Biodegradability of pharmaceutical industrial wastewater and formation of recalcitrant organic compounds during aerobic biological treatment

The biodegradability of different wastewater samples originated from the industrial production of three pharmaceuticals (naproxen, acyclovir, and nalidixic acid) was performed through the standard Zahn-Wellens test. Moreover, the wastewater composition before and during the test was evaluated in terms of parent compounds and main metabolites by LC/MS, and the biodegradability of the parent compounds was also assessed by performing extra Zahn-Wellens tests on synthetic solutions. The results, besides showing the relatively good biodegradability of acyclovir and naproxen, evidenced the masking role of the organic matrices, especially in the case of nalidixic acid. The latter compound showed to be recalcitrant and persistent, despite the apparently good performance of the Zahn-Wellens test. Deeper evaluation evidenced that the biodegradation of high concentrations of organic solvents and other biodegradable compound tended to "hide" the lack of removal of the target compound.

Removal of organics and degradation products from industrial wastewater by a membrane bioreactor integrated with ozone or UV/H₂O₂ treatment

The treatment of a pharmaceutical wastewater resulting from the production of an antibacterial drug (nalidixic acid) was investigated employing a membrane bioreactor (MBR) integrated with either ozonation or UV/H(2)O(2) process. This was achieved by placing chemical oxidation in the recirculation stream of the MBR. A conventional configuration with chemical oxidation as polishing for the MBR effluent was also tested as a reference. The synergistic effect of MBR when integrated with chemical oxidation was assessed by monitoring (i) the main wastewater characteristics, (ii) the concentration of nalidixic acid, (iii) the 48 organics identified in the raw wastewater and (iv) the 55 degradation products identified during wastewater treatment. Results showed that MBR integration with ozonation or UV/H(2)O(2) did not cause relevant drawbacks to both biological and filtration processes, with COD removal rates in the range 85-95%. Nalidixic acid passed undegraded through the MBR and was completely removed in the chemical oxidation step. Although the polishing configuration appeared to give better performances than the integrated system in removing 15 out of 48 secondary organics while similar removals were obtained for 19 other compounds. The benefit of the integrated system was however evident for the removal of the degradation products. Indeed, the integrated system allowed higher removals for 34 out of 55 degradation products while for only 4 compounds the polishing configuration gave better performance. Overall, results showed the effectiveness of the integrated treatment with both ozone and UV/H(2)O(2).

Effective organics degradation from pharmaceutical wastewater by an integrated process including membrane bioreactor and ozonation

The enhanced removal of organic compounds from a pharmaceutical wastewater resulting from the production of an anti-viral drug (acyclovir) was obtained by employing a membrane bioreactor (MBR) and an ozonation system. An integrated MBR-ozonation system was set-up by placing the ozonation reactor in the recirculation stream of the MBR effluent. A conventional treatment set-up (ozonation as polishing step after MBR) was also used as a reference. The biological treatment alone reached an average COD removal of 99%, which remained unvaried when the ozonation step was introduced. An acyclovir removal of 99% was also obtained with the MBR step and the ozonation allowed to further remove 99% of the residual concentration in the MBR effluent. For several of the 28 organics identified in the wastewater the efficiency of the MBR treatment improved from 20% to 60% as soon as the ozonation was placed in the recirculation stream. The benefit of the integrated system, with respect to the conventional treatment set-up was evident for the removal of a specific ozonation by-product. The latter was efficiently removed in the integrated system, being its abundance in the final effluent 20-fold lower than what obtained when ozonation was used as a polishing step. In addition, if the conventional treatment configuration is employed, the same performance of the integrated system in terms of by-product removal can only be obtained when the ozonation is operated for longer than 60 min. This demonstrates the effectiveness of the integrated system compared to the conventional polishing configuration.

Motor evoked potentials in the post-surgical follow-up of cervical spondylotic myelopathy

Eighteen patients (6 female, 12 male; average age 51 years, range 37-79) with clinical and radiological evidence (MRI) of cervical spondylotic myelopathy (CSM) were examined. The subjects were divided into two groups depending on whether radiology indicated single level (9 patients) or multilevel (9 patients) compression of the cervical cord. All of the patients underwent surgical decompression. Seriate exam with trans-cranial magnetic stimulation was performed in double session before surgery, and 3 and 12 months after surgery. The follow-up study of these patients revealed a statistically significant neurophysiological improvement only in those patients with single-level compression. In these cases, the cervical cord pathology revealed by MRI signal hyperintensity in T2 may at least partially consist of an edematous component and/or an initial demyelinization that has still a chance of recovery. In patients with multilevel damage, the compression may cause irreversible lesions.

Removal of nalidixic acid and its degradation products by an integrated MBR-ozonation system

Chemical-biological degradation of a widely spread antibacterial (nalidixic acid) was successfully obtained by an integrated membrane bioreactor (MBR)-ozonation process. The composition of the treated solution simulated the wastewater from the production of the target pharmaceutical, featuring high salinity and a relevant concentration of sodium acetate. Aim of treatment integration was to exploit the synergistic effects of chemical oxidation and bioprocesses, by adopting the latter to remove most of the COD and the ozonation biodegradable products. Integration was achieved by placing ozonation in the recirculation stream of the bioreactor effluent. The recirculation flow rate was three-fold the MBR feed, and the performance of the integrated system was compared to the standard polishing configuration (single ozonation step after the MBR). Results showed that the introduction of the ozonation step did not cause relevant drawbacks to both biological and filtration processes. nalidixic acid passed undegraded through the MBR and was completely removed in the ozonation step. Complete degradation of most of the detected ozonation products was better achieved with the integrated MBR-ozonation process than using the sequential treatment configuration, i.e. ozone polishing after MBR, given the same ozone dosage.

Neurology and the soul: from the origins until 1500

The mind-brain dichotomy recalls the soul-body duality and the tendency to individualize in the nervous system a location for the soul. In this paper, the author analyses some of the principal theories which attribute the soul to a cerebral location, from the origins until the year 1500.

Ischaemic stroke, factor V Leiden heterozygosity and left atrial thrombosis in sinus rhythm: a case report

We describe a 63-year-old man in sinus rhythm (SR) with an ischaemic stroke involving basal ganglia region on the right side. The patient was known to be heterozygous for factor V Leiden (FVL) mutation. On diagnostic work-up, no arterial sources of embolism were found. Transoesophageal echocardiography evidenced a left atrial (LA) thrombosis without relevant cardiopathies. LA thrombosis is generally associated to atrial fibrillation, atrial enlargement, mitral valve stenosis and left ventricular dysfunction, whereas mitral regurgitation is considered protective. To our knowledge, this is the first report of cardioembolic stroke related to a LA thrombosis in a patient in SR without risk factors for thrombus formation except for FVL heterozygosity.

"The moon" and "the blood": two emblematic symbols in headache and epilepsy according to scientific traditions of the Salerno Medical school and popular medicine in southern Italy

Before describing the state of knowledge on headache and epilepsy at the Salerno Medical School (SMS), we will briefly summarize in the first part its history through the centuries until the "golden period" of the 12th century when it reached its peak by outshining all others in teaching, studies and research. In the second part we will refer to Saint Donato, healer of epileptics in the south of Italy, whose worship is still alive today. The finding of common symbols in conceptions of headache and epilepsy, both in the scientific tradition of the School and in popular medicine, represents a link which is explicable by the wide dissemination of the school's doctrines.

Landfill wall revegetation combined with leachate recirculation: a convenient procedure for management of closed landfills

There is a need for a reliable sustainable option to effectively manage the landfill leachate generation. This study presents a simple procedure for the revegetation of the walls of closed landfills, employing the leachate as a fertirrigant. The native plants Lepidium sativum, Lactuca sativa, and Atriplex halimus, which suit the local climate, were chosen for this study in Southern Italy. The methodology was structured into three phases (i) early stage toxicity assessment phase (apical root length and germination tests), (ii) adult plant resistance assessment phase, and (iii) soil properties verification phase. The rationale of the proposed approach was first to look at the distinctive qualities and the potential toxicity in landfill leachates for fertigation purposes. Afterwards, through specific tests, the plants used were ranked in terms of resistance to the aqueous solution that contained leachate. Finally, after long-term irrigation, any possible worsening of soil properties was evaluated. The results demonstrated the real possibility of using blended leachate as a fertigant for the revegetation of the walls of closed landfills. In particular, the plants maintained good health when leachate was blended at concentrations of lower than 25 and 5%, respectively for A. halimus and Lepidium sativum. Irrigation tests showed good resistance of the plants, even at dosages of 112 and 133.5 mm m(-2), at maximum concentrations of 25 and 5%, respectively, for A. halimus and Lepidium sativum. The analysis of the total chlorophyll content and of aerial parts dried weight confirmed the results reported above.