Behaviour of the main nonsteroidal anti-inflammatory drugs in a membrane bioreactor treating urban wastewater at high hydraulic- and sludge-retention time.

The behaviour and removal efficiency of ibuprofen (IBU), diclofenac (DCF), ketoprofen (KPF), and naproxen (NPX) during the real urban wastewater treatment by an experimental full-scale MBR working at high sludge and hydraulic retention time (SRT, HRT) were determined. The MBR worked in denitrification/nitrification conformation at 35.4h of HRT (Q=0.45m3/h), 37 d of SRT and a recirculation flow rate of 4Q. The experiments were made under steady-state conditions, reaching a biodegradable organic matter removal higher than 99.5%. The MBR system showed similar removal capacity for IBU, NPX, and KTP (>95%), whose main transformation occurred in the aerobic reactor with a low contribution from the anoxic reactor. The system worked with complete nitrification, also achieving an effective retention of the unbiodegradable organic matter due to recirculation. DCF removal was low with negative removal yields for several samplings. Both removal and increase transformation of DCF also occurred in the aerobic reactor, this not being observed in the anoxic one. DCF tends to accumulate in the system and to be recirculated. Thus, during the sampling in which DCF influent concentration decreases, removal yields turn negative. The increase of DCF concentration in the aerobic bioreactor also contributes to the negative removal yields.

Fulminant systemic vasculitis in systemic lupus erythematosus. Case report and review of the literature.

Vasculitis in systemic lupus erythematosus (SLE) has a broad spectrum of clinical manifestations from cutaneous to visceral involvement and its prognosis ranges from mild to life-threatening. We report the case of a previously healthy 17-year-old woman with eight months' history of arthralgias and myalgias. Subsequently, she developed facial and lower limbs edema, and hair loss. Two weeks before admission to a secondary level hospital, she developed fever up to 40°C followed by abdominal pain, rectal bleeding, hematemesis and blisters on both legs, reason for which she was hospitalized. With active bullous SLE with rapidly progressive glomerulonephritis suspected, she was treated with methylprednisolone pulses without response. After one week of treatment, she was transferred to a tertiary level hospital. On admission she presented acute arterial insufficiency of the lower extremities, respiratory failure with apnea, metabolic acidosis and shock; six hours later she died. Autopsy findings showed active diffuse lupus nephritis and diffuse systemic vasculitis that involved vessels from the skin, brain, myocardium, spleen, iliac and renal arteries. In addition, serositis of the small intestine and colon, acute and chronic pericarditis, pericardial effusion and myocarditis were found. Immunologic tests confirmed SLE diagnosis. In this case the fulminant course was the result of SLE high disease activity, visceral vasculitis of several organs and late diagnosis, referral and treatment. Early diagnosis, and opportune referral to the rheumatologist for intensive treatment can improve the outlook in these patients.

The effect of moisture regimes on the anaerobic degradation of municipal solid waste from Metepec (México).

The State of México, situated in central México, has a population of about 14 million, distributed in approximately 125 counties. Solid waste management represents a serious and ongoing pressure to local authorities. The final disposal site ("El Socavón") does not comply with minimum environmental requirements as no liners or leachate management infrastructure are available. Consequently, leachate composition or the effects of rain water input on municipal solid waste degradation are largely unknown. The aim of this work was to monitor the anaerobic degradation of municipal solid waste (MSW), simulating the water addition due to rainfall, under two different moisture content regimes (70% and 80% humidity). The study was carried out using bioreactors in both laboratory and pilot scales. The variation of organic matter and pH was followed in the solid matrix of the MSW. The leachate produced was used to estimate the field capacity of the MSW and to determine the pH, COD, BOD and heavy metals. Some leachate parameters were found to be within permitted limits, but further research is needed in order to analyze the leachate from lower layers of the disposal site ("El Socavón").