Cor triatriatum and lipomatous hypertrophy of the interatrial septum in the elderly: a case report

Cor triatriatum is a rare congenital heart defect characterized by the presence of a fibromuscular membrane dividing the left atrium into two distinct chambers. Lipomatous hypertrophy of the atrial septum is an infrequently observed benign abnormality caused by large fatty tissue deposits in the interatrial septum. An increased incidence of atrial arrhythmias is described in both pathologies, while a significant obstruction of blood flow mimicking mitral stenosis is typically manifested in cor triatriatum. We report the case of a 75-year-old woman with a previously undescribed association of the above stated abnormalities detected by both transthoracic and transeosophageal echocardiography. Diagnosis was confirmed by means of computed tomography. The singular physiologic and anatomic factors underlying survival until such a late age are described. The diagnostic, therapeutic and surgical management is discussed and a short review of the literature performed

Palaeodemographic modelling supports a population bottleneck during the Pleistocene-Holocene transition in Iberia

Demographic change lies at the core of debates on genetic inheritance and resilience to climate change of prehistoric hunter-gatherers. Here we analyze the radiocarbon record of Iberia to reconstruct long-term changes in population levels and test different models of demographic growth during the Last Glacial-Interglacial transition. Our best fitting demographic model is composed of three phases. First, we document a regime of exponential population increase during the Late Glacial warming period (c.16.6-12.9 kya). Second, we identify a phase of sustained population contraction and stagnation, beginning with the cold episode of the Younger Dryas and continuing through the first half of the Early Holocene (12.9-10.2 kya). Finally, we report a third phase of density-dependent logistic growth (10.2-8 kya), with rapid population increase followed by stabilization. Our results support a population bottleneck hypothesis during the Last Glacial-Interglacial transition, providing a demographic context to interpret major shifts of prehistoric genetic groups in south-west Europe

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Long-term dietary change in Atlantic and Mediterranean Iberia with the introduction of agriculture : a stable isotope perspective

The Neolithic expansion in the Iberian Peninsula is marked by the introduction of livestock and domesticated crops which modified subsistence strategies in an unprecedented manner. Bulk collagen stable carbon and nitrogen isotope analysis has been essential to track these changes, which have largely been discussed in relation to particular geographic areas or single case studies. This paper reviews the available isotope literature to provide a regional, long-term synthesis of dietary changes associated with the expansion of the Neolithic and the establishment of farming economy in the Iberian Peninsula. Bulk collagen stable carbon and nitrogen isotope values of 763 human individuals and 283 faunal remains from the Mesolithic to the Late Neolithic period in Iberia (ca. 8000–3000 cal BC) were collated and analysed using a Bayesian mixing model. The results show that Mesolithic diets were isotopically diverse in both the Atlantic and Mediterranean regions of the Iberian Peninsula, and that a significant decrease in variability happened with the Neolithisation, culminating with the establishment of farming economies and reliance on terrestrial resources in the Late Neolithic

Simulations of Transport in Hard Particle Systems

We thank G. Gallavotti, J.L. Lebowitz and J. del Pozo for illuminating discussions. Financial support from Spanish Ministry MINECO Project FIS2017-84256-P is also acknowledged. We are also grateful for the computational resources and assistance provided by PROTEUS, the supercomputing center of the Institute Carlos I for Theoretical and Computational Physics at the University of Granada, Spain