Power Grids and Instrument Transformers up to 150 kHz: A Review of Literature and Standards.

The phenomenon of high-frequency distortion (HFD) in the electric grids, at both low-voltage (LV) and medium-voltage (MV) levels, is gaining increasing interest within the scientific and technical community due to its growing occurrence and the associated impact. These disturbances are mainly injected into the grid by new installed devices, essential for achieving decentralized generation based on renewable sources. In fact, these generation systems are connected to the grid through power converters, whose switching frequencies are significantly increasing, leading to a corresponding rise in the frequency of the injected disturbances. HFD represents a quite recent issue, but numerous scientific papers have been published in recent years on this topic. Furthermore, various international standards have also covered it, to provide guidance on instrumentation and related algorithms and indices for the measurement of these phenomena. When measuring HFD in MV grids, it is necessary to use instrument transformers (ITs) to scale voltages and currents to levels fitting with the input stages of power quality (PQ) instruments. In this respect, the recently released Edition 2 of the IEC 61869-1 standard extends the concept of the IT accuracy class up to 500 kHz; however, the IEC 61869 standard family provides guidelines on how to test ITs only at power frequency. This paper provides an extensive review of literature, standards, and the main outputs of European research projects focusing on HFD and ITs. This preliminary study of the state-of-the-art represents an essential starting point for defining significant waveforms to test ITs and, more generally, to achieve a comprehensive understanding of HFD. In this framework, this paper provides a summary of the most common ranges of amplitude and frequency variations of actual HFD found in real grids, the currently adopted measurement methods, and the normative open challenges to be addressed.

How Instrument Transformers Influence Power Quality Measurements: A Proposal of Accuracy Verification Tests.

The integration of renewable energy sources on a large scale in the electrical energy distribution systems, as well as the widespread of non-linear loads, has led to a significant increase in power quality (PQ) disturbances. For this reason, PQ monitoring is also becoming a key task in medium voltage (MV) grids. The measurement of PQ at MV levels can only be performed using instrument transformers (ITs) to scale down the level of voltage and current to levels suitable for the input stage of PQ instruments. However, no international standards currently require the verification of the errors introduced by ITs in the measurement of PQ phenomena. Moreover, this issue is only partially addressed in the scientific literature, where papers dealing with specific and limited aspects of the problem can be found. For this reason, this paper aims to comprehensively assess the issue, proposing IT accuracy verification tests for different PQ parameters. First, a set of PQ phenomena relevant for IT testing is chosen, as well as the associated ranges of variation, based on a review of the enforced standards and the scientific literature. For each selected PQ phenomenon, possible performance indices and test waveforms are proposed. Finally, the proposed procedure is validated by applying it to the characterization of two different types of commercial voltage transformers.

Erratum: Rodrigo-Mor et al. Principles of Charge Estimation Methods Using High-Frequency Current Transformer Sensors in Partial Discharge Measurements. Sensors 2020, 20, 2520.

The authors wish to make the following erratum to this paper [...].

Principles of Charge Estimation Methods Using High-Frequency Current Transformer Sensors in Partial Discharge Measurements.

This paper describes a simplified model and a generic model of high-frequency current transformer (HFCT) sensors. By analyzing the models, a universal charge estimation method based on the double time integral of the measured voltage is inferred. The method is demonstrated to be valid irrespective of HFCT sensor, assuming that its transfer function can be modelled as a combination of real zeros and poles. This paper describes the mathematical foundation of the method and its particularities when applied to measure nanosecond current pulses. In practice, the applicability of the method is subjected to the characteristics and frequency response of the sensor and the current pulse duration. Therefore, a proposal to use the double time integral or the simple time integral of the measured voltage is described depending upon the sensor response. The procedures used to obtain the respective calibration constants based on the frequency response of the HFCT sensors are explained. Two examples, one using a HFCT sensor with a broadband flat frequency response and another using a HFCT sensor with a non-flat frequency response, are presented.

Partial Discharges and Noise Discrimination Using Magnetic Antennas, the Cross Wavelet Transform and Support Vector Machines.

This paper presents a wavelet analysis technique together with support vector machines (SVM) to discriminate partial discharges (PD) from external disturbances (electromagnetic noise) in a GIS PD measuring system based on magnetic antennas. The technique uses the Cross Wavelet Transform (XWT) to process the PD signals and the external disturbances coming from the magnetic antennas installed in the GIS compartments. The measurements were performed in a high voltage (HV) GIS containing a source of PD and common-mode external disturbances, where the external disturbances were created by an electric dipole radiator placed in the middle of the GIS. The PD were created by connecting a needle to the main conductor in one of the GIS compartments. The cross wavelet transform and its local relative phase were used for feature extraction from the PD and the external noise. The features extracted formed linearly separable clusters of PD and external disturbances. These clusters were automatically classified by a support vector machine (SVM) algorithm. The SVM presented an error rate of 0.33%, correctly classifying 99.66% of the signals. The technique is intended to reduce the PD false positive indications of the common-mode signals created by an electric dipole. The measuring system fundamentals, the XWT foundations, the features extraction, the data analysis, the classification algorithm, and the experimental results are presented.

A Novel Antenna for Partial Discharge Measurements in GIS Based on Magnetic Field Detection.

This paper presents a new concept for partial discharge measurements in gas insulated systems (GIS). The proposed technique uses a novel GIS magnetic antenna that measures the magnetic field produced by partial discharges (PD) propagating in GIS. The foundations of the measurement technique and the magnetic antenna design are presented together with laboratory measurements. The magnetic antenna performance and the sensitivity of the acquisition system are studied. The bandwidth of the measurement system is in the high frequency and very high frequency (HF⁻VHF) range. Laboratory experiments demonstrate the suitability of the novel magnetic antenna-based measuring system for PD in GIS for corona, surface discharges, and free moving particles in SF6.

A Novel Approach for Partial Discharge Measurements on GIS Using HFCT Sensors.

This paper presents a novel measuring system for partial discharge (PD) measurements in Gas Insulated Systems (GIS) using high frequency current transformers (HFCT). The system is based on the measurement of the induced PD currents in the GIS enclosure. In opposition to the existing antenna technologies that measure the radiated energy in the very high frequency/ultra-high frequency (VHF/UHF) range, the proposed system measures the PD conducted currents in the high frequency (HF) range and below. The foundation of the measurements together with a detailed explanation of the sensor installed conveniently at the bolts of the GIS spacer are presented. An experimental study on the current distribution in the GIS enclosure is described to evaluate the impact of the sensor on the measurements. Laboratory experiments have been performed that show the suitability of this method to properly measure particle discharges caused by corona, surface and free moving particle discharges in SF6. Discharges in the range of 1 to 4 pC have been properly measured. An analysis to evaluate the performance of the method is shown, in comparison to VHF/UHF antenna measurements. The potential benefits of this novel technique rely on the small attenuation of PD signals in the GIS components in the HF range and sample rate reductions. Finally, a discussion on the potential applicability of present cluster and charge calculation techniques to the proposed PD GIS measurement using HFCT is presented.

[Compliance with current standards for the early detection of neonatal hearing loss]. / Cumplimiento de la normatividad vigente para la detección temprana de la hipoacusia neonatal.

OBJECTIVE: Assessing compliance with the section "Assessment of hearing" stipulated in the Technical Standard to Detect Alteration in children aged less than 10 years-old in Bogota. METHODS: This was a cross-sectional study which involved reviewing the medical records of all children born between July 1st and December 31st 2010 in two healthcare institutions in Bogota. Records were selected in which any of the following risk factors appeared: neonatal hyperbilirubinaemia involving phototherapy, neonatal exposure to ototoxic substances and/or <1.500 gr low birth weight. It was also ascertained whether children had been referred to an auditory evoked potential test as the prescribed screening test for neonatal hearing, as stipulated in mandatory Colombian technical standards for detecting abnormal growth and developmental in children aged less than ten years-old. RESULTS: Neither of the two institutions was making the aforementioned referral test. DISCUSSION: The results indicated significant difficulties in adherence to the protocol for the early detection of hearing loss regarding pertinent/current neonatal Colombian regulations.

Aproximación a la equidad en salud en perspectiva de dignidad: notas para una bioética social / Approach to equity in health in perspective of dignity: notes for a social bioethics / Aproximação à equidade em saúde em perspectiva de dignidade: notas para uma bioética social

Resumen Este escrito aborda la perspectiva sanitaria, en lo fundamental mercantil, por la cual se rigen los destinos de la salud en todo el mundo desde los últimos años del siglo XX, a partir de unas apreciaciones de Philip Musgrove, exfuncionario del Banco Mundial (BM) y exeditor de Health Affairs. Musgrove fue uno de los protagonistas en la elaboración del informe que terminó poniendo la salud abiertamente en manos del BM. Su visión de la salud era esencialmente economicista e individualista, e hizo a un lado cualquier mirada a la dignidad de los seres humanos, así se trate de un término que, como el amor o la belleza, sea de difícil definición, pero de importancia fundamental para la reflexión en bioética social. Se inicia este artículo con un breve recorrido alrededor de este concepto, para luego conectarlo con la estrategia de búsqueda y reducción de inequidades en salud, la cual resulta coherente con la mirada a los determinantes sociales, según el informe final de la comisión nombrada para este asunto. También se ofrece otra mirada para la reflexión sobre la equidad en salud, según los referentes entre la calidad de vida y el bienestar.

Abstract The paper addresses the health perspective, fundamentally commercial, which governs the health destinations around the world since the last years of the twentieth century, from an assessment of Philip Musgrove, a former World Bank (WB) official and former editor of Health Affairs. Musgrove was one of the protagonists in the preparation of the report that ended up putting health openly in the hands of the World Bank. His vision of health was essentially economistic and individualistic and set aside any glance at the dignity of human beings, whether it is a term that, like love or beauty, is difficult to define, but of vital importance for reflection in social bioethics. This article begins with a brief tour around this concept, and then connects it with the search strategy and reduction of inequities in health, which is consistent with the look at the social determinants, according to the final report of the commission appointed for this affair. Another look is also offered for reflection on equity in health, according to the referents between the quality of life and well-being.

Resumo Este artigo aborda a perspectiva sanitária, no fundamental comercial, pela qual se regem os destinos da saúde em todo o mundo desde os últimos anos do século XX, a partir de umas apreciações de Philip Musgrove, ex-funcionário do Banco Mundial (BM) e ex-editor de Health Affairs. Musgrove foi um dos protagonistas na preparação do relatório que acabou colocando a saúde abertamente nas mãos do BM. Sua visão da saúde era essencialmente economicista e individualista, e fez a um lado qualquer olhar para a dignidade dos seres humanos, assim trate-se de um termo que, como o amor ou a beleza, seja difícil de definir, mas de fundamental importância para a reflexão em bioética social. Este artigo começa com um breve passeio em torno deste conceito, para depois conectá-lo com a estratégia de busca e redução de desigualdades em saúde, o que é consistente com o olhar a os determinantes sociais, de acordo com o relatório final da comissão nomeada para este assunto. Também é oferecido outro olhar para a reflexão sobre a equidade em saúde, de acordo com os referentes entre qualidade de vida e o bem-estar.

[Prevalence of periodontal disease and oral hygiene indicators in high school students from Cartagena, Colombia]. / Enfermedad periodontal e indicadores de higiene bucal en estudiantes de secundaria Cartagena, Colombia.

OBJECTIVE: Determining the prevalence of periodontal disease, treatment needs and associated factors in students from the John F. Kennedy School in Cartagena. METHODS: This was a cross-sectional study of 392 students selected by proportional random sampling stratified to the size of each course, considering a population framework of 902 subjects. The Community Periodontal Index of Treatment Needs (CPITN) was measured as well as the Green & Vermillon oral hygiene index. A univariate analysis was made of percentages and bivariate analysis using odds ratios (OR) and 95 % confidence intervals (95 %CI). RESULTS: All participants presented at least one disease indicator, the presence of calculus being most frequent (45.1 %). Regarding the oral hygiene index, 77.7 % of the participants had high bacterial plaque indices. The bivariate analysis revealed an association between oral hygiene (OR=2.20; 1.27-3.81 95 %CI) and socioeconomic level (OR=0.44; 0.24-0.80 95 %CI). Multivariate analysis led to a model being obtained in which gender, socioeconomic level and state of hygiene explained periodontal disease severity and treatment needs. CONCLUSIONS: Periodontal disease load was extremely high, although most events were found to involve early stages, thereby allowing successful intervention to avoid disease progressing to advanced stages.

Bioethics of intervention, inter-culturality andnon-coloniality / Bioética de intervención, interculturalidad y no-colonialidad

The proposal of Intervention Bioethics (BI), which arose in the 1990s as a response to the Anglo-Saxon perspective of four universally presumed principles, which though necessary are insufficient in the Latin-American context, has continued its collective construction process. The article shows the common points between this proposal and Latin-American perspectives of inter-cultural and non-colonial issues. Simultaneously, the utilitarian perspective of John Stuart Mill opens the possibilities of approximation between utilitarianism and individual rights, ethically opposing positions for many authors. In addition, we show that BI has consonance with three Unesco declarations on culture, genetic heritage and human rights. All of these elements allow progress towards an epistemological statute of Intervention Bioethics, one of the more important proposals towards a Latin-American vision of this new interdisciplinary territory of knowledge.

La propuesta de Bioética de Intervención (BI) surgida en los años 1990 como respuesta a la mirada anglosajona de la bioética centrada en cuatro principios pretendidamente universales - que aunque necesarios son insuficientes al contexto latinoamericano - ha continuado su proceso de construcción colectiva. El artículo muestra los puntos comunes entre esta propuesta y perspectivas regionales latinoamericanas acerca de interculturalidad y no-colonialidad. A partir de la mirada utilitarista de John Stuart Mill, abre posibilidades de aproximación entre el utilitarismo y los derechos individuales, posturas éticas contrarias para muchos autores. Igualmente, muestra como la BI está en consonancia con el contenido de las tres declaraciones de la Unesco en asuntos relacionados con la cultura, patrimonio genético y derechos humanos. Todos estos elementos permiten avanzar hacia un estatuto epistemológico para la Bioética de Intervención, una de las propuestas más difundidas en la contextualización latinoamericana de este territorio interdisciplinar del conocimiento.

[Primary central nervous system tumours reported in Cartagena, 2001-2006]. / Tumores primarios del sistema nervioso central en Cartagena, 2001- 2006.

OBJECTIVES: Determining the frequency of primary central nervous system tumours diagnosed in Cartagena; Colombia, from 2001-2006 and determining the demographic, epidemiological and clinical characteristics of patients having central nervous system tumours reported by a single institution in Cartagena between 2001 and 2006. METHODS: A passive epidemiological surveillance descriptive study was carried out. The pathology reports of new diagnosed central nervous system primary tumours from all laboratories in Cartagena were taken and the available clinical records regarding these cases were analysed. The overall incidence rate and incidence rates by year, gender, age and histological type were estimated, with 95 % confidence intervals. Standardised morbidity rates were also calculated. RESULTS: There were 390 such cases during 2001-2006. The overall incidence rate was 6.91/100,000 people-year. Meningiomas were the most frequently occurring histological types (3.46/100,000 people-year). The provenance could only be determined in 43.1 % of cases. Standardised morbidity rates were higher in Cartagena regarding those reported in the United States and by the Colombian National Cancer Institute and the Population-based Cali Cancer Registry. CONCLUSIONS: There was a higher incidence of primary central nervous system tumours in Cartagena than in the rest of the country. Registry and surveillance systems should be improved and research into risk factors encouraged.

Sociedad occidental al sur: entre conocimiento, riesgo y miedo. Reflexiones en perspectiva bioética y de salud pública / South western society: between knowledge, risk and fear. Reflections on bioethics perspective and public health / Sociedade ocidental do sul: conhecimento, risco e medo. Reflexões sob a perspectiva bioética e de saúde pública

La sociedad actual recibe, entre otras denominaciones, modernidad tardía o reflexiva, y sociedad del conocimiento. A fin de explicarla se acude a múltiples abordajes pero sobre todo se advierte su complejidad y su intrincado sistema de relaciones. Se han buscado respuestas a sus más grandes problemas no sólo en la sociología sino también en las variadas formas de combinar análisis sociales con análisis políticos, económicos, culturales y filosóficos. Un papel relevante y difundido juega Ulrich Beck al caracterizar la sociedad del riesgo. Para él, la segunda modernidad tiene que ver con la forma como en occidente se ha ido presentando un cambio en las ideas impulsoras que preconizaban el progreso, el control, el pleno empleo y la explotación de la naturaleza. Fenómenos como la industrialización y el mercado dentro del capitalismo, para mencionar sólo uno de los procesos más influyentes en la sociedad moderna, han desembocado en la globalización, la individualización, la revolución de géneros, el subempleo y las amenazas planetarias, las cuales van conformando su perspectiva de la sociedad del riesgo, como la denomina Beck. Hay, sin embargo, un occidente al norte y otro al sur. Esto igualmente plantea desafíos, nuevas dinámicas y preguntas sobre el mundo y la supervivencia, pero también sobre aspectos centrales para los seres humanos, entre ellos, la salud. ¿Cuáles son las razones para prestar tanta atención al riesgo y que este, a su vez, se inmiscuya en todos los planos de la sociedad? ¿Cómo enfrentar los retos que la sociedad del riesgo plantea al área asistencial? ¿Qué implicaciones tiene hablar de conocimiento, riesgo, miedo y también desconocimiento en la atención en salud? Estas son sólo algunas de las preguntas que surgen de la dinámica social actual. En esta reflexión se tendrán en cuenta las características de la sociedad del riesgo enunciadas por Beck y su relación con los análisis de expertos en Salud Pública y Bioética Médica. Sobre todo, se reflexiona sobre estos asuntos teniendo en cuenta el perfil que han venido adquiriendo conocimiento, riesgo y miedo en el contexto de este occidente del sur, marcado por la injusticia social y las inequidades en salud...

Entre outras denominações, a sociedade atual recebe os nomes de modernidade tardia ou reflexiva e de sociedade do conhecimento. Para explicá-la recorre-se a múltiplas abordagens, mas, principalmente, adverte-se sobre sua complexidade e seu intrincado sistema de relações. Respostas aos seus maiores problemas vêm sendo buscadas não só na sociologia, mas também nas variadas formas de combinar análises sociais com análises políticas, econômicas, culturais e filosóficas. Ulrich Beck tem um papel relevante e difundido ao caracterizar a sociedade de risco. Para ele, a segunda modernidade tem a ver com a forma em que no ocidente vem sendo apresentada uma mudança nas ideias impulsionadoras que preconizavam o progresso, o controle, o emprego pleno e a exploração da natureza. Fenômenos como a industrialização e o mercado dentro do capitalismo, para mencionar apenas um dos processos que mais influem na sociedade moderna, desembocaram na globalização, na individualização, na revolução de gêneros, no subemprego e nas ameaças mundiais, e vão formando sua perspectiva da sociedade de risco, como a denomina Beck. Entretanto, existe um ocidente do norte e outro do sul. Isto igualmente apresenta desafios, novas dinâmicas e perguntas sobre o mundo e a supervivência, mas também quanto a aspectos essenciais para os seres humanos, entre eles, a saúde. Quais são os motivos para se dar tanta atenção ao risco e de que este, por sua vez, se introduza em todos os níveis da sociedade? Como enfrentar os desafios que a sociedade de risco apresenta para a área assistencial? Quais são as implicações de se falar em conhecimento, risco, medo e, também, desconhecimento no atendimento da saúde? Estas são somente algumas das perguntas que surgem da dinâmica social atual. Nesta reflexão serão levadas em consideração as características da sociedade de risco enunciadas por Beck e sua relação com as análises de expertos em saúde pública e bioética médica. Em especial, a reflexão sobre estes assuntos considera o perfil que vem adquirindo o conhecimento, o risco e o medo no contexto deste ocidente do sul, marcado pela injustiça social e pelas iniquidades na saúde...

Cumplimiento de la normatividad vigente para la detección temprana de la hipoacusia neonatal / Compliance with current standards for the early detection of neonatal hearing loss

Objetivo Evaluar el cumplimiento del apartado de "Valoración de la Capacidad Auditiva" estipulado en la Norma Técnica para la Detección de las Alteraciones en el menor de 10 años en la ciudad de Bogotá, Colombia. Método Se realizó un estudio transversal. Se revisaron las historias clínicas de todos los niños nacidos entre el 01 de julio y el 31 de diciembre de 2010, en dos instituciones de salud de la ciudad de Bogotá. Se seleccionaron aquellas en las que se presentaba cualquiera de los siguientes factores de riesgo: hiperbilirrubinemia neonatal con requerimiento de fototerapia, exposición neonatal a ototóxicos, bajo peso al nacer (<1 500 gramos) y se verificó la remisión a Potenciales Auditivos Evocados como prueba de detección de la hipoacusia neonatal de acuerdo a lo estipulado de manera obligatoria en la Norma Técnica para la Detección de las Alteraciones de Crecimiento y Desarrollo en el Menor de Diez Años. Resultados En ninguna de las dos instituciones se realizó la remisión a la prueba mencionada. Discusión Los resultados del estudioindican graves dificultades en la adherencia al protocolo de detección temprana de la hipoacusia neonatal vigente en la normatividad Colombiana.

Objective Assessing compliance with the section "Assessment of hearing" stipulated in the Technical Standard to Detect Alteration in children aged less than 10 years-old in Bogota. Methods This was a cross-sectional study which involved reviewing the medical records of all children born between July 1st and December 31st 2010 in two healthcare institutions in Bogota. Records were selected in which any of the following risk factors appeared: neonatal hyperbilirubinaemia involving phototherapy, neonatal exposure to ototoxic substances and/or <1.500 gr low birth weight. It was also ascertained whether children had been referred to an auditory evoked potential test as the prescribed screening test for neonatal hearing, as stipulated in mandatory Colombian technical standards for detecting abnormal growth and developmental in children aged less than ten years-old. Results Neither of the two institutions was making the aforementioned referral test. Discussion The results indicated significant difficulties in adherence to the protocol for the early detection of hearing loss regarding pertinent/current neonatal Colombian regulations.

Enfermedad periodontal e indicadores de higiene bucal en estudiantes de secundaria Cartagena, Colombia / Prevalence of periodontal disease and oral hygiene indicators in high school students from Cartagena, Colombia

Objetivo Determinar la prevalencia de la enfermedad periodontal, las necesidades de tratamiento y los factores asociados en estudiantes del Colegio John F. Kennedy de la ciudad de Cartagena. Método Estudio de corte transversal en 392 estudiantes seleccionados mediante muestreo aleatorio estratificado proporcional al tamaño de cada curso, teniendo en cuenta una población marco de 902 sujetos. Se midió el Índice Comunitario de Necesidades de Tratamiento Periodontal (ICPNT) y el índice de placa bacteriana de Green y Vermillon. Se realizó análisis univariado a partir de proporciones y análisis bivariado a través de Razones de Disparidad (OR), asumiendo intervalos de confianza del 95 %. Resultados El total de los participantes presentó al menos un indicador de enfermedad, siendo más frecuente la presencia de cálculos con 45,1 %. En cuanto al índice de higiene oral, el 77,7 % de los participantes presentaron índices de placa bacteriana altos. Al análisis bivariado se presentó asociación con la higiene oral (OR=2,20 IC 95 %; 1,27-3,81) y el estrato socioeconómico (OR= 0,44 IC 95 %; 0,24-0,80). En el análisis multivariable, se obtuvo un modelo en el cual el sexo, estrato y estado de higiene explican la severidad de la enfermedad periodontal y las necesidades de tratamiento. Conclusiones La enfermedad periodontal es extremadamente alta, a pesar de que la mayoría de los eventos se encontraron en los estadíos leves, lo que permite intervenir con éxito para evitar la progresión a estadíos más avanzados.

Objective Determining the prevalence of periodontal disease, treatment needs and associated factors in students from the John F. Kennedy School in Cartagena. Methods This was a cross-sectional study of 392 students selected by proportional random sampling stratified to the size of each course, considering a population framework of 902 subjects. The Community Periodontal Index of Treatment Needs (CPITN) was measured as well as the Green & Vermillon oral hygiene index. A univariate analysis was made of percentages and bivariate analysis using odds ratios (OR) and 95 % confidence intervals (95 %CI). Results All participants presented at least one disease indicator, the presence of calculus being most frequent (45.1 %). Regarding the oral hygiene index, 77.7 % of the participants had high bacterial plaque indices. The bivariate analysis revealed an association between oral hygiene (OR=2.20; 1.27-3.81 95 %CI) and socioeconomic level (OR=0.44; 0.24-0.80 95 %CI). Multivariate analysis led to a model being obtained in which gender, socioeconomic level and state of hygiene explained periodontal disease severity and treatment needs. Conclusions Periodontal disease load was extremely high, although most events were found to involve early stages, thereby allowing successful intervention to avoid disease progressing to advanced stages.

Tromboembolia coronaria múltiple como causa de infarto agudo de miocardio

La tromboembolia coronaria es una causa infrecuente y poco documentada de síndrome coronario agudo. En la bibliografía sólo se encuentran comunicaciones aisladas con escasa fundamentación angiográfica. En esta presentación se describe el caso de un varón de 32 años sin antecedentes cardiovasculares, que debuta con un cuadro de infarto agudo de miocardio con evidencia angiográfica de múltiples tromboembolias coronarias y evoluciona a shock cardiogénico y muerte. Se realiza, asimismo, una revisión de las causas y de las formas de presentación clínica de la tromboembolia coronaria.

Acute Myocardial Infarction Caused by Multiple Coronary Artery Embolisms Coronary artery embolism is a rare cause of acute coronary syndrome that is scarcely documented. Only a few case reports have been published but lack of solid angiographic evidence. We describe a 32-year old man without history of cardiovascular disease with a first episode of acute myocardial infarction with angiographic evidence of multiple thromboembolisms of the coronary arteries who developed cardiogenic shock and died. We review the causes and the clinical presentations of coronary artery embolism.

Tumores primarios del sistema nervioso central en Cartagena, 2001- 2006 / Primary central nervous system tumours reported in Cartagena, 2001-2006

Objetivos Determinar la frecuencia de los tumores primarios del sistema nervioso central, diagnosticados en Cartagena de Indias durante el periodo de 2001-2006 y, determinar las características demográficas, epidemiológicas y clínicas de los pacientes con tumores del sistema nervioso central de una institución de la ciudad, en el mismo periodo. Métodos Se realizó un estudio descriptivo de vigilancia epidemiológica pasiva. Se tomaron los reportes de patología con diagnóstico nuevo de tumor primario del sistema nervioso central de todos laboratorios de Cartagena y se analizaron las historias clínicas disponibles de estos casos. Se estimaron las tasas de incidencia general, por año, género, grupos de edad y tipo histológico con intervalos de confianza al 95 por ciento. Además se calcularon razones estandarizadas de morbilidad. Resultados Durante los años 2001 y 2006 se encontraron 390 casos. La tasa incidencia general fue de 6,91/100 000 personas-año. El tipo histológico más frecuente fue meningioma (3,46/100 000 personas-año). Sólo se determinó la procedencia en el 43,1 por ciento de los casos. Las razones estandarizadas de morbilidad fueron más altas en Cartagena con respecto a las de los Estados Unidos, el Instituto Nacional de Cancerología de Colombia y el Registro Poblacional de Cáncer de Cali. Conclusiones Hubo una frecuencia de tumores primarios del sistema nervioso central más elevada en Cartagena que en el resto del país. Se recomienda mejorar los sistemas de registro y vigilancia para determinar la magnitud real del problema y fomentar investigaciones en busca de factores de riesgo.

Objectives Determining the frequency of primary central nervous system tumours diagnosed in Cartagena; Colombia, from 2001-2006 and determining the demographic, epidemiological and clinical characteristics of patients having central nervous system tumours reported by a single institution in Cartagena between 2001 and 2006. Methods A passive epidemiological surveillance descriptive study was carried out. The pathology reports of new diagnosed central nervous system primary tumours from all laboratories in Cartagena were taken and the available clinical records regarding these cases were analysed. The overall incidence rate and incidence rates by year, gender, age and histological type were estimated, with 95 percent confidence intervals. Standardised morbidity rates were also calculated. Results There were 390 such cases during 2001-2006. The overall incidence rate was 6.91/100,000 people-year. Meningiomas were the most frequently occurring histological types (3.46/100,000 people-year). The provenance could only be determined in 43.1 percent of cases. Standardised morbidity rates were higher in Cartagena regarding those reported in the United States and by the Colombian National Cancer Institute and the Population-based Cali Cancer Registry. Conclusions There was a higher incidence of primary central nervous system tumours in Cartagena than in the rest of the country. Registry and surveillance systems should be improved and research into risk factors encouraged.

Calidad de vida y adaptación social de los cuidadores de adultos mayores / Quality of life and social adjustment of older adult caretakers

Introducción: La calidad de vida de los cuidadores de ancianos puede verse alterada por la exposición laboral que representa la atención de adultos mayores. Estas alteraciones pueden no ser percibidas por los trabajadores ni sus familias. Método: Se aplicaron test de calidad vida y adaptación social a los cuidadores de adultos mayores en centros de bienestar de Pereira y Santa Rosa de Cabal (Risaralda, Colombia). Resultados: Se evaluaron 69 cuidadores institucionalizados. Los test tuvieron un alto índice de confiabilidad interna. Se identificaron los componentes de las pruebas y se encontró que la gran mayoría de los cuidadores tenían adaptación social y que la calidad de vida oscilaba entre baja y mediana calidad de vida. Conclusiones: A pesar de ser una población con adecuadas condiciones sociales, se presentan riesgos por adaptación patológica e inadecuada calidad de vida...

Introduction: Caretakers’ quality of life may be altered, impacting heavily on the care they provide to the elderly in nursing homes. Methods: Different tests were applied to measure the quality of life, social adjustment, and social conditions of the caretakers in Pereira and Santa Rosa de Cabal (Risaralda, Colombia). Results: 69 institutionalized caretakers were evaluated. The test had a high level of internal reliability. The components of the tests were identified and showed that the great majority of caretakers had social adjustment, and that the quality of life was ranging between low and medium. Conclusions: In spite of being a population with suitable social conditions they present risks stemming from pathological adjustment and inadequate quality of life...

Las enfermedades infecciosas emergentes y la salud pública / Emergent infectious diseases and the public health

Se define como enfermedades infecciosas emergentes, aquellas cuya incidencia en el ser humano ha aumentado durante los últimos decenios o amenaza con aumentar en el futuro próximo. También se usa para enfermedades que, como el cólera, se han extendido a nuevas áreas geográficas o para otras, consideradas hace algún tiempo fácilmente controlables con quimioterapia y antibióticos pero que actualmente muestran resistencia, como la blenorragia o la malaria. Caben además entidades que, como la tuberculosis o la difteria, se convirtieron en problema de salud pública en gran parte debido al deterioro de los programas de prevención y control, hecho al que se suma, para la primera, la asociación con el VIH

Cólera en Colombia: descripción de algunos aspectos epidemiológicos a un año de diagnosticado el primer caso / Cholera in Colombia: description of some epidemiological aspects one year after the first case diagnosis

Luego de un año de confirmado el primer caso de cólera en Colombia (marzo 10 de 1991) en el puerto de Tumaco, al suroeste del país, se ha querido describir algunos hallazgos epidemiológicos teniendo en cuenta que aún la epidemia muestra una curva ascendente en varios sitios y por esto no puede establecer ninguna conclusión final. Hasta el 20 de marzo de 1992 se había informado 17.673 casos de cólera, de los cuales el 95 por ciento estaban en los 12 departamentos costeros, incluyendo la isla de San Andrés, los cuales tienen el 49 por ciento de la población colombiana. La enfermedad se diseminó siguiendo 3 rutas principales: Los océanos y los ríos Magdalena y Cauca pero se presentaron casos aislados en sitios donde la enfermedad no ha ocasionado un problema importante de salud pública y generalemnte se trataba de personas que ingirieron el Vibrio Cholerae en un sitio ya afectado y fueron a enfermar a otro. El comportamiento de la enfermedad, hasta el momento, es el referido para situaciones de epidemia, en las cuales se afectan todas las edades y no tiene preferencia por sexo. Al parecer, durante este siglo no se había detectado ningún caso de cólera en Suramérica; sin embargo, hay información de que en el siglo pasado se presentó un número no precisado de casos en las costas, con un cuadro clínico claramente compatible con el cólera asiático y que se conocía como "Cólera Nostras", "Colera Celeste", etc. La epidemia que afecta actualmente a la Américas hace parte de la llamada 7a pandemia, ocasionada por el biotipo El Tor que empezó en las islas Célebes en los años 60 y se reconoció por primera vez en el Africa en 1970