Intensification of UV-C tertiary treatment: Disinfection and removal of micropollutants by sulfate radical based Advanced Oxidation Processes.

This study explores the enhancement of UV-C tertiary treatment by sulfate radical based Advanced Oxidation Processes (SR-AOPs), including photolytic activation of peroxymonosulfate (PMS) and persulfate (PS) and their photocatalytic activation using Fe(II). Their efficiency was assessed both for the inactivation of microorganisms and the removal or micropollutants (MPs) in real wastewater treatment plant effluents. Under the studied experimental range (UV-C dose 5.7-57 J/L; UV-C contact time 3 to 28 s), the photolysis of PMS and PS (0.01 mM) increased up to 25% the bacterial removal regarding to UV-C system. The photolytic activation of PMS led to the total inactivation of bacteria (≈ 5.70 log) with the highest UV-C dose (57 J/L). However, these conditions were insufficient to remove the MPs, being required oxidant's dosages of 5 mM to remove above 90% of carbamazepine, diclofenac, atenolol and triclosan. The best efficiencies were achieved by the combination of PMS or PS with Fe(II), leading to the total removal of the MPs using a low UV-C dosage (19 J/L), UV-C contact time (9 s) and reagent's dosages (0.5 mM). Finally, high mineralization was reached (>50%) with photocatalytic activation of PMS and PS even with low reagent's dosages.

Micropollutants removal by full-scale UV-C/sulfate radical based Advanced Oxidation Processes.

The high chemical stability and the low biodegradability of a vast number of micropollutants (MPs) impede their correct treatment in urban wastewater treatment plants. In most cases, the chemical oxidation is the only way to abate them. Advanced Oxidation Processes (AOPs) have been experimentally proved as efficient in the removal of different micropollutants at lab-scale. However, there is not enough information about their application at full-scale. This manuscript reports the application of three different AOPs based on the addition of homogeneous oxidants [hydrogen peroxide, peroxymonosulfate (PMS) and persulfate anions (PS)], in the UV-C tertiary treatment of Estiviel wastewater treatment plant (Toledo, Spain) previously designed and installed in the facility for disinfection. AOPs based on the photolytic decomposition of oxidants have been demonstrated as more efficient than UV-C radiation alone on the removal of 25 different MPs using low dosages (0.05-0.5 mM) and very low UV-C contact time (4-18 s). Photolysis of PMS and H2O2 reached similar average MPs removal in all the range of oxidant dosages, obtaining the highest efficiency with 0.5 mM and 18 s of contact time (48 and 55% respectively). Nevertheless, PMS/UV-C reached slightly higher removal than H2O2/UV-C at low dosages. So, these treatments are selective to degrade the target compounds, obtaining different removal efficiencies for each compound regarding the oxidizing agent, dosages and UV-C contact time. In all the cases, H2O2/UV-C is more efficient than PMS/UV-C, comparing the ratio cost:efficiency (€/m3·order). Even H2O2/UV-C treatments are more efficient than UV-C alone. Thus, the addition of 0.5 mM of H2O2 compensates the increased of UV-C contact time and therefore the increase of electrical consumption, that it should be need to increase the removal of MPs by UV-C treatments alone.

¿Son los nuevos anticoagulantes orales iguales a las antivitaminas K para la isquemia aguda de los miembros inferiores? Revisión sistemática de la evidencia / Are the new oral anticoagulants the same as vitamin K antagonists for acute lower limb ischaemia? A systematic review of the evidence

INTRODUCCIÓN: Los nuevos anticoagulantes orales (dabigatran, ribaroxaban y apixaban) se presentan como alternativas a los antagonistas de la vitamina K (AVK) en la prevención de eventos embólicos en pacientes con fibrilación auricular (FA). No existen ensayos clínicos que comparen directamente estos fármacos para la prevención de la isquemia aguda (IA) de miembros inferiores. MATERIAL Y MÉTODOS: Este estudio presenta los ensayos clínicos aleatorizados (RE-LY, ROCKET-AF, ARISTOTLE) que describen la capacidad de prevención de IA entre estos nuevos fármacos. RESULTADOS: Los nuevos anticoagulantes orales han demostrado en diversos ensayos clínicos y metaanálisis una eficacia similar a los AVK en la prevención de accidente cerebrovascular y embolismo sistémico con un menor número de complicaciones en pacientes con FA no valvular. CONCLUSIONES: Todavía no disponemos de evidencia de calidad sobre el efecto de estos fármacos para la prevención de la IA de miembros inferiores. Son necesarios futuros ensayos clínicos en esta dirección

INTRODUCTION: New oral anticoagulants (apixaban, dabigatran, and rivaroxaban) are alternatives to vitamin-K antagonist (VKA) for preventing embolic events in patients withauricular auricular fibrillation. So far, direct comparative studies between agents in prevention of acute limb ischaemia are unavailable. MATERIAL AND METHODS: The present study shows the outcome from the 3 randomised clinical trials (RE-LY, ROCKET-AF, ARISTOTLE) regarding acute limb ischaemia risk prevention. RESULTS: Novel oral anticoagulant therapies have shown a non-inferior efficacy compared with VKAs in lowering cerebrovascular ischaemic events and systemic embolism risk in several randomised clinical trials as well as in meta-analysis. Moreover, they have been shown to have a decreased complication rate in non-valvularauricular auricular fibrillation. CONCLUSIONS: There is no high quality evidence available on the effect of these treatments in preventing acute limb ischaemia

Meta-analysis and adjusted indirect comparison of direct oral anticoagulants in prevention of acute limb ischemia in patients with atrial fibrillation.

BACKGROUND: Direct oral anticoagulants are being presented as alternatives to warfarin for preventing stroke in patients with atrial fibrillation. Yet direct comparative trials between these agents in prevention of acute limb ischemia (ALI) are unavailable so far. OBJECTIVE: To conduct an adjusted indirect comparison meta-analysis between direct oral agents for prevention of acute limb ischemia in atrial fibrillation. METHODS: We conducted a systematic literature review searching electronic databases (MEDLINE and Embase) and the Cochrane Library from January 1990 through November 2014. Two blinded investigators reviewed all potentially relevant articles in a parallel manner by using a priori defined criteria. To assess the long-term efficacy and safety of these agents, only randomized clinical trials (RCTs) with follow-up durations of >1 year were included. The primary efficacy outcome was the end point of acute limb ischemia and/or extremity embolism. RESULTS: A total of 44,563 patients from three RCTs met criteria for inclusion. Patients randomized to direct oral anticoagulants had a non-significant decreased risk for acute limb ischemia (risk ratio [RR]: 0.57, 95% confidence interval [CI]: 0.26-1.2). In the analysis between agents, however, rivaroxaban significantly lowered the risk of ALI compared to warfarin (RR: 0.23, 95% CI: 0.064-0.82), apixaban (RR: 0.26, 95% CI: 0.081-0.83), and dabigatran (RR: 0.24, 95% CI: 0.077-0.83). CONCLUSIONS: Significant differences in prevention of acute limb ischemia may exist between oral anticoagulant agents in patients with atrial fibrillation. Rivaroxaban lowers the risk of limb embolism versus warfarin, apixaban and dabigatran.

Expresión proteica de metaloproteinasa-2 (MMP-2) y su inhibidor tisular (TIMP-2) en aorta, fascia y plasma de pacientes con aneurisma de aorta abdominal / Protein expression of metalloproteinases-2 (MMP-2) and its tissue inhibitor (TIMP-2) in aorta, fascia and plasma of patients with abdominal aortic aneurysm

INTRODUCCIÓN: Existen datos que asocian los aneurismas de aorta abdominal (AAA) con un incremento de la prevalencia de la enfermedad herniaria. Una posible alteración estructural de la matriz extracelular puede ser común en el proceso degenerativo de la pared aórtica y de la fascia abdominal. OBJETIVO: Conocer la expresión de metaloproteinasas de matriz-2 (MMP-2) y el inhibidor tisular de metaloproteinasas-2 (TIMP-2) en pared aórtica, fascia abdominal y plasma de pacientes intervenidos de AAA frente a pacientes con enfermedad aórtica oclusiva (EAO). MATERIAL Y MÉTODOS: Estudio piloto, observacional prospectivo. Se analizó la expresión proteica de MMP-2 y TIMP-2 en 10 pacientes con AAA y 10 con EAO. Recogimos datos epidemiológicos, antecedentes de hernias y diámetros del AAA. El análisis se realizó por técnica de ELISA. RESULTADOS: En el subgrupo de AAA de mediano tamaño con antecedentes de hernia, encontramos sobreexpresión de MMP-2 en fascia y de TIMP-2 en aorta y fascia, respecto a EAO sin hernia (MMP-2 fascia: AAA = 4,53 [3,11-6,90]; EAO = 1,87 [1,45-2,90]; p = 0,04; TIMP-2 en aorta: AAA = 72,62 [9,26-161,12], EAO = 9,79 [5,55-25,61]; p = 0,04 y TIMP-2 en fascia: AAA = 35,24 [13,15-61,08], EAO = 4,98 [1,42-18,01]; p = 0,02). La MMP-2 y el TIMP-2 estaban aumentados en fascia de AAA con enfermedad herniaria frente a EAO sin hernia (MMP-2: 4,31 [3,35-6,35] versus 1,87 [1,45-2,90]; p = 0,009 y TIMP-2: 18,73 [7,76-57,97] versus 4,98 [1,42-18,01]; p = 0,08). En pared aórtica hubo aumento de TIMP-2 en AAA (29,27 [14,05-140,30] frente a EAO, 9,79 [6,19-32,74]; p = 0,06). CONCLUSIONES: La MMP-2 y el TIMP-2 están aumentados, en aorta y fascia de pacientes con AAA, sobre todo, en los de mediano tamaño, lo que indica cierto papel en la etiología. El incremento de MMP-2 y TIMP-2 en presencia de hernia potencia la idea de un mecanismo patogénico común

INTRODUCTION: There are data that associates abdominal aortic aneurysms (AAA) with an increased prevalence of hernia disease. A possible structural alteration of extracellular matrix may be common in the degenerative process of the aortic wall and the abdominal fascia. OBJECTIVE: Determine the expression of matrix metalloproteinases-2 (MMP-2) and tissue inhibitor of metalloproteinases-2 (TIMP-2) in aortic wall tissue, abdominal fascia, and plasma of patients undergoing AAA versus patients with aortic occlusive disease (EAO). MATERIAL AND METHODS: A pilot, prospective observational study was conducted, in which the protein expression of MMP-2 and TIMP-2 was analyzed in 10 patients with AAA, and in 10 with EAO, using an ELISA technique. Epidemiological data, history of hernias, and AAA diameters were collected. RESULTS: In the subgroup of medium sized AAA with a history of hernia, over-expression of MMP-2 was found in fascia, and of TIMP-2 in aorta and fascia. As regards EAO without hernia (MMP-2 fascia: AAA = 4.53 [3.11-6.90], EAO = 1.87 [1.45-2.90], P=.04; TIMP-2 in aorta: AAA = 72.62 [9.26-161.12], EAO = 9.79 [5.55-25.61], P=.04, and TIMP-2 in fascia: AAA = 35.24 [13.15-61.08], EAO =4.98 [1.42-18.01], P=.02).The MMP-2 and TIMP-2 was increased in AAA fascia hernia disease compared with EAO without hernia (MMP-2: 4.31 [3.35-6.35] versus 1.87 [1.45-2.90], P=.009, and TIMP-2: 18.73 [7.76-57.97] versus 4.98 [1.42-18.01], P=.08).There was an increased TIMP-2 in the aortic wall, AAA (29.27 [14.05-140.30] vs. EAO 9.79 [6.19-32.74], P=.06). CONCLUSIONS: The MMP-2 and TIMP-2 are increased in aorta and fascia of patients with AAA, especially in the medium size, suggesting a role in the etiology. The increase in MMP-2 and TIMP-2 in the presence of hernia, enhances the idea of a common pathogenic mechanism

Direct promoter induction of p19Arf by Pit-1 explains the dependence receptor RET/Pit-1/p53-induced apoptosis in the pituitary somatotroph cells.

Somatotrophs produce growth hormone (GH) and are the most abundant secretory cells of the pituitary. Somatotrophs express the transcription factor Pit-1 and the dependence receptor RET, its co-receptor GFRa1 and ligand GDNF. Pit-1 is a transcription factor essential for somatotroph proliferation and differentiation and for GH expression. GDNF represses excess Pit-1 expression preventing excess GH. In the absence of GDNF, RET behaves as a dependence receptor, becomes intracellularly processed and induces strong Pit-1 expression leading to p53 accumulation and apoptosis. How accumulation of Pit-1 leads to p53 expression is unknown. We have unveiled the relationship of Pit-1 with the p19Arf gene. There is a parallel correlation of RET processing, Pit-1 increase and ARF protein and mRNA expression. Interfering the pathway with RET, Pit-1 or p19Arf siRNA blocked apoptosis. We have found a Pit-1 DNA-binding element within the ARF promoter. Pit-1 directly regulates the CDKN2A locus and binds to the p19Arft promoter inducing p19Arf gene expression. The Pit-1-binding element is conserved in rodents and humans. RET/Pit-1 induces p19Arf/p53 and apoptosis not only in a somatotroph cell line but also in primary cultures of pituitary somatotrophs, where ARF siRNA interference also blocks p53 and apoptosis. Analyses of the somatotrophs in whole pituitaries supported the above findings. Thus Pit-1, a differentiation factor, activates the oncogene-induced apoptosis (OIA) pathway as oncogenes exerting a tight control in somatotrophs to prevent the disease due to excess of GH (insulin-resistance, metabolic disease, acromegaly).

GHRH proliferative action on somatotrophs is cell-type specific and dependent on Pit-1/GHF-1 expression.

To investigate the mechanisms by which the hypothalamic peptide GHRH influences cell division, we analyzed its effects on the proliferation of two different cell lines: CHO-4, an ovary-derived cell line, and GH3, a pituitary-derived cell line. We found that GHRH induces the proliferation of pituitary-derived cells but inhibits the proliferation of ovary-derived cells. We further characterized this dual effect of GHRH to find that the cytoplasmic signals induced by this hormone are similar in both cell lines. Moreover, in CHO-4 cells GHRH stimulates two well-known positive cell cycle regulators, c-myc and cyclin D1, but is unable to induce the degradation of the negative cell cycle regulator p27(Kip1). Significantly, when the Pit-1/GHF-1 gene is exogenously expressed in CHO-4 cells, the negative effect of GHRH on the proliferation of these cells is attenuated. Furthermore, when the levels of Pit-1 are downregulated by siRNA in GH3-GHRHR cells, the positive effects of GHRH on the proliferation of these cells are diminished. These findings add to our understanding of the molecules involved in the regulation of cell proliferation by GHRH, as we demonstrate for the first time that Pit-1 is not only required to drive the expression of the GHRH receptor, as previously described, but is also needed for the downstream effects that occur after its activation to modulate cell proliferation. These data suggest that the regulation of cell proliferation in response to a specific growth factor depends in certain cell populations on the presence of a tissue-specific transcription factor.