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Abstract: A study of the photodegradation of different pharmaceuticals [furosemide, ranitidine (hydrochloride), ofloxacine, phenazone, naproxen, carbamazepine and clofibric acid] in aqueous medium at various pHs by using a batch photoreactor and a photocatalytic membrane reactor working in recirculation regime was carried out. Polycrystalline TiO2 was used as the photocatalyst, and different membranes (NTR 7410, PAN GKSS HV3/T, N 30 F, NF PES 10) were tested. A different adsorption of the substrates onto the catalyst surface was observed owing to the hydrophilic/hydrophobic character of the catalyst, depending on the pH. The photodegradation of the seven molecules in the batch reactor was successfully carried out and the behaviour was in accordance with pseudo-first order kinetics. Furosemide and ranitidine were selected to carry out the study of rejection and photodegradation in the hybrid membrane system. The permeate flux of the treated water was in the 31.5–60.0L/(hm2) range for NTR 7410 membrane, whereas rejection values in the range 10–60% for furosemide and 5–30% for ranitidine in the dark (without photoreaction) were found. The degradation in the hybrid membrane photoreactor showed that the photocatalyst was retained by the membrane in the reaction ambient, while the membrane rejection towards the pollutants was not very satisfactory. A net decrease of the rejection down to 0 was observed in the contemporary presence of light, photocatalyst and oxygen. [Copyright &y& Elsevier]

Recommendations for dyslipidemia management aimed at reducing arterial occlusive events (AOEs) have been recently published. So far, no data have been reported on the management of dyslipidemia in chronic myeloid leukemia (CML) patients treated with nilotinib. We investigated 369 CML adult patients, stratified according to the new Systematic Coronary Risk Evaluation (SCORE) scoring system. Plasma levels of cholesterol, HDL, LDL, and triglycerides were measured prior to the start of nilotinib and after 3, 6, and 12 months. The 5-year cumulative incidence of AOEs was 15.9%. Patients with cholesterol levels > 200 mg/dL and LDL > 70 mg/dL 3 months after treatment showed a significantly higher incidence of AOEs (21.9 ± 4.6% vs 6.2 ± 2.5, P = 0.003). Patients belonging to the high and very high SCORE risk group showed a significant increase of AOEs (34.4 ± 6% vs 10 ± 2.1%, P < 0.001). In multivariate analysis, both high cholesterol and LDL levels and a high and very high SCORE risk remained significantly associated with the risk of AOEs (P = 0.008; HR = 3.5; 95% CI = 1.4-8.7 and P < 0.001; HR = 4.4; 95% CI = 2-9.8, respectively). Overall, 78 patients (21.1%) presented dyslipidemia at the time of CML diagnosis and 88 (23.3%) after starting nilotinib, but only 26 of them (29.5%) were treated with statins.Low LDL and cholesterol plasma levels are associated with a significant lower risk of AOEs in CML patients treated with nilotinib in the real life., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.)

Hypertension is a commonly reported comorbidity in patients diagnosed with chronic myeloid leukemia (CML), and its management represents a challenge in patients treated with 2nd- or 3rd-generation tyrosine kinase inhibitors (TKIs), considering their additional cardiovascular (CV) toxicity. The renin angiotensin system (RAS) contributes to hypertension genesis and plays an important role in atherosclerosis development, proliferation, and differentiation of myeloid hematopoietic cells. We analyzed a cohort of 192 patients with hypertension at CML diagnosis, who were treated with 2nd- or 3rd-generation TKIs, and evaluated the efficacy of RAS inhibitors (angiotensin-converting enzyme inhibitors (ACEi) and angiotensin-II receptor blockers (ARBs)) in the prevention of arterial occlusive events (AOEs), as compared with other drug classes. The 5-year cumulative incidence of AOEs was 32.7 ± 4.2%. Patients with SCORE ≥ 5% (high-very-high) showed a significantly higher incidence of AOEs (33.7 ± 7.6% vs 13.6 ± 4.8%, p = 0.006). The AOE incidence was significantly lower in patients treated with RAS inhibitors (14.8 ± 4.2% vs 44 ± 1%, p < 0.001, HR = 0.283). The difference in the low and intermediate Sokal risk group was confirmed but not in the high-risk group, where a lower RAS expression has been reported. Our data suggest that RAS inhibitors may represent an optimal treatment in patients with hypertension and CML, treated with 2nd or 3rd G TKIs.

Background: Limited information is available regarding the rate of long-term cardiovascular (CV) mortality in chronic myeloid leukaemia (CML) patients treated with second- and third-generation tyrosine kinase inhibitors (2 ndG /3 rdG TKIs) in the real-life practice., Methods: We identified 656 consecutive CML patients treated with nilotinib, dasatinib, bosutinib and ponatinib., Results: The 15-year CV-mortality free survival was 93 ± 2.8%. Age ≥65 years (p = 0.005) and a positive history of CV disease (p = 0.04) were significantly associated with a lower CV-mortality free survival. CV disease accounted for 16.5% and 5% of potential years of life lost (PYLL) in male and female patients, respectively. The standard mortality ratio (SMR) following ischemic heart disease (IHD) was 3.9 in males and 3.8 in female patients, meaning an excess of IHD deaths observed, in comparison with the population of control., Conclusion: Prevention strategies based on CV risk factors, in particular in those patients with a previous history of CV disease, should be considered., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Arterial occlusive events (AOEs) represent emerging complications in chronic myeloid leukemia (CML) patients treated with ponatinib. We identified 85 consecutive CML adult patients who were treated with ponatinib in 17 Italian centers. Patients were stratified according to the Systematic Coronary Risk Evaluation (SCORE) assessment, based on sex, age, smoking habits, systolic blood pressure, and total cholesterol levels. The 60-month cumulative incidence rate of AOEs excluding hypertension was 25.7%. Hypertension was reported in 14.1% of patients. The median time of exposure to ponatinib was 28 months (range, 3-69 months). Patients with a high to very high SCORE risk showed a significantly higher incidence rate of AOEs (74.3% vs 15.2%, P < 0.001). Patients aged ≥60 years showed a significantly higher incidence rate of AOEs (51.5% vs 16.9%, P = 0.008). In multivariate analysis, no association was found between AOEs and positive history of CV disease, age, dose of ponatinib, previous exposure to nilotinib, and comorbidities. Only the SCORE risk was confirmed as a significant predictive factor (P = 0.01; HR = 10.9; 95% C.I. = 1.7-67.8). Patients aged ≥60 years who were treated with aspirin had a lower incidence rate of AOEs (33.3% vs 61.8%). Among the 14 reported AOEs, 78.6% of them showed grade 3 to 4 toxicity. This real-life study confirmed the increased incidence of AOEs in CML patients treated with ponatinib, with high to very high SCORE risk. We suggest that patients aged ≥60 years who were treated with ponatinib should undergo prophylaxis with 100 mg/day of aspirin. Our findings emphasize personalized prevention strategies based on CV risk factors., (© 2019 The Authors Hematological Oncology Published by John Wiley & Sons Ltd.)

Objective: The aim of this study was to assess whether the Burnout Syndrome is clearly expressed in orthodontic practice and to identify its impact in both general dentistry and orthodontics., Materials and Methods: A questionnaire was administered to 366 operators in the dentistry-orthodontic field, hence a multi-factorial statistical analysis based on the multi-factorial method was carried out. Demographic data, the Maslach Burnout Inventory (MBI), divided into three subsets, Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA), and a specific questionnaire for orthodontists were analysed., Results: The analysis of the MBI showed that EE affects only 1/5 of the sample, DP significantly affects only 1/3 of the sample, while the RPA was reported to be low in 2/3 of the sample. General dentists were more affected from burnout as compared with orthodontists. The specific questionnaire highlighted that members of both categories had work-related stress, mostly due to management and financial issues related to the workplace., Conclusions: The research suggested that Italian orthodontists were less prone to Burnout Syndrome compared to general dentists. As life-style has a major impact on the onset of the syndrome, preventive measures and solutions could be useful in order to prevent the symptoms of the Burnout Syndrome., (Copyright © 2011 Società Italiana di Ortodonzia SIDO. Published by Elsevier Srl. All rights reserved.)

Some tests of mass transport on a sandwich liquid membrane (SwLM) for separation and concentration of Cu++ ion are reported and the results compared with the traditional supported liquid membrane (SLM) system both in terms of stability and flux. Moreover a chemical-physical model was developed evidencing the differences in the mass transport between the two systems studied. The obtained results showed an higher Cu++ flux in the SwLM (110.4 vs. 52.4 mmol/h.m2 referred to the effective pore surface) while lifetime was lower (6 vs. 15 h). The model evidenced a lower overall resistance to Cu++ ions transport through the SwLM than the SLM because the transport in the free solution did not suffer of the pores presence. Use of permanent hydrophilic membranes can improve the SwLM lifetime in view of industrial applications.