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Introducción: Se describen los signos clínicos de la anomalía de Morning Glory en una paciente femenina. Aunque esta anomalía es de baja prevalencia, la reportamos por la importancia del diagnóstico temprano debido a la asociación con alteraciones vasculares del sistema nervioso central que eventualmente son tratables. Objetivo: describir esta anomalía del disco óptico en una paciente atendida en el Hospital de San José, Bogotá. Métodos: búsqueda en la literatura de las manifestaciones clínicas, incidencia y patologías asociadas. Presentación del caso: mujer que consulta por pobre agudeza visual del ojo derecho cuya fundoscopia reveló una excavación cónica con disco óptico displásico y tejido glial alrededor de la pupila en 360 grados, pigmento retinocoroideo y aumento de los vasos retinianos que emergen del disco en distribución radial.

Introduction: We describe the clinical findings of morning glory optic disc anomaly, in a female patient. Despite the low prevalence of this optic disc malformation and although it has no specific treatment, we report this case, for timely diagnosis is important for associated vascular and central nervous system abnormalities may eventually be treated. Objective: to report this case of morning glory optic disc anomaly in a patient seen at Hospital de San José, Bogotá. Study design: case report. Methods: A search in the literature on the incidence, ophthalmological manifestations, clinical presentation and concomitant pathologies of morning glory optic disc anomaly, was conducted. Case report: female patient that consulted for decreased visual acuity in the right eye. Right eye fundus examination revealed a funnel-shaped excavation, dysplastic optic disc and glial tissue covering the peripapillary region circumferentially (360°), chorioretinal pigmentary changes, and increased number of retinal vessels emerging from the optical disc in a radial pattern.

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The COVID-19 pandemic significates an enormous number of patients with pneumonia that get complicated with severe acute respiratory distress syndrome (ARDS), some of them with refractory hypercapnia and hypoxemia that need mechanical ventilation (MV). Those patients who are not candidate to extracorporeal membrane oxygenation (ECMO), the extracorporeal removal of CO2 (ECCO2 R) can allow ultra protective MV to limit the transpulmonary pressures and avoid ventilatory induced lung injury (VILI). We report a first case of prolonged ECCO2 R support in 38 year male with severe COVID-19 pneumonia refractory to conventional support. He was admitted tachypneic and oxygen saturation 71% without supplementary oxygen. The patient's clinical condition worsens with severe respiratory failure, increasing the oxygen requirement and initiating MV in the prone position. After 21 days of protective MV, PaCO2 rise to 96.8 mmHg, making it necessary to connect to an ECCO2 R system coupled continuous veno-venous hemodialysis (CVVHD). However, due to the lack of availability of equipment in the context of the pandemic, a pediatric gas exchange membrane adapted to CVVHD allowed to maintain the removal of CO2 until completing 27 days, being finally disconnected from the system without complications and with a satisfactory evolution.

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En el presente artículo se aborda el ejercicio de la medicina tradicional y natural, mediante un análisis desde la teoría de las complejidades, con una interpretación de la organización y existencia de los seres vivos, a partir de regularidades no aplicadas en la medicina alopática y la medicina bioenergética al atender al hombre y su entorno sociocultural, lo cual propicia una práctica médica más sistémica, eficiente y ética. Además, se pretende perfeccionar la medicina bioenergética complementada por el enfoque sistémico complejo y su aplicación en diferentes escenarios. La citada teoría fortalece la visión científica de la medicina tradicional y natural desde los puntos de vista teórico y práctico.

In this work, the use of the traditional and natural medicine is investigated, by means of an analysis from the theory of complexities, with an interpretation of the organization and the existence of the alive beings, from regularities not applied in the alopathic and bioenergetic medicine, when assisting man and his social and cultural environment, which favors a more systemic, efficient and ethical medical practice. Besides, it is intended to improve the bioenergetic medicine, supplemented by the complex systemic approach and its application in different scenarios. The mentioned theory strengthens the scientific vision of the traditional and natural medicine from the theoretical and practical points of view.

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La primera ciencia de la complejidad que se acercó a la vida como fenómeno universal fue la termodinámica clásica, pero no lograba explicar completamente los fenómenos asociados a la vida misma, debido al carácter lineal de su estructura matemática, que imposibilitaba describir los sistemas alejados del equilibrio termodinámico (esto último considerado la primera gran característica de los organismos vivos como sistemas); lo más que tal ciencia podía esclarecer eran aquellos procesos delimitados por flujos débiles cercanos al equilibrio, en los cuales el sistema termodinámico alcanzaba un estado estacionario con una generación de entropía mínima (medida del desorden de un sistema), que mantenía a este muy próximo al equilibrio

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The interest for the research on enviromental mycobacteria has risen over the last decades, in part, due to a significant incidence rate rise. Reports from all over the world address the soil as the major source for human contamination. In Argentina two documents report the prevalence of atypical mycobacteriosis at Córdoba (1997), and the isolation of enviromental mycobacteria from soils of the Province of La Pampa (1999) respectively. The aim of our study was to confirm the presence of enviromental mycobacteria in soil of the city of Córdoba. The map of the city was divided in 9 regions according to avenues and major streets distribution. A total of 120 soil samples were recollected with spatula from a 10 x 10 cm square up to 1 cm deep. Samples were kept at 4 degrees C no more than 7 days. Soil samples were homogenized with destilled water in a 1:1 proportion, and decontaminated according to Petroff's method. The cultures were made in Lowestein-Jehnsen media and incubated at 37 degrees C controlling development every 7 days for 2 months. An acid-fast-bacilli smear was made from colonies obtained. Twenty three cultures (19%) were discarded due to contamination. Twenty cultures (17%) developed acid fast bacilli (AFB). Colonies obtained were sent to the Mycobacteria Service of the Instituto Nacional de Enfermedades Infecciosas Dr. Carlos G. Malbrán, in the city of Buenos Aires, for identification. A single isolation was identified as Mycobacterium triviale. A positive correlation was observed between the frequency of positive AFB isolation and the number of samples taken from park areas. The presence of enviromental mycobacteria in soils of Córdoba was confirmed. Results suggest higher odds of isolation in parklands and soils where animals live. Extensive works are needed to asset the features that allow and contribute the proliferation of mycobacteria in soils.

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The interest for the research on enviromental mycobacteria has risen over the last decades, in part, due to a significant incidence rate rise. Reports from all over the world address the soil as the major source for human contamination. In Argentina two documents report the prevalence of atypical mycobacteriosis at Córdoba (1997), and the isolation of enviromental mycobacteria from soils of the Province of La Pampa (1999) respectively. The aim of our study was to confirm the presence of enviromental mycobacteria in soil of the city of Córdoba. The map of the city was divided in 9 regions according to avenues and major streets distribution. A total of 120 soil samples were recollected with spatula from a 10 x 10 cm square up to 1 cm deep. Samples were kept at 4 degrees C no more than 7 days. Soil samples were homogenized with destilled water in a 1:1 proportion, and decontaminated according to Petroffs method. The cultures were made in Lowestein-Jehnsen media and incubated at 37 degrees C controlling development every 7 days for 2 months. An acid-fast-bacilli smear was made from colonies obtained. Twenty three cultures (19

) were discarded due to contamination. Twenty cultures (17

) developed acid fast bacilli (AFB). Colonies obtained were sent to the Mycobacteria Service of the Instituto Nacional de Enfermedades Infecciosas Dr. Carlos G. Malbrán, in the city of Buenos Aires, for identification. A single isolation was identified as Mycobacterium triviale. A positive correlation was observed between the frequency of positive AFB isolation and the number of samples taken from park areas. The presence of enviromental mycobacteria in soils of Córdoba was confirmed. Results suggest higher odds of isolation in parklands and soils where animals live. Extensive works are needed to asset the features that allow and contribute the proliferation of mycobacteria in soils.