Hipocalemia refractaria como manifestación clínica de síndrome de Cushing ectópico: a propósito de dos casos y revisión de la literatura

El síndrome de Cushing (SC) es un conjunto de signos y síntomas causado por el exceso de cortisol libre en el plasma. Sus manifestaciones clínicas son múltiples y en ocasiones poco específicas, haciendo difícil su sospecha clínica. La confirmación del hipercortisolismo es un proceso minucioso que debe hacerse ordenadamente para obtener un diagnóstico adecuado y preciso. A continuación se presentan dos casos de pacientes oncológicos cuya manifestación clínica paraneoplásica, por secreción ectópica de hormona adrenocorticotrópica (ACTH) y consecuente síndrome de Cushing asociado, fue una hipocalemia severa refractaria al tratamiento convencional. Siguiendo el abordaje presentado en las diferentes sociedades de endocrinología, se incluye un flujograma diagnóstico de pacientes con hipocalemia y una revisión actualizada de la literatura referente al SC ectópico

Economic cost of severe acute respiratory infection associated to influenza in Colombian children

Background: Influenza is considered a leading public health problem because its large economic burden of disease worldwide, especially in low-and middle-income countries, such as Colombia. Objective: We aimed to estimate the economic costs of influenzaconfirmed patients in a pediatric hospital in Cartagena, Colombia. Methods: We conducted a retrospective costing analysis. We estimated the direct (direct medical and out-of-pocket expenditures) and indirect costs for influenza-confirmed severe acute respiratory infection cases from a societal perspective. Total economic costs were calculated adding direct medical costs, out-of-pocket expenditures, and indirect costs owing to loss of productivity of caregivers. Mean, median, 95% confidence interval (95% CI) and interquartile range (IQR) of costs were measured. All costs are reported in USD ($1.00 = COP$2000.7) Results: Forty-four cases were included in the analysis: 30 had influenza B, 10 influenza A and B, and 4 influenza AH1N1. Thirty patients were hospitalized in the general ward, 14 went to the intensive care unit. The average duration of stay was ∼9 days (95% CI, 6.3-11.5). The median direct medical cost for hospitalized case in general ward was $743.50 (IQR$590.20-$1404.60) and in intensive care unit$4669.80 (IQR $1614.60-$7801.50). The economic cost per hospitalized case was $1826.10 (IQR$1343.30-$2376.50); direct medical costs represented 93.8$82.10 (IQR $41.10-$133.40) and the median out-of-pocket expenditure per case was $45.70 (IQR$29.50-$64.90). Conclusions: Severe acute respiratory infection is an important source of economic burden for the health system, families, and society in Colombia. Seasonal influenza vaccination should be strengthened to prevent more cases and save economic resources

Black Hole masses for 14 gravitational lensed quasars

We estimate black hole masses (M$_{\rm BH}$) for 14 gravitationally lensed quasars using the Balmer lines along with estimates based on MgII and CIV emission lines for four and two of them, respectively. We compare with results obtained for other lensed quasars. We use spectroscopic data from the Large Binocular Telescope (LBT), Magellan and the Very Large Telescope (VLT) to measure the FWHM of the broad emission lines. Combined with the bolometric luminosity measured from the spectra energy distribution, we estimate M$_{\rm BH}$ including uncertainties from microlensing and variability. We obtain MBH using the single-epoch method from the H$\alpha$ and/or H$\beta$ broad emission lines for 14 lensed quasars, including the first estimates for QJ0158-4325, HE0512-3329 and WFI2026-4536. The masses are typical of non-lensed quasars of similar luminosity, and the implied Eddington ratios are typical. We have increased the sample of lenses with estimates of MBH by 60%.Comment: 16 pages. Submitted to A&

Diseño y construcción de un pedal de bicicleta basado en sensores piezorresistivos para determinar la fuerza resultante

En el ciclismo colombiano, las pautas de entrenamiento se ajustan a partir de datos cualitativos basados en la observación directa al deportista. Esta investigación busca mejorar ese proceso por medio de la implementación de pedales instrumentados para obtener datos cuantitativos del rendimiento del ciclista. En este artículo se presenta el diseño y construcción de un prototipo de dispositivo dinamométrico que permite la captura de datos de fuerza en el pedal durante el gesto del pedaleo. El dispositivo funciona con base en un sensor de fuerza piezorresistivo (FlexiForce®) acoplado a un arreglo mecánico específico y a un sistema de acondicionamiento de señal que entrega un voltaje proporcional a la fuerza ejercida, cuyo registro y análisis se realiza por medio de LabVIEWTM. El dispositivo permite visualizar la fuerza del pedaleo en tiempo real.In the Colombian cycling, the training guidelines are adjusted from qualitative data based on the direct observation of the sportsman. The aim of this research was to improve this process by the implementation of instrumented pedals to collect quantitative data of the performance of the cyclist. In this article we present the design and construction of a prototype of a dynamometric device that allows the acquisition of force data in the pedal. The device works based in a piezoresistive force sensor (FlexiForce®) connected to a specific mechanical adjustment and a signal conditioning system that gives a proportional voltage to the exerted force, whose registry and analysis are made in LabVIEWTM. The device allows the visualization of the pedaling force in real time

Assessing Pandemic Preparedness, Response, and Lessons Learned From the Covid-19 Pandemic in Four South American Countries: Agenda for the Future

INTRODUCTION: The COVID-19 pandemic emerged in a context that lacked adequate prevention, preparedness, and response (PPR) activities, and global, regional, and national leadership. South American countries were among world\u27s hardest hit by the pandemic, accounting for 10.1% of total cases and 20.1% of global deaths. METHODS: This study explores how pandemic PPR were affected by political, socioeconomic, and health system contexts as well as how PPR may have shaped pandemic outcomes in Argentina, Brazil, Colombia, and Peru. We then identify lessons learned and advance an agenda for improving PPR capacity at regional and national levels. We do this through a mixed-methods sequential explanatory study in four South American countries based on structured interviews and focus groups with elite policy makers. RESULTS: The results of our study demonstrate that structural and contextual barriers limited PPR activities at political, social, and economic levels in each country, as well as through the structure of the health care system. Respondents believe that top-level government officials had insufficient political will for prioritizing pandemic PPR and post-COVID-19 recovery programs within their countries\u27 health agendas. DISCUSSION: We recommend a regional COVID-19 task force, post-pandemic recovery, social and economic protection for vulnerable groups, improved primary health care and surveillance systems, risk communication strategies, and community engagement to place pandemic PPR on Argentina, Brazil, Colombia, and Peru and other South American countries\u27 national public health agendas

Evaluación del impacto social de la Licenciatura en Educación Especial en dos subregiones de Antioquia, Colombia

This research paper presents the results of the evaluation of the social impact of the Special Education undergraduate program, of the University of Antioquia’s Education Faculty, in the East and Southwest subregions of the Antioquia department (Colombia). The main objective was to evaluate the impact of the Program among the graduates and other audiences. The methodology was carried out under a qualitative design, in the evaluative research modality, Social Programs impact type of evaluation. The results of the research were structured under the following categories: Assessment of the quality of the Program, the role of the Special Educator, significant experiences and their impact, and location and working conditions of the graduates. Finally, it poses recommendations to various academic units of the University.Keywords: special education, evaluation, social impact, graduates, occupational performance, assessment.En el presente artículo se dan a conocer los resultados de la evaluación del impacto social del programa de Licenciatura en Educación Especial, Facultad de Educación de la Universidad de Antioquia, en las subregiones de Oriente y Suroeste del departamento de Antioquia (Colombia), cuyo objetivo principal fue evaluar el impacto del Programa desde los egresados y otras audiencias. La metodología se llevó a cabo bajo un diseño cualitativo, modalidad de investigación evaluativa, tipo de evaluación de impacto de programas sociales. Los resultados se estructuraron bajo las categorías: valoración de la calidad del Programa, rol del educador especial, experiencias significativas y su impacto, y ubicación y condiciones laborales de los egresados y egresadas. Finalmente, se plantean recomendaciones a diferentes unidades académicas de la Universidad