Abstract The new coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), detected in Wuhan, China, causes coronavirus disease 2019 (COVID-19), which was declared pandemic, and has caused more than 19 million confirmed cases and more than 700 thousand deaths worldwide. When our institution was converted to COVID's hospital since early April 2020, specific care protocols were developed, with the aim of improving the quality of care and safety of patients and the staff involved in their management. Airway management represents one of the highest risks of direct contact infection with aerosol generation (orotracheal intubation, secretion aspiration, extubation, cardiopulmonary resuscitation, high flow oxygen therapy, noninvasive ventilation, and invasive ventilation). We present the current recommendations for airway management as well as a step-by-step airway management protocol to carry out a more secure procedure based on the literature reported so far.

Resumen El nuevo coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), detectado en Wuhan (China), causante de la enfermedad por coronavirus 2019 (COVID-19), que se declaró como pandemia, ha causado más de 19 millones de casos confirmados y más de 700 mil muertes en el mundo. Nuestra institución se reconvirtió a hospital COVID desde principios de abril del 2020, con lo que se desarrollaron protocolos de atención específicos, con el objetivo de mejorar la calidad de atención y seguridad de los pacientes y el personal involucrado en su manejo. El manejo de la vía aérea representa uno de los riesgos más altos de contagio por contacto directo en la generación de aerosoles (intubación orotraqueal, aspiración de secreciones, extubación, resucitación cardiopulmonar, terapia de oxígeno de alto flujo, ventilación no invasiva y ventilación invasiva). Presentamos las recomendaciones actuales para el manejo de la vía aérea, así como un protocolo de manejo paso a paso para llevar a cabo un procedimiento con mayor seguridad basados en la literatura reportada hasta el momento.

Abstract: Introduction: Sciatic neuropathy is rare and difficult to diagnose in pediatrics, and its long-term course has not been completely understood. Objective: To analyze the clinical presentation and evolution of a group of pediatric patients with sciatic neuropathy. Patients and Method: Retrospective anal ysis of the clinical characteristics of pediatric patients with sciatic neuropathy treated in two hospitals of Santiago between 2014 and 2018. Locomotor examination, muscle trophism, deep tendon reflexes, gait, sensation, and pain were assessed. Sciatic nerve conduction study and electromyography (EMG) were performed, and magnetic resonance imaging (MRI) in three patients. Results: Six patients were included with an average age of 11.8 years. The etiologies were traumatic (N = 2), by compression (N = 2), vascular (N = 1), and tumor (N = 1). All of the 6 patients presented foot drop and Achilles tendon hyporeflexia/areflexia, and 5 patients presented severe neuropathic pain. The EMG showed involvement of the sciatic nerve rami and dependent muscles. In two patients, a pelvic girdle and lower limbs MRI was performed, showing selective muscle involvement in sciatic territory. One patient underwent a lumbosacral plexus MRI, and subsequently histological study showing a benign neural tumor. Out of the three patients who were followed-up longer than one year presented motor sequelae and gait disorder. Conclusion: Sciatic neuropathy in the study group was secondary to different causes, predominantly traumatic and compressive etiologies. The three patients that were ina long-term follow-up presented significant motor sequelae. In most of the cases, neural injury wasassoci- ated with preventable causes, such as accidents and positioning in unconscious children, which is crucial in the prevention of a pathology with a high sequelae degree.

Resumen: Introducción: La neuropatía ciática es una entidad infrecuente y de difícil diagnóstico en Pediatría. Su evolución a largo plazo no ha sido claramente definida. Objetivo: Analizar la presentación clínica y evolución de un grupo de niños con neuropatía ciática. Pacientes y Método: Análisis retrospectivo de las características clínicas de pacientes pediátricos con neuropatía ciática atendidos en 2 hospitales de Santiago, entre 2014-2018. Se evaluó examen motor, trofismo muscular, reflejos osteotendíneos, marcha, sensibilidad y dolor. Se estudió neuroconducción de nervio ciático, electromiografía (EMG) y en 3 pacientes, Resonancia Magnética (RM). Resultados: Se incluyeron 6 pacientes, edad promedio 11,8 años. Hubo 2 causas traumáticas, 2 compresivas, 1 vascular y 1 tumoral. Los 6 pa cientes debutaron con pie caído e hiporreflexia/arreflexia aquiliana; 5 pacientes presentaron dolor neuropático severo. La EMG mostró en todos los casos compromiso en nervios y musculatura de pendientes del nervio ciático. En 2 casos se realizó RM de cintura pélvica y extremidades inferiores, mostrando compromiso muscular selectivo en pierna en territorio ciático. En 1 caso, se realizó RM de plexo lumbosacro, y luego estudio histológico, que concluyeron un tumor neural benigno. En los 3 pacientes que tuvieron seguimiento mayor a un año, se observaron secuelas motoras, con marcha alterada. Conclusión: La neuropatía ciática en este grupo fue secundaria a diversas etiologías, predominando las traumático-compresivas. En los 3 casos que tuvieron seguimiento a largo plazo se observaron secuelas motoras significativas. En la mayoría la lesión se asoció a causas prevenibles como accidentes y posicionamiento en niños con compromiso de conciencia, lo que resulta fundamental en la prevención de una patología con alto grado de secuelas.

OBJETIVO: O objetivo deste trabalho foi conhecer a diversidade de gêneros, os atributos estruturais e a distribuição da comunidade de hidracáridos, como assim também a sua possível influência sobre certos parâmetros abióticos, na sub-bacia do Rio Grande, San Luis; MÉTODOS: estabeleceram-se quatro locais de amostragem (C1, E1, E2 e E3) em dois períodos hidrológicos: águas altas (AA) e águas baixas (AB). Obtiverem-se 24 amostras com rede Surber e se realizou a caracterização hidráulica, física e química dos locais de amostragem. Calculou-se a densidade (ind.m-2), a riqueza genérica e o índice da diversidade de Shannon-Wiener; RESULTADOS: registraram-se 16 gêneros de hidracáridos. Não houve diferenças significativas entre cada local com relação aos parâmetros abióticos. Observou-se uma correlação positiva entre Sperchon, Torrentícola e Neoatractides com relação ao fluxo e à corrente, ao passo que Hygrobates mostrou uma correlação negativa. Não houve diferenças significativas nas abundâncias absolutas de hidracáridos entre os locais em AA e AB nem entre os pares de cada local em AA e em AB. Os gêneros que apresentaram as maiores densidades foram Hygrobates, Limnesia e Atractides, dos quais os dois primeiros apresentaram-se mais amplamente distribuídos. Os demais gêneros somente apareceram esporádicamente. De acordo com o índice de Kownacki, Hygrobates e Limnesia foram "dominantes", Atractides foi "subdominante", e o resto foi "não-dominante"; CONCLUSÕES: os gêneros encontrados apresentaram-se distantes tanto filogenéticamente quanto sistemáticamente. Porém, os espécimes desses gêneros foram similares morfológicamente, apresentando características adaptativas à habitats teófilos. A representatividade de Hygrobates e Limnesia poderia se dever à grande abundância de seus hospedeiros e presas na sub-bacia. A diminuição na densidade e as mudanças na composição de hidracáridos em E3 (local após barragem) poderiam ser explicadas pelas interações abióticas antes mencionadas.

AIM: The purpose of this work was to determine genera diversity, structural attributes and distribution of the Hydrachnidia assemblages and their possible influences with certain abiotic parameters along the sub-basin of the Grande River, a 6th order stream in the province of San Luis; METHODS: four sampling sites (C1, E1, E2 and E3) were established in two different hydrological periods: high waters (HW) and low waters (LW). Twenty-four samples were obtained using Surber sampler, and the hydraulic, physical and chemical characterization of the sampling sites was carried out. Density (ind.m-2), genus richness, Shannon-Wiener diversity index and Kownacki's dominance index were calculated; RESULTS: sixteen Hydrachnidia genera were observed. No significant differences were found between the abiotic parameters of each site. A positive correlation of Sperchon, Torrentícola and Neoatractides was observed in relation to flow and current velocity whereas Hygrobates showed a negative correlation. No significant differences were observed in Hydrachnidia abundances among the sites in HW and LW and between the pairs of each site in HW and LW. The genera with the highest densities were Hygrobates, Limnesia and Atractides, of which the first two were widely distributed. The rest only appeared sporadically. According to Kownacki's index Hygrobates and Limnesia were "dominant", Atractides were "subdominant" and the rest were "non dominant"; CONCLUSIONS: The found genera were distanced systematically and philogenetically. However, the specimens belonging to these genera exhibited very similar morphological characteristics, which were adaptations to rheophilous habitats. The representativity of Hygrobates and Limnesia might be due to the great abundance of their hosts and preys in the sub-basin. The decrease in the densities and the changes in the Hydrachnidia composition in E3 (post-dam site) might be explained by the biotic interactions previously mentioned.