Reforming of biomass-derived producer gas using toluene as model tar: Deactivation and regeneration studies in Ni and K-Ni catalysts.

Within the syngas production from biomass gasification, tar removal constitutes a chief issue to overcome for advanced catalytic systems. This work investigates the performance of Ni and Ni-K catalysts for reforming of derived-biomass producer gas using toluene as model tar. At 750 °C and 60Lg-1h-1, the stability test (70 h) revealed stable performances (CO2, CH4 and C7H8 conversions of 60, 95 and 100%, correspondingly) uniquely for the Ni-K catalyst. Although the efficient protection towards coking let by K was demonstrated, TPO studies over the post-reacted systems still evidenced the presence of carbon deposits for both samples. Conducting three successive reaction/regeneration cycles with different gasifying agents (air, steam and CO2) at 800 °C for 1h, the capability towards regeneration of both catalytic systems was assessed and the spent catalysts were characterized by XRD, SEM and TEM. While none of the regeneration treatments recovered the performance of the unpromoted catalyst, the Ni-K catalysts demonstrated the capability of being fully regenerated by air and CO2 and exhibited analogous catalytic performances after a series of reaction/regeneration cycles. Hence, it is proved that the addition of K into Ni catalysts not only enhances the resistance against deactivation but enables rather facile regenerative procedures under certain atmospheres (air and CO2).

Injury epidemiology in competing and non-competing spanish crossfit® practitioners / Epidemiología lesional en practicantes de crossfit® competidores y no competidores españoles

La falta de estudios sobre lesiones en Crossfit® en España, motiva la realización de este estudio epidemiológico descriptivo, observacional y retrospectivo, analizando la incidencia y las características de las lesiones sufridas por practicantes de Crossfit® competidores y no competidores. Se registraron las lesiones sufridas por 434 deportistas entre el 1 de enero y el 31 de diciembre de 2019. Se registraron datos sobre el número de lesiones, lesiones más frecuentes, distribución, tipo, ubicación, el momento en que ocurrieron y la causa de las lesiones que afectan el sistema musculoesquelético. La tasa de lesiones en esta población fue de 3,48 lesiones por 1000 horas de exposición al riesgo. El hombro y la zona lumbar fueron las zonas anatómicas más frecuentemente lesionadas, siendo el musculo y el tendón el tejido de asiento más habitual de las lesiones. El Powerlifting fue la actividad más lesiva. (AU)

The lack of studies on Crossfit® injuries in Spain, motivates the realization of this descriptive, observational and retrospective epidemiological study, analyzing the incidence and characteristics of injuries suffered by Crossfit® competitors and non-competitors.The injuries suffered by 434 athletes between from January 1st to December 31st 2019 were recorded. We collected data on the number of injuries, the most frequent injuries, their distribution, type, location, the moment at which these occurred and the cause of the injuries affecting the musculoeskeletal system. We found that the injury rate in this population was 3,48 injuries per 1000 hours of risk. The shoulder and lumbar area were the most frequently injured anatomical areas, with muscle and tendon being the most common seat tissue of injuries. Powerlifting was the most damaging activity. (AU)

Efficacy and safety of dolutegravir/rilpivirine in real-world clinical practice. GeSIDA study 1119.

INTRODUCTION: Dolutegravir/rilpivirine (DTG/RPV) is an effective antiretroviral (ART) regimen endorsed by clinical trials as a switch therapy. The aim of our study was to analyse the efficacy and safety of DTG/RPV in real-world clinical practice. METHODS: Observational, multicentre study of patients who started DTG/RPV. Efficacy, adverse events and metabolic changes at 48 weeks were analysed. RESULTS: A total of 348 patients were included; median time of HIV infection was 21.1 years, 33.7% were AIDS cases; median nadir CD4 was 160 cells/µL; 90.5% had received ≥3 lines of ART and 179 (53.8%) had prior virological failure. Convenience (43.5%), toxicity/intolerance (28.4%) and interactions (17.0%) were the main reasons for starting DTG/RPV. Previous regimens were protease inhibitors (PI) (31.6%), non-nucleoside reverse transcriptase inhibitors (NNRTI) (20.4%) and integrase strand transfer inhibitors (INSTI) (14.9%). Efficacy (HIV-RNA <50 copies/mL) at 48 weeks was 89.7% (95% CI 86.1-92.6) by intention-to-treat (ITT) and 94.2% (95% CI 91.3-96.4) by on treatment (OT); 10 patients (3.1%) were not suppressed (3 had abandoned ART). There was a mean decrease in triglycerides, total cholesterol, low-density lipoprotein-cholesterol, glutamic-pyruvic transaminase (GPT), gamma-glutamyl transferase (GGT) and alkaline phosphatase; creatinine increased with a decrease in glomerular filtration rate. CONCLUSIONS: This study confirms the effectiveness, tolerability and safety of DTG/RPV in real-world clinical practice in a different population from clinical trials, with many years of infection, low CD4 nadir, several previous treatment lines, more than half with virological failures, and one-third diagnosed with AIDS. The switch to DTG/RPV was safe with few discontinuations due to adverse effects. Modifications of the lipid and liver profiles were favourable. There were no relevant changes in kidney function.

First-Pass Effect in M1-Occlusion Stroke Patients Treated with Combined Stent-Retriever/Large-Bore Distal Aspiration Catheter Thrombectomy.

INTRODUCTION: Combined stent-retriever/large-bore distal aspiration catheter (LB-DAC) thrombectomy was recently introduced to treat large-vessel occlusion; however, it is unclear whether larger inner diameters improve outcomes. We compared angiographic and clinical outcomes in patients with occlusions of the M1 segment of the middle cerebral artery treated with mechanical thrombectomy using extra-LB-DAC versus LB-DAC in combination with stent-retrievers. METHODS: We analyzed consecutive patients with M1 occlusion included in the ROSSETTI registry treated with non-balloon guide catheter combined LB-DAC/stent-retriever thrombectomy between June 2019 and April 2022. We compared demographics, baseline clinical variables, procedural variables, angiographic outcomes, and clinical outcomes [National Institute of Health Stroke Scale score at 24 h (24h-NIHSS) and modified Rankin scale score at 3 months] between patients treated with extra-LB-DAC (Sofia Plus, MIVI Q6, Catalyst7; inner diameter, 0.068″-0.070″) versus LB-DAC (Sofia 5F, MIVI Q5, Catalyst 6; inner diameter, 0.055″-0.064″). Primary outcome was the first-pass effect (FPE) rate, defined as near-complete/complete reperfusion (mTICI 2c-3) after a single pass of the device. RESULTS: We included 324 patients (extra-LB-DAC, 185, 57.1% patients). Demographics, clinical data, and clinical outcomes were similar between the two groups; however, there was a trend towards improvement in National Institute of Health Stroke Scale score at 24 h (24h-NIHSS) in the cohort treated with extra-LB-DAC 9 points (IQR 4;16 points) vs. 12 points (IQR 4;18 points, P = 0.083). Patients treated with extra-LB-DAC had higher FPE rate (47% vs. 30.9%; P = 0.003) and higher modified FPE (mTICI ≥ 2b after a single pass) rate (65.9% vs 46.8%; P = 0.001). The use of extra-LB-DAC was an independent factor in predicting FPE (odds ratio 1.982, 95% confidence interval 1.250-3.143, P = 0.004). CONCLUSION: Our results suggest that in combined LB-DAC/stent-retriever thrombectomy, a larger aspiration catheter inner diameter is associated with higher rates of FPE and mFPE.

Manifestaciones cardiovasculares y síndrome compartimental asociado a mordedura por Phoneutria spp: Reporte de un caso / Cardiovascular manifestations and compartment syndrome associated with bite by Phoneutria spp: case report / Manifestações cardiovasculares e síndrome compartimental associadas à mordida de Phoneutria spp: Relato de caso

Se describen las características sobre el phoneutrismo a propósito de un caso. El phoneutrismo es el término con el que se conoce al accidente ocasionado por la mordedura de la araña phoneutria spp, la cual tiene una relevancia clínica dada por las características tóxicas de su veneno. Se presenta un caso de mordedura de la araña phoneutria spp de un paciente atendido en un hospital de alta complejidad de la ciudad de Medellín, Colombia, con manifestaciones cardiovasculares y hallazgos compatibles con un síndrome compartimental, lo cual es inusual en este tipo de arañas, por lo que se necesitó vigilancia en unidad de alta dependencia y fasciotomía cutánea. En Colombia este tipo de accidentes no son de reporte obligatorio, por tanto existe un alto riesgo de subregistro. Lo llamativo de este caso está en las manifestaciones cardiovasculares y la presencia de síndrome compartimental que no se ha descrito en la literatura con este subespecie de arañas.

The characteristics of phoneutrism are described in relation to a case. Phoneutrism is the term with which the accident caused by the bite of the phoneutria spp spider is known, which has clinical relevance given by the toxic characteristics of its venom. We present a case of a bite by the phoneutria spp spider in a patient treated at a high-complexity hospital in the city of Medellín, Colombia, with cardiovascular manifestations and findings compatible with compartment syndrome, which is unusual in this type of spiders, and required surveillance in a high dependency unit and cutaneous fasciotomy. In Colombia reporting this type of accident is not mandatory; therefore, there is a high risk of underreporting. What is striking about this case is the cardiovascular manifestations and the presence of compartment syndrome that has not been described in the literatura with this genre of spiders.

As características do fonutrismo são descritas em um relatório de um caso. Fonutrismo é o termo usado para descrever o acidente causado pela mordida da aranha Phoneutria spp, que é clinicamente relevante devido às características tóxicas de seu veneno. Apresentamos um caso de mordida de aranha por uma aranha Phoneutria em um paciente tratado em um hospital de alta complexidade na cidade de Medellín, Colômbia, com manifestações cardiovasculares e achados compatíveis com a síndrome compartimental, o que é incomum neste tipo de aranha, exigindo vigilância em uma unidade de alta de-pendência e fasciotomia cutânea. Na Colômbia, este tipo de acidente não é obrigatório, portanto, há um alto risco de subnotificação. O que é impressionante neste caso são as manifestações cardiovasculares e a presença da síndrome compartimental, que não foi descrita na literatura com esta subespécie de aranha.

Fractura de cadera en pacientes centenarios, ¿qué podemos esperar? / Hip fracture in centenarians, what can we expect?

Introducción: La mejoría de la esperanza de vida está incrementando la incidencia de fractura de cadera en centenarios. Nuestro objetivo es comparar las características basales de una serie de centenarios con fractura de cadera frente a controles de menor edad, analizando si existen diferencias en cuanto a complicaciones, mortalidad intrahospitalaria y supervivencia a corto-medio plazo. Material y métodos: Estudio retrospectivo, tipo caso control, sobre 24 centenarios y 48 controles octogenarios con fractura de cadera. Se analizó la presencia de comorbilidades y el índice de Charlson, la demora quirúrgica, las complicaciones, la estancia hospitalaria y la mortalidad durante el ingreso. Al alta se valoró la mortalidad precoz, la supervivencia después del año y el retorno a la funcionalidad previa. Resultados: No se encontraron diferencias significativas en parámetros basales ni en comorbilidades (p>0,05), siendo el paciente tipo una mujer con fractura extracapsular. La estancia hospitalaria fue mayor en el grupo control (p=0,038) y la complicación más frecuente la anemia, que precisó transfusión sanguínea (23/24 en los centenarios, p<0,0001). La mortalidad intrahospitalaria y acumulada al año en los centenarios fue del 33 y el 67%, respectivamente, frente al 10 y 25% en octogenarios (p=0,017, OR=4,3 [1,224-15,101] y p=0,110]. Solo 2 pacientes centenarios consiguieron volver a caminar tras la intervención, frente a un 53,84% que volvió a la situación funcional previa en los controles (p=0,003). Conclusiones: Frente a un grupo control de pacientes de menor edad, la mortalidad intrahospitalaria y en el primer año tras una fractura de cadera es significativamente mayor en los centenarios y muy pocos recuperan la actividad previa a la fractura.(AU)

Introduction: Hip fractures in centenarians are rising due to the increase in life expectancy. The objective of this study is to compare the characteristics of centenarians’ hip fracture with a younger control group, and to analyze whether there are differences in terms of in-hospital mortality, complications, and short-medium-term survival between them. Material and methods: Retrospective case-control study, with a series of 24 centenarians and 48 octogenarians with a hip fracture. Comorbidities and Charlson index, surgical delay, complications and mortality during admission, and hospital stay were analyzed. At discharge, early mortality, survival after one year, and return to previous functionality were assessed. Results: No significant differences were found in baseline parameters or comorbidities (P>.05), and the type of was a woman with an extracapsular fracture. Hospital stay was longer in the control group (P=.038), and the most frequent complication was anemia requiring transfusion (23/24 in centenarians, P<.0001). In-hospital mortality and accumulated at one year in the centenarians was 33 and 67%, respectively, compared to 10 and 25% in the octogenarians (P=.017, OR=4.3 [1,224-15,101] and P=.110). Only 2 centenarian patients were able to walk again after the intervention, while in the control group 53.84% returned to the previous functional situation (P=.003). Conclusions: Compared to a control group of younger patients, in-hospital mortality and in the first year after a hip fracture is significantly higher in centenarians, and very few recover activity prior to the fracture.(AU)

Hip fracture in centenarians, what can we expect? / Fractura de cadera en pacientes centenarios. ¿Qué podemos esperar?

Introduction: Hip fractures in centenarians are rising due to the increase in life expectancy. The objective of this study is to compare the characteristics of centenarians’ hip fracture with a younger control group, and to analyze whether there are differences in terms of in-hospital mortality, complications, and short-medium-term survival between them. Material and methods: Retrospective case-control study, with a series of 24 centenarians and 48 octogenarians with a hip fracture. Comorbidities and Charlson index, surgical delay, complications and mortality during admission, and hospital stay were analyzed. At discharge, early mortality, survival after one year, and return to previous functionality were assessed. Results: No significant differences were found in baseline parameters or comorbidities (P>.05), and the type of was a woman with an extracapsular fracture. Hospital stay was longer in the control group (P=.038), and the most frequent complication was anemia requiring transfusion (23/24 in centenarians, P<.0001). In-hospital mortality and accumulated at one year in the centenarians was 33 and 67%, respectively, compared to 10 and 25% in the octogenarians (P=.017, OR=4.3 [1,224-15,101] and P=.110). Only 2 centenarian patients were able to walk again after the intervention, while in the control group 53.84% returned to the previous functional situation (P=.003). Conclusions: Compared to a control group of younger patients, in-hospital mortality and in the first year after a hip fracture is significantly higher in centenarians, and very few recover activity prior to the fracture.(AU)

Introducción: La mejoría de la esperanza de vida está incrementando la incidencia de fractura de cadera en centenarios. Nuestro objetivo es comparar las características basales de una serie de centenarios con fractura de cadera frente a controles de menor edad, analizando si existen diferencias en cuanto a complicaciones, mortalidad intrahospitalaria y supervivencia a corto-medio plazo. Material y métodos: Estudio retrospectivo, tipo caso control, sobre 24 centenarios y 48 controles octogenarios con fractura de cadera. Se analizó la presencia de comorbilidades y el índice de Charlson, la demora quirúrgica, las complicaciones, la estancia hospitalaria y la mortalidad durante el ingreso. Al alta se valoró la mortalidad precoz, la supervivencia después del año y el retorno a la funcionalidad previa. Resultados: No se encontraron diferencias significativas en parámetros basales ni en comorbilidades (p>0,05), siendo el paciente tipo una mujer con fractura extracapsular. La estancia hospitalaria fue mayor en el grupo control (p=0,038) y la complicación más frecuente la anemia, que precisó transfusión sanguínea (23/24 en los centenarios, p<0,0001). La mortalidad intrahospitalaria y acumulada al año en los centenarios fue del 33 y el 67%, respectivamente, frente al 10 y 25% en octogenarios (p=0,017, OR=4,3 [1,224-15,101] y p=0,110]. Solo 2 pacientes centenarios consiguieron volver a caminar tras la intervención, frente a un 53,84% que volvió a la situación funcional previa en los controles (p=0,003). Conclusiones: Frente a un grupo control de pacientes de menor edad, la mortalidad intrahospitalaria y en el primer año tras una fractura de cadera es significativamente mayor en los centenarios y muy pocos recuperan la actividad previa a la fractura.(AU)

Lesión renal aguda y nefritis intersticial aguda debido a picadura por escorpión: reporte de caso / Acute kidney injury and acute interstitial nephritis due to scorpion sting: a case report / Lesão renal aguda e nefrite intersticial aguda devido a picadura por escorpião: reporte de caso

El envenenamiento debido a picadora de escorpiones es reportado en diferentes países de Suramérica, en algunos, como México, es un problema de salud pública. En Colombia el accidente por escorpiones no es de reporte obligatorio, por lo que hay subregistro de casos. Los accidentes por este tipo de animales ponzoñosos se asocian a manifestaciones locales, y en casos de gravedad moderada a severa, a problemas cardiovasculares y neurológicos. Sin embargo, es importante reconocer manifestaciones que, aunque reportadas con menos frecuencia, implican gran morbilidad, como la pancreatitis y las alteraciones renales, entre las que está la nefritis. Se reporta el caso de un varón de 46 años, que presentó un accidente por Tytus, con nefritis intersticial. Este es el primer reporte de esta complicación en Colombia. Nuestro objetivo principal es resaltar la importancia de una pronta identificación de casos y un oportuno inicio del tratamiento por parte del personal de la salud, que permitan disminuir la morbilidad y mortalidad de estos pacientes.

Scorpion poisoning is reported in different countries in South America, especially in Mexico, where it has become a public health issue. In Colombia this type of accident is not mandatory to report, therefore, there is underreporting of cases. Accidents caused by these poisonous animals are mainly associated with local manifestations and, in cases of moderate to severe severity, to cardiovascular and neurological problems. Nevertheless, it is important to recognize other manifestations which, despite being reported less frequently, are associated with high morbidity such as pancreatitis and renal alterations, among which is nephritis. The case of a 46-year-old male patient is reported, who had an accident due to Tytus and presented interstitial nephritis. This is the first report of this complication in Colombia, and based on this, the main objective is to highlight the importance of prompt identification and treatment by health personnel, in order to reduce morbidity and mortality in these patients.

O envenenamento devido a picadora de escorpiões é reportado em diferentes países da América Latina, em alguns, como México, é um problema de saúde pública. Na Colômbiao acidente por escorpiões não é de reporte obrigatório, porque há sub-registro de casos. Os acidentes por este tipo de animais peçonhentos se associam a manifestações locais, e em casos de gravidade moderada a severa, a problemas cardiovasculares e neurológicos. Entretanto, é importante reconhecer manifestações que, embora reportadas com menos frequência, implicam grande morbilidade, como a pancreatite e as alterações renais, entre as que está a nefrite. Se reporta o caso de um homem de 46 anos, que apresentou um acidente por Tytus, com nefrite intersticial. Este é o primeiro reporte desta complicação na Colômbia. Nosso objetivo principal é ressaltar a importância de uma breve identificação de casos e um oportuno início do tratamento por parte do pessoal da saúde, que permitam diminuir a morbilidade e mortalidade destes pacientes.

Primary total hip arthroplasty for acetabular fractures in elderly patients / Artroplastia total de cadera primaria en fractura de acetábulo en el paciente anciano

Introduction: Life expectancy has risen, leading to an increase in acetabular fractures in fragile patients. Total hip arthroplasty with a reinforcement cage is a technically complex option, but allows fracture control and early mobilization. Our aim is to assess whether the use of Burch-Schneider cage in fragile patients with acetabular fractures allows immediate load stabilization without threatening the early survival of the arthroplasty. Material and methods: Descriptive study of a series of 14 patients with acetabular fractures treated by a reinforcement cage associated with autologous bonegraft plus a cemented acetabular cup, and mobilization and bearing. Judet Letournel fracture types, surgical delay, and complications during admission were analyzed. Following hospital discharge we recorded the incorporation of grafts according to Gie's classification, presence of calcifications according to Brooker, consolidation of the fracture, loosening of implants and functional aspects according to the HHS and Merlé D’Aubigné Postel score. Results: The most common fracture was both columns (6/14), with a surgical delay being of 11 days mean and 21,5 days of length of stay. One patient died after surgery. The mean follow-up was 34.4 months. All fractures healed and the bonegraft was incorporated in all cases. The mean HHS was 82 points and the Merle Score was 15/18. There were no complications related to arthroplasty. Conclusions: Total hip arthroplasty with Burch-Schneider cage on bonegraft and no added osteosynthesis is a good option of treatment of all types of displaced acetabular fractures in a fragile patient.(AU)

Introducción: El aumento de esperanza de vida está produciendo un incremento de fracturas de cotilo en el paciente anciano. La artroplastia total con anillo de refuerzo es una opción técnicamente compleja, pero permite el control de la fractura, la movilización y la deambulación precoz. Nuestro objetivo es valorar si el uso del anillo de Burch-Schneider en las fracturas de cotilo del paciente anciano permite la estabilización sin poner en riesgo la supervivencia precoz de la artroplastia. Material y métodos: Estudio descriptivo sobre una serie de 14 pacientes con fracturas de cotilo tratados mediante anillo de refuerzo asociado a autoinjerto más implante acetabular cementado e inicio precoz de movilización y deambulación. Se analizaron los tipos de fractura según la clasificación de Judet Letournel, la demora quirúrgica y las complicaciones durante el ingreso. Al alta se valoró la incorporación de injertos según la clasificación de Gie, la presencia de calcificaciones según Brooker, la consolidación de la fractura, la movilización de implantes y los aspectos funcionales según la escala de HHS y Merlé D’Aubigné Postel. Resultados: La fractura más frecuente fue la de ambas columnas (6/14), la demora quirúrgica media de 11 días y la estancia media de 21,5 días. Un paciente falleció en el postoperatorio inmediato. El seguimiento medio fue de 34,4 meses. Todas las fracturas consolidaron e incorporaron el injerto. El HHS medio fue de 82 puntos y el Merle Score de 15/18. No hubo complicaciones relativas a la artroplastia. Conclusiones: La artroplastia primaria de cadera con anillo de BS sobre injerto sin osteosíntesis añadida es una buena opción en el tratamiento de todo tipo de fracturas de cotilo desplazadas en paciente frágil.(AU)

Artroplastia total de cadera primaria en fractura de acetábulo en el paciente anciano / Primary total hip arthroplasty for acetabular fractures in elderly patients

Introducción: El aumento de esperanza de vida está produciendo un incremento de fracturas de cotilo en el paciente anciano. La artroplastia total con anillo de refuerzo es una opción técnicamente compleja, pero permite el control de la fractura, la movilización y la deambulación precoz. Nuestro objetivo es valorar si el uso del anillo de Burch-Schneider en las fracturas de cotilo del paciente anciano permite la estabilización sin poner en riesgo la supervivencia precoz de la artroplastia. Material y métodos: Estudio descriptivo sobre una serie de 14 pacientes con fracturas de cotilo tratados mediante anillo de refuerzo asociado a autoinjerto más implante acetabular cementado e inicio precoz de movilización y deambulación. Se analizaron los tipos de fractura según la clasificación de Judet Letournel, la demora quirúrgica y las complicaciones durante el ingreso. Al alta se valoró la incorporación de injertos según la clasificación de Gie, la presencia de calcificaciones según Brooker, la consolidación de la fractura, la movilización de implantes y los aspectos funcionales según la escala de HHS y Merlé D’Aubigné Postel. Resultados: La fractura más frecuente fue la de ambas columnas (6/14), la demora quirúrgica media de 11 días y la estancia media de 21,5 días. Un paciente falleció en el postoperatorio inmediato. El seguimiento medio fue de 34,4 meses. Todas las fracturas consolidaron e incorporaron el injerto. El HHS medio fue de 82 puntos y el Merle Score de 15/18. No hubo complicaciones relativas a la artroplastia. Conclusiones: La artroplastia primaria de cadera con anillo de BS sobre injerto sin osteosíntesis añadida es una buena opción en el tratamiento de todo tipo de fracturas de cotilo desplazadas en paciente frágil.(AU)

Introduction: Life expectancy has risen, leading to an increase in acetabular fractures in fragile patients. Total hip arthroplasty with a reinforcement cage is a technically complex option, but allows fracture control and early mobilization. Our aim is to assess whether the use of Burch-Schneider cage in fragile patients with acetabular fractures allows immediate load stabilization without threatening the early survival of the arthroplasty. Material and methods: Descriptive study of a series of 14 patients with acetabular fractures treated by a reinforcement cage associated with autologous bonegraft plus a cemented acetabular cup, and mobilization and bearing. Judet Letournel fracture types, surgical delay, and complications during admission were analyzed. Following hospital discharge we recorded the incorporation of grafts according to Gie's classification, presence of calcifications according to Brooker, consolidation of the fracture, loosening of implants and functional aspects according to the HHS and Merlé D’Aubigné Postel score. Results: The most common fracture was both columns (6/14), with a surgical delay being of 11 days mean and 21,5 days of length of stay. One patient died after surgery. The mean follow-up was 34.4 months. All fractures healed and the bonegraft was incorporated in all cases. The mean HHS was 82 points and the Merle Score was 15/18. There were no complications related to arthroplasty. Conclusions: Total hip arthroplasty with Burch-Schneider cage on bonegraft and no added osteosynthesis is a good option of treatment of all types of displaced acetabular fractures in a fragile patient.(AU)

Primary total hip arthroplasty for acetabular fractures in elderly patients. / Artroplastia total de cadera primaria en fractura de acetábulo en el paciente anciano.

INTRODUCTION: Life expectancy has risen, leading to an increase in acetabular fractures in fragile patients. Total hip arthroplasty with a reinforcement cage is a technically complex option, but allows fracture control and early mobilization. Our aim is to assess whether the use of Burch-Schneider cage in fragile patients with acetabular fractures allows immediate load stabilization without threatening the early survival of the arthroplasty. MATERIAL AND METHODS: Descriptive study of a series of 14 patients with acetabular fractures treated by a reinforcement cage associated with autologous bonegraft plus a cemented acetabular cup, and mobilization and bearing. Judet Letournel fracture types, surgical delay, and complications during admission were analyzed. Following hospital discharge we recorded the incorporation of grafts according to Gie's classification, presence of calcifications according to Brooker, consolidation of the fracture, loosening of implants and functional aspects according to the HHS and Merlé D'Aubigné Postel score. RESULTS: The most common fracture was both columns (6/14), with a surgical delay being of 11 days mean and 21,5 days of length of stay. One patient died after surgery. The mean follow-up was 34.4 months. All fractures healed and the bonegraft was incorporated in all cases. The mean HHS was 82 points and the Merle Score was 15/18. There were no complications related to arthroplasty. CONCLUSIONS: Total hip arthroplasty with Burch-Schneider cage on bonegraft and no added osteosynthesis is a good option of treatment of all types of displaced acetabular fractures in a fragile patient.

Hip fracture in centenarians, what can we expect? / Fractura de cadera en pacientes centenarios, ¿qué podemos esperar?

INTRODUCTION: Hip fractures in centenarians are rising due to the increase in life expectancy. The objective of this study is to compare the characteristics of centenarians' hip fracture with a younger control group, and to analyze whether there are differences in terms of in-hospital mortality, complications, and short-medium-term survival between them. MATERIAL AND METHODS: Retrospective case-control study, with a series of 24 centenarians and 48 octogenarians with a hip fracture. Comorbidities and Charlson index, surgical delay, complications and mortality during admission, and hospital stay were analyzed. At discharge, early mortality, survival after one year, and return to previous functionality were assessed. RESULTS: No significant differences were found in baseline parameters or comorbidities (P>.05), and the type of was a woman with an extracapsular fracture. Hospital stay was longer in the control group (P=.038), and the most frequent complication was anemia requiring transfusion (23/24 in centenarians, P<.0001). In-hospital mortality and accumulated at one year in the centenarians was 33 and 67%, respectively, compared to 10 and 25% in the octogenarians (P=.017, OR=4.3 [1,224-15,101] and P=.110). Only 2 centenarian patients were able to walk again after the intervention, while in the control group 53.84% returned to the previous functional situation (P=.003). CONCLUSIONS: Compared to a control group of younger patients, in-hospital mortality and in the first year after a hip fracture is significantly higher in centenarians, and very few recover activity prior to the fracture.

Modelling the impact of fexinidazole use on human African trypanosomiasis (HAT) transmission in the Democratic Republic of the Congo.

Gambiense human African trypanosomiasis is a deadly disease that has been declining in incidence since the start of the Century, primarily due to increased screening, diagnosis and treatment of infected people. The main treatment regimen currently in use requires a lumbar puncture as part of the diagnostic process to determine disease stage and hospital admission for drug administration. Fexinidazole is a new oral treatment for stage 1 and non-severe stage 2 human African trypanosomiasis. The World Health Organization has recently incorporated fexinidazole into its treatment guidelines for human African trypanosomiasis. The treatment does not require hospital admission or a lumbar puncture for all patients, which is likely to ease access for patients; however, it does require concomitant food intake, which is likely to reduce adherence. Here, we use a mathematical model calibrated to case and screening data from Mushie territory, in the Democratic Republic of the Congo, to explore the potential negative impact of poor compliance to an oral treatment, and potential gains to be made from increases in the rate at which patients seek treatment. We find that reductions in compliance in treatment of stage 1 cases are projected to result in the largest increase in further transmission of the disease, with failing to cure stage 2 cases also posing a smaller concern. Reductions in compliance may be offset by increases in the rate at which cases are passively detected. Efforts should therefore be made to ensure good adherence for stage 1 patients to treatment with fexinidazole and to improve access to care.

Promoting bioeconomy routes: From food waste to green biomethane. A profitability analysis based on a real case study in eastern Germany.

Profitability studies are needed to establish the potential pathways required for viable biomethane production in the Brandenburg region of Germany. This work study the profitability of a potential biomethane production plant in the eastern German region of Brandenburg, through a specific practical scenario with data collected from a regional biogas plant located in Alteno (Schradenbiogas GmbH & Co. KG). Several parameters with potential economic influence such as distance of the production point to the grid, waste utilization percentage, and investment, were analyzed. The results illustrate a negative overall net present value with the scenario of no governmental investment, even when considering trading the CO2 obtained throughout the process. Subsidies needed to reach profitability varied with distance from 13.5 €/MWh to 19.3 €/MWh. For a fixed distance of 15 kms, the importance of percentage of waste utilization was examined. Only 100% of waste utilization and 75% of waste utilization would reach profitability under a reasonable subsidies scheme (16.3 and 18.8 €/MWh respectively). Concerning the importance of investment, a subsidized investment of at least 70% is demanded for positive net present values. Besides, the sensitivity analysis remarks the energy consumption of the biogas upgrading stage, the electricity price, and the energy consumption of biogas production as major parameters to be tackled for the successful implementation of biogas upgrading plants. The results here obtained invite to ponder about potential strategies to further improve the economic viability of this kind of renewable projects. In this line, using the CO2 separated to produce added-value chemicals can be an interesting alternative.

First modern human settlement recorded in the Iberian hinterland occurred during Heinrich Stadial 2 within harsh environmental conditions.

As the south-westernmost region of Europe, the Iberian Peninsula stands as a key area for understanding the process of modern human dispersal into Eurasia. However, the precise timing, ecological setting and cultural context of this process remains controversial concerning its spatiotemporal distribution within the different regions of the peninsula. While traditional models assumed that the whole Iberian hinterland was avoided by modern humans due to ecological factors until the retreat of the Last Glacial Maximum, recent research has demonstrated that hunter-gatherers entered the Iberian interior at least during Solutrean times. We provide a multi-proxy geoarchaeological, chronometric and paleoecological study on human-environment interactions based on the key site of Peña Capón (Guadalajara, Spain). Results show (1) that this site hosts the oldest modern human presence recorded to date in central Iberia, associated to pre-Solutrean cultural traditions around 26,000 years ago, and (2) that this presence occurred during Heinrich Stadial 2 within harsh environmental conditions. These findings demonstrate that this area of the Iberian hinterland was recurrently occupied regardless of climate and environmental variability, thus challenging the widely accepted hypothesis that ecological risk hampered the human settlement of the Iberian interior highlands since the first arrival of modern humans to Southwest Europe.

Pseudo-two-dimensional dynamics in a system of macroscopic rolling spheres.

We study in this work the dynamics of a collection of identical hollow spheres (ping-pong balls) that rest on a horizontal metallic grid. Fluidization is achieved by means of a turbulent air current coming from below. The upflow is adjusted so that the particles do not levitate over the grid, resulting in quasi-two-dimensional dynamics. We show that the behavior of diffusion and correlations in this system is particularly rich. Noticeably as well (and related to the complex dynamical behavior), a variety of phases appear, with important peculiarities with respect to analogous setups. We observe gas, liquid, glass, and hexagonal crystal phases. Most notably, we show that the melting of the hexagonal crystal occurs in coexistence with a liquid phase. This strikingly differs from the corresponding transition in a purely two-dimensional systems of air-fluidized disks, for which no phase coexistence has been reported in the literature.