Evaluation of cold-weather wastewater nitrification technology for removal of polar chemicals of emerging concern from rural Manitoba wastewaters.

Aerated lagoons, typically used by small communities, often provide limited removal of wastewater nutrients. Given increasingly stringent wastewater standards, it is imperative that effective, but economical and easy-to-operate, treatment technologies be developed. The Submerged Attached Growth Reactor (SAGR®) is a treatment process developed to perform nitrification near freezing temperatures. Previous tests on full-scale installations have shown that SAGR could consistently remove ammonia to below current Canadian standards and provide additional total suspended solids and biochemical oxygen demand removal. In this study, we evaluated removal of polar chemicals of emerging concern (CECs), including pharmaceuticals, personal care products, and pesticides, at SAGR installations in two Manitoba First Nations communities (MCN and LPFN) under cold winter conditions. Both showed some removal of diclofenac, naproxen, clarithromycin, metoprolol, and trimethoprim, likely by biotransformation. Average naproxen removal was 21% (2.53 × 103 ng L-1) in MCN and 64% (1.58 × 103 ng L-1) in LPFN. Atenolol was well-removed by SAGR, by 80% on average (range of 64%-94%). Clarithromycin, metoprolol, and trimethoprim removal was similar within and between systems, ranging from 54% to 76% (30.8-3.07 × 102 ng L-1 removed). Carbamazepine was detected in nearly all samples, but was not well-removed, consistent with other treatment studies. Overall, results showed that SAGR technology could moderately remove CECs, while providing the designed treatment performance for other parameters. This work will help to improve our understanding of wastewater treatment in small and/or remote communities with limited infrastructure and challenging cold-weather conditions.

Relationship between admission hypoalbuminemia and inhospital mortality in acute stroke.

This study aims at assessing the relation between hypoalbuminemia and inhospital mortality in patients with acute stroke. In this cross-sectional study, a total of 112 consecutively admitted patients with first acute stroke in Ahvaz Jundishapur Hospital were enrolled. All patients hospitalized for 7-9 days or expired in this period of time. Admission hypoalbuminemia (serum albumin < 3.5 mg dL(-) as well as other prognostic factors were determined and compared between the two groups. One hundred and twelve patients, 74 males and 38 females with the mean age of 69.2 +/- 12.1 (66-79) years were enrolled. Twenty nine (25.9%) patients expired during the hospitalization. Totally, admission hypoal buminemia was present in 49 (43.8%) patients. 43% of the patients were Hypoalbuminemia. Frequency of patients with admission hypoalbuminemia and is chemic heart disease was significantly higher in the nonsurvivors (75.8-32.5%, p = 0.001; 34.5 vs. 16.9%, p = 0.047, respectively). The mean Glasgow Coma Scale score was significantly lower in the nonsurvivors (8.1 +/- 1.8 vs. 9.4 +/- 0.5, p = 0.003). These three parameters remained significant in multivariate analysis. Sex, age, history of hypertension, diabetes mellitus, hypertriglyceridemia, hypercholesterolemia, anemia, heart failure and smoking habit, admission atrial fibrillation, ethnicity and stroke type were comparable between the two groups. In conclusion, hypoalbuminemia is an independent predictor of inhospital mortality in patients with acute stroke.

[Differential diagnosis of retinoblastoma: a retrospective study of 486 cases]. / Diagnostic différentiel du rétinoblastome: étude rétrospective de 486 cas.

OBJECTIVES: Detail the most frequent problems encountered in the differential diagnosis of retinoblastoma. PATIENTS: and method: We conducted a retrospective study on the children referred to the Curie Institute for suspicion of retinoblastoma between 2000 and 2006. Diagnosis was made by fundus examination using the indirect ophthalmoscope, ultrasonography, and MRI. RESULTS: Of the 486 children seen during this period, 408 had unilateral or bilateral retinoblastoma and 78 (16%) had another lesion: Coats disease (20 children, 25%), congenital malformations (23 children, 30%; coloboma, PHPV, microphthalmia, isolated or associated with retinal dysplasia), other tumors (10 children, 13%; astrocytomas and medulloepithelioma), combined hamartomas (six children, 8%), inflammatory diseases (six children, 8%) (Toxocara canis, cat scratch eye disease, or toxoplasmosis), and other diseases (13 children, 16%; corneal opacities, congenital cataract, or retinal detachment). DISCUSSION: Compared to previous series, this study shows the proportion of erroneous diagnosis has lowered (16%) compared to earlier studies by Balmer (1986; 30%), and Shields (1991; 42%). No cases of retinopathy of prematurity were seen in our series, demonstrating that screening is good or of a lower frequency in France. The frequency of PHPV has dropped. Coats disease remains a frequent and sometimes difficult diagnosis to make, particularly in advanced stages of the disease.