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The Bernese periacetabular osteotomy (PAO) is a surgical procedure used to treat hip dysplasia in young adults, but it carries the risk of neurological complications, including injury to the motor ascending branch of the rectus femoris (MABRF). This study aimed to describe anatomical considerations to prevent MABRF injuries during PAO. A cadaveric study was conducted on seven specimens. The original and modified PAO approaches were used, with and without disinsertion of the rectus femoris muscle origin. The femoral nerve was dissected in all specimens from the endopelvic position to the MABRF origin (T-point). The average distance from the anterosuperior iliac spine to the T-point was 10.2 ± 0.4 cm. To protect the MABRF, a safety zone was identified for the osteotome placement during the ischial cut. The osteotome was slid over the joint capsule, deflecting the iliocapsularis muscle medially and distally. This manoeuvre shields the MABRF with the iliocapsularis muscle, reducing the risk of neurological injury. Both the original and modified PAO approaches were considered safe techniques with low risk to the rectus femoris innervation. These findings offer valuable insights for surgeons performing PAO, emphasizing the significance of understanding anatomical relationships and implementing protective measures to enhance patient outcomes and minimize complications. In conclusion, implementing these anatomical considerations can help prevent MABRF injuries during PAO, contributing to safer and more successful surgical interventions for hip dysplasia in young adults.

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In this study, we address the ecological challenges posed by automotive battery recycling, a process notorious for its environmental impact due to the buildup of hazardous waste like foundry slag. We propose a relatively cheap and safe solution for lead removal and recovery from samples of this type of slag. The analysis of TCLP extracts revealed non-compliance with international regulations, showing lead concentrations of up to 5.4% primarily in the form of anglesite (PbSO4), as detected by XRF/XRD. We employed deep eutectic solvents (DES) as leaching agents known for their biodegradability and safety in hydrometallurgical processing. Five operational variables were systematically evaluated: sample type, solvent, concentration, temperature, and time. Using a solvent composed of choline chloride and glycerin in a 2:1 molar ratio, we achieved 95% lead dissolution from acidic samples at 90 °C, with agitation at 470 rpm, a pulp concentration of 5%, and a 5 h duration. Furthermore, we successfully recovered 55% of the lead in an optimized solution using an electrowinning cell. This research demonstrates the ability of DES to decontaminate slag, enabling compliance with regulations, the recovery of valuable metals, and new possibilities for the remaining material.

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Nowadays, deep eutectic solvents (DESs) are seen as environmentally friendly alternatives with the potential to replace traditional solvents used in hydrometallurgical processes. Although DESs have been successfully applied in the recovery of metals from secondary sources, there is still innovative potential regarding DESs as green leaching agents applied in the recovery of metals from primary sources like polysulfide ores. This study aimed to evaluate the characteristics of DESs as solvents for some of the main metals present in typical polymetallic concentrates, like Cu, Fe, Pb, and Zn. Thus, three DESs based on choline chloride (ChCl) were prepared: 1:2 ChCl-urea (also known as reline), 1:2 ChCl-ethylene glycol (also known as ethaline), and 1:2 ChCl-glycerol (also known as glyceline). Then, dissolution tests at 30 °C were carried out with these DESs and different metal- (Cu, Fe, Pb, and Zn) bearing compounds (sulfates, oxides, and sulfides). According to the dissolution tests, it was found that the solubility of the studied metals (expressed as g of metal per Kg of DES) was dictated by the bearing species, reaching the dissolution of the metals from sulfates with values as high as two orders of magnitude higher than the metal solubility values for metal oxides and sulfides.

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BACKGROUND: Sciatic nerve entrapment is an entity that generates disabling pain, mainly when the patient is sitting on the involved side. According to some studies, the presence of fibrovascular bands has been described as the main cause of this pathology, and the sciatic nerve's decompression by endoscopic release has been described as an effective treatment generally associated with a piriformis tenotomy. The aim of this study was to present the medium-term functional results of endoscopic release of the sciatic nerve without resection of the piriformis tendon. METHODS: This prospective, observational study included 57 patients who underwent an endoscopic operation for sciatic nerve entrapment between January 2014 and January 2019. In all cases, a detailed medical history was obtained and a physical examination and a functional evaluation were performed using the modified Harris hip score (mHHS), the 12-item International Hip Outcome Tool (iHOT-12), and the visual analog scale (VAS) for pain. All patients had pelvic radiographs and magnetic resonance imaging (MRI) scans of the hip on the involved side and underwent a prior evaluation by a spine surgeon. RESULTS: This study included 20 male and 37 female patients with a mean age of 43.6 years (range, 24 to 88 years) and a mean follow-up of 22.7 months. The median mHHS improved from 59 to 85 points. The median iHOT-12 improved from 60 to 85 points. The median VAS decreased from 7 to 2. Postoperative complications occurred in 12% of patients: 1 patient with extensive symptomatic hematoma, 3 patients with hypoesthesia, and 3 patients with dysesthesia. CONCLUSIONS: Endoscopic release of the sciatic nerve by resection of fibrovascular bands without piriformis tenotomy is a technique with good to excellent functional results comparable with those of techniques in the literature incorporating piriformis tenotomy. LEVEL OF EVIDENCE: Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.

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Developmental dysplasia of the hip (DDH) has been recognized to be a condition leading to osteoarthritis. Periacetabular osteotomy (PAO) has showed good results on hip preservation treatment for these cases. Nevertheless, intra-articular damage may be responsible for persistent post-operative symptoms, so treat the articular damage before or during the PAO has emerged as an alternative to address it. The objective is to identify the prevalence of intra-articular damage, functional outcomes of patients undergoing PAO with untreated intra-articular lesions and the survivorship free total hip arthroplasty (THA) at long-term follow-up. A retrospective review of 103 hips in 92 patients, mean age 26 years old (19-31), 96% females. Mean follow-up 7 years (range: 3-16). Intra-articular damage was evaluated with high-resolution magnetic resonance imaging (MRI) previous to perform the PAO, the chondral damage was evaluated using International Cartilage Repair Society classification. Harris Hip Score (HHS) was obtained in all patients. One hundred per cent of the cases had labral tears on MRI, hypertrophic labrum in 80.8% and paralabral cysts in 20.8%. Acetabular chondral damage was Grade 2 in 88.5% of the hips. HHS was good and excellent in 94%. Survivorship free of THA at 15 years was 87%. Chondrolabral damage is a common finding in patients with DDH. Despite that, excellent results are obtained with PAO without labral repair. We think the focus should be in the biomechanical and anatomical correction of the hip in patients with DDH.

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Thiosulfate leaching combined with ion-exchange resins is an innovative alternative for gold recovery. According to the properties of activated carbon, it could replace resins in the gold recovery process, improve efficiency, and reduce operating cost. In this research, the adsorption process of gold thiosulfate complex on thiol-modified activated carbon was studied. Thioglycolic acid (ATG) was impregnated in activated carbon, and its adsorption ability was tested with synthetic solutions of gold and sodium thiosulfate (Au 10 mg·L-1, Na2S2O3 0.1 mol·L-1, pH = 10.0). Carbon was characterized by infrared spectroscopy, SEM-EDS, PZC titration, hardness number measures, and proximal analysis. Synthetic solutions were also characterized by UV-vis spectroscopy and cyclic voltammetry. The percentage of volatile material increased from 10.0 to 13.9% due to the impregnation process of ATG. Infrared spectra show characteristic bands of C-H, S-H, and C-S bonds. In the adsorption tests, the ATG-impregnated carbon achieved 91% of gold recovery, while the same amount of ATG in the liquid phase stirred with unmodified activated carbon reached 90% of gold recovery. The 44.9% of gold recovered with activated carbon impregnated with ATG was eluted with sodium cyanide ([NaCN] = 0.2 mol·L-1; [NaOH] = 0.25 mol·L-1; [CH3CH2OH] = 30% V/V; pH = 12.0; t = 24 h). These results suggest the gold transferred from the thiosulfate complex to a new gold thiolate complex.

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Carbon reactivation is a strategy to reduce waste and cost in many industrial processes, for example, effluent treatment, food industry, and hydrometallurgy. In this work, the effect of physical and chemical reactivation of granular activated carbon (AC) was studied. Spent activated carbon (SAC) was obtained from a carbon in pulp (CIP) leaching process for gold extraction. Chemical and physical reactivations were evaluated using several acid-wash procedures (HCl, HNO3, H2SO4) and thermal treatment (650-950 °C) methods, respectively. The effect of the reactivation processes on the mechanical properties was evaluated determining ball pan hardness and normal abrasion in pulp resistance. The effect on the adsorptive properties was evaluated via the iodine number, the gold adsorption value (k expressed in mg Au/g AC), and Brunauer-Emmett-Teller (BET) surface area. Initial characterization of the SAC showed an iodine number of 734 mg I2/g AC, a k value of 1.37 mg Au/g AC, and a BET surface area of 869 m2/g. The best reactivation results of the SAC were achieved via acid washing with HNO3 at 20% v/v and 50 °C over 30 min, and a subsequent thermal reactivation at 850 °C over 1 h. The final reactivated carbon had an iodine number of 1199 mg I2/g AC, a k value of 14.9 mg Au/g AC, and a BET surface area of 1079 m²/g. Acid wash prior to thermal treatment was critical to reactivate the SAC. The reactivation process had a minor impact (<1% change) on the mechanical properties of the AC.

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OBJECTIVE: The aim of the present study was to evaluate the effectiveness of an educational tool for general physicians, based on rheumatological clinical simulation, for the diagnosis of rheumatoid arthritis and osteoarthritis. METHODS: A randomized clinical study was carried out, in which the physician research subjects were assigned to one of two groups: the experimental group (educational intervention for rheumatoid arthritis with clinical simulation) or the control group (educational intervention for the basic aspects of the diagnosis and treatment of osteoporosis). Four weeks after the educational intervention, the members of both groups completed an examination that included four clinical cases with real patients, two clinical cases with two clinical simulation models and six virtual clinical cases. In this examination, the participants noted clinical findings, established a diagnosis and defined the complementary tests they would request, if necessary, to corroborate their diagnosis. RESULTS: A total of 160 doctors participated (80 in the active educational intervention for rheumatoid arthritis and 80 in the control group), of whom 89 were women (56%). The mean age was 35 (standard deviation 7.7) years. Success was defined as a physician correctly diagnosing at least 10 of the 12 cases presented. A significant difference of 81.3% (95% confidence interval 72-90%; p < 0.001) in success was found in favour of the active group (88.8% versus 7.5%). A greater number of correct answers was found in the active group compared with the control group in the detection of clinical findings and in the number of complementary tests requested (p < 0.001). CONCLUSIONS: The study showed the effectiveness of an educational intervention based on clinical simulation to improve the diagnostic approach to rheumatoid arthritis and osteoarthritis. The results open a new horizon in the teaching of rheumatology.

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Introducción: la nutrición juega un papel crítico en la salud del adolescente, y el consumo de una dieta inadecuada puede influir desfavorablemente sobre el crecimiento somático y la maduración sexual, por lo que constituye una etapa crucial del desarrollo, en la que prevalecen con alta frecuencia trastornos nutricionales. Métodos: se desarrolló un estudio descriptivo transversal, con el objetivo principal de identificar y describir los gustos, preferencias y frecuencia de consumo de alimentos de los adolescentes de séptimo grado que asisten a la Secundaria Básica José María Heredia, en el curso 2009-2010. La población estuvo constituida por 192 adolescentes, a los cuales con previo consentimiento de los padres, se les aplicó una encuesta alimentaria de gustos, preferencias y frecuencia semanal de consumo de alimentos. Resultados: los grupos de alimentos que más gustaron fueron mantequilla, mayonesa y queso crema, dulces, confituras y refrescos, mayormente consumidos a diario, a diferencia de las frutas y vegetales. El 14,1 por ciento de los adolescentes gustaban de bebidas alcohólicas, y el 15,6 por ciento las consumía al menos una vez a la semana. Conclusiones: existen deficiencias en la educación alimentaria e inadecuados hábitos alimentarios en los adolescentes estudiados(AU)

Introduction: the nutrition plays a critical role in the adolescent health and the consumption of a inappropriate diet may to influence in an unfavorable way on the somatic growth and the sexual maturation being a crucial stage of development where frequently prevail the nutritional disorders. Methods: a cross-sectional and descriptive study was conducted to identify and to describe the tastes, preferences and frequency of food consumption of adolescent of 7th degree studying in the "José María Heredia" Secondary School in the 2009-2010 course. Sample included 192 adolescents and with the parents consent underwent to alimentary survey on tastes, preferences and weekly frequency of food consumption. Results: the more preferred foods were the butter, mayonnaise and cream-cheese, sweets, preserves and soft drinks, mainly consumed daily; unlike the fruits and vegetables. The 14,1 percent of adolescents preferred the alcohol and the 15,6 percent consumed them at least once a week. Conclusions: there are deficiencies in the alimentary education as well as inappropriate alimentary habits in the study adolescents(AU)

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PURPOSE: To determine the incidence of and factors that contribute to the development of hypothermia during hip arthroscopic surgery. METHODS: An analytic observational study was carried out in a cohort of 73 consecutive patients. All patients underwent hip arthroscopy for the treatment of femoroacetabular impingement. The patients' core temperature (esophageal) was measured throughout the surgery. Relevant information was collected on the patients (age, gender, body mass index, blood pressure) and on the procedure (volume and temperature of saline solution, pressure of fluid pump, surgery time, room temperature). The corresponding statistical analysis was performed with Stata 10.0 (StataCorp, College Station, TX), by use of a repeated-measures generalized estimating equations model. RESULTS: The patients' mean age was 33 years, and there were 39 female and 34 male patients. The mean body mass index was 23.9; systolic blood pressure, 97.5 mm Hg; and diastolic blood pressure, 52.2 mm Hg. The incidence of hypothermia below 35°C (95°F) was 2.7%. The multivariate statistical analysis of the results showed a direct relation between hypothermia and surgery time of more than 120 minutes (P < .001). There was an inverse relation between core body temperature and surgery time (P < .001), with a drop of 0.19°C/h (32.342°F/h). Of the patients, 68.22% had a decrease in temperature of more than 0.5°C (32.9°F) until the end of surgery. There was also a direct relation between core body temperature and saline solution temperature (P < .001), body mass index (P < .01), and diastolic blood pressure (P < .03). CONCLUSIONS: The incidence of hypothermia below 35°C (95°F) in patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement is 2.7%. The factors that contribute toward the development of hypothermia during hip arthroscopic surgery are prolonged surgery time, low body mass index, low blood pressure during the procedure, and low temperature of the arthroscopic irrigation fluid.

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Introducción: la adolescencia es una etapa crucial, con alta prevalencia de trastornos nutricionales, que luego continúan durante la vida adulta y se asocian con complicaciones a corto y a largo plazo. Objetivos: identificar la asociación entre el exceso de peso corporal y los antecedentes patológicos familiares de interés y algunos factores perinatales, la presencia de la hipertensión arterial y su relación con la historia familiar de hipertensión, el exceso de peso corporal y el incremento de adiposidad abdominal; y por último, identificar la presencia de acantosis nigricans y su relación con iguales factores. Métodos: se desarrolló un estudio descriptivo transversal para caracterizar el estado nutricional de los adolescentes de séptimo grado que asisten a la Secundaria Básica José María Heredia, en el curso 2009-2010. La población estuvo constituida por 192 adolescentes, a los cuales, con previo consentimiento de los padres, se les realizaron las mediciones antropométricas (peso, talla, circunferencia de cintura y se calculó el índice de masa corporal), y además se midió la tensión arterial y se buscaron signos clínicos de resistencia insulínica. También se aplicó una encuesta a los padres acerca de los antecedentes patológicos familiares y algunos datos de sus hijos. Resultados: se encontró que el 20,31 por ciento de los adolescentes presentaba sobrepeso u obesidad, lo cual se relacionó de forma significativa con la presencia de hipertensión arterial y signos clínicos de resistencia insulínica. La hipertensión arterial se halló en el 9,9 por ciento de los adolescentes, sin relación con factores hereditarios. Conclusiones: la obesidad y el sobrepeso corporal constituyen un problema de salud en la población adolescente estudiada, lo cual se asocia con la presencia de hipertensión arterial y resistencia insulínica, no existió relación en su comportamiento con factores no modificables (antecedentes patológicos familiares y personales)(AU)

Introduction: the adolescence is a decisive stage with a high level of prevalence of nutritional disorders that latter remains during the adulthood and are associated with short- and long term complications. Objectives: to identify the association between excess of body weight and the interesting family pathological backgrounds and some perinatal risks, the presence of high blood pressure and its relation to the family history of high blood pressure and the increase of abdominal adiposity and finally, to identify the presence of acanthosis nigricans and its relation with the similar factors. Methods: a cross-sectional and descriptive study was conducted to characterize the nutritional status of the adolescents of the seventh grade from the José María Heredia secondary school during 2009-2020. Group included 192 adolescents who with a previous consent of parents underwent anthropometric measurements (weight, height, waist circumference and estimation of the body mass index) and also the blood pressure and search of clinical signs of insulin resistance. A survey to parents on the family pathological backgrounds and on some data of their children was applied. Results: there was that the 20,31 percent of adolescents had excess weight or obesity, which was related in a significant way to the presence of a high blood pressure and clinical signs of insulin resistance. The high blood pressure was present in the 9,9 percent of adolescents without any relation to hereditary factors. Conclusions: obesity and body excess weight are a health problem in study adolescent population, which is associated with the presence of a high blood pressure and insulin resistance; there was not relation in its behavior to non-modifiable factors (family and personal pathological backgrounds)(AU)

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El Síndrome de Klinefelter (SK) afecta a aproximadamente 1 de cada 1000 varones nacidos vivos y se produce por la prescencia de más de un cromosoma X. Si bien el cariotipo característico de este desorden es 47,XXY existen otras variantes menos comunes. En este estudio se presenta el análisis citogenético realizado en linfocitos de sangre periférica de veinte y tres individuos afectados de SK, con el objeto de determinar las avriantes de este desorden genético. Se encotró que el 69,6 por ciento de individuos afectos presentan el carotipo 47,XXY; el 17 por ciento presentó mosaicos: 46,XY/47,XXY: y el restante 13 por ciento otras variantes: 46,XY/47,XXY,+microcromosoma (?); 48,XXYY: 49,XXXXY...

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A poluiçäo atmosférica é reconhecidamente um fator de risco para a saúde. Nas cidades industriais, a emissäo na atmosfera de gases tóxicos e partículas pelas indústrias soma-se à poluiçäo provocada pela circulaçäo de veículos, gerando muitas vezes situaçöes críticas para a saúde da populaçäo. Aplicou-se uma metodologia simples para identificar áreas e grupos populacionais mais vulneráveis a este tipo de poluiçäo ambiental. Para isto relacionaram-se, com a utilizaçäo desta metodologia, a dispersäo atmosférica dos poluentes e a distribuiçäo da populaçäo segundo diferentes padröes de condiçöes materiais de vida, utilizando como instrumento o geoprocessamento. Teve como objeto a cidade de Volta Redonda, importante pólo siderúrgico do Estado do Rio de Janeiro e considerada uma das cidades mais poluídas do país. Foram identificadas áreas com diferenciais significativos de poluiçäo e condiçöes de vida, e a zona noroeste da cidade foi a que apresentou a situaçäo mais crítica para os aspectos ambientais e sócio-econômicos.

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