Urban wastewater as a source of reclaimed water for irrigation: barriers and future possibilities

Water resources are under pressure worldwide, resulting in scarcity and deterioration of freshwater quality. According to European directives, we could reduce the pressure on water resources in urban areas by increasing the reuse of treated wastewater, reducing the impact on water bodies, and promoting water recycling through multiple uses of urban wastewater. Besides the need to address water supply challenges, wastewater treatment systems show environmental stewardship and innovative practices. Using reclaimed water for agricultural irrigation is gaining interest because of the drought conditions experienced in Europe over the past few years. Furthermore, using treated wastewater for agricultural irrigation may help to restore nutrients (N and P) to natural biogeochemical cycles. This review highlights the importance of water reuse, current legislation, and existing technologies to implement in wastewater treatment systems to meet the minimum requirements to produce reclaimed water to reuse in agricultural irrigation.info:eu-repo/semantics/publishedVersio

Modified shock index - a strong preditor of outcome among patients presenting ST-segment elevation myocardial infarction

Background: Prompt identification of higher risk patients presenting with ST-elevation myocardial infarction (STEMI) and undergoing primary percutaneous coronary intervention will allow a more assertive strategy and approach. Aim: To evaluate the modified shock index (MSI) - a ratio of heart rate (HR) to mean blood pressure (MAP), as a predictor of in hospital and 6-month mortality among patients (pts) admitted with STEMI. Methods: We analyzed retrospectively 2389 pts admitted consecutively in our coronary care unit with acute coronary syndrome, from July of 2009 to June 2014 and we selected those who presented with STEMI (n=1140). They were divided in two groups: group 1 – pts with MSI <1.3, n=1076, 94.4%); group 2 – pts with MSI ≥1.3 (n=64, 5.6%). For each group we compared clinical and laboratory features and adverse events. Primary endpoint was the occurrence of death at 6 months; follow-up was completed in 99% of patients. Results: Patients of group 2 were older (62±14 vs 67±14; p=0.003), more frequent women (19% vs 37.5%; p1 (18.0% vs 56.3%; p<0.001), Killip=4 (2.9% vs 28.1%; p<0.001), anaemia (20.9% vs 48.4%; p<0.001) and renal insufficiency (eGFR<60 ml/min) (21.8% vs 42.6%; p<0,001). They also presented more severe coronary disease - left main coronary artery or 3 vessels disease (16.3% vs 31.3%; p=0.005) and higher prevalence of moderate to severe systolic dysfunction (48.3% vs 68.9%; p=0.009). They required more often aminergic support (7.4% vs 50%; p<0.001), intra-aortic balloon pump (2.9% vs 38.3%; p<0.001) and mechanical ventilation (2.6% vs 17.4%; p<0.001). They also had higher prevalence of malignant arrhythmias (6.1% vs 15.6%; p= 0.008) and mechanical complications (1.7 vs 6.3%; p=0.031). Compared with 1st group, the 2nd group had 6.42 times higher in hospital mortality [OR 6.42; 95% CI (4.07 – 12.67)]; p <0.001] and 7.18 times higher 6-month mortality [OR 7.18; 95% CI (3.30 - 12.46)]; p <0.001]. After adjusting for different baseline characteristics in multivariate analysis, MSI ≥1.3 remained as independent predictor of overall 6-month mortality [OR 3.81, 95% CI (1.81-8.03), p<0.001]. Conclusion: Modified shock index ≥1.3 is a stronger predictor of in hospital and 6 month mortality among patients with STEMI

Consequences of sexual harassment in sport for female athletes

Sexual harassment research was first undertaken in the workplace and educational settings. Research on sexual harassment in sport is scarce but has grown steadily since the mid-1980s. Even so, very little is known about the causes and/or characteristics and/or consequences of sexual harassment in sport settings. This article reports on the findings from interviews with 25 elite female athletes in Norway who indicated in a prior survey (N =572) that they had experienced sexual harassment from someone in sport. The consequences of the incidents of sexual harassment that were reported were mostly negative, but some also reported that their experiences of sexual harassment had had no consequences for them. “Thinking about the incidents”, a “destroyed relationship to the coach”, and “more negative view of men in general” were the most often negative consequences mentioned. In addition, a surprising number had chosen to move to a different sport or to drop out of elite sport altogether because of the harassment

Low serum albumin – another prognostic marker?

Introduction: Population-based studies have suggested an association between low serum albumin levels and coronary atherosclerosis and heart failure. The role of albumin in the context of acute coronary syndromes (ACS) remains unclear, however, seems to associate with an adverse prognosis. Aim: The aim of the present study was to determine whether low serum albumin levels are associated with development of heart failure in ACS. Methods: Study of patients consecutively admitted for ACS in a Coronary Unit over 6 months. Patients with infectious complications were excluded. Results: One hundred sixty-eight patients were eligible for analysis. Males were predominant (81.5%) and the mean age was 61.7±13.4 years old. Low serum albumin levels (serum albumin <3.5g/dl) were present in 44.6%. No significant differences were observed regarding demographic characteristics, except higher mean age (p <0.001) and a higher prevalence of hypertension (p = 0.04) in the hypoalbuminemia group. This group had lower values of hemoglobin (p<0.001) and higher levels of pro-BNP (p=0.018) and C Reactive Protein (p<0.001). In univariate analysis, hypoalbuminemia was associated with a higher prevalence of heart failure (p=0.015, OR 2.45 CI95% 1.17-5.10) and the use of intra-aortic balloon (p = 0.005) during hospitalization. There were no statistically significant differences in the use of ionotropic drugs and invasive ventilation as well as in-hospital mortality. At follow-up at 6 months showed a positive association between hypoalbuminemia and mortality (p <0.05). Conclusions: The hypoalbuminemia was associated with an increased risk of heart failure during hospitalization and death at 6 months. Although the etiology of hypoalbuminemia remain unclear, albumin assay may be useful in risk stratification of acute coronary syndromes

Helicobacter pylori colonization of the adenotonsillar tissue : fact or fiction?

Objective: The transmission of the gastric pathogen Helicobacter pylori involves the oral route. Molecular techniques have allowed the detection of H. pylori DNA in samples of the oral cavity, although culture of H. pylori from these type of samples has been sporadic. Studies have tried to demonstrate the presence of H. pylori in adenotonsillar tissue, with contradictory results. Our aim was to clarify whether the adenotonsillar tissue may constitute an extra gastric reservoir for H. pylori. Methods: Sixty-two children proposed for adenoidectomy or tonsillectomy were enrolled. A total of 101 surgical specimens, 55 adenoid and 46 tonsils, were obtained. Patients were characterized for the presence of anti-H. pylori antibodies by serology. On each surgical sample rapid urease test, immunohistochemistry, fluorescence in situ hybridization (FISH) with a peptide nucleic acid probe for H. pylori, and polymerase chain reaction–DNA hybridization assay (PCR–DEIA) directed to the vacA gene of H. pylori were performed. Results: Thirty-nine percent of the individuals had anti-H. pylori antibodies. Rapid urease test was positive in samples of three patients, all with positive serology. Immunohistochemistry was positive in samples of two patients, all with negative serology. All rapid urease test or immunohistochemistry positive cases were negative by FISH. All samples tested were negative when PCR–DEIA for H. pylori detection was used directly in adenotonsillar specimens. Conclusions: The adenotonsillar tissue does not constitute an extra gastric reservoir for H. pylori infection, at least a permanent one, in this population of children. Moreover, techniques currently used for detecting gastric H. pylori colonization are not adequate to evaluate infection of the adenotonsillar tissues.Fundação para a Ciência e a Tecnologia (FCT)Serviço de Otorrinolaringologia do Hospital de São Marcos, Braga

Prevalence and risk factors for Giardia duodenalis infection among children: A case study in Portugal

<p>Abstract</p> <p>Background</p> <p><it>Giardia duodenalis </it>is a widespread parasite of mammalian species, including humans. The prevalence of this parasite in children residing in Portugal is currently unknown. This study intended to estimate <it>G. duodenalis </it>infection prevalence and identify possible associated risk factors in a healthy paediatric population living in the District of the Portuguese capital, Lisbon.</p> <p>Methods</p> <p>Between February 2002 and October 2008, 844 children were randomly selected at healthcare centres while attending the national vaccination program. A stool sample and a questionnaire with socio-demographic data were collected from each child. <it>Giardia </it>infection was diagnosed by direct examination of stools and antigen detection by ELISA.</p> <p>Results</p> <p>The population studied revealed a gender distribution of 52.8% male and 47.2% female. Age distribution was 47.4% between 0-5 years and 52.6% between 6-15 years.</p> <p>The prevalence of <it>Giardia </it>infection was 1.9% (16/844) when estimated by direct examination and increased to 6.8% (57/844) when ELISA results were added. The prevalence was higher among children aged 0-5 years (7.8%), than among older children (5.8%), and was similar among genders (6.9% in boys and 6.5% in girls). The following population-variables were shown to be associated risk factors for <it>G. duodenalis </it>infection: mother's educational level (odds ratio (OR)= 4.49; confidence interval (CI): 1.20-16.84), father's educational level (OR = 12.26; CI: 4.08-36.82), presence of <it>Helicobacter pylori </it>infection (OR = 1.82; CI: 1.05-3.15), living in houses with own drainage system (OR = 0.10; CI: 0.02-0.64) and reported household pet contact, especially with dogs (OR = 0.53; CI: 0.31-0.93).</p> <p>Conclusion</p> <p>The prevalence of giardiasis in asymptomatic children residing in the region of Lisbon is high. Several risk factors were associated with <it>Giardia </it>prevalence and highlight the importance of parents' education and sanitation conditions in the children's well being. The association between <it>G. duodenalis </it>and <it>H. pylori </it>seems an important issue deserving further investigation in order to promote prevention or treatment strategies.</p