A low-cost subsurface drainage technique to enhance gully bank stability in the sub-humid highlands of Ethiopia

Gully erosion is the leading cause of elevated sediment yields in the world. Few low-cost techniques are available for rehabilitating gullies. The objective of this research was to evaluate the applicability of a low-cost horizontal sub-surface drainage system for decreasing gully erosion by stabilizing gully banks. The study was conducted in the sub-humid Ethiopian highlands in two active gullies, one in a Vertisol and another in a Nitisol. One bank was drained with a plastic pipe, and the other bank acted as the control. The two opposite banks are hydrologically isolated from one another. The surrounding groundwater tables were continuously monitored for two years. Over two wet seasons, the average bank retreat in the Vertisol gully was 0.62 m for the control and 0.15 m for the drained bank. Similarly, in the Nitisol gully, in 1.1 m for the control and 0.29 m for the drained bank. The average groundwater table of the drained bank was 20% lower than the non-drained banks during the monitoring periods. These results suggest that bank dewatering maintained higher levels of stability of gully banks and promoted lower rates of bank retreat on both soil types. The initial cost of the dewatering treatments was significantly less than the conventional bank stabilization measures. Bank dewatering could be one of the technologies for gully rehabilitation. Gully management techniques in Ethiopia and elsewhere could benefit from integrating bank drainage with other physical and biological protective measures.

Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review

Upper extremity arthritis in children can be treated with joint aspiration, arthroscopy or arthrotomy, followed by antibiotics. The literature seems inconclusive with respect to the optimal drainage technique. Therefore, the objective of this systematic review was to identify the most effective drainage technique for septic arthritis of the upper extremity in children. Two independent investigators systematically searched the electronic MEDLINE, EMBASE and Cochrane databases for original articles that reported outcomes of aspiration, arthroscopy or arthrotomy for septic arthritis of the paediatric shoulder or elbow. Outcome parameters were clinical improvement, need for repetitive surgery or drainage, and complications. Out of 2428 articles, seven studies with a total of 171 patients treated by aspiration or arthrotomy were included in the systematic review. Five studies reported on shoulder septic arthritis, one study on elbow septic arthritis, and one study on both joints. All studies were retrospective, except for one randomized prospective study. No difference was found between type of treatment and radiological or clinical outcomes. Aspiration of the shoulder or elbow joint required an additional procedure in 44% of patients, while arthrotomy required 12% additional procedures. Conclusion: Both aspiration and arthrotomy can achieve good clinical results in children with septic arthritis of the shoulder or elbow joint. However, the scientific quality of the included studies is low. It seems that the first procedure can be aspiration and washout and start of intravenous antibiotics, knowing that aspiration may have a higher risk of additional drainage procedures. Cite this article: EFORT Open Rev 2021;6:651-657. DOI: 10.1302/2058-5241.6.200122

Association of gravity drainage and complications following Whipple: an analysis of the ACS-NSQIP targeted database

Background The optimal type of operative drainage following pancreaticoduodenectomy (PD) remains unclear. Our objective is to investigate risk associated with closed drainage techniques (passive [gravity] vs. suction) after PD. Methods We assessed operative drainage techniques utilized in patients undergoing PD in the ACS-NSQIP pancreas-targeted database from 2016 to 2018. Using multivariable logistic regression to adjust for characteristics of the patient, procedure, and pancreas, we examined the association between use of gravity drainage and postoperative outcomes. Results We identified 9665 patients with drains following PD from 2016 to 2018, of which 12.7% received gravity drainage. 61.0% had a diagnosis of adenocarcinoma or pancreatitis, 26.5% had a duct <3 mm, and 43.5% had a soft or intermediate gland. After multivariable adjustment, gravity drainage was associated with decreased rates of postoperative pancreatic fistula (odds ratio [OR] 0.779, 95% confidence interval [CI] 0.653–0.930, p=0.006), delayed gastric emptying (OR 0.830, 95% CI 0.693–0.988, p=0.036), superficial SSI (OR 0.741, 95% CI 0.572–0.959, p=0.023), organ space SSI (OR 0.791, 95% CI 0.658–0.951, p=0.012), and readmission (OR 0.807, 95% CI 0.679–0.958, p=0.014) following PD. Conclusions Gravity drainage is independently associated with decreased rates of CR-POPF, DGE, SSI, and readmission following PD. Additional prospective research is necessary to better understand the preferred drainage technique following PD.

A systematic review of the optimal drainage technique for septic hip arthritis in children

Introduction: The hip is one of the most commonly affected joints in paediatric septic arthritis. Drainage can be performed using arthrocentesis (articular needle aspiration), arthroscopy or arthrotomy. The objective of this systematic review was to identify the most effective drainage technique for septic hip arthritis in the paediatric population. Materials and methods: The electronic MEDLINE, EMBASE and Cochrane databases were systematically searched for original articles that reported outcomes of arthrocentesis, arthroscopy or arthrotomy for septic arthritis of the paediatric hip. Outcome parameters were additional drainage procedures, clinical outcomes and radiological sequelae. The quality of each of the included studies was assessed with the Methodological Index for Non-randomized Studies (MINORS) score. Results: Out of 2428 articles, 19 studies with a total of 406 hip joints were included in the systematic review. Additional arthroscopy or arthrotomy was performed in 15% of the hips treated with arthrocentesis, in 14% after arthroscopy and in 3% after arthrotomy. Inferior clinical outcomes and more radiological sequelae were seen in patients treated with an arthrotomy. A meta-analysis could not be performed due to the diversity and low quality of the studies (MINORS median 4 [range 2–15]). Conclusions: This systematic review gives a comprehensive overview of the available literature on treatment for septic hip arthritis in children. Arthrocentesis and arthroscopic procedures may have a higher risk of additional drainage procedures in comparison with arthrotomy. However, arthrotomy might be associated with inferior outcomes in the longer term. The included studies are diverse and the scientific quality is generally low.

Possibility of using compensatory urban drainage techniques as leisure units to expand public areas into subdivisions

Many housing estates of social interest have not contributed to implementing leisure areas and reducing their environmental and urban quality. This paper aims to propose a leisure unit using a compensatory urban drainage technique in a housing complex of social interest in the city of São José do Rio Preto, São Paulo, Brazil. The characterization of the area, land use and occupation surveys, area sectorization, and catchment division were carried out. Afterwards, proposals for interventions based on surface runoff were presented using calculations of existing runoff and future scenarios. Results related to environmental and social gains for the area are discussed, as well as the possibility of implementing decentralized compensatory techniques. Moreover, 156 rain gardens and 3 ditches were proposed throughout the subdivisions, which enabled a gain of 989m² of contribution area to infiltrate the whole area, and the use of the retention basin as a leisure area. The total storage volume achieved with the sum of all the techniques implemented was approximately 3,000 cubic meters more than that projected for the existing retention basin.