Valorization of phosphogypsum waste as asphaltic bitumen modifier

The accumulation of phosphogypsum waste from the fertilizer industries, which remain in regulated stacks occupying considerable land resources, is causing significant environment problems worldwide. In that sense, the scientific community is being pressured to find alternative ways for their disposal. In this research, we propose a novel application for phosphogypsum waste, as a modifier of bitumen for flexible road pavements. Viscous flow tests carried out on bitumen modified with a phosphogypsum waste and doped with sulfuric acid demonstrated an extraordinary increase in viscosity, at 60°C, when compared to a counterpart sample which had been modified with gypsum, the main component of phosphogypsum. Similarly, a significant improvement in the viscoelastic response of the resulting material at high temperatures was also found. FTIR (Fourier transform infrared spectroscopy) scans provided evidences of the existence of chemical reactions involving phosphorus, as revealed by a new absorption band from 1060 to 1180cm(-1), related to COP vibrations. This result points at phosphorus contained in the phosphogypsum impurities to be the actual "modifying" substance. Furthermore, no COP band was observed in the absence of sulfuric acid, which seems to be the "promoting" agent of this type of bond.

A 40-month multicentre, randomised placebo-controlled study to assess the efficacy and carry-over effect of repeated intra-articular injections of hyaluronic acid in knee osteoarthritis: the AMELIA project

Objective

AMELIA (OsteoArthritis Modifying Effects of Long-term Intra-articular Adant) was designed to compare against placebo the efficacy and safety of repeated injections of hyaluronic acid (HA) and its effect on disease progression over 40 months.

Methods

A multicentre, randomised, patient and evaluator-blinded, controlled study in 306 patients fulfilling American College of Rheumatology criteria for knee osteoarthritis, radiological grades II–III (Kellgren–Lawrence) and joint space width ≥2 mm. Patients received four cycles of five intra-articular HA or placebo injections with a follow-up of 6 months after the first and second cycles, and 1 year after the third and fourth cycles. Osteoarthritis Research Society International (OARSI) 2004 responder criteria were used to assess efficacy. The consumption of rescue medication was a secondary outcome. Adverse events were recorded for safety purposes.

Results

At the 40-month visit significantly more patients responded to HA compared with placebo (OARSI 2004, p=0.004). The number of responders to HA increased through the study, whereas those to placebo did not change. Significant differences were also found in favour of HA for each individual component of the OARSI 2004. No safety problems were recorded.

Conclusions

The results of AMELIA offer pioneer evidence that repeated cycles of intra-articular injections of HA not only improve knee osteoarthritis symptoms during the in-between cycle period but also exert a marked carry-over effect for at least 1 year after the last cycle. In this respect, it is not possible to establish if this carry-over effect reflects true osteoarthritis remission or just a modification of the disease's natural course.

ClinicalTrials.gov number, NCT00669032

[Illegal drug use by secondary school children in Belgium: north-south differences]

The study "Health Behaviour of Youngsters" regularly provides comparative data on health behaviour and related lifestyle of pupils from 11 to 18 years old. This study is based on repeated surveys among randomised representative samples of pupils, following the international standardised protocol from the WHO cross-national survey "Health Behaviour in School-aged Children". In Belgium, results from the 1990 survey (sample = 3528) show differences in illegal drugs use between the South (French-speaking) and the North (Flemish-speaking). For example, among the 17 year olds, 9.8% of the French-speaking pupils and 5.5% of the Flemish-speaking have already tried illegal drug(s) and in the same age groups, 2.9% and 1.5%, respectively declare to be regular users. The first hypotheses concerning those differences take into account the socio-economic and cultural environment as well as methodological problems inherent to these surveys.

In vivo analysis of disease modifying drug therapy activity in rheumatoid arthritis by sequential immunohistological analysis of synovial membrane interleukin 1 beta

OBJECTIVE

To assess sequential changes of synovial membrane interleukin 1 beta (IL-1 beta) in patients with rheumatoid arthritis receiving chrysotherapy and glucocorticoids.

METHODS

Sequential synovial biopsies taken before and after 2 and 12 weeks of treatment were analyzed by immunohistological techniques.

RESULTS

Significant decreases in IL-1 beta staining occurred in biopsies taken after 12 weeks' chrysotherapy, while mononuclear cell numbers were unchanged. Results were similar in patients receiving glucocorticoid and gold, and in those receiving gold alone.

CONCLUSION

These data suggest that chrysotherapy reduces IL-1 beta production in vivo, a property that has been shown in vitro, and that this change precedes changes in synovial membrane mononuclear cell numbers.

Anti-neutrophil cytoplasmic antibody-associated paraneoplastic vasculitis

A 68 year old man presented with a systemic necrotizing vasculitis and elevated levels of anti-neutrophil cytoplasmic antibody (ANCA) which responded to treatment with steroids and cyclophosphamide, with a decrease in the titre of ANCA until its disappearance. Four months later he presented with weakness, loss of weight, aphonia and dysphagia. A computerized tomography scan showed a solid mass in the anterior mediastinum, and histological studies revealed an undifferentiated adenocarcinoma. Vasculitis improved although the malignancy progressed and ANCA was persistently negative. Our case demonstrates an association between ANCA and paraneoplastic vasculitis.

[Flurbiprofen: therapeutic alternative in nephritic colic]

A double blind randomized study was conducted in 52 patients with renoureteric colic to compare the therapeutic efficacy of two analgesics given in a single intramuscular dose. Following the administration of 2 gm dipirone plus 20 mg hyoscine N-butylbromide (n = 26) or 150 mg flurbiprofen (n-26), the patients were assessed for pain intensity, relief and pain status for a period of one hour. Both treatments afforded a similar analgesic effect, with pain remitting in 76.9% of the cases. No significant differences were observed for the latency periods or degree of pain at 5, 10, 30 and 60 minutes following treatment. Additional analgesic therapy was required in 34.6% of the patients who received dipirone and 26.9% of the flurbiprofen group, the difference not being statistically significant. Overall both drugs were well tolerated and only local adverse effects were observed, pain being the most frequent.

Involvement of platelet-activating factor and tumour necrosis factor in the pathogenesis of joint inflammation in rabbits

We have studied the participation of platelet-activating factor (PAF) in antigen-induced arthritis in rabbits, as well as the possible co-operation between PAF and tumour necrosis factor (TNF) in their ability to induce joint inflammation when injected into the knees of healthy rabbits. The administration of two structurally different PAF receptor antagonists, BN52021 and Alprazolam, from 4 h before the intra-articular injection of ovalbumin in preimmunized rabbits, induced an important reduction in the synovial fluid volume, in the amount of cells infiltrating the articular cavity and the synovial membrane, as well as in the prostaglandin E2 (PGE2) concentration. Furthermore, proteoglycans of the articular cartilage, which were found diminished in animals with non-treated arthritis, were well preserved in rabbits treated with PAF antagonists. All the synovial fluids from joints with arthritis had detectable amounts of PAF. The injection of either TNF or PAF into the joints of normal rabbits induced a mild inflammation. When TNF was administered 1 h before PAF, a synergistic response was noted in the synovial fluid volume, in the accumulation of leucocytes, and in the amount of PGE2. The administration of BN50726, a hetrazepine with a potent PAF-receptor antagonist effect, induced a diminution in those parameters. Our results suggest that PAF may be an early and important mediator of joint damage, and that TNF can amplify the inflammatory response induced by PAF. PAF receptor antagonists could play some role in the treatment of inflammatory joint diseases.

[Renal fungal infection: presentation forms and therapeutic advances]

Fluconazole is a broad spectrum anti-fungal agent which combines good tolerance, efficacy and low toxicity, and offers useful advantages in the treatment of certain forms of mycosis. Three cases of renal fungal disease treated with surgery (nephrectomy in two cases and pyelolitectomy plus partial nephrectomy in the third one) and fluconazole or amphotericin B are presented. In all three cases there was at least one predisposing factor (diabetes, urolithiasis, urinary catheter, previous therapy with antibiotics, or AIDS), and the causing pathogens were Candida and Mucor. Administration of fluconazole 100 mg b.i.d. for 4 weeks in the two candida infected patients accomplished a complete cure of the disease. Incidence, etiopathology, presentation forms and diagnostic techniques of urinary mycosis are analyzed together with the current therapeutical options, making special reference to fluconazole.