Rising testicular cancer incidence in Spain despite declining mortality: an age-period-cohort analysis.

BACKGROUND: Testicular cancer, primarily affecting young men, has seen an alarming rise globally. This study delves into incidence and mortality trends in Spain from 1990 to 2019 using the Global Burden of Disease (GBD) database and the Age-Period-Cohort (A-P-C) model. METHODS: We analyzed GBD data on testicular cancer cases and deaths in Spain, calculating age-standardized rates (ASIR and ASMR) and employing Joinpoint regression to identify significant shifts. The A-P-C model further dissected the effects of age, period, and birth cohort on these trends. RESULTS: A striking doubling in testicular cancer incidence was observed, from 3.09 to 5.40 per 100,000 men (1.9% annual increase), while mortality rates remained stable and even decreased in younger age groups (0.34 to 0.26 per 100,000, 0.8% annual decrease). Joinpoint analysis revealed four distinct periods of increasing incidence, with a recent slowdown. The A-P-C model highlighted a consistent rise in incidence risk with each successive generation born after 1935, contrasting with a progressive decline in mortality risk across cohorts, particularly marked for those born since the 1960s. CONCLUSION: While mortality rates are encouraging, Spain reflects the global trend of escalating testicular cancer incidence. The A-P-C analysis suggests a generational influence, but the underlying causes remain elusive. Further research is crucial to understand these trends and implement effective prevention strategies to combat this growing health concern.

Entorhinal cortex astrocytic atrophy in human frontotemporal dementia.

The pathophysiology of Fronto Temporal Dementia (FTD) remains poorly understood, specifically the role of astroglia. Our aim was to explore the hypothesis of astrocytic alterations as a component for FTD pathophysiology. We performed an in-depth tri-dimensional (3-D) anatomical and morphometric study of glial fibrillary acidic protein (GFAP)-positive and glutamine synthetase (GS)-positive astrocytes in the human entorhinal cortex (EC) of FTD patients. The studies at this level in the different types of human dementia are scarce. We observed a prominent astrocyte atrophy of GFAP-positive astrocytes and co-expressing GFAP/GS astrocytes, characterised by a decrease in area and volume, whilst minor changes in GS-positive astrocytes in FTD compared to non-dementia controls (ND) samples. This study evidences the importance of astrocyte atrophy and dysfunction in human EC. We hypothesise that FTD is not only a neuropathological disease, but also a gliopathological disease having a major relevance in the understanding the astrocyte role in FTD pathological processes and development.

Adsorption of 2,4-dichlorophenoxyacetic acid on activated carbons from macadamia nut shells.

This study reports on the application of activated carbons from macadamia nut shells as adsorbents for the removal of 2,4-dichlorophenoxyacetic acid, a commonly used pesticide, from water. Different activating agents (FeCl3, ZnCl2, KOH and H3PO4) were used to obtain adsorbents within a wide range of porous texture and surface properties. The characterization of the resulting activated carbons was performed by N2 adsorption-desorption, elemental analysis, TG and pHPZC. The adsorption experiments were conducted in batch at 25, 45 and 65 °C. The adsorption kinetics on activated carbons obtained with FeCl3 H3PO4 or KOH was well described by the pseudo-second order model, whereas for the resulting from ZnCl2 activation the experimental data fit better the pseudo-first order model. The equilibrium studies were performed with the KOH- and ZnCl2-activated carbons, the two showing higher surface area values. In both cases, high adsorption capacities were obtained (c.a. 600 mg g-1) and the experimental data were better described by the Langmuir and Toth models. The thermodynamic study allows concluding the spontaneous and endothermic character of the adsorption process, as well as an increase of randomness at the solid/liquid interface. Breakthrough curves were also obtained and fitted to the logistic model.

Astrocyte S100ß expression and selective differentiation to GFAP and GS in the entorhinal cortex during ageing in the 3xTg-Alzheimer's disease mouse model.

The study of astrocytes and its role in the development and evolution of neurodegenerative diseases, including Alzheimer's disease (AD) is essential to fully understand their aetiology. The aim if this study is to deepen into the concept of the heterogeneity of astrocyte subpopulations in the EC and in particular the identification of differentially functioning astrocyte subpopulations that respond differently to AD progression. S100ß protein belongs to group of small calcium regulators of cell membrane channels and pumps that are expressed by astrocytes and is hypothesised to play and have a relevant role in AD development. We analysed the selective differentiation of S100ß-positive astrocytes into Glutamine synthetase (GS) and Glial fibrillary acidic protein (GFAP)-positive sub-groups in the entorhinal cortex (EC) of AD triple transgenic animal model (3xTg-AD). EC is the brain region earliest affected in humans AD but also in this closest animal model regarding their pathology and time course. We observed no changes in the number of S100ß-positive astrocytes between 1 and 18 months of age in the EC of 3xTg-AD mice. However, we identified relevant morphological changes in S100ß/GFAP positive astrocytes showing a significant reduction in their surface and volume whilst an increase in number and percentage. Furthermore, the percentage of S100ß/GS positive astrocyte population was also increased in 18 months old 3xTg-AD mice compared to the non-Tg mice. Our findings reveal the presence of differentially controlled astrocyte populations that respond differently to AD progression in the EC of 3xTg-AD mice. These results highpoints the major astrocytic role together with its early and marked affection in AD and arguing in favour of its importance in neurogenerative diseases and potential target for new therapeutic approaches.

Prominent and conspicuous astrocyte atrophy in human sporadic and familial Alzheimer's disease.

Pathophysiology of sporadic Alzheimer's disease (SAD) and familial Alzheimer's disease (FAD) remains poorly known, including the exact role of neuroglia and specifically astroglia, in part because studies of astrocytes in human Alzheimer's disease (AD) brain samples are scarce. As far as we know, this is the first study of a 3-D immunohistochemical and microstructural analysis of glial fibrillary acidic protein (GFAP)- and glutamine synthetase (GS)-positive astrocytes performed in the entorhinal cortex (EC) of human SAD and FAD samples. In this study, we report prominent atrophic changes in GFAP and GS astrocytes in the EC of both SAD and FAD characterised by a decrease in area and volume when compared with non-demented control samples (ND). Furthermore, we did not find neither astrocytic loss nor astrocyte proliferation or hypertrophy (gliosis). In contrast with the astrogliosis classically accepted hypothesis, our results show a highly marked astrocyte atrophy that could have a major relevance in AD pathological processes being fundamental and key for AD mnesic and cognitive alterations equivalent in both SAD and FAD.

Mortality rates for Parkinson's disease are increasing in Spain. An age-period-cohort and joinpoint analysis of mortality rates from 1981 to 2020.

BACKGROUND: Mortality in Parkinson's disease is increasing worldwide, but Spanish data need further study. OBJECTIVE: To analyse the mortality trends of Parkinson's disease in Spain between 1981 and 2020. METHODS: This observational retrospective study assessed the Parkinson's disease mortality data from 1981 to 2020 collected from the National Statistics Institute of Spain. Age-standardised mortality rates were analysed by age and sex groups, detecting significant mortality trends through a joinpoint analysis. Age-period-cohort effect and potential years of life lost analyses were conducted. The European standard population of 2013 was considered for the analyses. RESULTS: A total of 88 034 deaths were assessed. The overall age-standardised mortality rate rose throughout the period from 3.67 to 8.57 per 100 000 inhabitants. Mortality rates in men were higher than in women, 11.63 versus 6.57 deaths per 100 000 inhabitants. The sex ratio showed an increase in premature mortality in men during 2020. The overall joinpoint analysis recorded a rise in mortality, primarily since the 20th century, mainly in male and older groups, that matched with a period effect. The age effect was detected, confirming higher mortality at an older age. The analysis of potential years of life lost detected a growth in this rate, changing from 0.66 in 1981 to 1.06 in 2020. CONCLUSIONS: Mortality data for Parkinson's disease in Spain rose significantly in forty years. Mortality rate was higher in the male and age group above 75 years of age. The sex ratio showed premature mortality in men in 2020, which will need further study.

Life-cycle assessment of a microalgae-based fungicide under a biorefinery approach.

The aim of this work was to perform a life-cycle analysis of the production process of a fungicide based on amphidinols. Two scenarios were evaluated: (1) biorefinery process -biofungicide, fatty acids and carotenoids were considered as co-products-, and (2) biofungicide as only product. Inventory data were taken and scaled-up from previous work on pilot-scale reactors, as well as lab-scale downstream equipment. A yearly production of 22,000 L of fungicide, was selected as the production objective. Despite, photosynthetic biomass is a sink of anthropogenic CO2, harvesting and downstream processing have large carbon footprints that exceed the biomass fixed carbon. Producing the biofungicide resulted in 34.61 and 271.33 ton of CO2e (15 years) for the Scenarios 1 and 2, respectively. Different commercial agricultural fungicides were compared with the microalgal fungicide. A lower impact of the microalgal product for most of the indicators, including carbon footprint, was shown.

Criterios PERCIST, Hopkins y parámetros metabólicos de la PET/TC como factores pronósticos en el cáncer escamoso de cabeza y cuello / PERCIST and Hopkins criteria and PET/CT metabolic parameters as prognostic factors in squamous head and neck cancer

Objetivo Valorar la utilidad clínica de los criterios PERCIST, Hopkins y de los cambios en los parámetros cuantitativos de la PET/TC con [18F]FDG como factores pronósticos para la supervivencia libre de progresión (SLP) y la supervivencia cáncer específica (SCE) en pacientes con cáncer escamoso de cabeza y cuello tratados mediante quimiorradioterapia. Material y métodos Se valoraron retrospectivamente 40 pacientes (34 hombres) diagnosticados de cáncer escamoso de cabeza y cuello durante un intervalo de 8 años. Se utilizaron los criterios PERCIST y Hopkins para determinar la respuesta al tratamiento. Así mismo, se cuantificaron las variaciones de los parámetros metabólicos SUV máximo (ΔSUVmax), volumen metabólico tumoral (ΔMTV) y glicólisis tumoral total (ΔTLG) entre los estudios PET/TC pre- y postratamiento. El modelo de regresión de Cox, las curvas ROC y el método de Kaplan-Meier se aplicaron para el análisis de factores pronósticos y curvas de supervivencia. Resultado El seguimiento medio fue de 39,4 meses produciéndose 24 recidivas-progresiones y 22 muertes. Tanto los criterios PERCIST y Hopkins como los tres parámetros metabólicos fueron factores predictivos en análisis univariante y solo el ΔSUVmax en el multivariante. El análisis de supervivencia mostró curvas de SLP y SCE significativamente diferentes para los cinco parámetros considerados. Conclusión La aplicación de los criterios PERCIST y Hopkins, así como los ΔSUVmax, ΔMTV y ΔTLG de los estudios PET/TC demostraron ser factores pronósticos para la supervivencia en pacientes de nuestro entorno tratados por cáncer de cabeza y cuello. Los resultados podrían ayudar a personalizar el tratamiento (AU)

Aim To assess the clinical utility of PERCIST and Hopkins criteria and changes in [18F]FDG PET/CT quantitative parameters as prognostic factors for progression-free survival (PFS) and cancer-specific survival (CSS) in patients with head and neck squamous cell carcinoma treated by chemoradiotherapy. Material and methods Forty patients (34 men) diagnosed with head and neck squamous cell carcinoma were retrospectively assessed over an interval of 8 years. PERCIST and Hopkins criteria were used to assess response to treatment. Variations in the metabolic parameters maximum SUV (ΔSUVmax), metabolic tumor volume (ΔMTV) and total lesion glycolysis (ΔTLG) between pre- and post-treatment PET/CT studies were also determined. Cox regression model, ROC curves and Kaplan-Meier method were used for the analysis of prognostic factors and survival curves. Results The average follow-up was 39.4 months, with 24 progressions and 22 deaths. Both PERCIST and Hopkins criteria and the three metabolic parameters were predictive factors in the univariate analysis and only ΔSUVmax in the multivariate analysis. Survival analysis showed statistically significant differences in PFS and CSS curves for the five parameters considered. Conclusion Application of PERCIST and Hopkins criteria as well as ΔSUVmax, ΔMTV and ΔTLG from PET/CT studies proved to be prognostic factors for survival in patients in our setting treated for head and neck cancer. The results could help to personalize treatment (AU)

PERCIST and Hopkins criteria and PET/CT metabolic parameters as prognostic factors in squamous head and neck cancer.

AIM: To assess the clinical utility of PERCIST and Hopkins criteria and changes in [18F]FDG PET/CT quantitative parameters as prognostic factors for progression-free survival (PFS) and cancer-specific survival (CSS) in patients with head and neck squamous cell carcinoma treated by chemoradiotherapy. MATERIAL AND METHODS: Forty patients (34 men) diagnosed with head and neck squamous cell carcinoma were retrospectively assessed over an interval of 8 years. PERCIST and Hopkins criteria were used to assess response to treatment. Variations in the metabolic parameters maximum SUV (ΔSUVmax), metabolic tumor volume (ΔMTV) and total lesion glycolysis (ΔTLG) between pre- and post-treatment PET/CT studies were also determined. The Cox regression model, ROC curves and the Kaplan-Meier method were used for the analysis of prognostic factors and survival curves. RESULTS: The mean follow-up was 39.4 months, with 24 progressions and 22 deaths. Both PERCIST and Hopkins criteria and the three metabolic parameters were predictive factors in the univariate analysis and only ΔSUVmax was in the multivariate analysis. Survival analysis showed statistically significant differences in PFS and CSS curves for the five parameters considered. CONCLUSION: Application of PERCIST and Hopkins criteria as well as ΔSUVmax, ΔMTV and ΔTLG from PET/CT studies proved to be prognostic factors for survival in patients in our setting for treating head and neck cancer. The results may help to personalize treatment.

Neuroanatomical and morphometric study of S100ß positive astrocytes in the entorhinal cortex during ageing in the 3xTg-Alzehimer's disease mouse model.

Astrocytes contribute to the progression of neurodegenerative diseases, including Alzheimer's disease (AD). Here, we report the neuroanatomical and morphometric analysis of astrocytes in the entorhinal cortex (EC) of the aged wild type (WT) and triple transgenic (3xTg-AD) mouse model of AD. Using 3D confocal microscopy, we determined the surface area and volume of positive astrocytic profiles in male mice (WT and 3xTg-AD) from 1 to 18 months of age. We showed that S100ß-positive astrocytes were equally distributed throughout the entire EC in both animal types and showed no changes in Nv (number of cells/mm3) nor in their distribution at the different ages studied. These positive astrocytes, demonstrated an age-dependent gradual increase in their surface area and in their volume starting at 3 months of age, in both WT and 3xTg-AD mice. This last group demonstrated a large increase in both surface area and volume at 18 months of age when the burden of pathological hallmarks of AD is present (69.74% to 76.73% in the surface area and the volume, for WT and 3xTg-AD mice respectively). We observed that these changes were due to the enlargement of the cell processes and to less extend the somata. In fact, the volume of the cell body was increased by 35.82% in 18-month-old 3xTg-AD compared to WT. On the other hand, the increase on the astrocytic processes were detected as soon as 9 months of age where we found an increase of surface area and volume (36.56% and 43.73%, respectively) sustained till 18 month of age (93.6% and 113.78%, respectively) when compared age-matched non-Tg mice. Moreover, we demonstrated that these hypertrophic S100ß-positive astrocytes were mainly associated with Aß plaques. Our results show a severe atrophy in GFAP cytoskeleton in all cognitive areas; whilst within the EC astrocytes independent to this atrophy show no changes in GS and S100ß; which can play a key role in the memory impairment.

Asthma Mortality in Spain From 1980 to 2019: Trends and Perspectives in the New Treatment Era.

BACKGROUND AND OBJECTIVE: Previous studies suggest that asthma mortality rates in Spain have been decreasing in recent years. However, this trend is not homogeneous across age groups. Objective: To analyze asthma mortality rates over a 40-year period, focusing on changes associated with the development of new therapeutic approaches. METHODS: Death records and mid-year population data were collected from the National Statistics Institute. Using the direct method, agestandardized mortality rates were calculated for the overall population and for each sex and age group. Significant changes in mortality trends were identified using joinpoint regression analysis. The independent effects of age, period, and cohort and potential years of life lost due to asthma were also analyzed. RESULTS: Age-standardized asthma mortality rates decreased in Spain from 7.38 to 2.03 deaths per 100 000 from the first to the last quinquennium of the study (1980-1984 to 2015-2019) for the whole population. This decrease was more intense among men, where a decrease from 10.37/100 000 to 0.91/100 000 was observed compared with 5.53 to 2.77/100 000 in women. Mortality decreased in all age groups. During the last 3 years, the decrease stabilized in patients aged >64 years but increased in those aged 35-64. Mortality has been decreasing rapidly since the 1990s in patients aged <35 years. CONCLUSION: Asthma mortality rates began to decline in 1980. The decrease was observed among younger cohorts starting in the 1990s, thus confirming earlier trends. Improved diagnosis and development of new therapies for asthma may have played a role in the changes observed. Close monitoring of asthma mortality rates is necessary to confirm these trends.

Asthma Mortality in Spain From 1980 to 2019: Trends and Perspectives in the New Treatment Era

Background: Previous studies suggest that asthma mortality rates in Spain have been decreasing in recent years. However, this trend is not homogeneous across age groups. Objective: To analyze asthma mortality rates over a 40-year period, focusing on changes associated with the development of new therapeutic approaches. Methods: Death records and mid-year population data were collected from the National Statistics Institute. Using the direct method, agestandardized mortality rates were calculated for the overall population and for each sex and age group. Significant changes in mortality trends were identified using joinpoint regression analysis. The independent effects of age, period, and cohort and potential years of life lost due to asthma were also analyzed. Results: Age-standardized asthma mortality rates decreased in Spain from 7.38 to 2.03 deaths per 100 000 from the first to the last quinquennium of the study (1980-1984 to 2015-2019) for the whole population. This decrease was more intense among men, where a decrease from 10.37/100 000 to 0.91/100 000 was observed compared with 5.53 to 2.77/100 000 in women. Mortality decreased in all age groups. During the last 3 years, the decrease stabilized in patients aged >64 years but increased in those aged 35-64. Mortality has been decreasing rapidly since the 1990s in patients aged <35 years. Conclusion: Asthma mortality rates began to decline in 1980. The decrease was observed among younger cohorts starting in the 1990s, thus confirming earlier trends. Improved diagnosis and development of new therapies for asthma may have played a role in the changes observed. Close monitoring of asthma mortality rates is necessary to confirm these trends (AU)

Introducción: Estudios previos sugieren que las tasas de mortalidad en España han disminuido en los últimos años, aunque esta tendencia no se ha observado de forma homogénea en todos los grupos de edad. Objetivo: Se analizan las tasas de mortalidad por asma de los últimos 40 años en España, centrándose en los cambios relacionados con el desarrollo de nuevas terapias. Métodos: Se obtuvieron los registros de defunción y los datos de población del Instituto Nacional de Estadística. Se calcularon las tasas de mortalidad estandarizadas por edad utilizando el método directo para la población global y para cada sexo y grupos de edad. Se identificaron cambios significativos en las tendencias de mortalidad mediante modelos de regresión Joinpoint (puntos de cambio). También se analizaron los efectos de la edad, período y cohorte, y se calcularon los años potenciales de vida perdidos debido al asma. Resultados: Las tasas de mortalidad estandarizadas por asma disminuyeron en España de 7,38 a 2,03 muertes por 100.000 entre el primer y el último quinquenio del estudio (1980-1984 a 2015-2019) para la población general. Esta disminución fue más intensa entre los hombres, donde se observó una disminución de 10,37/100.000 a 0,91/100.000 frente a 5,53 a 2,77 / 100.000 en las mujeres. Todos los grupos de edad han reducido su mortalidad globalmente en el periodo estudiado. Mientras que los mayores de 64 años han estabilizado su descenso y la población entre 35 y 64 incluso ha incrementado la mortalidad en los últimos 3 años, los menores de 35 años mantienen un rápido descenso desde la década de 1990. Conclusión: Hay una disminución en las tasas de mortalidad por asma a partir de 1980, incluidas las cohortes más jóvenes a partir de la década de 1990, lo que confirma tendencias anteriores. Las mejoras en el diagnóstico y el desarrollo de nuevas terapias para el asma pueden tener un papel en estos hallazgos (AU)

Revisión sistemática y metaanálisis de los efectos hemodinámicos del etomidato frente a otros sedantes en pacientes sometidos a secuencia de intubación rápida / A systematic review and meta-analysis of the hemodynamic effects of etomidate versus other sedatives in patients undergoing rapid sequence intubation

Introducción: La secuencia de intubación rápida es una técnica de protección y rescate de la vía aérea que requiere el uso de sedantes para propiciar un adecuado escenario durante la intubación orotraqueal. Son utilizados diferentes sedantes inductores, siendo el etomidato el más común por sus cualidades farmacocinéticas y farmacodinámicas, donde resalta su estabilidad hemodinámica. Sin embargo, en comparación con otros sedantes esta superioridad es controvertida. Materiales y métodos: Se realizó un metaanálisis con un protocolo definido a priori y siguiendo las etapas de la guía PRISMA. Se calculó la diferencia de medias de la presión arterial sistólica antes y después de la administración del sedante, además de un metaanálisis de riesgos relativos de hipotensión. Resultados: Se incluyeron 10 estudios en los cuales la incidencia de hipotensión en el grupo de pacientes que recibió el etomidato osciló entre el 6,4% y el 75,2%, mientras que en los que recibieron otros sedantes osciló entre el 24,0% y el 65,9%. En los metaanálisis de diferencia de medias no se hallaron diferencias significativas de la presión arterial sistólica durante la preintubación 0,01mmHg (IC 95%: –0,90; 0,92), ni en la postintubación 0,98mmHg (IC 95%: –0,24; 2,20). Además, el metaanálisis de riesgos relativos indica que el riesgo de hipotensión es igual a un RR 1,19 (IC 95%: 0,92-1,54) entre quienes recibieron el etomidato y aquellos que recibieron los otros sedantes. Conclusiones: El riesgo de hipotensión posterior a la secuencia de intubación rápida con etomidato no presenta diferencias significativas comparado con otros sedantes. Sin embargo, hay heterogeneidad en los estudios incluidos.(AU)

Introduction: Rapid sequence intubation is an airway rescue and protection technique in which different sedatives are used to perform orotracheal intubation. Etomidate, due to its pharmacokinetic and pharmacodynamic qualities, particularly hemodynamic stability, is the most widely used sedative in this scenario. However, its superiority over other sedatives is controversial. Materials and methods: We performed a meta-analysis using a pre-designed protocol and PRISMA guidelines to evaluate the mean difference between systolic blood pressure before and after administration of the sedative. We also analyzed the relative risks of hypotension. Results: Ten studies were included. The incidence of hypotension in patients receiving etomidate ranged from 6.4% to 75.2%, and between 24.0% and 65.9% in patients receiving other sedatives. No significant differences were found in the mean difference in systolic blood pressure during pre-intubation 0.01mmHg (95% CI: –0.90; 0.92) or in post-intubation 0.98mmHg (95% CI: –0.24; 2.20). The relative risk analysis showed that the risk of hypotension is equal to an RR of 1.19 (95% CI: 0.92-1.54) between those who received etomidate and those who received the other sedatives. Conclusions: The risk of hypotension after rapid intubation sequence with etomidate does not differ significantly compared to other sedatives. However, the studies included in this review were heterogeneous.(AU)

A systematic review and meta-analysis of the hemodynamic effects of etomidate versus other sedatives in patients undergoing rapid sequence intubation.

INTRODUCTION: Rapid sequence intubation is an airway rescue and protection technique in which different sedatives are used to perform orotracheal intubation. Etomidate, due to its pharmacokinetic and pharmacodynamic qualities, particularly hemodynamic stability, is the most widely used sedative in this scenario. However, its superiority over other sedatives is controversial. MATERIALS AND METHODS: We performed a meta-analysis using a pre-designed protocol and PRISMA guidelines to evaluate the mean difference between systolic blood pressure before and after administration of the sedative. We also analyzed the relative risks of hypotension. RESULTS: Ten studies were included. The incidence of hypotension in patients receiving etomidate ranged from 6.4% to 75.2%, and between 24.0% and 65.9% in patients receiving other sedatives. No significant differences were found in the mean difference in systolic blood pressure during pre-intubation 0.01 mm Hg (95% CI: -0.90; 0.92) or in post-intubation 0.98 mmHg (95% CI: -0.24; 2.20). The relative risk analysis showed that the risk of hypotension is equal to an RR of 1.19 (95% CI: 0.92-1.54) between those who received etomidate and those who received the other sedatives. CONCLUSIONS: The risk of hypotension after rapid intubation sequence with etomidate does not differ significantly compared to other sedatives. However, the studies included in this review were heterogeneous.

Critical review of technologies for the on-site treatment of hospital wastewater: From conventional to combined advanced processes.

This review aims to assess different technologies for the on-site treatment of hospital wastewater (HWW) to remove pharmaceutical compounds (PhCs) as sustances of emerging concern at a bench, pilot, and full scales from 2014 to 2020. Moreover, a rough characterisation of hospital effluents is presented. The main detected PhCs are antibiotics and psychiatric drugs, with concentrations up to 1.1 mg/L. On the one hand, regarding the presented technologies, membrane bioreactors (MBRs) are a good alternative for treating HWW with PhCs removal values higher than 80% in removing analgesics, anti-inflammatories, cardiovascular drugs, and some antibiotics. Moreover, this system has been scaled up to the pilot plant scale. However, some target compounds are still present in the treated effluent, such as psychiatric and contrast media drugs and recalcitrant antibiotics (erythromycin and sulfamethoxazole). On the other hand, ozonation effectively removes antibiotics found in the HWW (>93%), and some studies are carried out at the pilot plant scale. Even though, some families, such as the X-ray contrast media, are recalcitrant to ozone. Other advanced oxidation processes (AOPs), such as Fenton-like or UV treatments, seem very effective for removing pharmaceuticals, Antibiotic Resistance Bacteria (ARBs) and Antibiotic Resistance Genes (ARGs). However, they are not implanted at pilot plant or full scale as they usually consider extra reactants such as ozone, iron, or UV-light, making the scale-up of the processes a challenging task to treat high-loading wastewater. Thus, several examples of biological wastewater treatment methods combined with AOPs have been proposed as the better strategy to treat HWW with high removal of PhCs (generally over 98%) and ARGs/ARBs (below the detection limit) and lower spending on reactants. However, it still requires further development and optimisation of the integrated processes.