Impact of (nano ZnO/multi-wall CNTs) prepared by arc discharge method on the removal efficiency of stable iodine 127I and radioactive iodine 131I from water

Radioactive iodine isotopes especially 131I are used for diagnosis and treatment of different types of cancer diseases. Due to the leak of radioactive iodine into the patient's urine in turn, the wastewater would be contaminated, so it is worth preparing a novel adsorption green material to remove the radioactive iodine from wastewater efficiently. The removal of 127I and 131I contaminants from aqueous solution is a problem of interest. Therefore, this work presents a new study for removing the stable iodine 127I- and radioactive iodine 131I from aqueous solutions by using the novel nano adsorbent (Nano ZnO/MWCNTs) which is synthesized by the arc discharge method. It is an economic method for treating contaminated water from undesired dissolved iodine isotopes. The optimal conditions for maximum removal are (5 mg/100 ml) as optimum dose with shacking (200 rpm) for contact time of (60 min), at (25 °C) in an acidic medium of (pH = 5). After the adsorption process, the solution is filtrated and the residual iodide (127I-) is measured at a maximum UV wavelength absorbance of 225 nm. The maximum adsorption capacity is (15.25 mg/g); therefore the prepared nano adsorbent (Nano ZnO/MWCNTs) is suitable for treating polluted water from low iodide concentrations. The adsorption mechanism of 127I- on to the surface of (Nano ZnO/MWCNTs) is multilayer physical adsorption according to Freundlich isotherm model and obeys the Pseudo-first order kinetic model. According to Temkin isotherm model the adsorption is exothermic. The removal efficiency of Nano ZnO/MWCNTs for stable iodine (127I-) from aqueous solutions has reached 97.23%, 89.75%, and 64.78% in case of initial concentrations; 0.1843 ppm, 0.5014 ppm and 1.0331 ppm, respectively. For the prepared radio iodine (131I-) solution of radioactivity (20 µCi), the dose of nano adsorbent was (10 mg/100 ml) and the contact time was (60 min) at (pH = 5) with shacking (200 rpm) at (25 °C). The filtration process was done by using a syringe filter of a pore size (450 nm) after 2 days to equilibrate. The removal efficiency reached (34.16%) after the first cycle of treatment and the percentage of residual radio iodine was (65.86%). The removal efficiency reached (94.76%) after five cycles of treatment and the percentage of residual radio iodine was (5.24%). This last percentage was less than (42.15%) which produces due to the natural decay during 10 days.

Preparation and characterization of a novel nanocomposite based on MnCr-layered double oxide and CoFe2O4 spinel ferrite for methyl orange adsorption

Herein, the adsorption of methyl orange (MO), a dangerous anionic dye, from an aqueous solution was investigated using a novel magnetic nanocomposite adsorbent. A nanocomposite entitled manganese chromium-layered double oxide/cobalt spinel ferrite, (MnCr)-LDO5wt.%/CoFe2O4, which links the interlayer structural characteristics of layered double oxides (LDOs) with the magnetic properties of spinel ferrites (SFs) was synthesized using the eco-friendly co-precipitation technique. Determination of structural parameters, crystallite size, and micro-strain was done using X-ray diffraction (XRD) analysis. Transmission electron microscopy (TEM) was used to determine grain shape and size. Surface analysis was performed using X-ray photoelectron spectroscopy (XPS) to identify elements and oxidation states present in the prepared nanocomposite. Vibrating sample magnetometer (VSM) was utilized to examine the magnetic characteristic. A comprehensive comparative study about the effectiveness and durability of CoFe2O4 and (MnCr)5wt.%/CoFe2O4 as nanoadsorbents for MO was conducted. Numerous variables, including contact time, MO concentration, adsorbent dosage, and pH were tested for their effects on the adsorption removal percentages. The findings showed that the maximum removal percentage was 86.1% for 25 ppm of MO was for 0.1 g/100 mL of (MnCr)-LDO5wt.%/CoFe2O4 at pH = 3. Investigations of isotherms and kinetics were conducted under batch conditions. The Langmuir isotherm matched the experimental data, for both nanoadsorbents, quite well due to the homogeneous distribution of active sites. Adsorption kinetics data were found to be compatible with intra-particle diffusion and pseudo-second order models for CoFe2O4 and (MnCr)5wt.%/CoFe2O4, respectively. A total of five adsorption-desorption cycles were performed to determine the prepared adsorbents' recyclable nature.

Modifying the health teaching process to increase the patient awareness

Funding Acknowledgements

Type of funding sources: None.

Background

Health teaching is an essential part of the patient journey at any healthcare facility.

Internal audit was carried out in one of the renowned healthcare institutions in the middle east , specifically in the outpatient department. The audit revealed the existence of some issues regarding patients’ familiarity with some aspects of knowledge about their conditions, medications, healthy diets, etc.…. Therefore, it was necessary to assess the patient’s understanding and to re-evaluate the introduced instructions regarding these topics. Nursing leaders in the aforementioned institution were inspired to conduct a quality improvement project that enhanced the patients outcome by assessing patient understanding concerning inpatient health teaching.

Aim

A quality improvement project aimed at assessing patients’ understanding regarding health teaching after open-heart surgeries during their hospital stay.

Process

A survey was conducted to assess the patient understanding regarding healthy diet , wound care after surgery, taking the medications, understanding diagnosis, daily activities, follow-up visits and deal with an emergency. Nurse leaders formed a group of internship nursing students to conduct the survey immediately after a health teaching process.

Data was collected and analyzed. Some interventions were implemented to fill the gap of health teaching process and improve the patients outcome.

Interventions

There were no leaflets or other health teaching materials that could be offered to the patient. 15 health education leaflets were developed to fill in this gap. The health teaching process took place at the time of discharge and the decision was to proceed the patient education from the time of admission. We validated and reinforced the health teaching content with the patient and family before discharge.All patients agreed that their relatives should attend the health teaching sessions and these interventions affected positively the results of survey.

Data Analysis

A group of 100 patients were involved in this survey and results revealed the following. It was found that there was a significant impact of the intervention, as shown in ( Figure 1). 69% of patients were only aware about their healthy diet compared with 92% after intervention. Regarding wound care, there was a 14% increase of patient awareness after the intervention. There was a significant difference in terms of the patient understanding about their own diagnosis after the process intervention that reached 27%. The survey showed satisfying numbers before and after the teaching process of follow up date and emergency contact.

Recommendations

Patient teaching is a continuous process starts from the day of admission.Each patient has a suitable way to cope with the provided information in terms of many aspects such as the education level, availability of relative.

Stereotactic LINAC radiosurgery for the treatment of typical intracranial meningiomas. Efficacy and safety after a follow-up of over 12 years

PURPOSE

The efficacy and safety of stereotactic radiosurgery (SRS) for treatment of intracranial meningiomas has been demonstrated in numerous studies with short- and intermediate-term follow-up. In this retrospective single-center study, we present long-term outcomes of SRS performed with a linear accelerator (LINAC) for typical intracranial meningiomas.

PATIENTS AND METHODS

Between August 1990 and December 2007, 148 patients with 168 typical intracranial meningiomas were treated with stereotactic LINAC-SRS, either as primary treatment or after microsurgical resection. A median tumor surface dose of 12 Gy (range 7-20 Gy) and a median maximum dose of 24.1 Gy (range 11.3-58.6 Gy) was applied. The median target volume was 4.7 ml (range 0.2-32.8 ml, SD ± 4.8 ml).

RESULTS

Overall mean radiological follow-up was 12.6 years. Tumor shrinkage was seen in 75 (44.6 %) and stable disease in 85 (50.6 %) cases. Eight of 168 meningiomas (4.8 %) showed local tumor progression. The tumor control rate (TCR) after 5, 10, and 15 years was 93.6 % at each time point, and the progression-free survival (PSF) rates were 92, 89, and 89 %, respectively. The neurological symptoms existing prior to LINAC-SRS improved in 77 patients (59.7 %), remained unchanged in 42 (32.6 %), and deteriorated in 10 (7.8 %) patients.

CONCLUSION

Our study emphasizes the efficacy of LINAC-SRS for de novo, residual and recurrent typical intracranial meningiomas. A high long-term local TCR with a low morbidity rate could be achieved. LINAC-SRS should thus be considered as a primary treatment option, as one arm of a combined treatment approach for incompletely resected meningiomas, or as a salvage therapy for recurrences.

Aminolevulinic acid-mediated photodynamic therapy of human meningioma: an in vitro study on primary cell lines

OBJECTIVE

Five-aminolevulinic acid (5-ALA)-induced porphyrins in malignant gliomas are potent photosensitizers. Promising results of ALA-PDT (photodynamic therapy) in recurrent glioblastomas have been published. Recently, 5-ALA-induced fluorescence was studied in meningioma surgery. Here, we present an experimental study of ALA-PDT in an in vitro model of primary meningioma cell lines.

METHODS

We processed native tumor material obtained intra-operatively within 24 h for cell culture. Epithelial membrane antigen (EMA) immunohistochemistry was performed after the first passage to confirm that cells were meningioma cells. For 5-ALA-PDT treatment, about 5000 cells per well were seeded in 20 wells of a blank 96-well plate. Each block of 4 wells was inoculated with 150 µL of 0, 25, 50 and 100 µg/mL 5-ALA solutions; one block was used as negative control without 5-ALA and without PDT. Following incubation for 3 h PDT was performed using a laser (635 nm, 18.75 J/cm²). The therapeutic response was analyzed by the water soluble tetrazolium salt (WST-1) cell viability assay 90 min after PDT.

RESULTS

5-ALA-PDT was performed in 14 primary meningioma cell lines. EMA expression was verified in 10 primary cell cultures. The remaining 4 were EMA negative and PDT was without any effect in these cultures. All 10 EMA-positive cell lines showed a significant and dose-dependent decrease in viability rate (p < 0.001). Cell survival at 5-ALA concentrations of 12.5, 25, 50 and 100 μg/mL was 96.5% ± 7.6%, 67.9% ± 29.9%, 24.0% ± 16.7% and 13.8% ± 7.5%, respectively. For the negative controls (no 5-ALA/PDT and ALA/no PDT), the viability rates were 101.72% ± 3.5% and 100.17% ± 3.6%, respectively. The LD50 for 5-ALA was estimated between 25 and 50 µg/mL.

CONCLUSION

This study reveals dose-dependent cytotoxic effects of 5-ALA-PDT on primary cell lines of meningiomas. Either 5-ALA or PDT alone did not affect cell survival. Further efforts are necessary to study the potential therapeutic effects of 5-ALA-PDT in vivo.

Combining novel technologies with improved logistics to reduce hemodialysis vascular access dysfunction

Hemodialysis (HD) vascular access dysfunction is currently a huge clinical problem for which there are no effective therapies. There are, however, a number of promising technologies that are currently at the experimental or clinical trial stage. We believe that the application of these novel technologies in combination with better clinical protocols for vascular access care could significantly reduce the current problems associated with HD vascular access.

Effect of alpha-stat vs. pH-stat strategies on cerebral oximetry during moderate hypothermic cardiopulmonary bypass

BACKGROUND AND OBJECTIVES

This study was undertaken to compare the effect of alpha-stat vs. pH-stat strategies for acid-base management on regional cerebral oxygen saturation (RsO2) in patients undergoing moderate hypothermic haemodilution cardiopulmonary bypass (CPB).

METHODS

In 14 adult patients undergoing elective coronary artery bypass grafting, an awake RsO2 baseline value was monitored using a cerebral oximeter (INVOS 5100). Cerebral oximetry was then monitored continuously following anaesthesia and during the whole period of CPB. Mean +/- SD of RsO2, CO2, mean arterial pressure and haematocrit were determined before bypass and during the moderate hypothermic phase of the CPB using the alpha-stat followed by pH-stat strategies of acid-base management. Alpha-stat was then maintained throughout the whole period of CPB.

RESULTS

The mean baseline RsO2 in the awake patient breathing room air was 59.6 +/- 5.3%. Following anaesthesia and ventilation with 100% oxygen, RsO2 increased up to 75.9 +/- 6.7%. Going on bypass, RsO2 significantly decreased from a pre-bypass value of 75.9 +/- 6.7% to 62.9 +/- 6.3% during the initial phase of alpha-stat strategy. Shifting to pH-stat strategy resulted in a significant increase of RsO2 from 62.9 +/- 6.3% to 72.1 +/- 6.6%. Resuming the alpha-stat strategy resulted in a significant decrease of RsO2 to 62.9 +/- 7.8% which was similar to the RsO2 value during the initial phase of alpha-stat.

CONCLUSION

During moderate hypothermic haemodilutional CPB, the RsO2 was significantly higher during the pH-stat than during the alpha-stat strategy. However, the RsO2 during pH-stat management was significantly higher than the baseline RsO2 value in the awake patient breathing room air, denoting luxury cerebral perfusion. In contrast, the RsO2 during alpha-stat was only slightly higher than the baseline RsO2, suggesting that the alpha-stat strategy avoids luxury perfusion, but can maintain adequate cerebral oxygen supply-demand balance during moderate hypothermic haemodilutional CPB.

Pattern of spontaneous breathing: potential marker for weaning outcome. Spontaneous breathing pattern and weaning from mechanical ventilation

OBJECTIVE

To quantitatively assess the spontaneous breathing (SB) pattern, during minimal ventilatory support, of patients who pass or fail weaning trials from mechanical ventilation.

DESIGN

A prospective, clinical trial.

SETTING

Intensive care unit of a university teaching hospital.

PATIENTS

Fifty-two tracheally intubated and hemodynamically stable patients who were judged clinically ready for extubation.

METHODS

Using a computerized respiratory profile monitor, continuous respiratory parameters were obtained while patients were receiving four or less synchronized intermittent mandatory (SIMV) breaths and during CPAP trials. Coefficients of variation (CV) of spontaneous tidal volumes and flows during SIMV trials as well as the entropies and dimensions of the breathing patterns during CPAP trials were used to assess the dynamical breathing behaviors of the patients who passed or failed weaning trials.

MEASUREMENTS AND RESULTS

Thirty-nine extubations were successful and 13 were not. The CV of the spontaneous tidal volumes (VT) and the spontaneous peak inspiratory flows (PF), the Kolmogorov entropy and the dimension of the SB patterns were compared in the two groups. The CV of VT (9.13 +/- 4.11 vs 26.07 +/- 6.94), the CV of PF (11.63 +/- 4.18 vs 29.88 +/- 12.07), the Kolmogorov entropy (0.09 +/- 0.03 bits/cycle vs 0.39 +/- 0.09 bits/cycle), and the dimension of the SB pattern (1.33 +/- 0.07 vs 3.93 +/- 0.47) were all significantly smaller (P < 0.05) in the successfully extubated group versus the group that failed extubation.

CONCLUSION

The spontaneous breathing pattern during minimal mechanical ventilatory support is more chaotic in patients who failed extubation trials compared to patients who passed extubation trials. Thus, we speculate that characterizing the SB pattern during minimal ventilatory support might be a useful tool in differentiating between extubation success and failure.

Apnea-induced hemoglobin desaturation during one-lung vs two-lung ventilation

PURPOSE

To compare the rate of apnea-induced hemoglobin desaturation during one-lung ventilation (OLV) vs. two-lung ventilation (TLV) in patients undergoing thoracic surgery.

METHODS

Six patients undergoing thoracotomy or thoracoscopy were included. Each patient served as his/her own control. The lungs were ventilated with oxygen 100% using TLV, followed after 20-30 min by OLV and the resultant PaO2 was measured. Apnea was then induced following the two techniques of ventilation, and the times for every 1% decrease in hemoglobin saturation from 100% to 95%, as monitored by pulse oximetry, were recorded. The times for every 1% decrease in the saturation were compared in the two groups.

RESULTS

The mean PaO2 value following TLV (445+/-99 mm Hg) was higher than the mean PaO2 following OLV (156+/-18 mm Hg). Also, the mean time for subsequent apnea induced hemoglobin desaturation from SpO2 100% to 95% following TLV was twice the time of desaturation following OLV (6.3+/-1.2 min vs. 3.2+/-0.5 min, P<0.05).

CONCLUSION

Hemoglobin desaturation occurs more rapidly during apnea following OLV than TLV. The rapid desaturation may be attributed to the decrease of FRC, associated with an increased transpulmonary shunting. The results suggest that two-lung ventilation with oxygen 100% provides a greater safety margin than one-lung ventilation with oxygen 100% whenever ventilation is interrupted.

Treatment of severe status asthmaticus with nitric oxide

The paper reports on a 13-year-old girl with chronic asthma who presented in acute respiratory failure following an exacerbation of her disease. Nitric oxide was added to the ventilator circuit at 7 ppm and then 15 ppm after the patient failed to respond to bronchodilators and steroids. This was followed by rapid improvement in respiratory mechanics and blood gases with no adverse effects. Nitric oxide appears to have a direct relaxing effect on the bronchial smooth muscle.

Fas (CD95)/Fas ligand interactions regulate antigen-specific, major histocompatibility complex-restricted T/B cell proliferative responses

The effect of Fas ligand (FasL) cytotoxicity on T/B collaboration was examined in vitro using cloned T helper 1 cells and antigen-pulsed, activated B cells. We compared antigen-pulsed B cells that had been activated through different membrane receptors (IgM, CD14 and CD40) for their ability to induce T cell proliferation and to respond to T cell help. We also used a Fas-Ig fusion protein, an inhibitor of FasL-mediated cytotoxicity, to determine the effect of FasL cytotoxicity on the T and B cell proliferative responses. The data show that the extent of both T and B cell proliferative responses correlate with the relative resistance of activated B cell populations to FasL cytotoxicity. Moreover, both T and B cell proliferation could be enhanced by Fas-Ig. Our results demonstrate that FasL cytotoxicity is a negative regulatory mechanism for both T and B cell proliferative responses and that Fas-Ig can be an immunopotentiating agent for both T and B cell immunity.