RESUMO
OBJECTIVE: The aim of this study was to analyze in a prospective cohort of hospitalized COVID-19 patients the relationship between biomarkers levels and their variation within the first 4 days since admission, and prognosis. METHODS: Prospective cohort study. Individuals with confirmed diagnosis of covid-19 admitted in our hospital were included. Blood samples were obtained systematically on days 1 and 4 of hospitalization. Levels of RCP, LDH, Ferritin and D-dimer, together with platelets, lymphocytes and neutrophils counts were measured. A combined outcome that included ICU admission and death was considered the primary outcome. Logistic regression analysis was performed. RESULTS: We included 335 patients with confirmed COVID-19. During their hospitalization, 23 (6.8%) needed ICU admission, and 10 (2.9%) died. In the multivariate analysis, a value of RCP greater than 10 mg/dl (OR 8.69, CI95% 1.45-52), an increase in RCP greater than 20% (OR 26.08, CI 95% 3.21-211.3), an increase in LDH greater than 20% (OR 6.29, CI 95% 1.84-21.44), a count of lymphocytes lower than 1500/mm3 (OR 2.74, CI 95% 1.04-7.23), a D-dimer value greater than 550 ng/ml (OR 9.8, CI 95% 1.78-53.9) and a neutrophil/lymphocyte index greater than 3(OR 4.5, CI 95% 1.43-14.19) were all associated with the primary outcome. CONCLUSIONS: Our study shows that the utilization of static and dynamic biomarkers may represent an important tool to assess prognosis of COVID-19 patients.
Assuntos
COVID-19/diagnóstico , Adulto , Idoso , Biomarcadores/análise , Contagem de Células Sanguíneas , COVID-19/mortalidade , Estudos de Coortes , Comorbidade , Cuidados Críticos/estatística & dados numéricos , Feminino , Testes Hematológicos , Humanos , Pacientes Internados , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Admissão do Paciente , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Resultado do TratamentoRESUMO
Objetivo: Analizar el efecto de la utilización/implementación de 3métodos para reducir peso en pacientes con sobrepeso u obesidad, durante un año de seguimiento. Material y métodos: El diseño corresponde a un ensayo clínico, aleatorizado y controlado, doble ciego, con 3brazos y 12 meses de seguimiento. Los pacientes se aleatorizaron en 3grupos de intervención: intervención motivacional de obesidad con enfermera entrenada previamente en intervención motivacional por psicólogos expertos (G1; n=60); intervención en consulta de menor intensidad, sin grupo motivacional, con apoyo de plataforma digital (G2; n=61) y un tercer grupo que recibía recomendación de perder peso y seguimiento en consulta de Atención Primaria (G3; n=59). Se midieron las variables antropométricas (peso, talla y perímetro de cintura abdominal) y se consideró como principal medida de la efectividad del tratamiento el porcentaje de pacientes que lograron al año reducir su peso ≥5%. Resultados: Todos los grupos disminuyeron significativamente el peso al final del estudio. Fue más intensa la disminución en el G1 (−5,6kg), seguido del G2 (−4,3kg) y del G3 (−1,7kg); media en su conjunto: −3,9kg. Los indicadores de relevancia clínica fueron en el G1/G3: riesgo relativo (RR): 4,99 (IC 95%: 2,71 a 9,18); reducción relativa del riesgo (RRR): 399,1% (de 171,3 a 818,0); reducción absoluta del riesgo (RAR): 65,3% (de 51,5 a 79,1) y NNT: 2 (de 2 a 2). En los grupos G2/G3: RR: 3,01 (de 1,57 a 5,76); RRR: 200,5% (de 57,0 a 475,5); RAR: 32,8% (de 16,9 a 48,7) y NNT: 4 (de 3 a 6). En los grupos G1/G2: RR: 1,66 (de 1,25 a 2,20); RRR: 66,1% (de 25,3 a 120,1); RAR: 32,5% (de 16,6 a 48,4) y NNT: 4 (de 3 a 7). Conclusiones: Los 3grupos consiguieron reducir el peso, si bien el grupo con intervención motivacional alcanzó la mayor disminución y los indicadores de relevancia clínica más favorables (AU)
Objective: To analyse the effect of the use/implementation of 3methods to reduce weight in overweight or obese patients during one year of follow up. Material and methods: The design corresponds to a double-blind, randomised, controlled clinical trial with 3arms, and 12 months of follow-up. Patients were randomised into 3intervention groups: obesity motivational intervention, with a nurse previously trained in motivational intervention by expert psychologists (G1; n=60); lower intensity consultation, non-motivational group, with digital platform support (G2; N=61), and a third group that received recommendations for weight loss and follow-up in Primary Care Clinic (G3; n=59). Anthropometric variables (weight, height, and abdominal-waist circumference) were measured, and the percentage of patients who managed to reduce their weight ≥5% was considered as the main measurement of treatment effectiveness. Results: All groups significantly decreased body weight at the end of the study, with a reduction in G1 (−5.6kg) followed by G2 (−4.3kg), and G3 (−1.7kg), with an overall mean: −3.9kg. The indicators of clinical relevance were in G1/G3: relative risk (RR): 4.99 (95% CI: from 2.71 to 9.18); relative risk reduction (RRR): 399.1% (171.3 to 818.0); Absolute risk reduction (RAR): 65.3% (from 51.5 to 79.1) and NNT: 2 (from 2 to 2). In the G2/G3 groups: RR: 3.01 (from 1.57 to 5.76); RRR: 200.5% (from 57.0 to 475.5); RAR: 32.8% (from 16.9 to 48.7) and NNT: 4 (from 3 to 6). In the G1/G2 groups: RR: 1.66 (from 1.25 to 2.20); RRR: 66.1% (from 25.3 to 120.1); RAR: 32.5% (from 16.6 to 48.4) and NNT: 4 (from 3 to 7). Conclusions: All 3groups were able to reduce weight. Although the group with motivational intervention achieved the greatest decrease, as well as the most favourable clinical relevance indicators (AU)
Assuntos
Humanos , Redução de Peso/fisiologia , Sobrepeso/diagnóstico , Sobrepeso/terapia , Seguimentos , Obesidade/complicações , Atenção Primária à Saúde , Antropometria/métodos , Telemedicina/métodos , Índice de Massa Corporal , Relação Cintura-Quadril/métodosRESUMO
OBJECTIVE: To analyse the effect of the use/implementation of 3methods to reduce weight in overweight or obese patients during one year of follow up. MATERIAL AND METHODS: The design corresponds to a double-blind, randomised, controlled clinical trial with 3arms, and 12 months of follow-up. Patients were randomised into 3intervention groups: obesity motivational intervention, with a nurse previously trained in motivational intervention by expert psychologists (G1; n=60); lower intensity consultation, non-motivational group, with digital platform support (G2; N=61), and a third group that received recommendations for weight loss and follow-up in Primary Care Clinic (G3; n=59). Anthropometric variables (weight, height, and abdominal-waist circumference) were measured, and the percentage of patients who managed to reduce their weight ≥5% was considered as the main measurement of treatment effectiveness. RESULTS: All groups significantly decreased body weight at the end of the study, with a reduction in G1 (-5.6kg) followed by G2 (-4.3kg), and G3 (-1.7kg), with an overall mean: -3.9kg. The indicators of clinical relevance were in G1/G3: relative risk (RR): 4.99 (95% CI: from 2.71 to 9.18); relative risk reduction (RRR): 399.1% (171.3 to 818.0); Absolute risk reduction (RAR): 65.3% (from 51.5 to 79.1) and NNT: 2 (from 2 to 2). In the G2/G3 groups: RR: 3.01 (from 1.57 to 5.76); RRR: 200.5% (from 57.0 to 475.5); RAR: 32.8% (from 16.9 to 48.7) and NNT: 4 (from 3 to 6). In the G1/G2 groups: RR: 1.66 (from 1.25 to 2.20); RRR: 66.1% (from 25.3 to 120.1); RAR: 32.5% (from 16.6 to 48.4) and NNT: 4 (from 3 to 7). CONCLUSIONS: All 3groups were able to reduce weight. Although the group with motivational intervention achieved the greatest decrease, as well as the most favourable clinical relevance indicators.
Assuntos
Entrevista Motivacional , Sobrepeso/terapia , Educação de Pacientes como Assunto , Terapia Assistida por Computador , Redução de Peso , Adulto , Idoso , Antropometria , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/enfermagem , Obesidade/terapia , Sobrepeso/enfermagem , Instruções Programadas como Assunto , Software , Telemedicina , Resultado do TratamentoRESUMO
No disponible
Assuntos
Humanos , Masculino , Adulto , Tuberculoma/tratamento farmacológico , Tuberculoma , Sons Respiratórios , Sons Respiratórios/diagnóstico , Isoniazida/uso terapêutico , Rifampina/uso terapêutico , Tosse/complicações , Tosse/etiologia , Febre/complicações , Radiografia Torácica/métodos , Radiografia Torácica , Busca de Comunicante/métodos , Busca de Comunicante , Piridoxina/uso terapêutico , Etambutol/uso terapêuticoRESUMO
Introducción: La asociación de ciclosporina A (CsA) y micofenolato mofetil (MMF) tiene un efecto inmunosupresor sinérgico y, en consecuencia, podría inducir una remisión del síndrome nefrótico en enfermos con glomeruloesclerosis segmentaria y focal resistente a esteroides y a CsA. Objetivo: Analizar la eficacia y el perfil de seguridad de la asociación CsA y MMF en enfermos con GSF resistente a ciclosporina A. Pacientes y método: 27 enfermos con GSF resistente a CsA recibieron tratamiento con CsA (4 mg/kg/día) asociada a MMF (2 g/día) durante 12 meses. El seguimiento total fue de 5 años. Como medida de resultado, se consideró la proporción de enfermos con remisión de la proteinuria y la evolución de la función renal a los 5 años. Resultados: Al finalizar el período de tratamiento, ningún paciente presentó remisión completa; 4 pacientes (14,8%) presentaron reducción de proteinuria a valores <3,5 g/día. Estos enfermos presentaban proteinuria basal (5,62 ± 2,19 frente a 8,1 ± 2,96 g/día, p = 0,042) y pendientes de FG (-0,08 ± 0,12 frente a -0,69 ± 0,38; p = 0,003) significativamente inferiores y mayor función renal basal (99,6 ± 12,9 frente a 85,05 ± 15,5 ml/min; p = 0,003). Dieciséis de los 27 enfermos (59,2%) presentaron una enfermedad renal progresiva o estadio V al final del período de seguimiento. Se apreciaron efectos adversos gastrointestinales en el 33,3% de los enfermos y nefrotoxicidad aguda transitoria en el 14,8%. El 22,2% de los enfermos precisó un incremento en la dosis y/o número de hipotensores durante los 12 meses de tratamiento. Conclusiones: En enfermos con GSF resistente a ciclosporina, el tratamiento con asociación de CsA y MMF durante 12 meses, aunque puede inducir reducciones parciales de la proteinuria, no modifica significativamente el curso evolutivo de la función renal (AU)
Introduction: The combination of cyclosporin A (CsA) and mycophenolate mofetil (MMF) has a synergistic immunosuppressive effect and, as a result, it may induce remission of nephrotic syndrome in patients with steroid- and CsA-resistant focal segmental glomerulosclerosis (FSGS). Objective: To analyse the efficacy and safety of the combined CsA and MMF treatment in patients with cyclosporin A-resistant FSGS. Patients and methods: Twenty-seven patients with CsA-resistant FSGS were treated for 12 months with CsA (4 mg/kg/day) combined with MMF (2 g/day). The overall follow-up was 5 years. The proportion of patients with remission of proteinuria and the evolution of kidney function after 5 years were used to measure the outcome. Results: At the end of the treatment period, no patients were in complete remission and 4 patients (14.8%) had reduced proteinuria to values <3.5g/day. These patients had significantly lower baseline proteinuria (5.62±2.19 compared to 8.1±2.96g/day, P=.042), significantly lower GFR (-0.08 compared to -0.69±0.38; P=.003) and higher baseline kidney function (99.6±12.9 compared to 85.05±15.5ml/min; P=.003). Sixteen out of the 27 patients (59.2%) had progressive or stage 5 kidney disease at the end of the follow-up period. Adverse gastrointestinal effects were observed in 33.3% of the patients and acute transitory nephrotoxicity in 14.8%. The dosage and/or number of anti-hypertensive drugs had to be increased in 22.2% of patients during the 12 months of treatment. Conclusions: Twelve months of combined CsA and MMF therapy does not significantly alter the evolution of kidney function in patients with cyclosporin-resistant FSGS, although it may induce partial reductions in proteinuria (AU)
Assuntos
Humanos , Ciclosporina/uso terapêutico , Ácido Micofenólico/uso terapêutico , Glomerulosclerose Segmentar e Focal/tratamento farmacológico , Combinação de Medicamentos , Resistência a Medicamentos , Proteinúria/tratamento farmacológico , Estudos ProspectivosRESUMO
INTRODUCTION: The combination of cyclosporin A (CsA) and mycophenolate mofetil (MMF) has a synergistic immunosuppressive effect and, as a result, it may induce remission of nephrotic syndrome in patients with steroid- and CsA-resistant focal segmental glomerulosclerosis (FSGS). OBJECTIVE: To analyse the efficacy and safety of the combined CsA and MMF treatment in patients with cyclosporin A-resistant FSGS. PATIENTS AND METHODS: Twenty-seven patients with CsA-resistant FSGS were treated for 12 months with CsA (4mg/kg/day) combined with MMF (2g/day). The overall follow-up was 5 years. The proportion of patients with remission of proteinuria and the evolution of kidney function after 5 years were used to measure the outcome. RESULTS: At the end of the treatment period, no patients were in complete remission and 4 patients (14.8%) had reduced proteinuria to values <3.5g/day. These patients had significantly lower baseline proteinuria (5.62±2.19 compared to 8.1±2.96g/day, P=.042), significantly lower GFR (-0.08 compared to -0.69±0.38; P=.003) and higher baseline kidney function (99.6±12.9 compared to 85.05±15.5ml/min; P=.003). Sixteen out of the 27 patients (59.2%) had progressive or stage 5 kidney disease at the end of the follow-up period. Adverse gastrointestinal effects were observed in 33.3% of the patients and acute transitory nephrotoxicity in 14.8%. The dosage and/or number of anti-hypertensive drugs had to be increased in 22.2% of patients during the 12 months of treatment. CONCLUSIONS: Twelve months of combined CsA and MMF therapy does not significantly alter the evolution of kidney function in patients with cyclosporin-resistant FSGS, although it may induce partial reductions in proteinuria.
Assuntos
Ciclosporina/administração & dosagem , Glomerulosclerose Segmentar e Focal/tratamento farmacológico , Imunossupressores/administração & dosagem , Ácido Micofenólico/análogos & derivados , Ciclosporina/efeitos adversos , Quimioterapia Combinada , Feminino , Humanos , Imunossupressores/efeitos adversos , Masculino , Pessoa de Meia-Idade , Ácido Micofenólico/administração & dosagem , Ácido Micofenólico/efeitos adversos , Projetos Piloto , Estudos ProspectivosRESUMO
Different start-up procedures of an upflow anaerobic sludge bed (UASB) digester were carried out. Start-up without inoculum (experiment A) was delayed for about 120 day. The digester reached 75-85% total suspended solids (TSS) removal, 54-58% total chemical oxygen demand (TCOD) removal and 63-73% biological oxygen demand (BOD5) removal at influent concentrations of 240-340 mg TCODil-1, temperatures of 13.5-15 degrees C and hydraulic retention times (HRT) of 10-11 h. Digested sludge was used as inoculum in experiment B. After the start-up period of 75 days, digester efficiencies were 58%, 41% and 54% for TSS, TCOD and BOD5 removal, respectively, working at 169 mg TCODil-1, temperature of 14 degrees C and HRT of 11 h. The sludge bed developed and stabilised quickly when using a hydraulically adapted inoculum (experiment C), but TCOD and BOD5 removals remained low and volatile fatty acids (VFA) accumulated in the effluent.
Assuntos
Bactérias Anaeróbias/fisiologia , Reatores Biológicos/microbiologia , Temperatura Baixa , Esgotos/microbiologia , Eliminação de Resíduos Líquidos/métodos , Biodegradação Ambiental , Cidades , Arquitetura de Instituições de Saúde , Ácidos Graxos Voláteis/análise , Estudos de Viabilidade , Fermentação , Projetos Piloto , Esgotos/química , Fatores de Tempo , Movimentos da ÁguaAssuntos
Pessoa de Meia-Idade , Feminino , Humanos , Carcinoma de Células Escamosas/secundário , Neoplasias Musculares/secundário , Neoplasias Pulmonares/patologia , Carcinoma de Células Escamosas , Evolução Fatal , Espectroscopia de Ressonância Magnética , Neoplasias Musculares , Neoplasias PulmonaresRESUMO
Intracraneal manifestations of Hodgkin's Disease (HD) are extremely rare, with an estimated incidence rate of approximately 0.5%. They can be classified as: 1) treatment-related leucoencephalopathy, 2) central nervous system infections, 3) paraneoplasic syndromes and 4) intracraneal lymphomas, which could be sub-classified into intraparenchymal or intradural masses. We describe a case of a 40 year-old male with mixed cellularity type HD who developed neurological manifestations as relapsed disease. Magnetic resonance imaging suggested leptomeningeal metastases and atypical cells were found in cerebrospinal fluid. The patient died from progressive disease refractory to third line chemotherapy. There are less than 50 similar cases reported in the literature. We review the clinical features and differential diagnosis of leptomeningeal metastases in Hodgkin's disease.
Assuntos
Adulto , Humanos , Masculino , Doença de Hodgkin/patologia , Neoplasias Meníngeas/secundário , Biópsia por Agulha , Bleomicina/administração & dosagem , Ciclofosfamida/administração & dosagem , Cisplatino/administração & dosagem , Citarabina/administração & dosagem , Diagnóstico Diferencial , Dacarbazina/administração & dosagem , Doença de Hodgkin/líquido cefalorraquidiano , Doença de Hodgkin/tratamento farmacológico , Doxorrubicina/administração & dosagem , Etoposídeo/administração & dosagem , Evolução Fatal , Leucoencefalopatia Multifocal Progressiva/induzido quimicamente , Leucoencefalopatia Multifocal Progressiva/patologia , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/líquido cefalorraquidiano , Prednisona/administração & dosagem , Procarbazina/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Recidiva , Síndromes Paraneoplásicas/patologia , Vimblastina/administração & dosagem , Vincristina/administração & dosagemAssuntos
Pessoa de Meia-Idade , Feminino , Humanos , Carcinoma de Células Escamosas/secundário , Neoplasias Pulmonares/patologia , Neoplasias Musculares/secundário , Carcinoma de Células Escamosas/diagnóstico por imagem , Evolução Fatal , Neoplasias Pulmonares/diagnóstico por imagem , Espectroscopia de Ressonância Magnética , Neoplasias Musculares/diagnóstico por imagemRESUMO
Intracraneal manifestations of Hodgkins Disease (HD) are extremely rare, with an estimated incidence rate of approximately 0.5%. They can be classified as: 1) treatment-related leucoencephalopathy, 2) central nervous system infections, 3) paraneoplasic syndromes and 4) intracraneal lymphomas, which could be sub-classified into intraparenchymal or intradural masses. We describe a case of a 40 year-old male with mixed cellularity type HD who developed neurological manifestations as relapsed disease. Magnetic resonance imaging suggested leptomeningeal metastases and atypical cells were found in cerebrospinal fluid. The patient died from progressive disease refractory to third line chemotherapy. There are less than 50 similar cases reported in the literature. We review the clinical features and differential diagnosis of leptomeningeal metastases in Hodgkins disease.(AU)
Assuntos
Adulto , Humanos , Masculino , Doença de Hodgkin/patologia , Neoplasias Meníngeas/secundário , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia por Agulha , Bleomicina/administração & dosagem , Cisplatino/administração & dosagem , Ciclofosfamida/administração & dosagem , Citarabina/administração & dosagem , Dacarbazina/administração & dosagem , Diagnóstico Diferencial , Doxorrubicina/administração & dosagem , Etoposídeo/administração & dosagem , Evolução Fatal , Doença de Hodgkin/líquido cefalorraquidiano , Doença de Hodgkin/tratamento farmacológico , Leucoencefalopatia Multifocal Progressiva/induzido quimicamente , Leucoencefalopatia Multifocal Progressiva/patologia , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/líquido cefalorraquidiano , Síndromes Paraneoplásicas/patologia , Prednisona/administração & dosagem , Procarbazina/administração & dosagem , Recidiva , Vimblastina/administração & dosagem , Vincristina/administração & dosagemAssuntos
Pessoa de Meia-Idade , Feminino , Humanos , Carcinoma de Células Escamosas/secundário , Neoplasias Pulmonares/patologia , Neoplasias Musculares/secundário , Carcinoma de Células Escamosas/diagnóstico por imagem , Evolução Fatal , Neoplasias Pulmonares/diagnóstico por imagem , Espectroscopia de Ressonância Magnética , Neoplasias Musculares/diagnóstico por imagemRESUMO
Intracraneal manifestations of Hodgkins Disease (HD) are extremely rare, with an estimated incidence rate of approximately 0.5%. They can be classified as: 1) treatment-related leucoencephalopathy, 2) central nervous system infections, 3) paraneoplasic syndromes and 4) intracraneal lymphomas, which could be sub-classified into intraparenchymal or intradural masses. We describe a case of a 40 year-old male with mixed cellularity type HD who developed neurological manifestations as relapsed disease. Magnetic resonance imaging suggested leptomeningeal metastases and atypical cells were found in cerebrospinal fluid. The patient died from progressive disease refractory to third line chemotherapy. There are less than 50 similar cases reported in the literature. We review the clinical features and differential diagnosis of leptomeningeal metastases in Hodgkins disease.(AU)
Assuntos
Adulto , Humanos , Masculino , Doença de Hodgkin/patologia , Neoplasias Meníngeas/secundário , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia por Agulha , Bleomicina/administração & dosagem , Cisplatino/administração & dosagem , Ciclofosfamida/administração & dosagem , Citarabina/administração & dosagem , Dacarbazina/administração & dosagem , Diagnóstico Diferencial , Doxorrubicina/administração & dosagem , Etoposídeo/administração & dosagem , Evolução Fatal , Doença de Hodgkin/líquido cefalorraquidiano , Doença de Hodgkin/tratamento farmacológico , Leucoencefalopatia Multifocal Progressiva/induzido quimicamente , Leucoencefalopatia Multifocal Progressiva/patologia , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/líquido cefalorraquidiano , Síndromes Paraneoplásicas/patologia , Prednisona/administração & dosagem , Procarbazina/administração & dosagem , Recidiva , Vimblastina/administração & dosagem , Vincristina/administração & dosagemRESUMO
The anaerobic treatment of raw domestic wastewater by a novel technology consisting of an Up-flow Anaerobic Sludge Bed (UASB) reactor combined with a completely mixed digester for the stabilisation of the UASB sludge was assessed. A pilot-scale plant of the so-called UASB-Digester system was located at the municipal wastewater treatment facility of Santiago de Compostela (Northwest of Spain). The main aim of the Digester was to enhance the biodegradation of influent solids retained in the UASB reactor at low temperatures, then increasing its specific methanogenic activity. The sludge drawn from the middle zone of the UASB entered the upper zone of the Digester and then circulated from the bottom of the Digester to the UASB bottom. Circulating in an automated semi-continuous way, the flow of this sludge stream was selected in order to set a previously defined hydraulic retention time (HRT) (16-27 d) in the digester. The Digester temperature was set at an optimum value ranging from 25 to 35 degrees C. The steady state efficiency of the UASB system, at 6-8 h of HRT, 15-16 degrees C of temperature and 330-360 mg l(-1) of influent total chemical oxygen demand (TCOD) was 79% of total suspended solids (TSS) removal, 52% of TCOD removal and 60% of biological oxygen demand (BOD5) removal. The hydrolysis of retained solids reached 85%, while excess sludge generation was only 7% of influent TCOD. A stable anaerobic (pre)treatment of diluted domestic wastewater was reached as the sludge concentration in the reactor remained mainly constant and the specific methanogenic activity showed a slight increase.
Assuntos
Bactérias Anaeróbias/fisiologia , Reatores Biológicos , Modelos Teóricos , Eliminação de Resíduos Líquidos/métodos , Biodegradação Ambiental , Oxigênio/análise , Esgotos/química , Movimentos da ÁguaAssuntos
Doença Pulmonar Obstrutiva Crônica/diagnóstico , Espirometria , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/etiologia , Fumar/efeitos adversosRESUMO
No disponible
Assuntos
Pessoa de Meia-Idade , Adulto , Idoso de 80 Anos ou mais , Idoso , Masculino , Feminino , Humanos , Espirometria , Tabagismo , Sulfóxidos , Atenção Primária à Saúde , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica , Benzimidazóis , Diagnóstico Diferencial , Quimioterapia Combinada , Estradiol , Doença da Mama Fibrocística , Doença da Mama FibrocísticaRESUMO
Raw domestic wastewater from the city of Santiago de Compostela (Northwest Spain) was fed into a pilot-scale hydrolytic up flow sludge bed (HUSB) digester with an active volume of 25.5 m3. The total influent chemical oxygen demand (COD) ranged from 360 to 470 mg/l, the influent SS varied from 190 to 370 mg/l, and the temperature was between 17 degrees and 20 degrees C. The organic load rate (OLR) applied increased step by step from 1.2 to 3.9 kgCOD/m3 x d, while the hydraulic retention time (HRT) decreased from 7.1 h to 2.9 h. A high suspended solids (SS) removal of about 82-85% from the influent was reached, most of which (81 to 88%) was eliminated by hydrolysis, while the rest remained in the purge stream. The total COD removal ranged from 46 to 59%. On the other hand, a high acidification of the COD remaining in the effluent was obtained, so the percent COD in the form of volatile fatty acids (VFA(COD)) with respect to total effluent COD was about 43% for the highest HRT applied, and about 27% for the lowest HRT. The soluble to total COD ratio (CODs/CODt) increased from 25-32% for the influent to 71-86% for the effluent. The results obtained confirm the viability and interest of direct anaerobic hydrolytic pre-treatment of domestic wastewater.
Assuntos
Bactérias Anaeróbias/fisiologia , Eliminação de Resíduos Líquidos/métodos , Reatores Biológicos , Cidades , Concentração de Íons de Hidrogênio , Hidrólise , Oxigênio/química , Movimentos da ÁguaRESUMO
We describe a 26-year-old white female with a history of Raynaud phenomenon, erythema nodosum, polyarthralgias, migraine, vertigo, seizures, transient ischemic attacks, one fetal loss, and false positive VDRL, who developed milk hypertension without overt lupus nephritis. She had positive antinuclear antibodies (ANA) and double-stranded deoxyribonucleic acid (dsDNA) antibodies. The lupus anticoagulant test (LAC) and cardiolipins antibodies (aCL) were positive. She was diagnosed as having a Systemic Lupus Erythematosus-like illness (SLE-like) with 'secondary' antiphospholipid syndrome (APS). Renal spiral computed tomography (CT) with intravenous (IV) contrast showed bilateral renal artery stenosis. Anticoagulation with acenocumarol was started. She became normotensive without antihypertensive drugs five months later. A follow-up renal spiral CT showed complete recanalization of both renal arteries, making thrombosis the more likely culprit pathology in the stenosis. After two years follow up the patient is normotensive. She remains on acenocumarol.
Assuntos
Síndrome Antifosfolipídica/complicações , Obstrução da Artéria Renal/etiologia , Acenocumarol/uso terapêutico , Adulto , Anticorpos Anticardiolipina/análise , Anticorpos Antinucleares/análise , Anticoagulantes/uso terapêutico , Síndrome Antifosfolipídica/diagnóstico por imagem , Síndrome Antifosfolipídica/fisiopatologia , DNA/imunologia , Feminino , Humanos , Hipertensão/complicações , Inibidor de Coagulação do Lúpus/análise , Doença de Raynaud/complicações , Artéria Renal/diagnóstico por imagem , Artéria Renal/fisiopatologia , Obstrução da Artéria Renal/diagnóstico por imagem , Obstrução da Artéria Renal/fisiopatologia , Tomografia Computadorizada por Raios XRESUMO
We report a case of a 35 year-old woman with idiopathic thrombocytopenic purpura (ITP) who, under treatment with immunosuppressive drugs, developed bilateral interstitial pulmonary disease. Previously she had been splenectomized and treated with corticosteroids and cyclosporin. During the clinical course, the patient developed alterations of the hepatogram and presented a positive serology for Epstein-Barr virus. The lung biopsy showed the histologic pattern of obliterative bronchiolitis, interstitial inflammatory infiltration and intraalveolar pneumonia (BOOP). We could not find in the literature a previous report in which ITP was associated with BOOP. Of interest was the spontaneous remission of the pulmonary disease after suppression of cyclosporin and positive serology for Epstein-Barr virus.