Integral evaluation of effective conversion of sewage sludge from WWTP into highly porous activated carbon.

Urban sewage sludge (SL) is a major concern due to the number of environmental problems it causes. Its application for different purposes is strictly regulated, limiting the possibilities of recycling and reusing this material. Thus, in this work, a complete study of a simple method to convert SL into activated carbon (AC) was carried out. The comprehensive study involves an evaluation of the main process parameters, such as the activating agent (AA) content (25 %, 33 %, 50 %), using the lowest amount of AA as novelty, different pyrolysis temperatures (600 and 800 °C), and purification conditions (6 M HCl:AC ratio, v:w). Under controlled and optimised conditions and through a single combined activation and pyrolysis step followed by acid purification, ACs with well-developed porosity can be obtained. Surface area values of around 870 m2/g and over 60 % carbon content were achieved, demonstrating that the prepared ACs could have applications in a wide variety of fields as high-value products. As an innovative aspect in this research, the gases streams and liquid effluents generated during the global process were analysed, achieving elimination of over 63 % of the concentration of the chemical elements contained in the SL during the chemical purification stage. Finally, mass, energy, and economic balances were carried out to estimate the production cost of AC derived from SL (<€ 8/kg AC).

Multifunctional roles of reticular fibroblastic cells: more than meets the eye?

Fibroblastic reticular cells (FRCs) are stromal cells found in secondary lymphoid organ. Despite its structural function in the lymph nodes being well established, recent studies indicate that the FRCs also play a key role in immunological processes, associated with cell transit, immune response, and cells activation quality, and contribute to peripheral tolerance. To this end, we focus this review on lymph nodes FRC characterization and discuss functional aspects such as production of cytokines and chemokines and their involvement in the immune response, seeking to establish whether certain subsets have a more functional specialization.

Porencefalia por encefalopatía crónica de la infancia / Porencephaly due to chronic encephalopathy in infancy

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Optic neuromyelitis syndrome in Brazilian patients.

OBJECTIVES: To report the clinical features and outcome of 24 Brazilian patients with optic neuromyelitis syndrome (ONM); discuss the underlying pathological events associated with the ONM syndrome; review the nosological situation of ONM in the group of inflammatory and demyelinating diseases of the central nervous system. PATIENTS AND METHODS: Patients with ONM treated at the Hospital da Lagoa, Rio de Janeiro were studied. Demographic, clinical, magnetic resonance imaging, cerebrospinal fluid, and pathological data were analysed. RESULTS: The study consisted of 20 women, four men of whom 10 were white and 14 Afro-Brazilians. Clinical course was recurrent in 22 cases and monophasic in two. Neurological manifestations at inclusion were: sensory impairment (66%), bilateral (41.6%) or unilateral blindness (20.8%), paraplegia or quadriplegia (37.5%). The EDSS was moderate/severe in 70.8%. The underlying pathological events were respectively pulmonary tuberculosis and upper respiratory infection in the two monophasic cases; in the 22 recurrent ONM patients: pulmonary tuberculosis (3), neurocysticercosis (1), polyarteritis nodosa (1), antinuclear antibody and rheumatoid factor (1), antiphospholipid antibody primary syndrome (1), diabetes mellitus (1), hypothyroidism (1), and amenorrhea-galactorrhea (4). Normal cerebrospinal fluid was found in 52% and an inflammatory profile in 48%. Only four recurrent ONM white patients had brain and spinal cord magnetic resonance imaging and cerebrospinal fluid findings compatible with the diagnosis of multiple sclerosis. Large lesions were seen in 62% of spinal magnetic resonance images. Six of 12 recurrent ONM Afro-Brazilian died. There were no statistical differences in the demographic data of the two ethnic groups. Afro-Brazilians were significantly more severely impaired and had a higher mortality rate than the white patients. CONCLUSION: These cases were classified as follows: two monophasic acute disseminated encephalomyelitis; one recurrent disseminated encephalomyelitis; three recurrent ONM associated with Hughes syndrome, autoantibodies and polyarteritis nodosa; six recurrent ONM with endocrinopathies; and finally, four multiple sclerosis cases. The remaining cases were not associated with any other condition. It would seem clear that ONM is a syndrome rather than a single disease.

Genetics, drugs and environmental factors in Parkinson's disease. A case-control study.

A case-control study of Parkinson's disease (PD) was conducted in the city of Rio de Janeiro based on the assumption that neurotoxins with secondary parkinsonian action may be related to the development of Parkinson's disease. Ninety-two subjects with PD and 110 controls were queried through a questionnaire in order to investigate possible risk factors for the disease. The following factors were studied: herbicides/pesticides, exposure to chemicals, ingestion of drugs with secondary PD effects, rural life, water well source, family history, cranial trauma and cigarette smoking. Study of mentioned factors was achieved through univariate, stratified and multivariate analyses. Univariate and multivariate analyses demonstrated that PD was positively associated with family history (OR = 14.5; CI = 2.98-91.38), with the use of drugs with secondary PD action (OR = 11.01; CI = 3.41-39.41) and with exposure to chemical agents (OR = 5.87; CI = 1.48-27.23). PD was found to be inversely associated with cigarette smoking (OR = 0.39; IC = 0.16-0.95). Stratified analysis only confirmed family history and drug use, besides demonstrating that cigarette consumption could be a protection factor, when aforementioned factors were involved. This study might be a warning as to the cares that need to be taken regarding drug use and occupational exposure to chemical agents, as both types of substances present secondary PD action.

Síndrome de Shy-Grager: relato de um caso clínico / Shy-Drager syndrome: case report

A síndrome de Shy-Drager é uma doença degenerativa do sistema nervoso central, de etiologia desconhecida, caracterizada por falência progressiva do sistema autonômico e atrofia de múltiplos sistemas. É relatado o caso de uma paciente do sexo feminino que aos 41 anos de idade foi estabelecido o diagnóstico de síndrome de Shy-Drager. Provas funcionais autônomas, exames laboratoriais e exame físico, principalmente minucioso exame neurológico, evidenciaram claramente a falência do sistema nervoso autônomo e sinais de atrofia multissistematizada. Seräo ressaltados aspectos clínicos-evolutivos que caracterizaram os 8 anos da enfermidade, de investigaçäo da funçäo autonômica e de diagnóstico diferencial - já que a doença foi confundida durante a fase inicial com outras enfermidades sistêmicas e do sistema nervoso

Sindrome de Shy-Drager: relato de um caso clinico

A sindrome de Shy-Drager e uma doenca degenerativa do sistema nervoso central, de etiologia desconhecida, caracterizada por falencia progressiva do sistema autonomo e atrofia de multiplos sistemas. E relatado o caso de uma paciente do sexo feminino que aos 41 anos de idade foi estabelecido o diagnostico de sindrome de Shy-Drager: Provas funcionais autonomas, exames laboratoriais e exame fisico, principalmente minucioso exame neurologico, evidnciaram claramente a falencia do sistema nervoso autonomo e sinais de atrofia multissistematizada. Serao ressaltados aspectos clinicos-evolutivos que caracterizaram os 8 anos da enfermidade, de investigacao da funcao autonomica e de diagnostico diferencial-ja que a doenca foi confundida durante a fase inicial com outras enfermidades sistemicas e do sistema nervoso.

Bonnet syndrome and posterior parasagittal tumor: clues to neural mechanisms.

A case of Bonnet syndrome associated with blindness due to bilateral eye disease and a posterior parasagittal meningioma is reported. It is assumed that visual afferent deprivation alone is not enough to produce the syndrome and that, in most instances, a 'cerebral factor' must be operative if hallucinoses are to occur. The distinction between hallucinosis and hallucinations is favored and a common neural circuit for the mediation of hallucinotic imageries in general is suggested. One should not immediately put the blame on obvious eye or visual pathways affections when facing cases of Bonnet syndrome, as they are not likely to explain the complex array of images perceived by any given patient. On the contrary, the possibility of a clinically covert intracranial disease should be always raised and intensively looked for.

[Persistent alpha-vegetative state]. / Estado vegetativo-alfa persistente.

After briefly reviewing the concepts of "coma" and "alpha-coma", we report the case of a patient with presumable Pick's disease who spent several weeks in a vegetative state with a normal and reactive EEG in the alpha range in the later stages of her illness. We (a) emphasize some implications of the appearance of the eyes in such patients, b) stress the importance of distinguishing alpha activity from true alpha rhythm and (c) suggest the category "alpha-coma" should include only those individuals bearing evidence of disorders of the junctional tegmentum of the pons and midbrain. In a complementary way, we propose that patients in a persistent vegetative state displaying normal EEG should be separately classified as persistent "alpha-vegetative state".

Estado vegetativo-alfa persistente / Persistent alpha-vegetative state

Após revisäo sumária dos conceitos de "coma" e "coma-alfa", relatamos o caso de uma paciente com doença de Pick provável que, nos estágios teminais da doença, permaneceu várias semanas em estado vegetativo com EEG de vigília normal e reativo à fotoestimulaçäo. Enfatizamos (a) algumas das implicaçöes do aspecto dos olhos nesses pacientes, (b) a importância de distinguir a atividade alfa do ritmo alfa verdadeiro e (c) sugerimos que a categoria "coma-alfa" inclua apenas aqueles com afecçöes do tegmento da junçäo pontomesencefálica, de qualquer natrueza reservando a designaçäo "estado vegetativo-alfa" persistente para os que se encontrem em estado vegetativo e exibam EEG em virgília idêntico ao normal

Bonnet syndrome and posterior parasagittal tumor: clues to neural mechanisms

Relatamos o caso de um paciente com sídrome de Bonnet com cegueira ocasionada por doença ocular bilateral e meningogeoma parassagital psoterior. Admite-se que, isoladamente, a deprivaçäo visual aferente é insuficiente para produzir a síndrome e que, na maior parte dos casos, um 'fator cerebral' deve operar para que a alucinose aconteça. Favorecemos a distinçäo entre alucinose e alucinaçäo e sugerimos que um circuito neural comum medeie as imagens alucinóticas de modo geral. Näo parece prudente responsabilizar de imediato afecçöes oculares ou ópticas óbvias quando diante de casos de síndrome de Bonnet, pois, provavelmente, näo justificaräo as imagens complexas percebidas pelo paciente. Ao contrário, deve-se investigar exaustivamente a possibilidade de doenças intracranianas clinicamente inaparentes

[Sodium dantrolene (dantrium) in the treatment of neurogenic muscular spasm]. / El dantroleno sódico (Dantrium) en el tratamiento del espasmo muscular neurogénico

Forty patients, whose ages varied from 4 to 65 years, presenting skeletal muscle spascitiy as sequel of cerebral palsy, spinovertebral trauma and cerebral vascular diseases were treated with Dantrium (dantrolene sodium), a drug muscle relaxing. Laboratory data included: electromiography, chronaximetry, EEG and blood and urine tests. Clinical followup revealed subjective improvement in the patients and also objective decrease of spasticity in a satisfactory number. Patients who had improvement with this therapy also had no beneficial results with other drugs.