OBJECTIVE: To identify the factors associated with the prescription of vaginal pessaries (VPs) as a conservative treatment for pelvic organ prolapse (POP). METHODS: A cross-sectional study was performed during two annual urogynecology and general obstetrics and gynecology meetings in 2017 (São Paulo, SP, Brazil). A 19-item deidentified questionnaire regarding experiences and practices in prescribing VPs for POP patients was distributed among gynecologists. Our primary outcome was the frequency of prescribing VPs as a conservative treatment for POP. The reasons for prescribing or not prescribing VPs were also investigated. Univariate and multivariate analyses with crude and adjusted odds ratios (ORs) were performed for variables associated with the prescription of pessaries. RESULTS: Three hundred forty completed surveys were analyzed. Half of the respondents (53.53%) were between 30-49 years old; most of them were female (73.53%), were from the Southeast Region (64.12%), were trained in obstetrics and gynecology (80.24%) or urogynecology (61.18%) and worked in private offices (63.42%). More than one-third (36.48%) attended four or more POP cases/week, and 97.65% (n=332) had heard or knew about VPs for POP; however, only 47.06% (n=160) prescribed or offered this treatment to patients. According to the multivariate analysis, physicians aged 18-35 years (OR=1.97[1.00-3.91]; p=0.04), those who participated in a previous urogynecology fellowship (OR=2.34[1.34-4.09]; p<0.01), those with relatively high volumes of POP cases (4 or +) (OR=2.23[1.21-4.47]; p=0.01) and those with PhD degrees (OR=2.75[1.01-7.54]; p=0.05) prescribed more pessaries. CONCLUSIONS: Most gynecologists did not prescribe VPs. Younger physician age, participation in a previous urogynecology fellowship, a PhD degree, and a relatively high volume of POP cases were associated with increased VP prescription rates.

The occurrence of nitrogenous compounds in industrial effluents at concentration levels above legal limits, is a well-known and serious pollution problem for the receiving body. The biological process for the removal of these substances, commonly referred to as ammoniacal nitrogen, is known as nitrification. Bacteria involved are mainly of the genuses Nitrosomonas and Nitrobacter. The aim of the present work was to study the effect of the hydraulic retention time (HRT) on the efficiency of ammonia removal from a petroleum refinery effluent using activated carbon particles as a biofilm support in an airlift bioreactor. The experiments were carried out using HRTs, equal to six, eight and ten hours. The results show that HRT equal to 8 and 10 hours were enough to reduce ammoniacal nitrogen concentration to levels below permited legal limits (5mg/L NH3-N). The reactor nitrifying performance was maximized at 85% removal of ammoniacal nitrogen, for a HRT equal to 10 hours.

Abstract - An Aerated Submerged Biological Filter was used to promote biological nitrification of a synthetic saline wastewater. Black PVC corrugated plates were used to make the structured packing of the 6 liter reactor. Nitrate, nitrite, and ammonia concentrations, pH and DO were periodically measured, according to APHA (1985). In spite of the deleterious effect of salinity, it was possible to obtain nitrogen removal efficiencies as high as 95% for a 25 g/L salt concentration after a three-day reaction in the batch reactor. Continuous operation using a NaCl concentration of 25 g/L was tested using three different hydraulic retention times: 7, 15, and 25 hours. An increase in ammonia removal was observed when the retention time was increased from 7 to 15 hours. However, no further notable increase was obtained for a 25 hour retention time, showing that nitrogen removal tends towards a maximum limit of about 80%.