Valoración quirúrgica del 5º radio

Este trabajo hace un repaso de la biomecánica y patomecánica del pie, además de describir la etiologíay la clínica del quintus varus y del 5º dedo en martillo. El autor describe un test valorativo pre- y post-quirúrgico para el 5º radio, así como las técnicasquirúrgicas de 5º radio habituales.

Soporte funcional del primer radio: revisión de varios casos clínicos

Los autores presentan una clasificación más actual de las patologías del pie, basándose en tres aspectos: morfológico, funcional y degenerativo. Esta nueva clasificación entendemos que reemplazaría a las que se han venido utilizando hasta el momento las cuales a menudo no son útiles para los podólogos. Asimismo en este artículo se describe el proceso de aplicación del soporte funcional del primer radio, las características de los materiales utilizados en su confección y varios casos clínicos, de diferente etiología a los cuales se le ha aplicado este tipo de soporte.

Deformación en flexión plantar del primer radio

La posición del primer radio tanto desde el plano frontal como desde el plano sagital, es de vital importancia para la consecución de una correcta y adecuada marcha, así como para mantener la estructura anatómica del pie durante la bipedestación estática. La deformidad en flexión plantar del primer radio modifica estos parámetros creando mecanismos compensatorios que pueden afectar a otras unidades funcionales articulares, tanto del mediopié como del retropié, lo que puede dar lugar a un patrón de metatarsalgia de difícil valoración al tener que contemplar y analizar varios diagnósticos y sus respectivos patrones mecánicos: el equino de columna lateral, el retropié varo compensado y el primer radio plantarflexionado flexible. Se presenta un caso clínico para su análisis conjunto.

Comparison of the power spectral changes of the voluntary surface electromyogram and M wave during intermittent maximal voluntary contractions.

INTRODUCTION: To compare the power spectral changes of the voluntary surface electromyogram (sEMG) and of the compound action potential (M wave) in the vastus medialis and vastus lateralis muscles during fatiguing contractions. METHODS: Interference sEMG and force were recorded during 48 intermittent 3-s isometric maximal voluntary contractions (MVC) from 13 young, healthy subjects. M waves and twitches were evoked using supramaximal femoral nerve stimulation between the successive MVCs. Mean frequency (F mean), and median frequency were calculated from the sEMG and M waves. Muscle fiber conduction velocity (MFCV) was computed by cross-correlation. RESULTS: The power spectral shift to lower frequencies was significantly greater for the voluntary sEMG than for the M waves (P < 0.05). Over the fatiguing protocol, the overall average decrease in MFCV (~25 %) was comparable to that of sEMG F mean (~22 %), but significantly greater than that of M-wave F mean (~9 %) (P < 0.001). The mean decline in MFCV was highly correlated with the mean decreases in both sEMG and M-wave F mean. CONCLUSIONS: The present findings indicated that, as fatigue progressed, central mechanisms could enhance the relative weight of the low-frequency components of the voluntary sEMG power spectrum, and/or the end-of-fiber (non-propagating) components could reduce the sensitivity of the M-wave spectrum to changes in conduction velocity.

Effects of anomalous propagation conditions on weather radar observations

In this chapter our objective is to provide an overview of the effects of anomalous propagation conditions on weather radar observations, based mostly on studies performed by the authors during the last decade, summarizing results from recent publications, presentations, or unpublished material. We believe this chapter may be useful as an introductory text for graduate students, or researchers and practitioners dealing with this topic. Throughout the text a spherical symmetric atmosphere is assumed and the focus is on the occurrence of ground and sea clutter and subsequent problems for weather radar applications. Other related topics such as long-path, over-the-horizon propagation and detection of radar targets (either clutter or weather systems) at long ranges is not considered here; however readers should be aware of the potential problems these phenomena may have as range aliasing may cause these echoes appear nearer than they are ¿ for more details see the discussion about second trip echoes by Zrnic, this volume.

Síndrome del dolor regional complejo tipo I en las fracturas del extremo distal del radio

Introducción: Las fracturas distales de radio (FDR) presentan diferentes resultadosfuncionales siendo desfavorables entre el 24% y el 31% de los casos. Una de lascomplicaciones más frecuentes es el síndrome del dolor regional complejo tipo I(SDRC-I), cuyo origen es desconocido. Sólo el 20-30% de los pacientes recuperarán sugrado de funcionalidad anterior.Objetivos: Estimar la prevalencia de SDRC-I tras una FDR de acuerdo a cuatro tipos detratamiento.Métodos: estudio de una serie de casos retrospectivos. La población de referencia hansido los 391 trabajadores afiliados a una Mutua en Cataluña y diagnosticados deFDR tras una lesión por accidente laboral durante lo años 2008-2010.Los casos han sido trabajadores accidentados que tras una FDR desarrollaron el SDRCI.Como variable dependiente se ha utilizado el diagnóstico de SDRC-I; como variablesindependientes el tipo de tratamiento, la edad, el sexo, la ocupación y el mecanismo dela lesión.Resultados: el 19,7% de la muestra ha desarrollado SDRC-I, siendo esta prevalenciasuperior en los pacientes intervenidos mediante la técnica de tracción bipolar o conagujas de Kirschner; 29,17% y 30,56% respectivamente, que para aquellos en los quese ha realizado un tratamiento conservador o una intervención quirúrgica con placa en Ty tornillos; 15,92% y 15,79%.Conclusiones El tratamiento conservador y la técnica quirúrgica de fijación con placaen T y tornillos han dado una menor prevalencia de SDRC-I.Los mecanismos de lesión asociados a una mayor fuerza presentan fracturas másinestables y requieren un tratamiento quirúrgico. Los tratamientos conservadores sonlos más usados en edades mayores relacionados con fracturas estables.A nivel clínico se extrae una recomendación profiláctica con Vitamina C para evitar laaparición de SDRC-I sobre los pacientes de edad comprendida entre los 36 y los 55años, con mecanismo lesional de caída o caída desde altura, intervenidos con agujas de Kirschner o tracción bipolar.

Production of nanometric particles in radio frequency glow discharges in mixtures of silane and methane

The formation of silicon particles in rf glow discharges has attracted attention due to their effect as a contaminant during film deposition or etching. However, silicon and silicon alloy powders produced by plasma¿enhanced chemical vapor deposition (PECVD) are promising new materials for sintering ceramics, for making nanoscale filters, or for supporting catalytic surfaces. Common characteristics of these powders are their high purity and the easy control of their stoichiometry through the composition of the precursor gas mixture. Plasma parameters also influence their structure. Nanometric powders of silicon¿carbon alloys exhibiting microstructural properties such as large hydrogen content and high surface/volume ratio have been produced in a PECVD reactor using mixtures of silane and methane at low pressure (-1 Torr) and low frequency square¿wave modulated rf power (13.56 MHz). The a¿Si1¿xCx:H powders were obtained from different precursor gas mixtures, from R=0.05 to R=9, where R=[SiH4]/([SiH4]+[CH4]). The structure of the a¿Si1¿xCx:H powder was analyzed by several techniques. The particles appeared agglomerated, with a wide size distribution between 5 and 100 nm. The silane/methane gas mixture determined the vibrational features of these powders in the infrared. Silicon-hydrogen groups were present for every gas composition, whereas carbon¿hydrogen and silicon¿carbon bonds appeared in methane¿rich mixtures (R-0.6). The thermal desorption of hydrogen revealed two main evolutions at about 375 and 660¿°C that were ascribed to hydrogen bonded to silicon and carbon, respectively. The estimated hydrogen atom concentration in the sample was about 50%.

An Adaptive Field Detection Method For Bridge Scour Monitoring Using Motion-Sensing Radio Transponders (RFIDs), TR-617, 2014

A comprehensive field detection method is proposed that is aimed at developing advanced capability for reliable monitoring, inspection and life estimation of bridge infrastructure. The goal is to utilize Motion-Sensing Radio Transponders (RFIDS) on fully adaptive bridge monitoring to minimize the problems inherent in human inspections of bridges. We developed a novel integrated condition-based maintenance (CBM) framework integrating transformative research in RFID sensors and sensing architecture, for in-situ scour monitoring, state-of-the-art computationally efficient multiscale modeling for scour assessment.

Changes in Aortic Pulse Wave Velocity in Hypertension Post-Menopausal Women: Comparison Between Calcium Channel Blocker (CCB) Vs Angiotensin Receptor Blocker (ARB) Regimen

Objective: To compare effects of a non-renin-angiotensin system (RAS) blocker, using a CCB, or a RAS blocker, using an ARB regimen on the arterial stiffness reduction in postmenopausal hypertensive women. Methods: In this prospective study, a total of 125 hypertensive women (age: 61.4_6 yrs; 98% Caucasian; BW: 71.9_14 kg; BMI: 27.3_5 kg/m2; SBP/ DBP: 158_11/92_9 mmHg) were randomized between ARB (valsartan 320mg_HCTZ) and CCB (amlodipine 10mg _ HCTZ). The primary outcome was carotid-femoral pulse wave velocity (PWV) changes after 38 weeks of treatment. Results: There were no significant differences in baseline demographic data between the two groups. Both treatments effectively lowered BP at the end of the study with similar (p>0.05) reductions in the valsartan (_22.9/_10.9 mmHg) and amlodipine based (_25.2/_11.7 mmHg) treatment groups. Despite a lower (p<0.05 for DBP) central SBP/DBP in the CCB group (_19.2/_10.3 mmHg) compared to the valsartan group (_15.7/_7.6 mmHg) at week 38, a similar reduction in carotid-femoral PWV (_1.7 vs _1.9 m/sec; p>0.05) was observed between both groups. The numerically larger BP reduction observed in the CCB group was associated with a much higher incidence of peripheral edema (77% vs 14%) than the valsartan group. Conclusion: In summary, BP lowering in postmenopausal women led to a reduction in arterial stiffness assessed by PWV measurement. Both regimens reduced PWV at 38 weeks of treatment to a similar degree, despite differences in BP lowering suggesting that the effect of RAS blockade to influence PWV may partly be independent of BP.

Roles of astrocytic sodium dynamics in the neurometabolic coupling : a study by cellular imaging

RESUME LARGE PUBLIC Le système nerveux central est principalement composé de deux types de cellules :les neurones et les cellules gliales. Ces dernières, bien que l'emportant en nombre sur les neurones, ont longtemps été considérées comme des cellules sans intérêts par les neuroscientifiques. Hors, les connaissances modernes à leurs sujets indiquent qu'elles participent à la plupart des tâches physiologiques du cerveau. Plus particulièrement, elles prennent part aux processus énergétiques cérébraux. Ceux-ci, en plus d'être vitaux, sont particulièrement intrigants puisque le cerveau représente seulement 2 % de la masse corporelle mais consomme environ 25 % du glucose (substrat énergétique) corporel. Les astrocytes, un type de cellules gliales, jouent un rôle primordial dans cette formidable utilisation de glucose par le cerveau. En effet, l'activité neuronale (transmission de l'influx nerveux) est accompagnée d'une augmentation de la capture de glucose, issu de la circulation sanguine, par les astrocytes. Ce phénomène est appelé le «couplage neurométabolique » entre neurones et astrocytes. L'ion sodium fait partie des mécanismes cellulaires entrant en fonction lors de ces processus. Ainsi, dans le cadre de cette thèse, les aspects dynamiques de la régulation du sodium astrocytaire et leurs implications dans le couplage neurométabolique ont été étudiés par des techniques d'imagerie cellulaires. Ces études ont démontré que les mitochondries, machineries cellulaires convertissant l'énergie contenue dans le glucose, participent à la régulation du sodium astrocytaire. De plus, ce travail de thèse a permis de découvrir que les astrocytes sont capables de se transmettre, sous forme de vagues de sodium se propageant de cellules en cellules, un message donnant l'ordre d'accroître leur consommation d'énergie. Cette voie de signalisation leur permettrait de fournir de l'énergie aux neurones suite à leur activation. RESUME Le glutamate libéré dans la fente synaptique pendant l'activité neuronale, est éliminé par les astrocytes environnants. Le glutamate est co-transporté avec des ions sodiques, induisant une augmentation intracellulaire de sodium (Na+i) dans les astrocytes. Cette élévation de Na+i déclenche une cascade de mécanismes moléculaires qui aboutissent à la production de substrats énergétiques pouvant être utilisés par les neurones. Durant cette thèse, la mesure simultanée du sodium mitochondrial (Na+mit) et cytosolique par des techniques d'imagerie utilisant des sondes fluorescentes spécifiques, a indiqué que les variations de Na+i induites par le transport du glutamate sont transmises aux mitochondries. De plus, les voies d'entrée et de sortie du sodium mitochondrial ont été identifiées. L'échangeur de Na+ et de Ca2+ mitochondrial semble jouer un rôle primordial dans l'influx de Na+mit, alors que l'efflux de Na+mit est pris en charge par l'échangeur de Na+ et de H+ mitochondrial. L'étude du Na+mit a nécessité l'utilisation d'un système de photoactivation. Les sources de lumière ultraviolette (UV) classiques utilisées à cet effet (lasers, lampes à flash) ayant plusieurs désavantages, une alternative efficace et peu coûteuse a été développée. Il s'agit d'un système compact utilisant une diode électroluminescente (LED) à haute puissance et de longueur d'onde de 365nm. En plus de leurs rôles dans le couplage neurométabolique, les astrocytes participent à la signalisation multicellulaire en transmettant des vagues intercellulaires de calcium. Ce travail de thèse démontre également que des vagues intercellulaires de sodium peuvent être évoquées en parallèle à ces vagues calciques. Le glutamate, suite à sa libération par un mécanisme dépendent du calcium, est réabsorbé par les transporteurs au glutamate. Ce mécanisme a pour conséquence la génération de vagues sodiques se propageant de cellules en cellules. De plus, ces vagues sodiques sont corrélées spatialement avec une consommation accrue de glucose par les astrocytes. En conclusion, ce travail de thèse a permis de montrer que le signal sodique astrocytaire, déclenché en réponse au glutamate, se propage à la fois de façon intracellulaire aux mitochondries et de façon intercellulaire. Ces résultats suggèrent que les astrocytes fonctionnent comme un réseau de cellules nécessaire au couplage énergétique concerté entre neurones et astrocytes et que le sodium est un élément clé dans les mécanismes de signalisations cellulaires sous-jacents. SUMMARY Glutamate, released in the synaptic cleft during neuronal activity, is removed by surrounding astrocytes. Glutamate is taken-up with Na+ ions by specific transporters, inducing an intracellular Na+ (Na+i) elevation in astrocytes which triggers a cascade of molecular mechanisms that provides metabolic substrates to neurons. Thus, astrocytic Na+i homeostasis represents a key component of the so-called neurometabolic coupling. In this context, the first part of this thesis work was aimed at investigating whether cytosolic Na+ changes are transmitted to mitochondria, which could therefore influence their function and contribute to the overall intracellular Na+ regulation. Simultaneous monitoring of both mitochondrial Na+ (Na+mit) and cytosolic Na+ changes with fluorescent dyes revealed that glutamate-evoked cytosolic Na+ elevations are indeed transmitted to mitochondria. The mitochondrial Na+/Ca2+ exchangers have a prominent role in the regulation of Na+mit influx pathway, and Na+mit extrusion appears to be mediated by Na+/H+ exchangers. To demonstrate the implication of Na+/Ca2+ exchangers, this study has required the technical development of an UV-flash photolysis system. Because light sources for flash photolysis have to be powerful and in the near UV range, the use of UV lasers or flash lamps is usually required. As an alternative to these UV sources that have several drawbaks, we developped a compact, efficient and lowcost flash photolysis system which employs a high power 365nm light emitting diode. In addition to their role in neurometabolic coupling, astrocytes participate in multicellular signaling by transmitting intercellular Ca2+ waves. The third part of this thesis show that intercellular Na+ waves can be evoked in parallel to Ca2+ waves. Glutamate released by a Ca2+ wave-dependent mechanism is taken up by glutamate transporters, resulting in a regenerative propagation of cytosolic Na+ increases. Na+ waves in turn lead to a spatially correlated increase in glucose uptake. In conclusion, the present thesis demonstrates that glutamate-induced Na+ changes occurring in the cytosol of astrocytes propagate to both the mitochondrial matrix and the astrocytic network. These results furthermore support the view that astrocytic Na+ is a signal coupled to the brain energy metabolism.

Exposure to radio-frequency electromagnetic fields from broadcast transmitters and risk of childhood cancer: a census-based cohort study.

We investigated the association between exposure to radio-frequency electromagnetic fields (RF-EMFs) from broadcast transmitters and childhood cancer. First, we conducted a time-to-event analysis including children under age 16 years living in Switzerland on December 5, 2000. Follow-up lasted until December 31, 2008. Second, all children living in Switzerland for some time between 1985 and 2008 were included in an incidence density cohort. RF-EMF exposure from broadcast transmitters was modeled. Based on 997 cancer cases, adjusted hazard ratios in the time-to-event analysis for the highest exposure category (>0.2 V/m) as compared with the reference category (<0.05 V/m) were 1.03 (95% confidence interval (CI): 0.74, 1.43) for all cancers, 0.55 (95% CI: 0.26, 1.19) for childhood leukemia, and 1.68 (95% CI: 0.98, 2.91) for childhood central nervous system (CNS) tumors. Results of the incidence density analysis, based on 4,246 cancer cases, were similar for all types of cancer and leukemia but did not indicate a CNS tumor risk (incidence rate ratio = 1.03, 95% CI: 0.73, 1.46). This large census-based cohort study did not suggest an association between predicted RF-EMF exposure from broadcasting and childhood leukemia. Results for CNS tumors were less consistent, but the most comprehensive analysis did not suggest an association.

A subcritical instability of wave-driven alongshore currents

The development of shear instabilities of a wave-driven alongshore current is investigated. In particular, we use weakly nonlinear theory to investigate the possibility that such instabilities, which have been observed at various sites on the U.S. coast and in the laboratory, can grow in linearly stable flows as a subcritical bifurcation by resonant triad interaction, as first suggested by Shrira eta/. [1997]. We examine a realistic longshore current profile and include the effects of eddy viscosity and bottom friction. We show that according to the weakly nonlinear theory, resonance is possible and that these linearly stable flows may exhibit explosive instabilities. We show that this phenomenon may occur also when there is only approximate resonance, which is more likely in nature. Furthermore, the size of the perturbation that is required to trigger the instability is shown in some circumstances to be consistent with the size of naturally occurring perturbations. Finally, we consider the differences between the present case examined and the more idealized case of Shrira et a/. [ 1997]. It is shown that there is a possibility of coupling between triads, due to the richer modal structure in more realistic flows, which may act to stabilize the flow and act against the development of subcritical bifurcations. Extensive numerical tests are called for.

Progress in front propagation research

We review the progress in the field of front propagation in recent years. We survey many physical, biophysical and cross-disciplinary applications, including reduced-variable models of combustion flames, Reid's paradox of rapid forest range expansions, the European colonization of North America during the 19th century, the Neolithic transition in Europe from 13 000 to 5000 years ago, the description of subsistence boundaries, the formation of cultural boundaries, the spread of genetic mutations, theory and experiments on virus infections, models of cancer tumors, etc. Recent theoretical advances are unified in a single framework, encompassing very diverse systems such as those with biased random walks, distributed delays, sequential reaction and dispersion, cohabitation models, age structure and systems with several interacting species. Directions for future progress are outlined