Abstract This article describes and characterizes the floating and pendular migration flows of a group of Venezuelan women in the border city of Arauca, Colombia. Using a qualitative methodological approach, field observations, in-depth interviews, focus groups, and a literature review of updated academic, regulatory, and institutional texts were conducted in an area of study with limited gender- based description. Thus, this study highlights the role of Venezuelan women as active migrant subjects and concludes that the labor, family, and social trajectories of the interviewed women are transversely modified by their migration experience, as they are subjected to various risks that expose their vulnerability as migrant women, in addition to risks derived from xenophobia and discrimination. Paradoxically, the migratory diaspora represents their only hope for having a better quality of life.

Resumen Este artículo describe y caracteriza los flujos migratorios flotantes y pendulares de un grupo de mujeres de nacionalidad venezolana en la ciudad fronteriza de Arauca-Colombia. Desde un enfoque metodológico cualitativo se realizaron observaciones de campo, entrevistas a profundidad, grupos focales y un levantamiento bibliográfico de textos académicos, normativos e institucionales actualizados sobre un área de estudio con enfoque de género poco descrita. Así, este análisis pone en evidencia el rol de la mujer venezolana como sujeto migrante activo y concluye que las trayectorias laborales, familiares y sociales de las entrevistadas se ven transversalmente modificadas por la migración que realizan, ya que se ven sometidas a distintos riesgos que ponen en evidencia su vulnerabilidad como mujeres migrantes, además de aquéllos derivados de la xenofobia y la discriminación. Al unísono, la diáspora migratoria representa paradójicamente para ellas, la única esperanza a la hora de obtener una mejor calidad de vida.

Abstract In this research, a descriptive analysis is carried out on the attitude of the students of the Faculty of Accounting and Administration of the Universidad Veracruzana, Coatzacoalcos campus, towards online education during the period of the Covid-19 pandemic. Regarding the processing of information, quantitative data collected with a survey that was applied to 425 students through Google Forms was used. With the data collected, a methodological sequence was applied to analyze the perception of the sample, the study is quantitative with a descriptive and cross-sectional scope. The results show empirical evidence that students have an unfavorable attitude towards online education, this is due to the lack of infrastructure, little social interaction, difficulties in teamwork, stress and anxiety. These results provide guidelines for the design of Educational Programs (EP) of this type at the UV and any other university.

Resumo Nesta pesquisa, é realizada uma análise descritiva sobre a atitude dos alunos da Faculdade de Contabilidade e Administração da Universidad Veracruzana, campus Coatzacoalcos, em relação à educação online durante o período da pandemia do Covid-19. Quanto ao tratamento das informações, foram utilizados dados quantitativos coletados com uma pesquisa aplicada a 425 alunos por meio do Google Forms. Com os dados coletados, foi aplicada uma sequência metodológica para analisar a percepção da amostra, o estudo é quantitativo com escopo descritivo e transversal. Os resultados mostram evidências empíricas de que os alunos têm uma atitude desfavorável em relação à educação online, isso se deve à falta de infraestrutura, pouca interação social, dificuldades no trabalho em equipe, estresse e ansiedade. Esses resultados fornecem diretrizes para o desenho de Programas Educacionais (EP) desse tipo na UV e em qualquer outra universidade.

Resumen El objetivo de la presente investigación fue realizar un análisis descriptivo sobre la actitud de los estudiantes de la Facultad de Contaduría y Administración de la Universidad Veracruzana, campus Coatzacoalcos, hacia la educación online durante el periodo de pandemia por la covid-19. Para el procesamiento de la información, se utilizaron datos cuantitativos recolectados con una encuesta que se aplicó a 425 estudiantes por medio de Google Forms. Con los datos recolectados se aplicó una secuencia metodológica para analizar la percepción de la muestra. El estudio fue cuantitativo, de alcance descriptivo y de corte transversal. Los resultados muestran evidencia empírica en torno a que los estudiantes poseen una actitud poco favorable hacia la educación online debido a la carencia de infraestructura, escasa interacción social, estrés y ansiedad. Estos resultados sirven de pauta para diseñar programas educativos (PE) de este tipo en la UV y en otra universidad.

Resumen La formación universitaria de docentes durante el confinamiento provocado por la pandemia de COVID-19 ha estado influida por diferentes factores. El objetivo de este estudio es analizar las experiencias de aprendizaje de un grupo de estudiantes de la carrera de licenciatura en Educación Básica de una universidad ecuatoriana. Se utilizó un enfoque cualitativo a través de un análisis del contenido temático de narrativas escritas a manera de reportes reflexivos. La investigación se organizó en el contexto del proyecto de perfeccionamiento de la formación docente atendiendo a las seis categorías que influyen directamente en la formación del estudiante y que delimitan el desafío didáctico y pedagógico de quienes se ocupan de formar docentes. Los resultados aluden a la brecha tecnológica que hace cada vez más visible la desigualdad social, pero a la vez la capacidad de reestructuración, adaptación al contexto virtual tanto de estudiantes en formación como de sus docentes. Todo ello, pese a que no hubo una preparación oportuna y suficiente en las estrategias de afrontamiento para el aprendizaje virtual de forma saludable en condiciones de confinamiento. Las experiencias contadas en voz de los y las estudiantes confirman las distintas percepciones sobre categorías que influyen en su formación y la necesidad de avanzar en una estrategia integradora entre los profesionales de la educación y la salud que incorpore las particularidades descritas para un enfoque más inclusivo de la formación docente.

Abstract Teachers’ university training during the confinement caused by the COVID-19 pandemic has been influenced by various factors. This research’s main objective was to analyse the learning experiences of undergraduate students in Basic Education at an Ecuadorian university. The current study involves a qualitative approach using a thematic content analysis of narratives written as reflective reports. The sample was composed by 5th semester students of the Basic Education career. They were between 19 and 38 years old, and their narratives were selected taking into account these selection parameters: the stories were set up in a reasonable and meaningful way, followed the structure: introduction, development, conclusion; and they were deep, but very clear in the reflections made that direct the future perspective of the subject in question. This study was organized as part of a project for the improvement of teachers’ training, taking into account the six categories that have a direct influence on student education and that define a didactic and pedagogical challenge of those who are in charge of university processes. According to the previous argument, some of these categories are the use of electronic devices and access to learning technologies; the adaptation and use of teaching strategies in the virtual context; the development of students' creativity during virtual learning; learning environment and family coexistence at home; and physical and emotional well-being. The findings indicate: greater relevance of information and communication technologies (ICT) as a platform for teaching and receiving classes; improvement of the teaching-learning process; means of social interaction; resources for research on the internet. Moreover, the training of future teachers currently depends on the possession of devices to be able to access training activities; this technological gap makes social inequality increasingly visible. Another important result is that the pandemic tested the capacity of both, students and teachers to restructure and adapt to the virtual context. This is related to the status of most teachers as digital migrants and of students as digital natives. In the case of teachers, they have not yet managed to adapt to the use of teaching strategies in the virtual context, while students mastered ICTs. For those who found their applications and tools for the first time in the context of the pandemic, it was a welcomed learning opportunity. The development of students' creativity during virtual learning was marked by the role assumed by teachers, as a consequence of the intensive use of ICTs that has allowed young people to keep busy and learn while having fun. Teachers have focused more on their use in order to enhance their emotional intelligence to face new and stressful situations in their professional practice. Regarding the family environment, beyond the leading role that families have assumed as facilitators of the teaching-learning process, members may hinder attention, concentration, comprehension, and memorization of knowledge due to the different distractions generated at home. According to some of the teachers in training consulted for this research, student and teacher communication was flexible, and many students have been able to pass every subject. The teachers in training consulted recognized the practices that threaten their physical and emotional well-being and the need to rethink new styles of healthcare for themselves and their families. Finally, it is concluded that the experiences manifested were presented bearing in mind the fundamental categories of the study. Students confirmed the different perceptions on categories that influence their training and the need to advance in an integrative strategy between education and health professionals that incorporates the particularities described for a more inclusive approach to teacher training.

ABSTRACT Introduction: The Resolution No. 16,264/13 of the Ministry of Education and Science (MEC) regulates the procedure and monitoring of school canteens in Paraguay. Its compliance could prevent negative consequences on public health. Objectives: Evaluate compliance to Resolution No. 16,264/13, sale of healthy food and operation of canteens in public schools in Tobatí. Materials and methods: A Cross-sectional study in 11 schools´ canteens. The questionaire was a survey based on Annex 2 of the Resolution and was approved by the FCQ-UNA Research Ethics Committee (242/16). Results: The food handlers of 8/11 canteens stated that they were familiar with Resolution No. 16.264/13 and most of them received the corresponding training. In 8/11 establishments it was found that floors, walls, and ceilings were not in good condition; 6/11 kept food contact surfaces clean; 7/8 had adequate ventilation. In all the canteens, only one staff handled food and money at the same time, most of them did not have the appropriate clothing (cap and apron). Most of the establishments sold sausages and sweet and salty snacks, where fruits and dairy products were also sold, and no vegetable meal menus available, nor were fried foods replaced by baked foods. Conclusion: compliance to Resolution No. 16,264/13 in most of these school canteens was low and the sale of food with high energy content and low nutritional value predominated.

RESUMEN Introducción: La Resolución N° 16.264/13 del Ministerio de Educación y Ciencia (MEC) reglamenta el procedimiento y monitoreo de las cantinas escolares del Paraguay. Su cumplimiento podría prevenir consecuencias negativas en salud pública. Objetivos: Evaluar el cumplimiento de la Resolución N° 16.264/13, venta de alimentos saludables y funcionamiento de cantinas de escuelas públicas de Tobatí. Materiales y métodos: Estudio transversal en las cantinas de 11 escuelas. El instrumento fue una encuesta elaborada en base al Anexo 2 de la mencionada Resolución. Este estudio fue aprobado por el Comité de Ética en Investigación de la FCQ-UNA (Dictamen 242/16). Resultados: Los manipuladores de 8/11 cantinas, afirmaron conocer la Resolución N° 16.264/13 y la mayoría no recibió capacitación correspondiente. En 8/11 establecimientos se constataron que los pisos, paredes y techos no estaban en buen estado; 6/11 mantenían limpias las superficies de contacto con alimentos; 7/8 contaba con ventilación adecuada. En todas las cantinas un solo personal manipula alimentos y dinero en simultáneo, la mayoría de ellos no contaba con la indumentaria adecuada (cofia y delantal). En los establecimientos estudiados, se observó con mayor frecuencia que se comercializaban embutidos y snacks dulces y salados, aunque también frutas y lácteos. No existían minutas con vegetales disponibles ni las preparaciones fritas se reemplazaban por las horneadas. Conclusión: El cumplimiento de la Resolución N° 16.264/13 en la mayoría de estas cantinas escolares fue bajo y en ellas predominó la venta de alimentos con alto contenido energético y escaso valor nutritivo.

Abstract Introduction: Acute kidney injury (AKI) occurs frequently in COVID-19 patients and is associated with greater morbidity and mortality. Knowing the risks of AKI allows for identification, prevention, and timely treatment. This study aimed to identify the risk factors associated with AKI in hospitalized patients. Methods: A descriptive, retrospective, cross-sectional, and analytical component study of adult patients hospitalized with COVID-19 from March 1 to December 31, 2020 was carried out. AKI was defined by the creatinine criteria of the KDIGO-AKI guidelines. Information, regarding risk factors, was obtained from electronic medical records. Results: Out of the 934 patients, 42.93% developed AKI, 60.59% KDIGO-1, and 9.9% required renal replacement therapy. Patients with AKI had longer hospital stay, higher mortality, and required more intensive care unit (ICU) admission, mechanical ventilation, and vasopressor support. Multivariate analysis showed that age (OR 1.03; 95% CI 1.02–1.04), male sex (OR 2.13; 95% CI 1.49–3.04), diabetes mellitus (DM) (OR 1.55; 95% CI 1.04–2.32), chronic kidney disease (CKD) (OR 2.07; 95% CI 1.06–4.04), C-reactive protein (CRP) (OR 1.02; 95% CI 1.00–1.03), ICU admission (OR 1.81; 95% CI 1.04–3.16), and vasopressor support (OR 7.46; 95% CI 3.34–16.64) were risk factors for AKI, and that bicarbonate (OR 0.89; 95% CI 0.84–0.94) and partial pressure arterial oxygen/inspired oxygen fraction index (OR 0.99; 95% CI 0.98–0.99) could be protective factors. Conclusions: A high frequency of AKI was documented in COVID-19 patients, with several predictors: age, male sex, DM, CKD, CRP, ICU admission, and vasopressor support. AKI occurred more frequently in patients with higher disease severity and was associated with higher mortality and worse outcomes.

RESUMO Introdução: Lesão renal aguda (LRA) ocorre frequentemente em pacientes com COVID-19 e associa-se a maior morbidade e mortalidade. Conhecer riscos da LRA permite a identificação, prevenção e tratamento oportuno. Este estudo teve como objetivo identificar fatores de risco associados à LRA em pacientes hospitalizados. Métodos: Realizou-se estudo descritivo, retrospectivo, transversal e de componente analítico de pacientes adultos hospitalizados com COVID-19 de 1º de março a 31 de dezembro, 2020. Definiu-se a LRA pelos critérios de creatinina das diretrizes KDIGO-LRA. Informações sobre fatores de risco foram obtidas de prontuários eletrônicos. Resultados: Dos 934 pacientes, 42,93% desenvolveram LRA, 60,59% KDIGO-1 e 9,9% necessitaram de terapia renal substitutiva. Pacientes com LRA apresentaram maior tempo de internação, maior mortalidade e necessitaram de mais internações em UTIs, ventilação mecânica e suporte vasopressor. A análise multivariada mostrou que idade (OR 1,03; IC 95% 1,02–1,04), sexo masculino (OR 2,13; IC 95% 1,49–3,04), diabetes mellitus (DM) (OR 1,55; IC 95% 1,04–2,32), doença renal crônica (DRC) (OR 2,07; IC 95% 1,06–4,04), proteína C reativa (PCR) (OR 1,02; IC 95% 1,00–1,03), admissão em UTI (OR 1,81; IC 95% 1,04–3,16) e suporte vasopressor (OR 7,46; IC 95% 3,34–16,64) foram fatores de risco para LRA, e que bicarbonato (OR 0,89; IC 95% 0,84–0,94) e índice de pressão parcial de oxigênio arterial/fração inspirada de oxigênio (OR 0,99; IC 95% 0,98–0,99) poderiam ser fatores de proteção. Conclusões: Documentou-se alta frequência de LRA em pacientes com COVID-19, com diversos preditores: idade, sexo masculino, DM, DRC, PCR, admissão em UTI e suporte vasopressor. LRA ocorreu mais frequentemente em pacientes com maior gravidade da doença e associou-se a maior mortalidade e piores desfechos.

ABSTRACT Isoflavonoid composition of freshly harvested soy sprouts of six cultivars grown in Colombia was analyzed. Evaluations on the effect of storage time at 12 °C and exogenous application of the elicitor 2,6-dichloro isonicotinic acid (INA) were carried out to establish their influence in the ability of soy sprouts for synthesizing isoflavonoids. In addition, elicited and non-elicited sprouts of soy cultivar Soy SK-7 was assessed for total phenolic content and antioxidant activity according to the growth stage (VE, VC, and V1) and tissues (cotyledon-epicotyl and hypocotyl-root). Isoflavonoid content and antioxidant capacity were dependent on the cultivar, growth stage, tissue, and storage time at 12 °C. Growth stages VE and V1 and the hypocotyl-root exhibited the highest total phenolic content and antioxidant activity. In general, 6”-O-malonylgenistin, daidzin and genistin were the major constituents in the cultivars. Soy SK-7 and Panorama 358 displayed the highest amounts of 6”-O-malonylgenistin (155.9 µg/g) and daidzin (83.5 µg/g), respectively. Results showed that the isoflavonoids and phenolic contents and antioxidant activity were significantly increased by application of INA. This information can be useful to produce soybean sprouts with increased amounts of bioactive compounds and improved response to abiotic and biotic stresses.

Resumen Este artículo determina la influencia del capital intelectual en el rendimiento financiero de las empresas del sector carrocero en el Ecuador. Para ello se aplica el modelo Coeficiente Intelectual de Valor Añadido (VAIC™) con la información de 96 estados financieros publicados por la Superintendencia de Compañías, Valores y Seguros, que luego de su depuración se redujeron a 43, correspondientes a las 15 empresas carroceras que se mantuvieron activas en el periodo 2014-2019. Este es un estudio descriptivo-explicativo cuyos resultados del análisis de regresión lineal múltiple reportan que el 31,0% del retorno sobre el activo y el 28,6% del retorno sobre el patrimonio son explicados por el VAIC™ y las variables de control, razón de endeudamiento y tamaño de la empresa. Con ello se comprueba la hipótesis de que el capital intelectual influye en el rendimiento financiero de las empresas del sector carrocero del Ecuador.

Abstract This article determines the influence of intellectual capital on the financial performance of companies in the bodybuilding sector in Ecuador. For this, the Value Added Intellectual Coefficient (VAIC™) model is applied with the information of 96 financial statements published by the Superintendence of Companies, Securities and Insurance, which after its purification was reduced to 43, corresponding to the 15 bodywork companies that they remained active in the 2014-2019 period. This is a descriptive - explanatory study whose results of the multiple linear regression analysis report that 31.0% of the return on assets, and 28.6% of the return on equity are explained by the VAIC™ and the control variables, debt ratio and company size. This confirms the hypothesis that intellectual capital influences the financial performance of companies in the bodybuilding sector in Ecuador.

Abstract Swallowing disorders are common clinical data in patients with Wallenberg syndrome, although with a broad clinical spectrum previously described. The objective of the study was to describe the characteristics of the spectrum of oropharyngeal dysphagia presentation in patients with Wallenberg syndrome. We performed a single-center, retrospective study in January 2016 and November 2020 with a series of cases and literature search. Data were collected from eight patients with ischemic spinal injury treated in the Phoniatrics Department of the General Hospital of Mexico. Eight cases were included, aged 28 and 74 years. In the first Fiber-optic Endoscopic Evaluation of Swallowing (FEES), the diagnosis was severe oropharyngeal dysphagia in 7 of the 8 patients (87.5%), compared to the second evaluation where mild oropharyngeal dysphagia was present in four patients, and severe oropharyngeal dysphagia on the other half. Oropharyngeal dysphagia can be found in 51-94% of patients with Wallenberg syndrome. In the first evaluation, difficulty with bolus propulsion of the oral phase in FEES was present in 62.5% of the patients. Still, in the second evaluation, the oral stage was reported with no alterations. Thus, patients could persist with severe dysphagia even passing the month of diagnosis. Wallenberg syndrome is a well-known condition that presents in a very variable way. Dysphagia could be severe, even passing the month after establishing the disease. The evaluation of dysphagia will allow their early rehabilitation and reduce the risk of complications.

Resumen Introducción: La lesión pulmonar inducida por la ventilación mecánica (LPIVM) depende, entre otras variables, de la cantidad de energía -medida en Joules- por unidad de tiempo transferida desde el ventilador al paciente, también llamada poder mecánico. El poder mecánico es una variable de desarrollo, posiblemente asociada a los desenlaces en pacientes sometidos a ventilación. Objetivo: Describir el valor del poder mecánico en pacientes con infección por SARS-CoV-2 y ventilados por otras causas y la relación entre días de ventilación mecánica, estancia en la UCI y mortalidad. Métodos: Estudio multicéntrico, analítico y observacional de cohorte realizado en pacientes con diagnóstico de infección por SARS-CoV-2 que requirieron soporte ventilatorio mecánico invasivo y pacientes ventilados por otras causas, durante más de 24 horas. Resultados: La cohorte incluyó 91 pacientes que recibieron ventilación mecánica en 3 centros de tercer nivel de la ciudad de Pereira, Colombia. El valor promedio del poder mecánico obtenido fue 22,7 ± 1 Joules/min. En el grupo de pacientes con infección por SARS-CoV-2 el valor obtenido fue mayor (26,8 ± 9), comparado con el grupo de pacientes sin infección por SARS-CoV-2 (18,2 ± 1) (p <0,001). Conclusiones: El poder mecánico es una variable importante a tener en cuenta en el monitoreo de la ventilación mecánica. El presente estudio encontró un valor promedio de poder mecánico de 22,7±1 Joules/min, siendo mayor en los pacientes con infección por SARS-CoV-2 en relación con más días de ventilación mecánica y estancia en UCI más prolongada.

Abstract Introduction: The ventilator-induced lung injury (VILI) depends on the amount of energy per minute transferred by the ventilator to the lung measured in Joules, which is called mechanical power. Mechanical power is a development variable probably associated with outcomes in ventilated patients. Objective: To describe the value of mechanical power in patients with SARS-CoV-2 infection and ventilated for other causes and its relationship between days of mechanical ventilation, length of stay in the intensive care unit (ICU), and mortality. Methods: A multicenter, analytical, observational cohort study was conducted in patients with SARS-CoV-2 infection who required invasive mechanical ventilation and patients ventilated for other causes for more than 24 hours. Results: The cohort included 91 patients on mechanical ventilation in three tertiary care centers in the city of Pereira, Colombia. The average value of the mechanical power found was 22.7 ± 1 Joules/ min. In the subgroup of patients with SARS-CoV-2 infection, the value of mechanical power was higher 26.8 ± 9 than in the subgroup of patients without a diagnosis of SARS-CoV-2 infection 18.2 ± 1 (p <0.001). Conclusions: Mechanical power is an important variable to consider during the monitoring of mechanical ventilation. This study found an average value of mechanical power of 22.7 ± 1 Joules/min, being higher in patients with SARS-CoV-2 infection related to longer days of mechanical ventilation and a longer stay in the ICU.

Abstract Introduction: There are aspects of COVID-19 pathogenesis that are still unknown. Objective: To determine the relationship between severity, mortality and viral replication in patients with COVID-19. Methods: Clinical characteristics, severity and mortality of 203 patients hospitalized for COVID-19 were analyzed and correlated with viral load (VL) and threshold cycle (TC) at admission; nasopharyngeal swab was obtained. Results: Mean VLs in surviving patients with mild to moderate, moderate to severe and severe disease were the following: 6.8 × 106, 7.6 × 107 and 1.0 × 109, respectively; and in patients with critical disease who died, VL was 1.70 × 109. TCs were 26.06, 24.07, 22.66 and 21.78 for the same groups. In those who died, a higher mean VL was observed at admission in comparison with those who survived (1.7 × 109 vs 9.84 × 106; p < 0.001). A significant correlation was observed between VL, severity and death (r = 0.254, p < 0.045 and r = 0.21, p < 0.015). High VL was associated with increased in-hospital mortality in comparison with low VL (OR = 2.926, p < 0.017). Conclusion: SARS-CoV-2 VL determined at hospital admission might classify risk simultaneously with other factors described in COVID-19.

Resumen Introducción: Aún se desconocen aspectos de la patogenia de COVID-19. Objetivo: Determinar la relación entre gravedad, mortalidad y replicación viral en pacientes con COVID-19. Métodos: Se analizaron características clínicas, gravedad de la enfermedad y mortalidad de 203 pacientes hospitalizados por COVID-19 y se correlacionaron con carga viral (CV) y ciclo umbral (Ct) al ingreso; se tomó hisopado nasofaríngeo. Resultados: Las CV medias en los pacientes sobrevivientes fueron las siguientes ante enfermedad leve a moderada, moderada a grave y grave: 6.8 × 106, 7.6 × 107 y 1.0 × 109; y en los pacientes con enfermedad crítica que fallecieron, la CV fue de 1.70 × 109. Los Ct fueron 26.06, 24.07, 22.66 y 21.78 para esos mismos grupos. En quienes fallecieron se observó mayor CV media al ingreso en comparación con quienes sobrevivieron (1.7 × 109 versus 9.84 × 106), p < 0.001. Se evidenció correlación significativa entre CV, gravedad y muerte (r = 0.254, p < 0.045 y r = 0.21, p < 0.015). La CV alta se asoció a mayor mortalidad intrahospitalaria en comparación con la CV baja (RM = 2.926, p < 0.017). Conclusión: La CV de SARS-CoV-2 determinada al ingreso hospitalario podría calificar el riesgo simultáneamente con otros factores descritos en COVID-19.

Resumen La neuroinmunología es una disciplina que cada vez amplía más sus horizontes en la comprensión de las enfermedades neurológicas. Contemporáneamente, y a la luz de los nexos fisiopatológicos de las enfermedades neurológicas y la inmunología, se han planteado enfoques diagnósticos y terapéuticos específicos. A pesar de los importantes avances de esta disciplina, existen múltiples dilemas que le conciernen y se filtran en la práctica clínica. En esta revisión, se presentan y discuten 15 controversias, las cuales se construyen con la información clínica disponible más actualizada. Los temas incluidos son: disminución de esteroides en recaídas de esclerosis múltiple; recomendaciones terapéuticas en esclerosis múltiple a la luz de la pandemia por el SARS-CoV-2; evidencia de vacunación en esclerosis múltiple y en otras enfermedades desmielinizantes; panorama actual del síndrome clínico y radiológico aislado; y fallas terapéuticas en esclerosis múltiple; además, criterios para suspender las terapias modificadoras de la enfermedad; evidencia del manejo en recaídas leves; recomendaciones para la profilaxis contra Strongyloides stercolaris; utilidad de un segundo ciclo de inmunoglobulina en el síndrome de Guillain-Barré; criterios para diferenciar una polineuropatía crónica desmielinizante inflamatoria de inicio agudo de un síndrome de Guillain-Barré y, utilidad de la enzima convertidora de angiotensina en neurosarcoidosis. En cada una de las controversias, se presenta la problemática general y se ofrecen recomendaciones específicas que pueden adoptarse en la práctica clínica diaria.

Abstract Neuroimmunology is a discipline that increasingly broadens its horizons in the understanding of neurological diseases. At the same time, and in front of the pathophysiological links of neurological diseases and immunology, specific diagnostic and therapeutic approaches have been proposed. Despite the important advances in this discipline, there are multiple dilemmas that concern and filter into clinical practice. This article presents 15 controversies and a discussion about them, which are built with the most up-to-date evidence available. The topics included in this review are: steroid decline in relapses of multiple sclerosis; therapeutic recommendations in MS in light of the SARS-CoV-2 pandemic; evidence of vaccination in multiple sclerosis and other demyelinating diseases; overview current situation of isolated clinical and radiological syndrome; therapeutic failure in multiple sclerosis, as well as criteria for suspension of disease-modifying therapies; evidence of the management of mild relapses in multiple sclerosis; recommendations for prophylaxis against Strongyloides stercolaris; usefulness of a second course of immunoglobulin in the Guillain-Barré syndrome; criteria to differentiate an acute-onset inflammatory demyelinating chronic polyneuropathy versus Guillain-Barré syndrome; and, the utility of angiotensin-converting enzyme in neurosarcoidosis. In each of the controversies, the general problem is presented, and specific recommendations are offered that can be adopted in daily clinical practice.

Resumen La necrosis apical bacteriana del mango es una enfermedad crítica reportada principalmente en Europa, que se caracteriza por la generación de lesiones necróticas en yemas y hojas, las cuales se extienden a través de los peciolos hacia los tallos. Su incidencia resulta en pérdidas económicas importantes debido a una disminución de la producción. Los agentes causales conocidos de esta enfermedad son las bacterias Pseudomonas syringae y Pantoea spp., que sobreviven como epífitas en la superficie de las plantas. En un cultivo de mango cv. Keitt de dos años, establecido en la Corporación Colombiana de Investigación Agropecuaria (AGROSAVIA), Centro de Investigación Motilonia, se evidenciaron síntomas de necrosis en yemas, hojas y ramas. Las plantas de mango se vieron afectadas de forma descendente hasta su muerte a los 30 días después los primeros síntomas. Se tomaron cinco muestras de tejido foliar afectado y pecíolos para aislar el agente causal y generar un diagnóstico a fin de realizar un manejo preciso de la enfermedad. Las muestras se desinfectaron superficialmente y se incubaron en cámara húmeda y medios de cultivo por tres días. Después de la incubación, las hifas, los exudados y las colonias bacterianas se sembraron en medios de cultivo sólidos. Los aislamientos obtenidos se caracterizaron a nivel morfológico y bioquímico. Los resultados arrojaron la presencia de bacterias identificadas como Pantoea spp. por amplificación y secuenciación de la región que codifica para la subunidad 16S del ARNr. Las pruebas de patogenicidad in vitro sugieren preliminarmente a Pantoea spp. como el agente causal de la enfermedad. Este trabajo es el primer reporte de necrosis apical por Pantoea spp. en mango para Colombia.

Abstract Bacterial apical necrosis of mango (Mangifera indica L.) is an acute disease reported mainly in Southern Europe, characterized by the generation of necrotic lesions in buds and leaves that spread through the petioles towards the stems. Its incidence results in significant economic losses due to a decrease in production. Known causative agents of this disease are the bacteria Pseudomonas syringae and Pantoea spp., which survive as epiphytes on plant surfaces. In a two-year-old mango cv. Keitt orchard, established at the Colombian Corporation for Agricultural Research (AGROSAVIA), Motilonia Research Station, mango trees exhibited symptoms of necrosis in buds, leaves, and branches. The mango plants were affected downwards, causing their death 30 days after the first symptoms. Five samples of affected leaf tissue and petioles were taken to isolate the causative agent and make a diagnosis to manage the disease properly. The samples were superficially disinfected and incubated in a humid chamber and culture media for three days. After incubation, hyphae, exudates, and bacterial colonies were plated on solid culture media. The isolates obtained were characterized morphologically and biochemically. The results showed the presence of bacteria identified as Pantoea spp. by amplifying and sequencing the region coding for the 16S subunit of rRNA. In vitro pathogenicity tests preliminarily suggest Pantoea spp. as the causative agent of the disease. This work is the first report of apical necrosis by Pantoea spp. in mango for Colombia.