No abstract

Cómo citar este artículo: Cortes JA, et al. Clinical practice guideline. Integral Care Guidelines for the prevention, early detection and treatment of pregnancy, childbirth and puerperium complications: Section on toxoplasmosis in pregnancy. Infectio 2017. http://dx.doi.org/10.22354/in.v21i2.654 AbstractToxoplasma infection, an aspect included in the Integral Care Guidelines for prevention, early detection and treatment of complications during pregnancy developed and sponsored by the Department of Science, Technology and Innovation, Colciencias and the Ministry of Health and Social Protection; was selected to develop recommendations that may contribute to its prevention diagnostic and treatment. Guidelines were developed through systematic review of literature, two panels of evaluation, gradation of evidence: SIGN (Scottish Intercollegiate Guidelines Network), discussion panel with users and patients, external evaluation and socioeconomical evaluation of the impact of recommendations. The Toxoplasma gondii infection that occurs during pregnancy may cause serious complications for the fetus and important sequelae for the newborn. A clinical guideline based on the best available scientific evidence, with emphasis on Colombian references, was performed. Experts in parasitology, neonatology and infectious diseases (adult and pediatric) developed the recommendations. It is suggested that the recommendations included in this guideline be followed by healthcare professionals in pregnancy care programs nationwide, with the purpose of lowering the morbidity and mortality related to this disease. Specific recommendations for diagnosis during the first trimester of the pregnancy, recommendations for prevention in noninfected women, identification of fetal or newborn infection and recommendations for treatment in those given cases are included. Guia de atencion integral para la prevencion, deteccion temprana y tratamiento de las complicaciones del embarazo: Sección de Toxoplasmosis ResumenComo parte de la Guia de atencion integral para la prevencion, deteccion temprana y tratamiento de las complicaciones del embarazo, desarrollada y financiada por el Departamento de Ciencia, Tecnologia e Innovacion, Colciencias, y el Ministerio de Salud y Proteccion Social de Colombia, se seleccionó a la infeccion por Toxoplasma para el desarrollo de recomendaciones para su prevencion, diagnostic° y tratamiento. La infeccion por Toxoplasma gondii (T. gondii) durante el embarazo puede resultar en graves complicaciones para el feto y dejar importantes secuelas al recien nacido. Se realizo una guia basada en la mejor evidencia disponible en ARTÍCULO ORIGINAL Integral Care Guidelines for the prevention, early detection and treatment of pregnancy, childbirth and puerperium complications. 103la literatura cientifica, con especial pertinencia a la informacion colombiana. Un consenso de expertos en parasitologia, ginecologia, neonatologia e infectologia, tanto de adultos como pediatrica, desarrollo las recomendaciones. Se propone que las recomendac...

Background The clinical presentation and severity of Multisystem Inflammatory Syndrome in Children associated with COVID-19 is widespread and presents a very low mortality rate in highincome countries. This research describes the clinical characteristics of MIS-C in critically ill children in middle-income countries compared to described series in high-income countries along with the factors associated with mortality and worse outcomes. Methods An observational cohort study was conducted in 14 PICUs in Colombia between April 01, 2020 and January 31, 2021. Patient´s age ranged between one month and 18 years and they met the requirements set forth by WHO for MIS-C. Results There were seventy-eight children in this study. The median age was seven years (IQR 1- 11), 18% (14/78) were under one year old, and 56% were male. Thirty-five percent (29/78) were obese or overweight. The PICU stay was six days (IQR 4-7), and 100% had a fever on admission lasting five days (IQR 3.7-6). Seventy percent (55/78) had diarrhea, and 87% (68/78) had shock or myocardial dysfunction (78%). Compared to the United Kingdom (UK) study, there were more children under the age of five (37% vs. 10%; p=0.004), and there was a higher frequency of obesity (29.5% vs. 10%; p=0.008). With regard to the US study, there was more lymphadenopathy (23% vs. 13%; p=0.02), diarrhea (70.5% vs. 53%; p=0.001), lymphopenia (64% vs. 35%; p=0.001), shock (87% vs. 35%; p=0.001), elevated troponin (51% vs. 31%; p=0.006) and elevated proBNP (82% vs 43%; p=0.001), as well as greater mortality (9% vs 1.8%; p=0.001). The group that did not survive had a longer duration of the disease until admission to the PICU (6 days vs. 5 days; p = 0.003), more frequency of ferritin above 500 ngr/mL (100% vs. 45%; p = 0.012) and more cardiovascular complications (100% vs. 54%; p = 0.019) compared to the group that survived. Conclusions Multisystem Inflammatory Syndrome in Children due to SARS-CoV-2 in critically ill children living in a middle-income country has some clinical, laboratory, and echocardiographic characteristics similar to those described in high-income countries. It was observed inflammatory response, and cardiovascular involvement were conditions that, added to the difficulties in accessing healthcare systems in countries with limited resources, may explain the higher mortality seen in these children.

61Del sujeto, la subjetividad y la subjetivación a la noción de la responsabilidad subjetiva en el conflicto armado en Colombia ResumenEste artículo comparte el diálogo interdisciplinar (sociología-antropología-filosofía-psicología social) del grupo Cuchavira de la UNAD, en torno al proceso de investigación creativo-hermenéutico, realizado con estudiantes de esta universidad que se encuentran en situación de reinserción-desmovilización, del conflicto armado colombiano. El equipo define un instrumento teórico de análisis-síntesis para abordar su investigación 7 y, a partir de los conceptos de sujeto, subjetividad y subjetivación en perspectiva histórico-teórica, se propone como categoría de análisis comprensiva el sujeto de la responsabilidad. La responsabilidad frente a la decisión de participar en el conflicto se lee como una "evasión" de los combatientes, quienes se amparan en la idea de obediencia ciega, la cual sustrae la subjetivación de los excesos producidos por el conflicto bélico. Las consecuencias más conocidas son los reiterados fracasos de los procesos de paz, desmovilización y reinserción, basados en la lógica de victimización de la memoria, culpabilidad del otro, exclusión de las intencionalidades y la interpelación de la responsabilidad subjetiva. De allí la importancia de visibilizar la condición del sujeto de la decisión con una resignificación subjetivo-colectiva en medio del conflicto.Palabras clave: conflicto armado, responsabilidad subjetiva, sujeto de la decisión, Subjetivación, Subjetividad.1 Psicóloga, magister en Educación y Desarrollo Humano, docente de la Universidad Nacional Abierta y a Distancia. E-mail: . juliana.caro@unad.edu.co 2 Psicólogo, magister en Investigación Social Interdisciplinaria, docente de la Universidad Nacional Abierta y a Distancia. E-mail: jose.herrera@ unad.edu.co 3 Sociólogo, magister en Estudios Culturales, docente de la Universidad Nacional Abierta y a Distancia. E-mail: luise.wilches@unad.edu.co 4 Licenciado en Filosofía y letras, magister en Educación y Desarrollo Humano, docente de la Corporación Universitaria Minuto de Dios. E-mail: edargos@gmail.com 5 Filósofa, magister en Psicoanálisis, docente de la Universidad Nacional Abierta y a Distancia. E-mail: carmen.jimenez@unad.edu.co 6 Psicóloga, magister en Psicología Comunitaria, docente de la Universidad Nacional Abierta y a Distancia UNAD. E-mail: martha.alvarez@unad.edu.co 7 Resignificando la paz: una experiencia educativa con los estudiantes reinsertados de la UNAD, proyecto de investigación quepretende construir una propuesta pedagógica en la UNAD con miras hacia una atención adecuada de estudiantes en condición de reinsertados-desmovilizados; con el fin de garantizarles su inserción a la vida social, y especialmente al sistema educativo unadista, partiendo de sus percepciones .Desbordes, Revista de Investigaciones de la Escuela de Ciencias Sociales, Artes y Humanidades -UNAD -/ Volúmen 4 • Enero -Diciembre • 2013 62 AbstractThe article offers the opportunity to share the interdisciplinary dialogue (s...

Immunoglobulins are heterodimeric proteins composed of 2 heavy chains and 2 light chains. Human immunoglobulin G (IgG) is a plasma derivative and contains more than 95% of IgG. The composition of IgG subclasses is similar to that of normal human plasma. Immunoglobulin therapy was first introduced more than 50 years ago, and its use has been described in numerous diseases. In Colombia, the importance of this immunomodulatory resource prompted the need for clinical practice guidelines to be available for its use. For this reason, a multidisciplinary group of experts was brought together and distributed in working groups, by specialties, in order to develop an initial manuscript. Systematic literature searches were undertaken; identified evidences were evaluated and classified to support a preliminary draft that was discussed, analyzed and amended. Recommendations were issued on the use of intravenous immunoglobulin in pathologies that include primary and secondary immunodeficiencies, autoimmune diseases, neurological disorders, infections, transplants and miscellaneous conditions; grades were assigned to each one of them according to the GRADE system. The final result translated into recommendations that are put forth with the purpose to inform, guide and support on optimal use of this immunomodulatory resource.