Laparoscopic approach in perforated appendicitis: increased incidence of surgical site infection?

BACKGROUND: The role of laparoscopy in the setting of perforated appendicitis remains controversial. A retrospective study was conducted to evaluate the early postoperative outcomes of laparoscopic appendectomy (LA) compared to open appendectomy (OA) in patients with perforated appendicitis. METHODS: A total of 1,032 patients required an appendectomy between January 2005 and December 2009. Among these patients, 169 presented with perforated appendicitis. Operation times, length of hospital stay, overall complication rates within 30 days, and surgical site infection (SSI) rates were analyzed. RESULTS: Out of the 169 evaluated patients, 106 required LA and 63 OA. Although operation times were similar in both groups (92 ± 31 min for LA vs. 98 ± 45 for OA, p = 0.338), length of hospital stay was shorter in the LA group (6.9 ± 3.8 days vs. 11.5 ± 9.2, p < 0.001). Overall complication rates were significantly lower in the LA group (32.1 vs. 52.4 %, p < 0.001), as were incisional SSI (1.9 vs. 22.2 %, p < 0.001). Organ/space SSI rates were similar in both groups (23.6 % after LA vs. 20.6 % after OA, p = 0.657). CONCLUSIONS: For perforated appendicitis, LA results in a significantly shorter hospital stay, fewer overall postoperative complications, and fewer wound infections compared to OA. Organ/space SSI rates were similar for both procedures. LA provides a safe option for treating patients with perforated appendicitis.

The late Miocene to Holocene erosion pattern of the Alpine foreland basin reflects Eurasian slab unloading beneath the western Alps rather than global climate change

We synthesized published data on the erosion of the Alpine foreland basin and apatite fission-track ages from the Alps to infer the erosional sediment budget history for the past 5 m.y. The data reveal that erosion of the Alpine foreland basin is highest in front of the western Alps (between 2 and 0.6 km) and decreases eastward over a distance of 700 km to the Austrian foreland basin (similar to 200 m). For the western Alps, erosion rates are >0.6 km/m.y., while erosion rates for the eastern foreland basin and the adjacent eastern Alps are <0.1 km/m.y., except for a small-scale signal in the Tauern Window. The results yield a large ellipsoidal, orogen-crossing pattern of erosion, centered along the western Alps. We suggest that accelerated erosion of the western Alps and their foreland basin occurred in response to regional-scale surface uplift, related to lithospheric unloading of the Eurasian slab along the Eurasian-Adriatic plate boundary. While we cannot rule out recent views that global climate change led to substantial erosion of the European Alps since 5 Ma, we postulate that regional-scale tectonic processes have driven erosion during this time, modulated by an increased erosional flux in response to Quaternary glaciations.

Slab rollback orogeny in the Alps and evolution of the Swiss Molasse basin

The stratigraphies of foreland basins have been related to orogeny, where continent–continent collision causes the construction of topography and the downwarping of the foreland plate. These mechanisms have been inferred for the Molasse basin, stretching along the northern margin of the European Alps. Continuous flexural bending of the subducting European lithosphere as a consequence of topographic loads alone would imply that the Alpine topography would have increased at least between 30 Ma and ca. 5–10 Ma when the basin accumulated the erosional detritus. This, however, is neither consistent with observations nor with isostatic mass balancing models because paleoaltimetry estimates suggest that the topography has not increased since 20 Ma. Here we show that a rollback mechanism for the European plate is capable of explaining the construction of thick sedimentary successions in the Molasse foreland basin where the extra slab load has maintained the Alpine surface at low, but constant, elevations.

Análisis de parámetros de fendas para la estimación de las propiedades mecánicas de vigas de madera de Pinus sylvestris L. Analysis of parameters for assessing drying fissures to estimate their influence on the mechanical properties of Pinus sylvestris L. wooden beams

El principal objetivo de este estudio es evaluar la influencia de las fendas de secado en las propiedades mecánicas de vigas de madera. Para esto, se utilizan 40 vigas de Pino silvestre (Pinus sylvestris L) de 4200 mm de longitud y 150x200 mm de sección que fueron ensayadas según norma EN 408. Las fendas se registran detalladamente atendiendo a su longitud y posición en cada cara de la viga, y midiendo el espesor y la profundidad cada 100mm a lo largo de la viga. Solo el 10% de la muestra es rechazada por las fendas, según los criterios establecidos por la norma española de clasificación visual UNE 56544. Para evaluar la influencia de las fendas en las propiedades mecánicas, se usan tres parámetros globales basados en el área, el volumen o la profundad de la fenda, y dos locales basados en la profundidad máxima y la profundidad en la zona de rotura. Además se determina la densidad de las piezas. Estos parámetros se comparan con las propiedades mecánicas (tensión de rotura, módulo de elasticidad y energía de rotura) y se encuentra escasa relación entre ellos. Las mejores correlaciones se encuentran entre los parámetros relacionados con la profundidad de las fendas, tanto con el módulo de elasticidad como con la tensión de rotura. The aim of this study is the evaluation of the influence of drying fissures on the mechanical properties of timber beams. For that purpose, 40 sawn timber pieces of Scots pine (Pinus sylvestris L.) with 150x200 mm in cross-section and 4200 mm in length have been tested according to EN 408, obtaining MOR and MOE. The fissures were registered in detail measuring their length and position in each face of the beam, and the thickness and depth every 100 mm in length. Only 10 % of the pieces were rejected because fissures, according to UNE 56544 Spanish visual grading standard. To evaluate the influence of fissures in mechanical properties three global parameters: Fissures Area Ratio or ratio between the area occupied by fissures and the total area in the neutral axis plane of the beam; Fissures Volume Ratio or ratio between volume of fissures and the total volume of the beam; Fissures Average Depth and two local parameters were used: Fissures Maximum Depth in the beam, and Fissures Depth in the broken zone of the beam. Also the density of the beams was registered. These parameters were compared with mechanical properties (tensile strength, elasticity modulus, and rupture energy) and the relationship between them had not been founded. The best relationship was founded between the elasticity modulus y the tensile strength with the parameters which included the depth of the fissures.

Correlating a documentary record of historical floods with the dendrochronological dating of a wooden decking in the old mint of Segovia (Spain)

the aim of this study is to apply an integrated methodological approximation where dendrochronology and documentary analysis allow us to reconstruct the historical flood record of the Segovia Mint. Our hypothesis is that differences between the dendrochronological data of the wooden decking pieces can be related to historical floods and, therefore, they could be used as proxy-source data in future palaeoflood research.

Experimental study on the effective width of flat slab structures under dynamic seismic loading

This paper investigates the effective width of reinforced concrete flat slab structures subjected to seismic loading on the basis of dynamic shaking table tests. The study is focussed on the behavior of corner slab? column connections with structural steel I- or channel-shaped sections (shearheads) as shear punching reinforcement. To this end, a 1/2 scale test model consisting of a flat slab supported on four box-type steel columns was subjected to several seismic simulations of increasing intensity. It is found from the test results that the effective width tends to increase with the intensity of the seismic simulation, and this increase is limited by the degradation of adherence between reinforcing steel and concrete induced by the strain reversals caused by the earthquake. Also, significant differences are found between the effective width obtained from the tests and the values predicted by formula proposed in the literature. These differences are attributed to the stiffening effect provided by the steel profiles that constitute the punching shear reinforcement.

Analysis of punching of a reinforced concrete slab within IRIS_2012

As part of the IRIS_2012 international benchmark, simulations were conducted to analyse impacts on reinforced concrete slabs by both rigid and deformable missiles. The analytical results were compared with physical tests conducted by the Technical Research Center VTT of Finland. In the impact discussed here, a rigid missile perforates the concrete slab. The missile is a thick steel tube filled with concrete with a total mass of 47.4 kg and strikes the target at 136 m/s. The target is a 250 mm thick, reinforced concrete slab that spans 2 m by 2 m and is held in a rigid supporting frame. Characterisation tests were provided for calibration of the parameters of the concrete models selected by the participants. Having reproduced those tests, the authors developed models for the slab and the missile. A damaged plasticity model was used for the concrete and the rebars were explicitly represented. The results obtained were very satisfactory in respect of the damage patterns caused in the concrete and the reinforcement; also, the calculated and measured values of the energy spent by the missile in perforating the slab differed by only 4%.

Analysis of teaching experience based on teaching by the case method. Application to reinforcing wooden floors

The technique of reinforcement of wooden floors is a matter clearly multidisciplinary. The teaching of the subject using the "traditional" method, explaining the theory first and then proposing and solving problems has not been successful. This paper discusses the results of a teaching experiencie. It has been the teaching of the subject by the case method. The results are clearly superior to those obtained with the traditional methodology.

Prefab wooden house, Pedrezuela

Proyecto wooden house

Calibration of calculation models of wooden guardrails with Operational Modal Analysis

This study analyses the differences between two calculation models for guardrails on building sites that use wooden boards and tubular steel posts. Wood was considered an isotropic material in one model and an orthotropic material in a second model. The elastic constants of the wood were obtained with ultrasound. Frequencies and vibration modes were obtained for both models through linear analysis using the finite element method. The two models were experimentally calibrated through operational modal analysis. The results obtained show that for the three types of wood under analysis, the model which considered them as an orthotropic material fitted the experimental results better than the model which considered them as an isotropic material.