RESUMO
An MBR treating filtrate from sludge ultra-dewatering (FSD) was studied to evaluate the real applicability to concentrated effluents. The MBR operation is comparable to conventional wastewater MBRs in terms of F/M and nitrogen to sludge ratios, SRT and MLSS in biological tanks. On the contrary, the volume treated is lower with a comparable pollution load, the effluent being concentrated in nitrogen and carbon. Very high and stable ammonium (97.7 ± 2.4%), total phosphorus (81.8 ± 11.9%), chemical (89.5 ± 2.3%) and biochemical oxygen demands (98.8 ± 0.7%) removals are observed despite a significant modification of the FSD composition. The MBR removal performances are whether comparable or greater than those reported at full-scale for Sharon or Anammox processes. The evolution of membranes properties, in particular, the decrease of permeability induced by the irreversible fouling, leads to a decrease of the daily permeate volume produced and an increase of the chemical cleaning need. The membrane lifespan was determined to be 5.5 years based on both the permeability loss and TSS in permeate. The permeability is directly correlated to the cumulated filtered flux of colloidal matter and a total of 350 kg O2/m2 of the membrane (COD in the supernatant) is needed to reach a permeability below 100 LMH/bar. The specific energy consumption is comparable to other wastewater MBRs in kWh/kgCOD removed but the intensive chemical cleanings need to be 2.5-4.5 times more frequent. Overall, it can be concluded that MBR is adapted to treat FSD efficiently.
Assuntos
Esgotos , Águas Residuárias , Esgotos/química , Eliminação de Resíduos Líquidos , Longevidade , Reatores Biológicos , Membranas Artificiais , NitrogênioAssuntos
Automação Laboratorial , Vírus BK/genética , Reação em Cadeia da Polimerase/métodos , Reação em Cadeia da Polimerase/normas , Infecções por Polyomavirus/diagnóstico , Infecções Tumorais por Vírus/diagnóstico , Automação Laboratorial/métodos , Automação Laboratorial/normas , Transplante de Medula Óssea/efeitos adversos , Transplante de Medula Óssea/normas , DNA Viral/análise , DNA Viral/genética , Humanos , Transplante de Rim/efeitos adversos , Transplante de Rim/normas , Tipagem Molecular/métodos , Tipagem Molecular/normas , Segurança do Paciente/normas , Reação em Cadeia da Polimerase/instrumentação , Infecções por Polyomavirus/transmissão , Infecções por Polyomavirus/virologia , Guias de Prática Clínica como Assunto/normas , Padrões de Referência , Transplantados , Infecções Tumorais por Vírus/transmissão , Infecções Tumorais por Vírus/virologia , Carga Viral , Organização Mundial da SaúdeRESUMO
(1) Clinical examination of the hips should be systematically performed in the newborn, in order to detect a possible congenital dislocation. This translates into hip joint instability, which can be evidenced by both Ortolani's and Barlow's signs, the latter being more sensitive. Special attention should be paid for abduction range, as limited abduction is a warning sign. (2) Use of imaging, especially sonography will be restricted to specific cases only. It's prescription, technical realization as well as interpretation have to be carefully done, so that it is actually relevant to uncertain or "at risk" situations. (3) Treatment if needed, should be ideally managed by a paediatric orthopaedic surgeon.
Assuntos
Luxação Congênita de Quadril/diagnóstico por imagem , Triagem Neonatal , Diagnóstico Diferencial , Luxação Congênita de Quadril/patologia , Luxação Congênita de Quadril/cirurgia , Humanos , Recém-Nascido , Procedimentos Ortopédicos , Radiografia , Fatores de Risco , UltrassonografiaRESUMO
UNLABELLED: Pigmented villonodular synovitis (PVS) is characterized by a locally aggressive synovial proliferation that engenders progressive destruction of cartilage and bone. Two cases, a diffuse and a localized form, are reported. CASE REPORT: 1) A 9.9-year-old boy followed up for a popliteal cyst presented with chronic arthritis of the left knee. Aspiration yielded a bloody synovial fluid. MRI showed a heterogeneous synovial process with decreased signal in both T1- and T2-weighted images. The diagnosis of PVS was made on histology of an excisional biopsy. A complete open synovectomy was then performed. 2) A 13.8-year-old boy had a palpable mass on the internal side of the right patellofemoral joint. MRI showed a heterogenous mass with areas of hypointensity on all spin echo sequences corresponding to hemosiderin deposits suggestive of PVS. Surgical excision of a reddish-brown circumscribed lesion was performed. Diagnosis of PVS was made at surgery and confirmed by histologic examination. CONCLUSION: PVS diagnosis is frequently delayed due to nonspecific symptoms. Bloody fluid aspiration and MRI are valuable tools for early diagnosis. Treatment is surgical: extensive synovectomy for the diffuse form, excision of the lesion for the localized form.
Assuntos
Articulação do Joelho/patologia , Sinovite Pigmentada Vilonodular/patologia , Adolescente , Artrite/etiologia , Criança , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Masculino , Sinovite Pigmentada Vilonodular/cirurgiaRESUMO
BACKGROUND: The prevalence and significance of vesicoureteral reflux (VUR) after kidney transplantation in adults varies between authors and there have been few reports in children. METHODS: We conducted a retrospective study in a single-centre paediatric cohort. Fifty-five of the 84 children who underwent kidney transplantation over a 5-year period were checked with routine cystography after a median of 8 months post-transplantation. Graft function and urinary-tract infections were assessed during the first 6 years after transplantation. RESULTS: VUR into the graft was present in 58% of the patients. Graft function and incidence of urinary-tract infections were similar in the two groups, independent of VUR. After having excluded infections attributed to the presence of a catheter, actuarial survival rates without pyelonephritis and without pyelonephritis following a first lower urinary-tract infection were worse in patients with VUR (P:=0.017 and P:=0.0039 respectively). None of the eight patients with VUR treated with antibiotic prophylaxis after a first acute pyelonephritis (APN) episode presented subsequent APN after 4.4+/-3.3 years on therapy. CONCLUSIONS: VUR to the graft occurred in more than half paediatric renal transplant recipients. This condition was associated with an increased risk of APN. Long-term antibiotic prophylaxis seems to be able to prevent APN in transplanted children with VUR.
Assuntos
Transplante de Rim , Complicações Pós-Operatórias , Refluxo Vesicoureteral/epidemiologia , Adolescente , Criança , Pré-Escolar , Intervalo Livre de Doença , Feminino , Seguimentos , Taxa de Filtração Glomerular , Humanos , Lactente , Transplante de Rim/mortalidade , Transplante de Rim/fisiologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Fatores de Tempo , Infecções Urinárias/epidemiologiaRESUMO
BACKGROUND: Nephrogenic rests generally constitute precursor lesions of Wilms' tumor. We report a case of right nephroblastomatosis with dysmorphic features. CASE REPORT: An enlargement of the right kidney was incidentally discovered in a 1-year-old girl with dysmorphic features but normal psychomotor development. Combined ultrasonography and computerized tomography (CT) scan showed right cortical nephroblastomatosis. Chemotherapy using actinomycin D and vincristin was successful; however, an hyperechogenic nodule was subsequently found, necessitating a right nephrectomy. CONCLUSION: The relationship between nephroblastomatosis and Wilms' tumor is discussed. This case report reminds us of the importance of a long-term follow-up including echography and CT scan in cases of nephroblastomatosis.
Assuntos
Neoplasias Renais/diagnóstico , Tumor de Wilms/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Feminino , Humanos , Lactente , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/terapia , Nefrectomia , Tomografia Computadorizada por Raios X , Ultrassonografia , Tumor de Wilms/diagnóstico por imagem , Tumor de Wilms/terapiaAssuntos
Uretra/anormalidades , Obstrução Uretral/patologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Diagnóstico Pré-Natal , Prognóstico , Uretra/embriologia , Uretra/cirurgia , Obstrução Uretral/diagnóstico , Obstrução Uretral/fisiopatologia , Obstrução Uretral/cirurgiaAssuntos
Fosfatase Alcalina/sangue , Transplante de Fígado/fisiologia , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Atresia Biliar/cirurgia , Bilirrubina/sangue , Ciclosporina/uso terapêutico , Seguimentos , Humanos , Imunossupressores/uso terapêutico , Lactente , Isoenzimas/sangue , Transplante de Fígado/imunologia , Masculino , Prednisolona/uso terapêutico , Tempo de Protrombina , gama-Glutamiltransferase/sangueRESUMO
Blunt abdominal trauma is common in children and induces significant morbidity and mortality. Trends in management of solid viscera lesions have changed over the past 15 years and a conservative approach is now preferred whenever possible. Such management has become possible in selected cases due to advances in pediatric intensive care and medical imaging. The authors provide a review-based on international literature data-of the respective roles of medical imaging studies in the initial management of blunt abdominal trauma in children. The place of these investigations is discussed for each organ, with emphasis on the diagnostic value of sonography and computed tomography. Diagnostic pitfalls and limitations in prognostic accuracy are discussed.
Assuntos
Traumatismos Abdominais/diagnóstico , Diagnóstico por Imagem/métodos , Traumatismos Abdominais/diagnóstico por imagem , Criança , Humanos , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
This study of 785 cases of vesicorenal reflux in 494 children treated endoscopically over a 7-year period was designed to evaluate the results obtained with three products used successively: Teflon, collagen and Macroplastic. Following Teflon injection, despite a 90% short-term success rate, recurrent reflux was subsequently observed in 16.71% of the ureters reviewed. The failure rate was 52.63% after collagen injection and 11.77% after Macroplastic. After one or two injections, complete resolution of reflux was obtained in 48% of children treated with collagen, versus 85.72% with Teflon and 93.33% with Macroplastic. In one half of cases, failure was related to the quality of the product and its modifications after injection. The marked resorption of collagen accounts for the poor results despite the large doses injected. Apart from one case of partial resorption of Teflon paste, the failures with this product were due to lateralisation or secondary elimination of the product from the injection site due to its fluidity. Macroplastic, due to its higher viscosity and absence of retraction, currently provides the best results with doses of less than 0.20 ml in children.
Assuntos
Colágeno , Dimetilpolisiloxanos , Politetrafluoretileno , Próteses e Implantes , Silicones , Ureteroscopia , Refluxo Vesicoureteral/terapia , Anuria/etiologia , Criança , Colágeno/administração & dosagem , Colágeno/efeitos adversos , Constrição Patológica/etiologia , Dimetilpolisiloxanos/administração & dosagem , Dimetilpolisiloxanos/efeitos adversos , Granuloma de Corpo Estranho/etiologia , Humanos , Injeções , Masculino , Politetrafluoretileno/administração & dosagem , Politetrafluoretileno/efeitos adversos , Próteses e Implantes/efeitos adversos , Recidiva , Silicones/administração & dosagem , Silicones/efeitos adversos , Falha de Tratamento , Resultado do Tratamento , Doenças Ureterais/etiologiaRESUMO
A 2-year-old boy was operated on for a left ureteral duplication with bilateral vesicoureteric reflux. Ten years later, he experienced two episodes of transient ascites following abdominal traumatism. A cystogram disclosed a peritoneal fistula. The fistulous orifice was localized by cystoscopy, and surgery was undertaken with success.
Assuntos
Ascite , Fístula/etiologia , Doenças Peritoneais/etiologia , Fístula da Bexiga Urinária/etiologia , Pré-Escolar , Humanos , Masculino , Período Pós-Operatório , Recidiva , Fatores de Tempo , Ureter/anormalidades , Urina , Refluxo Vesicoureteral/cirurgiaRESUMO
A case of spontaneous regression of the tumor type of multicystic dysplastic kidney (MDK) is reported. This case is consistent with recent data on the natural history of MDK. The classical therapeutic approach which involves surgery is discussed in the context of this case and of others with a similar course.
Assuntos
Rim/anormalidades , Doenças Renais Policísticas/congênito , Humanos , Hipertrofia , Recém-Nascido , Rim/patologia , Masculino , Remissão Espontânea , Fatores de TempoRESUMO
A 10 year-old girl presented with a progressive left ureteral colic with abdominal tenderness. Ultrasonography revealed pyelocalyceal dilatation and an intravenous pyelogram showed lateral deviation of the left ureter. Computed tomography confirmed retroperitoneal mass distinct from psoas. Laparotomy revealed an encapsulated retroperitoneal hematoma. No particular aetiology was found and the patient's health remained stable after treatment.
Assuntos
Hematoma/diagnóstico , Criança , Feminino , Hematoma/complicações , Hematoma/diagnóstico por imagem , Humanos , Radiografia , Espaço RetroperitonealRESUMO
The authors report a case of hydranencephaly which could result from a massive intake of oestrogens in a 18 week-gravid mother. After a brief clinical summary, the role of oestrogens in the triggering of a fetal circulatory disorder is discussed.
Assuntos
Anencefalia/induzido quimicamente , Transtornos Cerebrovasculares/induzido quimicamente , Dietilestilbestrol/efeitos adversos , Doenças Fetais/induzido quimicamente , Hidranencefalia/induzido quimicamente , Anticoncepcionais Orais Hormonais , Feminino , Humanos , Recém-Nascido , Masculino , GravidezRESUMO
An extra- and intra-hepatic bile duct dilatation has been observed in a child in the course of scarlet fever. Manifestations of cholestasis, cytolysis and inflammation were present. Pruritus disappeared within 2 months, biological abnormalities within 3 months and ultrasonic bile duct abnormalities between 3 and 6 months, with a follow-up of 9 months. This case report suggests a relationship between a transitory obstruction, possibly toxic in origin, of the bile ducts and the scarlet fever.
Assuntos
Colestase/etiologia , Escarlatina/complicações , Ductos Biliares Intra-Hepáticos , Criança , Dilatação Patológica/etiologia , Humanos , Masculino , UltrassonografiaRESUMO
A biphasic acute hepatitis A is reported in a child. The cholestatic form of the second episode was associated with an ultrasonographic thickening of the gallbladder and intrahepatic bile duct walls. A possible relationship between the abnormal US appearance of intrahepatic bile ducts and cholestasis is discussed.
Assuntos
Ductos Biliares Intra-Hepáticos/patologia , Colestase Intra-Hepática/etiologia , Hepatite A/complicações , Criança , Colestase Intra-Hepática/patologia , Feminino , Hepatite A/patologia , Humanos , Hipertrofia , UltrassonografiaRESUMO
Enterolithiasis in two neonates with oesophageal and anorectal atresia is reported. The features of the two cases and comparison with the literature, the particular appearance of these intracolonic calcifications and the importance of radiological examinations for associated digestive, urinary and pulmonary malformations are presented.
Assuntos
Anormalidades Múltiplas , Anus Imperfurado/complicações , Cálculos/complicações , Doenças do Colo/complicações , Atresia Esofágica/complicações , Anormalidades Múltiplas/diagnóstico por imagem , Anus Imperfurado/diagnóstico por imagem , Osso e Ossos/anormalidades , Cálculos/diagnóstico por imagem , Doenças do Colo/diagnóstico por imagem , Atresia Esofágica/diagnóstico por imagem , Humanos , Recém-Nascido , Rim/anormalidades , Masculino , RadiografiaRESUMO
629 ureteric reimplantations were performed in 356 children. Indications for reimplantation were 315 uni or bilateral ureteral reflux, 248 primary reflux and 67 secondary to ureteric duplication, ureterocele, vesical diverticula, neurogenic bladder, bladder neck obstruction, or ureteral obstruction, and 52 megaureters, 38 primary and 14 secondary megaureters. 61 reimplantations (14 megaureters) by Leadbetter-Politano, and 568 reimplantations (58 megaureters) by Cohen procedure were performed. 3 psoas hitching and 15 ureteroplasties, 14 Hendren and 1 Kalicinski procedures, were necessary. Primary results in reflux were 98.5% of success with Cohen operation and 100% with Leadbetter-Politano operation. Results were not so good in megaureter, 70% of success with Leadbetter-Politano operation and 75% with Cohen. Results were better with psoas hitching and ureteroplasty (86.5% of success).