ABSTRACT
Gadolinium (Gd) is a rare earth element (REE) used in the formulation of contrast agents for Magnetic Resonance Imaging (MRI) due to its paramagnetic properties. The growth in population and the improved quality of the healthcare systems over the last years, has promoted the use of MRI as an effective diagnostic tool thus increasing the consumption of gadolinium and its release into the wastewater treatment network. Therefore, the tracking and quantification of this metal in sewage treatment plants and water bodies, is of paramount importance since there are currently no specific rare earth treatment technologies installed in WWTPs, and consequently gadolinium is finally discharged into the environment. In this work, the presence of gadolinium and all other rare earth elements was monitored during a year in three WWTPs in northern Spain (Vuelta Ostrera and San Román in Cantabria and Galindo in País Vasco). These WWTPs are located close to urban centres with hospitals where MRI tests are performed. By tracing Gd throughout the wastewater treatment facilities, its presence was confirmed in water streams, in the order of ng per litter, and in sludge and ashes, in the order of mg per kilogram. A significant human influence was observed, with Gd anomaly values between 3.14 and 79.2 and anthropogenic Gd percentages above 90 %. The presence of Gd in water streams is affected by the sampling period due to the variations of the activity periods of the hospitals nearby the treatment plants. On the contrary, its content in sludge and ashes remains almost constant along the year. The concentration of this metal found in the ashes opens the door to its possible recovery together with other critical raw materials in the context of the circular economy.
ABSTRACT
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Subject(s)
Female , Adult , Humans , Hemangioma, Cavernous/complications , Sciatica/etiology , Spinal Cord Neoplasms/complications , Hemangioma, Cavernous/epidemiology , Hemangioma, Cavernous/physiopathology , Sciatica/classification , Sciatica/pathology , Sciatica/surgery , Magnetic Resonance SpectroscopySubject(s)
Hemangioma, Cavernous , Lumbar Vertebrae , Pain , Radiculopathy/etiology , Spinal Cord Neoplasms , Adult , Female , Hemangioma, Cavernous/complications , Hemangioma, Cavernous/pathology , Humans , Magnetic Resonance Imaging , Pain/etiology , Pain/physiopathology , Spinal Cord Neoplasms/complications , Spinal Cord Neoplasms/pathologyABSTRACT
Los tumores secretores de prolactina son más fuertes en las mujeres, en los varones son raros, con escasas manifestaciones clínicas lo que produce un retraso en su diagnóstico y por lo tanto un aumento de su tamaño a la hora del mismo. En la literatura revisada sólo se ha encontrado un caso de invasión extracraneal. Presentamos el caso de un varón, diagnosticado de macroprolactinoma, con destrucción ósea de la base del cráneo y exrtensión extracraneal a la porción ventral de las dos primeras vértebras cervicales. El objetivo fundamental de la presentación de este caso es destacar la rareza de prolactinomas de este tamaño con invasión extracraneal y la posibilidad de su tratamiento quirúrgico realizando una gran exposición de la base craneal mediante abordaje combinado transfrontal nasal-orbitario. Las diferentes opciones terapéuticas son valoradas, así como el manejo de las complicaciones, presentando los resultados obtenidos tras un período de seguimiento de dos años (AU)
