Adverse drug reactions in paediatric surgery: prospective study on frequency and risk related factors.

BACKGROUND: Paediatric patients are especially prone to experiencing adverse drug reactions (ADRs), and the surgical environment gathers many conditions for such reactions to occur. Additionally, little information exists in the literature on ADRs in the paediatric surgical population. We aimed to quantify the ADR frequency in this population, and to investigate the characteristics and risk factors associated with ADR development. METHODS: A prospective observational study was conducted in a cohort of 311 paediatric patients, aged 1-16 years, admitted for surgery at a tertiary referral hospital in Spain (2019-2021). Incidence rates were used to assess ADR frequency. Odds ratios (ORs) were calculated to evaluate the influence of potential risk factors on ADR development. RESULTS: Distinct ADRs (103) were detected in 80 patients (25.7%). The most frequent being hypotension (N = 32; 35%), nausea (N = 16; 15.5%), and emergence delirium (N = 16; 15.5%). Most ADRs occurred because of drug-drug interactions. The combination of sevoflurane and fentanyl was responsible for most of these events (N = 32; 31.1%). The variable most robustly associated to ADR development, was the number of off-label drugs prescribed per patient (OR = 2.99; 95% CI 1.73 to 5.16), followed by the number of drugs prescribed per patient (OR = 1.26, 95% CI 1.13 to 1.41), and older age (OR = 1.26, 95% CI 1.07 to 1.49). The severity of ADRs was assessed according to the criteria of Venulet and the Spanish Pharmacovigilance System. According to both methods, only four ADRs (3.9%) were considered serious. CONCLUSIONS: ADRs have a high incidence rate in the paediatric surgical population. The off-label use of drugs is a key risk factor for ADRs development.

Mujer y urología: ¿cuál es la situación en España? / Women in urology: What is their current situation in Spain?

Objetivo Analizar la situación actual de las mujeres en la especialidad de Urología en España. Material y métodos Estudio descriptivo a partir de los resultados de una encuesta electrónica remitida entre febrero y abril de 2020 a través de la base de datos del grupo de Residentes y Jóvenes Urólogos (RAEU) de la Asociación Española de Urología (AEU). Se analizaron las características demográficas de la encuesta y los resultados de la misma. Resultados Se obtuvieron 257 respuestas, correspondientes a 210 mujeres (81,71%) y 47 hombres (18,29%) procedentes de 111 hospitales en total. Se obtuvieron diferencias estadísticamente significativas (p<0,001), con una mayor proporción de hombres en todas las categorías, excepto en el grupo de adjuntas y adjuntos jóvenes (29-39años; p=0,789) y en el de residentes mujeres frente a residentes hombres (p=0,814). En los hospitales con unidades subespecializadas se encontró un mayor número de hombres en todas, excepto en la unidad de suelo pélvico, en la que no se observó una diferencia estadísticamente significativa (p=0,06). Respecto a cargos de responsabilidad, en solo 7 de 111 hospitales había jefas de servicio. Conclusiones La presencia de las mujeres en la especialidad de Urología es cada vez mayor, debido mayoritariamente a las generaciones más jóvenes. Sin embargo, el acceso de estas mujeres a puestos de relevancia es anecdótica (AU)

Objective To analyze the current state of women in urology in Spain. Material and methods Descriptive study based on the results of an online survey sent between February and April 2020 through the database of the Residents and Young Urologists group (RAEU) of the Spanish Association of Urology (AEU). Demographic characteristics of the survey and its results were analyzed. Results In total, 257 responses were obtained from 210 women (81.71%) and 47 men (18.29%) belonging to 111 hospitals. Statistically significant differences were observed (P<.001) with a higher proportion of men in all categories except for the group of young female and male attendings (29-39 years, P=.789), and the group of female residents against male residents (P=.814). The number of men was higher in hospitals with subspecialty units except for the Pelvic Floor Unit, where no statistically significant difference was observed (P=.06). Regarding positions of responsibility, only 7 out of 111 hospitals had female department chiefs. Conclusions Women's representation in urology is increasing, mainly due to the younger generations. However, the access of these women to relevant positions is anecdotal (AU)

Women in urology: what is their current situation in Spain?

OBJECTIVE: To analyze the current state of women in urology in Spain. MATERIAL AND METHODS: Descriptive study based on the results of an online survey sent between February and April 2020 through the database of the Residents and Young Urologists group (RAEU) of the Spanish Association of Urology (AEU). Characteristics of the survey and its results were analyzed. RESULTS: In total, 257 responses were obtained from 210 women (81.71%) and 47 men (18.29%) belonging to 111 hospitals. Statistically significant differences were observed (p < 0.001) with a higher proportion of men in all categories except for the group of young female and male attendings (29-39 years, p = 0.789), and the group of female residents against male residents (p = 0.814). The number of men was higher in hospitals with subspecialty units except for the Pelvic Floor Unit, where no statistically significant difference was observed (p = 0.06). Regarding positions of responsibility, only 7 out of 111 hospitals had female Department Chiefs. CONCLUSIONS: Women's representation in urology is increasing, mainly due to the younger generations. However, the access of these women to relevant positions is anecdotal.

Impacto del periodo de confinamiento por la pandemia COVID-19 en España sobre la salud y la atención recibida por los niños, niñas y jóvenes con discapacidad originada en la infancia / The impact of COVID-19 lockdown on the health and care of children and adolescents with a childhood-onset disability

Introducción Durante el periodo inicial del confinamiento por la COVID-19 se tomaron una serie de medidas de restricción que modificaron el día a día de la población. En este estudio se buscó conocer el impacto de este periodo en la salud física y mental de niños y jóvenes con discapacidad originada en la infancia, y de sus familias, y describir los cambios que se produjeron en el acceso a la educación y a los servicios de salud. Material y métodos Se realizó un estudio analítico observacional y transversal. Los datos se obtuvieron mediante una encuesta electrónica a través de una plataforma online realizada por la Academia Europea de Discapacidad Infantil. La encuesta incluyó preguntas sobre cuatro bloques temáticos: características sociodemográficas y de salud, impacto del confinamiento en la salud y bienestar, acceso a la educación y a los servicios de salud. Resultados Se obtuvieron 145 respuestas. El 45,5% de los niños y jóvenes eran totalmente dependientes. Se percibió un impacto sobre su salud física (54,5%), mental (47,6%) y sobre ambas (32%), mayores niveles de estrés (68,3%) y problemas de sueño (41,4%), así como una sobrecarga muy elevada en el 84,8% de los progenitores, sobre todo en familias de niños con mayor nivel de dependencia (p<0,001). El 55% de los niños y jóvenes no recibieron ningún tratamiento durante este periodo, ni siquiera remoto. Conclusiones El confinamiento afectó en gran medida la salud física y mental, así como a los servicios recibidos por los niños y jóvenes con discapacidad y sus familias (AU)

Introduction During the initial period of COVID-19 lockdown, restriction measures modified the day-to-day life of the population. This study sought to know the impact of this period on the physical and mental health of children and young people with disabilities originating in childhood, and their families, and to describe the changes that occurred in access to education and health services. Material and methods An observational and cross-sectional analytical study was carried out. The data were obtained by means of an electronic survey through an online platform carried out by the European Academy of Childhood Disability. The survey included questions on four thematic blocks: sociodemographic and health characteristics, impact of lock down on health and well-being, and access to education and health services. Results One hundred and forty-five responses were obtained. 45.5% of the children and young people were totally dependent. There was an impact on their physical (54.5%), mental health (47.6%) and both (32%), higher levels of stress (68.3%), and sleep problems (41.4%), as well as a high burden in 84.8% of parents, especially in families of children with a higher level of dependency (P=.00). 55% of children and young people did not receive any treatment during this period, not even remotely. Conclusions COVID lock down period greatly affected physical and mental health, as well as the services for children and young people with disabilities and their families (AU)

Carriage of multidrug-resistant Gram-negative bacilli: duration and risk factors.

Identification of risk factors influencing the duration of carriage of multidrug-resistant Gram-negative bacilli (MDR-GNB) may be useful for infection control. The aim of this study is to estimate the impact of several factors collected for routine hospital surveillance on the duration of carriage of selected MDR-GNB. From January 2015 to July 2021, patients with at least two clinical/surveillance samples positive for MDR-GNB different from ESBL-producing E. coli or AmpC - exclusively producing Enterobacterales were assessed. Microorganisms, age, number of admissions, clinical or rectal sample, sex, and admission service were evaluated as risk factors. Multivariate analysis was performed by a Cox proportional hazard model. A total of 1981 episodes of colonization were included. Involved microorganisms were ESBL-Klebsiella pneumoniae (KP) in 1057 cases (53.4%), other ESBL-non-E. coli Enterobacterales in 91 (4.6%), OXA-48-KP in 263 (13.3%), KPC-KP in 90 (4.5%), VIM-KP in 29 (1.5%), carbapenemase-producing non-KP Enterobacterales (CP-non-KP) in 124 (6.3%), and MDR Pseudomonas aeruginosa (MDR-PAER) in 327 (16.5%). No differences in duration of colonization were observed among ESBL-KP (median colonization time 320 days), ESBL-non-E. coli Enterobacterales (226 days), OXA48-KP (305 days), and MDR-PAER (321 days). For each group, duration of colonization was significantly longer than that of KPC-KP (median colonization time 60 days), VIM-KP (138 days), and CP-non-KP (71 days). Male sex (HR = 0.88; 95% CI 0.78-0.99), detection in Hepatology-Gastroenterology (HR = 0.71; 95% CI 0.54-0.93), clinical sample (HR = 0.61; 95% CI 0.53-0.69), and > 2 admissions after first detection (HR = 0.47; 95% CI 0.42-0.52) were independent predictors of longer carriage, whereas VIM-KP (HR = 1.61; 95% CI 1.04-2.48), KPC-KP (HR = 1.85; 95% CI 1.49-2.3), and CP-non-KP (HR = 1.92; 95% CI 1.49-2.47) were associated with shorter colonization time. Duration of colonization was significantly longer for ESBL-KP, other ESBL-non-E. coli Enterobacterales, OXA-48-KP, and MDR-PAER. For these microorganisms, prolonging surveillance up to 2.5-3 years should be considered. Male sex, clinical sample, multiple readmissions, admission service, and type of microorganism are independent predictors of the duration of carriage.

The armed conflict in Ukraine and the risks of inter-country surrogacy: the unsolved dilemma.

Commercial surrogacy in Ukraine has been legal since 2002, and although no official figures are released, estimates point to several thousand births occurring yearly. The country has long been regarded as one of the surrogacy capitals of the world, due to relatively affordable costs and effective targeted legislation making the surrogacy contracts enforceable. Would-be parents come from countries where surrogacy is banned or heavily restricted to start a family despite their infertility, a practice known as inter-country surrogacy. When a child is born through surrogacy, the surrogate mother forfeits her rights over the child, thus allowing the so-called "intended" or "commissioning" parents to be recognized as such on the Ukrainian birth certificate. Inter-country surrogacy has long been a highly controversial practice from an ethical and legal perspective, but the brutally destructive armed conflict erupted in the country over three months ago has laid bare all the pitfalls and deep flaws of such a system. Children born through surrogacy cannot be handed over to their intended parents, and surrogates risk legal issues and see their rights jeopardized by their choices even in a war setting, for instance if they decide to seek refuge abroad. The horrors of war thus risk victimizing the most vulnerable to an irreparable degree. An international effort is now more urgent than ever to seek a tenable balance between the desires of couples to achieve parenthood and the rights and freedom of often vulnerable women who risk exploitation and abuse and their children.

New psychoactive substances and low-income countries: a burgeoning (and neglected) crisis.

Abstract: New psychoactive substances (NPS) are compounds intended to replicate the effects of legal and illegal drugs. The continuous detec-tion of new NPS via several forensic toxicology techniques attests to the considerable NPS popularity all over the world, although such determinations rely on still indecisive findings, given the elusiveness inherent in NPS and the the lack of standardized and uniformly applied detection and screening techniques. A worrisome and neglected issue is the proliferation of NPS and other drugs of abuse in developing countries. Demographics may partly explain such an emerging threat, which in a globalized world is likely to have an impact that goes well beyond national borders, especially in light of the criminal organiza-tions' ability to function and operate in the cyberspace, harnessing the potential of the "dark web" to overstep the boundaries and oversight mechanisms put in place by nations and international institutions.

Clinical Presentation and Outcome of COVID-19 in a Latin American Versus Spanish Population: Matched Case-Control Study.

INTRODUCTION: Increased mortality has been reported in the Latin American population. The objective is to compare the clinical characteristics and outcome of Latin American and Spanish populations in a cohort of patients hospitalized with COVID-19 during the first year of the pandemic. METHODS: We retrospectively analysed all the Latin American patients (born in South or Central America) hospitalized in our centre from February 2020 to February 2021 and compared them with an age- and gender-matched group of Spanish subjects. Variables included were demographics, co-morbidities, clinical and analytical parameters at admission and treatment received. The primary outcomes were ICU admission and mortality at 60 days. A conditional regression analysis was performed to evaluate the independent baseline predictors of both outcomes. RESULTS: From the 3216 patients in the whole cohort, 216 pairs of case-controls (Latin American and Spanish patients, respectively) with same age and gender were analysed. COPD was more frequent in the Spanish group, while HIV was more prevalent in the Latin American group. Other co-morbidities showed no significant difference. Both groups presented with similar numbers of days from symptom onset, but the Latin American population had a higher respiratory rate (21 vs. 20 bpm, P = 0.041), CRP (9.13 vs. 6.22 mg/dl, P = 0.001), ferritin (571 vs. 383 ng/ml, P = 0.012) and procalcitonin (0.10 vs. 0.07 ng/ml, P = 0.020) at admission and lower cycle threshold of PCR (27 vs. 28.8, P = 0.045). While ICU admission and IVM were higher in the Latin American group (17.1% vs. 13% and 9.7% vs. 5.1%, respectively), this was not statistically significant. Latin American patients received remdesivir and anti-inflammatory therapies more often, and no difference in the 60-day mortality rate was found (3.2% for both groups). CONCLUSION: Latin American patients with COVID-19 have more severe disease than Spanish patients, requiring ICU admission, antiviral and anti-inflammatory therapies more frequently. However, the mortality rate was similar in both groups.

COVID-19 vaccine mandates: what are the current European public perspectives?

The article aims to elaborate on European policy choices for the prevention of SARS­CoV­2 contagion, with a close focus on the rules and regulations enacted in Italy so far. European states have ruled out generalized vaccination mandates but have so far preferred to exert a form of "moral suasion", through the introduction of a digital certificate which can only be granted to those who are vaccinated, cured of COVID-19 or tested negative through an antigen test in the previous 48 hours. Italy has applied this tool, dubbed "Green Pass", very rigorously: many daily activities, including going to work, are only allowed for those who have the certificate. A one-year Green Pass is issued after vaccination, although data show that vaccine protection may subside gradually over about six months; the cost of the antigen tests every 48 hours is to be borne by the patient. Testing the unvaccinated is essential to contain the spread of the infection, but it would have been more logical to mandate that all the unvaccinated undergo regular testing (for example every ten days), instead of imposing a test every 48 hours only to be allowed to engage in some activities. The authors stress that in order to minimize the risk of future possible pandemics, prevention strategies are needed, and poor countries need to be enabled to vaccinate their populations in order to prevent new variants from developing. The pledges made by world leaders in that regard during the recent G20 summit must therefore be honored, for the sake of global health that never in our lifetime has been so threatened.

The best interest of children born through medically assisted procreation procedures as construed in 2021 Italian Constitu- tional Court rulings 32 and 33.

ABSTRACT: The authors have set out to briefly analyze the 2021 Constitutional Court rulings n.32 and 33, regarding the situation of children born in, or otherwise being raised by, same-sex couples. Such judgments address the problem by taking into account the fundamental principle of the child's best interests. This article is meant to highlight the issues that may arise if such interests were to be translated into specific law provisions or safeguards for the children's sake. Moreover, the authors aimed to focus on the valuable elements laid out in the Court rulings, while also highlighting the more critical and controversial elements therein.

Substance abuse in times of COVID-19 pandemic: a "perfect storm" for substance use disorder and mental health?

ABSTRACT: Our lives and communities have been besieged by COVID-19 for almost two years, and society and its functioning have been turned upside down and upset, through limitations and restrictions aimed at stemming the spread of the SARS-CoV-2 virus. Severe levels of anxiety, distress and uncertainty have taken a huge toll on our daily lives from the social, professional and emotional perspectives, but it is still rather unclear how serious an impact the emergency has had on a class of particularly vulnerable individuals: those with substance abuse issues. Particularly, we would like to draw attention to a uniquely troublesome development: forced isolation resulting from pandemic-related restrictions and how it has impacted drug users and their efforts to achieve recovery.

Impact of remdesivir according to the pre-admission symptom duration in patients with COVID-19.

BACKGROUND: The use of remdesivir has demonstrated a significant reduction in the time to recovery in patients with COVID-19. However, the impact on mortality is still controversial. Therefore, it is necessary to evaluate whether there is a specific subgroup of patients in whom an active antiviral therapy also reduces the mortality. METHODS: Patients admitted for >48 h in our hospital for a SARS-CoV-2 confirmed or suspected infection from February 2020 to February 2021 were retrospectively analysed. The primary outcome of the study was mortality at 30 days. Univariate and multivariate analyses were performed to identify predictors of mortality. RESULTS: In total, 2607 patients (438 receiving remdesivir and 2169 not) were included with a median (IQR) age of 65 (54-77) years and 58% were male. Four hundred and seventy-six were admitted to the ICU (18.3%) and 264 required invasive mechanical ventilation (10.1%). The global 30 day mortality rate was 10.7%. Pre-admission symptom duration of 4-6 days and ≤3 days was associated with a 1.5- and 2.5-fold increase in the mortality rate, respectively, in comparison with >6 days and treatment with remdesivir was independently associated with a lower mortality rate (OR = 0.382, 95% CI = 0.218-0.671). The analysis showed that the major difference was among patients with shorter pre-admission symptom duration (<6 days). CONCLUSIONS: Patients with ≤3 days and 4-6 days from symptom onset to admission are associated with a 2.5- and 1.5-fold higher risk of death, respectively. Remdesivir was associated with 62% reduced odds of death versus standard-of-care and its survival benefit increased with shorter duration of symptoms.

Features of aerobic granular sludge formation treating fluctuating industrial saline wastewater at pilot scale.

A pilot-scale sequencing batch reactor, with a working volume of 3 m3, was installed in a fish cannery to develop aerobic granular sludge treating the produced effluents. Depending on the nitrogen (N) and organic matter (COD) concentration, the effluents were named in this study as medium-low-strength (Stage I) and high-strength (Stage II) wastewater. The composition of the wastewater was found to be a crucial factor to select granule-forming organisms. With medium-low-strength wastewater as feeding, the first granules were observed after 30 days, but the extremely high COD/N ratios of the wastewater provoked the overgrowth of filamentous bacteria after 4 months of operation (Stage I). When treating high-strength wastewater, stable aggregates with good settleability appeared, but well-shaped granules were not observed since the granulation process was not completed. The system was able to remove both COD (70-95%) and N (30-90%) treating both types of effluents. Biomass growth was the main N removal pathway. The reactor was found to be robust against factory production stops and, thus, a suitable alternative to treat wastewater from industries with discontinuous operation.

Uterus transplant update: innovative fertility solutions and the widening horizons of bioengineering.

Uterus transplantation (UTx) aimed at restoring fertility for women suffering from uterine factor infertility has been making significant strides over the past years, leading to the first successful outcome of live birth in 2014. Nonetheless, the ethical issues raised by such a procreative option are uniquely complex and multifaceted. UTx presents unique features, and the most significant risks it entails are the multiple surgeries required and the need for immunosuppressive drugs to prevent organ rejection. Post-transplantation immunosuppressive therapy, rejection monitoring, and immune tolerance are all crucial aspects That affect UTx outcomes and ensuing pregnancy success rates. In time, an alternative tool might become clinically available that could solve all those issues: tissue engineering relying on a combination of cells, biomaterials, and growth factors that harness the body's innate ability to regenerate and repair reproductive organs. Mastering such techniques could lead in the medium-long term to the creation of a bioengineered uterus for the purpose of transplantation, based on scaffolds derived from decellularized organs or tissues that can be recellularized by several types of autologous somatic/stem cells, in particular for uterine tissue engineering.

Increasing diversion of prescribed benzodiazepines and Z-drugs to new psychoactive substances.

ABSTRACT: Over the last few years reports have indicated an increase in the number, type and availability of new psychoactive substances belonging to the benzodiazepine class. These molecules may pose high risks to users, since the majority have never undergone clinical trials or tests so their pharmacology and toxicology is largely unknown. However the new drug scenario emerging from the COVID-19 global pandemic seems to play a role in increasing the diversion of prescribed benzodiazepines and Z-drug. A brief presentation of this phenomenon is hereby presented. The awareness and response activities at national and international levels related to this issue should be enforced.

Management of GHB acute intoxications.

Intoxications related to γ-Hydroxybutyric acid (GHB), arising from its success as recreational drug due to its psychotropic properties, are significantly and alarmingly jeopardizing public health, posing major challenges to medical staff. In recent years, GHB's prodrug γ-butyrolactone (GBL) has often supplanted GHB in recreational settings, owing to its lower cost and the ease with which it can be obtained, mainly due to its various legal industrial applications. The Authors intend to stress that symptoms should be assessed and confirmed by timely toxicological analyses by highly-trained, expert professionals. Such tests aimed at analytical confirmation are instrumental in providing physicians valuable indications in terms of the proper pharmacological treatments in order to revert the adverse, or even fatal, side effects, particularly when the overall intoxication picture looks ambiguous. At the time being, little is known about the pharmacological therapies effective in GHB intoxication cases; further comprehensive research is therefore essential, if we are to tackle such a burgeoning public health emergency before it is too late.

Beginning of life ethics at the dawn of a new era of genome editing: are bioethical precepts and fast-evolving biotechnologies irreconcilable?

The amazing and almost unimaginable advances that have unfolded over the past decades in biotechnologies (heritable germline editing in particular) have brought bioethical issues to the forefront, sparking public debate and increasing attention worldwide. Such mind-blowing progress has already resulted in major improvement and enhancements for humans, and holds the potential for even more. Technology and bioengineering have begun to take over in the life sciences industry. Man's capacity to genetically engineer the biological world is nothing short of mind-boggling in its current magnitude, and may even evolve, in a not too distant future, into attempts to fuse man and machine into a cohesive bioengineered entity; a "super human being", endowed with enhanced cognitive and physical capabilities and impervious to disease, may be not too far down the road. That will not come without caveats, however. In fact, scientific advancements at such an accelerated pace have already negatively affected our cultural, ethical, and legal values and our ability to harness the opportunities and face the dangers posed by such developments. As a matter of fact, science seems to consistently outpace public morals, ethics and policymaking, which calls for a high degree of caution and common answers.

Fentanyl analogues potency: what should be known.

Fentanyl is a full synthetic opioid acting as a strong µ-opioids receptor agonist. As other opioids, it exerts effects on central nervous systems like euphoria, sedation, anesthesia and respiratory depression at high dosage. It is the parent compound of the high potent opioids class, characterized by a potency up to 10,000 fold higher than mor- phine, currently prescribed as anesthetic and pain killers. Anyway, the diversion of fentanyl analogues has been reported since their appear- ance on the market, rising until alarming rate. Every year, new synthetic alternatives to the controlled fentanyl are proposed on the black market causing an increasing number of fatalities all over the World. Due to the high potency of this class of substances, it may be difficult to ana- lytically detect the molecules in biological matrices and find the actual cause of the deaths. Moreover, an additional analytical challenge is represented by the emergence of newly synthesized derivatives. In this concern, the harmonization of international guidelines, the adoption of common legal responses and the enforcement of international collaboration is desirable to face this alarming public health threat.

Assessment of a fast method to predict the biochemical methane potential based on biodegradable COD obtained by fractionation respirometric tests.

The biochemical methane potential test (BMP) is the most common analytical technique to predict the performance of anaerobic digesters. However, this assay is time-consuming (from 20 to over than 100 days) and consequently impractical when it is necessary to obtain a quick result. Several methods are available for faster BMP prediction but, unfortunately, there is still a lack of a clear alternative. Current aerobic tests underestimate the BMP of substrates since they only detect the easily biodegradable COD. In this context, the potential of COD fractionation respirometric assays, which allow the determination of the particulate slowly biodegradable fraction, was evaluated here as an alternative to early predict the BMP of substrates. Seven different origin waste streams were tested and the anaerobically biodegraded organic matter (CODmet) was compared with the different COD fractions. When considering adapted microorganisms, the appropriate operational conditions and the required biodegradation time, the differences between the CODmet, determined through BMP tests, and the biodegradable COD (CODb) obtained by respirometry, were not significant (CODmet (57.8026 ± 21.2875) and CODb (55.6491 ± 21.3417), t (5) = 0.189, p = 0.853). Therefore, results suggest that the BMP of a substrate might be early predicted from its CODb in only few hours. This methodology was validated by the performance of an inter-laboratory studyconsidering four additional substrates.