Background: Published safety data in pregnant epileptic women suggests that oxcarbazepine (OXC) may be a treatment option in nonepileptic pregnant women with substance use disorders (SUDs) and psychiatric symptomatology. Objective: To compare safety outcomes associated with OXC exposure versus non-exposure in nonepileptic pregnant women with SUD and comorbid psychiatric symptomatology. Methods: A retrospective chart review was conducted to identify pregnant women 18 years or older with a SUD who delivered at the study site. Exclusion criteria included a current diagnosis of epilepsy/seizure disorder; concurrent use of lithium, anticonvulsants, medications with a Risk Evaluation and Mitigation Strategy program or a black box warning for potential fetal toxicity; and multi-parity. Eligible patients were divided into two groups based on OXC exposure. Results: The OXC group included 94 mother-neonate pairs versus 194 mother-neonate pairs in the non-OXC group. Baseline characteristics differed in mean number of prior pregnancies (2.8 vs 2.2 in the OXC and non-OXC group, respectively, P = .03). No significant differences were found regarding emergent cesarean or maternal hyponatremia. Average gestational age at OXC initiation was 19.8 weeks. No significant differences were found in the rates of prematurity, physical characteristics, malformation, and neonatal abstinence syndrome. Conclusion: OXC may be considered for management of SUD with comorbid psychiatric symptomatology in nonepileptic pregnant women. Further studies should be conducted to determine statistical significance in larger sample sizes.
Incorporation of iodate into calcite (CaCO3) may be used as an in situ treatment strategy for radioiodine in contaminated soils and groundwater, but the presence of other contaminants may inhibit its efficiency. To this end, the potential for chromate to interfere with iodate incorporation into CaCO3 was investigated as an example of how co-located contaminants may impact in situ remediation efficacy. Here, batch precipitation experiments were periodically sub-sampled over 21 days to determine the kinetic effects of chromate on iodate removal and incorporation into calcite. From these experiments, a decrease in iodate removal from >60 to <40% was observed upon chromate addition (1–112 ppm of chromate) and ≤11% of chromate was removed with a minor dependence upon the initial chromate concentration. Analysis of the solid phase using extended X-ray absorption fine structure (EXAFS) spectroscopy informed by ab initio molecular dynamics simulations revealed that the iodate incorporation mode remains unchanged by the presence of chromate. Iodate readily substitutes for carbonate (CO3 2–), and the calcite structure is charge-balanced primarily by substituting H+ for Ca2+. Furthermore, chromate incorporated as a nearest neighbor to iodate did not contribute to the EXAFS fit; therefore, iodate and chromate clustering is unlikely when co-incorporated into calcite.
Technetium-99 (Tc) contamination remains a major environmental problem at legacy nuclear reprocessing sites, including the Hanford Site (Washington State, U.S.A.) where ∼700 Ci of Tc has been released into the subsurface. Developing enhanced attenuation and efficient remediation strategies for released Tc requires a complete understanding of retardation processes and Tc mass flux, including the different mechanisms by which Tc is immobilized in the subsurface and the effect of localized subsurface conditions. Selection of over 30 sediments from Hanford waste disposal sites, based on historical information and sediment characterization, for analysis by autoradiography revealed that Tc concentrations were generally below the detection limit of 5 mg Tc/g sediment. When Tc was measurable in vadose zone sediments, it was predominantly present as TcO4 – in water films associated with fine-grained sediments, with a maximum of 12% of the total Tc present in the acid-extractable fraction, defined here as the immobile fraction. However, beneath one waste disposal site, where sediments containing minerals with reducing capacity intercepted miscellaneous fission product recovery waste and waste from the bismuth phosphate process, the amount of Tc present in the immobile fraction was 53% of the total. Characterization of Tc-containing phases present in these field-contaminated sediments for the first time using Tc K-edge X-ray absorption near edge structure spectroscopy revealed that, as well as Tc present as Tc(VII)O4 – in pore water associated with fine-grained sediments, Tc was also (i) physically encapsulated within solid phases precipitated from other waste components and in multicomponent phosphate minerals; and (ii) present as mixed Tc(VII)/Tc(IV)/other reduced Tc species in localized reducing zones. These results will be used to develop improved long-term Tc remediation strategies optimized for field application, through stimulation of conditions that enhance Tc attenuation.
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