Life Cycle Assessment of a system for the extraction and transformation of Waste Water Treatment Sludge (WWTS)-derived lipids into biodiesel.

In recent years, the demand for biofuels has been growing exponentially, as has the interest in biodiesel produced from organic matrices. Particularly interesting, due to its economic and environmental advantages, is the use of the lipids present in sewage sludge as a raw material for the synthesis of biodiesel. The possible processes of this biodiesel synthesis, starting from lipid matter, are represented by the conventional process with sulfuric acid, by the process with aluminium chloride hexahydrate and by processes that use solid catalysts such as those consisting of mixed metal oxides, functionalized halloysites, mesoporous perovskite and functionalized silicas. In literature there are numerous Life Cycle Assessment (LCA) studies concerning biodiesel production systems, but not many studies consider processes that start from sewage sludge and that use solid catalysts. In addition, no LCA studies were reported on solid acid catalysts nor on those based on mixed metal oxides which present some precious advantages, over the homogeneous analogous ones, such as higher recyclability, prevention of foams and corrosion phenomena, and an easier separation and purification of biodiesel product. This research work reports the results of a comparative LCA study applied to a system that uses a solvent free pilot plant for the extraction and transformation of lipids from sewage sludge via seven different scenarios that differ in the type of catalyst used. The biodiesel synthesis scenario using aluminium chloride hexahydrate as catalyst has the best environmental profile. Biodiesel synthesis scenarios using solid catalysts are worse due to higher methanol consumption which requires higher electricity consumption. The worst scenario is the one using functionalized halloysites. Further future developments of the research require the passage from the pilot scale to the industrial scale in order to obtain environmental results to be used for a more reliable comparison with the literature data.

Extrapyramidal syndromes in neuroleptic-treated patients: prevalence, risk factors, and association with tardive dyskinesia.

Prevalence and risk factors for extrapyramidal syndromes (EPS) were investigated in a sample of 1,559 patients. The overall prevalence of EPS was 29.4% (N = 458). Among the EPS-diagnosed patients, parkinsonism as assessed by the presence of core parkinsonian symptoms (rigidity, tremor, bradykinesia) was present in 65.9% of patients (N = 302), akathisia in 31.8% (N = 145), and acute dystonia in 2.1% (N = 10). Old age and long-term neuroleptic drug (NL) treatment were significantly associated with EPS in both the univariate and the multivariate analyses, whereas no relationship was observed with average NL daily doses and current NL treatment. EPS was diagnosed in 50.2% of 285 patients with persistent tardive dyskinesia (TD). Distribution of EPS in patients with TD showed that tremor and akathisia were more frequent in peripheral TD cases than in orofacial TD cases. Furthermore, there was a stronger association of NL-induced parkinsonism with peripheral TD than with orofacial TD. This study suggests that the association between EPS and TD may be limited to specific subtypes of TD. Peripheral TD showed a higher association with parkinsonism and with akathisia, suggesting that these symptoms may share a common pathophysiology.

Persistent tardive dyskinesia: demographic and pharmacological risk factors.

The demographic, clinical and pharmacological risk factors for persistent tardive dyskinesia (TD) were investigated in a sample of 1745 patients. When simultaneously adjusting for the effects of demographic and pharmacological factors using multivariate logistic regression, female sex and advanced age were positively and significantly associated with increased risk of TD. Interaction between these two variables, investigated by cross-stratification, was significant. Furthermore, high neuroleptic dose and concomitant use of neuroleptic and antiparkinsonian drugs were both significantly associated with increased risk of TD. The results support the view that both vulnerability factors and high neuroleptic doses contribute to the occurrence of TD and further stress the relevance of a conservative use of antipsychotic medication, particularly in older women.

Pattern of therapeutic intervention and role of psychiatric settings: a survey in two regions of Italy.

A survey of therapeutic intervention was conducted on 1513 patients treated in different psychiatric settings-psychiatric hospitals (PH), private facilities (PF), community mental health centers (CMHC) and psychiatric wards in general hospitals (PWGH). Psychotropic drugs, mainly neuroleptics and benzodiazepines, were widely prescribed irrespective of diagnosis, and 39% of patients treated with neuroleptics received two or more drugs. Psychotherapeutic intervention and social measures were administered in 21% and 20% of cases respectively, and 17% of patients received no treatment. The observed distribution of treatments over settings was compared with the expected one under the hypothesis that the two factors were independent. Differences between settings in therapeutic strategies, after adjustment for possible confounders (sex, age, education, diagnosis) were: no specific treatment was more than expected in PH and largely below unity in PF and PWGH, where treatment with psychotropic drugs alone was overrepresented; CMHC showed the most balanced therapeutic approach.

Response to dexamethasone in affective disorder outpatients.

Plasma cortisol suppression following 1 mg dexamethasone administration was investigated in patients with affective disorders. Twenty-nine depressed outpatients, 8 bipolar depressed inpatients during manic or hypomanic phase, and twelve healthy volunteers entered the study. Depressed patients were divided into 2 groups according to Research Diagnostic Criterio of Spitzer et al. (1978). The first group consisted of 10 patients affected by minor depressive disorders. The second group was formed of 19 patients with major depressive disorders (7 bipolar, 12 unipolar). No difference between patients and controls was found in baseline 4.00 p.m. serum cortisol levels. Healthy volunteers, patients with minor depressive disorders and bipolar subjects in manic or hypomanic phase showed normal suppression. On the other hand, only 42% of patients with major depressive disorders showed suppression. These results suggest that altered response to dexamethasone is a state-dependent phenomenon. Moreover, a dexamethasone suppression test is able to identify subgroups of suppressor in affected patients.