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Buscaroli E, Lavrnić S, Blasioli S, Gentile SL, Solimando D, Mancuso G, Anconelli S, Braschi I, Toscano A. Efficient dissipation of acetamiprid, metalaxyl, S-metolachlor and terbuthylazine in a full-scale free water surface constructed wetland in Bologna province, Italy: A kinetic modeling study. Environ Res 2024; 247:118275. [PMID: 38246295 DOI: 10.1016/j.envres.2024.118275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/11/2024] [Accepted: 01/18/2024] [Indexed: 01/23/2024]
Abstract
The study investigated the dissipation ability of a vegetated free water surface (FWS) constructed wetland (CW) in treating pesticides-contaminated agricultural runoff/drainage water in a rural area belonging to Bologna province (Italy). The experiment simulated a 0.1% pesticide agricultural water runoff/drainage event from a 12.5-ha farm by dissolving acetamiprid, metalaxyl, S-metolachlor, and terbuthylazine in 1000 L of water and pumping it into the CW. Water and sediment samples from the CW were collected for 4 months at different time intervals to determine pesticide concentrations by multiresidue extraction and chromatography-mass spectrometry analyses. In parallel, no active compounds were detected in the CW sediments during the experimental period. Pesticides dissipation in the wetland water compartment was modeled according to best data practices by fitting the data to Single First Order (SFO), First Order Multi-Compartment (FOMC) and Double First Order in Parallel (DFOP) kinetic models. SFO (except for metalaxyl), FOMC and DFOP kinetic models adequately predicted the dissipation for the four investigated molecules, with the DFOP kinetic model that better fitted the observed data. The modeled distribution of each pesticide between biomass and water in the CW highly correlated with environmental indexes as Kow and bioconcentration factor. Computed DT50 by DFOP model were 2.169, 8.019, 1.551 and 2.047 days for acetamiprid, metalaxyl, S-metolachlor, and terbuthylazine, respectively. Although the exact degradation mechanisms of each pesticide require further study, the FWS CW was found to be effective in treating pesticides-contaminated agricultural runoff/drainage water within an acceptable time. Therefore, this technology proved to be a valuable tool for mitigating pesticides runoff occurring after intense rain events.
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Affiliation(s)
- Enrico Buscaroli
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, Viale G. Fanin 40-50, 40127 Bologna, Italy
| | - Stevo Lavrnić
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, Viale G. Fanin 40-50, 40127 Bologna, Italy
| | - Sonia Blasioli
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, Viale G. Fanin 40-50, 40127 Bologna, Italy
| | | | - Domenico Solimando
- Consorzio di Bonifica Canale Emiliano Romagnolo, Via E. Masi 8, 40137 Bologna, Italy
| | - Giuseppe Mancuso
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, Viale G. Fanin 40-50, 40127 Bologna, Italy
| | - Stefano Anconelli
- Consorzio di Bonifica Canale Emiliano Romagnolo, Via E. Masi 8, 40137 Bologna, Italy
| | - Ilaria Braschi
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, Viale G. Fanin 40-50, 40127 Bologna, Italy.
| | - Attilio Toscano
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, Viale G. Fanin 40-50, 40127 Bologna, Italy
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Mancuso G, Lavrnić S, Canet-Martí A, Zaheer A, Avolio F, Langergraber G, Toscano A. Performance of lagoon and constructed wetland systems for tertiary wastewater treatment and potential of reclaimed water in agricultural irrigation. J Environ Manage 2023; 348:119278. [PMID: 37832301 DOI: 10.1016/j.jenvman.2023.119278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/21/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023]
Abstract
Climate change poses challenges to agricultural water resources, both in terms of quantity and quality. As an adaptation measure, the new European Regulation (EU) 2020/741 establishes different water quality classes for the use of reclaimed water in agricultural irrigation. Italy is also working on the definition of a new regulation on reclaimed water reuse for agricultural irrigation (in substitution of the current one) that will also include the specific requirements imposed by the European one. Nature-based Solutions (NBS) can be a cost-effective and environmentally friendly way to facilitate water reclamation and reuse. The present study reports the outcomes of a long-term monitoring campaign of two NBS (e.g., a constructed wetland (CW) and a lagoon system (LS)) comparing influent and effluent concentrations of different contaminants (e.g., E. coli, BOD5, TSS, TN and TP) with the threshold values imposed by the new regulations. The results showed that in both the case studies, E. coli (about 100 CFU 100 mL-1) and BOD5 (lower than 25 mg L-1) mean effluent concentration need to be further reduced in reclaimed water to be suitable for unlimited reuse. As a negative aspect, in both the monitored NBS, an increase in TSS mean concentration in the effluent was observed, up to 40 mg L-1 in the case of the LS, making reclaimed water unsuitable for agricultural reuse. The CW has proven to be more effective in nitrogen removal (the effluent mean concentration was 3.4 mg L-1), whereas the LS was better at phosphorus removal (with an effluent mean concentration of 0.4 mg L-1). Based on the results, recommendations were made to further improve the performance of both systems in order to have adequate water quality, even for class A. Furthermore, the capacity of reclaimed water to meet crop water and nutrient needs was analyzed, and total nitrogen removal rate coefficients were calculated for the design of future LSs.
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Affiliation(s)
- Giuseppe Mancuso
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, viale Giuseppe Fanin 50, Bologna, 40127, Italy.
| | - Stevo Lavrnić
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, viale Giuseppe Fanin 50, Bologna, 40127, Italy
| | - Alba Canet-Martí
- University of Natural Resources and Life Sciences, Vienna (BOKU), Department of Water Atmosphere and Environment, Institute of Sanitary Engineering and Water Pollution Control, Muthgasse 18, Vienna, 1190, Austria
| | - Ammad Zaheer
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, viale Giuseppe Fanin 50, Bologna, 40127, Italy
| | - Francesco Avolio
- HERA SpA - Water Direction, via Razzaboni 80, Modena, 41122, Italy
| | - Guenter Langergraber
- University of Natural Resources and Life Sciences, Vienna (BOKU), Department of Water Atmosphere and Environment, Institute of Sanitary Engineering and Water Pollution Control, Muthgasse 18, Vienna, 1190, Austria
| | - Attilio Toscano
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, viale Giuseppe Fanin 50, Bologna, 40127, Italy
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Canet-Martí A, Grüner S, Lavrnić S, Toscano A, Streck T, Langergraber G. Comparison of simple models for total nitrogen removal from agricultural runoff in FWS wetlands. Water Sci Technol 2022; 85:3301-3314. [PMID: 35704412 DOI: 10.2166/wst.2022.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Free water surface (FWS) wetlands can be used to treat agricultural runoff, thereby reducing diffuse pollution. However, as these are highly dynamic systems, their design is still challenging. Complex models tend to require detailed information for calibration, which can only be obtained when the wetland is constructed. Hence simplified models are widely used for FWS wetlands design. The limitations of these models in full-scale FWS wetlands is that these systems often cope with stochastic events with different input concentrations. In our study, we compared different simple transport and degradation models for total nitrogen under steady- and unsteady-state conditions using information collected from a tracer experiment and data from two precipitation events from a full-scale FWS wetland. The tanks-in-series model proved to be robust for simulating solute transport, and the first-order degradation model with non-zero background concentration performed best for total nitrogen concentrations. However, the optimal background concentration changed from event to event. Thus, to use the model as a design tool, it is advisable to include an upper and lower background concentration to determine a range of wetland performance under different events. Models under steady- and unsteady-state conditions with simulated data showed good performance, demonstrating their potential for wetland design.
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Affiliation(s)
- Alba Canet-Martí
- Department of Water, Atmosphere and Environment, Institute of Sanitary Engineering and Water Pollution Control, University of Natural Resources and Life Sciences, Vienna (BOKU), Muthgasse 18, Vienna 1190, Austria E-mail:
| | - Sabrina Grüner
- Department of Water, Atmosphere and Environment, Institute of Sanitary Engineering and Water Pollution Control, University of Natural Resources and Life Sciences, Vienna (BOKU), Muthgasse 18, Vienna 1190, Austria E-mail: ; Department of Biogeophysics, University of Hohenheim, Emil-Wolff-Str. 27, Stuttgart 70599, Germany
| | - Stevo Lavrnić
- Department of Agricultural and Food Sciences, Alma Mater Studiorum-University of Bologna, Viale Giuseppe Fanin 50, Bologna 40127, Italy
| | - Attilio Toscano
- Department of Agricultural and Food Sciences, Alma Mater Studiorum-University of Bologna, Viale Giuseppe Fanin 50, Bologna 40127, Italy
| | - Thilo Streck
- Department of Biogeophysics, University of Hohenheim, Emil-Wolff-Str. 27, Stuttgart 70599, Germany
| | - Guenter Langergraber
- Department of Water, Atmosphere and Environment, Institute of Sanitary Engineering and Water Pollution Control, University of Natural Resources and Life Sciences, Vienna (BOKU), Muthgasse 18, Vienna 1190, Austria E-mail:
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Braschi I, Blasioli S, Lavrnić S, Buscaroli E, Di Prodi K, Solimando D, Toscano A. Removal and fate of pesticides in a farm constructed wetland for agricultural drainage water treatment under Mediterranean conditions (Italy). Environ Sci Pollut Res Int 2022; 29:7283-7299. [PMID: 34476700 PMCID: PMC8763787 DOI: 10.1007/s11356-021-16033-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/14/2021] [Indexed: 06/13/2023]
Abstract
A non-waterproofed surface flow constructed wetland (SFCW), treating agricultural drainage water in Northern Italy, was investigated to gain information on the potential ability for effective pesticide abatement. A mixture of insecticide imidacloprid, fungicide dimethomorph, and herbicide glyphosate was applied, by simulating a single rain event, into 470-m-long water course of the SFCW meanders. The pesticides were monitored in the wetland water and soil for about 2 months after treatment. Even though the distribution of pesticides in the wetland was not uniform, for each of them, a mean dissipation of 50% of the applied amount was already observed at ≤7 days. The dissipation trend in the water phase of the wetland fitted (r2 ≥ 0.8166) the first-order model with calculated DT50 of 20.6, 12.0, 5.8, and 36.7 days for imidacloprid, dimethomorph, glyphosate, and the glyphosate metabolite AMPA, respectively. The pesticide behavior was interpreted based on the chemical and physical characteristics of both the substances and the water-soil system. Despite the fast abatement of glyphosate, traces were detected in the water until the end of the trial. The formation of soluble 1:1 complex between glyphosate and calcium, the most representative cation in the wetland water, was highlighted by infrared analyses. Such a soluble complex was supposed to keep traces of the herbicide in solution.
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Affiliation(s)
- Ilaria Braschi
- Department of Agricultural and Food Sciences, Alma Mater Studiorum University of Bologna, viale G. Fanin 44, 40127, Bologna, Italy
- GRIFA Gruppo di Ricerca Fitofarmaci e Ambiente, via Ospedale 72, 09124, Cagliari, Italy
| | - Sonia Blasioli
- Department of Agricultural and Food Sciences, Alma Mater Studiorum University of Bologna, viale G. Fanin 44, 40127, Bologna, Italy.
| | - Stevo Lavrnić
- Department of Agricultural and Food Sciences, Alma Mater Studiorum University of Bologna, viale G. Fanin 44, 40127, Bologna, Italy
| | - Enrico Buscaroli
- Department of Agricultural and Food Sciences, Alma Mater Studiorum University of Bologna, viale G. Fanin 44, 40127, Bologna, Italy
| | - Katia Di Prodi
- GRIFA Gruppo di Ricerca Fitofarmaci e Ambiente, via Ospedale 72, 09124, Cagliari, Italy
- Central Laboratory of Conserve Italia Group, Conserve Italia Soc. Coop. Agricola, via P. Poggi 11, 40068, San Lazzaro di Savena, BO, Italy
| | - Domenico Solimando
- Consorzio di Bonifica Canale Emiliano Romagnolo, via E. Masi 8, 40137, Bologna, Italy
| | - Attilio Toscano
- Department of Agricultural and Food Sciences, Alma Mater Studiorum University of Bologna, viale G. Fanin 44, 40127, Bologna, Italy
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Nan X, Lavrnić S, Toscano A. Potential of constructed wetland treatment systems for agricultural wastewater reuse under the EU framework. J Environ Manage 2020; 275:111219. [PMID: 32858266 DOI: 10.1016/j.jenvman.2020.111219] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 07/30/2020] [Accepted: 08/09/2020] [Indexed: 06/11/2023]
Abstract
One of the solutions for the problems regarding increasing water scarcity and pollution of water resources can be wastewater reuse. Constructed wetlands (CWs) are a sustainable and cost-effective technology for wastewater treatment. If they are able to produce effluent of a needed quality, they can be a valuable addition for wastewater reuse schemes. This review studied 39 treatment systems based on CWs, and it assessed their characteristics and performance on pollutant removal. Moreover, their potential to reach the new European Union standards for agricultural wastewater reuse was evaluated. The results showed that the combination of CWs with additional technologies (e.g. UV treatment, anaerobic reactors) can further increase their performance and provide better removal efficiencies in comparison with conventional horizontal and vertical subsurface flow CWs. Particularly, hybrid systems showed a better removal of organic matter and bacterial indicators than single-stage CWs. For most of the systems considered, the concentrations of biochemical oxygen demand and total suspended solids in treated effluent were below the limits for agricultural reuse. However, that was often not the case with Escherichia coli and therefore it is recommended to add a disinfection unit to the systems in order to achieve the levels required in the case of agricultural reuse.
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Affiliation(s)
- Xi Nan
- Department of Agricultural and Food Sciences, Alma Mater Studiorum-University of Bologna, Viale Giuseppe Fanin 50, 40127, Bologna, Italy.
| | - Stevo Lavrnić
- Department of Agricultural and Food Sciences, Alma Mater Studiorum-University of Bologna, Viale Giuseppe Fanin 50, 40127, Bologna, Italy.
| | - Attilio Toscano
- Department of Agricultural and Food Sciences, Alma Mater Studiorum-University of Bologna, Viale Giuseppe Fanin 50, 40127, Bologna, Italy.
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Lavrnić S, Alagna V, Iovino M, Anconelli S, Solimando D, Toscano A. Hydrological and hydraulic behaviour of a surface flow constructed wetland treating agricultural drainage water in northern Italy. Sci Total Environ 2020; 702:134795. [PMID: 31726347 DOI: 10.1016/j.scitotenv.2019.134795] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/11/2019] [Accepted: 10/01/2019] [Indexed: 06/10/2023]
Abstract
A surface flow constructed wetland (SFCW) treating agricultural drainage water was investigated with the aim to detect modifications in hydrological and hydraulic characteristics after more than a decade of operation. Ponded infiltration tests were conducted to estimate the saturated hydraulic conductivity, Ks, of the surface soil layer at the point scale. At the global scale, infiltration rate, i, was computed from the water balance to detect leakages from the pervious wetland surface. Tracer tests were conducted to analyse the existence of preferential flow inside the system and to estimate its hydraulic retention time (HRT). Clogging phenomena occurred given a mean Ks value of 30 mm h-1 was measured near the SFCW inlet, that was 9.61 times lower than the value at the outlet zone. The estimated infiltration losses were two orders of magnitude lower than infiltration measured at the point scale. The results also confirmed the existence of a moderate amount of preferential flow paths and dead zones in the SFCW as the actual HRT (6.7 days) was shorter than the nominal one (8.1 days). Despite this, it can be concluded that the system performance is still good after 17 years of operation.
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Affiliation(s)
- S Lavrnić
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, Viale Giuseppe Fanin 50, Bologna 40127, Italy.
| | - V Alagna
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, Viale Giuseppe Fanin 50, Bologna 40127, Italy; Department of Agricultural, Food and Forest Sciences, University of Palermo, Viale delle Scienze, 90128 Palermo, Italy.
| | - M Iovino
- Department of Agricultural, Food and Forest Sciences, University of Palermo, Viale delle Scienze, 90128 Palermo, Italy.
| | - S Anconelli
- Consorzio di Bonifica Canale Emiliano Romagnolo, Via Ernesto Masi 8, Bologna 40137, Italy.
| | - D Solimando
- Consorzio di Bonifica Canale Emiliano Romagnolo, Via Ernesto Masi 8, Bologna 40137, Italy.
| | - A Toscano
- Alma Mater Studiorum - University of Bologna, Department of Agricultural and Food Sciences, Viale Giuseppe Fanin 50, Bologna 40127, Italy.
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Lavrnić S, Cristino S, Zapater-Pereyra M, Vymazal J, Cupido D, Lucchese G, Mancini B, Mancini ML. Effect of earthworms and plants on the efficiency of vertical flow systems treating university wastewater. Environ Sci Pollut Res Int 2019; 26:10354-10362. [PMID: 30761495 DOI: 10.1007/s11356-019-04508-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
One of the possible ways to improve the operation efficiency of constructed wetlands and to prevent their clogging is the application of earthworms. They have already been successfully applied for vermicomposting and for sludge dewatering and treatment. A few studies have already examined the effect of earthworms on the treatment of wastewater by vertical flow constructed wetlands (VFCWs), but none of them have provided a yearlong research result from an open-air system or compared the effect that different seasons in a temperate climate area can have on these invertebrates. The goal of this research was to estimate the effect that earthworms and plants have on VFCW's operation. Four mesocosms (a filter, a filter with earthworms, a VFCW and a VFCW with earthworms) were built and their influent and effluent water quality was monitored for a period of 1 year. They were fed with wastewater coming from a building of the University of Bologna (Italy). The results have shown that the presence of earthworms in this specific system did not reduce the organic matter content of the substrate, but it has positively influenced plants' growth. However, since neither earthworms nor plants had a statistically significant effect on the effluent quality, it can be concluded that the integration of these invertebrates cannot improve wastewater treatment of vertical flow filters or constructed wetlands.
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Affiliation(s)
- Stevo Lavrnić
- Campus de Puerto Real, University of Cádiz, Polígono San Pedro s/n, Puerto Real, 11519, Cádiz, Spain.
- Dipartimento di Ingegneria Civile, Chimica, Ambientale e dei Materiali, University of Bologna, Via Umberto Terracini 28, 40131, Bologna, Italy.
| | - Sandra Cristino
- Dipartimento di Scienze Biologiche, Geologiche e Ambientali, University of Bologna, Via San Giacomo 12, 40126, Bologna, Italy
| | | | - Jan Vymazal
- Faculty of Environmental Sciences, Czech University of Life Sciences Prague, Kamycka 129, 165 21, Praha 6, Czech Republic
| | - Domenico Cupido
- Dipartimento di Ingegneria Civile, Chimica, Ambientale e dei Materiali, University of Bologna, Via Umberto Terracini 28, 40131, Bologna, Italy
| | - Giovanni Lucchese
- Dipartimento di Ingegneria Civile, Chimica, Ambientale e dei Materiali, University of Bologna, Via Umberto Terracini 28, 40131, Bologna, Italy
| | - Benedetta Mancini
- Dipartimento di Scienze Biologiche, Geologiche e Ambientali, University of Bologna, Via San Giacomo 12, 40126, Bologna, Italy
| | - Maurizio L Mancini
- Dipartimento di Ingegneria Civile, Chimica, Ambientale e dei Materiali, University of Bologna, Via Umberto Terracini 28, 40131, Bologna, Italy
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Lavrnić S, Mancini ML. Can constructed wetlands treat wastewater for reuse in agriculture? Review of guidelines and examples in South Europe. Water Sci Technol 2016; 73:2616-2626. [PMID: 27232397 DOI: 10.2166/wst.2016.089] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
South Europe is one of the areas negatively affected by climate change. Issues with water shortage are already visible, and are likely to increase. Since agriculture is the biggest freshwater consumer, it is important to find new water sources that could mitigate the climate change impact. In order to overcome problems and protect the environment, a better approach towards wastewater management is needed. That includes an increase in the volume of wastewater that is treated and a paradigm shift towards a more sustainable system where wastewater is actually considered as a resource. This study evaluates the potential of constructed wetlands (CWs) to treat domestic wastewater and produce effluent that will be suitable for reuse in agriculture. In South Europe, four countries (Greece, Italy, Portugal and Spain) have national standards that regulate wastewater reuse in agriculture. Wastewater treatment plants (WWTPs) that are based on CWs in these four countries were analysed and their effluents compared with the quality needed for reuse. In general, it was found that CWs have trouble reaching the strictest standards, especially regarding microbiological parameters. However, their effluents are found to be suitable for reuse in areas that do not require water of the highest quality.
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Affiliation(s)
- Stevo Lavrnić
- University of Cádiz, Campus de Puerto Real, Polígono San Pedro s/n, Puerto Real 11519, Cádiz, Spain E-mail: ; Dipartimento di Ingegneria Civile, Chimica, Ambientale e dei Materiali, University of Bologna, Viale Risorgimento 2, Bologna 40136, Italy
| | - Maurizio L Mancini
- Dipartimento di Ingegneria Civile, Chimica, Ambientale e dei Materiali, University of Bologna, Viale Risorgimento 2, Bologna 40136, Italy
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Popov I, Lavrnić S, Jelić S, Jezdić S, Jasović A. Chemoembolization for liver metastases from colorectal carcinoma: risk or a benefit. Neoplasma 2002; 49:43-8. [PMID: 12044059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Results from clinical trials do not allow definitive conclusions about the role of chemoembolization (ChE) in the treatment of colorectal cancer (CRC) liver metastases. The aim of present phase II study was to investigate toxicity and efficacy of ChE for patients, with unresectable colorectal liver metastases after failure of 5-FU based chemotherapy. Secondary endpoint was clinical benefit measurement. Eleven patients were enrolled in first stage (two-stage Simon design), 2 males/9 females, median age 60 (46-71). Performance status was I in 8 patients and II in 3 patients. All patients had radical surgery, 7 of them adjuvant chemotherapy and 4 systemic chemotherapy. The ChE regimen consisted of an injection of iodinated oil Lipiodol with mitomycin C (3 mg/ml). Repeated treatments were performed at 9- to 12-week intervals. We applied 17 ChE (median 1/pts.). Clinical benefit was a composite of measurements of pain, ECOG performance status, weight and tumor fever. Study was stopped after first stage because non of the patients (pts) achieved objective response (RECIST). Stable disease occurred in 5 pts (45%). Median time to progression was 3 months (range 3-9 months). Median survival was 9 months (range 4-16 months). A decrease of the baseline carcinoembryonic antigen level occurred in 0% of the cases. Clinical benefit was recorded in one patient. Common toxicity included a "postembolization syndrome," which consisted of fever, pain in the right upper quadrant, nausea, and vomiting. Grades 3-4 toxicity (NCI-CTC) followed transaminases 6/11, LDH 4/11. In addition, a drop in F V levels was noted in 5 pts, F VII in 9, F IX in 2 and F X in 10 pts. Decrease in At III levels occurred in 6 pts and FDP appeared in one. Thus, The ChE as performed in the present study did not appear to bring any benefit; furthermore, significant liver toxicity compromises the safety of such procedure.
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Affiliation(s)
- I Popov
- Institute of Oncology and Radiology of Serbia, Belgrade, F.R. Yugoslavia.
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Lavrnić D, Jarebinski M, Rakocević-Stojanović V, Stević Z, Lavrnić S, Pavlović S, Trikić R, Tripković I, Nesković V, Apostolski S. Epidemiological and clinical characteristics of myasthenia gravis in Belgrade, Yugoslavia (1983-1992). Acta Neurol Scand 1999; 100:168-74. [PMID: 10478580 DOI: 10.1111/j.1600-0404.1999.tb00733.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This is the first epidemiological study of myasthenia gravis (MG) in the area of Belgrade. During the survey period (1983 1992), 124 incidental cases of MG were observed, producing an average annual incidence rate of 7.1 per million population (women, 8.3; men, 5.8). Age and sex specific incidence rates for females demonstrated a bimodal pattern, with the first peak in the age group between 20 and 40, and the second peak in the age group 70-80. The age-specific rates for males showed unimodal pattern, reaching a maximum in the age group between 60 and 80. There was a tendency of more frequent disease appearance in the urban as opposed to the suburban districts. On the prevalence day, December 31, 1992, the point prevalence rate was 121.5 per million (women, 142.5; men, 98.8). Only for incidental cases, the point prevalence rate was 77.1 (women, 83.2; men, 70.4). The average annual mortality rate was 0.47 per million (females, 0.52; males, 0.42), while cumulative lethality was 5.6 (women, 5.6; men, 5.7). Most frequently initial symptoms were ocular, occurring in 58% patients. Through the period of investigation ocular symptoms were generalized in 68%, most frequently in the first 2 years (62.5%). Thymoma was confirmed in 11.3% of patients. In this group there was equal presence of both sexes, older median age at onset, and more severe clinical course of MG. Associated autoimmune disease was found in 17 out of 124 incidental cases (13.7%). The most common were thyroid diseases (7.3%). Family history of MG was recorded in 2 cases belonging to 1 family (1.6%).
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Affiliation(s)
- D Lavrnić
- Institutes of Neurology, School of Medicine, University of Belgrade, Yugoslavia
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Alcaz S, Djordjević M, Dragutinović G, Lavrnić S, Apostolski S. [von Recklinghausen's neurofibromatosis]. SRP ARK CELOK LEK 1991; 119:285-7. [PMID: 1807001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We present a case of unusual clinical picture of the well defined Morbus Von Recklinghausen. In a 35-year-old male patient, after an uncontrolled rapid movement of the neck, the disease was suddenly manifested with spastic quadriparesis. Three years later the clinical picture showed spastic quadriplegia. Antalgic torticollis confirmed by X-ray of the neck clearly showed vertebral subluxation at the level of C3-C4. However, additional magnetic resonance imaging revealed large extradural tumorous formation at the level of C1-C2, and two small oval tumours in the splenium of the corpus callosum as well as in the left lateral ventricle. "Café au lait" spots, "molluscum fibrosum" and few subcutaneous fibromas appeared as skin changes which explained the possible nature of the registered intracranial and intraspinal tumours. Neurosurgery has been performed at the spinal level with good results; it confirmed the diagnosis of Von Recklinghausen's Neurofibromatosis.
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Affiliation(s)
- S Alcaz
- Neuropsychiatric Hospital, Kovin
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Goldner B, Lavrnić S, Birovljev-Stojanović V. [Pseudotumorous shadows of pleural origin]. Plucne Bolesti 1986; 38:158-62. [PMID: 3786567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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