Cemented total hip arthroplasty with retention of some existing hardware

We report a case of a 63-year-old man who presented an end stage hip osteoarthritis 42 years after a proximal femoral osteotomy performed for the treatment of an intracapsular femoral neck fracture. A cemented total hip arthroplasty was implanted using a standard posterior approach. The osteotomy hardware was totally covered with a new cortical bone formation. A layer of bone tissue was removed, the screw heads were broken and the nail plate was also removed. The screw threaded portions were retained because they did not interfere with cemented femoral stem implantation. Fourteen years after total hip arthroplasty, the patient reported no pain and expressed high satisfaction with the surgery. The hip radiograph showed wear of the polyethylene cup and no periprosthetic osteolysis. Retention of hardware can be considered, especially in patients who have had hardware for several years, without any negative symptoms

Transcatheter closure of a fenestration in intracardiac Fontan circulation

We present a case of tricuspid atresia and the treatment that was used in a child now aged 12. The malformation was corrected at the age of five through intracardiac Fontan circulation. Later, the child developed a right-to-left shunt due to dehiscence in the intra-atrial conduit, causing significant desaturation. This was treated by transcatheter closure with a 10 mm Amplatzer device at 8 years of age. Currently the child is asymptomatic with no residual shunts, and the position of the device is normal. The percutaneous closure of Fontan fenestrations using the Amplatzer device is a therapeutic approach that provides good results. It results in normal oxygen saturation and has low morbidity. The technique is simple, available to most cardiac catheterization laboratories, safe, and offers a reasonable cost-benefit ratio. In addition, the design of the device is suitable for this type of defect

Environmental Costs of Government-Sponsored Agrarian Settlements in Brazilian Amazonia

Brazil has presided over the most comprehensive agrarian reform frontier colonization program on Earth, in which ~1.2 million settlers have been translocated by successive governments since the 1970's, mostly into forested hinterlands of Brazilian Amazonia. These settlements encompass 5.3% of this ~5 million km2 region, but have contributed with 13.5% of all land conversion into agropastoral land uses. The Brazilian Federal Agrarian Agency (INCRA) has repeatedly claimed that deforestation in these areas largely predates the sanctioned arrival of new settlers. Here, we quantify rates of natural vegetation conversion across 1911 agrarian settlements allocated to 568 Amazonian counties and compare fire incidence and deforestation rates before and after the official occupation of settlements by migrant farmers. The timing and spatial distribution of deforestation and fires in our analysis provides irrefutable chronological and spatially explicit evidence of agropastoral conversion both inside and immediately outside agrarian settlements over the last decade. Deforestation rates are strongly related to local human population density and road access to regional markets. Agrarian settlements consistently accelerated rates of deforestation and fires, compared to neighboring areas outside settlements, but within the same counties. Relocated smallholders allocated to forest areas undoubtedly operate as pivotal agents of deforestation, and most of the forest clearance occurs in the aftermath of government-induced migration

Migraine aura: retracting particle-like waves in weakly susceptible cortex

Cortical spreading depression (SD) has been suggested to underlie migraine aura. Despite a precise match in speed, the spatio-temporal patterns of SD and aura symptoms on the cortical surface ordinarily differ in aspects of size and shape. We show that this mismatch is reconciled by utilizing that both pattern types bifurcate from an instability point of generic reaction-diffusion models. To classify these spatio-temporal pattern we suggest a susceptibility scale having the value [sigma]=1 at the instability point. We predict that human cortex is only weakly susceptible to SD ([sigma]<1), and support this prediction by directly matching visual aura symptoms with anatomical landmarks using fMRI retinotopic mapping. We discuss the increased dynamical repertoire of cortical tissue close to [sigma]=1, in particular, the resulting implications on migraine pharmacology that is hitherto tested in the regime ([sigma]>>1), and potentially silent aura occurring below a second bifurcation point at [sigma]=0 on the susceptible scale

The porin and the permeating antibiotic: A selective diffusion barrier in gram-negative bacteria

Gram-negative bacteria are responsible for a large proportion of antibiotic resistant bacterial diseases. These bacteria have a complex cell envelope that comprises an outer membrane and an inner membrane that delimit the periplasm. The outer membrane contains various protein channels, called porins, which are involved in the influx of various compounds, including several classes of antibiotics. Bacterial adaptation to reduce influx through porins is an increasing problem worldwide that contributes, together with efflux systems, to the emergence and dissemination of antibiotic resistance. An exciting challenge is to decipher the genetic and molecular basis of membrane impermeability as a bacterial resistance mechanism. This Review outlines the bacterial response towards antibiotic stress on altered membrane permeability and discusses recent advances in molecular approaches that are improving our knowledge of the physico-chemical parameters that govern the translocation of antibiotics through porin channel

From sulfite liquor to vanillin: effect of crystallization process on the yield, purity, and polymorphic form of crystals

Different approaches for vanillin crystallization were performed using an aqueous solution, with low concentrations of this potential food and pharmaceutical phenolic compound, obtained from adsorption/desorption experiments applied to an oxidized solution of lignin isolated from softwood sulfite liquor. The process yield and purity of the vanillin crystals were determined, and the thermal stability of the two resulting polymorphic forms was analyzed by DSC. Crystallization processes by swift cooling and evaporation with heat favor the nucleation of metastable vanillin crystals (Form II) with lower yields than slow evaporative and cooling processes that crystallize vanillin into the stable polymorph (Form I) with yields around 80%. Moreover, the polymorphic form of vanillin, yield, and purity were found to be highly dependent on the conditions of the crystallization process, mainly the temperature and the range of temperature variation. The melting points of polymorphic Form I and II were found to be 82.6 and 81.0 degrees C, respectively, proving that Form I is the most thermodynamically stable vanillin crystal form. In conclusion, the process conditions for vanillin crystallization strongly affect the polymorphic form, the process yield, the contents, and the type of impurities in the final product, consequently, influencing its potential industrial applications

Using the Juvenile Arthritis Disease Activity Score based on erythrocyte sedimentation rate or C-reactive protein level: results from the Portuguese register

Our aims were to evaluate the correlation between Juvenile Arthritis Disease Activity Score 27-joint reduced count (JADAS27) with erythrocyte sedimentation rate (ESR) and JADAS27 with C-reactive protein (CRP) scores and to test the agreement of both scores on classifying each disease activity state. We also aimed at verifying the correlation of the 2 scores across juvenile idiopathic arthritis (JIA) categories and to check the correlation between JADAS27-ESR and clinical JADAS27 (JADAS27 without ESR)

Lignin Valorization for Added-Value Chemicals: Kraft Lignin versus Lignin Fractions

Lignin is a raw material that can potentially be converted into valuable compounds through depolymerization reactions in addition to its use as a polymer or material. However, the chemical recalcitrance and the heterogeneous composition and structure of lignin make it challenging to establish processes that add value to this complex aromatic biopolymer. In this work, solvent fractionation was applied to obtain lignin fractions with a narrowed molecular weight and specific structural characteristics, improving its homogeneity and purity. A kraft lignin was submitted to fractionation using different ratios of acetone, ranging from 60 to 15% v/v, in aqueous mixtures. The composition, structure, and molecular weight of each fraction were studied and their potential applications were evaluated. The most water-soluble fraction has more phenolic OH, less aliphatic OH groups, and shows the lowest content of aryl-ether linkages, which is in accordance with its highest degree of condensation. On the other hand, the insoluble fraction from the mixture with 60% of acetone has the lowest molecular weight and the highest content of inorganic material. Radar plots were applied for lignin fractions evaluation and the fraction with the highest potential (IF 30:70) was submitted to alkaline oxidation with O-2. The results were compared with the products yielded from kraft lignin. An increase of about 13 and 19% was found for vanillin and syringaldehyde, respectively, when the fraction IF 30:70 was submitted to oxidation. In conclusion, the proposed fractionation process showed to be an effective method to obtain lignin fractions with specific composition and structural characteristics that could improve its potential as a source of high added-value monomeric phenolic compounds