Quantification and characterization of water and wastewater in dairy farms II. Effluent quality and treatment process efficiency

This study was carried out in three dairy production areas in Buenos Aires. Effluent quality, treatment process efficiency, water management strategies and environmental contamination risk by effluent discharge, was characterized in 9 dairy farms. Holding area feces were measured. Treatment lagoons were sampled. Physicochemical and microbiological qualities, and BOD and COD were determined, and used as environmental risk indicators. Plate-cooler water management strategies were established in order to divide the dairy farms in two groups (G1 and G2). Treatment lagoons were inefficient in regards to effluent treatment. BOD, COD, nitrogen (N), phosphorus (P) and enterococci found in the samples were not within acceptable values according to effluent discharge guidelines. NPK concentration would allow its potential use as a nutrient source. Variability found in the several parameters measured is related to the different lagoons? characteristics and water management strategies. Significant differences (p<0.05) were detected in N and P contents between G1 and G2. Proper environmental management in animal production systems requires an appropriate wastewater handling within each farm.Fil: Nosetti, L. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Buenos Aires, ArgentinaFil: Herrero, M.A. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Buenos Aires, ArgentinaFil: Pol, M. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Buenos Aires, ArgentinaFil: Maldonado May, V. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Producción Animal. Buenos Aires, ArgentinaFil: Korol, S. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Cátedra de Higiene y Sanidad. Buenos Aires, ArgentinaFil: Rossi, S. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Cátedra de Higiene y Sanidad. Buenos Aires, ArgentinaFil: Gemini, V. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Cátedra de Higiene y Sanidad. Buenos Aires, ArgentinaFil: Flores, M. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Salud Pública. Buenos Aires, ArgentinaEl estudio fue realizado en tres cuencas lecheras de Buenos Aires. Se caracterizaron en 9 establecimientos, la calidad de efluentes, la eficiencia de los sistemas de tratamiento, la estrategia del manejo del agua en el ordeño y el riesgo de contaminación ambiental por el vertido de efluentes. Fueron cuantificadas las heces en corrales de espera. Se tomaron muestras de las lagunas de tratamiento, analizando la calidad fisicoquímica y microbiológica. La DBO y DQO fueron utilizados como indicadores de riesgo ambiental. Los tambos fueron agrupados según la utilización del agua de la placa de refrescado (G1 y G2). Las lagunas no resultaron eficientes ya que no completaron el tratamiento de los efluentes, tampoco se obtuvieron valores aceptables de DQO, DBO, Nitrógeno (N), Fósforo (P) y enterococos, compatibles con normativas de vertido para evitar la contaminación de cursos de agua. La concentración de NPK permitiría su uso potencial como abono. La variabilidad de los parámetros analizados se relaciona a las diferentes características de las lagunas y a los sistemas de reutilización de agua. Se encontraron diferencias significativas (p<0.05), entre G1 y G2, para el contenido de nitrógeno y fósforo. Las necesidades de una gestión ambiental adecuada en los sistemas de producción animal, requiere de un manejo apropiado de estos residuos dentro del mismo establecimiento

Modulation of 5-fluorouracil as adjuvant systemic chemotherapy in colorectal cancer: the IGCS-COL multicentre, randomised, phase III study

The aims of this multicentre, randomised phase III trial were to evaluate: ( 1) the role of levamisol (LEV); and ( 2) the role of folinic acid ( FA), added to 5-fluorouracil (5FU) in the adjuvant treatment of colorectal cancer. Patients with histologically proven, radically resected stage II or III colon or rectal cancer were eligible. The study had a 2 x 2 factorial design with four treatment arms: ( a) 5FU alone, (b) 5FU+LEV, ( c) 5FU+FA, ( d) 5FU+LEV+FA, and two planned comparisons, testing the role of LEV and of FA, respectively. From March 1991, to September 1998, 1327 patients were randomised. None of the two comparisons resulted in a significant disease-free (DFS) or overall (OAS) survival advantage. The hazard ratio (HR) of relapse was 0.89 (95% confidence intervals (CI): 0.73 - 1.09) for patients receiving FA and 0.99 ( 95% CI 0.80 - 1.21) for those receiving LEV; corresponding HRs of death were 1.02 ( 95% CI: 0.80 - 1.30) and 0.94 ( 95% CI 0.73 - 1.20). Nonhaematological toxicity ( all grade vomiting, diarrhoea, mucositis, congiuntivitis, skin, fever and fatigue) was significantly worse with FA, while all other toxicities were similar. In the present trial, there was no evidence that the addition of FA or LEV significantly prolongs DFS and OAS of radically resected colorectal cancer patients

Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease: A multicenter prospective study

107noNonalcoholic fatty liver disease (NAFLD) represents the hepatic manifestation of metabolic syndrome and may evolve into hepatocellular carcinoma (HCC). Only scanty clinical information is available on HCC in NAFLD. The aim of this multicenter observational prospective study was to assess the clinical features of patients with NAFLD-related HCC (NAFLD-HCC) and to compare them to those of hepatitis C virus (HCV)-related HCC. A total of 756 patients with either NAFLD (145) or HCV-related chronic liver disease (611) were enrolled in secondary care Italian centers. Survival was modeled according to clinical parameters, lead-time bias, and propensity analysis. Compared to HCV, HCC in NAFLD patients had a larger volume, showed more often an infiltrative pattern, and was detected outside specific surveillance. Cirrhosis was present in only about 50% of NAFLD-HCC patients, in contrast to the near totality of HCV-HCC. Regardless of tumor stage, survival was significantly shorter (P = 0.017) in patients with NAFLD-HCC, 25.5 months (95% confidence interval 21.9-29.1), than in those with HCV-HCC, 33.7 months (95% confidence interval 31.9-35.4). To eliminate possible confounders, a propensity score analysis was performed, which showed no more significant difference between the two groups. Additionally, analysis of patients within Milan criteria submitted to curative treatments did not show any difference in survival between NAFLD-HCC and HCV-HCC (respectively, 38.6 versus 41.0 months, P = nonsignificant) Conclusions: NAFLD-HCC is more often detected at a later tumor stage and could arise also in the absence of cirrhosis, but after patient matching, it has a similar survival rate compared to HCV infection; a future challenge will be to identify patients with NAFLD who require more stringent surveillance in order to offer the most timely and effective treatment. (Hepatology 2016;63:827-838)openopenPiscaglia F.; Svegliati-Baroni G.; Barchetti A.; Pecorelli A.; Marinelli S.; Tiribelli C.; Bellentani S.; Bernardi M.; Biselli M.; Caraceni P.; Domenicali M.; Garuti F.; Gramenzi A.; Lenzi B.; Magalotti D.; Cescon M.; Ravaioli M.; Del Poggio P.; Olmi S.; Rapaccini G.L.; Balsamo C.; Di Nolfo M.A.; Vavassori E.; Alberti A.; Benvegnau L.; Gatta A.; Giacomin A.; Vanin V.; Pozzan C.; Maddalo G.; Giampalma E.; Cappelli A.; Golfieri R.; Mosconi C.; Renzulli M.; Roselli P.; Dell'isola S.; Ialungo A.M.; Risso D.; Marenco S.; Sammito G.; Bruzzone L.; Bosco G.; Grieco A.; Pompili M.; Rinninella E.; Siciliano M.; Chiaramonte M.; Guarino M.; Camma C.; Maida M.; Costantino A.; Barcellona M.R.; Schiada L.; Gemini S.; Lanzi A.; Stefanini G.F.; Dall'aglio A.C.; Cappa F.M.; Suzzi A.; Mussetto A.; Treossi O.; Missale G.; Porro E.; Mismas V.; Vivaldi C.; Bolondi L.; Zoli M.; Granito A.; Malagotti D.; Tovoli F.; Trevisani F.; Venerandi L.; Brandi G.; Cucchetti A.; Bugianesi E.; Vanni E.; Mezzabotta L.; Cabibbo G.; Petta S.; Fracanzani A.; Fargion S.; Marra F.; Fani B.; Biasini E.; Sacco R.; Morisco F.; Caporaso N.; Colombo M.; D'ambrosio R.; Croce L.S.; Patti R.; Giannini E.G.; Loria P.; Lonardo A.; Baldelli E.; Miele L.; Farinati F.; Borzio M.; Dionigi E.; Soardo G.; Caturelli E.; Ciccarese F.; Virdone R.; Affronti A.; Foschi F.G.; Borzio F.Piscaglia, F.; Svegliati-Baroni, G.; Barchetti, A.; Pecorelli, A.; Marinelli, S.; Tiribelli, C.; Bellentani, S.; Bernardi, M.; Biselli, M.; Caraceni, P.; Domenicali, M.; Garuti, F.; Gramenzi, A.; Lenzi, B.; Magalotti, D.; Cescon, M.; Ravaioli, M.; Del Poggio, P.; Olmi, S.; Rapaccini, G. L.; Balsamo, C.; Di Nolfo, M. A.; Vavassori, E.; Alberti, A.; Benvegnau, L.; Gatta, A.; Giacomin, A.; Vanin, V.; Pozzan, C.; Maddalo, G.; Giampalma, E.; Cappelli, A.; Golfieri, R.; Mosconi, C.; Renzulli, M.; Roselli, P.; Dell'Isola, S.; Ialungo, A. M.; Risso, D.; Marenco, S.; Sammito, G.; Bruzzone, L.; Bosco, G.; Grieco, A.; Pompili, M.; Rinninella, E.; Siciliano, M.; Chiaramonte, M.; Guarino, M.; Camma, C.; Maida, M.; Costantino, A.; Barcellona, M. R.; Schiada, L.; Gemini, S.; Lanzi, A.; Stefanini, G. F.; Dall'Aglio, A. C.; Cappa, F. M.; Suzzi, A.; Mussetto, A.; Treossi, O.; Missale, G.; Porro, E.; Mismas, V.; Vivaldi, C.; Bolondi, L.; Zoli, M.; Granito, A.; Malagotti, D.; Tovoli, F.; Trevisani, F.; Venerandi, L.; Brandi, G.; Cucchetti, A.; Bugianesi, E.; Vanni, E.; Mezzabotta, L.; Cabibbo, G.; Petta, S.; Fracanzani, A.; Fargion, S.; Marra, F.; Fani, B.; Biasini, E.; Sacco, R.; Morisco, F.; Caporaso, N.; Colombo, M.; D'Ambrosio, R.; Croce, L. S.; Patti, R.; Giannini, E. G.; Loria, P.; Lonardo, A.; Baldelli, E.; Miele, L.; Farinati, F.; Borzio, M.; Dionigi, E.; Soardo, G.; Caturelli, E.; Ciccarese, F.; Virdone, R.; Affronti, A.; Foschi, F. G.; Borzio, F

Multicentre international trial of laparoscopic lavage for Hinchey III acute diverticulitis (LLO Study)

Background: Laparoscopic lavage was proposed in the 1990s to treat purulent peritonitis in patients with perforated acute diverticulitis. Prospective randomized trials had mixed results. The aim of this study was to determine the success rate of laparoscopic lavage in sepsis control and to identify a group of patients that could potentially benefit from this treatment. Methods: This retrospective multicentre international study included consecutive patients from 24 centres who underwent laparoscopic lavage from 2005 to 2015. Results: A total of 404 patients were included, 231 of whom had Hinchey III acute diverticulitis. Sepsis control was achieved in 172 patients (74·5 per cent), and was associated with lower Mannheim Peritonitis Index score and ASA grade, no evidence of free perforation, absence of extensive adhesiolysis and previous episodes of diverticulitis. The operation was immediately converted to open surgery in 19 patients. Among 212 patients who underwent laparoscopic lavage, the morbidity rate was 33·0 per cent; the reoperation rate was 13·7 per cent and the 30-day mortality rate 1·9 per cent. Twenty-one patients required readmission for early complications, of whom 11 underwent further surgery and one died. Of the 172 patients discharged uneventfully after laparoscopic lavage, a recurrent episode of acute diverticulitis was registered in 46 (26·7 per cent), at a mean of 11 (range 2–108) months. Relapse was associated with younger age, female sex and previous episodes of acute diverticulitis. Conclusion: Laparoscopic lavage showed a high rate of successful sepsis control in selected patients with perforated Hinchey III acute diverticulitis affected by peritonitis, with low rates of operative mortality, reoperation and stoma formation

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Insight into replication effectiveness of laser-textured micro and nanoscale morphology by injection molding

Detailed analysis and characterization of injection-molded polypropylene (PP) specimens produced with laser-textured molds has been performed. Ultrashort pulsed laser surface structuring was exploited to produce sub-micrometric surface features on injection molds over areas of 2400 mm2, including two-dimensional hole and cone arrays, and ridges parallel and perpendicular to the injection direction. Replication effectiveness was evaluated in terms of surface roughness parameters, Filling Volume Fraction (FVF) and Power Spectral Density (PSD), after which detailed comparison of the topography in the same region on plastic samples and molds was performed. A scatterometry setup was employed based on optical diffraction of a probe laser beam to assess replication fidelity over the entire surface of each PP sample with a measurement technique suitable for optimization and quality control in an industrial production environment. Of the tested surface morphologies, greatest replication effectiveness was achieved with LIPSS oriented parallel to the injection direction, where the arithmetic mean height of plastic samples (Sa = 37 ± 4 nm) was 97 % of the corresponding value of the mold (Sa = 38 ± 6 nm), while the average FVF was 86 ± 9 % and the PSD indicated ripple-like features with a spacing of λ≃0.9 μm. Direct comparison of the topography in selected regions highlighted local variability in the transfer effectiveness of individual surface features. The investigation demonstrated that micro and nanoscale morphology can effectively be transferred via injection molding over large areas relevant to industrial applications, while careful attention must be paid to the size and nature of defects in relation to the specific functional surface under consideration

Consumare il welfare. L'esperienza italiana del secondo dopoguerra

Perch\ue9 simboli della societ\ue0 dei consumi sono ormai i supermercati e l\u2019automobile invece degli asili nido e degli ospedali? Eppure, nella seconda met\ue0 del Novecento, lo sviluppo della societ\ue0 dei consumi si \ue8 accompagnato ai grandi cambiamenti nei servizi sanitari, educativi e assistenziali: nella loro organizzazione complessiva, comuni e regioni hanno infatti progressivamente assunto un ruolo centrale, sostituendosi cos\uec ad altre forme di assistenza che sono andate scomparendo, come il welfare aziendale e quello offerto dai grandi enti statali. Con la presa in carico da parte dello Stato di queste nuove funzioni, la cittadinanza assume finalmente quel carattere universale che include salute ed educazione, ma, in una societ\ue0 di cittadini-consumatori, deve confrontarsi con l\u2019altro universalismo, quello del consumo, che si esprime con la libert\ue0 di scegliere e comperare ci\uf2 che si vuole con la sola mediazione del denaro. L\u2019obiettivo di fornire aiuto a chi \ue8 in difficolt\ue0 diventa cos\uec volont\ue0 di garantire la qualit\ue0 della vita a tutti coloro che vivono in un determinato territorio. Qualit\ue0 della vita e servizi divengono i parametri assoluti attraverso cui il welfare entra nell\u2019epoca della societ\ue0 dei consumi. Il libro indaga questo passaggio fondamentale, che ha costruito, nel bene e nel male, la societ\ue0 in cui viviamo