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patients, a megaprothesis is simpler to use and faster. The femur is better suited to massive reconstruction than the tibia, where coverage must be ensured along with extensor mechanism continuity. LEVEL OF EVIDENCE V; expert opinion.Prosthetic joint infection (PJI) is a rare-and dreaded-complication of arthroplasty requiring multidisciplinary care. Given the dual goal of treating the infection and maintaining satisfactory function, it is preferable to determine how and when the implanted components can be retained. Bacteria and fungi organize themselves into biofilms that shield them from antibiotics and the immune system. This biofilm is in place after 15 days of active infection. Some antibiotics have a better activity on biofilms. The following factors have a negative impact on the probability of a successful debridement, antibiotics and implant retention (DAIR) intervention fracture or revision, use of cement, bacteremia, kidney and/or liver failure, immunosuppression and elevated CRP. Hematogenous infections have a worse prognosis than early postoperative infections. Using a decision algorithm increases the chances of DAIR being successful. The KLIC score applies to early postoperative infections ( less then 4 weeks postoperative anrral center for any PJI, although it is preferable that early infections be treated at the facility that performed the implantation.Dual-mobility and constrained cups can stabilise most recurrent dislocations of total hip arthroplasty (THA), but may fail in case of hip abductor mechanism loss. For such complex situations, we developed an original artificial iliofemoral and ischiofemoral ligament reconstruction technique using a polyglactin 910 mesh (Vicryl ™) associated to repositioning of a Lefèvre constrained liner adapted to hip range of motion to prevent cam effects. The technique was implemented in 2 patients showing recurrent dislocation after THA, associating total femur replacement and cemented constrained liner in a metal reinforcement ring. Torin 2 In one of the 2 cases, the abductor mechanism had been entirely sacrificed. This simple and accessible salvage technique prevented recurrence of dislocation at 12 months' follow-up in these complex cases, previously subject to several episodes per year.
Antegrade nailing of humeral fractures is a proven technique with well-documented results. The standard surgical approach requires incision of the supraspinatus tendon to insert a nail, which comes with the risk of damaging the rotator cuff. The aims of this study were to describe a new surgical technique for arthroscopic humeral nailing that does not require opening the rotator cuff and to report the clinical and radiological outcomes of this technique.

This was a single center, retrospective study of patients who had a humeral shaft or surgical neck fracture at our hospital in 2017 and underwent antegrade intramedullary nailing by arthroscopy. The nail was introduced through the rotator interval without opening the rotator cuff. All were reviewed at 1-year postoperative clinical examination (joint range of motion and Constant score) plus AP and lateral radiographs of the shoulder.

Eighteen patients (12 women, 6 men) with a mean age of 65.4 years (37-84) were included retrospectively. One patient died during the follow-up period thus 17 patients were available for analysis. At the 1-year follow-up, the mean forward flexion was 152.1° (90-180), the mean external rotation was 56.1° (30-80), the mean absolute Constant score was 73.9 (54-88) points and the mean adjusted Constant score was 93.5 (67-100) points. Bone union was achieved in 16/17 patients (94%) with 1 patient experiencing a nonunion. There were no complications.

Arthroscopic antegrade nailing of humeral shaft and surgical neck fractures through the rotator interval yields good clinical and radiological results in our hands. This new, rotator cuff-sparing technique is a viable option for treating humeral fractures by arthroscopy.

IV; retrospective study without control group.
IV; retrospective study without control group.The HIV-1 epidemic in the US has historically been dominated by subtype B. HIV subtype diversity has not been extensively examined in most US cities to determine whether non-B variants have become established, as has been observed in many other global regions. We describe the diversity of non-B variants and present evidence of local transmission of non-B HIV in San Francisco. Viral sequences collected from patients between 2000 and 2016 were matched to the San Francisco HIV/AIDS case registry. HIV subtype was determined using COMET. Phylogenies were reconstructed using the pol region of subtypes A, C, D, G, CRF01_AE, CRF02_AG, and CRF07_BC, with reference sequences from the LANL HIV database. Associations of non-B subtypes and circulating recombinant forms (CRFs) with patient characteristics were assessed using multivariable logistic regression. Out of 11,381 sequences, 10,669 were from 7235 registry cases, of which 141 (2%) had non-B subtypes and CRFs and 72 (1%) had unique recombinant forms. CRF01_AE (0.8%) and subtype C (0.5%) were the most prevalent non-B forms. The frequency of non-B subtypes and CRFs increased in San Francisco during years 2000-2016. Out of 146 transmission events involving non-B study sequences, 18% indicated local transmission within the study population and 74% appeared to be inward migration of the virus. Compared to 7016 cases with only subtype B, 141 cases with non-B sequences were more likely to be of non-US country of birth (aOR = 11.02; p  less then  0.001), of Asian/Pacific-Islander race/ethnicity (aOR = 3.17; p  less then  0.001), and diagnosed after 2009 (aOR = 4.81; p  less then  0.001). Results suggest that most non-B infections were likely acquired outside the US and that local transmission of non-B forms has occurred but so far has not produced extensive transmission networks. Thus, non-B variants were not widely established in San Francisco, an observation that differs from cities worldwide with more diverse epidemics.The population genetic structure of Aedes aegypti (Linnaeus, 1762) has been studied in order to understand its role as an efficient vector. Several studies utilized an integrative approach; to combine genetic and phenotypic data to determine its population structure but these studies have only focused on female populations. To address this particular gap, our study compared the population variability and structuring between its male and female populations using phenotypic and genetic data from a highly-urbanized and dengue-endemic region of the Philippines, Metropolitan Manila. Five mosquito populations comprised of female (n = 137) and male (n = 49) adult mosquitoes were used in this study. All mosquito individuals underwent geometric morphometric (26 landmarks), and genetic (11 microsatellite loci) analyses. Results revealed that FST estimates (genetic) were 0.055 and 0.009 while QST estimates (phenotypic) were 0.318 and 0.309 in in male and female populations, respectively. Wing shape variation plots showed that male populations were distinctly separated from each other while female populations overlapped.
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