Assessment of wastewater effluent quality in Thessaly region, Greece, for determining its irrigation reuse potential.

The objective of the present study is to assess wastewater effluent quality in Thessaly region, Greece, in relation to its physicochemical and microbiological burden as well as its toxic potential on a number of organisms. Wastewater may be used for agricultural as well as for landscape irrigation purposes; therefore, its toxicity potential is quite important. Thessaly region has been chosen since this region suffers from a distinct water shortage in summer period necessitating alternative water resources. During our research, treated effluents from four wastewater treatment plants operating in the region (Larissa, Volos, Karditsa, and Tirnavos) were tested for specific physicochemical and microbiological parameters [biochemical oxygen demand (BOD(5)), chemical oxygen demand (COD), total suspended solids (TSS), pH, electrical conductivity, selected metals presence (Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Zn, As), and fecal coliforms' (FC) number]. The effluents were also tested for their toxicity using two different bioassays (Daphnia magna immobilization test and Phytotoxkit microbiotest). The findings were compared to relative regulations and guidelines regarding wastewater reuse for irrigation. The results overall show that secondary effluents in Thessaly region are generally acceptable for reuse for irrigation purposes according to limits set by legislation, if effective advanced treatment methods are applied prior to reuse. However, their potential toxicity should be closely monitored, since it was found that it may vary significantly in relation to season and location, when indicator plant and zooplankton organisms are used.

Combined pancreatic islet-lung transplantation: a novel approach to the treatment of end-stage cystic fibrosis.

Patients with end-stage cystic fibrosis (CF) and severe CF-related diabetes (CFRD) may benefit from combined lung-pancreatic islet transplantation. In the present study, we report the long-term follow-up of four end-stage CF patients treated with combined bilateral lung and pancreatic islet transplantation from the same donor. All patients were C-peptide negative (<0.5 microg/L) and inadequately controlled despite intensive insulin treatment. One patient was transplanted with 4 019 +/- 490 islet equivalent/kg injected into the transverse colic vein using a surgical approach. In the remaining three patients, islets were cultured for 3-6 days and transplanted by percutaneous transhepatic catheterization of the portal vein. In all patients, islet allograft recovery was recognized by elevation in the plasma level of C-peptide (>0.5 microg/L). At 6 months after transplantation, one patient showed multiple episodes of acute lung transplant rejection and a progressive decline in pancreatic islet cell function. Three out of four patients experienced an improved control of glucose levels with a HbA1c of 5.2%, 7% and 6% respectively at 1.5, 2 and 15 years follow-up. Compared with the pretransplant period, there was a 50% reduction in mean daily insulin needs. Pulmonary function remained satisfactory in all patients. In conclusion, our cases series shows that combined bilateral lung and pancreatic islet transplantation may be a viable therapeutic option for patients with end-stage CF and CFRD.