RESUMEN
Ozone has been successfully employed in water treatment due to its ability to oxidize a wide variety of refractory compounds. In order to increase the process efficiency and optimize its economy, the implementation of heterogeneous catalysts has been encouraged. In this context, the use of cheap and widely available natural materials is a promising option that would promote the utilization of ozone in a cost-effective water treatment process. This review describes the use of natural clays, zeolites and oxides as supports or active catalysts in the ozonation process, with emphasis on the structural characteristics and modifications performed in the raw natural materials; the catalytic oxidation mechanism; effect of the operating parameters and degradation efficiency outcomes. According to the information compiled, more research in realistic scenarios is needed (i.e., real wastewater matrix or continuous operation in pilot scale) in order to transfer this technology to the treatment of real wastewater streams.
Asunto(s)
Contaminantes Ambientales , Ozono , Contaminantes Químicos del Agua , Purificación del Agua , Zeolitas , Catálisis , Arcilla , Óxidos , Ozono/química , Aguas Residuales , Contaminantes Químicos del Agua/análisis , Zeolitas/químicaRESUMEN
Presentamos dos casos de dolor lumbar de tipo inflamatorio y dolor alternante en nalgas, quedesarrollaron disnea progresiva con adenopatías mediastinales e hiliares y signos de enfermedad pulmonar intersticial a la tomografía de tórax. El diagnóstico de sarcoidosis se confirmó con biopsia cutánea en un caso y con biopsia pulmonar a cielo abierto en el otro. Se discute esta forma inusual de presentación de estas dos patologías y se revisan los casos similares de la literatura
Asunto(s)
Dolor de la Región Lumbar , Sarcoidosis , Espondilitis , ArtropatíasRESUMEN
Two cases were presented with initial symptoms of inflammatory low back pain and alternate buttock pain. They developed a progressive dyspnea with bilateral mediastinal and hiliar lymphadenopathy and pulmonary interstitial disease as visualized with chest CT scan. Sarcoidosis diagnosis was confirmed by biopsy in both cases--in one case by skin biopsy and in the other by open lung biopsy. These clinical forms of spondyloarthropathy and sarcoidosis were unusual and were compared with similar cases present in the literature.
Asunto(s)
Dolor de la Región Lumbar/etiología , Sarcoidosis/complicaciones , Espondilitis/complicaciones , Adulto , Femenino , Glucocorticoides/uso terapéutico , Humanos , Dolor de la Región Lumbar/diagnóstico por imagen , Dolor de la Región Lumbar/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Prednisolona/uso terapéutico , Radiografía Torácica , Sarcoidosis/diagnóstico por imagen , Sarcoidosis/tratamiento farmacológico , Espondilitis/diagnóstico por imagen , Espondilitis/tratamiento farmacológico , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
We present 5 new cases of coexisting sarcoidosis and Sjögren syndrome (SS) and review the literature for additional cases in order to analyze the clinical, immunologic, and histologic characteristics that may help physicians differentiate the mimicry of SS by sarcoidosis from a true coexistence of both autoimmune diseases. We considered the coexistence of sarcoidosis with SS to be when patients presented specific histologic patterns of both diseases, simultaneously or at different times.Fifty-nine patients were included in the analysis (54 identified in the literature search plus our 5 unpublished cases): 49 (83%) patients were female and 10 (17%) were male, with a mean age at diagnosis of 50 years. According to the histopathologic examination of the exocrine glands performed in 53 cases, we defined coexistence of sarcoidosis and SS in 28 cases, while in the remaining 25 patients, sarcoidosis mimicked SS. Clues to identifying when sarcoidosis coexists with SS were a higher prevalence of systemic manifestations (arthritis and uveitis) and positive immunologic parameters (antinuclear antibodies, rheumatoid factor, and anti-Ro/SS-A), as well as the existence of a focal sialadenitis (Chisholm-Mason score grades III-IV, with a CD4+ lymphocytic infiltration) in the salivary gland biopsy. In patients first diagnosed with primary SS, the appearance of some clinical features such as hilar adenopathies, uveitis, or hypercalcemia leads to the diagnosis of coexisting sarcoidosis. A careful application of the new American-European consensus criteria had a sensitivity of 93% and a specificity of 92% in identifying when SS coexists with sarcoidosis.In conclusion, the association of sarcoidosis with SS leads to a true coexistence of both diseases in more than half the patients described in the literature, while in the remaining patients, sarcoidosis mimics SS. In light of these results, sarcoidosis should not be considered as an exclusion criterion for the diagnosis of SS, and in patients with a suspected overlap of the two diseases, application of the new American-European consensus criteria for diagnosis of SS should be mandatory.
Asunto(s)
Sarcoidosis/diagnóstico , Sarcoidosis/patología , Síndrome de Sjögren/diagnóstico , Síndrome de Sjögren/patología , Adulto , Anciano , Comorbilidad , Diagnóstico Diferencial , Femenino , Humanos , Hipercalcemia/etiología , Persona de Mediana Edad , Uveítis/etiologíaRESUMEN
El término síndrome antifosfolípido se introdujo para definir a aquellos pacientes que presentaban manifestaciones clínicas (trombosis, trombocitopenia y abortos espontáneos) y presencia de anticuerpos como el anticoagulante lúpico y el anticuerpo anticardiolipina. El síndrome antifosfolípido puede aparecer en pacientes que no presentan manifestaciones clínicas ni biológicas de ninguna otra enfermedad (síndrome antifosfolípido primario) o asociarse a otras patologías (síndrome antifosfolípido secundario). Se han descrito en el síndrome antifosfolípido lesiones a nivel cardiovascular, en sistema nervioso central, manifestaciones pulmonares, hepáticas, renales y en las glándulas suprarrenales, todo esto ocasionado por el proceso trombótico vascular, tanto arterial comovenoso que suelen presentar estos pacientes. El mecanismo patogénico es todavía desconocido. Por otra parte, el diagnóstico de síndrome antifosfolípido primario o secundario deberá hacerse en base al estudio cuidadoso de la posible existencia de otra enfermedad asociada, fundamentalmente lupus eritematoso sistémico, siendo importante destacar que no es infrecuente que la primera manifestación de éste sea un síndrome antifosfolípido. En el tratamiento se intentará suprimir los anticuerpos antifosfolípidos y utilizar en forma apropiada los agentes antiagregantes, anticoagulantes y fibrinolíticos indicados según el caso