Development of osteomalacia in a post-liver transplant patient receiving adefovir dipivoxil

We report the case of a patient treated with living donor-related liver transplantation who suffered from osteomalacia during adefovir dipivoxil (ADV)-containing antiviral therapy for lamivudine-resistant hepatitis B virus infection. The patient had generalized bone pain, with severe hypophosphatemia after 20 mo of ADV therapy. Radiographic studies demonstrated the presence of osteomalacia. The peak plasma ADV level was 38 ng/mL after administration of ADV at 10 mg/d. It was also found that ADV affected the metabolism of tacrolimus, a calcineurin-inhibitor, and caused an increase in the plasma levels of tacrolimus. The disability was reversed with the withdrawal of ADV and with mineral supplementation. ADV can cause an elevation of plasma tacrolimus levels, which may be associated with renal dysfunction. High levels of ADV and tacrolimus can cause nephrotoxicity and osteomalacia. This case highlights the importance of considering a diagnosis of osteomalacia in liver transplantation recipients treated with both ADV and tacrolimus

Enhanced Photoactivity with Nanocluster-Grafted Titanium Dioxide Photocatalysts

Titanium dioxide (TiO₂), as an excellent photocatalyst, has been intensively investigated and widely used in environmental purification. However, the wide band gap of TiO₂ and rapid recombination of photogenerated charge carriers significantly limit its overall photocatalytic efficiency. Here, efficient visible-light-active photocatalysts were developed on the basis of TiO₂ modified with two ubiquitous nanoclusters. In this photocatalytic system, amorphous Ti(IV) oxide nanoclusters were demonstrated to act as hole-trapping centers on the surface of TiO₂ to efficiently oxidize organic contaminants, while amorphous Fe(III) or Cu(II) oxide nanoclusters mediate the reduction of oxygen molecules. Ti(IV) and Fe(III) nanoclusters-modified TiO₂ exhibited the highest quantum efficiency (QE = 92.2%) and reaction rate (0.69 μmol/h) for 2-propanol decomposition among previously reported photocatalysts, even under visible-light irradiation (420–530 nm). The desirable properties of efficient photocatalytic performance with high stability under visible light with safe and ubiquitous elements composition enable these catalysts feasible for large-scale practical applications