Combined chemically enhanced primary sedimentation and biofiltration process for low cost municipal wastewater treatment.

The main objective of wastewater treatment is to remove carbon and other nutrients from municipal and industrial effluents in order to protect the environment and human health. Typical wastewater treatment is usually achieved by a combination of physical, chemical and biological methods. In this work, municipal wastewater was depurated using chemically enhanced primary treatment (CEPT) in combination with a pilot-scale trickling filter. Lab scale experiments (Jar-tests) were carried out in order to determine the optimum dosage of chemicals. Selection criteria were the organic load removal efficiency and the low operational cost. Coagulation-flocculation process was conducted through polyaluminium chloride (PAC) and the cationic polyelectrolyte (Zetag 8180) addition. By combining CEPT and trickling filter, tCOD (total Chemical Oxygen Demand), sCOD (soluble Chemical Oxygen Demand), BOD5 (5-day Biochemical Oxygen Demand), NH4+-N, TSS (Total Suspended Solids), VSS (Volatile Suspended Solids) and PO43--P removal efficiencies were estimated to be 89, 82, 93, 60, 96, 96 and 78%, respectively. It is concluded that biological filtration contributed significantly in nutrients removal processes. Moreover, the obtained effluent was low in carbon and rich in nitrogen, which can be applied for restricted irrigation after disinfection, complying with the discharge limits set in the Greek Joint Ministerial Decree 145116/2011.

[New therapeutics]. / Nouvelles thérapeutiques.

Daily medical practice triggers reflexes in the use of drugs which must nevertheless always be adapted to new knowledge. Physician assistants and residents in the clinical ward of Internal Medicine of Sion Hospital summarize six recently published clinical treatments to which primary care physicians or in hospital-based internal medicine have to pay a particular attention. Quinolones are widely used but associated with QT interval widening, morphine delays and attenuate ticagrelor action in patients with myocardial infarction, evolocumab, a monoclonal antibody impact in reducing lipids and cardiovascular events, impact of statins on influenza vaccine effectiveness, vitamin D treatment for the prevention of functional decline, high dose dexamethasone for the treatment of immune thrombocytopenia.

La pratique médicale quotidienne suscite des réflexes dans l'utilisation de médicaments qui doivent sans cesse être adaptés aux nouvelles connaissances. Les médecins du Service de médecine interne de Sion résument six publications sur des traitements auxquels le praticien ambulatoire ou hospitalier doit porter une attention particulière. L'effet des quinolones sur l'intervalle QT, l'administration concomitante de morphine et de ticagrélor en cas de syndrome coronarien aigu, la place d'un anticorps monoclonal pour abaisser le taux de cholestérol, l'impact des statines sur l'efficacité vaccinale, la rôle de la vitamine D à haute dose pour ralentir le déclin de la performance physique, le stéroïde de choix en cas de thrombopénie auto-immune.

[Home visits by GPs - Considerations in Europe and in Switzerland]. / Visite à domicile par le médecin de famille : état des lieux en Europe et en Suisse.

Home visits are essential for promoting the ability to remain at home and prevent nursing home admissions ; general practitioners play a key role in the development of this specific ambulatory care. Although the frequency of home visits seems to be overall decreasing in recent years, they remain essential, given the expected demographic changes. This is why education on home visits should be introduced in the training of our students during early years. However, there is a gap in literature regarding the optimal number and length of home visits, as well as the kind of groups most likely to benefit from them and thus more research is needed to enlighten these aspects of home visits.

Les visites à domicile (VAD) jouent un rôle primordial dans la promotion du maintien à domicile pour une population de plus en plus âgée ; le médecin de famille est le chef d'orchestre parmi les intervenants dans cette prise en charge. Bien que la fréquence des VAD semble diminuer globalement ces dernières années, celles-ci vont rester essentielles aux soins ambulatoires étant donné les changements démographiques attendus. C'est pourquoi l'enseignement sur les VAD devrait être introduit dans la formation de nos étudiants dès les premières années d'études. D'autre part, notre connaissance sur le nombre optimal et la durée des VAD, ainsi que les groupes de patients les plus susceptibles d'en bénéficier vont demander le développement d'études ciblées à l'avenir.