Electrodialysis with Bipolar Membranes for the Generation of NaOH and HCl Solutions from Brines: An Inter-Laboratory Evaluation of Thin and Ultrathin Non-Woven Cloth-Based Ion-Exchange Membranes

The SEArcularMINE project aims to recover critical raw materials (CRMs) from brines from saltworks, thus facing a CRM shortage within Europe. To promote a fully circular scheme, the project valorises concentrated brines using electrodialysis with bipolar membranes (EDBM) to generate the required amounts of reactants (i.e., acids and bases). Regarding the performances of new non-woven cloth ion-exchange membranes (Suez): (i) an ultra-thin non-woven polyester cloth and (ii) a thin polypropylene cloth acting as the support structures were assessed. Additionally, the anion layer includes a catalyst to promote the water dissociation reaction. The effect of current density (100, 200, and 300 A m^-2) on the performance of two combinations of membranes in an inter-laboratory exercise using 2 M NaCl was evaluated. According to statistical analysis ANOVA, there was an agreement on the results obtained in both laboratories. NaOH/HCl solutions up to 0.8 M were generated working at 300 A m^-2 using both combinations of membranes. Regarding the performance parameters, stack set-ups incorporating thin polypropylene membranes showed lower specific energy consumption (SEC) and higher specific productivity (SP) than ultra-thin polypropylene ones. Hence, for ultra-thin polypropylene membranes, SEC was reported to be between 2.18 and 1.69 kWh kg^-1_NaOH and SP between 974 and 314 kg m^-2 y^-1.

[The effect of donepezil in comparison with conventional treatment on cognitive functioning and the performance of the patient in a prospective cohort of patients with Alzheimer's disease treated in routine clinical practice in Spain]

AIMS

Our aim was to perform a secondary analysis of a 12-month-long, non-blind, multi-centre prospective cost-of-illness study. The analysis assessed the effect of donepezil on cognitive functioning and the performance of patients with possible or probable Alzheimer's disease, compared to that of other drugs for dementia.

PATIENTS AND METHODS

A sample of 700 patients took part in the study (76.8 ± 6.6 years of age, 67.3% females): 600 (31.4% drug-naive) received donepezil and 100 (9% drug-naive) were given other drugs for dementia.

RESULTS

The mean variations corrected by the baseline values and the centre of the total scores on the Folstein minimental test, the clinical dementia rating and Blessed dementia rating scales at 12 months were significantly lower in patients treated with donepezil: -1.23 ± 3.41 versus -2.26 ± 3.07 (p = 0.006), 0.20 ± 0.68 versus 0.39 ± 1.03 (p = 0.014) and 1.28 ± 3.31 versus 2.04 ± 2.84 (p = 0.027), respectively.

CONCLUSIONS

This secondary analysis shows that the deterioration in the cognitive functioning and performance of patients with the passage of time is slower with donepezil than with other drugs for dementia in routine medical practice. Since these results were observed in a post hoc analysis, formal prospective clinical trials should be conducted to confirm these findings.

[The cost of informal care associated to incapacitating neurological disease having high prevalence in Spain]

INTRODUCTION

The aim of the present work is to review the Spanish literature on informal care cost in patients with a high prevalence of incapacitating neurological diseases. Stroke, dementia (including Alzheimer's disease), Parkinson's disease and multiple sclerosis were distinguished in this group.

METHODS

The different methods of evaluation of the informal care were also reviewed prior to analyzing the national literature on the topic. A systematical search was done in MEDLINE, ECONLIT, ABI-INFORM, CSIC data bases, IME (Index Medicus) and ISOC databases. Google was also used for searching <<grey literature>>. Initially, approximately 300 national and international articles were identified and reviewed. Only 11 works were selected to be included and analyzed in depth. Only articles that estimated informal costs from a patient sample of one of the mention diseases considered to fulfill the inclusion criteria.

RESULTS

Seven articles referred to Alzheimer's disease, three to stroke, and one to multiple sclerosis.

CONCLUSIONS

In spite of the difficulty of comparing studies of different countries and of the methodological differences between the Spanish studies, there is an agreement that the non-health care costs (informal and indirect costs) had a greater weight than the health care ones on the total estimated cost of each one of the diseases studies.

[Subarachnoid hemorrhage as a form of onset of systemic lupus erythematosus]

INTRODUCTION

The most frequent cause of spontaneous subarachnoid hemorrhage (SAH) is rupture of intracranial arterial aneurysms (> 70%). The remainder are due to many different aetiologies. Although SAH is a relatively common neuropathological finding in systemic lupus erythematosus (SLE), it is normally due to the extent of the intercerebral hemorrhage and not to its isolated presentation.

CLINICAL CASE

We report the case of a 34 year old woman who presented with non-traumatic SAH at the onset of her lupus disorder. The patient was attended for SAH and at the same time a multisystemic disorder and severe thrombocytopenia were found, leading to a diagnosis of SLE. The neuroimaging techniques, selective cerebral arteriography, cerebral and spinal magnetic resonance, and magnetic resonance angiography did not show any vascular malformations. The patient was treated with immunosuppressive therapy, nimodipine, and following angiographic tests, with antiaggregants and anticoagulants.

CONCLUSIONS

The greater frequency of SAH in patients with lupus, as compared to the general population, has been attributed to the presence of intracranial vasculitis. However, neuropathological studies have shown that true vasculitis is very infrequent in the central nervous system of SLE patients. In the case we describe, the first in which SAH appeared at the onset of the disease, we consider that the origin of the hemorrhage was her high arterial blood pressure and thrombopenia.

[Record of neurological emergencies at a tertiary care hospital]

INTRODUCTION AND OBJECTIVE

There is a progressive increase in the demand for multidisciplinary attention from the Emergency Medical Services. The objective of this study was to determine the proportion of neurological conditions in the total hospital emergency workload, their demographic composition and medical needs.

PATIENTS AND METHODS

We present an observational study of a cohort of histories of neurological emergencies at a tertiary hospital during a period of one year.

RESULTS

On analysis of all emergencies, 1,592 were neurological conditions. The duty neurologist was consulted in 87.9% of the cases. The average age was 59, and the majority were women (56.3%). Maximum demand was between 14.00 and 19.59 hours. Monday was the day of the week when most were seen. The commonest causes of consultation were change in strength or language, headache and epileptic crises. The complementary investigation done most frequently was a blood test. Cerebral CT scan were done in 31.9% of the patients. The diagnoses most often made, as a group, were cerebrovascular disease followed by epilepsy and headache. The majority of the patients were referred to Primary Care Centres or for neurological consultation. When the patients were grouped according to the specialties with doctors on duty, the second largest group were seen by the emergency neurologist at our hospital.

CONCLUSION

In view of the above results, we consider the presence of a neurologist in the Emergency Department to be fully justified.

[Predictive mortality factors and the development of major complications in non-traumatic subarachnoid hemorrhage]

Our aim was to analyze death prognostic factors in the first six months or the development of major neurological complications (delayed brain ischaemia and rebleeding) or general complications (cardiorespiratory, hydroelectrolytic or infectious) in non-traumatic subarachnoid haemorrhage. We carried out an observational study of a historical cohort of 111 patients admitted consecutively to our Centre between 1986 and 1992 and who were diagnosed as having subarachnoid haemorrhage based upon clinical data and confirmed in all cases by brain computerized tomography (CT) scan and/or lumbar puncture. Clinical variables upon admission were collected prospectively and radiological data were obtained retrospectively. We performed a logistic regression analysis which showed as significant predictive variables for death in the first six months a score on the Hunt-Hess scale greater than 2, a score on the Glassow scale of less than 9, female, aged over 50 and rebleeding. As predictive factors for delayed brain ischaemia we identified the female sex and the existence of earlier general complications. In the development of rebleeding a significant predictive factor was high blood pressure antecedents although this may have been controlled upon admission. For the appearance of general complications, significant predictive factors were more than 2 on the Hunt-Hess scale and hypertension antecedents. The use of these predictive parameters may help evaluate a prognosis in subarachnoid haemorrhage patients and also help make decisions in the management of this pathology.

[Application of immunologic methods to the analysis of bio-leaching bacteria]

Pure cultures of Thiobacillus ferrooxidans and mixed cultures of Thiobacillus ferrooxidans and Leptospirillum ferrooxidans isolated from the Matahambre mine (Cuba) were used to fit immunodiffusion and immunoelectron microscopy to the study of iron oxidizing bacteria. The possibilities, advantages and limits of those techniques have been studied from both the identification and the serological characterization points of view. Finally, the efficiency of these methods was tested by applying them to the identification of microorganisms from acidic waters from the mine.

Thiobacillus ferrooxidans detection using immunoelectron microscopy

A specific, fast and very sensitive immunoelectron microscopy method was developed to morphologically and serologically distinguish different cultures of iron oxidizers. Bacteria isolated from the acidic waters of "Matahambre" and "Mina Delita" mines (Cuba) were characterized. An antiserum specific to Thiobacillus ferrooxidans did not react with other bacteria also present in the acidic waters of mine drainage. Our results suggest the occurrence of some strains of Thiobacillus ferrooxidans, Thiobacillus thiooxidans and Leptospirillum ferrooxidans in these waters.