Quantification of the response of circulating epithelial cells to neodadjuvant treatment for breast cancer: a new tool for therapy monitoring

INTRODUCTION: In adjuvant treatment for breast cancer there is no tool available with which to measure the efficacy of the therapy. In contrast, in neoadjuvant therapy reduction in tumour size is used as an indicator of the sensitivity of tumour cells to the agents applied. If circulating epithelial (tumour) cells can be shown to react to therapy in the same way as the primary tumour, then this response may be exploited to monitor the effect of therapy in the adjuvant setting. METHOD: We used MAINTRAC(® )analysis to monitor the reduction in circulating epithelial cells during the first three to four cycles of neoadjuvant therapy in 30 breast cancer patients. RESULTS: MAINTRAC(® )analysis revealed a patient-specific response. Comparison of this response with the decline in size of the primary tumour showed that the reduction in number of circulating epithelial cells accurately predicted final tumour reduction at surgery if the entire neoadjuvant regimen consisted of chemotherapy. However, the response of the circulating tumour cells was unable to predict the response to additional antibody therapy. CONCLUSION: The response of circulating epithelial cells faithfully reflects the response of the whole tumour to adjuvant therapy, indicating that these cells may be considered part of the tumour and can be used for therapy monitoring

Anthropogenic organic micro-pollutants and pathogens in the urban water cycle: assessment, barriers and risk communication (ASKURIS)

In urban areas, water often flows along a partially closed water cycle in which treated municipal wastewater is discharged into surface waters which are one source of raw waters used for drinking water supply. A number of organic micro-pollutants (OMP) can be found in different water compartments. In the near future, climatic and demographic changes will probably contribute to an increase of OMP and antibiotic-resistant pathogens in aquatic ecosystems. The occurrence of OMP, possible adverse effects on aquatic organisms and human health and the public perception must be carefully assessed to properly manage and communicate potentially associated risks and to implement appropriate advanced treatment options at the optimum location within the water cycle. Therefore, the interdisciplinary research project ASKURIS focuses on identification and quantification, toxicological assessment and removal of organic micro-pollutants and antibiotic-resistant pathogens in the Berlin water cycle, life cycle-based economic and environmental assessment, public perception and management of potential risks

Patients' feedback after computer-assisted diagnostic interviews for mental disorders

Little is known about how psychotherapy patients perceive and evaluate computer-assisted diagnostic interviews for mental disorders. Using the World Health Organization's Composite International Diagnostic Interview in its computer-administered form, psychologists interviewed 236 psychotherapy patients, who evaluated the interview with regard to content, comprehensibility, and acceptance. More than 87% of patients evaluated the interview positively. Higher symptom severity and comorbidity, but not depression, were associated with a slightly lower but still favorable appraisal. The results indicate that the use of computerized clinical diagnostic interviews, previously usually restricted to research, seems to be a time-efficient, economical, and acceptable approach for the diagnostic phase of psychotherapy. The indications of diminished acceptability among multimorbid and severely disturbed patients warrant further study. Implications for quality assurance and practice research networks are discussed.Wir wissen wenig darüber, wie Psychotherapiepatienten computergestützte Interviews für psychische Störungen erleben und bewerten. Trainierte Psychologen untersuchten 236 konsekutive Patienten einer Psychotherapieambulanz mit dem Composite International Diagnostic Interview (CIDI) in seiner computergestützen Version.. Danach beurteilten die befragten Patienten das Interview auf der Basis einer 15 Items umfassenden Liste hinsichtlich Inhalt, Verständlichkeit und Akzeptanz. 87% der Patienten bewerteten das Interview positiv, und gaben z.B. an froh zu sein, dass “die Befragung so genau und ausführlich war”. Größere Symptombelastung und höhere Komorbidität, nicht aber das Ausmaß an Depression, waren mit einer etwas schlechteren, absolut gesehen aber immer noch guten Bewertung des Interviews assoziiert. Die Ergebnisse zeigen, dass computergestützte Interviews, die bisher fast nur im Forschungsbereich eingesetzt wurden, eine zeit- und kosteneffiziente sowie für den Patienten akzeptable Möglichkeit für die Eingangsdiagnostik psychotherapeutischer Behandlungen darstellen. Die Hinweise auf eine geringere Akzeptanz bei multi-morbiden und stärker beeinträchtigten Patienten sollten weiter untersucht werden. Implikationen für die Qualitätssicherung und Praxisforschungsnetzwerke werden diskutiert

Advancing Sequential Managed Aquifer Recharge Technology (SMART) Using Different Intermediate Oxidation Processes

Managed aquifer recharge (MAR) systems are an efficient barrier for many contaminants. The biotransformation of trace organic chemicals (TOrCs) strongly depends on the redox conditions as well as on the dissolved organic carbon availability. Oxic and oligotrophic conditions are favored for enhanced TOrCs removal which is obtained by combining two filtration systems with an intermediate aeration step. In this study, four parallel laboratory-scale soil column experiments using different intermittent aeration techniques were selected to further optimize TOrCs transformation during MAR: no aeration, aeration with air, pure oxygen and ozone. Rapid oxygen consumption, nitrate reduction and dissolution of manganese confirmed anoxic conditions within the first filtration step, mimicking traditional bank filtration. Aeration with air led to suboxic conditions, whereas oxidation by pure oxygen and ozone led to fully oxic conditions throughout the second system. The sequential system resulted in an equal or better transformation of most TOrCs compared to the single step bank filtration system. Despite the fast oxygen consumption, acesulfame, iopromide, iomeprol and valsartan were degraded within the first infiltration step. The compounds benzotriazole, diclofenac, 4-Formylaminoantipyrine, gabapentin, metoprolol, valsartan acid and venlafaxine revealed a significantly enhanced removal in the systems with intermittent oxidation compared to the conventional treatment without aeration. Further improvement of benzotriazole and gabapentin removal by using pure oxygen confirmed potential oxygen limitation in the second column after aeration with air. Ozonation resulted in an enhanced removal of persistent compounds (i.e., carbamazepine, candesartan, olmesartan) and further increased the attenuation of gabapentin, methylbenzotriazole, benzotriazole, and venlafaxine. Diatrizoic acid revealed little degradation in an ozone–MAR hybrid system