Treatment of fatty solid waste from the meat industry in an anaerobic sequencing batch reactor: start-up period and establishment of the design criteria.

An anaerobic sequencing batch reactor (AnSBR) was used to treat the dissolved air flotation skimmings from a cooked pork meat plant. During the start-up period, the reactor was operated in fed-batch mode for 25 days and 7 batches were treated. The SBR was inoculated with sludge taken from a reactor treating distillery vinasse. The results showed that this kind of sludge is a very good source of inoculum for digesters treating residues with a high content in fats and long-chain fatty acids because it was able to adapt very rapidly to the new substrate and, from the second batch on, the sludge was already able to metabolize the fatty residue at quite high rates. The AnSBR was then operated with 5 batches per week for 110 days and the quantity of VS added per batch was regularly increased until the maximum treatment capacity of the reactor (i.e. maximum loading rate) was reached. The maximum organic loading rates were found to be 0.16 g VS/g VSS d, or 0.224 g VS/g VSS.batch when the reactor is fed 5 times a week. The biodegradability of the skimmings was very high, with more than 97% of TS removal, and the methane production was 880+/-90 mL of methane/g of VS(added).

[Long-term results of interferential current stimulation in the treatment of bladder instability]. / Résultats à long-terme de la stimulation par courants interférentiels dans le traitement de l'instabilité vésicale.

OBJECTIVE: To study the late results of interferential current stimulation in the treatment of detrusor instability. MATERIAL AND METHODS: 62 patients with detrusor instability refractory to medical treatment by anticholinergic drugs were treated by interferential current stimulation. This technique combines the advantages of retraining stimulation with external application. This retrospective study was based on 62 patients (43 children, 11 men and 8 women) presenting with detrusor instability between January 1990 and December 1997. All patients were assessed clinically and by a radiological, bacteriological and urodynamic work-up prior to treatment. The mean follow-up was 5 years (range: 18 months to 10 years). RESULTS: The results of this technique were excellent, with 80.9% of cures at one year, but they tended to fade over time to 40% of cures at 5 years. However, results which deteriorate after one year can generally be maintained by performing 5 maintenance sessions every 12 or 18 months. CONCLUSION: Treatment of detrusor instability by interferential current is a reliable technique which constitutes an alternative to the other methods of retraining stimulation and can be performed in cases of instability refractory to anticholinergic drugs, before considering neuromodulation or surgery. Five to 10 maintenance sessions every 12 or 18 months ensure stable long-term results in the majority of cases.

[Rehabilitation of female urinary incontinence. Techniques and indications]. / Rééducation uro-gynécologique féminine. Techniques et indications.

Female uro-gynaecological retraining was initially confined to prophylactic management during the post-partum period. It has gradually been extended to other diseases, either alone or as a complement to medical or surgical treatment. The results of clinical examination and complementary investigations, especially urodynamic studies, now allow the application of increasingly precise retraining techniques. This progress essentially concerns the three types of technique most frequently used: Manual retraining concerns the bulbospongiosus muscles, as well as the levator ani muscles. Biofeedback is increasingly used to qualitatively improve muscle contraction. Electrostimulation can promote the action of various groups of tonic or phasic muscle fibres. Apart from these endocavitary techniques, retraining is also evolving towards a global management of the abdominopelvic sphere., where it is indicated in the management of the post-partum period and various gynaecological and urinary diseases. However, concomitant diseases such as perineo-abdominodiaphragmatic imbalance, an anorectal problem, a sexual problem or finally painful symptoms, must also be taken into account in some cases. Retraining must be very precisely prescribed, confirming application of all of these techniques and adapting them to the national health refund classification. The number of sessions varies according to the disease, but rarely exceeds 30 sessions in the initial prescription. On the other hand, like any muscle system, the pelvic floor must be maintained by means of several sessions per year. The success of this retraining treatment essentially depends on several factors: the quality of the therapist, his training, his spirit of integration in a multidisciplinary team, but also the patient's motivation.

[Treatment of bladder instability with interferential current. Report of 20 cases: preliminary results]. / Traitement de l'instabilité vésicale par courants interférentiel. A propos de 20 cas: résultats préliminaries.

20 patients with unstable bladder unresponsive to medical treatment by anticholinergics were treated by interferential current retraining stimulations. This technique combines the advantages of retraining stimulation with external application. Each patient received 6 to 20 stimulation sessions at a rate of one per week in children and two per week in adults. 18 patients were clinically and urodynamically improved with resolution of incontinence and the follow up urodynamic assessment showed return of normal bladder volume and tone. No adverse effects were observed. No recurrences of the symptoms were observed with a mean follow-up of 18 months. The authors believe that this reliable technique constitutes an alternative to other retraining stimulation methods.