[Treatment of late onset Perthes disease with hip arthroscopy and arthrodiastasis with an external fixator. Case report]

BACKGROUND

The prognosis of late onset Perthes cases is usually poor and the proposed treatments vary based on the surgeon's preferences and experience, as well as on the available resources. Most of them are salvage procedures with a short follow-up and non-standardized application criteria.

METHODS

Hip arthroscopy and arthrodiastasis with external fixator are indicated for certain situations in Perthes disease. Based on the results obtained with each of these techniques separately, both of them were used to treat a case of Perthes disease involving a poor prognosis.

RESULTS

Results two years after surgery are good.

CONCLUSIONS

The use of both techniques together may produce a good result in these patients.

A pilot study of an enhanced mental health assessment during routine and discharge medicals in the British Armed Forces

OBJECTIVES

A pilot study to assess the practicality of introducing an enhanced mental health assessment (EMHA) into all routine and discharge medicals of the UK Armed Forces in order to facilitate treatment prior to and on return to civilian life.

METHODS

A pilot study was conducted using an EMHA questionnaire with questions about depression, anxiety, post-traumatic stress disorder, alcohol use, sleep and anger/irritability. At pilot sites, the EMHA was completed during all routine and discharge medicals between May 2011 and July 2011. At the end of the study period, qualitative data were collected from participating medical officers and practice managers regarding their opinions about the pilot study.

RESULTS

The quantitative data revealed an average pick-up rate for mental health (MH) problems. Out of the four military medical centres who participated and the 325 questionnaires collected, one referral to a Department of Community Mental Health was made. 26 (8%) patients were categorised as 'some concern and patient offered advice and/or reassurance'. The vast majority of patients were found to have no evidence of MH problems. However, using a validated alcohol screening tool, 64% of service personnel were found to have a score indicating 'higher risk drinking'. Analysis of the qualitative data suggests that the EMHA is an easy tool to implement with minimal additional time and resources needed. The interviewees pointed out a number of limitations and suggestions for possible further studies.

CONCLUSIONS

The pilot study successfully demonstrated that the EMHA questionnaire is easy to administer, does not take up a large amount of additional resources or manpower and provides a useful check of MH status. The study picked up an average number of MH cases and the questions on alcohol consumption highlighted that military personnel may be at a 'higher risk of drinking'.

Rotational Moulding and Powder Processing of Natural Fibre Reinforced Thermoplastics

The present paper describes the development of a new processing technology: rotational moulding of natural fibre reinforced thermoplastics. Different polymer-natural fibre and polymer-flour systems have been characterised. A rotomoulding grade of high density polyethylene has been used as the polymer matrix for the experiments. Fibres, including jute, sisal and cabuya, as well as wood, pecan and rice shell flour of different types have been used as reinforcements.

The rotomoulding process for those composite systems has been studied using an in-house built two-axis rotomoulding rig with variable speed. The final products have been characterised with special emphasis on estimating the level of dispersion of the fibres and their degree of orientation, as well as the consolidation, sintering and bubble formation processes during the different stages. Comparisons have been made with other powder processing routes, involving the sintering of fibre (or flour) reinforced polymer particles including compression moulding.

Morphological characterisation techniques have been adapted to determine the structure-property relationships in these materials at different processing stages. Important improvements in the compression strength of the natural fibre reinforced rotomoulded products compared to the unreinforced materials, accompanied of a good dispersion level of the reinforcing fibres have been reported.

Optimization of the mineralization of a mixture of phenolic pollutants under a ferrioxalate-induced solar photo-Fenton process

The mineralization of solutions containing a mixture of three phenolic compounds, gallic, p-coumaric and protocatechuic acids, in a ferrioxalate-induced solar photo-Fenton process was investigated. The reactions were carried out in a pilot plant consisting of a compound parabolic collector (CPC) solar reactor. An optimization study was performed combining a multivariate experimental design and neuronal networks that included the following variables: pH, temperature, solar power, air flow and initial concentrations of H(2)O(2), Fe(II) and oxalic acid. Under optimal conditions, total elimination of the original compounds and 94% TOC removal of the mixture were achieved in 5 and 194 min, respectively. pH and initial concentrations of H(2)O(2) and Fe(II) were the most significant factors affecting the mixture mineralization. The molar correlation between consumed hydrogen peroxide and removed TOC was always between 1 and 3. A detailed analysis of the reaction was presented. The values of the pseudo-first-order mineralization kinetic rate constant, k(TOC), increased as initial Fe(II) and H(2)O(2) concentrations and temperature increased. The optimum pH value also slightly increased with greater Fe(II) and hydrogen peroxide concentrations but decreased when temperature increased. OH and O(2)(-) radicals were the main oxidative intermediate species in the process, although singlet oxygen ((1)O(2)) also played a role in the mineralization reaction.

Mineralization of integrated gasification combined-cycle power-station wastewater effluent by a photo-Fenton process

The aim of this work was to study the mineralization of wastewater effluent from an integrated-gasification combined-cycle (IGCC) power station sited in Spain to meet the requirements of future environmental legislation. This study was done in a pilot plant using a homogeneous photo-Fenton oxidation process with continuous addition of H(2)O(2) and air to the system. The mineralization process was found to follow pseudo-first-order kinetics. Experimental kinetic constants were fitted using neural networks (NNs). The NNs model reproduced the experimental data to within a 90% confidence level and allowed the simulation of the process for any values of the parameters within the experimental range studied. At the optimum conditions (H(2)O(2) flow rate=120 mL/h, [Fe(II)]=7.6 mg/L, pH=3.75 and air flow rate=1 m(3)/h), a 90% mineralization was achieved in 150 min. Determination of the hydrogen peroxide consumed and remaining in the water revealed that 1.2 mol of H(2)O(2) was consumed per each mol of total organic carbon removed from solution. This result confirmed that an excess of dissolved H(2)O(2) was needed to achieve high mineralization rates, so continuous addition of peroxide is recommended for industrial application of this process. Air flow slightly improved the mineralization rate due to the formation of peroxo-organic radicals which enhanced the oxidation process.