Desarrollo de un Sistema con Potencial Aplicación de Fototerapia para Ictericia Neonatal / Design of a System with a Potential Application to Neonatal Jaundice Phototherapy

RESUMEN En este proyecto se diseñó y construyó un prototipo con potencial aplicación a un sistema de fototerapia para ictericia neonatal utilizando por primera vez LEDs de 10 W de alta potencia. Se describe la metodología aplicada para el diseño de los diferentes circuitos electrónicos que se utilizaron para la alimentación de la corriente de excitación de los LEDs, se describe el método de control de corriente mediante el uso de la modulación por ancho de pulsos, Pulse Width Modulation (PWM, por sus siglas en inglés), generados por el circuito integrado 555. Se diseñó la placa de circuito impreso mediante la ayuda del simulador Orcad Layout. Se utilizaron dos LEDs de alta potencia de 10 W para el propósito de conservar la intensidad requerida para el tratamiento, minimizando el espacio utilizado por la cantidad de LEDs utilizados en los equipos convencionales. Entre las limitaciones que se presentaron en esta investigación fue el uso de la plataforma Arduino, ya que se tienen varias oportunidades de mejora para darle el mejor uso al microcontrolador, y de esta manera digitalizar el sistema de una forma más completa, reduciendo la circuitería de control. El prototipo presentado cumple con los requerimientos necesarios para un sistema de fototerapia.

ABSTRACT This project consisted in the design and construction of a prototype with potential application to a phototherapy system for neonatal jaundice using for the first-time high power 10 W LEDs. The methodology for the design of different electronic circuits which were used for feeding the drive current of the LEDs, the current control method described using pulse width modulation (PWM) generated by the known 555 integrated circuit is described. The printed circuit board was designed with the help of the Orcad Layout simulator. Two high-power 10 W LEDs were used for maintaining the intensity required for the treatment, minimizing the space used by the number of LEDs used in the conventional equipment. Among the limitations presented in this research was the use of the Arduino platform, due to several improve that can be used to improve and increase the use of this microcontroller, and in this way to digitize the system, reducing the circuitry of control. The prototype presented meets the requirements for a phototherapy system according to the different references used.

Diagnóstico bacteriológico de tuberculosis pulmonar mediante fibrobroncoscopía en pacientes con VIH / Bacteriological diagnosis of lung tuberculosis through bronchoscopy in HIV-infected patients

Tuberculosis can be lethal in HIV infected people. Lung is the organ most frequently involved, but clinical and radiological features are not typical of the disease. Diagnostic certification demands acid-fast bacillus microscopy and mycobacterial cultures on sputum. Some patients need bronchoscopy to obtain samples due to insufficient sputum. We reported a 9.1 percent diagnostic yield using bronchoscopy. Clinical suspicion before bronchoscopy had low positive predictive value of tuberculosis (10.8 percent). 47.8 percent of tuberculosis cases were not suspected before this procedure. Tuberculosis patients showed CD4 < 200 cells/mL (48.8 in average) and less use of ART (antiretroviral therapy). Cultures contributed to the diagnosis of 35 percent of tuberculosis cases but with a delay of 30 days. Induced sputum is a less costly alternative to bronchoscopy with a similar diagnostic yield.

La tuberculosis puede ser letal en pacientes infectados por VIH. El compromiso pulmonar es más frecuente en ellos y su cuadro clínico-radiológico no es típico de la enfermedad. El diagnóstico se confirma con baciloscopía y cultivo de Koch en esputo. Los pacientes sin esputo pueden requerir broncoscopía. Encontramos un rendimiento de 9,1 por ciento en diagnóstico de tuberculosis pulmonar por broncoscopía. La sospecha clínica de tuberculosis previa a broncoscopía tuvo bajo valor predictivo positivo (10,8 por ciento). 47,8 por ciento de los pacientes con Tuberculosis no fueron sospechados antes de la broncoscopía por lo que recomendamos este procedimiento en pacientes VIH con alteraciones radiológicas y síntomas respiratorios. Los casos de tuberculosis tenían CD4 < 200 células/mL (promedio 48,8) y menos uso de TAR: terapia antiretroviral. El 35 por ciento de los casos de tuberculosis se diagnosticó por cultivo (demora mínima de 30 días). El esputo inducido es una alternativa a la broncoscopía menos costosa y de similar rendimiento.

[2012: news in neurology]. / Neurologie.

In 2012, intramuscular midazolam appears as effective as intravenous lorezepam for the first line treatment of convulsive status epilepticus. Perampanel, a new anti-epileptic drug, will be soon available. Two oral treatments are now available for stroke prevention in atrial fibrillation setting. The methylphenidate and the Tai Chi could increase the walk capacity of patients suffering from Parkinson disease. A comprehensive cardiac work-up is essential for some congenital myopathy. A new drug against migraine seems free from vasoconstrictive effect. Antioxidants are harmful in Alzheimer disease. Some oral medication will be available for multiple sclerosis.

Nutrición para el entrenamiento y la competición / Nutrition for training and competition

La nutrición es un factor relevante en el rendimiento deportivo. El objetivo de la nutrición deportiva es aportar la cantidad de energía apropiada, otorgar nutrientes para la mantención y reparación de los tejidos y, mantener y regular el metabolismo corporal. Entre los macronutrientes más relevantes para el deportista están los Hidratos de Carbono, cuyo aporte se ajusta de acuerdo al entrenamiento, semana previa a la competencia, día de la competición y recuperación. Otro aspecto central, es asegurar una hidratación adecuada, para lo cual es fundamental implementar planes adaptados a los requerimientos individuales como parte del programa de entrenamiento. Finalmente, es importante considerar el uso de suplementos en los deportistas basados en la evidencia de la medicina actual, de manera de obtener beneficios a partir de ellos, evitar riesgo de salud y de dopaje.

Nutrition is an important factor in sports performance. The goal of sports nutrition is to provide the proper amount of energy, nutrients for maintenance and repair of tissues and, preserve and regulate body metabolism. Among the most important macronutrient for the athlete are carbohydrate, whose intake is adjusted according to the training a week before the competition, the day of the competition, and the recovery after it. Another focus is to ensure an adequate hydration, which is essential for implementing specifics plans to individual requirements as part of the training program. Finally, it is important to consider the use of supplements in athletes based on current medical evidence, to obtain benefits from them, and to avoid health risks and doping.

PCR detection of colostrum-associated Maedi-Visna virus (MVV) infection and relationship with ELISA-antibody status in lambs.

A recent large-scale experimental study showed that bottle-feeding ovine colostrum from seropositive ewes results in high MVV-seroconversion in lambs. In contrast, relatively few lambs that naturally suckled colostrum from seropositive dams seroconverted as a result of it. Furthermore, lambs fed uninfected bovine colostrum readily seroconverted when mixed with ovine-colostrum lambs indicating that horizontal MVV transmission between lambs was efficient. MVV-infection was further investigated in the same samples using two PCR tests targeting sequences in the long-terminal repeats (LTR) and POL MVV genes. PCR-tests confirmed previous serological findings. However, the LTR-PCR was more sensitive and allowed detecting infection earlier than the other tests, including 5-8% of new-born lambs from seropositive dams, providing more evidence that prenatal MVV-infection may be more important than considered. The degree of agreement between PCR and antibody tests in individual samples was low up to 6 months of age and moderate at 10 months-old. Nine percent of lambs were always PCR-negative but seroconverted and 19% of lambs were PCR-positive at least once and did not seroconvert. However, seroconversion was associated with increasing number of times lambs were PCR-positive and ovine colostrum-fed lambs were more frequently PCR-positive than other lambs. The significance of these findings in terms of MVV-infection, epidemiology and control is discussed.

Relative contribution of colostrum from Maedi-Visna virus (MVV) infected ewes to MVV-seroprevalence in lambs.

Maedi-visna virus (MVV) seroprevalence associated with consumption of colostrum from seropositive ewes was investigated in 276 housed lambs from birth to 300 days-old. At birth, lambs were allocated to five experimental groups according to the maternal MVV-serological status, source and mode of feeding colostrum (bovine or ovine and bottle fed or suckled from the dam) and type of horizontal MVV-exposure (raised with the dam or separately with other lambs). The risk of being seropositive at 300 days-old was associated with feeding ovine colostrum from seropositive ewes and increased with intake of bottle-fed ovine colostrum and was higher in lambs separated from their dams and raised with other experimental lambs compared to lambs raised with their dams. Approximately 75-87% of ELISA-positive results in lambs that had ovine colostrum was attributable to colostrum itself. However, approximately only 16% of naturally raised and 29-61% of bottle-fed ovine colostrum lambs were ELISA-positive as a result feeding ovine colostrum. These results confirm that ovine colostrum from seropositive ewes can be a major source of MVV but its overall contribution to seroprevalence in natural conditions is relatively low, and shows that horizontal MVV transmission can be an important source of infection in new-born lambs.

Comparative effects of colchicine and silymarin on CCl4-chronic liver damage in rats.

The comparative effects of colchicine (10 micrograms day-1, p.o.) and silymarin (50 mg kg-1, p.o.) each given for 5 days a week on the chronic carbon tetrachloride (CCl4) liver damage were studied. Treatment with CCl4 resulted in a marked reduction of Na+, K+, and Ca2(+)-ATPases in plasma liver membranes as compared to vehicles or either silymarin or colchicine alone. Collagen content in livers of animals treated with CCl4 was increased about four-fold as compared to controls and histological examination of liver samples showed that collagen increase distorted the normal liver architecture. Colchicine or silymarin treatment completely prevented all the changes observed in CCl4-cirrhotic rats (namely, lipid peroxidation, Na+, K+ and Ca(2+)-ATPases), except for liver collagen content which was reduced only 55% as compared with CCl4-treated rats and for alkaline phosphatase and glutamic pyruvic transaminase which still remained above controls. In the CCl4 + silymarin group, the loss of glycogen content was completely prevented. However, when rats were treated with CCl4 + colchicine, liver glycogen content could not be restored. The hepatoprotective effects of colchicine or silymarin were very similar in regard to the prevention of chronic liver damage.