    2017-01-01

    Refractory pharmaceuticals remain in biologically treated wastewater and are continuously discharged into aquatic systems due to their limited biodegradability. Electrochemical oxidation is promising for the treatment of such refractory compounds, in particular using a boron doped diamond (BDD) anode. This study investigates the role of salts, such as sulfates and chlorides in the electrochemical treatment of wastewater. The presence of sulfates accelerated the removal of ciprofloxacin and sulfamethoxazole, but had no effect on the oxidation of salbutamol. This comparison highlights the selectivity of the reaction between organics and sulfate radicals. The addition of chlorides into the solution led to a remarkably-faster degradation of ciprofloxacin. However, incomplete mineralization was observed at high current densities due to the significant formation of halogenated organic compounds (AOX). The formation of refractory and toxic compounds such as ClO_4"− and AOX can be limited under the control of (i) applied current intensity and (ii) duration of electrolysis. Electrochemical oxidation of concentrated biologically-treated hospital wastewater investigated the excellent removal of biorefractory pharmaceuticals and confirmed the acceleration effect of salts on pharmaceutical degradation.

  15. Pharmaceuticals removal and microbial community assessment in a continuous fungal treatment of non-sterile real hospital wastewater after a coagulation-flocculation pretreatment.

    Science.gov (United States)

    Mir-Tutusaus, J A; Parladé, E; Llorca, M; Villagrasa, M; Barceló, D; Rodriguez-Mozaz, S; Martinez-Alonso, M; Gaju, N; Caminal, G; Sarrà, M

    2017-06-01

    Hospital wastewaters are a main source of pharmaceutical active compounds, which are usually highly recalcitrant and can accumulate in surface and groundwater bodies. Fungal treatments can remove these contaminants prior to discharge, but real wastewater poses a problem to fungal survival due to bacterial competition. This study successfully treated real non-spiked, non-sterile wastewater in a continuous fungal fluidized bed bioreactor coupled to a coagulation-flocculation pretreatment for 56 days. A control bioreactor without the fungus was also operated and the results were compared. A denaturing gradient gel electrophoresis (DGGE) and sequencing approach was used to study the microbial community arisen in both reactors and as a result some bacterial degraders are proposed. The fungal operation successfully removed analgesics and anti-inflammatories, and even the most recalcitrant pharmaceutical families such as antibiotics and psychiatric drugs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. The occurrence and distribution of pharmaceutical compounds in the effluents of a major sewage treatment plant in Northern Taiwan and the receiving coastal waters

    International Nuclear Information System (INIS)

    Fang, Tien-Hsi; Nan, Fan-Hua; Chin, Tzong-Shean; Feng, Hui-Min

    2012-01-01

    The pharmaceutical residues in waste water from the largest sewage treatment plant (STP) in Northern Taiwan and in seawater around the effluent discharged area were determined. An environmental risk assessment for the marine environment was conducted based on the environment risk quotient (ERQ). The concentrations of the analyzed compounds in STP influent and effluent were generally higher than those found in coastal seawater. Relatively higher values were found at the estuarine mouth and the discharged area, suggesting that the STP effluent is a point source. The removal efficiency and half life of the analyzed compounds were 6.3–46.8% and 3–18 days, respectively. The ERQ value theoretical calculation was generally greater than 1. However, when the measured concentrations replaced the predicated concentrations, the ERQ values were considerably lower than 1. Therefore, our results call for a re-evaluation of the risks posed by pharmaceuticals to coastal marine ecosystems in Northern Taiwan.

  17. Systematic Desensitization Of Test Anxiety: A Comparison Of Group And Individual Treatment

    Science.gov (United States)

    Scissons, Edward H.; Njaa, Lloyd J.

    1973-01-01

    The results indicate the effectiveness of both individual desensitization and group desensitization in the treatment of high test anxiety. More research is needed in comparing the effectiveness of group desensitization and individual desensitization with intratreatment variables. (Author)

  18. Convergence of biomarkers, bioinformatics and nanotechnology for individualized cancer treatment

    Science.gov (United States)

    Phan, John H.; Moffitt, Richard A.; Stokes, Todd H.; Liu, Jian; Young, Andrew N.; Nie, Shuming; Wang, May D.

    2013-01-01

    Recent advances in biomarker discovery, biocomputing, and nanotechnology have raised new opportunities for the emerging field of personalized medicine in which disease detection, diagnosis, and therapy are tailored to each individual’s molecular profile, and also for predictive medicine that uses genetic/molecular information to predict disease development, progression, and clinical outcome. Here we discuss advanced biocomputing tools for cancer biomarker discovery and multiplexed nanoparticle probes for cancer biomarker profiling, together with prospects and challenges in correlating biomolecular signatures with clinical outcome. This bio-nano-info convergence holds great promise for molecular diagnosis and individualized therapy of cancer and other human diseases. PMID:19409634

  19. Effect of ultrasonic and ozone pre-treatments on pharmaceutical waste activated sludge's solubilisation, reduction, anaerobic biodegradability and acute biological toxicity.

    Science.gov (United States)

    Pei, Jin; Yao, Hong; Wang, Hui; Shan, Dan; Jiang, Yichen; Ma, Lanqianya; Yu, Xiaohua

    2015-09-01

    Ultrasonic and ozone pre-treatment technologies were employed in this study to improve the anaerobic digestion efficiency of pharmaceutical waste activated sludge. The sludge solubilisation achieved 30.01% (150,000 kJ/kg TS) and 28.10% (0.1g O3/g TS) after ultrasonic treatment and ozone treatment. The anaerobic biodegradability after ultrasonic treatment was higher compared to ozonation due to the higher cumulative methane volume observed after 6 days (249 ml vs 190 ml). The ozonated sludge released the highest concentration of Cu(2+) into the liquid phase (6.640 mg L(-1)) compared to 0.530 mg/L for untreated sludge and 0.991 mg/L for sonicated sludge. The acute toxicity test measured by luminescent bacteria showed that anaerobic digestion could degrade toxic compounds and result in a reduction in toxicity. The main mechanism of action led to some differences in the treated sludge exhibiting higher potential for methane production from pharmaceutical waste sludge with ultrasonic treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Gender-related differences in individuals seeking treatment for kleptomania.

    Science.gov (United States)

    Grant, Jon E; Potenza, Marc N

    2008-03-01

    Understanding variations in disease presentation in men and women is clinically important as differences may reflect biological and sociocultural factors and have implications for prevention and treatment strategies. Few empirical investigations have been performed in kleptomania, particularly with respect to gender-related influences. From 2001--2007, 95 adult subjects (n=27 [28.4%] males) with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined kleptomania were assessed on sociodemographics and clinical characteristics, including symptom severity, comorbidity, and functional impairment, to identify gender-related differences. Men and women showed substantial symptom severity and functional impairment. Compared with affected men, women with kleptomania were more likely to be married (47.1% vs 25.9%; P=.039), have a later age at shoplifting onset (20.9 vs 14 years of age; P=.001), steal household items (PKleptomania is similarly associated with significant impairment in women and men. Gender-related differences in clinical features and co-occurring disorders suggest that prevention and treatment strategies incorporate gender considerations.

  1. Pharmaceutical Cocrystals

    OpenAIRE

    Korotkova, Elena I.; Kratochvíl, B.

    2014-01-01

    Cocrystals are very interesting and useful product. In this paper the main information about cocrystals is presented. It is shown that cocrystals are solid substances, which consist of few components mixed together. There are a lot of ways of cocrystals production and application. It is shown that cocrystals can be applied in medicine and pharmaceutical industry for improving different properties such as dissolution rate, melting point, solubility, chemical stability etc. Another way of cocry...

  2. Group or Individual treatment: What is More Effective in Childhood and Juvenile Obesity?

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Garcia Pereira

    2015-01-01

    Full Text Available Objective: the objective was to compare the efficacy of individual treatment (consulting and group treatment combined with individualized care, in childhood and juvenile obesity situations. Methodology: The study was carried out in 2 different places: in the Nutrition Clinic of the Integrated Health Clinic of UNIARA and in another clinical school. In both places there was a treatment with individual consultations, however, in the Integrated Health Clinic of UNIARA treatment was also done in group care. The target individuals were composed of children and adolescents of both sexes who participated in the consultations, however, only patients who were above the 85th percentile for BMI, according to the international reference population (NCHS, 2000, were included in the sample which was composed of 58 individuals. The choice of clinical records occurred at random in both places. Results: the most effective program in the positive change in dietary habits was group together with individual treatment, where 20 patients (68.96% showed some change in eating behavior. In individual treatment, 11 patients (37.93% showed some change in dietary habits existing before treatment. There was a reduction in the rate of obesity of 24% for patients in groups, however, both types of treatment were favorable to changes in dietary habits and weight reduction. The findings showed that the strategy of individualized care together with group care is an alternative for the treatment of overweight.

  3. Contribution of hospital effluents to the load of pharmaceuticals in urban wastewaters: identification of ecologically relevant pharmaceuticals.

    Science.gov (United States)

    Santos, Lúcia H M L M; Gros, Meritxell; Rodriguez-Mozaz, Sara; Delerue-Matos, Cristina; Pena, Angelina; Barceló, Damià; Montenegro, M Conceição B S M

    2013-09-01

    The impact of effluent wastewaters from four different hospitals: a university (1456 beds), a general (350 beds), a pediatric (110 beds) and a maternity hospital (96 beds), which are conveyed to the same wastewater treatment plant (WWTP), was evaluated in the receiving urban wastewaters. The occurrence of 78 pharmaceuticals belonging to several therapeutic classes was assessed in hospital effluents and WWTP wastewaters (influent and effluent) as well as the contribution of each hospital in WWTP influent in terms of pharmaceutical load. Results indicate that pharmaceuticals are widespread pollutants in both hospital and urban wastewaters. The contribution of hospitals to the input of pharmaceuticals in urban wastewaters widely varies, according to their dimension. The estimated total mass loadings were 306 g d(-1) for the university hospital, 155 g d(-1) for the general one, 14 g d(-1) for the pediatric hospital and 1.5 g d(-1) for the maternity hospital, showing that the biggest hospitals have a greater contribution to the total mass load of pharmaceuticals. Furthermore, analysis of individual contributions of each therapeutic group showed that NSAIDs, analgesics and antibiotics are among the groups with the highest inputs. Removal efficiency can go from over 90% for pharmaceuticals like acetaminophen and ibuprofen to not removal for β-blockers and salbutamol. Total mass load of pharmaceuticals into receiving surface waters was estimated between 5 and 14 g/d/1000 inhabitants. Finally, the environmental risk posed by pharmaceuticals detected in hospital and WWTP effluents was assessed by means of hazard quotients toward different trophic levels (algae, daphnids and fish). Several pharmaceuticals present in the different matrices were identified as potentially hazardous to aquatic organisms, showing that especial attention should be paid to antibiotics such as ciprofloxacin, ofloxacin, sulfamethoxazole, azithromycin and clarithromycin, since their hazard quotients

  4. Potential Impacts of Pharmaceutical Uses of Transgenic Tobacco: The Case of Human Serum Albumin and Gaucher's Disease Treatment

    OpenAIRE

    Kostandini, Gentian

    2004-01-01

    This thesis examines the size and distribution of benefits from the use of transgenic tobacco as a production vehicle for pharmaceutical proteins. Ex-ante welfare benefits are estimated for the introduction of two biotech innovations. In both cases economic surplus model with imperfect competition is employed to assess the size and distribution of benefits from these alternative uses of tobacco. An introductory chapter presents an overview of the topic followed by chapters 2 and 3 which conta...

  5. Classification System for Individualized Treatment of Adult Buried Penis Syndrome.

    Science.gov (United States)

    Tausch, Timothy J; Tachibana, Isamu; Siegel, Jordan A; Hoxworth, Ronald; Scott, Jeremy M; Morey, Allen F

    2016-09-01

    The authors present their experience with reconstructive strategies for men with various manifestations of adult buried penis syndrome, and propose a comprehensive anatomical classification system and treatment algorithm based on pathologic changes in the penile skin and involvement of neighboring abdominal and/or scrotal components. The authors reviewed all patients who underwent reconstruction of adult buried penis syndrome at their referral center between 2007 and 2015. Patients were stratified by location and severity of involved anatomical components. Procedures performed, demographics, comorbidities, and clinical outcomes were reviewed. Fifty-six patients underwent reconstruction of buried penis at the authors' center from 2007 to 2015. All procedures began with a ventral penile release. If the uncovered penile skin was determined to be viable, a phalloplasty was performed by anchoring penoscrotal skin to the proximal shaft, and the ventral shaft skin defect was closed with scrotal flaps. In more complex patients with circumferential nonviable penile skin, the penile skin was completely excised and replaced with a split-thickness skin graft. Complex patients with severe abdominal lipodystrophy required adjacent tissue transfer. For cases of genital lymphedema, the procedure involved complete excision of the lymphedematous tissue, and primary closure with or without a split-thickness skin graft, also often involving the scrotum. The authors' overall success rate was 88 percent (49 of 56), defined as resolution of symptoms without the need for additional procedures. Successful correction of adult buried penis often necessitates an interdisciplinary, multimodal approach. Therapeutic, IV.

  6. [Hospital pharmaceutical practice in prison].

    Science.gov (United States)

    Harcouët, L

    2010-09-01

    Since 1994, hospital pharmaceutical teams have been in charge of pharmaceutical tasks in "unités de consultation et de soins ambulatoires" (UCSA), which are hospital consulting care units in French prisons. In 2008, pharmaceutical team in Parisian prisons received 6500 prescriptions and prepared 85,000 nominative bags containing drugs. Prisoners were 1.3% to receive treatments against HIV, 8.2% cardiovascular drugs, 7.2% opioid substitution treatments, and 52.9% psychoactive drugs, including 39.3% hypnotics, 40.5% anxiolytics, 11.3% antidepressants and 12.2% neuroleptics. In prison, the dichotomy between somatic and mental care is marked, attitudes of prisoners about their medicines are complex (important claims, embezzlement, etc.) and it is difficult for law defendants to maintain treatment confidentiality and to prepare prison outing in terms of health. To attenuate the heterogeneity of drug distribution systems in French prisons, we propose pharmaceutical analysis of prescriptions and nominative dispensation, computerization in UCSA in coordination with hospitals, a better contribution of prison medical and pharmaceutical staff in hospital "drug committees" and the redaction of pharmaceutical guidelines. Acting in concert with multidisciplinary medical staff in UCSA, pharmaceutical teams have to develop epidemiological studies to improve knowledge in prisoner's health and also prevention and health care in prison. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  7. Identification of some factors affecting pharmaceutical active compounds (PhACs) removal in real wastewater. Case study of fungal treatment of reverse osmosis concentrate.

    Science.gov (United States)

    Badia-Fabregat, Marina; Lucas, Daniel; Gros, Meritxell; Rodríguez-Mozaz, Sara; Barceló, Damià; Caminal, Glòria; Vicent, Teresa

    2015-01-01

    Many technologies are being developed for the efficient removal of micropollutants from wastewater and, among them, fungal degradation is one of the possible alternative biological treatments. In this article, some factors that might affect pharmaceutically active compounds (PhACs) removal in a fungal treatment of real wastewater were identified in batch bioreactor treating reverse osmosis concentrate (ROC) from urban wastewater treatment plant (WWTP). We found that degradation of PhACs by Trametes versicolor was enhanced by addition of external nutrients (global removal of 44%). Moreover, our results point out that high aeration might be involved in the increase in the concentration of some PhACs. In fact, conjugation and deconjugation processes (among others) affect the removal assessment of emerging contaminants when working with real concentrations in comparison to experiments with spiked samples. Moreover, factors that could affect the quantification of micropollutants at lab-scale experiments were studied. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Doctors and pharmaceutical industry.

    Science.gov (United States)

    Beran, Roy G

    2009-09-01

    The pharmaceutical industry is seen as seducing doctors by providing expensive gifts, subsidising travel and underwriting practice expenses in return for those doctors prescribing products that otherwise they would not use. This paints doctors in a very negative light; suggests doctors are available to the highest bidder; implies doctors do not adequately act as independent agents; and that doctors are driven more by self-interest than by patient needs. Similar practices, in other industries, are accepted as normal business behaviour but it is automatically assumed to be improper if the pharmaceutical industry supports doctors. Should the pharmaceutical industry withdraw educational grants then there would be: fewer scientific meetings; reduced attendance at conferences; limited post graduate education; and a depreciated level of maintenance of professional standards. To suggest that doctors prescribe inappropriately in return for largesse maligns their integrity but where there is no scientific reason to choose between different treatments then there can be little argument against selecting the product manufactured by a company that has invested in the doctor and the question arises as to whether this represents bad medicine? This paper will examine what constitutes non-professional conduct in response to inducements by the pharmaceutical industry. It will review: conflict of interest; relationships between doctors and pharma and the consequences for patients; and the need for critical appraisal before automatically decrying this relationship while accepting that there remain those who do not practice ethical medicine.

  9. Bismuth absorption from sup 205 Bi-labelled pharmaceutical bismuth compounds used in the treatment of peptic ulcer disease

    Energy Technology Data Exchange (ETDEWEB)

    Dresow, B.; Fischer, R.; Gabbe, E.E.; Wendel, J.; Heinrich, H.C. (Eppendorf University Hospital, Hamburg (Germany))

    1992-04-01

    The absorption of bismuth from five {sup 205}Bi-labelled pharmaceutically used bismuth compounds was studied in man. From single oral doses of all compounds under investigation only <0.1% bismuth was absorbed and excreted with the urine. A significantly higher absorption was observed from the colloidal bismuth subcitrate and the basic bismuth gallate than from the basic bismuth salicylate, nitrate and aluminate. No retention of bismuth in the whole body was found from the single dose experiment. The biologic fast-term half-lives of absorbed bismuth were calculated to be 0.12 and 1.5 days. 14 refs., 2 figs., 1 tab.

  10. Whole body dosimetry for treatment individualized neuroblastoma with 131I-MIBG

    International Nuclear Information System (INIS)

    Ferrer Gracia, C.; Luquero Llopis, N.; Sanchez Munoz, F.; Plaza Aparicio, R.; Huerga Cabrerizo, C.; Corredoira Silva, E.; Serrada Hierro, A.

    2013-01-01

    It according to in this study, that in therapy with 1 31I-MIBG for the treatment of neuroblastoma, it can prescribe and manage dose whole body accurately, allowing individualized treatments and major activities that in the treatments based on a fixed activity according to weight management. (Author)

  11. Couple Discord and Depression in Couples during Couple Therapy and in Depressed Individuals during Depression Treatment

    Science.gov (United States)

    Atkins, David C.; Dimidjian, Sona; Bedics, Jamie D.; Christensen, Andrew

    2009-01-01

    The association between depression and relationship distress as well as the impact of treatment for the one on the other was examined across 2 treatment-seeking samples: individuals seeking treatment for depression (N = 120) and couples seeking marital therapy (N = 134 couples). Although there was a baseline association between depression and…

  12. An Integrated, Multidimensional Treatment Model for Individuals Living with HIV, Mental Illness, and Substance Abuse

    Science.gov (United States)

    Bouis, Stephanie; Reif, Susan; Whetten, Kathryn; Scovil, Janet; Murray, Andrea; Swartz, Marvin

    2007-01-01

    The challenge of providing effective treatment services for the growing population of HIV-positive individuals who are also dually diagnosed with substance use and mental disorders has only recently been recognized as an important public health concern affecting both HIV treatment and prevention. This article describes a treatment model that was…

  13. Enhanced pharmaceutical removal from water in a three step bio-ozone-bio process

    NARCIS (Netherlands)

    Wilt, de Arnoud; Gijn, van Koen; Verhoek, Tom; Vergnes, Amber; Hoek, Mirit; Rijnaarts, Huub; Langenhoff, Alette

    2018-01-01

    Individual treatment processes like biological treatment or ozonation have their limitations for the removal of pharmaceuticals from secondary clarified effluents with high organic matter concentrations (i.e. 17 mg TOC/L). These limitations can be overcome by combining these two processes for a

  14. Are pharmacological properties of anticoagulants reflected in pharmaceutical pricing and reimbursement policy? Out-patient treatment of venous thromboembolism and utilization of anticoagulants in Poland.

    Science.gov (United States)

    Bochenek, T; Czarnogorski, M; Nizankowski, R; Pilc, A

    2014-06-01

    Pharmacotherapy with vitamin K antagonists (VKA) and low-molecular-weight heparins (LMWH) is a major cost driver in the treatment of venous thromboembolism (VTE). Major representatives of anticoagulants in Europe include: acenocoumarol and warfarin (VKA), enoxaparin, dalteparin, nadroparin, reviparin, parnaparin and bemiparin (LMWH). Aim of this report is to measure and critically assess the utilization of anticoagulants and other resources used in the out-patient treatment of VTE in Poland. To confront the findings with available scientific evidence on pharmacological and clinical properties of anticoagulants. The perspectives of the National Health Fund (NHF) and the patients were adopted, descriptive statistics methods were used. The data were gathered at the NHF and the clinic specialized in treatment of coagulation disorders. Non-pharmacological costs of treatment were for the NHF 1.6 times higher with VKA than with LMWH. Daily cost of pharmacotherapy with LMWH turned out higher than with VKA (234 times for the NHF, 42 times per patient). Within both LMWH and VKA the reimbursement due for the daily doses of a particular medication altered in the manner inversely proportional to the level of patient co-payment. Utilization of long-marketed and cheap VKA was dominated by LMWH, when assessed both through the monetary measures and by the actual volume of sales. Pharmaceutical reimbursement policy favored the more expensive equivalents among VKA and LMWH, whereas in the financial terms the patients were far better off when remaining on a more expensive alternative. The pharmaceutical pricing and reimbursement policy of the state should be more closely related to the pharmacological properties of anticoagulants.

  15. Seasonal variation in the occurrence and removal of pharmaceuticals and personal care products in a wastewater treatment plant in Xiamen, China

    International Nuclear Information System (INIS)

    Sun, Qian; Lv, Min; Hu, Anyi; Yang, Xiaoyong; Yu, Chang-Ping

    2014-01-01

    Highlights: • The occurrence and removal of 50 PPCPs in a WWTP were investigated over one year. • 39 PPCPs were detected in the influent, 14 PPCPs could be removed >50% in WWTP. • Most PPCPs showed higher concentrations in cold seasons in the influent and effluent. • Temperature and HRT may contribute to the seasonal variation of PPCP removal. - Abstract: The occurrence and seasonal variation of 50 pharmaceuticals and personal care products (PPCPs) in a wastewater treatment plant (WWTP) in Xiamen, China was investigated over a period of one year. Among the targets, 39 PPCPs were detected in the influent. The highest concentration was observed for acetaminophen, with the average concentration in the influent of 2963.5 ng/L. The seasonal variation of PPCPs in the influent was observed. For most pharmaceuticals, highest concentrations were in March 2013, followed by December 2012, while the concentrations were lower in August 2012 and May 2013. Among the detected PPCPs, 14 targets could be removed more than 50% in the WWTP. The activated sludge treatment process contributed to most of PPCP removal, while the adsorption to the particles in the primary treatment and the transformation under UV radiation in the disinfection treatment also contributed to the PPCP removal. Among the detected PPCPs in the influent, 36 PPCPs could be detected in the final effluent of the WWTP. Significantly higher concentrations of PPCPs were observed in effluent samples collected in March 2013 compared to other seasons, suggesting higher concentrations of PPCPs could be discharged into the surrounding seawater during this period

  16. Seasonal variation in the occurrence and removal of pharmaceuticals and personal care products in a wastewater treatment plant in Xiamen, China

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Qian; Lv, Min; Hu, Anyi; Yang, Xiaoyong; Yu, Chang-Ping, E-mail: cpyu@iue.ac.cn

    2014-07-30

    Highlights: • The occurrence and removal of 50 PPCPs in a WWTP were investigated over one year. • 39 PPCPs were detected in the influent, 14 PPCPs could be removed >50% in WWTP. • Most PPCPs showed higher concentrations in cold seasons in the influent and effluent. • Temperature and HRT may contribute to the seasonal variation of PPCP removal. - Abstract: The occurrence and seasonal variation of 50 pharmaceuticals and personal care products (PPCPs) in a wastewater treatment plant (WWTP) in Xiamen, China was investigated over a period of one year. Among the targets, 39 PPCPs were detected in the influent. The highest concentration was observed for acetaminophen, with the average concentration in the influent of 2963.5 ng/L. The seasonal variation of PPCPs in the influent was observed. For most pharmaceuticals, highest concentrations were in March 2013, followed by December 2012, while the concentrations were lower in August 2012 and May 2013. Among the detected PPCPs, 14 targets could be removed more than 50% in the WWTP. The activated sludge treatment process contributed to most of PPCP removal, while the adsorption to the particles in the primary treatment and the transformation under UV radiation in the disinfection treatment also contributed to the PPCP removal. Among the detected PPCPs in the influent, 36 PPCPs could be detected in the final effluent of the WWTP. Significantly higher concentrations of PPCPs were observed in effluent samples collected in March 2013 compared to other seasons, suggesting higher concentrations of PPCPs could be discharged into the surrounding seawater during this period.

  17. [The implementation of innovative medical technologies: biological pharmaceuticals for the treatment of psoriasis--a case study].

    Science.gov (United States)

    Tal, Orna; Lomnicky, Yosef

    2012-06-01

    Advanced health systems worldwide strive to adopt new technologies that will ensure improved health and better clinical outcomes. The implementation of new medical technologies is affected by medical factors as well as economic and social forces, influencing both the individual and the health care providers. Chronic disease management is a major challenge to governments, as a result of the cumulative effects of chronic morbidity, life expectancy, quality of life and the national burden of disease due to accelerating medical expenditure. Psoriasis, a common chronic disease, for which advanced technologies were recently implemented, was chosen as a case study. The distribution of utility of various technologies for the treatment of psoriasis over the past nine years was analyzed to categorize "patterns of behavior" in accordance with the lifecycle of medical technology described in the Literature. It is expected that these changing trends will produce overall economic consequences, on direct expenditure combined with a reduction in some health services. Analyzing these clinical and economic trends, may add important considerations for the adoption of emerging medical technologies, presenting an important tool for policymakers at at all levels.

  18. Smartphone and Mobile Application Utilization Prior to and Following Treatment Among Individuals Enrolled in Residential Substance Use Treatment

    Science.gov (United States)

    Dahne, Jennifer; Lejuez, C. W.

    2015-01-01

    Background Following completion of substance use treatment, it is crucial for patients to continue to utilize skills learned in treatment for optimal treatment outcomes. Mobile applications (apps) on smartphones offer a unique platform to promote utilization of evidence-based skills following completion of substance use treatment. Despite the promise of mobile apps and smartphones for treatment delivery, it remains unknown whether patients in substance use treatment in the United States have access to smartphones and utilize mobile apps on smartphones. The present study sought to determine smartphone utilization among individuals enrolled in one residential substance use treatment center in the U.S catering specifically to low-income adults. Methods Participants included 251 individuals at a residential substance use treatment center in Washington DC admitted to the center between March, 2014 and January, 2015. During the intake process, participants completed interviewer-administered demographics and psychiatric questionnaires as well as a self-report of technology utilization. Results Results indicated that the majority of patients in this residential substance use treatment center owned mobile phones prior to treatment entry (86.9%) and expected to own mobile phones after leaving treatment (92.6%). Moreover, the majority of these phones were (68.5%) or will be smartphones (72.4%) on which patients reported utilizing mobile applications (Prior to treatment: 61.3%; Post treatment: 64.3%) and accessing the internet (Prior to treatment: 61.3%; Post treatment: 65.9%). Conclusions Mobile phone and smartphone ownership among this sample were comparable to ownership among U.S. adults broadly. Findings suggest that smartphones and mobile apps may hold clinical utility for fostering continued use of treatment skills following substance use treatment completion. PMID:26231698

  19. The initial pharmaceutical development of an artesunate/amodiaquine oral formulation for the treatment of malaria: a public-private partnership

    Directory of Open Access Journals (Sweden)

    Gaudin Karen

    2011-05-01

    Full Text Available Abstract Background Artemisinin-based combination therapy is currently recommended worldwide for the treatment of uncomplicated malaria. Fixed-dose combinations are preferred as they favour compliance. This paper reports on the initial phases of the pharmaceutical development of an artesunate-amodiaquine (ASAQ bilayer co-formulation tablet, undertaken following pre-formulation studies by a network of scientists and industrials from institutions of both industrialized and low income countries. Methods Pharmaceutical development was performed by a research laboratory at the University Bordeaux Segalen, School of Pharmacy, for feasibility and early stability studies of various drug formulations, further transferred to a company specialized in pharmaceutical development, and then provided to another company for clinical batch manufacturing. The work was conducted by a regional public-private not-for-profit network (TropiVal within a larger Public Private partnership (the FACT project, set up by WHO/TDR, Médecins Sans Frontières and the Drugs for Neglected Disease initiative (DNDi. Results The main pharmaceutical goal was to combine in a solid oral form two incompatible active principles while preventing artesunate degradation under tropical conditions. Several options were attempted and failed to provide satisfactory stability results: incorporating artesunate in the external phase of the tablets, adding a pH regulator, alcoholic wet granulation, dry granulation, addition of an hydrophobic agent, tablet manufacturing in controlled conditions. However, long-term stability could be achieved, in experimental batches under GMP conditions, by physical separation of artesunate and amodiaquine in a bilayer co-formulation tablet in alu-alu blisters. Conduction of the workplan was monitored by DNDi. Conclusions Collaborations between research and industrial groups greatly accelerated the process of development of the bi-layered ASAQ tablet. Lack of public

  20. The initial pharmaceutical development of an artesunate/amodiaquine oral formulation for the treatment of malaria: a public-private partnership.

    Science.gov (United States)

    Lacaze, Catherine; Kauss, Tina; Kiechel, Jean-René; Caminiti, Antonella; Fawaz, Fawaz; Terrassin, Laurent; Cuart, Sylvie; Grislain, Luc; Navaratnam, Visweswaran; Ghezzoul, Bellabes; Gaudin, Karen; White, Nick J; Olliaro, Piero L; Millet, Pascal

    2011-05-23

    Artemisinin-based combination therapy is currently recommended worldwide for the treatment of uncomplicated malaria. Fixed-dose combinations are preferred as they favour compliance. This paper reports on the initial phases of the pharmaceutical development of an artesunate-amodiaquine (ASAQ) bilayer co-formulation tablet, undertaken following pre-formulation studies by a network of scientists and industrials from institutions of both industrialized and low income countries. Pharmaceutical development was performed by a research laboratory at the University Bordeaux Segalen, School of Pharmacy, for feasibility and early stability studies of various drug formulations, further transferred to a company specialized in pharmaceutical development, and then provided to another company for clinical batch manufacturing. The work was conducted by a regional public-private not-for-profit network (TropiVal) within a larger Public Private partnership (the FACT project), set up by WHO/TDR, Médecins Sans Frontières and the Drugs for Neglected Disease initiative (DNDi). The main pharmaceutical goal was to combine in a solid oral form two incompatible active principles while preventing artesunate degradation under tropical conditions. Several options were attempted and failed to provide satisfactory stability results: incorporating artesunate in the external phase of the tablets, adding a pH regulator, alcoholic wet granulation, dry granulation, addition of an hydrophobic agent, tablet manufacturing in controlled conditions. However, long-term stability could be achieved, in experimental batches under GMP conditions, by physical separation of artesunate and amodiaquine in a bilayer co-formulation tablet in alu-alu blisters. Conduction of the workplan was monitored by DNDi. Collaborations between research and industrial groups greatly accelerated the process of development of the bi-layered ASAQ tablet. Lack of public funding was the main obstacle hampering the development process

  1. Treatment of Proper Name Retrieval Deficits in an Individual with Temporal Lobe Epilepsy

    Science.gov (United States)

    Minkina, Irene; Ojemann, Jeffrey G.; Grabowski, Thomas J.; Silkes, JoAnn P.; Phatak, Vaishali; Kendall, Diane L.

    2013-01-01

    Purpose: Studies investigating language deficits in individuals with left temporal-lobe epilepsy have consistently demonstrated impairments in proper name retrieval. The aim of this Phase I rehabilitation study was to investigate the effects of a linguistically distributed word retrieval treatment on proper name retrieval in an individual with…

  2. Pharmaceutical powder compaction technology

    National Research Council Canada - National Science Library

    Çelik, Metin

    2011-01-01

    "Revised to reflect modern pharmaceutical compacting techniques, this Second Edition guides pharmaceutical engineers, formulation scientists, and product development and quality assurance personnel...

  3. Simultaneous determination of several veterinary pharmaceuticals in effluents from urban, livestock and slaughterhouse wastewater treatment plants using a simple chromatographic method.

    Science.gov (United States)

    Cavenati, Simone; Carvalho, Pedro N; Almeida, C Marisa R; Basto, M Clara P; Vasconcelos, M Teresa S D

    2012-01-01

    Minocycline, oxytetracycline, tetracycline, enrofloxacin and ceftiofur, commonly used veterinary pharmaceuticals, were searched in four urban, two livestock and two slaughterhouse effluents from wastewater treatment plants (WWTPs) in the north of Portugal. A simple method that includes solid-phase extraction followed with analysis by high-performance liquid chromatography with diode array detector was established and applied to the simultaneous determination of the five pharmaceuticals in WWTP effluents. This method, which is expeditious, inexpensive and available in most laboratories, showed to be useful for screening for problematic levels of drugs in WWTP effluents. It is known that several livestock and slaughterhouse effluents (pre-treated or treated) are discharged to the urban network before discharge into the environment. The presence of these drugs in such effluents can constitute a significant environmental problem that should be addressed, by the monitoring of these drugs and by implementation of methodologies that contribute to their decrease/elimination from wastewaters. Minocycline (≤6 μg L(-1)), oxytetracycline (≤7 μg L(-1)), tetracycline (≤6 μg L(-1)) and enrofloxacin (effluents. Detectable levels of enrofloxacin (effluents.

  4. Pandemic pharmaceutical dosing effects on wastewater treatment: no adaptation of activated sludge bacteria to degrade the antiviral drug oseltamivir (Tamiflu®) and loss of nutrient removal performance.

    Science.gov (United States)

    Slater, Frances R; Singer, Andrew C; Turner, Susan; Barr, Jeremy J; Bond, Philip L

    2011-02-01

    The 2009-2010 influenza pandemic saw many people treated with antivirals and antibiotics. High proportions of both classes of drugs are excreted and enter wastewater treatment plants (WWTPs) in biologically active forms. To date, there has been no study into the potential for influenza pandemic-scale pharmaceutical use to disrupt WWTP function. Furthermore, there is currently little indication as to whether WWTP microbial consortia can degrade antiviral neuraminidase inhibitors when exposed to pandemic-scale doses. In this study, we exposed an aerobic granular sludge sequencing batch reactor, operated for enhanced biological phosphorus removal (EBPR), to a simulated influenza-pandemic dosing of antibiotics and antivirals for 8 weeks. We monitored the removal of the active form of Tamiflu(®), oseltamivir carboxylate (OC), bacterial community structure, granule structure and changes in EBPR and nitrification performance. There was little removal of OC by sludge and no evidence that the activated sludge community adapted to degrade OC. There was evidence of changes to the bacterial community structure and disruption to EBPR and nitrification during and after high-OC dosing. This work highlights the potential for the antiviral contamination of receiving waters and indicates the risk of destabilizing WWTP microbial consortia as a result of high concentrations of bioactive pharmaceuticals during an influenza pandemic. © 2010 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  5. EU pharmaceutical expenditure forecast.

    Science.gov (United States)

    Urbinati, Duccio; Rémuzat, Cécile; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher

    2014-01-01

    With constant incentives for healthcare payers to contain their pharmaceutical budgets, forecasting has become critically important. Some countries have, for instance, developed pharmaceutical horizon scanning units. The objective of this project was to build a model to assess the net effect of the entrance of new patented medicinal products versus medicinal products going off-patent, with a defined forecast horizon, on selected European Union (EU) Member States' pharmaceutical budgets. This model took into account population ageing, as well as current and future country-specific pricing, reimbursement, and market access policies (the project was performed for the European Commission; see http://ec.europa.eu/health/healthcare/key_documents/index_en.htm). In order to have a representative heterogeneity of EU Member States, the following countries were selected for the analysis: France, Germany, Greece, Hungary, Poland, Portugal, and the United Kingdom. A forecasting period of 5 years (2012-2016) was chosen to assess the net pharmaceutical budget impact. A model for generics and biosimilars was developed for each country. The model estimated a separate and combined effect of the direct and indirect impacts of the patent cliff. A second model, estimating the sales development and the risk of development failure, was developed for new drugs. New drugs were reviewed individually to assess their clinical potential and translate it into commercial potential. The forecast was carried out according to three perspectives (healthcare public payer, society, and manufacturer), and several types of distribution chains (retail, hospital, and combined retail and hospital). Probabilistic and deterministic sensitivity analyses were carried out. According to the model, all countries experienced drug budget reductions except Poland (+€41 million). Savings were expected to be the highest in the United Kingdom (-€9,367 million), France (-€5,589 million), and, far behind them

  6. High Levels of Antibiotic Resistance Genes and Their Correlations with Bacterial Community and Mobile Genetic Elements in Pharmaceutical Wastewater Treatment Bioreactors.

    Directory of Open Access Journals (Sweden)

    Wenda Tao

    Full Text Available To understand the diversity and abundance of antibiotic resistance genes (ARGs in pharmaceutical wastewater treatment bioreactors, the ARGs in sludge from two full-scale pharmaceutical wastewater treatment plants (PWWTPs were investigated and compared with sludge samples from three sewage treatment plants (STPs using metagenomic approach. The results showed that the ARG abundances in PWWTP sludge ranged from 54.7 to 585.0 ppm, which were higher than those in STP sludge (27.2 to 86.4 ppm. Moreover, the diversity of ARGs in PWWTP aerobic sludge (153 subtypes was higher than that in STP aerobic sludge (118 subtypes. In addition, it was found that the profiles of ARGs in PWWTP aerobic sludge were similar to those in STP aerobic sludge but different from those in PWWTP anaerobic sludge, suggesting that dissolve oxygen (DO could be one of the important factors affecting the profiles of ARGs. In PWWTP aerobic sludge, aminoglycoside, sulfonamide and multidrug resistance genes were frequently detected. While, tetracycline, macrolide-lincosamide-streptogramin and polypeptide resistance genes were abundantly present in PWWTP anaerobic sludge. Furthermore, we investigated the microbial community and the correlation between microbial community and ARGs in PWWTP sludge. And, significant correlations between ARG types and seven bacterial genera were found. In addition, the mobile genetic elements (MGEs were also examined and correlations between the ARGs and MGEs in PWWTP sludge were observed. Collectively, our results suggested that the microbial community and MGEs, which could be affected by DO, might be the main factors shaping the profiles of ARGs in PWWTP sludge.

  7. ORIGINS AND RAMIFICATIONS OF PHARMACEUTICALS ...

    Science.gov (United States)

    Perhaps more so than with any other class of pollutants, the occurrence of pharmaceuticals and personal care products (PPCPS) in the environment highlights the immediate, intimate, and inseparable connection between the personal activities of individual citizens and their environment. PPCPS, in contrast to other types of pollutants, owe their origins in the environment directly to their worldwide, universal, frequent, highly dispersed, and individually small but cumulative usage by multitudes of individuals - as opposed to the larger, highly delineated, and more controllable industrial manufacturing/usage of most high- volume synthetic chemicals. Many PPCPs (as well as their metabolites and transformation products) can enter the environment following ingestion or application by the user or administration to domestic animals. Disposal of unused/expired PPCPs in landfills and in domestic sewage is another route to the environment. The aquatic environment serves as the major, ultimate receptacle for these chemicals, for which little is known with respect to actual or potential adverse effects. Domestic sewage treatment plants are not designed to remove PPCPS, and the efficiencies with which they are removed vary from nearly complete to ineffective. While PPCPs in the environment (or domestic drinking water) are not regulated, and even though their concentrations are extremely low (ng/L-@Lg/L), the consequences of exposure to multiple compounds having different as w

  8. Group vs. Individual Treatment for Acute Insomnia: A Pilot Study Evaluating a “One-Shot” Treatment Strategy

    Directory of Open Access Journals (Sweden)

    Pam Boullin

    2016-12-01

    Full Text Available Background: Despite undeniable evidence for the efficacy and effectiveness of Cognitive Behaviour Therapy for Insomnia (CBT-I, the potential for its widespread dissemination and implementation has yet to be realised. A suggested reason for this is that traditional CBT-I is considered too burdensome for deployment, in its current form, within the context of where it would be most beneficial—Primary Care. One strategy, aimed to address this, has been to develop briefer versions of CBT-I, whilst another has been to deliver CBT-I in a group format. An alternative has been to attempt to address insomnia during its acute phase with a view to circumventing its progression to chronic insomnia. The aim of the present study was to compare a brief version of CBT-I (one-shot when delivered individually or in groups to those with acute insomnia. Method: Twenty-eight individuals with acute insomnia (i.e., meeting full DSM-5 criteria for insomnia disorder for less than three months self-assigned to either a group or individual treatment arm. Treatment consisted of a single one-hour session accompanied by a self-help pamphlet. Subjects completed measures of insomnia severity, anxiety and depression pre-treatment and at one-month post-treatment. Additionally, daily sleep diaries were compared between pre-treatment and at the one-month follow up. Results: There were no significant between group differences in treatment outcome on any sleep or mood measures although those in the group treatment arm were less adherent than those who received individual treatment. Furthermore, the combined (group and individual treatment arms pre-post test effect size on insomnia symptoms, using the Insomnia Severity Index, was large (d = 2.27. Discussion: It appears that group treatment is as efficacious as individual treatment within the context of a “one shot” intervention for individuals with acute insomnia. The results are discussed with a view to integrating one-shot CBT

  9. Oral Health Condition and Treatment Needs of a Group of Nigerian Individuals with Down Syndrome

    Science.gov (United States)

    Oredugba, Folakemi A.

    2007-01-01

    Objective: This study was carried out to determine the oral health condition and treatment needs of a group of individuals with Down syndrome in Nigeria. Method: Participants were examined for oral hygiene status, dental caries, malocclusion, hypoplasia, missing teeth, crowding and treatment needs. Findings were compared with controls across age…

  10. Identifying Empirically Supported Treatments for Pica in Individuals with Intellectual Disabilities

    Science.gov (United States)

    Hagopian, Louis P.; Rooker, Griffin W.; Rolider, Natalie U.

    2011-01-01

    The purpose of the current study was to critically examine the existing literature on the treatment of pica displayed by individuals with intellectual disabilities. Criteria for empirically supported treatments as described by Divisions 12 and 16 of APA, and adapted for studies employing single-case designs were used to review this body of…

  11. Individualized treatment of multidrug-resistant tuberculosis using therapeutic drug monitoring

    Directory of Open Access Journals (Sweden)

    Mathieu S Bolhuis

    2016-01-01

    Conclusion: TDM is highly valuable to individualize and optimize treatment of complex MDR-TB patients. TDM is routinely applied in Tuberculosis Center Beatrixoord, and high success rates for treatment of MDR-TB patients have been achieved. DBS and LSS make implementation of TDM feasible, even in low- and middle-income countries.

  12. Treatment Adherence, Competence, and Outcome in Individual and Family Therapy for Adolescent Behavior Problems

    Science.gov (United States)

    Hogue, Aaron; Henderson, Craig E.; Dauber, Sarah; Barajas, Priscilla C.; Fried, Adam; Liddle, Howard A.

    2008-01-01

    This study examined the impact of treatment adherence and therapist competence on treatment outcome in a controlled trial of individual cognitive-behavioral therapy (CBT) and multidimensional family therapy (MDFT) for adolescent substance use and related behavior problems. Participants included 136 adolescents (62 CBT, 74 MDFT) assessed at intake,…

  13. An Evidence-Based Systematic Review on Communication Treatments for Individuals with Right Hemisphere Brain Damage

    Science.gov (United States)

    Blake, Margaret Lehman; Frymark, Tobi; Venedictov, Rebecca

    2013-01-01

    Purpose: The purpose of this review is to evaluate and summarize the research evidence related to the treatment of individuals with right hemisphere communication disorders. Method: A comprehensive search of the literature using key words related to right hemisphere brain damage and communication treatment was conducted in 27 databases (e.g.,…

  14. Adaptive brachytherapy of cervical cancer, comparison of conventional point A and CT based individual treatment planning

    International Nuclear Information System (INIS)

    Wanderaas, Anne D.; Langdal, Ingrid; Danielsen, Signe; Frykholm, Gunilla; Marthinsen, Anne B. L; Sundset, Marit

    2012-01-01

    Background. Locally advanced cervical cancer is commonly treated with external radiation therapy combined with local brachytherapy. The brachytherapy is traditionally given based on standard dose planning with prescription of dose to point A. Dosimetric aspects when changing from former standard treatment to individualized treatment plans based on computed tomography (CT) images are here investigated. Material and methods. Brachytherapy data from 19 patients with a total of 72 individual treatment fractions were retrospectively reviewed. Standard library plans were analyzed with respect to doses to organs at risk (OARs), and the result was compared to corresponding delivered individualized plans. The theoretical potential of further optimization based on prescription to target volumes was investigated. The treatments were performed with a Fletcher applicator. Results. For standard treatment planning, the tolerance dose limits were exceeded in the bladder, rectum and sigmoid in 26%, 4% and 15% of the plans, respectively. This was observed most often for the smallest target volumes. The individualized planning of the delivered treatment gave the possibility of controlling the dose to critical organs to below certain limits. The dose was still prescribed to point A. An increase in target dose coverage was achieved when additional individual optimization was performed, while still keeping the dose to the OARs below predefined limits. Relatively low average target coverage, especially for the largest volumes was however seen. Conclusion. The individualized delivered treatment plans ensured that doses to OARs were within acceptable limits. This was not the case in 42% of the corresponding standard plans. Further optimized treatment plans were found to give an overall better dose coverage. In lack of MR capacity, it may be favorable to use CT for planning due to possible protection of OARs. The CT based target volumes were, however, not equivalent to the volumes described

  15. Treatment Adherence, Competence, and Outcome in Individual and Family Therapy for Adolescent Behavior Problems

    OpenAIRE

    Hogue, Aaron; Henderson, Craig E.; Dauber, Sarah; Barajas, Priscilla C.; Fried, Adam; Liddle, Howard A.

    2008-01-01

    This study examined the impact of treatment adherence and therapist competence on treatment outcome in a controlled trial of individual cognitive–behavioral therapy (CBT) and multidimensional family therapy (MDFT) for adolescent substance use and related behavior problems. Participants included 136 adolescents (62 CBT, 74 MDFT) assessed at intake, discharge, and 6-month follow-up. Observational ratings of adherence and competence were collected on early and later phases of treatment (192 CBT ...

  16. [Individualized clinical treatment from the prospective of hepatotoxicity of non-toxic traditional Chinese medicine].

    Science.gov (United States)

    Yang, Nan; Chen, Juan; Hou, Xue-Feng; Song, Jie; Feng, Liang; Jia, Xiao-Bin

    2017-04-01

    Traditional Chinese medicine has a long history in clinical application, and been proved to be safe and effective. In recent years, the toxicity and side-effects caused by the western medicine have been attracted much attention. As a result, increasing people have shifted their attention to traditional Chinese medicine. Nonetheless, due to the natural origin of traditional Chinese medicine and the lack of basic knowledge about them, many people mistakenly consider the absolute safety of traditional Chinese medicine, except for well-known toxic ones, such as arsenic. However, according to the clinical practices and recent studies, great importance shall be attached to the toxicity of non-toxic traditional Chinese medicine, in particular the hepatotoxicity. Relevant studies indicated that the toxicity of non-toxic traditional Chinese medicine is closely correlated with individual gene polymorphism and constitution. By discussing the causes and mechanisms of the hepatotoxicity induced by non-toxic traditional Chinese medicine in clinical practices, we wrote this article with the aim to provide new ideas for individualized clinical therapy of traditional Chinese medicine and give guidance for rational and safe use of traditional Chinese medicine. Copyright© by the Chinese Pharmaceutical Association.

  17. Pharmacologic and non-pharmacologic treatments for chronic pain in individuals with HIV: a systematic review

    Science.gov (United States)

    Merlin, Jessica S.; Bulls, Hailey W.; Vucovich, Lee A.; Edelman, E. Jennifer; Starrels, Joanna L.

    2016-01-01

    Chronic pain occurs in as many as 85% of individuals with HIV and is associated with substantial functional impairment. Little guidance is available for HIV providers seeking to address their patients’ chronic pain. We conducted a systematic review to identify clinical trials and observational studies that examined the impact of pharmacologic or non-pharmacologic interventions on pain and/or functional outcomes among HIV-infected individuals with chronic pain in high-development countries. Eleven studies met inclusion criteria and were mostly low or very low quality. Seven examined pharmacologic interventions (gabapentin, pregabalin, capsaicin, analgesics including opioids) and four examined non-pharmacologic interventions (cognitive behavioral therapy, self-hypnosis, smoked cannabis). The only controlled studies with positive results were of capsaicin and cannabis, and had short-term follow-up (≤12 weeks). Among the seven studies of pharmacologic interventions, five had substantial pharmaceutical industry sponsorship. These findings highlight several important gaps in the HIV/chronic pain literature that require further research. PMID:27267445

  18. Predictors of treatment utilization and barriers to treatment utilization among individuals with lifetime cannabis use disorder in the United States.

    Science.gov (United States)

    Kerridge, Bradley T; Mauro, Pia M; Chou, S Patricia; Saha, Tulshi D; Pickering, Roger P; Fan, Amy Z; Grant, Bridget F; Hasin, Deborah S

    2017-12-01

    To present information on predictors of treatment utilization and barriers to treatment utilization among individuals with lifetime DSM-5 cannabis use disorder (CUD). Face-to-face survey of a representative sample of the adult US general population (n=36,309). Treatment rates for CUD were low in this general population survey (13.7%). Severity of CUD and comorbidity of other lifetime drug use disorders were significant predictors of lifetime treatment utilization for CUD. Preference for self-reliance, minimizing problems, fear of stigma, and financial and structural issues were among the most frequently endorsed reasons for respondents not seeking treatment when they perceived the need for treatment among individuals with lifetime CUD, regardless of whether they eventually utilized treatment at some time in their lives. Given the rising prevalence of CUD in the US over the past decade and currently low treatment rates for CUD, increased provision for services for CUD appears critically needed, especially those that screen for and treat, when present, other drug use disorders. Programs to reduce stigma and financial barriers are needed, as well as programs to increase awareness among the general public, health care professionals about the nature and seriousness of CUD, and the availability and effectiveness of treatment for this disorder. Copyright © 2017. Published by Elsevier B.V.

  19. The effects of an individual, multistep intervention on adherence to treatment in hemodialysis patients.

    Science.gov (United States)

    Rafiee Vardanjani, Leila; Parvin, Neda; Mahmoodi Shan, Gholamreza

    2015-07-01

    The present study was conducted to investigate the effect of individual, multistep intervention on adherence to treatment in hemodialysis patients referred to a hemodialysis center in Shahrekord, Iran. In this interventional study, hemodialysis patients referring the center of the study were randomly assigned into two control and intervention groups (each 33). The control group received routine treatment, recommended dietary and fluid restrictions. The intervention group participated in eight individual interventional sessions accompanied routine treatment. At the beginning and the end of the study, routine laboratory tests and end-stage renal disease-adherence questionnaire were filled out for patients in both groups. The data were analyzed using Mann-Whitney and Wilcoxon tests. At the end of the study, the two groups showed a significant difference in all domains of adherence except adherence to diet and adherence was better in the intervention group (p adherence to dialysis program (p = 0.04, r = 0.254). After intervention, serum phosphorus decreased significantly in the intervention group (p Adherence to treatment is one of the major problems in hemodialysis patients; however, comprehensive interventions are required in view of individual condition. Implications for Rehabilitation Adherence to treatment means that all patients' behaviors (diet, fluids and drugs intake) should be in line with the recommendations given by healthcare professionals. There is evidence on the association between adherence to treatment and decreased risk of hospitalization in dialysis patients. Individual structured programs are most likely to be successful in encouraging adherence to treatment.

  20. Basic pharmaceutical technology

    OpenAIRE

    Angelovska, Bistra; Drakalska, Elena

    2017-01-01

    The lecture deals with basics of pharmaceutical technology as applied discipline of pharmaceutical science, whose main subject of study is formulation and manufacture of drugs. In a broad sense, pharmaceutical technology is science of formulation, preparation, stabilization and determination of the quality of medicines prepared in the pharmacy or in pharmaceutical industry

  1. The Experience of Couples in the Process of Treatment of Pathological Gambling: Couple vs. Individual Therapy

    Science.gov (United States)

    Tremblay, Joël; Dufour, Magali; Bertrand, Karine; Blanchette-Martin, Nadine; Ferland, Francine; Savard, Annie-Claude; Saint-Jacques, Marianne; Côté, Mélissa

    2018-01-01

    Context: Couple treatment for pathological gambling is an innovative strategy. There are some results supporting its potential effectiveness, but little is known about the subjective experiences of the participants. Objective: The aim of this article is to document the experiences of gamblers and their partners participating in one of two treatments, namely individual or couple. Method: In a study aiming to evaluate the efficacy of the Integrative Couple Treatment for Pathological Gambling (ICT-PG), couples who were entering specialized treatment for the addiction of one member who was a pathological gambler were randomly assigned to individual or ICT-PG. Nine months after their admission to treatment, gamblers and partners (n = 21 couples; n = 13 ICT-PG; n = 8 individual treatment) were interviewed in semi-structured interviews. A sequenced thematization method was used to extract the major themes. Results: This study highlighted five major themes in the therapeutic process noted by the gamblers and their partners mainly after the couple treatment but also partly through the individual therapy. These were: (1) the gamblers' anxiety about having to reveal their gambling problems in couple therapy; (2) the wish to develop a mutually beneficial understanding of gambling and its effects on the partners in the two types of treatments; (3) the transformation of negative attributions through a more effective intra-couple communication fostered by the couple therapy; (4) the partners' contribution to changes in gambling behavior and prevention of relapses, which were both better supported in couple therapy; and (5) the interpersonal nature of gambling and its connections with the couples' relationship. However, gamblers who were in individual treatment were more likely to mention that their partners' involvement was not necessary. Participants likewise made a few recommendations about the conditions underlying the choice of one treatment method or the other. Discussion

  2. The Experience of Couples in the Process of Treatment of Pathological Gambling: Couple vs. Individual Therapy

    Directory of Open Access Journals (Sweden)

    Joël Tremblay

    2018-01-01

    Full Text Available Context: Couple treatment for pathological gambling is an innovative strategy. There are some results supporting its potential effectiveness, but little is known about the subjective experiences of the participants.Objective: The aim of this article is to document the experiences of gamblers and their partners participating in one of two treatments, namely individual or couple.Method: In a study aiming to evaluate the efficacy of the Integrative Couple Treatment for Pathological Gambling (ICT-PG, couples who were entering specialized treatment for the addiction of one member who was a pathological gambler were randomly assigned to individual or ICT-PG. Nine months after their admission to treatment, gamblers and partners (n = 21 couples; n = 13 ICT-PG; n = 8 individual treatment were interviewed in semi-structured interviews. A sequenced thematization method was used to extract the major themes.Results: This study highlighted five major themes in the therapeutic process noted by the gamblers and their partners mainly after the couple treatment but also partly through the individual therapy. These were: (1 the gamblers' anxiety about having to reveal their gambling problems in couple therapy; (2 the wish to develop a mutually beneficial understanding of gambling and its effects on the partners in the two types of treatments; (3 the transformation of negative attributions through a more effective intra-couple communication fostered by the couple therapy; (4 the partners' contribution to changes in gambling behavior and prevention of relapses, which were both better supported in couple therapy; and (5 the interpersonal nature of gambling and its connections with the couples' relationship. However, gamblers who were in individual treatment were more likely to mention that their partners' involvement was not necessary. Participants likewise made a few recommendations about the conditions underlying the choice of one treatment method or the other

  3. Functional Recovery in Major Depressive Disorder: Providing Early Optimal Treatment for the Individual Patient

    Science.gov (United States)

    Katzman, Martin A; Habert, Jeffrey; McIntosh, Diane; MacQueen, Glenda M; Milev, Roumen V; McIntyre, Roger S; Blier, Pierre

    2018-01-01

    Abstract Major depressive disorder is an often chronic and recurring illness. Left untreated, major depressive disorder may result in progressive alterations in brain morphometry and circuit function. Recent findings, however, suggest that pharmacotherapy may halt and possibly reverse those effects. These findings, together with evidence that a delay in treatment is associated with poorer clinical outcomes, underscore the urgency of rapidly treating depression to full recovery. Early optimized treatment, using measurement-based care and customizing treatment to the individual patient, may afford the best possible outcomes for each patient. The aim of this article is to present recommendations for using a patient-centered approach to rapidly provide optimal pharmacological treatment to patients with major depressive disorder. Offering major depressive disorder treatment determined by individual patient characteristics (e.g., predominant symptoms, medical history, comorbidities), patient preferences and expectations, and, critically, their own definition of wellness provides the best opportunity for full functional recovery. PMID:29024974

  4. Integrating Estimates of the Social and Individual Costs of Caregiving into Dementia Treatment Trials

    Directory of Open Access Journals (Sweden)

    Charles D. Phillips

    2016-01-01

    Full Text Available A variety of new treatments for dementia are awaiting or undergoing randomized clinical trails. These trials focus on outcomes such as changes in cognitive function, physical function, or amyloid plaques. What is quite important and is too often missing from these trials are estimates of the impact of these treatments on the social and individual costs of providing care for those facing dementia. Until outcomes such as family caregiver time and caregiver burden are included in trails of dementia treatments, the picture of how well these treatments work will be distressingly incomplete.

  5. Current suicidal ideation in treatment-seeking individuals in the United Kingdom with gambling problems.

    Science.gov (United States)

    Ronzitti, Silvia; Soldini, Emiliano; Smith, Neil; Potenza, Marc N; Clerici, Massimo; Bowden-Jones, Henrietta

    2017-11-01

    Studies show higher lifetime prevalence of suicidality in individuals with pathological gambling. However, less is known about the relationship between pathological gambling and current suicidal ideation. We investigated socio-demographic, clinical and gambling-related variables associated with suicidality in treatment-seeking individuals. Bivariate analyses and logistic regression models were generated on data from 903 individuals to identify measures associated with aspects of suicidality. Forty-six percent of patients reported current suicidal ideation. People with current suicidal thoughts were more likely to report greater problem-gambling severity (psuicidality. Logistic regression models suggested that past suicidal ideation (psuicidality. Our findings suggest that the severity of anxiety disorder, along with a lifetime history of suicidal ideation, may help to identify treatment-seeking individuals with pathological gambling with a higher risk of suicidality, highlighting the importance of assessing suicidal ideation in clinical settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. 47 CFR 65.102 - Petitions for exclusion from unitary treatment and for individual treatment in determining...

    Science.gov (United States)

    2010-10-01

    ... granted for a period of two years if the cost of capital for interstate exchange service is so low as to... required rate of return for interstate exchange access services. (b) A petition for exclusion from unitary... and for individual treatment in determining authorized return for interstate exchange access service...

  7. Pharmaceutical and personal care products in domestic wastewater and their removal in anaerobic treatment systems: Septic tank – up flow anaerobic filter.

    Directory of Open Access Journals (Sweden)

    Juan Pablo Arrubla Vélez

    2016-01-01

    Full Text Available In several countries around the world, Pharmaceutical and Personal Care Products (PPCPs exist in aquatic environments, a fact that increases the awareness within the scientific community with respect to their possible fate and environment effects. This research presents a preliminary monitoring of use, consumption and presence of PPCPs in wastewater from a treatment plant in a rural area of Pereira (Colombia. Domestic sewage is treated in a septic tank followed by an Up-Flow Anaerobic Filter and its effluent is discharged into the Otún River, upstream of the water intake of the supply system of the city. The compounds monitored in this research included ibuprofen, naproxen, diclofenac, aspirin, ketoprofen, caffeine, galaxolide, tonalide and dihydrojasmonate. An adapted method of multi-residue analysis was used, which is based on solid phase extraction with hydrophilic-lipophilic balance cartridges, and determination by gas chromatography-mass spectrometry. The removal efficiencies demonstrated that the treatment plant could eliminate less than 50% of dihydrojasmonate, diclofenac and galaxolide existing in wastewater; concentration of aspirin, naproxen and tonalide could only be reduced in 15%; and caffeine, ibuprofen and ketoprofen were not removed. Results provided basic information to decide over the necessity of complementary treatments for effluents from systems with the mentioned units.

  8. The removal of pharmaceuticals, personal care products, endocrine disruptors and illicit drugs during wastewater treatment and its impact on the quality of receiving waters.

    Science.gov (United States)

    Kasprzyk-Hordern, Barbara; Dinsdale, Richard M; Guwy, Alan J

    2009-02-01

    A 5-month monitoring program was undertaken in South Wales in the UK to determine the fate of 55 pharmaceuticals, personal care products, endocrine disruptors and illicit drugs (PPCPs) in two contrasting wastewater plants utilising two different wastewater treatment technologies: activated sludge and trickling filter beds. The impact of treated wastewater effluent on the quality of receiving waters was also assessed. PPCPs were found to be present at high loads reaching 10kgday(-1) in the raw sewage. Concentrations of PPCPs in raw sewage were found to correlate with their usage/consumption patterns in Wales and their metabolism. The efficiency of the removal of PPCPs was found to be strongly dependent on the technology implemented in the wastewater treatment plant (WWTP). In general, the WWTP utilising trickling filter beds resulted in, on average, less than 70% removal of all 55 PPCPs studied, while the WWTP utilising activated sludge treatment gave a much higher removal efficiency of over 85%. The monitoring programme revealed that treated wastewater effluents were the main contributors to PPCPs concentrations (up to 3kg of PPCPsday(-1)) in the rivers studied. Bearing in mind that in the cases examined here the WWTP effluents were also major contributors to rivers' flows (dilution factor for the studied rivers did not exceed 23 times) the effect of WWTP effluent on the quality of river water is significant and cannot be underestimated.

  9. Fenton treatment of bio-treated fermentation-based pharmaceutical wastewater: removal and conversion of organic pollutants as well as estimation of operational costs.

    Science.gov (United States)

    Cheng, Yunqin; Chen, Yunlu; Lu, Juncheng; Nie, Jianxin; Liu, Yan

    2018-04-01

    The Fenton process is used as a tertiary treatment to remove organic pollutants from the effluent of bio-treated pharmaceutical wastewater (EBPW). The optimal and most appropriate Fenton conditions were determined by an orthogonal array test and single-factor experiments. The removal of chemical oxygen demand (COD) was influenced by the following factors in a descending order: H 2 O 2 /Fe(II) molar ratio > H 2 O 2 dosage > reaction time. Under the most appropriate Fenton conditions (H 2 O 2 /Fe(II) molar ratio of 1:1, H 2 O 2 dosage of 120 mg L -1 and reaction time of 10 min), the COD and dissolved organic carbon (DOC) were removed with efficiencies of 62 and 53%, respectively, which met the national discharge standard (GB 21903-2008) for the Lake Tai Basin, China. However, the Fenton treatment was inadequate for removal of N compounds, and the removal of organic nitrogen led to an increment in N-NH 3 from 3.28 to 19.71 mg L -1 . Proteins and polysaccharides were completely removed, and humic acids (HAs) were partly removed with an efficiency of 55%. Three-dimensional excitation/emission matrix spectra (3DEEMs) indicated complete removal of fulvic acid-like substances and 90% reduction in the florescence intensity of humic acid-like substances. Organic pollutants with molecular weights (MW) > 10 kDa were completely removed, MW 5-10 kDa were degraded into smaller MW ones, and some low molecular weight acids (MW 0.1-1 kDa) were mineralized during the Fenton process. Some species, including pharmaceutical intermediates and solvents were detected by gas chromatography-mass spectrometry (GC-MS). The operational costs of the Fenton's treatment were estimated to be 0.58 yuan RMB/m 3 EBPW based on reagent usage and iron sludge treatment and disposal.

  10. Event-related potentials reflect the efficacy of pharmaceutical treatments in children and adolescents with attention deficit/hyperactivity disorder.

    Science.gov (United States)

    Yamamuro, Kazuhiko; Ota, Toyosaku; Iida, Junzo; Nakanishi, Yoko; Matsuura, Hiroki; Uratani, Mitsuhiro; Okazaki, Kosuke; Kishimoto, Naoko; Tanaka, Shohei; Kishimoto, Toshifumi

    2016-08-30

    Few objective biological measures of pharmacological treatment efficacy exist for attention deficit/hyperactivity disorder (ADHD). Although we have previously demonstrated that event-related potentials (ERPs) reflect the effects of osmotic-release methylphenidate in treatment of naïve pediatric patients with ADHD, whether this is true for the therapeutic effects of atomoxetine (ATX) is unknown. Here, we used the Japanese version of the ADHD rating-scale IV to evaluate 14 patients with ADHD, and compared their ERP data with 14 age- and sex-matched controls. We measured P300 and mismatch negativity (MMN) components during an auditory oddball task before treatment (treatment naïve) and after 2 months of ATX treatment. Compared with controls, P300 components at baseline were attenuated and prolonged in the ADHD group at Fz (fronto-central), Cz (centro-parietal), Pz (parietal regions), C3 and C4 electrodes. ATX treatment reduced ADHD symptomology, and after 2 months of treatment, P300 latencies at Fz, Cz, Pz, C3, and C4 electrodes were significantly shorter than those at baseline. Moreover, MMN amplitudes at Cz and C3 electrodes were significantly greater than those at baseline. Thus, ERPs may be useful for evaluating the pharmacological effects of ATX in pediatric and adolescent patients with ADHD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Development of a pharmaceutical form containing calixarene molecules for the treatment of intact or injured skin contaminated by uranium

    International Nuclear Information System (INIS)

    Spagnul, A.

    2009-11-01

    The first objective of this research thesis was to develop a formulation containing a tricarboxylic calixarene for cutaneous application for the local treatment of skin contamination by uranium. A second objective is to assess the efficiency of a calixarene nano-emulsion for such a treatment. In a first part, the author proposes an overview of risks associated with skin contamination by uranium, and of current treatments and treatments under development. In the second part, the author presents the oil-in-water-type nano-emulsion, reports an in vitro assessment of the decontamination efficiency of the calixarene nano-emulsion, reports an in vivo assessment of this efficiency (on pig ear skin explants contaminated by uranium), and presents the main publications and a patent request related to this research work

  12. Dental Treatment in a State-Funded Primary Dental Care Facility: Contextual and Individual Predictors of Treatment Need?

    Science.gov (United States)

    Wanyonyi, Kristina L; Radford, David R; Gallagher, Jennifer E

    2017-01-01

    This study examined individual and contextual factors which predict the dental care received by patients in a state-funded primary dental care training facility in England. Routine clinical and demographic data were extracted from a live dental patient management system in a state-funded facility using novel methods. The data, spanning a four-year period [2008-2012] were cleaned, validated, linked by means of postcode to deprivation status, and analysed to identify factors which predict dental treatment need. The predictive relationship between patients' individual characteristics (demography, smoking, payment status) and contextual experience (deprivation based on area of residence), with common dental treatments received was examined using unadjusted analysis and adjusted logistic regression. Additionally, multilevel modelling was used to establish the isolated influence of area of residence on treatments. Data on 6,351 dental patients extracted comprised of 147,417 treatment procedures delivered across 10,371 courses of care. Individual level factors associated with the treatments were age, sex, payment exemption and smoking status and deprivation associated with area of residence was a contextual predictor of treatment. More than 50% of children (care in the form of 'instruction and advice', compared with 46% of working age adults (18-64 years); p = 0.001. The odds of receiving treatment increased with each increasing year of age amongst adults (p = 0.001): 'partial dentures' (7%); 'scale and polish' (3.7%); 'tooth extraction' (3%; p = 0.001), and 'instruction and advice' (3%; p = 0.001). Smokers had a higher likelihood of receiving all treatments; and were notably over four times more likely to receive 'instruction and advice' than non-smokers (OR 4.124; 95% CI: 3.088-5.508; p = 0.01). A further new finding from the multilevel models was a significant difference in treatment related to area of residence; adults from the most deprived quintile were more likely

  13. Dental Treatment in a State-Funded Primary Dental Care Facility: Contextual and Individual Predictors of Treatment Need?

    Directory of Open Access Journals (Sweden)

    Kristina L Wanyonyi

    Full Text Available This study examined individual and contextual factors which predict the dental care received by patients in a state-funded primary dental care training facility in England.Routine clinical and demographic data were extracted from a live dental patient management system in a state-funded facility using novel methods. The data, spanning a four-year period [2008-2012] were cleaned, validated, linked by means of postcode to deprivation status, and analysed to identify factors which predict dental treatment need. The predictive relationship between patients' individual characteristics (demography, smoking, payment status and contextual experience (deprivation based on area of residence, with common dental treatments received was examined using unadjusted analysis and adjusted logistic regression. Additionally, multilevel modelling was used to establish the isolated influence of area of residence on treatments.Data on 6,351 dental patients extracted comprised of 147,417 treatment procedures delivered across 10,371 courses of care. Individual level factors associated with the treatments were age, sex, payment exemption and smoking status and deprivation associated with area of residence was a contextual predictor of treatment. More than 50% of children (<18 years and older adults (≥65 years received preventive care in the form of 'instruction and advice', compared with 46% of working age adults (18-64 years; p = 0.001. The odds of receiving treatment increased with each increasing year of age amongst adults (p = 0.001: 'partial dentures' (7%; 'scale and polish' (3.7%; 'tooth extraction' (3%; p = 0.001, and 'instruction and advice' (3%; p = 0.001. Smokers had a higher likelihood of receiving all treatments; and were notably over four times more likely to receive 'instruction and advice' than non-smokers (OR 4.124; 95% CI: 3.088-5.508; p = 0.01. A further new finding from the multilevel models was a significant difference in treatment related to area

  14. Individualized cost-effective conventional ovulation induction treatment in normogonadotrophic anovulatory infertility (WHO group 2).

    Science.gov (United States)

    Eijkemans, Marinus J C; Polinder, Suzanne; Mulders, Annemarie G M G J; Laven, Joop S E; Habbema, J Dik F; Fauser, Bart C J M

    2005-10-01

    Conventional treatment in normogonadotrophic anovulatory infertility (WHO 2) consists of clomiphene citrate (CC), followed by exogenous gonadotrophins (FSH) and IVF. Response to these treatments may be predicted on the basis of individual patient characteristics. We aimed to devise a patient-tailored, cost-effective treatment algorithm involving the above-mentioned treatment modalities, based on individual patient characteristics. Sixteen prognostic groups are defined, according to the presence or absence of: age >30 years, amenorrhea, elevated androgen levels and obesity. The chances of response with each of the three treatments were calculated using prediction models. Treatment costs were based on the data of 240 patients visiting a specialist academic fertility unit. Outcome was an ongoing pregnancy within 12 months after initiation of treatment. The costs per pregnancy of three different strategies were compared, with a threshold for cost-effectiveness of 10 000. The strategy CC + FSH + IVF compared with FSH + IVF generated more pregnancies against lower costs. Compared with CC + IVF, it also produced more pregnancies, but at higher costs. For costs per pregnancy were less than 10 000. For women >30 years old, costs per pregnancy were 25 000 and over 200 000, when presenting with normal or elevated androgen levels, respectively. The conventional treatment protocol is efficient for women aged 30 years old with elevated androgen levels, FSH may be skipped.

  15. Concept for individualized patient allocation: ReCompare—remote comparison of particle and photon treatment plans

    International Nuclear Information System (INIS)

    Lühr, Armin; Baumann, Michael; Löck, Steffen; Roth, Klaus; Helmbrecht, Stephan; Jakobi, Annika; Petersen, Jørgen B; Just, Uwe; Krause, Mechthild; Enghardt, Wolfgang

    2014-01-01

    Identifying those patients who have a higher chance to be cured with fewer side effects by particle beam therapy than by state-of-the-art photon therapy is essential to guarantee a fair and sufficient access to specialized radiotherapy. The individualized identification requires initiatives by particle as well as non-particle radiotherapy centers to form networks, to establish procedures for the decision process, and to implement means for the remote exchange of relevant patient information. In this work, we want to contribute a practical concept that addresses these requirements. We proposed a concept for individualized patient allocation to photon or particle beam therapy at a non-particle radiotherapy institution that bases on remote treatment plan comparison. We translated this concept into the web-based software tool ReCompare (REmote COMparison of PARticlE and photon treatment plans). We substantiated the feasibility of the proposed concept by demonstrating remote exchange of treatment plans between radiotherapy institutions and the direct comparison of photon and particle treatment plans in photon treatment planning systems. ReCompare worked with several tested standard treatment planning systems, ensured patient data protection, and integrated in the clinical workflow. Our concept supports non-particle radiotherapy institutions with the patient-specific treatment decision on the optimal irradiation modality by providing expertise from a particle therapy center. The software tool ReCompare may help to improve and standardize this personalized treatment decision. It will be available from our website when proton therapy is operational at our facility

  16. Reliability and Validity of a Treatment Barriers Scale for Individuals With Alcohol Use Disorder.

    Science.gov (United States)

    Possemato, Kyle; Funderburk, Jennifer; Spinola, Suzanne; Hutchison, Dezarie; Maisto, Stephen A; Lantinga, Larry J; Oslin, David W

    2016-01-01

    Few studies have measured addiction-specific barriers to treatment. A measurement of barriers with psychometric support that has been tested in diverse samples and that assesses multiple components of addiction treatment barriers is needed to inform providers and treatment programs. This paper aims to provide an initial psychometric investigation of a measure of barriers to seeking addictions treatment. Data were collected from 196 Veterans Affairs primary care patients with Alcohol Use Disorder that participated in a randomized clinical trial. A Principal Components Analysis revealed that the 32-item Treatment Barriers Scale (TBS) can be reduced to 14 items, measuring 4 factors: stigma, dislike of the treatment process, alcohol problem identification, and logistical concerns. Acceptable internal consistent reliability (α = .64-.76) and excellent precision of alpha (α = 0.001-0.009) was found for each subscale. Support for the measure's concurrent validity was found, for example, participants who reported more motivation to reduce their drinking perceived significantly fewer barriers to care. Support for the measure's predictive validity was also found, including that more barriers were related to future drinking among all participants and less mental health and addictions treatment visits among participants in one treatment condition. Conclusions/ Importance: Our results provide initial support for the utility of the TBS-14 among primary care patients with Alcohol Use Disorder. Use of the TBS-14 could enable healthcare providers to better understand patient-specific treatment barriers, provide corrective information on treatment misconceptions, and inform individualized treatment plans that increase patient engagement in addiction services.

  17. [Legal Framework of Autologous Fat Usage in Point-of-Care Treatments in Plastic and Aesthetic Surgery - Risks of Criminal Prosecution and Infringement of Medical Law Due to Pharmaceutical Regulations].

    Science.gov (United States)

    Faltus, T

    2016-08-01

    The use of autologous fat, especially for (stem) cell-assisted lipotransfer in plastic and aesthetic surgery, has regularly been regarded as the manufacture and application of so called Advanced Therapy Medicinal Products (ATMP). However, the in-house production of such pharmaceuticals at the point-of-care (PoC) in the surgeon's practice is not permitted without an official manufacturing license. Therefore, before beginning such treatments, a pharmaceutical manufacturing license has to be granted to the surgeon to avoid criminal prosecution and negative consequences due to infringement of professional regulations. Because such a license is linked to compliance with GMP standard, in-house manufacturing of such pharmaceuticals also implies extra technical and personnel expenses. The surgeon is obliged to check that the available autologous fat based applications are in compliance with pharmaceutical legislation. Repeated infringements of pharmaceutical regulations are incompatible with medical reliability - a prerequisite for the license to practice medicine. © Georg Thieme Verlag KG Stuttgart · New York.

  18. An Investigation of the Differential Effects of Group versus Individual Treatment on Vocational Indecision and Indecisiveness.

    Science.gov (United States)

    Cooper, Stewart E.; Van Matre, Gene

    The differential effects of individual versus group treatment on career indecision and general indecisiveness among career counseling clients were investigated. Data were obtained from 24 career-undecided students seeking vocational counseling through the counseling center of a midwestern state university. Twelve subjects participated in the group…

  19. Early Therapeutic Alliance and Treatment Outcome in Individual and Family Therapy for Adolescent Behavior Problems

    Science.gov (United States)

    Hogue, Aaron; Dauber, Sarah; Stambaugh, Leyla Faw; Cecero, John J.; Liddle, Howard A.

    2006-01-01

    The impact of early therapeutic alliance was examined in 100 clients receiving either individual cognitive-behavioral therapy (CBT) or family therapy for adolescent substance abuse. Observational ratings of adolescent alliance in CBT and adolescent and parent alliance in family therapy were used to predict treatment retention (in CBT only) and…

  20. Treatment of Bruxism in Individuals with Developmental Disabilities: A Systematic Review

    Science.gov (United States)

    Lang, Russell; White, Pamela J.; Machalicek, Wendy; Rispoli, Mandy; Kang, Soyeon; Aquilar, Jeannie; O'Reilly, Mark; Sigafoos, Jeff; Lancioni, Giulio; Didden, Robert

    2009-01-01

    We reviewed studies involving the treatment of bruxism (i.e., teeth clenching or teeth grinding) in individuals with developmental disabilities. Systematic searches of electronic databases, journals, and reference lists identified 11 studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) participants, (b) procedures…

  1. A Randomized Trial of Individual and Couple Behavioral Alcohol Treatment for Women

    Science.gov (United States)

    Mccrady, Barbara S.; Epstein, Elizabeth E.; Cook, Sharon; Jensen, Noelle; Hildebrandt, Thomas

    2009-01-01

    Although alcohol use disorders (AUDs) adversely affect women, research on efficacious treatments for women is limited. In this randomized efficacy trial of 102 heterosexual women with AUDs, the authors compared alcohol behavioral couple therapy (ABCT) and alcohol behavioral individual therapy (ABIT) on percentage of days abstinent (PDA) and…

  2. Surgery as an Adjunctive Treatment for Multidrug-Resistant Tuberculosis : An Individual Patient Data Metaanalysis

    NARCIS (Netherlands)

    Fox, Gregory J.; Mitnick, Carole D.; Benedetti, Andrea; Chan, Edward D.; Becerra, Mercedes; Chiang, Chen-Yuan; Keshavjee, Salmaan; Koh, Won-Jung; Shiraishi, Yuji; Viiklepp, Piret; Yim, Jae-Joon; Pasvol, Geoffrey; Robert, Jerome; Shim, Tae Sun; Shin, Sonya S.; Menzies, Dick; van der Werf, Tjip S.

    2016-01-01

    Background. Medical treatment for multidrug-resistant (MDR)-tuberculosis is complex, toxic, and associated with poor outcomes. Surgical lung resection may be used as an adjunct to medical therapy, with the intent of reducing bacterial burden and improving cure rates. We conducted an individual

  3. 5 CFR 307.104 - Treatment of individuals serving under VRAs.

    Science.gov (United States)

    2010-01-01

    ... REGULATIONS VETERANS RECRUITMENT APPOINTMENTS § 307.104 Treatment of individuals serving under VRAs. (a... service employees, may be reassigned, promoted, demoted, or transferred in accordance with the provisions... disqualifies a person for a VRA. (d) The Veterans Recruitment Appointment date for a recently separated veteran...

  4. A mindful eating group as an adjunct to individual treatment for eating disorders: a pilot study.

    Science.gov (United States)

    Hepworth, Natasha S

    2011-01-01

    The objective of this study was to investigate potential benefits of a Mindful Eating Group as an adjunct to long-term treatment for a variety of eating disorders. Individuals (N = 33) attending treatment at an outpatient treatment facility participated in the 10-week intervention designed to enhance awareness around hunger and satiety cues. Disordered eating symptoms were assessed pre- and post-intervention using the EAT-26. Significant reductions were found on all subscales of the EAT-26 with large effect sizes. No significant differences were identified between eating disorder diagnoses. Results suggest potential benefits of an adjunct mindfulness group intervention when treating a variety of eating disorders. Limitations are discussed.

  5. Towards personalized therapy for multiple sclerosis: prediction of individual treatment response.

    Science.gov (United States)

    Kalincik, Tomas; Manouchehrinia, Ali; Sobisek, Lukas; Jokubaitis, Vilija; Spelman, Tim; Horakova, Dana; Havrdova, Eva; Trojano, Maria; Izquierdo, Guillermo; Lugaresi, Alessandra; Girard, Marc; Prat, Alexandre; Duquette, Pierre; Grammond, Pierre; Sola, Patrizia; Hupperts, Raymond; Grand'Maison, Francois; Pucci, Eugenio; Boz, Cavit; Alroughani, Raed; Van Pesch, Vincent; Lechner-Scott, Jeannette; Terzi, Murat; Bergamaschi, Roberto; Iuliano, Gerardo; Granella, Franco; Spitaleri, Daniele; Shaygannejad, Vahid; Oreja-Guevara, Celia; Slee, Mark; Ampapa, Radek; Verheul, Freek; McCombe, Pamela; Olascoaga, Javier; Amato, Maria Pia; Vucic, Steve; Hodgkinson, Suzanne; Ramo-Tello, Cristina; Flechter, Shlomo; Cristiano, Edgardo; Rozsa, Csilla; Moore, Fraser; Luis Sanchez-Menoyo, Jose; Laura Saladino, Maria; Barnett, Michael; Hillert, Jan; Butzkueven, Helmut

    2017-09-01

    Timely initiation of effective therapy is crucial for preventing disability in multiple sclerosis; however, treatment response varies greatly among patients. Comprehensive predictive models of individual treatment response are lacking. Our aims were: (i) to develop predictive algorithms for individual treatment response using demographic, clinical and paraclinical predictors in patients with multiple sclerosis; and (ii) to evaluate accuracy, and internal and external validity of these algorithms. This study evaluated 27 demographic, clinical and paraclinical predictors of individual response to seven disease-modifying therapies in MSBase, a large global cohort study. Treatment response was analysed separately for disability progression, disability regression, relapse frequency, conversion to secondary progressive disease, change in the cumulative disease burden, and the probability of treatment discontinuation. Multivariable survival and generalized linear models were used, together with the principal component analysis to reduce model dimensionality and prevent overparameterization. Accuracy of the individual prediction was tested and its internal validity was evaluated in a separate, non-overlapping cohort. External validity was evaluated in a geographically distinct cohort, the Swedish Multiple Sclerosis Registry. In the training cohort (n = 8513), the most prominent modifiers of treatment response comprised age, disease duration, disease course, previous relapse activity, disability, predominant relapse phenotype and previous therapy. Importantly, the magnitude and direction of the associations varied among therapies and disease outcomes. Higher probability of disability progression during treatment with injectable therapies was predominantly associated with a greater disability at treatment start and the previous therapy. For fingolimod, natalizumab or mitoxantrone, it was mainly associated with lower pretreatment relapse activity. The probability of

  6. Photocatalytic treatment of pharmaceutical wastewater using new multiwall-carbon nanotubes/TiO{sub 2}/SiO{sub 2} nanocomposites

    Energy Technology Data Exchange (ETDEWEB)

    Czech, Bożena, E-mail: bczech@hektor.umcs.lublin.pl [Department of Environmental Chemistry, Faculty of Chemistry, Maria Curie-Skłodowska University, Lublin (Poland); Buda, Waldemar [Department of Adsorption, Faculty of Chemistry, Maria Curie-Skłodowska University, Lublin (Poland)

    2015-02-15

    For the photocatalytic removal of bisphenol A (BPA) and carbamazepine (CBZ) from water solution a new multiwall-carbon nanotubes and TiO{sub 2}/SiO{sub 2} nanocomposites (MWCNT–TiO{sub 2}–SiO{sub 2}) were applied. Nanocomposites with the addition of 0.15–17.8 wt% MWCNT show high potential for the removal of both pollutants. The starting concentration of each contaminant was halved during 20 min of UVA irradiation. The decomposition process of CBZ over investigated nanocomposites proceeded differently than it was observed for the classical photocatalyst P25. The kinetics of the removal followed as a pseudo-first order regime with the k{sub 1} in range 0.0827–0.1751 min{sup −1} for BPA and 0.0131–0.0743 min{sup −1} for CBZ. Toxicity to Vibrio fischeri and Daphnia magna was significantly reduced indicating formation of non-toxic products of photooxidation of tested contaminants. - Highlights: • MWCNT enhanced TiO{sub 2} activity in UVA and the removal of BPA and CBZ. • At least 50% PPCPs removal during 30 min of photocatalytic treatment was observed. • MWCNT changed the mechanism of CBZ decomposition but not BPA. • Decomposition products of both BPA and CBZ possessed low toxicity. • Photocatalysis may be recommended for the initial treatment of pharmaceutical wastewater.

  7. Environmental exposure of pharmaceuticals and musk fragrances in the Somes River before and after upgrading the municipal wastewater treatment plant Cluj-Napoca, Romania.

    Science.gov (United States)

    Moldovan, Zaharie; Chira, Romeo; Alder, Alfredo C

    2009-08-01

    Pharmaceutically active substances are a class of emerging contaminants, which has led to increasing concern about potential environmental risks. After excretion, substantial amounts of unchanged pharmaceuticals and their metabolites are discharged into domestic wastewaters. The absence of data on the environmental exposure in Eastern Europe is significant, since use patterns and volumes differ from country to country. In Romania, the majority of wastewater, from highly populated cities and industrial complex zones, is still discharged into surface waters without proper treatment or after inefficient treatment. In respect to this, it is important to determine the environmental occurrence and behavior of pharmaceuticals and personal care products (PPCPs) in wastewaters and surface waters. The objective of the present study was to investigate the occurrence of selected PPCPs during the transport in the Somes River by mass flow analysis before and after upgrading a municipal wastewater treatment plant (WWTP) in Cluj-Napoca, which serves 350,000 inhabitants and is the largest plant discharging into the Somes River. The concentrations of PPCPs at Cluj-Napoca can be correlated with the high population and a high number of hospitals located in the catchment area leading to higher mass flows. The results of this study are expected to provide information, with respect to the Romanian conditions, for environmental scientists, WWTP operators, and legal authorities. The data should support the improvement of existing WWTPs and implementation of new ones where necessary and, therefore, minimize the input of contaminants into ambient waters. The PPCPs were selected on the basis of consumption at the regional scale, reported aquatic toxicity, and the suitability of the gas chromatography/mass spectrometry (GC/MS) method for the determination of the compounds at trace levels. The studied PPCPs, caffeine (stimulant), carbamazepine (antiepileptic), pentoxifylline (anticoagulant

  8. Evidence to practice: treatment of anxiety in individuals with autism spectrum disorders.

    Science.gov (United States)

    Lang, Russell; Mahoney, Richard; El Zein, Farah; Delaune, Elizabeth; Amidon, Megan

    2011-01-25

    What treatment improves social interactions and reduces reports of anxiety symptoms in individuals with autism spectrum disorders (ASD) and a co-occurring anxiety disorder? Systematic reviews and randomized clinical trials suggest that cognitive behavior therapy in tandem with direct instruction of social skills using applied behavior analysis intervention components may be effective for treating anxiety in individuals with high functioning ASD. For individuals with ASD, an anxiety disorder, and an intellectual disability, systematic desensitization may be effective. Intervention should emphasize teaching social skills. Reinforcers (ie, rewards based upon the client's interests) should be used to encourage participation in therapy. Treatment should incorporate visual aides and family involvement. Intervention components involving abstract concepts, visualization, and discussions of emotions are less useful given difficulties in abstract reasoning and communication inherent to ASD.

  9. Pharmaceutical and personal care products in domestic wastewater and their removal in anaerobic treatment systems: septic tank - upflow anaerobic filter

    DEFF Research Database (Denmark)

    Arrubla, Juan Pablo; Cubillos, Janneth A.; Ramírez Vargas, Carlos Andrés

    2016-01-01

    of use, consumption and presence of PPCPs in wastewater from a treatment plant in a rural area of Pereira (Colombia). Domestic sewage is treated in a septic tank followed by an Up-Flow Anaerobic Filter and its ef uent is discharged into the Otún River, upstream of the water intake of the supply system...

  10. Occurrence and fate of illicit drugs and pharmaceuticals in wastewater from two wastewater treatment plants in Costa Rica

    NARCIS (Netherlands)

    Causanilles, A.; Ruepert, C.; Ibáñez, M.; Emke, E.; Hernández, F.; de Voogt, P.

    2017-01-01

    Chemical analysis of raw wastewater in order to assess the presence of biological markers entering a wastewater treatment plant can provide objective information about the health and lifestyle of the population connected to the sewer system. This work was performed in a tropical country of Central

  11. Oral cavity infection: an adverse effect after the treatment of oral cancer in aged individuals.

    Science.gov (United States)

    Pan, Jie; Zhao, Jun; Jiang, Ning

    2014-01-01

    The immune compromised patients after treatment of oral cancer may have a chance of infection by drug-resistant opportunistic microbes. We investigated the occurrence of opportunistic microorganisms in aged individuals receiving follow-up examinations after treatment of oral cancer in China. These patients were used as test group and the respective age grouped healthy individuals as control group. In this study, the oral cavity microorganisms such as bacteria and yeast were taken for the analysis. After the screening of representative microorganisms, their aptitude of pervasiveness against drugs was studied. Here, we used antimicrobial agents which are common in clinical practice. We also performed studies to investigate the presence of toxin genes in methicillin-resistant S. aureus (MRSA). The results indicate that the prevalence of drug-resistant microbes was more pronounced in oral cancer patients after initial treatment above 70 years old. The oxacillin resistance of S. aureus isolate confirms that the prevalence of MRSA is increasing in accordance to age-factor and immune compromise in elderly patients. This study reveals the occurrence of drug-resistant opportunistic microorganisms in oral cavity after treatment for oral cancer in aged individuals. Special attention should be directed to MRSA during the treatment of oral cancer, and to realize the fact of immune compromise in elderly patients.

  12. Use of conventional, complementary, and alternative treatments for pain among individuals seeking primary care treatment with buprenorphine-naloxone

    Science.gov (United States)

    Barry, Declan T.; Savant, Jonathan D.; Beitel, Mark; Cutter, Christopher J.; Moore, Brent A.; Schottenfeld, Richard S.; Fiellin, David A.

    2012-01-01

    Previous studies have not examined patterns of pain treatment use among patients seeking office-based buprenorphine-naloxone treatment (BNT) for opioid dependence. Objectives To examine, among individuals with pain seeking BNT for opioid dependence, the use of pain treatment modalities, perceived efficacy of prior pain treatment, and interest in pursuing pain treatment while in BNT. Methods 244 patients seeking office-based BNT for opioid dependence completed measures of demographics, pain status (i.e. “chronic pain (CP)” [pain lasting at least 3 months] vs. “some pain (SP)” [pain in the past week not meeting the duration criteria for chronic pain]), pain treatment use, perceived efficacy of prior pain treatment, and interest in receiving pain treatment while in BNT. Results In comparison to the SP group (N = 87), the CP group (N = 88) was more likely to report past-week medical use of opioid medication (AOR 3.2, 95% CI 1.2–8.4), lifetime medical use of non-opioid prescribed medication (AOR 2.2, 95% CI 1.1–4.7), and lifetime use of prayer (AOR 2.8, 95% CI 1.2–6.5), and was less likely to report lifetime use of yoga (AOR 0.2, 95% CI 0.1–0.7) to treat pain. While the two pain groups did not differ on levels of perceived efficacy of prior lifetime pain treatments, in comparison to the SP group, the CP group was more likely to report interest in receiving pain treatment while in BNT (P pain seeking BNT for opioid dependence report a wide range of conventional, complementary, and alternative pain-related treatments and are interested (especially those with CP) in receiving pain management services along with BNT. PMID:23041680

  13. Using Functional Analysis as a Framework to Guide Individualized Treatment for Negative Symptoms

    Directory of Open Access Journals (Sweden)

    Tania M. Lincoln

    2017-12-01

    Full Text Available Although numerous interventions are available for negative symptoms, outcomes have been unsatisfactory with pharmacological and psychological interventions producing changes of only limited clinical significance. Here, we argue that because negative symptoms occur as a complex syndrome caused and maintained by numerous factors that vary between individuals they are unlikely to be treated effectively by the present “one size fits all” approaches. Instead, a well-founded selection of those interventions relevant to each individual is needed to optimize both the efficiency and the efficacy of existing approaches. The concept of functional analysis (FA can be used to structure existing knowledge so that it can guide individualized treatment planning. FA is based on stimulus—response learning mechanisms taking into account the characteristics of the organism that contribute to the responses, their consequences and the contingency with which consequences are tied to the response. FA can thus be flexibly applied to the level of individual patients to understand the factors causing and maintaining negative symptoms and derive suitable interventions. In this article we will briefly introduce the concept of FA and demonstrate—exemplarily—how known psychological and biological correlates of negative symptoms can be incorporated into its framework. We then outline the framework's implications for individual assessment and treatment. Following the logic of FA, we argue that a detailed assessment is needed to identify the key factors causing or maintaining negative symptoms for each individual patient. Interventions can then be selected according to their likelihood of changing these key factors and need to take interactions between different factors into account. Supplementary case vignettes exemplify the usefulness of functional analysis for individual treatment planning. Finally, we discuss and point to avenues for future research guided by this

  14. The Key to Individualized Addiction Treatment is Comprehensive Assessment and Monitoring of Symptoms and Behavioral Change

    Directory of Open Access Journals (Sweden)

    Thomas F. Hilton

    2015-10-01

    Full Text Available Modern health services now strive for individualized treatment. This approach has been enabled by the increase in knowledge derived from neuroscience and genomics. Substance use disorders are no exception to individualized treatment even though there are no gene-specific medications yet available. What is available is the ability to quickly and precisely assess and monitor biopsychosocial variables known to vary during addiction recovery and which place addicts at increased risk of relapse. Monitoring a broad spectrum of biopsychosocial health enables providers to address diverse genome-specific changes that might trigger withdrawal from treatment or recovery relapse in time to prevent that from occurring. This paper describes modern measurement tools contained in the NIH Patient-Reported Outcomes Measurement Information System (PROMIS and the NIH Toolbox and suggests how they might be applied to support recovery from alcohol and other substance use disorders in both pharmacological and abstinence-oriented modalities of care.

  15. Spontaneous harm reduction: a barrier for substance-dependent individuals seeking treatment?

    Directory of Open Access Journals (Sweden)

    Fontanella Bruno José Barcellos

    2005-01-01

    Full Text Available OBJETIVE: Greater information regarding motivations and treatment barriers faced by substance-dependent individuals has clinical and public health implications. This study aimed to formulate hypotheses regarding psychological, social and family variables that can be constructed as motivations or subjective barriers for the early seeking of formal treatment. METHODS: A qualitative study was conducted in an intentional sample (selected through saturation and variety of types of 13 substance-dependent individuals who sought treatment. In-depth, semi-structured interviews were conducted using open questions, and the transcribed data were subjected to qualitative analysis. RESULTS: Four types of spontaneous harm reduction measures were identified, according to the subjective logic of each participant: having some periods at rest (not using and recovering from adverse effects; caretaking by close acquaintances (relatives, partners, drug dealers and alcoholic beverage sellers; selectivity regarding substance source, type and means of administration; establishing "healthy" limits of ingestion. CONCLUSIONS: The measures identified might represent barriers to the early seeking of treatment but might also represent spontaneous learning of abilities beneficial to future treatment. Health care professionals should take into consideration their existence and should address them in clinical settings. Issues representative of the formulated categories should be presented in structured questionnaires used in future quantitative studies of barriers to treatment in this population.

  16. Spontaneous harm reduction: a barrier for substance-dependent individuals seeking treatment?

    Directory of Open Access Journals (Sweden)

    Bruno José Barcellos Fontanella

    2005-12-01

    Full Text Available OBJETIVE: Greater information regarding motivations and treatment barriers faced by substance-dependent individuals has clinical and public health implications. This study aimed to formulate hypotheses regarding psychological, social and family variables that can be constructed as motivations or subjective barriers for the early seeking of formal treatment. METHODS: A qualitative study was conducted in an intentional sample (selected through saturation and variety of types of 13 substance-dependent individuals who sought treatment. In-depth, semi-structured interviews were conducted using open questions, and the transcribed data were subjected to qualitative analysis. RESULTS: Four types of spontaneous harm reduction measures were identified, according to the subjective logic of each participant: having some periods at rest (not using and recovering from adverse effects; caretaking by close acquaintances (relatives, partners, drug dealers and alcoholic beverage sellers; selectivity regarding substance source, type and means of administration; establishing "healthy" limits of ingestion. CONCLUSIONS: The measures identified might represent barriers to the early seeking of treatment but might also represent spontaneous learning of abilities beneficial to future treatment. Health care professionals should take into consideration their existence and should address them in clinical settings. Issues representative of the formulated categories should be presented in structured questionnaires used in future quantitative studies of barriers to treatment in this population.

  17. Cancer treatment disparities in HIV-infected individuals in the United States.

    Science.gov (United States)

    Suneja, Gita; Shiels, Meredith S; Angulo, Rory; Copeland, Glenn E; Gonsalves, Lou; Hakenewerth, Anne M; Macomber, Kathryn E; Melville, Sharon K; Engels, Eric A

    2014-08-01

    HIV-infected individuals with cancer have worse survival rates compared with their HIV-uninfected counterparts. One explanation may be differing cancer treatment; however, few studies have examined this. We used HIV and cancer registry data from Connecticut, Michigan, and Texas to study adults diagnosed with non-Hodgkin's lymphoma, Hodgkin's lymphoma, or cervical, lung, anal, prostate, colorectal, or breast cancers from 1996 to 2010. We used logistic regression to examine associations between HIV status and cancer treatment, adjusted for cancer stage and demographic covariates. For a subset of local-stage cancers, we used logistic regression to assess the relationship between HIV status and standard treatment modality. We identified predictors of cancer treatment among individuals with both HIV and cancer. We evaluated 3,045 HIV-infected patients with cancer and 1,087,648 patients with cancer without HIV infection. A significantly higher proportion of HIV-infected individuals did not receive cancer treatment for diffuse large B-cell lymphoma (DLBCL; adjusted odds ratio [aOR], 1.67; 95% CI, 1.41 to 1.99), lung cancer (aOR, 2.18; 95% CI, 1.80 to 2.64), Hodgkin's lymphoma (aOR, 1.77; 95% CI, 1.33 to 2.37), prostate cancer (aOR, 1.79; 95% CI, 1.31 to 2.46), and colorectal cancer (aOR, 2.27; 95% CI, 1.38 to 3.72). HIV infection was associated with a lack of standard treatment modality for local-stage DLBCL (aOR, 2.02; 95% CI, 1.50 to 2.72), non-small-cell lung cancer (aOR, 2.43; 95% CI, 1.46 to 4.03), and colon cancer (aOR, 4.77; 95% CI, 1.76 to 12.96). Among HIV-infected individuals, factors independently associated with lack of cancer treatment included low CD4 count, male sex with injection drug use as mode of HIV exposure, age 45 to 64 years, black race, and distant or unknown cancer stage. HIV-infected individuals are less likely to receive treatment for some cancers than uninfected people, which may affect survival rates. © 2014 by American Society of Clinical

  18. Are medical treatments for individuals and groups like single-play and multiple-play gambles?

    Directory of Open Access Journals (Sweden)

    Michael L. DeKay

    2006-11-01

    Full Text Available People are often more likely to accept risky monetary gambles with positive expected values when the gambles will be played more than once. We investigated whether this distinction between single-play and multiple-play gambles extends to medical treatments for individual patients and groups of patients. Resident physicians and medical students (extit{n} = 69 and undergraduates (extit{n} = 99 ranked 9 different flu shots and a no-flu-shot option in 1 of 4 combinations of perspective (individual patient vs. group of 1000 patients and uncertainty frame (probability vs. frequency. The rank of the no-flu-shot option (a measure of preference for treatment vs. no treatment was not significantly related to perspective or participant population. The main effect of uncertainty frame and the interaction between perspective and uncertainty frame approached significance (0.1 {extgreater} extit{p} {extgreater} 0.05, with the no-flu-shot option faring particularly poorly (treatment faring particularly well when decisions about many patients were based on frequency information. Undergraduate participants believed that the no-flu-shot option would be less attractive (treatment would be more attractive in decisions about many patients, but these intuitions were inconsistent with the actual ranks. These results and those of other studies suggest that medical treatments for individuals and groups are not analogous to single-play and multiple-play monetary gambles, perhaps because many people are unwilling to aggregate treatment outcomes over patients in the same way that they would compute net gains or losses over monetary gambles.

  19. Beyond price: individuals' accounts of deciding to pay for private healthcare treatment in the UK.

    Science.gov (United States)

    Exley, Catherine; Rousseau, Nikki; Donaldson, Cam; Steele, Jimmy G

    2012-03-07

    Delivering appropriate and affordable healthcare is a concern across the globe. As countries grapple with the issue of delivering healthcare with finite resources and populations continue to age, more health-related care services or treatments may become an optional 'extra' to be purchased privately. It is timely to consider how, and to what extent, the individual can act as both a 'patient' and a 'consumer'. In the UK the majority of healthcare treatments are free at the point of delivery. However, increasingly some healthcare treatments are being made available via the private healthcare market. Drawing from insights from healthcare policy and social sciences, this paper uses the exemplar of private dental implant treatment provision in the UK to examine what factors people considered when deciding whether or not to pay for a costly healthcare treatment for a non-fatal condition. Qualitative interviews with people (n = 27) who considered paying for dental implants treatments in the UK. Data collection and analysis processes followed the principles of the constant comparative methods, and thematic analysis was facilitated through the use of NVivo qualitative data software. Decisions to pay for private healthcare treatments are not simply determined by price. Decisions are mediated by: the perceived 'status' of the healthcare treatment as either functional or aesthetic; how the individual determines and values their 'need' for the treatment; and, the impact the expenditure may have on themselves and others. Choosing a private healthcare provider is sometimes determined simply by personal rapport or extant clinical relationship, or based on the recommendation of others. As private healthcare markets expand to provide more 'non-essential' services, patients need to develop new skills and to be supported in their new role as consumers.

  20. Individual differences in aversion to ambiguity regarding medical tests and treatments: association with cancer screening cognitions.

    Science.gov (United States)

    Han, Paul K J; Williams, Andrew E; Haskins, Amy; Gutheil, Caitlin; Lucas, F Lee; Klein, William M P; Mazor, Kathleen M

    2014-12-01

    Aversion to "ambiguity"-uncertainty about the reliability, credibility, or adequacy of information-about medical tests and treatments is an important psychological response that varies among individuals, but little is known about its nature and extent. The purpose of this study was to examine how individual-level ambiguity aversion relates to important health cognitions related to different cancer screening tests. A survey of 1,074 adults, ages 40 to 70 years, was conducted in four integrated U.S. healthcare systems. The Ambiguity Aversion in Medicine (AA-Med) scale, a measure of individual differences in aversion to ambiguity (AA) about medical tests and treatments, was administered along with measures of several cancer screening-related cognitions: perceived benefits and harms of colonoscopy, mammography, and PSA screening, and ambivalence and future intentions regarding these tests. Multivariable analyses were conducted to assess the associations between AA-Med scores and cancer screening cognitions. Individual-level AA as assessed by the AA-Med scale was significantly associated (P ambiguity. Individual-level AA constitutes a measurable, wide-ranging cognitive bias against medical intervention, and more research is needed to elucidate its mechanisms and effects. ©2014 American Association for Cancer Research.

  1. Removal of pharmaceuticals and unspecified contaminants in sewage treatment effluents by activated carbon filtration and ozonation: Evaluation using biomarker responses and chemical analysis.

    Science.gov (United States)

    Beijer, Kristina; Björlenius, Berndt; Shaik, Siraz; Lindberg, Richard H; Brunström, Björn; Brandt, Ingvar

    2017-06-01

    Traces of active pharmaceutical ingredients (APIs) and other chemicals are demonstrated in effluents from sewage treatment plants (STPs) and they may affect quality of surface water and eventually drinking water. Treatment of effluents with granular activated carbon (GAC) or ozone to improve removal of APIs and other contaminants was evaluated at two Swedish STPs, Käppala and Uppsala (88 and 103 APIs analyzed). Biomarker responses in rainbow trout exposed to regular and additionally treated effluents were determined. GAC and ozone treatment removed 87-95% of the total concentrations of APIs detected. In Käppala, GAC removed 20 and ozonation (7 g O 3 /m 3 ) 21 of 24 APIs detected in regular effluent. In Uppsala, GAC removed 25 and ozonation (5.4 g O 3 /m 3 ) 15 of 25 APIs detected in effluent. GAC and ozonation also reduced biomarker responses caused by unidentified pollutants in STP effluent water. Elevated ethoxyresorufin-O-deethylase (EROD) activity in gills was observed in fish exposed to effluent in both STPs. Gene expression analysis carried out in Käppala showed increased concentrations of cytochrome P450 (CYP1As and CYP1C3) transcripts in gills and of CYP1As in liver of fish exposed to effluent. In fish exposed to GAC- or ozone-treated effluent water, gill EROD activity and expression of CYP1As and CYP1C3 in gills and liver were generally equal to or below levels in fish held in tap water. The joint application of chemical analysis and sensitive biomarkers proved useful for evaluating contaminant removal in STPs with new technologies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Muscle relaxation for individuals having tattoos removed through laser treatment: possible effects regarding anxiety and pain.

    Science.gov (United States)

    Huang, Faye; Chou, Wen-Jiun; Chen, Tien-Hsing; Chen, Ching; Hsieh, Yu-Lian; Chong, Mian-Yoon; Hung, Chi-Fa; Lin, Shu-Ching; Tsai, Hsiu-Huang; Wang, Liang-Jen

    2016-08-01

    Effectively managing pain is vital for the well-being and satisfaction of patients undergoing dermatologic treatments involving lasers. This study investigates the potential outcome of using muscle relaxation techniques to reduce pain among people having their tattoos removed with laser treatment. This study consists of 56 participants (mean age 18.1 ± 2.1 years) that had tattoos removed using the principle of selective photothermolysis. These participants underwent muscle relaxation before receiving the laser treatment. Their peripheral skin temperatures (PST) were measured both at the beginning and the end of the muscle relaxation period. Then, the Beck Anxiety Inventory was applied to evaluate anxiety levels. Once the laser treatment was completed, pain levels were measured using a visual analogue scale. A total of 125 person-sessions of laser treatment and psychometric assessments were performed in this study. The muscle relaxation method significantly increased the PST of the participants while reducing the levels of anxiety and pain throughout the course of the laser treatment procedure. The PST, anxiety scores, and pain scores all showed significant correlations with one another. According to the results obtained, this study proposes that muscle relaxation techniques be considered possibly auxiliary treatment options for individuals having tattoos removed through laser treatment. Additional studies with a comparison group and a larger sample size are required in the future to confirm the effectiveness of such intervention.

  3. Anglo-Saxon experience in the implementation of correctional treatment and the Polish individual rehabilitation program

    Directory of Open Access Journals (Sweden)

    Maciej Bernasiewicz

    2012-12-01

    Full Text Available The authors cite American and British research on the effectiveness of correctional treatment. On that basis, they describe several crucial factors that affect the success of rehabilitation (e.g., educators’ skills, working with families of juvenile offenders. The article broadly discusses the specific juvenile residential treatment program that has been implemented in Florida. The conclusions of this program are drawn from the research conducted through interviews with juvenile offenders (young adults who have effectively completed the process of rehabilitation in correctional facilities. Furthermore, the authors discuss an individual program of rehabilitation (IPR implemented in Polish correctional facilities. Using the experience and the impact of correctional treatment in the West, it is proposed to introduce certain modifications in the planning and implementation of Polish correctional treatment programs (IPR s.

  4. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients' data

    DEFF Research Database (Denmark)

    Thiébaut, Rodolphe; Leproust, Sandy; Chêne, Geneviève

    2007-01-01

    BACKGROUND: Despite three decades of prenatal screening for congenital toxoplasmosis in some European countries, uncertainty remains about the effectiveness of prenatal treatment. METHODS: We did a systematic review of cohort studies based on universal screening for congenital toxoplasmosis. We did...... a meta-analysis using individual patients' data to assess the effect of timing and type of prenatal treatment on mother-to-child transmission of infection and clinical manifestations before age 1 year. Analyses were adjusted for gestational age at maternal seroconversion and other covariates. FINDINGS......: We included 26 cohorts in the review. In 1438 treated mothers identified by prenatal screening, we found weak evidence that treatment started within 3 weeks of seroconversion reduced mother-to-child transmission compared with treatment started after 8 or more weeks (adjusted odds ratio [OR] 0.48, 95...

  5. Biodegradation and reversible inhibitory impact of sulfamethoxazole on the utilization of volatile fatty acids during anaerobic treatment of pharmaceutical industry wastewater

    International Nuclear Information System (INIS)

    Cetecioglu, Zeynep; Ince, Bahar; Gros, Meritxell; Rodriguez-Mozaz, Sara; Barceló, Damia; Ince, Orhan; Orhon, Derin

    2015-01-01

    This study evaluated the chronic impact and biodegradability of sulfamethoxazole under anaerobic conditions. For this purpose, a lab-scale anaerobic sequencing batch reactor was operated in a sequence of different phases with gradually increasing sulfamethoxazole doses of 1 to 45 mg/L. Conventional parameters, such as COD, VFA, and methane generation, were monitored with corresponding antimicrobial concentrations in the reactor and the methanogenic activity of the sludge. The results revealed that anaerobic treatment was suitable for pharmaceutical industry wastewater with concentrations of up to 40 mg/L of sulfamethoxazole. Higher levels exerted toxic effects on the microbial community under anaerobic conditions, causing the inhibition of substrate/COD utilization and biogas generation and leading to a total collapse of the reactor. The adverse long-term impact was quite variable for fermentative bacteria and methanogenic achaea fractions of the microbial community based on changes inflicted on the composition of the residual organic substrate and mRNA expression of the key enzymes. - Highlights: • Chronic impact of sulfamethoxazole was lethal at 45 mg/L on the microbial community. • Sulfamethoxazole was highly biodegradable under anaerobic conditions. • While the COD removal stopped, the sorption of sulfamethoxazole into the sludge increased. • Sulfamethoxazole has a reversible inhibitory effect on acetoclastic methanogens

  6. Biodegradation and reversible inhibitory impact of sulfamethoxazole on the utilization of volatile fatty acids during anaerobic treatment of pharmaceutical industry wastewater

    Energy Technology Data Exchange (ETDEWEB)

    Cetecioglu, Zeynep, E-mail: cetecioglu@itu.edu.tr [Istanbul Technical University, Environmental Engineering Department, 34469 Maslak, Istanbul (Turkey); Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003 Girona (Spain); Ince, Bahar [Bogazici University, Institute of Environmental Sciences, Rumelihisarustu - Bebek, 34342 Istanbul (Turkey); Gros, Meritxell; Rodriguez-Mozaz, Sara; Barceló, Damia [Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003 Girona (Spain); Ince, Orhan; Orhon, Derin [Istanbul Technical University, Environmental Engineering Department, 34469 Maslak, Istanbul (Turkey)

    2015-12-01

    This study evaluated the chronic impact and biodegradability of sulfamethoxazole under anaerobic conditions. For this purpose, a lab-scale anaerobic sequencing batch reactor was operated in a sequence of different phases with gradually increasing sulfamethoxazole doses of 1 to 45 mg/L. Conventional parameters, such as COD, VFA, and methane generation, were monitored with corresponding antimicrobial concentrations in the reactor and the methanogenic activity of the sludge. The results revealed that anaerobic treatment was suitable for pharmaceutical industry wastewater with concentrations of up to 40 mg/L of sulfamethoxazole. Higher levels exerted toxic effects on the microbial community under anaerobic conditions, causing the inhibition of substrate/COD utilization and biogas generation and leading to a total collapse of the reactor. The adverse long-term impact was quite variable for fermentative bacteria and methanogenic achaea fractions of the microbial community based on changes inflicted on the composition of the residual organic substrate and mRNA expression of the key enzymes. - Highlights: • Chronic impact of sulfamethoxazole was lethal at 45 mg/L on the microbial community. • Sulfamethoxazole was highly biodegradable under anaerobic conditions. • While the COD removal stopped, the sorption of sulfamethoxazole into the sludge increased. • Sulfamethoxazole has a reversible inhibitory effect on acetoclastic methanogens.

  7. Enhanced pharmaceutical removal from water in a three step bio-ozone-bio process.

    Science.gov (United States)

    de Wilt, Arnoud; van Gijn, Koen; Verhoek, Tom; Vergnes, Amber; Hoek, Mirit; Rijnaarts, Huub; Langenhoff, Alette

    2018-07-01

    Individual treatment processes like biological treatment or ozonation have their limitations for the removal of pharmaceuticals from secondary clarified effluents with high organic matter concentrations (i.e. 17 mg TOC/L). These limitations can be overcome by combining these two processes for a cost-effective pharmaceutical removal. A three-step biological-ozone-biological (BO 3 B) treatment process was therefore designed for the enhanced pharmaceutical removal from wastewater effluent. The first biological step removed 38% of ozone scavenging TOC, thus proportionally reducing the absolute ozone input for the subsequent ozonation. Complementariness between biological and ozone treatment, i.e. targeting different pharmaceuticals, resulted in cost-effective pharmaceutical removal by the overall BO 3 B process. At a low ozone dose of 0.2 g O 3 /g TOC and an HRT of 1.46 h in the biological reactors, the removal of 8 out of 9 pharmaceuticals exceeded 85%, except for metoprolol (60%). Testing various ozone doses and HRTs revealed that pharmaceuticals were ineffectively removed at 0.1 g O3/g TOC and an HRT of 0.3 h. At HRTs of 0.47 and 1.46 h easily and moderately biodegradable pharmaceuticals such as caffeine, gemfibrozil, ibuprofen, naproxen and sulfamethoxazole were over 95% removed by biological treatment. The biorecalcitrant carbamazepine was completely ozonated at a dose of 0.4 g O 3 /g TOC. Ozonation products are likely biodegraded in the last biological reactor as a 17% TOC removal was found. No appreciable acute toxicity towards D. magna, P. subcapitata and V. fischeri was found after exposure to the influents and effluents of the individual BO 3 B reactors. The BO 3 B process is estimated to increase the yearly wastewater treatment tariff per population equivalent in the Netherlands by less than 10%. Overall, the BO 3 B process is a cost-effective treatment process for the removal of pharmaceuticals from secondary clarified effluents. Copyright

  8. Spatial patterns of pharmaceuticals and wastewater tracers in the Hudson River Estuary.

    Science.gov (United States)

    Cantwell, Mark G; Katz, David R; Sullivan, Julia C; Shapley, Daniel; Lipscomb, John; Epstein, Jennifer; Juhl, Andrew R; Knudson, Carol; O'Mullan, Gregory D

    2018-06-15

    The widespread use of pharmaceuticals by human populations results in their sustained discharge to surface waters via wastewater treatment plants (WWTPs). In this study, 16 highly prescribed pharmaceuticals were quantified along a 250 km transect of the Hudson River Estuary and New York Harbor to describe their sources and spatial patterns. Sampling was conducted over two dry weather periods in May and July 2016, at 72 sites which included mid-channel and nearshore sites, as well as locations influenced by tributaries and WWTP outfalls. The detection frequency of the study pharmaceuticals was almost identical between the May and July sampling periods at 55% and 52%, respectively. Six pharmaceuticals were measurable at 92% or more of the sites during both sampling periods, illustrating their ubiquitous presence throughout the study area. Individual pharmaceutical concentrations were highly variable spatially, ranging from non-detect to 3810 ng/L during the study. Major factors controlling concentrations were proximity and magnitude of WWTP discharges, inputs from tributaries and tidal mixing. Two compounds, sucralose and caffeine, were evaluated as tracers to identify wastewater sources and assess pharmaceutical behavior. Sucralose was useful in identifying wastewater inputs to the river and concentrations showed excellent correlations with numerous pharmaceuticals in the study. Caffeine-sucralose ratios showed potential in identifying discharges of untreated wastewater occurring during a combined sewage overflow event. Many of the study pharmaceuticals were present throughout the Hudson River Estuary as a consequence of sustained wastewater discharge. Whereas some concentrations were above published effects levels, a more complete risk assessment is needed to understand the potential for ecological impacts due to pharmaceuticals in the Hudson River Estuary. Published by Elsevier Ltd.

  9. Evidence to practice: treatment of anxiety in individuals with autism spectrum disorders

    OpenAIRE

    Russell Lang; Richard Mahoney; Farah El Zein; et al

    2011-01-01

    Russell Lang, Richard Mahoney, Farah El Zein, Elizabeth Delaune, Megan AmidonTexas State University-San Marcos, TX, USADate of preparation: 23rd December 2010 Conflict of interest: None declaredClinical question: What treatment improves social interactions and reduces reports of anxiety symptoms in individuals with autism spectrum disorders (ASD) and a co-occurring anxiety disorder? Results: Systematic reviews and randomized clinical trials suggest that cognitive behavior therapy in tandem wi...

  10. Transport and transformation of pharmaceuticals and other contaminants of emerging concern from wastewater discharge through surface water to drinking water intake and treatment

    Science.gov (United States)

    The ubiquitous presence of pharmaceuticals, hormones, and other contaminants of emerging concern (CECs) in surface-water resources have necessitated research that better elucidates pathways of transport and transformation for these compounds from their discharged wastewater, thro...

  11. Actor modelling and its contribution to the development of integrative strategies for management of pharmaceuticals in drinking water.

    Science.gov (United States)

    Titz, Alexandra; Döll, Petra

    2009-02-01

    Widespread presence of human pharmaceuticals in water resources across the globe is documented. While some, but certainly not enough, research on the occurrence, fate and effect of pharmaceuticals in water resources has been carried out, a holistic risk management strategy is missing. The transdisciplinary research project "start" aimed to develop an integrative strategy by the participation of experts representing key actors in the problem field "pharmaceuticals in drinking water". In this paper, we describe a novel modelling method, actor modelling with the semi-quantitative software DANA (Dynamic Actor Network Analysis), and its application in support of identifying an integrative risk management strategy. Based on the individual perceptions of different actors, the approach allows the identification of optimal strategies. Actors' perceptions were elicited by participatory model building and interviews, and were then modelled in perception graphs. Actor modelling indicated that an integrative strategy that targets environmentally-responsible prescription, therapy, and disposal of pharmaceuticals on one hand, and the development of environmentally-friendly pharmaceuticals on the other hand, will likely be most effective for reducing the occurrence of pharmaceuticals in drinking water (at least in Germany where the study was performed). However, unlike most other actors, the pharmaceutical industry itself does not perceive that the production of environmentally-friendly pharmaceuticals is an action that helps to achieve its goals, but contends that continued development of highly active pharmaceutical ingredients will help to reduce the occurrence of pharmaceuticals in the water cycle. Investment in advanced waste or drinking water treatment is opposed by both the wastewater treatment company and the drinking water supplier, and is not mentioned as appropriate by the other actors. According to our experience, actor modelling is a useful method to suggest effective

  12. Deliverable navigation for multicriteria IMRT treatment planning by combining shared and individual apertures

    International Nuclear Information System (INIS)

    Fredriksson, Albin; Bokrantz, Rasmus

    2013-01-01

    We consider the problem of deliverable Pareto surface navigation for step-and-shoot intensity-modulated radiation therapy. This problem amounts to calculation of a collection of treatment plans with the property that convex combinations of plans are directly deliverable. Previous methods for deliverable navigation impose restrictions on the number of apertures of the individual plans, or require that all treatment plans have identical apertures. We introduce simultaneous direct step-and-shoot optimization of multiple plans subject to constraints that some of the apertures must be identical across all plans. This method generalizes previous methods for deliverable navigation to allow for treatment plans with some apertures from a collective pool and some apertures that are individual. The method can also be used as a post-processing step to previous methods for deliverable navigation in order to improve upon their plans. By applying the method to subsets of plans in the collection representing the Pareto set, we show how it can enable convergence toward the unrestricted (non-navigable) Pareto set where all apertures are individual. (paper)

  13. Surgery as an Adjunctive Treatment for Multidrug-Resistant Tuberculosis: An Individual Patient Data Metaanalysis.

    Science.gov (United States)

    Fox, Gregory J; Mitnick, Carole D; Benedetti, Andrea; Chan, Edward D; Becerra, Mercedes; Chiang, Chen-Yuan; Keshavjee, Salmaan; Koh, Won-Jung; Shiraishi, Yuji; Viiklepp, Piret; Yim, Jae-Joon; Pasvol, Geoffrey; Robert, Jerome; Shim, Tae Sun; Shin, Sonya S; Menzies, Dick; Ahuja, S; Ashkin, D; Avendaño, M; Banerjee, R; Bauer, M; Burgos, M; Centis, R; Cobelens, F; Cox, H; D'Ambrosio, L; de Lange, W C M; DeRiemer, K; Enarson, D; Falzon, D; Flanagan, K; Flood, J; Gandhi, N; Garcia-Garcia, L; Granich, R M; Hollm-Delgado, M G; Holtz, T H; Hopewell, P; Iseman, M; Jarlsberg, L G; Kim, H R; Lancaster, J; Lange, C; Leimane, V; Leung, C C; Li, J; Menzies, D; Migliori, G B; Narita, M; Nathanson, E; Odendaal, R; O'Riordan, P; Pai, M; Palmero, D; Park, S K; Pena, J; Pérez-Guzmán, C; Ponce-de-Leon, A; Quelapio, M I D; Quy, H T; Riekstina, V; Royce, S; Salim, M; Schaaf, H S; Seung, K J; Shah, L; Shean, K; Sifuentes-Osornio, J; Sotgiu, G; Strand, M J; Sung, S W; Tabarsi, P; Tupasi, T E; Vargas, M H; van Altena, R; van der Walt, M; van der Werf, T S; Westenhouse, J; Yew, W W

    2016-04-01

    Medical treatment for multidrug-resistant (MDR)-tuberculosis is complex, toxic, and associated with poor outcomes. Surgical lung resection may be used as an adjunct to medical therapy, with the intent of reducing bacterial burden and improving cure rates. We conducted an individual patient data metaanalysis to evaluate the effectiveness of surgery as adjunctive therapy for MDR-tuberculosis. Individual patient data, was obtained from the authors of 26 cohort studies, identified from 3 systematic reviews of MDR-tuberculosis treatment. Data included the clinical characteristics and medical and surgical therapy of each patient. Primary analyses compared treatment success (cure and completion) to a combined outcome of failure, relapse, or death. The effects of all forms of resection surgery, pneumonectomy, and partial lung resection were evaluated. A total of 4238 patients from 18 surgical studies and 2193 patients from 8 nonsurgical studies were included. Pulmonary resection surgery was performed on 478 patients. Partial lung resection surgery was associated with improved treatment success (adjusted odds ratio [aOR], 3.0; 95% confidence interval [CI], 1.5-5.9; I(2)R, 11.8%), but pneumonectomy was not (aOR, 1.1; 95% CI, .6-2.3; I(2)R, 13.2%). Treatment success was more likely when surgery was performed after culture conversion than before conversion (aOR, 2.6; 95% CI, 0.9-7.1; I(2)R, 0.2%). Partial lung resection, but not pneumonectomy, was associated with improved treatment success among patients with MDR-tuberculosis. Although improved outcomes may reflect patient selection, partial lung resection surgery after culture conversion may improve treatment outcomes in patients who receive optimal medical therapy. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  14. Disparities in the treatment and outcomes of lung cancer among HIV-infected individuals

    Science.gov (United States)

    Suneja, Gita; Shiels, Meredith S.; Melville, Sharon K.; Williams, Melanie A.; Rengan, Ramesh; Engels, Eric A.

    2013-01-01

    Objectives HIV-infected people have elevated risk for lung cancer and higher mortality following cancer diagnosis than HIV-uninfected individuals. It is unclear whether HIV-infected individuals with lung cancer receive similar cancer treatment as HIV-uninfected individuals. Design/methods We studied adults more than 18 years of age with lung cancer reported to the Texas Cancer Registry (N = 156 930) from 1995 to 2009. HIV status was determined by linkage with the Texas enhanced HIV/AIDS Reporting System. For nonsmall cell lung cancer (NSCLC) cases, we identified predictors of cancer treatment using logistic regression. We used Cox regression to evaluate effects of HIV and cancer treatment on mortality. Results Compared with HIV-uninfected lung cancer patients (N = 156 593), HIV-infected lung cancer patients (N = 337) were more frequently young, black, men, and with non-Hispanic distant stage disease. HIV-infected NSCLC patients less frequently received cancer treatment than HIV-uninfected patients [60.3 vs. 77.5%; odds ratio 0.39, 95% confidence interval (CI) 0.30–0.52, after adjustment for diagnosis year, age, sex, race, stage, and histologic subtype]. HIV infection was associated with higher lung cancer-specific mortality (hazard ratio 1.34, 95% CI 1.15–1.56, adjusted for demographics and tumor characteristics). Inclusion of cancer treatment in adjusted models slightly attenuated the effect of HIV on lung cancer-specific mortality (hazard ratio 1.25; 95% CI 1.06–1.47). Also, there was a suggestion that HIV was more strongly associated with mortality among untreated than among treated patients (adjusted hazard ratio 1.32 vs. 1.16, P-interaction = 0.34). Conclusion HIV-infected NSCLC patients were less frequently treated for lung cancer than HIV-uninfected patients, which may have affected survival. PMID:23079809

  15. Optimal chemotherapy for leukemia: a model-based strategy for individualized treatment.

    Directory of Open Access Journals (Sweden)

    Devaraj Jayachandran

    Full Text Available Acute Lymphoblastic Leukemia, commonly known as ALL, is a predominant form of cancer during childhood. With the advent of modern healthcare support, the 5-year survival rate has been impressive in the recent past. However, long-term ALL survivors embattle several treatment-related medical and socio-economic complications due to excessive and inordinate chemotherapy doses received during treatment. In this work, we present a model-based approach to personalize 6-Mercaptopurine (6-MP treatment for childhood ALL with a provision for incorporating the pharmacogenomic variations among patients. Semi-mechanistic mathematical models were developed and validated for i 6-MP metabolism, ii red blood cell mean corpuscular volume (MCV dynamics, a surrogate marker for treatment efficacy, and iii leukopenia, a major side-effect. With the constraint of getting limited data from clinics, a global sensitivity analysis based model reduction technique was employed to reduce the parameter space arising from semi-mechanistic models. The reduced, sensitive parameters were used to individualize the average patient model to a specific patient so as to minimize the model uncertainty. Models fit the data well and mimic diverse behavior observed among patients with minimum parameters. The model was validated with real patient data obtained from literature and Riley Hospital for Children in Indianapolis. Patient models were used to optimize the dose for an individual patient through nonlinear model predictive control. The implementation of our approach in clinical practice is realizable with routinely measured complete blood counts (CBC and a few additional metabolite measurements. The proposed approach promises to achieve model-based individualized treatment to a specific patient, as opposed to a standard-dose-for-all, and to prescribe an optimal dose for a desired outcome with minimum side-effects.

  16. Effectiveness of individualized, integrative outpatient treatment for females with anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Freudenberg, Cara; Jones, Rebecca A; Livingston, Genvieve; Goetsch, Virginia; Schaffner, Angela; Buchanan, Linda

    2016-01-01

    The effectiveness of an individualized outpatient program was investigated in the treatment of bulimia nervosa (BN) and anorexia nervosa (AN). Participants included 151 females who received outpatient eating disorder treatment in the partial hospitalization program, the intensive outpatient program, or a combination of the two programs. Outcome measures included the Eating Disorder Inventory (EDI-2), Beck Depression Inventory (BDI-II), frequency of binge eating and purging, and mean body weight. Findings included significant increases in weight for the AN group, reductions in binge eating frequency for the BN group, and reductions in EDI-2 and BDI-II scores and purging frequency for both groups. This study provides preliminary support for the efficacy of a multimodal program for the treatment of both anorexia nervosa and bulimia nervosa.

  17. Continuous-flow photocatalytic treatment of pharmaceutical micropollutants: Activity, inhibition, and deactivation of TiO2 photocatalysts in wastewater effluent

    KAUST Repository

    Carbonaro, Sean

    2013-01-01

    Titanium dioxide (TiO2) photocatalysts have been shown to be effective at degrading a wide range of organic micropollutants during short-term batch experiments conducted under ideal laboratory solution conditions (e.g., deionized water). However, little research has been performed regarding longer-term photocatalyst performance in more complex matrices representative of contaminated water sources (e.g., wastewater effluent, groundwater). Here, a benchtop continuous-flow reactor was developed for the purpose of studying the activity, inhibition, and deactivation of immobilized TiO2 photocatalysts during water treatment applications. As a demonstration, degradation of four pharmaceutical micropollutants (iopromide, acetaminophen, sulfamethoxazole, and carbamazepine) was monitored in both a pH-buffered electrolyte solution and a biologically treated wastewater effluent (WWE) to study the effects of non-target constituents enriched in the latter matrix. Reactor performance was shown to be stable over 7d when treating micropollutants in buffered electrolyte, with 7-d averaged kobs values (acetaminophen=0.97±0.10h-1; carbamazepine=0.50±0.04h-1; iopromide=0.49±0.03h-1; sulfamethoxazole=0.79±0.06h-1) agreeing closely with measurements from short-term circulating batch reactions. When reactor influent was switched to WWE, treatment efficiencies decreased to varying degrees (acetaminophen=40% decrease; carbamazepine=60%; iopromide=78%; sulfamethoxazole=54%). A large fraction of the catalyst activity was recovered upon switching back to the buffered electrolyte influent after 4d, suggesting that much of the observed decrease resulted from reversible inhibition by non-target constituents (e.g., scavenging of photocatalyst-generated OH). However, there was also a portion of the decrease in activity that was not recovered, indicating WWE constituents also contributed to photocatalyst deactivation (acetaminophen=6% deactivation; carbamazepine=24%; iopromide=16

  18. Cross-sex hormonal treatment and body uneasiness in individuals with gender dysphoria.

    Science.gov (United States)

    Fisher, Alessandra D; Castellini, Giovanni; Bandini, Elisa; Casale, Helen; Fanni, Egidia; Benni, Laura; Ferruccio, Naika; Meriggiola, Maria Cristina; Manieri, Chiara; Gualerzi, Anna; Jannini, Emmanuele; Oppo, Alessandro; Ricca, Valdo; Maggi, Mario; Rellini, Alessandra H

    2014-03-01

    Cross-sex hormonal treatment (CHT) used for gender dysphoria (GD) could by itself affect well-being without the use of genital surgery; however, to date, there is a paucity of studies investigating the effects of CHT alone. This study aimed to assess differences in body uneasiness and psychiatric symptoms between GD clients taking CHT and those not taking hormones (no CHT). A second aim was to assess whether length of CHT treatment and daily dose provided an explanation for levels of body uneasiness and psychiatric symptoms. A consecutive series of 125 subjects meeting the criteria for GD who not had genital reassignment surgery were considered. Subjects were asked to complete the Body Uneasiness Test (BUT) to explore different areas of body-related psychopathology and the Symptom Checklist-90 Revised (SCL-90-R) to measure psychological state. In addition, data on daily hormone dose and length of hormonal treatment (androgens, estrogens, and/or antiandrogens) were collected through an analysis of medical records. Among the male-to-female (MtF) individuals, those using CHT reported less body uneasiness compared with individuals in the no-CHT group. No significant differences were observed between CHT and no-CHT groups in the female-to-male (FtM) sample. Also, no significant differences in SCL score were observed with regard to gender (MtF vs. FtM), hormone treatment (CHT vs. no-CHT), or the interaction of these two variables. Moreover, a two-step hierarchical regression showed that cumulative dose of estradiol (daily dose of estradiol times days of treatment) and cumulative dose of androgen blockers (daily dose of androgen blockers times days of treatment) predicted BUT score even after controlling for age, gender role, cosmetic surgery, and BMI. The differences observed between MtF and FtM individuals suggest that body-related uneasiness associated with GD may be effectively diminished with the administration of CHT even without the use of genital surgery for Mt

  19. Predicting Retrograde Autobiographical Memory Changes Following Electroconvulsive Therapy: Relationships between Individual, Treatment, and Early Clinical Factors.

    Science.gov (United States)

    Martin, Donel M; Gálvez, Verònica; Loo, Colleen K

    2015-06-19

    Loss of personal memories experienced prior to receiving electroconvulsive therapy is common and distressing and in some patients can persist for many months following treatment. Improved understanding of the relationships between individual patient factors, electroconvulsive therapy treatment factors, and clinical indicators measured early in the electroconvulsive therapy course may help clinicians minimize these side effects through better management of the electroconvulsive therapy treatment approach. In this study we examined the associations between the above factors for predicting retrograde autobiographical memory changes following electroconvulsive therapy. Seventy-four depressed participants with major depressive disorder were administered electroconvulsive therapy 3 times per week using either a right unilateral or bitemporal electrode placement and brief or ultrabrief pulse width. Verbal fluency and retrograde autobiographical memory (assessed using the Columbia Autobiographical Memory Interview - Short Form) were tested at baseline and after the last electroconvulsive therapy treatment. Time to reorientation was measured immediately following the third and sixth electroconvulsive therapy treatments. Results confirmed the utility of measuring time to reorientation early during the electroconvulsive therapy treatment course as a predictor of greater retrograde amnesia and the importance of assessing baseline cognitive status for identifying patients at greater risk for developing later side effects. With increased number of electroconvulsive therapy treatments, older age was associated with increased time to reorientation. Consistency of verbal fluency performance was moderately correlated with change in Columbia Autobiographical Memory Interview - Short Form scores following right unilateral electroconvulsive therapy. Electroconvulsive therapy treatment techniques associated with lesser cognitive side effects should be particularly considered for

  20. Evidence to practice: treatment of anxiety in individuals with autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Russell Lang

    2011-01-01

    Full Text Available Russell Lang, Richard Mahoney, Farah El Zein, Elizabeth Delaune, Megan AmidonTexas State University-San Marcos, TX, USADate of preparation: 23rd December 2010 Conflict of interest: None declaredClinical question: What treatment improves social interactions and reduces reports of anxiety symptoms in individuals with autism spectrum disorders (ASD and a co-occurring anxiety disorder? Results: Systematic reviews and randomized clinical trials suggest that cognitive behavior therapy in tandem with direct instruction of social skills using applied behavior analysis intervention components may be effective for treating anxiety in individuals with high functioning ASD. For individuals with ASD, an anxiety disorder, and an intellectual disability, systematic desensitization may be effective.Implementation: Intervention should emphasize teaching social skills. Reinforcers (ie, rewards based upon the client's interests should be used to encourage participation in therapy. Treatment should incorporate visual aides and family involvement. Intervention components involving abstract concepts, visualization, and discussions of emotions are less useful given difficulties in abstract reasoning and communication inherent to ASD.Keywords: autism, ASD, Asperger's, anxiety, cognitive behavior therapy, applied behavior analysis

  1. Individual negative symptoms and domains - Relevance for assessment, pathomechanisms and treatment.

    Science.gov (United States)

    Kaiser, Stefan; Lyne, John; Agartz, Ingrid; Clarke, Mary; Mørch-Johnsen, Lynn; Faerden, Ann

    2017-08-01

    The negative symptoms of schizophrenia can be divided into two domains. Avolition/apathy includes the individual symptoms of avolition, asociality and anhedonia. Diminished expression includes blunted affect and alogia. Until now, causes and treatment of negative symptoms have remained a major challenge, which is partially related to the focus on negative symptoms as a broad entity. Here, we propose that negative symptoms may become more tractable when the different domains and individual symptoms are taken into account. There is now increasing evidence that the relationship with clinical variables - in particular outcome - differs between the domains of avolition/apathy and diminished expression. Regarding models of negative symptom formation, those relevant to avolition/apathy are now converging on processes underlying goal-directed behavior and dysfunctions of the reward system. In contrast, models of the diminished expression domains are only beginning to emerge. The aim of this article is to review the specific clinical, behavioral and neural correlates of individual symptoms and domains as a better understanding of these areas may facilitate specific treatment approaches. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Meta-STEPP: subpopulation treatment effect pattern plot for individual patient data meta-analysis.

    Science.gov (United States)

    Wang, Xin Victoria; Cole, Bernard; Bonetti, Marco; Gelber, Richard D

    2016-09-20

    We have developed a method, called Meta-STEPP (subpopulation treatment effect pattern plot for meta-analysis), to explore treatment effect heterogeneity across covariate values in the meta-analysis setting for time-to-event data when the covariate of interest is continuous. Meta-STEPP forms overlapping subpopulations from individual patient data containing similar numbers of events with increasing covariate values, estimates subpopulation treatment effects using standard fixed-effects meta-analysis methodology, displays the estimated subpopulation treatment effect as a function of the covariate values, and provides a statistical test to detect possibly complex treatment-covariate interactions. Simulation studies show that this test has adequate type-I error rate recovery as well as power when reasonable window sizes are chosen. When applied to eight breast cancer trials, Meta-STEPP suggests that chemotherapy is less effective for tumors with high estrogen receptor expression compared with those with low expression. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Markers of anthropogenic contamination: A validated method for quantification of pharmaceuticals, illicit drug metabolites, perfluorinated compounds, and plasticisers in sewage treatment effluent and rain runoff.

    Science.gov (United States)

    Wilkinson, John L; Swinden, Julian; Hooda, Peter S; Barker, James; Barton, Stephen

    2016-09-01

    An effective, specific and accurate method is presented for the quantification of 13 markers of anthropogenic contaminants in water using solid phase extraction (SPE) followed by high performance liquid chromatography (HPLC) tandem mass spectrometry (MS/MS). Validation was conducted according to the International Conference on Harmonisation (ICH) guidelines. Method recoveries ranged from 77 to 114% and limits of quantification between 0.75 and 4.91 ng/L. A study was undertaken to quantify the concentrations and loadings of the selected contaminants in 6 sewage treatment works (STW) effluent discharges as well as concentrations in 5 rain-driven street runoffs and field drainages. Detection frequencies in STW effluent ranged from 25% (ethinylestradiol) to 100% (benzoylecgonine, bisphenol-A (BPA), bisphenol-S (BPS) and diclofenac). Average concentrations of detected compounds in STW effluents ranged from 3.62 ng/L (ethinylestradiol) to 210 ng/L (BPA). Levels of perfluorinated compounds (PFCs) perfluorooctanoic acid (PFOA) and perfluorononanoic acid (PFNA) as well as the plasticiser BPA were found in street runoff at maximum levels of 1160 ng/L, 647 ng/L and 2405 ng/L respectively (8.52, 3.09 and 2.7 times more concentrated than maximum levels in STW effluents respectively). Rain-driven street runoff may have an effect on levels of PFCs and plasticisers in receiving rivers and should be further investigated. Together, this method with the 13 selected contaminants enables the quantification of various markers of anthropogenic pollutants: inter alia pharmaceuticals, illicit drugs and their metabolites from humans and improper disposal of drugs, while the plasticisers and perfluorinated compounds may also indicate contamination from industrial and transport activity (street runoff). Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Part-time sick leave as a treatment method for individuals with musculoskeletal disorders.

    Science.gov (United States)

    Andrén, Daniela; Svensson, Mikael

    2012-09-01

    There is increasing evidence that staying active is an important part of a recovery process for individuals on sick leave due to musculoskeletal disorders (MSDs). It has been suggested that using part-time sick-leave rather than full-time sick leave will enhance the possibility of full recovery to the workforce, and several countries actively favor this policy. The aim of this paper is to examine if it is beneficial for individuals on sick leave due to MSDs to be on part-time sick leave compared to full-time sick leave. A sample of 1,170 employees from the RFV-LS (register) database of the Social Insurance Agency of Sweden is used. The effect of being on part-time sick leave compared to full-time sick leave is estimated for the probability of returning to work with full recovery of lost work capacity. A two-stage recursive bivariate probit model is used to deal with the endogeneity problem. The results indicate that employees assigned to part-time sick leave do recover to full work capacity with a higher probability than those assigned to full-time sick leave. The average treatment effect of part-time sick leave is 25 percentage points. Considering that part-time sick leave may also be less expensive than assigning individuals to full-time sick leave, this would imply efficiency improvements from assigning individuals, when possible, to part-time sick leave.

  5. Understanding the role of individual consumer-provider relationships within assertive community treatment.

    Science.gov (United States)

    Stanhope, Victoria; Matejkowski, Jason

    2010-08-01

    The widespread adoption of assertive community treatment has resulted in a shift from an individual model to a team model of case management. The shift has had implications for individual relationships between case managers and consumers, but still little is known about how these relationships develop in teams. This exploratory mixed methods study looked at how case managers and consumers negotiate individual relationships within a team model. Quantitative methods identified high and low service intensity relationships between consumers and case managers and qualitative methods explored and compared these relationships. Consumers in high service intensity relationships described a preference for certain case managers and the burden of working with multiple people. Case managers invested high service intensity relationships with special therapeutic value, articulated the challenges of coordinating care across the team, and utilized team limit setting techniques. In contrast, low service intensity relationships were more likely to reflect integration with the entire team. Findings suggest that teams need to consider how individual relationships enhance care for their consumers and how to nurture these relationships while maintaining the support necessary for case managers and consumers.

  6. Association between community pharmacy loyalty and persistence and implementation of antipsychotic treatment among individuals with schizophrenia.

    Science.gov (United States)

    Zongo, Frank E; Moisan, Jocelyne; Grégoire, Jean-Pierre; Lesage, Alain; Dossa, Anara Richi; Lauzier, Sophie

    2018-01-01

    Non-adherence is a major obstacle to optimal treatment of schizophrenia. Community pharmacists are in a key position to detect non-adherence and put in place interventions. Their role is likely to be more efficient when individuals are loyal to a single pharmacy. To assess the association between the level of community pharmacy loyalty and persistence with and implementation of antipsychotic drug treatment among individuals with schizophrenia. A cohort study using databases from the Quebec health insurance board (Canada) was conducted among new antipsychotic users insured by Quebec's public drug plan. Level of community pharmacy loyalty was assessed as the number of pharmacies visited in the year after antipsychotics initiation. Persistence was defined as having an antipsychotic supply in the user's possession on the 730 th day after its initiation and implementation as having antipsychotics in the user's possession for ≥80% of the days in the second year after antipsychotics initiation (among persistent only). Generalized linear models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (95%CI). 6,251 individuals were included in the cohort and 54.1% had their drug prescriptions filled in >1 pharmacy. When compared to those who had their prescriptions filled in a single pharmacy, those who had their prescriptions filled in ≥4 different pharmacies were 22% more likely to be non-persistent (aPR = 1.22; 95%CI = 1.10-1.37) and 49% more likely to have an antipsychotic for loyalty in the context of severe mental illness indicates that this healthcare organisation factor might be associated with antipsychotics persistence and implementation. Identification of individuals with low community pharmacy loyalty and initiatives to optimize community pharmacy loyalty could contribute to enhanced persistence and implementation. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Skin care education and individual counselling versus treatment as usual in healthcare workers with hand eczema

    DEFF Research Database (Denmark)

    Ibler, K.S.; Jemec, G.B.E.; Thomsen, S.F.

    2012-01-01

    Objective: To evaluate the effect of a secondary prevention programme with education on skin care and individual counselling versus treatment as usual in healthcare workers with hand eczema. Design: Randomised, observer blinded parallel group superiority clinical trial. Setting: Three hospitals...... in Denmark. Participants: 255 healthcare workers with self reported hand eczema within the past year randomised centrally and stratified by profession, severity of eczema, and hospital. 123 were allocated to the intervention group and 132 to the control group. Interventions: Education in skin care...

  8. Random forests of interaction trees for estimating individualized treatment effects in randomized trials.

    Science.gov (United States)

    Su, Xiaogang; Peña, Annette T; Liu, Lei; Levine, Richard A

    2018-04-29

    Assessing heterogeneous treatment effects is a growing interest in advancing precision medicine. Individualized treatment effects (ITEs) play a critical role in such an endeavor. Concerning experimental data collected from randomized trials, we put forward a method, termed random forests of interaction trees (RFIT), for estimating ITE on the basis of interaction trees. To this end, we propose a smooth sigmoid surrogate method, as an alternative to greedy search, to speed up tree construction. The RFIT outperforms the "separate regression" approach in estimating ITE. Furthermore, standard errors for the estimated ITE via RFIT are obtained with the infinitesimal jackknife method. We assess and illustrate the use of RFIT via both simulation and the analysis of data from an acupuncture headache trial. Copyright © 2018 John Wiley & Sons, Ltd.

  9. Does brand differentiate pharmaceuticals?

    Science.gov (United States)

    Bednarik, Josef

    2005-12-01

    Role of marketing in pharmaceutical industry is increasing and inspiration by successful brands known from consumer goods market influenced pharmaceutical companies enough to switch their attention to branding initiatives. Still there is little evidence that pharmaceutical brands represent anything more than product only. This study aims to explore the area of branding in pharmaceutical industry. Central hypothesis of the research has been that brand and its emotional content differentiate pharmaceuticals as well as rational data derived from clinical studies. It has been tested by extensive review of available literature as well as by primary research focused on drivers of physicians' attitudes towards products and their influence on prescribing behavior. The research has been conducted in the sample of psychiatrists in the Czech Republic. No evidence about pharmaceutical brand exceeding value of product has been found in reviewed literature. Nevertheless, the primary research conducted in the sample of Czech psychiatrists indicates that emotional brand in pharmaceutical industry exists and enables author to draw a model of Customer/product life cycle that describes likely impact of functional, emotional and self-expressive benefits throughout pharmaceutical product's market presence. Pharmaceutical brand is likely to develop differently than the same of consumer goods products--it seems to be built predominantly on long-term positive experience. Marketing role in this process should lie in finding relevant product position and building brand identity compliant with real product capabilities.

  10. Early Nonresponse in the Antipsychotic Treatment of Acute Mania: A Criterion for Reconsidering Treatment? Results From an Individual Patient Data Meta-Analysis.

    Science.gov (United States)

    Welten, Carlijn C M; Koeter, Maarten W J; Wohlfarth, Tamar D; Storosum, Jitschak G; van den Brink, Wim; Gispen-de Wied, Christine C; Leufkens, Hubert G M; Denys, Damiaan A J P

    2016-09-01

    To investigate whether early nonresponse to antipsychotic treatment of acute mania predicts treatment failure and, if so, to establish the best definition or criterion of an early nonresponse. Short-term efficacy studies assessing antipsychotics that were submitted to the Dutch Medicines Evaluation Board during an 11-year period as part of the marketing authorization application for the indication of acute manic episode of bipolar disorder. Pharmaceutical companies provided their raw patient data, which enabled us to perform an individual patient data meta-analysis. All double-blind, randomized, placebo-controlled trials assessing the efficacy of antipsychotics for acute manic episode of bipolar disorder were included (10 trials). All patients with data available for completer analysis (N = 1,243), symptom severity scores on the Young Mania Rating Scale (YMRS) at weeks 0, 1, and 2 and at study end point (week 3 or 4). The a priori chances of nonresponse and nonremission at study end point were 40.9% (95% CI, 38.2%-43.6%) and 65.3% (95% CI, 62.0%-68.6%), respectively. Early nonresponse in weeks 1 and 2, defined by cutoff scores ranging from a ≤ 10% to a ≤ 50% reduction in symptoms compared to baseline on the YMRS, significantly predicted nonresponse (≤ 0% symptom reduction) and nonremission (YMRS score higher than 8) in week 3. The predictive value of early nonresponse (PVnr_se) at week 1 for both nonresponse and nonremission at study end point declined linearly with increasing cutoff scores of early nonresponse; nonresponse: 76.0% (95% CI, 69.7%-82.3%) for a ≤ 10% response to 48.7% (95% CI, 45.5%-51.9%) for a ≤ 50% response; nonremission: 92.2% (95% CI, 88.3%-96.1%) for a ≤ 10% response to 76.8% (95% CI, 74.4%-79.5%) for a ≤ 50% response. A similar linear decline was observed for increasing cutoff scores of early nonresponse at week 2 for nonresponse, but not for nonremission at end point: nonresponse 90.3% (95% CI, 84.6%-96.0%) for a ≤ 10% response

  11. Pharmaceutical manufacturing facility discharges can substantially increase the pharmaceutical load to U.S. wastewaters

    Science.gov (United States)

    Scott, Tia-Marie; Phillips, Patrick J.; Kolpin, Dana W.; Colella, Kaitlyn M.; Furlong, Edward T.; Foreman, William T.; Gray, James L.

    2018-01-01

    Discharges from pharmaceutical manufacturing facilities (PMFs) previously have been identified as important sources of pharmaceuticals to the environment. Yet few studies are available to establish the influence of PMFs on the pharmaceutical source contribution to wastewater treatment plants (WWTPs) and waterways at the national scale. Consequently, a national network of 13 WWTPs receiving PMF discharges, six WWTPs with no PMF input, and one WWTP that transitioned through a PMF closure were selected from across the United States to assess the influence of PMF inputs on pharmaceutical loading to WWTPs. Effluent samples were analyzed for 120 pharmaceuticals and pharmaceutical degradates. Of these, 33 pharmaceuticals had concentrations substantially higher in PMF-influenced effluent (maximum 555,000 ng/L) compared to effluent from control sites (maximum 175 ng/L). Concentrations in WWTP receiving PMF input are variable, as discharges from PMFs are episodic, indicating that production activities can vary substantially over relatively short (several months) periods and have the potential to rapidly transition to other pharmaceutical products. Results show that PMFs are an important, national-scale source of pharmaceuticals to the environment.

  12. Individual treatment of hotel and restaurant waste water in rural areas.

    Science.gov (United States)

    Van Hulle, S W H; Ghyselbrecht, N; Vermeiren, T J L; Depuydt, V; Boeckaert, C

    2012-01-01

    About 25 hotels, restaurants and pubs in the rural community Heuvelland are situated in the area designated for individual water treatment. In order to meet the legislation by the end of 2015, each business needs to install an individual waste water treatment system (IWTS). To study this situation, three catering businesses were selected for further research. The aim of the study was to quantify the effluent quality and to assess IWTS performance for these catering businesses. First of all, the influence of discharging untreated waste water on the receiving surface water was examined. The results showed a decrease in water quality after the discharge point at every business. With the collected data, simulations with the software WEST were performed. With this software two types of IWTSs with different (buffer) volumes were modelled and tested for each catering business. The first type is a completely mixed activated sludge reactor and the second type is a submerged aerobic fixed-bed reactor. The results of these simulations demonstrate that purification with an IWTS is possible if the capacity is large enough and if an adequate buffer volume is installed and if regular maintenance is performed.

  13. Drugs in Your Drinking Water: Removing Pharmaceutical Pollution

    Science.gov (United States)

    Richardson, K.

    2017-12-01

    Pharmaceuticals, mostly estrogen-based hormones and antibiotics, are increasingly polluting waterways and contaminating municipal drinking water sources. A 2008 study funded by the American Water Works Association Research Foundation and the WateReuse Foundation tested 19 drinking water treatment plants across the United States. The study found pharmaceuticals and metabolites at all of the locations tested. These plants provide drinking water for over 28 million Americans - yet only five states test for pharmaceuticals. A 2007 US Government Accountability Office study of male smallmouth bass showed ovarian tissue in their gonads and concluded the combination of EDCs (Endocrine Disrupting Chemicals) likely caused the feminization of the male fish. The purpose of this project is to determine whether bivalves can effectively remove pharmaceuticals as well as other CECs (Contaminants of Emerging Concern).Pharmaceuticals, specifically ibuprofen, were found to be resistant to chemical and mechanical filtration methods, such as coffee grounds and activated carbon, so biological filtration methods are used. Three types of common mollusks (Sphaeriidae `fingernail clams', freshwater mussels, scallops) will be used to assess the potential for biological remediation of the chemical pollutants. Fifteen specimens of each species will be used - a total of 45 individuals. Each group of five will be introduced to either an NSAID (ibuprofen), oil (vegetable) or hormone (estrogen, pending approval). This creates an array of 3 species and 3 contaminants, for a 3x3 grid of nine sample groups. Water is contaminated with pollutant levels similar to EPA measurements. The concentration will be measured before and after the introduction of the specimens using a UV spectrophotometer, at regular time intervals. As mollusks are capable of filtering up to two liters of water a day, the 37.8 liter tanks are filtered at a rate of 10 liters a day. A successful trial of bivalves reducing and

  14. Organic Wastewater Compounds, Pharmaceuticals, andColiphage in Ground Water Receiving Discharge from OnsiteWastewater Treatment Systems near La Pine, Oregon:Occurrence and Implications for Transport

    Science.gov (United States)

    Hinkle, Stephen J.; Weick, Rodney J.; Johnson, Jill M.; Cahill, Jeffery D.; Smith, Steven G.; Rich, Barbara J.

    2005-01-01

    The occurrence of organic wastewater compounds (components of 'personal care products' and other common household chemicals), pharmaceuticals (human prescription and nonprescription medical drugs), and coliphage (viruses that infect coliform bacteria, and found in high concentrations in municipal wastewater) in onsite wastewater (septic tank effluent) and in a shallow, unconfined, sandy aquifer that serves as the primary source of drinking water for most residents near La Pine, Oregon, was documented. Samples from two types of observation networks provided basic occurrence data for onsite wastewater and downgradient ground water. One observation network was a group of 28 traditional and innovative (advanced treatment) onsite wastewater treatment systems and associated downgradient drainfield monitoring wells, referred to as the 'innovative systems network'. The drainfield monitoring wells were located adjacent to or under onsite wastewater treatment system drainfield lines. Another observation network, termed the 'transect network', consisted of 31 wells distributed among three transects of temporary, stainless-steel-screened, direct-push monitoring wells installed along three plumes of onsite wastewater. The transect network, by virtue of its design, also provided a basis for increased understanding of the transport of analytes in natural systems. Coliphage were frequently detected in onsite wastewater. Coliphage concentrations in onsite wastewater were highly variable, ranging from less than 1 to 3,000,000 plaque forming units per 100 milliliters. Coliphage were occasionally detected (eight occurrences) at low concentrations in samples from wells located downgradient from onsite wastewater treatment system drainfield lines. However, coliphage concentrations were below method detection limits in replicate or repeat samples collected from the eight sites. The consistent absence of coliphage detections in the replicate or repeat samples is interpreted to indicate

  15. Bothersome Tics in Patients with Chronic Tic Disorders: Characteristics and Individualized Treatment Response to Behavior Therapy

    Science.gov (United States)

    McGuire, Joseph F.; Piacentini, John; Scahill, Lawrence; Woods, Douglas W.; Villarreal, Robert; Wilhelm, Sabine; Walkup, John T.; Peterson, Alan L.

    2015-01-01

    This report examined the most frequently reported bothersome tics among individuals with chronic tic disorders and evaluated the improvement and remission of tics and their associated characteristics. Youths and adults (N = 240) were randomly assigned to receive the comprehensive behavioral intervention for tics (CBIT) or psychoeducation and supportive therapy (PST). At baseline, motor tics and tics with an urge were rated as more bothersome relative to vocal tics and tics without premonitory urges. The five most common bothersome tics included eye blinking, head jerks, sniffing, throat clearing, and other complex motor tics. While CBIT outperformed PST across tic type and urge presence, tics preceded by premonitory urges at baseline had higher severity at posttreatment across treatment condition. Six individual tic types had lower severity at posttreatment following CBIT relative to PST. Baseline urge presence was associated with tic remission for CBIT but not PST. Specific bothersome tics were more likely to remit with CBIT relative to PST. Findings suggest that individual tics respond and remit differently to CBIT relative to PST, with implications highlighting the negative reinforcement hypothesis in tic symptom maintenance. PMID:25988365

  16. Individualized rituximab treatment for relapsing neuromyelitis optica: a pediatric case report.

    Science.gov (United States)

    He, Dian; Yu, YunLi; Yan, WeiBo; Dai, QingQing; Xu, Zhu; Chu, Lan

    2014-08-01

    Neuromyelitis optica is an autoimmune inflammatory disorder of the central nervous system. Current therapeutic approaches are based on small uncontrolled trials, case series, or case reports. There are only a few case reports describing rituximab for pediatric neuromyelitis optica. A 7-year-old girl with neuromyelitis optica had high disease activity with recurrent myelitis and steroid dependence. A remarkable increase of CD19(+) B-cell count in the peripheral blood mononuclear cells and seropositivity for anti-aquaporin 4 antibody were detected at each attack. After induction therapy with rituximab, the CD19(+) B-cell number was significantly reduced and sustained at low levels. The level of serum anti-aquaporin 4 antibody normalized. She was relapse-free over 1-year follow-up period. An individualized maintenance therapy scheme is underway. Treatment with rituximab for relapsing neuromyelitis optica requires an individualized regimen to optimize the frequency and dosage of administration to maximize efficacy yet minimize overtreatment and cost. Personal levels of CD19(+) B cells in peripheral blood mononuclear cells at previous attacks and responsiveness to rituximab in induction therapy may be two useful indicators in establishing individualized maintenance therapy schemes for relapsing neuromyelitis optica. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Bothersome tics in patients with chronic tic disorders: Characteristics and individualized treatment response to behavior therapy.

    Science.gov (United States)

    McGuire, Joseph F; Piacentini, John; Scahill, Lawrence; Woods, Douglas W; Villarreal, Robert; Wilhelm, Sabine; Walkup, John T; Peterson, Alan L

    2015-07-01

    This report examined the most frequently reported bothersome tics among individuals with chronic tic disorders and evaluated the improvement and remission of tics and their associated characteristics. Youths and adults (N = 240) were randomly assigned to receive the comprehensive behavioral intervention for tics (CBIT) or psychoeducation and supportive therapy (PST). At baseline, motor tics and tics with an urge were rated as more bothersome relative to vocal tics and tics without premonitory urges. The five most common bothersome tics included eye blinking, head jerks, sniffing, throat clearing, and other complex motor tics. While CBIT outperformed PST across tic type and urge presence, tics preceded by premonitory urges at baseline had higher severity at posttreatment across treatment condition. Six individual tic types had lower severity at posttreatment following CBIT relative to PST. Baseline urge presence was associated with tic remission for CBIT but not PST. Specific bothersome tics were more likely to remit with CBIT relative to PST. Findings suggest that individual tics respond and remit differently to CBIT relative to PST, with implications highlighting the negative reinforcement hypothesis in tic symptom maintenance. CLINICALTRIALS. NCT00218777; NCT00231985. Published by Elsevier Ltd.

  18. Exploring the perceived usefulness of practical food groups in day treatment for individuals with eating disorders.

    Science.gov (United States)

    Biddiscombe, Rachel J; Scanlan, Justin Newton; Ross, Jessica; Horsfield, Sarah; Aradas, Jessica; Hart, Susan

    2018-04-01

    Recovery from eating disorders is a challenging process. Emerging literature suggests that occupational therapists may provide a useful contribution in delivering purposeful eating-related interventions as a potential treatment to support sustained cognitive and behavioural changes for individuals with eating disorders. This study aimed to evaluate participants' perceptions of the contribution of occupational therapy practical food groups (food based outings and cooking groups) in supporting their functional recovery. Individuals attended practical food groups as part of standard treatment at an outpatient eating disorders day program. Ninety-nine participants completed questionnaires at discharge and up to three follow-up points (6, 12 and 24 months). Questions related to practical food groups were analysed, exploring participants' experiences and perceived usefulness of groups using rating-scale and open-ended questions. Open-ended responses were analysed using thematic analysis. Descriptive statistics were calculated for responses to rating-scale questions. At discharge, participants rated the importance and usefulness of practical food groups as high (4.73 and 4.43 on 5-point scales, respectively), but tended to rate their enjoyment of the groups lower (3.50 on a 5-point scale). Some skill transfer was typically reported by participants at discharge (3.92 on a 5-point scale). One core theme, 'success through participation', emerged from qualitative comments. Six subthemes were also identified: helpful components of practical food groups; perceived benefit of exposure; impact of applying cognitive and behavioural skills; challenges affecting participation; facilitating adaptation; and influence of eating disorders on challenging feared foods. This study highlights that participation in practical food groups was perceived as useful in assisting individuals to improve eating behaviours and, in some circumstances, transfer these skills into their lives outside of

  19. Predictors of residential treatment retention among individuals with co-occurring substance abuse and mental health disorders.

    Science.gov (United States)

    Choi, Sam; Adams, Susie M; MacMaster, Samuel A; Seiters, John

    2013-01-01

    A significant number of individuals with co-occurring substance abuse and mental health disorders do not engage, stay, and/or complete residential treatment. The purpose of this study is to identify factors during the initial phase of treatment which predict retention in private residential treatment for individuals with co-occurring substance use and mental health disorders. The participants were 1,317 individuals with co-occurring substance abuse and mental health disorders receiving treatment at three residential treatment centers located in Memphis, TN, Malibu, CA, and Palm Springs, CA. Bivariate analysis and logistic regression were utilized to identify factors that predict treatment retention at 30 days. The findings indicate a variety of factors including age, gender, types of drug, Addiction Severity Index Medical and Psychiatric scores, and readiness to change. These identified factors could be incorporated into pretreatment assessments, so that programs can initiate preventive measures to decrease attrition and improve treatment outcomes.

  20. The behaviour of pharmaceuticals in anaerobic digester sludge

    OpenAIRE

    Campbell, Alison

    2013-01-01

    Pharmaceuticals are biologically active compounds that may be consumed in hundreds of tonnes per year, and which are excreted into municipal sewerage systems. Many pharmaceuticals persist during sewage treatment, and significant environmental risk has been linked to incomplete removal of pharmaceuticals. Evaluation of this risk is important and should be as representative as possible, taking into consideration all significant exposure routes and removal processes. Sludge treatment processes a...

  1. Satisfactory patient-based outcomes after surgical treatment for idiopathic clubfoot: includes surgeon's individualized technique.

    Science.gov (United States)

    Mahan, Susan T; Spencer, Samantha A; Kasser, James R

    2014-09-01

    Treatment of idiopathic clubfoot has shifted towards Ponseti technique, but previously surgical management was standard. Outcomes of surgery have varied, with many authors reporting discouraging results. Our purpose was to evaluate a single surgeon's series of children with idiopathic clubfoot treated with a la carte posteromedial and lateral releases using the Pediatric Outcomes Data Collection Instrument (PODCI) with a minimum of 2-year follow-up. A total of 148 patients with idiopathic clubfoot treated surgically by a single surgeon over 15 years were identified, and mailed PODCI questionnaires. Fifty percent of the patients were located and responded, resulting in 74 complete questionnaires. Median age at surgery was 10 months (range, 5.3 to 84.7 mo), male sex 53/74 (71.6%), bilateral surgery 31/74 (41.9%), and average follow-up of 9.7 years. PODCI responses were compared with previously published normal healthy controls using t test for each separate category. Included in the methods is the individual surgeon's operative technique. In PODCIs where a parent reports for their child or adolescent, there was no difference between our data and the healthy controls in any of the 5 categories. In PODCI where an adolescent self-reports, there was no difference in 4 of 5 categories; significant difference was only found between our data (mean = 95.2; SD = 7.427) and normal controls (mean = 86.3; SD = 12.5) in Happiness Scale (P = 0.0031). In this group of idiopathic clubfoot patients, treated with judicious posteromedial release by a single surgeon, primarily when surgery was treatment of choice for clubfoot, patient-based outcomes are not different from their normal healthy peers through childhood and adolescence. While Ponseti treatment has since become the treatment of choice for clubfoot, surgical treatment, in some hands, has led to satisfactory results. Level III.

  2. Motivational assessment of non-treatment buprenorphine research participation in heroin dependent individuals.

    Science.gov (United States)

    Papke, Gina; Greenwald, Mark K

    2012-06-01

    Heroin abuse remains an important public health problem, particularly in economically disadvantaged areas. Insight into this problem is gained from interviewing addicted individuals. However, we lack systematic data on factors that motivate heroin users to participate in non-treatment research that offers both financial incentives (compensation) and non-financial incentives (e.g., short-term medication). To better understand the relative importance of several types of personal motivations to participate in non-treatment buprenorphine research, and to relate self-motivations to social, economic, demographic and drug use factors. Heroin dependent volunteers (N=235 total; 57 female and 178 male; 136 African American, 86 Caucasian, and 13 Other) applied for non-therapeutic buprenorphine research in an urban outpatient setting from 2004 to 2008. We conducted a semi-structured behavioral economic interview, after which participants ranked 11 possible motivations for research participation. Although the study was repeatedly described as non-treatment research involving buprenorphine, participants often ranked some treatment-related motivations as important (wanting to reduce/stop heroin use, needing a medication to get stabilized/detoxify). Some motivations correlated with income, heroin use, and years since marketing of buprenorphine. Two dimensions emerged from principal component analysis of motivation rankings: (1) treatment motivation vs. greater immediate needs and (2) commitment to trying alternatives vs. a more accepting attitude toward traditional interventions. In summary, heroin addicts' self-motivations to engage in non-therapeutic research are complex--they value economic gain but not exclusively or primarily--and relate to variables such as socioeconomic factors and drug use. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  3. Advanced-stage III/IV follicular lymphoma. Treatment strategies for individual patients

    Energy Technology Data Exchange (ETDEWEB)

    Heinzelmann, Frank; Bamberg, Michael; Weinmann, Martin [Dept. of Radiation Oncology, Univ. of Tuebingen (Germany); Ottinger, Hellmut [Dept. of Bone Marrow Transplantation, Univ. of Essen (Germany); Engelhard, Marianne [Dept. of Radiation Oncology, Univ. of Essen (Germany); Soekler, Martin [Dept. of Internal Medicine II, Univ. of Tuebingen (Germany)

    2010-05-15

    Background: in patients with advanced-stage III/IV follicular lymphoma (FL), there are many treatment options available. The current challenge is to choose the optimal strategy for the individual patient. Methods: the literature was reviewed with respect to treatment strategies in patients with advanced FL by screening the PubMed databank. Results: in advanced-stage III/IV FL, median survival may approach 8-10 years. Treatment strategies include a watch-and-wait strategy, chemoimmunotherapy, monotherapy with rituximab, and - as an experimental approach so far - radioimmunotherapy. The use of autologous hematopoietic stem cell transplantation (HSCT) for patients in first remission or chemosensitive relapse prolongs progression-free survival while the effect on overall survival remains unclear compared to standard chemotherapy. However, long-term results are flawed by high relapse rates and risk of secondary malignancies. In patients with relapsed/chemoresistant disease, allogeneic HSCT constitutes the only curative approach but is associated with high treatment-related mortality. In the palliative setting, low-dose involved-field irradiation constitutes an effective treatment option in order to control local symptoms with potential long-lasting response. Conclusion: in case of advanced-disease FL, asymptomatic patients can be managed expectantly. In symptomatic patients, chemoimmunotherapy is regarded as standard therapy. In symptomatic elderly patients with relevant comorbidities, rituximab {+-} single-agent chemotherapy, or low-dose involved-field radiotherapy might be appropriate. For younger patients with chemoresistant/relapsed disease, allogeneic HSCT might be considered, since advances in supportive care and better patient selection have resulted in improved outcomes. (orig.)

  4. The relationship of gender and gender identity to treatment adherence among individuals with bipolar disorder.

    Science.gov (United States)

    Sajatovic, Martha; Micula-Gondek, Weronika; Tatsuoka, Curtis; Bialko, Christopher

    2011-08-01

    It has been demonstrated that 46% to 48% of individuals with bipolar disorder (BD) are at least partially nonadherent with prescribed medication. Reports of whether male gender is a predictor of treatment nonadherence in BD have been inconsistent. The construct of gender may also be a matter of cultural orientation, and psychological gender, as a component of self-perception, may affect the experience of mental illness. Gender identity is the subjective experience of one's individuality as male or female. This cross-sectional study evaluated gender and gender identity among men and women with BD as they relate to self-reported medication treatment adherence. This secondary analysis of a larger study on treatment adherence evaluated men and women with BD being treated with mood-stabilizing medications in a community mental health clinic. Gender identity and treatment adherence were evaluated using the Bem Sex Role Inventory (BSRI) and the Tablets Routine Questionnaire, respectively. Other measures included assessing BD symptoms using the Hamilton Depression Rating Scale and mania symptoms using the Young Mania Rating Scale, as well as psychosocial support with the Interpersonal Support Evaluation List and locus of control with the Multidimensional Health Locus of Control Scale. Mean age of the 70 men and 70 women with type I BD was 43.1 years for adherent patients and 40.8 years for nonadherent patients. Women with BD had mean scores on the BSRI consistent with general population norms, whereas men with BD had scores suggesting lower levels of self-perceived masculinity than population norms. There were no differences between men and women on adherence; however, men with high BSRI masculinity scores had less adherence than other men in the sample (P = 0.04). Lower scores on the "powerful others" dimension of locus of control were associated with lower adherence. For women, there was no relationship between BSRI masculinity scores and adherence. Gender identity in

  5. Availability of and access to orphan drugs: an international comparison of pharmaceutical treatments for pulmonary arterial hypertension, Fabry disease, hereditary angioedema and chronic myeloid leukaemia.

    Science.gov (United States)

    Blankart, Carl Rudolf; Stargardt, Tom; Schreyögg, Jonas

    2011-01-01

    Market authorization does not guarantee patient access to any given drug. This is particularly true for costly orphan drugs because access depends primarily on co-payments, reimbursement policies and prices. The objective of this article is to identify differences in the availability of orphan drugs and in patient access to them in 11 pharmaceutical markets: Australia, Canada, England, France, Germany, Hungary, the Netherlands, Poland, Slovakia, Switzerland and the US. Four rare diseases were selected for analysis: pulmonary arterial hypertension (PAH), Fabry disease (FD), hereditary angioedema (HAE) and chronic myeloid leukaemia (CML). Indicators for availability were defined as (i) the indications for which orphan drugs had been authorized in the treatment of these diseases; (ii) the application date; and (iii) the date upon which these drugs received market authorization in each country. Indicators of patient access were defined as (i) the outcomes of technology appraisals; (ii) the extent of coverage provided by healthcare payers; and (iii) the price of the drugs in each country. For PAH we analysed bosentan, iloprost, sildenafil, treprostinil (intravenous and inhaled) as well as sitaxentan and ambrisentan; for FD we analysed agalsidase alfa and agalsidase beta; for HAE we analysed icatibant, ecallantide and two complement C1s inhibitors; for CML we analysed imatinib, dasatinib and nilotinib. Most drugs included in this study had received market authorization in all countries, but the range of indications for which they had been authorized differed by country. The broadest range of indications was found in Australia, and the largest variations in indications were found for PAH drugs. Authorization process speed (the time between application and market authorization) was fastest in the US, with an average of 362 days, followed by the EU (394 days). The highest prices for the included drugs were found in Germany and the US, and the lowest in Canada, Australia and

  6. Structural redundancy of data from wastewater treatment systems. Determination of individual balance equations.

    Science.gov (United States)

    Spindler, A

    2014-06-15

    Although data reconciliation is intensely applied in process engineering, almost none of its powerful methods are employed for validation of operational data from wastewater treatment plants. This is partly due to some prerequisites that are difficult to meet including steady state, known variances of process variables and absence of gross errors. However, an algorithm can be derived from the classical approaches to data reconciliation that allows to find a comprehensive set of equations describing redundancy in the data when measured and unmeasured variables (flows and concentrations) are defined. This is a precondition for methods of data validation based on individual mass balances such as CUSUM charts. The procedure can also be applied to verify the necessity of existing or additional measurements with respect to the improvement of the data's redundancy. Results are given for a large wastewater treatment plant. The introduction aims at establishing a link between methods known from data reconciliation in process engineering and their application in wastewater treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Pharmaceutical marketing research and the prescribing physician.

    Science.gov (United States)

    Greene, Jeremy A

    2007-05-15

    Surveillance of physicians' prescribing patterns and the accumulation and sale of these data for pharmaceutical marketing are currently the subjects of legislation in several states and action by state and national medical associations. Contrary to common perception, the growth of the health care information organization industry has not been limited to the past decade but has been building slowly over the past 50 years, beginning in the 1940s when growth in the prescription drug market fueled industry interest in understanding and influencing prescribing patterns. The development of this surveillance system was not simply imposed on the medical profession by the pharmaceutical industry but was developed through the interactions of pharmaceutical salesmen, pharmaceutical marketers, academic researchers, individual physicians, and physician organizations. Examination of the role of physicians and physician organizations in the development of prescriber profiling is directly relevant to the contemporary policy debate surrounding this issue.

  8. Development of antibiotic resistance genes in microbial communities during long-term operation of anaerobic reactors in the treatment of pharmaceutical wastewater.

    Science.gov (United States)

    Aydin, Sevcan; Ince, Bahar; Ince, Orhan

    2015-10-15

    Biological treatment processes offer the ideal conditions in which a high diversity of microorganisms can grow and develop. The wastewater produced during these processes is contaminated with antibiotics and, as such, they provide the ideal setting for the acquisition and proliferation of antibiotic resistance genes (ARGs). This research investigated the occurrence and variation in the ARGs found during the one-year operation of the anaerobic sequencing batch reactors (SBRs) used to treat pharmaceutical wastewater that contained combinations of sulfamethoxazole-tetracycline-erythromycin (STE) and sulfamethoxazole-tetracycline (ST). The existence of eighteen ARGs encoding resistance to sulfamethoxazole (sul1, sul2, sul3), erythromycin (ermA, ermF, ermB, msrA, ereA), tetracycline (tetA, tetB, tetC, tetD, tetE, tetM, tetS, tetQ, tetW, tetX) and class Ι integron gene (intΙ 1) in the STE and ST reactors was investigated by quantitative real-time PCR. Due to the limited availability of primers to detect ARGs, Illumina sequencing was also performed on the sludge and effluent of the STE and ST reactors. Although there was good reactor performance in the SBRs, which corresponds to min 80% COD removal efficiency, tetA, tetB, sul1, sul2 and ermB genes were among those ARGs detected in the effluent from STE and ST reactors. A comparison of the ARGs acquired from the STE and ST reactors revealed that the effluent from the STE reactor had a higher number of ARGs than that from the ST reactor; this could be due to the synergistic effects of erythromycin. According to the expression of genes results, microorganisms achieve tetracycline and erythromycin resistance through a combination of three mechanisms: efflux pumping protein, modification of the antibiotic target and modifying enzymes. There was also a significant association between the presence of the class 1 integron and sulfamethoxazole resistance genes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Influence of Psychiatric and Personality Disorders on Smoking Cessation Among Individuals in Opiate Dependence Treatment.

    Science.gov (United States)

    Cooperman, Nina A; Lu, Shou-En; Richter, Kimber P; Bernstein, Steven L; Williams, Jill M

    2016-01-01

    attempt or not (C-statistic of .79, 95% CI [0.70, 0.88]). Compared to existing treatments, smoking cessation treatments that can be tailored to address the individual needs of people with specific psychiatric disorders or personality disorder traits may better help those in opiate dependence treatment to set a cessation goal, attempt to quit, and eventually quit smoking.

  10. Influence of Psychiatric and Personality Disorders on Smoking Cessation among Individuals in Opiate Dependence Treatment

    Science.gov (United States)

    Cooperman, Nina A.; Lu, Shou-En; Richter, Kimber P.; Bernstein, Steven L.; Williams, Jill M.

    2016-01-01

    .85]) and ever making a quit attempt or not (C-statistic of .79, 95% CI[0.70, 0.88]). Conclusions Compared to existing treatments, smoking cessation treatments that can be tailored to address the individual needs of people with specific psychiatric disorders or personality disorder traits may better help those in opiate dependence treatment to set a cessation goal, attempt to quit, and eventually quit smoking. PMID:27064523

  11. Review on Physicochemical, Chemical, and Biological Processes for Pharmaceutical Wastewater

    Science.gov (United States)

    Li, Zhenchen; Yang, Ping

    2018-02-01

    Due to the needs of human life and health, pharmaceutical industry has made great progress in recent years, but it has also brought about severe environmental problems. The presence of pharmaceuticals in natural waters which might pose potential harm to the ecosystems and humans raised increasing concern worldwide. Pharmaceuticals cannot be effectively removed by conventional wastewater treatment plants (WWTPs) owing to the complex composition, high concentration of organic contaminants, high salinity and biological toxicity of pharmaceutical wastewater. Therefore, the development of efficient methods is needed to improve the removal effect of pharmaceuticals. This review provides an overview on three types of treatment technologies including physicochemical, chemical and biological processes and their advantages and disadvantages respectively. In addition, the future perspectives of pharmaceutical wastewater treatment are given.

  12. Serological Response to Treatment of Syphilis with Doxycycline Compared with Penicillin in HIV-infected Individuals

    DEFF Research Database (Denmark)

    Salado-Rasmussen, Kirsten; Hoffmann, Steen; Cowan, Susan

    2016-01-01

    Serological response to treatment of syphilis with orally administered doxycycline or intramuscularly administered penicillin was assessed in patients with concurrent HIV. All HIV-infected individuals diagnosed with syphilis attending 3 hospitals in Copenhagen, Denmark were included. Odds ratios...... (ORs) with 95% confidence intervals (CI) associated with serological outcome were modelled using propensity-score-adjusted logistic regression analysis. In total, 202 cases were treated with doxycycline or intramuscular penicillin. At 12 months, serological failure was observed in 12 cases (15......%) treated with doxycycline and in 8 cases (17%) treated with penicillin (OR 0.78 (95% CI 0.16-3.88), p = 0.76). The serological cure rate at 12 months was highest in patients with primary syphilis (100%), followed by patients with secondary (89%), early latent (71%) and late latent (67%) syphilis (p = 0...

  13. Clinician identification of elevated symptoms of depression among individuals seeking treatment for substance misuse.

    Science.gov (United States)

    Hobden, Breanne; Carey, Mariko; Bryant, Jamie; Sanson-Fisher, Rob; Oldmeadow, Christopher

    2017-12-01

    Depression is common among those experiencing alcohol and other drug (AOD) disorders. It has been suggested that identifying depressive symptoms among this group is important for case management. Despite this, there is a lack of research examining how well clinicians perform this task within this setting. To determine the: (i) accuracy of clinician identified elevated symptoms of depression among clients seeking treatment for AOD misuse as compared to a standardized self-report psychiatric screening tool; and (ii) clinician and client characteristics associated with accurate identification of elevated symptoms of depression. The study used a descriptive cohort design. Participants from two Australian AOD outpatient clinics reported demographic data and completed the Patient Health Questionnaire (PHQ-9) to identify elevated symptoms of depression. Clinicians were asked to indicate the presence or absence of depression for individual clients. Client and clinician data were compared. Sensitivity of clinician identified elevated symptoms of depression, compared with the PHQ-9, was moderate at 73.0% (95% CI=63.7, 81.0) and specificity was low with 49.5% (95% CI=39.9, 61.2) accurately identified as not having elevated symptoms of depression. AOD clinicians' years' of experience, clients' main substance and length of treatment were associated with accuracy of identification. Clinicians identify elevated symptoms of depression with moderate accuracy amongst individuals with AOD disorders. There is a tendency to over-identify which may contribute to inaccuracies. Routine screening may assist in improving identification of depressive symptoms and place greater focus on mental health comorbidities. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  14. Pica and rumination behavior among individuals seeking treatment for eating disorders or obesity.

    Science.gov (United States)

    Delaney, Charlotte B; Eddy, Kamryn T; Hartmann, Andrea S; Becker, Anne E; Murray, Helen B; Thomas, Jennifer J

    2015-03-01

    Pica and rumination disorder (RD)-formerly classified within DSM-IV Feeding and Eating Disorders of Infancy or Early Childhood-are now classified within DSM-5 Feeding and Eating Disorders. Though pica and RD have been studied in select populations (e.g., pregnant women, intellectually disabled persons), their typical features and overall prevalence remain unknown. This study examined the clinical characteristics and frequency of DSM-5 pica and RD among individuals seeking treatment for eating disorders and obesity. We conducted structured interviews with adolescent and young adult females from a residential eating disorder center (N = 149), and adult males and females with overweight or obesity from an outpatient weight-loss clinic (N = 100). Several participants reported ingesting non-nutritive substances (e.g., ice) for weight-control purposes. However, only 1.3% (n = 2; 95% CI: .06% to 5.1%) at the residential eating disorder center and 0% at the weight-loss clinic met DSM-5 criteria for pica, consuming gum and plastic. Although no eating disorder participants were eligible for an RD diagnosis due to DSM-5 trumping rules, 7.4% (n = 11; 95% CI: 4.0% to 12.9%) endorsed rumination behavior under varying degrees of volitional control. At the weight-loss clinic, 2.0% (n = 2; 95% CI: 0.1% to 7.4%) had RD. DSM-5 pica and RD were rare in our sample of individuals seeking treatment for eating disorders and obesity, but related behaviors were more common. The wide range of pica and rumination presentations highlights the challenges of differential diagnosis with other forms of disordered eating. © 2014 Wiley Periodicals, Inc.

  15. Model-Based Individualized Treatment of Chemotherapeutics: Bayesian Population Modeling and Dose Optimization.

    Directory of Open Access Journals (Sweden)

    Devaraj Jayachandran

    Full Text Available 6-Mercaptopurine (6-MP is one of the key drugs in the treatment of many pediatric cancers, auto immune diseases and inflammatory bowel disease. 6-MP is a prodrug, converted to an active metabolite 6-thioguanine nucleotide (6-TGN through enzymatic reaction involving thiopurine methyltransferase (TPMT. Pharmacogenomic variation observed in the TPMT enzyme produces a significant variation in drug response among the patient population. Despite 6-MP's widespread use and observed variation in treatment response, efforts at quantitative optimization of dose regimens for individual patients are limited. In addition, research efforts devoted on pharmacogenomics to predict clinical responses are proving far from ideal. In this work, we present a Bayesian population modeling approach to develop a pharmacological model for 6-MP metabolism in humans. In the face of scarcity of data in clinical settings, a global sensitivity analysis based model reduction approach is used to minimize the parameter space. For accurate estimation of sensitive parameters, robust optimal experimental design based on D-optimality criteria was exploited. With the patient-specific model, a model predictive control algorithm is used to optimize the dose scheduling with the objective of maintaining the 6-TGN concentration within its therapeutic window. More importantly, for the first time, we show how the incorporation of information from different levels of biological chain-of response (i.e. gene expression-enzyme phenotype-drug phenotype plays a critical role in determining the uncertainty in predicting therapeutic target. The model and the control approach can be utilized in the clinical setting to individualize 6-MP dosing based on the patient's ability to metabolize the drug instead of the traditional standard-dose-for-all approach.

  16. Model-Based Individualized Treatment of Chemotherapeutics: Bayesian Population Modeling and Dose Optimization

    Science.gov (United States)

    Jayachandran, Devaraj; Laínez-Aguirre, José; Rundell, Ann; Vik, Terry; Hannemann, Robert; Reklaitis, Gintaras; Ramkrishna, Doraiswami

    2015-01-01

    6-Mercaptopurine (6-MP) is one of the key drugs in the treatment of many pediatric cancers, auto immune diseases and inflammatory bowel disease. 6-MP is a prodrug, converted to an active metabolite 6-thioguanine nucleotide (6-TGN) through enzymatic reaction involving thiopurine methyltransferase (TPMT). Pharmacogenomic variation observed in the TPMT enzyme produces a significant variation in drug response among the patient population. Despite 6-MP’s widespread use and observed variation in treatment response, efforts at quantitative optimization of dose regimens for individual patients are limited. In addition, research efforts devoted on pharmacogenomics to predict clinical responses are proving far from ideal. In this work, we present a Bayesian population modeling approach to develop a pharmacological model for 6-MP metabolism in humans. In the face of scarcity of data in clinical settings, a global sensitivity analysis based model reduction approach is used to minimize the parameter space. For accurate estimation of sensitive parameters, robust optimal experimental design based on D-optimality criteria was exploited. With the patient-specific model, a model predictive control algorithm is used to optimize the dose scheduling with the objective of maintaining the 6-TGN concentration within its therapeutic window. More importantly, for the first time, we show how the incorporation of information from different levels of biological chain-of response (i.e. gene expression-enzyme phenotype-drug phenotype) plays a critical role in determining the uncertainty in predicting therapeutic target. The model and the control approach can be utilized in the clinical setting to individualize 6-MP dosing based on the patient’s ability to metabolize the drug instead of the traditional standard-dose-for-all approach. PMID:26226448

  17. Maintaining Professional Relationships in an Interdisciplinary Setting: Strategies for Navigating Nonbehavioral Treatment Recommendations for Individuals with Autism.

    Science.gov (United States)

    Brodhead, Matthew T

    2015-05-01

    Due to an increase in research and clinical application of behavior analysis with individuals with autism spectrum disorder (ASD), one setting a Board Certified Behavior Analyst (BCBA) may work within is an interdisciplinary setting, where multiple disciplines collaborate to improve the outcomes of individuals with ASD. In some cases, nonbehavioral colleagues could recommend nonbehavioral treatments, setting the occasion for the BCBA to offer an alternative treatment to or question the nonbehavioral treatment. However, excessive questioning or critiques of nonbehavioral treatments by the BCBA may unintentionally erode professional relationships between the BCBA and their nonbehavioral colleagues. Because an erosion of professional relationships may occur when a BCBA questions a nonbehavioral treatment, a decision-making model for determining whether or not the proposed nonbehavioral treatment is worth addressing may be useful. The purpose of this paper is to outline such a decision-making model in order to assist the BCBA in assessing nonbehavioral treatments while maintaining an ethical balance between professional relationships and the well-being and safety of the individual with ASD. Such a model could assist the BCBA in becoming familiar with the proposed treatment, understanding the perspective of the nonbehavioral colleague and assessing the negative impacts the treatment could have on the individual with ASD. With this information, the BCBA will be in a better position to decide whether or not addressing the nonbehavioral treatment is worth the possibility of eroding a professional relationship.

  18. Technical progress, the concept of individualized cancer treatment and the innovation of computer-assisted radiotherapy planning

    International Nuclear Information System (INIS)

    Merkle, K.; Tanneberger, S.; Matschke, S.

    1985-01-01

    After a first step of cancerogenesis, the further development of the tumor is an individual process. At the end of this process the tumor is formed as an individual in the individual. The individuality of cancer exists on the level of organs, tissues and cells and includes an individual tumor-host relationship. Today, optimized cancer treatment requires a most precise biological characterization possible of the tumor and of the tumor-host relationship, which will provide objective information about the individual character of every tumor. Routine analysis and strict therapeutic consideration of the clinical and biological individuality of human cancer can offer real chances for the improvement of cancer treatment. A routine acquisition of individual tumor characteristics will be possible only if methods and equipment are available for the registration of suitable parameters. In this context technical innovations have an essential influence on the realization of the concept of individualized cancer treatment. With the method of flow cytophotometry and other techniques examples are given in how far the ideas of individual cancer management can be realized by introduction of new technical solutions into medical research and clinical practice. Unfortunately there is still a lack of methodology in individualizing cancer treatment. The individualization of radiotherapy is connected to an extremely high degree of technical innovations. Particularly this refers to the topometrical description of the target volume in relation to the adjacent anatomical structures and the body contour as well as the fitting of isodoses to the shape and size of the target volume. As an example of innovation of a technical solution for individual radiotherapy planning the computer-assisted radiotherapy planning system DOPSY is described. (author)

  19. A structural model of treatment program and individual counselor leadership in innovation transfer.

    Science.gov (United States)

    Joe, George W; Becan, Jennifer E; Knight, Danica K; Flynn, Patrick M

    2017-03-23

    A number of program-level and counselor-level factors are known to impact the adoption of treatment innovations. While program leadership is considered a primary factor, the importance of leadership among clinical staff to innovation transfer is less known. Objectives included explore (1) the influence of two leadership roles, program director and individual counselor, on recent training activity and (2) the relationship of counselor attributes on training endorsement. The sample included 301 clinical staff in 49 treatment programs. A structural equation model was evaluated for key hypothesized relationships between exogenous and endogenous variables related to the two leadership roles. The importance of organizational leadership, climate, and counselor attributes (particularly counseling innovation interest and influence) to recent training activity was supported. In a subset of 68 counselors who attended a developer-led training on a new intervention, it was found that training endorsement was higher among those with high innovation interest and influence. The findings suggest that each leadership level impacts the organization in different ways, yet both can promote or impede technology transfer.

  20. Assessing the population equivalent and performance of wastewater treatment through the ratios of pharmaceuticals and personal care products present in a river basin: Application to the River Thames basin, UK.

    Science.gov (United States)

    Nakada, Norihide; Hanamoto, Seiya; Jürgens, Monika D; Johnson, Andrew C; Bowes, Michael J; Tanaka, Hiroaki

    2017-01-01

    The quality of surface waters in lowland rivers is largely dependent on the efficiency of wastewater treatment. Even in the developed countries, there have been difficulties in evaluating the effectiveness of wastewater management and the proportion of wastewater content (WWC) in the river, as well as in estimating the contributing human population. This study aimed to develop a wastewater quality and quantity assessment based on the occurrence of pharmaceuticals in the receiving waters. A survey of 53 pharmaceuticals in 324 samples (river water and influent and effluent of sewage (wastewater) treatment plants) was carried out in southern England in the River Thames catchment over four years. Carbamazepine was selected as stable marker and from its concentration WWC in the rivers and cumulative human populations along the catchment were estimated. The estimated population had a strong relationship (R 2 =0.94) with that reported by the local water company. The concentration ratio of the labile marker caffeine to carbamazepine indicated the efficiency of wastewater treatment in the different treatment systems (i.e. trickling filter or activated sludge) and in the receiving waters. The ratio in some river samples revealed unexpected discharges of untreated or poorly treated wastewater, with a total concentration of the analytes (up to 20μg/L) five times higher than that in treated wastewater. Such information could be valuable to estimate the discharge or occurrence of not only non-targeted chemicals, but also pathogens within the basin. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Pharmaceutical cocrystals: an overview.

    Science.gov (United States)

    Qiao, Ning; Li, Mingzhong; Schlindwein, Walkiria; Malek, Nazneen; Davies, Angela; Trappitt, Gary

    2011-10-31

    Pharmaceutical cocrystals are emerging as a new class of solid drugs with improved physicochemical properties, which has attracted increased interests from both industrial and academic researchers. In this paper a brief and systematic overview of pharmaceutical cocrystals is provided, with particular focus on cocrystal design strategies, formation methods, physicochemical property studies, characterisation techniques, and recent theoretical developments in cocrystal screening and mechanisms of cocrystal formations. Examples of pharmaceutical cocrystals are also summarised in this paper. Copyright © 2011 Elsevier B.V. All rights reserved.

  2. Choice between delayed food and immediate opioids in rats: treatment effects and individual differences.

    Science.gov (United States)

    Panlilio, Leigh V; Secci, Maria E; Schindler, Charles W; Bradberry, Charles W

    2017-11-01

    Addiction involves maladaptive choice behavior in which immediate drug effects are valued more than delayed nondrug rewards. To model this behavior and extend our earlier work with the prescription opioid oxycodone, we allowed rats to choose between immediate intravenous delivery of the short-acting opioid remifentanil and delayed delivery of highly palatable food pellets. Treatment drugs were tested on a baseline where remifentanil was preferred over food. Treatment with a high dose of the opioid antagonist naltrexone decreased but did not reverse the preference for remifentanil. Treatment with the serotonin 5-HT 2C agonist lorcaserin decreased remifentanil and food self-administration nonselectively. Across conditions in which the alternative to delayed food was either a moderate dose of oxycodone, a moderate or high dose of remifentanil, a smaller more immediate delivery of food, or timeout with no primary reinforcement, choice was determined by both the length of the delay and the nature of the alternative option. Delayed food was discounted most steeply when the alternative was a high dose of remifentanil, which was preferred over food when food was delayed by 30 s or more. Within-subject comparisons showed no evidence for trait-like impulsivity or sensitivity to delay across these conditions. Choice was determined more by the current contingencies of reinforcement than by innate individual differences. This finding suggests that people might develop steep delay-discounting functions because of the contingencies in their environment, and it supports the use of contingency management to enhance the relative value of delayed nondrug reinforcers.

  3. Biricodar. Vertex Pharmaceuticals.

    Science.gov (United States)

    Dey, Saibal

    2002-05-01

    Vertex is developing biricodar as a chemosensitizing agent designed to restore the effectiveness of chemotherapeutic agents in tumor multidrug resistance. By November 1998, phase II trials had commenced for biricodar, in combination with chemotherapy, for five common cancer indications: breast, ovarian, soft-tissue sarcomas, small cell lung cancer and prostate cancer. Phase II trials were ongoing in January 2002. By March 2000, Vertex was the sole developer of biricodar, as an agreement made in 1996 with BioChem Pharma (now Shire Pharmaceuticals), for the development and marketing of biricodar in Canada was terminated. Biricodar is the free base compound, which also has a citrate salt analog known as VX-710-3. Vertex has published three patents, WO-09615101, WO-09636630 and WO-09736869, disclosing derivatives of biricodar that are claimed for the treatment of multidrug resistant protein and P-glycoprotein-mediated multidrug resistant tumors. In January 2002, a Banc of America analyst report forecast that biricodar had a 30% chance of reaching the market with a launch date in the second half of 2005, with peak sales estimated at $250 million.

  4. A meta-analysis of the effectiveness of individually oriented Cognitive Behavioral Treatment (CBT) for severe agressive behavior in adolescents

    NARCIS (Netherlands)

    Hoogsteder, L.M.; Stams, G.J.J.M.; Figge, M.A.; Changoe, K.; van Horn, J.E.; Hendriks, J.; Wissink, I.B.

    2015-01-01

    This meta-analysis, including six studies (13 effect sizes) and 164 adolescents, examined the effectiveness of individually oriented treatment (which means that the intervention contained at least an individual component, possibly in combination with group and/or family therapy) with CBT-elements

  5. Measuring the individual benefit of a medical or behavioral treatment using generalized linear mixed-effects models.

    Science.gov (United States)

    Diaz, Francisco J

    2016-10-15

    We propose statistical definitions of the individual benefit of a medical or behavioral treatment and of the severity of a chronic illness. These definitions are used to develop a graphical method that can be used by statisticians and clinicians in the data analysis of clinical trials from the perspective of personalized medicine. The method focuses on assessing and comparing individual effects of treatments rather than average effects and can be used with continuous and discrete responses, including dichotomous and count responses. The method is based on new developments in generalized linear mixed-effects models, which are introduced in this article. To illustrate, analyses of data from the Sequenced Treatment Alternatives to Relieve Depression clinical trial of sequences of treatments for depression and data from a clinical trial of respiratory treatments are presented. The estimation of individual benefits is also explained. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Development of a semi-quantitative risk assessment model for evaluating environmental threat posed by the three first EU watch-list pharmaceuticals to urban wastewater treatment plants: An Irish case study.

    Science.gov (United States)

    Tahar, Alexandre; Tiedeken, Erin Jo; Clifford, Eoghan; Cummins, Enda; Rowan, Neil

    2017-12-15

    Contamination of receiving waters with pharmaceutical compounds is of pressing concern. This constitutes the first study to report on the development of a semi-quantitative risk assessment (RA) model for evaluating the environmental threat posed by three EU watch list pharmaceutical compounds namely, diclofenac, 17-beta-estradiol and 17-alpha-ethinylestradiol, to aquatic ecosystems using Irish data as a case study. This RA model adopts the Irish Environmental Protection Agency Source-Pathway-Receptor concept to define relevant parameters for calculating low, medium or high risk score for each agglomeration of wastewater treatment plant (WWTP), which include catchment, treatments, operational and management factors. This RA model may potentially be used on a national scale to (i) identify WWTPs that pose a particular risk as regards releasing disproportionally high levels of these pharmaceutical compounds, and (ii) help identify priority locations for introducing or upgrading control measures (e.g. tertiary treatment, source reduction). To assess risks for these substances of emerging concern, the model was applied to 16 urban WWTPs located in different regions in Ireland that were scored for the three different compounds and ranked as low, medium or high risk. As a validation proxy, this case study used limited monitoring data recorded at some these plants receiving waters. It is envisaged that this semi-quantitative RA approach may aid other EU countries investigate and screen for potential risks where limited measured or predicted environmental pollutant concentrations and/or hydrological data are available. This model is semi-quantitative, as other factors such as influence of climate change and drug usage or prescription data will need to be considered in a future point for estimating and predicting risks. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Individual psychological therapy in the outpatient treatment of adults with anorexia nervosa.

    Science.gov (United States)

    Hay, Phillipa J; Claudino, Angélica M; Touyz, Stephen; Abd Elbaky, Ghada

    2015-07-27

    Anorexia nervosa is a disorder with high morbidity and significant mortality. It is most common in young adult women, in whom the incidence may be increasing. The focus of treatment has moved to an outpatient setting, and a number of differing psychological therapies are presently used in treatment. This is an update of a Cochrane review which was last published in 2008. To assess the effects of specific individual psychological therapies for anorexia nervosa in adults or older adolescents treated in an outpatient setting. We searched the Cochrane Depression, Anxiety and Neurosis Review Group Specialised Register (CCDANCTR) (16 July 2014). This register includes relevant randomised controlled trials from: the Cochrane Library (all years), MEDLINE (1950 to date), EMBASE (1974 to date), and PsycINFO (1967 to date). We screened reference lists of all included studies and sent letters to identified, notable researchers requesting information on unpublished or ongoing studies. All randomised controlled trials of one or more individual outpatient psychological therapies for adults with anorexia nervosa, as defined by DSM-5 or similar international criteria. We selected a range of outcome variables, including physical state, severity of eating disorder attitudes and beliefs, interpersonal function, and general psychiatric symptom severity. Continuous outcome data comparisons used the mean or standardised mean difference (MD or SMD), and binary outcome comparisons used the risk ratio (RR). Two review authors (PH and AC or ST) extracted data independently. We identified 10 trials from the search, with a total of 599 anorexia nervosa participants, and included them in the review. Seven had been identified in the previous versions of this review and we now include three new trials. We now deem one previously identified ongoing trial to be ineligible, and six ongoing trials are new for this update. Two of the 10 trials included children. Trials tested diverse psychological

  8. Addressing Social Anxiety Concurrently With Prison-Based Sex Offender Treatment: A Case of Individual Needs in an Era of Manualized Treatment.

    Science.gov (United States)

    Lasher, Michael P; Webb, Jon R; Stinson, Jill D; Cantrell, Peggy J

    2017-07-01

    Emotional regulation may be an underaddressed therapeutic target in sex offender treatment. This article presents a case report of "Adam," a Caucasian male referred to a prison-based sex offender treatment program. Adam's social anxiety was recognized as an antecendent to his sexual offending, and treatment of such, as a critical adjunct to sex offender treatment, is discussed herein. Adam's individualized treatment included aspects of rational emotive behavior therapy and time-limited dynamic psychotherapy. Adam showed an increased understanding of his anxiety and improvement in his social interactions, both in the context of treatment groups and with female staff, and was willing to continue follow-up care in the community. This case provides support for the individualized treatment of incarcerated offenders as opposed to exclusively utilizing manualized psychoeducational interventions.

  9. PHARMACEUTICALS AND PERSONAL CARE PRODUCTS ...

    Science.gov (United States)

    Modern sanitary practices result in large volumes of human waste, as well as domestic and industrial sewage, being collected and treated at common collection points, wastewater treatment plants (WWTP). In recognition of the growing use of sewage sludges as a fertilizers and as soilamendments, and the scarcity of current data regarding the chemical constituents in sewage sludges, the United States National Research Council (NRC) in 2002 produced a report on sewage sludges. Among the NRC's recommendations was the need for investigating the occurrence of pharmaceuticals and personal care products (PPCPs) in sewage sludges. PPCPsare a diverse array of non-regulated contaminants that had not been studied in previous sewage sludges surveys but which are likely to be present. The focus of this paper will be to review the current analytical methodologies available for investigating whether pharmaceuticals are present in WWTP-produced sewage sludges, to summarize current regulatory practices regarding sewage sludges, and to report on the presence of pharmaceuticals in sewage sludges. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subta

  10. Occurrence and potential transport of selected pharmaceuticals and other organic wastewater compounds from wastewater-treatment plant influent and effluent to groundwater and canal systems in Miami-Dade County, Florida

    Science.gov (United States)

    Foster, Adam L.; Katz, Brian G.; Meyer, Michael T.

    2012-01-01

    An increased demand for fresh groundwater resources in South Florida has prompted Miami-Dade County to expand its water reclamation program and actively pursue reuse plans for aquifer recharge, irrigation, and wetland rehydration. The U.S. Geological Survey, in cooperation with the Miami-Dade Water and Sewer Department (WASD) and the Miami-Dade Department of Environmental Resources Management (DERM), initiated a study in 2008 to assess the presence of selected pharmaceuticals and other organic wastewater compounds in the influent and effluent at three regional wastewater-treatment plants (WWTPs) operated by the WASD and at one WWTP operated by the City of Homestead, Florida (HSWWTP).

  11. EU pharmaceutical expenditure forecast

    OpenAIRE

    Urbinati, Duccio; Rémuzat, Cécile; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher

    2014-01-01

    Background and Objectives: With constant incentives for healthcare payers to contain their pharmaceutical budgets, forecasting has become critically important. Some countries have, for instance, developed pharmaceutical horizon scanning units. The objective of this project was to build a model to assess the net effect of the entrance of new patented medicinal products versus medicinal products going off-patent, with a defined forecast horizon, on selected European Union (EU) Member States’ ph...

  12. Parental cancer: Characteristics of users of child-centred counselling versus individual psycho-oncological treatment.

    Science.gov (United States)

    Inhestern, Laura; Geertz, Wiebke; Schulz-Kindermann, Frank; Bergelt, Corinna

    2018-03-01

    The aims of this study were to investigate the characteristics of users of a specific child-centred counselling service (COSIP) and to compare those to parents using an individual psycho-oncological treatment (PO). We conducted a retrospective analysis on data of users of COSIP and users of PO. Database was the routine assessment (demographic and disease-related characteristics, GAD-7, PHQ-9, EORTC QLQ-C30, and current concerns) of an outpatient psycho-oncological clinic with additional child-centred counselling. A total of 151 patients and 49 partners with children ≤21 years were included. We conducted descriptive analyses and group comparisons. Fifty-nine patients and partners used COSIP only or additionally to individual psycho-oncological service. PO users were more depressed and were more anxious than COSIP users. Patients using PO reported worse emotional functioning than patients using COSIP. Partners using PO reported worse global quality of life and more symptoms of fatigue than partners using COSIP. With regard to current concerns, patients using COSIP reported child-related issues more frequently than PO users. PO users reported symptoms of anxiety, depressive symptoms, or exhaustion more frequently than COSIP users. The findings demonstrate that patients and partners self-referring to PO or COSIP are highly burdened. COSIP users experience different psychosocial burden than PO users. As poor mental state of parents is a risk factor for the development of mental problems in children, parents using only PO may benefit from additional child-centred support. Accordingly, the need for COSIP should be assessed continuously during PO of patients with children ≤21 years. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Individualized Selection of Beam Angles and Treatment Isocenter in Tangential Breast Intensity Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Penninkhof, Joan, E-mail: j.penninkhof@erasmusmc.nl [Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands); Spadola, Sara [Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands); Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna (Italy); Breedveld, Sebastiaan; Baaijens, Margreet [Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands); Lanconelli, Nico [Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna (Italy); Heijmen, Ben [Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands)

    2017-06-01

    Purpose and Objective: Propose a novel method for individualized selection of beam angles and treatment isocenter in tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: For each patient, beam and isocenter selection starts with the fully automatic generation of a large database of IMRT plans (up to 847 in this study); each of these plans belongs to a unique combination of isocenter position, lateral beam angle, and medial beam angle. The imposed hard planning constraint on patient maximum dose may result in plans with unacceptable target dose delivery. Such plans are excluded from further analyses. Owing to differences in beam setup, database plans differ in mean doses to organs at risk (OARs). These mean doses are used to construct 2-dimensional graphs, showing relationships between: (1) contralateral breast dose and ipsilateral lung dose; and (2) contralateral breast dose and heart dose (analyzed only for left-sided). The graphs can be used for selection of the isocenter and beam angles with the optimal, patient-specific tradeoffs between the mean OAR doses. For 30 previously treated patients (15 left-sided and 15 right-sided tumors), graphs were generated considering only the clinically applied isocenter with 121 tangential beam angle pairs. For 20 of the 30 patients, 6 alternative isocenters were also investigated. Results: Computation time for automatic generation of 121 IMRT plans took on average 30 minutes. The generated graphs demonstrated large variations in tradeoffs between conflicting OAR objectives, depending on beam angles and patient anatomy. For patients with isocenter optimization, 847 IMRT plans were considered. Adding isocenter position optimization next to beam angle optimization had a small impact on the final plan quality. Conclusion: A method is proposed for individualized selection of beam angles in tangential breast IMRT. This may be especially important for patients with cardiac risk factors or an

  14. Removal of Pharmaceuticals from Wastewater by Intermittent Electrocoagulation

    Directory of Open Access Journals (Sweden)

    Benny Marie B. Ensano

    2017-01-01

    Full Text Available The continuous release of emerging contaminants (ECs in the aquatic environment, as a result of the inadequate removal by conventional treatment methods, has prompted research to explore viable solutions to this rising global problem. One promising alternative is the use of electrochemical processes since they represent a simple and highly efficient technology with less footprint. In this paper, the feasibility of treating ECs (i.e., pharmaceuticals using an intermittent electrocoagulation process, a known electrochemical technology, has been investigated. Diclofenac (DCF, carbamazepine (CBZ and amoxicillin (AMX were chosen as being representative of highly consumed drugs that are frequently detected in our water resources and were added in synthetic municipal wastewater. The removal efficiencies of both individual and combined pharmaceuticals were determined under different experimental conditions: hydraulic retention time (HRT (6, 19 and 38 h, initial concentration (0.01, 4 and 10 mg/L and intermittent application (5 min ON/20 min OFF of current density (0.5, 1.15 and 1.8 mA/cm2. Results have shown that these parameters have significant effects on pharmaceutical degradation. Maximum removals (DCF = 90%, CBZ = 70% and AMX = 77% were obtained at a current density of 0.5 mA/cm2, an initial concentration of 10 mg/L and HRT of 38 h.

  15. Immunological changes in human immunodeficiency virus (HIV)-infected individuals during HIV-specific protease inhibitor treatment

    DEFF Research Database (Denmark)

    Ullum, H; Katzenstein, T; Aladdin, H

    1999-01-01

    The present study examines the influence of effective anti-retroviral treatment on immune function, evaluated by a broad array of immunological tests. We followed 12 individuals infected with human immunodeficiency virus (HIV) for 6 months after initiation of combination anti-retroviral treatment...

  16. Attitudes and preferences towards exercise training in individuals with alcohol use disorders in a residential treatment setting.

    Science.gov (United States)

    Stoutenberg, Mark; Warne, James; Vidot, Denise; Jimenez, Erika; Read, Jennifer P

    2015-02-01

    Alcohol use disorders (AUD) are a major public health concern due to their association with several acute and chronic health conditions. Exercise training offers a myriad of physical and mental health benefits, and may be a promising adjunct intervention for those in AUD treatment. The purpose of this study was to explore the possible role of exercise training as a treatment strategy by examining the attitudes, beliefs, and preferences of individuals entering residential AUD treatment. Surveys were administered to eligible individuals with AUD within 2days of intake to one of two residential treatment centers. The survey asked respondents about their attitudes, beliefs, and preferences towards exercise training as a part of their residential treatment. Respondents were in favor of receiving exercise counseling as part of their treatment (70.6%), in a face-to-face format (90.0%), and from an exercise counselor at the treatment center (55.5%). The top reported benefits included: improved health, feeling good about oneself, and feeling more confident. The most commonly reported barriers to exercise training included transportation issues, lack of motivation, knowledge, and proper equipment, and cost. Our study supports previous work in individuals with substance abuse disorders and suggests that exercise training would be widely accepted as a part of residential treatment for AUD. This study also identified several strategies that can be used to individualize exercise training programs to better meet the needs of AUD patients and maximize their participation in future interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Response to comment on “Persistence of pharmaceutical compounds and other organic wastewater contaminants in a conventional drinking-water-treatment plant”

    Science.gov (United States)

    Stackelberg, Paul E.; Furlong, Edward T.; Meyer, Michael T.; Zaugg, Steven D.; Henderson, Alden K.; Reissman, Dori B.

    2006-01-01

    The U.S. Geological Survey (USGS) and the Centers for Disease Control thank Dr. Till for her comments concerning our research (Till, 2005) and welcome the opportunity to respond. The primary objective of our study was to evaluate the potential for organic wastewater-related contaminants (OWCs), including pharmaceuticals, to survive a conventional drinking-water-treatment process and persist in potable-water supplies (Stackelberg et al., 2004). Our study was supported by two USGS laboratories: the National Water Quality Laboratory (NWQL), which provided the HPLC/ESI-MS and CLLE GC/MS data and the Ocala Water Quality and Research Laboratory (OWQRL), which provided the LC/MS data (Stackelberg et al., 2004). Although discussed as distinct techniques by Dr. Till and indicated by differing acronyms to distinguish the laboratories producing the data, as described in our paper, the two LC/MS methods are very similar; they consist of a solid-phase extraction method with analysis of the extract produced using high-performance liquid chromatography coupled to an electrospray ionization mass spectrometer operated in the positive mode. The NWQL and OWQRL report ‘trace’ and ‘ultratrace’ determinations of analytes that provide significant benefit for describing the presence and fate of low-level contaminants. For mass spectral methods, an analyte is qualitatively identified by its retention time on the chromatographic column as well as the presence of two or more confirming ions with area ratios that match that of the reference standard compounds. Because of a recognized increased risk of false positives, these qualitative identification criteria are used in conjunction with abundant quality-control samples (detailed below) to confirm detection prior to making an estimate of the concentration. These qualitative identification criteria must be met before a compound is considered present (or detected) in a sample (Oblinger Childress et al., 1999). When a compound has been

  18. Patterns and trends of potentially inappropriate high-density lipoprotein cholesterol testing in Australian adults at high risk of cardiovascular disease from 2008 to 2014: analysis of linked individual patient data from the Australian Medicare Benefits Schedule and Pharmaceutical Benefits Scheme.

    Science.gov (United States)

    Hajati, Farshid; Atlantis, Evan; Bell, Katy J L; Girosi, Federico

    2018-03-08

    We examine the extent to which the adult Australian population on lipid-lowering medications receives the level of high-density lipoprotein cholesterol (HDL-C) testing recommended by national guidelines. We analysed records from 7 years (2008-2014) of the 10% publicly available sample of deidentified, individual level, linked Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) electronic databases of Australia. The PBS data were used to identify individuals on stable prescriptions of lipid-lowering treatment. The MBS data were used to estimate the annual frequency of HDL-C testing. We developed a methodology to address the issue of 'episode coning' in the MBS data, which causes an undercounting of pathology tests. We used a published figure on the proportion of unreported HDL-C tests to correct for the undercounting and estimate the probability that an HDL-C test was performed. We judged appropriateness of testing frequency by comparing the HDL-C testing rate to guidelines' recommendations of annual testing for people at high risk for cardiovascular disease. We estimated that approximately 49% of the population on stable lipid-lowering treatment did not receive any HDL-C test in a given year. We also found that approximately 19% of the same population received two or more HDL-C tests within the year. These levels of underutilisation and overutilisation have been changing at an average rate of 2% and -4% a year, respectively, since 2009. The yearly expenditure associated with test overutilisation was approximately $A4.3 million during the study period, while the cost averted because of test underutilisation was approximately $A11.3 million a year. We found that approximately half of Australians on stable lipid-lowering treatment may be having fewer HDL-C testing than recommended by national guidelines, while nearly one-fifth are having more tests than recommended. © Article author(s) (or their employer(s) unless otherwise stated in the text

  19. Individualized treatment of craniovertebral junction malformation guided by intraoperative computed tomography.

    Science.gov (United States)

    Li, Lianfeng; Wang, Peng; Chen, LiFeng; Ma, Xiaodong; Bu, Bo; Yu, Xinguang

    2012-04-01

    This study was designed to report our preliminary experience of intraoperative computed tomography (iCT) using a mobile scanner with integrated neuronavigation system (NNS). The objective of this study was to assess the feasibility and potential utility of iCT with integrated NNS in individualized treatment of craniovertebral junction malformation (CVJM). The surgical management of congenital craniovertebral anomalies is complex due to the relative difficulty in accessing the region, critical relationships of neurovascular structures, and the intricate biomechanical issues involved. We reported our first 19 complex CVJM cases including 11 male and 8 female patients from January, 2009 to June, 2009 (mean age, 33.9 y; age range, 13 to 58 y). A sliding gantry 40-slice CT scanner was installed in a preexisting operating room. Image data was transferred directly from the scanner into the NNS using an automated registration system. We applied this technology to transoral odontoidectomy in 17 patients. Moreover, with the extra help of iCT integrated with NNS, odontoidectomy through posterior midline approach, and transoral atlantal lateral mass resection were, for the first time, performed for treatment of complex CVJM. NNS was found to correlate well with the intraoperative findings, and the recalibration was uneven in all cases with an accuracy of 1.6 mm (1.6: 1.2 to 2.0). All patients were clinically evaluated by Nurick grade criteria, and neurological deficits were monitored after 3 months of surgery. Fifteen patients (79%) were improved by at least 1 Nurick grade, whereas the grade did not change in 4 patients (21%). iCT scanning with integrated NNS was both feasible and beneficial for the surgical management of complex CVJM. In this unusual patient population, the technique seemed to be valuable in negotiating complex anatomy and achieving a safe and predictable decompression.

  20. Pharyngeal electrical stimulation for treatment of poststroke dysphagia: individual patient data meta-analysis of randomised controlled trials

    OpenAIRE

    Scutt, Polly; Lee, Han S.; Hamdy, Shaheen; Bath, Philip M.W.

    2015-01-01

    Background. Dysphagia after stroke is common, associated independently with poor outcome, and has limited treatment options. Pharyngeal electrical stimulation (PES) is a novel treatment being evaluated for treatment of poststroke dysphagia. Methods. We searched electronically for randomised controlled trials of PES in dysphagic patients within 3 months of stroke. Individual patient data were analysed using regression, adjusted for trial, age, severity, and baseline score. The coprimary outcom...

  1. Individual trajectories in stress covary with immunity during recovery from cancer diagnosis and treatments.

    Science.gov (United States)

    Thornton, Lisa M; Andersen, Barbara L; Crespin, Timothy R; Carson, William E

    2007-02-01

    Research connects stressful events with altered immune regulation, but the role of subjective stress is uncertain. Using a longitudinal design, we provide a statistically powerful test of the relationship between subjective stress (perceived stress, emotional distress) and immunity (T cell blastogenesis, natural killer cell cytotoxicity, [NKCC]) as individuals adjust to a severe stressor, a cancer diagnosis and its treatments. Women with regional breast cancer (N=113) were assessed at diagnosis/surgery and reassessed 4, 8, 12, and 18 months later. Latent growth curve analysis tested two hypotheses: (1) initial levels of subjective stress will correlate inversely with initial levels of immunity, and (2) rate of change in subjective stress will correlate inversely with rate of change in immunity. As predicted by Hypothesis 1, participants with high initial subjective stress showed poor initial blastogenesis. As predicted by Hypothesis 2, participants exhibiting an early, rapid decline in subjective stress also showed rapid improvement in NKCC. Follow-up analyses revealed perceived stress to be strongly related to immune function, while emotional distress was not. This is the first study to investigate trajectories in stress and immunity during recovery from a major stressor. Results imply that NK and T cells are sensitive to different aspects of the stress response. While T cell blastogenesis correlated with initial (peak) subjective stress, NKCC correlated with change (improvement) in subjective stress. These data highlight the importance of subjective stress, particularly stress appraisals, in the immune response to a major stressor.

  2. Comparison of craving for opioid in opioid-dependent individuals and people under methadone maintenance treatment

    Directory of Open Access Journals (Sweden)

    Azita Chehri

    2014-02-01

    Full Text Available Background: Methadone Maintenance Therapy (MMT is the most important treatment for opioid -dependency recurrence. The aim of this study was to compare the craving level in opioid-dependent individuals and people under methadone maintenance therapy. Methods: In this case – control study, 120 men with opioid dependency were selected through cluster sampling method. They were divided into two groups, 60 people in opioid-dependent group and 60 people in MMT group. Both groups were matched for age, sex, marital status, education, duration of opioid dependency and method of consumption. Then, they completed INCAS Substance Abuse Profile (ISAP, opiate withdrawal symptoms checklist, self–report of craving, Desire for Drug Questionnaire (DDQ, Obsessive Compulsive Drug Use Scale (OCDUS and visual cue-induced craving questionnaire. Data were analyzed by SPSS 15 using t-test and ANOVA. Results: Mean craving for drug significantly was lower in MMT group comparing opioid-dependent group (P<0.01. Conclusion: Methadone Maintenance Therapy decreased the craving for drugs and substances This can have an important role in relapse prevention.

  3. [An individual approach to the surgical treatment and medical rehabilitation of duodenal ulcer patients].

    Science.gov (United States)

    Kochetkov, A V; Barashkov, V G; Papazov, V I

    1996-01-01

    Since 1986 403 patients have been treated according to the following programme: successive preparation for surgery, the operative intervention chosen individually for each patient, the purposeful medical rehabilitation. Different types of vagotomy with draining operations were performed in 85.6% of the cases, stomach resection--in 14.4% of the patients. The mortality rate was 0%. The indications for various types of vagotomy, stomach resection and different types of draining operations were determined. Rehabilitation of 55% of the patients after the operative treatment took place at the gastroenterological department, the others--at an outpatient department. The indications for rehabilitation, its volume and time were established. The best remote results in the follow-up periods up to five years were obtained after truncal vagotomy and stomach resection. Ulcer recurrences were noted in 3.5% and 5.2% of the cases respectively. Recurrences of the disease were noted in 7.8% after combined vagotomy and in more than 20% after SPV. Nine patients out of 34 with recurrent ulcers were reoperated with good results, the others were successfully treated by conservative therapy.

  4. What factors predict individual subjects' re-learning of words during anomia treatment?

    Directory of Open Access Journals (Sweden)

    William Hayward

    2014-04-01

    Full Text Available A growing number of studies are addressing methodological approaches to treating anomia in persons with aphasia. What is missing from these studies are validated procedures for determining which words have the greatest potential for recovery. The current study evaluates the usefulness of several word-specific variables and one subject-specific measure in predicting success in re-learning problematic words. Methods: Two participants, YPR and ODH, presented with fluent aphasia and marked anomia. YPR’s Aphasia Quotient on the Western Aphasia Battery was 58.8; ODH’s AQ was 79.5. Stimuli were 96 pictures chosen individually for each participant from among those that they named incorrectly on multiple baselines. Subsequently, participants were presented with each picture and asked to indicate whether they could name it covertly, or “in their head.” Each subject completed a biweekly anomia treatment for these pictures. We performed separate statistical analyses for each subject. Dependent variables included whether each word was learned during treatment (Acquisition and the number of sessions required to learn each word (#Sessions. We used logistic regression models to evaluate the association of (self-reported covert naming success with Acquisition, and linear regression models to assess the relationship between (self-reported covert naming success and #Sessions. Starting with the predictors of covert naming accuracy, number of syllables (#syllables, number of phonemes (#phonemes, and frequency, we used backwards elimination methods to select the final regression models. Results: By the end of 25 treatment sessions, YPR had learned 90.2% (37/41 of the covertly correct words but only 70.4% (38/54 of the covertly incorrect words. In the unadjusted analysis, covert naming was significantly associated with Acquisition, OR=3.89, 95% CI: (1.19, 12.74, p=0.025. The result remained significant after adjustment for #phonemes (the only other predictor

  5. Failure after Success: Correlates of Recidivism among Individuals Who Successfully Completed Coerced Drug Treatment

    Science.gov (United States)

    Sung, Hung-En; Belenko, Steven

    2005-01-01

    A subset of criminal offenders diverted from prison to treatment return to crime after successful completion of treatment. Identifying correlates of recidivism among treatment completers will improve our ability to help treated offenders to better capitalize on their treatment experiences. Data from 156 mandated clients of long-term residential…

  6. Breast cancer patients' satisfaction with individual therapy goals and treatment in a standardized integrative medicine consultancy service.

    Science.gov (United States)

    Hack, Carolin C; Antoniadis, Sophia; Hackl, Janina; Langemann, Hanna; Schwitulla, Judith; Fasching, Peter A; Beckmann, Matthias W; Theuser, Anna-Katharin

    2018-04-27

    Complementary medicine services are nowadays usually quite heterogeneous, and little information is available on standards for running an integrative medicine consultancy service. This study aimed to assess patients' satisfaction with a standardized treatment service on integrative medicine. Using a cross-sectional design, 75 breast cancer patients from the integrative medicine consultancy service at the University Breast Center for Franconia were evaluated between January 2016 and March 2017. At primary consultation, patients answered a standardized questionnaire on their medical history and treatment goals regarding integrative medicine. In a subsequent interview, patients evaluated their satisfaction with the treatment service and individual treatment goals. 72% of the patients (n = 54) reported high satisfaction with the overall approach of the treatment service. 76% of the patients (n = 57) were very satisfied or satisfied with their individual treatment plans. The most frequently reported goals were to slow tumor progression (n = 64, 85.3%), reducing the side effects of conventional cancer treatments (n = 60, 80%), and a desire to participate actively in the treatment of breast cancer (n = 64, 85.3%). Using a standardized procedure in integrative medicine allows a high quality level to be offered to patients. Overall, breast cancer patients report very high satisfaction with the integrative medicine consultancy service and state long-term treatment goals. Hence, long-term treatment with integrative medicine methods should be taken into consideration.

  7. Effectiveness of integrating individualized and generic complementary medicine treatments with standard care versus standard care alone for reducing preoperative anxiety.

    Science.gov (United States)

    Attias, Samuel; Keinan Boker, Lital; Arnon, Zahi; Ben-Arye, Eran; Bar'am, Ayala; Sroka, Gideon; Matter, Ibrahim; Somri, Mostafa; Schiff, Elad

    2016-03-01

    Preoperative anxiety is commonly reported by people undergoing surgery. A significant number of studies have found a correlation between preoperative anxiety and post-operative morbidity. Various methods of complementary and alternative medicine (CAM) were found to be effective in alleviating preoperative anxiety. This study examined the relative effectiveness of various individual and generic CAM methods combined with standard treatment (ST) in relieving preoperative anxiety, in comparison with ST alone. Randomized controlled trial. Holding room area Three hundred sixty patients. Patients were randomly divided into 6 equal-sized groups. Group 1 received the standard treatment (ST) for anxiety alleviation with anxiolytics. The five other groups received the following, together with ST (anxiolytics): Compact Disk Recording of Guided Imagery (CDRGI); acupuncture; individual guided imagery; reflexology; and individual guided imagery combined with reflexology, based on medical staff availability. Assessment of anxiety was taken upon entering the holding room area (surgery preparation room) ('pre-treatment assessment'), and following the treatment, shortly before transfer to the operating room ('post-treatment assessment'), based on the Visual Analogue Scale (VAS) questionnaire. Data processing included comparison of VAS averages in the 'pre' and 'post' stages among the various groups. Preoperatively, CAM treatments were associated with significant reduction of anxiety level (5.54-2.32, peffective than individualized CAM (Peffective than generic CDRGI. In light of the scope of preoperative anxiety and its implications for public health, integration of CAM therapies with ST should be considered for reducing preoperative anxiety. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. The effect of cross-sex hormonal treatment on gender dysphoria individuals' mental health: a systematic review.

    Science.gov (United States)

    Costa, Rosalia; Colizzi, Marco

    2016-01-01

    Cross-sex hormonal treatment represents a main aspect of gender dysphoria health care pathway. However, it is still debated whether this intervention translates into a better mental well-being for the individual and which mechanisms may underlie this association. Although sex reassignment surgery has been the subject of extensive investigation, few studies have specifically focused on hormonal treatment in recent years. Here, we systematically review all studies examining the effect of cross-sex hormonal treatment on mental health and well-being in gender dysphoria. Research tends to support the evidence that hormone therapy reduces symptoms of anxiety and dissociation, lowering perceived and social distress and improving quality of life and self-esteem in both male-to-female and female-to-male individuals. Instead, compared to female-to-male individuals, hormone-treated male-to-female individuals seem to benefit more in terms of a reduction in their body uneasiness and personality-related psychopathology and an amelioration of their emotional functioning. Less consistent findings support an association between hormonal treatment and other mental health-related dimensions. In particular, depression, global psychopathology, and psychosocial functioning difficulties appear to reduce only in some studies, while others do not suggest any improvement in these domains. Results from longitudinal studies support more consistently the association between hormonal treatment and improved mental health. On the contrary, a number of cross-sectional studies do not support this evidence. This review provides possible biological explanation vs psychological explanation (direct effect vs indirect effect) for the hormonal treatment-induced better mental well-being. In conclusion, this review indicates that gender dysphoria-related mental distress may benefit from hormonal treatment intervention, suggesting a transient reaction to the nonsatisfaction connected to the incongruent body

  9. Recent Advances of Individual BODIPY and BODIPY-Based Functional Materials in Medical Diagnostics and Treatment.

    Science.gov (United States)

    Marfin, Yuriy S; Solomonov, Alexey V; Timin, Alexander S; Rumyantsev, Evgeniy V

    2017-01-01

    The group of fluorophores on boron dipyrrin platform (4,4- difluoro-4-bora3a,4a-diaza-s-indacene, also known as BODIPY) has attracted much attention in the field of molecular sensorics, including sensing of biomolecules and bioprocesses. Structural diversity of existing BODIPY with ample opportunities of directed modification of compounds makes this class of fluorophores attractive for medical and biological purposes. The recent progress in the design and functionalization of BODIPY allows using them for modification of drug micro- and nanocarriers in order to improve their therapeutic effect in cancer treatment. At the same time, integration of BODIPY into drug carriers provides the possibility of in vitro and in vivo real time imaging of used drug carriers. The high fluorescent intensity and low toxicity of BODIPY granted for conjugation with different biomolecules. The present review focuses on the recent advances for application of individual BODIPY in medical diagnostics, antimicrobial activity, as well as establishing the role of BODIPY in labeling of biomolecules (e.g. proteins, hormones and DNA). Also the review highlights the potential of BODIPY in functionalization of drug micro- and nanocarriers in order to achieve better therapeutic efficiency compared with non-modified materials. The advantages derived from the use of BODIPY for preparation and modification of drug carriers are critically evaluated and potential for future challenges, especially concerning the design of innovative multi-functional BODIPY-based nanocarriers, is discussed in detail using representative examples from literature. Our objective was to show that BODIPY are powerful tools for bioimaging, labeling of biomolecules and construction of new multifunctional drug carriers. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  10. Adherence to Follow-up Recommendations Among Individuals in the Philadelphia Glaucoma Detection and Treatment Project.

    Science.gov (United States)

    Hark, Lisa A; Leiby, Benjamin E; Waisbourd, Michael; Myers, Jonathan S; Fudemberg, Scott J; Mantravadi, Anand V; Dai, Yang; Gilligan, John P; Resende, Arthur F; Katz, L Jay

    2017-08-01

    To evaluate rates of adherence to free follow-up eye exam appointments among participants in the Philadelphia Glaucoma Detection and Treatment Project. Ophthalmologists and testing equipment were brought directly to participants at risk for glaucoma at 43 community sites in Philadelphia. Those diagnosed with glaucoma-related pathology were recommended to return for follow-up to be reexamined on site. Rates of adherence and clinical and demographic risk factors for adherence were evaluated. Five hundred thirty-one participants were diagnosed with glaucoma-related conditions and recommended to attend community-based follow-up exams. Follow-up adherence rate was 61.2% (n=325/531). Significant factors associated with greater eye exam appointment adherence, based on our univariable analysis, included final diagnosis of glaucoma (risk ratio [RR]=1.33; 95% confidence interval [CI], 1.13-1.57), male sex (RR=1.19; 95% CI, 1.04-1.36), white race (RR=1.26; 95% CI, 1.08-1.48), age (RR=1.17; 95% CI, 1.00-1.37) recommendation for glaucoma medication (RR=1.52; 95% CI, 1.35-1.71), recommendation for laser peripheral iridotomy (RR=1.18; 95% CI, 1.02-1.35), diagnosis of age-related macular degeneration (RR=1.42; 95% CI, 1.13-1.77) and an increased intraocular pressure (>22 mm Hg in the worse eye) (RR=1.23; 95% CI, 1.06-1.42). On the basis of our multivariable model, diagnosis, sex, and recommended glaucoma medications were significantly associated with follow-up adherence. This study demonstrates that individuals living in underserved urban communities would take advantage of free eye exams in community sites and return for follow-up eye exams in these same settings. Future studies could investigate interventions to improve eye exam appointment adherence in community-based settings to detect glaucoma-eye conditions.

  11. Comparing barriers to mental health treatment and substance use disorder treatment among individuals with comorbid major depression and substance use disorders.

    Science.gov (United States)

    Mojtabai, Ramin; Chen, Lian-Yu; Kaufmann, Christopher N; Crum, Rosa M

    2014-02-01

    Barriers to both mental health and substance use disorder treatments have rarely been examined among individuals with comorbid mental health and substance use disorders. In a sample of 393 adults with 12-month major depressive episodes and substance use disorders, we compared perceived barriers to these two types of treatments. Data were drawn from the 2005-2011 U.S. National Surveys on Drug Use and Health. Overall, the same individuals experienced different barriers to mental health treatment versus substance use disorder treatment. Concerns about negative views of the community, effects on job, and inconvenience of services were more commonly reported as reasons for not receiving substance use disorder treatment. Not affording the cost of care was the most common barrier to both types of treatments, but more commonly reported as a barrier to mental health treatment. Improved financial access through the Affordable Care Act and parity legislation and integration of mental health and substance use disorder services may help to reduce treatment barriers among individuals with comorbid mental health and substance disorders. © 2013.

  12. Membrane Bioprocesses for Pharmaceutical Micropollutant Removal from Waters

    Directory of Open Access Journals (Sweden)

    Matthias de Cazes

    2014-10-01

    Full Text Available The purpose of this review work is to give an overview of the research reported on bioprocesses for the treatment of domestic or industrial wastewaters (WW containing pharmaceuticals. Conventional WW treatment technologies are not efficient enough to completely remove all pharmaceuticals from water. Indeed, these compounds are becoming an actual public health problem, because they are more and more present in underground and even in potable waters. Different types of bioprocesses are described in this work: from classical activated sludge systems, which allow the depletion of pharmaceuticals by bio-degradation and adsorption, to enzymatic reactions, which are more focused on the treatment of WW containing a relatively high content of pharmaceuticals and less organic carbon pollution than classical WW. Different aspects concerning the advantages of membrane bioreactors for pharmaceuticals removal are discussed, as well as the more recent studies on enzymatic membrane reactors to the depletion of these recalcitrant compounds.

  13. Endocrine active chemicals, pharmaceuticals, and other chemicals of concern in surface water, wastewater-treatment plant effluent, and bed sediment, and biological characteristics in selected streams, Minnesota-design, methods, and data, 2009

    Science.gov (United States)

    Lee, Kathy E.; Langer, Susan K.; Barber, Larry B.; Writer, Jeff H.; Ferrey, Mark L.; Schoenfuss, Heiko L.; Furlong, Edward T.; Foreman, William T.; Gray, James L.; ReVello, Rhiannon C.; Martinovic, Dalma; Woodruff, Olivia R.; Keefe, Steffanie H.; Brown, Greg K.; Taylor, Howard E.; Ferrer, Imma; Thurman, E. Michael

    2011-01-01

    This report presents the study design, environmental data, and quality-assurance data for an integrated chemical and biological study of selected streams or lakes that receive wastewater-treatment plant effluent in Minnesota. This study was a cooperative effort of the U.S. Geological Survey, the Minnesota Pollution Control Agency, St. Cloud State University, the University of St. Thomas, and the University of Colorado. The objective of the study was to identify distribution patterns of endocrine active chemicals, pharmaceuticals, and other organic and inorganic chemicals of concern indicative of wastewater effluent, and to identify biological characteristics of estrogenicity and fish responses in the same streams. The U.S. Geological Survey collected and analyzed water, bed-sediment, and quality-assurance samples, and measured or recorded streamflow once at each sampling location from September through November 2009. Sampling locations included surface water and wastewater-treatment plant effluent. Twenty-five wastewater-treatment plants were selected to include continuous flow and periodic release facilities with differing processing steps (activated sludge or trickling filters) and plant design flows ranging from 0.002 to 10.9 cubic meters per second (0.04 to 251 million gallons per day) throughout Minnesota in varying land-use settings. Water samples were collected from the treated effluent of the 25 wastewater-treatment plants and at one point upstream from and one point downstream from wastewater-treatment plant effluent discharges. Bed-sediment samples also were collected at each of the stream or lake locations. Water samples were analyzed for major ions, nutrients, trace elements, pharmaceuticals, phytoestrogens and pharmaceuticals, alkylphenols and other neutral organic chemicals, carboxylic acids, and steroidal hormones. A subset (25 samples) of the bed-sediment samples were analyzed for carbon, wastewater-indicator chemicals, and steroidal hormones; the

  14. [Fourcroy and pharmaceutical journals].

    Science.gov (United States)

    Bonnemain, Bruno

    2011-04-01

    Cadet de Gassicourt wrote a brief Eloge of Fourcroy in January 1810 as he died in December of 1809. Fourcroy had a major role concerning the new ideas on the place of pharmacy at the beginning of the 19th century. Fourcroy has had a key influence for the start of several pharmaceutical journals that wanted to emphasize the link between the new chemistry and pharmacy. None of these journals created with him will survive and one has to wait for 1909 to see the creation, without Fourcroy, of a new pharmaceutical journal, the "Journal de Pharmacie" that will become "Journal de Pharmacie et des Sciences accessoires", then "Journal de Pharmacie et de Chimie", before taking the name of"Annales Pharmaceutiques Françaises", the present official journal of the French Academy of Pharmacy. In spite of the essential role of Fourcroy at the start of pharmaceutical journals, Cadet did not even mention it in his Eloge of 1810.

  15. Rheology in Pharmaceutical Sciences

    DEFF Research Database (Denmark)

    Aho, Johanna; Hvidt, Søren; Baldursdottir, Stefania

    2016-01-01

    Rheology is the science of flow and deformation of matter. Particularly gels and non-Newtonian fluids, which exhibit complex flow behavior, are frequently encountered in pharmaceutical engineering and manufacturing, or when dealing with various in vivo fluids. Therefore understanding rheology......, together with the common measurement techniques and their practical applications. Examples of the use of rheological techniques in the pharmaceutical field, as well as other closely related fields such as food and polymer science, are also given....... is important, and the ability to use rheological characterization tools is of great importance for any pharmaceutical scientist involved in the field. Flow can be generated by shear or extensional deformations, or a combination of both. This chapter introduces the basics of both shear and extensional rheology...

  16. Correction of glutathione deficiency in the lower respiratory tract of HIV seropositive individuals by glutathione aerosol treatment.

    Science.gov (United States)

    Holroyd, K J; Buhl, R; Borok, Z; Roum, J H; Bokser, A D; Grimes, G J; Czerski, D; Cantin, A M; Crystal, R G

    1993-10-01

    Concentrations of glutathione, a ubiquitous tripeptide with immune enhancing and antioxidant properties, are decreased in the blood and lung epithelial lining fluid of human immunodeficiency virus (HIV) seropositive individuals. Since the lung is the most common site of infection in those who progress to AIDS it is rational to consider whether it is possible to safely augment glutathione levels in the epithelial lining fluid of HIV seropositive individuals, thus potentially improving local host defence. Purified reduced glutathione was delivered by aerosol to HIV seropositive individuals (n = 14) and the glutathione levels in lung epithelial lining fluid were compared before and at one, two, and three hours after aerosol administration. Before treatment total glutathione concentrations in the epithelial lining fluid were approximately 60% of controls. After three days of twice daily doses each of 600 mg reduced glutathione, total glutathione levels in the epithelial lining fluid increased and remained in the normal range for at least three hours after treatment. Strikingly, even though > 95% of the glutathione in the aerosol was in its reduced form, the percentage of oxidised glutathione in epithelial lining fluid increased from 5% before treatment to about 40% three hours after treatment, probably reflecting the use of glutathione as an antioxidant in vivo. No adverse effects were observed. It is feasible and safe to use aerosolised reduced glutathione to augment the deficient glutathione levels of the lower respiratory tract of HIV seropositive individuals. It is rational to evaluate further the efficacy of this tripeptide in improving host defence in HIV seropositive individuals.

  17. 42 CFR 416.48 - Condition for coverage-Pharmaceutical services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Condition for coverage-Pharmaceutical services. 416... Coverage § 416.48 Condition for coverage—Pharmaceutical services. The ASC must provide drugs and... direction of an individual designated responsible for pharmaceutical services. (a) Standard: Administration...

  18. Conceptualizing Pharmaceutical Plants

    DEFF Research Database (Denmark)

    Larsen, Bent Dalgaard; Jensen, Klaes Ladeby; Gjøl, Mikkel

    2006-01-01

    In the conceptual design phase of pharmaceutical plants as much as 80%-90% of the total cost of a project is committed. It is therefore essential that the chosen concept is viable. In this design process configuration and 3D models can help validate the decisions made. Designing 3D models...... is a complex task and requires skilled users. We demonstrate that a simple 2D/3D configuration tool can support conceptualizing of pharmaceutical plants. Present paper reports on preliminary results from a full scale implementation project at a Danish engineering company....

  19. Global gene mining and the pharmaceutical industry

    International Nuclear Information System (INIS)

    Knudsen, Lisbeth E.

    2005-01-01

    Worldwide efforts are ongoing in optimizing medical treatment by searching for the right medicine at the right dose for the individual. Metabolism is regulated by polymorphisms, which may be tested by relatively simple SNP analysis, however requiring DNA from the test individuals. Target genes for the efficiency of a given medicine or predisposition of a given disease are also subject to population studies, e.g., in Iceland, Estonia, Sweden, etc. For hypothesis testing and generation, several bio-banks with samples from patients and healthy persons within the pharmaceutical industry have been established during the past 10 years. Thus, more than 100,000 samples are stored in the freezers of either the pharmaceutical companies or their contractual partners at universities and test institutions. Ethical issues related to data protection of the individuals providing samples to bio-banks are several: nature and extent of information prior to consent, coverage of the consent given by the study person, labeling and storage of the sample and data (coded or anonymized). In general, genetic test data, once obtained, are permanent and cannot be changed. The test data may imply information that is not beneficial to the patient and his/her family (e.g., employment opportunities, insurance, etc.). Furthermore, there may be a long latency between the analysis of the genetic test and the clinical expression of the disease and wide differences in the disease patterns. Consequently, information about some genetic test data may stigmatize patients leading to poor quality of life. This has raised the issue of 'genetic exceptionalism' justifying specific regulation of use of genetic information. Discussions on how to handle sampling and data are ongoing within the industry and the regulatory sphere, the European Agency for the Evaluation of Medicinal Products (EMEA) having issued a position paper, the Council for International Organizations of Medical Sciences (CIOMS) having a working

  20. Who seeks care where? Utilization of mental health and substance use disorder treatment in two national samples of individuals with alcohol use disorders.

    Science.gov (United States)

    Edlund, Mark J; Booth, Brenda M; Han, Xiaotong

    2012-07-01

    Only a fraction of individuals with alcohol use disorders (AUDs) receive any AUD treatment during a given year. If a substantial proportion of individuals with unmet need for AUD treatment are receiving mental health treatment, accessibility of AUD treatment could potentially be improved by implementing strategies to ensure that individuals receiving mental health care are referred to the AUD sector or by increasing rates of AUD treatment in individuals receiving mental health treatment. We assessed patterns and predictors of mental health treatment and AUD treatment among individuals with 12-month AUDs, using secondary data analyses from two national surveys, the National Survey on Drug Use and Health (NSDUH; n = 4,545 individuals with AUDs) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; n = 3,327 individuals with AUDs). In both NSDUH and NESARC, 8% of individuals with AUDs reported past-year AUD treatment. Among individuals with AUDs, mental health treatment was more common than AUD treatment, with 20% of NSDUH respondents and 11% of NESARC respondents reporting receiving mental health treatment. Greater mental health morbidity increased the odds of mental health treatment, and AUD severity increased the odds of AUD treatment. Mental health morbidity also increased the odds of AUD treatment, mainly by increasing the odds of receiving the category of both AUD and mental health treatment. Because individuals with AUDs are more likely to receive mental health treatment than AUD treatment, a key opportunity to improve the overall accessibility of treatment for AUDs may be to focus on improving AUD treatment among individuals receiving mental health treatment.

  1. Evolution of Applied Behavior Analysis in the Treatment of Individuals With Autism

    Science.gov (United States)

    Wolery, Mark; Barton, Erin E.; Hine, Jeffrey F.

    2005-01-01

    Two issues of each volume of the Journal of Applied Behavior Analysis were reviewed to identify research reports focusing on individuals with autism. The identified articles were analyzed to describe the ages of individuals with autism, the settings in which the research occurred, the nature of the behaviors targeted for intervention, and the…

  2. 26 CFR 1.408-4 - Treatment of distributions from individual retirement arrangements.

    Science.gov (United States)

    2010-04-01

    ... transfer incident to divorce), be deemed a distribution to such individual from such account or annuity of... an individual retirement account by reason of the application of section 408(e)(2), paragraph (a)(1... section 408(f) shall not apply to such amount. (g) Transfer incident to divorce—(1) General rule. The...

  3. An investigation of the differential effectiveness of bibliotherapy and self-regulatory treatments in individuals with panic attacks

    OpenAIRE

    Febbraro, Gregorio A. R.

    1997-01-01

    Several studies targeting individuals with panic disorder have demonstrated that Cognitive-behavioral treatment (CST) is the psychological treatment of choice. CST interventions that include exposure to panic symptoms, along with cognitive restructuring. breathing retraining, and relaxation training are more effective than any of these components administered alone. Past studies have demonstrated the efficacy of imparting the above CBT components in the form of bibliotherapy (BT) ...

  4. Clinical Impact of a Pharmaceutical Care Programme Developed in a Family Health Unit: Results of a Pharmacist-Physician Collaboration in the Treatment of Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Mónica Condinho

    2016-07-01

    Full Text Available Introduction: The positive impact of pharmacist-physician collaborative care has been reported in the international literature, although examples of this impact are limited in Portugal. We aim to underline the clinical added value for hypertensive patients that results from pharmacist-physician collaborations. Methods: A community trial was conducted at a Portuguese family health unit for 19 months. The intervention group was randomly selected from the global records and members of the group received pharmaceutical care in addition to physician care. The comparison group received only physician care. Both groups were comparable at the beginning of the study. In the intervention group, we analysed the hypertensive patients to evaluate the impact of pharmacist-physician collaboration on the patients’ blood pressure levels. This evaluation was performed by comparing the obtained blood pressure levels with the levels at baseline and between the groups. Results: A total of 17 patients with hypertension were enrolled in the pharmaceutical care programme, 12 of whom were female. The mean age was 68.50±3.26 years and, on average, each patient consumed 6.06±0.93 medicinal products. Thirteen patients were uncontrolled. Compared with the baseline, the intervention group achieved mean reductions of 28.85±5.90 mmHg (p < 0.0005 and 11.23±2.75 mmHg (p < 0.005 in their systolic and diastolic blood pressure, respectively. Considering the comparison group, improvements of 18.63±6.44 mmHg (p = 0.011 in systolic blood pressure and 9.03±2.63 mmHg ( p < 0.005 in diastolic blood pressure were observed. Conclusion: Pharmacist-physician collaborative care adds clinical value to the typical physician care provided to hypertensive patients within the context of a Portuguese family health unit.

  5. Consumption-based approach for assessing the contribution of hospitals towards the load of pharmaceutical residues in municipal wastewater.

    Science.gov (United States)

    Le Corre, Kristell S; Ort, Christoph; Kateley, Diana; Allen, Belinda; Escher, Beate I; Keller, Jurg

    2012-09-15

    Hospitals are considered as major sources of pharmaceutical residues discharged to municipal wastewater, but recent experimental studies showed that the contribution of hospitals to the loads of selected, quantifiable pharmaceuticals in sewage treatment plant (STP) influents was limited. However such conclusions are made based on the experimental analysis of pharmaceuticals in hospital wastewater which is hindered by a number of factors such as access to suitable sampling sites, difficulties in obtaining representative samples and availability of analytical methods. Therefore, this study explores a refined and extended consumption-based approach to predict the contribution of six selected Australian hospitals to the loads of 589 pharmaceuticals in municipal wastewater. In addition, the possibility that hospital-specific substances are present at levels that may pose a risk for human health was evaluated. For 63 to 84% of the pharmaceuticals investigated, the selected hospitals are not a major point source with individual contributions likely to be less than 15% which is in line with previous experimental studies. In contrast, between 10 and 20% of the pharmaceuticals consumed in the selected hospitals are exclusively used in these hospitals. For these hospital-specific substances, 57 distinct pharmaceuticals may cause concerns for human health as concentrations predicted in hospital effluents are less than 100-fold lower than effect thresholds. However, when concentrations were predicted in the influent of the corresponding STP, only 12 compounds (including the antineoplastic vincristine, the antibiotics tazobactam and piperacillin) remain in concentration close to effect thresholds, but further decrease is expected after removal in STP, dilution in the receiving stream and drinking water treatment. The results of this study suggest that risks of human exposure to the pharmaceuticals exclusively administered in the investigated hospitals are limited and

  6. Dysregulation of autism-associated synaptic proteins by psychoactive pharmaceuticals at environmental concentrations.

    Science.gov (United States)

    Kaushik, Gaurav; Xia, Yu; Pfau, Jean C; Thomas, Michael A

    2017-11-20

    Autism Spectrum Disorders (ASD) are complex neurological disorders for which the prevalence in the U.S. is currently estimated to be 1 in 50 children. A majority of cases of idiopathic autism in children likely result from unknown environmental triggers in genetically susceptible individuals. These triggers may include maternal exposure of a developing embryo to environmentally relevant minute concentrations of psychoactive pharmaceuticals through ineffectively purified drinking water. Previous studies in our lab examined the extent to which gene sets associated with neuronal development were up- and down-regulated (enriched) in the brains of fathead minnows treated with psychoactive pharmaceuticals at environmental concentrations. The aim of this study was to determine whether similar treatments would alter in vitro expression of ASD-associated synaptic proteins on differentiated human neuronal cells. Human SK-N-SH neuroblastoma cells were differentiated for two weeks with 10μM retinoic acid (RA) and treated with environmentally relevant concentrations of fluoxetine, carbamazepine or venlafaxine, and flow cytometry technique was used to analyze expression of ASD-associated synaptic proteins. Data showed that carbamazepine individually, venlafaxine individually and mixture treatment at environmental concentrations significantly altered the expression of key synaptic proteins (NMDAR1, PSD95, SV2A, HTR1B, HTR2C and OXTR). Data indicated that psychoactive pharmaceuticals at extremely low concentrations altered the in vitro expression of key synaptic proteins that may potentially contribute to neurological disorders like ASD by disrupting neuronal development. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Pharmaceutical packaging handbook

    National Research Council Canada - National Science Library

    Bauer, Edward J

    2009-01-01

    ... of the modern world. Pharmaceutical products and health care in developing countries and remote parts of the world seems like magic. Diseases that were once fatal and chronic conditions that destroyed lives have slowly been conquered by modern medicine. Views of the body, unimaginable for most of the last century with X rays, are now possible with new i...

  8. An assessment of individual-level factors associated with alcohol treatment utilization among Mexican Americans.

    Science.gov (United States)

    Reingle Gonzalez, Jennifer M; Caetano, Raul; Mills, Britain A; Vaeth, Patrice A C

    2014-01-01

    The purpose of this study is to identify enabling factors for treatment utilization for alcohol-related problems, and to evaluate how enabling factors vary by need for treatment, among two samples of Mexican American adults. These two distinct samples included 2,595 current and former drinkers (one sample included 787 U.S./Mexico border residents; the other sample included 740 Mexican Americans living in U.S. cities not proximal to the border). Need for treatment (alcohol disorder severity) and (male) gender were the primary correlates of treatment utilization; and there was no moderation in the enabling factors by need for treatment as "enablers" of utilization. Further theoretical and empirical research is necessary to determine which mechanisms are driving disparities in treatment utilization across racial/ethnic groups generally, and Hispanic national groups specifically. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. The Effectiveness of Pharmaceutical Marketing

    NARCIS (Netherlands)

    E.R. Kappe

    2011-01-01

    textabstractPharmaceutical marketing effectiveness comprises the measurement of marketing efforts of pharmaceutical firms towards doctors and patients. These firms spend billions of dollars yearly to promote their prescription drugs. This dissertation provides empirical analyses and methods to

  10. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. 416.936 Section 416.936 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determining...

  11. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. 404.1536 Section 404.1536 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining...

  12. Impact of cancer diagnosis and treatment on glycaemic control among individuals with colorectal cancer using glucose lowering drugs

    NARCIS (Netherlands)

    Zanders, M.M.J.; van Herk-Sukel, M.P.P.; Herings, R.M.C.; van de Poll-Franse, L.V.; Haak, H.

    2016-01-01

    Aims This study aims to evaluate the impact of cancer and its treatment on HbA1c values among individuals with colorectal cancer (CRC) using glucose-lowering drugs (GLDs). Methods Patients with primary CRC (1998–2011) were selected from the Eindhoven Cancer Registry and linked to the PHARMO Database

  13. Models of Alcohol and Other Drug Treatment for Consideration When Working with Deaf and Hard of Hearing Individuals.

    Science.gov (United States)

    Guthmann, Debra

    This paper discusses several models for treating chemical dependency in individuals who are deaf or hard of hearing. It begins by describing the 12-step model, a comprehensive, multi-disciplinary approach to the treatment of addiction which is abstinence oriented and based on the principles of Alcoholics Anonymous. This model includes group…

  14. Contamination and Harm Relevant UCS-Expectancy Bias in Spider Phobic Individuals : Influence of Treatment

    NARCIS (Netherlands)

    van Overveld, Mark; de Jong, Peter J.; Huijding, Jorg; Peters, Madelon L.

    2010-01-01

    Phobic individuals expect aversive UCS's following encounters with phobic stimuli. Previous research using a thought-experiment procedure showed that contamination rather than harm-related outcome expectancies differentiated best between high and low spider fearful undergraduates. This study

  15. Looking at CER from the pharmaceutical industry perspective.

    Science.gov (United States)

    Dubois, Robert W

    2012-05-01

    Comparative effectiveness research (CER) is increasing as an element of health care reform in the United States. By comparing drugs against other drugs or other therapies instead of just to placebo, CER has the potential to improve decisions about the appropriate treatment for patients. But the growth of CER also brings an array of questions and decisions for purchasers and policy makers that will not be easy to answer and which require significant dialogue to fully understand and address. To describe some of the impact, both positive and negative, that comparative effectiveness research (CER) may have on the pharmaceutical industry. As CER data proliferate, questions are being raised about who can access the data, who can discuss it, and in what forums. Regulations place different communication restrictions on the pharmaceutical industry than on other health care stakeholders, which creates a potential inequality. Another CER consideration will be the tendency to apply average results to individuals, even if not every individual experiences the average result. Policy makers should implement CER findings carefully with a goal toward accommodating flexibility. A final impact to consider is whether greater expectations for CER will have a negative or positive effect on incentives for drug innovation. In some cases, CER may increase development costs or decrease market size. In other cases, better targeting of trial populations could result in lower development costs. The rising expectations and growth in CER raise questions about information access, communication restrictions, flexible implementation policies, and incentives for innovation. Members of the pharmaceutical industry should be cognizant of the questions and should be participating in dialogues now to pave the way for future solutions.

  16. On the Comparison of Cognitive Function in Substance Abusers and Addicts under Methadone Treatment with Normal Individuals

    Directory of Open Access Journals (Sweden)

    reza mohammadzadeghan

    2015-09-01

    Full Text Available Objective: This study was an attempt to compare cognitive functioning in substance abusers and addicts under methadone treatment with normal individuals. Method: The current study was a causal-comparative one. The statistical population of this research consisted of all male substance abusers who had referred to addiction treatment centers of Khoy city in 2013. The total of 40 addicts under methadone treatment, 40 active drug users, and 40 non-addicts were selected as the participants of this study via convenience sampling method. Wisconsin Card Sorting Test and Wechsler Memory Scale were administered to the three groups for data collection purposes. Results: The results showed that the substance abusers’ scores in Wisconsin card sorting test and Wechsler memory scale were significantly different from those of addicts under methadone treatment and normal individuals. In the same way, there was a significant difference between addicts under methadone treatment and normal individuals in terms of cognitive function however, there was no significant difference between these two groups in terms of perseveration error. Conclusion: It can be concluded that chronic use of psychoactive substances causes damage to multiple brain regions such as prefrontal cortex and hippocampus and, thereby, it leads to cognitive malfunctioning in these areas.

  17. Behavioral Treatments and Pharmacotherapy: Acceptability Ratings by Elderly Individuals in Residential Settings.

    Science.gov (United States)

    Burgio, Louis D.; Sinnott, Jan

    1990-01-01

    Presented residents of life care community and nursing homes with scenarios of older woman. Client varied by cognitive capacity and behavior problem (aggression, verbal abuse, noncompliance). Participants rated three treatments: differential reinforcement of incompatible behavior (DRI), time-out, and haloperidol. All treatments were acceptable;…

  18. Pharmacogenetics and individual responses to treatment of hyperglycemia in type 2 diabetes

    DEFF Research Database (Denmark)

    Engelbrechtsen, Line; Galijatovic, Ehm Astrid Andersson; Roepstorff, Søren

    2015-01-01

    The aim of this study was to summarize current knowledge and provide perspectives on the relationships between human genetic variants, type 2 diabetes, antidiabetic treatment, and disease progression. Type 2 diabetes is a complex disease with clear-cut diagnostic criteria and treatment guidelines...

  19. Guide for health professionals addressing oral care for individuals in oncological treatment based on scientific evidence.

    Science.gov (United States)

    Carvalho, Caroline Gomes; Medeiros-Filho, João Batista; Ferreira, Meire Coelho

    2018-02-22

    Oncological treatment can cause changes in the oral cavity compromising oral functions. The aim of the study was, based on a systematic review, to draft a guide directed at the team of health professionals involved in the oral care of oncological patients. A systematic search of the literature was performed for articles published between 2000 and April 2017. Searches were made of electronic databases and hand search. The inclusion criteria were systematic reviews of randomized clinical trials (RCTs) and RCTs published in English, involving pediatric and adult oncological patients and focused on the prevention and treatment of oral complications as well as studies addressing the maintenance of oral health. Among the 1237 studies identified, 129 were pre-selected and 54 were selected to form the basis for the clinical guide. The studies analyzed stress the need for oral assessments as well as preventive and curative actions prior to oncological treatment. To minimize the severity of oral problems, the studies emphasize daily oral care, the treatment of xerostomia with saliva substitute and hydration, and low-level laser therapy, nystatin, acyclovir, respectively, for the prevention and treatment of oral mucositis, oral candidiasis, and infection by herpes simplex virus. Thus, the guide produced addresses oral assessments and professional and home care before, during, and after oncological treatment. The guide drafted has the function of assisting health professionals involved in the oral care of patients with cancer, enabling the prevention or treatment of oral complications stemming from oncological treatment.

  20. Gender-related clinical and neurocognitive differences in individuals seeking treatment for pathological gambling

    DEFF Research Database (Denmark)

    Grant, Jon E; Chamberlain, Samuel R; Schreiber, Liana R N

    2012-01-01

    Understanding variations in disease presentation in men and women is clinically important as differences may reflect biological and sociocultural factors and have implications for selecting appropriate prevention and treatment strategies. The aim of this study was to investigate clinical and cogn...... and cognitive differences in treatment-seeking people with pathological gambling as a function of gender....

  1. Psychotherapeutic Treatment of a Gastrointestinal Disorder: Individual and Family Systems Perspectives.

    Science.gov (United States)

    Bauknight, S. Terry

    A 17-year-old boy presented for treatment with chronic diarrhea that had proven refractory to medical treatment for a period of five years. The problem was sufficiently debilitating to cause highly erratic school attendance. Anamnesis revealed no precipitating event, though it was discovered that the patient's mother was a moderately compensated,…

  2. Early Magnesium Treatment After Aneurysmal Subarachnoid Hemorrhage Individual Patient Data Meta-Analysis

    NARCIS (Netherlands)

    Mees, Sanne M. Dorhout; Algra, Ale; Wong, George K. C.; Poon, Wai S.; Bradford, Celia M.; Saver, Jeffrey L.; Starkman, Sidney; Rinkel, Gabriel J. E.; van den Bergh, Walter M.

    2015-01-01

    Background and Purpose—Delayed cerebral ischemia (DCI) is an important cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Trials of magnesium treatment starting <4 days after symptom onset found no effect on poor outcome or DCI in SAH. Earlier installment of treatment might be

  3. Early Magnesium Treatment After Aneurysmal Subarachnoid Hemorrhage Individual Patient Data Meta-Analysis

    NARCIS (Netherlands)

    Dorhout Mees, Sanne M.; Algra, Ale; Wong, George K. C.; Poon, Wai S.; Bradford, Celia M.; Saver, Jeffrey L.; Starkman, Sidney; Rinkel, Gabriel J. E.; van den Bergh, Walter M.; van Kooten, F.; Dirven, C. M.; van Gijn, J.; Vermeulen, M.; Rinkel, G. J. E.; Boet, R.; Chan, M. T. V.; Gin, T.; Ng, S. C. P.; Zee, B. C. Y.; Al-Shahi Salman, R.; Boiten, J.; Kuijsten, H.; Lavados, P. M.; van Oostenbrugge, R. J.; Vandertop, W. P.; Finfer, S.; O'Connor, A.; Yarad, E.; Firth, R.; McCallister, R.; Harrington, T.; Steinfort, B.; Faulder, K.; Assaad, N.; Morgan, M.; Starkman, S.; Eckstein, M.; Stratton, S. J.; Pratt, F. D.; Hamilton, S.; Conwit, R.; Liebeskind, D. S.; Sung, G.; Kramer, I.; Moreau, G.; Goldweber, R.; Sanossian, N.

    2015-01-01

    Delayed cerebral ischemia (DCI) is an important cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Trials of magnesium treatment starting <4 days after symptom onset found no effect on poor outcome or DCI in SAH. Earlier installment of treatment might be more effective, but

  4. Early Magnesium Treatment after Aneurysmal Subarachnoid Hemorrhage : Individual Patient Data Meta-Analysis

    NARCIS (Netherlands)

    Dorhout Mees, Sanne M.; Algra, Ale; Wong, George K C; Poon, Wai S.; Bradford, Celia M.; Saver, Jeffrey L.; Starkman, Sidney; Rinkel, Gabriel J E; Van Den Bergh, Walter M.

    2015-01-01

    Background and Purpose-Delayed cerebral ischemia (DCI) is an important cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Trials of magnesium treatment starting <4 days after symptom onset found no effect on poor outcome or DCI in SAH. Earlier installment of treatment might be

  5. Tropical Journal of Pharmaceutical Research

    African Journals Online (AJOL)

    Journal Homepage Image. We seek to encourage pharmaceutical and allied research of tropical and international relevance and to foster multidisciplinary research and collaboration among scientists, the pharmaceutical industry and the healthcare professionals. We publish articles in pharmaceutical sciences and related ...

  6. Past-Year Treatment Utilization Among Individuals Meeting DSM-5 PTSD Criteria: Results From a Nationally Representative Sample.

    Science.gov (United States)

    Hale, Andrew C; Sripada, Rebecca K; Bohnert, Kipling M

    2018-03-01

    Little is known regarding treatment utilization among individuals meeting DSM-5 criteria for posttraumatic stress disorder (PTSD). Data were analyzed from the third wave of the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample using DSM-5 criteria. Factors related to increased odds of PTSD treatment utilization for individuals meeting lifetime criteria included some college education versus less than a high school degree (odds ratio [OR]=3.17), having health insurance versus no insurance (OR=2.86), having a comorbid phobia disorder versus not having a phobia disorder (OR=1.36), and greater PTSD symptom count (OR=1.11). Older age (OR=.40), identifying as black or Asian versus white non-Hispanic (OR=.70 and OR=.28, respectively), and greater social functioning (OR=.98) were associated with decreased odds of PTSD treatment utilization. Results highlight factors that may be useful in identifying population subgroups with PTSD that are at risk for underutilization of services.

  7. Investigation into the Individualized Treatment of Traditional Chinese Medicine through a Series of N-of-1 Trials

    Science.gov (United States)

    Yang, Peilan; Wang, Jie; Wu, Yingen; Zi, Suna; Tang, Jie; Wang, Zhenwei

    2018-01-01

    Purpose To compare the efficacy of individualized herbal decoction with standard decoction for patients with stable bronchiectasis through N-of-1 trials. Methods We conducted a single center N-of-1 trials in 17 patients with stable bronchiectasis. Each N-of-1 trial contains three cycles. Each cycle is divided into two 4-week intervention including individualized decoction and fixed decoction (control). The primary outcome was patient self-reported symptoms scores on a 1–7 point Likert scale. Secondary outcomes were 24-hour sputum volume and CAT scores. Results Among 14 completed trials, five showed that the individualized decoction was statistically better than the control decoction on symptom scores (P traditional Chinese medicine individual diagnosis and treatment. PMID:29552084

  8. Delay discounting, treatment motivation and treatment retention among substance-dependent individuals attending an in inpatient detoxification program

    NARCIS (Netherlands)

    Stevens, Laura; Verdejo-García, Antonio; Roeyers, Herbert; Goudriaan, Anna E.; Vanderplasschen, Wouter

    2015-01-01

    Recent studies consistently indicate high rates of delay discounting in drug users, which refers to a strong tendency to devaluate delayed rewards. Many addiction treatment programs however, place high demands on the ability to postpone immediate gratification. Therefore, these programs may be

  9. Patients’ perception regarding the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment: a qualitative study

    Directory of Open Access Journals (Sweden)

    Rosiane Davina da Silva

    2017-09-01

    Full Text Available Abstract Background Tuberculosis remains an important disease which mainly affects the majority of vulnerable individuals in society, who are subjected to poor living conditions and difficulties to access the services of public health. Under these circumstances, the present study aims to understand patients’ perception in relation to the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment. Methods A qualitative descriptive cross sectional study was conducted in one large municipality at the state of Paraíba, Northeast of Brazil. The study subjects, who were residents of the study site, covered all tuberculosis cases diagnosed between March and June 2015. The sample was defined by the criteria of response saturation. All interviews were audio recorded, and data analysis was developed through the hermeneutic dialectic method and the theory of Generative Route Sense. The project was approved by the Research Ethics Committee of the University of São Paulo (USP. Results A total of 13 individuals were interviewed and the responses were identified into two analytical categories: the difficulties they had and the enabling factors they could mention during their tuberculosis treatment. Patients brought up social exclusion as an obstacle to treatment adherence, which, along with stigmatization, weakened their link with family members and health professionals. Moreover, economic precariousness was a major hindrance to the maintenance of a proper diet and transportation access to health centers. However, social support and directly observed treatment helped to break down barriers of prejudice and to promote individual and family empowerment. Finally, patients also reported that their will to live and faith gave them the strength to continue with the treatment. Conclusions According to patients in this study, social support and the strengthening of links with family members and health professionals may reduce

  10. Patients' perception regarding the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment: a qualitative study.

    Science.gov (United States)

    da Silva, Rosiane Davina; de Luna, Fernanda Darliane Tavares; de Araújo, Aguinaldo José; Camêlo, Edwirde Luiz Silva; Bertolozzi, Maria Rita; Hino, Paula; Lacerda, Sheylla Nadjane Batista; Fook, Sayonara Maria Lia; de Figueiredo, Tânia Maria Ribeiro Monteiro

    2017-09-19

    Tuberculosis remains an important disease which mainly affects the majority of vulnerable individuals in society, who are subjected to poor living conditions and difficulties to access the services of public health. Under these circumstances, the present study aims to understand patients' perception in relation to the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment. A qualitative descriptive cross sectional study was conducted in one large municipality at the state of Paraíba, Northeast of Brazil. The study subjects, who were residents of the study site, covered all tuberculosis cases diagnosed between March and June 2015. The sample was defined by the criteria of response saturation. All interviews were audio recorded, and data analysis was developed through the hermeneutic dialectic method and the theory of Generative Route Sense. The project was approved by the Research Ethics Committee of the University of São Paulo (USP). A total of 13 individuals were interviewed and the responses were identified into two analytical categories: the difficulties they had and the enabling factors they could mention during their tuberculosis treatment. Patients brought up social exclusion as an obstacle to treatment adherence, which, along with stigmatization, weakened their link with family members and health professionals. Moreover, economic precariousness was a major hindrance to the maintenance of a proper diet and transportation access to health centers. However, social support and directly observed treatment helped to break down barriers of prejudice and to promote individual and family empowerment. Finally, patients also reported that their will to live and faith gave them the strength to continue with the treatment. According to patients in this study, social support and the strengthening of links with family members and health professionals may reduce social exclusion and other difficulties they face, thus encouraging them

  11. Radiographic structural findings in the mandibular condyles of young individuals receiving orthodontic treatment

    International Nuclear Information System (INIS)

    Peltola, J.S.; Nystroem, M.; Koenoenen, M.; Wolf, J.

    1995-01-01

    Radiographic findings in mandibular condyles were studied from the pre- and post-treatment panoramic radiographs of 625 orthodontic patients. The subjects' mean age was 11 years at the start and 14 years at the end of active orthodontic treatment. Radiographic condylar findings were seen in 14 subjects before treatment and in 54 subjects after treatment. In age-related controls condylar findings were seen in 3%. The condylar findings was ''flattening only'' in half of the patients and in one-third of the controls with condylar findings. Activator treatment was associated with condylar findings. Condylar findings increased with age in the orthodontically treated subjects, but not in the unselected population controls. This may mean that condyles become more sensitive with age in children. Increase with age may be partly due to the radiographic interpretation, since minor condylar findings are difficult to observe in young children, and partly due to differences in treatment modalities and the duration of treatment. 44 refs., 1 fig., 3 tabs

  12. Fate of bulk organic matter, nitrogen, and pharmaceutically active compounds in batch experiments simulating soil aquifer treatment (SAT) using primary effluent

    KAUST Repository

    Abel, Chol D T

    2013-06-30

    Reduction of bulk organic matter, nitrogen, and pharmaceutically active compounds from primary effluent during managed aquifer recharge was investigated using laboratory-scale batch reactors. Biologically stable batch reactors were spiked with different concentrations of sodium azide to inhibit biological activity and probe the effect of microbial activity on attenuation of various pollutants of concern. The experimental results obtained revealed that removal of dissolved organic carbon correlated with active microbial biomass. Furthermore, addition of 2 mM of sodium azide affected nitrite-oxidizing bacteria leading to accumulation of nitrite-nitrogen in the reactors while an ammonium-nitrogen reduction of 95.5 % was achieved. Removal efficiencies of the hydrophilic neutral compounds phenacetin, paracetamol, and caffeine were independent of the extent of the active microbial biomass and were >90 % in all reactors, whereas removal of pentoxifylline was dependent on the biological stability of the reactor. However, hydrophobic ionic compounds exhibited removal efficiency >80 % in batch reactors with the highest biological activity as evidenced by high concentration of adenosine triphosphate. © 2013 Springer Science+Business Media Dordrecht.

  13. Fate of bulk organic matter, nitrogen, and pharmaceutically active compounds in batch experiments simulating soil aquifer treatment (SAT) using primary effluent

    KAUST Repository

    Abel, Chol D T; Sharma, Saroj K.; Maeng, Sungkyu; Magic-Knezev, Aleksandra; Kennedy, Maria Dolores; Amy, Gary L.

    2013-01-01

    Reduction of bulk organic matter, nitrogen, and pharmaceutically active compounds from primary effluent during managed aquifer recharge was investigated using laboratory-scale batch reactors. Biologically stable batch reactors were spiked with different concentrations of sodium azide to inhibit biological activity and probe the effect of microbial activity on attenuation of various pollutants of concern. The experimental results obtained revealed that removal of dissolved organic carbon correlated with active microbial biomass. Furthermore, addition of 2 mM of sodium azide affected nitrite-oxidizing bacteria leading to accumulation of nitrite-nitrogen in the reactors while an ammonium-nitrogen reduction of 95.5 % was achieved. Removal efficiencies of the hydrophilic neutral compounds phenacetin, paracetamol, and caffeine were independent of the extent of the active microbial biomass and were >90 % in all reactors, whereas removal of pentoxifylline was dependent on the biological stability of the reactor. However, hydrophobic ionic compounds exhibited removal efficiency >80 % in batch reactors with the highest biological activity as evidenced by high concentration of adenosine triphosphate. © 2013 Springer Science+Business Media Dordrecht.

  14. Hypnosis Attitudes: Treatment Effects and Associations With Symptoms in Individuals With Cancer.

    Science.gov (United States)

    Mendoza, Maria Elena; Capafons, Antonio; Jensen, Mark P

    2017-07-01

    Attitudes about hypnosis are associated with hypnotic responsiveness. However, little is known about how hypnosis attitudes change with treatment and if those changes are associated with better outcomes. This study examined whether an intervention based on the Valencia Model of Waking Hypnosis combined with Cognitive-Behavioral Therapy changed attitudes about hypnosis in a sample of patients with a history of cancer. The results indicated that the intervention improved attitudes toward hypnosis, relative to a control intervention, and the improvements remained stable at 3-month follow-up. Analyses also showed that changes in some attitudes were associated with treatment-related improvements. The findings are consistent with the idea that attitudes about hypnosis play a role in hypnosis treatment outcome, supporting the importance of addressing such beliefs at the onset of and throughout treatment.

  15. Experienced and anticipated discrimination reported by individuals in treatment for substance use disorders within the Netherlands

    NARCIS (Netherlands)

    van Boekel, L.C.; Brouwers, E.P.M.; van Weeghel, J.; Garretsen, H.F.L.

    2016-01-01

    Experiences and expectations of discrimination (anticipated discrimination) may delay treatment seeking among people with substance use disorders. In addition, experienced and anticipated discrimination can be a barrier to successful recovery and rehabilitation. The aim of this study was to study

  16. Perceived Stigma and Treatment-Seeking Behavior in Individuals with Substance Use Disorder in Baghdad

    Directory of Open Access Journals (Sweden)

    Qahtan Q. Mohammed

    2016-12-01

    Conclusions The study concluded that perceived stigma among substance abusers has no impact upon their treatment-seeking behavior, and also, perceived stigma among substance abusers is insignificantly correlated with their socio-demographic variables.

  17. The efficacy of individual treatment of subjective tinnitus with cognitive behavioural therapy.

    Science.gov (United States)

    Canals, Pascual; Pérez Del Valle, Belén; Lopez, Francisco; Marco, Amparo

    2016-01-01

    It has been a long time since subjective tinnitus cases were described for the first time but they still lack a treatment with proven effectiveness. The main goal of this study was to evaluate the effectiveness of cognitive behavioural therapy in these patients. Between 2012 and 2013, 310 patients that suffered from subjective tinnitus were studied. Of these, 267 were included in treatment based on cognitive behavioural therapy. The monitoring period lasted 18 months for most cases, while it lasted 21 months for 11 patients. Considering patients that interrupted their treatment as failures, the percentage of recovery was 95.7%. Cognitive behavioural therapy should always be included in the treatment of people suffering from tinnitus. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  18. Topical analgesic added to paraffin enhances paraffin bath treatment of individuals with hand osteoarthritis.

    Science.gov (United States)

    Myrer, Joseph William; Johnson, Aaron Wayne; Mitchell, Ulrike H; Measom, Gary J; Fellingham, Gilbert W

    2011-01-01

    To compare treating patients with symptomatic hand osteoarthritis (OA) with paraffin baths only (PO) (100% wax) or paraffin baths 80% wax with 20% topical analgesic (PTA). Subjects met criteria of the American College of Rheumatology for classifying symptomatic hand OA and had a Dreiser's index score >5 points. Current and average pain at rest and with movement was assessed with visual analogue scales. Hand function was assessed by the functional index for hand OA (FIHOA). Both groups had a significant reduction in their 'current' pain 15 min after the first and twelfth treatments compared to pre-treatment but there was no difference between groups (t = 0.10, p > 0.05). The PTA group had greater improvement over the 12 treatment sessions for their pain at rest (t = 2.92, p paraffin produced significantly greater pain relief at rest and during movement than paraffin baths alone after 12 treatments. Additionally, the PTA group experienced greater improved hand function.

  19. Pollution Pathways of Pharmaceutical Residues in the Aquatic Environment on the Island of Mallorca, Spain

    DEFF Research Database (Denmark)

    Rodríguez-Navas, Carlos; Björklund, Erland; Bak, Søren Alex

    2013-01-01

    , including wastewater-treatment plant effluents, municipal solid waste landfill leachates, groundwater (GW), and marine water. An overall set of 19 pharmaceuticals has been identified in the environment of the 27 human pharmaceuticals investigated in this study. WWTP effluents are the main source......, but minor, possible source of introduction of pharmaceuticals to GW aquifers. Finally, WWTP effluents ending in the Mediterranean Sea, primarily highly urbanized coastal areas, cause pharmaceutical residues to occur in marine water bodies....

  20. The effects of an individualized exercise intervention on body composition in breast cancer patients undergoing treatment

    OpenAIRE

    Battaglini,Claudio; Bottaro,Martim; Dennehy,Carolyn; Rae,Logan; Shields,Edgar; Kirk,David; Hackney,Anthony

    2007-01-01

    CONTEXT AND OBJECTIVE: Changes in metabolism have been reported in the majority of patients undergoing cancer treatment, and these are usually characterized by progressive change in body composition. The effects of aerobic exercise programs to combat the cancer and cancer treatment-related side effects, which include the negative changes in body composition, have been extensively reported in the literature. However, few resistance exercise intervention studies have hypothesized that breast ca...

  1. Schistosomiasis and HIV in rural Zimbabwe: efficacy of treatment of schistosomiasis in individuals with HIV coinfection

    DEFF Research Database (Denmark)

    Kallestrup, Per; Zinyama, Rutendo; Gomo, Exnevia

    2006-01-01

    There is evidence from experimental models that the praziquantel-induced clearance of schistosomiasis is dependent on the host's immune response. Consequently, human immunodeficiency virus (HIV)-related immunodeficiency may impair the effect of praziquantel treatment.......There is evidence from experimental models that the praziquantel-induced clearance of schistosomiasis is dependent on the host's immune response. Consequently, human immunodeficiency virus (HIV)-related immunodeficiency may impair the effect of praziquantel treatment....

  2. Removal of pharmaceuticals in WWTP effluents by ozone and ...

    African Journals Online (AJOL)

    2013-02-12

    Feb 12, 2013 ... discharge of effluents by wastewater treatment plants (WWTPs) that are not ... The efficiency of ozone in removing pharmaceuticals and personal care ...... assessment and modeling of an ozonation step for full-scale munic-.

  3. Pharmaceutical care: the PCNE definition 2013.

    Science.gov (United States)

    Allemann, Samuel S; van Mil, J W Foppe; Botermann, Lea; Berger, Karin; Griese, Nina; Hersberger, Kurt E

    2014-06-01

    Twenty-three years after Hepler and Strand published their well-known definition of Pharmaceutical Care (PhC), confusion remains about what the term includes and how to differentiate it from other terms. The board of the Pharmaceutical Care Network Europe (PCNE) felt the need to redefine PhC and to answer the question: "What is Pharmaceutical Care in 2013". The aims of this paper were to review existing definitions of PhC and to describe the process of developing a redefined definition. A literature search was conducted in the MEDLINE database (1964-January 2013). Keywords included "Pharmaceutical Care", "Medication (Therapy) Management", "Medicine Management", and "Pharmacist Care" in the title or abstract together with the term "defin*". To ease comparison between definitions, we developed a standardised syntax to paraphrase the definitions. During a dedicated meeting, a moderated discussion about the definition of PhC was organised. The initial literature search produced 186 hits, with eight unique PhC definitions. Hand searching identified a further 11 unique definitions. These 19 definitions were paraphrased using the standardised syntax (provider, recipient, subject, outcome, activities). Fourteen members of PCNE and 10 additional experts attended the moderated discussion. Working groups of increasing size developed intermediate definitions, which had similarities and differences to those retrieved in the literature search. At the end of the session, participants reached a consensus on a "PCNE definition of Pharmaceutical Care" reading: "Pharmaceutical Care is the pharmacist's contribution to the care of individuals in order to optimize medicines use and improve health outcomes". It was possible to paraphrase definitions of PhC using a standardised syntax focusing on the provider, recipient, subject, outcomes, and activities included in PhC practice. During a one-day workshop, experts in PhC research agreed on a definition, intended to be applicable for the

  4. Individualization of treatments with drugs metabolized by CES1: combining genetics and metabolomics

    DEFF Research Database (Denmark)

    Rasmussen, Henrik B.; Bjerre, Ditte; Linnet, Kristian

    2015-01-01

    CES1 is involved in the hydrolysis of ester group-containing xenobiotic and endobiotic compounds including several essential and commonly used drugs. The individual variation in the efficacy and tolerability of many drugs metabolized by CES1 is considerable. Hence, there is a large interest in in...

  5. The effects of physiotherapy for female urinary incontinence: individual compared with group treatment

    NARCIS (Netherlands)

    Janssen, C.C.M.; Lagro-Janssen, A.L.M.; Felling, A.J.A.

    2001-01-01

    OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126

  6. The effects of physiotherapy for female urinary incontinence: individual compared with group treatment.

    NARCIS (Netherlands)

    Janssen, C.C.M.; Lagro-Janssen, A.L.M.; Felling, A.J.A.

    2001-01-01

    OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126

  7. No differences between group versus individual treatment of childhood anxiety disorders in a randomised clinical trial

    NARCIS (Netherlands)

    Liber, Juliette M.; van Widenfelt, Brigit M.; Utens, Elisabeth M. W. J.; Ferdinand, Robert F.; van der Leeden, Adelinde J. M.; van Gastel, Willemijn; Treffers, Philip D. A.

    2008-01-01

    The present study compares an individual versus a group format in the delivery of manualised cognitive-behavioural therapy (FRIENDS) for children with anxiety disorders. Clinically referred children (aged 8 to 12) diagnosed with Separation Anxiety Disorder (n = 52), Generalised Anxiety Disorder (n =

  8. Predicting and preventing ovarian hyperstimulation syndrome (OHSS: the need for individualized not standardized treatment

    Directory of Open Access Journals (Sweden)

    Fiedler Klaus

    2012-04-01

    Full Text Available Abstract Ovarian hyperstimulation syndrome (OHSS is the most serious complication of controlled ovarian stimulation (COS as part of assisted reproductive technologies (ART. While the safety and efficacy of ART is well established, physicians should always be aware of the risk of OHSS in patients undergoing COS, as it can be fatal. This article will briefly present the pathophysiology of OHSS, including the key role of vascular endothelial growth factor (VEGF, to provide the foundation for an overview of current techniques for the prevention of OHSS. Risk factors and predictive factors for OHSS will be presented, as recognizing these risk factors and individualizing the COS protocol appropriately is the key to the primary prevention of OHSS, as the benefits and risks of each COS strategy vary among individuals. Individualized COS (iCOS could effectively eradicate OHSS, and the identification of hormonal, functional and genetic markers of ovarian response will facilitate iCOS. However, if iCOS is not properly applied, various preventive measures can be instituted once COS has begun, including cancelling the cycle, coasting, individualizing the human chorionic gonadotropin trigger dose or using a gonadotropin-releasing hormone (GnRH agonist (for those using a GnRH antagonist protocol, the use of intravenous fluids at the time of oocyte retrieval, and cryopreserving/vitrifying all embryos for subsequent transfer in an unstimulated cycle. Some of these techniques have been widely adopted, despite the scarcity of data from randomized clinical trials to support their use.

  9. Combination antiretroviral therapy improves cognitive performance and functional connectivity in treatment-naïve HIV-infected individuals.

    Science.gov (United States)

    Zhuang, Yuchuan; Qiu, Xing; Wang, Lu; Ma, Qing; Mapstone, Mark; Luque, Amneris; Weber, Miriam; Tivarus, Madalina; Miller, Eric; Arduino, Roberto C; Zhong, Jianhui; Schifitto, Giovanni

    2017-10-01

    Our study aimed to investigate the short-term effect of combination antiretroviral therapy (cART) on cognitive performance and functional and structural connectivity and their relationship to plasma levels of antiretroviral (ARV) drugs. Seventeen ARV treatment-naïve HIV-infected individuals (baseline mean CD4 cell count, 479 ± 48 cells/mm 3 ) were age matched with 17 HIV-uninfected individuals. All subjects underwent a detailed neurocognitive and functional assessment and magnetic resonance imaging. HIV-infected subjects were scanned before starting cART and 12 weeks after initiation of treatment. Uninfected subjects were assessed once at baseline. Functional connectivity (FC) was assessed within the default mode network while structural connectivity was assessed by voxel-wise analysis using tract-based spatial statistics (TBSS) and probabilistic tractography within the DMN. Tenofovir and emtricitabine blood concentration were measured at week 12 of cART. Prior to cART, HIV-infected individuals had significantly lower cognitive performance than control subjects as measured by the total Z-score from the neuropsychological tests assessing six cognitive domains (p = 0.020). After 12 weeks of cART treatment, there remained only a weak cognitive difference between HIV-infected and HIV-uninfected subjects (p = 0.057). Mean FC was lower in HIV-infected individuals compared with those uninfected (p = 0.008), but FC differences became non-significant after treatment (p = 0.197). There were no differences in DTI metrics between HIV-infected and HIV-uninfected individuals using the TBSS approach and limited evidence of decreased structural connectivity within the DMN in HIV-infected individuals. Tenofovir and emtricitabine plasma concentrations did not correlate with either cognitive performance or imaging metrics. Twelve weeks of cART improves cognitive performance and functional connectivity in ARV treatment-naïve HIV-infected individuals with relatively

  10. Pharmaceutical market in Serbia

    Directory of Open Access Journals (Sweden)

    Veselin Tima Dickov

    2012-02-01

    Full Text Available Marketing concept formed around the focus on the consumers, their needs, wants and demands, evolves in the case of pharmaceutical into a care of the complex interest of constituents generating demand on this market and #8211; pres scribers whose role is to select therapies, pharmacists who dispense drugs within a specialized distribution channel to the final consumer -patient, alongside the payers and #8211; the state and or insurance companies refund a part of or total costs of the pharmaceutical product. A special challenge that the subject raises is the existence of controversy generated from two sources. Marketing controversy stems from criticism leveled at the effectiveness and efficiency of marketing activities and the debatable ethical code of conduct. [J Intercult Ethnopharmacol 2012; 1(1.000: 44-51

  11. Automation and Intensity Modulated Radiation Therapy for Individualized High-Quality Tangent Breast Treatment Plans

    International Nuclear Information System (INIS)

    Purdie, Thomas G.; Dinniwell, Robert E.; Fyles, Anthony; Sharpe, Michael B.

    2014-01-01

    Purpose: To demonstrate the large-scale clinical implementation and performance of an automated treatment planning methodology for tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: Automated planning was used to prospectively plan tangential breast IMRT treatment for 1661 patients between June 2009 and November 2012. The automated planning method emulates the manual steps performed by the user during treatment planning, including anatomical segmentation, beam placement, optimization, dose calculation, and plan documentation. The user specifies clinical requirements of the plan to be generated through a user interface embedded in the planning system. The automated method uses heuristic algorithms to define and simplify the technical aspects of the treatment planning process. Results: Automated planning was used in 1661 of 1708 patients receiving tangential breast IMRT during the time interval studied. Therefore, automated planning was applicable in greater than 97% of cases. The time for treatment planning using the automated process is routinely 5 to 6 minutes on standard commercially available planning hardware. We have shown a consistent reduction in plan rejections from plan reviews through the standard quality control process or weekly quality review multidisciplinary breast rounds as we have automated the planning process for tangential breast IMRT. Clinical plan acceptance increased from 97.3% using our previous semiautomated inverse method to 98.9% using the fully automated method. Conclusions: Automation has become the routine standard method for treatment planning of tangential breast IMRT at our institution and is clinically feasible on a large scale. The method has wide clinical applicability and can add tremendous efficiency, standardization, and quality to the current treatment planning process. The use of automated methods can allow centers to more rapidly adopt IMRT and enhance access to the documented

  12. Pharmaceutical Research Strategies

    OpenAIRE

    Phlippen, Sandra; Vermeersch, Ad

    2008-01-01

    textabstractThis study analyses 1400 research projects of the top 20 R&D-spending pharmaceuticals to identify the determinants of successful research projects. We provide clear evidence that externally sourced projects and projects involving biotechnologies perform better than internal projects and chemical projects, respectively. Controlling for these effects, we find that big pharma should either build a critical mass of disease area knowledge or diversify projects over different DA’s in or...

  13. The pharmaceutical quality revolution

    Directory of Open Access Journals (Sweden)

    Jordi Botet

    2016-01-01

    Full Text Available Pharmaceutical products are patient-oriented. If they had a deficient quality they might put live at risk. Ensuring their quality is not, however, a straightforward task and this is why different approaches have been used along the way. This article analyzes them and shows how our present approach, if well implemented, is very effective in ensuring quality.Methods. This article analyzes the current pharmaceutical quality system as described by international guidances in the light of practical experience gathered by the author as an international GMP-consultant.Result. Nowadays we have come to understand that as quality is a global concept in terms of time and of requirements, it has to be assured in a global way too. This is why quality assurance is a permanent process that starts during the development of a product and goes on during its manufacturing life. Manufacturing should be performed within a pharmaceutical quality system which ensures GMP compliance. Decisions should be science and risk-based. Products and processes are monitored by means of critical variables.Conclusions. The approach followed in the 21st century for ensuring quality is very effective and allows for a progressive reduction of the level of quality risk. However, this quality system is either comprehensive or there is no quality

  14. Individualized Treatment for Tobacco Dependence in Addictions Treatment Settings: The Role of Current Depressive Symptoms on Outcomes at 3 and 6 Months.

    Science.gov (United States)

    Zawertailo, Laurie A; Baliunas, Dolly; Ivanova, Anna; Selby, Peter L

    2015-08-01

    Individuals with concurrent tobacco dependence and other addictions often report symptoms of low mood and depression and as such may have more difficulty quitting smoking. We hypothesized that current symptoms of depression would be a significant predictor of quit success among a group of smokers receiving individualized treatment for tobacco dependence within addiction treatment settings. Individuals in treatment for other addictions were enrolled in a smoking cessation program involving brief behavioral counseling and individualized dosing of nicotine replacement therapy. The baseline assessment included the Patient Health Questionnaire (PHQ9) for depression. Smoking cessation outcomes were measured at 3 and 6 months post-enrollment. Bivariate associations between cessation outcomes and PHQ9 score were analyzed. Of the 1,196 subjects enrolled to date, 1,171 (98%) completed the PHQ9. Moderate to severe depression (score >9) was reported by 28% of the sample, and another 29% reported mild depression (score between 5 and 9). Contrary to the extant literature and other findings by our own group, there was no association between current depression and cessation outcome at either 3 months (n = 1,171) (17.0% in those with PHQ9 > 9 vs. 19.8% in those with PHQ9 addictions treatment setting. These data indicate that patients in an addictions treatment setting can successfully quit smoking regardless of current depressive symptoms. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Dosimetric comparison between fixed and individualized activity in Graves' disease treatment with 131I

    International Nuclear Information System (INIS)

    Melgar Perez, J.; Orellana Salas, A.; Santaella Guardiola, Y.; Arrocha Acevedo, J. F.

    2013-01-01

    A patient-especific method has been used to calculate the therapeutic 1 '3 1 I activity to administer to patients with Graves disease in order to obtain the optimal thyroid dose. The aim of this study was to analyze the dose variation in contrast to the fixed a ctivity regimen. In 30 patients, biokinetic and morfological parameters were estimated from planar scintigraphic images obtained at 4, 24 and 96 hours after injection of 123 I and 131 I activities were calculated to deliver 120 Gy to the thyroid. Comparative dose calculations were carried out assuming that the individual patients had been treated according to 370 MBq activity administration. Activity (or dose) was reduced by an average factor of 2.4 and up to a factor 4.9 for an individual patient. The implemen ted method seeks a balance among the accuracy of the calculations, resource consumption and patient comfort. (Author)

  16. Temporal variations and trends in loads of commonly used pharmaceuticals to large wastewater treatment plants in Sweden, a case study (Ryaverket)

    DEFF Research Database (Denmark)

    Paxeus, Nicklas; Bester, Kai; El-taliawy, Haitham

    Loads of individual commonly used analgesics (ibuprofen, diclofenac), antibiotics (sulfamethoxazole, trimethoprim), β-blockers (atenolol, metoprolol, sotalol, propranolol) and neuroleptics (carbamazepine, citalopram) to a large scale operating WWTP in Sweden (Ryaverket) were studied by monitoring...

  17. Adherence to diet and fluid restriction of individuals on hemodialysis treatment and affecting factors in Turkey.

    Science.gov (United States)

    Efe, Dilek; Kocaöz, Semra

    2015-04-01

    This study was conducted to determine adherence to diet and fluid restriction in hemodialysis-treated individuals and the affecting factors in Turkey. This descriptive study was conducted between 15 October 2010 and 15 January 2011 in subjects who voluntarily agreed to participate in the study from three dialysis centers in a city located in the Central Anatolia Region of Turkey. One hundred and twenty-one individuals treated with hemodialysis made up the study sample. The data were collected using a questionnaire consisting of 41 questions and the Dialysis Diet and Fluid Non-adherence Questionnaire. The data were evaluated with percentage, median, Mann-Whitney U-test, Kruskal-Wallis test, Student's t-test in independent samples and Spearman's rank correlation coefficient. The authors found that 98.3% of the individuals experienced non-adherence to diet and 95.0% with fluid restriction. The authors found a weak and negative relationship between calcium levels and non-adherence to fluid restriction, a weak relationship between phosphorus levels and diet non-adherence frequency and degree and the fluid non-adherence frequency scores, and a moderate positive relationship between phosphorus levels and fluid restriction non-adherence degree scores (P < 0.05). Based on these results, regular training and information regarding diet and fluid restriction must be provided to individuals aged 21-35 years with no one in the family to help with their care, those who consumed salted food, or had interdialytic weight gain of 4.5 kg or more. © 2014 The Authors. Japan Journal of Nursing Science © 2014 Japan Academy of Nursing Science.

  18. Adsorptive removal of selected pharmaceuticals by mesoporous silica SBA-15

    International Nuclear Information System (INIS)

    Bui, Tung Xuan; Choi, Heechul

    2009-01-01

    The removal of five selected pharmaceuticals, viz., carbamazepine, clofibric acid, diclofenac, ibuprofen, and ketoprofen was examined by batch sorption experiments onto a synthesized mesoporous silica SBA-15. SBA-15 was synthesized and characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), N 2 adsorption-desorption measurement, and point of zero charge (PZC) measurement. Pharmaceutical adsorption kinetics was rapid and occurred on a scale of minutes, following a pseudo-second-order rate expression. Adsorption isotherms were best fitted by the Freundlich isotherm model. High removal rates of individual pharmaceuticals were achieved in acidic media (pH 3-5) and reached 85.2% for carbamazepine, 88.3% for diclofenac, 93.0% for ibuprofen, 94.3% for ketoprofen, and 49.0% for clofibric acid at pH 3 but decreased with increase in pH. SBA-15 also showed high efficiency for removal of a mixture of 5 pharmaceuticals. Except for clofibric acid (35.6%), the removal of pharmaceuticals in the mixture ranged from 75.2 to 89.3%. Based on adsorption and desorption results, the mechanism of the selected pharmaceuticals was found to be a hydrophilic interaction, providing valuable information for further studies to design materials for the purpose. The results of this study suggest that mesoporous-silica-based materials are promising adsorbents for removing pharmaceuticals from not only surface water but also wastewater of pharmaceutical industrial manufactures.

  19. Adsorptive removal of selected pharmaceuticals by mesoporous silica SBA-15

    Energy Technology Data Exchange (ETDEWEB)

    Bui, Tung Xuan, E-mail: bxtung@gist.ac.kr [Department of Environmental Science and Engineering, Gwangju Institute of Science and Technology (GIST), 261 Cheomdan-gwagiro, Buk-gu, Gwangju 500-712 (Korea, Republic of); Choi, Heechul, E-mail: hcchoi@gist.ac.kr [Department of Environmental Science and Engineering, Gwangju Institute of Science and Technology (GIST), 261 Cheomdan-gwagiro, Buk-gu, Gwangju 500-712 (Korea, Republic of)

    2009-09-15

    The removal of five selected pharmaceuticals, viz., carbamazepine, clofibric acid, diclofenac, ibuprofen, and ketoprofen was examined by batch sorption experiments onto a synthesized mesoporous silica SBA-15. SBA-15 was synthesized and characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), N{sub 2} adsorption-desorption measurement, and point of zero charge (PZC) measurement. Pharmaceutical adsorption kinetics was rapid and occurred on a scale of minutes, following a pseudo-second-order rate expression. Adsorption isotherms were best fitted by the Freundlich isotherm model. High removal rates of individual pharmaceuticals were achieved in acidic media (pH 3-5) and reached 85.2% for carbamazepine, 88.3% for diclofenac, 93.0% for ibuprofen, 94.3% for ketoprofen, and 49.0% for clofibric acid at pH 3 but decreased with increase in pH. SBA-15 also showed high efficiency for removal of a mixture of 5 pharmaceuticals. Except for clofibric acid (35.6%), the removal of pharmaceuticals in the mixture ranged from 75.2 to 89.3%. Based on adsorption and desorption results, the mechanism of the selected pharmaceuticals was found to be a hydrophilic interaction, providing valuable information for further studies to design materials for the purpose. The results of this study suggest that mesoporous-silica-based materials are promising adsorbents for removing pharmaceuticals from not only surface water but also wastewater of pharmaceutical industrial manufactures.

  20. Individualized Infliximab Treatment Guided by Patient-managed eHealth in Children and Adolescents with Inflammatory Bowel Disease.

    Science.gov (United States)

    Carlsen, Katrine; Houen, Gunnar; Jakobsen, Christian; Kallemose, Thomas; Paerregaard, Anders; Riis, Lene B; Munkholm, Pia; Wewer, Vibeke

    2017-09-01

    To individualize timing of infliximab (IFX) treatment in children and adolescents with inflammatory bowel disease (IBD) using a patient-managed eHealth program. Patients with IBD, 10 to 17 years old, treated with IFX were prospectively included. Starting 4 weeks after their last infusion, patients reported a weekly symptom score and provided a stool sample for fecal calprotectin analysis. Based on symptom scores and fecal calprotectin results, the eHealth program calculated a total inflammation burden score that determined the timing of the next IFX infusion (4-12 wk after the previous infusion). Quality of Life was scored by IMPACT III. A control group was included to compare trough levels of IFX antibodies and concentrations and treatment intervals. Patients and their parents evaluated the eHealth program. There were 29 patients with IBD in the eHealth group and 21 patients with IBD in the control group. During the control period, 94 infusions were provided in the eHealth group (mean interval 9.5 wk; SD 2.3) versus 105 infusions in the control group (mean interval 6.9 wk; SD 1.4). Treatment intervals were longer in the eHealth group (P eHealth-individualized timing of IFX treatments, with treatment intervals of 4 to 12 weeks, was accompanied by no significant development of IFX antibodies. Patients reported better control and improved knowledge of their IBD.

  1. The effect of cross-sex hormonal treatment on gender dysphoria individuals' mental health: a systematic review

    Directory of Open Access Journals (Sweden)

    Costa R

    2016-08-01

    Full Text Available Rosalia Costa,1 Marco Colizzi2 1Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, Tavistock Centre, 2Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK Abstract: Cross-sex hormonal treatment represents a main aspect of gender dysphoria health care pathway. However, it is still debated whether this intervention translates into a better mental well-being for the individual and which mechanisms may underlie this association. Although sex reassignment surgery has been the subject of extensive investigation, few studies have specifically focused on hormonal treatment in recent years. Here, we systematically review all studies examining the effect of cross-sex hormonal treatment on mental health and well-being in gender dysphoria. Research tends to support the evidence that hormone therapy reduces symptoms of anxiety and dissociation, lowering perceived and social distress and improving quality of life and self-esteem in both male-to-female and female-to-male individuals. Instead, compared to female-to-male individuals, hormone-treated male-to-female individuals seem to benefit more in terms of a reduction in their body uneasiness and personality-related psychopathology and an amelioration of their emotional functioning. Less consistent findings support an association between hormonal treatment and other mental health-related dimensions. In particular, depression, global psychopathology, and psychosocial functioning difficulties appear to reduce only in some studies, while others do not suggest any improvement in these domains. Results from longitudinal studies support more consistently the association between hormonal treatment and improved mental health. On the contrary, a number of cross-sectional studies do not support this evidence. This review provides possible biological explanation vs psychological explanation (direct effect vs indirect effect

  2. Immunological changes in human immunodeficiency virus (HIV)-infected individuals during HIV-specific protease inhibitor treatment

    DEFF Research Database (Denmark)

    Ullum, H; Katzenstein, T; Aladdin, H

    1999-01-01

    The present study examines the influence of effective anti-retroviral treatment on immune function, evaluated by a broad array of immunological tests. We followed 12 individuals infected with human immunodeficiency virus (HIV) for 6 months after initiation of combination anti-retroviral treatment...... including a protease inhibitor. Unstimulated and pokeweed mitogen (PWM)-, interleukin (IL)-2- and phytohaemagglutinin (PHA)-stimulated lymphocyte proliferative responses increased during follow-up reaching average levels from 1.3-fold (PHA) to 3.7-fold (PWM) above baseline values. The total CD4+ lymphocyte...

  3. Biomarkers for Success: Using Neuroimaging to Predict Relapse and Develop Brain Stimulation Treatments for Cocaine-Dependent Individuals.

    Science.gov (United States)

    Hanlon, C A; Dowdle, L T; Jones, J L

    2016-01-01

    Cocaine dependence is one of the most difficult substance use disorders to treat. While the powerful effects of cocaine use on behavior were documented in the 19th century, it was not until the late 20th century that we realized cocaine use was affecting brain tissue and function. Following a brief introduction (Section 1), this chapter will summarize our current knowledge regarding alterations in neural circuit function typically observed in chronic cocaine users (Section 2) and highlight an emerging body of literature which suggests that pretreatment limbic circuit activity may be a reliable predictor of clinical outcomes among individuals seeking treatment for cocaine (Section 3). Finally, as the field of addiction research strives to translate this neuroimaging data into something clinically meaningful, we will highlight several new brain stimulation approaches which utilize functional brain imaging data to design noninvasive brain stimulation interventions for individuals seeking treatment for substance dependence disorders (Section 4). © 2016 Elsevier Inc. All rights reserved.

  4. Surgical treatment of a Pattern I Obstructive Sleep Apnea Syndrome individual - clinical case report

    Directory of Open Access Journals (Sweden)

    Christiane Cavalcante Feitoza

    Full Text Available Obstructive Sleep Apnea Syndrome (OSA is a multifactorial disease that highly alters a persons quality of life. It is characterized by the repeated interruption of breathing during sleep, due to an obstruction or the collapse of the upper airways. Since it is a multifactorial etiological disorder, it requires a thorough diagnosis and treatment with an interdisciplinary team, which comprises several professionals such as a surgical dentist, phonoaudiologist, otorhinolaryngologist, sleep doctor, neurologist and physiotherapist. The diagnosis and the degree of severity of the syndrome is determined through a polysomnography examination. After that, the best form of treatment is devised depending on the gravity of the case. In cases of moderate to severe apnea, invasive treatment through surgical procedures such as maxillomandibular advancement remains the preferred option as it increases the posterior air space, reducing and/or eliminating the obstruction. Thus, improving the patients respiratory function and, consequently, his quality of life as it is shown in the clinical case at hand. In which the male patient, facial pattern type I, 41 years of age, diagnosed with moderate OSA (Apnea-Hypopnea Index - AHI of 23.19, decided to have a surgical treatment instead of a conservative one, resulting in the cure of apnea (AHI of 0.3.

  5. Stand and individual tree growth response to treatments in young natural hardwoods

    Science.gov (United States)

    Daniel J. Robison; Tracy San Filipo; Charlie Lawrence III; Jamie L. Schuler; Bryan J. Berenguer

    2012-01-01

    Young even-aged upland Piedmont mixed hardwood and pine stands were treated with a variety of fertilizer and release (competition control) treatments. The sites studied are on the NC State University Hill Demonstration Forest in central North Carolina, and are characterized by formerly highly eroded agricultural sites (Richter et al. 2000) now in their third rotation...

  6. Development of a Theoretically Based Treatment for Sentence Comprehension Deficits in Individuals with Aphasia

    Science.gov (United States)

    Kiran, Swathi; Caplan, David; Sandberg, Chaleece; Levy, Joshua; Berardino, Alex; Ascenso, Elsa; Villard, Sarah; Tripodis, Yorghos

    2012-01-01

    Purpose: Two new treatments, 1 based on sentence to picture matching (SPM) and the other on object manipulation (OM), that train participants on the thematic roles of sentences using pictures or by manipulating objects were piloted. Method: Using a single-subject multiple-baseline design, sentence comprehension was trained on the affected sentence…

  7. Measuring Social Communication Behaviors as a Treatment Endpoint in Individuals with Autism Spectrum Disorder

    Science.gov (United States)

    Anagnostou, Evdokia; Jones, Nancy; Huerta, Marisela; Halladay, Alycia K.; Wang, Paul; Scahill, Lawrence; Horrigan, Joseph P.; Kasari, Connie; Lord, Cathy; Choi, Dennis; Sullivan, Katherine; Dawson, Geraldine

    2015-01-01

    Social communication impairments are a core deficit in autism spectrum disorder. Social communication deficit is also an early indicator of autism spectrum disorder and a factor in long-term outcomes. Thus, this symptom domain represents a critical treatment target. Identifying reliable and valid outcome measures for social communication across a…

  8. Fear less : Individual differences in fear conditioning and their relation to treatment outcome in anxiety disorders

    NARCIS (Netherlands)

    Duits, P.|info:eu-repo/dai/nl/412437694

    2016-01-01

    Findings from animal and human experimental studies highlight the importance of fear conditioning processes in the development and treatment of anxiety disorders. The work reported in this thesis was focused on potential abnormalities in the acquisition and extinction of fear in patients with

  9. Effects of cross-sex hormone treatment on cortical thickness in transsexual individuals.

    Science.gov (United States)

    Zubiaurre-Elorza, Leire; Junque, Carme; Gómez-Gil, Esther; Guillamon, Antonio

    2014-05-01

    Untreated transsexuals have a brain cortical phenotype. Cross-sex hormone treatments are used to masculinize or feminize the bodies of female-to-male (FtMs) or male-to-female (MtFs) transsexuals, respectively. A longitudinal design was conducted to investigate the effects of treatments on brain cortical thickness (CTh) of FtMs and MtFs. This study investigated 15 female-to-male (FtMs) and 14 male-to-female (MtFs) transsexuals prior and during at least six months of cross-sex hormone therapy treatment. Brain MRI imaging was performed in a 3-Tesla TIM-TRIO Siemens scanner. T1-weighted images were analyzed with FreeSurfer software to obtain CTh as well as subcortical volumetric values. Changes in brain CTh thickness and volumetry associated to changes in hormonal levels due to cross-sex hormone therapy. After testosterone treatment, FtMs showed increases of CTh bilaterally in the postcentral gyrus and unilaterally in the inferior parietal, lingual, pericalcarine, and supramarginal areas of the left hemisphere and the rostral middle frontal and the cuneus region of the right hemisphere. There was a significant positive correlation between the serum testosterone and free testosterone index changes and CTh changes in parieto-temporo-occipital regions. In contrast, MtFs, after estrogens and antiandrogens treatment, showed a general decrease in CTh and subcortical volumetric measures and an increase in the volume of the ventricles. Testosterone therapy increases CTh in FtMs. Thickening in cortical regions is associated to changes in testosterone levels. Estrogens and antiandrogens therapy in MtFs is associated to a decrease in the CTh that consequently induces an enlargement of the ventricular system. © 2014 International Society for Sexual Medicine.

  10. The effect of cross-sex hormonal treatment on gender dysphoria individuals' mental health: a systematic review

    OpenAIRE

    Costa, Rosalia; Colizzi, Marco

    2016-01-01

    Rosalia Costa,1 Marco Colizzi2 1Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, Tavistock Centre, 2Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK Abstract: Cross-sex hormonal treatment represents a main aspect of gender dysphoria health care pathway. However, it is still debated whether this intervention translates into a better mental well-being for the individual and ...

  11. Identification of Individuals With Undiagnosed Diabetes and Pre-Diabetes in a Danish Cohort Attending Dental Treatment

    DEFF Research Database (Denmark)

    Holm, Niels-Christian Reimers; Belstrøm, Daniel; Østergaard, Jakob Appel

    2016-01-01

    BACKGROUND AND OBJECTIVE: It is estimated that 3.6% and 13.6% of the Danish population suffer from undiagnosed type 2 diabetes and pre-diabetes, respectively. Periodontitis is an established complication to diabetes. Identification of individuals with diabetes and pre-diabetes is important...... to reduce diabetes-related complications including periodontitis. The objective of the study was to identify individuals with undiagnosed diabetes or pre-diabetes among individuals attending a dental setting for diagnosis and treatment. METHODS: 291 adults with no history of diabetes were included......c levels corresponding to guideline values for diabetes and pre-diabetes respectively. Higher proportions of patients with undiagnosed diabetes and pre-diabetes were observed in the periodontitis group (32.7%) than in the control group (17.4%) (p=0.054). Identification of diabetes and pre-diabetes...

  12. Efficacy of hormonal and mental treatments with MMPI in FtM individuals: cross-sectional and longitudinal studies.

    Science.gov (United States)

    Oda, Hiroyuki; Kinoshita, Toshihiko

    2017-07-17

    Cross-sex hormone treatment (CSHT) is an important option for gender dysphoria (GD) individuals to improve the quality of life. However, in Japan, sex reassignment surgery (SRS) and CSHT for GD had been discontinued until 1998 (over 30 years). After resumption, the number of GD individuals wishing treatment rapidly increased. On the other hand, the number of medical institutions available for evaluation was limited. For this reason, hormonal treatment has been administered to GD individuals requiring the prompt start of CSHT in the absence of mental health assessment by specialists. In this study, we examined the efficacy of CSHT and psychotherapy. The participants were 155 female-to-male (FtM) individuals who consulted our gender identity clinic, and were definitively diagnosed. A cross-sectional study was conducted by dividing them into two groups: groups with and without CSHT on the initial consultation (Group CSHT: n = 53, Group no-CSHT: n = 102). In all participants, Minnesota Multiphasic Personality Inventory (MMPI) and blood hormone tests were performed on the initial consultation. In addition, CSHT was combined with psychotherapy for a specific period in Group no-CSHT, and FtM individuals in whom an additional MMPI test could be conducted (Group combined treatment (CT), n = 14) were enrolled in a longitudinal study. In the cross-sectional study, there was no significant difference on the MMPI test. In the longitudinal study, there were improvements in the clinical scales other than the Mf scale on the MMPI test. In Group CT, the D, Sc, and Si scale scores on the initial consultation were significantly higher than in Group CSHT. However, there was no clinical scale with a significantly higher value after the start of treatment. The Pd scale score was significantly lower. CSHT improved mental health. Psychotherapy-combined CSHT may further improve it. The study was reviewed and approved by the Ethics Committee of Kansai Medical University (A

  13. Morphology as the starting point for individualized cancer treatment; La morfologia como punto de partida del tratamiento oncologico individualizado

    Energy Technology Data Exchange (ETDEWEB)

    Sanz Ortega, J.

    2009-07-01

    Historically, the histopathological diagnosis has been essential for the proper treatment of cancer. Today, in the new era of individualized cancer treatment, pathologists acquire a new role for identifying therapeutic targets, detection of hereditary syndromes; to select the most suitable molecular technique for each sample or to assess individual response to neoadjuvant therapy. The objective of this review is to show how we must combine and integrate new gross examination, microscopic and immunohistochemical data with molecular pathology, taking the example of colorectal cancer. Immunohistochemistry for DNA repair genes, the study of K-ras mutations and circumferential resection margin in rectal adenocarcinoma are part of this new reality. Therefore, besides making the correct diagnosis and staging of the tumor, we can play a key role in risk stratification of cancer and individualized treatment. Integration of the molecular study with the morphology and clinical data by pathologists may improve the efficiency of genetic tests and save costs. Phenotype precedes genotype in the clinical management algorithm of the disease. (Author) 19 refs.

  14. Treatment of human and livestock helminth infections in a mobile pastoralist setting at Lake Chad: Attitudes to health and analysis of active pharmaceutical ingredients of locally available anthelminthic drugs.

    Science.gov (United States)

    Greter, Helena; Cowan, Noemi; Ngandolo, Bongo N; Kessely, Hamit; Alfaroukh, Idriss O; Utzinger, Jürg; Keiser, Jennifer; Zinsstag, Jakob

    2017-11-01

    Mobile pastoralists face challenges in accessing quality health care and medication for managing human and animal diseases. We determined livestock disease priorities, health seeking behaviour of people bearing helminthiases and - placing particular emphasis on trematode infections - treatment strategies and outcome satisfaction among mobile pastoralists of four ethnic groups in the Lake Chad area using focus group discussions. People suffering from schistosomiasis were interviewed about symptoms, health seeking behaviour and their satisfaction with respect to the provided treatment. Anthelminthic drugs for human and veterinary use obtained from various health care structures were analysed for active pharmaceutical ingredients (API) and quantity, using high pressure liquid chromatography-UV and liquid chromatography combined with tandem mass spectrometry. Most people suffering from schistosomiasis sought treatment at health care centres. Yet, they also consulted informal providers without medical training. Regarding animal health, self-mediated therapy was common to manage suspected livestock fascioliasis. Self-reported treatment satisfaction for human schistosomiasis and trematodiasis treatment outcome in livestock were low. Mobile pastoralists perceived the purchased drugs to be of low quality. Among 33 products locally sold as anthelminthic drugs for human or veterinary use, 27 contained albendazole or mebendazole, varying between 91% and 159% of the labelled amount. Six products were sold loosely with incomplete information and their API could not be identified. No counterfeit anthelminthic drugs were detected. None of the samples contained praziquantel or triclabendazole, the drugs of choice against schistosomiasis and fascioliasis, respectively. The perceived unsatisfactory treatment outcomes in humans and animals infected with trematodes are most likely due to empiric diagnosis and the resulting use of inadequate therapy for human schistosomiasis and the

  15. Part-time sick leave as a treatment method for individuals with musculoskeletal disorders

    OpenAIRE

    Andrén, Daniela; Svensson, Mikael

    2009-01-01

    There is increasing evidence that staying active is an important part of a recovery process for individuals on sick leave due to musculoskeletal disorders (MSDs). It has been suggested that using part-time sick-leave rather than full-time sick leave will enhance the possibility of full recovery to the workforce, and several countries actively favor this policy. However, to date only few studies have estimated the effect of using part-time sick leave in contrast to full-time sick leave. In thi...

  16. The argument for pharmaceutical policy.

    Science.gov (United States)

    Traulsen, Janine Morgall; Almarsdóttir, Anna Birna

    2005-02-01

    Pharmaceutical policy is a global concern. It has become a hot political topic in most countries--developed as well as developing--and can be found on the agenda of international organizations such as WHO, OECD, EU, WTO and even the World Bank. Pharmaceutical policy affects everyone in the world of pharmacy and it is therefore imperative that it be understood, discussed and debated within the pharmacy profession and included in the curriculum of schools of pharmacy. This, the first article in a series, argues for the importance of the academic discipline of pharmaceutical policy analysis and the involvement of pharmacists in this endeavour. The aim of the authors is to stimulate an informed and critical appreciation of this field. The authors begin with an introduction to the field of pharmaceutical policy, introducing several important concepts and current trends including: medicines regulation; how pharmaceutical policy is made; pharmaceutical policy as a dynamic process; and the new public health as a global issue. The article ends with a short description of the remaining five articles in the series which will deal with important aspects of pharmaceutical policy. The topics include: economic pressures on health care systems; drug utilization from the clinical viewpoint (rational use of medicines); the impact of pharmaceutical policy on patients and the patient impact on pharmaceutical policy; the professional perspective; and finally the last article which deals with studying and evaluating pharmaceutical policy.

  17. [Logistics in the pharmaceutical service].

    Science.gov (United States)

    Stanko, P; Fulmeková, M

    2005-11-01

    The conception of the field of pharmaceutical service defines pharmaceutical service as the basic part of pharmacy, the principal task of which is to provide pharmaceutical care as an inseparable part of providing health care. It represents a set of professional activities of the pharmacist oriented to securing human and veterinary pharmaceutical products and health care products and to optimising effective, safe and quality pharmacotherapy. Technically, pharmaceutical service is an applied discipline, as it makes use of knowledge gained in other pharmaceutical, medical, psychological, social, and economic sciences. Because of its interdisciplinary character it is necessary to extend the theory of pharmaceutical service in such a way so that it may reflect all aspects of its sphere of activity. One of the possibilities is to define the pharmacy premises as an independent functional unit which operates on the basis of valid legal standards in such a way that on the one hand it secures the provision of health (pharmaceutical) care, and on the other hand it maintains its cost-effectiveness. To keep the quality of care of the patient and the economic aspect in balance, it is necessary to define the term pharmaceutical logistics also under the conditions of Slovak (Czech) pharmacy as early satisfaction of the requirements of the patient (client) in the pharmacy premises, which means that the appropriate pharmaceutical product or health care product and the appropriate information must be at the right time in the required amount and required quality in the right place.

  18. Predictors for individual patient antibiotic treatment effect in hospitalized community-acquired pneumonia patients.

    Science.gov (United States)

    Simonetti, A F; van Werkhoven, C H; Schweitzer, V A; Viasus, D; Carratalà, J; Postma, D F; Oosterheert, J J; Bonten, M J M

    2017-10-01

    Our objective was to identify clinical predictors of antibiotic treatment effects in hospitalized patients with community-acquired pneumonia (CAP) who were not in the intensive care unit (ICU). Post-hoc analysis of three prospective cohorts (from the Netherlands and Spain) of adult patients with CAP admitted to a non-ICU ward having received either β-lactam monotherapy, β-lactam + macrolide, or a fluoroquinolone-based therapy as empirical antibiotic treatment. We evaluated candidate clinical predictors of treatment effects in multiple mixed-effects models by including interactions of the predictors with empirical antibiotic choice and using 30-day mortality, ICU admission and length of hospital stay as outcomes. Among 8562 patients, empirical treatment was β-lactam in 4399 (51.4%), fluoroquinolone in 3373 (39.4%), and β-lactam + macrolide in 790 (9.2%). Older age (interaction OR 1.67, 95% CI 1.23-2.29, p 0.034) and current smoking (interaction OR 2.36, 95% CI 1.34-4.17, p 0.046) were associated with lower effectiveness of fluoroquinolone on 30-day mortality. Older age was also associated with lower effectiveness of β-lactam + macrolide on length of hospital stay (interaction effect ratio 1.14, 95% CI 1.06-1.22, p 0.008). Older age and smoking could influence the response to specific antibiotic regimens. The effect modification of age and smoking should be considered hypothesis generating to be evaluated in future trials. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  19. Technology-Facilitated Diagnosis and Treatment of Individuals with Autism Spectrum Disorder: An Engineering Perspective

    Directory of Open Access Journals (Sweden)

    Xiongyi Liu

    2017-10-01

    Full Text Available The rapid development of computer and robotic technologies in the last decade is giving hope to perform earlier and more accurate diagnoses of the Autism Spectrum Disorder (ASD, and more effective, consistent, and cost-conscious treatment. Besides the reduced cost, the main benefit of using technology to facilitate treatment is that stimuli produced during each session of the treatment can be controlled, which not only guarantees consistency across different sessions, but also makes it possible to focus on a single phenomenon, which is difficult even for a trained professional to perform, and deliver the stimuli according to the treatment plan. In this article, we provide a comprehensive review of research on recent technology-facilitated diagnosis and treat of children and adults with ASD. Different from existing reviews on this topic, which predominantly concern clinical issues, we focus on the engineering perspective of autism studies. All technology facilitated systems used for autism studies can be modeled as human machine interactive systems where one or more participants would constitute as the human component, and a computer-based or a robotic-based system would be the machine component. Based on this model, we organize our review with the following questions: (1 What are presented to the participants in the studies and how are the content and delivery methods enabled by technologies? (2 How are the reactions/inputs collected from the participants in response to the stimuli in the studies? (3 Are the experimental procedure and programs presented to participants dynamically adjustable based on the responses from the participants, and if so, how? and (4 How are the programs assessed?

  20. Effect of individual or combined treatment of heat or radiation on clostridium perfringens spores

    Energy Technology Data Exchange (ETDEWEB)

    El-Zawahry, Y A; El-Fouly, M Z; Aziz, N H

    1986-01-01

    Separate treatments of high temperature had considerable effect on Cl.perfrigens spores suspended in saline solution especially at 90 and 100[sup 0]C, while 70 and 80[sup 0]C had only slight effect on the spores viabilty. The decimal reduction times (D[sub T]) were 33.7, 26, 4, 10.7 and 2.8 at 70, 80, 90 and 100[sup 0]C for NCTC 8798 strain and were 45.1, 27.1, 10.2 and 4.0 for the Egyptian strain at the same degrees of temperature respectively. Heat treatment pre-irradiation at 70 and 80[sup 0]C for 30 and 60 min decreased the viable spore numbers by about 0.5 to 3.0 log cycles, but the treatment had no effect on increasing the sensitivity of the rest spores to radiation. The decimal reduction dose (D[sub 10]-value) for the spores was almost the same as the control but there was a tendency to reduce the shoulder part in the radiation response curve especially when the spores were subjected to 80[sup 0]C for 60 min. On the other hand, irradiation pre-heat treatment with doses from 1-10 KGY was sufficient to decrease the spore numbers from 0.2 to 5.0 log cycles and had a sensitizing effect on subsequently heated spores especially those exposed to 90 and 100[sup 0]C. Meanwhile the rate of inactivation for spores exposed to 70 and 80[sup 0]C after irradiation increased only during the first ten minutes. Thereafter, the rate of inactivation was almost the same for the non-irradiated spores. The D[sub 10]-values for the spores irradiated with 10 KGY were 0.77 and 0.84 minutes for NCTC 8798 strain and Egyptian strain at 100[sup 0]C respectively and the spores were completely destroyed before 5 minutes.

  1. Deep pharma: psychiatry, anthropology, and pharmaceutical detox.

    Science.gov (United States)

    Oldani, Michael

    2014-06-01

    Psychiatric medication, or psychotropics, are increasingly prescribed for people of all ages by both psychiatry and primary care doctors for a multitude of mental health and/or behavioral disorders, creating a sharp rise in polypharmacy (i.e., multiple medications). This paper explores the clinical reality of modern psychotropy at the level of the prescribing doctor and clinical exchanges with patients. Part I, Geographies of High Prescribing, documents the types of factors (pharmaceutical-promotional, historical, cultural, etc.) that can shape specific psychotropic landscapes. Ethnographic attention is focused on high prescribing in Japan in the 1990s and more recently in the Upper Peninsula of Michigan, in the US. These examples help to identify factors that have converged over time to produce specific kinds of branded psychotropic profiles in specific locales. Part II, Pharmaceutical Detox, explores a new kind of clinical work being carried out by pharmaceutically conscious doctors, which reduces the number of medications being prescribed to patients while re-diagnosing their mental illnesses. A high-prescribing psychiatrist in southeast Wisconsin is highlighted to illustrate a kind of med-checking taking place at the level of individual patients. These various examples and cases call for a renewed emphasis by anthropology to critically examine the "total efficacies" of modern pharmaceuticals and to continue to disaggregate mental illness categories in the Boasian tradition. This type of detox will require a holistic approach, incorporating emergent fields such as neuroanthropology and other kinds of creative collaborations.

  2. Global risk of pharmaceutical contamination from highly populated developing countries.

    Science.gov (United States)

    Rehman, Muhammad Saif Ur; Rashid, Naim; Ashfaq, Muhammad; Saif, Ameena; Ahmad, Nasir; Han, Jong-In

    2015-11-01

    Global pharmaceutical industry has relocated from the west to Asian countries to ensure competitive advantage. This industrial relocation has posed serious threats to the environment. The present study was carried out to assess the possible pharmaceutical contamination in the environment of emerging pharmaceutical manufacturing countries (Bangladesh, China, India and Pakistan). Although these countries have made tremendous progress in the pharmaceutical sector but most of their industrial units discharge wastewater into domestic sewage network without any treatment. The application of untreated wastewater (industrial and domestic) and biosolids (sewage sludge and manure) in agriculture causes the contamination of surface water, soil, groundwater, and the entire food web with pharmaceutical compounds (PCs), their metabolites and transformed products (TPs), and multidrug resistant microbes. This pharmaceutical contamination in Asian countries poses global risks via product export and international traveling. Several prospective research hypotheses including the development of new analytical methods to monitor these PCs/TPs and their metabolites, highly resistant microbial strains, and mixture toxicity as a consequence of pharmaceutical contamination in these emerging pharmaceutical exporters have also been proposed based on the available literature. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Imidacloprid seed treatments affect individual ant behavior and community structure but not egg predation, pest abundance or soybean yield.

    Science.gov (United States)

    Penn, Hannah J; Dale, Andrew M

    2017-08-01

    Neonicotinoid seed treatments are under scrutiny because of their variable efficacy against crop pests and for their potential negative impacts on non-target organisms. Ants provide important biocontrol services in agroecosystems and can be indicators of ecosystem health. This study tested for effects of exposure to imidacloprid plus fungicide or fungicide-treated seeds on individual ant survival, locomotion and foraging capabilities and on field ant community structure, pest abundance, ant predation and yield. Cohorts of ants exposed to either type of treated seed had impaired locomotion and a higher incidence of morbidity and mortality but no loss of foraging capacity. In the field, we saw no difference in ant species richness, regardless of seed treatment. Blocks with imidacloprid did have higher species evenness and diversity, probably owing to variable effects of the insecticide on different ant species, particularly Tetramorium caespitum. Ant predation on sentinel eggs, pest abundance and soybean growth and yield were similar in the two treatments. Both seed treatments had lethal and sublethal effects on ant individuals, and the influence of imidacloprid seed coating in the field was manifested in altered ant community composition. Those effects, however, were not strong enough to affect egg predation, pest abundance or soybean yield in field blocks. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  4. Correlates of Unstructured Antiretroviral Treatment Interruption in a Cohort of HIV-Positive Individuals in British Columbia

    Science.gov (United States)

    Samji, Hasina; Chen, Yalin; Salters, Kate; Montaner, Julio S. G.; Hogg, Robert S.

    2014-01-01

    Treatment interruptions (TIs) limit the therapeutic success of combination antiretroviral therapy and are associated with higher morbidity and mortality. HIV-positive individuals dealing with concurrent health issues, access challenges and competing life demands are hypothesized to be more likely to interrupt treatment. Individuals were included if they initiated cART ≥1 year prior to interview date and had a CD4 cell count or initial regimen recorded at initiation. Using pharmacy recording, TIs were defined as a patient-initiated interruption in treatment ≥90 consecutive days during the 12 months preceding or following the study interview. 117 (15%) of 768 participants included in this study had a TI during the study window. 76.0% of participants were male, 27.5% were of Aboriginal ethnicity and the median age was 46 (interquartile range (IQR): 40–52). In multivariable logistic regression, TIs were significantly associated with current illicit drug use (adjusted odds ratio [aOR]: 1.68, 95% confidence interval [CI]: 1.05–2.68); perception of overall health (aOR: 1.64 95% CI: 1.05–2.55); being unemployed (aOR: 2.22, 95% CI: 1.16–4.23); and younger age at interview (aOR: 0.57, 95% CI: 0.44–0.75, per 10 year increment). Addressing socioeconomic barriers to treatment retention is vital for supporting the continuous engagement of patients in care. PMID:24781638

  5. Nationwide reconnaissance of contaminants of emerging concern in source and treated drinking waters of the United States: Pharmaceuticals

    Science.gov (United States)

    Mobile and persistent chemicals that are present in urban wastewater, such as pharmaceuticals, may survive on-site or municipal wastewater treatment and post-discharge environmental processes. These pharmaceuticals have the potential to reach surface and groundwaters, essential d...

  6. An analysis of functional communication training as an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities.

    Science.gov (United States)

    Kurtz, Patricia F; Boelter, Eric W; Jarmolowicz, David P; Chin, Michelle D; Hagopian, Louis P

    2011-01-01

    This paper examines the literature on the use of functional communication training (FCT) as a treatment for problem behavior displayed by individuals with intellectual disabilities (ID). Criteria for empirically supported treatments developed by Divisions 12 and 16 of the American Psychological Association (Kratochwill & Stoiber, 2002; Task Force, 1995) and adapted by Jennett and Hagopian (2008) for evaluation of single-case research studies were used to examine the support for FCT. Results indicated that FCT far exceeds criteria to be designated as a well-established treatment for problem behavior exhibited by children with ID and children with autism spectrum disorder, and can be characterized as probably efficacious with adults. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. How does dialectical behavior therapy facilitate treatment retention among individuals with comorbid borderline personality disorder and substance use disorders?

    Science.gov (United States)

    Bornovalova, Marina A; Daughters, Stacey B

    2007-12-01

    For individuals presenting with comorbid borderline personality disorder (BPD) and substance use disorders (SUD), rates of treatment dropout from combined mental health and substance abuse treatment centers approach 80%, rendering dropout the rule rather than the exception. Several studies indicate that utilizing a more comprehensive treatment such as Dialectical Behavior Therapy (DBT) may be useful for client retention; however, given the scope and effort required to conduct this treatment, it may be more practical to determine which specific components within DBT are useful in retaining clients in substance use treatment. Thus, the purpose of the current paper is first to determine what exact deficits underlie treatment dropout among the BPD-SUD comorbidity. Second, we review and evaluate effectiveness of DBT retention-enhancing strategies by assembling work from other samples and literatures that also tests retention-enhancing strategies discussed in DBT. As a last step, the paper will conclude with a discussion on methodological limitations and potential future directions in this line of research.

  8. Gender-related clinical and neurocognitive differences in individuals seeking treatment for pathological gambling.

    Science.gov (United States)

    Grant, Jon E; Chamberlain, Samuel R; Schreiber, Liana R N; Odlaug, Brian L

    2012-09-01

    Understanding variations in disease presentation in men and women is clinically important as differences may reflect biological and sociocultural factors and have implications for selecting appropriate prevention and treatment strategies. The aim of this study was to investigate clinical and cognitive differences in treatment-seeking people with pathological gambling as a function of gender. 501 adult subjects (n = 274 [54.7%] females) with DSM-IV pathological gambling presenting for various clinical research trials over a 9-year period were assessed in terms of sociodemographics and clinical characteristics. A subset (n = 77) had also undertaken neuropsychological assessment with the Stop-signal and set-shift tasks. PG in females was associated with significantly worse disease severity, elevated mood and anxiety scores, and history of affective disorders, later age of study presentation, later age of disease onset, and elevated risk of having a first-degree relative with gambling or alcohol problems. These findings were of small effect size (0.20-0.35). Additionally, PG in females was associated with proportionately more non-strategic gambling with medium effect size (0.61). In contrast, PG in males was associated with a significantly greater lifetime history of an alcohol use disorder and any substance use disorder (small effect sizes 0.22-0.38); and slower motoric reaction times (medium effect size, 0.50). Response inhibition and cognitive flexibility were similar between the groups. These data suggest that important differences exist in the features of pathological gambling in women and men. Findings are of considerable relevance to clinicians and in terms of targeted treatments. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Organization of medical aid and treatment of individuals affected in radiation accidents

    International Nuclear Information System (INIS)

    Mikhajlov, M.G.; Andreev, E.A.; Bliznakov, V.

    1979-01-01

    The emergency programme of the medical service for radiation accidents constitutes part of the whole emergency programme of the establishment whose production process is derectly connected with the utilization of ionizing radiation sources. The chief of the establishment health centre also heads the operative radiation accident group. When a radiation accident occurs the medical personnel, according to a previously developed plan, reports at the Health centre. The medical aid is based on the principle of step treatment and evacuation of the affected persons, according to the prescriptions. The first step of the medical evacuation is the health centre; the second - the District hospital, where a team of specialists is formed, all of them previously well trained in the recognition and treatment of radiation sickness. The third step is the specialized clinic for radiation injuries. Persons, who have received irradiation dose of up to 100 rad, or are in a shock state, or have incorporated radioactive substances, are temporarily hospitalized at the health centre. The assistance rended to them consists of: control of shock, asphyxia and bleeding, primary surgical treatment of wounds in cases of complex injuries, deactivation under dosimetric control, attempt for accelerated removal of the radioactive substances, etc. At the District hospital and the specialized clinic the therapeutic measures are conformed to the pathogenetic mechanism and severity of clinical symptoms, and their dynamics. Their aim is first of all to block the earlier radiation effects, to prevent and to treat the haemorrhagic phenomena and infectious complications, to restore the activity of the blood organs, etc. (A.B.)

  10. Dosimetric comparison fixed-individualized activity in the treatment of serious disease with I -131

    International Nuclear Information System (INIS)

    Melgar Perez, J.; Orellana Salas, A.; Santaella, Y.; Arrocha Acevedo, J. F.

    2013-01-01

    The iodine-131 therapy has become the treatment with radiopharmaceuticals more frequent in our country, as well as the largest source of exposure to ionizing radiation for members who surround the patient. The aim of this article is to analyse the recommendations of radiological protection which are delivered to the patient receiving radiation discharge, in terms of the duration of the same time, taking into account the radiopharmaceutical dose, the time of entry, the dose rate measured at one meter and the family environment among others. (Author)

  11. Bariatric surgery: the challenges with candidate selection, individualizing treatment and clinical outcomes

    Science.gov (United States)

    2013-01-01

    Obesity is recognized as a global health crisis. Bariatric surgery offers a treatment that can reduce weight, induce remission of obesity-related diseases, and improve the quality of life. In this article, we outline the different options in bariatric surgery and summarize the recommendations for selecting and assessing potential candidates before proceeding to surgery. We present current data on post-surgical outcomes and evaluate the psychosocial and economic effects of bariatric surgery. Finally, we evaluate the complication rates and present recommendations for post-operative care. PMID:23302153

  12. Comorbid psychiatric diagnoses among individuals presenting to an addiction treatment program for alcohol dependence.

    LENUS (Irish Health Repository)

    Lyne, John Paul

    2011-01-01

    A retrospective patient record review was conducted to examine comorbid psychiatric diagnoses, and comorbid substance use, among 465 patients below 45 years of age, presenting to a national alcohol addiction treatment unit in Dublin, between 1995 and 2006. Rates were high for depressive disorder (25.3%) particularly among females (35.4%). Lifetime reported use of substances other than alcohol was 39.2%, and further analysis showed significantly higher rates of deliberate self-harm among this group. Lifetime reported use of ecstasy was also significantly associated with depression in this alcohol-dependent population using logistic regression analysis. Implications and limitations of the findings are discussed.

  13. What makes individuals with gastroesophageal reflux disease dissatisfied with their treatment?

    DEFF Research Database (Denmark)

    Bytzer, Peter

    2009-01-01

    BACKGROUND & AIMS: Despite the efficacy of proton pump inhibitors (PPIs) as therapeutics for patients with gastroesophageal reflux disease (GERD) in randomized controlled trials, a number of studies have shown that a proportion of patients with GERD are not satisfied with their treatment....... This article reviews the possible reasons why patients are dissatisfied with the way their disease is managed. METHODS: Studies published between 1970 and 2007 were identified from PubMed, EMBASE, and the author's existing database. The 2708 publications were reviewed, and irrelevant ones were excluded. Eleven...

  14. 3. Radioactive pharmaceutical medications

    International Nuclear Information System (INIS)

    2006-01-01

    In the chapter common definitions of for radio-pharmacy are given. Radio-pharmacy medications are pharmacy medications which contain minor amount of one or several radionuclides (radioactive tracers), those radiation ability is applying in diagnostic or therapeutic purposes. At the same time radionuclides with more short life time, which are ether gamma-radiators or beta-radiators are applying. The following items for such radioisotopes production; radionuclides applying in nuclear medicine; radio-pharmaceutics; radio-toxicity; quality insurance; order for 18 F-PDG production; radionuclide analysis are considered

  15. Regulation of Pharmaceutical Prices

    DEFF Research Database (Denmark)

    Kaiser, Ulrich; Mendez, Susan J.; Rønde, Thomas

    On April 1, 2005, Denmark changed the way references prices, a main determinant of reimbursements for pharmaceutical purchases, are calculated. The previous reference prices, which were based on average EU prices, were substituted to minimum domestic prices. Novel to the literature, we estimate...... the joint eects of this reform on prices and quantities. Prices decreased more than 26 percent due to the reform, which reduced patient and government expenditures by 3.0 percent and 5.6 percent, respectively, and producer revenues by 5.0 percent. The prices of expensive products decreased more than...

  16. Care ideologies reflected in 4 conceptions of pharmaceutical care.

    Science.gov (United States)

    Björkman, Ingeborg K; Bernsten, Cecilia B; Sanner, Margareta A

    2008-12-01

    Different ways to practice pharmaceutical care have been developed. One expression of this fact is the existence of many different classification systems to document drug-related problems (DRPs). Evidence suggests that classification systems have different characteristics and that these characteristics reflect different conceptions of pharmaceutical care. To increase the understanding of conceptions of pharmaceutical care, underlying values and beliefs (ideologies) can be explored. To explore various conceptions of pharmaceutical care to identify the care ideologies on which these conceptions are based. Representatives of 4 selected conceptions of pharmaceutical care were interviewed in face-to-face meetings. During the interviews, 4 basic questions were asked. Three were focused on pharmaceutical care and 1 on DRPs. Interview transcripts were analyzed by an inductive method inspired by grounded theory. The conceptions studied were Strand, Granada-II, PCNE v5.0, and Apoteket. In Strand, patients are given a more active role in the pharmaceutical care process, as compared to Granada-II, PCNE v5.0, and Apoteket. Pharmacists in all the conceptions of pharmaceutical care assume they have special knowledge that patients benefit from. However, they use their knowledge in different ways in the various pharmaceutical care conceptions. In Strand, individual goals of drug therapy are established together with the patient, whereas in Granada-II, PCNE, and Apoteket goals are not explicitly discussed. The identified differences correspond to different care ideologies. The pharmaceutical care conceptions are based on different care ideologies. The ideology is expressed in how therapy goals are set and patient needs defined. Strand is based on a patient-centered ideology; patient therapy goals and needs are defined by the patient together with the practitioners. Granada-II, PCNE, and Apoteket are based on an evidence-based medicine approach; patient therapy goals and needs are

  17. Pharmaceuticals as Groundwater Tracers - Applications and Limitations

    Science.gov (United States)

    Scheytt, T. J.; Mersmann, P.; Heberer, T.

    2003-12-01

    Pharmaceutically active substances and metabolites are found at concentrations up to the microgram/L-level in groundwater samples from the Berlin (Germany) area and from several other places world wide. Among the compounds detected in groundwater are clofibric acid, propyphenazone, diclofenac, ibuprofen, and carbamazepine. Clofibric acid, the active metabolite of clofibrate and etofibrate (blood lipid regulators) is detected in groundwater at maximum concentrations of 7300 ng/L. Among the most important input paths of drugs are excretion and disposal into the sewage system. Groundwater contamination is likely to be due to leaky sewage systems, influent streams, bank filtration, and irrigation with effluent water from sewage treatment plants. There are no known natural sources of the above mentioned pharmaceuticals. The use of pharmaceuticals as tracers may include: (a) Quantification of infiltration from underground septic tanks (b) Detection of leaky sewage systems / leaky sewage pipes (c) Estimation of the effectiveness of sewage treatment plants (d) Identification of transport pathways of other organic compounds (e) Quantification of surface water / groundwater interaction (f) Characterization of the biodegradation potential. The use of pharmaceuticals as tracers is limited by variations in input. These variations depend on the amount of drugs prescribed and used in the study area, the social structure of the community, the amount of hospital discharge, and temporal concentration variations. Furthermore, the analysis of trace amounts of pharmaceuticals is sophisticated and expensive and may therefore limit the applicability of pharmaceuticals as tracers. Finally, the transport and degradation behavior of pharmaceuticals is not fully understood. Preliminary experiments in the laboratory were conducted using sediment material and groundwater from the Berlin area to evaluate the transport and sorption behavior of selected drugs. Results of the column experiments

  18. Bioremediation Kinetics of Pharmaceutical Industrial Effluent

    Directory of Open Access Journals (Sweden)

    M. Šabić

    2015-05-01

    Full Text Available In recent years, concerns about the occurrence and fate of pharmaceuticals that could be present in water and wastewater has gained increasing attention. With the public’s enhanced awareness of eco-safety, environmentally benign methods based on microorganisms have become more accepted methods of removing pollutants from aquatic systems. This study investigates bioremediation of pharmaceutical wastewater from pharmaceutical company Pliva Hrvatska d.o.o., using activated sludge and bioaugmented activated sludge with isolated mixed bacterial culture. The experiments were conducted in a batch reactor in submerged conditions, at initial concentration of organic matter in pharmaceutical wastewater, expressed as COD, 5.01 g dm–3 and different initial concentrations of activated sludge, which ranged from 1.16 to 3.54 g dm–3. During the experiments, the COD, pH, concentrations of dissolved oxygen and biomass were monitored. Microscopic analyses were performed to monitor the quality of activated sludge. Before starting with the bioremediation in the batch reactor, toxicity of the pharmaceutical wastewater was determined by toxicity test using bacteria Vibrio fischeri. The obtained results showed that the effective concentration of the pharmaceutical wastewater was EC50 = 17 % and toxicity impact index was TII50 = 5.9, meaning that the untreated pharmaceutical industrial effluent must not be discharged into the environment before treatment. The results of the pharmaceutical wastewater bioremediation process in the batch reactor are presented in Table 1. The ratio γXv ⁄ γX maintained high values throughout all experiments and ranged from 0.90 and 0.95, suggesting that the concentrations of biomass remained unchanged during the experiments. The important kinetic parameters required for performance of the biological removal process, namely μmax, Ks, Ki, Y and kd were calculated from batch experiments (Table 2. Figs. 1 and 2 show the experimental

  19. Electrochemical biosensors in pharmaceutical analysis

    OpenAIRE

    Gil, Eric de Souza; Melo, Giselle Rodrigues de

    2010-01-01

    Given the increasing demand for practical and low-cost analytical techniques, biosensors have attracted attention for use in the quality analysis of drugs, medicines, and other analytes of interest in the pharmaceutical area. Biosensors allow quantification not only of the active component in pharmaceutical formulations, but also the analysis of degradation products and metabolites in biological fluids. Thus, this article presents a brief review of biosensor use in pharmaceutical analysis, fo...

  20. Pharmaceuticals labelled with stable isotopes

    International Nuclear Information System (INIS)

    Krumbiegel, P.

    1986-11-01

    The relatively new field of pharmaceuticals labelled with stable isotopes is reviewed. Scientific, juridical, and ethical questions are discussed concerning the application of these pharmaceuticals in human medicine. 13 C, 15 N, and 2 H are the stable isotopes mainly utilized in metabolic function tests. Methodical contributions are given to the application of 2 H, 13 C, and 15 N pharmaceuticals showing new aspects and different states of development in the field under discussion. (author)

  1. Pharmaceutical drugs, WWTP, and hydric bodies

    Directory of Open Access Journals (Sweden)

    Quezia Bezerra Cass

    2007-12-01

    Full Text Available In the last decade, special attention has been given to the presence of pharmaceutical compounds in the aquatic environment; once that the continuous supply and persistence of these substances can be severally prejudicial to the biota. Thus, the development and application of new technologies that allows the removal or diminishes these contaminants has been the focus of the environment sanitation area. However, the absence of specific monitoring programs at the waste water treatment plant (WWTP, unfeasibly the behaviour evaluation of pharmaceutical drugs in the installed plants. The aim work, based on the factors involved in the input of these contaminants in the environment, and take attention to the pathway in the implementation of adequate treatment systems to minimize the deterioration of the aquatic ecosystems.

  2. Primary ovary choriocarcinoma: individual DNA polymorphic analysis as a strategy to confirm diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Fernando Nalesso

    2013-04-01

    Full Text Available Primary choriocarcinoma of the ovary is rare. Furthermore, this tumor can arise from gestational tissue or pure germ cells of the ovary, with the latter resulting in non-gestational choriocarcinoma. While the clinical characteristics and histology of both tumor types are identical, differentiation of these tumors is necessary for effective treatment. One strategy for the differentiation of these tumors types is to assay for the presence of paternal DNA. Accordingly, in the present case, a patient with primary choriocarcinoma of the ovary with a non-gestational origin was confirmed by DNA analysis. The patient subsequently exhibited an excellent response to chemotherapy, and following surgery, achieved complete remission. A pathological analysis of surgical specimens further confirmed the absence of tumor.

  3. An evaluation of prosthetic status and treatment needs among institutionalized elderly individuals of Delhi, India

    Directory of Open Access Journals (Sweden)

    Nisha Yadav

    2017-01-01

    Full Text Available Context: Oral health is essential for elderly person's general health and well-being. The most common oral problem in elderly is tooth loss which results due to periodontal diseases and caries. Prosthetic status is very important as it is related to dietary intake and maintaining nutritional status. Hence, to promote the oral health of the elderly, we need to know their prosthetic status and need. Aims: The aim of this study is to find the prosthetic status and need of 65–74 years old elderly residing in old age homes of Delhi, India. Settings and Design: A cross-sectional study was conducted among a total of 464 residents of 20 old age homes of Delhi, India. Material and Methods: Residents with age group of 64–75 were included in the study. The prosthetic status with treatment need was recorded using the World Health Organization Oral Health Assessment Form (1997. Statistical Analysis Used: Chi-square test and t-test were used to find significance of variables. P < 0.05 was considered significant. Results: Full removable dentures were worn by 7.30% of participants with predominance in upper arch, and one bridge was seen in 9.10% of participants with predominance in lower arch. Full removable denture was required in 25.20% of participants. Most of participants required multiunit prosthesis in both upper as well as lower arch (42.20% and 36.20%, respectively. Conclusion: The present study underlines a considerable need for dental treatment in elderly as the prosthetic status of participants was poor, and prosthetic needs were high.

  4. Radiation therapy of malignant melanoma: Experience with high individual treatment doses

    International Nuclear Information System (INIS)

    Habermalz, H.J.; Fischer, J.J.

    1984-01-01

    Melanoma is a complex tumor, metastasizes early both by lymphatic and blood vessels, and which may invoke a significant host ''immune,'' response. One can imagine a number of potentially useful roles for an effective radiation therapy regimen: 1. Treatment of the primary lesion. For small lesions located on the extremities, surgery may be simpler and obviate the risk of radiation failure. In other areas, e.g., head and neck, which may require more cosmetically or functionally debilitating surgery, a trial of radiation therapy may be worthwhile. 2. Preoperative radiation to the primary lesion before surgical resection in the hope of preventing tumor dissemination. 3. Prophylactic, local and regional lymph node radiation therapy. It has been popular in the past to remove malignant melanoma with wide local excision and dissection of adjacent node areas. It is still an open question whether some or any additional patients will be cured by the more vigorous local and extended treatment. Generally, those procedures have fallen into disfavor because of the associated morbidity. Presumably subclinical amounts of malignant melanoma could be sterilized with doses of radiation smaller than those necessary for bulk tumor. Wide field irradiation to the areas surrounding the primary lesion and the adjacent lymph nodes, to doses causing little morbidity, may well be worth clinical trial. 4. In combination with other forms of therapy, e.g., chemotherapy, immunotherapy, hyperthermia, to reduce the number of malignant cells in localized areas known to contain diseases. This may be particularly important prior to initiation of immunotherapy which may be much more effective in the absence of gross disease

  5. Individual and group-based parenting programmes for the treatment of physical child abuse and neglect.

    Science.gov (United States)

    Barlow, J; Johnston, I; Kendrick, D; Polnay, L; Stewart-Brown, S

    2006-07-19

    Child physical abuse and neglect are important public health problems and recent estimates of their prevalence suggest that they are considerably more common than had hitherto been realised. Many of the risk factors for child abuse and neglect are not amenable to change in the short term. Intervening to change parenting practices may, however, be important in its treatment. Parenting programmes are focused, short-term interventions aimed at improving parenting practices in addition to other outcomes (many of which are risk factors for child abuse e.g. parental psychopathology, and parenting attitudes and practices), and may therefore be useful in the treatment of physically abusive or neglectful parents. To assess the efficacy of group-based or one-to-one parenting programmes in addressing child physical abuse or neglect. A range of biomedical and social science databases were searched including MEDLINE, EMBASE, CINAHL, PsychINFO, Sociofile, Social Science Citation Index, ASSIA, the Cochrane Library, Campbell Library (including SPECTR and CENTRAL), National Research Register (NRR) and ERIC, from inception to May 2005. Only randomised controlled trials or randomised studies that compared two treatments were included. Studies had to include at least one standardised instrument measuring some aspect of abusive or neglectful parenting. In the absence of studies using objective assessments of child abuse, studies reporting proxy measures of abusive parenting were included. Only studies evaluating the effectiveness of standardised group-based or one-to-one parenting programmes aimed at the treatment of physical child abuse or neglect were included. Studies were also only eligible for inclusion if they had targeted parents of children aged 0-19 years who had been investigated for physical abuse or neglect. The treatment effect for each outcome in each study was standardised by dividing the mean difference in post-intervention scores for the intervention and treatment

  6. Association between weight bias internalization and metabolic syndrome among treatment-seeking individuals with obesity.

    Science.gov (United States)

    Pearl, Rebecca L; Wadden, Thomas A; Hopkins, Christina M; Shaw, Jena A; Hayes, Matthew R; Bakizada, Zayna M; Alfaris, Nasreen; Chao, Ariana M; Pinkasavage, Emilie; Berkowitz, Robert I; Alamuddin, Naji

    2017-02-01

    Weight stigma is a chronic stressor that may increase cardiometabolic risk. Some individuals with obesity self-stigmatize (i.e., weight bias internalization, WBI). No study to date has examined whether WBI is associated with metabolic syndrome. Blood pressure, waist circumference, and fasting glucose, triglycerides, and high-density lipoprotein cholesterol were measured at baseline in 178 adults with obesity enrolled in a weight-loss trial. Medication use for hypertension, dyslipidemia, and prediabetes was included in criteria for metabolic syndrome. One hundred fifty-nine participants (88.1% female, 67.3% black, mean BMI = 41.1 kg/m 2 ) completed the Weight Bias Internalization Scale and Patient Health Questionnaire (PHQ-9, to assess depressive symptoms). Odds ratios and partial correlations were calculated adjusting for demographics, BMI, and PHQ-9 scores. Fifty-one participants (32.1%) met criteria for metabolic syndrome. Odds of meeting criteria for metabolic syndrome were greater among participants with higher WBI, but not when controlling for all covariates (OR = 1.46, 95% CI = 1.00-2.13, P = 0.052). Higher WBI predicted greater odds of having high triglycerides (OR = 1.88, 95% CI = 1.14-3.09, P = 0.043). Analyzed categorically, high (vs. low) WBI predicted greater odds of metabolic syndrome and high triglycerides (Ps metabolic syndrome require further exploration. © 2017 The Obesity Society.

  7. Radionuclide determination of individual kidney function in the treatment of chronic renal obstruction

    International Nuclear Information System (INIS)

    Belis, J.A.; Belis, T.E.; Lai, J.C.; Goodwin, C.A.; Gabriele, O.F.

    1982-01-01

    Differential radionuclide renal scans can be useful in the management of patients with chronic partial obstruction of 1 kidney. The /sup 99m/Tc diethylenetriaminepentaacetic acid perfusion scan can be used to assess glomerular blood flow. The 131 I orthoiodohippurate renal scan provides qualitative functional information from scintigrams and quantitative evaluation of effective renal plasma flow to each kidney, as well as a total excretory index. Sequential /sup 99m/Tc diethylenetriaminepentaacetic acid and 131 I orthoiodohippurate renal scans were used to assess individual renal function before and after surgical correction of unilateral chronic renal obstruction in 31 patients. The preservation of cortical perfusion on /supb 99m/Tc diethylenetriaminepentaacetic acid scans indicated that potential existed for partial recovery of renal function. Effective renal plasma flow and excretory index determined in conjunction with the 131 I orthoiodohippurate scans provided a quantitative assessment of preoperative renal function, an evaluation of the effect of surgery and a sensitive method for long-term evaluation of differential renal function. Correction of ureteropelvic junction obstruction usually resulted in improvement in unilateral renal function. Neither nephrolithotomy nor extended pyelolithotomy diminished renal function in the kidney subjected to an operation and often improved it. Patients with long-standing distal ureteral obstruction had the least improvement in renal function postoperatively

  8. Welfare Effects of Pharmaceutical Informative Advertising

    OpenAIRE

    Paris Cleanthous

    2011-01-01

    Pharmaceutical markets are characterized by a high degree of innovation, complexity and uncertainty, especially markets of idiosyncratic symptomatolgy and response to treatment such as the antidepressant market. It may, therefore, be unreasonable to assume that consumers are aware of all antidepressants for sale at the time of purchase, as is the case in traditional models of consumer choice. Such an assumption will bias demand curves towards being more elastic and the evaluation of consumer ...

  9. Pharmaceutical drugs, WWTP, and hydric bodies

    OpenAIRE

    Quezia Bezerra Cass; Eny Maria Vieira; Juliana Cristina Barreiro; Ricardo Wagner Reis Filho

    2007-01-01

    In the last decade, special attention has been given to the presence of pharmaceutical compounds in the aquatic environment; once that the continuous supply and persistence of these substances can be severally prejudicial to the biota. Thus, the development and application of new technologies that allows the removal or diminishes these contaminants has been the focus of the environment sanitation area. However, the absence of specific monitoring programs at the waste water treatment plant (WW...

  10. Prevalence of antisocial personality disorder among Chinese individuals receiving treatment for heroin dependence: a meta-analysis

    Science.gov (United States)

    ZHONG, Baoliang; XIANG, Yutao; CAO, Xiaolan; LI, Yan; ZHU, Junhong; CHIU, Helen F. K.

    2014-01-01

    Background Studies from Western countries consistently report very high rates of comorbid Antisocial Personality Disorder (ASPD) among individuals with heroin addiction, but the reported proportion of Chinese individuals with heroin addiction who have co-morbid ASPD varies widely, possibly because Chinese clinicians do not consider personality issues when treating substance abuse problems. Aim Conduct a meta-analysis of studies that assessed the proportion of Chinese individuals with heroin dependence who have comorbid ASPD. Methods We searched for relevant studies in both Chinese databases (China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, Taiwan Electronic Periodical Services) and western databases (PubMed, EMBASE, and PsycInfo). Two authors independently retrieved the literature, identified studies that met pre-defined inclusion and exclusion criteria, assessed the quality of included studies, and extracted the data used in the analysis. Statistical analysis was performed using StatsDirect 3.0 and R software. Results The search yielded 15 eligible studies with a total of 3692 individuals with heroin dependence. Only 2 of the studies were rated as high-quality studies. All studies were conducted in rehabilitation centers or hospitals. The pooled lifetime prevalence of ASPD in these subjects was 30% (95%CI: 23%-38%), but the heterogeneity of results across studies was great (I2 =95%, p<0.001). Men had a higher prevalence than women (44% vs. 21%), and injection heroin users had higher prevalence than those who smoked heroin (44% vs. 27%). Studies that were methodologically stronger had higher reported prevalence of ASPD among heroin dependent individuals. Conclusions There are substantial methodological problems in the available literature about ASPD in Chinese individuals receiving treatment for heroin dependence, but we estimate that about one-third of them meet criteria for ASPD. Further work is needed to increase clinicians

  11. Eculizumab treatment: stochastic occurrence of C3 binding to individual PNH erythrocytes

    Directory of Open Access Journals (Sweden)

    Michela Sica

    2017-06-01

    Full Text Available Abstract Background C5 blockade by eculizumab prevents complement-mediated intravascular hemolysis in paroxysmal nocturnal hemoglobinuria (PNH. However, C3-bound PNH red blood cells (RBCs, arising in almost all treated patients, may undergo extravascular hemolysis reducing clinical benefits. Despite the uniform deficiency of CD55 and of CD59, there are always two distinct populations of PNH RBCs, with (C3+ and without (C3− C3 binding. Methods T