Cambios en los valores extremos de variables climáticas en Colombia asociados a cambio climático

Se presenta un análisis detallado de lluvia en diferentes escalas temporales y espaciales sobre Colombia, también se lleva a cabo un análisis adicional del escalamiento entre la precipitación y la temperatura limitada por la relación de Clausius-Clapeyron, tratando de explicar el límite de intensificación de las precipitaciones extremas, los datos utilizados para hacer los análisis fue proporcionado por EPM, la base de datos tiene 86 estaciones de precipitación, además de 9 estaciones de temperatura en la región de Antioquia, ambas variables con registros temporales cada 15 minutos, para el análisis sobre Colombia se utilizaron los datos satelital TRMM (tropical rainfall measure mission) con intensidades de lluvia cada 3 horas y temperaturas de NCEP / NCAR cada 6 horas, los análisis muestran cambios en la intensidad, frecuencia y duración de los fenómenos extremos y la forma en la agregación temporal hace que sea imposible evaluar adecuadamente las tendencias a largo plazo; para la precipitación se encontró que para agregaciones temporales mayores de 12 horas las tendencias ya no son significativas, para agregaciones temporales menores las tendencias se vuelven significativas del decil 60 al decil 99, los análisis sobre las temperaturas no muestran un comportamiento homogéneo sobre Antioquia, pero relación entre la precipitación y la temperatura muestra una escalamiento similar a la relación Clausius-Clapeyron limitando la intensificación de la precipitación.Abstract: detailed analysis of rain at different temporal and spatial scales on Colombia is presented, an additional analysis of scaling between precipitation and temperature limited by the Clausius-Clapeyron relation is also carried out trying to explain the limit of growing of the extreme precipitations , the data used to made those analisys was provided by EPM, the data base have 86 stations of precipitation , in addition to 9 temperature stations over the Antioquia region, both variables with temporary records every 15 minutes, for the analysis over Colombia were used satelital TRMM data (tropical rainfall measure mission) with rainfall intensities every 3 hours and temperatures of NCEP / NCAR every 6 hours, the analisys show changes in intensity, frequency and duration of extreme events and how the temporal aggregation makes it impossible to adequately assess longterm trends; for the precipitation was found that for temporary aggregations greater than 12 hours the trends are no longer significant, for the smaller temporaly agregation the trend changes become significant from decile 60 to decile 99, the analisys on the temperatures show no homogenous behavior over Antioquia, but relation between precipitation and temperature shows a close scaling due the Clausious-Clapeyron relation limiting the intensification of precipitation.Maestrí

Asociación entre tamización de cáncer de próstata, vinculación al sistema de salud y factores asociados en adultos mayores: análisis secundario de la encuesta SABE Bogotá, Colombia

Introduction Prostate cancer is a high prevalence disease in our male population. Early diagnosis is important in order to improve its prognosis. The aim of this article is to describe the factors associated with prostate cancer screening of older adults in Bogotá, Colombia. Materials and methods The study used data from the Bogotá 2012 Health, WellBeing, and Ageing (Salud, Bienestar y Envejecimiento [SABE]) survey, which included 736 men aged 60 years or older. The dependent variable used was self-reported prostate screening in the last 2 years. An analysis was performed to determine the between this variable and socio-demographic variables and comorbidities using multivariate analysis. Results There was a prevalence of prostate cancer of 3.15%, with 57.8% of the population having had at least one prostate examination. Those affiliated to a health insurance scheme were more likely to be screened than the uninsured with an OR: 8.81, 95% CI: 2.92-26.63, P less than .001, as those affiliated to subsidized social security health scheme OR: 3.70, 95% CI: 1.20-11.41, P =.023, respectively). Conclusion There is inequity in the opportunity of screening for prostate cancer according to the type of health insurance scheme. Early detection strategies must be strengthened in order to include the entire population. Further studies are needed to provide more information on this issue. © 2018, Sociedad Colombiana de Urología. Publicado por Thieme Revinter Publicações Ltda., Rio de Janeiro, Brazil

Hypoparathyroidism: Basis for the approach and appropiate treatment

RESUMEN: El hipoparatiroidismo es definido como hipocalcemia en presencia de hormona paratiroidea baja (< 20 pg/mL) o indetectable. Es una enfermedad rara con una prevalencia estimada de 37 casos por 100.000 habitantes. Aunque la etiología es variada, la causa más frecuente, en 75 % de los casos, es el hipoparatiroidismo posoperatorio. Esta situación puede ocurrir en cualquier cirugía de cuello, pero es más frecuente en la resección de tiroides. Otras causas infrecuentes incluyen trastornos autoinmunes como el síndrome poliglandular tipo 1, desórdenes genéticos como la anomalía de DiGeorge o trastornos funcionales como la hipomagnesemia. Los síntomas agudos más importantes de la hipocalcemia son la irritación neuromuscular, como parestesias y convulsiones. Crónicamente se pueden presentar calcificaciones en varios sitios del cuerpo incluyendo los ganglios basales. El diagnóstico y enfoque de esta enfermedad parte de un valor disminuido de calcio combinado con PTH menor de 20 pg/mL, siempre excluyéndose hipomagnesemia. Además, debe solicitarse fósforo y calciuria de 24 horas. El tratamiento se realiza con reposición oral de calcio y vitamina D activa (calcitriol). En algunos casos con hipercalciuria se pueden usar diuréticos tipo tiazida. Recientemente se aprobó en Estados Unidos y Europa, el uso de hormona recombinante paratiroidea 1-84 en pacientes con hipoparatiroidismo que no estén controlados fácilmente con calcio y calcitriol o en aquellos que tengan complicaciones o deterioro en la calidad de vida. Palabras clave: Calcio; Fósforo; Hipocalcemia; Hipoparatiroidismo; Paratiroides.ABSTRACT: Hypoparathyroidism is an infrequent disorder. The main characteristic is low calcium with low PTH. The estimate prevalence is 37 cases per 100.000 inhabitants. The most frequent cause (75 % of all cases) is removal of parathyroid gland during neck surgery. Other causes are polyglandular autoimmune syndrome type 1, genetic disorders such as DiGeorge anomaly, or functional disorders like hypomagnesemia. Hypocalcemia may produce neuromuscular symptoms and seizures. Chronic manifestations include ectopic calcifications. The diagnosis of hypoparathyroidism is made when calcium is below normal in presence of low or undetectable PTH (< 20 pg/mL). Magnesium, phosphorus and 24-hour urine calcium should be measured in all patients with hypoparathyroidism. The management of this disease is with calcium supplements plus active vitamin D (calcitriol). In some cases, with hypercalciuria, a thiazide diuretic may be used. Recently, the use of recombinant PTH 1-84 was approved in the United Stated and Europe. This treatment is indicated in patients with uncontrolled hypoparathyroidism despite increasing doses of calcium and calcitriol or in patients with complications of hypoparathyroidism or deceased quality of life. Key words: Calcium; Hypocalcemia; Hypoparathyroidism; Parathyroid; Phosphorus

Hiperplasia adrenal congénita asociada a mutación no descrita en el gen CYP17A1

Introducción: La deficiencia de 17?-hidroxilasa / 17,20-liasa es causada por un defecto en el gen CYP17A1 que codifica una enzima que expresa tanto actividad 17?-hidroxilasa como 17,20-liasa en las glándulas suprarrenales y las gónadas. El fenotipo de esta condición es muy característico, pero lo pueden compartir otros defectos enzimáticos. La adecuada relación genotipo-fenotipo es importante para el correcto diagnóstico, enfocar el tratamiento y la consejería a los pacientes.  Objetivo del caso: Reportar por primera vez una variante genética potencialmente relacionada con una hiperplasia adrenal congénita  en una paciente con un fenotipo compatible con una deficiencia de 17?-hidroxilasa y la 17,20-liasa. Presentación del caso: Se presenta el caso de una mujer que consultó por infantilismo sexual y amenorrea primaria en presencia de cariotipo 46XX. Durante su evolución cursó con hipertensión e hipokalemia que condujo a la sospecha diagnóstica de una hiperplasia adrenal congénita (HAC).  El estudio genético reveló una mutación de cambio de sentido erróneo, homocigota, en el exón 8, c.1250 T>C; p. Phe417Ser del gen de la CYP17A1.  Se ha demostrado previamente que mutaciones en esta localización suprimen las actividades 17?-hidroxilasa y la 17,20-liasa lo que explica el fenotípico clínico observado. Reportamos por primera vez en el mundo la mutación de cambio de sentido erróneo, c.1250 T>C; p. Phe417Ser, en el gen CYP17A1, relacionada con la HAC. Conclusión: Los análisis genéticos en todos los pacientes con HAC son necesarios para definir la frecuencia de esta y otras mutaciones en la población colombiana y relacionar el fenotipo de la enfermedad con su genotipo

Human Transmissible Spongiform Encephalopathy: Case Report

RESUMEN: Se presenta el caso de una mujer de 64 años con un cuadro clínico de ocho meses de duración, consistente en deterioro motor y cognitivo, que progresó rápidamente. Recibió tratamiento con quinacrina sin obtener beneficios y falleció en estado terminal, por choque séptico secundario a bronconeumonía por broncoaspiración. El cerebro fue donado para investigación y su estudio histopatológico reveló la presencia de lesiones espongiformes, astrogliosis y depósitos de proteína priónica (PrPRes) confirmados por Western blot. Todos estos rasgos se consideran característicos de la enfermedad por priones. Con este caso, no solo se informa sobre una enfermedad infrecuente en la casuística colombiana, sino que por primera vez en el país se usan simultáneamente la inmunohistoquímica y el Western blot como herramientas para el diagnóstico de estas enfermedadesSUMMARY: We report the case of a 64 year-old woman with motor and cognitive deterioration that progressed rapidly during eight months. She was unsuccessfully treated with quinacrine, and died in a terminal status, by septic shock secondary to bronchopneumonia by broncho-aspiration. The brain was donated for research and the histopathological analysis showed spongiform changes, astrogliosis and prion protein (PrPRes) deposits, confirmed by Western blot (WB). These features are considered characteristic of prion diseases, which are uncommon in Colombia. We highlight that its diagnosis was made for the first time in this country by the simultaneous use of immunohistochemistry and Western blo

Body fat measurement by bioelectrical impedance and air displacement plethysmography: a cross-validation study to design bioelectrical impedance equations in Mexican adults

<p>Abstract</p> <p>Background</p> <p>The study of body composition in specific populations by techniques such as bio-impedance analysis (BIA) requires validation based on standard reference methods. The aim of this study was to develop and cross-validate a predictive equation for bioelectrical impedance using air displacement plethysmography (ADP) as standard method to measure body composition in Mexican adult men and women.</p> <p>Methods</p> <p>This study included 155 male and female subjects from northern Mexico, 20–50 years of age, from low, middle, and upper income levels. Body composition was measured by ADP. Body weight (BW, kg) and height (Ht, cm) were obtained by standard anthropometric techniques. Resistance, R (ohms) and reactance, Xc (ohms) were also measured. A random-split method was used to obtain two samples: one was used to derive the equation by the "all possible regressions" procedure and was cross-validated in the other sample to test predicted versus measured values of fat-free mass (FFM).</p> <p>Results and Discussion</p> <p>The final model was: FFM (kg) = 0.7374 * (Ht²/R) + 0.1763 * (BW) - 0.1773 * (Age) + 0.1198 * (Xc) - 2.4658. R²was 0.97; the square root of the mean square error (SRMSE) was 1.99 kg, and the pure error (PE) was 2.96. There was no difference between FFM predicted by the new equation (48.57 ± 10.9 kg) and that measured by ADP (48.43 ± 11.3 kg). The new equation did not differ from the line of identity, had a high R²and a low SRMSE, and showed no significant bias (0.87 ± 2.84 kg).</p> <p>Conclusion</p> <p>The new bioelectrical impedance equation based on the two-compartment model (2C) was accurate, precise, and free of bias. This equation can be used to assess body composition and nutritional status in populations similar in anthropometric and physical characteristics to this sample.</p

Low complexity energy management system for the UNIGRID microgrid

El presente trabajo muestra los resultados obtenidos en el proyecto para un sistema de gestión energética. Actualmente, no se posee un sistema de gestión en la institución. El crecimiento de la demanda energética en las instalaciones de la Universidad del Norte requiere la implementación de este tipo de sistema para el aprovechamiento de los recursos de los que se dispone. Una solución a este problema es desarrollar un algoritmo de control que permita gestionar la demanda y generación de energía. En este caso, se gestionarán los recursos de generación renovable y térmica de las cuales dispone la universidad. Se analizaron dos alternativas, una de lógica difusa y otra de máquinas de estados. Basado en criterios de ingeniería como cambio de estado, bajo nivel de complejidad, capacidad de respuesta y conocimientos previos se eligió la opción de las máquinas de estado porque brindo una solución más simple para la problemática que se presenta. Esto permite la creación de una base de desarrollo para mejoras en el sistema de generación de la universidad para suplir parte de la demanda que la misma presenta. Este diseño tiene una operación continua de 24 horas acumulando y entregando energía para satisfacer la demanda de la universidad. Lo que representa una disminución en la dependencia del Sistema Eléctrico Nacional. Se pudo concluir que el sistema de gestión energética opera adecuadamente y logra que se supla de forma automática la demanda energética según la información que le es dada por el usuario encargado.This work shows the results obtained in the project for an energy management system. Currently, there is no management system in the institution. The growth in energy demand at the facilities of the Universidad del Norte requires the implementation of this type of system to take advantage of the available resources. A solution to this problem is to develop a control algorithm that allows to manage the demand and generation of energy. In this case, the renewable and thermal generation resources available to the university will be managed. Two alternatives were analyzed, one for fuzzy logic and the other for state machines. Based on engineering criteria such as change of state, low level of complexity, responsiveness and previous knowledge, the option of state machines was chosen because it provides a simpler solution for the problems that arise. This allows the creation of a development base for improvements in the generation system of the university to supply part of the demand that it presents. This design has a 24-hour continuous operation, accumulating and delivering energy to meet the demand of the university. Which represents a decrease in dependence on the National Electric System. It was concluded that the energy management system operates properly and achieves that the energy demand is automatically supplied according to the information given to it by the user in charge

Hypoparathyroidism: Basis for the approach and appropiate treatment

Hypoparathyroidism is an infrequent disorder. The main characteristic is low calcium with low PTH. The estimate prevalence is 37 cases per 100.000 inhabitants. The most frequent cause (75 % of all cases) is removal of parathyroid gland during neck surgery. Other causes are polyglandular autoimmune syndrome type 1, genetic disorders such as DiGeorge anomaly, or functional disorders like hypomagnesemia. Hypocalcemia may produce neuromuscular symptoms and seizures. Chronic manifestations include ectopic calcifications. The diagnosis of hypoparathyroidism is made when calcium is below normal in presence of low or undetectable PTH (< 20 pg/mL). Magnesium, phosphorus and 24-hour urine calcium should be measured in all patients with hypoparathyroidism. The management of this disease is with calcium supplements plus active vitamin D (calcitriol). In some cases, with hypercalciuria, a thiazide diuretic may be used. Recently, the use of recombinant PTH 1-84 was approved in the United Stated and Europe. This treatment is indicated in patients with uncontrolled hypoparathyroidism despite increasing doses of calcium and calcitriol or in patients with complications of hypoparathyroidism or deceased quality of life

Asociación entre tamización de cáncer de próstata, vinculación al sistema de salud y factores asociados en adultos mayores: análisis secundario de la encuesta SABE Bogotá, Colombia

Introduction Prostate cancer is a high prevalence disease in our male population. Early diagnosis is important in order to improve its prognosis. The aim of this article is to describe the factors associated with prostate cancer screening of older adults in Bogotá, Colombia. Materials and methods The study used data from the Bogotá 2012 Health, WellBeing, and Ageing (Salud, Bienestar y Envejecimiento [SABE]) survey, which included 736 men aged 60 years or older. The dependent variable used was self-reported prostate screening in the last 2 years. An analysis was performed to determine the between this variable and socio-demographic variables and comorbidities using multivariate analysis. Results There was a prevalence of prostate cancer of 3.15%, with 57.8% of the population having had at least one prostate examination. Those affiliated to a health insurance scheme were more likely to be screened than the uninsured with an OR: 8.81, 95% CI: 2.92-26.63, P less than .001, as those affiliated to subsidized social security health scheme OR: 3.70, 95% CI: 1.20-11.41, P =.023, respectively). Conclusion There is inequity in the opportunity of screening for prostate cancer according to the type of health insurance scheme. Early detection strategies must be strengthened in order to include the entire population. Further studies are needed to provide more information on this issue. © 2018, Sociedad Colombiana de Urología. Publicado por Thieme Revinter Publicações Ltda., Rio de Janeiro, Brazil