Experimental Techniques to Measure Hypnotic Levels During Surgery

[Abstract] The administration of anesthetics during a surgical procedure has been done historically in a manual way with the anesthesiologist deciding what amounts and at what rates to use. Over the last few decades there has been a rapid increase in the automation of many medical areas including anesthesiology, with that increased level of automation have also appeared new ways to measure the level of sedation in patients. Historically, one of the most frequently index used has been the BIS, which has proven rather reliable as an indicator. More recently, another index called PSI has attracted interest of practitioners. In this article a comparison of these two indexes was performed. Data recording BIS and PSI values from surgical operations for several patients were collected and analyzed. The results seem to indicate that it is to be expected that in 95% of the cases the correlation between the BIS and PSI index will be at least 0.6866.This work has been supported by the grant DPI2010-18278 of the Spanish Governmenthttps://doi.org/10.17979/spudc.978849749808

Estrategias de Control en la Práctica de Anestesia

Resumen: Este artículo se centra en el modelado y control de la hipnosis durante la anestesia de pacientes sometidos a intervenciones quirúrgicas. Por un lado en este trabajo se aborda el problema del modelado del proceso presentando resultados validados con pacientes reales. Asimismo, se propone un controlador avanzado para regular el estado hipnótico. El algoritmo empleado se basa en combinar una acción nominal obtenida a partir de la dinámica inversa juntamente con una acción correctora que se obtiene a partir de un controlador predictivo. El trabajo persigue desarrollar una técnica que permita la regulación del estado del paciente y que tenga características de adaptabilidad a los diferentes individuos. Se muestran resultados preliminares de la estrategia propuesta para demostrar la eficiencia del sistema. Palabras clave: Anestesia, BIS, Propofol, Control, Control PID, Control Predictivo, Control Adaptativ

A Novel Fuzzy Algorithm to Introduce New Variables in the Drug Supply Decision-Making Process in Medicine

One of the main challenges in medicine is to guarantee an appropriate drug supply according to the real needs of patients. Closed-loop strategies have been widely used to develop automatic solutions based on feedback variables. However, when the variable of interest cannot be directly measured or there is a lack of knowledge behind the process, it turns into a difficult issue to solve. In this research, a novel algorithm to approach this problem is presented. The main objective of this study is to provide a new general algorithm capable of determining the influence of a certain clinical variable in the decision making process for drug supply and then defining an automatic system able to guide the process considering this information. Thus, this new technique will provide a way to validate a given physiological signal as a feedback variable for drug titration. In addition, the result of the algorithm in terms of fuzzy rules and membership functions will define a fuzzy-based decision system for the drug delivery process. The method proposed is based on a Fuzzy Inference System whose structure is obtained through a decision tree algorithm. A four-step methodology is then developed: data collection, preprocessing, Fuzzy Inference System generation, and the validation of results. To test this methodology, the analgesia control scenario was analysed. Specifically, the viability of the Analgesia Nociception Index (ANI) as a guiding variable for the analgesic process during surgical interventions was studied. Real data was obtained from fifteen patients undergoing cholecystectomy surgery

Expresión génica de interleucina 1 en la deficiencia de proteínas y vitamina A

Tomando como referencia los niveles de ingestión de proteínas y vitamina A informados en los estudios de la población cubana durante la epidemia de neuropatía de 1993, se ejecutó un biomodelo en ratas, con el objetivo de evaluar la incidencia de estos niveles sobre algunos indicadores del estado nutricional y de la respuesta inmune. Para ello se ensayaron 4 dietas: control, deficiente en proteínas, deficiente en vitamina A y deficiente en proteínas y vitamina A. La Interleucina 1 (IL-1) se evaluó a partir de su expresión en las placas de Peyer y los resultados obtenidos se relacionaron con indicadores del estado nutricional como peso, ingesta, recambio proteico, proteínas plasmáticas y vitamina A, con indicadores inmunológicos (conteo celular y complemento hemolítico total) y con el estudio histológico realizado en timo, bazo e hígado. La deficiencia de proteínas disminuyó la expresión génica de IL-1, la cual se asoció con lesiones degenerativas y de atrofia en los órganos estudiados. La deficiencia de proteínas y vitamina A provocó una estimulación de la expresión génica de IL-1, asociada además con indicadores sensibles del estado inflamatorio, que pudiera ser el resultado de una movilización deficiente de retinol hacia los tejidos. Los resultados obtenidos en el biomodelo abren la posibilidad de utilización de las citocinas en la detección de afectaciones subclínicas del sistema inmune provocadas por deficiencias nutricionalesGene expression of Interleukin 1 in vitamin A and protein deficiency. The influence of low levels of protein and vitamin A on indicators of the immune response was assayed in rats. The levels of protein and vitamin A intake of the Cuban population affected by epidemic neuropathy in 1993 was reproduced in 4 diets: control, protein deficiency (DP), vitamin A deficiency (DA), protein and vitamin A deficiency (DAP). The Peyer’s patches evaluated the Interleukin 1 expression gene and was related with corporal weight, food intake, serum protein, vitamin A, immunology indicators and histology evaluation (spleen, thymus and liver). Protein deficiency generated a significant decrease of the expression gene of Interleukin 1. Atrophy signs in lymphoid tissues and morphologic changes in the liver were associated with the dietary protein utilization. Protein and vitamin A deficiency generated significant stimulation of the Interleukin 1 expression gene with increase of the level of the inflammatory state indicators as serum a protein, total complement and neutrophils. This stimulation could be generated by a deficient retinol mobilization to tissues. These results support the hypothesis of the function of citokines as mediators of subclinical symthoms of the immune system during the nutritional affectation

Propuesta metodológica para la enseñanza de la Lucha Canaria en la educación básica

Se presenta una propuesta metodológica para introducir la enseñanza de la Lucha Canaria en los currículos de Educación Física, en las etapas de Educación Infantil, Primaria, Secundaria y Bachillerato, describiendo la relación entre los elementos prescriptivos y los contenidos propios del deporte más identificativo de las Islas Canarias. Se ha adaptado esta propuesta a las nuevas corrientes metodológicas, para el desarrollo de las capacidades básicas del alumnado, incorporándose las investigaciones desarrolladas en el ámbito universitario de la Comunidad, así como la literatura y otras publicaciones relacionadas.ES