Abstract: Introduction: Idiopathic sudden hearing loss (SHL) is a relatively frequent entity in the adult population with unk nown cause in most cases. There are few studies in pediatric age and its diagnosis and management are a challenge for health professionals. Objective: To relate macrolide therapy as a causal agent of sudden hearing loss in pediatric patients. Clinical Case: 3-year-old girl with no relevant pathological history, with normal neonatal hearing screening and age-appropriate language development. She consulted due to an upper airway infectious process, treated on an outpatient basis with azithromycin for 3 days. One week later, she developed bilateral hearing loss, confirmed with Brainstem Auditory Evoked Potentials (BAEP), and started treatment with oral methylprednisolone and intratympanic corticosteroids. During treatment, imaging, laboratory, and genetic studies were performed, ruling out other causes of SHL, so the recent use of macrolides was considered as a possible diagnosis. As no clinical improvement was observed 6 weeks after the treatment, confirmed by the absence of response in the steady-state auditory evoked potentials and BAEP, simultaneous bilateral cochlear implant surgery was carried out. Four years after surgery, the patient showed good speech-language develop ment and adequate school performance. Conclusions: Ototoxicity is a cause that must be considered in the case of SHL in childhood. A multidisciplinary approach will allow effective treatment in these patients, in which early management with an adequate hearing aid will restore hearing and achieve adequate speech development and linguistic competence.

Resumen: Introducción: La hipoacusia súbita (HS) idiopática es una entidad relativamente frecuente en población adulta, y en la mayoría de los casos se desconoce su causa. Hay pocos estudios en edad pediátrica, siendo su diagnóstico y manejo un reto para los profesionales de salud. Objetivo: Relacionar la toma de macrólidos como agente causal de HS en pacientes pediátricos. Caso Clínico: Preescolar de 3 años sin an tecedentes patológicos de interés, habiendo pasado screening auditivo neonatal y con desarrollo del lenguaje adecuado a la edad. Consultó por historia de proceso infeccioso de vía aérea superior tratado ambulatoriamente con azitromicina durante 3 días. Después de 1 semana de finalizado el antibió tico, evolucionó con HS bilateral, confirmada con Potenciales Evocados Auditivos de Tronco Cere bral (PEATC). Se trató con metilprednisolona oral y corticoterapia intratimpánica. Paralelamente se completó estudio de imágenes, laboratorio y genético descartando otras causas de HS, quedando como posibilidad diagnóstica el uso reciente de macrólidos. Al no observarse mejoría tras 6 semanas de tratamiento, constatado con la ausencia de respuesta en los Potenciales Evocados Auditivos de estado estable (PEAee) y PEATC, se realizó implantación coclear bilateral simultánea. En los 4 años de seguimiento, evolucionó con buen desarrollo del lenguaje y rendimiento escolar adecuado. Con clusiones: La ototoxicidad se debe tener presente frente a un caso de HS en la infancia. Un abordaje multidisciplinar permitirá un tratamiento eficaz en estos pacientes, en los que un manejo precoz con la ayuda auditiva adecuada permitirá restaurar la audición y alcanzar un desarrollo del habla y una competencia lingüística adecuada.

Abstract Purpose: To report the perceptions and actions undertaken by members of the Mexican Society of Ophthalmology (SMO) during the first months of the COVID-19 pandemic. The paper focuses on the association between professional characteristics and the extent of implementation of the recommendations published by the SMO. Methods: An online survey at Google® Forms was sent via email to ophthalmologists registered with the SMO. A total of 3,296 questionnaires were sent. Two principal variables were selected for the purpose of analyzing the exploratory hypotheses: seniority of the respondents and type of practice. Results: A total of 363 replies were obtained (11.01%). At the time of the survey, 223 ophthalmologists (61.3%) were continuing to see patients in their clinics, while 140 participants (38.5%) had ceased all activities. The main reason for stopping clinical work was the fear that the practices would become transmission hubs. There was a statistical association between higher seniority and discontinuing patient care (p = 0.002). A total of 107 (29.7%) participants continued performing surgical procedures. Participants with less than 10 years of experience had a higher probability of engaging in emergency surgical procedures (p = 0.04). The most commonly employed preventive measure was the use of face masks for patients, followed by the use of N95 respirators by doctors. Conclusion: The majority of the participants maintained their clinical work; in contrast, less than a third continued surgical activities. There was great diversity in the actions taken and in the adoption of SMO recommendations. The use of personal protective equipment was the most employed security measure.

Resumen Objetivo: Analizar el impacto de la emergencia sanitaria por COVID-19 en las percepciones y acciones de los miembros de la Sociedad Mexicana de Oftalmología (SMO) durante los primeros meses. Se describe la asociación entre las características profesionales y la implementación de medidas de bioseguridad publicadas por la SMO Método: Encuesta en línea, mediante Google® Forms, enviada por correo electrónico a oftalmólogos registrados en la SMO. Se enviaron en total 3296 cuestionarios. Se codificaron dos variables principales para analizar las hipótesis exploratorias: experiencia de los encuestados y tipo de práctica. Resultados: Se obtuvieron 363 respuestas (11.01%). Al momento de la encuesta, 223 (61.3%) oftalmólogos continuaban la atención clínica y 140 (38.5%) habían cesado toda actividad. La principal razón para detener el trabajo clínico fue el temor a convertirse en centros de transmisión. Hubo una asociación entre la mayor experiencia y la interrupción de la atención al paciente (p = 0.002). Continuaron realizando cirugías 107 (29.7%) oftalmólogos. Los participantes con menos de 10 años de experiencia tenían mayor probabilidad de realizar cirugías de emergencia (p = 0.04). La medida de seguridad más empleada fue el uso de cubrebocas en los pacientes, seguido del uso de mascarillas N95 por parte de los médicos. Conclusiones: La mayoría de los participantes mantuvieron su trabajo clínico, pero menos de un tercio continuaron las actividades quirúrgicas. Hubo una gran diversidad en las acciones emprendidas y en la adopción de las recomendaciones de la SMO. El uso de equipo de protección personal fue la acción más frecuente entre los participantes.

Abstract Objective: To analyze the degree of satisfaction of hospital pharmacy residents and identify areas of improvement in their training. Method: A survey (5-point Likert scale) was administered among fourth-year hospital pharmacy residents due to complete their residency in 2018. Bivariate and multivariate logistic regression analyses was performed to identify the association of each independent variable with overall satisfaction. Results: 67.4% (91/135) of residents filled out the questionnaire. The mean overall satisfaction rate was acceptable-good (3.52 ± 0.92); 86.8% of residents had received an individualized training program, with 50% of them considering their individualized training program to be very well attuned to their day-to-day professional practice. The work of the tutor and other staff members involved in resident education was rated as positive by 63.7% and 72.5% of residents, respectively. A total of 15.4% of residents said that their units had a supervision and progressive empowerment protocol in place. With respect to the level of on-call responsibility bestowed on them, 81% of residents considered it to be adequate; 69.2% considered the supervision they received to be adequate. As many as 96.7% of residents dedicated less than 10 hours per week to teaching or research activities; 35.2% of residents had produced five or less articles or congress presentations as first authors. Residents that had defended or were in the process of writing their PhD dissertation were 30.8%; 45.1% were involved in an Research project. Finally, 89% of residents rated the training received as positive, with 75.8% of them stating that they would select the same hospital again. In the statistical analysis, an association was found between overall satisfaction and several variables, with the work done by the main tutor being independently related to overall satisfaction. Conclusions: Overall satisfaction with the training received by fourth-year residents was acceptable. The work of the tutor and other staff members involved in resident education were the variables with the greatest influence on overall satisfaction, albeit only the tutor´s work achieved statistical significance. The supervision of residents’ progress, the coaching provided by other staff members during clinical rotations, and research were identified as areas for improvement.

Resumen Objetivo: Analizar el grado de satisfacción de los residentes de la especialidad de farmacia hospitalaria e identificar áreas de mejora en su formación. Método: Cuestionario on line con 51 preguntas dirigido a residentes de cuarto año en Farmacia Hospitalaria que finalizaban su formación en 2018. Se realizó un análisis bivariante y multivariante para identificar la asociación de cada una de las variables independientes con respecto a la satisfacción global y delimitar en qué medida las asociaciones pudieran explicarse por el efecto del resto de variables recogidas en el estudio. Resultados: Un total de 91 (67,4%) residentes cumplimentaron el cuestionario. La media de satisfacción global fue aceptable-buena (3,52 ± 0,92). El 86,8% disponía de un Plan Individualizado de Formación y el 50% valoraron su adaptación al programa de la especialidad como buena o muy buena. El 63,7% valoró positivamente la labor del tutor principal y un 72,5% la del resto de adjuntos. El 15,4% contestó que su servicio disponía de un protocolo de supervisión y responsabilidad progresiva. El 81% consideró adecuado el nivel de responsabilidad en las guardias y el 69,2% su supervisión. El 96,7% disponía de menos de 10 horas semanales para actividades docentes o de investigación. Un 35,2% tenía cinco o menos publicaciones o comunicaciones a congresos como primer autor y un 45,1% participaba en algún proyecto de investigación. Un 89% valoró positivamente la formación recibida en su centro y un 75,8% de los residentes volvería a elegir el mismo hospital. El análisis estadístico mostró una asociación respecto a la satisfacción global con significación estadística de varias variables, siendo la labor del tutor principal la que se relacionó de forma independiente con la satisfacción global. Conclusiones: La satisfacción global con la formación recibida es aceptable, siendo la tutorización del tutor principal y la del resto de farmacéuticos de los servicios de farmacia los factores que afectan a la satisfacción global, si bien sólo la del tutor de un modo estadísticamente significativo. Como áreas de mejora se han detectado la supervisión de la formación, la labor del colaborador docente farmacéutico en las rotaciones clínicas y la investigación.

RESUMO Identificar e classificar as informações disponíveis sobre o COVID-19 e o tratamento oftalmológico de acordo com o nível de evidência, dentro de quatro tópicos principais de interesse: evidência do vírus nas lágrimas e na superfície ocular, infecção pela via conjuntival, manifestações oculares e recomendações de melhores práticas. Foi realizada uma revisão estruturada no PubMed, ScienceDirect, LILACS, SciELO, Biblioteca Cochrane e Google Scholar no COVID-19 e oftalmologia. A planilha de Níveis de Evidência 2011 do Oxford Centre for Evidence Based Medicine 2011 foi usada para avaliações de qualidade. Mil e dezoito itens foram identificados na busca; Foram incluídos 26 registros na síntese qualitativa, que incluiu 6 revisões de literatura, 10 séries de casos ou estudos transversais, 4 relatos de casos e 6 descrições de intervenções. Dezessete dos 26 registros (65%) foram classificados como nível 5 no sistema de classificação da metodologia Oxford CBME, o restante foi no nível 4. As evidências geradas no COVID-19 e na oftalmologia até o momento são limitadas, embora isso seja compreensível dadas as circunstâncias. Tanto a possível presença de partículas virais em lágrimas e conjuntiva quanto o potencial de transmissão conjuntival permanecem controversos. As manifestações oculares não são frequentes e podem se assemelhar a infecção viral da superfície ocular. A maioria das recomendações baseia-se nas estratégias implementadas pelos países asiáticos durante surtos anteriores de coronavírus. Há necessidade de estudos aprofundados avaliando essas estratégias no cenário da SARS-CoV-2. Enquanto isso, os planos para a aplicação dessas medidas devem ser implementados com cautela, levando em consideração o contexto de cada país e submetidos a auditorias periódicas.

ABSTRACT To identify and classify available information regarding COVID-19 and eye care according to the level of evidence, within four main topics of interest: evidence of the virus in tears and the ocular surface, infection via the conjunctival route, ocular manifestations, and best practice recommendations. A structured review was conducted in PubMed, ScienceDirect, LILACS, SciELO, the Cochrane Library and Google Scholar on COVID-19 and ophthalmology. The Oxford Centre for Evidence Based Medicine 2011 Levels of Evidence worksheet was used for quality assessments. 1018 items were identified in the search; 26 records were included in the qualitative synthesis, which encompassed 6 literature reviews, 10 case series or cross-sectional studies, 4 case reports, and 6 intervention descriptions. Seventeen out of 26 records (65%) were categorized as level 5 within the Oxford CBME methodology grading system, the rest were level 4. The evidence generated on COVID-19 and ophthalmology to date is limited, although this is understandable given the circumstances. Both the possible presence of viral particles in tears and conjunctiva, and the potential for conjunctival transmission remain controversial. Ocular manifestations are not frequent and could resemble viral infection of the ocular surface. Most recommendations are based on the strategies implemented by Asian countries during previous coronavirus outbreaks. There is a need for substantive studies evaluating these strategies in the setting of SARS-CoV-2. In the meantime, plans for applying these measures must be implemented with caution, taking into account the context of each individual country, and undergo regular evaluation.

To identify and classify available information regarding COVID-19 and eye care according to the level of evidence, within four main topics of interest: evidence of the virus in tears and the ocular surface, infection via the conjunctival route, ocular manifestations, and best practice recommendations. A structured review was conducted in PubMed, ScienceDirect, LILACS, SciELO, the Cochrane Library and Google Scholar on COVID-19 and ophthalmology. The Oxford Centre for Evidence Based Medicine 2011 Levels of Evidence worksheet was used for quality assessments. 1018 items were identified in the search; 26 records were included in the qualitative synthesis, which encompassed 6 literature reviews, 10 case series or cross-sectional studies, 4 case reports, and 6 intervention descriptions. Seventeen out of 26 records (65%) were categorized as level 5 within the Oxford CBME methodology grading system, the rest were level 4. The evidence generated on COVID-19 and ophthalmology to date is limited, although this is understandable given the circumstances. Both the possible presence of viral particles in tears and conjunctiva, and the potential for conjunctival transmission remain controversial. Ocular manifestations are not frequent and could resemble viral infection of the ocular surface. Most recommendations are based on the strategies implemented by Asian countries during previous coronavirus outbreaks. There is a need for substantive studies evaluating these strategies in the setting of SARS-CoV-2. In the meantime, plans for applying these measures must be implemented with caution, taking into account the context of each individual country, and undergo regular evaluation.

Identificar e classificar as informações disponíveis sobre o COVID-19 e o tratamento oftalmológico de acordo com o nível de evidência, dentro de quatro tópicos principais de interesse: evidência do vírus nas lágrimas e na superfície ocular, infecção pela via conjuntival, manifestações oculares e recomendações de melhores práticas. Foi realizada uma revisão estruturada no PubMed, ScienceDirect, LILACS, SciELO, Biblioteca Cochrane e Google Scholar no COVID-19 e oftalmologia. A planilha de Níveis de Evidência 2011 do Oxford Centre for Evidence Based Medicine 2011 foi usada para avaliações de qualidade. Mil e dezoito itens foram identificados na busca; Foram incluídos 26 registros na síntese qualitativa, que incluiu 6 revisões de literatura, 10 séries de casos ou estudos transversais, 4 relatos de casos e 6 descrições de intervenções. Dezessete dos 26 registros (65%) foram classificados como nível 5 no sistema de classificação da metodologia Oxford CBME, o restante foi no nível 4. As evidências geradas no COVID-19 e na oftalmologia até o momento são limitadas, embora isso seja compreensível dadas as circunstâncias. Tanto a possível presença de partículas virais em lágrimas e conjuntiva quanto o potencial de transmissão conjuntival permanecem controversos. As manifestações oculares não são frequentes e podem se assemelhar a infecção viral da superfície ocular. A maioria das recomendações baseia-se nas estratégias implementadas pelos países asiáticos durante surtos anteriores de coronavírus. Há necessidade de estudos aprofundados avaliando essas estratégias no cenário da SARS-CoV-2. Enquanto isso, os planos para a aplicação dessas medidas devem ser implementados com cautela, levando em consideração o contexto de cada país e submetidos a auditorias periódicas.

ABSTRACT There are few studies about parasitic infections in Crotalus triseriatus (Wagler, 1830), an endemic rattlesnake from the highlands of central Mexico. This species occupies several habitats, from conserved forested regions to heavily impacted landscapes. To increase the parasitological knowledge of this reptile species without impacting populations, we obtained fecal samples of 16 rattlesnakes between 2012 and 2014 from Toluca Valley, Mexico. By using flotation technique, we found oocysts of Eimeria sp. and eggs of Capillariidae sp. The most frequent parasite was Eimeria sp. (62.5%). This study provides the first records of occurrence of parasites in reptilian feces from Mexico. Our results may be important for wildlife conservation purposes, for example, they could indicate of the population health of this species during processes of translocation.

Abstract In Mexico, chili cultivation has a long cultural tradition and is one of the main centers of origin and domestication. An average of 97,306 ha is planted annually in the north of the country. However, the productivity of the chili crop is very erratic due to biotic and abiotic factors that occur during its development. Extreme temperatures and water availability are two of the dominant abiotic stressors. The objective of this work was to know the effect of global warming, on the thermal range of the chili crop. A historical analysis was performed on the variation of the number of hours with temperature inside and outside the thermal range of chili, and a similar analysis in the climatic scenarios 2050 and 2070 in the RCPs 4.5 and 8.5. Both in the historical analysis and in the climatologies we found positive and negative effects of global warming. Global warming will favor chilli cultivation with a surface increase (22.6%) with hourly temperature within development thresholds (15 to 32 °C) and a surface increase (15.8%) within the optimum temperature range (18 to 28 °C). Chili cultivation will be limited by the increase (20.8%) in the surface area with hourly temperature above the upper threshold (32 °C) and an increase (18.5%) in the area with a night time temperature above the upper threshold of night temperature (18 °C) in RCP 4.5 and in climatology 2050. High temperature stress will have an effect on the yield decrease due to the negative effect on pollination and fruit binding processes.

Resumen En México el cultivo del chile tiene una larga tradición cultural y es uno de los principales centros de origen y domesticación, anualmente se siembran en promedio 97 306 ha en el Norte Centro del país. Sin embargo, la productividad del cultivo de chile es muy errática debido a factores bióticos y abióticos que se presentan durante su desarrollo. Temperaturas extremas y la disponibilidad de agua son dos de los factores de estrés abiótico dominantes. El objetivo de este trabajo fue conocer el efecto del calentamiento global, sobre el rango térmico del cultivo de chile. Se realizó un análisis histórico sobre la variación del número de horas con temperatura dentro y fuera del rango térmico de chile, y un análisis similar en los escenarios climáticos 2050 y 2070 en los RCP 4.5 y 8.5. Tanto en el análisis histórico como en las climatologías se encontraron efectos positivos y negativos del calentamiento global. El calentamiento global favorecerá al cultivo de chile con un aumento de la superficie (22.6%) con temperatura horaria dentro de los umbrales de desarrollo (15 a 32 °C) y un aumento de la superficie (15.8%) dentro del rango de temperatura óptima (18 a 28 °C). El cultivo de chile se verá limitado por el aumento (20.8%) de la superficie con temperatura horaria mayor al umbral superior (32 °C) y un aumento (18.5%) de la superficie con temperatura nocturna horaria mayor al umbral superior de temperatura nocturna (18 °C) en el RCP 4.5 y en la climatología 2050. El estrés por temperatura alta repercutirá en la disminución del rendimiento debido al efecto negativo en los procesos de polinización y amarre de frutos.

The aim of the present research was to determinate the type of tissue present in a sample obtained from an embryogenic callus of Coco Cumbé Palm, Parajubaea cocoides Burret and somatic embryos on globular stage. For this purpose, in order to the protocol established in the histotechnology analysis procedure manual of Patology Service from "Carlos Andrade Marín" Hospital (HCAM, according its acronyms in Spanish) was proceeded located in Quito, Pichincha, Ecuador. The results showed that the embryogenic calli are conformed by meristematic cells and although present cells with starch granules near to embryogenic cells, indicating embryos formation. In somatic embryos case, was verified that these were in globular stage, because of these showed a characteristic structure of the first development stage, named protoderm. Therefore was determined that calli present distinctive characteristics of embryogenic competence and viability of the somatic embryos

El objetivo propuesto para este estudio fue determinar el tipo de tejido presente en una muestra obtenida de callos embriogénicos y de embriones somáticos en estado globular de Palma Coco Cumbé (Parajubaea cocoides Burret). Para esto se procedió según el protocolo establecido en el manual de procedimiento de análisis histotecnológico del Servicio de Patología del Hospital "Carlos Andrade Marín" (HCAM), ubicado en Quito, Pichincha, Ecuador. Los resultados mostraron que los callos embriogénicos están conformados por células meristemáticas y que además presentan células con gránulos de almidón, muy cercanas a las embriogénicas, indicador este, de la formación de embriones. En el caso de los embriones somáticos se comprobó que estos se encontraban en etapa globular, pues presentaban una estructura característica de la primera etapa de desarrollo embrionario denominada protoderma. Se determinó además que los callos presentan características distintivas de competencia embriogénica y viabilidad de los embriones somáticos

ABSTRACT The objective of the study was to determine the frequency and characteristics of dyslipidemia in patients with HIV in highly active antiretroviral therapy (HAART) in a Peruvian public hospital. A cross-sectional study was carried out in patients with complete lipid profile after receiving at least six months of HAART. Dyslipidemia was defined according to the criteria of the NCEP-ATP III. We reviewed 2 975 clinical histories, and included 538 (18.1%) in the analysis. The frequency of dyslipidemia was 74.7%. HAART regimens which include protease inhibitors (PI) (odds ratio [OR]: 1.22; confidence interval at 95% [CI 95%]: 1.11-1.33) and to be older than 40 years (OR: 1.17; CI 95%: 1.05-1.28) were associated with dyslipidemia, adjusted by viral load, CD4 lymphocyte level and gender. In conclusion, dyslipidemia was very common in our sample and was mainly associated with the use of PI. It is necessary to promote the dyslipidemia control as part of the comprehensive care of the patient with HIV.

RESUMEN El objetivo del estudio fue determinar la frecuencia y características de la dislipidemia en pacientes con VIH en terapia antirretroviral de gran actividad (TARGA) en un hospital público peruano. Se realizó un estudio transversal en pacientes que tuvieran un perfil lipídico completo luego de recibir al menos seis meses de TARGA. La dislipidemia se definió según los criterios NCEP-ATP III. Se revisaron 2975 historias clínicas, 538 (18.1%) fueron incluidas en el análisis. La frecuencia de dislipidemia fue 74.7%. Los esquemas de TARGA que incluían inhibidores de la proteasa (IP) (OR 1.22; IC95% 1,11-1,34) y la edad mayor de 40 años (OR 1.17; IC95% 1,06-1,29) mostraron asociación con dislipidemia, ajustado por carga viral, nivel de células CD4 y sexo. En conclusión, la dislipidemia fue muy frecuente en la muestra estudiada y estuvo asociada principalmente al uso de IP. Es necesario promover el control de la dislipidemia como parte de la atención integral del paciente con infección por VIH.

ABSTRACT There is little information on the presence of the Mycobacterium avium-Intracellulare (MAC) complex in Peru. Five cases of MAC infection are described in patients with HIV/AIDS at the National Hospital Dos de Mayo, Lima - Peru. The patients presented, mainly, persistent fever, chronic diarrhea, consumptive syndrome, pancytopenia and citofagocitosis. In all of them, resistant acid-alcohol bacilli were identified in feces, so they received antituberculous treatment. The culture of feces was negative for Mycobacterium tuberculosis and, later, in all cases MAC was identified using a molecular test (genotype) in the culture of feces. Three patients received treatment for MAC right after identification; however, they all died. Before presentations similar to the reported, we suggest the use of higher performance methods (blood culture, myeloculture, molecular tests), as well as early associating drugs with activity for MAC to antitubercular scheme with the intention of improving the prognosis of this group of patients.

RESUMEN Existe poca información sobre la presencia del complejo Mycobacterium avium-intracellulare (MAC) en el Perú. Se describen cinco casos de infección por MAC en pacientes con VIH/SIDA del Hospital Nacional Dos de Mayo, Lima-Perú. Los pacientes presentaron, principalmente, fiebre persistente, diarrea crónica, síndrome consuntivo, pancitopenia y citofagocitosis. En todos ellos se identificó bacilos acido-alcohol resistentes en heces, por lo que recibieron tratamiento antituberculoso. El cultivo de heces fue negativo para Mycobacterium tuberculosis y, posteriormente, en todos se identificó a MAC mediante una prueba molecular (Genotype) en el cultivo de heces. Tres pacientes recibieron tratamiento para MAC luego de la identificación; sin embargo, todos fallecieron. Ante presentaciones similares a lo reportado, se sugiere el uso de métodos de mayor rendimiento (hemocultivo, mielocultivo, pruebas moleculares), así como asociar tempranamente drogas con actividad para MAC al esquema antituberculoso con la intención de mejorar el pronóstico de este grupo de pacientes.

There is little information on the presence of the Mycobacterium avium-Intracellulare (MAC) complex in Peru. Five cases of MAC infection are described in patients with HIV/AIDS at the National Hospital Dos de Mayo, Lima - Peru. The patients presented, mainly, persistent fever, chronic diarrhea, consumptive syndrome, pancytopenia and citofagocitosis. In all of them, resistant acid-alcohol bacilli were identified in feces, so they received antituberculous treatment. The culture of feces was negative for Mycobacterium tuberculosis and, later, in all cases MAC was identified using a molecular test (genotype) in the culture of feces. Three patients received treatment for MAC right after identification; however, they all died. Before presentations similar to the reported, we suggest the use of higher performance methods (blood culture, myeloculture, molecular tests), as well as early associating drugs with activity for MAC to antitubercular scheme with the intention of improving the prognosis of this group of patients.

Existe poca información sobre la presencia del complejo Mycobacterium avium-intracellulare (MAC) en el Perú. Se describen cinco casos de infección por MAC en pacientes con VIH/SIDA del Hospital Nacional Dos de Mayo, Lima-Perú. Los pacientes presentaron, principalmente, fiebre persistente, diarrea crónica, síndrome consuntivo, pancitopenia y citofagocitosis. En todos ellos se identificó bacilos acido-alcohol resistentes en heces, por lo que recibieron tratamiento antituberculoso. El cultivo de heces fue negativo para Mycobacterium tuberculosis y, posteriormente, en todos se identificó a MAC mediante una prueba molecular (Genotype) en el cultivo de heces. Tres pacientes recibieron tratamiento para MAC luego de la identificación; sin embargo, todos fallecieron. Ante presentaciones similares a lo reportado, se sugiere el uso de métodos de mayor rendimiento (hemocultivo, mielocultivo, pruebas moleculares), así como asociar tempranamente drogas con actividad para MAC al esquema antituberculoso con la intención de mejorar el pronóstico de este grupo de pacientes.

The objective of the study was to determine the frequency and characteristics of dyslipidemia in patients with HIV in highly active antiretroviral therapy (HAART) in a Peruvian public hospital. A cross-sectional study was carried out in patients with complete lipid profile after receiving at least six months of HAART. Dyslipidemia was defined according to the criteria of the NCEP-ATP III. We reviewed 2 975 clinical histories, and included 538 (18.1%) in the analysis. The frequency of dyslipidemia was 74.7%. HAART regimens which include protease inhibitors (PI) (odds ratio [OR]: 1.22; confidence interval at 95% [CI 95%]: 1.11-1.33) and to be older than 40 years (OR: 1.17; CI 95%: 1.05-1.28) were associated with dyslipidemia, adjusted by viral load, CD4 lymphocyte level and gender. In conclusion, dyslipidemia was very common in our sample and was mainly associated with the use of PI. It is necessary to promote the dyslipidemia control as part of the comprehensive care of the patient with HIV.

El objetivo del estudio fue determinar la frecuencia y características de la dislipidemia en pacientes con VIH en terapia antirretroviral de gran actividad (TARGA) en un hospital público peruano. Se realizó un estudio transversal en pacientes que tuvieran un perfil lipídico completo luego de recibir al menos seis meses de TARGA. La dislipidemia se definió según los criterios NCEP-ATP III. Se revisaron 2975 historias clínicas, 538 (18.1%) fueron incluidas en el análisis. La frecuencia de dislipidemia fue 74.7%. Los esquemas de TARGA que incluían inhibidores de la proteasa (IP) (OR 1.22; IC95% 1,11-1,34) y la edad mayor de 40 años (OR 1.17; IC95% 1,06-1,29) mostraron asociación con dislipidemia, ajustado por carga viral, nivel de células CD4 y sexo. En conclusión, la dislipidemia fue muy frecuente en la muestra estudiada y estuvo asociada principalmente al uso de IP. Es necesario promover el control de la dislipidemia como parte de la atención integral del paciente con infección por VIH.

Abstract: This paper introduces a general framework for the analysis of single user Multiple Input-Multiple Output (MIMO) transmission schemes using Spatial Modulation (SM). We present a comparative analysis for the four basic SM schemes considering: Bit Error Rate (BER) performance, detection complexity, spectral efficiency and total amount of transmit antennas used. Results show that single RF chain schemes have better performance while generalized versions have better spectral efficiency. Results also show that all SM schemes have reduced detection complexity when compared to the conventional Spatial Multiplexing/Successive Interference Cancelation (SMux/SIC) scheme, however the amount of transmit antennas used for SM schemes is significantly higher than the required by the conventional SMux scheme. Additionally, a scheme which combines SM and SMux techniques is analyzed. These results can be useful as design criteria for the next generation of wireless communication systems.

Resumen: En este trabajo se presenta un marco general para el análisis de los esquemas de transmisión Multiple Input-Multiple Output (MIMO) monousuario con modulación espacial (SM). Se presenta un análisis comparativo de los cuatro esquemas SM básicos considerando el desempeño en tasa de bits erróneos (BER), complejidad en la detección, eficiencia espectral y cantidad total de antenas transmisoras utilizadas. Los resultados muestran que los sistemas que utilizan un solo transmisor RF tienen un mejor desempeño mientras que las versiones generalizadas tienen una mejor eficiencia espectral. Se muestra que todos los esquemas SM tienen una complejidad de detección menor en comparación con el esquema convencional de multiplexaje espacial (SMux) que usa cancelación sucesiva de interferencias (SIC), sin embargo la cantidad de antenas de transmisión utilizadas para los sistemas SM es significativamente mayor que la requerida por el esquema convencional SMux. Adicionalmente se analiza un esquema que combina las técnicas SM y SMux. Estos resultados pueden ser útiles como criterios de diseño en sistemas de comunicaciones inalámbricas de la siguiente generación.

En ocasiones cuando se manipula una gran cantidad de datos muestreados, se requiere reducir dicha cantidad para conservar solo una representación de estos. Aquí dos aspectos son importantes; por un lado no se quiere que la cantidad de datos sea demasiado extensa y por el otro no se quiere perder información. Para la reconstrucción de datos generalmente se requiere de una interpolación. En este trabajo se presenta una optimización a la técnica de interpolación digital basada en el filtrado rápido FFT. El interpolador resultante es una versión simplificada factible de implantaciones hardware, que resulta ideal para la reconstrucción de señales pasa-bajas, con muestreo adecuado. Como casos de estudio se utilizan señales de viento y temperatura. La señal de temperatura, tiene un muestreo adecuado y con el uso del interpolador presenta un error de 3.95% para una reducción del 99.61% de datos. La señal de viento es caótica y no tiene un muestreo adecuado por lo que el interpolador no mejora la reconstrucción de la señal en comparación a los promedios. Típicamente estas señales se almacenan en promedios de 10 minutos, en las cuales, la señal de viento presenta un error 8.6 veces mayor que la señal de temperatura. Para reducir este error en la señal de viento es recomendable aumentar la velocidad de muestreo y los niveles de cuantización en equipos de medición de dicha señal.

Frequently, when great amounts ofsampled data are manipulated, it is necessary to reduce them to a fraction that truly represents the data. Here two elements are important; neither is it desirable for the amount of data to be too extensive; nor is it desirable to lose key information. For the data econstruction,it is often required a interpolation technique. This work proposes an optimization of the fast FIR filtering-based DSP interpolation technique. The resulting interpolator is a feasible, simplified version of hardware implementations, which is ideal for the reconstruction of band-limited signals with adequate sampling. In case studies included in this work, wind and temperature signals are used. The temperature signal has a suitable sampling rate and with the use of the interpolator it presents an error of 3.95% for a reduction of 99.61% of the data. The wind signal is very unpredictable and it does not have a suitable sampling rate. Hence, the interpolator does not improve the reconstruction of the signal in comparison to the averages. Typically, an average signal value is recorded for each 10 minute period, in which, the wind signal presents an error 8.6 times greater than the temperature signal. In order to reduce this error in the wind signal, it is recommended to increase the sampling rate and the quantization levels in measurement equipment.

The Cystoisospora belli, before denominated as Isospora belli, is the etiologic agent of cystoisosoporiasis, an opportunistic infection affecting immunocompromised patients, characterized by chronic diarrhea and weight loss. The incidence of chronic diarrhea for this agent, in HIV patients, has decreased considerably. This thanks to the advent of highly active antiretroviral therapy (HAART), which has improved the patient’s immune response and decrease viral load. We present six cases of cystoisosoporiasis recurrent and refractory to treatment in HIV patients, who was being treated with with trimethoprim / sulfamethoxazole (TMP / SMX) orally as a prophylaxis. Five of these patients passed away due to the infection, despite of the fact that they had a good response to HAART (adequate increase in CD4 and viral load undetectable) and they had been treated with second line drugs.

La Cystoisospora belli, antes denominada Isospora belli, es el agente etiológico de la cystoisosporiasis, una infección oportunista que afecta a pacientes inmunodeprimidos, caracterizada por diarrea crónica y pérdida ponderal. La incidencia de diarrea crónica por este agente, en pacientes infectados por el VIH, ha disminuido considerablemente. Ello gracias al advenimiento de la terapia antirretroviral de gran actividad (TARGA), con la que se ha logrado mejorar la respuesta inmunológica del paciente y disminuir su carga viral. Se presentan seis casos de cystoisosporiasis recurrente y refractaria en pacientes con infección por VIH, en quienes se diagnosticó cystoisosporiasis pese a que previamente se encontraban recibiendo profilaxis con trimetropin/sulfametoxazol (TMP/SMX). Cinco de ellos evolucionaron de manera tórpida y fallecieron, a pesar de una buena respuesta al TARGA (adecuado incremento de CD4 y disminución de la carga viral hasta rangos indetectables), y de tratamiento con TMP/SMX por vía oral y otros medicamentos de segunda línea.