The Berbeo-Sardi Angle (BSA): An Innovative Method to Effectively Estimate Pelvic Retroversion in Anteroposterior Radiographs-A Correlation With Traditional Parameters.

STUDY: Design: Diagnostic studies-concordance between diagnostic tests. OBJECTIVES: The purpose of this study was to develop a novel spinopelvic parameter (Berbeo-Sardi angle [BSA], the angle formed at the intersection of a line that connects the inferior margin of the sacroiliac joint to the midpoint of a horizontal line joining both femoral heads) measurable in anteroposterior radiographs that indirectly estimates pelvic retroversion and correlates with traditional measurements like pelvic tilt (PT). SUMMARY: Sagittal balance appraisal and surgical planning rely on the interpretation of spinopelvic parameters. An increased PT reflects pelvic retroversion as a compensatory mechanism to limit sagittal imbalance and correlates with increased pain and disability. However, poor imaging techniques and incorrect patient positioning frequently hamper landmark identification in lateral radiographs, and with no measurable angles in anteroposterior radiographs, it is often impossible to determine PT and pelvic retroversion. METHODS: Whole-spine radiographs from 105 consecutive patients were used to retrospectively measure conventional spinopelvic parameters and the BSA. Intraclass correlation coefficient was used to assess a quantitative correlation between the PT and BSA as indirect measures of pelvic retroversion. RESULTS: Average values for pelvic incidence, lumbar lordosis, sacral slope, PT, and BSA were 46.5° (±10.23), 48.56° (±12.30), 29.97° (±9.77), 16.94° (±8.03), and 54.47° (±4.05), respectively. We encountered a moderately strong correlation (r = -0.66) between PT and BSA. Receiver operating characteristic plot analysis revealed that a BSA threshold of 46° has a sensitivity of 90% to identify pathologic PT values (>20°), whereas a BSA ≥60° has a specificity of 90% to rule out pelvic retroversion using anteroposterior radiographs. CONCLUSIONS: There is a moderately strong correlation between the BSA, an innovative spinopelvic parameter measurable in anteroposterior radiographs, and PT. BSA seems to show great promise in simplifying spinopelvic appraisal by easily estimating pelvic retroversion associated with sagittal imbalance, while avoiding image-quality issues often encountered in lateral radiographs. LEVEL OF EVIDENCE: Level III.

Criterio de parada de la promediación de la respuesta auditiva de estado estable / Stopping criteria for averaging the multiple auditory steady-state response

Introducción y objetivos: El presente estudio pretende examinar la eficiencia de la técnica de promediación para obtener potenciales evocados auditivos de estado estable en sujetos normoyentes y proveer de un criterio de parada cuantitativo a intensidades cercanas al umbral de audibilidad. Métodos: Una mezcla de 4 tonos continuos (500, 1.000, 2.000 y 4.000 Hz) modulados en amplitud entre 89 y 115 Hz, fueron simultáneamente presentados a ambos oídos a una intensidad de 40 dB HL. Fueron promediados un total de 128 segmentos de registro (23,9 min). Resultados: La técnica de promediación aunque resultó eficiente en la mayoría de los casos, no siempre pudo extraer la señal, incluso después de promediarse durante un período prolongado de tiempo. Se propuso además un análisis del ruido de fondo basado en la evaluación de la varianza del ruido en la vecindad de la señal. Conclusiones: Se proponen parámetros cuantificables para ayudar a establecer un criterio deparada de la promediación durante el registro de los potenciales evocados auditivos de estado estable (AU)

Introduction and objectives: The aim of this study was to examine the efficiency of the averaging technique for estimating multiple auditory steady state responses in normal hearing subjects and to provide quantifiable stopping criteria at near-threshold intensities. Methods: Multiple amplitude-modulated (89-115 Hz) tones (500, 1,000, 2,000 and 4,000 Hz) were simultaneously presented to both ears at a fixed intensity of 40 dB HL. A total of 128 data epochs were averaged (23.9 minutes).Results: The results showed that ‘‘classic’’ ensemble averaging, although accurate and time efficient in most cases, could not extract all near-threshold MSSR from noise, even after recording a considerable number of sweeps. The present study also proposed a different approach to evaluate the background noise based on evaluating the mean of the variance close to the signal. Conclusions: The study proposed quantitative parameters to establish stopping criteria during auditory steady-state recordings (AU)

[Stopping criteria for averaging the multiple auditory steady-state response]. / Criterio de parada de la promediación de la respuesta auditiva de estado estable.

INTRODUCTION AND OBJECTIVES: The aim of this study was to examine the efficiency of the averaging technique for estimating multiple auditory steady state responses in normal hearing subjects and to provide quantifiable stopping criteria at near-threshold intensities. METHODS: Multiple amplitude-modulated (89-115 Hz) tones (500, 1,000, 2,000 and 4,000 Hz) were simultaneously presented to both ears at a fixed intensity of 40 dB HL. A total of 128 data epochs were averaged (23.9 minutes). RESULTS: The results showed that "classic" ensemble averaging, although accurate and time-efficient in most cases, could not extract all near-threshold MSSR from noise, even after recording a considerable number of sweeps. The present study also proposed a different approach to evaluate the background noise based on evaluating the mean of the variance close to the signal. CONCLUSIONS: The study proposed quantitative parameters to establish stopping criteria during auditory steady-state recordings.

Hemorragia subaracnoidea espontanea: diagnostico y tratamiento / Spontaneus Subarchnoid Haemorrhage: diagnosis and treatment

Dentro del capítulo de Enfermedades Cerebrovasculares, la hemorragia sub-aracnoidea ocupa el 5 por ciento todos los eventos de disfunción neurológica cuya manifestación inicial se caracteriza por cuadro clínico de inicio súbito. Su mortalidad inicial alcanza el 40 por ciento y la morbilidad al final el primer mes del ictus se aproxima al 40 por ciento de los pacientes que sobreviven la crisis inicial. Para modificar el impacto que la enfermedad produce, debemos reconocer sus manifestaciones clínicas, precisar nuestro diagnóstico y utilizar las estrategias terapéuticas reconocidas en forma oportuna para evitar complicaciones como el re-sangrado y adelantarnos a la isquemia cerebral que produce el vasoespasmo

Controle de raiva no Brasil de 1980 a 1990 / Rabies control in Brazil from 1980 to 1990

Descreve-se a situaçäo epidemiológica da raiva no Brasil no período de 1980-1990, em que o Programa Nacional de Profilaxia da Raiva foi estruturado em todo País. Säo mostradas as principais açöes de controle da raiva desenvolvidas para se chegar aos resultados, considerados positivos. A raiva no Brasil registrou uma reduçäo importante nos casos humanos (78 por cento) e caninos (90 por cento) na metade da série analisada. No final da década, houve um recrudescimento de casos em algumas partes do País, principalmente na regiäo Nordeste que apresentou 70 por cento dos casos em 1990. A raiva humana transmitida por morcegos também apresentou um incremento importante, chegando a 15,1 por cento do total. O programa executado pelos Estados e municípios atende a 350.000 pessoas agredidas por animais e também vacina cerca de 9.000.000 de animais anualmente. A vigilância epidemiológica é considerada fundamental e para isso se elaboraram indicadores para a definiçäo de áreas de risco