Production of lead metal by molten-salt electrolysis with energy-efficient electrodes

"The U.S. Bureau of Mines investigated electrode designs for electrowinning lead metal from a LiCl-KCl-PbCl2 electrolyte at 450 deg C. The major objective of this investigation was to decrease the energy requirement for lead electrowinning. Electrolysis was performed in a bench-scale cell using several graphite electrode assemblies. Such parameters as electrode spacing, current density, and chlorine gas removal from the anode were investigated in the bench-scale tests. An optimum electrode assembly, termed the sawtooth design, was scaled up and operated at 3,000 and 4,000 A. The sawtooth electrodes operating at 3,000 A produced lead for 0.66 Kw.H/kg. The electrodes were constructed by cutting large triangular grooves in the electrode surfaces. The electrodes were placed together such that the triangular peaks of one electrode projected into the triangular valleys of the other electrode. Chlorine did not build up on the anode with the sawtooth electrodes." - NIOSHTIC-2NIOSHTIC no. 10008548199

Infections in patients affected by liver cirrhosis: an update

Patients with liver cirrhosis present an increased incidence of infections. The main cause has been founded in alterations of the enteric flora and of the intestinal barrier probably due to portal hypertension, in addition to a reticulo-endothelial system dysfunction. Furthermore, those living with cirrhosis can report a high predisposition to sepsis and septic shock, due to the excessive response of pro-inflammatory cytokines and a complessive hemodynamic derangement. By the analysis in the experimental model of the cirrhotic rat, it was demonstrated that radio-labelled Escherichia coli given by the oral route resulted in the location of the bacteria in the gut, the ascitic fluid and mesenteric lymph nodes, a phenomenon known as bacterial translocation. Bacteria encountered with the highest frequency are those colonizing the intestinal tract, such as E. coli, Klebsiella pneumoniae and Enterobacteriaceae, intracellular bacteria and parasites are reported with a lower frequency. Multi-drug resistant bacteria are cultured with the highest frequency in those with frequent hospitalisations and report both high septic shock and mortality rates. Spontaneous bacterial peritonitis (SBP) is the commonest infection in cirrhotic, estimated to occur in 10-30% of the cases with ascites. A practical approach may include administration of a protected penicillin, III generation cephalosporin or quinolones in uncomplicated cases. Instead, in complicated cases and in nosocomial SBP, administration of cephalosporin or quinolones can be burned by the high resistance rate and drugs active against ESBL-producing bacteria and multi-drug resistant Gram positive bacteria have to be considered as empiric therapy, until cultures are available. When cultures are not readily available and patients fail to improve a repeated diagnostic paracentesis should be performed. Current investigations suggest that norfloxacin 400 mg/day orally has been reported to successfully prevent SBP in patients with low-protein ascites and patients with prior SBP

Visceral leishmaniasis in immunocompromised: Diagnostic and therapeutic approach and evaluation of the recently released IDSA guidelines

Visceral Leishmaniasis (VL) is a chronic infectious disease endemic in tropical and sub-tropical areas including the Mediterranean basin, caused by a group of protozoan parasites of the genus Leishmania and transmitted by phlebotomine sandflies. Typically, VL is classified as a zoonotic infection when Leishmania infantum is the causative agent and as an anthroponotic one when L. donovani is the causative agent. Immunocompromised patients, in particular HIV positive, are considered at risk of VL. They may present atypical signs and poor response to the treatment due to a compromission of T-helper and regulatory cells activity. Also pregnancy can be considered a condition predisposing to Leishmania reactivation and to the changes in immune response, due to a switch toward a Th2 response reported in this condition of the life. Laboratory diagnosis is based on microscopy for parasites detection on bone-marrow or spleen aspirates. Value of serology remains high in term of sensibility, but a positive test has to be confirmed by microscopy or molecular tests. Hypergammaglobulinemia and pancytopenia are the main alteration identified by blood examination. Treatment is based on use of liposomal amphotericin B (L-AmB) whose administration is associated to lower incidence of side effects, in respect to antimonials and other formulations of AmB. Use of Miltefosine needs further investigation when L. infantum is the causative agent. Relapses to treatment are observed in coinfected HIV patients. They can benefit of a second cycle, but cumulative efficacy of the treatment can be low

Concomitant Interferon-alfa and chemotherapy in hepatitis C and colorectal cancer: a case report

Hepatitis C virus (HCV) infection is one of the main causes of liver disease worldwide. Patients undergoing surgery are at risk of acquiring acute HCV infection and those undergoing surgical eradication of a neoplasia may be indicated for adjuvant treatment. Therefore, unlike chronic infection, such patients may simultaneously need antiviral therapy with interferon for acute hepatitis C and cytotoxic chemotherapy. To date, no data are available regarding the efficacy and tolerability of concomitant interferon treatment and antineoplastic chemotherapy in the setting of acute hepatitis C treatment. Here, we report the case of a 60-yearold man who developed acute hepatitis C after left hemicolectomy for an adenocarcinoma. He received concomitant antiviral treatment with interferon-α and adjuvant chemotherapy with capecitabine and oxaliplatin. Both treatments were well tolerated and the patient completed the scheduled therapies. HCV infection was eradicated and the patient is free of neoplastic disease two years and 6 months after surgery

Use of lung ultrasound in COVID-19: comparison with ultra-high-resolution computed tomography among 29 patients at "D. Cotugno" hospital, Naples, Italy

: Ultra-High-Resolution Computed Tomography (U-HR-CT) is the reference imaging technique for pneumonia in the new coronavirus disease (COVID-19). Pulmonary Ultrasound (LUS) could be a valid diagnostic alternative for the imaging of COVID-19. Our study aimed to investigate the clinical performance of LUS in the initial evaluation of pneumonia in COVID-19 patients, compared to standard U-HR-CT. Among 29 patients with confirmed COVID-19, all U-HR-CT hallmarks showed an excellent concordance with LUS findings according to Cohen coefficient. In our experience, LUS is a viable alternative to U-HR-CT, with the advantages of being radiation-free, flexible, cost-effective, and reasonably reducing nosocomial transmission risks because performed at bed-side

Differences among confirmed and not-confirmed COVID-19 patients at "D.Cotugno" hospital, Naples (Italy): what we learned from first suspected cases?

: Clinical presentation of COVID-19 is common to other respiratory infections. We compared the characteristics at hospital admission of confirmed and not-confirmed COVID-19 patients, in the early phase of the epidemic. Thirty-seven suspected patients were enrolled, and COVID-19 was confirmed in 17. Confirmed patients are older, have more frequently contact with confirmed cases. Distinctive clinical characteristics among COVID-19 were the grand-glass opacities at CT scan, and a pO2/FiO2 ratio less than 250. In not-confirmed group, Influenza represented the most frequent alternative diagnosis. This study contributes to highlight the characteristics to consider at hospital admission in order to promptly suspect COVID-19

Evolving epidemiology of HIV/AIDS in Campania region, 2011–2018: Is HIV/AIDS population in Campania different?

Objectives: Data on HIV/AIDS cases in Italy are collected using a standardised form. Regional epidemiology may vary. We described the epidemiological and clinical characteristics of newly diagnosed persons with HIV in the ‘Cotugno’ hospital in Naples during 2011–2018 and compared them with national data to identify similarities and differences. Methods: Data source for the Campania region is the data collection forms sent to the national surveillance system. The data source for the national data is from the periodic annual bulletins on HIV/AIDS published by the National Institute of Health. Results: In all, 1149 persons with HIV were diagnosed in ‘Cotugno’ (69.7% of those diagnosed in Campania). Persons with HIV in Campania showed many similarities with the Italian population: men were in the majority in both groups (about 75%), foreign origin was about 30%, heterosexuals were the most represented risk group, followed by men who have sex with men and injecting drug use in both samples. Some notable differences are also present. Among the risk factors for HIV acquisition, injecting drug use is significantly more common in Campania. Among the reasons for testing, significant differences are evident for almost all reasons, with screening activities (testing for concurrent diseases, for diagnosis of sexually transmitted diseases, screening in hospital during maternity care and screening in drug-addition services or prisons) being more common at the national level. The Campania population has a more severe disease pattern, with a significantly higher proportion of patients diagnosed with less than 200 CD4 cells/µL and AIDS. For each variable, we compared trends in the Campania region and in Italy using Spearman’s correlation coefficient. Almost all trends show a weak correlation. Conclusion: In conclusion, the prevalence of injecting drug use is still consistent, and requires specific campaigns. The reasons for testing are different: screening activities work less in Campania than in Italy. This untimely approach contributes to a more severe clinical picture in Campania

Parietal intrahemispheric source connectivity of resting-state electroencephalographic alpha rhythms is abnormal in Naïve HIV patients

Previous evidence showed abnormal parietal sources of resting-state electroencephalographic (EEG) delta (< 4 Hz) and alpha (8-12 Hz) rhythms in treatment-Naive HIV (Naive HIV) subjects, as cortical neural synchronization markers in quiet wakefulness. Here, we tested the hypothesis that these local abnormalities may be related to functional cortical dysconnectivity as an oscillatory brain network disorder.The present EEG database regarded 128 Naive HIV and 60 Healthy subjects. The eLORETA freeware estimated lagged linear EEG source connectivity (LLC). The area under receiver operating characteristic (AUROC) curve indexed the accuracy in the classification between Healthy and HIV individuals.Parietal intrahemispheric LLC solutions in alpha sources were abnormally lower in the Naive HIV than in the control group. Furthermore, those abnormalities were greater in the Naive HIV subgroup with executive and visuospatial deficits than the Naive HIV subgroup with normal cognition. AUROC curves of those LLC solutions exhibited moderate/good accuracies (0.75-0.88) in the discrimination between the Naive HIV individuals with executive and visuospatial deficits vs. Naive HIV individuals with normal cognition and control individuals.In quiet wakefulness, Naive HIV subjects showed clinically relevant abnormalities in parietal alpha source connectivity. HIV may alter a parietal "hub" oscillating at the alpha frequency in quiet wakefulness as a brain network disorder