Selection of indicator contaminants of emerging concern when reusing reclaimed water for irrigation - A proposed methodology.

Organic and microbial contaminants of emerging concern (CECs), even though not yet regulated, are of great concern in reclaimed water reuse projects. Due to the large number of CECs and their different characteristics, it is useful to include only a limited number of them in monitoring programs. The selection of the most representative CECs is still a current and open question. This study presents a new methodology for this scope, in particular for the evaluation of the performance of a polishing treatment and the assessment of the risk for the environment and the irrigated crops. As to organic CECs, the methodology is based on four criteria (occurrence, persistence, bioaccumulation and toxicity) expressed in terms of surrogates (respectively, concentrations in the secondary effluent, removal achieved in conventional activated sludge systems, Log Kow and predicted-no-effect concentration). It consists of: (i) development of a dataset including the CECs found in the secondary effluent, together with the corresponding values of surrogates found in the literature or by in-field investigations; (ii) normalization step with the assignment of a score between 1 (low environmental impact) and 5 (high environmental impact) to the different criteria based on threshold values set according to the literature and experts' judgement; (iii) CEC ranking according to their final score obtained as the sum of the specific scores; and (iv) selection of the representative CECs for the different needs. Regarding microbial CECs, the selection is based on their occurrence and their highest detection frequency in the secondary effluent and in the receiving water, the antibiotic consumption patterns, and recommendations by national and international organisations. The methodology was applied within the ongoing reuse project SERPIC resulting in a list of 30 indicator CECs, including amoxicillin, bisphenol A, ciprofloxacin, diclofenac, erythromycin, ibuprofen, iopromide, perfluorooctane sulfonate (PFOS), sulfamethoxazole, tetracycline, Escherichia coli, faecal coliform, 16S rRNA, sul1, and sul2.

Genotipo VHC emergente en Castellón / No disponible

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[The management of acute cerebrovascular disorders at the Emergency Services at the Castellon General Hospital]. / Enfermedad vásculocerebral aguda atendida en el servicio de Urgencias del Hospital General de Castellón.

OBJECTIVE: To analyse the policy for hospital admission in the case of the patients who come to the Emergency Ward with acute cerebrovascular disorders. METHOD: The study was based on a retrospective analysis of the release reports from the Emergency Ward of Castellón General Hospital in the course of 1991, in which stroke, or transitory ischemic attack (TIA) were diagnosed. RESULTS: 514 patients were attended to who went to the Emergency Ward because of cerebrovascular disorder. Of these, 57.2% were referred to hospital, with 42% being sent home. It was observed that 10.65% (n = 23) they did not accomplish the criteria for stroke. There was an overwhelming number of cases of TIA diagnosed (50.2%) in patients who were not admitted, contrasting with only 7.5% being selected for admission. We considered possible explanations for this. CONCLUSIONS: We observed that as far as making the decision to admit a patient with acute cerebrovascular disorder, priority for admission was given in those cases which showed the worst neurological deficiencies, and had a worse prognosis as a consequence. Similarly, the older age (average 76.5 years old) was a prominent factor as far as those who were not admitted.

[A study of mortality in patients with acute cerebrovascular pathology in the Castellon General Hospital]. / Análisis de mortalidad en pacientes con patología cerebrovascular aguda en el Hospital General de Castellón.

OBJECTIVE: To analyse the hospital death rate caused by acute cardiovascular disorder and their factors conducted. METHODS: We made a retrospective review of all patients suffering from this pathology who had gone into the Casualty Ward of the Castellón General Hospital in the course of 1991: we also looked for all patients with acute cardiovascular disorder who had died in the hospital. We studied the risk factors for the patients referred using a univariant analysis, comparing those still living with those who had died. RESULTS: We find 514 patients diagnosed as having acute cardiovascular disorder, with an stroke/TIA incidence rate of 188 cases per 100,000 inhabitants. The proportion of referred patients was 52%. Among these, the death rate was 27.8%. Factors affecting the death rate were the age of the patients, the reduction in the level of consciousness, and lateral gaze at the start of the stroke. CONCLUSIONS: We believe that the high death rate in our selection was due to the severity of the strokes and the advanced age of the patients, as was in accordance with the methodology used in the gathering of data, which made it possible to include patients who died early.