Análisis del plano sagital en las escoliosis idiopáticas tratadas con instrumentación Cotrel-Dubousset

Se analiza la evolución del plano sagital en 50 enfermos con escoliosis idiopática intervenidos mediante artrodesis posterior con instrumentación de Cotrel-Dubousset con un seguimiento medio de 72 meses. Se recogieron los valores evolutivos de cifosis torácica medida entre T5 y T12 y de lordosis lumbar medida entre Ll y L5. Las curvas escolióticas fueron clasificadas según King et al. Los resultados obtenidos mostraron que no existía una variación global significativa de la cifosis torácica tras la cirugía. Sólo en aquellos enfermos que previamente existía una hipocifosis torácica existía una mejoría estadísticamente significativa de la misma con la intervención. Se evidenció una clara tendencia al incremento de la cifosis torácica con el tiempo. La lordosis lumbar se mantuvo, en la mayoría de los casos, dentro de límites fisiológicos. La instrumentación de Cotrel-Dubousset ofrece ventajas evidentes respecto a instrumentaciones previas en lo que respecta a la obtención de una curva más fisiológica en el plano sagital. Permite corregir la hipocifosis torácica severa y mantener la lordosis lumbar dentro de límites normales, incluso en instrumentaciones por debajo de L3.Sagittal plane analysis of 50 patients with idiopathic scoliosis treated with Cotrel- Dubousset instrumentation was performed. Mean follow-up was 72 months. The values of thoracic kyphosis from T5 to T12 and lumbar lordosis from L1 to L5 were retrospectively reviewed. Scoliotic curves were classified according to King et al. The results showed that there was not any significant change in thoracic kyphosis after surgery. Only those patients with preoperative thoracic hypokyphosis achieved a significant realignment. There was an obvious increase of thoracic kyphosis with time. Lumbar lordosis was maintained within normal limits in the mayority of patients. Cotrel-Dubousset instrumentation achieves better sagittal alignment than previous systems. It corrects thoracic hypokyphosis and preserves lumbar lordosis, even when the instrumentation is carried out lower than L3

Avulsión de la tuberosidad anterior de la tibia asociada a rotura del tendón cuadricipital

Se presenta 1 caso de fractura-avulsión de la tuberosidad anterior de la tibia asociada a rotura del tendón cuadricipital en un varón de 16 años. Tras el tratamiento quirúrgico de la fractura tuberositaria, y a pesar de haber pasado inicialmcnte inadvertida la lesión tendinosa, el resultado final a los 9 meses ha sido satisfactorio.A case of avulsion-fracture of the anterior tibial tubercle associated with rupture of the cuadricipital tendon in a 16-ycars-old boy is presented. After surgical treatment, in spite of having overlooked initially the tendinous lesion, the functional result at 9 months follow-up has been satisfactory

Pseudotumor de pisiforme: a propósito de 1 caso

Se presenta 1 caso de pseudotumor del pisiforme con dolor crónico en eminencia hipotenar y compresión del nervio cubital en un varón de 33 años. El diagnóstico histológico definitivo fue de callo hipertrófico con degeneración cartilaginosa focal del hueso pisiforme. Se presupone el origen laboral de la lesión, secundaria a microtraumatismos repetidos por martillo neumático. Se practicó exéresis simple del hueso, con un resultado excelente a los 6 meses. Los autores piensan que el tratamiento de elección hubiera sido la inmovilización precoz al comienzo de la sintomatología.A case of pseudotumor of the pisiform vvith cronic pain in the hipothenar eminence and compression neuropathy of the ulnar nerve in Guyon's canal in a 33 year old man is reported. Pathologic diagnosis was consistent vvith hypertrophic fracture callus and focal degenerative changes in the articular surface of the pisiform. Repetitive minor trauma in his job as a miner, while using pneumatic hammer is presumed to be the main etiologic factor. Simple excision of the pisiform was performed vvith excelent functional result at 6 months. The authors believe that early inmobilization when the symptoms started, vvould have been the ideal treatmen

Cotilos roscado y atornillado recubiertos de hidroxiapatita: estudio comparativo

Se estudian 122 cotilos recubiertos de hidroxiapatita, 45 roscados y 77 atornillados, con un seguimiento medio de 3,8 años. La valoración clínica se hizo según el protocolo de Johnston comparando el estado previo y el actual, obteniendo un 93 % de excelentes y buenos resultados en los cotilos roscados y un 83 % con los atornillados. El cotilo roscado ofreció mejores puntuaciones en las necrosis avasculares (p<0,01) y artrosis primarias (p<0,05). El resultado clínico fue mejor en la artrosis primaria que en los recambios (p<0,05) y las artropatías inflamatorias (p<0,01). No se evidenciaron aflojamientos, encontrándose como única diferencia la posición más horizontal de los implantes roscados. En el sexo masculino fue más frecuente la aparición de calcificaciones periarticulares. Se produjeron un 7% de luxaciones que se asociaron a la mayor altura del cotilo sobre la lágrima y a la menor longitud del cuello femoral por encima del trocánter menor.One hundred twenty two hidroxyapatite-coated acetabular implants, 45 threaded and 77 fixed with screws, were reviewed. The average follow-up period was 3.8 years. The results have been very encouraging, obtaining 93% of excellent and good results with threaded cups and 83 % when fixed with screws. Threaded cups had better scores for avascular necrosis (p<0.01) and primary osteoarthrosis (p<0.05). The worse results were achieved for patients with revisions and inflamatory diseases. No evidence of loosening was found. The placement of threaded cups was more horizontal. Male sex was associated with developing of heterotopic ossification. There were 7% of dislocations associated with a longes distance from the teardrop and as shorter length of the calcar from the lesser trochanter

Técnica de Imhäuser en el pie zambo : resultados a medio y largo plazo

Se revisan un total de 60 pies con equinovaro congénito pertenecientes a 48 pacientes, todos con un seguimiento superior a 5 años. En todos los casos se realizó un tratamiento combinado: ortopédico (manipulaciones y enyesados desde el nacimiento) y quirúrgico (correcciones según el método de Imhäuser modificado). Se valoró morfológica, funcional y radiográficamente cada caso. En la valoración global sólo 1 caso fue considerado malo, 13 regulares (21,6%), 6 por pies planos valgos, 3 por pronato de antepié y 4 por adducto de antepié, y 12 buenos (20%), aunque presentaban alguna alteración morfológica o funcional mínima, y 34 excelentes (56,6%). Se concluye que: 1) la técnica de Imhäuser ofrece en este trabajo el 77% de excelentes y buenos resultados; 2) el 2.° y 3.cr se pueden resumir en uno solo, el hemitrasplante del tibial anterior, y 3) los resultados clínicos, morfológicos y funcionales son superiores a los radiográficos.—We cheked 42 patients with club-feet (60 feet), all of them with follow-up over 5 years. All the patients received a mixed treatment: orthopaedic (manipulation and plastering) and surgical (Imhäuser technique modified). We evaluated morphological, functional and radiographic parameters. In the overall evaluation only one of the cases was considered bad result; 13 (21.6%) fair results, 6 with valgus flat feet, 3 with pronatus forefoot and 4 with adductus forefoot; 12 (20%) good results, with a minimal morphologic or functional alterations; 34 (56.6%) were excellents results. Conclutions: 1) Imhäuser technic had 77% of good or excellent results in this work; 2) the second and third Imhäuser surgical times can be summarized in only one: the external hemitrasplant of the tibial anterior tendon, and 3) clinics, morphologics and functional results are better than radiographics results

Recovery of the first ever multi-year lidar dataset of the stratospheric aerosol layer, from Lexington, MA, and Fairbanks, AK, January 1964 to July 1965

We report the recovery and processing methodology of the first ever multi-year lidar dataset of the stratospheric aerosol layer. A Q-switched ruby lidar measured 66 vertical profiles of 694 nm attenuated backscatter at Lexington, Massachusetts, between January 1964 and August 1965, with an additional nine profile measurements conducted from College, Alaska, during July and August 1964. We describe the processing of the recovered lidar backscattering ratio profiles to produce mid-visible (532 nm) stratospheric aerosol extinction profiles (sAEP532) and stratospheric aerosol optical depth (sAOD532) measurements, utilizing a number of contemporary measurements of several different atmospheric variables. Stratospheric soundings of temperature and pressure generate an accurate local molecular backscattering profile, with nearby ozone soundings determining the ozone absorption, which are used to correct for two-way ozone transmittance. Two-way aerosol transmittance corrections are also applied based on nearby observations of total aerosol optical depth (across the troposphere and stratosphere) from sun photometer measurements. We show that accounting for these two-way transmittance effects substantially increases the magnitude of the 1964/1965 stratospheric aerosol layer's optical thickness in the Northern Hemisphere mid-latitudes, then ∼ 50 % larger than represented in the Coupled Model Intercomparison Project 6 (CMIP6) volcanic forcing dataset. Compared to the uncorrected dataset, the combined transmittance correction increases the sAOD532 by up to 66 % for Lexington and up to 27 % for Fairbanks, as well as individual sAEP532 adjustments of similar magnitude. Comparisons with the few contemporary measurements available show better agreement with the corrected two-way transmittance values. Within the January 1964 to August 1965 measurement time span, the corrected Lexington sAOD532 time series is substantially above 0.05 in three distinct periods, October 1964, March 1965, and May–June 1965, whereas the 6 nights the lidar measured in December 1964 and January 1965 had sAOD values of at most ∼ 0.03. The comparison with interactive stratospheric aerosol model simulations of the Agung aerosol cloud shows that, although substantial variation in mid-latitude sAOD532 are expected from the seasonal cycle in the stratospheric circulation, the Agung cloud's dispersion from the tropics would have been at its strongest in winter and weakest in summer. The increasing trend in sAOD from January to July 1965, also considering the large variability, suggests that the observed variations are from a different source than Agung, possibly from one or both of the two eruptions that occurred in 1964/1965 with a Volcanic Explosivity Index (VEI) of 3: Trident, Alaska, and Vestmannaeyjar, Heimaey, south of Iceland. A detailed error analysis of the uncertainties in each of the variables involved in the processing chain was conducted. Relative errors for the uncorrected sAEP532 were 54 % for Fairbanks and 44 % Lexington. For the corrected sAEP532 the errors were 61 % and 64 %, respectively. The analysis of the uncertainties identified variables that with additional data recovery and reprocessing could reduce these relative error levels. Data described in this work are available at https://doi.org/10.1594/PANGAEA.922105 (Antuña-Marrero et al., 2020a)

Validez predictiva del examen de ingreso a la carrera de medicina de la Facultad de Ciencias Médicas (UNC)

La Universidad Nacional de Córdoba asume el compromiso de formación de profesionales responsables, considerando a la educación con un significado primordial. El Departamento de Admisión de Facultad de Ciencias Médicas motiva una revisión minuciosa de los procesos de enseñanza y evaluación en los Ciclos de Nivelación y el rendimiento académico de los alumnos. Objetivo: Analizar validez predictiva del examen de ingreso a la carrera de Medicina respecto al promedio general y Práctica Final Obligatoria (PFO). Metodología: estudio longitudinal, retrospectivo de la cohorte 2006. Se analizó la correlación entre la nota del ingreso y la nota final de la Práctica Final Obligatoria y se utilizó un modelo de regresión lineal para analizar la relación entre la nota de ingreso y el promedio de la carrera (p<0,05). Resultados: El análisis de regresión lineal demostró que hay asociación positiva entre la nota de ingreso y el promedio de la carrera (p<0,0001). La nota de ingreso resultó ser predictor del promedio general de la carrera

Evaluation of night-time aerosols measurements and lunar irradiance models in the frame of the first multi-instrument nocturnal intercomparison campaign

The first multi-instrument nocturnal aerosol optical depth (AOD) intercom-parison campaign was held at the high-mountain Iza ̃na Observatory (Tener-ife, Spain) in June 2017, involving 2-minutes synchronous measurements fromtwo different types of lunar photometers (Cimel CE318-T and Moon Preci-sion Filter Radiometer, LunarPFR) and one stellar photometer. The Robotic Lunar Observatory (ROLO) model developed by the U.S. Geological Survey(USGS) was compared with the open-access ROLO Implementation for Moonphotometry Observation (RIMO) model. Results showed rather small differ-ences at Iza ̃na over a 2-month time period covering June and July, 2017(±0.01 in terms of AOD calculated by means of a day/night/day coherencetest analysis and±2 % in terms of lunar irradiance). The RIMO model hasbeen used in this field campaign to retrieve AOD from lunar photometricmeasurements. No evidence of significant differences with the Moon’s phase angle wasfound when comparing raw signals of the six Cimel photometers involved inthis field campaign.The raw signal comparison of the participating lunar photometers (Cimeland LunarPFR) performed at coincident wavelengths showed consistent mea-surements and AOD differences within their combined uncertainties at 870 nmand 675 nm. Slightly larger AOD deviations were observed at 500 nm, point-ing to some unexpected instrumental variations during the measurement pe-riod.Lunar irradiances retrieved using RIMO for phase angles varying between0◦and 75◦(full Moon to near quarter Moon) were compared to the irradi-ance variations retrieved by Cimel and LunarPFR photometers. Our resultsshowed a relative agreement within±3.5 % between the RIMO model andthe photometer-based lunar irradiances.The AOD retrieved by performing a Langley-plot calibration each nightshowed a remarkable agreement (better than 0.01) between the lunar pho-tometers. However, when applying the Lunar-Langley calibration using RIMO,AOD differences of up to 0.015 (0.040 for 500 nm) were found, with differ-ences increasing with the Moon’s phase angle. These differences are thoughtto be partly due to the uncertainties in the irradiance models, as well asinstrumental deficiencies yet to be fully understood.High AOD variability in stellar measurements was detected during thecampaign. Nevertheless, the observed AOD differences in the Cimel/stellarcomparison were within the expected combined uncertainties of these twophotometric techniques. Our results indicate that lunar photometry is amore reliable technique, especially for low aerosol loading conditions.The uncertainty analysis performed in this paper shows that the com-bined standard AOD uncertainty in lunar photometry is dependent on thecalibration technique (up to 0.014 for Langley-plot with illumination-basedcorrection, 0.012-0.022 for Lunar-Langley calibration, and up to 0.1 for the 2 Sun-Moon Gain Factor method). This analysis also corroborates that theuncertainty of the lunar irradiance model used for AOD calculation is withinthe 5-10 % expected range.This campaign has allowed us to quantify the important technical diffi-culties that still exist when routinely monitoring aerosol optical propertiesat night-time. The small AOD differences observed between the three typesof photometers involved in the campaign are only detectable under pristinesky conditions such as those found in this field campaign. Longer campaignsare necessary to understand the observed discrepancies between instrumentsas well as to provide more conclusive results about the uncertainty involvedin the lunar irradiance model

Evaluation of night-time aerosols measurements and lunar irradiance models in the frame of the first multi-instrument nocturnal intercomparison campaign

The first multi-instrument nocturnal aerosol optical depth (AOD) intercomparison campaign was held at the high-mountain Izaña Observatory (Tenerife, Spain) in June 2017, involving 2-min synchronous measurements from two different types of lunar photometers (Cimel CE318-T and Moon Precision Filter Radiometer, LunarPFR) and one stellar photometer. The Robotic Lunar Observatory (ROLO) model developed by the U.S. Geological Survey (USGS) was compared with the open-access ROLO Implementation for Moon photometry Observation (RIMO) model. Results showed rather small differences at Izaña over a 2-month time period covering June and July, 2017 (±0.01 in terms of AOD calculated by means of a day/night/day coherence test analysis and ± 2% in terms of lunar irradiance). The RIMO model has been used in this field campaign to retrieve AOD from lunar photometric measurements. No evidence of significant differences with the Moon's phase angle was found when comparing raw signals of the six Cimel photometers involved in this field campaign. The raw signal comparison of the participating lunar photometers (Cimel and LunarPFR) performed at coincident wavelengths showed consistent measurements and AOD differences within their combined uncertainties at 870 nm and 675 nm. Slightly larger AOD deviations were observed at 500 nm, pointing to some unexpected instrumental variations during the measurement period. Lunar irradiances retrieved using RIMO for phase angles varying between 0° and 75° (full Moon to near quarter Moon) were compared to the irradiance variations retrieved by Cimel and LunarPFR photometers. Our results showed a relative agreement within ± 3.5% between the RIMO model and the photometer-based lunar irradiances. The AOD retrieved by performing a Langley-plot calibration each night showed a remarkable agreement (better than 0.01) between the lunar photometers. However, when applying the Lunar-Langley calibration using RIMO, AOD differences of up to 0.015 (0.040 for 500 nm) were found, with differences increasing with the Moon's phase angle. These differences are thought to be partly due to the uncertainties in the irradiance models, as well as instrumental deficiencies yet to be fully understood. High AOD variability in stellar measurements was detected during the campaign. Nevertheless, the observed AOD differences in the Cimel/stellar comparison were within the expected combined uncertainties of these two photometric techniques. Our results indicate that lunar photometry is a more reliable technique, especially for low aerosol loading conditions. The uncertainty analysis performed in this paper shows that the combined standard AOD uncertainty in lunar photometry is dependent on the calibration technique (up to 0.014 for Langley-plot with illumination-based correction, 0.012–0.022 for Lunar-Langley calibration, and up to 0.1 for the Sun-Moon Gain Factor method). This analysis also corroborates that the uncertainty of the lunar irradiance model used for AOD calculation is within the 5–10% expected range. This campaign has allowed us to quantify the important technical difficulties that still exist when routinely monitoring aerosol optical properties at night-time. The small AOD differences observed between the three types of photometers involved in the campaign are only detectable under pristine sky conditions such as those found in this field campaign. Longer campaigns are necessary to understand the observed discrepancies between instruments as well as to provide more conclusive results about the uncertainty involved in the lunar irradiance models.This work has been developed within the framework of the activities of the World Meteorological Organization (WMO) Commission for Instruments and Methods of Observations (CIMO) Izaña Testbed for Aerosols and Water Vapour Remote Sensing Instruments. AERONET sun photometers at Izaña have been calibrated within the AERONET Europe TNA, supported by the European Union’s Horizon 2020 research and innovation program under grant agreement no. 654109 (ACTRIS‒2). CE318-T linearity check has been performed as part of the ESA-funded project “Lunar spectral irradiance measurement and modelling for absolute calibration of EO optical sensors” under ESA contract number: 4000121576/17/NL/AF/hh. LunarPFR has been performing measurements since 2014 in Norway thanks to Svalbard Science Forum funded project, 2014–2016. The authors would like to thank AERONET team for their support and also to NASA’s Navigation and Ancillary Information Facility (NAIF) at the Jet Propulsion Laboratory to help the implementation of the “SPICE” ancillary information system used in this study. We also thank Izaña's ITs for their work to implement the RIMO model in the free-access server. Special thanks should be given to Tom Stone, who has kindly provided us with the USGS/ROLO irradiance values used in the model comparison analysis. This work has also received funding from the European Union’s Horizon 2020 research and innovation programme and from Marie Skłodowska-Curie Individual Fellowships (IF) ACE-GFAT (grant agreement no. 659398). The authors are grateful to Spanish MINECO (CTM2015-66742-R) and Junta de Castilla y León (VA100P17)

Retrieval of aerosol properties from zenith sky radiance measurements

This study explores the potential to retrieve aerosol properties with the GRASP algorithm (Generalized Retrieval of Atmosphere and Surface Properties) using as input measurements of zenith sky radiance (ZSR), which are sky radiance values measured in the zenith direction, recorded at four wavelengths by a ZEN-R52 radiometer. To this end, the ZSR measured at 440, 500, 675 and 870 nm by a ZEN-R52 (ZSRZEN), installed in Valladolid (Spain), is employed. This instrument is calibrated by intercomparing the signal of each channel with coincident ZSR values simulated (ZSRSIM) at the same wavelengths with a radiative transfer model (RTM). These simulations are carried out using the GRASP forward module as RTM and the aerosol information from a co-located CE318 photometer belonging to AERONET (AErosol RObotic NETwork) as input. The dark signal and the signal dependence on temperature are characterized and included in the calibration process. The uncertainties for each channel are quantified by an intercomparison with a co-located CE318 photometer, obtaining lower values for shorter wavelengths; they are between 3 % for 440 nm and 21 % for 870 nm. The proposed inversion strategy for the aerosol retrieval using the ZSRZEN measurements as input, i.e. so-called GRASP-ZEN, assumes the aerosol as an external mixture of five pre-calculated aerosol types. A sensitivity analysis is conducted using synthetic ZSRZEN measurements, pointing out that these measurements are sensitive to aerosol load and type. It also assesses that the retrieved aerosol optical depth (AOD) values in general overestimate the reference ones by 0.03, 0.02, 0.02 and 0.01 for 440, 500, 675 and 870 nm, respectively. The calibrated ZSRZEN measurements, recorded during 2.5 years at Valladolid, are inverted by the GRASP-ZEN strategy to retrieve some aerosol properties like AOD. The retrieved AOD shows a high correlation with respect to independent values obtained from a co-located AERONET CE318 photometer, with determination coefficients (r2) of 0.86, 0.85, 0.79 and 0.72 for 440, 500, 675 and 870 nm, respectively, and finding uncertainties between 0.02 and 0.03 with respect to the AERONET values. Finally, the retrieval of other aerosol properties, like aerosol volume concentration for total, fine and coarse modes (VCT, VCF and VCC, respectively), is also explored. The comparison against independent values from AERONET presents r2 values of 0.57, 0.56 and 0.66 and uncertainties of 0.009, 0.016 and 0.02 µm3 µm−2 for VCT, VCF and VCC, respectively.</p