Treatment efficiency and economic feasibility of biological oxidation, membrane filtration and separation processes, and advanced oxidation for the purification and valorization of olive mill wastewater.

Olive mill wastewater (OMW) is a major waste stream resulting from numerous operations that occur during the production stages of olive oil. The resulting effluent contains various organic and inorganic contaminants and its environmental impact can be notable. The present work aims at investigating the efficiency of (i) jet-loop reactor with ultrafiltration (UF) membrane system (Jacto.MBR), (ii) solar photo-Fenton oxidation after coagulation/flocculation pre-treatment and (iii) integrated membrane filtration processes (i.e. UF/nanofiltration (NF)) used for the treatment of OMW. According to the results, the efficiency of the biological treatment was high, equal to 90% COD and 80% total phenolic compounds (TPh) removal. A COD removal higher than 94% was achieved by applying the solar photo-Fenton oxidation process as post-treatment of coagulation/flocculation of OMW, while the phenolic fraction was completely eliminated. The combined UF/NF process resulted in very high conductivity and COD removal, up to 90% and 95%, respectively, while TPh were concentrated in the NF concentrate stream (i.e. 93% concentration). Quite important is the fact that the NF concentrate, a valuable and polyphenol rich stream, can be further valorized in various industries (e.g. food, pharmaceutical, etc.). The above treatment processes were found also to be able to reduce the initial OMW phytotoxicity at greenhouse experiments; with the effluent stream of solar photo-Fenton process to be the least phytotoxic compared to the other treated effluents. A SWOT (Strength, Weakness, Opportunities, Threats) analysis was performed, in order to determine both the strengths of each technology, as well as the possible obstacles that need to overcome for achieving the desired levels of treatment. Finally, an economic evaluation of the tested technologies was performed in an effort to measure the applicability and viability of these systems at real scale; highlighting that the cost cannot be regarded as a 'cut off criterion', since the most cost-effective option in not always the optimum one.

A systematic review of Fusobacterium necrophorum-positive acute tonsillitis: prevalence, methods of detection, patient characteristics, and the usefulness of the Centor score.

The purpose of this study was to review the current evidence for an association between Fusobacterium necrophorum (FN) and acute tonsillitis (AT), to assess the prevalence of FN in AT, to identify the better FN detection method, and to characterize the clinical characteristics of FN-positive patients with uncomplicated AT. A systematic literature search was conducted in the PubMed, EMBASE, and SweMed+ databases for studies reporting on the recovery rates of FN in patients with AT. A total of 498 unique records were identified. Eleven studies were included in a qualitative synthesis and six studies were included in a meta-analysis. Considerable heterogeneity (I2 = 60 %) and risk of bias and confounders was found among the studies, though a subset of studies (prospective) had lower heterogeneity and higher study quality. FN was recovered significantly more frequently from patients (21.2 %) compared to healthy controls (7.6 %) (p < 0.001). FN recovery rates were similar between culture-based studies (20.3 %) and studies using polymerase chain reaction (PCR) methodology (22.2 %) (p = 0.462). The typical FN-positive AT patient was a smoking young (15-25 years) male presenting with tonsillar exudates and a Centor score of 2 or higher. A clear association between FN and AT was found. FN is likely to be a significant and prevalent pathogen in AT, especially in teenagers and young adults. However, no evidence for causality between FN and AT has been established and it is unexplored if timely antibiotic therapy directed against FN accelerates the resolution of symptoms and decreases the risk of complications.

Prevalence of tonsillar human papillomavirus infections in Denmark.

The incidence of tonsillar carcinomas associated with Human Papillomavirus (HPV) infection has increased dramatically over the last three decades. In fact, currently in Scandinavia, HPV-associated cases account for over 80 % of tonsillar carcinoma cases. Yet, the epidemiology and natural history of tonsillar HPV infections remains poorly characterized. Our aim was to characterize such infections in the Danish population in tumor-free tonsillar tissue. Unlike previous studies, we considered both palatine tonsils. We examined both tonsils from 80 patients with peritonsillar abscess (n = 25) or chronic tonsillar disease (n = 55). HPV was detected by nested PCR with PGMY 09/11 and GP5+/GP6+L1 consensus primers, and typed by sequencing. Samples were also analyzed using a higher-throughput method, the CLART HPV 2 Clinical Array Assay. The overall prevalence of HPV tonsillar infection was 1.25 % (1/80, 95 % CI 0.03-6.77 %) by nested PCR, and 0 % by CLART HPV2 Clinical Array. The HPV-positive patient was a 16-year-old female with recurrent tonsillitis and tonsillar hypertrophy. The type detected was HPV6. HPV was not detected in the contralateral tonsil of this patient. Compared to cervical HPV infections in Denmark, tonsillar HPV infections are 10- to 15-fold less frequent. In the HPV-positive patient in this study, HPV was detected in only one of the tonsils. This raises the possibility that prior studies may underestimate the prevalence of HPV infections, as they do not consider both palatine tonsils.

Antibody development to Fusobacterium necrophorum in patients with peritonsillar abscess.

A polymicrobial mixture of aerobic and anaerobic bacteria is commonly recovered from peritonsillar abscess (PTA) aspirates. Previous studies have suggested a role for Fusobacterium necrophorum (FN) in the development of PTA. The purpose of the current study was to explore whether anti-FN antibodies were produced in patients with PTA. We developed a novel immunofluorescence-based method to measure anti-FN antibody levels in acute and convalescent sera from 15 patients with PTA and 47 patients with chronic tonsillar conditions (controls) undergoing acute or elective tonsillectomy, respectively. Bacterial cultures were performed on tonsillar cores and surfaces, pus aspirates, and blood. An increase in anti-FN antibody levels (of at least doubling of the previous level) was observed in 8 of 11 (73 %) PTA patients with FN-positive pus aspirate cultures (FN-positive patients). In contrast, the four FN-negative PTA patients did not have an increase in anti-FN antibody levels (p = 0.026). The change in anti-FN antibody levels in FN-positive PTA patients was also significantly greater than that for FN-positive electively tonsillectomized patients (p = 0.0014) and all electively tonsillectomized patients (p < 0.001). Our results validate FN as a significant and prevalent pathogen in PTA. This finding has implications for the diagnostic work-up of PTA and may also have implications for the treatment of acute tonsillitis.

The role of viruses in the pathogenesis of peritonsillar abscess.

Peritonsillar abscess (PTA) is the most frequent complication of acute tonsillitis and a prevalent cause for acute admission to otorhinolaryngology departments. Our aim was to examine the role of viruses in the pathogenesis of PTA, as this has not previously been considered. We examined both palatine tonsils from 25 patients undergoing acute tonsillectomy for PTA, using PCR-based assays for herpes simplex virus-1 and -2 (HSV-1 and -2), adenovirus, Epstein-Barr virus (EBV), influenza A and B, and respiratory syncytial virus (RSV) A and B. We similarly examined tonsils from 55 patients undergoing elective tonsillectomy due to chronic tonsillar conditions. These patients served as a control group, as they did not have a clinically apparent infection at the time of surgery. Only HSV-1 (5/80, 6.3%), adenovirus (11/80, 13.8%), and EBV (71/80, 88.8%) were detected in our study population. There was no statistically significant difference in the frequency of these viruses across different diagnostic groups. Quantification of EBV load demonstrated no differences between the PTA and the elective tonsillectomy group, nor between the abscessed and non-abscessed tonsil of PTA patients. In summary, our data do not support a significant role for the examined viruses in the pathogenesis of PTA.

[National survey on out-of-hospital difficult intubation management]. / Enquête nationale sur la prise en charge de l'intubation difficile en médecine d'urgence préhospitalière.

OBJECTIVES: Difficult intubation rate is higher in the prehospital setting than in the operating room. Goal of this survey was to assess compliance of the French prehospital mobile emergency unit (Smur) to the recent French guidelines for the difficult airway management. STUDY DESIGN: National phone survey. METHODS: A phone questionnaire was proposed to one senior emergency physician of all 380 French Smur. Seven questions were asked about intubation devices used, availability of a written difficult intubation algorithm and intubation training of the Smur's physicians. RESULTS: Guidelines of the recent French consensus conference on difficult intubation are only partly followed by the Smur. Only 60% of the Smur perform systematic rapid intubation sequence, plastic laryngoscope blades are used by more than 50% of the Smur and less than 50% of the Smur have a written difficult intubation management algorithm available. The Gum elastic Bougie is available in 58% of the Smur and the intubating laryngeal mask airway in 71%, whereas initial formation for difficult intubation devices used is provided to the emergency physicians in only 58% of the Smur. CONCLUSION: This survey shows that the French guidelines for the difficult airway management are only partially followed by the French Smur. An effort should be made for a larger diffusion of these guidelines towards the emergency physicians working in the Smur.

An overview of the microbiology of acute ear, nose and throat infections requiring hospitalisation.

This study is the first to provide an extensive overview of the microbiology of acute ear, nose and throat infections requiring hospitalisation. All 2,028 cases of acute infections admitted between 1 January 2001 and 31 December 2006 were reviewed to assess the use of pre-admission antibiotics, microbiological results, antibiotic and surgical management and length of hospitalisation. Infections of the oropharynx accounted for the vast majority of admissions, followed by ear infections, and cutaneous neck abscesses. Peritonsillar abscess was the most frequent diagnosis, accounting for over one third of admissions (39.8%, 808 out of 2,028). Complete microbiological data were available for 1,430 cultures, and were analysed for trends with respect to diagnosis, age, gender and use of pre-admission antibiotics. Forty-six percent (657 out of 1,430) of cultures yielded no growth or normal flora. This value increased to 77.0% (298 out of 387) in patients with pre-admission antibiotics. The distribution of microbiological isolates varied significantly between patients with and without pre-admission antibiotics, as well as with respect to age and gender. The most frequently isolated bacteria were Group A Streptococcus (13.7%, 196 out of 1,430), Fusobacterium necrophorum (13.6%, 195 out of 1,428) and Staphylococcus aureus (8.0%, 114 out of 1,430). Fusobacterium necrophorum was primarily isolated from cases of peritonsillar abscess (90.8%, 177 out of 195). This study suggests that F. necrophorum is a far more widespread pathogen in otorhinolaryngology than previously reported, and questions the value of routine culturing, as results rarely altered initial treatment. Further research on the microbiological variations with age and gender is recommended to better target culturing and treatment, and enhance our understanding of the pathogenesis of ear, nose and throat infections.

[The synthesis of oximes and O-acetyl derivatives with biological activity]. / Sinteza unor oxime si derivati O-acetilati cu activitate biologica.

Data about synthesis of some oximes and their O-acetyl derivates are shown here. This item also emphasize the results of testing the antimicrobial, antifungal, antilevural and anti-inflammatory action of the synthesized oximes.

[2-R-mercapto-1, 3, 4-thyadiazol derivates having biological activity. Note I]. / Derivati ai 2-R-5-mercapto-1, 3, 4-tiadiazolului, cu activitate biologica. Nota I.

The importance of 1,3,4-thyadiazol nucleus is illustrated by the fact that it enters the structure of many compounds having different biological activities. In this paper the results of some investigations for obtaining new derivates of 1,3,4-thydiazol 2,5 distributed are presented. Based upon the presented diagram 13 2-R-5-mercapto-1,3,4-thyadiazols, analysed both physico-chemically and biologically were synthetized.