Spondylodiscitis in the elderly patient: clinical mid-term results and quality of life

Focusing on spondylodiscitis in elderly patients current literature does not contain much information.

Procedural and mid-term results in patients with aortic stenosis treated with implantation of 2 (in-series) CoreValve prostheses in 1 procedure

This study sought to assess post-procedural and mid-term outcome of patients, in which a second "in-series" CoreValve prosthesis (Medtronic, Minneapolis, Minnesota) was implanted during the same procedure.

Impact of suborbital climate changes in the North Atlantic on ice sheet dynamics at the Mid-Pleistocene Transition

[1] Early and Mid-Pleistocene climate, ocean hydrography and ice sheet dynamics have been reconstructed using a high-resolution data set (planktonic and benthicδ18O time series, faunal-based sea surface temperature (SST) reconstructions and ice-rafted debris (IRD)) record from a high-deposition-rate sedimentary succession recovered at the Gardar Drift formation in the subpolar North Atlantic (Integrated Ocean Drilling Program Leg 306, Site U1314). Our sedimentary record spans from late in Marine Isotope Stage (MIS) 31 to MIS 19 (1069–779 ka). Different trends of the benthic and planktonic oxygen isotopes, SST and IRD records before and after MIS 25 (∼940 ka) evidence the large increase in Northern Hemisphere ice-volume, linked to the cyclicity change from the 41-kyr to the 100-kyr that occurred during the Mid-Pleistocene Transition (MPT). Beside longer glacial-interglacial (G-IG) variability, millennial-scale fluctuations were a pervasive feature across our study. Negative excursions in the benthicδ18O time series observed at the times of IRD events may be related to glacio-eustatic changes due to ice sheets retreats and/or to changes in deep hydrography. Time series analysis on surface water proxies (IRD, SST and planktonicδ18O) of the interval between MIS 31 to MIS 26 shows that the timing of these millennial-scale climate changes are related to half-precessional (10 kyr) components of the insolation forcing, which are interpreted as cross-equatorial heat transport toward high latitudes during both equinox insolation maxima at the equator.

Climate variability of the mid- and high-latitudes of the Southern Hemisphere in ensemble simulations from 1500 to 2000 AD

To increase the sparse knowledge of long-term Southern Hemisphere (SH) climate variability, we assess an ensemble of 4 transient simulations over the last 500 yr performed with a state-of-the-art atmosphere ocean general circulation model. The model is forced with reconstructions of solar irradiance, greenhouse gas (GHG) and volcanic aerosol concentrations. A 1990 control simulation shows that the model is able to represent the Southern Annular Mode (SAM), and to some extent the South Pacific Dipole (SPD) and the Zonal Wave 3 (ZW3). During the past 500 yr we find that SPD and ZW3 variability remain stable, whereas SAM shows a significant shift towards its positive state during the 20th century. Regional temperatures over South America are strongly influenced by changing both GHG concentrations and volcanic eruptions, whereas precipitation shows no significant response to the varying external forcing. For temperature this stands in contrast to proxy records, suggesting that SH climate is dominated by internal variability rather than external forcing. The underlying dynamics of the temperature changes generally point to a combination of several modes, thus, hampering the possibilities of regional reconstructing the modes from proxy records. The linear imprint of the external forcing is as expected, i.e. a warming for increase in the combined solar and GHG forcing and a cooling after volcanic eruptions. Dynamically, only the increase in SAM with increased combined forcing is simulated.

Automatic extraction of the mid-facial plane for cranio-maxillofacial surgery planning

Recently developed computer applications provide tools for planning cranio-maxillofacial interventions based on 3-dimensional (3D) virtual models of the patient's skull obtained from computed-tomography (CT) scans. Precise knowledge of the location of the mid-facial plane is important for the assessment of deformities and for planning reconstructive procedures. In this work, a new method is presented to automatically compute the mid-facial plane on the basis of a surface model of the facial skeleton obtained from CT. The method matches homologous surface areas selected by the user on the left and right facial side using an iterative closest point optimization. The symmetry plane which best approximates this matching transformation is then computed. This new automatic method was evaluated in an experimental study. The study included experienced and inexperienced clinicians defining the symmetry plane by a selection of landmarks. This manual definition was systematically compared with the definition resulting from the new automatic method: Quality of the symmetry planes was evaluated by their ability to match homologous areas of the face. Results show that the new automatic method is reliable and leads to significantly higher accuracy than the manual method when performed by inexperienced clinicians. In addition, the method performs equally well in difficult trauma situations, where key landmarks are unreliable or absent.