Secondary effluent reclamation: combination of pre-treatment and disinfection technologies

A study was carried out to evaluate the efficiency of secondary effluent additional treatment, using a combination of pre-treatments (ring filter, physico-chemical and infiltration-percolation) followed by disinfection methods (chlorine dioxide, peracetic acid and ultraviolet light). Three different indicator microorganisms were determined: E. coli, total coliforms and somatic bacteriophages. The results show better efficiency of physico-chemical and infiltration-percolation processes. Bacteriophages were eliminated to a lesser extent than bacterial indicators in all the treatment systems. Chlorine dioxide and peracetic acid seems to be more efficient in disinfection than ultraviolet light when a ring filter is the pre-treatment used. For the same doses and contact times, the efficiency of the disinfection methods is higher when the pre-treatment used is the physico-chemical or the infiltration-percolation system. The final effluent quality from the physico-chemical treatment train and the infiltration-percolation treatment train, followed by the disinfectants, achieves an E. coli content that allows the reuse in most of the uses described in the Spanish legislation for wastewater reuse.

Differential effects of phenylalanine ammonia lyase, cinnamyl alcohol dehydrogenase, and energetic metabolism inhibition on resistance of appropriate host and nonhost cereal-rust interactions

ABSTRACT Effects of phenylpropanoid and energetic metabolism inhibition on resistance were studied during appropriate host and nonhost cereal-rust interactions. In the appropriate barley-Puccinia hordei interaction, phenylalanine ammonia lyase (PAL) and cinnamyl alcohol dehydrogenase (CAD) inhibition reduced penetration resistance in two genotypes, suggesting a role for phenolics and lignins in resistance. Interestingly, penetration resistance of the barley genotype 17.5.16 was not affected by phenylpropanoid biosynthesis but penetration resistance was almost completely inhibited by D-mannose, which reduces the energy available in plant host cells. This suggests a parallel in the cellular basis of penetration resistance between 17.5.16 rust and mlo barleys powdery mildew interaction. Results revealed differing patterns of programmed cell death (PCD) in appropriate versus nonhost rust interactions. PAL and CAD inhibitors reduced PCD (hypersensitivity) in appropriate interactions. Conversely, they had no effect in PCD of wheat to P. hordei; whereas D-mannose dramatically reduced nonhost resistance and allowed colony establishment. The differential effects of inhibitors in the expression of the different resistances and the commonalities with the cereal-powdery mildew interaction is analyzed and discussed.

Genotypes of the C677T and A1298C polymorphisms of the MTHFR gene as a cause of human spontaneous embryo loss

BACKGROUND Polymorphisms C677T and A1298C of the MTHFR gene have been implicated in fetal viability. In this study, we determined the allele and genotype frequencies of these polymorphisms in different populations, including spontaneous abortion (SA) fetal tissues, with the objective of evaluating their impact on fetal viability. METHODS 342 samples of fetal tissues, selected from SA occurring during the 1980s, 230 samples from subjects born in the 1980s and a third set of samples from 204 subjects born in the 1950s, were genotyped by using TaqMan probes. RESULTS The wild CC genotype of the C677T polymorphism showed a strong protective effect against abortion (0.03 in SA versus 0.47 in 1950s and 0.43 in 1980s) (P < 0.0001). Genotypes of three mutations in the combinations of polymorphisms for C677T and A1298C showed a very low frequency in the living population; however, the three mutations genotypes were over expressed in the SA group (0.02 in 1950s; 0.03 in 1980s and 0.17 in SA) (P < 0.0001). Samples with four mutations (n = 2) were found only in the SA group. CONCLUSIONS There is no linkage disequilibrium between C667T and A1298C polymorphisms. Fetal viability is directly related to the CC genotype as a protector while the three and four mutation MTHFR genotypes appear to be a determinant on fetal non-viability and SA.

Radiologic evaluation of the cement mantle in the femoral shaft. A comparative study using a fast-set or a standard-set cement

INTRODUCTION

At present a wide spectrum of cement types are available for cemented total hip arthroplasty (CTHA). All types have the same objective, i.e. to prolong the life of the implant for as long as possible. The purpose of this study was to compare the radiologic cement mantle of CTHA using cement with fast or standard setting characteristics.

METHOD

A prospective comparative study of patients who underwent CTHA was performed: the first group received fast setting cement (Cemex System Fast), the second group received standard setting cement (Cemex System). A radiologic evaluation of the cement mantle was done using Barrack's classification. In order to give the study clinical relevance we assembled Barrack's classification in two groups: 1) Low risk group (Types A and B); 2) High risk group (Types C and D). According to ISO 5833:2002, the international standard was used to perform physico-chemical (polymerization temperature, setting time) and mechanical testing (compression strength, bending strength and bending modulus).

RESULTS

The fast setting cement showed a shorter setting time and a higher polymerization temperature. The mechanical performances of both cements met the ISO limits. At a mean follow-up of 23 months (11-37 months) no statistically significant radiological difference was found in the radiologic cement mantle between the two groups either in the post-operative X-ray evaluation (p=0.32) or in the last follow-up (p=0.72). Statistical evaluation was done comparing the two sub-groups, i.e. low risk and high risk.

CONCLUSIONS

The use of fast or standard setting cement does not produce any difference in the quality of the radiologic cement mantle in the short-term. Both cements comply with ISO 5833 requirements.

Evaluation of the triangular fibrocartilage in cadaveric wrists by means of arthrography, magnetic resonance (MR) imaging, and MR arthrography

PURPOSE

To evaluate the diagnostic accuracy of arthrography, magnetic resonance (MR) imaging, and MR arthrography in the detection and localization of defects of the triangular fibrocartilage (TFC) in cadaveric wrists, using arthroscopy as a reference standard.

MATERIAL AND METHODS

Twenty-four specimen wrists were evaluated. The different imaging modalities were blinded to reviewers and were interpreted independently. A classification of TFC defects was used for the evaluation of images in the different imaging modalities, thus permitting a more uniform correlation. Two cases were excluded from the MR imaging study because of poor image quality. Contingency tables with the chi-square test and Fisher's exact test were used for statistical analysis.

RESULTS

Defects of the TFC were identified in 17 of the 24 specimen wrists by means of arthroscopy, and 16 defects were observed when arthrography was carried out. With MR imaging 14 defects of the TFC were detected in the 22 specimen wrists evaluated, and with MR arthrography 16 defects were observed. Most defects were central or combined (two or more defects). In comparison to arthroscopy, the accepted diagnostic gold standard, the following results were found for arthrography in the detection of TFC defects: sensitivity 95%, specificity 100%, and accuracy 95% (P<0.0005); for MR imaging: sensitivity 86%, specificity 85%, and accuracy 70% (P<0.002); and for MR arthrography: sensitivity 100%, specificity 85%, and accuracy 95% (P<0.0005).

CONCLUSION

The results of the study seem to indicate that both arthrography and MR arthrography have high accuracy, and either would be useful for evaluation of the TFC. The combined approach using both techniques would have a very high accuracy equivalent to that resulting from arthroscopy.

Catalytic wet peroxidation of phenol in a fixed bed reactor

Iron-containing mesostructured materials (Fe-SBA-15) are suitable for continuous treatment of phenolic aqueous solutions by means of catalytic wet peroxide oxidation (CWPO) in a packed-bed reactor. These materials were successfully extruded, crushed and sieved with a particle size ranging from 1 to 1.6 mm using mineral clay and methyl cellulose as binders. Non-significant changes have been found in the textural and structural properties of the extruded material in comparison to the parent powder Fe-SBA-15 material. Activity of extruded catalyst in terms of phenol degradation and TOC reduction has been monitored in a continuous mode. The increase of residence time enhances significantly the TOC degradation. The catalyst stability, taking into account the loss of iron species from the catalyst into the aqueous solution, has also been examined. The catalytic results of Fe-SBA-15 material in comparison to a homogeneous catalytic test prove the relevant role of the solid catalyst in the oxidation process.

[Cranial wounds of the skull caused by a fencing-foil]

Penetrating stab cranial wounds of the skull by fencing-foil are rare in western countries.

CASE REPORT

This 46-year-old man suffered a penetrating stab wound of the skull through the right orbital region. As a consequence he developed an intracranial hematoma requiring surgical evacuation.

DISCUSSION AND CONCLUSIONS

Damage of intracranial contents due to transorbital penetrating objects other than missiles is a rare event.

Perioperative intravenous iron preserves iron stores and may hasten the recovery from post-operative anaemia after knee replacement surgery

In unilateral total knee replacement (TKR), perioperative blood loss, low transfusion thresholds and short hospital stay result in patients being discharged with low haemoglobin (Hb). We assessed the effects of perioperative administration of intravenous iron, with or without erythropoietin, plus a restrictive transfusion threshold (Hb < 80 g L(-1)) both on transfusion rate and recovery from post-operative anaemia. TRK patients received iron sucrose (2 x 200 mg per 48 h, iv) (Group IVI, n = 129). Patients with admission Hb < 130 g L(-1), also received erythropoietin (1 x 40 000 IU, sc) (Group EPO, n = 19). Perioperative clinical and laboratory data were obtained. Mean Hb loss was 36 g L(-1), but only seven patients were transfused (5%). Pre-operatively, 66 (45%) patients did not have enough stored iron to compensate Hb loss. At post-operative day 30, only 15% were anaemic, 70% of Hb loss and 92% of pre-operative Hb were recovered and ferritin increased by 73 microg L(-1) (P < 0.01), although erythropoietic response was higher in patients receiving erythropoietin (P < 0.05). No adverse effects of iron sucrose or erythropoietin were witnessed. This protocol seems to reduce allogeneic blood transfusion rate and may hasten the recovery from post-operative anaemia in TKR patients, without depleting iron stores. Further studies are needed to ascertain which patients may benefit of extended intravenous iron and/or erythropoietin administration.

A simple technique for shoulder arthrography

PURPOSE

To present a systematic approach to teaching a technique for arthrography of the shoulder. Using an adhesive marker-plate with radiopaque coordinates, precise sites for puncture can be identified and the need for fluoroscopic guidance obviated.

MATERIAL AND METHODS

Forty-six glenohumeral arthrograms were performed in 45 patients; in 1 case involving examination of both shoulders. The stages of the technique are described in detail, as are the fundamental aspects of achieving an effective glenohumeral injection. Pain intensity was measured in all patients using a verbal description scale.

RESULTS

Shoulder arthrography was successful in all cases. Average time taken for the procedure was 7 min, with no difference in the respective times required by an experienced radiologist and a resident. The procedure was well tolerated by most patients, with slight discomfort being observed in a very few cases.

CONCLUSION

The arthrographic technique used in this study is simple, safe, rapid, and reproducible, and has the advantage of precise localization of the site for puncture without need for fluoroscopic guidance. The procedure described in this study can be of help in teaching residents and can reduce the learning curve for radiologists with no experience in arthrographic methods. It also reduces the time of exposure to fluoroscopy.

A prospective trial comparing oocyte donor ovarian response and recipient pregnancy rates between suppression with gonadotrophin-releasing hormone agonist (GnRHa) alone and dual suppression with a contraceptive vaginal ring and GnRH

BACKGROUND

Contraceptive treatment before gonadotrophin-releasing hormone agonist administration presents advantages in women with a tendency to hyper-response and simplifies donor-recipient treatment synchronization. This study compares response to gonadotrophin stimulation under hypophyseal suppression in oocyte donors with or without vaginal contraceptive pretreatment.

METHODS

One hundred and ninety oocyte donors were recruited in a single centre and prospectively assigned to one of two treatment groups, according to the day of the week menstruation initiated: Group VC-, no prior vaginal contraceptive and Group VC+, prior vaginal contraceptive.

RESULTS

VC+ patients presented a significantly higher cancellation rate, lower plasma estradiol levels and fewer follicles >12 mm on the day of hCG, versus the VC- group. Number of oocytes recovered was significantly lower in the VC+ group. All the cases of severe ovarian hyperstimulation syndrome (SOHSS) were in the VC- group. Pregnancy rates by embryo transfer to synchronic recipients were similar between VC+ and VC- (59.5 versus 57.9%, respectively).

CONCLUSIONS

Vaginal contraceptive pretreatment resulted in a higher ovarian suppression, whereas SOHSS rate was lower than in donors who did not receive pretreatment. There were no differences in pregnancy rates between the two groups of synchronic oocyte recipients.

Recombinant X chromosome in a prenatal diagnosis

The prenatal cytogenetic study of an amniotic fluid sample of a 39-year-old female showed one X chromosome with a fragment of extra material in the short arm. The G-band pattern suggested that the extra material could be the long arm of an X chromosome. Several complementary studies were performed in order to better clarify the origin of the material. These studies included parental karyotypes, microsatellite typing and comparative genomic hybridization (CGH). The results obtained allowed us to conclude that the derivative chromosome arose de novo as a recombinant X chromosome with duplication of Xq and partial deletion of Xp. Once informed, the parents decided to continue with the pregnancy, after which a healthy girl was born with no apparent disorders.

Heavy metal speciation and phytotoxic effects of three representative sewage sludges for agricultural uses

The environmental impact of sewage sludges depends on the availability and phytotoxicity of their heavy metal. The influence of representative sludges (dewatered anaerobic, pelletization, and composted sludge) on the availability of heavy metals, and their effects on seed germination were compared. The total heavy metal concentrations were below the maximum permitted for land-applied waste and the differences among them were small. The DTPA-extracted metal concentrations were rather different. The sequential extraction of the compost showed a slight increase in Cd and Cu availability, and a decrease in the availability of Fe, Mn, Ni and Zn. Pelletization increased the availability of Ni and slightly reduced that of Cr. The dewatering sludge led to greater availability of Cr and Mn but reduced the concentration of Cd. The three different sludges also affected seed germination and root elongation in different ways. The most serious adverse effects were caused by the dewatered sludge extract.

Donor age and degree of HLA matching have a major impact on the outcome of unrelated donor haematopoietic cell transplantation for chronic myeloid leukaemia

We analysed the outcome of 92 consecutive unrelated donor haematopoietic cell transplantations (UD-HCTs) performed in Spain to treat adult patients with CML in the first chronic phase (1CP). Patients' and donors' median age was 32 (15-49) and 36 (22-56) years, respectively. In all, 73 pairs (79%) matched for A, B+/-C and DRB1+/-DQB1 loci and 19 had > or =1 mismatch. Their probability of survival and disease-free survival at 4 years were 50 and 46%, respectively. Pretransplant factors associated with a better survival were patient age <25 years (P=0.035), donor age < or =36 years (P=0.012), use of cyclosporine since day -7 (P=0.001), and matching 8/8, 9/10 or 10/10 loci at allele level (P=0.003). In multivariate analysis only donor age (P=0.003; RR=3.1 (95% CI: 1.3-7.1)) and degree of HLA-matching (P=0.009; RR: 7.7 (95% CI: 1.8-33)) maintained their significance. The addition of these two variables to the EBMT prognostic score allowed an adequate risk assessment for patients receiving a UD-HCT during 1CP. Our analysis shows that in patients with a young and fully allele-matched donor, UD-HCT should be considered in the initial therapeutic algorithm due to its excellent outcome (92% survival at 2 years).

[Anesthetic management for thoracoscopic repair of type I esophageal atresia with continuous-flow single-lung ventilation]

We describe a continuous flow mode of ventilation for repair of type I esophageal atresia in an infant. This type of atresia is defined by distal stenosis of the esophagus with a proximal blind pouch and no connection to the tracheobronchial tree. In traditional repair procedures the surgical approach is by thoracotomy, but newer videoassisted thoracoscopic techniques have introduced novel challenges to ventilatory mechanics in these low-weight infants. The literature contains little discussion of the anesthetic management or respiratory mechanics of these patients. Trying to maintain adequate tidal volume and oxygenation while thoracoscopic maneuvers take place increases the risk of barotrauma. Single-lung ventilation with a continuous flow respirator was effective in the case we report.

The treatment of mice with Lactobacillus casei induces protection against Babesia microti infection

In this study, we report that administration of Lactobacillus casei confers protection to mice against the intracellular protozoan Babesia microti. Mice treated with L. casei orally or intraperitoneally were inoculated 7 days later with an infectious dose of B. microti. Mice treated with lactobacilli showed significant reduction in the percentage of parasitized erythrocytes (PPE) compared to untreated mice. When mice were inoculated intraperitoneally with L. casei 3 or 0 days before challenge with B. microti, the PPE was significantly lower compared to untreated mice and there were no differences between treated mice and mice immune to B. microti infection. When mice treated with live or dead L. casei were compared to mice inoculated with Freund Complete Adjuvant before a B. microti infection, a significant reduction of PPE was observed. These results show the protective effect of L. casei administered to mice against a B. microti infection and suggest that it might act by stimulating the innate immune system.