ABSTRACT Background: The primary aim of this study is to assess the survival rates of individuals diagnosed with Community-Acquired Pneumonia (CAP) post-hospitalization in Colombia. Additionally, explore potential risk factors associated with decreased long-term survival. Methods: A retrospective cohort study was conducted in a hospital in Colombia, evaluating survival at 3, 6 and 12 months in CAP patients, using the Kaplan-Meier method. Stratifications were made by age, sex, comorbidity, and severity. The comparison of survival curves was performed using the Log-Rank test, a multivariate analysis with Cox regression was performed to study possible risk factors that affected 12-month survival in patients with CAP. Results: 3688 subjects were admitted, with a mortality of 16.3 % per year. Survival at three, six, and twelve months was 92.9 % (95 % CI 92–93 %), 88.8 % (95 % CI 87–90 %), and 84.2 % (95 % CI 82–85 %), respectively. Analysis stratified by pneumonia severity index, 12-month survival was 98.7 % in Class I, 95.6 % in Class II, 87.41 % in Class III, 77.1 % in Class IV, and 65.8 % in class-V (p < 0.001). Cox-regression showed that being male (HR = 1.44; 95 % CI 1.22–1.70; p < 0.001), an elevated pneumonia severity index (HR = 4.22; 95 % CI 1.89–9.43; p < 0.001), a high comorbidity index (HR = 2.29; 95 % CI 1.89–2.84; p < 0.001) and vasopressor requirement (HR = 2.22; 95 % CI < 0.001) were associated with a lower survival at twelve months of follow-up. Conclusion: Survival in patients with CAP who require hospitalization decreases at 3, 6, and 12 months of follow-up, being lower in patients older than 65 years, men, high comorbidity, and in subjects with severe presentation of the disease. Background CommunityAcquired Community Acquired (CAP posthospitalization post Colombia Additionally longterm long term Methods 3 1 KaplanMeier Kaplan Meier method age sex LogRank Log Rank test 12month month Results 368 admitted 163 16 16. year three six 929 92 9 92. (9 9293 93 92–9 %, , %) 888 88 8 88. 8790 87 90 87–9 842 84 2 84. 8285 82 85 82–8 respectively 987 98 7 98. I 956 95. II 8741 41 87.4 III 771 77 77. IV 658 65. classV class V 0.001. 0001 0.001 . 0 001 Coxregression HR 1.44 144 44 1.22–1.70 122170 22 70 0.001, 4.22 422 4 1.89–9.43 189943 89 43 2.29 229 29 1.89–2.84 189284 2.22 222 followup. followup follow up. up follow-up Conclusion followup, up, years men disease 36 ( 92– 879 87– 828 82– 874 87. 000 0.00 00 1.4 14 1.22–1.7 12217 4.2 42 1.89–9.4 18994 2.2 1.89–2.8 18928 0.0 1. 1.22–1. 1221 4. 1.89–9. 1899 2. 1.89–2. 1892 0. 1.22–1 122 1.89–9 189 1.89–2 1.22– 1.89– 18 1.22 1.89 1.2 1.8

ABSTRACT A urinary sediment is a tool used for years to characterize renal manifestations of primary and secondary diseases, which requires standardization and learning to interpret it. In patients admitted to the intensive care unit, it is often not performed, or several factors must be taken into account for its interpretation due to the patient's hemodynamic status, glomerular filtration, tubular excretion, water reabsorption, and solutes. In addition to the acid-base balance, which can vary significantly in critically ill patients with different pathophysiological conditions? A review of the conditions for the interpretation of urinalysis is presented.

RESUMEN El sedimento urinario es una herramienta utilizada hace tantos años para caracterizar manifestaciones renales de enfermedades primarias y secundarias, que es necesario realizar una estandarización y aprender a interpretar el mismo. En los pacientes ingresados a la unidad de cuidados intensivos, muchas veces no se realiza, o hay que tener en cuenta varios factores para su interpretación debido al estado hemodinámico del paciente a la filtración glomerular, la excreción tubular, la reabsorción de agua y los solutos además del equilibrio acido-base, los cuales pueden variar significativamente en pacientes en estado crítico con diferentes condiciones fisiopatológicas. Se presenta una revisión de las condiciones para la interpretación del urianálisis.

ABSTRACT The goal of this research was to economically assess the implementation of an improvement program with four intervention areas in El Chico National Park, Hidalgo, Mexico. This study utilized the methodology of discrete choice experiments, which was conducted with 23 participants using the citizen’s jury approach. By means of a mixed logit model, it was found that the total willingness to pay for the implementation of the improvements in the park was $0.95 USD above the current rate. The most valued area of intervention was regulation of visits, followed by actions to improve forest health and the continuous training of guards. The levels of intervention related to fuel management were not significant. These preferences must be considered by the decision-makers and administrators of the park in order to integrate the opinions of the people who live in this protected natural area and its zone of influence and decide whether they coincide with its conservation goals, in accordance with current environmental legislation..

RESUMEN El objetivo de la presente investigación fue valorar económicamente la implementación de un programa de mejoras con cuatro áreas de intervención en el Parque Nacional El Chico, en Hidalgo, México. Se aplicó la metodología de experimentos de elección discreta usando el enfoque de jurado de ciudadanos con 23 participantes. Mediante un modelo logit mixto se encontró que la disponibilidad a pago total por la implementación de las mejoras en el parque fue de $0,95 USD, lo que representa un 50 % por arriba de la tarifa vigente al momento de la aplicación del ejercicio. El área de intervención más valorada fue la sanidad forestal, seguida de la regulación del turismo y, en tercer lugar, la capacitación a los vigilantes de manera continua. Los niveles de intervención relacionados con el manejo de combustibles no resultaron significativos. Estas preferencias deberán ser consideradas por los tomadores de decisiones y administradores del Parque con la finalidad de que integren las opiniones de los pobladores que habitan en esta área natural protegida y su zona de influencia, y decidir su coincidencia con los propósitos de conservación del mismo, de acuerdo con lo previsto por la legislación ambiental vigente.

RESUMEN Introducción: La pandemia de la COVID-19 ha generado problemas de salud física y mental en los universitarios. Objetivos: Determinar la relación entre nivel de actividad física y estado de ánimo en estudiantes universitarios durante el confinamiento por la COVID-19. Métodos: Participaron 215 estudiantes universitarios, edad 22,09 ± 2,61 (108 mujeres y 107 hombres) durante el confinamiento por la COVID-19. Fueron aplicados instrumentos en formato digital durante el mes de junio del año 2020. El nivel de actividad física se evaluó utilizando el Cuestionario Internacional de Actividad Física (IPAQ), forma corta, y el estado de ánimo se evaluó con la Escala de Valoración del Estado de Ánimo (EVEA). Resultados: Estado de ánimo alegría presentó una correlación positiva significativa con todas las variables de actividad física, excepto con tiempo sentado. Estado de ánimo tristeza-depresión presentó una correlación negativa con equivalente metabólico de actividad física vigorosa (r -0,201; p= 0,003) y equivalente metabólico total (r -0,172; p= 0,011). Estado de ánimo ansiedad se correlacionó negativamente con equivalente metabólico de actividad física vigorosa (r -0,163; p= 0,017) y equivalente metabólico total (r -0,162; p= 0,018). Conclusiones: El nivel de actividad física se relaciona positivamente con el estado de ánimo, principalmente con el nivel de alegría, sin embargo, estas correlaciones presentan un tamaño del efecto pequeño.

ABSTRACT Introduction: The COVID-19 pandemic has generated physical and mental health problems in university students. Objectives: To determine the relationship between physical activity level and mood in university students during COVID-19 confinement. Methods: 215 university students aged 22.09 ± 2.61 (108 women and 107 men) participated during the confinement due to the COVID-19 pandemic. Instruments in digital format were applied during the month of June 2020. Physical activity level was assessed using the International Physical Activity Questionnaire (IPAQ) short form and mood was assessed using the Mood Rating Scale (EVEA). Results: Mood joy presents a significant positive correlation with all variables of physical activity, except with sitting time. Sadness-depression mood showed a negative correlation with metabolic equivalent of vigorous physical activity (r -0.201; p= 0.003) and total metabolic equivalent (r -0.172; p= 0.011). Mood anxiety was negatively correlated with metabolic equivalent of vigorous physical activity (r -0.163; p= 0.017) and total metabolic equivalent (r -0.162; p= 0.018). Conclusions: The level of physical activity is positively related to mood, mainly with the level of joy, however, these correlations have a small effect size.

Abstract Coronary artery disease (CAD) and ischemic heart disease (IHD) are often indistinctly used terms. Both combined have generated, over the past years, concerns about sex disparities in their presentation. From an epidemiological perspective, females have several disadvantages regarding the prevention, diagnosis, and treatment of CAD. Most of the general cardiovascular risk factors affect women more frequently, or with a higher morbidity and mortality association. Besides, atypical manifestations of the disease and uncommon forms of CAD represent a diagnostic challenge for clinicians. Even if current treatments for CAD have no apparent sex bias, women representation in clinical trials and treatment patterns analyzed in clinical practice refuse this statement. Several disparities are caused by inevitable sex-particularities, but many of them are more social, cultural, and dogmatic beliefs that have to be addressed and overhaul. (CAD IHD (IHD terms generated years presentation perspective prevention diagnosis frequently association Besides clinicians bias statement sexparticularities, sexparticularities particularities, particularities sex-particularities social cultural overhaul

ABSTRACT Introduction: Superposing 3D models is an imminent need. However, current methods rely on marking multiple points on the maxilla and mandible, which could increase point marking and overlapping errors. Objective: This study aimed at developing a method for superimposing 3D models of the maxillary and mandibular arches with Autodesk Inventor® engineering software, using a single universal coordinate system (UCS) point superposition. Methods: A total of 104 STL (stereolithography) models of the maxillary and mandibular arches exported from My iTero® platform were retrospectively selected, in which T0 and T1 were the initial and refinement periods, respectively (n=26 per group). The X, Y, and Z coordinates associated with a single point in each arch were inserted into the models with SlicerCMF® software for model orientation. The arch models with UCS registration were transferred to Autodesk Inventor® for superimposition and to measure tooth movements performed during Invisalign® treatment. Arch expansion, intrusion and rotation were analyzed by two examiners. The statistics were performed using intraclass correlation coefficients (ICC), Dahlberg’s formula, and t-test (p<0.05). Results: A reliable method of superimposing 3D digital models using a single UCS point in the maxilla and mandible was developed. ICC showed excellent intra- and inter-examiner correlation (ICC>0.90). A systematic error was not found concerning linear and angular measurements (<1mm and <1.5°, respectively). Digital dental movements could be analyzed, including arch expansion, dental intrusion, and tooth rotation. Conclusions: The developed method was proven reliable and reproducible for superimposing 3D models of the maxillary and mandibular arches by using UCS system. Introduction D need However errors Objective Inventor (UCS superposition Methods 10 stereolithography (stereolithography iTero selected T periods n=26 n26 n 26 (n=2 group. group . group) X Y SlicerCMF orientation Invisalign treatment expansion examiners ICC, , (ICC) Dahlbergs Dahlberg s formula ttest t test p<0.05. p005 p p<0.05 0 05 (p<0.05) Results intra interexaminer inter examiner ICC>0.90. ICC090 ICC>0.90 90 (ICC>0.90) <1mm 1mm mm 15 1 5 <1.5° respectively. respectively) Conclusions n=2 n2 2 (n= (ICC p00 p<0.0 (p<0.05 ICC09 ICC>0.9 9 (ICC>0.90 <1.5 n= (n p0 p<0. (p<0.0 ICC0 ICC>0. (ICC>0.9 <1. p<0 (p<0. ICC>0 (ICC>0. <1 p< (p<0 ICC> (ICC>0 < (p< (ICC> (p

RESUMO Introdução: A sobreposição de modelos 3D é uma necessidade iminente. No entanto, os métodos atuais dependem da marcação de múltiplos pontos na maxila e na mandíbula, o que pode aumentar a incorporação de erros no processo de sobreposição. Objetivo: O objetivo desse estudo foi desenvolver um método para sobrepor modelos 3D das arcadas superior e inferior utilizando o software de engenharia Autodesk Inventor®, por meio da marcação de um único ponto em cada arcada, usando o sistema de coordenadas universal (UCS). Métodos: No total, 104 modelos STL das arcadas superior e inferior exportados da plataforma My iTero® foram selecionados retrospectivamente, onde T0 foi o período inicial e T1, o de refinamento (n=26 por grupo). As coordenadas X, Y e Z associadas a um único ponto em cada arcada foram inseridas nos modelos usando o software SlicerCMF®. Os modelos com os pontos UCS demarcados foram transferidos para o software Autodesk Inventor® para realizar a sobreposição e medir os movimentos dentários realizados durante o tratamento com Invisalign®. Os movimentos de expansão, intrusão e rotação foram analisados por dois examinadores. A análise estatística foi realizada usando os coeficientes de correlação intra-classe (ICC), fórmula de Dahlberg e teste t (p<0,05). Resultados: Foi desenvolvido um método confiável de sobreposição de modelos digitais 3D usando um único ponto UCS na maxila e mandíbula. O ICC apresentou excelente correlação intra e inter-avaliadores (ICC>0,90). Não foi encontrado erro sistemático nas medidas lineares e angulares (<1mm e <1,5°, respectivamente). Os movimentos dentários puderam ser analisados por meio do método proposto, incluindo expansão da arcada, intrusão e rotação dentária. Conclusão: O método desenvolvido provou ser confiável e reprodutível para sobreposição de modelos 3D das arcadas superior e inferior usando o sistema UCS com marcação de ponto único. Introdução D iminente entanto mandíbula Objetivo Inventor UCS. . (UCS) Métodos total 10 iTero retrospectivamente T T1 n=26 n26 n 26 (n=2 grupo. grupo grupo) X SlicerCMF SlicerCMF® Invisalign Invisalign® examinadores intraclasse classe ICC, , (ICC) p<0,05. p005 p p<0,05 0 05 (p<0,05) Resultados interavaliadores inter avaliadores ICC>0,90. ICC090 ICC>0,90 90 (ICC>0,90) <1mm 1mm mm 15 1 5 <1,5° respectivamente. respectivamente respectivamente) proposto dentária Conclusão (UCS n=2 n2 2 (n= (ICC p00 p<0,0 (p<0,05 ICC09 ICC>0,9 9 (ICC>0,90 <1,5 n= (n p0 p<0, (p<0,0 ICC0 ICC>0, (ICC>0,9 <1, p<0 (p<0, ICC>0 (ICC>0, <1 p< (p<0 ICC> (ICC>0 < (p< (ICC> (p

Resumen Las neoplasias apendiculares se presentan hasta en el 50 % de los casos como un episodio de apendicitis aguda. Existen características demográficas, clínicas y radiológicas que aumentan las posibilidades de un tumor apendicular subyacente, sin embargo, en la mayoría de los casos, son los hallazgos intraoperatorios los que alertan al cirujano. A pesar de que el tipo histológico determina la radicalidad del manejo quirúrgico de estos pacientes, algunas características macroscópicas pueden orientar a las patologías específicas y a una conducta adecuada. En general, los objetivos del manejo quirúrgico inicial se cumplen con una resección limitada al apéndice cecal, asociada a la citología de mucina y biopsia de los implantes peritoneales si están presentes, reservando las resecciones extendidas, como hemicolectomía derecha oncológica, para los pacientes con compromiso extenso de la base o del mesenterio apendicular ante la sospecha de neoplasias neuroendocrinas o adenocarcinoma del apéndice cecal.

Abstract Appendicular neoplasms present in up to 50% of cases as an episode of acute appendicitis. There are demographic, clinical and radiological characteristics that increase the chances of an underlying appendicular tumor; however, in most cases are the intraoperative findings that alert the surgeon. Although the histological type determines the radical nature of the surgical management of these patients, some macroscopic characteristics can guide specific pathologies and appropriate behavior. In general, the objectives of initial surgical management are met with a limited resection of the cecal appendix, associated with mucin cytology and biopsy of peritoneal implants if present, reserving extended resections such as oncological right hemicolectomy for patients with extensive compromise of the base or appendicular mesentery when neuroendocrine neoplasms or adenocarcinoma of the cecal appendix are suspected.

Resumen La posibilidad de encontrar una neoplasia benigna o maligna del ovario, de forma inesperada durante una intervención quirúrgica abdominal, es una realidad para todos los especialistas en cirugía. Si bien en muchos casos se tratará de una lesión benigna, el riesgo de cáncer no debe subestimarse, ya que, por ejemplo, la ruptura intraoperatoria de una lesión quística maligna puede reestadificar a una paciente con cáncer de ovario del estadio IA al IC, con todas las consecuencias que esto implica, como la necesidad de requerir quimioterapia adyuvante y tener un peor pronóstico. Por otro lado, en mujeres premenopáusicas debe discutirse con la familia o la paciente (idealmente) el riesgo e implicaciones de la ooforectomía uni o bilateral, incluso si esto amerita dejar el quirófano para obtener el consentimiento, o posponer el procedimiento definitivo para un segundo tiempo. La consulta intraoperatoria a un ginecólogo, siempre que sea posible, se debe llevar a cabo con el fin de respaldar la conducta adoptada. Conocer el manejo adecuado de las masas anexiales encontradas de forma incidental durante una cirugía abdominal, es una prioridad para todos los cirujanos generales.

Abstract The possibility of finding a benign or malignant neoplasm of the ovary unexpectedly during abdominal surgery is a reality for all specialists in surgery. Although in many cases it will be a benign lesion, the risk of cancer should not be underestimated, since, for example, the intraoperative rupture of a malignant cystic lesion may well re-stage a patient with ovarian cancer from stage IA to IC, with the consequences that this implies, such as the need for adjuvant chemotherapy and a worse prognosis. On the other hand, in premenopausal women, the risk and implications of unilateral or bilateral oophorectomy should be discussed with the family or the patient (ideally), even if this implies leaving the operating room to obtain consent, or postponing the definitive procedure for a second time. Intraoperative consultation with a gynecologist, whenever possible, should be carried out in order to support the adopted behavior. Knowing the proper management of adnexal masses found incidentally during abdominal surgery is a priority for all general surgeons.

ABSTRACT The main aim of this paper is to describe the development and validation of a new test apparatus for measuring complex stiffness modulus and fatigue of asphalt mix, so-called FADECOM. Both evaluations are executed with cyclic loading and continuous modes, in order to demonstrate the effectiveness of test results when applied to asphalt pavement design solutions. Results obtained with the new apparatus are compared to existing methods designed on the same mechanical principles, and which are already calibrated and taken as international standardized references. Methods presented in this paper are based on Discrete Fourier Transform (DFT) analysis of data recorded by the test apparatus; a parametric code which executes the analysis was implemented in C++. Interlaboratory comparisons of test results with FADECOM indicate random deviations of approximately 3 microstrains (x 10-6 µdef) for determination of fatigue strain at 106 cycles, and less than 10% relative difference for complex stiffness modulus. Agreement with FADECOM demonstrates direct applicability of the new method for obtaining accurate data for dynamic numerical simulations comprising asphalt pavement design.

Abstract The moral values of good living Sumak Kawsay related to the respect for the Quichua language and culture represent a fundamental tool in Ecuadorian society and in school context. Therefore, the main objective of this study seeks to learn more about common and differentiating elements from the opinions of teachers and from the contents of textbooks in Ecuador. The research project was carried out in an indigenous community with 60 indigenous teachers of the rural school Mushauk Rimak located in San Lucas. A qualitative method was applied to the analysis of semi-open interviews in Spanish with the participating teachers. The results indicate that San Lucas teachers impart to students the values of respect for language and culture associated with the moral values of Sumak Kawsay. This aspect of the program is also reflected in the teaching materials in Quichua, component of the implementation of bilingual-intercultural education in the indigenous communities at the national level. The conclusion of the study points to the value of Sumak Kawsay as reflected in the content of textbooks and the efforts of teachers to revitalize the Quichua language and transmit the language to students despite the possibility that the bilingual program does not enjoy acceptance by all parents in this locality.

Resumen Los valores morales de buen vivir Sumak Kawsay relacionado con el respeto por la lengua y cultura quichua representan una herramienta fundamental en la sociedad ecuatoriana y en el contexto escolar. Consecuentemente con esta idea, el objetivo principal de este trabajo es averiguar los elementos comunes y diferenciadores entre las opiniones del profesorado indígena y los contenidos de los libros de texto de diferentes materias escolares de Ecuador. La investigación se desarrolló en un contexto indígena ecuatoriano con 60 docentes indígenas de la escuela rural Mushuk Rimak ubicada en la parroquia de San Lucas. Se utilizó la investigación cualitativa mediante las entrevistas semiabiertas en lengua castellana, que se realizaron a todos los docentes participantes. Los resultados indican que, en la comunidad indígena de San Lucas, los docentes transmiten al alumnado el valor del respeto por la lengua y cultura quichua vinculado con los valores morales del Sumak Kawsay. Este aspecto está reflejado también en los materiales educativos en quichua gracias a la política de implementación de educación bilingüe intercultural en los pueblos indígenas a nivel nacional en Ecuador. Las conclusiones destacan el valor del Sumak Kawsay en los libros de textos y la labor de los docentes de rescatar el idioma quichua y transmitirlo al alumnado a pesar que la aceptación del programa bilingüe no es unánime entre los padres y las madres de familia de esta localidad.

Resumen La colangiopancreatografía retrógrada endoscópica (CPRE) es uno de los procedimientos endoscópicos más complejos y ampliamente utilizados. El equipo encargado de realizar una CPRE debe ofrecer la máxima eficiencia y seguridad durante el procedimiento. Para lograr calidad en la realización de CPRE deben establecerse indicadores de calidad. El presente manuscrito es el consenso desarrollado por la AMEG sobre indicadores de calidad en atención de la salud al efectuar una CPRE. Dichos indicadores se establecen dentro de un marco conceptual que toma en cuenta la evidencia científica disponible en la actualidad y la disponibilidad de recursos en nuestro país.

Abstract Endoscopic Retrograde Cholangiopancreatography (ERCP) is one of the most complex and widely used endoscopic procedures. The team that performs an ERCP must offer maximum efficiency and safety during the procedure. To achieve quality in the performance of an ERCP, quality indicators must be established. This manuscript is the consensus developed by the AMEG on quality indicators in health care when implementing ERCP. These indicators are established within a conceptual framework that takes into account the currently available scientific evidence and the availability of resources in our country.

Abstract Héctor Abad-Gómez, Colombian physician, university professor, journalist and human rights defender, was murdered in Medellín in 1987. He was a pioneer public health activist engaged in various fields. While being student his restless and dissatisfied mind, led him to fight for a better and safer water and food. He specialized in the University of Minnesota (USA), at his return to the country he led the establishment of the Rural Medical Service. Forced to exile for several years he was WHO consultant to several countries in the Americas and Asia. In 1956 he founded the Preventive Medicine and Public Health Department of the University of Antioquia. He carried out the first recorded mass community vaccination against polio in the world. He initiated a community health agents program known as “Rural health promoters” that later would be implemented nationally. In 1962 he first proposed the application of epidemiological methods to study violence; he was visiting professor at the University of California; he coined the term “polyiatry” for a specialty dedicated to the health populations; he was director of the Colombian National School of Public Health that currently bears his name. Héctor Abad-Gómez ventured into political life, in accordance with Virchow dictum that “politics is medicine on a large scale”. The lives of both have interesting similarities except for the tragic and premature death of the former that still receives rejection today in social, political and academic levels, both in Colombia and abroad.

Resumen Héctor Abad Gómez, médico salubrista colombiano, profesor universitario, periodista y defensor de los derechos humanos, fue asesinado en Medellín en 1987. Fue pionero de la salud pública en sus diversos campos, inquieto e inconforme, comprometido desde su vida estudiantil en la lucha por el agua potable y por los alimentos inocuos. Se especializó en la Universidad de Minnesota (EE.UU.) y a su regreso al país lideró el establecimiento del servicio médico rural. En el exilio por varios años, fue consultor de la Organización Mundial de la Salud para varios países de América y Asia. En 1956, de nuevo en Colombia, fundó el Departamento de Medicina Preventiva y Salud Pública de la Universidad de Antioquia, realizó la primera vacunación masiva registrada contra la poliomielitis en el mundo e inició el programa de agentes comunitarios de salud, conocido como «promotoras rurales de salud», que se implementó en todo el país. En 1962 propuso por primera vez en el mundo estudiar la violencia aplicando el método epidemiológico, y la «poliatría» como especialidad dedicada a la salud de las poblaciones. Fue director de la Escuela Nacional de Salud Pública que actualmente lleva su nombre. Fue profesor visitante en la Universidad de California. Para él, como decía Virchow, «la política es medicina a gran escala», y por ello incursionó en la vida política. Las vidas de ambos tienen interesantes similitudes, excepto la forma trágica de la prematura muerte de Héctor Abad Gómez, que todavía hoy recibe el rechazo en todos los estamentos sociales, políticos y académicos, tanto en Colombia como en el extranjero.

Abstract Héctor Abad-Gómez, Colombian physician, university professor, journalist and human rights defender, was murdered in Medellín in 1987. He was a pioneer public health activist engaged in various fields. While being student his restless and dissatisfied mind, led him to fight for a better and safer water and food. He specialized in the University of Minnesota (USA), at his return to the country he led the establishment of the Rural Medical Service. Forced to exile for several years he was WHO consultant to several countries in the Americas and Asia. In 1956 he founded the Preventive Medicine and Public Health Department of the University of Antioquia. He carried out the first recorded mass community vaccination against polio in the world. He initiated a community health agents program known as “Rural health promoters” that later would be implemented nationally. In 1962 he first proposed the application of epidemiological methods to study violence; he was visiting professor at the University of California; he coined the term “polyiatry” for a specialty dedicated to the health populations; he was director of the Colombian National School of Public Health that currently bears his name. Héctor Abad-Gómez ventured into political life, in accordance with Virchow dictum that “politics is medicine on a large scale”. The lives of both have interesting similarities except for the tragic and premature death of the former that still receives rejection today in social, political and academic levels, both in Colombia and abroad.

Resumen Héctor Abad Gómez, médico salubrista colombiano, profesor universitario, periodista y defensor de los derechos humanos, fue asesinado en Medellín en 1987. Fue pionero de la salud pública en sus diversos campos, inquieto e inconforme, comprometido desde su vida estudiantil en la lucha por el agua potable y por los alimentos inocuos. Se especializó en la Universidad de Minnesota (EE.UU.) y a su regreso al país lideró el establecimiento del servicio médico rural. En el exilio por varios años, fue consultor de la Organización Mundial de la Salud para varios países de América y Asia. En 1956, de nuevo en Colombia, fundó el Departamento de Medicina Preventiva y Salud Pública de la Universidad de Antioquia, realizó la primera vacunación masiva registrada contra la poliomielitis en el mundo e inició el programa de agentes comunitarios de salud, conocido como «promotoras rurales de salud», que se implementó en todo el país. En 1962 propuso por primera vez en el mundo estudiar la violencia aplicando el método epidemiológico, y la «poliatría» como especialidad dedicada a la salud de las poblaciones. Fue director de la Escuela Nacional de Salud Pública que actualmente lleva su nombre. Fue profesor visitante en la Universidad de California. Para él, como decía Virchow, «la política es medicina a gran escala», y por ello incursionó en la vida política. Las vidas de ambos tienen interesantes similitudes, excepto la forma trágica de la prematura muerte de Héctor Abad Gómez, que todavía hoy recibe el rechazo en todos los estamentos sociales, políticos y académicos, tanto en Colombia como en el extranjero.

Abstract Purpose: Aicardi syndrome was originally described in 1965, as a triad of abnormalities that includes partial or total agenesis of the corpus callosum, chorioretinal lacunae, and infantile spasms. Case report: A 1-month-old female was evaluated in the Genetics department with a history of epilepsy, total agenesis of the corpus callosum, and vertebral dysgenesis with scoliosis identified during a previous neurological evaluation. An ophthalmological examination revealed microphthalmia of the right eye and microcornea in the left eye; the rest of the anterior segment showed no alterations. Fundoscopy revealed chorioretinal lesions compatible with chorioretinal lacunae that integrated the diagnosis of Aicardi syndrome. Conclusions: We emphasize the importance of a careful ophthalmologic examination in all patients to identify ophthalmological and systemic abnormalities at an early age and the development and implementation of an individualized therapy plan.

Resumen Objetivo: El síndrome de Aicardi fue descrito en 1965 como una tríada de anormalidades que incluye agenesia parcial o total del cuerpo calloso, lagunas coriorretinianas y espasmos infantiles. Se presenta el caso de una paciente con diagnóstico de síndrome de Aicardi que debutó con manifestaciones neurológicas, por lo que se decidió su abordaje multidisciplinario. Caso clínico: Paciente de sexo femenino, de 1 mes de edad, que llega al departamento de genética con antecedentes de epilepsia (espasmos infantiles), agenesia total de cuerpo calloso y disgenesia vertebral con escoliosis encontradas durante la evaluación neurológica previa. El examen oftalmológico reveló microftalmia en el ojo derecho, microcórnea en el ojo izquierdo presentó y resto del segmento anterior sin alteraciones. En la fundoscopia se observaron lesiones coriorretinianas compatibles con lagunas coriorretinianas, así como coloboma de nervio óptico, por lo que se diagnostica síndrome de Aicardi. Conclusiones: Enfatizamos la importancia del examen oftalmológico completo en todos los pacientes para detectar de manera oportuna cualquier anormalidad, además de realizar siempre un abordaje sistémico que permita un diagnóstico sindromático, e individualizar el plan terapéutico.