Hybrid microalgae-activated sludge system for carbon-efficient wastewater treatment.

Engineered microalgae-bacteria systems can play a key role in the realisation of energy-efficient carbon-neutral wastewater treatment technologies. An attempt was made to develop a hybrid microalgae-activated sludge (HMAS) system coupling carbon capture with domestic wastewater treatment. Photobioreactors internally illuminated with red light-emitting diodes (LEDs), and inoculated with mixed microbial culture, resulted in substantial savings in operational cost. System performance was evaluated at about 600 µmol/m2 s LED irradiance while treating synthetic municipal wastewater in a chemostat for about 2 months, containing about 250 mg/L soluble chemical oxygen demand (SCOD), 90 mg/L NH3-N and 10 mg/L orthophosphate. Carbon dioxide was supplied into the HMAS at 25 mL/min, 25% v/v. SCOD was efficiently removed from the wastewater (up to 70%) and bacterial oxygen requirement of >2 mg/L was met through microalgal photosynthesis. The system demonstrated its potential in achieving carbon-efficient wastewater treatment.

Dietary management of maternal phenylketonuria with glycomacropeptide and amino acids supplements: A case report.

BACKGROUND: In maternal PKU, protein substitute (PS) is provided by phenylalanine (PHE)-free l-amino acids (AA), but glycomacropeptide-based protein substitute (GMP) is an alternative consideration. OBJECTIVE: To describe the first Portuguese Maternal Phenylketonuria (MPKU) partially managed with GMP. CASE REPORT: A 31 year old MPKU female with classical PKU (mutations P281L/P281L), diagnosed by newborn screening, had a lifelong history of poor metabolic control. She has a history of partial bicornuate uterus and had a previous miscarriage in the first trimester. Pre-conception, her median blood PHE was 462 µmol/L but throughout pregnancy the median reduced to 258 µmol/L. GMP provided 30 g/day protein equivalent (46 mg/day PHE). Total protein equivalent from PS increased from 58 to 86 g/day during pregnancy but AA provided all additional protein equivalent intake. Both GMP and AA were well tolerated with no morning sickness. Normal morphologic evaluation and adequate fetal growth with cephalic biometry near the 5th percentile was determined. The infant was born at 39.3 weeks: weight 2570 g (3rd percentile), length 47.5 cm (10th percentile) and head circumference (HC) of 31.5 cm (1st percentile). In the neonatal period, the infant had craniofacial dimorphism with metopic suture prominence. Father also had bitemporal narrowing. By 12 months of age, the infant's weight (15th percentile), length (50th percentile) and HC (10th-50th percentile) were normal although bitemporal narrowing persisted. CONCLUSIONS: This is the first case reporting the use of GMP in MPKU. Its PHE content did not adversely affect metabolic control although it only provided part of the PS intake. Some intrauterine development delay occurred in the last trimester, although we consider that this is unlikely to be associated with MPKU syndrome or the use of GMP. More published data is essential to examine the impact of using GMP in MPKU on morning sickness severity and aversion, maternal weight gain, blood amino acid concentrations and variability of blood PHE concentrations.

Energy-efficient stirred-tank photobioreactors for simultaneous carbon capture and municipal wastewater treatment.

Algal based wastewater treatment (WWT) technologies are attracting renewed attention because they couple energy-efficient sustainable treatment with carbon capture, and reduce the carbon footprint of the process. A low-cost energy-efficient mixed microalgal culture-based pilot WWT system, coupled with carbon dioxide (CO2) sequestration, was investigated. The 21 L stirred-tank photobioreactors (STPBR) used light-emitting diodes as the light source, resulting in substantially reduced operational costs. The STPBR were operated at average optimal light intensity of 582.7 µmol.s(-1).m(-2), treating synthetic municipal wastewater containing approximately 250, 90 and 10 mg.L(-1) of soluble chemical oxygen demand (SCOD), ammonium (NH4-N), and phosphate, respectively. The STPBR were maintained for 64 days without oxygen supplementation, but had a supply of CO2 (25 mL.min(-1), 25% v/v in N2). Relatively high SCOD removal efficiency (>70%) was achieved in all STPBR. Low operational cost was achieved by eliminating the need for mechanical aeration, with microalgal photosynthesis providing all oxygenation. The STPBR achieved an energy saving of up to 95%, compared to the conventional AS system. This study demonstrates that microalgal photobioreactors can provide effective WWT and carbon capture, simultaneously, in a system with potential for scaling-up to municipal WWT plants.

Axial mesodermal dysplasia complex: a new case with parental consanguinity.

A female is described with axial mesodermal dysplasia complex (AMDC) born to a consanguineous couple. This is thought to be the first description of a patient with AMDC born to consanguineous parents.

[Initial assessment of heart murmurs in children: role of complementary diagnostic tests]. / Avaliação inicial do sopro cardíaco na criança: papel dos exames complementares de diagnóstico.

UNLABELLED: Heart murmur, most of them innocent, are the most common reason for referrals to a pediatric cardiologist. OBJECTIVE: The objective of this study was to analyse the utility of the electrocardiogram (ECG) and echocardiography in the initial assessment of heart murmurs in an asymptomatic pediatric population. MATERIAL AND METHODS: For each of 170 consecutive children who were seen for first time evaluation of a heart murmur, the clinical diagnosis was registered and the patients were classified as having innocent murmur (IM), pathologic murmur (PM), or possible pathologic murmur (PPM). The results of ECG and echocardiogram two-dimensional/Doppler were registered and changes in diagnosis were recorded and compared with the original impressions. RESULTS: After ECG no diagnosis was changed. After two-dimensional/Doppler echocardiogram the clinical diagnosis of innocent murmur in 118 children was changed to pathologic in one (one trivial pulmonary stenosis); pathologic murmurs in 43 children was changed to innocent in two; and possible pathologic in nine children was changed to innocent in six and possible pathologic in three. The clinical examinations had a sensitivity of 97.6%, specificity of 93.6%, positive predictive value of 95.3%, and negative predictive value of 99.1%. CONCLUSIONS: Clinical assessment by a Pediatric Cardiologist is sufficient to distinguish pathologic from innocent heart murmurs. Echocardiography, although diagnostic when heart disease is suspected, is unnecessary in a pediatric patient with clinically diagnosed innocent murmur.

Acute gastric volvulus and congenital posterolateral diaphragmatic hernia.

Acute gastric volvulus in infancy is a rare disorder and a surgical emergency. Prompt clinical suspicion and radiological assessment are essential for this life-threatening condition. We report a 3-month-old female case, admitted for an initial suspicion of an intestinal obstruction. She presented unproductive retching, respiratory distress, epigastric distension and lethargy. It was not possible to introduce a naso-gastric tube. A radiological contrast study showed an occluded cardio-esophageal junction without passage of barium, two gastric fluid levels and a horizontally positioned stomach occupying the inferior portion of the left hemithorax, suggesting a left diaphragmatic hernia. Laparotomy revealed an acute mesenterico-axial gastric volvulus with a left posterolateral diaphragmatic hernia. The stomach volvulus was untwisted, the diaphragmatic defect was repaired after reduction of the herniated contents and no gastropexy was done. At 3 and 6-months follow-up examination the infant was asymptomatic and thriving.

Symmetrical enchondromatosis of the hands and feet in two sisters.

We report two Portuguese sisters aged 9 and 12 years with symmetric well-circumscribed radiolucent cystic lesions on the long bone metaphysis of the hands and feet. The eldest also has soft tissue calcifications. They have no dysmorphic features and their growth is normal. Plasma values of parathyroid hormone (PTH), calcium, phosphorus, magnesium, and alkaline phosphatase are normal. Cerebral computed tomography (CT) scan shows no intracranial calcifications. A Raynaud phenomenon became evident during the last year in the eldest. The incisional biopsy of the left proximal metatarsial was performed through an area of typical radiographic appearance. The pathology specimen consisted of enchondroma tissue. The present cases are an extremely rare instance of this pathology, with symmetrical involvement of the hands and feet and a familial incidence.

Rhizomelic chondrodysplasia punctata-like phenotype in a newborn male with normal peroxisomal function.

A newborn male with the characteristic phenotype of classic rhizomelic chondrodysplasia punctata (RCDP) and with the usual and severe radiographic skeletal abnormalities is described. The parents were young, healthy, and not consanguineous; the mother had not used licit or illicit drugs, alcohol, or tobacco during pregnancy and had not been exposed to radiation or teratogenic chemicals. The clinical phenotype led us to study peroxisomal function. Plasmalogen content in erythrocytes, membrane, and fibroblasts; dihydroxyacetone phosphate acyltransferase (DHAP-AT), alkyldehydroxyaceton phosphate synthetase (a gift from Professor Henk van der Boch, Utrech) in fibroblasts; and phytanic and pristanic acids in plasma showed normal values. Immunocytofluorescence study with antibodies against peroxisomal membrane showed normal organelles. We found no reference in the literature of a case of RCDP with normal peroxisomal functions, but non-CDP has been described with peroxisomal dysfunction. This phenotype (RCDP) may be due to other metabolic error.

[Cleft sternum in an infant]. / Fenda esternal em lactente.

The authors report the clinical case of a female black infant, one month 22 days old, with sternal malformation (complete sternal cleft). She didn't show other associated malformations. Early surgical repair was done with success. The relevant nomenclature of sternal defects is discussed.

[Vascular rings: surgical treatment]. / Anéis vasculares: tratamento cirúrgico.

From 1982 to 1992, nine patients underwent correction of vascular rings. The diagnosis was strongly suggested by symptoms of tracheoesophageal obstruction and was confirmed by barium esophagogram and angiography. Endoscopic studies were considered unnecessary and potentially harmful. Seven patients had double aortic arch, one patient right aortic arch with aberrant left subclavian artery and left ligamentum arteriosum and one patient anomalous origin of the left pulmonary artery. The anomaly was approached through a left thoracotomy in every patient. There were no operative or late deaths. When patients are symptomatic, vascular rings should be promptly repaired. The surgical risk is minimal, and the long term results are excellent.