Hospital effluents management: Chemical, physical, microbiological risks and legislation in different countries.

Hospital wastewater (HWW) can contain hazardous substances, such as pharmaceutical residues, chemical hazardous substances, pathogens and radioisotopes. Due to these substances, hospital wastewater can represent a chemical, biological and physical risk for public and environmental health. In particular, several studies demonstrate that the main effects of these substances can't be neutralised by wastewater treatment plants (WWTPs). These substances can be found in a wide range of concentrations due to the size of a hospital, the bed density, number of inpatients and outpatients, the number and the type of wards, the number and types of services, the country and the season. Some hazardous substances produced in hospital facilities have a regulatory status and are treated like waste and are disposed of accordingly (i.e., dental amalgam and medications). Legislation is quite homogeneous for these substances in all industrial countries. Problems that have emerged in the last decade concern substances and microorganisms that don't have a regulatory status, such as antibiotic residues, drugs and specific pathogens. At a global level, guidelines exist for treatment methods for these effluents, but legislation in all major industrial countries don't contain limitations on these parameters. Therefore, a monitoring system is necessary for these effluents as well as for substances and pathogens, as these elements can represent a risk to the environment and public health.

MRI dosimetry: a fast quantitative MRI method to determine 3D absorbed dose distributions.

RATIONALE AND OBJECTIVES: Magnetic resonance imaging (MRI) techniques seem to be very promising for 3D dosimetry studies, but long imaging acquisition time limits their use. A new fast T1 mapping protocol, easy to implement on a conventional MR imager, has been used to determine dose distributions on Fricke gels. METHODS: The method has been tested on manganese chloride (MnCl2) doped ferrous gelatin gels. The T1 measuring times range from 1 minute 40 seconds to 3 minutes 30 seconds for a 256x256 matrix image. RESULTS: The two- and three-dimensional profiles agree with those obtained with conventional dosimetry techniques (ion chambers). The precision and the spatial resolution principally depend on the signal-to-noise ratio of the used imaging RF coil. For example, for a surface coil, the accuracy is about 2.5% with a 1.56 mm spatial resolution. CONCLUSION: These preliminary results support the feasibility of the proposed technique for accurate MRI dosimetry studies and also have potential for various clinical quantitative MRI applications.

[Palliative biliary-digestive bypass with a Kehr tube for neoplastic surgical cholestatic jaundice]. / Bypass bilio-digestivo palliativo con tubo di Kehr per ittero colostatico chirurgico neoplastico.

The authors, in some rare cases of surgical neoplastic icterus operation, had to adopt a technique of biliary-digestive bypass with prosthesis on account of the technical-anatomical and general conditions of the patients. That prosthesis has been made out of the typical Keher's duct which can be generally found in every general surgery. The above mentioned authors describe the operations they have carried out, their directions and the results of six cases which have been treated with a technique similar to Kron's.