Basilar invagination: surgical results

Basilar invagination (BI) is a congenital craniocervical junction (CCJ) anomaly represented by a prolapsed spine into the skull-base that can result in severe neurological impairment. In this paper, we retrospective evaluate the surgical treatment of 26 patients surgically treated for symptomatic BI. BI was classified according to instability and neural abnormalities findings. Clinical outcome was evaluated using the Nürick grade system. A total of 26 patients were included in this paper. Their age ranged from 15 to 67 years old (mean 38). Of which, 10 patients were male (38%) and 16 (62%) were female. All patients had some degree of tonsillar herniation, with 25 patients treated with foramen magnum decompression. Nine patients required a craniocervical fixation. Six patients had undergone prior surgery and required a new surgical procedure for progression of neurological symptoms associated with new compression or instability. Most of patients with neurological symptoms secondary to brainstem compression had some improvement during the follow-up. There was mortality in this series, 1 month after surgery, associated with a late removal of the tracheal cannula. Management of BI requires can provide improvements in neurological outcomes, but requires analysis of the neural and bony anatomy of the CCJ, as well as occult instability. The complexity and heterogeneous presentation requires attention to occult instability on examination and attention to airway problems secondary to concomitant facial malformations.Basilar invagination (BI) is a congenital craniocervical junction (CCJ) anomaly represented by a prolapsed spine into the skull-base that can result in severe neurological impairment. Materials and Methods: In this paper, we retrospective evaluate the sur527884sem informaçãosem informaçã

A Unique 16U CubeSat Architecture for 1.5m GSD Commercial Earth Observation

Satellite operators frequently use 3U and 6U CubeSats for Earth Observation (EO) applications. These nanosatellites do have a few challenges when addressing the needs of the commercial EO sector: ✔the demand for more spatial, spectral and radiometric detail ✔the long term reliability of the satellite bus, and ✔accuracy of the satellite imagery. This poster introduces a 16U CubeSat architecture to address these challenges by optimizing the imaging payload to fit in a 12U volume and the satellite bus within a 4U volume

Radiocirurgia estereotáxica para metástases de coluna vertebral: revisão de literatura

OBJECTIVE: The spine is the most common location for bone metastases. Since cure is not possible, local control and relief of symptoms is the basis for treatment, which is grounded on the use of conventional radiotherapy. Recently, spinal radiosurgery has been proposed for the local control of spinal metastases, whether as primary or salvage treatment. Consequently, we carried out a literature review in order to analyze the indications, efficacy, and safety of radiosurgery in the treatment of spinal metastases. METHODS: We havereviewed the literature using the PubMed gateway with data from the MEDLINE library on studies related to the use of radiosurgery in treatment of bone metastases in spine. The studies were reviewed by all the authors and classified as to level of evidence, using the criterion defined by Wright. RESULTS: The indications found for radiosurgery were primary control of epidural metastases (evidence level II), myeloma (level III), and metastases known to be poor responders to conventional radiotherapy - melanoma and renal cell carcinoma (level III). Spinal radiosurgery was also proposed for salvage treatment after conventional radiotherapy (level II). There is also some evidence as to the safety and efficacy of radiosurgery in cases of extramedullar and intramedullar intradural metastatic tumors (level III) and after spinal decompression and stabilization surgery. CONCLUSION: Radiosurgery can be used in primary or salvage treatment of spinal metastases, improving local disease control and patient symptoms. It should also be considered as initial treatment for radioresistant tumors, such as melanoma and renal cell carcinoma.OBJETIVO: A coluna vertebral é o local mais comum de metástases ósseas. Uma vez que a cura não pode ser obtida, o controle local e o alívio dos sintomas é a base do tratamento, sendo este fundamentado no uso de radioterapia convencional. Recentemente, a radiocirurgia espinhal foi proposta para o controle local das metástases na coluna, seja como tratamento primário ou de resgate. Dessa forma, realizamos uma revisão da literatura para analisar as indicações, a eficácia e a segurança da radiocirurgia no tratamento das metástases da coluna. MÉTODOS: A revisão de literatura foi realizada no portal PubMed - dados da biblioteca MEDLINE, sobre os estudos relacionados ao uso da radiocirurgia no tratamento para metástases ósseas na coluna vertebral. Os estudos foram revisados por todos os autores e classificados quanto ao nível de evidência, utilizando critério definido por Wright. RESULTADOS: As indicações encontradas para radiocirurgia foram: controle primário de metástases epidurais (nível II de evidência), mieloma (nível III) e metástases sabidamente pouco responsivas à radioterapia convencional - melanoma e carcinoma de células renais - (nível III). A radiocirurgia espinhal também foi proposta para o tratamento de resgate após falha da radioterapia convencional (nível II). Existe ainda alguma evidência quanto à segurança e a eficácia da radiocirurgia em casos de tumores metastáticos intradurais extramedulares e intramedulares (nível III), e após cirurgias de descompressão e estabilização da coluna. CONCLUSÃO: A radiocirurgia, portanto, pode ser usada no tratamento primário ou de resgate de metástases espinhais, melhorando o controle local da doença e dos sintomas dos pacientes. Deve ainda ser considerada como tratamento inicial para tumores radiorresistentes, como melanoma e carcinoma de células renais.24725

Há um período exato para cirurgia em pacientes com paraplegia secundária à compressão medular não traumática?

Paraplegia is a well-defined state of complete motor deficit in lower limbs, regardless of sensory involvement. The cause of paraplegia usually guides treatment, however, some controversies remain about the time and benefits for spinal cord decompression in nontraumatic paraplegic patients, especially after 48 hours of the onset of paraplegia. The objective of this study was to evaluate the benefits of spinal cord decompression in such patients. We describe three patients with paraplegia secondary to non-traumatic spinal cord compression without sensory deficits, and who were surgically treated after more than 48 hours of the onset of symptoms. All patients, even those with paraplegia during more than 48 hours, had benefits from spinal cord decompression like recovery of gait ability. The duration of paraplegia, which influences prognosis, is not a contra-indication for surgery. The preservation of sensitivity in this group of patients should be considered as a positive prognostic factor when surgery is taken into account.A paraplegia é uma condição de déficit motor completo dos membros inferiores, independente do envolvimento de sensibilidade. A causa da paraplegia normalmente guia o tratamento, porém existem controversas sobre o momento e o benefício da descompressão medular em pacientes paraplégicos, principalmente após 48 horas do início dessa condição. O objetivo deste trabalho foi avaliar o beneficio da descompressão medular nesses pacientes. Foram descritos três pacientes com paraplegia secundária à compressão medular não traumática, sem déficits sensoriais e que foram submetidos à cirurgia após 48 horas do início dessa condição. Todos os pacientes, inclusive aqueles com mais de 48 horas do início dos sintomas, apresentaram melhora neurológica com a descompressão medular, como a recuperação da habilidade de marcha. A duração da paraplegia, que influencia no prognóstico, não é uma contraindicação absoluta para o procedimento cirúrgico. A preservação de sensibilidade desse grupo de pacientes deve ser considerada como fator prognóstico positivo quando a cirurgia for levada em conta.50851

Histometric analysis of alveolar bone regeneration with expanded polytetrafluoroethylene (e-PTFE) and latex membranes

AIM: To investigate the amount of connective tissue migrated into the extraction socket using EPTFE and latex membranes. METHODS: Seventeen rats were selected and randomly divided into 3 groups: e-PTFE membrane (n = 6), Latex membrane (n = 6) and Control (no membrane, n=5). After extraction of the maxillary right incisor, the animals of the test groups were subjected to alveolar guided bone regeneration (GBR) surgery and received an expanded polytetrafluoroethylene (e-PTFE) and a latex membrane, respectively. Thirty days after surgery, the animals were killed and histometric analysis was done to evaluate the migration of connective tissue. Data were analyzed statistically by one-way ANOVA and multiple-comparison Tukey's test at 5% significance level. RESULTS: There was statistically significant difference between groups e-PTFE and Latex (p=0.001), and between groups e-PTFE and Control (p=0.012), but no significant difference was found between groups Latex and Control (p=0.416). CONCLUSIONS: The e-PTFE membrane showed better results and appeared more adequate for GBR therapy, forming a barrier to prevent the migration of connective tissue into the extraction socket. The latex membrane, on the other hand, did not show benefits over the control group

TeSeR – Technology for Self-Removal – Status of a Horizon 2020 project to ensure the Post-Mission-Disposal of any future spacecraft

No abstract available

Earth Observation Technologies: Low-End-Market Disruptive Innovation

After decades of traditional space businesses, the space paradigm is changing. New approaches to more efficient missions in terms of costs, design, and manufacturing processes are fostered. For instance, placing big constellations of micro- and nano-satellites in Low Earth Orbit and Very Low Earth Orbit (LEO and VLEO) enables the space community to obtain a huge amount of data in near real-time with an unprecedented temporal resolution. Beyond technology innovations, other drivers promote innovation in the space sector like the increasing demand for Earth Observation (EO) data by the commercial sector. Perez et al. stated that the EO industry is the second market in terms of operative satellites (661 units), micro- and nano-satellites being the higher share of them (61%). Technological and market drivers encourage the emergence of new start-ups in the space environment like Skybox, OneWeb, Telesat, Planet, and OpenCosmos, among others, with novel business models that change the accessibility, affordability, ownership, and commercialization of space products and services. This chapter shows some results of the H2020 DISCOVERER (DISruptive teChnOlogies for VERy low Earth oRbit platforms) Project and focuses on understanding how micro- and nano-satellites have been disrupting the EO market in front of traditional platforms

Midterm results of endovascular treatment of iliac artery lesions: analysis of 59 cases

BACKGROUND: Endovascular treatment of peripheral arterial occlusive disease has become increasingly frequent in the past few years. Because it is a less invasive procedure, lower morbidity and mortality rates are associated with this form of treatment. OBJECTIVES: To describe the endovascular procedures performed in iliac arteries for the treatment of peripheral arterial occlusive disease. METHODS: This retrospective study assesses 59 cases of iliac artery angioplasty performed according to a specific protocol from January 2004 to February 2010. RESULTS: Mean age of patients was 62 years (minimum: 42, maximum: 89). Thirty seven were male (62.72%) and 22 female (37.28%). The main indications for treatment were moderate to severe intermittent claudication in 30 cases (50.84%) and rest pain or trophic lesions (critical ischemia) in 29 cases (49.15%). Postoperative follow-up included ankle-brachial index measurements and a duplex ultrasound at 30 days, 3 months, 6 months, 12 months, and every 6 months thereafter. Minimum follow-up time was 3 months, and maximum, 72 months (6 years), with primary and secondary patency rates of 91.37 and 94.82%, respectively. CONCLUSIONS: The results of this case series, combined with literature review results, allow to conclude that the endovascular approach is an effective and safe option to treat peripheral arterial occlusive disease in iliac arteries