ABSTRACT Maternal infectious diseases are frequent complications of pregnancy and can cause negative outcomes. Perinatal infections can cause serious damage to fetal central nervous system (CNS), but incidence of symptomatic congenital infections at birth is low. Complete and multidisciplinary (obstetric, infectologist, microbiologist, neonatologist/pediatrician, psychologist) evaluation of the pregnant women is crucial to define fetal prognosis. The ultrasound (US) surveillance has an irreplaceable role in identifying serious fetal damage and complications. Complete evaluation of the fetus in selected cases needs to be integrated with invasive prenatal diagnosis, particularly amniocentesis, which has optimal predictive values in excluding vertical transmission, and fetal magnetic resonance imaging (MRI), which can add important anatomical detail when fetal CNS damage is suspected. Congenital infections, furthermore, need to be considered in differential diagnosis of some common abnormal CNS findings at prenatal US. With the present review, we intend to provide an overview of the major perinatal infections and the role of US diagnosis in their assessment to recognize fetal CNS damage. We highlight the most recognizable syndromes due to congenital infections by linking etiopathogenesis with pathology and imaging. In particular, we focus on US diagnostic and prognostic values in relation to other invasive and noninvasive prenatal diagnosis options and summarize up-to-date recommendations on US evaluation of most common findings. Cytomegalovirus (CMV) is the most common cause of congenital infection, while Toxoplasmosis is the most preventable cause of infectious CNS damage; rubella, varicella virus, and herpes viruses, even if rarely, may be responsible for extremely serious fetal damage, while Zika virus is an emerging concern on global scale. How to cite this article Masini L, Apicella M, De Luca C, Valentini P, Manfredi R, Lanzone A, De Santis M. Fetal Central Nervous System and Infectious Diseases. Donald School J Ultrasound Obstet Gynecol 2017;11(4):314-327.
Early evidence suggests that in-utero stem cell transplantation represents a new therapeutic strategy for different congenital disease. Moreover, gene therapy constitutes one of the most promising new approach to treat a wide spectrum of genetic disorders. It was shown that the fetus could represent an ideal recipient because of his immunologic early naiveté in gestation that reduces the risk of immunoreactions. Clinical experience in human fetus was performed in order to treat immunodeficiency and metabolic disorders, hemoglobinopathies and some other genetic diseases. Use of alternative source (i.e., cord blood, placenta, membrane, amniotic fluid, fetal tissue) of stem cell transplanted has been only one of the several strategies to improve donor cell advantages on host stem cell. The present review focused on the clinical use and therapeutic potential of in-utero stem cell transplantation, reporting the outcome of human cases treated and the limits of this therapy and possible future applications.
Data on the association between cholelithiasis and diabetes often are controversial and are mostly based on autopsies or on hospital series. Therefore, we designed a case-control study to determine the prevalence of diabetes mellitus in a group of subjects with gallstones or having undergone cholecystectomy (cases) and compared these with a control group of subjects without gallstones, selected during an epidemiological study performed on a free-living population sample. The subjects were matched for sex, age, and body mass index. We enlisted 336 cases and 336 controls, aged 30 to 69 years. All subjects with fasting glycemic levels of < 140 mg/dL and without a documented history of diabetes were submitted to a simplified oral glucose tolerance test (OGTT). All subjects who underwent OGTT were classified according to the National Diabetes Data Group (NDDG) criteria. The prevalence of diabetes in the subjects affected by gallstone disease was significantly higher than that in controls (11.6% vs. 4.8%; odds ratio [OR], 2.55; 95% confidence interval [CI], 1.39-4.67). Diabetes was more frequent in subjects with gallstone disease than in the control group, even according to sex (18.3% vs. 9.9% for men: OR, 2.03; 95% CI, 0.99-4.2; 9.3% vs. 2.6% for women: OR, 3.85; 95% CI, 1.4-10.6). We conclude that an altered glucose metabolism may increase the risk of developing cholelithiasis in certain subjects.
Pregnant women may be at higher risk of severe complications associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which may lead to obstetrical complications. We performed a case control study comparing pregnant women with severe coronavirus disease 19 (cases) to pregnant women with a milder form (controls) enrolled in the COVI-Preg international registry cohort between March 24 and July 26, 2020. Risk factors for severity, obstetrical and immediate neonatal outcomes were assessed. A total of 926 pregnant women with a positive test for SARS-CoV-2 were included, among which 92 (9.9%) presented with severe COVID-19 disease. Risk factors for severe maternal outcomes were pulmonary comorbidities [aOR 4.3, 95% CI 1.9-9.5], hypertensive disorders [aOR 2.7, 95% CI 1.0-7.0] and diabetes [aOR2.2, 95% CI 1.1-4.5]. Pregnant women with severe maternal outcomes were at higher risk of caesarean section [70.7% (n = 53/75)], preterm delivery [62.7% (n = 32/51)] and newborns requiring admission to the neonatal intensive care unit [41.3% (n = 31/75)]. In this study, several risk factors for developing severe complications of SARS-CoV-2 infection among pregnant women were identified including pulmonary comorbidities, hypertensive disorders and diabetes. Obstetrical and neonatal outcomes appear to be influenced by the severity of maternal disease.
Indice
Introduccion
Capitulo 1. El Canto del Fuego. Una educacion libre y consciente
Por Moira Alquezar, Francisco Ramallo
Creacion del espacio
Construir y (auto)conocerse
Los dias en la escuela
Referencias
Capitulo 2. Casa Alegre: espacio de encuentro, aprendizaje, creacion y exploracion
Por Mariela Federman
Breve descripcion del proyecto
Como nacio Casa Alegre
El comienzo
Actividades que realizamos
Algunas observaciones
Un poquito de mi recorrido
Capitulo 3. Como llegamos a la Escuela del Mar
Por Luisina Palombo, Florencia Suriani
Como llegamos nosotras a la Escuela del Mar
Escuela del Mar: ano 2017
Como llegaron ellos a la Escuela del Mar
Referencias
Capitulo 4. Un relato a tres voces
I. Relato de una madre
Por Lorena Zubiri
II. Relato de una maestra
Por Laura Fernandez
III. Relato de un maestro
Por Emiliano Zubiri
Capitulo 5. Proyecto Waldorf Mar del Plata
Por Patricia Weissmann
Rudolf Steiner y la Antroposofia
Primera Escuela Waldorf
Pedagogia Waldorf
Escuela o Jardin Inicial (primer septenio)
Escuela Primaria (7 a 14 anos)
Escuela Secundaria (15 a 18 anos)
Papel de la Antroposofia
Proyecto Waldorf Mar del Plata
Financiacion
Formacion de los maestros
Referencias
Capitulo 6. Curso de Formacion en Pedagogia Waldorf-Zona Costa Atlantica
Por Leonora Bozzani, Leonardo Di Meglio, Nicolas Martin
La Pedagogia Waldorf
Todas las diversas formaciones en Pedagogia Waldorf quieren aportar
Objetivos generales del Curso de Formacion
Trabajos personales
Aspecto economico
Capitulo 7. Impulso Waldorf de Villa Gesell
Por Nicolas Martin
Capitulo 8. Aprendizaje y juego en la naturaleza: las Escuelas Bosque se siembran en nuestro pais
Por Colectivo EBA (Escuelas Bosque Argentina)
Origenes y desarrollo internacional
Caracteristicas principales
a. Entorno natural
b. Infraestructura minimalista
c. Libertad y autonomia
d. Juego libre
A modo de cierre
Capitulo 9. Una experiencia de Pedagogia Critica en Mar del Plata: Bachillerato Popular America Libre
Por Mariana Buzeki, Ines Canale
Educacion Popular y Pedagogia Critica
El Bachi
Referencias
Capitulo 10. Centro Cultural America Libre. La casa del pueblo
Por Martin Rodriguez Vignone
La casa del pueblo
Actividades propuestas
Praxis: hacia un teatro de grupo
La experiencia del Bachillerato Popular
Referencias
Capitulo 11. Centro Integrador Comunitario Barrio “El Martillo”
Por Javier Perez Amsler
Nuevas experiencias educativas sociales
Los CIC como articuladores entre Estado y demandas sociales
Los trabajadores
Los vecinos: ninas, ninos, adolescentes, adultos
Problematicas sociales y modos de abordaje
Experiencias educativas alternativas en el marco de los CIC
El CIC como politica publica vinculada a la educacion
Conclusiones
Referencias
Capitulo 12. Desde el Bachi. Bachillerato Popular Proyecto Uno
Por Colectivo Bachillerato Popular Proyecto Uno
Pensando una propuesta pedagogica
Como se construye el bachi dia a dia
Hacia la oficializacion
Desafios
Capitulo 13. Educacion Democratica: la Asamblea como organo de gestion
Por Malala Erhart
Sin Libertad no es posible ejercer la autonomia
?Como es una Asamblea?
Una pregunta frecuente
Antecedentes de la Educacion Democratica
Reflexion final
Referencias
Capitulo 14. La bitacora matrix
Por Simon Martinez, Mabel Oddone
(de)Formacion del Pasado
(co)Formacion del Futuro
?Como cultivar actitudes que se liberen de las logicas escolarizantes?
?Como formar maestrxs que posean un discurso frente a lxs estudiantes que no reproduzca dominacion e inequidad?
?Cual sera el sendero que delinee el nuevo mapa de nuestro peregrinaje en el universo de la formacion?
Capitulo 15. La escuela secundaria en transformacion
Por Alberto Croce
?Cual es el horizonte?
Los caminos de la transformacion
a. Modificaciones en el regimen academico de la secundaria
b. Modificaciones en los contenidos y maneras de ensenar
c. Condiciones institucionales de trabajo
El gran desafio
Referencias
Capitulo 16. Plan de Educacion Ambiental-Mar Chiquita Sustentable (PLANMAR)
Amartya
Plan de Educacion Ambiental de Mar Chiquita
Escuela Sustentable
Referencias
Capitulo 17. Una Educacion para el buen vivir
Por Alberto Croce
Abya Yala
El Buen Vivir
Hacia una Educacion para el Buen Vivir
Los Educadores para el Buen Vivir
A manera de conclusion
Referencias
INDICE
1. Viejas nuevas pedagogias en el Siglo XXI.
2. Mas alla del territorio escolar: narrativas descoloniales y educacion alternativa en America Latina.
SECCION 1: “ALTERNATIVAS EN LA ESCUELA”
3. Cooperativa Tierra Nueva. Escuela Amuyen.
4. Jardin de Infantes Dulce Compania. Escuela Loris Malaguzzi.
5. Escuela de Educacion Estetica N°1 de Olivos.
SECCION 2: “EDUCACIONES ALTERNATIVAS”
6. Escuela Experimental del Mar.
7. ERAP G-078: Escuela Rural Paso Cordova.”Una escuela del nuevo milenio”.
8. Bachillerato Popular de Jovenes y Adultos “Agustin Tosco”.
SECCION 3: “HACIA LAS ALTERNATIVAS A LA EDUCACION”
9. Tierra Fertil. Una educacion libre, autogestionada y “antipedagogica”.
10. La experiencia de UALALA: Pedagogia libertaria para la desescolarizacion.
11. EnRonda.
12. Encuentros Educativos. Un relato No Educativo.
13. El pequeno jaibana: saber ancestral y resistencia infantil ante el saber impuesto.
14. Recuento y balance. Se hace camino al andar.
