Novel PVDF-PEG-CaCO3 Membranes to Achieve the Objectives of the Water Circular Economy by Removing Pharmaceuticals from the Aquatic Environment.

In the aquatic environment, substances of pharmacological origin are common contaminants. The difficulty of removing them from water is a problem for the implementation of a circular economy policy. When recycling water, an effort should be made to remove, or at least, minimize the presence of these substances in the water. Porous membranes with a new functionality consisting in their adsorption capacity towards pharmaceutical substances have been developed. A Polyvinylidene Fluoride (PVDF) membrane with Calcium Carbonate (CaCO3) nanoparticles as an adsorbent was prepared. By implementing an integrated filtration-adsorption process using sulphadiazine, as a representative of pharmacological substances, 57 mg/m2 of adsorption capacity has been obtained, which is an improvement in adsorption properties of more than 50 times that of a commercial membrane. At the same time the membrane permeability is 0.29 m3/(h·m2·bar), which means that the membrane's permeability was improved by 75%.

Modification of Ceramic Membranes with Carbon Compounds for Pharmaceutical Substances Removal from Water in a Filtration-Adsorption System.

The aim of this work is to develop a new type of carbon-ceramic membranes for the removal of pharmaceutical substances from water. The membranes were prepared by the chemical modification method using an organosilicon precursor-octadecyltrichlorosilane (ODTS). Graphene oxide, multi-walled carbon nanotubes with carboxylic groups, and single-walled carbon nanotubes were used in the modification process. The filtration properties and adsorption properties of the developed membranes were tested. In order to characterize the membrane, the water permeability, the change of the permeate flux in time, and the adsorbed mass of the substance were determined. Additionally, the surface properties of the membranes were characterized by contact angle measurements and porosimetry. The antibiotic tetracycline was used in the adsorption tests. Based on the results, the improved adsorption properties of the modified membrane in relation to the unmodified membrane were noticed. Novel ceramic membranes modified with MWCNT are characterized by 45.4% removal of tetracycline and permeate flux of 520 L·h·m-2·bar-1. We demonstrated the ability of modified membranes to adsorb pharmaceuticals from water streams that are in contact with the membrane. Novel membranes retain their filtration properties. Therefore, such membranes can be used in an integrated filtration-adsorption process.

Prospective Evaluation of the NETest as a Liquid Biopsy for Gastroenteropancreatic and Bronchopulmonary Neuroendocrine Tumors: An ENETS Center of Excellence Experience.

BACKGROUND: There is a substantial unmet clinical need for an accurate and effective blood biomarker for neuroendocrine neoplasms (NEN). We therefore evaluated, under real-world conditions in an ENETS Center of Excellence (CoE), the clinical utility of the NETest as a liquid biopsy and compared its utility with chromogranin A (CgA) measurement. METHODS: The cohorts were: gastroenteropancreatic NEN (GEP-NEN; n = 253), bronchopulmonary NEN (BPNEN; n = 64), thymic NEN (n = 1), colon cancer (n = 37), non-small-cell lung cancer (NSCLC; n = 63), benign lung disease (n = 59), and controls (n = 86). In the GEPNEN group, 164 (65%) had image-positive disease (IPD, n = 135) or were image-negative but resection-margin/biopsy-positive (n = 29), and were graded as G1 (n = 106), G2 (n = 49), G3 (n = 7), or no data (n = 2). The remainder (n = 71) had no evidence of disease (NED). In the BPNEN group, 43/64 (67%) had IPD. Histology revealed typical carcinoids (TC, n = 14), atypical carcinoids (AC, n = 14), small-cell lung cancer (SCLC, n = 11), and large-cell neuroendocrine carcinoma (LCNEC, n = 4). Disease status (stable or progressive) was evaluated according to RECIST v1.1. Blood sampling involved NETest (n = 563) and NETest/CgA analysis matched samples (n = 178). NETest was performed by PCR (on a scale of 0-100), with a score ≥20 reflecting a disease-positive status and >40 reflecting progressive disease. CgA positivity was determined by ELISA. Samples were deidentified and measurements blinded. The Kruskal-Wallis, Mann-Whitney U, and McNemar tests, and the area under the curve (AUC) of the receiver-operating characteristics (ROC) were used in the statistical analysis. RESULTS: In the GEPNEN group, NETest was significantly higher (34.4 ± 1.8, p < 0.0001) in disease-positive patients than in patients with NED (10.5 ± 1, p < 0.0001), colon cancer patients (18 ± 4, p < 0.0004), and controls (7 ± 0.5, p < 0.0001). Sensitivity for detecting disease compared to controls was 89% and specificity was 94%. NETest levels were increased in G2 vs. G1 (39 ± 3 vs. 32 ± 2, p = 0.02) and correlated with stage (localized: 26 ± 2 vs. regional/distant: 40 ± 3, p = 0.0002) and progression (55 ± 5 vs. 34 ± 2 in stable disease, p = 0.0005). In the BPNEN group, diagnostic sensitivity was 100% and levels were significantly higher in patients with bronchopulmonary carcinoids (BPC; 30 ± 1.3) who had IPD than in controls (7 ± 0.5, p < 0.0001), patients with NED (24.1 ± 1.3, p < 0.005), and NSCLC patients (17 ± 3, p = 0.0001). NETest levels were higher in patients with poorly differentiated BPNEN (LCNEC + SCLC; 59 ± 7) than in those with BPC (30 ± 1.3, p = 0.0005) or progressive disease (57.8 ± 7), compared to those with stable disease (29.4 ± 1, p < 0.0001). The AUC for differentiating disease from controls was 0.87 in the GEPNEN group and 0.99 in BPC patients (p < 0.0001). Matched CgA analysis was performed in 178 patients. In the GEPNEN group (n = 135), NETest was significantly more accurate for detecting disease (99%) than CgA positivity (53%; McNemar test χ2 = 87, p < 0.0001). In the BPNEN group (n = 43), NETest was significantly more accurate for disease detection (100%) than CgA positivity (26%; McNemar's test χ2 = 30, p < 0.0001). CONCLUSIONS: The NETest is an accurate diagnostic for GEPNEN and BPNEN. It exhibits tumor biology correlation with grading, staging, and progression. CgA as a biomarker is significantly less accurate than NETest. The NETest has substantial clinical utility that can facilitate patient management.

Differentiating between benign and malignant adnexal lesions with contrast-enhanced transvaginal ultrasonography.

OBJECTIVE: To analyze the relationship between contrast kinetics in tumorous vessels and lesion histologic type in an attempt to differentiate between malignant and benign disease. METHODS: In a single-center prospective study, patients who had been referred for elective surgery because of a diagnosis of unilateral and/or bilateral adnexal masses were enrolled at Dr Jan Biziel University Hospital, Bydgoszcz, Poland, between January 2012 and September 2013. Participants underwent contrast-enhanced ultrasonography examination (CEUS). Contrast kinetics were obtained and compared with the neovascularization of the tumor. Accuracy, and positive and negative predictive values were calculated. RESULTS: Among 160 enrolled patients, 84 underwent CEUS examination and 51 lesions were studied. Baseline and maximum color Doppler intensities were significantly higher in malignant than in benign tumors (P < 0.001 for both). Similarly, the absolute and relative increases in color Doppler intensity were significantly higher in malignant tumors (P < 0.001). The estimated positive predictive value was 97.1%, the negative predictive value was 100%, and the accuracy was 100%. Peak enhanced intensity of fractional color Doppler Area and area under the time-intensity curve (S-parameter) correlated significantly with the histology of the lesion (P < 0.001). Probability curves demonstrated that higher S-parameter values were correlated with a higher risk of malignancy. CONCLUSION: Transvaginal CEUS is a reliable and reproducible way to differentiate between benign and malignant adnexal lesions.

[Gastric myoelectrical activity in children and youth with dyspeptic symptoms]. / Zaburzenia czynnosci mioelektrycznej zoladka u dzieci i mlodziezy z objawami dyspeptycznymi.

THE AIM: of the study was to analyze gastric myoelectrical activity in children and youth with dyspeptic symptoms. MATERIAL AND METHODS: 113 children and youth aged 4.5 to 18 years (mean age 13.4 years) with dyspeptic symptoms were enrolled into the study. They were divided into 4 groups: group I--30 patients--without gastrooesophageal acid reflux GER (-) and Helicobacter pylori infection Hp (-), group II--35 patients, GER (+) Hp (-); group III--20 patients, GER (-) Hp (+); group IV --28 patients, GER (+) Hp (+). Gastrooesophageal acid reflux was recognized using 24-hour pH-metry. Helicobacter pylori infection was diagnosed based on histopathological examination of gastric body and/or antrum specimens, urease test and (or) C13 urea breath test. Gastric myoelectrical activity was performed using multichannel electrogastrography (Medtronic POLYGRAM NETTM). Six EGG electrodes were fixed on the subject's abdomen in standard places. Fasting EGG was recorded for 30 minutes followed by one hour postprandial recording after an ingestion of standard meal. Variables assessed were: dominant frequency (DF), the power of the dominant frequency (DP), percentage of bradygastria, normal, tachygastria and arrhythmia frequency, dominant frequency instability coefficient (DFIC), dominant power instability coefficient (DPIC) recorded from each channel (C1, C2, C3, C4) and average percentage slow wave coupling (%SWC) among channels. Comparisons were performed using Kruskal-Wallis's test. RESULTS: In comparison to group II GER (+) Hp (-) in group I GER (-) Hp (-) were recorded significantly higher percentage of bradygastria frequency in C1 and C2 (5% vs 2% and 4% vs. 1%) and postprandialy significantly higher percentage of arrhythmia in C4 (18% vs 13%). In comparison to group Ill GER (-) Hp (+) in group I GER (-) Hp (-) fasting were observed significantly lower dominant frequency (2.89 vs 3.07 cpm), higher percentage of tachygastria frequency in C1 (3% vs. 1%), lower percentage of arrhythmia frequency in C2 (20% vs 29%), higher DPIC in C4 (1.46 vs 1.27), higher average percentage %SWC 2-3 (70% vs 59%) and postprandialy lower DFIC in C4 (0.45 vs 0.54). In comparison to group IV GER (+) Hp (+) in group I GER (-) Hp (-) fasting were recorded lower percentage of arrhythmia frequency in C1 and C2 (18% vs 27% and 20% vs 30%) and postprandialy lower percentage of arrhythmia frequency in C2 (11% vs 17%) and lower DFIC in C2 (0.37 vs 0.48). In comparison to group Ill GER (-) Hp (+) in group II GER (+) Hp (-) fasting were observed significantly lower percentage of bradygastria frequency in C1 (2% vs 4%), higher DPIC in C2 (1.87 vs 1.28), higher average percentage %SWC 1-3 and 2-3 (71% vs 63% and 71% vs 59%) and postprandialy higher percentage of bradygastria frequency in C1 (5% vs 3%) and higher average percentage %SWC 3-4 (68% vs 58%). In comparison to group IV GER (+) Hp (+) in group II GER (+) Hp (-) fasting were recorded significantly higher percentage of normal frequency in C1 and C2 (76% vs 68% and 75% vs 67%) and higher average percentage %SWC 1-2 (77% vs 69%) and postprandialy significantly lower percentage of arrhythmia frequency in C1 (12% vs 18%). In comparison to group IV GER (+) Hp (+) in group Ill GER (-) Hp (+) fasting were observed significantly higher dominant frequency (3.07 vs. 2.87 cpm, p < or = 0.01) and lower percentage of tachygastria frequency in C1 (1% vs 2%) and postprandialy lower percentage of bradygastria frequency in C1 and C2 (3% vs 5% and 3% vs 5%) and lower DFIC in C2 (0.33 vs 0.48). CONCLUSION: In dyspeptic children and youth Helicobacter pylori infection and/ or gastrooesophageal acid reflux have influence on the gastric myoelectrical activity EGG abnormalities in patients with these diseases are varied, mostly preprandialy and recorded from proximal part of the stomach.

[Value of pH-metric examination in diagnosing gastroesophageal reflux in children and youth with typical and atypical clinical symptoms of gastroesophageal reflux disease]. / Wartosc badania pH-metrycznego w rozpoznawaniu refluksu zoladkowo-przelykowego u dzieci i mlodziezy z typowymi i nieswoistymi objawami klinicznymi choroby refluksowej przelyku.

AIM: The aim of work was an estimation of pH-metric examination in diagnosing of gastroesophageal reflux in children with typical and atypical symptoms of the gastroesophageal reflux disease. MATERIAL AND METHODS: 121 children were analysed with suspected to gastroesophageal reflux disease. Depending on reported ailments they were divided into 2 groups. Group I patients with typical symptoms of gastroesophageal reflux disease were including: heartburn, rebounding; while the second group consisted of those with atypical symptoms: nausea, vomiting, chest pain, abdominal pain. 24-hour pH-metric examination was performed in each patient. RESULTS: On the basis of pH-metric examination gastroesophageal reflux was diagnosed in 85.2% patients from I group and 44.8% patients from group II. CONCLUSION: The most important examination determining diagnosis of gastroesophageal reflux in children with both typical and atypical symptoms of this illness should be pH-metric examination of the esophagus. In children with atypical symptoms in consideration of differential diagnosis we should take into account a possibility of gastroesophageal reflux.

Assessment of the value of pHmetry results in diagnostics of gastroesphageal reflux as a cause of obstructive bronchitis in children.

BACKGROUND: The study assessed the incidence of pathologic gastroesophageal reflux in children with obstructive bronchitis and analyzed the correlation of pHmetric parameters with the incidence of obstructive bronchitis according to age groups. MATERIAL/METHODS: 109 children aged from 4 months to 17 years with the history of at least two documented incidents of obstructive bronchitis during the period of one year were examined. Each patient underwent 24h esophageal pHmetry. The analyzed patients were divided into 3 age groups: I - 4 months-2 years, II - 3-9 years, III - 10-17 years; each of the obtained groups was divided into 2 subgroups according to the frequency of obstructive bronchitis (a - 2-4 times a year and b - over 4 times a year). RESULTS: Gastroesophageal reflux was diagnosed on the basis of pHmetry in 62.4% of patients. It was demonstrated in own material that gastroesophageal reflux is more frequent in boys (64.7%) than in girls (35.3%). Comparison of pHmetric parameters in children suffering from obstructive bronchitis more and less frequently did not demonstrate higher pHmetric parameters in children with more frequent occurrence of obstructive bronchitis in any of the age groups. Although gastroesophageal reflux occurred frequently in children with obstructive bronchitis, no proportional correlation was found between the pHmetric parameters and frequency of obstructive bronchitis CONCLUSIONS: Esophageal pHmetry should be performed in children with obstructive bronchitis in order to confirm or exclude gastroesophageal reflux as a cause of recurrent obstructive bronchitis.