Contribution of hospital effluents to the load of pharmaceuticals in urban wastewaters: Identification of ecologically relevant pharmaceuticals

The impact of effluent wastewaters from four different hospitals: a university (1456 beds), a general (350 beds), a pediatric (110 beds) and a maternity hospital (96 beds), which are conveyed to the same wastewater treatment plant (WWTP), was evaluated in the receiving urban wastewaters. The occurrence of 78 pharmaceuticals belonging to several therapeutic classes was assessed in hospital effluents and WWTP wastewaters (influent and effluent) as well as the contribution of each hospital in WWTP influent in terms of pharmaceutical load. Results indicate that pharmaceuticals are widespread pollutants in both hospital and urban wastewaters. The contribution of hospitals to the input of pharmaceuticals in urban wastewaters widely varies, according to their dimension. The estimated total mass loadings were 306 g d− 1 for the university hospital, 155 g d− 1 for the general one, 14 g d− 1 for the pediatric hospital and 1.5 g d− 1 for the maternity hospital, showing that the biggest hospitals have a greater contribution to the total mass load of pharmaceuticals. Furthermore, analysis of individual contributions of each therapeutic group showed that NSAIDs, analgesics and antibiotics are among the groups with the highest inputs. Removal efficiency can go from over 90% for pharmaceuticals like acetaminophen and ibuprofen to not removal for β-blockers and salbutamol. Total mass load of pharmaceuticals into receiving surface waters was estimated between 5 and 14 g/d/1000 inhabitants. Finally, the environmental risk posed by pharmaceuticals detected in hospital and WWTP effluents was assessed by means of hazard quotients toward different trophic levels (algae, daphnids and fish). Several pharmaceuticals present in the different matrices were identified as potentially hazardous to aquatic organisms, showing that especial attention should be paid to antibiotics such as ciprofloxacin, ofloxacin, sulfamethoxazole, azithromycin and clarithromycin, since their hazard quotients in WWTP effluent revealed that they could pose an ecotoxicological risk to algae.

Medição automática do diâmetro da aorta torácica em imagens de tomografia computorizada

O calibre da artéria aorta torácica é avaliado em situações de suspeita de patologia ou em pacientes com pre-disposição para desenvolverem doenças vasculares. A medição das suas dimensões, em duas direcções diametralmente opostas e, assim, fulcral na avaliação desta estrutura. Para tal, o exame de primeira linha definido é a Angiografia por Tomografia Computorizada (Angio-TC), injectando-se um produto de contraste na veia radial que irá opacificar os vasos, permitindo a sua distinção das estruturas adjacentes. O presente trabalho, inserido na disciplina de Dissertação/ Projecto/ Estágio Profissional do Mestrado em Engenharia de Computação e Instrumentação Médica e com a cooperação da empresa Efficientia, foi sugerido pela equipa de Angio-TC do Centro Hospitalar de Vila Nova de Gaia (CHVNG) e tem por objectivo o desenvolvimento de uma aplicação para a medição e registo automático do diâmetro da aorta torácica em nove pontos anatómicos pre-definidos em imagens de Tomografia Computorizada (TC). A aplicação foi desenvolvida no ambiente integrado de processamento e análise de imagem, Fiji, sendo a metodologia composta pelas etapas de segmentação, desenho da linha central, determinação dos planos de cortes, segmentação e medição da aorta nos planos de corte. Os resultados obtidos pela metodologia proposta são concordantes com os obtidos por especialistas para o conjunto de teste utilizado neste trabalho.