Valvuloplastia pulmonar con balón resultados a corto y largo plazo del complexo Hospitalario Universitario a Coruña

Evaluar los resultados a corto y largo plazo de la valvuloplastia pulmonar con balón en el Complexo Hospitalario Universitario A Coruña. Metodología: Revisión de las historias clínicas, datos hemodinámicos y seguimiento ecocardiográfico de los pacientes sometidos a valvuloplastia pulmonar en nuestra institución entre marzo de 1998 y marzo de 2011. Resultados: En 13 años, se han realizado 81 valvuloplastias pulmonares, de las cuales 67 fueron evaluadas. 56.7% fueron mujeres, con una mediana de edad de 2 meses y un peso de 4.7 kg. 25% de los casos tenían otras malformaciones cardiacas asociadas y en el 65% se encontró una válvula pulmonar en cúpula. El procedimiento fue exitoso en el 82% de los casos, con una morbilidad del 1.49% y sin mortalidad asociada en nuestra serie. Los resultados a largo plazo muestran una incidencia de reestenosis del 23%, la cual se asocio a un gradiente pico post valvuloplastia > 30 mmHg (p <0.001). La insuficiencia pulmonar fue observada en el 86.5% de los casos, siendo leve en la mayoría de ellos. La mortalidad global de nuestra seria fue del 4.5%. Discusión: La valvuloplastía pulmonar con balón, es para nuestra población, el tratamiento de elección en la estenosis pulmonar, con buenas tasas de éxito y baja morbilidad asociada al procedimiento. A largo plazo, la incidencia de lesiones residuales (estenosis y/o insuficiencia) así como los tiempos libres de reintervención, son comparables con los publicados en la literatura.

Análisis de supervivencia en pacientes con prótesis valvular biológica, Fundación Cardioinfantil-Instituto de Cardiología, Colombia, 2005-2013

Introducción: A partir de la década de los cincuenta el manejo de la enfermedad valvular presenta cambios significativos cuando se incorporan los reemplazos valvulares tanto mecánicos como biológicos dentro de las opciones de tratamiento quirúrgico (1). Las válvulas biológicas se desarrollaron como una alternativa que buscaba evitar los problemas relacionados con la anticoagulación y con la idea de utilizar un tejido que se comportara hemodinámicamente como el nativo. Este estudio está enfocado en establecer la sobrevida global y la libertad de reoperación de la válvula de los pacientes sometidos a reemplazo valvular aórtico y mitral biológicos en la Fundación Cardioinfantil - IC a 1, 3, 5 y 10 años. Materiales y métodos: Estudio de cohorte retrospectiva de supervivencia de pacientes sometidos a reemplazo valvular aórtico y/o mitral biológico intervenidos en la Fundación Cardioinfantil entre 2005 y 2013. Resultados: Se obtuvieron 919 pacientes incluidos en el análisis general y 876 (95,3%) pacientes con seguimiento efectivo para el análisis de sobrevida. La edad promedio fue 64años. La sobrevida a 1, 3, 5 y 10 años fue 95%,90%,85% y 69% respectivamente. El seguimiento efectivo para el desenlace reoperación fue del 55% y se encontró una libertad de reoperación del 99%, 96%, 93% y 81% a los 1, 3, 5 y 10 años. No hubo diferencias significativas entre la localización de la válvula ni en el tipo de válvula aortica empleada. Conclusiones: La sobrevida de los pacientes que son llevados a reemplazo valvular biológico en este estudio es comparable a grandes cohortes internacionales. La sobrevida de los pacientes llevados a reemplazo valvular con prótesis biológicas en posición mitral y aortica fue similar a 1, 3, 5 y 10 años.

The balloon.

Pertenece a un amplio programa infantil de lectura que abarca distintos niveles de edad y, por tanto, de conocimientos. Se abordan las necesidades de lectura en los niños y la amplia variedad de habilidades que necesitan adquirir para su aprendizaje y, se destaca, también, la importancia de la narración en las historias y el orden recomendado para su lectura. Narra cómo se cumple el deseo de la vecina de Wilf de subir en globo.

A three-dimensional magnetometer for motion sensing of a balloon-carried atmospheric measurement package

An instrument is described which carries three orthogonal geomagnetic field sensors on a standard meteorological balloon package, to sense rapid motion and position changes during ascent through the atmosphere. Because of the finite data bandwidth available over the UHF radio link, a burst sampling strategy is adopted. Bursts of 9s of measurements at 3.6Hz are interleaved with periods of slow data telemetry lasting 25s. Calculation of the variability in each channel is used to determine position changes, a method robust to periods of poor radio signals. During three balloon ascents, variability was found repeatedly at similar altitudes, simultaneously in each of three orthogonal sensors carried. This variability is attributed to atmospheric motions. It is found that the vertical sensor is least prone to stray motions, and that the use of two horizontal sensors provides no additional information over a single horizontal sensor

A double-Gerdien instrument for simultaneous bipolar air conductivity measurements on balloon platforms

A bipolar air conductivity instrument is described for use with a standard disposable meteorological radiosonde package. It is intended to provide electrical measurements at cloud boundaries, where the ratio of the bipolar air conductivities is affected by the presence of charged particles. The sensors are two identical Gerdien-type electrodes, which, through a voltage decay method, measure positive and negative air conductivities simultaneously. Voltage decay provides a thermally stable approach and a novel low current leakage electrometer switch is described which initiates the decay sequence. The radiosonde supplies power and telemetry, as well as measuring simultaneous meteorological data. A test flight using a tethered balloon determined positive (σ+) and negative (σ−) conductivities of σ+ = 2.77±0.2 fS m−1 and σ− = 2.82±0.2 fS m−1, respectively, at 400 m aloft, with σ+/σ− = 0.98±0.04.

A lightweight balloon-carried cloud charge sensor

Despite the importance of microphysical cloud processes on the climate system, some topics are under-explored. For example, few measurements of droplet charges in nonthunderstorm clouds exist. Balloon carried charge sensors can be used to provide new measurements. A charge sensor is described for use with meteorological balloons, which has been tested over a range of atmospheric temperatures from -60 to 20 degrees C, in cloudy and clear air. The rapid time response of the sensor (to >10 V s(-1)) permits charge densities from 100 fC m(-3) to 1 nC m(-3) to be determined, which is sufficient for it to act as a cloud edge charge detector at weakly charged horizontal cloud boundaries.

Comparison of balloon-carried atmospheric motion sensors with Doppler lidar turbulence measurements

Magnetic sensors have been added to a standard weather balloon radiosonde package to detect motion in turbulent air. These measure the terrestrial magnetic field and return data over the standard uhf radio telemetry. Variability in the magnetic sensor data is caused by motion of the instrument package. A series of radiosonde ascents carrying these sensors has been made near a Doppler lidar measuring atmospheric properties. Lidar-retrieved quantities include vertical velocity (w) profile and its standard deviation (w). w determined over 1 h is compared with the radiosonde motion variability at the same heights. Vertical motion in the radiosonde is found to be robustly increased when w>0.75 m s−1 and is linearly proportional to w. ©2009 American Institute of Physics

A method for estimating the turbulent kinetic energy dissipation rate from a vertically pointing Doppler lidar, and independent evaluation from balloon-borne in situ measurements

A method of estimating dissipation rates from a vertically pointing Doppler lidar with high temporal and spatial resolution has been evaluated by comparison with independent measurements derived from a balloon-borne sonic anemometer. This method utilizes the variance of the mean Doppler velocity from a number of sequential samples and requires an estimate of the horizontal wind speed. The noise contribution to the variance can be estimated from the observed signal-to-noise ratio and removed where appropriate. The relative size of the noise variance to the observed variance provides a measure of the confidence in the retrieval. Comparison with in situ dissipation rates derived from the balloon-borne sonic anemometer reveal that this particular Doppler lidar is capable of retrieving dissipation rates over a range of at least three orders of magnitude. This method is most suitable for retrieval of dissipation rates within the convective well-mixed boundary layer where the scales of motion that the Doppler lidar probes remain well within the inertial subrange. Caution must be applied when estimating dissipation rates in more quiescent conditions. For the particular Doppler lidar described here, the selection of suitably short integration times will permit this method to be applicable in such situations but at the expense of accuracy in the Doppler velocity estimates. The two case studies presented here suggest that, with profiles every 4 s, reliable estimates of ϵ can be derived to within at least an order of magnitude throughout almost all of the lowest 2 km and, in the convective boundary layer, to within 50%. Increasing the integration time for individual profiles to 30 s can improve the accuracy substantially but potentially confines retrievals to within the convective boundary layer. Therefore, optimization of certain instrument parameters may be required for specific implementations.

Charge measurements in stratiform cloud from a balloon based sensor

Abstract. The electrification of stratiform clouds has is little investigated in comparison with thunderstorms and fair weather atmospheric electricity. Theory indicates that, at the upper and lower horizontal boundaries of layer clouds, charging will arise from vertical flow of cosmogenic ions in the global atmospheric electric circuit. Charge is transferred to droplets and particles, affecting cloud microphysical processes such as collision and droplet activation. Due to the lack of in-situ measurements, the magnitude and distribution of charge in stratiform clouds is not well known. A sensitive, inexpensive, balloon borne charge sensor has been developed to make in-situ measurements of edge charging in stratiform cloud using a standard meteorological radiosonde system. The charge sensor has now been flown through over 20 stratiform clouds and frequently detected charge up to 200 pC m-3 near cloud edges. These results are compared with measurements from the same sensor used to investigate charge in particle layers, such as volcanic ash from the Eyjafjallajökull eruption, and Saharan dust in the Cape Verde Isles. 1.

Balloon-borne disposable radiometer for cloud detection

A low cost, disposable instrument for measuring solar radiation during meteorological balloon flights through cloud layers is described. Using a photodiode detector and low thermal drift signal conditioning circuitry, the device showed less than 1% drift for temperatures varied from +20 °C to −35 °C. The angular response to radiation, which declined less rapidly than the cosine of the angle between the incident radiation and normal incidence, is used for cloud detection exploiting the motion of the platform. Oriented upwards, the natural motion imposed by the balloon allows cloud and clear air to be distinguished by the absence of radiation variability within cloud, where the diffuse radiation present is isotropic. The optical method employed by the solar radiation instrument has also been demonstrated to provide higher resolution measurements of cloud boundaries than relative humidity measurements alone.

Summertime stratospheric processes at northern mid-latitudes: comparisons between MANTRA balloon measurements and the Canadian Middle Atmosphere Model

In this paper we report on a study conducted using the Middle Atmospheric Nitrogen TRend Assessment (MANTRA) balloon measurements of stratospheric constituents and temperature and the Canadian Middle Atmosphere Model (CMAM). Three different kinds of data are used to assess the inter-consistency of the combined dataset: single profiles of long-lived species from MANTRA 1998, sparse climatologies from the ozonesonde measurements during the four MANTRA campaigns and from HALOE satellite measurements, and the CMAM climatology. In doing so, we evaluate the ability of the model to reproduce the measured fields and to thereby test our ability to describe mid-latitude summertime stratospheric processes. The MANTRA campaigns were conducted at Vanscoy, Saskatchewan, Canada (52◦ N, 107◦ W)in late August and early September of 1998, 2000, 2002 and 2004. During late summer at mid-latitudes, the stratosphere is close to photochemical control, providing an ideal scenario for the study reported here. From this analysis we find that: (1) reducing the value for the vertical diffusion coefficient in CMAM to a more physically reasonable value results in the model better reproducing the measured profiles of long-lived species; (2) the existence of compact correlations among the constituents, as expected from independent measurements in the literature and from models, confirms the self-consistency of the MANTRA measurements; and (3) the 1998 measurements show structures in the chemical species profiles that can be associated with transport, adding to the growing evidence that the summertime stratosphere can be much more disturbed than anticipated. The mechanisms responsible for such disturbances need to be understood in order to assess the representativeness of the measurements and to isolate longterm trends.

A self-calibrating electrometer for atmospheric charge measurements from a balloon platform

Charged aerosol particles and water droplets are abundant throughout the lower atmosphere, and may influence interactions between small cloud droplets. This note describes a small, disposable sensor for the measurement of charge in non-thunderstorm cloud, which is an improvement of an earlier sensor [K. A. Nicoll and R. G. Harrison, Rev. Sci. Instrum. 80, 014501 (2009)]. The sensor utilizes a self-calibrating current measurement method. It is designed for use on a free balloon platform alongside a standard meteorological radiosonde, measuring currents from 2 fA to 15 pA and is stable to within 5 fA over a temperature range of 5 °C to −60 °C. During a balloon flight with the charge sensor through a stratocumulus cloud, charge layers up to 40 pC m−3 were detected on the cloud edges.

Note: Active optical detection of cloud from a balloon platform

A disposable backscatter instrument is described for optical detection of cloud in the atmosphere from a balloon-carried platform. It uses an ultra-bright light emitting diode (LED) illumination source with a photodiode detector. Scattering of the LED light by cloud droplets generates a small optical signal which is separated from background light fluctuations using a lock-in technique. The signal to noise obtained permits cloud detection using the scattered LED light, even in daytime. The response is interpreted in terms of the equivalent visual range within the cloud. The device is lightweight (150 g) and low power (∼30 mA), for use alongside a conventional meteorological radiosonde.

Note: A balloon-borne accelerometer technique for measuring atmospheric turbulence

A weather balloon and its suspended instrument package behave like a pendulum with a moving pivot. This dynamical system is exploited here for the detection of atmospheric turbulence. By adding an accelerometer to the instrument package, the size of the swings induced by atmospheric turbulence can be measured. In test flights, strong turbulence has induced accelerations greater than 5g, where g = 9.81 m s−2. Calibration of the accelerometer data with a vertically orientated lidar has allowed eddy dissipation rate values of between 10−3 and 10−2 m2 s−3 to be derived from the accelerometer data. The novel use of a whole weather balloon and its adapted instrument package can be used as a new instrument to make standardized in situ measurements of turbulence.