Use of biological treatments in patients with hidradenitis suppurativa.

INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic skin disease which causes a great impact in the quality of life. Multiple therapeutic options have been proposed, and recently the potential use of biological drugs in severe cases has been postulated. MATERIAL AND METHODS: A retrospective study from seven tertiary Spanish centers reviewing the charts of patients with HS treated with biological drugs was performed. Retrieved information included epidemiological data, clinical features, pain intensity, Hurley stage, laboratory data and therapeutic outcomes. RESULTS: Nineteen patients were included in the study; 10 men (52.6%) and 9 women. Eight patients (42%) showed a Hurley severity stage II and 11 a stage III (57.8%). Adalimumab was prescribed as the first biological treatment in nine out of 19 cases (47.3%), whereas infliximab was prescribed in seven cases (36.8%), ustekinumab in two cases (10.5%) and etanercept in one (5.2%). A complete response was observed in three patients (two cases with infliximab and one case with ustekinumab), a partial improvement in 10 patients and in six patients no clinical improvement was noted. One patient referred worsening of the skin symptoms. In 6 cases, a second biological treatment was prescribed. In three of such cases, a partial improvement was noted, whereas in three cases no clinical improvement was observed. In two cases a switch to a third biological drug was indicated, with a partial improvement in one case. DISCUSSION AND CONCLUSIONS: Biological drugs could be a potential and effective therapeutic option for patients with severe HS. Complete and persistent clinical responses are rarely obtained (15%) and partial responses are achieved in approximately 50% of patients. No specific markers for a therapeutic response have been identified. No definitive conclusions regarding the most effective biological drug for HS could be drawn. Higher dosage schedules seem to be associated with higher response rates. The lack of response of one particular drug does not preclude a potential efficacy to another biological treatment.

Pilot-scale road subbase made with granular material formulated with MSWI bottom ash and stabilized APC fly ash: environmental impact assessment.

A granular material (GM) to be used as road sub-base was formulated using 80% of weathered bottom ash (WBA) and 20% of mortar. The mortar was prepared separately and consisted in 50% APC and 50% of Portland cement. A pilot-scale study was carried on by constructing three roads in order to environmentally evaluate the performance of GM in a real scenario. By comparing the field results with those of the column experiments, the overestimations observed at laboratory scale can be explained by the potential mechanisms in which water enters into the road body and the pH of the media. An exception was observed in the case of Cu, whose concentration release at the test road was higher. The long-time of exposure at atmospheric conditions might have favoured oxidation of organic matter and therefore the leaching of this element. The results obtained showed that immobilization of all heavy metals and metalloids from APC is achieved by the pozzolanic effect of the cement mortar. This is, to the knowledge of the authors, the only pilot scale study that is considering reutilization of APC as a safe way to disposal.

A possible recycling method for high grade steels EAFD in polymer composites.

This work evaluates the feasibility of incorporating electric arc furnace dust (EAFD), as filler in a polymer matrix, to obtain a moldable heavyweight sheet, useful for acoustic insulation in automotive industry. For this purpose EAFD from a steel factory that manufactures high quality steels, was characterized and different formulations of composites were prepared. Physical and mechanical properties, as well as fire behaviour were tested and compared with a polymer composite compounded with common mineral fillers. Optimum formulation with 25% EAFD fulfils the RoHs Directive used by automotive industry to regulate heavy metals content. Leaching test was also performed on prepared composites to classify the material after use.