Autotrophic nitrogen removal by a two-step SBR process applied to mixed agro-digestate.

The aim of this research was to evaluate the applicability of partial-nitritation/anammox processes for biological N removal from a centrifuge supernatant coming from a full scale anaerobic digester fed on a mixture of piggery manure, poultry manure, and agro-wastes. Stable partial nitritation was achieved at pilot-scale (650L SBR), obtaining a suitable influent for the anammox lab-scale SBR reactor (3L). The anammox lab scale reactor was fed with increasing fractions of the partial nitritation effluent, blended with synthetic wastewater. In the last 100days no dilution was used. The nitrogen loading rate applied to the anammox reactor was 0.5-0.6gNL(-)(1)d(-)(1) and the average nitrogen removal was 91±10%. During the first days of operation with undiluted supernatant, the maximum anammox activity in the SBR decreased, but recovered afterwards, suggesting the ability of the anammox biomass to acclimate to the wastewater. N2O emissions in both reactors were also measured.

Hepatitis C virus infection and liver disease in children with thalassemia.

Antibody to the recently identified HCV and type of liver disease were investigated in 25 children with homozygous beta thalassemia. All patients were tested at regular intervals by second generation ORTHO-ELISA test. 19/25 (76%) patients were found repeatedly positive: in 11 cases seroconversion from anti-HCV- to anti-HCV+ status could be also documented. Liver disease was more severe in anti-HCV positive children. Seroconversion however did not produce major changes in liver disease outcome.

[An atypical case of juvenile polyps]. / Un caso atipico di polipo giovanile.

The authors report a case of Juvenile Polyps set up early in the first months of life, whose bleeding leads to a severe iron deficiency anemia. The atypical seat of the polyp (the jejunal tract) vanished the usual instrumental diagnostic procedures.

[A case of pseudocyst of the spleen]. / Un caso di pseudocisti della milza.

The authors report a case of pseudocyst of the spleen in a five years old girls whose only complaint was a slight pain in the left upper quadrant. A palpable globular mass was confirmed to be a splenic cyst by instrumental procedures regarded as the first ones to employ in such cases, ultrasonography and CT scan. The diagnosis of pseudocyst was possible only after the surgical spleen removal when the absence of an epithelial lining was histologically found. A short excurses on splenic cysts, from etiology to therapy, follows. Moreover the after splenectomy management of paediatric patients is discussed.

Successful use of high-dose cyclophosphamide in a child with severe autoimmune hemolytic anemia.

We report the case of a five-month-old boy with a life-threatening autoimmune hemolytic anemia that was unresponsive to conventional therapy with steroids, high-dose immunoglobulin, azathioprine and splenectomy. Despite these therapies, the patient's condition worsened, requiring 2-3 blood transfusions/day, since the hemoglobin level was constantly below 4 g/dl. We eventually increased immunosuppression by giving high-dose cyclophosphamide and the child showed a striking, sudden improvement, followed by complete recovery. No major long-term complications were observed.