Resumen Introducción: Las malformaciones congénitas del sistema nervioso central (SNC) son el segundo defecto congénito más común después de las malformaciones cardiacas y pueden asociarse a mortalidad y discapacidad infantil. Objetivo: estudiar la incidencia de las principales malformaciones congénitas del SNC y factores asociados en recién nacidos atendidos en un hospital público de segundo nivel en Tuxtla Gutiérrez, Chiapas. Métodos: estudio descriptivo, que incluyó a 113 recién nacidos con malformaciones del SNC. Se precisó el diagnóstico, se obtuvo información de los padres: edad, escolaridad, ocupación, control prenatal, ingesta de ácido fólico, exposición a plaguicidas. Se integró una base de datos en el programa estadístico Epi Info versión 3.4.3, se realizó un análisis univariado y bivariado mediante la prueba chi cuadrada y un valor p < 0.05 se consideró un resultado significativo. Resultados: las malformaciones más frecuentes fueron: hidrocefalia (45.1%), Arnold-Chiari (32.7%) y encefalocele (8.0%). El porcentaje de casos fue más elevado (78.8%) en madres cuyo primer embarazo fue entre los 13 y 20 años (p < 0.05). El 40.2% de las madres durante el embarazo estuvieron expuestas a insecticidas y 39.8% a herbicidas y fungicidas. Únicamente el 15.4% de las madres consumieron ácido fólico durante el primer trimestre del embarazo. Conclusión: es grave y preocupante la alta incidencia de anormalidades congénitas del SNC, lo cual podrían estar asociado con la exposición de plaguicidas y deficiencias en la ingesta de ácido fólico. Consecuentemente se necesita fortalecer la atención prenatal y la alfabetización en salud para coadyuvar en la disminución de estos padecimientos.

Abstract Introduction: Malformations of the central nervous system (CNS), the type of congenital defect second only to cardiac malformations, cause infant disability and mortality. Objective: The aim of the study was to evaluate the incidence of congenital malformations of the CNS in newborns treated at a regional public hospital in Southern Mexico and explore the associated factors. Methods: This descriptive study included 113 newborns with CNS malformations. A specific diagnosis was provided and information was obtained from the parents in relation to age, schooling, occupation, prenatal control, intake of folic acid, and exposure to pesticides. A database was created in the statistical program Epi Info version 3.4.3 to carry out univariate and bivariate analyses using the Chi-square test, with significance considered at p < 0.05. Results: The most frequent malformations were hydrocephalus (45.1%), Arnold-Chiari (32.7%), and encephalocele (8.0%). Of the 113 newborns herein examined, a greater percentage of congenital malformations was found when the first pregnancy took place in mothers 12-19 versus over 19 years of age (78.8% vs. 21.2%, respectively; p < 0.05). Furthermore, 40.2% of mothers were exposed to insecticides and 39.8% to herbicides and/or fungicides before or during pregnancy. Only 15.4% of the mothers consumed folic acid during the first trimester of pregnancy. Conclusion: The incidence of congenital abnormalities of the CNS in newborns is a serious problem, perhaps associated with exposure of the mother to pesticides and a deficient intake of folic acid. Therefore, it is necessary to strengthen prenatal care and health literacy to help reduce the occurrence of these disorders.

Abstract Fecal Immunochemical Test (FIT) followed by a colonoscopy is an efficacious strategy to improve the adenoma detection rate and Colorectal Cancer (CRC). There is no organized national screening program for CRC in Brazil. The aim of this research was to describe the implementation of an organized screening program for CRC through FIT followed by colonoscopy, in an urban low-income community of São Paulo city. The endpoints of the study were: FIT participation rate, FIT positivity rate, colonoscopy compliance rate, Positive Predictive Values (PPV) for adenoma and CRC, and the rate of complications. From May 2016 to October 2019, asymptomatic individuals, 50-75 years old, received a free kit to perform the FIT. Positive FIT (≥ 50 ng/mL) individuals were referred to colonoscopy. 10,057 individuals returned the stool sample for analysis, of which (98.2%) 9,881 were valid. Women represented 64.8% of the participants. 55.3% of individuals did not complete elementary school. Positive FIT was 7.8% (776/9881). The colonoscopy compliance rate was 68.9% (535/776). There were no major colonoscopy complications. Adenoma were detected in 63.2% (332/525) of individuals. Advanced adenomatous lesions were found in 31.4% (165/525). CRC was diagnosed in 5.9% (31/525), characterized as adenocarcinoma: in situ in 3.2% (1/31), intramucosal in 29% (9/31), and invasive in 67.7% (21/31). Endoscopic treatment with curative intent for CRC was performed in 45.2% (14/31) of the cases. Therefore, in an urban low-income community, an organized CRC screening using FIT followed by colonoscopy ensued a high participation rate, and high predictive positive value for both, adenoma and CRC.

ABSTRACT This article presents the development and testing of a tactile interface prototype, HaptTech, that applies vibrotactile stimulation patterns to the fingertip, as well as an analysis of its performance when coupled to the commercial kinesthetic interface Novint Falcon. Its applicability in digital entertainment expects to improve the level of immersion into virtual reality scenarios. In the first experiment, a group of 75 subjects compared three different vibration stimuli that emulated different textures. They evaluated the stimuli on a 1 to 10 scale, where 1 means 'non-perceivable differences' and 10 means 'entirely differentiable'. The obtained mean values were 9 (textures 1 and 3), 8,29 (textures 1 and 2), and 7,43 (textures 2 and 3), indicating HaptTech's capability to reproduce differentiable stimuli. In the second experiment, 31 subjects evaluated the coupling between HaptTech and Novint Falcon. They perceived differences when the HaptTech system was activated in the context of a comparison between kinesthetic and vibrotactile plus kinesthetic stimuli. In the third experiment, the subjects evaluated the similarity between the perceived stimuli on the hand and a visualized texture pattern in a virtual environment. The resulting median values were 8, 8, and 9 for textures 1, 2, and 3, respectively, which demonstrate that the subjects perceived a high correspondence for each one.

RESUMEN Este artículo presenta el desarrollo y pruebas de un prototipo de interfaz táctil, HaptTech, que aplica al dedo patrones de estímulo vibrotáctil, así como un análisis de su desempeho cuando se acopla con la interfaz cinestésica comercial Novint Falcon. Su aplicabilidad en el entretenimiento digital espera mejorar el nivel de inmersión en escenarios de realidad virtual. En el primer experimento, un grupo de 75 personas comparó tres estímulos de vibración que emulaban diferentes texturas. Evaluaron el estímulo en una escala de 1 a 10, donde 1 significa 'diferencias no perceptibles' diferencias y 10 significa 'completamente diferenciables'. Los promedios fueron 9 (texturas 1 y 3), 8,29 (texturas 1 y 2) y 7,43 (texturas 2 y 3), indicando la capacidad del HaptTech de reproducir estímulos diferenciables. En el segundo experimento, 31 sujetos evaluaron el acople entre HaptTech y Novint Falcon. Los participantes percibieron diferencias cuando el sistema HaptTech se activaba en el contexto de una comparación entre estímulos cinestésicos y estímulos cinestésicos y vibrotáctiles. En el tercer experimento, los sujetos evaluaron la similitud entre el estímulo percibido en la mano y un patrón de textura visualizado en un ambiente virtual. Las medianas resultantes fueron 8, 8 y 9 para las texturas 1, 2, y 3 respectivamente, lo cual demuestra que los sujetos percibieron una alta correspondencia para cada una.

Resumen Las prácticas evaluativas estandarizadas son utilizadas en la educación con el fin de medir determinadas competencias del alumnado. En esta investigación, con el objetivo de indagar cómo afecta la prueba estandarizada Saber 11 la práctica de enseñanza y las subjetividades del personal docente de educación media de dos colegios de Chía y Bogotá, se realizó un estudio de caso múltiple a través de la aplicación de entrevistas semiestructuradas a docentes de educación media que orientaran asignaturas relacionadas con las áreas evaluadas en las pruebas Saber 11 y una revisión de documentos de nivel institucional y nacional. Los datos obtenidos se procesaron por medio de una codificación deductiva en el software NVIVO y fueron analizados a través de un modelo analítico narrativo en el que se utilizó la concepción hermenéutica del paradigma interpretativo. Los resultados muestran que existen aspectos ambivalentes en la práctica de enseñanza, es decir, que pueden considerarse contrarios y, sin embargo, se presentan en el mismo contexto. En este sentido, se presenta: una relación directa entre la práctica de enseñanza y el estándar frente a prácticas de enseñanza libres, responsabilidad docente con respecto a los resultados de las pruebas Saber 11, así como no responsabilidad y oposición al estándar y actitud crítica frente a una reivindicación de este. A partir de lo anterior, se propone el concepto de práctica de enseñanza ambivalente, el cual se considera como una práctica de resistencia relacionada con la parresía y cuidado de sí, que hace parte de la reflexión y juicio de la educación por parte del profesorado.

Abstract Standardized evaluative practices are used in education to measure student competences. In this research, with the aim of investigating how the Saber 11 standardized test affects the teaching practice and subjectivities of secondary school teachers from two schools in Chía and Bogotá, a multiple case study was conducted through the application of semi-structured interviews with high school teachers who will guide subjects related to the areas evaluated in the Saber 11 tests and a review of documents at the institutional and national level. The data obtained were processed through deductive coding in the NVIVO software and were analyzed through a narrative analytical model using the hermeneutical conception of the interpretive paradigm. The results showed that there are ambivalent aspects in teaching practice, that is, they can be considered contrary and, nevertheless, are presented in the same context. In this sense, the following is presented: a direct relationship between teaching practices and the standard versus free teaching practices, teacher responsibility regarding the results of the Saber 11 tests, as well as no responsibility and, opposition to the standard and a critical attitude towards the demand of the same. Based on the foregoing, the concept of ambivalent teaching practice is proposed, which is defined as a resistance practice related to parrhesia and self-care that is part of teachers' reflection and judgment of education.

Resumen Dada la relevancia actual de la investigación acerca de cómo se aborda la educación en y para la diversidad en la educación superior, es que este trabajo tiene por objetivo analizar la literatura científica sobre diversidad e inclusión en la educación superior publicada en la Web of Sciences y Scopus entre 2011 y 2020. Se analizaron 112 artículos en función de indicadores bibliométricos: producción temporal, por revistas y autor, fuentes de información, instrumentos y procedimientos, y análisis temático. Los hallazgos indican un aumento de productividad en el 2019, una tendencia a la colaboración, un predominio de estudios cuantitativos, y temáticas sobre creencias, actitudes y saberes, formas de diversidad y educación para la diversidad. Estos hallazgos respaldan la necesidad de avanzar hacia nuevas comprensiones de diversidad de este tópico de investigación.

Abstract Given the current relevance of research on how education in and for diversity is addressed in higher education, this paper aims to analyze the scientific literature on diversity and inclusion in higher education published in the Web of Sciences and Scopus between 2011 and 2020. A total of 112 articles were analyzed in terms of bibliometric indicators: temporal production, by journals and author, sources of information, instruments and procedures, and thematic analysis. The findings indicate an increase in productivity in 2019, a trend towards collaboration, a predominance of quantitative studies, and themes on beliefs, attitudes and knowledges, forms of diversity, and diversity education. These findings support the need to move toward new understandings about diversity on this research topic.

RESUMO O cumprimento das metas dos Objetivos de Desenvolvimento Sustentável e o reforço das competéncias para a cidadania global representam grandes desafios para as nações e, especialmente, para os seus sistemas educativos. Neste contexto, propomos a conceção de um modelo de coordenadas curriculares visando a formação de competéncias para o desenvolvimento sustentável e a cidadania global, no âmbito da Instituição Universitária Pascual Bravo (Colômbia). A partir de uma abordagem qualitativa, com um âmbito descritivo e uma conceção teórica fundamentada, foi realizada uma caracterização que revela a necessidade de avançar nos modelos curriculares do ensino superior cuja base o conhecimento teórico e prático, a fim de promover o desenvolvimento sustentável e os estilos de vida. Nesta base, é proposto um modelo de gestão curricular que permite refletir sobre a importância de articular estas competéncias com os objetivos da missão da instituição. Conclui-se que, com a sua aplicação, a comunidade académica pode adotar a ferramenta teórica e estabelecer um desenho que favoreça a atualização do currículo com enfoque no desenvolvimento sustentável.

ABSTRACT The fulfillment ofthe targets of the Sustainable Development Goals and the strengthening of the competencies to be global citizens brings out great challenges to the nations and, especially to their educational systems. In this context, the design of a model of curricular coordinates aimed at the formation of skills for sustainable development and world citizenship, within la Institución Universitaria Pascual Bravo (Pascual Bravo University Institution for its English conversion) (Colombia), is proposed. From a qualitative approach, with a descriptive scope and grounded theory design, a characterization was carried out that reveals the need to advance in higher education curricular models, whose base is theoretical and practical knowledge in order to promote the development and sustainable life styles. From there, a curricular management model is proposed that allows to reflect on the importance of articulating these competencies to the missionary purposes. It is concluded that, with its application, the academic community can adopt the theoretical tool and establish a design that favors curricular updating with a focus on sustainable development.

RESUMEN El cumplimiento de las metas de los Objetivos de Desarrollo Sostenible y el fortalecimiento de las competencias para ser ciudadanos globales plantea grandes desafios a las naciones y especialmente, a sus sistemas educativos. En este contexto, se propone el diseno de un modelo de coordenadas curriculares dirigido a la formación de competencias para el desarrollo sostenible y la ciudadanía mundial, dentro de la Institución Universitaria Pascual Bravo (Colombia). Desde un enfoque Qualitativo, con alcance descriptivo y el diseno de teoria fundamentada, se realizó una caracterización que devela la necesidad de avanzar en modelos curriculares de educación superior, cuya base sean los conocimientos teóricos y prácticos a fin de promover el desarrollo y los estilos de vida sostenible. A partir de ahi, se plantea modelo de gestión curricular que permita reflexionar sobre la importancia de articular dichas competencias a los propósitos misionales. Se concluye que, con su aplicación, la comunidad académica puede adoptar la herramienta teórica y establecer un diseno que favorezca la actualización curricular con enfoque hacia el desarrollo sostenible.

RESUMO - O feijão-caupi é um alimento muito importante para as populações das regiões Norte e Nordeste do Brasil, representando uma excelente fonte de proteínas e minerais. O objetivo deste estudo foi avaliar o potencial de 100 genótipos de feijão-caupi para biofortificação de ferro, zinco e proteína, e qualidade de cozimento. Os teores de ferro e zinco foram analisados por espectrometria de fluorescência de raios X; o conteúdo de proteínas foi baseado na determinação de nitrogênio, pelo método de Kjeldahl; e a qualidade de cozimento foi avaliada com uso de panela de pressão elétrica e cozedor de Mattson. A superioridade dos genótipos para ferro, zinco, proteínas e qualidade de cozimento foi realizada utilizando-se o índice de qualidade nutricional e de cozimento. O teor de ferro variou de 3,58 a 6,06 mg 100g-1, com uma média geral de 4,66 mg 100g-1, enquanto o teor de zinco entre 2,35 e 4,57 mg 100g-1 e média de 3,31 mg 100g-1. O ter de proteínas apresentou amplitude de 20,82 a 26,92 g 100g-1 e média de 24,30 g 100g-1. A porcentagem de grãos cozidos variou de 20 a 98%, com média de 68,7%. Os grãos da linhagem MNC11-1023E-28 apresentam melhor perfil de qualidade nutricional e de cocção, apresentando potencial como um alimento para atender às demandas dos consumidores e reverter a deficiência de ferro, zinco e proteínas na população brasileira.

ABSTRACT - Cowpea is a very important food for the populations of the North and Northeast regions of Brazil, representing an excellent source of proteins and minerals. The purpose of this study was to evaluate the potential of 100 cowpea genotypes for biofortification of iron, zinc, and proteins, and cooking quality of the grain. The iron and zinc contents were analyzed by x-ray fluorescence spectrometry; protein content was based on nitrogen determination, using the Kjeldahl method; and cooking quality was assessed using an electric pressure cooker and Mattson cooker. The superiority of genotypes for iron, zinc, proteins, and cooking quality was carried out using the nutritional quality and cooking index. The iron content ranged from 3.58 to 6.06 mg 100g-1, with an overall average of 4.66 mg 100g-1, while the zinc content between 2.35 and 4.57 mg 100g-1 and average of 3.31 mg 100g-1. Protein range ranged from 20.82 to 26.92 g 100g-1 and an average of 24.30 g 100g-1. The percentage of cooked grains ranged from 20 to 98%, with an average of 68.7%. The line MNC11-1023E-28 has the best profile of nutritional and cooking quality, showing potential as a food to meet consumer demands and reverse iron and zinc deficiency in the Brazilian population.

Resumo: As cochonilhas escama (Hemiptera: Diaspididae), são espécies fitófagas que ocorrem nas principais regiões biogeográficas do mundo. Devido à importância dos diaspidídeos como pragas, existe um amplo interesse nos países que exportam e importam produtos agrícolas não processados no aumento do conhecimento desse grupo, o que inclui pragas invasoras e quarentenárias de grande importância econômica. A diversidade, distribuição geográfica e hospedeiros de diaspidídeos foram estudadas de novembro de 2002 a dezembro de 2018 em 34 municípios do estado do Espírito Santo, Brasil. Quarenta espécies de Diaspididae de 27 gêneros foram coletadas e identificadas. As espécies Acutaspis perseae (Comstock), A. umbonifera (Newstead), Aonidiella aurantii (Maskell), Comstockaspis perniciosa (Comstock), Lepidosaphes beckii (Newman), Lepidosaphes gloverii (Packard), Morganella longispina (Morgan), Mycetaspis apicata (Newstead) e Thysanofiorinia nephelii (Maskel) foram encontradas pela primeira vez no Espírito Santo. Cinquenta e sete novas associações de hospedeiros foram observadas, em um total de 25 espécies de diaspidídeos; estes incluem 13 novos registros de famílias em um total de 11 espécies de diaspidídeos e nove famílias de plantas. Myrtaceae, Moraceae e Arecaceae foram as famílias botânicas com o maior número de espécies de diaspidídeos observadas. Selenaspidus articulatus (Morgan) foi a espécie mais polífaga, com 17 espécies de plantas hospedeiras de 12 famílias observadas, seguida por Pseudaonidia trilobitiformis (Green) e Parlatoria proteus (Curtis). Com esses novos registros, 41 espécies e 28 gêneros de Diaspididae foram registrados no Espírito Santo.

Abstract: Armored scale insects (Hemiptera: Diaspididae), are phytophagous species that occur in major biogeographic regions of the world. Because of the importance of diaspidids as pests, there is widespread interest in countries that export and import unprocessed agricultural products in increased knowledge of this group which includes invasive and quarantine pests of great economic concern. The diversity, geographic distribution, and host of diaspidids were studied from November 2002 to December 2018 in 34 municipalities in the state of Espírito Santo, Brazil. Forty species of Diaspididae from 27 genera were collected and identified. The species Acutaspis perseae (Comstock), A. umbonifera (Newstead), Aonidiella aurantii (Maskell), Comstockaspis perniciosa (Comstock), Lepidosaphes beckii (Newman), Lepidosaphes gloverii (Packard), Morganella longispina (Morgan), Mycetaspis apicata (Newstead), and Thysanofiorinia nephelii (Maskel) were found for the first time in Espírito Santo. The plant families Myrtaceae, Moraceae, Arecaceae, Asparagaceae, and Rutaceae had the greatest number of host plant species of armored scale. Fifty-seven new host associations were observed for 25 species of diaspidids and 11 diaspidid species were recorded for the first time from nine families of plants. Selenaspidus articulatus (Morgan) was the most polyphagous species observed with 17 host plant species from 12 families, followed by Pseudaonidia trilobitiformis (Green), and Parlatoria proteus (Curtis). With these new records, 41 species and 28 genera of Diaspididae have been recorded in Espírito Santo.

Resumen Con datos del Sistema de Información Agroalimentaria y Pesquera se caracteriza la productividad de maíz grano en el ámbito municipal de Campeche, México, mediante estadística multivariada, análisis espacial de la producción y aplicación de una encuesta a productores para así determinar los factores que condicionan la competitividad del sector en el interior del estado. A medida que se pasa del norte al sur del estado, el autoconsumo y empleo de semillas criollas para la siembra aumenta, por lo que se reduce la competitividad (beneficio/costo): Hopelchén (1.80, norte del estado), Champotón (1.38, centro) y Candelaria (0.97, sur). De acuerdo con la encuesta, se concluye que aspectos de sanidad, desorganización de productores y falta de esquemas de comercialización limitan la productividad de maíz en el estado.

Abstract With data from Agri-Food and Fisheries Information System, the productivity of grain maize in the state of Campeche was characterized at the municipal level, through multivariate statistics, spatial analysis of production and the application of a survey to farmers, to determine the factors that condition the competitiveness of the sector within the state. It was found that as one moves from the north to the south of the state, self-consumption and use of native seeds for sowing increases; which reduces competitiveness (benefit/cost): Hopelchén (1.80, north of the state), Champotón (1.38, center) and Candelaria (0.97, south). According to the survey carried, it was concluded that aspects of agricultural health, disorganization of farmers and lack of commercialization schemes, limit the productivity of corn in the state.

ABSTRACT Introduction: one of the strategies considered when dealing with mental health problems during the COVID-19 pandemic was the use of telepsychiatry. Objective: to determine whether urban or rural origin is associated with the development of depressive disorders in patients consulting through telepsychiatry in a referral hospital in Paraguay. Methodology: observational, descriptive of cross-association, and cross-sectional study. A non-probabilistic sampling of consecutive cases was carried out. Electronic records of patients treated at the Psychiatry Service of the “Hospital de Clínicas” of the “Universidad Nacional de Asunción” between March and June 2021 were used. Descriptive statistics were applied for all variables. For the comparison of groups with nominal qualitative variables, the Chi-square test was used, calculating the odds ratio according to sex and area of residence, considering a p˂0.05 as significant. Student's t-test was also used to compare a nominal variable with a quantitative variable. Results: 907 clinical records were analyzed, finding 92 patients with depressive spectrum disorders. When analyzing the association between rural and urban environment with the presence of a depressive episode, a significant association was found between rural environment and the diagnosis of a depressive disorder (OR=7.81, χ2=63.33, p<0.001). Conclusion: our results do not agree with previous studies related to the subject. This could be due, at least in part, to the impact that social and economic conditions have on the development of mental disorders, such as depression.

RESUMEN Introducción: una de las estrategias que se consideraron a la hora de hacer frente a los problemas de salud mental durante la pandemia de COVID-19 fue la utilización de la telepsiquiatría. Objetivo: determinar si la procedencia urbana o rural se asocia al desarrollo de trastornos depresivos en pacientes que consultan a través de telepsiquiatría en un Hospital de referencia de Paraguay. Metodología: estudio observacional, descriptivo de asociación cruzada, de corte transversal. Se realizó un muestreo no probabilístico, de casos consecutivos. Se utilizaron fichas electrónicas de pacientes tratados en el Servicio de Psiquiatría del Hospital de Clínicas de la Universidad Nacional de Asunción entre marzo y junio de 2021. Se aplicó estadística descriptiva para todas las variables. Para la comparación de grupos con variables cualitativas nominales se utilizó la prueba de Chi cuadrado, calculando el odds ratio según sexo y área de residencia, considerando una p˂0,05 como significativa. Se utilizó, además, la prueba T de Student para comparar una variable nominal con una variable cuantitativa. Resultados: se analizaron 907 fichas clínicas, encontrándose 92 pacientes con trastornos del espectro depresivo. Al analizar la asociación entre el ambiente rural y urbano con la presencia de un episodio depresivo, se encontró una asociación significativa entre el ambiente rural y el diagnóstico de un trastorno depresivo (OR=7,81, χ2=63,33, p<0,001). Conclusión: nuestros resultados no condicen con estudios previos relacionados al tema. Esto podría deberse, al menos en parte, al impacto que las condiciones sociales y económicas tienen en el desarrollo de trastornos mentales, como la depresión.

Abstract We present the case of a 54-year-old patient who presented with a history of 2 years with angina. Invasive studies revealed critical coronary artery stenosis coexisting with obstructive hypertrophic miopathy. This is a rare association with only isolated case reports.

Resumen Se presenta el caso de un paciente de 54 años que consulta por angina de esfuerzo de 2 años de evolución en quien se identifica una dilatación ectásica del árbol coronario con lesiones ateroscleróticas críticas y miocardiopatía hipertrófica septal obstructiva. Una revisión bibliográfica revela que es una asociación infrecuente de la cual solo existen reportes de casos aislados.

ABSTRACT Introduction: Common variable immunodeficiency is an inborn error of immunity that has its peak incidence in adulthood. It is characterized by an increased susceptibility to respiratory infections, autoimmunity and malignancy, secondary to a state of hypogammaglobulinemia and immunodysregulation, caused by mutations and partially understood genetic interactions. The diagnosis is one of exclusion, has great clinical heterogeneity and is commonly misinterpreted. Objective: To describe a clinical case of a patient affected by an inborn error of immunity. Methods: Retrospective description of a case report. Conclusions: Common variable immunodeficiency disorder should be considered within the differential diagnoses in every patient who presents any of its clinical manifestations, mainly those related to recurrent respiratory infections, an antecedent that the patient may present as relevant during the first-level consultations with general medicine physicians or with specialists. Its diagnostic approach consists in measuring serum immunoglobulin levels, an easily accessible laboratory test for any clinic physician regardless of their healthcare level, while its treatment is based on the periodic administration of exogenous human immunoglobulin intravenously or subcutaneously.

RESUMEN Introducción: La inmunodeficiencia común variable es un error innato de la inmunidad que tiene su pico de incidencia en la edad adulta. Se caracteriza por una susceptibilidad aumentada a padecer infecciones respiratorias, autoinmunidad y malignidad, secundario a un estado de hipogammaglobulinemia e inmunodisregulación, causado por mutaciones e interacciones genéticas parcialmente comprendidas. El diagnóstico es de exclusión, tiene una gran heterogeneidad clínica y comúnmente es diagnosticado de forma errónea. Objetivo: Describir un caso clínico de un paciente afectado por un error innato de la inmunidad. Caso clínico: Hombre de 35 años que se presenta a la consulta de Medicina Interna - Inmunología refiriendo un cuadro clínico de 3 años de evolución consistente en múltiples episodios de infecciones sino-pulmonares en los últimos meses, presentaba tos productiva, dificultad respiratoria y pérdida de peso no intencional de aproximadamente 8 kg. Conclusiones: La inmunodeficiencia común variable debe considerarse dentro de los diagnósticos diferenciales en todo paciente que presente alguna de sus manifestaciones clínicas, principalmente aquellas relacionadas con infecciones respiratorias a repetición, antecedente que el paciente puede presentar como relevante en sus consultas de primer nivel con medicina general o con especialistas. Su aproximación diagnóstica consiste en la solicitud de niveles séricos de inmunoglobulinas, prueba de laboratorio de fácil acceso para cualquier clínico independiente de su nivel de atención y su tratamiento se fundamenta en la administración periódica de inmunoglobulina humana exógena de forma endovenosa o subcutánea.

Introduction The COVID-19 pandemic generated many controversies in the management of critically ill pediatric patients. The main ones were about ventilatory support, phenotypic differences between adults and children, and acute and subacute clinical forms. For this reason, the Respiratory Committee (RC) of the Latin American Society of Pediatric Intensive Care (SLACIP) generated a document to summarize the recommendations with the best evidence. The objective of these recommendations is to provide an update on issues related to pediatric COVID-19. Methods and Materials The Respiratory Committee created a group composed of 19 pediatric kinesiologists/physiotherapists and intensivists from 8 Latin American countries and defined on 3/27/20 the 15 most relevant topics, assigning 3 referents and 2 reviewers for each. The manuscripts went through 4 stages until their final version. The complete document was freely distributed on 22/05/20 and updated twice (07/08/20 and 02/09/21). For the current version there were 3 special collaborators. Result The material consists of a complete 94-page document and an executive summary. The topics included are case definition, epidemiology, clinical classification, subacute inflammatory syndrome, personal protective equipment, aerosolization situations (intubation, extubation, suctioning, sampling, filter replacement, cardiopulmonary resuscitation, early mobilization), high flow cannula support, invasive, non-invasive and high frequency mechanical ventilation, pharmacological treatment, laboratory and imaging. Conclusion The purpose of this document is to serve as a guide for nurses, kinesiologists/physiotherapists and physicians in the management of critically ill pediatric patients with COVID-19.

Introducción La pandemia por COVID-19 generó muchas controversias en el manejo de los pacientes pediátricos críticos. Las principales fueron sobre el soporte ventilatorio, las diferencias fenotípicas entre adultos y niños y las formas clínicas aguda y subaguda.Por esa razón el Comité Respiratorio (CR) de la Sociedad Latinoamericana de Cuidados Intensivos Pediátricos (SLACIP) generó un documento para resumir las recomendaciones con mayor evidencia. El objetivo de estas recomendaciones es brindar una actualización de temas relacionados a COVID-19 pediátrico.Métodos y Materiales El Comité Respiratorio creó un grupo compuesto por 19 kinesiólogos/fisioterapeutas y médicos intensivistas pediátricos de 8 países de Latinoamérica y definió el 27/03/20 los 15 temas más relevantes, asignando 3 referentes y 2 revisores por cada uno. Los manuscritos pasaron por 4 etapas hasta su versión final. El documento completo se distribuyó libremente el 22/05/20, actualizándose en dos oportunidades (07/08/20 y el 02/09/21). Para la versión actual se contó con 3 colaboradores especiales.Resultado El material se compone de un documento completo de 94 páginas y un resumen ejecutivo. Los temas incluidos son definición de caso, epidemiología, clasificación clínica, síndrome inflamatorio subagudo, equipos de protección personal, situaciones de aerosolización (intubación, extubación, aspiración, toma de muestras, recambio de filtros, reanimación cardiopulmonar, movilización temprana), soporte con cánula de alto flujo, ventilación mecánica invasiva, no invasiva y de alta frecuencia, tratamiento farmacológico, laboratorio e imágenes.Conclusión La elaboración de este documento ha tenido como fin servir de guía para enfermeros, kinesiólogos/fisioterapeutas y médicos en el manejo de pacientes pediátricos en estado crítico por COVID-19.