Sustainability of using vineyard pruning residues as an energy source: Combustion performances and environmental impact

Open burning of agricultural waste is still a common practice as it is a rapid method for waste disposal, although natural biomass, including agriculture residues, can be exploited as a renewable energy source. We assessed the viability and sustainability of using vineyard pruning residues, as wood chips, for energy conversion. Wood chips, obtained from vineyards in the Prosecco DOCG region (Italy), were characterized in terms of chemical composition, calorific value, ash content and humidity. Combustion tests were performed in a medium-size biomass boiler (maximum power 500 kW) to assess the viability of the approach in terms of sustainable steady-state combustion. Primary emissions of both macro- and micro-pollutants were measured to assess the environmental impact. An analytical method was purposely developed for the determination of polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) and in three matrices: fly ashes, condensate and gas. The results showed that vineyard pruning residues can be used for energy conversion in medium- and large-scale biomass boilers. Primary emissions of measured pollutants were all below limit values set by current European legislation except for particulate matter, for which current available abatement technologies are required to contain emissions, abatement technologies are required to contain emissions, thus making the use of vineyard pruning residues unsuitable for combustion in domestic appliances where such technologies are not installed. Bottom ashes produced during combustion were also characterized to assess whether they can be recycled in the vineyard as soil amendments/fertilizer. Copper content in combustion ashes exceeded limit values for ashes to be used as fertilizers in agricultural fields for some European countries but not for others, indicating that ashes may need to be disposed as waste

Endoscopic radiofrequency ablation for the treatment of severe gastric antral vascular ectasia in patients with cirrhosis

Introduction Gastric antral vascular ectasia is a significant cause of gastrointestinal bleeding in patients with cirrhosis. Aim To assess safety/efficacy and cost/advantages of radiofrequency ablation for the treatment of gastric antral vascular ectasia in patients with cirrhosis. Materials and methods Patients with cirrhosis and severe gastric antral vascular ectasia who underwent radiofrequency ablation were enrolled. Clinical data, gastric antral vascular ectasia grade, and gastric antral vascular ectasia-related hospitalizations were collected. Primary outcome was defined as the absence of transfusion over the 6 months after radiofrequency. An economic analysis was performed in the same period. Results Forty patients (50% Child B) were enrolled (80% refractory to argon plasma coagulation). Gastric antral vascular ectasia eradication was obtained in all patients and 65% of these patients achieved primary outcome. After radiofrequency, mean number of red blood cells transfusions dropped (from 25 to 0.9, P < 0.0001), with a parallel increase in hemoglobin (from 8 to 10.5 g/dL, P < 0.0001). No major complication occurred and liver function remained stable in all patients. The cost-analysis demonstrated a profound reduction of health care cost (from euro 536.084 to euro 189.044 in the 6 months before vs. after radiofrequency, respectively). These results were confirmed in the subgroup analysis in patients refractory to argon plasma coagulation. Conclusions Radiofrequency ablation is safe and effective for the treatment of gastric antral vascular ectasia in patients with cirrhosis, including those refractory to argon plasma coagulation. Although the cost of single radiofrequency ablation is relatively high, the cost-analysis demonstrated considerable saving

Endoscopic radiofrequency ablation for the treatment of severe gastric antral vascular ectasia in patients with cirrhosis

Introduction Gastric antral vascular ectasia is a significant cause of gastrointestinal bleeding in patients with cirrhosis. Aim To assess safety/efficacy and cost/advantages of radiofrequency ablation for the treatment of gastric antral vascular ectasia in patients with cirrhosis. Materials and methods Patients with cirrhosis and severe gastric antral vascular ectasia who underwent radiofrequency ablation were enrolled. Clinical data, gastric antral vascular ectasia grade, and gastric antral vascular ectasia-related hospitalizations were collected. Primary outcome was defined as the absence of transfusion over the 6 months after radiofrequency. An economic analysis was performed in the same period. Results Forty patients (50% Child B) were enrolled (80% refractory to argon plasma coagulation). Gastric antral vascular ectasia eradication was obtained in all patients and 65% of these patients achieved primary outcome. After radiofrequency, mean number of red blood cells transfusions dropped (from 25 to 0.9, P < 0.0001), with a parallel increase in hemoglobin (from 8 to 10.5 g/dL, P < 0.0001). No major complication occurred and liver function remained stable in all patients. The cost-analysis demonstrated a profound reduction of health care cost (from euro 536.084 to euro 189.044 in the 6 months before vs. after radiofrequency, respectively). These results were confirmed in the subgroup analysis in patients refractory to argon plasma coagulation. Conclusions Radiofrequency ablation is safe and effective for the treatment of gastric antral vascular ectasia in patients with cirrhosis, including those refractory to argon plasma coagulation. Although the cost of single radiofrequency ablation is relatively high, the cost-analysis demonstrated considerable saving