Effects of porous media, macrophyte type and hydraulic retention time on the removal of organic load and micropollutants in constructed wetlands.

The performance of horizontal subsurface flow constructed wetlands in the removal of micropollutants from a wastewater treatment plant effluent was evaluated at mesocosm level. Fifteen mesocosms were studied following a modified Latin Square experimental design with six additional points. Three variables at three levels were studied: porous media -PM- (river gravel, fine volcanic gravel and coarse volcanic gravel), macrophyte type -M- (Thypa latiffolia, Phragmites australis, and Cyperus papyrus) and hydraulic retention time -HRT- (1, 3 and 5 days). As response variables the removal percentages of the total organic load of the effluent (BOD5) and the loads of several micropollutants (caffeine, galaxolide, tonalide, alkylphenols and their monoethoxylates and diethoxylates, methyl dihydrojasmonate, sunscreen UV-15 and parsol) were used. The results showed that the systems remove between 70% and 75% of the organic load and that all the micropollutants were degraded at different extents, from 55% to 99%. The HRT was the variable that showed major effects on the treatment process, while M and PM showed no statistically significant differences in the used experimental conditions.

Comparison of Multispot EIA with Western blot for confirmatory serodiagnosis of HIV.

BACKGROUND: Recent improvements in the sensitivity of immunoassays (IA) used for HIV screening, coupled with increasing recognition of the importance of rapid point-of-care testing, have led to proposals to adjust the algorithm for serodiagnosis of HIV so that screening and confirmation can be performed using a dual or triple IA sequence that does not require Western blotting for confirmation. One IA that has been proposed as a second or confirmatory test is the Bio-Rad Multispot(®) Rapid HIV-1/HIV-2 Test. This test would have the added advantage of differentiating between HIV-1 and HIV-2 antibodies. OBJECTIVE: To compare the sensitivity and type-specificity of an algorithm combining a 3rd generation enzyme immunoassay (EIA) followed by a confirmatory Multispot with the conventional algorithm that combines a 3rd generation EIA (Bio-Rad GS HIV-1/HIV-2 Plus O EIA) followed by confirmatory Western blot (Bio-Rad GS HIV-1 WB). METHODS: 8760 serum specimens submitted for HIV testing to the New York City Public Health Laboratory between May 22, 2007, and April 30, 2010, tested repeatedly positive on 3rd generation HIV-1-2+O EIA screening and received parallel confirmatory testing by WB and Multispot (MS). RESULTS: 8678/8760 (99.1%) specimens tested WB-positive; 82 (0.9%) tested WB-negative or indeterminate (IND). 8690/8760 specimens (99.2%) tested MS-positive, of which 14 (17.1%) had been classified as negative or IND by WB. Among the HIV-1 WB-positive specimens, MS classified 26 (0.29%) as HIV-2. Among the HIV-1 WB negative and IND, MS detected 12 HIV-2. CONCLUSION: MS detected an additional 14 HIV-1 infections among WB negative or IND specimens, differentiated 26 HIV-1 WB positives as HIV-2, and detected 12 additional HIV-2 infections among WB negative/IND. A dual 3rd generation EIA algorithm incorporating MS had equivalent HIV-1 sensitivity to the 3rd generation EIA-WB algorithm and had the added advantage of detecting 12 HIV-2 specimens that were not HIV-1 WB cross-reactors. In this series an algorithm using EIA followed by MS would have resulted in the expedited referral of 38 specimens for HIV-2 testing and 40 specimens for nucleic acid confirmation. Further testing using a combined gold standard of nucleic acid detection and WB is needed to calculate specificity and validate the substitution of MS for WB in the diagnostic algorithm used by a large public health laboratory.

[Analysis of prescriptions in primary care: evaluation of a system of indicators]. / Análisis de la prescripción en atención primaria: evaluación de un sistema de indicadores.

OBJECTIVE: To evaluate a system of qualitative indicators which serve as a tool for prioritising the level of intervention in Base Health Districts (BHDs). DESIGN: Retrospective, descriptive study. SETTING: Primary Care. MEASUREMENTS AND MAIN RESULTS: Medical prescription dispensed by the doctors from 36 BHDs in the Costa de Ponent (Barcelona) region in 1995 were analysed, with different qualitative indicators used. Three stages of indicators were established. 25% of the BHDs had a %PIV < 75%; 25% of them over 80%; and the rest between 75 and 80%. CONCLUSIONS: The three stages of indicators described contribute different and complementary information to the qualitative prioritising of pharmaceutical prescription. Absence of correlation between the third-stage indicators suggests the importance of choosing them according to the desired pharmacological group and in line with a pre-established criterion for selecting medicines.

Pharmacokinetics of the combination of ticarcillin with clavulanic acid in renal insufficiency.

The pharmacokinetics of ticarcillin and clavulanic acid were studied by blood and urine assay methods in 25 patients divided into five groups with varying degrees of renal insufficiency i.e. mild, moderate and severe renal insufficiency, almost anuric patients and those requiring haemodialysis (groups A to E). A single dose of 5.2 g Timentin (5.0 g ticarcillin and 200 mg clavulanic acid) was administered intravenously by infusion over 30 min. The average elimination half-life (T1/2) of ticarcillin increased from 0.95 h in patients with creatinine clearance (Clcr) of 80 ml/min to 1.8, 4.4, 6.9 and 11.2 h respectively in mild, moderate and severe renal insufficiency and in almost anuric patients. The T1/2 values for clavulanic acid were 0.75, 0.9, 2.0, 2.5 and 4.8 h in the same groups. The area under concentration-time curve (AUC) for ticarcillin increased from 787 to 2839 mg/l/h and for clavulanic acid from 12.8 to 29 mg/l/h when group mean values from patients with mild and severe renal insufficiency were compared. The plasma clearance (Clpl) of clavulanic acid was in all groups greater than that of ticarcillin i.e. 166 and 100 ml/min vs. 79.2 and 25.0 ml/min when comparing mean values from groups with mild and severe renal insufficiency respectively. The plasma clearance ratio clavulanic acid/ticarcillin increased proportionally to the degree of renal insufficiency from a value of 1.5 in normal subjects to between 3.3 and 3.8 in more advanced cases.(ABSTRACT TRUNCATED AT 250 WORDS)