A Smart System for the Contactless Measurement of Energy Expenditure.

Energy Expenditure (EE) (kcal/day), a key element to guide obesity treatment, is measured from CO2 production, VCO2 (mL/min), and/or O2 consumption, VO2 (mL/min). Current technologies are limited due to the requirement of wearable facial accessories. A novel system, the Smart Pad, which measures EE via VCO2 from a room's ambient CO2 concentration transients was evaluated. Resting EE (REE) and exercise VCO2 measurements were recorded using Smart Pad and a reference instrument to study measurement duration's influence on accuracy. The Smart Pad displayed 90% accuracy (±1 SD) for 14-19 min of REE measurement and for 4.8-7.0 min of exercise, using known room's air exchange rate. Additionally, the Smart Pad was validated measuring subjects with a wide range of body mass indexes (BMI = 18.8 to 31.4 kg/m2), successfully validating the system accuracy across REE's measures of ~1200 to ~3000 kcal/day. Furthermore, high correlation between subjects' VCO2 and λ for CO2 accumulation was observed (p < 0.00001, R = 0.785) in a 14.0 m3 sized room. This finding led to development of a new model for REE measurement from ambient CO2 without λ calibration using a reference instrument. The model correlated in nearly 100% agreement with reference instrument measures (y = 1.06x, R = 0.937) using an independent dataset (N = 56).

Sugar Concentration Measurement System Using Radiofrequency Sensor.

A sugar solution measurement system was developed based on the dielectric properties of the sucrose molecule. An ac conductivity and tan δ study as a function of the frequency was performed to find the suitable frequency range for the measuring system. The results indicate that it is possible to obtain a better response of the sensor using the frequencies as the maxima peak in tan δ appears. Developed setup for sucrose solution was appropriate to measure in a 0.15 to 1 g/mL range with an experimental error of about 3%. The proposed system improves the measurement time over some other methods.

Altered lymphatics in an ovine model of congenital heart disease with increased pulmonary blood flow.

Abnormalities of the lymphatic circulation are well recognized in patients with congenital heart defects. However, it is not known how the associated abnormal blood flow patterns, such as increased pulmonary blood flow (PBF), might affect pulmonary lymphatic function and structure. Using well-established ovine models of acute and chronic increases in PBF, we cannulated the efferent lymphatic duct of the caudal mediastinal node and collected and analyzed lymph effluent from the lungs of lambs with acutely increased PBF (n = 6), chronically increased PBF (n = 6), and age-matched normal lambs (n = 8). When normalized to PBF, we found that lymph flow was unchanged following acute increases in PBF but decreased following chronic increases in PBF. The lymph:plasma protein ratio decreased with both acute and chronic increases in PBF. Lymph bioavailable nitric oxide increased following acute increases in PBF but decreased following chronic increases in PBF. In addition, we found perturbations in the transit kinetics of contrast material through the pleural lymphatics of lambs with chronic increases in PBF. Finally, there were structural changes in the pulmonary lymphatic system in lambs with chronic increases in PBF: lymphatics from these lambs were larger and more dilated, and there were alterations in the expression of vascular endothelial growth factor-C, lymphatic vessel endothelial hyaluronan receptor-1, and Angiopoietin-2, proteins known to be important for lymphatic growth, development, and remodeling. Taken together these data suggest that chronic increases in PBF lead to both functional and structural aberrations of lung lymphatics. These findings have important therapeutic implications that warrant further study.

Heat Transfer in Cassava Starch Biopolymers: Effect of the Addition of Borax.

In recent years, polymer engineering, at the molecular level, has proven to be an effective strategy to modulate thermal conductivity. Polymers have great applicability in the food packaging industry, in which transparency, lightness, flexibility, and biodegradability are highly desirable characteristics. In this work, a possible manner to adjust the thermal conductivity in cassava starch biopolymer films is presented. Our approach is based on modifying the starch molecular structure through the addition of borax, which has been previously used as an intermolecular bond reinforcer. We found that the thermal conductivity increases linearly with borax content. This effect is related to the crosslinking effect that allows the principal biopolymer chains to be brought closer together, generating an improved interconnected network favoring heat transfer. The highest value of the thermal conductivity is reached at a volume fraction of 1.40% of borax added. Our analyses indicate that the heat transport improves as borax concentration increases, while for borax volume fractions above 1.40%, heat carriers scattering phenomena induce a decrement in thermal conductivity. Additionally, to obtain a deeper understanding of our results, structural, optical, and mechanical characterizations were also performed.

Non-invasive ventilation and airway exchange catheter using a novel adapter in a difficult airway patient with post-extubation respiratory failure.

Post-extubation respiratory failure in patients with difficult airway is considered a challenge for the health team. Some intratracheal devices such as airway exchange catheters (AECs) could be used during scheduled tube removing to ensure a rapid access to airway in the case of requiring emergent reintubation. Nevertheless, using such devices could impede adequate non-invasive mechanical ventilation (NIMV) support because of the air leaks generated by interfering with mask interfaces. We describe the case of a woman with a very difficult airway in whom an AEC was placed before scheduled extubation and then developed post-extubation respiratory failure. Mask interface was adequately sealed by using a novel tube adapter for NIMV and successful non-invasive ventilation was provided while maintaining the AEC placed in the trachea until the emergency reintubation risk was overcome.

Prevalence of GBA p.K198E mutation in Colombian and Hispanic populations.

We aimed to replicate a recent study that found a high frequency of the GBA p.K198E mutant in Colombian patients with PD. We identified the p.K198E substitution at a lower frequency in our cohort of Colombians with PD (2.1%), and this was not significantly different than controls (1.7%, P = 0.86) emphasizing the need for larger genetic studies in Latin America.

Genetic characterization of Parkinson's disease patients in Ecuador and Colombia.

To help address the scarcity of studies on the genetics of Parkinson's disease (PD) in Latin America, we screened 426 Ecuadorians with PD and 80 Colombians (PD = 55, Control = 26) for mutations within several PD-related genes. Among Colombians, we identified several variants within PARKIN and PINK1 genes.

Analysis of the environmental impact using the waste reduction algorithm in polypropylene production by applying grade transitions strategies in Colombia.

The global manufacturing sector faces a significant challenge about minimizing environmental impacts without witnessing the adverse effects on the market competitiveness. A cleaner production methodology must involve different approaches for minimizing or recycling waste streams, obtaining at the same time economical and environmental advantages for manufacturing companies (Severo et al., J Clean Prod 142:87-97, 2017). In the polypropylene production process, more than 60 grades of polypropylene are produced. To achieve this target, changes in the process variables are carried out, due to the continuous operation process. Those changes generate a mixture of resins with intermediate properties (transition), which must be minimized. Moreover, failures during the transitions process generate a large extra amount of material that represents a significant impact on the environment, when it is considered as waste. In this paper, an environmental analysis was made by applying a waste reduction algorithm (WAR) to establish the potential impact of a polypropylene production process over the environment, applying grade transitions strategies and then to demonstrate how the improvement of transition times implies a significant reduction of plastic waste. It was found that the reduction of transitions time minimizes the environmental impact based on real industry data. Last should be considered for the real polymer plant analyzed and future projects.

Postictal neurogenic pulmonary edema: Case report and brief literature review.

Cardiopulmonary complications associated with epilepsy are generally associated with generalized tonic-clonic seizures, as a consequence of systemic adrenergic discharge and release of inflammatory mediators. We present a case of a 34-year-old woman with a history of Focal epilepsy since adolescence, who presented self-limited pulmonary edema following a focal to bilateral tonic-clonic seizure with subsequent resolution of the symptoms. We also made a brief review of neurogenic pulmonary edema, its proposed pathophysiology, treatment and its relation with sudden unexpected death in epilepsy (SUDEP).

Changes in sleep patterns after vagus nerve stimulation, deep brain stimulation or epilepsy surgery: Systematic review of the literature.

PURPOSE: Perform a systematic review of the literature on the effects of vagus nerve stimulation (VNS), deep brain stimulation (DBS) and epilepsy surgery in subjective and objective sleep parameters. METHODS: We performed a literature search in the main medical databases: Medline, Embase, Cochrane, DARE and LILACS, looking for studies that evaluated the effects of VNS, DBS or epilepsy surgery on sleep parameters. In all, 36 studies, coming from 11 countries, including reviews, cohort studies, case series and case reports were included. RESULTS: VNS induces sleep apnoea dependent of the stimulation variables. This condition can be reverted modifying these settings. Surgical procedures for epilepsy cause an improvement in objective and subjective sleep parameters that depend on the success of the procedure evaluated through ictal frequency control. There is evidence that non-pharmacologic treatment of epilepsy has different effects on sleep patterns. CONCLUSION: It is advisable to include objective and subjective sleep parameters in the initial evaluation and follow-up of patients considered for invasive procedures for epilepsy control, especially with VNS due to the risk of sleep apnoea. More high quality studies are needed.

Edema pulmonar postictal: revisión de la bibliografía / Postictal pulmonary oedema: a review of the literature

Introducción. El edema pulmonar neurógeno postictal es una patología poco frecuente con gravedad variable, probablemente en relación con la muerte súbita asociada a la epilepsia (SUDEP). La frecuencia es mayor en pacientes con crisis tonicoclónicas generalizadas de larga duración o con estado epiléptico. Objetivo. Por medio de una revisión de la bibliografía se pretende describir las características clínicas, la fisiopatología, los hallazgos radiológicos, el tratamiento y el pronóstico de los pacientes con edema pulmonar postictal. Desarrollo. Se realizó una búsqueda de la bibliografía en las bases de datos PubMed, Embase, Cochrane y BVS empleando una combinación de términos libres. Se aplicaron como límites de búsqueda: artículos publicados desde el 1 de enero de 2000 hasta el 26 de abril de 2018 y artículos que contaran con el resumen disponible. En total se revisaron 23 artículos, en su mayoría casos clínicos, de los cuales se obtuvo la información para desarrollar la revisión. Conclusiones. En el edema pulmonar postictal, el tipo de crisis más frecuentemente comunicada es la tonicoclónica generalizada. Las manifestaciones clínicas más habituales fueron disnea y taquicardia de aparición en los minutos posteriores a la crisis. En los paraclínicos, el hallazgo más frecuente fue leucocitosis. En general se encontró un buen pronóstico en la mayoría de los casos, con mejoría del edema entre las 12 y las 96 horas. Únicamente dos de los 21 pacientes comunicados fallecieron. Además, en un estudio clínico de patología en pacientes con SUDEP, el edema pulmonar apareció en la mayoría de los casos

Introduction. Postictal neurogenic pulmonary oedema is an infrequent condition of varying severity, probably related to sudden unexpected death in epilepsy (SUDEP). It is more frequent in patients with generalised tonic-clonic seizures of long duration or with status epilepticus. Aim. Based on a review of the literature, the aim is to describe the clinical characteristics, pathophysiology, radiological findings, treatment and prognosis of patients with postictal pulmonary oedema. Development. A search of the literature was performed in the PubMed, Embase, Cochrane Database of Systematic Reviews and BVS databases using a combination of free terms. The limits of the search applied were: papers published between 1 January 2000 and 26 April 2018, and papers for which the abstract was available. Altogether 23 papers were found, most of which were clinical cases, and used to extract the information needed to carry out the review. Conclusions. In postictal pulmonary oedema, generalised tonic-clonic seizures are the most frequently reported type. The most common clinical manifestations were dyspnoea and tachycardia appearing within a few minutes after the seizure. Among the paraclinical findings the most frequent was leukocytosis. In general terms, a good prognosis was found in most cases, with improvement of the oedema within a period of between 12 and 96 hours. Only two of the 21 patients reported died. In addition, in a clinical pathology study in patients with SUDEP, pulmonary oedema appeared in most cases

Paquimeningitis hipertrófica. Manifestación inusual en las vasculitis anca-positivas / Hypertrophic Pachymeningitis. Unusual manifestation in vasculitis anca-positive

Introducción: La vasculitis ANCA-positiva es una patología que se caracteriza por daño en vasos de pequeño calibre secundario a auto-anticuerpos. El compromiso del sistema nervioso central es poco común, con complicaciones serias y de difícil diagnóstico. Por eso presenta-mos 3 casos de pacientes con paquimeningitis hipertrófica como manifestación neurológica de vasculitis ANCA-positiva, estudiados en el Hospital Universitario San Ignacio de Bogotá. Casos:Se tratan de dos hombres y una mujer. El hombre del primer caso presentó clínica progresiva de 1 año de evolución de dolor ocular, alteración de la agudeza visual, limitación para los movimientos oculares y disartria (Imagen 1).

Hallazgos radiológicos en sistema nervioso central (SNC) del síndrome de MELAS: reporte de caso / Radiological findings of MELAS syndrome in central nervous system (CNS): case report

RESUMEN Presentamos el caso clínico de una paciente adulta joven con episodios recurrentes sugestivos de ataque cerebrovascular, con cambios radiológicos típicos de enfermedad de MELAS con confirmación genética de mutación en el gen A3243G.

SUMMARY A clinical case of a young adult patient with recurrent episodes suggestive of stroke, with typical radiological changes of MELAS disease with genetic confirmation of mutation in A3243G gene.

Secuestro pulmonar una infrecuente causa de hipertensión pulmonar persistente en el recién nacido reporte de un caso / Pulmonary sequestration an uncommon cause of persistent pulmonary hypertension in the newborn case report

Resumen La hipertensión pulmonar persistente del recién nacido (HPPRN) es una entidad frecuente en las unidades de cuidados intensivos neonatales (UCIN), sin embargo, algunas de sus causas pasan desapercibidas, debido a su baja frecuencia y poca asociación con esta patología. A propósito de un caso en nuestra UCIN, en un neonato a término que presentó HPPRN secundario a una malformación pulmonar, raramente asociada con esta patología en este grupo etareo, ya que se encontró mayor disposición a factores propios del nacimiento, y noxas maternas. El paciente presentó dificultad respiratoria horas después de su nacimiento, con evolución y persistencia de su sintomatología, por lo que se necesitó de diversos medios diagnósticos para establecer su etiología. Es importante destacar que el primer ecocardiograma doppler no mostró ninguna alteración anatómica o funcional, reportado normal; con posterior empeoramiento clínico del neonato, por lo que se ordenó un control ecocardiografico, y se evidenció una presión pulmonar estimada de 71 mmHg; se continuó el estudio etiológico con imágenes complementarias, en esta caso una tomografia de tórax contrastada, y finalmente fue corroborado con un cateterismo cardiaco, lo cual permitió a su vez, manejo terapéutico y corrección de anomalía estructural de vasos pulmonares.

Abstract Persistent pulmonary hypertension of the newborn (PPHN) is a common feature in neonatal intensive care units (NICUs), but some of its causes go unnoticed due to their low frequency and low association with this pathology. A case in our NICU, in a term neonate who presented PPHN secondary to a pulmonary malformation, rarely associated with this pathology in this age group, since it was found more disposition to factors of the birth, and maternal noxas. The patient presented respiratory difficulty hours after birth, with evolution and persistence of their symptoms, which required different diagnostic methods to establish their etiology. It is important to note that the first Doppler echocardiogram did not show any anatomical or functional alterations, which were normal; With subsequent clinical worsening of the neonate, so that an echocardiographic control is ordered, evidencing an estimated pulmonary pressure of 71 mmHg; The etiological study was followed with complementary images, in this case, a contrast-enhanced chest tomography, and finally it was corroborated with cardiac catheterization, allowing, in turn, therapeutic management and correction of structural abnormality of pulmonary vessels.

Prevalencia de helicobacter pylori en un grupo de pacientes pediátricos infectados por el virus de la inmunodeficiencia humana / Prevalence of helicobacter pylori in a sample of pediatric patients infected by human inmunodeficiency virus

Se realizó un estudio cuantitativo, descriptivo transversal y no experimental sobre la prevalencia de Helicobacter pylori en pacientes pediátricos infectados por el virus de inmunodeficiencia humana (VIH), internados en el Hospicio San José, Santa Lucía Milpas Altas, Sacatepéquez, Guatemala, durante los meses de noviembre 2012 a enero 2013. La población completa fue conformada por 40 pacientes pediátricos de ambos sexos, entre los 3 y 12 años de edad, que padecen infección por VIH. Para el diagnóstico de infección por H. pylori se utilizó la detección de antígeno en heces por inmunocromatografía. Se encontró un resultado positivo en el 35%, con una mayor incidencia en varones, correspondiendo al 71.4% de los casos. En cuanto a la distribución por edades, el rango de edad con más casos positivos fue el comprendido entre los 7 y 8 años, con un 66.7% de los casos. La prevalencia de H. pylori en la población pediátrica VIH positiva estudiada fue mayor que la reportada en poblaciones similares, pero menor a la reportada en la población pediátrica VIH negativo. Se recomienda realizar un estudio multicéntrico para confirmar la prevalencia de H. pylori en la población pediátrica guatemalteca VIH positivo.

Aquantitative, descriptive, transversal, non experimental study was conducted on the prevalence of Helicobacter pylori in pediatric patients infected with the human immunodeficiency virus (HIV), who were admitted in the Hospice San Jose, Santa Lucia Milpas Altas, Sacatepequez, Guatemala, during November 2012 through January 2013. The study population included pediatric patients of both sexes, aged 3 to 12 years, who are infected with HIV. For the diagnosis of H. pylori infection an antigen stool test by immunochromatography was used. The population in the study period amounted to 40 patients in whom a positive result of 35% was found, 71.4% from male patients. In the age distribution it was found that the age range with more positive cases (66.7%) was between 7 and 8 years. The prevalence of H. pylori in the studied HIV positive pediatric population was higher than reported in similar populations, yet lower than reported in the HIV negative pediatric population. It is recommended that a multicenter study confirm the prevalence of H. pylori in the HIV positive Guatemalan pediatric population.

Obsolescencia e idiomática de las referencias bibliográfi cas de la Revista de la Sociedad Española de Enfermería Nefrológica: años 1998,1999, 2003, 2006 y 2008 / Obsolescence and language use in bibliographical references in the magazines of the Spanish Nephrology Nursing Society: years 1998,1999, 2003, 2006 and 2008

Objetivo: llevar a cabo un análisis bibliométrico para conocer y evaluar la obsolescencia e idiomática de las referencias bibliográfi cas de los artículos publicados en la Revista de la Sociedad Española de Enfermería Nefrológica. Material y método: se ha realizado un estudio descriptivo longitudinal retrospectivo. Se han utilizado los cuatro números de los volúmenes 1, 2, 6, 9 y 11 de la Revista de la Sociedad Española de Enfermería Nefrológica. Los indicadores bibliométricos analizados han sido la obsolescencia e idiomática. Resultado: se han revisado 168 artículos, con un total de 1166 referencias bibliográfi cas, con una mediana de 5, una desviación estándar ± 6,54, un máximo de 39 y un mínimo de 0 referencias bibliográficas por artículo. El índice total de referencias por artículo ha alcanzado las 6,94 referencias bibliográfi cas por artículo. El Índice de Obsolescencia ha sido de 6,1 años, el Índice de Price ha sido del 41,62 % y el Índice de Inmediatez ha alcanzado el 3,4%. En cuanto al idioma manejado por los autores en el ámbito de la enfermería nefrología, han sido el español (54,87%; 95%IC 51,98-57,7) y el inglés (44,13% 95 %IC 41,29-47,07) los más utilizados. Conclusión: el análisis de las referencias bibliográficas de los artículos publicados en la Revista ha presentado parámetros similares a otras revistas sobre ciencias de la salud. Ahora bien, se aprecian unos buenos datos de obsolescencia, situación que revela la buena vigencia de la mayoría de las referencias estudiadas (AU)

Aim: to carry out a bibliometric analysis to determine and evaluate the obsolescence and language use in the bibliographical references of the articles published in the Magazine of the Spanish Nephrology Nursing Society. Material and method: a retrospective longitudinal descriptive study was carried out. The four issues of volumes 1, 2, 6, 9 and 11 of the Magazine of the Spanish Nephrology Nursing Society were used. The bibliometric indicators analysed were obsolescence and language. Result: 168 articles were reviewed, with a total of 1166 bibliographical references, with a median of 5, a standard deviation of ± 6.54, a maximum of 39 and a minimum of 0 bibliographical references per article. The total index of references per article was 6.94 bibliographical references per article. The Obsolescence Index was 6.1 years, the Price Index was 41.2 % and the Immediacy Index was 3.4%. As regards the language used by the authors in the sphere of nephrology nursing, Spanish (54.87%; 95%CI 51.98-57.7) and English (44.13% 95%CI 41.29-47.07) were the most used. Conclusion: The analysis of the bibliographical references in the articles published in the magazines showed similar parameters to other magazines on health sciences. However, good obsolescence data were obtained, which shows the relevance of most of the references studied (AU)

Distracción osteogénica en la línea media mandibular: reporte de un caso / Osteogenic distraction of the mandibular mid-line: case Report

Se hace una revisión de la literatura sobre la evolución de la distracción osteogénica y su uso en lo hueso maxilares. Se presenta caso de distracción osteogénica en la línea media mandibular de una paciente femenina de 18 años de edad con una secuela de fractura producida por proyectil de arma de fuego. Aunque la paciente tuvo una cicatriz fibrosa y compromiso del tejido blando, la distracción fue posible. La distracción no ocurrió a una rata de 1:1 (mm tornillo vs distancia ósea).se logró ampliar 7mm transversalmente el arco en la parte anterior y 4 mm en la parte posterior. Se obtiene un resultado favorable y estable luego de 9 meses de seguimiento.

Toxina botulínica para el manejo de pacientes con bruxismo / Botulinic toxin in the management of patients with bruxism

Se pretendió evaluar clínicamente la eficacia de la toxina botulínica tipo A-Botox – para el tratamiento de pacientes con bruxismo, evaluando 21 pacientes de ambos sexos entre 21 y 45 años de edad con bruxismo, que cumplieron con los criterios de inclusión. La toxina fue diluida en concentraciones de 5 U en 1 ml de suero fisiológico al 0,9 por ciento, se distribuyo en 10 sitios de infiltración total (5 sitios por cada lado). La piel fue desinfectada con algodón impregnado en alcohol. Se inyectaron 5 U de Botox en cada punto seleccionado en el Masetero y en el temporal, los cuales se marcaron previamente a la aplicación del medicamento. Se realizo un examen inicial y una remisión a los tres meses y a los seis meses para evaluar el dolor mediante una escala visual análoga (EVA) la presencia del dolor a la palpación en músculos masticatorios. Seis (6) hombres y las 15 mujeres con edad promedio de 29.±6.6 años mostraron una disminución de dolor de 5 puntos en la escala visual análoga en los tres primeros meses y de dos puntos a los seis meses luego de la aplicación de la tóxina. El 66.6 por ciento de los pacientes relatar tener bruxismo en menor medida mientras que el 33.3 por ciento relata no tener cambios en la intensidad del bruxismo tanto a los tres como a los seis meses. Solamente se presentó como efecto adverso, disminución en la salivación, tanto a los tres como a los seis meses en un solo paciente. La aplicación de toxina botulínica constituyen una alternativa terapéutica innovadora, segura y efectiva para el tratamiento del dolor en los músculos de la masticación, disminuye la intensidad del bruxismo, presenta pocos efectos adversos transitorios. El efecto benéfico de la toxina para el manejo del dolor muscular es más notorio a los tres que a los seis meses...

Sindrome nefrotico en la ninez; presentacion de un caso y revision de la literatura medica / Neprhotic syndrome in childhood; a case presentation and medical literature review

Se presenta un caso confirmado de sindrome nefrotico, atendido en el Hospital Universitario Metropolitano de Barranquilla, servicio de Pediatria, el cual fue tratado con Albumina Hummana, diureticos y Prednisona durante tres semanas, el cual se quiere dejar como ejemplo del probable incremente de la incidencia del Sindrome Nefrotico, para alertar al cuerpo medico de la necesidad de buscar esta enfermedad. especialmente en ninos entre 1 y 6 anos