Application of Surfactant Modified Natural Zeolites for the Removal of Salicylic Acid—A Contaminant of Emerging Concern

This work aimed to test composites (surfactant modified zeolites prepared by treatment of natural zeolites—clinoptilolite (IZ CLI) and/or phillipsite (PHIL75)-rich tuffs with two different amounts of cationic surfactants: cetylpyridinium chloride (CPyCl) and Arquad® 2HT-75 (ARQ)) for the adsorption of salicylic acid (SA)—a common contaminant of emerging concern. Adsorption of SA was studied at different initial drug concentrations (in the range of 2–100 mg/L) in water solution. The Langmuir isotherm model showed the highest adsorption was achieved by bilayer composite of IZ CLI and CPyCl—around 11 mg/g. Kinetic runs were performed by using the initial drug concentration of 20 mg/L in the time interval from 0 to 75 min and pseudo-second order had good correlation with experimental data. The influence of the four different temperatures on the SA adsorption was also investigated and thermodynamic parameters suggested that the adsorption drug onto composites is an exothermic and nonspontaneous process, followed by the decrease of randomness at the solid/liquid interface during the adsorption. Zeta potential and Fourier-transform infrared spectroscopy with attenuated total reflectance (FTIR-ATR) had been performed for the characterization of composites after adsorption of SA confirming the presence of the drug at composite surfaces.

Tautomers of the Orotate Anion Have Anti-Inflammatory Effects in the Correction of Drug-Induced Hepatitis in Rats

The purpose of this paper was to conduct a comparative experimental study of the anti-inflammatory effects of tautomeric forms of orotic acid in the correction of drug-induced hepatitis in rats. Materials and Methods. A total of 40 rats (Rattus norvegicus Berk.) were randomly divided into 5 groups: control group (n = 10); intervention group with drug-induced hepatitis (n = 15); animals with drug-induced hepatitis who were injected with orotic acid (ОА) tautomers: initial oxo-form (n = 5), hydroxy-form (n = 5) and dihydroxyform (n = 5) at a dose of 0.5 g/kg body weight a day in the course of 14 days. The tautomers were obtained by mechanical activation in a planetary ball mill AGO-2C for 1 (hydroxy-form) and 6 (dihydroxyform) hours. In the blood of animals of all experimental groups, the content of leukocytes, granulocytes, lymphocytes, and monocytes was determined. Liver sections were stained with hematoxylin and eosin to assess the histo- and cytostructure of the tissues, and immunohistochemically using a set of monoclonal antibodies to detect the expression of the CD68+ macrophage marker. Results. It was found that when correcting drug-induced hepatitis with the hydroxy-form of OA, the severity of leuko- and monocytosis decreased and the number of lymphocytes was restored. The number of CD68+ macrophages with a pro-inflammatory phenotype decreased in the group receiving the hydroxy-form of OA (by a factor of 1.32; p = 0.019), but remained unchanged at the administration of oxo- and dihydroxy-forms of OA. The intensity of reaction product expression decreased by a factor of 1.5 in the group administered with the initial drug and by a factor of 1.9 in animals administered with mechanically activated drugs (p = 0.0001). Thus, the obtained data indicate a pronounced anti-inflammatory activity of the hydroxyform of OA, which can substantiate its use as a hepatoprotective agent. For citation: Pazinenko K.A., Chuchkova N.N., Smetanina M.V. Tautomers of the Orotate Anion Have Anti-Inflammatory Effects in the Correction of Drug-Induced Hepatitis in Rats. Journal of Medical and Biological Research, 2021, vol. 9, no. 4, pp. 366–373. DOI: 10.37482/2687-1491-Z074

An unusual recurrent ileocolonic injury

Potassium binders (Kayexalate® and Sorbisterit®) are commonly used to treat hyperkaliemia. They are made of sodium or calcium polystyrene sulfonate. Their use is associated with multiple adverse effects including ileocolonic (or more rarely upper digestive tract) injuries which can lead to necrosis or perforations. This side effect is mostly seen in patients with chronic kidney disease or constipation. It presents with abdominal pain, diarrhea or hematochezia. The diagnosis is made when the histo-logical analysis of samples from the erythematous or ulcerated digestive wall finds polystyrene sulfonate crystals embedded in the mucosa. This diagnosis can be suspected by taking a careful initial drug inventory, if the clinician is aware of this rare but serious adverse effect. The lack of specificity of clinical symptoms and endoscopic lesions makes this inventory even more essential. Treatment is mainly supportive and requires cessation of the drug, while surgery is inevitable in the most severe cases.

The roles of history, chance, and natural selection in the evolution of antibiotic resistance

History, chance, and selection are the fundamental factors that drive and constrain evolution. We designed evolution experiments to disentangle and quantify effects of these forces on the evolution of antibiotic resistance. Previously we showed that selection of the pathogen Acinetobacter baumannii in both structured and unstructured environments containing the antibiotic ciprofloxacin produced distinct genotypes and phenotypes, with lower resistance in biofilms as well as collateral sensitivity to b-lactam drugs (Santos-Lopez et al. 2019). Here we study how this prior history influences subsequent evolution in new b-lactam antibiotics. Selection was imposed by increasing concentrations of ceftazidime and imipenem and chance differences arose as random mutations among replicate populations. The effects of history were reduced by increasingly strong selection in new drugs, but not erased, at times revealing important contingencies. A history of selection in structured environments constrained resistance to new drugs and led to frequent loss of resistance to the initial drug by genetic reversions and not compensatory mutations. This research demonstrates that despite strong selective pressures of antibiotics leading to genetic parallelism, history can etch potential vulnerabilities to orthogonal drugs.

Initial drug prescription in outpatient department: principal approach

One of the primary tasks for a doctor when meeting a patient for the first time is to gain his affection and trust. It is not always possible during the first visit to make an accurate diagnosis and prescribe pathogenetic therapy, because this often requires a deep additional examination. However, it is imperative to demonstrate knowledge and confidence, provide psychological support and alleviate the suffering of the patient, especially in the case of rheumatic disease accompanied by severe pain. Such a patient should be immediately prescribed adequate analgesic therapy. The main tool for controlling pain in diseases of the joints and spine are non-steroidal anti-inflammatory drugs. Moreover, their prescription should be deliberate and balanced, taking into account the clinical picture and comorbid pathology.The article presents two clinical observations, illustrating the formation of a diagnostic and therapeutic concept at an outpatient appointment.

Removal of Pharmaceutical Residues from Wastewater using Activated Carbon from Rice Husks

The presence of pharmaceutical residues in discharges that end up in rivers is a growing concern for the disruption of aquatic ecosystems and human health. The risk of exposure to these medical wastes becomes greater because they are not biodegradable even after sewage treatment. This study aimed to remove trimethoprim (antibiotic), paracetamol (painkiller), and nevirapine (anti-retroviral) from wastewater using activated carbon made from rice husks, an agricultural waste that was investigated as a potential adsorbent. The instrument used for analysis was a liquid chromatography-tandem mass spectrometer (LC-MS/MS). The powdered carbon of rice husks was carbonated at a temperature of 500oC and then activated by phosphoric acid to increase its porosity. After activation, it was successfully characterized by the use of Scanning electron microscopy which showed irregular cavities with open fine pores. Fourier transform infrared showed different functional groups which determined adsorbent- adsorbate interactions while X-ray diffraction revealed amorphous particle arrangement. The effects of the adsorbent dose, contact time, pH, and initial drug concentration were studied. Freundlich and Langmuir's isotherms were used in the evaluation of adsorption phenomena. Thus, obtained results showed that rice husks activated carbon is an effective adsorbent.

Byproducts from the edible oil industry as potential adsorbent for the removal of Pregabalin from aqueous solution

Removal of Pregabalin from aqueous solution as well as industrial effluent using a new, efficient and cost-effective activated carbon derived from groundnut seed cake powder (GNSCP) and coconut cake powder (CCP) has been presented in this study. Experimentation has been carried out by optimizing various parameters such as pH, contact time, dosage, temperature and initial drug concentration using a batch adsorption model. Surface texture and morphology of the activated carbons have been analyzed by HR SEM; Characterization of the adsorbents has been carried out using FTIR and PXRD. Bio-sorption of Pregabalin using GNSCP and CCP followed pseudo-second-order kinetics. Langmuir adsorption isotherm suits the best for the present study. Thermodynamic studies showed that the adsorption of the drug onto the chosen adsorbents is a spontaneous and feasible process. The maximum adsorption capacity for the uptake of Pregabalin by GNSCP was found to be 9.71 mg/g and with CCP 9.83 mg/g. Suitability of the adsorbents for the treatment of industrial effluent has also been carried out and found to have 98 % removal of the drug from the effluent.

Real-World Experience With Pasireotide Lar in Acromegaly Resistant to First-Generation Somatostatin Analogs: A Single Center 1-Year Observation

Introduction: First generation somatostatin analogs (SSAs) are the treatment of choice in persistent acromegaly after transsphenoidal surgery. However, they are effective in 25% to 45 % of patients and a second generation SSA - pasireotide LAR may be a more effective alternative. Aim Our aim was to evaluate the impact of 1-year treatment with pasireotide LAR on disease control and on glucose metabolism in patients with acromegaly after debulking surgery resistant to first-generation SSAs. Material and methods In this single-center prospective study 29 consecutive patients with resistant acromegaly were treated with pasireotide LAR. The initial drug dose was 40 mg i.m. every 28 days. If patient did not achieve biochemical control (GH <2.5 ng/mL and IGF-1 ≤ULN for age and sex) at month 3, the dose was increased to 60 mg i.m. every 28 days. Assessment (GH, IGF-1, glucose, HbA1c) was performed at month 3, 6, 9 and 12. Results: In total, 22 patients (10 females, 12 males) completed a 1-year treatment. Mean age was 41.8±13.8 years. Twelve patients (54.5%) were ≤ 40 years old (including 6 (27.3%) patients of age ≤30 years). At baseline, mean IGF-1 level was 2.3 (SD 0.7) x ULN (age- and sex-specific) (583.9 ng/mL; SD 182.2) and mean GH concentration was 3.9 (SD 2.8) ng/mL. Both values decreased significantly after 1 year of treatment (P<0.001). Pasireotide LAR dose was increased to 60 mg in 16 (72.7%) patients and decreased to 20 mg in one patient patient due to worsening of diabetes control. The magnitude of mean GH level decrease was the largest within first 6 months (mean change from baseline: -1.75 ng/mL, 95% CI: -2.64, -0.85, P=0.0006). Mean IGF-1 level decreased rapidly within the first 3 months (mean change from baseline: -153.20 ng/mL, 95% CI: -203.20, -103.19, P<0.0001) and remained low during 12-month follow-up. GH level ≤ 1 ng/mL and ≤2.5 ng/mL was achieved by 7 (31.8%) and 17 (77.3%) patients, respectively. Six patients (27.3%) achieved normal IGF-1 level (IGF-1 ≤1 x ULN) (P=0.0275). IGF-1 ≤1.3 x ULN was observed in 11 (50.0%) of patients. Full biochemical control (GH ≤1 ng/mL and IGF-1 ≤1 x ULN) was achieved in 3 (13.6%) patients. Pasireotide LAR treatment resulted in significant increase of mean fasting glucose level: 119.2 (SD 17.3) vs. 107.5 (SD 13.9) mg/dL, P<0.001. The largest change was observed in first 3 months, and it remained stable until month 12. HbA1c level also increased significantly during first 3 months and stayed on similar level during follow-up (mean for month 12: 6.3 (SD 0.6) vs. 5.9 (SD 0.5) % at baseline, P<0.001). Conclusions: Pasireotide LAR is an effective treatment in most patients with persistent acromegaly after surgical debulking resistant to first generation SSAs. The largest increase of glycemia occurs during first 3 months of treatment and it remains stable afterwards.

Effects of khat use on response to antipsychotic medications in patients with newly diagnosed schizophrenia: a retrospective study

Background: Khat contains the amphetamine-like cathinone, and can trigger onset of schizophrenia and exacerbate pre-existing psychosis. However, it remains unknown whether the use of khat complicates the outcome of schizophrenia treatment. Aims: We tested the hypothesis that patients with schizophrenia who are using khat will fail to respond to standard antipsychotic treatment. Methods: We retrospectively studied a consecutive series of patients who presented to an adult psychiatric clinic in Al-Amal Psychiatric Hospital in Jazan, Saudi Arabia, between January 1, 2013 and December 31, 2016. Patients with newly diagnosed schizophrenia on antipsychotic monotherapy (n = 1007, 817 men) were included and categorized into khat and non-khat users. A khat chewing index was developed to further categorize low, mild, moderate and heavy khat users. Antipsychotic medications were reviewed to determine their potential and the cause of substitution in association with khat use. Results: There were 483 (48%) khat users. Olanzapine, haloperidol and aripiprazole were the most frequently used drugs (46.3%, 15.6% and 10%, respectively). The retention rate of the initial drug differed between the khat users and nonusers (53.8% and 78.4%, respectively). The proportion of moderate and heavy users (55% and 49%, respectively) who changed their initial drug was greater than that of low and mild users (35.6% and 44.7%, respectively). Lack of drug efficacy was the most appealing reason for switching the initial drug among moderate (51.7%) and heavy khat users (48.4%). Conclusions: Khat use hinders an individual’s response to initial antipsychotic drug treatment for schizophrenia. Further studies are warranted to investigate the treatment decisions for this group of patients.