Estudio de las coinfecciones por otros patógenos respiratorios en pacientes pediátricos con diagnóstico de covid-19

Introducción: La coinfección de COVID-19 con otros patógenos respiratorios en pediatría ha sido poco estudiada. Resulta de interés conocer las características y cuadro clínico de pacientes que presenten coinfecciones con COVID-19. Objetivo: Estudiar la coinfección de SARS-CoV-2 con patógenos incluidos en el Panel RP 2.0 FilmArray® en muestras de pacientes pediátricos en un hospital del tercer nivel. Materiales y métodos: Durante abril a agosto de 2021 se realizó un estudio prospectivo descriptivo sobre 21 muestras de Hisopado Nasofaríngeo de pacientes pediátricos positivos para SARS-CoV-2 (iAMP® COVID-19 Detection Kit de Atila Biosystems). Se procesaron por PCR multiplex Filmarray® RP 2.0. Luego se describieron las características y síntomas de los pacientes. Resultados: 12/21 (60%) fueron pacientes ambulatorios y 8/21 (40%) internados. El 57% de los pacientes fueron mayores de 5 años, el 24% menores de 1 año y el 19% entre 1 y 5 años. El síntoma más frecuente fue fiebre 18/21 (86%). El 90,5% (19/21) de las muestras no mostraron detección de otros patógenos. En una muestra se detectó Rhino/enterovirus y en otra Coronavirus NL63; ambas pertenecieron a dos pacientes con enfermedades de base. Conclusión: La tasa de coinfecciones fue del 9,5%. Este número podría deberse a la baja circulación de patógenos respiratorios en un contexto con medidas de prevención de los contagios. En el estado actual de incremento de circulación de virus respiratorios endémicos, es de interés la búsqueda de coinfecciones con COVID-19.Introduction: The co-infection of COVID-19 with other respiratory pathogens in pediatrics has been little studied. It is of interest to know the characteristics and clinical picture of patients who present co-infections with COVID-19. Objective: To study the co-infection of SARS-CoV-2 with pathogens included in the RP Panel 2.0 FilmArray® in samples from pediatric patients in a third-level hospital. Materials and methods: During April to August 2021, a prospective descriptive study was conducted on 21 Nasopharyngeal Swab samples from pediatrics patients positive for SARS-CoV-2 (iAMP® COVID- 19 Detection Kit from Attila Biosystems). They were processed by PCR multiplex Filmarray® RP 2.0. The characteristics and symptoms of the patients were then described. Results: 12/21 (60%) were outpatients and 8/21 (40%) were hospitalized. 57% of patients were older than 5 years, 24% under 1 year and 19% between 1 and 5 years. The most frequent symptom was fever 18/21 (86%). 90,5% (19/21) of the samples showed no detection of other pathogens. Rhino/enterovirus was detected in one sample and NL63 in another Coronavirus; both belonged to two patients with underlying diseases. Conclusion: The rate of co-infections was 9,5%. This number could be due to the low circulation of respiratory pathogens in a context with measures to prevent contagion. In the current state of increased circulation of endemic respiratory viruses, the search for co-infections with COVID-19 is of interest

A merchant mechanism for electricity transmission expansion

We propose a merchant mechanism to expand electricity transmission based on long-term financial transmission rights (FTRs). Due to network loop flows, a change in network capacity might imply negative externalities on existing transmission property rights. The system operator thus needs a protocol for awarding incremental FTRs that maximize investors ’ preferences, and preserves certain currently unallocated FTRs (or proxy awards) so as to maintain revenue adequacy. In this paper we define a proxy award as the best use of the current network along the same direction as the incremental awards. We then develop a bi-level programming model for allocation of long-term FTRs according to this rule and apply it to different network topologies. We find that simultaneous feasibility for a transmission expansion project crucially depends on the investor-preference and the proxy-preference parameters. Likewise, for a given amount of pre-existing FTRs the larger the current capacity the greater the need to reserve some FTRs for possible negative externalities generated by the expansion changes

A Merchant Mechanism for Electricity Transmission Expansion

We propose a merchant mechanism to expand electricity transmission based on long-term financial transmission rights (FTRs). Due to network loop flows, a change in network capacity might imply negative externalities on existing transmission property rights. The system operator thus needs a protocol for awarding incremental FTRs that maximize investors’ preferences, and preserves certain currently unallocated FTRs (or proxy awards) so as to maintain revenue adequacy. In this paper we define a proxy award as the best use of the current network along the same direction as the incremental awards. We then develop a bi-level programming model for allocation of long-term FTRs according to this rule and apply it to different network topologies. We find that simultaneous feasibility for a transmission expansion project crucially depends on the investor-preference and the proxy-preference parameters. Likewise, for a given amount of pre-existing FTRs the larger the current capacity the greater the need to reserve some FTRs for possible negative externalities generated by the expansion changes. Copyright Springer Science+Business Media, Inc. 2006Electricity transmission, Financial transmission rights, Merchant transmission expansion, Bi-level programming, Power flow model, L51, L91, L94, Q40,

Muscle involvement in leprosy: study of the anterior tibial muscle in 40 patients Alterações musculares na lepra: estudo do músculo tibial anterior em 40 pacientes

The involvement of skeletal striated muscle in leprosy is considered secondary due to peripheral neuropathy, but some studies point it to a primary muscle lesion. In order to investigate the muscle involvement in leprosy, we studied 40 patients (lepromatous 23, tuberculoid 13, borderline 2 and indeterminate 2). The motor nerve conduction of the peroneal nerves had a reduction of the velocity, decreased compound muscle action potential and sometimes absence of potentials. The electromyographic study of the anterior tibial muscle showed signs of recent and chronic denervation in 77.5% of the cases and no myopathic potentials. The anterior tibial muscle biopsy revealed denervation in 45% of the cases, interstitial inflammatory myopathy in 30% and mixed (myopathic and neuropathic) pattern in 12.5%. Acid fast bacillus was detected in 25% of the cases, always in the interstitial tissue. Inflammatory reaction was present in the interstitial space and in patients with the lepromatous type. The histological findings clearly defined the presence of the so-called "Leprous Interstitial Myositis" on the top of denervation signs.<br>O envolvimento do músculo estriado na lepra é considerado secundário à lesão dos nervos periféricos, mas alguns estudos relataram acometimento muscular primário. A fim de verificar esta controvérsia estudamos 40 pacientes com lepra, sendo 23 da forma lepromatosa, 13 da tuberculoide, 2 borderline e 2 indeterminada. Realizamos a neurocondução do nervo peroneiro, junto com eletromiografia e biópsia do músculo tibial anterior. Encontramos redução de velocidade de condução, da amplitude e algumas vezes ausência de potenciais no nervo peroneiro. A eletromiografia do tibial anterior mostrou sinais de desinervação recente e crônica em 77,5% dos casos e não foi encontrada evidência de padrão "miopático". A biópsia do músculo tibial anterior revelou desinervação em 45% dos casos, miopatia inflamatória intersticial em 30% e padrão misto (miopático e neuropático) em 12,5%. Bacilos alcool-ácido resistentes foram encontrados em 25% dos casos, sempre localizados no perimisio e endomisio. Na forma lepromatosa, a reação inflamatória estava presente no espaço intersticial. Os dados histológicos claramente definiram a presença de "Miosite Lepromatosa Intersticial" sobreposta às alterações histológicas encontradas em desinervação