Compresión del nervio supraescapular por un ganglión en un deportista: a propósito de un caso

Se describe el caso de un joven jugador de balonmano con un síndrome de compresión del nervio supraescapular de su hombro derecho por un ganglión, haciendo una revisión de la etiología, clínica, diagnóstico y tratamiento de este raro síndrome.Supraescapular nerve entrapment caused by a ganglion in a young handball player is reported. Ethiology, clinical, diagnosis and treatment of this rare syndrome is revised

Post-eruption morphological evolution and vegetation dynamics of the Blanco River, southern Chile

In this study, we analysed the morphological evolution of a channel segment in the Blanco River in southern Chile that was affected by the Chaitén Volcano eruption occurred in 2008–2009. Through a series of high-resolution satellite images from 2005 to 2019 that represents the entire pre- and post-eruptive dynamics and land covers, we tracked the geomorphological evolution of a 5.65-km-long river segment using channel form indices and also monitored the vegetation dynamics using object-based image analysis (OBIA). Discharge record for the Blanco River was also reconstructed to support the analysis of channel morphologic process. The study aims at examining whether a) the river channel is still adjusting 10 years after the eruption and if so, at what magnitude and, b) the recovered riparian vegetation plays a significant role in stabilising the river streambanks and terraces. We found that even 10 years after the eruption, the Blanco River channel planform is still adjusting, showing a simpler and stable channel configuration in the upstream reaches of the valley, where a certain degree of equilibrium appears to have been attained. More dynamic morphologies were observed in the reaches downstream that have to accommodate the arrival of large amounts of freshly eroded sediments. Our analysis showed that the occurrence of competent floods capable of reworking the river channel matches with the geomorphic indices and mark the post-eruption adjustments of the channel. Finally, the in-channel and riparian vegetation does not play a significant role in stabilising the active channel, streambanks, and terraces, reinforcing the recolonization of sedimentary active areas occurring elsewhere in the valley.This research was developed within the frame of the project FONDECYT 1170413 funded by the Chilean Government. Authors acknowledge the support of the Economy and Knowledge Department of the Catalan Government through the Fluvial Dynamics Research Group (RIUS) SGR017-459

Luxación anterior de codo en la infancia : a propósito de 1 caso

La luxación anterior de codo es una lesión excepcional que suele ocurrir cuando existen factores facilitadores como una hiperlaxitud articular, una hipoplasia de olécranon o deformidades adquiridas por traumatismo previo. El propósito de este artículo es presentar un nuevo caso con esta lesión en un niño de 8 años de edad sin factores facilitadores aparentes, así como analizar la fisiopatología de la lesión, las opciones terapéuticas y el pronóstico futuroAnterior dislocation of the elbow is a rare lesion. Hipermobility of joint, olecranon hipoplasy or elbow postraumatic deformities predisposed to the anterior dislocation of the elbow. The purpose of this paper is to point out a new case with this rare lesion in a child of 8 years old, without predisponent factors. We analized the injury phisiopathology, therapeutic options and future pronostic

Análisis funcional y cinemático de la marcha en un paciente con lesión medular lumbar incompleta

Este estudio de investigación pretende analizar la evolución de la marcha en un paciente con lesión medular incompleta, tras ser sometido a un programa de entrenamiento de la marcha de forma asistida con soporte parcial del peso corporal con el sistema Lokomat®. Para ello se ha realizado una exploración física y funcional con las escalas de evaluación más utilizadas a éste nivel, conjuntamente con el análisis videográfico, permitiéndonos observar correlaciones entre los datos obtenidos en los apartados de pasos por minuto, velocidad y longitud de paso. Para poder corroborar estos datos, se ha realizado un estudio cinemático utilizando dos cámaras de alta definición, con una velocidad de filmación fijada en 100 imágenes por segundo, procesadas directamente a un ordenador, y realizando la Transformación de 2D a 3D, con el método Direct Linear Transformation (DLT) dado por el Performance Analysis System (APAS).The aim of this research study is to analyze the evolution of gait in a patient with incomplete lumbar spine injury, who was placed on an assisted gait training program with partial body-weight support using the Lokomat® system. A physical and functional assessment was carried out taking into account standard evaluation scales together with video analysis, which allowed us to observe correlations between the data collected for steps per minute, step speed and step length. To corroborate these data, a kinematic study was carried out using two high-resolution cameras with a shooting speed fixed at 100 images per second. Images were transferred directly to a computer and converted from 2D to 3D using the Direct Linear Transformation (DLT) method in the Ariel Performance Analysis System (APAS).Peer Reviewe

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

Tratamiento quirúrgico de la fractura de acetábulo con luxación posterior de cadera: análisis retrospectivo de 20 casos

Entre 1985 y 1990 fueron intervenidos en nuestro servicio 20 pacientes con fractura acetabular y luxación posterior de cadera, con edades desde 22 a 53 años, 18 (90%) eran varones. Los accidentes de tráfico fueron la causa de 18 (90%) de las lesiones. Diez (50%) presentaron lesiones asociadas de importancia. Se estudió su evolución con un seguimiento medio de 5 años (rango de 3.5 a 8.1). La fractura de pared posterior ha sido la que con mayor frecuencia se ha asociado a la luxación (50%), seguida de la transversa y de pared posterior (30%). Hemos obtenido 14 (70%) resultados satisfactorios; 2 pacientes precisaron artroplastia total a los 3 años. No se observó peor evolución en los casos de mayor edad, pero sí en aquéllos que fueron intervenidos pasadas las 3 semanas del accidente. Se comentan aspectos de la evaluación preoperatoria.Between 1985 and 1990, 20 patients aged from 22 to 53 years with fracture of the acetabulum and posterior dislocation of the femoral head were treated surgically. Eighteen (90%) were male. Eighteen (90%) of the fractures were sustained in a motor-vehicle accident. Ten (50%) patients had multiple associated injuries. The average duration of the follow-up period was 5 years (range from 3.5 to 8.1). Ten (50%) of the dislocations were associated with posterior wall fracture. We observed 14 (70%) satisfactory results; 2 patients needed a THA 3 years later. Best results were achieved with early treatment. Aspects of the preoperative evaluation are commented

EP-1502: High resolution portal image prediction for radiotherapy treatment verification & in vivo dosimetry

International audiencePurpose/Objective: Historically designed as a control system for patient positioning for radiotherapy treatment, Electronic Portal Imaging Devices (EPIDs) are nowadays widely used for quality assurance and dosimetric verifications in new irradiation techniques. One of the main advantages of the EPID is its high resolution which can detect small details. The objective of this study is to compare the EPID image acquired during the treatment with a predicted high resolution portal image computed by Monte Carlo (MC) simulation. A new method for prediction of high resolution EPID images is tested for in vivo treatment verification. Materials and Methods: Experiments were carried out on a Siemens ARTISTETM, equipped with a 160-MLCTM, and its Siemens OptivueTM 1000 EPID. This EPID has an active detection area of 41 x 41 cm2 and a matrix of 1024 x 1024 pixels. A model of this linac and the EPID was developed with the MC code Penelope, and commissioned. We focus on a breast treatment conformational beam (6 MV) on the CIRS adult female phantom. The CT-scan of the phantom was used as input, and Hounsfield numbers were converted in density and atomic composition, so as to obtain a voxelized geometry used in the Penelope code. Particles exiting the phantom and impinging on the EPID are simulated up to the EPID in order to compute the predicted portal image by scoring the energy deposited in the phosphor layer on a 1024 x 1024 virtual grid. The simulated image was then smoothed using a denoising algorithm in order to keep the high resolution advantage. Several denoising algorithms were tested, among them IRON, LASG and a recently developed one called DPGLM. For now, we use the gamma-index technique to evaluate the accuracy of the simulated image against the experimental one. Results: Figure 1 shows the acquired image and the simulated one. The gamma-index is satisfied for 94.4 % of the pixels for 3.5 % and 3.5 mm criterion. The DPGLM gives the best result toward accuracy and computed time. Indeed, the denoising of 1024 x 1024 images takes about 1h30 mn, 2h and 5 mn using DPGLM, IRON, and LASG, respectively. The LASG algorithm is really fast but the result is too smoothed for the high resolution purpose. Conclusions: This work is the first step in the aim of in vivo dosimetry by comparing experimental portal images with high resolution predicted images obtained using MC simulations in a voxelized geometry. First results obtained on a breast treatment are encouraging, and we can expect to detect treatment errors