Presence and toxicity of drugs used to treat SARS-CoV-2 in Llobregat River, Catalonia, Spain.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a strain of coronavirus that causes COVID-19 (coronavirus disease 2019), the respiratory illness responsible for the on-going COVID-19 pandemic. In March 2020, it was declared global pandemic, causing millions of deaths. An evident tendency of global pharmaceutical consumption due to COVID-19 pandemic should be seen worldwide, and this increase might suppose an environmental threat. Pharmaceuticals administrated at home or in pharmacies are excreted by faeces and urine after consumption, and wastewater treatment plants (WWTPs) are not able to remove all pharmaceuticals residues that eventually will end up in the aquatic media (rivers and sea). For this reason, analytical techniques such as liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) have become prominent to identify and quantify pharmaceuticals residues in aquatic matrices. In view of the scarce data on the occurrence of pharmaceuticals used as COVID-19 treatment, the aim of the present study was to evaluate the presence of these class of pharmaceuticals in river water which were dexamethasone, prednisone, ciprofloxacin, levofloxacin, remdesivir, ritonavir, lopinavir, acetaminophen, hydroxychloroquine, chloroquine and cloperastine, their toxicity in the aquatic environment using D. magna and to perform an exhaustive risk assessment in seven points of the Llobregat river basin. Dexamethasone, cloperastine and acetaminophen were the pharmaceuticals with higher concentrations, showing mean levels between 313 and 859 ng L-1.

[I125 low dose rate brachytherapy in localized prostate cancer. Preliminary results after 5 years]. / Braquiterapia de baja tasa (I125) en el cáncer de próstata localizado. Resultados preliminares a 5 años.

OBJECTIVES: Prostatic brachytherapy by permanent implant of I125 or Pd103 is a therapeutic option in the treatment of organ confined prostate cancer We analyze preliminary results and complications after five years in the group of patients who received I125 low dose rate brachytherapy as the only intention-to-cure treatment and evaluate the differences with the standard treatment (surgery). METHODS: From a case series of more than 400 patients treated with brachytherapy as radical intention-to-cure monotherapy for organ-confined prostate cancer we excluded patients with less than 12 months of follow-up for statistical analysis; the study group includes 275 patients enrolled between april 1999 and December 2003. Mean follow-up is 31 months (12-68). Biochemical failure was defined in accordance to the ASTRO criteria. Statistical survival analysis was carried out with the SPSS statistical software using the Kaplan Meyer method. Urinary and gastrointestinal complications were evaluated in accordance to the RTOG criteria. RESULTS: Mean age was 68 years (range 49-83 years). 93% of the patients presented a clinical stage < or ='3dT2a and 7% T2b, with 60 8% of the cases having a PSA < or ='3d 10 ng/ml. Gleason score was < or ='3d 6 in 94% of the cases. 9% of the cases had a prostate volume > 50 cc. Overall 5 year survival was 96%, with a 97% disease-free survival and a 99% biochemical failure-free survival. Figure 3 and tables II-VI summarize the complications in various series including this. CONCLUSIONS: Multiple published series seem to show similar results on biochemical control of the disease when comparing surgery and low dose rate brachytherapy in organ-confined disease. In comparison to surgery, brachytherapy has the advantage of having a lower percentage of immediate postoperative complications, lower incontinence rate, and a higher number of patients preserving erectile function.

Braquiterapia de baja tasa (I125) en el cáncer de próstata localizado. Resultados preliminares a 5 años / I125 low dose rate brachytherapy in localized prostate cancer. Preliminary results after 5 years

OBJETIVO: La braquiterapia prostáticacon implantes permanentes de semillas de I125 ó 103Pdes una opción terapéutica en el tratamiento del cáncerprostático organoconfinado. Analizamos los resultadospreliminares y las complicaciones a cinco años en elgrupo de pacientes tratados con braquiterapia de bajatasa (I125) como tratamiento único de intención curativay evaluamos las diferencias existentes con el tratamientoestándar (cirugía).MÉTODOS: Sobre una casuística que supera los 400pacientes tratados con braquiterapia como monoterapiay con intención curativa radical por adenocarcinomade próstata organoconfinado, hemos excluido elgrupo de pacientes con un seguimiento menor a 12meses para el análisis estadístico de resultados y com-plicaciones, por lo tanto el grupo a estudio consta de275 pacientes reclutados desde abril de 1999 adiciembre del 2003. El seguimiento medio de la seriees de 31 meses (12-68 m). Se consideró fallo bioquímicocuando los pacientes cumplieron los criterios marcadospor la ASTRO. El análisis estadístico de supervivenciase realizó con el paquete estadístico SPSS y elmétodo de Kaplan-Meyer. Las complicaciones urinariasy digestivas fueron evaluadas de acuerdo con los criteriosde la RTOG RESULTADOS: La edad media del grupo fue de 68años con un rango (49-83 años). El 93% de los pacientespresentaron un estadio clínico 50cc. la supervivencia global a los 5 años esdel 96%, con una supervivencia libre de enfermedadde 97% y una con una supervivencia libre de fallo bioquímicodel 99% al mismo tiempo. Las complicacionesde las diferentes series incluida la nuestra están recogidasen la Figura3 y Tablas II-VI.CONCLUSIÓN: Las múltiples series publicadas en laliteratura parecen poner de manifiesto los mismos resultadosde control bioquímico de la enfermedad cuandose compara la cirugía con la braquiterapia de bajatasa en enfermedad organoconfinada. La braquiterapiapresenta frente a la cirugía la ventaja de tener menorporcentaje de complicaciones en el postoperatorioinmediato, menor índice de incontinencias y una preservaciónde la función eréctil en mayor número depacientes

OBJECTIVES: Prostatic brachytherapy bypermanent implant of I125 or Pd103 is a therapeuticoption in the treatment of organ confined prostate cancer.We analyze preliminary results and complications afterfive years in the group of patients who received I125low dose rate brachytherapy as the only intention-tocuretreatment and evaluate the differences with thestandard treatment (surgery).METHODS: From a case series of more than 400patients treated with brachytherapy as radical intentionto-cure monotherapy for organ-confined prostate cancerwe excluded patients with less than 12 months offollow-up for statistical analysis; the study group includes275 patients enrolled between april 1999 andDecember 2003. Mean follow-up is 31 months (12-68). Biochemical failure was defined in accordance tothe ASTRO criteria. Statistical survival analysis wascarried out with the SPSS statistical software using theKaplan Meyer method. Urinary and gastrointestinalcomplications were evaluated in accordance to theRTOG criteria.RESULTS: Mean age was 68 years (range 49-83years). 93% of the patients presented a clinical stage 50 cc. Overall 5 year survival was 96%, with a 97%disease-free survival and a 99% biochemical failure-freesurvival. Figure 3 and tables II-VI summarize thecomplications in various series including this.CONCLUSIONS: Multiple published series seem toshow similar results on biochemical control of the diseasewhen comparing surgery and low dose rate brachytherapyin organ-confined disease. In comparison to surgery,brachytherapy has the advantage of having a lowerpercentage of immediate postoperative complications,lower incontinence rate, and a higher number ofpatients preserving erectile function