Dimitrios Petrakis

Removal of chlorinated phenols from aqueous solutions by adsorption on alumina pillared clays and mesoporous alumina aluminum phosphates

Abstract Alumina pillared montmorillonite (AIPMt) and mesoporous alumina aluminum phosphates (AAPs) were contacted with aqueous, 2,4-dichlorophenol, 2,4,6-trichlorophenol and pentachlorophenol solutions, at a concentration range between 25 and 250 μg/litre, in batch equilibrium experiments, in order to determine their adsorption properties. The removal of chlorophenols by the adsorbents increase with increasing chlorine substitution in their molecules. In the case of pentachlorophenol, the increased affinity allows adsorption to occur much more efficiently than in the case of other compounds. AIPMt material adsorbs 26.3% of 2,4-dichlorophenol, 75.6% of 2,4,6-trichlorophenol and 95.2% of pentachlorophenol at equilibrium. The adsorption of chlorophenols on mesoporous AAPs is much less pronounced as compared to clays but increases with the ratio of P Al , as the surface acidity of those solids also increases. The AAP mixture with a ratio P Al = 0.6 adsorbs 14.8% of 2,4-dichlorophenol, 27.1% of 2,4,6-trichlorophenol and 58.3% of pentachlorophenol. The amounts of chlorophenols decomposed during the treatment increase in AAPs and especially in those with a higher P Al ratio (=0.6).

BLEACHING PROPERTIES OF ALUMINA-PILLARED ACID-ACTIVATED MONTMORILLONITE

The bleaching of cottonseed oil by alumina-pillared (Al-pillared) acid-activated clays was investigated. Acid activation of a Ca-rich montmorillonite (CMS STx-1) following treatment with 1, 4, and 8 eq/L sulfuric-acid solutions, as well as subsequent pillaring with alumina, produces new materials. These materials have bleaching properties dependent upon the extent of activation of the clay prior to pillaring. The pillared acid-activated montmorillonites possessed higher bleaching efficiency compared to pillared products of the untreated clay. Mild activation of the montmorillonite matrix, pillaring with the Keggin ion [Al13O4(OH)24(H2O)12]7+, and calcination temperatures to 500°C produced materials with the best fractional degree of bleaching. Direct comparison to the performance of a commercial bleaching earth (Tonsil Optimum 214, Sud-Chemie AG. Moosburg, Germany) shows that the efficiency of the Al-pillared acid-activated montmorillonite may be improved. The optimization of the bleaching process is achieved via a judicious utilization of intermediate surface area, relatively high acidity, and enhanced pore volume.

A layered magnetic iron/iron oxide nanoscavenger for the analytical enrichment of ng-L−1 concentration levels of heavy metals from water

Magnetically driven separation techniques have received considerable attention in recent decade because of their great potential application. In this study, we investigate the application of an unmodified layered magnetic Fe/Fe(2)O(3) nanoscavenger for the analytical enrichment and determination of sub-parts per billion concentrations of Cd(II), Pb(II), Ni(II), Cr(VI) and As(V) from water samples. The synthesized nanoscavenger was characterized by BET, TGA, XRD and IR and the parameters influencing the extraction and recovery of the preconcentration process were assessed by atomic absorption spectrometry. The possible mechanism of the enrichment of heavy metals on Fe/Fe(2)O(3) was proposed, which involved the dominant adsorption and reduction. The nanoscale size offers large surface area and high reactivity of sorption and reduction reactions. The obtained limits of detection for the metals studied were in the range of 20-125 ng L(-1) and the applicability of the nanomaterial was verified using a real sample matrix. The method is environmentally friendly as only 15 mg of nanoscavenger are used, no organic solvent is required for the extraction and the experiment is performed without the need for filtration or preparation of packed preconcentration columns.

Prognostication in cancer of unknown primary (CUP): development of a prognostic algorithm in 311 cases and review of the literature.

BACKGROUND CUP represents a heterogeneous population of patients with systemic malignancy and variable outcomes. Identification of clinical, pathologic and laboratory parameters with prognostic utility could contribute to estimation of death hazard and tailoring of therapy. PATIENTS AND METHODS Clinical, pathologic and laboratory data from 311 patients with CUP diagnosed in a single university centre from 1988 to 2011 were examined for prognostic significance in univariate, multivariate and Classification and Regression Tree (CART) analyses. We analysed all published CUP prognostic algorithms in PubMed and EmBase from 1985 to date in order to describe defining characteristics. RESULTS Most patients harboured poorly differentiated adenocarcinoma or carcinoma (85%) in visceral sites (62%) and were managed with combination chemotherapy. Median overall survival for all patients was 8 months (95% CI 6.7-9.1). Multivariate analysis established that only leucocytosis (HR 0.37, p=0.001, cut off <10,000/mm(3) leucocytes), clinicopathologic CUP subgroup (HR 2.44, p=0.001 for the visceral subgroup) and performance status (HR 0.58, p=0.002 for PS 0-1) retained independent prognostic significance. These three parameters were used for developing a prognostic algorithm (Ioannina Score for CUP Outpatient Oncologic Prognostication, I-SCOOP) which produced a dynamic 5-tier point score and classified patients in low, intermediate and high risk groups with median survival times of 36, 11-14 and 5-8 months respectively. We identified 15 published CUP series describing prognostic algorithms with common, as well as distinct, patient characteristics and prognosticators. CONCLUSIONS We developed a simple and easy to use CUP prognostic algorithm based on readily available clinicopathologic and laboratory variables. However, analysis of all published series revealed lack of prognosticator consensus, highlighting the heterogeneity of the disease.

Psychiatric manifestations, personality traits and health-related quality of life in cancer of unknown primary site

Psychiatric manifestations and personality traits are known to influence cancer patients. We aimed to assess psychological distress symptoms, psychosocial factors and health‐related quality of life (HRQoL) in cancer of unknown primary site (CUP) and to test whether these parameters differ between CUP and Metastatic (MKPC) or Non‐Metastatic Known Primary Cancers (N‐MKPC) after controlling for demographics and clinical variables.

Management of patients with recurrent/advanced cervical cancer beyond first line platinum regimens: Where do we stand? A literature review

BACKGROUND Cervical cancer is the fourth most common cancer affecting women worldwide. Despite advances in screening and human papillomavirus (HPV) vaccination, a significant number of women present with or develop advanced disease. Palliative platinum-based chemotherapy (CT) is the standard first-line treatment for metastatic/recurrent cervical cancer. The prognosis remains poor and effective second line options are urgently needed. METHODS We searched the English-language medical literature as well as relevant guideline databases, published from January 1981 to December 2015 and identified publications related to cervical cancer and its therapies. Our effort was to highlight the available treatment options in the setting of recurrent/metastatic disease. RESULTS Although there have been important advances in the management of women with cervical cancer, the optimal treatment for patients with locally recurrent and metastatic disease after platinum failure is still problematic. Overall, there is a trend in terms of longer overall survival (OS) and better quality of life for the combination of cisplatin/paclitaxel (PC) as compared to the doublets of cisplatin/topotecan (TC), cisplatin/vinorelbine (VC), and cisplatin/gemcitabine (GC). Currently available single agents beyond first-line platinum-based therapy have limited efficacy in this setting and include topoisomerase inhibitors, vinca alkaloids, taxanes, alkylating agents and antimetabolites. Several targeted therapies have demonstrated activity in advanced cervical cancer. Bevacizumab has been evaluated in a phase III trial using doublets of cisplatin with paclitaxel or topotecan and has been approved in the first-line setting by the U. S. Food and Drug Administration. Selective targeting of angiogenic kinases by tyrosine kinase inhibitors (TKIs) may represent a novel therapeutic tool in this setting, but its use alone or in combination with CT is still investigational. Early reports have implicated PI3KCA somatic mutations suggesting that mTOR-targeted agents should be explored in this disease. Development of the immune checkpoint programmed cell death 1 (PD-1) and T-lymphocyte-associated molecule-4 (CTLA-4) inhibitors have been of considerable interest, leading to ongoing phase II studies in patients with advanced cervical cancer. CONCLUSIONS Progress in the management of recurrent and advanced cervical cancer patients has been slow and restricted to palliative intent. These patients should be considered for clinical trials of novel targeted agents and/or immunotherapy.

Long-term survivors among patients with cancer of unknown primary

There is a general conception among oncologists that CUP patients behave poorly to treatment and carry a dismal survival. In this paper we are trying to elucidate the different groups of CUP patients and to describe in details the diagnostic and therapeutic management of the prognostically favorable patients. Clinicians should be aware that the favorable CUP cases must be treated according to recent guidelines with either specific locoregional and/or systemic therapy and that they commonly enjoy a long survival. Survival data of 219 CUP patients treated at Ioannina University Hospital from 1995 until 2011 are also presented.

An unusual presentation of a patient with advanced prostate cancer, massive ascites and peritoneal metastasis: Case report and literature review.

We describe the case of a patient with prostate cancer, ascites, omental and bone metastases, an extremely rare clinical variant that warrants further investigation, and review the relevant literature.

Lung cancer during pregnancy: A narrative review.

Graphical abstract

Severe resistant hypoglycemia in a patient with a pancreatic neuroendocrine tumor on sunitinib treatment

OBJECTIVESunitinib is a tyrosine kinase inhibitor used in the therapy of pancreatic neuroendocrine tumors (PNETs), metastatic renal cancer and gastrointestinal stromal tumors. We describe a patient with PNET who presented with severe hypoglycemia following sunitinib administration.CASE REPORTA 64-year old man with known metastatic PNET presented with a history of recurring episodes of severe, life-threatening hypoglycemia 3 months after initiation of sunitinib treatment. Investigations during symptomatic hypoglycemia revealed inappropriately increased plasma insulin and C-peptide levels, consistent with endogenous hyperinsulinemia. No immune staining for insulin was observed in tissue samples from peritoneal metastatic tumor lesions, and serum anti-insulin antibodies were negative. Medical management with diazoxide, methylprednisolone and ocreotide was ineffective; continuous intravenous infusion of glucagon was required to maintain euglycemia. Following discontinuation of sunitinib there was gradual improvement in both the severity and frequency of the hypoglycemia. Six months later, the patient remained free of hypoglycemic episodes.CONCLUSIONSWe describe a patient with PNET who experienced severe, life-threatening hypoglycemia following sunitinib use. It is important that glucose levels of patients treated with sunitinib are monitored on a regular basis; those patients with diabetes may need to have their antidiabetic treatment adjusted to prevent hypoglycemia.