Cirugía de la columna lumbar degenerativa

En una realidad la gran demanda actual de fusiones de la columna lumbar. Los resultados clínicos obtenidos con la fusión posterolateral se ven claramente superados con las fusiones anteroposteriores. Se realiza una revisión bibliográfica de las diferentes formas de fusión de la columna lumbar y la reaparición del concepto de soporte de columna anterior. Se establecen las indicaciones y las ventajas de la fusión anteroposterior lumbar, describiéndose las posibles vías de abordaje posterior y anteriores abiertas y mínimamente invasivas. Se clasifican los modernos implantes utilizados para soporte de la columna anterior. Se detallan ventajas e inconvenientes de las vías anterior y posterior.It is a reality the increasing number of the lumbar fusions. Clinical results show that the anteroposterior lumbar fusions achieve greater success rates than the posterolateral ones. A paper review of the different ways of lumbar fusion is carried out whit the update of the anterior column support concept. Indications and advantages: posterior, anterior and minimal invasive ones. The last spine cages used for anterior column support art classified. Advantages and drawbacks of the both approaches anterior and posterior are studied

A low-voltage low-power front-end for wearable EEG systems

A low-voltage and low-power front-end for miniaturized, wearable EEG systems is presented. The instrumentation amplifier, which removes the electrode drift and conditions the signal for a 10-bit A/D converter, combines a chopping strategy with quasi-FGMOS (QFG) transistors to minimize low frequency noise whilst enabling operation at 1 V supply. QFG devices are also key to the A/D converter operating at 1.2 V with 70dB of SNR and an oversampling ratio of 64. The whole system consumes less than 2uW at 1.2V.Published versio

Phase diffusion as a model for coherent suppression of tunneling in the presence of noise

We study the stabilization of coherent suppression of tunneling in a driven double-well system subject to random periodic $\delta-$function ``kicks''. We model dissipation due to this stochastic process as a phase diffusion process for an effective two-level system and derive a corresponding set of Bloch equations with phase damping terms that agree with the periodically kicked system at discrete times. We demonstrate that the ability of noise to localize the system on either side of the double-well potenital arises from overdamping of the phase of oscillation and not from any cooperative effect between the noise and the driving field. The model is investigated with a square wave drive, which has qualitatively similar features to the widely studied cosinusoidal drive, but has the additional advantage of allowing one to derive exact analytic expressions.Comment: 17 pages, 4 figures, submitted to Phys. Rev.

Two-state theory of nonlinear Stochastic Resonance

An amenable, analytical two-state description of the nonlinear population dynamics of a noisy bistable system driven by a rectangular subthreshold signal is put forward. Explicit expressions for the driven population dynamics, the correlation function (its coherent and incoherent part), the signal-to-noise ratio (SNR) and the Stochastic Resonance (SR) gain are obtained. Within a suitably chosen range of parameter values this reduced description yields anomalous SR-gains exceeding unity and, simultaneously, gives rise to a non-monotonic behavior of the SNR vs. the noise strength. The analytical results agree well with those obtained from numerical solutions of the Langevin equation.Comment: 4 pages, 1 figur

Effect of a long-term afforestation of pine in a beech domain in NE-Spain revealed by analytical pyrolysis (Py-GC/MS).

Poster presentado en lal EGU General Assembly 2015, held 12-17 April, 2015 in Vienna, Austria. id.12736The replacement of native beech forests (Fagus sylvatica) by Scots pine (Pinus sylvestris) afforestation may exert changes in soil properties, particularly in soil organic matter (SOM) [1]. It is known that the products generated by Pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS) pyrolysis of organic matter are related to their origin [2 and references therein]. Therefore this technique can be used to investigate said changes. In this work, Py-GC/MS is used to study changes in SOM quality surrogated to the effect of the centennial replacement of beech by Scots pine. The soils studied were two acid soil profiles developed on quartzites under a humid climate at an altitude of 1400-1500 masl from Moncayo (Iberian range, NE-Spain). For each soil profile three organic layers (litter: OL, fragmented litter OF and humified litter OH) and the mineral soil horizons (Ah, E, Bhs and C) were sampled. After 100 years since the pine afforestation, differences in the relative abundance of lipids released by pyrolysis were observed in the O-layers ranging from 3.82-7.20% in pine soils and 0.98-1.25% in beech soils. No differences were observed in mineral horizons with depth except for the C horizons where beech lipid content was much higher (21.25%) than in that under pine (1.07%). Both pine and beech soils show similar nitrogen compounds relative contents along the soil profile, increasing from OL to Ah (3.49-9.11% and 2.75-11.73% in beech and pine respectively) with a conspicuous reduction in the E horizon. It is remarkable the absence of nitrogen compounds in beech Bhs and C horizons. The relative content of aromatic compounds in O-layers show opposite trends for beech and pine; an enrichment in aromatic compounds is observed in beech OL layer (12.39%) decreasing to 4.11% in OH layer in contrast, whereas for pine O-layers the aromatic compounds relative abundance was higher in the OH (5.83%) than in the OL layer (2.8%). Mineral Ah and E horizons show similar values in both beech (18.30-10.09%) and pine (15.81-10.01%) soils; nevertheless the relative abundance of aromatic compounds content is higher in beech mineral horizons Bhs (41.96%) and C (30.91%) than in those under pine (11.43% and 13.04% for Bhs and C respectively). Polycyclic aromatic hydrocarbons (PAHs) were only observed in the mineral soil horizons showing similar relative abundances ranging from 0.61-6.63% in beech and 0.96-3.05% in pine soils. The highest PAHs relative abundance was found in the Bhs horizon under beech. This may indicate the occurrence of fire events in the area and its translocation and accumulation by leaching from top soil in the spodic horizon. Differences in the relative abundances of lignin derived pyrolysis products (Methoxyphenols) were mainly observed in the O-layers whereas the relative abundances were similar for the mineral horizons that ranged from 1.49-4.31% in beech and 1.42-4.67% in pine. Lignin relative abundance is much higher in OH beech layer (31.88%) than in pine OH layer (14.99%) whereas similar relative contents were found in OL and OF layers ranging from 26.21-27-12% and 20.22-25.92% in beech and pine respectively. In the soil developed under beech the polysaccharide derived moieties show a relative content increase along the profile from a 9.86% in OL layer to a 29.86% in E horizon followed by a remarkable decrease in the Bhs (4.86%) and C (11.22%). Besides, the polysaccharide relative abundance in the soil under pine show a similar trend ranging from 12-23% to 30.65% but the decrease in Bhs and C horizons was found less marked (26.83% and 24.12% respectively).This study is part of the results of the FUEGOSOL (CGL2013-43440-R) and GEOFIRE Projects (CGL2012-38655-C04-01) funded by the Spanish Ministry for Economy and Competitiveness. N.T Jiménez-Morillo is funded by a FPI research grant (BES-2013-062573).Peer Reviewe

Efficacy and safety of ablation for people with non-paroxysmal atrial fibrillation.

: The optimal rhythm management strategy for people with non-paroxysmal (persistent or long-standing persistent) atrial fibrilation is currently not well defined. Antiarrhythmic drugs have been the mainstay of therapy. But recently, in people who have not responded to antiarrhythmic drugs, the use of ablation (catheter and surgical) has emerged as an alternative to maintain sinus rhythm to avoid long-term atrial fibrillation complications. However, evidence from randomised trials about the efficacy and safety of ablation in non-paroxysmal atrial fibrillation is limited. : To determine the efficacy and safety of ablation (catheter and surgical) in people with non-paroxysmal (persistent or long-standing persistent) atrial fibrillation compared to antiarrhythmic drugs. : We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, conference abstracts, clinical trial registries, and Health Technology Assessment Database. We searched these databases from their inception to 1 April 2016. We used no language restrictions. : We included randomised trials evaluating the effect of radiofrequency catheter ablation (RFCA) or surgical ablation compared with antiarrhythmic drugs in adults with non-paroxysmal atrial fibrillation, regardless of any concomitant underlying heart disease, with at least 12 months of follow-up. : Two review authors independently selected studies and extracted data. We evaluated risk of bias using the Cochrane 'Risk of bias' tool. We calculated risk ratios (RRs) for dichotomous data with 95% confidence intervals (CIs) a using fixed-effect model when heterogeneity was low (I² &lt;= 40%) and a random-effects model when heterogeneity was moderate or substantial (I² &gt; 40%). Using the GRADE approach, we evaluated the quality of the evidence and used the GRADE profiler (GRADEpro) to import data from Review Manager 5 to create 'Summary of findings' tables. : We included three randomised trials with 261 participants (mean age: 60 years) comparing RFCA (159 participants) to antiarrhythmic drugs (102) for non-paroxysmal atrial fibrillation. We generally assessed the included studies as having low or unclear risk of bias across multiple domains, with reported outcomes generally lacking precision due to low event rates. Evidence showed that RFCA was superior to antiarrhythmic drugs in achieving freedom from atrial arrhythmias (RR 1.84, 95% CI 1.17 to 2.88; 3 studies, 261 participants; low-quality evidence), reducing the need for cardioversion (RR 0.62, 95% CI 0.47 to 0.82; 3 studies, 261 participants; moderate-quality evidence), and reducing cardiac-related hospitalisation (RR 0.27, 95% CI 0.10 to 0.72; 2 studies, 216 participants; low-quality evidence) at 12 months follow-up. There was substantial uncertainty surrounding the effect of RFCA regarding significant bradycardia (or need for a pacemaker) (RR 0.20, 95% CI 0.02 to 1.63; 3 studies, 261 participants; low-quality evidence), periprocedural complications, and other safety outcomes (RR 0.94, 95% CI 0.16 to 5.68; 3 studies, 261 participants; very low-quality evidence). : In people with non-paroxysmal atrial fibrillation, evidence suggests a superiority of RFCA to antiarrhythmic drugs in achieving freedom from atrial arrhythmias, reducing the need for cardioversion, and reducing cardiac-related hospitalisations. There was uncertainty surrounding the effect of RFCA with significant bradycardia (or need for a pacemaker), periprocedural complications, and other safety outcomes. Evidence should be interpreted with caution, as event rates were low and quality of evidence ranged from moderate to very low.<br/

Strong coupling theory for driven tunneling and vibrational relaxation

We investigate on a unified basis tunneling and vibrational relaxation in driven dissipative multistable systems described by their N lowest lying unperturbed levels. By use of the discrete variable representation we derive a set of coupled non-Markovian master equations. We present analytical treatments that describe the dynamics in the regime of strong system-bath coupling. Our findings are corroborated by ``ab-initio'' real-time path integral calculations.Comment: 4 LaTeX pages including 3 figure

Microcanonical quantum fluctuation theorems

Previously derived expressions for the characteristic function of work performed on a quantum system by a classical external force are generalized to arbitrary initial states of the considered system and to Hamiltonians with degenerate spectra. In the particular case of microcanonical initial states explicit expressions for the characteristic function and the corresponding probability density of work are formulated. Their classical limit as well as their relations to the respective canonical expressions are discussed. A fluctuation theorem is derived that expresses the ratio of probabilities of work for a process and its time reversal to the ratio of densities of states of the microcanonical equilibrium systems with corresponding initial and final Hamiltonians.From this Crooks-type fluctuation theorem a relation between entropies of different systems can be derived which does not involve the time reversed process. This entropy-from-work theorem provides an experimentally accessible way to measure entropies.Comment: revised and extended versio

Coherence Resonance and Noise-Induced Synchronization in Globally Coupled Hodgkin-Huxley Neurons

The coherence resonance (CR) of globally coupled Hodgkin-Huxley neurons is studied. When the neurons are set in the subthreshold regime near the firing threshold, the additive noise induces limit cycles. The coherence of the system is optimized by the noise. A bell-shaped curve is found for the peak height of power spectra of the spike train, being significantly different from a monotonic behavior for the single neuron. The coupling of the network can enhance CR in two different ways. In particular, when the coupling is strong enough, the synchronization of the system is induced and optimized by the noise. This synchronization leads to a high and wide plateau in the local measure of coherence curve. The local-noise-induced limit cycle can evolve to a refined spatiotemporal order through the dynamical optimization among the autonomous oscillation of an individual neuron, the coupling of the network, and the local noise.Comment: five pages, five figure