Degradation of high concentrations of azithromycin when present in a high organic content wastewater by using a continuously fed laboratory-scale UASB bioreactor.

As the presence of emergent contaminants in wastewater, such as antibiotics, has become a threat for public health, the evaluation of strategies to treat them has been gaining importance. A critical example of this situation can be found in wastewaters coming from the pharmaceutical industry, where high concentrations of antibiotics are sometimes accompanied by high organic contents. Even the agroindustry can be affected by a similar problem when cattle infections are treated with antibiotics and part of the antibiotic-contaminated milk has to be wasted. With these situations in mind, in the present study we evaluated a progressive acclimation strategy for a granular sludge in a UASB reactor treating a high organic-content synthetic wastewater contaminated with azithromycin. In parallel, we tested a previously reported low-cost method for azithromycin determination by spectrophotometry, obtaining results comparable with liquid chromatography coupled to mass spectrometry. Although azithromycin has been reported as recalcitrant and resistant to biological degradation, the antibiotic was removed with efficiencies over 50% for wastewater with 10 mg L-1 of azithromycin and a COD of more than 4000 mgO2 L-1. Furthermore, efficiencies over 40% were achieved for wastewater with higher azithromycin concentrations (80 mg L-1) and a COD of 20,000 mgO2 L-1. A careful acclimation strategy permitted the partial removal of azithromycin from wastewater when treating concentrations comparable and higher than what would be expected for domestic and hospital wastewaters, even when its chemical oxygen demand is considerably higher than the average maximum of around 1000 mgO2 L-1.

Analisis de la mortalidad en funcion de la gravedad: estudio comparativo en dos unidades de cuidado intensivo / Analysis of mortality according to severity: comparative study in two intensive care units

La cuantificacion de la gravedad o grado de compromiso de los pacientes criticos es una medida que permite de evaluacion de la efectividad terapeutica desarrollada, asi como la comparacion entre las diferentes modalidades terapeuticas aplicadas a los pacientes. De los diversos indices descritos en la literatura medica hemos implantado el "Therapeutic Intervention Scoring System" (TISS), descrito por Cullen en Harvard. El presente informe hace referencia a nuestra experiencia con el TISS en el manejo de 643 pacientes. Nuestros hallazgos en dos unidades de cuidado intensivo de Bogota, Hospital San Juan de Dios y Clinica Santa Rosa de la Caja Nacional de Prevision Social, permiten concluir que el TISS es un sistema de cuantificacion del grado de compromiso de los pacientes que puede ser aplicado facilmente en nuestro medio, dado su poco requerimiento tecnologico, que nos ha permitido conparar las actividades terapeuticas en diferentes unidades, tanto locales como foraneas. Adicionalmente el TISS nos ha permitido analizar administrativamente estos dos servicios, asi como utilizar mas recionalmente el personal de enfermeria de los mismos. Se incluyen en este informe datos generales sobre mortalidad tanto global como descriminada por gravedad y edades, que dado el numero de pacientes analizados podria ser util como punto de partida para un analisis comparativo sobre el cuidado intensivo que se practica en nuestro pais