Earthquake crisis unveils the growth of an incipient continental fault system.

Large continental faults extend for thousands of kilometres to form boundaries between rigid tectonic blocks. These faults are associated with prominent topographic features and can produce large earthquakes. Here we show the first evidence of a major tectonic structure in its initial-stage, the Al-Idrissi Fault System (AIFS), in the Alboran Sea. Combining bathymetric and seismic reflection data, together with seismological analyses of the 2016 Mw 6.4 earthquake offshore Morocco - the largest event ever recorded in the area - we unveil a 3D geometry for the AIFS. We report evidence of left-lateral strike-slip displacement, characterise the fault segmentation and demonstrate that AIFS is the source of the 2016 events. The occurrence of the Mw 6.4 earthquake together with historical and instrumental events supports that the AIFS is currently growing through propagation and linkage of its segments. Thus, the AIFS provides a unique model of the inception and growth of a young plate boundary fault system.

Postoperative hyperglycaemia control reduces postoperative complications in patients subject to total knee arthroplasty.

BACKGROUND: The aim of our study was the early detection and treatment of patients with unknown alterations of the hydrocarbon metabolism subject to total knee arthroplasty in order to reduce the incidence of postoperative complications. METHODS: Patients were classified as non-diabetic patients (group 1), diabetic patients (group 2) and patients with stress hyperglycaemia (group 3). The last two groups were recommended assessment by a primary care physician (PCP). After one year follow-up the groups were compared with respect to incidence of postoperative complications. The groups were also compared regarding the decrease or increase of HbA1c levels with the incidence of complications. RESULTS: Of the 228 patients, 116 (50%) were included in group 1, 40 (17.5%) in group 2 and 72 (31.6%) in group 3. Patients that consulted their PCP presented lower medical complication rates than those who did not (9.2% vs. 26.4%, P=0.020). Not being attended by a PCP was an independent predictive factor of medical complication (odds ratio (OR): 21.3; 95% confidence interval (95% CI): 4.6-98.5), surgical site infection (OR: 4.1; 95% CI: 1.1-15.0) and mechanical complication (OR: 5.0; 95% CI: 1.3-18.8). A decrease of HbA1c value was related to less medical systemic complications (7.3% vs. 24.2%, P=0.035). CONCLUSIONS: Patients with hyperglycaemia during the postoperative total knee arthroplasty period, who are controlled by the PCP present lower incidence of complications. Decrease of HbA1c value during postoperative total knee arthroplasty period leads to a lower rate of medical complications.

Clinical outcome in patients with peripheral artery disease and renal artery stenosis.

BACKGROUND: There is controversy on the influence of renal artery stenosis on outcome in patients with peripheral artery disease. PATIENTS AND METHODS: The 12-month impact of renal artery stenosis on declining renal function, control of hypertension, and incidence of major cardiovascular events in 100 consecutive patients undergoing angiography for peripheral artery disease was evaluated. RESULTS: A total of 60 patients had renal artery stenosis: 32 mild, 16 moderate, and 12 severe stenosis. There were no significant differences in either the decline of renal function (2.7 +/- 18% vs 0.9 +/- 16%), control of hypertension (139 +/- 16 vs 139 +/- 22 mm Hg) or number of antihypertensive drugs (1.8 +/- 1.0 vs 1.6 +/- 0.8). Patients with renal artery stenosis had an increased incidence of major cardiovascular events (odds ratio: 2.3; 95% confidence interval: 1.03-5.4), but on multivariate analysis its influence disappeared. CONCLUSIONS: Patients with peripheral artery disease having renal artery stenosis had similar decline of renal function and control of hypertension. They had an increased incidence of major cardiovascular events, but it may be explained by the confounding effect of additional variables.