Superabsorbent polymer as a supplement substrate of constructed wetland to retain pesticides from agricultural runoff.

Surface water runoff can export pesticides from agricultural fields into adjacent aquatic ecosystems, where they may pose adverse effects to organisms. Constructed wetlands (CWs) are widely used to treat agricultural runoff contaminated by pesticides, but the removal of hydrophilic pesticides is usually low. In this study, we suggest superabsorbent polymer (SAP), a cross-linked hydrophilic polymer, as a supplement to substrates of CWs and tested the hypothesis that SAP results in an enhanced removal of hydrophilic pesticides. Therefore, batch experiments were conducted to study the retention capacity of water-saturated SAP (w-SAP) for several hydrophilic pesticides. Retention of the pesticides on w-SAP was related to the ionization state and water solubility of the pesticides. The retention of neutral pesticides, imidacloprid, metalaxyl and propiconazole, was about 20% higher than that measured for anionic pesticides, bentazone, glyphosate and MCPA. The retention of the pesticides by w-SAP mainly resulted from their distribution in the gel-water phase of w-SAP, while less water soluble pesticides might have also been adsorbed on the molecular backbone of SAP. Furthermore, we tested the efficacy of w-SAP for treatment of runoff water contaminated by pesticides in lab-scale horizontal subsurface flow CWs. SAP in CWs improved the removal of the pesticides, including the recalcitrant ones. The removal enhancement was owing to the increase of hydraulic retention time and improvement of biodegradation. The removal of the pesticides in SAP containing CWs was > 93% for MCPA, glyphosate, and propiconazole, 62 - 99% for imidacloprid, 50 - 84% for metalaxyl, and 38 - 73% for bentazone. In the control gravel CWs, the removal was > 98% for glyphosate, generally > 83% for MCPA and propiconazole, 46 - 98% for imidacloprid, 32 - 97% for metalaxyl, and 9 - 96% for bentazone.

Retention and distribution of pesticides in planted filter microcosms designed for treatment of agricultural surface runoff.

Pesticides in agricultural surface water runoff cause a major threat to freshwater systems. Installation of filter systems or constructed wetlands in areas of preferential run-off is a possible measure for pesticides abatement. To develop such systems, combinations of filter materials suitable for retention of both hydrophilic and hydrophobic organic pesticides were tested for pesticide removal in planted microcosms. The retention of six pesticides frequently detected in surface waters (bentazone, MCPA, metalaxyl, propiconazole, pencycuron, and imidacloprid) was evaluated in unplanted and planted pot experiments with novel bed material mixtures consisting of pumice, vermiculite, water super-absorbent polymer (SAP) for retention of ionic and water soluble pesticides, and synthetic hydrophobic wool for adsorption of hydrophobic pesticides. The novel materials were compared to soil with high organic matter content. The highest retention of the pesticides was observed in the soil, with a considerable translocation of pesticides into the plants, and low leaching potential, in particular for the hydrophobic compounds. However, due to the high retention of pesticides in soil, environmental risks related to their long term mobilization cannot be excluded. Mixtures of pumice and vermiculite with SAP resulted in high retention of i) water and ii) both hydrophilic and hydrophobic pesticides but with much lower leaching potential compared to the mineral systems without SAP. Mixtures of such materials may provide near natural treatment options in riparian strips and also for treatment of rainwater runoff without the need for water containment systems.

ENSAT registry-based randomized clinical trials for adrenocortical carcinoma.

Adrenocortical carcinoma (ACC) is an orphan disease lacking effective systemic treatment options. The low incidence of the disease and high cost of clinical trials are major obstacles in the search for improved treatment strategies. As a novel approach, registry-based clinical trials have been introduced in clinical research, so allowing for significant cost reduction, but without compromising scientific benefit. Herein, we describe how the European Network for the Study of Adrenal Tumours (ENSAT) could transform its current registry into one fit for a clinical trial infrastructure. The rationale to perform randomized registry-based trials in ACC is outlined including an analysis of relevant limitations and challenges. We summarize a survey on this concept among ENSAT members who expressed a strong interest in the concept and rated its scientific potential as high. Legal aspects, including ethical approval of registry-based randomization were identified as potential obstacles. Finally, we describe three potential randomized registry-based clinical trials in an adjuvant setting and for advanced disease with a high potential to be executed within the framework of an advanced ENSAT registry. Thus we, therefore, provide the basis for future registry-based trials for ACC patients. This could ultimately provide proof-of-principle of how to perform more effective randomized trials for an orphan disease.

Pitfalls in the diagnostics of aldosterone-producing adrenocortical carcinoma.

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Corticotropinoma as the underlying cause of intermittent Cushing's syndrome in a patient previously diagnosed with primary pigmented nodular adrenocortical disease.

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Low-dose etomidate for the management of severe hypercortisolaemia in different clinical scenarios: a case series and review of the literature.

BACKGROUND: Severe Cushing's syndrome (SCS) is associated with acute cardiovascular, metabolic and infectious complications. It is considered an emergency, requiring an immediate diagnosis, together with a broad spectrum of supportive and hypocortisolaemic treatments. Surgical intervention, aimed at removing the source of cortisol or adrenocorticotropic hormone (ACTH), is the optimal treatment in most cases of Cushing's syndrome. However, in hypercortisolaemic states, surgical intervention has high rates of perioperative mortality and morbidity. Oral adrenal steroidogenesis inhibitors, even if more effective in combination, are not always efficient enough or well tolerated. Despite their common use, a more potent, parental, immediate, and thus life-saving, therapy is necessary. METHODS: The authors present three different clinical scenarios of etomidate treatment in patients hospitalized in the third reference endocrinological centre in Poland between 2016 and 2017. RESULTS: Patients with Cushing's disease, ectopic Cushing's syndrome and adrenocortical carcinoma presented with severe hypercortisolaemia and exacerbated cortisol-dependent comorbidities. In these three cases, etomidate acted as an accurate, well tolerated and effective cortisol-lowering drug for several days or even months. Patients were monitored in a general ward setting, and no side effects of the therapy were observed. CONCLUSIONS: In doses far lower than those used for anaesthesia, etomidate works as a useful cortisol-lowering therapy in patients intolerant to or unable to take oral medications. Additionally, if urgent, the most potent and effective medical intervention is necessary, and clinicians should be aware of such a therapeutic option.

Prognostic factors in adrenocortical carcinoma: data from a large Polish series.

Introduction Adrenocortical carcinoma (ACC) is a rare malignancy, associated with poor outcome and few therapeutic options. Despite increasing attention, the knowledge about the clinical course and treatment of these tumors is limited. Objectives Survival rates in ACC are still low and the percentage of relapse is high. Thus, it is crucial to identify the prognostic factors of overall survival (OS) and recurrence­free survival (RFS). Patients and methods This was a retrospective analysis of 66 patients diagnosed with ACC between 2002 and 2015. Results The median OS was 43.5 months, 78.19 months for stage I + II, 22.95 months for stage III, and 19.54 months for stage IV ACC. Older age, stage IV ACC, margin status R2, and no mitotane treatment were associated with poor OS. Low Ki67 and mitotic indices were related to improved OS in a univariate analysis. The median RFS was 101.1 months. Disease recurrence after potentially curative surgery was reported in 1 patient (25%) with stage I, 12 patients (46%) with stage II, and 9 patients (45%) with stage III ACC. Male sex and no mitotane treatment were associated with a reduced RFS in a multivariate analysis and higher Ki67 and mitotic indices in the univariate analysis. Conclusions Ki67 and mitotic indices should be considered as prognostic factors when planning the adjuvant treatment of ACC. Mitotane treatment may be independently associated with better outcomes regardless of the tumor stage.

Acclimation of aerobic-activated sludge degrading benzene derivatives and co-metabolic degradation activities of trichloroethylene by benzene derivative-grown aerobic sludge.

The acclimation of aerobic-activated sludge for degradation of benzene derivatives was investigated in batch experiments. Phenol, benzoic acid, toluene, aniline and chlorobenzene were concurrently added to five different bioreactors which contained the aerobic-activated sludge. After the acclimation process ended, the acclimated phenol-, benzoic acid-, toluene-, aniline- and chlorobenzene-grown aerobic-activated sludge were used to explore the co-metabolic degradation activities of trichloroethylene (TCE). Monod equation was employed to simulate the kinetics of co-metabolic degradation of TCE by benzene derivative-grown sludge. At the end of experiments, the mixed microbial communities grown under different conditions were identified. The results showed that the acclimation periods of microorganisms for different benzene derivatives varied. The maximum degradation rates of TCE for phenol-, benzoic acid-, toluene-, aniline- and chlorobenzene-grown aerobic sludge were 0.020, 0.017, 0.016, 0.0089 and 0.0047 mg g SS(-1) h(-1), respectively. The kinetic of TCE degradation in the absence of benzene derivative followed Monod equation well. Also, eight phyla were observed in the acclimated benzene derivative-grown aerobic sludge. Each of benzene derivative-grown aerobic sludge had different microbial community composition. This study can hopefully add new knowledge to the area of TCE co-metabolic by mixed microbial communities, and further the understanding on the function and applicability of aerobic-activated sludge.