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- Osterlund, P., et al.
(författare)
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Continuation of fluoropyrimidine treatment with S-1 after cardiotoxicity on capecitabine- or 5-fluorouracil-based therapy in patients with solid tumours : a multicentre retrospective observational cohort study
- 2022
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Ingår i: ESMO Open. - : Elsevier. - 2059-7029. ; 7:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Capecitabine- or 5-fluorouracil (5-FU)-based chemotherapy is widely used in many solid tumours, but is associated with cardiotoxicity. S-1 is a fluoropyrimidine with low rates of cardiotoxicity, but evidence regarding the safety of switching to S-1 after 5-FU- or capecitabine-associated cardiotoxicity is scarce.Patients and methods: This retrospective study (NCT04260269) was conducted at 13 centres in 6 countries. The primary endpoint was recurrence of cardiotoxicity after switch to S-1-based treatment due to 5-FU- or capecitabine-related cardiotoxicity: clinically meaningful if the upper boundary of the 95% confidence interval (CI; by competing risk) is not including 15%. Secondary endpoints included cardiac risk factors, diagnostic work-up, treatments, outcomes, and timelines of cardiotoxicity.Results: Per protocol, 200 patients, treated between 2011 and 2020 [median age 66 years (range 19-86); 118 (59%) males], were included. Treatment intent was curative in 145 (73%). Initial cardiotoxicity was due to capecitabine (n = 170), continuous infusion 5-FU (n = 22), or bolus 5-FU (n = 8), which was administered in combination with other chemotherapy, targeted agents, or radiotherapy in 133 patients. Previous cardiovascular comorbidities were present in 99 (50%) patients. Cardiotoxic events (n = 228/200) included chest pain (n = 125), coronary syndrome/ infarction (n = 69), arrhythmia (n = 22), heart failure/cardiomyopathy (n = 7), cardiac arrest (n = 4), and malignant hypertension (n = 1). Cardiotoxicity was severe or life-threatening in 112 (56%) patients and led to permanent capecitabine/5-FU discontinuation in 192 (96%). After switch to S-1, recurrent cardiotoxicity was observed in eight (4%) patients (95% CI 2.02-7.89, primary endpoint met). Events were limited to grade 1-2 and occurred at a median of 16 days (interquartile range 7-67) from therapy switch. Baseline ischemic heart disease was a risk factor for recurrent cardiotoxicity (odds ratio 6.18, 95% CI 1.36-28.11).Conclusion: Switching to S-1-based therapy is safe and feasible after development of cardiotoxicity on 5-FU- or capecitabine-based therapy and allows patients to continue their pivotal fluoropyrimidine-based treatment.
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- Ekblad, M., et al.
(författare)
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Influence of operational conditions and wastewater properties on the removal of organic micropollutants through ozonation
- 2021
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Ingår i: Journal of Environmental Management. - : Elsevier BV. - 0301-4797. ; 286
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to evaluate the influence of operational conditions and wastewater properties on the removal of pharmaceuticals, contrast media and antibiotics through ozonation, in order to facilitate the optimization of treatment and its implementation on a full scale. Pilot-scale ozone oxidation trials were performed on treated wastewater, before and after post-precipitation, over a seven-month period, including summer and winter months. Hydraulic retention times as short as 7 min were found to be sufficient for organic micropollutant removal. A short hydraulic retention time reduces both investment costs and land use. Neither the choice of ozone dispersion method, a static mixer or a Venturi injector, nor the wastewater temperature had any significant effect on the removal efficiency of organic micropollutants, however, higher removal was achieved after on-site post-precipitation with aluminum chloride.
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- Ekblad, M., et al.
(författare)
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Is dissolved COD a suitable design parameter for ozone oxidation of organic micropollutants in wastewater?
- 2019
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697. ; 658, s. 449-456
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Tidskriftsartikel (refereegranskat)abstract
- Ozone oxidation of organic micropollutants in biologically treated wastewater was investigated in pilot-scale after a high- and a low loaded activated sludge process. Higher ozone doses were required to remove organic micropollutants in the effluent wastewater from the high loaded activated sludge process. Further comparison of the micropollutant removal was based on normalized ozone doses, expressed as g O3/g DOC and g O3/g soluble COD (sCOD). A clear difference was noted for the two effluents when the micropollutant removal was normalized by DOC. This difference disappeared almost completely when the removal was linked to ozone doses normalized by sCOD. The dose-response curves for the organic micropollutants were practically linear in the removal range up to 95%. A linear prediction model was developed and compared with literature values to test the transferability of the obtained results. Results from this comparison indicated that the slope of the dose-response functions could be used to predict the removal efficiency of organic micropollutants at a third plant with an average uncertainty of 10%. The modeled ozone requirements were then set in relation to the COD concentrations in the discharged water from approximately 90 Swedish activated sludge treatment plants with and without nitrogen removal. This comparison highlighted the need for a well-functioning biological treatment for an effective ozone oxidation of organic micropollutants. The results in this study suggest that soluble COD should be further explored for design and modeling of ozone oxidation of organic micropollutants in biologically treated wastewater.
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- El-taliawy, H., et al.
(författare)
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Ozonation efficiency in removing organic micro pollutants from wastewater with respect to hydraulic loading rates and different wastewaters
- 2017
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Ingår i: Chemical Engineering Journal. - : Elsevier BV. - 1385-8947. ; 325, s. 310-321
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Tidskriftsartikel (refereegranskat)abstract
- Organic micro pollutants can be removed from water by ozonation. In this article we studied the performance of ozonation under real life conditions and compared results of the same ozonation pilot plant installed at different wastewater treatment plants (WWTPs) thus operating with different waters. The comparability of the removal and reaction rate constants from one waste water treatment plant were low in respect to reaction rate, removal as well as to response to the specific ozone dose. Neither pH-value nor residual nitrite concentrations were the driving force considering these differences. Further tests with different loadings were conducted at the same WWTP under different weather conditions. For the different hydraulic loading of the biological plant, the ozonation was running with rather similar removal rates concerning the same specific (TOC normalized) ozone dose. The compounds that were removed quantitatively under dry weather were still removed well with three times dry weather flow. Using a dataset from one WWTP to optimize operation in another one is thus questionable.
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- Krustrup, P., et al.
(författare)
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Effects of recreational football on women's fitness and health: adaptations and mechanisms
- 2018
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Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 118:1, s. 11-32
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Tidskriftsartikel (refereegranskat)abstract
- The review describes the fitness and health effects of recreational football in women aged 18-65 years. The review documents that 2 × 1 h of recreational football training for 12-16 weeks causes marked improvements in maximal oxygen uptake (5-15%) and myocardial function in women. Moreover, mean arterial blood pressure was shown to decrease by 2-5 mmHg in normotensive women and 6-8 mmHg in hypertensive women. This review also show that short-term (< 4 months) and medium-term (4-16 months) recreational football training has major beneficial impact on metabolic health profile in women, with fat losses of 1-3 kg and improvements in blood lipid profile. Lastly, 2 × 1 h per week of recreational football training for women elevates lower extremity bone mineralisation by 1-5% and whole-body bone mineralization by 1-2% within 4-12-month interventions. These training adaptations are related to the high heart rates, high number of fast runs, and multiple changes of direction and speed occurring during recreational football training for untrained women. In conclusion, regular small-sided football training for women is an intense and versatile type of training that combines elements of high-intensity interval training (HIIT), endurance training and strength training, thereby providing optimal stimuli for cardiovascular, metabolic and musculoskeletal fitness. Recreational football, therefore, seems to be an effective tool for prevention and treatment of lifestyle diseases in young and middle-aged women, including hypertension, type 2 diabetes and osteopenia. Future research should elucidate effects of football training for elderly women, and as treatment and rehabilitation of breast cancer patients and other women patient groups.
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