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

Meeting abstrac

Fatal vascular complication due to metallosis

Metallosis is a well-known complication at the site of total hip and knee arthroplasty. Vascular involvement of this complication is rare and generally results from vascular compression by a mass or pseudotumor. In the present report, we have described a case of lower limb acute arterial ischemia due to arterial injury as a complication of metallosis with a fatal outcome

El fundamento científico de la función de filtro del médico general The scientific basis for the gatekeeping role of general practicioners

Los servicios sanitarios cuentan con niveles de atención, lo que optimiza los resultados. Los niveles tienen "filtros" que aumentan la prevalencia de enfermedad entre los pacientes que llegan a niveles sucesivamente altos. En este trabajo se justifica la existencia del filtro del médico general con respecto al especialista y al hospital por el aumento de la prevalencia de enfermedad en la población derivada de primaria a hospitalaria. Se utilizan ejemplos empíricos respecto al dolor abdominal, dolor precordial y hemorragia rectal. En este último ejemplo, la prevalencia del cáncer de recto y de sigma pasa del 0,1% en la población al 2% en la consulta del médico general (por efecto del filtro personal y familiar) y al 36% en la consulta del especialista (por efecto del filtro del médico general). La selección aumenta el valor predictivo positivo de las pruebas diagnósticas que solicita el especialista, y evita el contacto innecesario con los especialistas a muchos pacientes con hemorragia rectal por causa benigna, que permanecen en su nivel (de la familia, o del médico general).<br>Health services are organized by levels of care, which improves outcomes. These levels are "filters" that lead to a progressive increase in the prevalence of diseases in higher levels of care. We studied and justified the role of the general practitioner as filter, or gatekeeper, to specialists and hospitals. This role leads to greater prevalence of diseases in the referral population. We analyzed empirical data on abdominal pain, chest pain and rectal bleeding as examples. As to rectal bleeding, the prevalence of rectum and sigma carcinomas increases from 0.1% in the population, to 2% in general practitioners' waiting rooms (as a consequence of personal and family filters), and to 36% in specialists' waiting rooms (as a consequence of the gate-keeping role general practitioners play). This increase in prevalence improves the positive predictive value of the specialist's diagnostic testing, and patient selection avoids unnecessary contacts of specialists with patients having benign causes of rectal bleeding (who remain at their appropriate family or general practitioners' level)

Learning by Heart: Cultural Patterns in the Faunal Processing Sequence during the Middle Pleistocene

Social learning, as an information acquisition process, enables intergenerational transmission and the stabilisation of cultural forms, generating and sustaining behavioural traditions within human groups. Archaeologically, such social processes might become observable by identifying repetitions in the record that result from the execution of standardised actions. From a zooarchaeological perspective, the processing and consumption of carcasses may be used to identify these types of phenomena at the sites. To investigate this idea, several faunal assemblages from Bolomor Cave (Valencia, Spain, MIS 9-5e) and Gran Dolina TD10-1 (Burgos, Spain, MIS 9) were analysed. The data show that some butchery activities exhibit variability as a result of multiple conditioning factors and, therefore, the identification of cultural patterns through the resulting cutmarks presents additional difficulties. However, other activities, such as marrow removal by means of intentional breakage, seem to reflect standardised actions unrelated to the physical characteristics of the bones. The statistical tests we applied show no correlation between the less dense areas of the bones and the location of impacts. Comparison of our experimental series with the archaeological samples indicates a counter-intuitive selection of the preferred locus of impact, especially marked in the case of Bolomor IV. This fact supports the view that bone breakage was executed counterintuitively and repetitively on specific sections because it may have been part of an acquired behavioural repertoire. These reiterations differ between levels and sites, suggesting the possible existence of cultural identities or behavioural predispositions dependant on groups. On this basis, the study of patterns could significantly contribute to the identification of occupational strategies and organisation of the hominids in a territory. In this study, we use faunal data in identifying the mechanics of intergenerational information transmission within Middle Pleistocene human communities and provide new ideas for the investigation of occupational dynamics from a zooarchaeological approach

Experimental Butchering of a Chimpanzee Carcass for Archaeological Purposes

Two archaeological assemblages from the Sierra de Atapuerca sites show evidence of anthropogenic cannibalism. These are the late Early Pleistocene level TD6-2 at Gran Dolina, and the Bronze Age level MIR4 in the Mirador Cave. Despite the chronological distance between these two assemblages, they share the common feature that the human remains exhibit a high frequency of anthropogenic modifications (cut marks, percussion pits and notches and peeling). This frequency could denote special treatment of bodies, or else be the normal result of the butchering process. In order to test these possibilities, we subjected a chimpanzee carcass to a butchering process. The processing was intensive and intended to simulate preparation for consumption. In doing this, we used several simple flakes made from quartzite and chert from quarries in the Sierra de Atapuerca. The skull, long bones, metapodials and phalanges were also fractured in order to remove the brain and bone marrow. As a result, about 40% of the remains showed some kind of human modification. The frequency, distribution and characteristics of these modifications are very similar to those documented on the remains of Homo antecessor from TD6-2. In case of the MIR4 assemblage, the results are similar except in the treatment of skulls. Our results indicate that high frequencies of anthropogenic modifications are common after an intensive butchering process intended to prepare a hominin body for consumption in different contexts (both where there was possible ritual behavior and where this was not the case and the modifications are not the result of special treatment).This work was supported by Ministry of Economy and Competitiveness (MINECO) of Spain Government, project nº CGL2012-38434-C03-03 and project nº HAR2012-32548Peer reviewe