Fracturas proximales de fémur. Osteosíntesis con tornillo-placa deslizante versus clavo gamma

Presentamos un estudio retrospectivo de noventa fracturas del fémur proximal tratados con clavo GAMMA o tornillo-placa dinámico de cadera (DHS). No encontramos diferencias en la duración de la intervención, pérdida hemática, ni estancia hospitalaria. Sin embargo, la serie con clavo GAMMA inició el apoyo más temprano, aunque en la revisión al final del seguimiento no había diferencias significativas en cuanto a la función de la cadera. El fracaso de la síntesis ocurrió en cuatro casos con el DHS, pero las complicaciones intraoperatorias fueron más frecuentes con el clavo GAMMA, principalmente elevada incidencia de fracturas de la diáfisis femoral, asociado en parte al diseño del implante. Recomendamos el empleo del clavo GAMMA sólo para las fracturas inestables del fémur proximal.We report a prospective study of ninety fractures of proximal femur treated by either the GAMMA nail or the dynamic hip screw (DHS). We found no difference in operating time, blood loss or stay in the hospital. However, the GAMMA nail group had a earlier full weight-bearing, but there was no significant difference in hip function at final review. There was failure of proximal fixation in four cases with the DHS. More intra-operative complications were recorded in the GAMMA nail group, mainly a high incidence of femoral shaft fracture which we relate in part to the design of the implant. We only recommend the use of the GAMMA nail for unstable intertrochanteric fractures of the proximal femur

Rendimento da pupunheira em função da densidade de plantio, diâmetro de corte e manejo dos perfilhos no Vale do São Francisco Effect of density, cut-off diameter classes and shoot number on production and yield of irrigated plant peach palm at San Francisco River Valley

Com o objetivo de avaliar o rendimento de palmito de pupunheira irrigada em função da densidade de plantio, diâmetro de corte do estipe e o manejo dos perfilhos, instalou-se um experimento na Estação Experimental de Bebedouro da Embrapa Semi-Árido, Petrolina, PE. O delineamento utilizado foi de blocos ao acaso em parcelas subdivididas, sendo as parcelas constituídas por dois espaçamentos (2,0 x 1,0 m - E1 e 2,0 x 2,0 m - E2) e as subparcelas em arranjo fatorial 2 x 2, compreendendo dois manejos de perfilhos e duas classes de diâmetros de corte. As colheitas foram feitas a partir de 16 meses até os 69 meses após o plantio e realizadas com intervalos consecutivos de mais ou menos três meses. Pelos resultados, evidenciaram-se efeitos significativos para espaçamento, manejo de perfilhos e classe de diâmetro de corte. Não foram constatadas interações entre os tratamentos. Houve efeito significativo de espaçamento sobre o rendimento, diâmetro de corte, comprimento e peso médio do palmito. O rendimento e o peso do palmito da pupunheira foram de 545 e 434 kg ha-1 ano-1 e 147 g e 180 g nos espaçamentos E1 e E2, respectivamente. O diâmetro de corte afetou a altura da planta e peso médio do palmito. O manejo de perfilho afetou o rendimento e o peso médio do palmito, com 532 e 446 kg ha-1 e 177 e 149 g de palmito, respectivamente, no manejo de quatro e todos os perfilhos por planta. Pelos resultados, infere-se, como orientação técnica para os produtores de áreas irrigadas do Submédio São Francisco, o cultivo da pupunha no espaçamento de 2 m x 1 m, o manejo de quatro perfilhos por planta e o corte da planta com diâmetro variando de 10 a 12 cm, a 30 cm do nível do solo.<br>The objective of this experiment was to evaluate the effect of planting density, cut-off diameter classes and shoot number on heart of palm production on irrigated peach palm. The experimental layout was a randomized split-plot design with a factorial arrangement in the split-plot with four replicates. The whole plots were plant spacing S¹ - 2 x 1 m and S² - 2 x 2 m and the subplots were 12 m² (with factorial arrangement of two diameters and two shoot number). The harvesting was done from 16 to 69 months after planting with three months interval. The cut-off diameter class affected significantly the production. The yields of heart of palm at diameter classes 10 cm and 12 cm were 494 and 484 kg ha-1 year-1 and, respectively. The average weight of heart of palm for the cut-off diameters 10 cm and 12 cm were 149 g and 178 g and yield of heart of palm were 545 and 434 kg ha-1 year-1, respectively. Planting space affect all the parameters evaluated, except the average plant height. The results allow to point out, as information for the irrigated areas of the San Francisco Valley, the cultivation of peach palm spaced 2 x 1 m and cut-off diameter of de stem from 10 to 12 cm about 30 cm up the grownd

A Protective Factor Against Mental Health Problems in Youths?: A Critical Note on the Assessment of Self-Compassion

Self-compassion, which refers to the tendency of being kind and understanding to oneself when confronted with personal failings and difficulties, is increasingly investigated as a protective factor within the context of mental health problems. In this invited paper, I will briefly introduce the concept of self-compassion and give an overview of the research that has examined its relationship with psychopathology in youth. Then I will make my critical point regarding the assessment of self-compassion: the scales that are currently used for measuring this construct include a large number of reversely scored, negative items that measure the precise opposite of having compassion with oneself. I present evidence (partly on the basis of own data) that these negative items do not reflect the true protective nature of self-compassion and tend to inflate the relation with psychopathology. My recommendation is to remove the negative items from the scales and to assess self-compassion by means of a set of items that truly reflect its protective nature

Challenges and opportunities for innovation in bioinformed sustainable materials

Nature provides a rich source of information for the design of novel materials; yet there remain significant challenges in the design and manufacture of materials that replicate the form, function, and sustainability of biological solutions. Here, we identify key challenges and promising approaches to the development of materials informed by biology. These challenges fall into two main areas; the first relates to harnessing biological information for materials innovation, including key differences between biological and synthetic materials, and the relationship between structure and function. We propose an approach to materials innovation that capitalizes on biodiversity, together with high-throughput characterization of biological material architectures and properties, linked to environmental and ecological context. The second area relates to the design and manufacture of bioinformed materials, including the physical scale of material architectures and manufacturing scale up. We suggest ways to address these challenges and promising prospects for a bioinformed approach to materials innovation

Renin-angiotensin system inhibitors effect before and during hospitalization in COVID-19 outcomes: Final analysis of the international HOPE COVID-19 (Health Outcome Predictive Evaluation for COVID-19) registry.

The use of Renin-Angiotensin system inhibitors (RASi) in patients with coronavirus disease 2019 (COVID-19) has been questioned because both share a target receptor site. HOPE-COVID-19 (NCT04334291) is an international investigator-initiated registry. Patients are eligible when discharged after an in-hospital stay with COVID-19, dead or alive. Here, we analyze the impact of previous and continued in-hospital treatment with RASi in all-cause mortality and the development of in-stay complications. We included 6503 patients, over 18 years, from Spain and Italy with data on their RASi status. Of those, 36.8% were receiving any RASi before admission. RASi patients were older, more frequently male, with more comorbidities and frailer. Their probability of death and ICU admission was higher. However, after adjustment, these differences disappeared. Regarding RASi in-hospital use, those who continued the treatment were younger, with balanced comorbidities but with less severe COVID19. Raw mortality and secondary events were less frequent in RASi. After adjustment, patients receiving RASi still presented significantly better outcomes, with less mortality, ICU admissions, respiratory insufficiency, need for mechanical ventilation or prone, sepsis, SIRS and renal failure (p RASi historic use, at admission, is not related to an adjusted worse prognosis in hospitalized COVID-19 patients, although it points out a high-risk population. In this setting, the in-hospital prescription of RASi is associated with improved survival and fewer short-term complications