(searched for: 10.29328/journal.apcr.1001028)
Published: 3 January 2022
Archives of Pathology and Clinical Research, Volume 6, pp 001-004; https://doi.org/10.29328/journal.apcr.1001028
Treatment options in multiple myeloma (MM) based on novel agents are often limited by dose-related neurotoxicity. Bortezomib, a highly active reversible proteasome inhibitor, frequently causes peripheral neuropathy (PN). Bortezomib-induced PN (BIPN) is characterized by a length-dependent, sensory, axonal polyneuropathy (PNP) with predominant small fiber-affection. Following dose reduction or drug discontinuation, BIPN resolves within 3-4 months in the majority of patients. The pathophysiological mechanisms of BIPN are unclear. Rare cases of a severe demyelinating or mixed BIPN with prominent motor involvement have been attributed to autoimmune or inflammatory reactions. A case report, including nerve pathology, is presented of a 59-year-old man with stage III IgG-κ MM who was treated with bortezomib on the occurrence of progressive disease. After the fourth cycle, he developed a painful distal symmetric sensory PNP followed by gait instability and muscle weakness increasing over 3 months despite early cessation of bortezomib. Neurological examination revealed a distal flaccid tetraparesis mainly of the lower limbs with sensory loss and severe ataxia, electrophysiological features of a mixed axonal-demyelinating PNP, and pathomorphological evidence of neuritis. Steroid treatment was initiated, and partial recovery of the neurological symptoms within 6 months was observed. While a neurotoxic effect may explain the initial distal sensory disturbances, the worsening of neurological dysfunction after bortezomib withdrawal and the clinical pattern with steroid-responsive muscle weakness predominantly of the legs are consistent with an immune-mediated mechanism. This is in line with the sural nerve biopsy findings. Toxic BIPN followed by an immune-mediated BIPN in the same patient has not been reported before.
Published: 1 July 2006
Journal of Environmental Engineering and Science, Volume 5, pp 335-348; https://doi.org/10.1139/s06-016
Air pollution control residues (APCR) from municipal waste incinerators are usually considered as hazardous wastes because of their high contents in easily soluble Pb and other toxic metal contaminants. The objective of this research was to compare various techniques using Pb adsorption on Sphagnum peat moss (MT) for the treatment of alkaline leachates produced during the decontamination of various types of APCR including used lime (CU), electrofilter ashes (CE), and boiler ashes (CC). Regeneration tests of saturated MT using hydrochloric and sulphuric acids have revealed that excessive acid consumption (>250 kg acid/metric ton of treated APCR) are necessary for the elution of metals. However, the incineration of the saturated MT and its possible valorization represents an interesting way to explore for the management of the adsorbent. This method allows to reduce by a factor of 3 or 4 the mass of residues and increases in the same proportion the Pb content in the incinerated MT. Finally, the present study has highlighted that ion exchange on the anionic functional groups of MT would be one of the most important mechanisms implied in the Pb fixation on this natural sorbent during the treatment of very alkaline leachates (pH > 11) of APCR.Key words: lead, leaching, incinerator, air pollution control residues (APCR), removal, peat, adsorption, toxicity characteristic leaching procedure (TCLP).[Journal translation]
American Journal of Hypertension, Volume 13, pp 61-65; https://doi.org/10.1016/S0895-7061(99)00140-5
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