Advanced oxidation of bleached eucalypt kraft pulp mill effluent.

In this study a poorly biodegradable (BOD/COD = 0.3) industrial alkaline ECF bleaching filtrate was treated using different advanced oxidation processes to evaluate their use in combined chemical-biological treatment aimed at increasing recalcitrant COD removal and improving final effluent quality. Oxidative treatments included ozonation combined with hydrogen peroxide (2, 5, 10, 20 mmol L(-1) O3/0.7, 2, 5, 10 mmol L(-1) H2O2) and photocatalysis with hydrogen peroxide (UV/2, 4 and 8 mmolL(-1) H2O2) and with TiO2 (UV/TiO2/0.7 and 4 mmol L(-1) H2O2). The O3/H2O2 process increased effluent biodegradability by up to 68% as a result of increasing BOD and decreasing COD. Increasing the O3 dose had a greater effect on biodegradability improvement and lignin and colour removal efficiencies than increasing the H2O2 dose. A combined oxidant dose of 5 mmol L(-1) O3 and 2 mmol L(-1) H2O2 resulted in 75% lignin removal, 40% colour removal and 6% carbohydrate loss without mineralizing the organic carbon. The photocatalytic processes led to a decrease in effluent biodegradability through combined decrease in BOD and increase in COD and did not result in efficient lignin or colour removal. Photocatalytic oxidation was apparently inhibited by the high chloride and COD levels in the alkaline filtrate, and may be more efficient in recalcitrant COD removal if performed after biological.

Interest of conventional clinical, biochemical and bioimpedance measurements as indicators of mortality risk in critical patients.

Risk assessment is nowadays an essential part of the management of seriously ill subjects, and multiple scoring methods are available, based on single or preferably multiple determinations. Some of these protocols have been successfully used around the world, and they permit the prediction of outcomes in different clinical populations. However, many indices are labor-intensive or demand an expanded set of biochemical determinations, thus representing an economical burden. Aiming to evaluate the prognostic value of ordinary variables that are already present in the clinical observation, 50 consecutive patients admitted at the intensive care unit were prospectively documented. Methods included clinical (age, sex, stay in ICU, FIO2), biochemical (serum albumin, hemoglobin, glucose, creatinine, WBC count), and bioimpedance variables (resistance, reactance, body impedance coefficient). All these values were registered at admission and before discharge or death, and compared with survival rate. Initially only WBC count was significantly different in survivors, but ongoing documentation revealed that later on, four indices were endowed with prognostic impact: serum album, glucose levels, WBC count and FIO2 requirements. Organ or function-sustaining procedures were also associated with outcome, nominally mechanical ventilation, vasoactive drugs, and enteral/parenteral nutrition. Furthermore, patients submitted to two or three of these methods exhibited higher mortality than those receiving just one, with even better result for those not requiring any. It is concluded that observation of ongoing changes in conventional clinical variables available in the clinical chart are a valid means of estimating the mortality risk in critical cases.

Avaliaçäo da composiçäo corporal em gestantes de termo / Assessment of body composition in pregnant women at term

A gravidez acompanha-se de modificaçoes fisiológicas bem conhecidas nos compartimentos hídricos e energéticos maternos, que se somam a hipertrofias orgânicas e ao aparecimento de um bloco feto-placentario. Conseqüentemente, a composiçao corporal sofre alteraçoes, porém poucos estudos têm documentado tal fenomeno. O advento da bioimpedância favoreceu a obtençao das informaçoes desejadas de forma pratica e segura. Objetivos. Foram os propósitos deste trabalho: registrar as principais variaveis antropométricas numa populaçao de gestantes de termo; determinar as medidas de composiçao corpórea pela bioimpedância; comparar esses achados com os primeiros, assim como com outras metodologias relatadas na literatura. Métodos. A populaçao consistiu de 30 gestantes de termo admitidas no período pré-parto, sem complicaçoes, sofrimento fetal ou gravidez múltipla, e submetidas às seguintes mensuraçoes: Antropometria - Peso, altura, índice de massa corporal, prega cutânea do tríceps, circunferência muscular do braço; Bioimpedância - Gordura corporal, massa magra, agua total, agua intra e extracelular, terceiro espaço e relaçao sódio/potassio permut vel. Resultados. Observaram-se valores de peso corporal e índice de massa corporal aumentados, porém inteiramente compatíveis com a situaçao fisiológica das gestantes. A agua corpórea total situava-se na mesma faixa percentual de mulheres nao-gravidas, tal como ja suspeitado por outros autores, porém com indícios de expansao do extracelular e formaçao de terceiro espaço. A massa gorda elevou-se, porém, também em proporçoes nao muito diferentes do relatado anteriormente em levantamentos antropométricos. Conclusoes. Nas condiçoes do presente trabalho, em que uma equaçao de bioimpedância para uso geral foi aplicada, o método demonstrou resultados compatíveis com as informaçoes clínicas disponíveis, as verificaçoes antropométricas e os registros de outros investigadores. Conclui-se que a impedância bioelétrica é um procedimento de avaliaçao promissor na gravidez, justificando estudos ulteriores com esta metodologia.

[Assessment of body composition in pregnant women at term]. / Avaliação da composição corporal em gestantes de termo.

BACKGROUND: Pregnancy is associated with well-known physiologic changes of maternal fluid and energy compartments, along with organ hypertrophies and the appearance of fetal and placental tissues. As a consequence, body composition is modified, but this phenomenon has not been well documented. The advent of bioimpedance has contributed to the documentation of the desired information in a safe and practical way. AIMS: The aims of this study were: To register the principal anthropometric variables in a population of pregnant women at term; To determine body composition by bioimpedance analysis; To compare these findings with the former results, as well as with other assessment procedures reported in the literature. PATIENTS AND METHOD: The population consisted of 30 pregnant women at term admitted for delivery, without complications, fetal distress or multiple pregnancy, and submitted to the following measurements: Anthropometry--Weight, height, body mass index, triceps skinfold, arm muscle circumference; Bioimpedance analysis--Body fat, lean body mass, total water, intra and extra-cellular water, third space, and exchangeable Na/K ratio. RESULTS: Body weight and body mass index were increased but within the expected values for these patients. Total body water was similar to results in non-pregnant women when expressed as percentage, in accordance with other studies, but with a trend toward increase in the extracellular compartment and presence of third space fluid. Body fat was elevated, but the proportions were not much different from previous anthropometric surveys. CONCLUSIONS: In the conditions of this investigation, in which a bioimpedance equation for general use was employed, the method indicated results that were consistent with the clinical course, anthropometric documentation, and the findings of other groups. It is concluded that bioimpedance analysis compares favorably with other assessment procedures in pregnancy, and further studies with this method should be undertaken.

Measurement of body composition changes during hemodialysis by bioimpedance analysis.

Monitoring of fluid exchanges during hemodialysis is essential for the safety and efficacy of the procedure. Bioimpedance analysis has been used for the measurement of body compartments in many settings, but experience during hemodialysis is relatively scare. In a prospective study of 28 cases of chronic renal failure treated by long-term hemodialysis on an outpatient basis, body composition studies were done immediately before and after the dialysis session. Methods included body weight, serum albumin, hematocrit, hemoglobin, sodium and osmolality. These variables were compared with impedance (BIA) findings, namely lean body mass, body fat, total water, extra and intra-cellular water, third space, and exchangeable sodium/potassium ratio. Patients lost weight and improved hematocrit, hemoglobin, osmolality and serum sodium during the therapy, and BIA measurements were consistent with these changes. Lean body mass and body fat markedly changed along the dialysis session (respectively -24.5% and + 7.5%), and these results were out of proportion regarding known gains and losses in that period. It is concluded that BIA was useful for monitoring water fluxes during hemodialysis, but provided unreliable information about body fat and lean body mass.

[Comparative study of arginine and glutamine supplements in malnourished surgical patients]. / Estudo comparativo de suplementos de arginina e glutamina em pacientes cirúrgicos desnutridos.

Protein-calorie malnutrition is frequently diagnosed in patients with serious digestive conditions displaying obstructive symptoms, notably in esophageal cancer. In the present study a homogeneous group of subjects affected by esophageal cancer and candidates for elective surgery was randomly treated by one of the following oral supplements: arginine (group I), glutamine (group II), or mixed commercial amino acids (Group III-controls). The methods included nutritional measurements (biochemical and anthropometric assement), immunologic survey (skin tests), and general clinical and surgical findings, with emphasis on surgical morbidity. Body weight remained stable throughout the study, whereas serum albumin, total lymphocytes and skin tests tended to improve in all groups, with statistical confirmation for albumin in arginine-treated cases (group II). Post-operative hospitalization was numerically shorter during glutamine supplementation, and this trend was statistically significant when total morbidity was compared between the groups. It is concluded that: 1) Malnutrition and anergy were a major problem in this population, with equally severe post-operative morbidity; 2) Administration of arginine enabled serum albumin levels to improve; 3) Glutamine-treated subjects displayed reduced post-operative morbidity; 4) No side effects could be attributed to the therapy here employed.