Aim of this study was to provide an up-to-date assessment of the antibiotics contaminating the aqueous environment in Italy, for a better understanding of risks for the ecosystem and human health. ...Antibiotics were first listed in order of their theoretical environmental loads, then were measured in wastewater of some sewage treatment plants (STPs) and in rivers in Italy. Macrolides, particularly clarithromycin and spiramycin, and quinolones, particularly ciprofloxacin and
l-floxacin/ofloxacin, were the most abundant antibiotics in untreated wastewater. Several of them were not removed in STPs and still remained in the treated wastewater, and a total estimate of 7–14
tons of active principles were discharged annually into the aqueous environment in Italy through this route. Results of the analysis of rivers in northern Italy agreed with these figures, with an average load of 5
kg/day, or about 1.8
tons/year, of antibiotics flowing in the River Po, at sampling sites covering a basin comprising about one-fifth of the Italian population. In conclusion, antibiotics, particularly macrolides and quinolones, are widespread environmental contaminants, and urban STPs are confirmed a major source of the contamination.
•Monitoring occurrence and fate of perfluorinated compounds in the aqueous environment.•Industrial wastes are the main source of contamination in a highly industrialized urban area.•Perfluorinated ...substances were not removed in sewage treatment plants.•Surface water contamination was increasing from north to south in the Lambro river basin.•Ground and drinking water were also contaminated in industrial areas.
Perfluorinated substances are listed among emerging contaminants because they are globally distributed, environmentally persistent, bioaccumulative and potentially harmful. In a three-year monitoring campaign (2010–2013) we investigated the occurrence, sources and fate of nine perfluoroalkylcarboxylic acids and three perfluoroalkylsulfonic acids, in the most industrialized region of Italy. Composite samples were collected in influents and effluents of wastewater treatment plants (WWTPs), in the main rivers flowing through the basin, and in raw groundwater and finished drinking water. Samples were analyzed by liquid chromatography tandem mass spectrometry. Perfluorinated substances were not removed in WWTPs and those receiving industrial wastes discharged up to 50 times the loads of WWTPs receiving municipal wastes. The mass balance of the emissions in the River Lambro basin showed continuously increasing contamination from north to south and differences in the composition of homologues in the west and east sides of the basin. Ground and drinking water were contaminated in industrial areas, but these substances were removed well in Milan. Contamination from industrial sources was prevalent over urban sources, contributing to 90% of the loads measured at the closure of the basin. The River Lambro was confirmed as one of the main sources of contamination in the Po River.
According to the scientific literature, childrens’ cognitive development is not complete until adolescence. Therefore, the problems inherent in children serving as witnesses are crucial. In ...preschool‐aged children, false memories may be identified because of misinformation and insight bias. Additionally, they are susceptible of suggestions. The aim of this study was to verify the levels of suggestibility in children between three and 5 years of age. Ninety‐two children were examined (44 male, 48 female; M = 4.5 years, SD = 9.62). We used the correlation coefficient (Pearson's r) and the averages variance by SPSS statistical program. The results concluded that: younger children are almost always more susceptible to suggestibility. The dimension of immediate recall was negatively correlates with that of total suggestibility (r = −0.357 p < 0.001). Social compliance and source monitoring errors contribute to patterns of suggestibility, because older children shift their answers more often (r = 0.394 p < 0.001). Younger children change their answers more times (r = −0.395 p < 0.001).
Levels of polychlorinated dibenzo-
p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) were measured in the breast milk of mothers living in Giugliano (Campania, Italy), an area at increased ...risk of PCDD and PCDF exposure caused by recent and serious open-air waste-combustion accidents. Polychlorinated biphenyls (PCBs) in milk samples were also studied. Breast milk was also monitored in two cities in northern Italy, Milan and Piacenza, which were selected as controls. Other variables, such as diet and age of the mothers, were also studied. PCDD/F and PCB levels and congener profiles in breast-milk samples were similar in all these cities, though total PCDD/F and DL-PCB TEQs in samples from Giugliano were significantly lower than those in Milan and Piacenza (8.65
pg WHO-TEQ in Giugliano vs. 11.0 and 9.94
pg WHO-TEQ in Milan and Piacenza respectively). Thus no direct correlations were found between PCDD/F and PCB levels in breast milk and the suspected increased exposure through open-air waste combustion in Giugliano. Diet did not seem to affect PCDD/F and PCB levels, whereas a significant correlation was observed between the mother’s age and an increased concentration of PCDDs/Fs and PCBs in milk. Comparison of these findings with those of previous surveys in Italy in 2000–2001 showed a marked reduction of PCDD/F (about 60%) and DL-PCB (about 20%) levels in breast milk occurring over the last 10
years. This might well be a result of well functioning legislation, for example European Directives on of the reduction of the emission limits of PCDDs/Fs and PCBs from waste incineration set by EU Directive 2000/76/EC implemented in 2000, or Commission Regulations such as (EC) No. 466/2001 and 1881/2006 setting maximum levels for certain contaminants in foodstuffs.
The most relevant human urinary metabolites of cocaine (nine metabolites) were measured in urban wastewater in Italy and USA. A novel analytical method based on liquid chromatography tandem mass ...spectrometry allowed the identification of ecgonine, ecgonine methyl ester and the pyrolytic derivatives of cocaine in untreated wastewater. The aim of this study was to verify whether the pattern of cocaine metabolites in wastewater reflected the human excretion profile in urine. The performance of the method was good, with recoveries higher than 60% and limits of quantifications in the low ng/L range. The stability in untreated wastewater was assessed for all metabolites and the best storage condition resulted freezing samples immediately after collection and keep them frozen until analysis. All the selected compounds were measured in wastewater at concentrations up to 1.5 μg/L and their weekly loads were calculated during a five weeks monitoring campaign in Milan (Italy). The profiles of cocaine metabolites in wastewater matched with those in human urine reported in the literature, suggesting that measures in wastewater reflect the real human excretion and that wastewater analysis is suitable for assessing drug consumption. Benzoylecgonine was confirmed as the best target for estimating cocaine use by wastewater analysis, while cocaine itself should not be considered because its amount in wastewater is affected by other environmental sources such as transport, handling and consumption. Results suggested that the measurement of other metabolites in combination with benzoylecgonine might reflect 60% of an administered dose of cocaine providing also information on different patterns of use.
► Cocaine and its most relevant urinary metabolites were measured in urban wastewater in Italy and USA. ► Weekly loads of the main metabolites of cocaine increased during the weekend. ► The pattern of cocaine metabolites in wastewater reflected the human excretion profile in urine. ► Wastewater analysis of drugs metabolites is suitable for assessing drug consumption in a population. ► Wastewater analysis can provide information on different pattern of use of a drug.
Abstract Background Wastewater analysis can provide estimates of illicit drug (ID) consumption in local communities. Methods We used repeated raw wastewater analysis in urban wastewater treatment ...plants to estimate loads of cocaine, heroin, methamphetamine, and cannabis consumed daily by the inhabitants of two cities in Northern Italy, Milan and Como, from 2005 to 2009. Results Daily cocaine loads did not change in Milan from 2005 to 2008 but fell 45% in 2009 (ANOVA, p < 0.001, followed by Tukey–Kramer HSD test 2009 vs. others, p < 0.05), and there was a similar drop in Como (41%, p < 0.0001, t -test). Heroin also fell from 2008 to 2009 in Milan (66%, ANOVA, p < 0.001, followed by Tukey–Kramer 2009 vs. others, p < 0.05) and Como (26%, p = 0.017, t -test). However, methamphetamine, which had risen in Milan from 2005 to 2008, rose further in 2009 (Kruskal–Wallis test, p < 0.001, followed by Steel–Dwass 2009 or 2008 vs. previous, p < 0.05), and cannabis, which was falling from 2005 to March 2009, rose again in September 2009 (40%, p = 0.027, t -test). Conclusions Results suggest a trend toward a decrease in consumption of costly ID, such as cocaine and heroin. This might be due to a reduction in the number of consumers and/or to a change in their behaviour since there was also an increase in the consumption of less expensive ID. This itself might reflect a drop in consumers’ money supply, caused by the economic crisis. Wastewater analysis was useful to estimate ID consumption levels in local communities in real time and promptly identify changes in trends.
Deferiprone was shown to reverse iron deposition in Friedreich's ataxia. This multi-center, unblinded, single-arm pilot study evaluated safety and efficacy of deferiprone for reducing cerebral iron ...accumulation in neurodegeneration with brain iron accumulation. Four patients with genetically-confirmed pantothenate kinase-associated neurodegeneration, and 2 with parkinsonism and focal dystonia, but inconclusive genetic tests, received 15 mg/kg deferiprone bid. Magnetic resonance imaging and neurological examinations were conducted at baseline, six and 12 months. Chelation treatment caused no apparent hematologic or neurological side effects. Magnetic resonance imaging revealed decreased iron accumulation in the globus pallidus of 2 patients (one with pantothenate kinase-associated neurodegeneration). Clinical rating scales and blinded video rating evaluations documented mild-to-moderate motor improvement in 3 patients (2 with pantothenate kinase-associated neurodegeneration). These results underline the safety and tolerability of deferiprone, and suggest that chelating treatment might be effective in improving neurological manifestations associated with iron accumulation. (Clinicaltrials.gov Identifier: NTC00907283).
: Endometrial cancer (EC) is one of the most frequent gynecological cancers worldwide. The gold standard treatment of EC is most certainly surgery and may very well be the only therapy in the early ...stages of disease. To improve outcomes in non-early EC, adjuvant therapy is often employed but this is not standardized. Adjuvant options can include radiotherapy, chemotherapy or a combination of both. Adjuvant chemotherapy could be indicated in high-risk stage I and II or advanced stage EC. Several clinical trials are ongoing in an attempt to define the optimal adjuvant treatment. Furthermore, chemotherapy is the front-line therapy in advanced unresectable, metastatic or recurrent endometrial cancer.
: Herein, the authors review the first-line chemotherapy for the treatment of endometrial cancer and provide their expert perspectives on these therapies.
: Chemotherapy is fundamental in advanced/recurrent EC. Further evidence is needed to characterize the role of adjuvant chemotherapy. Future studies should consider genomic and molecular heterogeneities to identify even more efficient tailored therapies.
Controlled breathwork practices have emerged as potential tools for stress management and well-being. Here, we report a remote, randomized, controlled study (NCT05304000) of three different daily ...5-min breathwork exercises compared with an equivalent period of mindfulness meditation over 1 month. The breathing conditions are (1) cyclic sighing, which emphasizes prolonged exhalations; (2) box breathing, which is equal duration of inhalations, breath retentions, and exhalations; and (3) cyclic hyperventilation with retention, with longer inhalations and shorter exhalations. The primary endpoints are improvement in mood and anxiety as well as reduced physiological arousal (respiratory rate, heart rate, and heart rate variability). Using a mixed-effects model, we show that breathwork, especially the exhale-focused cyclic sighing, produces greater improvement in mood (p < 0.05) and reduction in respiratory rate (p < 0.05) compared with mindfulness meditation. Daily 5-min cyclic sighing has promise as an effective stress management exercise.
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•Daily 5-minute breathwork and mindfulness meditation improve mood and reduce anxiety•Breathwork improves mood and physiological arousal more than mindfulness meditation•Cyclic sighing is most effective at improving mood and reducing respiratory rate
In a remotely conducted randomized controlled trial, Yilmaz Balban et al. study the psychophysiological effects of controlled breathwork compared with mindfulness meditation. Breathwork produces greater improvement in mood and reduction in respiratory rate, while both result in reduction in negative emotion including state anxiety.
Suppression of sex-steroid secretion is required in a variety of gynecological conditions. This can be achieved using gonadotropin releasing hormone (GnRH) agonists that bind pituitary gonadotropin ...receptors and antagonize the link-receptor of endogenous GnRH, inhibiting the mechanism of GnRH pulsatility. On the other hand, GnRH antagonists immediately reduce gonadal steroid levels, avoiding the initial stimulatory phase of the agonists. Potential benefits of GnRH antagonists over GnRH agonists include a rapid onset and reversibility of action. Older GnRH antagonists are synthetic peptides, obtained by modifications of certain amino acids in the native GnRH sequence. They require subcutaneous injections, implantation of long-acting depots. The peptide structure is responsible for histamine-related adverse events and the tendency to elicit hypersensitivity reactions.
Research has worked towards the development of non-peptidic molecules exerting antagonist action on GnRH. They are available for oral administration and may have a more beneficial safety profile in comparison with peptide GnRH antagonists. This article focuses on the data of the literature about elagolix, a novel non-peptidic GnRHantagonist, in the treatment of endometriosis.
Elagolix demonstrated efficacy in the management of endometriosis-associated pain and had an acceptable safety and tolerability profile. However, further studies are necessary to evaluate its non-inferiority in comparison with other endometriosis's treatments.
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