Environmental exposure of pharmaceuticals and musk fragrances in the Somes River before and after upgrading the municipal wastewater treatment plant Cluj-Napoca, Romania

Background, aim, and scope: Pharmaceutically active substances are a class of emerging contaminants, which has led to increasing concern about potential environmental risks. After excretion, substantial amounts of unchanged pharmaceuticals and their metabolites are discharged into domestic wastewaters. The absence of data on the environmental exposure in Eastern Europe is significant, since use patterns and volumes differ from country to country. In Romania, the majority of wastewater, from highly populated cities and industrial complex zones, is still discharged into surface waters without proper treatment or after inefficient treatment. In respect to this, it is important to determine the environmental occurrence and behavior of pharmaceuticals and personal care products (PPCPs) in wastewaters and surface waters. The objective of the present study was to investigate the occurrence of selected PPCPs during the transport in the Somes River by mass flow analysis before and after upgrading a municipal wastewater treatment plant (WWTP) in Cluj-Napoca, which serves 350,000 inhabitants and is the largest plant discharging into the Somes River. The concentrations of PPCPs at Cluj-Napoca can be correlated with the high population and a high number of hospitals located in the catchment area leading to higher mass flows. The results of this study are expected to provide information, with respect to the Romanian conditions, for environmental scientists, WWTP operators, and legal authorities. The data should support the improvement of existing WWTPs and implementation of new ones where necessary and, therefore, minimize the input of contaminants into ambient waters. Materials and methods: The PPCPs were selected on the basis of consumption at the regional scale, reported aquatic toxicity, and the suitability of the gas chromatography/mass spectrometry (GC/MS) method for the determination of the compounds at trace levels. The studied PPCPs, caffeine (stimulant), carbamazepine (antiepileptic), pentoxifylline (anticoagulant), cyclophosphamide (cytostatic), ibuprofen (analgesic), and galaxolide (musk fragrance), were determined in samples of the Somes River. The analytes were enriched by solid-phase extraction and subsequently determined by GC/MS. Caffeine, pentoxifylline, and galaxolide were determined underivatized, whereas the acidic pharmaceuticals carbamazepine, cyclophosphamide, and ibuprofen were determined after derivatization with N-methyl-N-(trimethylsilyl)-trifluoroacetamide. Results and discussion: The concentrations in the Somes River varied from below 10ng/L up to 10μg/L. A substantial decrease of the exposure in the Somes River could be observed due to the upgrade of the municipal WWTP in Cluj-Napoca. The loads in the river stretch between Cluj-Napoca and Dej (Somes Mic) varied strongly: caffeine (400-2,000g/day), carbamazepine (78-213g/day), galaxolide (140-684g/day), ibuprofen (84-108g/day). After the upgrade of the WWTP Cluj-Napoca, the concentrations in the Somes of caffeine, pentoxifylline, cyclophosphamide, galaxolide, and tonalide were significantly reduced (over 75%). One might be cautious comparing both studies because the relative efficiency of the WWTP's removal of PPCP was not evaluated. However, the significantly lower concentrations of most compounds after the upgrade of the WWTP Cluj-Napoca allow one to infer that the technical measures at the source substantially reduced inputs of contaminants to the receiving river. Dej loads of the poorly biodegradable substance carbamazepine increased by a factor of 2-3 as a result of wastewater discharges into the river. The disproportionate increase in caffeine loads by a factor of 4 below Cluj-Napoca indicates inputs of untreated wastewater from the Somes Mare due to the discharge of untreated wastewater derived from Bistrita, Nasaud, and Beclean (115,000 inhabitants). Conclusions: The relative contribution of treated and untreated wastewater in surface water might be assessed by measuring chemical markers. Recalcitrant pharmaceuticals like carbamazepine are suitable as chemical markers for estimating the relative contribution of wastewater in surface water. The easily degradable caffeine might be a good indicator for raw sewage and hardly treated wastewaters. Recommendations and perspectives: Municipal WWTPs have the potential of a significant contribution in reducing the load of contaminants to ambient waters. The efficiency of the wastewater treatment in Cluj-Napoca improved considerably after the upgrade of the WWTP. Therefore, it is crucial that several WWTPs must be implemented or improved in the Somes Valley Watershed in order to reduce the discharge of contaminants in the Somes River from these point source

Pharmaceutical and Personal Care Products in the SomeŞ River Basin, Romania

p>Abstract. The mass flows of selected pharmaceuticals and personal care products (PPCPs) were studied in the aqueous compartment of the river Someş in Romania. PPCPs distribution was correlated with wastewater treatment plant effluents in the receiving river water. Carbamazepine, pentoxyfylline, ibuprofen, diazepam, galaxolide, tonalide and triclosan were determined in wastewater effluents with individual concentrations up to 800 ng/L. Caffeine was measured at concentrations up to 43 000 ng/L. Due to the high contamination of WWTP effluents, the receiving river was also polluted. The most abundant PPCPs measured in the Someş were caffeine, galaxolide, carbamazepine and triclosan, with concentrations ranging from 10 to 400 ng/L. The loads increased significantly after the confluence of the river Somesul Mic with the river Someşul Mare after Dej. The highest loads were observed for caffeine (800ndash;2400 g/d), galaxolide (410ndash;860 g/d), triclosan (200ndash;310 g/d) and carbamazepine (170ndash;240 g/d) suggesting the discharge of wastewater without proper treatment into the Someş. These results show that the upgrading of the WWTPs in the River Basin is of high importance to reduce the effluent load of contaminants into the Someş. This study is a first overview of PPCPs along the Romanian stretch of the Someş River./p

Procedimiento de obtención de fracciones de lípidos con dióxido de carbono presurizado a partir de lana o lanolina

Referencia OEPM: P200101341.-- Fecha de solicitud: 11/06/2001.-- Titular: Consejo Superior de Investigaciones Científicas (CSIC), Universitat Politècnica de Catalunya (UPC).Peer reviewe

Laparoscopic approach of acute pancreatitis collections: a serie of four cases

Introduction: Acute pancreatitis (AP) is one of the most unpredictable pathologies of the digestive system. AP can be associated with multiple local or systemic complications. Approximately 15-20% of patients develop moderate severe or severe pancreatitis. The moderate severe form of disease is associated with local complications, as necrosis of the pancreatic and/or peripancreatic tissue and transient organ failure. One of the most common local complications in AP is the development of peripancreatic fluid collections (PFC). Proper management of PFC necessitates accurate diagnosis and treatment by a multidisciplinary team. Moreover, tratment has turned from open surgery (associated with high mortality and morbidity), therefore the latest literature shows data justifying the use of minimally invasive procedures. Case presentantion: We present a serie of 4 patients, with ages comprised between 54 and 70 years old with peripancreatic fluid collections, more precisely, walled-off necrosis (WON), infected WON in the lesser sac and one with ANC treated laparoscopically. Conclusion: Minimally invasive procedures of PFC, especially for acute necrotic collections (ANC) include radiological, endoscopic or surgical approach. Formerly, a primary necrosectomy was the frontrunner treatment, however it is associated with high rates of mortality and morbidity. At the present moment the step-up approach management is preferred. The main and most common issue of all minimally invasive procedures is the difficult removal of the necrotic debris and the adequate drainage of the collection in one procedure. To conclude, even though pancreatitis has an unforeseeable evolution, the minimally invasive techniques seem to be promising in the managament of PFC. Case particularities: This present paper presents a serie of four cases of AP complicated with PFC admitted to the Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca. All cases were managed pure laparoscopically

Non-resectional management of splenic injuries in laparoscopic surgery

Introducere: Leziunile splenice iatrogene în chirurgia abdominală reprezintă o complicație subestimată și este important să fie recunoscute intraoperator pentru a se asigura un management adecvat. Dintre procedurile chirurgicale cu cea mai mare rată a leziunilor splenice se numără: hemicolectomia stângă (1-8%), procedeele antireflux în chirurgia deschisă (3-20%), nefrectomia stângă (4-13%) și reconstrucția aortei abdominale proximale și a ramurilor acesteia (21-60%). Pentru a gestiona acest tip de complicație, poate fi necesară splenectomia, dar tratamentul conservator prin orice mijloace, cu scopul de a obține o hemostază adecvată, ar trebui utilizat în orice situație. Serie de cazuri: Vom prezenta trei cazuri clinice care au constat în diferite leziuni splenice apărute în timpul procedurilor laparoscopice, care au fost gestionate conservator, fără a fi necesară efectuarea splenectomiei. Primul caz a constat într-o efracție splenică la un pacient cirotic în timpul unei rectosigmoidectomii laparoscopice, al doilea pacient a suferit o hemoragie prin decapsulare splenică în timpul unei cure laparoscopice a herniei hiatale, iar în ultimul caz am gestionat o leziune splenică apărută la introducerea trocarelor pentru o suprarenalectomie dreaptă laparoscopică la un pacient cu obezitate morbidă. Discuții: Seria de cazuri prezentate sunt foarte ilustrative pentru un tratament non-rezecțional efectuat laparoscopic în managementul adecvat al leziunilor splenice iatrogene. Hemostaza a fost realizată printr-o combinație de presiune locală aplicată cu o meșă, electrochirurgie și materiale șau substanțe hemostatice. Concluzie: În concluzie, considerăm că managementul conservator al hemoragiilor splenice ce pot apărea în timpul intervențiilor chirurgicale laparoscopice ar trebui stăpânit de orice chirurg generalist, și de preferință, realizat laparoscopic.Background: Splenic iatrogenic injuries in abdominal surgery represent an underestimated complication and it is important to be recognised intraoperatively to assure a proper management. Among surgical procedures with the highest rate of splenic injuries the following are to be mentioned: left hemicolectomy (1-8%), open anti-reflux procedures (3-20%), left nephrectomy (4-13%) and reconstruction of the proximal abdominal aorta and its branches (21-60%). In order to manage this type of complication, splenectomy may be required, but conservative treatment by any means with the aim of acquiring proper haemostasis should be employed at any chance. Case series: We are going to present three clinical cases which consisted of different splenic injuries during laparoscopic procedures, which were managed conservatively, without needing to perform a splenectomy. First case consisted of a splenic effraction in a cirrhotic patient during a laparoscopic rectosigmoidectomy, the second patient suffered a bleeding by splenic decapsulation during a routine laparoscopic hiatal hernia repair, and in the last case we have encountered a splenic injury when inserting the trocars for a laparoscopic right adrenalectomy in a patient with morbid obesity. Discussion: The case series presented are very illustrative of a non-resectional treatment performed laparoscopically for a proper management of splenic iatrogenic injuries. Haemostasis was established by a combination of application pressure with a mesh, electrosurgery and haemostatic materials or substances. Conclusion: In summary, we consider that conservative management of splenic bleedings which may occur during laparoscopic intervention should be mastered by any general surgeon and preferably established laparoscopically