RESUMEN
Resumen: La hemoglobinuria paroxística nocturna es un trastorno adquirido de las células madre hematopoyéticas que se caracteriza por episodios de hemólisis intravascular. Aunque es una enfermedad poco frecuente, afecta en su mayor parte a adultos jóvenes, sin distinción de sexo. Comunicamos el caso de un paciente de 32 años de edad, que acudió a consulta con cuadro clínico de palidez, ictericia, hemoglobinuria y dolor en el hipocondrio derecho. El estudio de citometría de flujo de médula ósea reportó la ausencia de marcadores CD55 y CD59, indicativos del diagnóstico de hemoglobinuria paroxística nocturna, además de una imagen tomográfica hipodensa en el hígado compatible con absceso. En la bibliografía médica éste es el primer caso en el que se describe la coexistencia de estas dos afecciones.
Abstract: Paroxysmal nocturnal hemoglobinuria is an acquired disorder of hematopoietic stem cells characterized by episodes of intravascular hemolysis. Although it is a rare disease, it mostly affects young adults, regardless of sex. We present the case of a 32-year-old man with acute symptoms of paleness, jaundice, hemoglobinuria and pain in the right hypochondrium. The study of flow cytometry of bone marrow reported the absence of CD55 and CD59 markers, diagnostic indicators of nocturnal paroxysmal hemoglobinuria in addition to a hypodense tomographic image in the liver compatible with abscess. In the medical literature, this is the first case in which the coexistence of these two medical conditions is described.
RESUMEN
The evaluation of exposure to extremely low-frequency (ELF) magnetic fields using broadband measurement techniques gives satisfactory results when the field has essentially a single frequency. Nevertheless, magnetic fields are in most cases distorted by harmonic components. This work analyses the harmonic components of the ELF magnetic field in an outdoor urban context and compares the evaluation of the exposure based on broadband measurements with that based on spectral analysis. The multiple frequency rule of the International Commission on Non-ionizing Radiation Protection (ICNIRP) regulatory guidelines was applied. With the 1998 ICNIRP guideline, harmonics dominated the exposure with a 55% contribution. With the 2010 ICNIRP guideline, however, the primary frequency dominated the exposure with a 78% contribution. Values of the exposure based on spectral analysis were significantly higher than those based on broadband measurements. Hence, it is clearly necessary to determine the harmonic components of the ELF magnetic field to assess exposure in urban contexts.