Kawasaki disease (KD) is an acute systemic vasculitis of childhood. The diagnosis can be made in a patient who presents with a prolonged high fever and meeting at least four of five criteria including polymorphous rash, mucosal changes, extremity changes (including swelling and/or palmar and plantar erythema), bilateral nonsuppurative conjunctivitis, and unilateral cervical lymphadenopathy. Atypical KD refers to patients who have not met the full criteria and in whom atypical features may be present. We discuss a case of a 6-year-old male who presented to the Emergency Department with torticollis. A series of investigations for elevated inflammatory markers revealed dilated coronary artery aneurysms on echocardiogram, and thus he was diagnosed with atypical KD. His only other criteria were bilateral nonsuppurative conjunctivitis and a prior brief febrile illness. He was treated with high-dose intravenous immune globulin (IVIG) and low-dose aspirin. Low-molecular-weight heparin and atenolol were added due to the presence of giant aneurysms.

BiOCl@Fe3O4 photocatalyst was synthesized to activate peroxymonosulfate (PMS) for atenolol (ATL) degradation under simulated sunlight irradiation in present study. XRD, SEM, adsorbability and pore size distribution of BiOCl@Fe3O4 were analyzed. Magnetic BiOCl performed high activity in PMS activation and could be easily solid-liquid separation by applying an external magnetic field. Many parameters were inspected, including scavengers, PMS concentration, catalyst dosage, pH, anions (Cl- and CO3-). h+, SO4-, HO, O2-, SO5- were involved in ATL degradation in BiOCl@Fe3O4/PMS/sunlight system. The second-order rate constant of the reaction between ATL and SO4- (kATL, SO4-) was estimated via laser flash photolysis experiments. Moreover, ATL mineralization was followed by TOC analyzer. Twelve possible intermediate products were identified through LC-QTOF-MS analysis, and six ATL degradation pathways were concluded. This type of magnetic photocatalyst is characterized by ease of separation, high activation and good reusability. It may have application potential in refractory organic pollutants degradation.

This study assessed the ability to remove micro-pollutants from wastewater using herbaceous species (Phragmites australis L.) and trees (Salix matsudana Koidz.) in constructed wetland (CW) systems. The targets of the study were as follows: (i) pharmaceuticals like diclofenac, ketoprofen, and atenolol; (ii) 4-n-NP (4-n-nonylphenol) and the ethoxylated derivatives monoethoxylated nonylphenol (NP1EO) and diethoxylated nonylphenol (NP2EO); (iii) triclosan, a bactericide used in personal care products. The 12 CW systems, filled with clay and gravel, were irrigated with wastewater from municipal area of Pagnana (Tuscany, Italy) and influent and effluent water samples analyzed periodically by gas chromatography-mass spectrometry (GC-MS/MS). The removal efficiency of CWs planted with willow and common red ranged from 8.4 up to 100%, with the higher removal efficiency for triclosan. On the contrary, the removal efficiency of NPs and NPEOs appears lower than pharmaceuticals. Data demonstrated that P. australis efficiently removed NP, diclofenac, and atenolol, while S. matsudana preferentially removed NP1EO, NP2EO, ketoprofene, and triclosan. A specific selection of plants used in CWs could be exploited for the removal of specific xenobiotics from wastewater.

In arid and semi-arid areas the use of treated wastewater for crop irrigation and other agricultural practices, such as the use of pesticides, increase the number of emerging contaminants (ECs) in crops. Hazards of these practices to human being are largely unknown since there are few studies yet covering a short range of compounds and most of them under non-realistic conditions. This study aims at assessing this problem that will become global soon in an area of Saudi Arabia heavily affected by the reuse of treated wastewater and pesticide in order to ascertain its scale. The novelty of the study relays in the large number of ECs covered and the variety of crops (cabbage, barley, green beans, eggplants, chili, tomato and zucchini) analysed. Extraction procedure developed provided an appropriate extraction yield (up to 50% of the compounds were recovered within a 70-120% range), with good repeatability (relative standard deviations below 20% in most cases) and sensitivity (LOQ < 25 ng g-1) for the model compounds. Determination by liquid chromatography quadrupole time-of-flight (LC-QqTOF-MS) is able to identify >2000 contaminants. Sixty-four ECs were identified in wastewater but of the sixty-four compounds, six pharmaceuticals (atenolol, caffeine, carbamazepine and its metabolites 10,11-epoxycarbamazepine, gemfibrozil, and naproxen) and seven pesticides (acetamiprid, atrazine deethyl, azoxystrobin, bupirimate, diazinon, malathion, pirimicarb and some of their metabolites) were detected in plants. Furhermore, one metabolite of the ibuprofen (not detected in water or soil), the ibuprofen hexoside was also found in plants. Up to our knowledge, this study demonstrate for the first time the accumulation of ECs in crops irrigated with treated wastewater under real non-controlled environmental conditions.

Animal models are frequently used for in vitro physiologic and drug transport studies of the colon, but there exists significant pressure to improve assay throughput as well as to achieve tighter control of experimental variables than can be achieved with animals. Thus, development of a primary in vitro colonic epithelium cultured as high resistance with transport protein expression and functional behavior similar to that of a native colonic would be of enormous value for pharmaceutical research. A collagen scaffold, in which the degree of collagen cross-linking was present as a gradient, was developed to support the proliferation of primary colonic cells. The gradient of cross-linking created a gradient in stiffness across the scaffold, enabling the scaffold to resist deformation by cells. mRNA expression and quantitative proteomic mass spectrometry of cells growing on these surfaces as a monolayer suggested that the transporters present were similar to those in vivo. Confluent monolayers acted as a barrier to small molecules so that drug transport studies were readily performed. Transport function was evaluated using atenolol (a substrate for passive paracellular transport), propranolol (a substrate for passive transcellular transport), rhodamine 123 (Rh123, a substrate for P-glycoprotein), and riboflavin (a substrate for solute carrier transporters). Atenolol was poorly transported with an apparent permeability ( Papp) of <5 × 10-7 cm s-1, while propranolol demonstrated a Papp of 9.69 × 10-6 cm s-1. Rh123 was transported in a luminal direction ( Papp,efflux/ Papp,influx = 7) and was blocked by verapamil, a known inhibitor of P-glycoprotein. Riboflavin was transported in a basal direction, and saturation of the transporter was observed at high riboflavin concentrations as occurs in vivo. It is anticipated that this platform of primary colonic epithelium will find utility in drug development and physiological studies, since the tissue possesses high integrity and active transporters and metabolism similar to that in vivo.

Background The aim of this study was to determine carrier frequencies of the polymorphic markers G1846A (CYP2D6*4) and C100T (CYP2D6*10) of the CYP2D6 gene in coronary heart disease (CHD) patients in Russian and Yakut ethnic groups. The association between the administration of higher doses of bisoprolol and metoprolol and the carriage of these polymorphic markers related to the decreased function of the haplotype of CYP2D6 was also studied. Methods The study included 201 CHD patients (aged 66±8.7 years) receiving metoprolol in titrated dose (12.5-150 mg), bisoprolol (2.5-10 mg) or atenolol (50 mg). Ninety-three patients were Russian (30 men and 63 women), and 108 patients were Yakut (54 men and 54 women). Results In genotyping CHD patients in the Russian and Yakut ethnic groups, there was no significant difference in the prevalence rate of the polymorphic markers G1846A (10.8 vs. 10.2; p=0.871) and C100T (16.1 vs. 16.2; p=1). In patients carrying the polymorphic marker G1846A, the dose of bisoprolol was established to be lower than that in the control group (p=0.0289). Conclusions The carriage frequency of polymorphic markers, which theoretically should differ between Russians and Yakuts as representatives of two different races, in practice turned out to be the same.

A total of 58 samples were collected from hospitals, municipal wastewater treatment plants (WWTPs), a receiving water body (Dagu Drainage Canal, DDC), and adjacent farmland in Tianjin City, China, in May and November 2013 and were analyzed for five common β-blockers (atenolol, sotalol, metoprolol, propranolol, and nadolol) to elucidate their source, occurrence and fate in a typical city in China. The profiles of the enantiomers of the β-blockers in some samples were examined. Sotalol, metoprolol and propranolol were frequently detected, atenolol was less frequently detected, and nadolol was mostly not detected. Generally, the concentrations in hospital wastewaters occurred from <LOQ to 10 μg/L, while concentrations in municipal WWTP water samples ranged from <LOQ to 5.2 μg/L. Hence, both hospitals and WWTPs acted as sources of β-blockers in the environment. Sotalol, metoprolol and propranolol were determined in soils adjacent to the DDC with concentrations up to hundreds of ng/kg in the topsoil and declining levels in the subsoil. Seasonal variation was observed with samples obtained in May showing higher concentrations, both in the canal and the adjacent soil, which could be ascribed to greater consumption of these drugs, lower temperature and less precipitation in the spring and the former winter. Enantiomeric fractions (EFs) of metoprolol and propranolol in soil samples showed a trend of enrichment of E1 (first-eluted) compared to E2 (second-eluted), while sotalol was almost racemic. In the DDC, no significant difference was found for the pair enantiomers of each β-blocker, while in hospital and WWTP wastewaters, E1 predominated.