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Two advanced oxidation processes (AOPs), namely ozone/H2O2 and UV/H2O2, were tested at pilot scale as zero-liquid-discharge alternative treatments for the removal of microbiological (bacteria and viruses), chemical (compounds of emerging concern (CECs)) and genotoxic responses from tertiary municipal wastewater for indirect potable reuse (IPR). The AOP treated effluents were further subjected to granular activated carbon (GAC) adsorption and UV disinfection, following the concept of multiple treatment barriers. As a reference, a consolidated advanced wastewater treatment train consisting of ultrafiltration, UV disinfection, and reverse osmosis (RO) was also employed. The results showed that, for the same electrical energy applied, the ozone/H2O2 treatment was more effective than the UV/H2O2 treatment in removing CECs. Specifically, the ozone/H2O2 treatment, intensified by high pressure and high mixing, achieved an average CECs removal efficiency higher than UV/H2O2 (66.8% with respect to 18.4%). The subsequent GAC adsorption step, applied downstream the AOPs, further improved the removal efficiency of the whole treatment trains, achieving rates of 98.5% and 96.8% for the ozone/H2O2 and UV/H2O2 treatments, respectively. In contrast, the ultrafiltration step of the reference treatment train only achieved a removal percentage of 22.5%, which increased to 99% when reverse osmosis was used as the final step. Microbiological investigations showed that all three wastewater treatment lines displayed good performance in the complete removal of regulated and optional parameters according to both national and the European Directive 2020/2184. Only P. aeruginosa resulted resistant to all treatments with a higher removal by UV/H2O2 when higher UV dose was applied. In addition, E. coli STEC/VTEC and enteric viruses, were found to be completely removed in all tested treatments and no genotoxic activity was detected even after a 1000-fold concentration. The obtained results suggest that the investigated treatments are suitable for groundwater recharge to be used as a potable water source being such a procedure an IPR. The intensified ozone/H2O2 or UV/H2O2 treatments can be conveniently incorporated into a multi-barrier zero-liquid-discharge scheme, thus avoiding the management issues associated with the retentate of the conventional scheme that uses reverse osmosis. By including the chemical cost associated with using 11-12 mg/L of H2O2 in the cost calculations, the overall operational cost (energy plus chemical) required to achieve 50% average CECs removal in tertiary effluent for an hypothetical full-scale plant of 250 m3/h (or 25,000 inhabitants) was 0.183 /m3 and 0.425 /m3 for ozone/H2O2 and UV/H2O2 treatment train, respectively.
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Agua Potable , Ozono , Contaminantes Químicos del Agua , Purificación del Agua , Aguas Residuales , Peróxido de Hidrógeno/química , Escherichia coli , Oxidación-Reducción , Carbón Orgánico , Purificación del Agua/métodos , Ozono/química , Contaminantes Químicos del Agua/química , Rayos UltravioletaRESUMEN
UV-C at 254â¯nm and vacuum UV (VUV) at 185â¯nm are the two major emission lines of a low-pressure mercury lamp. Upon absorption of VUV photons, water molecules and selected inorganic anions generate hydroxyl (HO.) and other redox radicals, both capable of degrading organic micropollutants (OMPs), thereby offering the opportunity to reduce H2O2 and energy consumption in UV-based advanced oxidation process (AOP). To be successfully scaled-up, the dual-wavelength VUV+UV/H2O2 AOP requires laboratory-scale experiments to establish design criteria. The figures of merit typically used for reporting and interpreting quasi-collimated beam results for UV-based AOPs (time, dose, absorbed energy and EEO) are insufficient and inaccurate when employed for dual-wavelength AOP such as the VUV+UV/H2O2 AOP, and do not support system scale-up. In this study, we introduce a novel figure of merit, useful absorbed energy (uAE), defined as fraction of absorbed energy that results in the generation of oxidative radicals. Here, results of quasi-collimated beam VUV+UV/H2O2 AOP experiments on four different water matrices are used to introduce 2D plots that employ both uAEUV and uAEVUV as a novel method to represent laboratory-scale experiments of VUV+UV/H2O2 AOP and demonstrate how the 2D plots sufficiently support scale-up of the AOP.
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This study explored process synergies attainable by integrating a vacuum ultraviolet-based advanced oxidation process with biofiltration. A comparison using granular activated carbon or granular zeolite as filtration media were examined in context of advanced wastewater treatment for potable reuse. Six biofiltration columns, three with granular activated carbon and three with granular zeolite, were operated in parallel and batch-fed daily with nitrified secondary effluent. After achieving a pseudo-steady state through the filter columns, vacuum ultraviolet treatment was applied as pre-treatment or as post-treatment, at two different applied energies (i.e., VUV-E1=1 kWh/m3 and VUV-E10=10 kWh/m3). Once granular activated carbon had transitioned to biologically activated carbon, as determined based on soluble chemical oxygen demand removal, adsorption was still observed as the main mechanism for contaminants of emerging concern and nitrate removal. Vacuum ultraviolet pre-treatment markedly improved contaminants of emerging concern removal through the integrated system, achieving 40% at VUV-E1 and 90% at VUV-E10. When applied as post-treatment to zeolite column effluents, VUV-E1 and VUV-E10 further increased contaminants of emerging concern removal by 20% and 90%, respectively. In the zeolite system, vacuum ultraviolet pre-treatment also increased soluble chemical oxygen demand removal efficiency, indicating that higher energy vacuum ultraviolet increased biodegradability. Total prokaryotes were two-fold more abundant in biologically activated carbon than in zeolite, with vacuum ultraviolet pretreatment markedly affecting microbial diversity, both in terms of richness and composition. Media type only marginally affected microbial richness in the biofilters but showed a marked impact on structural composition. No clear relationship between compositional structure and depth was observed.
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Contaminantes Químicos del Agua , Purificación del Agua , Zeolitas , Carbón Orgánico/química , Oxidación-Reducción , Rayos Ultravioleta , Vacio , Aguas Residuales/química , Contaminantes Químicos del Agua/químicaRESUMEN
The prevalence of vector-associated parasitic infections is high in central-southern Italy. The deltaic coastal plain of the Volturno River has been suspected, by veterinary practitioners, to have a high accidental incidence of Dirofilaria repens. Thus, the goal of this study was to evaluate the prevalence of dirofilariasis and other coinfections frequently described in dogs living in the Volturno area. Blood samples of 100 clinical asymptomatic dogs were examined using a Knott's technique and polymerase chain reaction in order to identify microfilariae. Other vector-borne coinfections were also investigated using ELISA kits. The results were analysed using statistical and Geographic Information System (GIS) software. Microfilariae of D. repens were detected in 10% of the dogs surveyed, with a presence of antibodies against Ehrlichia canis (4/10) and Dirofilaria immitis (1/10). Such high incidence should be considered in light of the zoonotic potential for D. repens and the support for more regular use of repellents to prevent the spread of this disease. The GIS analyses indicated that the study area provides suitable conditions to sustain populations of mosquito vectors and D. repens parasites throughout much of the year.
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Dirofilaria immitis , Dirofilaria repens , Dirofilariasis , Enfermedades de los Perros , Animales , Dirofilariasis/parasitología , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/parasitología , Perros , Italia/epidemiología , PrevalenciaRESUMEN
NbRe-based superconducting thin films recently received relevant interest in the field of low-temperature electronics. However, for these materials the electrical conduction mechanisms, in particular in the normal state, still need to be investigated in more detail. Here, NbRe and NbReN films of different thicknesses have been deposited on two different substrates, namely monocrystalline Si and [Formula: see text] buffered Si. The films were characterized by DC electrical transport measurements. Moreover, a connection with the charge carriers fluctuation processes has been made by analyzing the electrical noise generated in the normal state region. Despite the films morphology seems not to be affected by the substrate used, a lower noise level has been found for the ones grown on [Formula: see text], in particular for NbReN. From this study it emerges that both NbRe and NbReN ultrathin films are of very good quality, as far as the low-temperature electrical noise and conduction are concerned, with noise levels competitive with NbN. These results may further support the proposal of using these materials in a nanowire form in the field of superconducting electronics.
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INTRODUCTION: Factor XI (FXI) deficiency is a rare congenital hemostatic disorder associated with increased bleeding tendency in trauma, surgery or when other hemostatic defects are present. Perioperative hemostatic management of a patient with a severe FXI deficiency undergoing major oncological liver and colorectal surgery with therapeutic plasma exchange (TPE) with fresh frozen plasma (FFP) is reported. CASE DESCRIPTION: A 54-year-old male with severe FXI deficiency was scheduled for resection of synchronous rectal cancer and multiple liver metastases. Baseline prothrombin time (PT) was 97 %, activated partial thromboplastin time (aPTT) 89 s(s) and FXI levels <1 IU/dL. The rotational thromboelastometry (ROTEM™) presented a prolonged INTEM clotting time (CT) = 443 s (RV 100-240 s) and a clot formation time (CFT) = 110 s (RV 30-100 s). TPE with FFP was carried out achieving FXI levels up to 46 IU/dL and an aPTT of 33 s, normalizing thromboelastometry parameters to an INTEM CT = 152 s and a CFT = 86 s before the procedure. After surgery, the patient received daily FFP to maintain FXI levels above 30 IU/dL until discharge on the eighth day. A total of 30 FFP units were transfused during hospital stay. No significant bleeding events neither transfusion related complications were observed during the perioperative period. CONCLUSION: Given the lack of correlation between FXI levels and bleeding risk, a multidisciplinary approach based on daily FXI levels monitoring, close clinical assessment and factor supplementation is mandatory. In conclusion, TPE with FFP is an efficacious alternative strategy to correct severe FXI deficiency in patients undergoing major surgery.
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Neoplasias Colorrectales/terapia , Deficiencia del Factor XI/terapia , Neoplasias Hepáticas/terapia , Intercambio Plasmático/métodos , Neoplasias Colorrectales/complicaciones , Deficiencia del Factor XI/complicaciones , Hemorragia/complicaciones , Hemostasis , Hemostáticos/uso terapéutico , Humanos , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/secundario , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Tiempo de Tromboplastina Parcial , Plasma , Plasmaféresis , Tiempo de Protrombina , Reproducibilidad de los Resultados , Tromboelastografía , ViscosidadRESUMEN
A comprehensive pilot study was carried out to experimentally assess the potential of newly developed treatment trains integrating two-stage AOPs and biofiltration to reach potable reuse water quality standards from municipal wastewater. The processes consisted of a two-stage AOPs with (carbon or limestone) biofiltration, the first AOP (O3/H2O2) serving as pre-treatment to biofiltration and the second AOP (UV254/H2O2) serving as post-biofiltration finishing step to ensure advanced disinfection. A comprehensive monitoring campaign was put in place resulting from the combination of targeted, non-targeted and suspect screening measurements. It was found that 13 organic micropollutants were detected from a list of 219 suspects although at ng/L level only. For the treatment conditions piloted in this study (O3â¯=â¯13⯱â¯0.5â¯mg/L, H2O2â¯=â¯11⯱â¯0.4â¯mg/L for the O3/H2O2 process, and UVâ¯=â¯410⯱â¯63.5â¯mJ/cm2, H2O2â¯=â¯5â¯mg/l for the UV254/H2O2 process), it was possible to estimate the overall removal efficacy for each unit process, which was found to follow this order: RO (99%)⯠>â¯BAC (87%) >â¯O3-H2O2 (78%)⯠>â¯BAL (67%) â¯>â¯UV/H2O2 (43%)⯠>â¯AOP contact chamber (19%)⯠>â¯UF(0%), with the treatment train integrating two AOPs and granular biofiltration with activated carbon (O3/H2O2 + BAC + UV254/H2O2) showing superior performance with a 99% abatement in total micropollutants. No ecotoxicologically-positive response was generally observed for any of the effluent samples from the tested trains, even when pre-concentration factors up to 100-1000 times were employed to increase the sensitivity of the bioassay methods.
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Agua Potable/química , Filtración/métodos , Aguas Residuales/química , Contaminantes Químicos del Agua/análisis , Purificación del Agua/métodos , Carbón Orgánico/química , Desinfección , Peróxido de Hidrógeno/química , Oxidación-Reducción , Ozono/química , Proyectos Piloto , Rayos UltravioletaRESUMEN
PURPOSE: To present our experience in the management of acute large bone defects treated with the use of vascularized fibular grafts supported by Ilizarov circular external frames. PATIENTS AND METHODS: During a period of 6 years (from 2007 to 2013) 8 patients with acute large bone defects (IVB according to Winquist modified classification) were treated at our institution with early bone reconstruction by means of microvascular fibular grafts. All patients were evaluated by the use of the following parameters: X-ray consolidation, discharge time, duration of treatment, malalignment of the lower limb and final leg length discrepancy, knee and ankle mobility (ROM), pain (VAS), number of eventual additive treatments (plastic surgery, etc.), walking independence (use of crutches), possibility to get back to work, subjective evaluation about the treatment and the result (SF-36, personal feelings about circular external fixator dressing) RESULTS: The mean treatment time, often connected to the mean consolidation time, was 61 weeks and the mean number of operations was 7.6. Six of the eight patients got back to their previous daily activities and work, without any further issues. DISCUSSION: based on our experience, Ilizarov and fibular vascular grafts are not alternatives, as often reported in literature. Their combined use, especially in lesions as those classified as Winquist IV B, can represent an effective tool in the surgeon's hands to solve the most difficult cases of acute bone loss caused by severe high-energy traumas.
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Trasplante Óseo/métodos , Técnica de Ilizarov , Diferencia de Longitud de las Piernas/cirugía , Procedimientos de Cirugía Plástica/métodos , Adulto , Anciano , Anciano de 80 o más Años , Fijadores Externos , Femenino , Peroné/trasplante , Estudios de Seguimiento , Humanos , Extremidad Inferior/cirugía , Masculino , Persona de Mediana Edad , Radiografía , Tibia/cirugía , Resultado del TratamientoRESUMEN
BACKGROUND: Etoricoxib is a selective inhibitor of cyclooxygenase 2 used mainly to treat osteoarticular pain. Here, we report the case of a patient who developed acute kidney failure and immune hemolytic anemia after the use of etoricoxib. STUDY DESIGN AND METHODS: An 83-year-old female patient developed immune hemolytic anemia and acute kidney failure after treatment with etoricoxib for articular pain. Given the acute kidney failure, she required five hemodialysis sessions. She was discharged after 17 days. The case of immune hemolytic anemia and kidney failure was fully resolved. RESULTS: The direct antiglobulin test was not only positive for IgG but also for C3b and C3d, showing a very intense reactivity (++++). The eluate's reactivity was weaker (++) and showed no defined specificity. The investigation of unexpected antibodies in the serum of the patient showed a reactivity pattern similar to the eluate's: weak reactivity without specificity. The serum of the patient was compared to urine and plasma samples of two groups of volunteers. The indirect antiglobulin test showed only a very strong reactivity with the urine samples of the volunteers who had received etoricoxib. DISCUSSION: Considering that positive eluate is not the typical serologic profile of drug-induced immune hemolytic anemia, developing in-house techniques to show the causal link between them may be of interest to guide the treatment and avoid the empirical use of drugs. CONCLUSION: Etoricoxib must be considered as a possible cause of acute kidney failure in cases of immune hemolytic anemia.
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Anemia Hemolítica/inducido químicamente , Etoricoxib/toxicidad , Lesión Renal Aguda/inmunología , Anciano de 80 o más Años , Complemento C3b/metabolismo , Complemento C3d/metabolismo , Prueba de Coombs , Femenino , Humanos , Inmunoglobulina G/metabolismoRESUMEN
In hemodialysis patients, vertebral fractures were associated with elevated sclerostin levels, suggesting that sclerostin could reflect bone fragility in these patients. INTRODUCTION: Fragility fractures are common in hemodialysis patients. The aims of our study were to determine the prevalence of vertebral fracture and analyze associations between sclerostin serum levels and vertebral fractures in hemodialysis patients. METHODS: Ninety-two hemodialysis patients and 100 controls matched for age and sex were studied. Bone mineral density was measured by ultrasonography at non-dominant heel. The markers of bone turnover included serum osteocalcin, C-terminal telopeptide, and sclerostin. All participants underwent radiography of the thoracic and lumbar spine to ascertain the presence of vertebral fractures. RESULTS: Bone ultrasound parameters at calcaneus were significantly lower in hemodialysis patients compared with controls; bone turnover markers and parathyroid hormone level were significantly higher, while serum of 25-OH-D3 was significantly lower in hemodialysis group. One or more moderate or severe vertebral fractures were found in 38 hemodialysis patients, whereas in control group, 10 patients had a vertebral fracture. In hemodialysis group, the comparison between patients with and without vertebral fractures showed that the patients with vertebral fractures had the serum sclerostin levels statistically higher than patients without vertebral, while serum levels of 25-OH-D3 was significantly lower in patients with vertebral fractures compared to the patients without vertebral fractures. Multivariate analysis disclosed that sclerostin levels were associated with an increased risk of vertebral fractures in hemodialysis patients after adjusting for multiple variables. CONCLUSIONS: Our data shows high prevalence of vertebral fractures in hemodialysis patients and that it is associated with elevated sclerostin levels, reflecting bone fragility in these patients.
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Proteínas Morfogenéticas Óseas/sangre , Fracturas Osteoporóticas/etiología , Diálisis Renal/efectos adversos , Fracturas de la Columna Vertebral/etiología , Deficiencia de Vitamina D/complicaciones , Proteínas Adaptadoras Transductoras de Señales , Anciano , Anciano de 80 o más Años , Densidad Ósea/fisiología , Estudios de Casos y Controles , Femenino , Marcadores Genéticos , Talón/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Osteoporosis/complicaciones , Osteoporosis/diagnóstico por imagen , Osteoporosis/fisiopatología , Fracturas Osteoporóticas/sangre , Fracturas Osteoporóticas/diagnóstico por imagen , Fracturas Osteoporóticas/fisiopatología , Radiografía , Medición de Riesgo/métodos , Fracturas de la Columna Vertebral/sangre , Fracturas de la Columna Vertebral/diagnóstico por imagen , Fracturas de la Columna Vertebral/fisiopatología , Ultrasonografía , Calcificación Vascular/sangre , Calcificación Vascular/etiología , Deficiencia de Vitamina D/fisiopatologíaRESUMEN
CHF6001 is an inhaled phosphodiesterase 4 (PDE4) inhibitor in development for the treatment of obstructive lung diseases. The efficacy and safety of CHF6001 were investigated in a double blind, placebo controlled, 3-way cross-over study using the allergen challenge model. Thirty-six atopic asthmatics who were not taking inhaled corticosteroids and who demonstrated a late asthmatic response (LAR) to inhaled allergen at screening were randomised to receive CHF6001 400 µg or 1200 µg or placebo administered once a day using a dry powder inhaler. The three treatment periods were 9 days; allergen challenges were performed on day 9 and induced sputum was obtained after 10 h from challenge. Washout periods between treatments were up to 5 weeks. Both CHF6001 doses significantly attenuated the LAR; the primary endpoint analysis showed that CHF6001 400 µg and 1200 µg caused reductions of 19.7% (p = 0.015) and 28.2% (p < 0.001) respectively of the weighted FEV1 AUC4-10h compared with placebo. The difference between the CHF6001 doses was not statistically significant (p = 0.223). Compared with placebo, CHF6001 caused greater reduction in sputum eosinophil counts, although these changes were not statistically significant. CHF6001 was well tolerated, with similar numbers of adverse events in each treatment period. This inhaled PDE4 inhibitor has the potential to provide clinical benefits in patients with atopic asthma.
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Asma/tratamiento farmacológico , Inhibidores de Fosfodiesterasa 4/administración & dosificación , Sulfonamidas/administración & dosificación , para-Aminobenzoatos/administración & dosificación , Administración por Inhalación , Adulto , Alérgenos/inmunología , Asma/inmunología , Asma/fisiopatología , Estudios Cruzados , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Inhaladores de Polvo Seco , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Inhibidores de Fosfodiesterasa 4/efectos adversos , Inhibidores de Fosfodiesterasa 4/farmacología , Esputo , Sulfonamidas/efectos adversos , Sulfonamidas/farmacología , Resultado del Tratamiento , para-Aminobenzoatos/efectos adversos , para-Aminobenzoatos/farmacologíaRESUMEN
BACKGROUND: Unlike cytotoxic agents, novel antineoplastic drugs can variably affect thyroid function and so impair patient outcomes. However, the widely used standard thyroid tests have demonstrated low sensitivity for detecting early thyroid damage that leads to dysfunction of the gland. To find a more reliable thyroid marker, we assessed the presence of antibodies binding thyroid hormones (thAbs) in a cancer population undergoing potentially thyrotoxic treatment. METHODS: From April 2010 to September 2013, 82 patients with hematologic malignancies treated with tyrosine kinase inhibitors or immunoregulatory drugs were recruited. Healthy volunteers (n = 104) served as control subjects. Thyroid function, autoimmunity tests, thAbs, and thyroid sonography were assessed once during treatment. RESULTS: Overall, thAb positivity was recorded in 13% of the entire cohort. In most cases, the thAbs were of a single type, with a predominance of T3 immunoglobulin G. More specifically, thAbs were detected in 11 cancer patients; and abnormal levels of thyroid-stimulating hormone, thyroglobulin antibody, and thyroperoxidase antibody were detected in 6 (p = 0.05), 0 (p = 0.0006), and 2 cancer patients (p = 0.001) respectively. Ultrasonographic alterations of the thyroid were observed in 12 cancer patients. In contrast, of the 104 healthy control subjects, only 1 was positive for thAbs (1%). CONCLUSIONS: We have demonstrated for the first time that thAbs are a reliable marker of early thyroid dysfunction when compared with the widely used standard thyroid tests. A confirmatory prospective trial aiming at evaluating thAbs at various time points during treatment could clarify the incidence and timing of antibody appearance.
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AIMS: To evaluate the diversity of Pseudomonads and antibiotic resistance profiles of Pseudomonas aeruginosa in a hospital wastewater treatment plant (HWTP) located in Rio de Janeiro city, Brazil. Due its intrinsic multidrug resistance and its ability to colonize several environments, we selected Ps. aeruginosa isolates as indicator of antimicrobial resistance frequency. METHODS AND RESULTS: Twenty-seven Ps. aeruginosa strains isolated from five stages of HWTP identified by rrs 16S rDNA sequencing were submitted against 12 antimicrobials through disc diffusion method. Among these isolates, 62·9% showed aztreonam resistance, followed by ticarcillin/clavulanic acid (33·3%) and cefepime (22·2%). Of these isolates, 22·2% were classified as multidrug-resistant (MDR ≥ 3 classes). Five 16S rRNA gene libraries of Pseudomonas genus were constructed, one for each stages of the plant, yielding 93 sequences clustered in 41 Operational Taxonomic Units (OTUs). Each treatment step showed unique OTU's composition, suggesting changes in Pseudomonas spp. communities during the process. Several Pseudomonas species involved in biodegradation and bioremediation of xenobiotics were detected suggesting a positive impact in the wastewater treatment. CONCLUSIONS: Our strategy using metagenomics associated with the isolation of Ps. aeruginosa strains as bio-indicator allowed us to assess their antimicrobial susceptibility, the viability and diversity of Pseudomonas species in the hospital wastewater. SIGNIFICANCE AND IMPACT OF THE STUDY: The presence of MDR bacteria from treated effluents alerts for the need to improve these systems to avoid the spreading of resistance genes in aquatic ecosystems. This has special relevance in Brazil, where a significant portion of the population has no access to treated water.
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Antibacterianos/farmacología , Farmacorresistencia Bacteriana/genética , Hospitales , Pseudomonas , Aguas Residuales/microbiología , Brasil , Pseudomonas/efectos de los fármacos , Pseudomonas/genética , Purificación del AguaRESUMEN
BACKGROUND AND AIMS: Hyperphosphatemia increases the risk of cardiovascular morbidity but the use of medicines as a source of phosphate has not been investigated yet. This study aims to explore the use of absorbable phosphate-containing drugs in CKD patients. METHODS AND RESULTS: Incident CKD patients were identified within the Arianna database (containing data from 158,510 persons in Caserta (Southern Italy) registered with 123 general practitioners) from 2005 to 2011. Drugs prescribed to these patients were classified as phosphate-containing based on the summary of product characteristics (SPC), PubChem and Micromedex. The number and duration of prescriptions for these drugs as well as the overall intake of phosphate were estimated. Out of 1989 CKD patients, 1381 (70%) were prescribed 266 medicinal products containing absorbable phosphate over a median follow-up of 6 years (interquartile range (IQR) = 5.2-6.0). Most patients were prescribed ATC A (650; 47.1%) and C (660; 47.8%) phosphate-containing drug products targeting the gastrointestinal and cardiovascular system for a median of 232 (IQR: 56-656) and 224 (IQR: 56-784) days respectively. CONCLUSIONS: Several medications, especially chronically prescribed ones, contain absorbable phosphate. This study's findings confirm the relevance of medicines as a phosphate source for the first time.
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Hiperfosfatemia/complicaciones , Fosfatos/administración & dosificación , Fosfatos/efectos adversos , Medicamentos bajo Prescripción/efectos adversos , Insuficiencia Renal Crónica/complicaciones , Fármacos Cardiovasculares/efectos adversos , Fármacos Cardiovasculares/química , Enfermedades Cardiovasculares/etiología , Fármacos Gastrointestinales/efectos adversos , Fármacos Gastrointestinales/química , Humanos , Italia , Fosfatos/farmacocinética , Medicamentos bajo Prescripción/química , Factores de RiesgoRESUMEN
OBJECTIVES: It has been postulated that VDR polymorphisms influence mortality in CKD by directly modifying VDR protein levels or VDR sensitivity in target organs. Here we aimed at evaluating the possible association of VDR FokI and BsmI gene polymorphisms with co-morbid conditions of CKD at different stages. DESIGN AND METHODS: The patients included in this study were a Sicilian cohort of 171 subjects, at CKD stage 1-2 (n=49), stage 3 (n=34), stage 4-5 (n=34), and hemodialysis (HD) (n=54). Almost 70% of patients were also suffering from heart disease, with/without diabetes and/or hypertension, and 40% were also suffering of hypertension, with/without diabetes and/or heart disease; only around 20% had no co-morbid conditions. RESULTS: A highly significant association was found between the BsmI B minor allele and heart disease in all CKD stages. Indeed, the odds ratio calculation showed that patients bearing either the bB or BB genotype had, respectively, a seven-fold and around twelve-fold increased risk for heart disease. Instead, the presence of bb wild-type genotype was associated with a fifty-fold reduced risk for heart disease, suggesting that the b allele may display a protective effect. No association was found for FokI genotypes with the different co-morbid conditions. CONCLUSIONS: We first demonstrated that the VDR BsmI B allele may be considered as a genetic determinant for heart disease and hypertension in CKD, independently from disease stage. Thus, the screening for VDR variants should be regarded as a way to better address preventive strategies and improving the management of CKD co-morbid conditions.
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Predisposición Genética a la Enfermedad/genética , Cardiopatías/genética , Polimorfismo de Nucleótido Simple/genética , Receptores de Calcitriol/genética , Insuficiencia Renal Crónica/genética , Alelos , Femenino , Frecuencia de los Genes/genética , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , RiesgoRESUMEN
Several 'exotic' mammalian species (e.g. rabbits, rodents, ferrets and hedgehogs) live in close proximity to humans as companion pets. Skin diseases (SD) are frequent causes of morbidity in exotic pet mammals, and most of those SDs have a zoonotic potential. The purpose of this study was to determine the frequencies and types of zoonotic dermatosis (ZD) in client-owned, exotic pet mammals in Southern Italy. Six-hundred and fifty-five medical records of exotic pet mammals examined between 2011 and 2012, across twenty private practice veterinary clinics around the Naples area (Italy), were retrospectively evaluated and screened for animals diagnosed with SDs (rabbits n = 455, guinea pigs n = 93, ferrets n = 64, hedgehogs n = 19, chinchillas n = 13 and rats n = 11). The records of animals diagnosed with SD, whose causative agents had a zoonotic potential, were selected for analysis. The Mann-Whitney independent test was used for statistical analysis. A P value ≤ 0.05 was considered statistically significant. Eighty-two records (12.5%) of animals with ZD were identified. Of those, 56.1% (46/82) were affected by fungal infections and 42.7% (35/82) by parasitic infections. No zoonotic bacterial or viral infections were diagnosed. Dermatophytosis was significantly diagnosed more frequently in younger animals. The results of this survey indicate that exotic pet mammals may serve as active carriers for many highly contagious pathogens with zoonotic potential. Awareness and vigilance by the veterinary practitioner is crucial in the prevention of occurrences of ZDs. Children frequently come in close contact with exotic pets. To prevent the unplanned transmission of pathogen from pet to human, an active routine screening examination and preventative treatments are strongly recommended for every newly purchased pet mammal.
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Dermatomicosis/veterinaria , Mascotas/microbiología , Zoonosis/epidemiología , Animales , Dermatomicosis/epidemiología , Humanos , Italia/epidemiologíaRESUMEN
A novel mechanistic model that describes the vacuum UV advanced oxidation process in an annular photoreactor initiated by 172 nm and 185 nm (in combination with 253.7 nm, with and without exogenous H2O2) is presented in this paper. The model was developed from first principles by incorporating the vacuum UV-AOP kinetics into the theoretical framework of in-series continuous flow stirred tank reactors. After conducting a sensitivity analysis, model predictions were compared against experiments conducted under a variety of conditions: (a) photo-induced formation of hydrogen peroxide by water photolysis at 172 nm (for both air- and oxygen-saturated conditions); (b) photo-induced formation of hydrogen peroxide by water photolysis at 185 + 253.7 nm (in the presence of formic acid, with and without the initial addition of hydrogen peroxide); (c) direct photolysis of hydrogen peroxide by 253.7 nm; (d) degradation of formic acid by 185 + 253.7 nm (with and without initial addition of hydrogen peroxide); and (e) degradation of formic acid by 253.7 nm (with the addition of exogenous hydrogen peroxide). In all cases, the model was able to accurately predict the time-dependent profiles of hydrogen peroxide and formic acid concentrations. Two newly recognized aspects associated with water photolysis were identified through the use of the validated model. Firstly, unlike the 185 nm and 253.7 nm cases, water photolysis by the 172 nm wavelength revealed a depth of photoactive water layer an order of magnitude greater (â¼230-390 µm, depending on the specific operating conditions) than the 1-log photon penetration layer (â¼18 µm). To further investigate this potentially very important finding, a computational fluid dynamics model was set up to assess the role of transport mechanisms and species distributions within the photoreactor annulus. The model confirmed that short-lived hydroxyl radicals were present at a radial distance far beyond the â¼18 µm photon penetration layer. Secondly, kinetic simulations showed that the higher penetration depth of hydroxyl radicals was not caused by diffusive or convective transport phenomena but rather the effect of non-linear behavior of the complex reaction kinetics involved in the process.
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Peróxido de Hidrógeno/química , Modelos Teóricos , Fotólisis , Rayos Ultravioleta , Agua/química , Formiatos/química , Radical Hidroxilo/química , Cinética , Oxidación-Reducción , VacioRESUMEN
OBJECTIVES: Guinea pigs have been indicated as a potential source of zoophilic dermatophytes that cause human dermatomycosis. The purpose of this study was to evaluate the prevalence of dermatophytes as well as saprophytic fungi in asymptomatic pet guinea pigs in Southern Italy. METHODS: Two-hundred pet guinea pigs were enrolled from both private veterinary clinics and pet shops in the Campania region, Italy, from August 2012 to September 2013. Samples were collected using the MacKenzie's toothbrush technique. The plates were incubated for four weeks at 25°C and identification of the fungal colonies was based on both macroscopic and microscopic characteristics. RESULTS: Two pathogenic dermatophytes were isolated in 9 (4·5%) of 200 guinea pigs; Epidermophyton species in 2 (1%) and Scopulariopsis species in 7 (3·5%). Saprophytic dermatophytes were isolated from 151 (75·5%) animals enrolled. No fungal growth was observed in 40 (20%) guinea pigs. CLINICAL SIGNIFICANCE: The results of this study indicate a low prevalence of pathogenic dermatophytes in pet guinea pigs in Southern Italy but the presence of Epidermophyton and Scopulariopsis species in asymptomatic pet guinea pigs.