La coxartrosis en los pacientes con osteopetrosis: su tratamiento quirúrgico

Se presentan un caso de osteopetrosis en un paciente de 22 años de edad que consultó por dolor en la cadera izquierda, siendo diagnosticado de coxartrosis izquierda secundaria a la osteopetrosis. Fue tratado inicialmente de forma quirúrgica realizándosele una osteotomía de la cadera afectada. Varios años después, tras la reaparición del dolor se procedió a la implantación de una prótesis total de cadera que evolucionó satisfactoriamente.A case of osteopetrosis in a 22-year-old patient who consulted by pain in the left hip is presented. He was diagnosed of degenerative osteoarthritis of the left hip secondary to osteopetrosis. Initially, it was treated surgically by an osteotomy of the proximal femur. Several years later\ after the pain reappearance, the authors treated the patient by a total hip arthroplasty with satisfactory outcome

La braquimetatarsia: presentación de un caso

Se presenta el caso de una mujer de 24 años de edad que consultó por una metatarsalgia central y una alteración estética del antepié derecho. Se trató mediante un alargamiento progresivo del metatarsiano con un mini fijador externo, a lo que se asoció una osteotomía distal del primer metatarsiano. Se consiguió un correcto alineamiento del metatarsiano, la desaparición de la metatarsalgia y la corrección del valguismo del primer metatarsiano. La paciente quedó satisfecha aunque persistió una ligera limitación funcional pero sin dolor. Conclusiones: Se aconseja este tipo de intervención en los acortamientos de metatarsianos, utilizando para la misma un fijador externo que permite elongar el metatarsiano corto de forma progresiva, teniendo en cuenta las posibles complicaciones de la técnica y la larga duración que el tratamiento requiere.A case of a 24-year-old woman affected of symptomatic IV brachymetatarsia associated to a cosmetic trouble of the right foot is presented. She was treated by means of a progressive lengthening of the IV metatarsal bone with a mini external fixator and a distal osteotomy of the first metatarsal bone. It was obtained a correct alignment of the IV metatarsal, healing of metatarsalgia, and correction of the valgus deformity of the I metatarsal bone. The patient was very satisfied with the cosmetic result, although a slight functional limitation but without pain persisted. Conclusions: Metatarsal lengthening may be indicated in the management of symptommatic brachymetatarsia. We recommend the use of a mini external fixator that allows progressive lengthening of the short bone, considering the possible complications of the technique and the long duration that the treatment needs

Rotura no traumática de componente cerámica-cerámica en PTC: presentación de un caso y revisión de la literatura.

Las fracturas de los componentes cerámicos empleados en artroplastia total de cadera (ATC) son infrecuentes. El objetivo de nuestro trabajo es presentar un caso de rotura precoz no traumática de componente ce - rámica-cerámica en ATC y revisar la literatura en relación con esta complicación. Se trata de un paciente de 58 años diagnosticado de necrosis avascular de cabeza femoral, fue intervenido mediante ATC, implantándosele un par cerámica-cerámica. A los 4 meses de la intervención, sin antecedente traumático previo, se observó fractura de la cúpula de cerámica de la prótesis. El paciente precisó de recambio protésico, utilizándose el par cerámica-polietileno. La fractura de los componentes del par cerámica- cerámica es poco frecuente. El fallo puede ser debido a un defecto de fabricación o en la colocación del implante. Los pacientes deben ser informados sobre la posibilidad de sufrir esta complicación antes de la implantación de una PTC con par cerámica-cerámica.Fractures of ceramic components used in total hip replacement (THR) are uncommon. To report a case of early non-traumatic rupture ceramic-ceramic component in THR and review the literature regarding this complication. A 58 years diagnosed with avascular necrosis of the femoral head, was operated by THR, a ceramic-on -ceramic. At 4 months after surgery, without previous trauma, fracture was observed ceramic dome of the prosthesis. The patient required replacement, using the ceramic-on-polyethylene. The fracture of ceramic components is rare. The failure may be due to a manufacturing defect or implant placement. Patients should be informed about the possi - bility of having this complication before implantation of a THR ceramic-on-ceramic

Bremsstrahlung in Alpha-Decay

We present the first fully quantum mechanical calculation of photon radiation accompanying charged particle decay from a barrier resonance. The soft-photon limit agrees with the classical results, but differences appear at next-to-leading-order. Under the conditions of alpha-decay of heavy nuclei, the main contribution to the photon emission stems from Coulomb acceleration and may be computed analytically. We find only a small contribution from the tunneling wave function under the barrier.Comment: 12 pages, 2 Postscript figure

Complicaciones de la cirugía sustitutiva de la cadera en los pacientes con osteopetrosis

Se presenta un caso de osteopetrosis en un paciente de 45 años de edad que consultó por dolor en la cadera derecha, siendo diagnosticado de coxar-trosis derecha secundaria a la osteopetrosis. Fue tratado quirúrgicamente realizándosele una prótesis total de cadera no cementada. Dicha inter-vención presentó complicaciones tanto intraoperatorias como postoperato-rias que precisaron el recambio del componente femoral. Tras la reinter-vención, la evolución ha sido satisfactoria, siendo correcta la situación clíni-ca del paciente a los 5 años de evolución.A case of osteopetrosis in a 45-year-old patient that consulted by pain in the right hip is presented. He was diagnosed of degenerative osteoarthritis of the right hip secondary to osteopetrosis. He was managed surgically by a cementless total hip arthroplasty. This mentioned operation presented intra-operative and post-operative complications that were treated by means of a replacement of the femoral component of the arthroplasty. After the revision, the evolution has been satisfactory, with a correct clinical situation of the patient after 5 years of follow-up

Luxación traumática del tendón del tibial posterior asociada a rotura completa del ligamento deltoideo.

Objetivo: La luxación traumática del tendón del tibial posterior (TTP) en el tobillo es una pato - logía infrecuente. El diagnóstico en la fase aguda no es la norma, produciendo cuadros de dolor crónico en la zona media del tobillo que dan lugar a un diagnóstico en la fase crónica. El objetivo es presentar un caso clínico de luxación de TTP asociado a una rotura completa del ligamento deltoideo tratado en la fase aguda. Material y Método: Paciente de 48 años de edad, que tras accidente de motocicleta sufrió una luxación del TTP asociado con rotura completa del ligamento deltoideo. Se realizó sutura directa de las lesiones e inmovilización con yeso durante 6 semanas. Posteriormente estuvo en tratamiento rehabilitador. Resultados: El resultado funcional del paciente fue excelente para todas las actividades personales. Conclusiones: El diagnóstico temprano de esta pa - tología es fundamental para evitar retardos en el tratamiento y posibles repercusiones funcionales en el tobillo y arquitectura del pie.Purpose: Traumatic dislocation of the posterior tibial tendon (PTT) of the ankle is a very rare lesion. It is not common to make the diagnosis during the acute phase. The dalay in diagnosis generates chronic pain symptoms in the middle part of the ankle; it is in the chronic phase when diagnosis is usually made. The aim of the study is to present a case of PTT dislocation associated to a complete tear of the deltoid ligament, which was treated in the acute phase. Material and Method: A 48-year old patient had a PTT dislocation associated to a complete tear of the deltoid ligament, due to a motorcycle accident. Direct suture of the lesions and cast immobi - lization for six weeks was conducted. Afterwards, the patient completed treatment with rehabilitation techniques. Results: Definitive functional outcome was excellent for all normal life activities. Conclusions: T he diagnosis of the posterior tibial tendon dislocation during the acute phase is mandatory to minimize delay in treatment and functional sequels in the ankle and foot architecture

Coupled modes of North Atlantic Ocean-atmosphere variability and the onset of the Little Ice Age

This research was funded by grants from the US National Science Foundation P2C2 program (AGS-1501856, and AGS-1502224). BIC was supported by the NASA Modeling, Analysis, and Prediction program (NASA #80NSSC17K0265).Hydroclimate extremes in North America, Europe, and the Mediterranean are linked to ocean and atmospheric circulation anomalies in the Atlantic, but the limited length of the instrumental record prevents complete identification and characterization of these patterns of covariability especially at decadal to centennial timescales. Here we analyze the coupled patterns of drought variability on either side of the North Atlantic Ocean basin using independent climate field reconstructions spanning the last millennium in order to detect and attribute epochs of coherent basin-wide moisture anomalies to ocean and atmosphere processes. A leading mode of broad-scale moisture variability is characterized by distinct patterns of North Atlantic atmosphere circulation and sea surface temperatures. We infer a negative phase of the North Atlantic Oscillation and colder Atlantic sea surface temperatures in the middle of the 15th century, coincident with weaker solar irradiance and prior to strong volcanic forcing associated with the early Little Ice Age.Publisher PDFPeer reviewe

Two-qubit gate operations in superconducting circuits with strong coupling and weak anharmonicity

We investigate theoretically the implementation of two-qubit gates in a system of two coupled superconducting qubits. In particular, we analyze two-qubit gate operations under the condition that the coupling strength is comparable to or even larger than the anharmonicity of the qubits. By numerically solving the time-dependent Schr\"odinger equation, we obtain the dependence of the two-qubit gate fidelity on the system parameters in the case of direct and indirect qubit-qubit coupling. Our numerical results can be used to identify the "safe" parameter regime for experimentally implementing two-qubit gates with high fidelity in these systems

European and Mediterranean hydroclimate responses to tropical volcanic forcing over the last millennium

Volcanic eruptions have global climate impacts, but their effect on the hydrologic cycle is poorly understood. We use a modified version of superposed epoch analysis, an eruption year list collated from multiple data sets, and seasonal paleoclimate reconstructions (soil moisture, precipitation, geopotential heights, and temperature) to investigate volcanic forcing of spring and summer hydroclimate over Europe and the Mediterranean over the last millennium. In the western Mediterranean, wet conditions occur in the eruption year and the following 3 years. Conversely, northwestern Europe and the British Isles experience dry conditions in response to volcanic eruptions, with the largest moisture deficits in posteruption years 2 and 3. The precipitation response occurs primarily in late spring and early summer (April–July), a pattern that strongly resembles the negative phase of the East Atlantic Pattern. Modulated by this mode of climate variability, eruptions force significant, widespread, and heterogeneous hydroclimate responses across Europe and the Mediterranean

Six Centuries of Upper Indus Basin Streamflow Variability and Its Climatic Drivers

Our understanding of the full range of natural variability in streamflow, including how modern flow compares to the past, is poorly understood for the Upper Indus Basin because of short instrumental gauge records. To help address this challenge, we use Hierarchical Bayesian Regression with partial pooling to develop six centuries long (1394–2008 CE) streamflow reconstructions at three Upper Indus Basin gauges (Doyian, Gilgit, and Kachora), concurrently demonstrating that Hierarchical Bayesian Regression can be used to reconstruct short records with interspersed missing data. At one gauge (Partab Bridge), with a longer instrumental record (47 years), we develop reconstructions using both Bayesian regression and the more conventionally used principal components regression. The reconstructions produced by principal components regression and Bayesian regression at Partab Bridge are nearly identical and yield comparable reconstruction skill statistics, highlighting that the resulting tree ring reconstruction of streamflow is not dependent on the choice of statistical method. Reconstructions at all four reconstructions indicate that flow levels in the 1990s were higher than mean flow for the past six centuries. While streamflow appears most sensitive to accumulated winter (January–March) precipitation and summer (May–September) temperature, with warm summers contributing to high flow through increased melt of snow and glaciers, shifts in winter precipitation and summer temperatures cannot explain the anomalously high flow during the 1990s. Regardless, the sensitivity of streamflow to summer temperatures suggests that projected warming may increase streamflow in coming decades, though long-term water risk will additionally depend on changes in snowfall and glacial mass balance