Sustainable use of wastes as reactive material in permeable reactive barrier for remediation of acid mine drainage: Batch and continuous studies.

The aim of this work was to evaluate the feasibility of the use of different industrial and agricultural wastes as reactive materials in Permeable Reactive Barriers (PRB) for Acid Mine Drainage (AMD) remediation. Sugar foam (SF), paper mill sludge (PMS), drinking water sludge (DWS) and olive mill waste (OMW) were evaluated in terms of pH neutralization and metal removal from AMD. Laboratory batch tests and continuous pilot scale up-flow columns containing 82% of Volcanic Slag (VS), as porous fill material, and 18% w/w of one of the industrial and agricultural wastes previously indicated, were tested. From the batch tests it was observed that the reactive material presenting the best results were the SF and the PMS. The results obtained in all the PRB were accurately described by a pseudo-first order model, presenting coefficient of determination higher than 0.96 in all the cases. During the continuous operation of the PRB, the porosity and hydraulic retention time (HRT) of most of the up-flow columns strongly decreased due to chemical precipitation and biofilm growth. The SF presented a significant number of fine particles that were washed out by the liquid flow, generating an effluent with very high total suspended solid concentration. Despite SF was the material with the highest alkalinity potential, the reduction of the HRT limited its neutralization and metal removal capacity. PMS and DWS presented the best pollutant removal yields in the continuous operation of the PRB, ranging from 55 to 99% and 55-95% (except in the case of the Mn), respectively. These results allowed the metal removal from the AMD. Additionally, these wastes presented very good biological sulphate reduction. Based on these results, the use of PMS and DWS as reactive material in PRB would allow to simultaneously valorise the industrial waste, which is very interesting within the circular economy framework, and to remove metals from the AMD by means of a low-cost and environmentally sustainable procedure.

Mejora significativa de la estabilidad a carga axial con el fijador externo pélvico pretensado: análisis biomecánico en un modelo con lesión Tile tipo C / Significant improvement in axial load stability with the pre-tensioned pelvic external fixator: A biomechanical analysis in a model with type C Tile lesion

Objetivo: Comprobar si la aplicación de fijación externa mediante barra curva conectada a clavos de Schanz supraacetabulares confiere mayor estabilidad al anillo pélvico con una lesión tipo Tile C1 cuando se realiza el montaje con la barra pretensada que con el montaje estándar (sin pretensar). Material y métodos: Pelvis sintéticas (N=5) con lesión verticalmente inestable estabilizada con ambos montajes, se sometieron a carga axial progresiva. Se midieron las fuerzas aplicadas y las variaciones en las posiciones de marcadores situados en la articulación sacroilíaca y la sínfisis se registraron con un sistema óptico. Se determinaron los desplazamientos relativos entre las superficies lesionadas, la rigidez, la resistencia y el modo de fallo de cada montaje. Resultados: Con el fijador pretensado, la rigidez del montaje en la articulación sacroilíaca resultó muy superior a la del montaje convencional (p=0,043) multiplicándola por 3,45, siendo 2,06 veces mayor en la sínfisis. La resistencia ante el fallo también fue superior, multiplicándola por 2 (p=0,043). Discusión: El aumento de estabilidad a carga axial con el fijador externo pretensado concuerda con su capacidad de producir compresión activa simultánea en los elementos posteriores y anteriores del anillo pélvico, demostrada previamente. Este resultado soporta los excelentes resultados clínicos preliminares obtenidos como tratamiento provisional. Conclusiones: El fijador externo pretensado aumenta la estabilidad axial de los elementos óseos posteriores del anillo pélvico con lesión tipo Tile C1 en modelo sintético, sin disminuir la capacidad de estabilización anterior propia de la fijación externa anterior.(AU)

Objective: The aim of our work is to check if the use of a pre-tensed bar connected to 2supra-acetabular Schanz pins is more stable in a pelvic with a tile C1 injury. Material and methods: We used synthetic pelvis (N=5) with a unstable vertical injury, stabilized with both the standard and the pre-tensed system. They both were submitted to axial loading. We measured applied forces and the position of markers that were positioned in the sacroiliac and symphysis joints. We determined the relative movements between injured surfaces, rigidity, resistance and when each system failed. Results: When using the pre-tensed fixator, the rigidity was much higher in the sacro-iliac joint (P=.043) being 3.45 times higher, being also 2.06 times higher in pubic symphysis (P=.043). The resistance against failure was 2 times higher too (P=.043). Discussion: The increased axial stability with the pre-tensed external fixator accords with its ability to make active compression in both posterior and anterior elements of the pelvic ring, which was previously demonstrated. This result supports the preliminary clinic outcomes that were obtained. Conclusions: The pre-tensed external fixator increases the axial stability of the pelvic ring's posterior elements in a synthethic pelvis with a Tile C1 injury, without decreasing it's capacity to achieve an anterior stability.(AU)

[Translated article] Significant improvement in axial load stability with the pre-tensioned pelvic external fixator: A biomechanical analysis in a model with type C Tile lesion / Mejora significativa de la estabilidad a carga axial con el fijador externo pélvico pretensado: análisis biomecánico en un modelo con lesión Tile tipo C

Objetivo: Comprobar si la aplicación de fijación externa mediante barra curva conectada a clavos de Schanz supraacetabulares confiere mayor estabilidad al anillo pélvico con una lesión tipo Tile C1 cuando se realiza el montaje con la barra pretensada que con el montaje estándar (sin pretensar). Material y métodos: Pelvis sintéticas (N=5) con lesión verticalmente inestable estabilizada con ambos montajes, se sometieron a carga axial progresiva. Se midieron las fuerzas aplicadas y las variaciones en las posiciones de marcadores situados en la articulación sacroilíaca y la sínfisis se registraron con un sistema óptico. Se determinaron los desplazamientos relativos entre las superficies lesionadas, la rigidez, la resistencia y el modo de fallo de cada montaje. Resultados: Con el fijador pretensado, la rigidez del montaje en la articulación sacroilíaca resultó muy superior a la del montaje convencional (p=0,043) multiplicándola por 3,45, siendo 2,06 veces mayor en la sínfisis. La resistencia ante el fallo también fue superior, multiplicándola por 2 (p=0,043). Discusión: El aumento de estabilidad a carga axial con el fijador externo pretensado concuerda con su capacidad de producir compresión activa simultánea en los elementos posteriores y anteriores del anillo pélvico, demostrada previamente. Este resultado soporta los excelentes resultados clínicos preliminares obtenidos como tratamiento provisional. Conclusiones: El fijador externo pretensado aumenta la estabilidad axial de los elementos óseos posteriores del anillo pélvico con lesión tipo Tile C1 en modelo sintético, sin disminuir la capacidad de estabilización anterior propia de la fijación externa anterior.(AU)

Objective: The aim of our work is to check if the use of a pre-tensed bar connected to 2supra-acetabular Schanz pins is more stable in a pelvic with a tile C1 injury. Material and methods: We used synthetic pelvis (N=5) with a unstable vertical injury, stabilized with both the standard and the pre-tensed system. They both were submitted to axial loading. We measured applied forces and the position of markers that were positioned in the sacroiliac and symphysis joints. We determined the relative movements between injured surfaces, rigidity, resistance and when each system failed. Results: When using the pre-tensed fixator, the rigidity was much higher in the sacro-iliac joint (P=.043) being 3.45 times higher, being also 2.06 times higher in pubic symphysis (P=.043). The resistance against failure was 2 times higher too (P=.043). Discussion: The increased axial stability with the pre-tensed external fixator accords with its ability to make active compression in both posterior and anterior elements of the pelvic ring, which was previously demonstrated. This result supports the preliminary clinic outcomes that were obtained. Conclusions: The pre-tensed external fixator increases the axial stability of the pelvic ring's posterior elements in a synthethic pelvis with a Tile C1 injury, without decreasing it's capacity to achieve an anterior stability.(AU)

Significant improvement in axial load stability with the pre-tensioned pelvic external fixator: A biomechanical analysis in a model with type C Tile lesion. / Mejora significativa de la estabilidad a carga axial con el fijador externo pélvico pretensado: análisis biomecánico en un modelo con lesión Tile tipo C.

OBJECTIVE: The aim of our work is to check if the use of a pre-tensed bar connected to 2supra-acetabular Schanz pins is more stable in a pelvic with a tile C1 injury. MATERIAL AND METHODS: We used synthetic pelvis (N=5) with a unstable vertical injury, stabilized with both the standard and the pre-tensed system. They both were submitted to axial loading. We measured applied forces and the position of markers that were positioned in the sacroiliac and symphysis joints. We determined the relative movements between injured surfaces, rigidity, resistance and when each system failed. RESULTS: When using the pre-tensed fixator, the rigidity was much higher in the sacro-iliac joint (P=.043) being 3.45 times higher, being also 2.06 times higher in pubic symphysis (P=.043). The resistance against failure was 2 times higher too (P=.043). DISCUSSION: The increased axial stability with the pre-tensed external fixator accords with its ability to make active compression in both posterior and anterior elements of the pelvic ring, which was previously demonstrated. This result supports the preliminary clinic outcomes that were obtained. CONCLUSIONS: The pre-tensed external fixator increases the axial stability of the pelvic ring's posterior elements in a synthethic pelvis with a Tile C1 injury, without decreasing it's capacity to achieve an anterior stability.

[Translated article] Significant improvement in axial load stability with the pre-tensioned pelvic external fixator: A biomechanical analysis in a model with type C Tile lesion.

OBJECTIVE: The aim of our work is to check if the use of a pre-tensed bar connected to 2 supra-acetabular Schanz pins is more stable in a pelvic with a tile C1 injury. MATERIAL AND METHODS: We used synthetic pelvis (N = 5) with a unstable vertical injury, stabilized with both the standard and the pre-tensed system. They both were submitted to axial loading. We measured applied forces and the position of markers that were positioned in the sacroiliac and symphysis joints. We determined the relative movements between injured surfaces, rigidity, resistance and when each system failed. RESULTS: When using the pre-tensed fixator, the rigidity was much higher in the sacro-iliac joint(P=.043) being 3.45 times higher, being also 2.06 times higher in pubic symphysis (P=.043). The resistance against failure was 2 times higher too (P=.043). DISCUSSION: The increased axial stability with the pre-tensed external fixator accords with its ability to make active compression in both posterior and anterior elements of the pelvic ring, which was previously demonstrated. This result supports the preliminary clinic outcomes that were obtained. CONCLUSIONS: The pre-tensed external fixator increases the axial stability of the pelvic ring's posterior elements in a synthethic pelvis with a Tile C1 injury, without decreasing it's capacity to achieve an anterior stability.

The Kidney, Liver, Index surgery and C reactive protein score is a predictor of treatment response in acute prosthetic joint infection.

PURPOSE: This work seeks to verify the utility of the KLIC score as a predictor of treatment success or failure in patients with knee and hip acute prosthetic joint infections (APJI). These patients were treated in our centre, which is not a prosthetic joint infection reference centre. The KLIC score assesses factors such as chronic kidney failure (2 points) (Kidney), liver disease (1.5 points) (Liver), revision surgery or femoral neck fracture (1.5 points)and cemented prosthesis (2 points) (Index surgery) and a C-reactive protein level (CRP) greater than 11.5 mg/dL (2.5 points), as a predictor of treatment success or failure in patients with knee and hip acute prosthetic joint infections (APJI). METHODS: We retrospectively reviewed 30 patients with APJI who were treated using debridement, antibiotics, irrigation and retention (DAIR) treatment between January 2007 and December 2016. Patients' KLIC scores were calculated. The main outcome was success or failure of DAIR treatment of APJI. RESULTS: DAIR treatment succeeded in 21 cases and failed in nine cases. Differences in outcome were found according to the KLIC score. For KLIC scores >2 and ≤4, there were three successes and zero failures; for scores 4-5, there were nine successes and two failures; for scores >5 and ≤7,there were nine successes and four failures; and for scores >7, there were zero successes and three failures (p = 0.025). We found a positive predictive value and negative predictive value of 33% and 100% for scores ≤4 (score for calculations: 3.5), 43% and 84% for scores 4-5 (4.5), 50% and 68% for scores >5 and ≤7 (5.5), and 100% and 76% for scores >7 (7.5), respectively. The area under the ROC curve was 0.762 (95% confidence interval, 0.569-0.955). CONCLUSIONS: The KLIC score was useful in predicting success or failure of DAIR treatment of APJI. This supports the conclusion that with a score < 3.5, treatment is likely to succeed and with a score of >6, it is likely to fail.

Correction to: The Kidney, Liver, Index surgery and C reactive protein score is a predictor of treatment response in acute prosthetic joint infection.

There is an error in the name of one of the author in the original publication. The correct name is I Rodríguez-Delourme and not Delourne.

[Communicating the diagnosis to the patient with neurological diseases]. / La comunicación del diagnóstico al paciente en las enfermedades neurológicas.

INTRODUCTION: Communicating the diagnosis of a neurodegenerative disease entails a significant emotional burden for the patient, their family and/or caregivers Adequate information on the disease and symptoms that they are going to have to face can greatly help to improve their perception of the seriousness of the condition. Communicating bad news to the patients and their families is a very common practice in the medical activity but also a very difficult task. Most of the doctors have only received limited or non-regulated training on this subject. METHODS: The studies published regarding methodology to be used when communicating the diagnosis have been analyzed beginning with the publication of Grau et al. on the satisfaction of patients suffering multiple sclerosis with the information received. CONCLUSIONS: Training programs for medical specialists or other health care professionals who act as case managers and the elaboration of protocols for the communicating of the diagnosis, such as those that are used in the clinical pathways, are necessary to improve scientific and human quality of the information given to the patient.

Influence of dietary source of docosahexaenoic and arachidonic acids on their incorporation into membrane phospholipids of red blood cells in term infants.

Here we studied whether the chemical structure of dietary arachidonic and docosahexaenoic acids in full-term infant diets affects their incorporation into erythrocyte membrane phospholipids. From birth to 3 months, infants were fed breast milk (n = 9) or formula milk containing arachidonic acid and docosahexaenoic acid provided by egg phospholipids (n = 10) or by low-eicosapentaenoic acid fish oil and fungal triglycerides (n = 10). We compared the fatty acid composition of erythrocyte phosphatidylethanolamine, phosphatidylcholine and sphingomyelin before and after administration of the experimental diet. At 3 months, infants on formula milk showed lower concentrations of docosahexaenoic acid (in phosphatidylcholine and in phosphatidylethanolamine) and arachidonic acid (in phosphatidylcholine) than those receiving breast milk. We conclude the incorporation of the two fatty acids into erythrocyte phospholipids depends mainly on the lipid composition of the diet received rather than the chemical form in which they are delivered.

[Multiple bladder inverted papillomas]. / Papilomas invertidos vesicales múltiples.

OBJECTIVE: To describe the clinical and histological findings of the unusual involvement of the urinary bladder by multiple inverted papillomas of transitional cells. METHODS/RESULTS: A 53-year-old male presented with obstructive symptoms and gross hematuria lasting for one year. Ultrasound examination of the urinary bladder demonstrated two polypoid masses. Transurethral resection was performed and histopathological examination of specimens showed a subepithelial, non-atypical cell proliferation arranged in a trabecular pattern. DNA-ploidy showed diploid population and ki-67 determination revealed a low proliferation index. CONCLUSIONS: Multiple inverted papillomas of the urinary bladder are very rare. Histological examination is essential for the definitive diagnosis. Determination of DNA-ploidy and proliferative index may be useful for appropriate management of this disease.

Facial nerve paralysis after epidural blood patch.

BACKGROUND. A 35-year-old parturient developed a unilateral facial nerve palsy after an epidural blood patch for treatment of subarachnoid-cutaneous fistula. CONCLUSIONS. Idiopathic facial paralysis and other pathogenic mechanisms are discussed. The course of the events support the suggestion that changes in subarachnoid and epidural pressures after an epidural blood patch could precipitate an injury to the 7th nerve.

Protective effect of antibiotics on mortality risk from acute respiratory infections in Mexican children.

A case-control study of mortality from acute respiratory infections (ARI) among children under five years of age was conducted in Naucalpan, an urban-suburban area of Mexico City, and in rural localities of Tlaxcala, Mexico. The study found that ARI deaths tended to occur in the poorest neighborhoods; 78% of the deceased study subjects were infants under six months old; and 68% of the deaths occurred at home. Comparison of the data for cases (fatalities) and control children who had severe ARI but recovered showed that failure to receive antibiotics was associated with death (odds ratio 28.5, 95% confidence interval 2.1-393.4). This antibiotic effect was controlled for numerous potentially confounding factors. It is evident that antibiotics had a much greater effect in the early days of the illness than later on. In general, the findings strongly support PAHO/WHO primary health care strategies--including such strategies as standardized management of severe ARI cases--that seek to reduce childhood ARI mortality.