Enhanced Catalytic Performance of N-Doped Carbon Sphere-Supported Pd Nanoparticles by Secondary Nitrogen Source Regulation for Formic Acid Dehydrogenation.

The development of catalysts with high selectivity, good catalytic activity, and excellent cycle performance is of significance for the application of formic acid (HCOOH, FA) as a hydrogen support. Herein, Pd is deposited on a series of N-doped carbons, which are prepared by cocarbonization of N-containing zeolite imidazole frameworks (ZIF-8) and other N/C sources (melamine, xylitol, urea, and glucose), for hydrogen generation from FA. The results demonstrate that the introduction of a secondary N/C source further affects the catalytic performance of Pd by adjusting the morphology, specific surface area, N content, and type of carbon. The effects of N atoms and the favorable reaction pathways of FA dehydrogenation were revealed by theoretical calculation. This work will improve the understanding of N doping on the decomposition mechanism of FA and provide a new approach for the rational design of metal-N-C materials.

Highly Efficient Absorption of CO2 by Protic Ionic Liquids-Amine Blends at High Temperatures.

In view of the increasingly serious harm of CO2 to the environment, it is highly desirable to develop effective CO2 absorbents. In this work, we demonstrated an efficient absorption of CO2 by blends of protic ionic liquids (PILs) plus amines. The density and viscosity of investigative four PILs-amine mixtures were measured. By systematically studying the effects of the solution ratio, temperature, CO2 partial pressure, and water content on the absorption of CO2, it is found that the 3-dimethylamino-1-propylamine acetate ([DMAPAH][OAc]) plus ethanediamine (EDA) mixture shows the highest CO2 uptake of 0.295 g CO2 per g absorbent at 50 °C and 1 bar and a further increase in the absorption of CO2 to 0.299 g/g by adding water with a mass fraction of 20%. Furthermore, the absorption mechanism of CO2 in the presence and absence of water has also been investigated by FTIR and NMR spectra.

Real World Outcomes and Hepatotoxicity of Infliximab in the Treatment of Steroid-Refractory Immune-Related Adverse Events.

BACKGROUND AND AIMS: Current guidelines state that infliximab is contraindicated for the treatment of immune checkpoint inhibitor-related hepatitis (ir-hepatitis) due to the risk of inducing further liver damage. As this recommendation is largely based on the use of infliximab for rheumatologic diseases, we evaluated the efficacy and hepatotoxicity of infliximab in patients with steroid-refractory immune-related adverse events (irAEs). METHODS: We retrospectively reviewed consecutive patients treated with infliximab for irAEs at Princess Margaret Cancer Centre. To assess hepatotoxicity, we compared the mean value of ALT, AST, and total bilirubin (BT) before and after infliximab treatment. We used logistic regression to assess factors associated with infliximab efficacy. RESULTS: Between January 2010 and February 2019, 56 patients were identified. The median age of the patients was 63 (27-84) years. Colitis was the most frequent toxicity (66%), followed by pneumonitis (11%). Infliximab was used to treat ir-hepatitis in one patient. The median number of infliximab doses was 1 (1-3) and led to toxicity resolution in 43 (76%) patients. The mean ALT, AST, and BT levels before and after infliximab treatment were not statistically different. The patient treated for ir-hepatitis had a complete recovery, with no incremental liver toxicity. CONCLUSIONS: In this dose-limited setting, infliximab was effective in resolving irAEs and did not induce hepatotoxicity.

Safety of two-hour intermittent intravenous infusions of tacrolimus in the allogeneic hematopoietic stem cell transplantation unit.

At our institution, tacrolimus is used as a second-line agent for the prevention and treatment of graft-versus-host-disease in the allogeneic hematopoietic stem cell transplantation (HSCT) unit after patients have experienced a serious or intolerable adverse event to cyclosporine. As per our standard practice, tacrolimus is administered via 2-h intermittent IV infusions (IIVs) every 12 h rather than continuous IV infusion. Shorter infusion times are cautioned due to concerns of higher rates of nephrotoxicity, neurotoxicity and infusion-related reactions, although there is a paucity of data to support this claim. Our primary objective was to evaluate the safety of a 2-h IIV of tacrolimus in an adult HSCT population. We retrospectively reviewed the charts of 104 patients who received tacrolimus by IIV (3574 doses; median = 22, range 1-158, IQR = 28) from 2002 to 2016. Primary outcomes collected include rates of nephrotoxicity, neurotoxicity and infusion-related reactions. One (0.9%) grade 2 infusion-related reaction occurred and resolved without discontinuation of tacrolimus. Of 16 incidences (13.6%) of nephrotoxicity, all but 10 (8.5%) cases resolved. Precipitating factors for nephrotoxicity unrelated to tacrolimus were identified in all 10 cases. There were 41 incidences (35%) of neurotoxicity, of which, 8 (6.8%) were considered serious. All neurotoxicity reverted to baseline or resolved completely. We propose that a 2-h IIV of tacrolimus is a safe method of administration in the adult HSCT setting.

Polyethyleneimine-Modified Amorphous Silica for the Selective Adsorption of CO2/N2 at High Temperatures.

Mechanochemistry is very attractive as an efficient, solvent-free, and simplified technique for the preparation of composite adsorbents. Here, a series of polyethyleneimine (PEI)-modified SiO2 adsorbents were prepared via mechanical ball milling for selective adsorption of CO2 at high temperatures. The structural properties of these adsorbents were characterized by XRD, SEM, TGA, FTIR, and N2 adsorption-desorption. This method can better disperse the PEI evenly in the SiO2 as well as maintain the porous structure of the adsorbents by comparing with the impregnated adsorbents. These adsorbents presented appreciable performance in separating CO2 at high temperatures, and the CO2 adsorption capacity of PEI(70%)/SiO2 is up to 2.47 mmol/g at 70 °C and 1.5 bar, which is significantly higher than that of the same type of CO2 adsorbent reported in the literature. Furthermore, the adsorbent of PEI(70%)/SiO2 provided an ideally infinite selectivity for CO2/N2 (15:85) at 70 °C. These results showed that mechanical grinding methods are a simple and effective approach to producing amine-modified silica composite adsorbents.

Persistent Diarrhea after Celiac Plexus Block in a Pancreatic Cancer Patient: Case Report and Literature Review.

BACKGROUND: Neurolytic celiac plexus block is increasingly used to treat refractory pain associated with abdominal malignancies, especially pancreatic cancer. While self-limiting diarrhea can occur commonly in patients post procedure, a very rare risk of persistent diarrhea exists. OBJECTIVE: We present a case of a 70 year old female with locally advanced pancreatic adenocarcinoma who was hospitalized for persistent severe diarrhea post celiac plexus block and discuss management options for this adverse effect. DESIGN: A review of the current literature within the past 20 years (PubMed and Ovid databases) was conducted to discuss alternatives of management. MEASUREMENTS/RESULTS: Ninety-three entries were found in total including duplicates and only two were included for relevance. Management options that were discussed included anti-motility agents, alpha-adrenergic agonists, and somastatin analog (octreotide). Our patient was initially treated with loperamide, hyoscine, psyllium, and cholestyramine before responding to octreotide. The patient was discharged on long-acting octreotide after her bowel routine stabilized. CONCLUSIONS: Persistent diarrhea is a very rare complication of celiac plexus block and current literature regarding proper management is based largely on anecdotal evidence. For this patient octreotide was an effective agent for the management of this complication.

Outpatient parenteral antimicrobial therapy for surgery patients: A comparison with previous standard of care.

BACKGROUND: Current literature reports that outpatient parenteral antimicrobial therapy (OPAT) programs improve cure rates, and reduce length of hospitalization and costs. OPAT programs are still relatively new in Canada. OBJECTIVE: To evaluate the benefits of an OPAT program initiated at a multispecialty tertiary care facility in Toronto, Ontario, compared with the previous standard of care. METHODS: The present retrospective observational study was conducted using data from a group of surgical patients who were treated for active infections. Between February 1, 2010 and November 30, 2010, a total of 108 surgical patients were enrolled in the OPAT program. Patients were matched 1:1 with historical controls discharged between January 1, 2001 and January 1, 2010 according to age, sex, type of surgery, infection and comorbidities (Charlson Comorbidity Index). Cure rate, 30-day rehospitalization and length of stay were evaluated as primary end points. RESULTS: Of 108 eligible OPAT patients, 21 were matched to the control group using the prespecified criteria. For this cohort, the OPAT program was associated with improved cure rates (OPAT 61.7% versus control 57.1%; P>0.10), reduction in rehospitalization rate (14.3% versus 28.6%; P>0.10) and reduced length of stay (10.7 versus 13.9 days, P>0.10) compared with the control group. CONCLUSIONS: For this cohort of surgery patients, the OPAT program demonstrated a trend toward improved outcomes but did not achieve statistical significance. Due to the lack of statistical power, further evaluation is required to determine the full benefit of OPAT to patients and the health care system.

HISTORIQUE: D'après les rapports bibliographiques actuels, les programmes d'antibiothérapie parentérale ambulatoire (ATPA) améliorent les taux de guérison et réduisent la durée d'hospitalisation et les coûts. Les programmes d'ATPA sont encore relativement nouveaux au Canada. OBJECTIF: Évaluer les avantages d'un programme d'ATPA lancé dans un centre de soins tertiaires multidisciplinaire de Toronto, en Ontario, par rapport aux normes de soins antérieures. MÉTHODOLOGIE: Les chercheurs ont mené la présente étude d'observation rétrospective à l'aide des données d'un groupe de patients opérés traités en raison d'infections actives. Entre le 1er février et le 30 novembre 2010, 108 patients opérés ont été inscrits au programme d'ATPA. Les patients ont été jumelés 1:1 avec des sujets témoins historiques qui ont obtenu leur congé entre le 1er janvier 2001 et le 1er janvier 2010 d'après leur âge, leur sexe, le type d'opération, l'infection et les comorbidités (indice de comorbidité de Charlson). Les paramètres principaux étaient le taux de guérison, la réhospitalisation au bout de 30 jours et la durée d'hospitalisation. RÉSULTATS: Sur les 108 patients du programme d'ATPA admissibles, 21 ont été jumelés au groupe témoin au moyen des critères pré-définis. Dans cette cohorte, le programme d'ATPA s'associait à un meilleur taux de guérison (61,7 % pour l'ATPA par rapport à 57,1 % pour le groupe témoin; P>0,10), à une réduction du taux de réhospitalisation (14,3 % par rapport à 28,6 %; P>0,10) et à diminution de la durée d'hospitalisation (10,7 par rapport à 13,9 jours, P>0,10) que dans le groupe témoin. CONCLUSIONS: Auprès de cette cohorte de patients opérés, le programme d'ATPA démontrait une tendance vers de meilleures issues, sans pour autant avoir de signification statistique. En raison de l'absence d'efficacité statistique, il faudra approfondir l'évaluation afin de déterminer les avantages du programme d'ATPA pour les patients et le système de santé.