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Material Extrusion (MEX) currently stands as the most widespread Additive Manufacturing (AM) process, but part quality deficiencies remain a barrier to its generalized industrial adoption. Quality control in MEX is a complex task as extrusion performance impacts the consistency of mechanical properties and the surface finish, dimensional accuracy, and geometric precision of manufactured parts. Recognizing the need for early-stage process monitoring, this study explores the potential of integrating Laser Triangulation Sensors (LTS) into MEX/P manufacturing equipment for layer-wise 3D inspections. Using a double-bridge architecture, an LTS-based sub-micrometric inspection system operates independently from the manufacturing process, enabling comprehensive digitization and autonomous reconstruction of the target layer's topography. Surface texture is then computed using standardized indicators and a new approach that provides insight into layer quality uniformity. A case study evaluating two alternative extruder head designs demonstrates the efficacy of this integrated approach for layer quality characterization. Implementing a generalized layer-wise procedure based on this integration can significantly mitigate quality issues in MEX manufacturing and optimize process parameter configurations for enhanced performance.
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Human carnivory is atypical among primates. Unlike chimpanzees and bonobos, who are known to hunt smaller monkeys and eat them immediately, human foragers often cooperate to kill large animals and transport them to a safe location to be shared. While it is known that meat became an important part of the hominin diet around 2.6-2 Mya, whether intense cooperation and food sharing developed in conjunction with the regular intake of meat remains unresolved. A widespread assumption is that early hominins acquired animal protein through klepto-parasitism at felid kills. This should be testable by detecting felid-specific bone modifications and tooth marks on carcasses consumed by hominins. Here, deep learning (DL) computer vision was used to identify agency through the analysis of tooth pits and scores on bones recovered from the Early Pleistocene site of DS (Bed I, Olduvai Gorge). We present the first objective evidence of primary access to meat by hominins 1.8 Mya by showing that the most common securely detectable bone-modifying fissipeds at the site were hyenas. The absence of felid modifications in most of the carcasses analyzed indicates that hominins were the primary consumers of most animals accumulated at the site, with hyenas intervening at the post-depositional stage. This underscores the role of hominins as a prominent part of the early Pleistocene African carnivore guild. It also stresses the major (and potentially regular) role that meat played in the diet that configured the emergence of early Homo.
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Carnívoros , Hominidae , Hyaenidae , Animales , Humanos , Pan troglodytes , Huesos , Carne , Pan paniscusRESUMEN
RESUMEN INTRODUCCIÓN: El estado migrañoso es una complicación de la migraña, los pacientes a menudo son hospitalizados para estudios diagnósticos o tratamiento. Una alternativa para el manejo son las salas de infusión, lo que permite minimizar los ingresos hospitalarios y la realización de exámenes innecesarios. OBJETIVO: Determinar la respuesta terapéutica y los factores asociados con esta en pacientes con estado migrañoso tratados en una sala de infusión. METODOLOGÍA: estudio de cohorte retrospectiva cuya población fueron pacientes con estado migrañoso atendidos en sala de infusión entre febrero y agosto del 2019. La información sobre variables sociodemográficas, variable clínicas y el manejo terapéutico se obtuvo a partir de la revisión de historias clínicas. Se evaluó la respuesta con escala análoga del dolor al inicio y al final del tratamiento; los pacientes con mejoría mayor al 50 % se consideraron respondedores. Se evaluaron los factores predictores de la respuesta terapéutica mediante regresión logística. RESULTADOS: Se incluyeron 124 pacientes, con promedio de edad de 36 (DE = 12) años, de los cuales el 82,3 % fueron mujeres. La duración promedio del estado migrañoso fue 8 (DE = 4) días, el 73,4 % de los casos se presentó sin aura y 97 (78,2 %) fueron respondedores. Los factores predictores de buena respuesta fueron el uso de dexametasona (OR 4,3) y no usar lidocaína (OR 6,0). CONCLUSIONES: La mayoría de los pacientes tuvo buena respuesta, lo que sugiere que las salas de infusión constituyen una buena alternativa al manejo intrahospitalario de la migraña. En nuestra experiencia, el esteroide constituye parte fundamental del manejo del estado migrañoso una vez se ha instaurado.
ABSTRACT INTRODUCTION: Status migrainosus is a complication of migraine, patients are often hospitalized for diagnostic studies and/or treatment. An alternative for the management, are the outpatient infusion center, minimizing hospital admissions and unnecessary examinations. OBJECTIVE: To determine the therapeutic response and associated factors in patients with migraine status treated in an infusion room. METHODOLOGY: Retrospective cohort study whose population was migraine patients attended in an infusion room between February and August 2019. Information on sociodemographic, clinical, and therapeutic management variables was obtained from the review of medical records. The response was evaluated with an analogous pain scale at the beginning and at the end of the treatment; Those patients with improvement greater than 50 % were considered responders. Predictive factors of therapeutic response were evaluated using logistic regression. RESULTS: 124 patients were included, with an average age of 36 (SD = 12 years), 82.3 % were women. The average duration of the migraine state was 8 (SD = 4 days), 73.4 % of the cases were without aura and 97 (78.2 %) were responders. The predictors of good response were the use of dexamethasone (OR: 4.3) and not using lidocaine (OR: 6.0). CONCLUSIONS: Most of the patients had a good response, which identified the outpatient infusion center as a good alternative to inpatient treatment of headache. In our experience, the steroid constitutes a fundamental part of the management of the status migrainosus once it has been established.
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Pronóstico , Infusiones Intravenosas , Migraña sin Aura , Estudios de Cohortes , Trastornos MigrañososRESUMEN
Material extrusion based additive manufacturing is used to make three dimensional parts by means of layer-upon-layer deposition. There is a growing variety of polymers that can be processed with material extrusion. Thermoplastic polyurethanes allow manufacturing flexible parts that can be used in soft robotics, wearables and flexible electronics applications. Moreover, these flexible materials also present a certain degree of viscoelasticity. One of the main drawbacks of material extrusion is that decisions related to specific manufacturing configurations, such as the inner-structure design, shall affect the final mechanical behaviour of the flexible part. In this study, the influence of inner-structure design factors upon the viscoelastic relaxation modulus, E(t), of polyurethane parts is firstly analysed. The obtained results indicate that wall thickness has a higher influence upon E(t) than other inner-design factors. Moreover, an inadequate combination of those factors could reduce E(t) to a small fraction of that expected for an equivalent moulded part. Next, a viscoelastic material model is proposed and implemented using finite element modelling. This model is based on a generalized Maxwell model and contemplates the inner-structure design. The results show the viability of this approach to model the mechanical behaviour of parts manufactured with material extrusion additive manufacturing.
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The dimensional and geometrical quality of additively manufactured parts must be increased to match industrial requirements before they can be incorporated to mass production. Such an objective has a great relevance in the case of features of linear size that are affected by dimensional or geometrical tolerances. This work proposes a design for additive manufacturing strategy that uses the re-parameterization of part design to minimize shape deviations from cylindrical geometries. An analysis of shape deviations in the frequency domain is used to define a re-parameterization strategy, imposing a bi-univocal correspondence between verification parameters and design parameters. Then, the significance of variations in the process and design factors upon part quality is analyzed using design of experiments to determine the appropriate extension for modelling form deviation. Finally, local deviations are mapped for design parameters, and a new part design including local compensations is obtained. This strategy has been evaluated upon glossy surfaces manufactured in a Vero™ material by polymer jetting. The results of the proposed example showed a relevant improvement in dimensional quality, as well as a reduction of geometrical deviations, outperforming the results obtained with a conventional scaling compensation.
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OBJETIVO: el propósito de este estudio fue determinar los principales desenlaces clínicos en lactantes con insuficiencia respiratoria aguda (IRA), tratados con cánula nasal de alto flujo (CNAF) en una unidad de cuidado intensivo pediátrico (UCIP). MATERIALES Y MÉTODOS: se realizó un estudio observacional descriptivo de cohorte histórica, se reclutaron niños entre 1 y 24 meses que ingresaron a la UCIP de un hospital de referencia con diagnóstico de IRA (Julio 1, 2016 a junio 30, 2017) tratados con CNAF como terapia inicial. Los datos extraídos incluyeron variables demográficas, clínicas y principales desenlaces. RESULTADOS: se identificaron 112 casos que cumplieron los criterios de inclusión durante el periodo del estudio. El diagnóstico más frecuente fue neumonía multilobar (41%), seguido por bronquiolitis (34%). Se encontró que el 22.4% de los niños poseía alguna comorbilidad, siendo la más frecuente la displasia broncopulmonar. El virus más frecuentemente aislado fue el virus sincitial respiratorio (VSR) en el 37.5% de los casos. De los 112 pacientes, 59 niños (53%) requirieron intubación traqueal. Los factores asociados con el riesgo de intubación fueron el diagnóstico de neumonía multilobar, el uso de sedación, el aislamiento de VSR y el sexo femenino. CONCLUSIONES: la CNAF es un sistema de soporte respiratorio no invasivo, seguro, bien tolerado y capaz de disminuir la necesidad de intubación y los días de estancia en cuidado intensivo. En niños con IRA, el diagnóstico de neumonía multilobar, la necesidad de sedación, la presencia de comorbilidades asociadas y el sexo femenino son factores asociados con la necesidad de requerir ventilación mecánica invasiva.
OBJECTIVE: the purpose of this study was to determine the main clinical outcomes in infants with acute respiratory failure (ARF), treated with a high-flow nasal cannula (CNAF) in a pediatric intensive care unit (PICU). MATERIALS AND METHODS: a retrospective observational study was conducted on a cohort of children between 1 and 24 months of age who were admitted to the PICU entered UCIP of a referral hospital with a diagnosis of ARF treated with CNAF as initial therapy. The data extracted included demographic and clinical variables and main outcomes. RESULTS: 112 cases were identified that met the inclusion criteria during the study period. The most frequent diagnosis was pneumonia (41%), followed by bronchiolitis (34%). It was found that 22.4% of the children had some comorbidity, the most frequent being bronchopulmonary dysplasia. The most frequently isolated virus was respiratory syncytial virus (RSV) in 37.5% of the cases. Of the 112 patients, 59 children (53%) required tracheal intubation. The factors associated with the risk of intubation were the diagnosis of pneumonia, the use of sedation, the isolation of RSV and the female gender. CONCLUSIONS: CNAF is a non-invasive respiratory support system, capable of reducing the need for intubation and days of stay in intensive care. In children with ARF, the diagnosis of pneumonia, the need for sedation, the presence of associated comorbidities, and the female gender are factors associated with the need to require invasive mechanical ventilation.
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Humanos , Masculino , Femenino , Lactante , Respiración Artificial , Insuficiencia Respiratoria/tratamiento farmacológico , Cánula , Intubación , Neumonía/tratamiento farmacológico , Bronquiolitis , Colombia , Unidades de Cuidados IntensivosRESUMEN
In order to compete with traditional manufacturing processes, Additive Manufacturing (AM) should be capable of producing medium to large batches at industrial-degree quality and competitive cost-per-unit. This paper proposes a systematic framework approach to the problem of fulfilling dimensional and geometric requirements for medium batch sizes of AM parts, which has been structured as a three-step optimization methodology. Firstly, specific work characteristics are analyzed so that information is arranged according to an Operation Space (factors that could have an influence upon quality) and a Verification Space (formed by quality indicators and requirements). Standard process configuration leads to characterization of the standard achievable quality. Secondly, controllable factors are analyzed to determine their relative influence upon quality indicators and the optimal process configuration. Thirdly, optimization of part dimensional and/or geometric definition at the design level is performed in order to improve part quality and meet quality requirements. To evaluate the usefulness of the proposed framework under quasi-industrial condition, a case study is presented here which is focused on the dimensional and geometric optimization of surgical-steel tibia resection guides manufactured by Laser-Power Bed Fusion (L-PBF). The results show that the proposed approach allows for part quality improvement to a degree that matches the initial requirements.
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Lemierre's syndrome is an infrequent disease characterized by septic thrombosis of the internal jugular vein followed by pulmonary embolism generally occurring after upper respiratory and gastrointestinal tract infections. We present the case of a 15-year-old female patient with postseptal cellulitis and cervical abscess who developed pulmonary embolism and pleural effusion secondary to internal jugular vein thrombosis. Cultures were positive for Streptococcus anginosus, antibiotic treatment was established with satisfactory clinical outcome. High clinical suspicion is required for a diagnosis. The mainstay of treatment is a multidisciplinary approach based on two essential pillars: antibiotic therapy and surgical drainage. This is an important case because of the unusual presentation, the isolation of an infrequent pathogen, and the primary infection site (postseptal cellulitis), which are rare characteristics of this condition in the pediatric population.
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Celulitis (Flemón)/diagnóstico , Síndrome de Lemierre/etiología , Enfermedades Orbitales/diagnóstico , Infecciones Estreptocócicas/complicaciones , Streptococcus anginosus/aislamiento & purificación , Adolescente , Antibacterianos/uso terapéutico , Celulitis (Flemón)/microbiología , Celulitis (Flemón)/terapia , Diagnóstico Diferencial , Drenaje , Femenino , Humanos , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/microbiología , Imagen por Resonancia Magnética , Enfermedades Orbitales/microbiología , Enfermedades Orbitales/cirugía , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/microbiología , Tomografía Computarizada por Rayos XRESUMEN
Objective: To evaluate the early response of onabotulinumtoxinA as a treatment tool in patients with chronic migraine (CM) and medication overuse (MO). Patients and Methods: This is a retrospective study in patients with CM and MO who received two cycles of onabotulinumtoxinA infiltrations following PREEMPT protocol. We evaluated the efficacy of onabotulinumtoxinA in MO resolution, defined as less than 10 days/month of acute medication intake (triptans, opioids, and combinations) or 15 days/month (non-steroidal anti-inflammatory drugs - and simple analgesics). In addition, we analyzed changes in headache frequency, pain intensity, and headache-related disability (MIDAS scale). A multivariate analysis was carried out to identify factors independently related to MO resolution. Results: We included 139 consecutive patients with CM and MO. After 2 cycles of onabotulinumtoxinA, 73.4% had ≥50% reduction in acute medication intake and 57.6% achieved MO resolution. 7.9% of patients did not use any acute medication after treatment. Even though both MO-ongoing group and MO-resolution group improve in headache frequency, the reduction was significantly higher for the group which discontinued the use of acute medication after onabotulinumtoxinA treatment (p < 0.001). In this group, 73.0% reduced headache frequency ≥50%. Daily headache changed from 71.2 to 23.2% (p < 0.001). Both groups showed an improvement in pain intensity and in MIDAS score (p < 0.05). In the multivariate analysis we observed that MO resolution had an inverse association with medication intake at baseline (OR:0.294, p < 0.05) and a direct association with frequency (OR:20.455, p < 0.001) and MIDAS score (OR: 6.465, p < 0.05) improvements. Conclusion: OnabotulinumtoxinA has an early beneficial effect on the discontinuation of acute medication in a substantial proportion of patients with CM and MO. Therefore, onabotulinumtoxinA might be considered a therapeutic tool in CM with MO.
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Efficient, economic, and simple monitoring methods are important to develop successful integrated management for Asian citrus psyllid (ACP) especially in developing countries. Two 5-wk tests were carried out to study the capture of ACP adults using yellow sticky traps by adding commercial citrus fruit scents (lemon, tangerine, or orange) or commercial coconut oil (first test) and to compare these baits with commercial lures (Alpha Scents and Pest Wizard) (second test) under natural infestation conditions. In the first test, the following treatments were carried out: yellow sticky traps baited with 1) coconut oil; 2) lemon, tangerine, or orange commercial scents; or 3) unbaited yellow sticky tramps (control). In the second test, treatments were as follows: traps baited with 1) coconut oil; 2) lemon, tangerine, or orange commercial scents; 3) two different commercial lures (Pest Wizard and Alpha Scents); and 4) unbaited traps. In the first experiment, the results obtained showed that traps with a coconut oil lure captured 4.4 ACP adults per trap per week, whereas control traps caught 1 ACP adult. In the second test, coconut oil (4.5 adults per trap per week) and Alpha Scents (4.2 individuals) lures also exhibited a higher capture in comparison to all citrus scents (3.1 individuals) and Pest Wizard (3.5 individuals), and control (2 individuals). In conclusion, these results suggest that the use of commercial attractants, mainly coconut oil, can be more attractive than unbaited traps and this may be helpful for integrating into integrated pest management programs intended for ACP.
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Hemípteros , Control de Insectos/instrumentación , Animales , Citrus , Colombia , Femenino , Bosques , Masculino , Aceites de PlantasRESUMEN
INTRODUCCIÓN: El cuidador familiar es la fuente más importante de apoyo social y requiere desarrollar habilidades para reforzar las conductas de autocuidado en su familiar. El objetivo de este estudio fue determinar la competencia de cuidado de los cuidadores familiares de los pacientes con falla cardiaca (FC) en una institución de cuarto nivel de complejidad. MATERIALES Y MÉTODOS: Estudio descriptivo de corte transversal. Con un tamaño de muestra de 41 cuidadores familiares de personas con FC que asisten al programa de FC en una institución de salud de cuarto nivel, durante el segundo semestre del 2016. Para la recolección de la información se utilizó el instrumento "CUIDAR" que cuenta con pruebas de validez de constructo y consistencia interna con un alfa de Cronbach de 0.93. Se realizó un análisis descriptivo con distribución de frecuencias absolutas y relativas. RESULTADOS: El nivel de competencia global para el cuidado en el hogar de los cuidadores familiares de los pacientes con FC fue medio y alto. Las dimensiones que alcanzaron un nivel más alto de competencia fueron Disfrutar e Instrumental y Procedimental. DISCUSIÓN: Una adecuada competencia para el cuidado en los cuidadores se convierte en un factor que puede influir de manera positiva en el manejo de la persona. CONCLUSIONES: Una adecuada competencia del cuidador familiar va a permitir una mejor adaptación a los nuevos requerimientos de la vida del paciente con su enfermedad y pueden ayudar a prevenir las descompensaciones.
INTRODUCCIÓN: The family caretaker is the most important source of social support and requires developing skills to reinforce self-care conducts in their relatives. The aim of this study was to determine the care skills of family caretakers of patients with heart failure (HF) in an institution with tier IV level of complexity. MATERIALS AND METHODS: This was a cross-sectional descriptive study, with a sample size of 41 family caretakers of people with HF attending the HF program in a tier IV health institution, during the second semester of 2016. The 'CUIDAR' instrument was used to collect information. Said instrument has construct validity and internal consistency tests with Cronbach's alpha of 0.93. A descriptive analysis was performed with absolute and relative distribution frequencies. RESULTS: The global skill level for homecare of family caretakers of patients with HF was medium and high. The dimensions reaching the highest level of skills were enjoyment, instrumental, and procedural. DISCUSSION: An adequate care skill in caretakers becomes a factor that can positively influence upon managing a person. CONCLUSIONS: Adequate skills of family caretakers will permit better adaptation to the new life requirements of patients with their disease and can help to prevent decompensations.
INTRODUÇÃO: O cuidador familiar é a mais importante fonte de apoio social e precisa desenvolver habilidades para melhorar os comportamentos de autocuidado em seu familiar. O objetivo deste estudo foi determinar a competência de cuidado dos cuidadores familiares de pacientes com insuficiência cardíaca (IC) em uma instituição de quarto nível de complexidade. MATERIAIS E MÉTODOS: Estudo descritivo de coorte transversal. O tamanho de amostra foi de 41 cuidadores familiares de pessoas com IC que frequentam o programa de IC em uma instituição de saúde de quarto nível, durante a metade do segundo semestre de 2016. Para a coleta da informação, utilizou-se o instrumento "CUIDAR" que tem validade de construto e consistência interna, com um alfa de Cronbach de 0.93. Foi realizada uma análise descritiva com distribuição de frequências absolutas e relativas. RESULTADOS: O nível de competência global para o atendimento domiciliar dos cuidadores familiares de pacientes com IC foi médio e alto. As dimensões que atingiram um nível mais alto de competência foram Desfrutar e Instrumental e Processual. DISCUSSÃO:Uma apropriada competência para o cuidado em cuidadores se torna um fator que pode influenciar positivamente a gestão da pessoa. CONCLUSÕES: Uma adequada competência do cuidador familiar vai permitir uma melhor adaptação às novas exigências da vida do paciente com a doença e podem ajudar a evitar as descompensações.
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Humanos , Pacientes , Competencia Clínica , Cuidadores , Insuficiencia CardíacaRESUMEN
We report the case of a 56-year-old female patient, with a three-day history of hematemesis, melena, abdominal wall hematoma and epistaxis associated with thrombocytopenia and anemia. Idiopathic thrombocytopenic purpura was diagnosed and she was treated with dexamethasone for four days. The patient developed acute respiratory failure with signs of systemic inflammatory response. Blood and pleural fluid cultures grew Pasteurella canis. This is the first case, to our knowledge, of P. canis empyema associated with hemorrhagic septicemia without epidemiological background and the third case of septicemia caused by P. canis reported in the literature.
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Empiema Pleural/complicaciones , Septicemia Hemorrágica/microbiología , Infecciones por Pasteurella/complicaciones , Pasteurella/aislamiento & purificación , Empiema Pleural/microbiología , Femenino , Humanos , Persona de Mediana Edad , Pasteurella/clasificaciónRESUMEN
We report the case of a 56-year-old female patient, with a three-day history of hematemesis, melena, abdominal wall hematoma and epistaxis associated with thrombocytopenia and anemia. Idiopathic thrombocytopenic purpura was diagnosed and she was treated with dexamethasone for four days. The patient developed acute respiratory failure with signs of systemic inflammatory response. Blood and pleural fluid cultures grew Pasteurella canis. This is the first case, to our knowledge, of P. canis empyema associated with hemorrhagic septicemia without epidemiological background and the third case of septicemia caused by P. canis reported in the literature.
Comunicamos el caso de una mujer de 56 años de edad, con un cuadro clínico de tres días de evolución caracterizado por hematemesis, melena, hematoma en la pared abdominal y epistaxis, asociado a trombocitopenia y anemia. Con un probable diagnóstico de un púrpura trombocitopénico idiopático, se trató con dexametasona por cuatro días. Evolucionó con una insuficiencia respiratoria aguda con signos de respuesta inflamatoria sistémica, por un empiema pleural izquierdo con aislamiento de Pasteurella canis en hemocultivos y líquido pleural. Este es el primer caso, según nuestro conocimiento, de un empiema por P. canis asociado a una septicemia hemorrágica, sin antecedentes epidemiológicos; y tercero de una sepsis por P. canis publicado en el mundo.
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Femenino , Humanos , Persona de Mediana Edad , Empiema Pleural/complicaciones , Septicemia Hemorrágica/microbiología , Infecciones por Pasteurella/complicaciones , Pasteurella/aislamiento & purificación , Empiema Pleural/microbiología , Pasteurella/clasificaciónRESUMEN
Se presenta una revisión de los estudios aleatorizados a doble ciego y controlados con placebo, publicados en la literatura científica sobre el tratamiento farmacológico y con terapias complementarias de la neuropatía periférica dolorosa, asociada al virus de la inmunodeficiencia humana adquirida (VIH), publicados entre enero de 1996 y octubre de 2015. Se localizaron 219 artículos y se seleccionaron para análisis 20 estudios. Los 20 estudios seleccionados incluyeron 2.246 pacientes con neuropatía sensitiva distal asociada a HIV (HIV-SN) característicamente dolorosa, en la forma de polineuropatía sensitiva distal (DSP) o neuropatía por antiretrovirales (ATN) y correspondieron a estudios controlados. Los resultados de esta revisión muestran la eficacia de la capsaicina al 8%, el cannabis fumado y el factor de crecimiento neural recombinante humano (rhNGF) en el manejo del dolor de la DSP. La lamotrigina y la acetilcarnitina son medicaciones prometedoras en la ATN de los pacientes con HIV. Sin embargo, es necesaria la búsqueda de nuevas estrategias terapéuticas en el manejo de la DSP y la ATN.
We present a systematic of the randomized, double-blind, placebo-controlled studies published in the scientific literature concerning the pharmacological treatment and complementary therapies of the painful peripheral neuropathy associated with the human acquired immunodeficiency virus (HIV), between January, 1996 and octubre, 2015. The analysis comprises 20 studies selected from a total of 219 articles located. The 20 controlled studies selected included 2246 patients with HIV-associated distal sensory neuropathy (HIV-SN), characteristically painful, in the form of distal sensory polyneuropathy (DSP) or antiretroviral neuropathy (ATN). The results of this revision show the efficacy of 8% capsaicin, smoked cannabis and recombinant human neural growth factor (rhNGF) in pain management of DSP. Lamotrigine and Acetyl-L carnitine are promising medications in the ATN of HIV patients. Notwithstanding, a search for new therapeutic strategies for the management of DSP and ATN is still necessary.
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El compromiso neurológico de la enfermedad de Chagas que afecta el sistema nervioso suele ser una manifestación crónica de esta entidad con predominio de afectación del sistema nervioso autonómico. El presente artículo hace el reporte de un caso de síndrome de Guillain-Barré en un paciente con enfermedad de Chagas aguda y revisión de la literatura.
The neurological impairment of Chagas disease that affects the nervous system is usually a chronic manifestation of this condition and predominantly affects the autonomic nervous system. This article presents a case of Guillain-Barré syndrome in a patient with acute Chagas disease as well as a literature review.
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Humanos , Femenino , Adulto , Enfermedad de Chagas , Síndrome de Guillain-Barré , Enfermedades del Sistema Nervioso Autónomo , Literatura de Revisión como AsuntoRESUMEN
La infección por el virus de la inmunodeficiencia humana (VIH) tiene una alta incidencia con 2,7 millones de casos reportados en el 2010. La Neuropatía Sensitiva Distal Periférica (NSDP) es la enfermedad del sistema nervioso periférico más común por la infección por VIH. Esta entidad característicamente dolorosa puede presentarse asociada directamente con la infección: polineuropatía distal simétrica (PDS) o de manera secundaria a la neurotoxicidad de algunos agentes antirretrovirales: neuropatía toxica antirretroviral (NTA). Para explicar su fisiopatología se han propuesto varias hipótesis; la más recientemente aceptada sugiere que existe un grado de sinergia entre NTA y PDS, con mecanismos inflamatorios en común. Otros mecanismos propuestos son la disfunción mitocondrial por depleción de la polimerasa gamma mitocondrial, el déficit de creatina y la toxicidad directa de proteínas del virus, especialmente la glicoproteína 120. Se requieren futuras investigaciones que permitan el desarrollo de nuevas acciones terapéuticas para el manejo y tratamiento de la NSDP.
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Humanos , VIH , Dolor , Sistema Nervioso PeriféricoRESUMEN
Diabetes is a metabolic disease affecting approximately 300 million people worldwide. Neuropathy is one of its frequent complications, and may affect sensory, motor, and autonomic nerves. Its pathophysiology has not fully been elucidated. Several hypotheses have been proposed, and mitochondria have been suggested to play a significant role. This article reviews the mechanisms involved in mitochondrial dysfunction and development of diabetic neuropathy, consisting mainly of oxidative and inflammatory stress, changes in intracellular calcium regulation, apoptotic processes, and changes in mitochondrial structure and function that may lead to development of diabetic neuropathy.