Treatment of aqueous wastes by means of Thermophilic Aerobic Membrane Reactor (TAMR) and nanofiltration (NF): process auditing of a full-scale plant.

This work focuses on the Thermophilic Aerobic Membrane Reactor (TAMR) process. The research was carried out on a full-scale facility where, all along a 12-year period, daily monitoring and process audit tests were conducted for the process analysis and optimization. The plant treated -light and high-strength aqueous wastes and two different configurations were adopted: (1) thermophilic biological reactor + ultrafiltration (TAMR) and (2) TAMR + nanofiltration (TAMR + NF). In the latter case, the average chemical oxygen demand removal yield was equal to 89% and an effective denitrification (nitrogen oxides removal equal to 96%) was achieved by reducing the dissolved oxygen concentration in the bioreactor. Low specific sludge production was observed. Poor sludge settling properties were measured by a lab-scale settling test; respirometric tests (nitrogen uptake rate and ammonia uptake rate) showed the presence of denitrification and the inhibition of nitrification. Hydrodynamic tests revealed the presence of a significant dead space, thus showing room for improving the overall process performance. Finally, the rheological properties of the sludge were measured as a function of the biomass concentration, pH, temperature, and aeration scheme.

[Treatment of uremia in frail elderly patients: the issue of prolonged conservative management]. / L'anziano fragile e la terapia dell'uremia: il tema della terapia conservativa prolungata.

The chronic use of renal replacement therapy in frail elderly patients sometimes provides no tangible benefits and may even have a negative fallout on their quality of life, making prolonged conservative management a reasonable option. However, this is mostly a feeling, since very few papers have addressed this issue and there is no evidence-based medicine related to it. On the other hand, ethical issues are extraordinarily relevant and in this clinical setting extend beyond topics such as end-of-life care and advance care planning. It is evident that clinical decision-making in frail elderly patients with endstage renal disease may be very difficult and needs to be supported by ad hoc clinical trials. In the meantime, the ethical issues must be discussed in society.

CD105-assessed micro-vessel density is associated with malignancy recurrence in laryngeal squamous cell carcinoma.

AIMS: Angiogenesis is essential for malignancies growth. CD105 is a proliferation-associated protein abundantly expressed in angiogenic endothelial cells. The aim of this study has been to determine the expression of CD105 in laryngeal squamous cell carcinoma (SCC) and to investigate the role of CD105-assessed mean vascular density (MVD) in predicting patients' prognosis. METHODS: The sections of 43 consecutive cases of laryngeal SCC were stained with mouse monoclonal antibody CD105. All the measures were performed by a computer-based image analysis system. The percentage of the fields occupied by CD105-assessed micro-vessels was determined. RESULTS: The mean CD105-assessed MVD were 11% and 6% in laryngeal SCC with and without malignancy recurrence, respectively. Multivariate logistic regression stated that CD105-assessed MVD was significantly related to disease recurrence (p=0.030). CONCLUSIONS: Our preliminary results suggest that CD105-assessed MVD may be a valuable parameter for predicting patients having an increased risk of developing laryngeal carcinoma loco-regional recurrence.