Relación de la Capacidad Funcional con la Afectación Musculoesquelética en la Gonartrosis en Pacientes que Acuden al Departamento de Medicina Física y Rehabilitación del Hospital Regional Honorio Delgado Espinoza, Arequipa – 2017

La gonartrosis es una afección articular crónica degenerativa, progresiva caracterizada por la degeneración, pérdida del cartílago y alteración del hueso subcondral, asociado con cambios en los tejidos blandos, teniendo como síntomas: dolor, rigidez y desalineación articular, la impotencia funcional, la pérdida de fuerza y la masa muscular en la articulación afectada, siendo el cuádriceps uno de los más afectados, por ende es importante determinar el grado de afección tanto a nivel muscular como en el arco de movimiento. Como consecuencia de esta sintomatología se obtiene limitaciones funcionales que impiden la realización de actividades diarias y el adecuado desenvolvimiento en la sociedad. En consecuencia, en la siguiente investigación donde analizaremos y determinaremos los resultados de la relación que existe entre la afección y la función de la articulación de la rodilla, comenzando en el Capítulo I fundamentando y formulando el problema, planteando objetivos, justificando el propósito del proyecto y detallando ciertos términos a considerar. En el Capítulo II realizamos una revisión bibliográfica de antecedentes y marco teórico, profundizando acerca de la anatomía de la rodilla, la gonartrosis y sus principales síntomas. Luego en Capítulo III describimos la hipótesis, variables y las definiciones operacionales. En el Capítulo IV explica la metodología de la investigación, en el Capítulo V el Procedimiento de Análisis de Datos y por último Capítulo VI se mostrarán los resultados de la investigación.Tesi

Identificación serológica de Brucella abortus en perros (Canis lupus familiaris) de 27 ganaderías bovinas pertenecientes a los municipios de Metapán y El Porvenir, Santa Ana, El Salvador

La investigación se llevó a cabo durante los meses de noviembre 2016 a mayo 2017 en los municipios de Metapán y El Porvenir en el departamento de Santa Ana; dichos municipios fueron seleccionados debido a que en ellos se reportó la mayor cantidad de casos de brucelosis bovina en la región occidental del país, durante el año 2015. Se muestrearon 90 perros de los cuales 48 correspondían a 15 unidades productivas en el Municipio de Metapán y 42 a 12 unidades productivas en el municipio de El Porvenir. Se extrajeron aproximadamente 5 mililitros de sangre entera por ejemplar, para analizar por medio de la prueba de Rosa de Bengala obteniendo 8 y 18 muestras seropositivas respectivamente; demostrando serológicamente la circulación de Brucella abortus en los perros de las unidades productivas analizadas. La seroprevalencia general de Brucella abortus en perros fue 28.89% resultando ser más elevada en comparación a otros estudios realizados a nivel mundial; y una seroprevalencia general en unidades productivas de 59.25%. El sexo y la edad no fueron factores estadísticamente determinantes para la presencia de los anticuerpos dirigidos contra Brucella abortus. La seroprevalencia más elevada en perros se obtuvo en el municipio de El Porvenir donde el 100% de unidades productivas muestreadas fueron reactoras y el 42.85% de perros seropositivos, coincidiendo con la mayor seroprevalencia de Brucella abortus en bovinos reportado por el Ministerio de Agricultura y Ganadería en el año 2015 para dicho municipio. Los resultados obtenidos presentan información epidemiológica importante que contribuirá a la toma de decisiones por parte de las autoridades pertinentes

Asteroid Redirect Crewed Mission Space Suit and EVA System Architecture Trade Study

The Asteroid Redirect Crewed Mission (ARCM) requires a Launch/Entry/Abort (LEA) suit capability and short duration Extra Vehicular Activity (EVA) capability for Orion. The EVAs will involve a two-person crew for approximately four hours. Currently, two EVAs are planned with one contingency EVA in reserve. Providing this EVA capability is very challenging due to system level constraints and a new and unknown environment. The goal of the EVA architecture for ARCM is one that builds upon previously developed technologies and lessons learned, and that accomplishes the ARCM mission while providing a stepping stone to future missions and destinations. The primary system level constraints are to 1) minimize system mass and volume and 2) minimize the interfacing impacts to the baseline Orion design. In order to minimize the interfacing impacts and to not perturb the baseline Orion schedule, the concept of adding "kits" to the baseline system is proposed. These kits consist of: an EVA kit (converts LEA suit to EVA suit), EVA Servicing and Recharge Kit (provides suit consumables), the EVA Tools, Translation Aids & Sample Container Kit (the tools and mobility aids to complete the tasks), the EVA Communications Kit (interface between the EVA radio and the MPCV), and the Cabin Repress Kit (represses the MPCV between EVAs). This paper will focus on the trade space, analysis, and testing regarding the space suit (pressure garment and life support system). Historical approaches and lessons learned from all past EVA operations were researched. Previous and current, successfully operated EVA hardware and high technology readiness level (TRL) hardware were evaluated, and a trade study was conducted for all possible pressure garment and life support options. Testing and analysis was conducted and a recommended EVA system architecture was proposed. Pressure garment options that were considered for this mission include the currently in-use ISS EVA Mobility Unit (EMU), all variations of the Advanced Crew Escape Suit (ACES), and the Exploration Z-suit. For this mission, the pressure garment that was selected is the Modified ACES (MACES) with EVA enhancements. Life support options that were considered included short closed-loop umbilicals, long open-loop umbilicals, the currently in-use ISS EMU Portable Life Support System (PLSS), and the currently in development Exploration PLSS. For this mission, the life support option that was selected is the Exploration PLSS. The greatest risk in the proposed architecture is viewed to be the comfort and mobility of the baseline MACES and the delicate balance between adding more mobility features while not compromising landing safety. Feasibility testing was accomplished in low fidelity analogs and in the JSC Neutral Buoyancy Laboratory (NBL) to validate the concept before a final recommendation on the architecture was made. The proposed architecture was found to meet the mission constraints, but much more work is required to determine the details of the required suit upgrades, the integration with the PLSS, and the rest of the tools and equipment required to accomplish the mission. This work and further definition of the remaining kits will be conducted in government fiscal year 14

Asteroid Redirect Crewed Mission Space Suit and EVA System Architecture Trade Study

The Asteroid Redirect Crewed Mission (ARCM) requires a Launch/Entry/Abort (LEA) suit capability and short duration Extra Vehicular Activity (EVA) capability from the Orion spacecraft. For this mission, the pressure garment selected for both functions is the Modified Advanced Crew Escape Suit (MACES) with EVA enhancements and the life support option that was selected is the Exploration Portable Life Support System (PLSS) currently under development for Advanced Exploration Systems (AES). The proposed architecture meets the ARCM constraints, but much more work is required to determine the details of the suit upgrades, the integration with the PLSS, and the tools and equipment necessary to accomplish the mission. This work has continued over the last year to better define the operations and hardware maturation of these systems. EVA simulations were completed in the Neutral Buoyancy Lab (NBL) and interfacing options were prototyped and analyzed with testing planned for late 2014. This paper discusses the work done over the last year on the MACES enhancements, the use of tools while using the suit, and the integration of the PLSS with the MACES

Surface chemistry and nano-/microstructure engineering on photocatalytic In2S3 nanocrystals

Colloidal nanocrystals (NCs) compete with molecular catalysts in the field of homogenous catalysis, offering easier recyclability and a number of potentially advantageous functionalities, such as tunable band gaps, plasmonic properties, or a magnetic moment. Using high-throughput printing technologies, colloidal NCs can also be supported onto substrates to produce cost-effective electronic, optoelectronic, electrocatalytic, and sensing devices. For both catalytic and technological application, NC surface chemistry and supracrystal organization are key parameters determining final performance. Here, we study the influence of the surface ligands and the NC organization on the catalytic properties of In2S3, both as a colloid and as a supported layer. As a colloid, NCs stabilized by inorganic ligands show the highest photocatalytic activities, which we associate with their large and more accessible surfaces. On the other hand, when NCs are supported on a substrate, their organization becomes an essential parameter determining performance. For instance, NC-based films produced through a gelation process provided five-fold higher photocurrent densities than those obtained from dense films produced by the direct printing of NCs.Peer ReviewedPostprint (author's final draft

Peripartum cardiomyopathy, diagnostic challenge

La miocardiopatía periparto es un trastorno que se presenta clínicamente como un síndrome de insuficiencia cardiaca en mujeres en el periodo periparto. En su fisiopatología juega un papel fundamental la prolactina junto con una base genética que predispone al desarrollo de la enfermedad. Para su diagnóstico es necesario cumplir con tres criterios: que se desarrolle en el último mes de embarazo o 5 meses post parto, ausencia de otra causa de los signos y síntomas junto con disfunción de VI. En cuanto a las pruebas diagnósticas, es esencial la ecocardiografía, ya que confirma parte de los criterios diagnósticos y además descarta algunos diagnósticos diferenciales. Posterior a confirmar el diagnóstico, se debe realizar una estratificación de la gravedad de la paciente, debido a que puede ser una patología potencialmente mortal por shock cardiogénico, arritmias o complicaciones como embolia debido a trombos cavitarios. El manejo se realiza similar a cualquier otra falla cardiaca aguda, y cuando se logre estabilización se debe iniciar tratamientos según directrices para falla cardiaca, esto tomando en cuenta los medicamentos contraindicados en el embarazo: IECA, ARA II, ARNI, MRA, y atenolol. Además, se debe tomar la decisión del momento y la forma de terminar con el embarazo; en general, se recomienda terminar el embarazo debido a que este actúa como un aumento del gasto cardiaco, se prefiere la cesárea en pacientes en shock y el parto vaginal cuando hay estabilidad.  Al tratamiento para la falla se debe agregar en la mayoría de las pacientes bromocriptina, para inhibir los efectos de la prolactina, junto con anticoagulación. El pronóstico varía con una mortalidad de 2% a 12% a los 6 meses y 24% a los 24 meses. Puede recurrir en embarazos posteriores, sin embargo, son seguros con un adecuado seguimiento y tratamiento, excepto en pacientes que no recuperaron la FE.Peripartum cardiomyopathy is a disorder that presents clinically as a heart failure syndrome in women in the peripartum period. Prolactin plays a fundamental role in its pathophysiology along with a genetic basis that predisposes to the development of the disease. For its diagnosis it is necessary to meet three criteria, which develops in the last month of pregnancy or 5 months postpartum, absence of another cause of signs and symptoms along with LV dysfunction. As for diagnostic tests, echocardiography is essential since it confirms part of the diagnostic criteria and rules out some differential diagnoses. After confirming the diagnosis, a stratification of the severity of the patient should be performed, because it can be a life-threatening pathology due to cardiogenic shock, arrhythmias, or complications such as embolism due to cavitary thrombi. Management is similar to any other acute heart failure and when stabilization is achieved, treatments should be initiated according to guidelines for heart failure, this taking into account the drugs contraindicated in pregnancy: ACE inhibitor,  ARA II,  ARNI, MRA, and atenolol. In addition, the decision of the time and way to end the pregnancy must be made; In general, it is recommended to terminate the pregnancy because it acts as an increase in cardiac output, cesarean section is preferred in patients in shock and vaginal delivery when there is stability.  To the treatment for failure should be added in most patients bromocriptine, to inhibit the effects of prolactin, along with anticoagulation. The prognosis varies with a mortality of 2% to 12% at 6 months and 24 % at 24 months, may recur in subsequent pregnancies, however, they are safe with adequate follow-up and treatment, except in patients who did not recover EF in whom pregnancy is not recommended

Lights, fiber, action! A primer on in vivo fiber photometry

Fiber photometry is a key technique for characterizing brain-behavior relationships in vivo. Initially, it was primarily used to report calcium dynamics as a proxy for neural activity via genetically encoded indicators. This generated new insights into brain functions including movement, memory, and motivation at the level of defined circuits and cell types. Recently, the opportunity for discovery with fiber photometry has exploded with the development of an extensive range of fluorescent sensors for biomolecules including neuromodulators and peptides that were previously inaccessible in vivo. This critical advance, combined with the new availability of affordable “plug-and-play” recording systems, has made monitoring molecules with high spatiotemporal precision during behavior highly accessible. However, while opening exciting new avenues for research, the rapid expansion in fiber photometry applications has occurred without coordination or consensus on best practices. Here, we provide a comprehensive guide to help end-users execute, analyze, and suitably interpret fiber photometry studies

A bivalent live-attenuated vaccine for the prevention of equine influenza virus

Vaccination remains the most effective approach for preventing and controlling equine influenza virus (EIV) in horses. However, the ongoing evolution of EIV has increased the genetic and antigenic differences between currently available vaccines and circulating strains, resulting in suboptimal vaccine efficacy. As recommended by the World Organization for Animal Health (OIE), the inclusion of representative strains from clade 1 and clade 2 Florida sublineages of EIV in vaccines may maximize the protection against presently circulating viral strains. In this study, we used reverse genetics technologies to generate a bivalent EIV live-attenuated influenza vaccine (LAIV). We combined our previously described clade 1 EIV LAIV A/equine/Ohio/2003 H3N8 (Ohio/03 LAIV) with a newly generated clade 2 EIV LAIV that contains the six internal genes of Ohio/03 LAIV and the HA and NA of A/equine/Richmond/1/2007 H3N8 (Rich/07 LAIV). The safety profile, immunogenicity, and protection efficacy of this bivalent EIV LAIV was tested in the natural host, horses. Vaccination of horses with the bivalent EIV LAIV, following a prime-boost regimen, was safe and able to confer protection against challenge with clade 1 (A/equine/Kentucky/2014 H3N8) and clade 2 (A/equine/Richmond/2007) wild-type (WT) EIVs, as evidenced by a reduction of clinical signs, fever, and virus excretion. This is the first description of a bivalent LAIV for the prevention of EIV in horses that follows OIE recommendations. In addition, since our bivalent EIV LAIV is based on the use of reverse genetics approaches, our results demonstrate the feasibility of using the backbone of clade 1 Ohio/03 LAIV as a master donor virus (MDV) for the production and rapid update of LAIVs for the control and protection against other EIV strains of epidemiological relevance to horses