ABSTRACT Introduction: Regional anesthesia techniques have been used for many years and there are surgeries where they are the ones of choice due to the proven benefits they provide, as is the case with anesthesia forces is a section, which is not free of complications, but the neurological ones are the ones. Most feared, due to the complexity of the situation and the possible outcomes they could entail. Objective: To describe the evolution of a postpartum patient who was diagnosed with Pneumocephalus after epidural anesthesia. Clinical case: Postpartum patient with a history of migraine headache, which after undergoing epidural anesthesia, began with light to moderate headache that was initially relieved with analgesics, then had a generalized tonic-clonic seizure that required intubation and transfer to the intensive therapy. Using computed axial tomography, small Pneumocephalus was detected in the parietal region in addition to signs of cerebral edema. The condition progressed satisfactorily. Within hours, the patient was transferred to the ward where she was reunited with her baby and day slater she was discharged without squeals. Conclusions: Pneumocephalus as a complication of epidural anesthesia in pregnant patients generally does not have great clinical repercussions and disappears only in a period of no more than 72 hours, but sometime sit can occur as a serious complication that can lead to permanent neurological damage and even death, death.

RESUMEN Introducción: La utilidad de las técnicas de anestesia regional se ha mostrado por muchos años, estas son las de elección por los beneficios que aporta, como es el caso de la cesárea, aunque no están exentas de complicaciones, y las neurológicas que son las más temidas por la gravedad del cuadro clínico presentado y los posibles desenlaces. Objetivo: Describir la evolución clínica de la puérpera con diagnóstico de neumoencéfalo después de anestesia neuroaxial peridural. Presentación de caso: Se trata de una paciente puérpera con antecedente de cefalea migrañosa que después de ser sometida a una anestesia peridural, comienza con dolor de cabeza ligero a moderado que en un principio aliviaba con analgésicos, después hace una convulsión tónica clónico generalizada que fue necesaria intubar y trasladar a terapia intensiva. Mediante la tomografía axial computarizada se detecta neumoencéfalo de pequeñas proporciones en región parietal, además, de signos de edema cerebral, el cuadro evoluciona satisfactoriamente, la paciente a las horas es trasladad a sala donde se reencuentra con su bebe y días después es dada de alta sin secuelas. Conclusiones: El neumoencéfalo como complicación de la anestesia peridural en la paciente gestante, generalmente no tienen gran repercusión clínica y desaparece solo en un período no mayor de 72 horas, pero en ocasiones puede presentarse como complicación grave que puede acarrear daño neurológico permanente e incluso la muerte.

Abstract Objective: to assess the occurrence of overweight/obesity in patient with epilepsy (PWEs) and to relate it to cognitive aspects and clinical variables. Methodology: the measurements of waist circumference, calf circumference, arm circumference, and the body mass index were related to the scores of the Mini-Mental State Examination and the Brief Cognitive Battery-Edu, as well as to the clinical variables of 164 PWEs, with a significance level of p < 0.05. Data were compared to a similar control group (CG) comprising 71 cases. Linear and multiple logistic regression models were used to assess factors related to cognitive aspects. Results: the mean age of the PWEs was 49.8 ± 16.6 years with a mean length of epilepsy of 22 ± 15.9 years. Overweight/obesity occurred in 106 (64.6 %) PWEs and in 42 (59.1 %) CG subjects. The PWEs had a worse performance in several cognitive functions when compared to CG subjects. In the PWEs, overweight/obesity was associated with lower educational level, older age, and cognitive impairment. Greater waist circumference, overweight, age at the first seizure, and use of polytherapy with antiseizure medications were predictive factors of memory impairment in multiple linear regression. Greater arm and calf circumference values were associated with better performance in several cognitive areas. Conclusion: the occurrence of overweight/obesity in PWEs and CG subjects was high. Cognitive impairment occurred in a high number of PWEs and was associated with overweight, greater waist circumference values, and clinical aspects of epilepsy. Better cognitive performance was associated with greater arm and calf circumference.

Resumen Objetivo: evaluar la ocurrencia de sobrepeso/obesidad en pacientes con epilepsia y relacionarla con aspectos cognitivos y variables clínicas. Metodología: las medidas de circunferencia de cintura, circunferencia de pantorrilla, circunferencia de brazo e índice de masa corporal se relacionaron con los puntajes del Mini-Mental State Exam y de la Batería Cognitiva Breve-Edu, así como con las variables clínicas de 164 pacientes con epilepsia, con un nivel de significación de p < 0,05. Los datos se compararon con un grupo de control similar (GC) compuesto por 71 casos. Se utilizaron modelos de regresión logística lineal y múltiple para evaluar factores relacionados con aspectos cognitivos. Resultados: la edad media de las pacientes con epilepsia fue de 49,8 ± 16,6 años con una duración media de la epilepsia de 22 ± 15,9 años. Presentaron sobrepeso/obesidad 106 (64,6 %) pacientes con epilepsia y 42 (59,1 %) sujetos del GC. Los pacientes con epilepsia tuvieron un peor desempeño en varias funciones cognitivas en comparación con los sujetos del GC. En las pacientes con epilepsia, el sobrepeso/obesidad se asoció con menor nivel educativo, mayor edad y deterioro cognitivo. La mayor circunferencia de la cintura, el sobrepeso, la edad de la primera convulsión y el uso de politerapia con medicamentos anticonvulsivos fueron factores predictivos del deterioro de la memoria en la regresión lineal múltiple. Los valores mayores de circunferencia del brazo y la pantorrilla se asociaron con un mejor rendimiento en varias áreas cognitivas. Conclusión: la incidencia de sobrepeso/obesidad en sujetos pacientes con epilepsia y GC fue alta. El deterioro cognitivo ocurrió en un alto número de pacientes con epilepsia y se asoció con sobrepeso, mayores valores de circunferencia de la cintura y aspectos clínicos de la epilepsia. Un mejor rendimiento cognitivo se asoció con una mayor circunferencia del brazo y la pantorrilla.

Resumo O succinato de desvenlafaxina (DVS) inibe seletivamente a recaptação da serotonina e é aprovado para transtornos depressivos maiores. Esta pesquisa investigou a influência do DVS na modulação da monoamina cerebral e do estresse oxidativo em camundongos. O potencial antiepiléptico de DVS (10, 20 ou 30 mg / kg / i.p.) Em pentilenotetrazole (PTZ; 85 mg / kg) com i.p. via de administração, estricnina (STR; 75 mg / kg) com i.p. via, pilocarpina (400 mg / kg) com s.c. rota e convulsão induzida por MES de eletrochoque máximo em modelos de camundongos. As atividades de estresse oxidativo, ou seja, superóxido dismutase (SOD), glutationa (GSH) e peroxidação lipídica (LPO), bem como ácido gama-aminobutírico (GABA) nos cérebros de camundongos convulsivos induzidos por PTZ. O tratamento com DVS aumentou a latência para desenvolver crises e diminuiu a mortalidade em roedores contra convulsões induzidas por PTZ, STR e pilocarpina. Os resultados de siezures conduzidos por MES revelaram que o DVS reduziu significativamente a duração e a mortalidade da extensão tônica dos membros posteriores. Os níveis de cérebro, SOD, GSH e GABA aumentaram significativamente (P < 0,01) e o LPO reduziu significativamente (P < 0,01) após o tratamento com DVS. Além disso, o DVS não apresentou sinais de coordenação motora no teste do rotarod. Demonstramos o papel do DVS na gênese da convulsão em camundongos sob condição de controle e atenua o dano oxidativo induzido por PTZ.

Abstract Desvenlafaxine succinate (DVS) inhibits serotonin reuptake selectively and is approved for major depressive disorders. This research investigated influence of DVS on modulating brain monoamine and oxidative stress in mice. The antiepileptic potential of DVS (10, 20, or 30 mg/kg/i.p.) in pentylenetetrazole (PTZ; 85 mg/kg) with i.p. route of administration, strychnine (STR; 75 mg/kg) with i.p. route, pilocarpine (400 mg/kg) with s.c. route and maximal electroshock MES-induced convulsion in mouse models. The activities of oxidative stress, i.e. superoxide dismutase (SOD), glutathione (GSH) and lipid peroxidation (LPO) as well as gamma-aminobutyric acid (GABA) in the brains of PTZ-induced convulsive mice. Treatment with DVS increased the latency to develop siezures and declined mortalities in rodents against PTZ, STR and pilocarpine-induced convulsions. Results of MES-leaded siezures revealed that DVS reduced tonic hind limb extension duration and mortalities significantly. Brain, SOD, GSH and GABA level were significantly (P<0.01) increased and LPO reduced significantly (P<0.01) after DVS treatment. Furthermore, the DVS did not show any motor coordination signs in the rotarod test. We demonstrated that the role of DVS in convulsion genesis in mice under control condition and attenuate the PTZ-induced oxidative damage.

Abstract The aim of the present study was to investigate the usefulness of multidrug resistance protein 1 (MDR1) and neuropeptide Y (NPY) levels in predicting the efficacy of levetiracetam (LEV) plus oxcarbazepine (OXC) treatment administered to children with epilepsy and to determine their prognosis. Overall, 193 children with epilepsy admitted to the hospital were enrolled and randomly divided into two groups according to different treatment methods: group A (n = 106, treated with LEV plus OXC combination) and group B (n = 87, treated with OXC only). After treatment, compared with group B, group A exhibited a remarkably higher total effective rate and a significantly lower total adverse reaction rate. Areas under the curve for MDR1 and NPY for predicting ineffective treatment were 0.867 and 0.834, whereas those for predicting epilepsy recurrence were 0.916 and 0.829, respectively. Electroencephalography abnormalities, intracranial hemorrhage, neonatal convulsion, premature delivery, and MDR1 and NPY levels were independent risk factors for poor prognosis in children with epilepsy. Serum MDR1 and NPY levels exhibited a high predictive value for early epilepsy diagnosis, treatment efficacy assessment, and prognostication in children with epilepsy treated with LEV plus OXC combination. MDR (MDR1 (NPY (LEV (OXC Overall 19 methods n 106 combination 87 only. only . only) 0867 0 867 0.86 0834 834 0.834 0916 916 0.91 0829 829 0.829 respectively abnormalities hemorrhage convulsion delivery diagnosis assessment (MDR 10 8 086 86 0.8 083 83 0.83 091 91 0.9 082 82 0.82 08 0. 09 9

Abstract In the 17th century, on horseback between the Middle Ages and the Modern Age, Diego Saavedra Fajardo witnesses the first decline of the Hispanic Universal Monarchy. For a diplomat and treatise writer, key for the understanding of the European upheaval in this century, there appears an internal debate between the theoretical possibility of a universal government, protected both by historical circumstances and by a desire for mimesis and overcoming the previous Empires; and its factual impossibility due to the political and religious dismemberment of Christianity, the Protestant Reformation, and the genesis and triumph of the modern States after the Peace of Westphalia. The main goal of the article is to demonstrate the presence in Saavedra of the positively judged possibility of a universal government pivoted around the Hispanic Monarchy. The methodology has been based on the critical analysis of the different works of the author, comparing them with the previous idea of Universal Monarchy, contrasted with the concept of Modern State. The main result has been the clarification of both concepts in Saavedra, concluding that he is not contrary to the abstract idea of the universality of the power of the Spanish Monarchy, although he is a defender of its scarce real viability.

Resumen En pleno siglo XVII, a caballo entre la Edad Media y la Edad Moderna, Diego Saavedra Fajardo es testigo de la primera decadencia de la Monarquía Universal Hispánica. Para un diplomático y tratadista clave para la comprensión de la convulsión europea en este siglo, se crea el debate interno entre la posibilidad teórica de un gobierno universal, amparado tanto por las circunstancias históricas como por un deseo de mímesis y superación de los Imperios anteriores; y su imposibilidad fáctica ante el desmembramiento político y religioso de la Cristiandad, la Reforma protestante, y la génesis y triunfo de los Estados modernos tras la Paz de Westfalia. El objetivo principal del artículo es demostrar la presencia en Saavedra de la posibilidad enjuiciada positivamente de un gobierno universal alrededor de la Monarquía hispánica. La metodología ha partido del análisis crítico de las distintas obras del autor, comparándolas con la idea previa de la Monarquía universal enfrentada al concepto de Estado Moderno. El resultado principal ha sido la clarificación de ambos conceptos en Saavedra, concluyendo que no es contrario a la idea abstracta de universalidad del poder de la Monarquía de España, si bien es defensor de su escasa viabilidad real.

Resumen: Introducción: la luxofractura glenohumeral posterior (LFGHP) es una lesión poco frecuente. Puede ser secundaria a una crisis convulsiva, casos de electrocución, o por traumatismo directo. Su diagnóstico suele ser tardío, lo que aumenta la tasa de complicaciones y secuelas. Caso clínico: paciente de sexo masculino de 52 años, trasladado a centro de alta complejidad por convulsión tónico-clónica y LFGHP derecha. En el estudio inicial con radiografías se confirma lesión de hombro derecho y se diagnostica luxación glenohumeral posterior simple de hombro izquierdo no pesquisada previamente. Se complementa estudio con tomografía computarizada (TC) de ambos hombros, observándose una LFGHP bilateral, lo que demuestra agravamiento intrahospitalario de la lesión del hombro izquierdo. Se realiza reducción abierta y osteosíntesis con placa bloqueada bilateral en un tiempo. El hombro izquierdo requirió dos reintervenciones, una por falla de osteosíntesis y otra para liberación articular. Dos años después del procedimiento el paciente evoluciona satisfactoriamente con 5% en la escala Quick DASH y un puntaje de 72 y 76 en la escala de Constant en el hombro derecho e izquierdo, respectivamente. Conclusión: la LFGHP es una lesión poco frecuente que requiere un alto índice de sospecha para evitar el retraso diagnóstico y la aparición de secuelas. En casos de convulsión se debe sospechar compromiso bilateral. Con un tratamiento quirúrgico oportuno se pueden obtener resultados satisfactorios y reintegración del paciente a sus actividades habituales.

Abstract: Introduction: posterior glenohumeral fracture dislocation (PGHFD) is a rare injury. It may present secondary to a seizure, electrocution or due to direct trauma. It is usually missed, and late diagnosis is common which increases the rate of complications and sequalae. Case report: 52 year old male, transferred to a reference trauma center due to a tonic-clonic seizure and a right PGHFD. Upon admission radiographs are requested and right shoulder injury is confirmed. Additionally, a simple left posterior glenohumeral dislocation (that was missed in the initial assessment of the patient) is observed. A computed tomography (CT) scan is obtained for both shoulders to plan surgery. The CT scan showed a bilateral PGHFD with severe comminution in the left shoulder, showing considerable worsening of the left shoulder since admission. Open reduction and bilateral locked plate osteosynthesis were performed in a one stage surgery. At two years follow up the patient evolved favorably with a Quick DASH score of 5% and a CONSTANT score of 72 and 76 for his right and left shoulder, respectively. Conclusion: PGHFD is an infrequent injury, which requires a high level of suspicion to avoid diagnostic delay and prevent complications and sequelae. Bilateral cases may be seen in cases of seizure. With prompt surgical treatment, satisfactory results can be achieved with a complete return to normal activities.

ABSTRACT INTRODUCTION: Seizures are the initial clinical symptom in 30 to 50 % of patients with brain tumors. With a high percentage, gliomas and meningiomas have been reported as tumors associated with epilepsy, these also being frequent tumors in Colombia. Currently in the country there are no studies that specify which are the most frequent brain tumors related to epilepsy, an investigation being necessary to clarify these data. OBJECTIVE: To determine the most frequent brain tumors associated with epilepsy in patients at the Erasmo Meoz University Hospital in Cúcuta. METHODS: Medical records were collected from all patients over 18 years of age who were admitted to the Neurosurgery service of the Erasmo Meoz University Hospital in Cúcuta with a diagnosis of brain tumor between 2015 and 2018. RESULTS: 220 patients were included, 56% were female. The mean age was 48 years; 98 cases (45%) presented with epilepsy. The most frequent brain tumor related to epilepsy were gliomas (46 cases). The glioma with the highest frequency of seizures was glioblastoma (27 cases). Low-grade gliomas had a higher percentage of epilepsy (82%) than high-grade gliomas (71%). In men, the most frequent tumor related to epilepsy was glioblastoma and in women, meningioma. The most frequent location was the frontal region (27%). CONCLUSIONS: Gliomas are the most common type of brain tumor associated with epilepsy, with the most common tumor in this group being glioblastoma.

RESUMEN INTRODUCCIÓN: Las crisis epilépticas son la manifestación clínica inicial en un 30-50 % de los pacientes con tumores cerebrales. Algunos de los tumores más frecuentes, como los gliomas y los meningiomas se asocian con manifestaciones epilépticas. En el país no hay estudios que especifiquen cuáles son los tumores del encéfalo más frecuentemente relacionados con epilepsia. OBJETIVO: Determinar los tumores del encéfalo más frecuentes relacionados con epilepsia en pacientes del hospital Universitario Erasmo Meoz, en Cúcuta, Colombia entre los años 2015 y 2018. METODOLOGÍA: Estudio retrospectivo. Se recolectaron historias clínicas de pacientes mayores de 18 años que ingresaron al servicio de Neurocirugía del Hospital Universitario Erasmo Meoz, en Cúcuta, Colombia con diagnóstico de tumor del encéfalo entre el año 2015 y el 2018. RESULTADOS: Se incluyeron 220 historias, el 56 % correspondió al sexo femenino y la media de edad fue de 48 años; 98 (45 %) de los casos presentó crisis epilépticas. El tumor del encéfalo más frecuente relacionado con epilepsia fue el glioma (46 casos). El tipo de glioma que más se relacionó con crisis epilépticas fue el glioblastoma (27 casos); 82 % de los gliomas de bajo grado se manifestaron con epilepsia, y 71 % de los de alto grado (70,6 %). En los hombres el tumor más frecuente relacionado con epilepsia fue el glioblastoma y en las mujeres el meningioma. La localización tumoral más frecuente fue la región frontal (27 %). CONCLUSIONES: Los gliomas son el tipo de tumor cerebral más común relacionado con epilepsia, siendo el glioblastoma el tumor más frecuente de este grupo.

This paper discusses core principles such as play, collaboration, and agency that support the online workshops offered by the Global Play Brigade (GPB), an international community of activists from different areas, who got together to fight against the global crisis that threatened the world in so many ways due to the covid-19 pandemic. To exemplify part of the theoretical and methodological approach involved in the plan and, the workshop, as well as its goals and one of the sessions, will be described along with perspectives aligned to Spinoza, Vygotsky, Freire, and some other authors to promote understanding of how people can be affected towards social change. It is known that there are many facets to the current turmoil, so the GPB seeks to create spaces in which creativity and critical thinking can create possibilities for emotional support, development, hope, and action.

Este artículo aborda principios fundamentales como el juego, la colaboración y la agencia que son la base de los talleres en línea ofrecidos por Global Play Brigade (GPB), una comunidad internacional de activistas en diferentes áreas, que se unieron para luchar contra la crisis global que amenazaba la mundo de diferentes maneras debido a la pandemia de covid-19. Para ejemplificar parte del enfoque teórico-metodológico involucrado en el plan, el taller en sí y sus objetivos, se describirá una de las sesiones junto con perspectivas alineadas con Spinoza, Vygotsky, Freire y algunos otros autores para comprender cómo las personas pueden verse afectadas en para cambiar Social. Es claro que la convulsión actual tiene muchas facetas, por lo que GPB busca generar espacios en los que la creatividad y el pensamiento crítico posibiliten el apoyo emocional, el desarrollo, la esperanza y la acción.

Este artigo discute princípios fundamentais como brincar, colaboração e agência que são base para os workshops online oferecidos pela Global Play Brigade (GPB), uma comunidade internacional de ativistas em diferentes áreas, que se uniram para lutar contra a crise global que ameaçava o mundo de diferentes maneiras devido à pandemia da covid-19. Para exemplificar parte da abordagem teórico-metodológica envolvida no plano, o próprio workshop e seus objetivos, uma das sessões será descrita juntamente com perspectivas alinhadas a Spinoza, Vygotsky, Freire e alguns outros autores para entender como as pessoas podem ser afetadas no intuito de mudança social. É notório que a turbulência atual apresenta muitas facetas, por isso o GPB busca criar espaços nos quais a criatividade e o pensamento crítico possibilitem suporte emocional, desenvolvimento, esperança e ação.

RESUMO Introdução: Mais de 40% da população corre um risco variável de contrair malária em países onde a sua transmissão persiste, o que constitui um grande problema de saúde global. Objetivo: Identificar as características clínicas, evolução e tratamento de crianças com distúrbios neurológicos causados pelo Plasmodium falciparum como formas de apresentação da malária. Método: Foi realizado um estudo observacional descritivo de uma série de casos em uma amostra aleatória de 30 pacientes internados no “Dr. Loeri Comba”, Guiné Equatorial, com diagnóstico de malária por este protozoário e alterações neurológicas associadas, no período de junho de 2017 a setembro de 2019. Resultados: Convulsão (33,3%) e coma (30%) foram as formas clínicas mais frequentes, especialmente em menores de quatro anos. Parasitemia elevada não esteve presente em todos eles, embora tenha sido o que predominou (63,3%). A resposta ao tratamento com artesunato intravenoso como medicamento de escolha foi favorável (90%), incorporando também vitaminas em altas doses na forma complexa, sulfato de zinco, anticonvulsivantes, dexametasona e manitol, criando um protocolo de tratamento próprio no serviço de Pediatria. Houve três mortes por infecção respiratória do tipo de pneumonia associada à malária. Conclusões: Crianças com alterações neurológicas causadas pelo Plasmodium falciparum na malária, como formas de apresentação do mesmo, não são evidenciadas apenas no estado de coma que causa a doença, mas também em outras formas de apresentação com comprometimento da consciência e presença de convulsões.

ABSTRACT Introduction: More than 40% of the population has a variable risk of contracting malaria in countries where its transmission persists, which constitutes a major global health problem. Objective: To identify the clinical characteristics, evolution and treatment of children with neurological disorders caused by Plasmodium falciparum as forms of malaria. Method: An observational, descriptive study of a series of cases was carried out in a random sample of 30 patients, who were admitted to the Clinic “Dr. Loeri Comba”, in Equatorial Guinea, with a diagnosis of malaria caused by this protozoan, and with associated neurological alterations, during the period from June 2017 to September 2019. Results: Seizure (33.3%) and coma (30%) were the most frequent clinical forms, especially in those under four years of age. High parasitaemia was not present in all of them, although it predominated in the 63.3%. The response to treatment with intravenous artesunate as the drug of choice was favorable (90%), also incorporating vitamins at high doses in complex form, zinc sulfate, anticonvulsants, dexamethasone and mannitol, creating a treatment protocol of its own in the Pediatric service. There were three deaths from respiratory infection, caused by the type of pneumonia associated with malaria. Conclusions: Children with neurological alterations caused by Plasmodium falciparum in malaria are not only evidenced in the coma state that causes the disease, but also in other forms of presentation with impaired consciousness and presence of seizures.

RESUMEN Introducción: Más del 40 % de la población corre un riesgo variable de contraer paludismo en los países en donde persiste su transmisión, lo que constituye un importante problema de salud mundial. Objetivo: Identificar las características clínicas, evolución y tratamiento de niños con alteraciones neurológicas provocadas por Plasmodium falciparum como formas de presentación del paludismo. Método: Se hizo un estudio observacional, descriptivo, de serie de casos en una muestra aleatoria de 30 pacientes, que ingresaron en el Policlínico “Dr. Loeri Comba”, Guinea Ecuatorial, con diagnóstico de paludismo por este protozoo y alteraciones neurológicas asociadas, durante el período comprendido desde junio de 2017 hasta septiembre de 2019. Resultados: La convulsión (33,3 %) y el estado de coma (30 %) fueron las formas clínicas más frecuentes, sobre todo en los menores de cuatro años de edad. La alta parasitemia no estuvo presente en todos ellos, aunque fue la que predominó (63,3 %). La respuesta al tratamiento con artesunato intravenoso como medicamento de elección fue favorable (90 %), incorporándose además vitaminas a altas dosis en forma de complejo, sulfato de zinc, anticonvulsivantes, dexametasona y manitol, creando un protocolo de tratamiento propio en el servicio de Pediatría. Hubo tres fallecidos por infección respiratoria del tipo de neumonía asociado al paludismo. Conclusiones: Los niños con alteraciones neurológicas provocadas por el Plasmodium falciparum en el paludismo, como formas de presentación del mismo, no solo se evidencia en el estado de coma que provoca la enfermedad, sino también en otras formas de presentación con afectación de la conciencia y presencia de convulsiones.

Resumo: A pandemia da covid-19 e o subsequente processo de confinamento conduziram a linhas de convulsão em diferentes setores da sociedade. Marcado por um contexto de instabilidade e incerteza, onde diferentes manifestações de transformação tecnológica, económica e social potenciam novas práticas e convenções, bem como suscitam novos e renovados desafios deontológicos, o jornalismo não é exceção. Com base nas respostas de um inquérito a 890 jornalistas portugueses, o presente artigo procura mapear os efeitos do estado de emergência de março a abril de 2020 nas práticas e rotinas, e nos preceitos ético-profissionais de uma atividade que avoca uma reavivada relevância num ambiente de desinformação e “infodemia”. Mais do que revelarem novos problemas, os resultados sugerem uma acentuação dos desafios e dilemas pré-existentes. No plano das práticas, indicia-se uma domiciliação relativamente transversal da atividade. Este fenómeno é acompanhado por marcas de despersonalização do contacto com as fontes e eventos, e por sinais de isolamento social dos jornalistas. No campo ético-deontológico, sublinha-se a emergência de questões deontológicas particulares no contexto da pandemia, onde os aspetos relacionados com o rigor - rejeição do sensacionalismo, distinção clara entre factos e opiniões ou repúdio de quaisquer formas de censura -, assim como os elementos subjacentes ao contacto com as fontes, assumem especial dimensão.

Abstract: The covid-19 pandemic and the subsequent process of confinement led to lines of convulsion in different sectors of society. Marked by a context of instability and uncertainty, where different manifestations of technological, economic and social transformation enhance new practices and conventions, as well as raising new and renewed deontological challenges, journalism is no exception. Based on the responses of a survey answered by 890 Portuguese journalists, this article seeks to map the effects of the March-April 2020 state of emergency on practices and routines, and on the ethical-professional precepts of an activity that calls for a revived relevance in an environment of disinformation and “infodemic”. More than revealing new problems, the results obtained suggest the intensification of the pre-existing challenges and dilemmas. In terms of practices, it is indicated that the activity is relatively domiciled. This phenomenon is accompanied by marks of depersonalization of contact with sources and events, and by signs of social isolation from journalists. In the ethical-deontological field, the emergence of particular deontological issues in the context of the pandemic, where aspects related to rigour - rejection of sensationalism, a clear distinction between facts and opinion or repudiation of any form of censorship - as well as to subsequent elements underlying contact with the sources, take on a special dimension.

ABSTRACT The COVID-19 pandemic currently affects millions of people including the pediatric population. The clinical manifestations in children are diverse: respiratory, gastrointestinal, hematological, neurological and systemic. In order to describe the various clinical and neurological manifestations during the evolution of the disease, we documented a series of cases of pediatric patients with COVID-19. Various mechanisms are proposed through which SARS-CoV-2 would cause neurological injury (direct injury, secondary to an immune response, among others) with variable clinical characteristics (seizures, muscle weakness, sensorial disorder). Studies on clinical characteristics and prognostic factors in children and adolescents with SARS-CoV-2 are limited, therefore, this report provides a spectrum of neurological manifestations associated with SARS-CoV-2 in pediatric population.

RESUMEN La pandemia por la COVID-19 afecta actualmente a millones de personas sin exceptuar la población pediátrica. Las manifestaciones clínicas en niños son variables: respiratorias, gastrointestinales, hematológicas, neurológicas y sistémicas. Con el objetivo de describir las diversas presentaciones clínicas y neurológicas durante la evolución de la enfermedad se documentó una serie de casos de pacientes pediátricos con la COVID-19. Se plantean diversos mecanismos a través de los cuales el SARS-CoV-2 causaría daño neurológico (daño directo, secundario a respuesta inmune, entre otras) con características clínicas variables (convulsiones, debilidad muscular, trastorno del sensorio). Los estudios sobre características clínicas y factores pronósticos en niños y adolescentes con SARS-CoV-2 son limitados, por lo cual el presente reporte contribuye con un espectro de manifestaciones neurológicas asociadas al SARS-CoV-2 en población pediátrica.

ABSTRACT Public space has traditionally been a refuge for communities in periods of social upheaval. Being the engine and filter that balances social relations between citizens, it is occupied, discussed, claimed, and transgressed. The globalization of social networks has driven the displacement of social demands towards the virtual world. However, the square continues to be the physical symbol in which the collectivity finds and recognizes itself in most of the claims. This article aims to determine, through an extrapolable graphic methodology, which urban and socio-political parameters mark the capacity of space to receive demonstrations or revolts. These social choreographies represent, above all, an act of transformation and appropriation of the city. They reaffirm the figure of the agora as a timeless lexeme. Through three Ibero-American case studies–in contexts of dictatorship, stability, and crisis–differential singularities and common rites inherent in human behavior have been observed.

RESUMEN El espacio público ha sido tradicionalmente refugio civil en periodos de convulsión social. Siendo el motor y filtro que equilibra las relaciones sociales entre ciudadanos, es ocupado, discutido, reclamado y transgredido. La globalización de las redes sociales ha impulsado el desplazamiento de las demandas sociales hacia el mundo virtual. Sin embargo, la plaza sigue constituyendo, en la mayoría de las expresiones reivindicativas, el símbolo físico en el que se encuentra y reconoce la colectividad. El presente artículo pretende determinar, a través de una metodología gráfica extrapolable, qué parámetros urbanos y sociopolíticos marcan la capacidad de un espacio para acoger manifestaciones o revueltas. Estas coreografías sociales representan, ante todo, un acto de transformación y apropiación de la ciudad, reafirmando la figura del ágora como lexema atemporal. Recorriendo tres casos de estudio del arco iberoamericano –en contextos de dictadura, estabilidad y crisis– se observan singularidades diferenciales y ritos comunes inherentes al comportamiento humano.

ABSTRACT The COVID-19 pandemic currently affects millions of people including the pediatric population. The clinical manifestations in children are diverse: respiratory, gastrointestinal, hematological, neurological and systemic. In order to describe the various clinical and neurological manifestations during the evolution of the disease, we documented a series of cases of pediatric patients with COVID-19. Various mechanisms are proposed through which SARS-CoV-2 would cause neurological injury (direct injury, secondary to an immune response, among others) with variable clinical characteristics (seizures, muscle weakness, sensorial disorder). Studies on clinical characteristics and prognostic factors in children and adolescents with SARS-CoV-2 are limited, therefore, this report provides a spectrum of neurological manifestations associated with SARS-CoV-2 in pediatric population.

RESUMEN La pandemia por la COVID-19 afecta actualmente a millones de personas sin exceptuar la población pediátrica. Las manifestaciones clínicas en niños son variables: respiratorias, gastrointestinales, hematológicas, neurológicas y sistémicas. Con el objetivo de describir las diversas presentaciones clínicas y neurológicas durante la evolución de la enfermedad se documentó una serie de casos de pacientes pediátricos con la COVID-19. Se plantean diversos mecanismos a través de los cuales el SARS-CoV-2 causaría daño neurológico (daño directo, secundario a respuesta inmune, entre otras) con características clínicas variables (convulsiones, debilidad muscular, trastorno del sensorio). Los estudios sobre características clínicas y factores pronósticos en niños y adolescentes con SARS-CoV-2 son limitados, por lo cual el presente reporte contribuye con un espectro de manifestaciones neurológicas asociadas al SARS-CoV-2 en población pediátrica.

La pandemia del COVID-19 y la consecuente cuarentena han generado una crisis a nivel mundial en las diferentes sociedades del planeta. El artículo describe una tríada emocional iniciática: el miedo, la ansiedad y la angustia. Pero también distingue una serie de factores, en dos etapas, que potencian estas emociones de comienzo. En la primera, la incertidumbre, la cuarentena y la sobre información; mientras que, en la segunda, la complejidad se incrementa con las dificultades económicas, creando un clima de fastidio y malhumor, la escolaridad online que llevó a una convulsión en los hogares y las nuevas tecnologías de aprendizaje y, por último, el “Home Office”, que también implicó pelear por lugares de intimidad dentro de la casa. Todo este análisis progresivo, muestra un contexto que vulnerabiliza familias, parejas e individuos y lleva a encontrar recursos personales y poner en juego la resiliencia. El artículo se cierra con interrogantes pos cuarentena que invitan a reflexionar sobre este período crítico.

A pandemia do COVID-19 e a quarentena subsequente geraram uma crise mundial nas diferentes sociedades do planeta. O artigo descreve uma tríade emocional iniciática: medo, ansiedade e angústia. Mas também distingue uma série de fatores, em duas etapas, que aprimoram essas emoções iniciais. No primeiro, incerteza, quarentena e superinformação; enquanto, no segundo, a complexidade aumenta con las dificuldades econômicas, criando um clima de aborrecimento e mau humor, escolaridade on-line que levou a uma apreensão nos lares e novas tecnologias de aprendizado e, finalmente, o “Home office”, que também envolvia brigas por lugares íntimos dentro de casa. Toda essa análise progressiva mostra um contexto que torna famílias, casais e indivíduos vulneráveis e leva a encontrar recursos pessoais e colocar a resiliência em risco. O artigo termina com perguntas pós-quarentena que nos convidam a refletir sobre esse período crítico.

The COVID-19 pandemic and the subsequent quarantine have generated a worldwide crisis in the different societies of the planet. The article describes an initiatory emotional triad: fear, anxiety, and anguish. But it also distinguishes a series of factors, in two stages, that enhance these beginning emotions. In the first, uncertainty, quarantine, and over information; while in the second, the complexity increases with the economic problem creating a climate of annoyance and grumpiness, online schooling that led to a seizure in homes and new learning technologies and, finally, the “Home Office ”, which also involved fighting for intimate places inside the house. All this progressive analysis, shows a context that makes families, couples and individuals vulnerable and leads to finding personal resources and putting resilience at stake. The article closes with post-quarantine questions that invite us to reflect on this critical period.

Abstract Methemoglobinemia is a clinical syndrome secondary to the oxidation of iron in hemoglobin, preventing its adequate binding to oxygen. Subsequently, red blood cells are unable to appropriately capture oxygen and deliver it to the tissues, causing hypoxia. We describe a case of a patient who presented neurological symptoms in the context of methemoglobinemia as an adverse reaction to the administration of EMLA.

Resumen La metahemoglobinemia es un síndrome clínico que se produce por la oxidación del hierro de la hemoglobina impidiendo su adecuada unión al oxígeno, de forma que existe dificultad por parte de los glóbulos rojos tanto para captar el oxígeno, como para cederlo a los tejidos ocasionando hipoxia tisular. Describimos el caso de una paciente que presentó síntomas neurológicos y metahemoglobinemia como reacción adversa por contacto con crema de anestésico tópico (EMLA).