Útero bicorporeo - doble cérvix con embarazo gemelar en una sola cavidad uterina: reporte de caso / Bicorporeo uterus - double cervix with twin pregnancy in a single uterine cavity: case report

El embarazo gemelar en una de las cavidades uterinas del útero bicorpóreo es una rara presentación clínica. La viabilidad de este tipo de embarazo es de baja probabilidad, dado que esta malformación puede condicionar parto prematuro, placentación anormal, restricción del crecimiento fetal o progresión anormal del trabajo de parto. Se presenta un caso de un útero bicorpóreo con doble cérvix y una gestación gemelar en unas de las cavidades uterinas, con muerte fetal de uno de los fetos y parto pretérmino de 28 semanas del otro gemelo. Dada la rareza de la presentación se describen el caso y los hallazgos imagenológicos representativos.

Twin pregnancy in one of the uterine cavities of the bicoporous uterus is a rare clinical presentation. The viability of this type of pregnancy is unlikely since this malformation can lead to premature delivery, abnormal placentation, fetal growth restriction or abnormal progression of labor. We present a case of bicoporous uterus with double cervix with twin pregnancy in one of the uterine cavities, with stillbirth of one of the fetuses and preterm delivery of the other twin at 28 weeks. Given the rarity of the presentation, the case and representative imaging findings are described.

Evaluación de un modelo explicativo del riesgo suicida con base en factores familiares / Evaluation of an explanatory model of suicide risk based on family factors

Resumen El suicidio es una problemática de salud mental de alto impacto en la sociedad actual, tanto en el mundo como en Colombia. Dentro de las conceptualizaciones modernas como el modelo socioecológico de la prevención del suicidio, se ha reconocido que los factores familiares son determinantes muy importantes del riesgo y la protección. El presente estudio tuvo como propósito evaluar un modelo explicativo del riesgo por ideación suicida en adolescentes que involucre las dimensiones de socialización parental y la funcionalidad familiar percibida, así como establecer la influencia del estilo de socialización de padres y madres. Para tales objetivos, se desarrolló un estudio cuantitativo, de alcance explicativo y de corte transversal. A una muestra de 268 adolescentes de 12 a 16 años, el 51.9 % de sexo femenino y 48.1 % masculino, ubicados en la ciudad de Valledupar, Colombia, se aplicó la Escala de socialización parental en la adolescencia (ESPA-29), el APGAR Familiar y la Escala de Ideación Suicida BECK-HF. Mediante SPSS 25 y AMOS 25 se evaluaron cinco modelos explicativos diferentes. El modelo de mejores indicadores de bondad de ajuste (χ. = 22.2, p = .022, CMINDF = 2.023, CFI = .968, TLI = .919, NFI = .942, RMSEA = .061) establece una influencia de la aceptación/implicación de ambos padres sobre el funcionamiento familiar, lo que reduce el nivel de ideación suicida. En este último, también inciden directamente la edad y la coerción/imposición del padre. Como conclusión, se demuestra la importancia del funcionamiento familiar, de las conductas de apoyo y afecto de la dimensión aceptación/implicación, pues presentan un efecto protector ante el riesgo suicida. De igual manera, los datos ponen de relieve que las conductas de coerción/imposición del padre, mas no de la madre, fueron un factor de riesgo. Como limitante de este estudio se presenta la no inclusión de otros factores en el modelo que podrían influir en el riesgo suicida, por lo que se sugiere realizar investigaciones que tengan en cuenta estos otros factores a nivel social e intrapersonales, pero con evaluaciones desde el modelo explicativo, que poco se evidencia en la literatura científica.

Abstract Suicide is a high-impact mental health problem in today's society, both in the world and in Colombia: in fact, epidemiological data shows that there has been an upward trend in the suicide rate both in the country and in the city of Valledupar, which is the local context of interest. On the other hand, within modern conceptualizations such as the socio-ecological model of suicide prevention, it has been recognized that family factors are very important determinants of risk and protection. The different investigations reviewed as antecedents show congruently that family dysfunction as well as coercive paternal socialization behaviors are risk factors for suicide. Likewise, adequate family functionality and parental acceptance, and involvement behaviors are protective factors. Similarly, different studies have shown that older adolescents and females are at greater risk of suicidal behavior. The purpose of this study was to evaluate an explanatory model of the risk of suicidal ideation, which involved the dimensions of parental socialization and perceived family functionality, as well as to establish the influence of the parents' socialization style, based on the findings of previous studies. For this purpose, a quantitative, explanatory and cross-sectional study was developed. The ESPA-29, the APGAR and the BECK-HF Suicidal Ideation Scale were applied to a sample of 268 adolescents from the city of Valledupar, Colombia. A simple random sampling was used for the selection of participants within a neighborhood of the city of Valledupar. The sample consisted of 51.9 % female and 48.1 % male adolescents. The approval of the parents was obtained through an informed consent of the legal representative, as well as an informed consent for the adolescents, which complies with the characteristics requested by the Colegio Colombiano de Psicólogos. Using SPSS 25 and AMOS 25, five different explanatory models were evaluated, with a SEM modeling-Path Analysis. The model of best goodness of fit indicators (χ. = 22.2, p = .022, CMINDF = 2.023, CFI = .968, TLI = .919, NFI = .942, RMSEA = .061) establishes an influence of acceptance/involvement of both parents on family functioning, which reduces the level of suicidal ideation; age and coercion/imposition of the father also directly affect the latter. The data demonstrate the importance of family functioning and of supportive and affective behaviors of the acceptance/involvement dimension, since they present a protective effect against suicidal risk. In the same way, the data shows that the coercion/imposition behaviors of the father, but not the mother, were a risk factor. Although the father's authoritarian style did predict a greater risk of suicidal ideation, it was the indulgent style, and not the authoritative style, that presented the lowest risk. Although the measurements obtained by this research do not allow us to unambiguously explain why this difference occurs between the study's findings and what is suggested by the scientific literature regarding maternal and paternal styles of socialization in the face of suicide, there are possible determining factors for the results. The possibility is raised that, at a cultural level, beliefs about the maternal role in families in the Colombian Caribbean region, which arise from a formation of matrilocal families, influence the perception of greater acceptability of punishment by the mother towards their children. On the other hand, there is the lack of evidence of significant differences in terms of suicide risk according to sex. Some directions are suggested for future research, mainly to broaden the research spectrum on the role of the family in suicide prevention and to corroborate in the context of the Colombian Caribbean region the finding about the absence of effect of coercion/imposition behaviors carried out by the mother.

Transformaciones ocupacionales en la implementación del Acuerdo de Paz en un espacio territorial de capacitación y reincorporación para excombatientes: un estudio de caso / Occupational transformations for the implementation of the Peace Agreement in a territorial space for the reinsertion and training of former combatants: a case study / Transformações ocupacionais na implementação do Acordo de Paz em um espaço territorial de treinamento e reincorporação para ex-combatentes: um estudo de caso

En noviembre de 2016 se firmó el Acuerdo Final para la Terminación del Conflicto y la Construcción de una Paz Estable y Duradera entre las Fuerzas Armadas Revolucionarias de Colombia - Ejército del Pueblo (FARC-EP) y el Gobierno Nacional de Colombia. Esto posibilitó a los integrantes de este grupo insurgente el tránsito a la vida civil y a la legalidad. El objetivo del estudio fue conocer cómo son y cómo se dan las transformaciones y reconfiguraciones ocupacionales y comunicativas de los excombatientes de las FARC-EP en su tránsito a la participación en la vida civil y política. Se recogieron narrativas de un grupo de excombatientes de las FARC-EP ubicados en un espacio territorial de capacitación y reincorporación, a través de observación participante, cartografía social y entrevistas. El análisis revela los retos de asumir la vida civil frente a nuevas interacciones, significados y formas de ocuparse en dos escenarios: la reconfiguración personal (identidad, cambios de rol, ajuste de rutinas, prácticas cotidianas y nuevos aprendizajes ocupacionales) y la reconfiguración social (expectativas de participación y reconocimiento, tensiones, reconciliaciones con su entorno y participación política). Se concluye que las transformaciones para la construcción de paz deben basarse en principios de justicia e inclusión social.

In November 2016, the final Agreement for the End of the Conflict and the Construction of a Stable and Lasting Peace was signed between the Revolutionary Armed Forces of Colombia ­ People's Army (FARC-EP) and the National Government. This made it possible for the members of the insurgency to move on to civilian life and legality. The aim of this study is to find out which are the occupational and communicational transformations and reconfigurations of the former combatants of the FARC-EP , and how they happen in the transition to participation in civilian and political life. Narratives of a group of former combatants of the FARC-EP at the Territorial Space of Training and Reincorporation of the village La Cooperativa were collected through participant observation, social mapping and interviews. The analysis reveals the challenges of assuming civilian life in the face of new interactions, meanings and ways of dealing with it in two scenarios: personal reconfiguration (identity, role changes, adjustment of routines, daily practices and new occupational learning), and social reconfiguration (expectations of participation and recognition, tensions, reconciliation with their setting and political participation). The study concludes that the transformations for the construction of peace must be based on principles of justice and social inclusion.

Em novembro de 2016, a assinatura do acordo final para a terminação do conflito e construção de paz estável e durável foi feita entre guerrilha das FARC-EP (Forças Armadas Revolucionárias da Colômbia ­ Exército Popular (FARC-EP) e o Governo Nacional da Colômbia. Isto permitiu que os integrantes deste grupo insurgente, fizessem a transição para a vida civil e para a legalidade. O objetivo do estudo foi estabelecer, da maneira mais única e possível, as transformações e as reconfigurações ocupacionais e comunicativas dos ex-combatentes das FARC-EP e a transição para a vida civil e política. Narrativas de um grupo de ex-combatentes das FARC-EP, pertencentes ao Espaço Territorial de Treinamento e à Reincorporação da calçada Cooperativa, foram produzidas por meio da observação participante, do mapeamento social e de entrevistas. A análise revelou os desafios de assumir a vida civil diante de novas interações, significados e formas de lidar em dois cenários: reconfiguração pessoal (identidade, mudanças de papéis, ajustes da rotina, práticas cotidianas e novos aprendizes ocupacionais); e reconfiguração social (expectativas de participação e reconhecimento, tensão, reconciliação com o meio ambiente e participação política). Concluiu-se que as transformações para a construção da paz devem basear-se em princípios de justiça e inclusão social.

Caracterización del perfil antigénico de extractos proteicos solubles de cepas de Trypanosoma cruzi / Antigenic profile characterization of soluble protein extracts from two Trypanosoma cruzi strains

El parásito Trypanosoma cruzi es el agente causal de la enfermedad de Chagas. El mismo presenta una amplia diversidad biológica y genética, por lo cual se lo agrupa en 6 unidades taxonómicas discretas. Las cepas Y, CL Brener y una aislada en Paraguay aún no caracterizada en su totalidad fueron empleadas en este estudio con el fin de determinar sus perfiles proteico y antigénico para aportar en la investigación sobre esta enfermedad en nuestro país, aplicando técnicas como SDS-PAGE, ELISA y Western blot. Se observaron semejanzas en los perfiles proteicos de los extractos solubles de Y Lote 73 e Y Lote 74, siendo ambos obtenidos a partir de la misma cepa, así como perfil diferente de éstos con los de CL Brener y Py. Se detectaron bandas de proteínas de pesos moleculares comunes entre extractos, principalmente las consideradas de bajo peso molecular. Se constató la capacidad antigénica al ensayar los 4 extractos frente a sueros chagásicos, no chagásicos, controles positivos y negativos, se evidenció la importancia de confirmar el diagnóstico con pruebas de principios diferentes. Además, se detectaron proteínas antigénicas comunes a los 3 extractos empleados en el Western blot, las que podrían ser estudiadas con mayor profundidad debido a su potencial antigénico, característica de interés para fines diagnósticos.

The parasite Trypanosoma cruzi is the causal agent of Chagas disease.It presents a wide biological and genetic diversity, therefore it is grouped into 6 taxonomic units..The strains Y, CL Brener and one strain isolated in Paraguaywere used in this study in order to determine their protein and antigenic profiles, applying techniques such as SDS-PAGE, ELISA and Western blot. Similarities were observed in the protein prifles of the soluble extracts of Lot 73 Y and Lot 74 Y both obtained from the same strain, and the different profile of these with those of CL Brener and Py strains. Protein bands of common molecular weights, manly those consideredlow, were detected between extracts. By testing the four extracts against chagasic and non-chagasic sera, positive and negative controls, the antigenic capacity was verified and the importance of utilizing different test to confirm diagnosis was shown. In addition antigenic proteins common to the three extracts used in the Western blot were detected and can be further investigated due to their antigenic potential, an interesting characteristic for diagnostic purpose.

Síndrome de Cotard asociado a trastorno depresivo mayor con síntomas catatonicos: informe de caso / Síndrome de Cotard associada ao transtorno depressivo maior com sintomas catatonicos: relato de caso / Cotard Syndrome Associated to major depressive disorder with catatonic symptoms: case report

Catatonia is a neuropsychiatric syndrome with abnormal postures, mutism and stupor. Colombia has a prevalence of 11.4% of psychiatric patients. Objective: To discuss the clinical curse of a 34-year-old woman with major depressive disorder that presents to emergency department with nihilistic delirium and catatonic symptoms. Case presentation: A young woman with history of unipolar major depression with psychotic features was hospitalized nine months ago. She was medicated with a pharmacological treatment she did not remember. At admission, the patient had three days of bizarre behavior, mutism and negativism. Paraclinics and brain computer tomography did not report any abnormality or changes. Treatment began with benzodiazepine, which achieved full remission of catatonic symptoms. After this, she developed anhedonia, sadness and nihilistic delusions and was considered as a relapse of a previous depressive episode from nine months ago, associated with CotardÆs syndrome. Sertraline was added with gradual increase to 100mg and 5mg of olanzapine, getting a complete remission of psychotic and mood symptoms. Discussion: Affective disorders are most common cause of catatonia. There has already been a history of similar reports, but in few times these three entities were associated; this is the first case reported in Hospital Universitario de Santander, with informed consent. Conclusions: It is unusual for a depressed patient to present denial delusions and catatonic symptoms simultaneously; therefore this case is unusual and may contribute to literature. The catatonic symptoms make it difficult to explore other mental spheres, though they may be secondary to a medical condition, therefore, it is essential to dismiss organic pathologies and give initial treatment, so we can discover the underlying etiopsychopathology.

A catatonia é uma síndrome neuropsiquiatrica com posturas anormais, silêncio e estupor. A Colômbia tem uma prevalência de 11,4% de pacientes psiquiatricos. Objetivo: Discutir o caso clínico de uma mulher de 34 anos com uma história de transtorno depressivo maior que chega ao departamento de emergência com delírios niilistas e os sintomas catatónicos. Relato de caso: Foi relatado o caso de uma jovem adulta com transtorno depressivo maior e sintomas psicóticos que tinha sido hospitalizada nove meses antes, a quem deram alta com tratamento medicamentoso que ela não se lembrava. A paciente chegou ao pronto socorro do Hospital Universitário de Santander, apresentando três dias de um comportamento incomum, mutismo e negativismo. Exames laboratoriais e tomografia do crânio normal. O tratamento foi iniciado com uma benzodiacepina que a remeteu aos sintomas catatónicos. Posteriormente demonstrou anedonia, tristeza e delírios niilistas; considerou-se que seu estado correspondia a uma recorrência de episódio depressivo, começado nove meses antes, relacionado com a síndrome de Cotard. Gradualmente a paciente foi medicada com sertralina de 150,0 mg a 5,0 mg e olanzapina de 5.0 mg, obtendo a remissção dos sintomas afetivos e psicoticos. Discussão: A desordem afetiva é a causa mais comum de catatonia. Hß relatos semelhantes, embora poucos onde coexistam os três sintomas; este é o primeiro caso relatado no Hospital Universitário de Santander, com prévio consentimento informado. Conclusões: É incomum para uma pessoa deprimida ter delírios de negação e sintomas catatónicos simultaneamente, de modo que este caso, por ser único, gera novidade para a literatura. No caso, os sintomas catatónicos dificultam a exploração de outras esferas mentais e podem ser considerados secundários a uma condição médica, motivo pelo qual é essencial excluir causas orgânicas, trata-los prontamente e assim esclarecer a psicopatologia subjacente.

Pensamiento y política: Arendt con Lacan / Thought and politics: Arendt with Lacan

Uno de los libros más emblemáticos de Hannah Arendt, Eichmann en Jerusalén. Un estudio sobre la banalidad del mal, introduce conceptos como banalidad del mal, que continúan produciendo comentarios encendidos en diferentes latitudes. Aquí nos queremos detener en otra de las polémicas que despierta el libro sobre el juicio realizado en Jerusalén. Arendt afirma: “Cuánto más se le escuchaba, más evidente era que su incapacidad para hablar iba estrechamente unida a su incapacidad para pensar…” (Arendt, 1999: 80). Lo que aquí nos proponemos es interrogar ¿qué significa pensar? para Freud y Lacan y a partir de ahí, cuestionar si Eichmann pensó o no. Nuestro trabajo se centra en la noción del pensar que procede de los griegos y pasa por Descartes, para centrarnos en lo que el psicoanálisis sitúa como pensar a partir de la definición de Lacan: pienso donde no soy, luego soy donde no pienso.

Eichmann in Jerusalem: A Report on the Banality of Evil is one of the most emblematic Hannah Arendt's books. It introduces concepts such as the banality of evil, which continue raising excited comments in different latitudes. Here, we want to focus on another controversy aroused by the book and based on Eichmann's trial in Jerusalem. Arendt says: “The longer one listened to him, the more obvious it became that his inability to speak was closely connected with an inability to think” (Arendt, 1999: 80). We propose here to examine what thinking is for Freud and Lacan, and thus to question whether Eichmann thought or did not.

L’une des œuvres les plus emblématiques d’Hannah Arendt est celle d’Eichmann à Jérusalem. Il s’agit d’une étude introduisant des concepts tels que la banalité du mal, qui continuent à produire des commentaires enflammés sous différentes latitudes. Le présent article s’arrête donc sur l’une des polémiques provoquée par le livre à l'occasion du procès Eichann à Jérusalem. Arendt affirme: ®Plus on l'écoutait, plus on se rendait à l'évidence que son incapacité à parler était étroitement liée à son incapacité à penser…” (Arendt, 1999: 80). Ce travail pose donc la question : qu’est-ce que penser veut dire pour Freud et pour Lacan? Question à partir de laquelle on s’interrogera pour savoir si Eichmann a pensé ou non.

Violencia y política / Violence and politics / Les duels, l’ecriture

Pensar la política post-Auschwitz significa repen-sar la relación entre violencia y política. Nos in-teresa reflexionar acerca de eso que llamamos civilización es un prodigioso andamiaje de ocul-tamiento de la realidad más siniestra...

In retrospect post-Auschwitz politics means re-thinking the relationship between violence and politics. Our target is to reflect about what we call civilization, prodigious scaffolding of concealment of the most sinister reality...

Penser la politique post-Auschwitz veut dire re-penser le rapport entre la violence et la politique. Nous cherchons ici à réfléchir sur ce que l’on appelle civilisation, prodigieux échafaudage de dissimulation de la réalité la plus funeste...