Information and Communication Technologies (ICTS) as a Tool for Intercultural Education. A collaborative experience in secondary education in Tlapa de Comonfort, Guerrero, Mexico

This paper discusses the collaborative experience of creating educational materials for a secondary school in Tlapa de Comonfort, Guerrero, México. In this school, students from Nahuatl, Tun savi, Me'phaa and Spanish speaking communities live and learn together. The intercultural context provides challenges for science education that we sought to address. The use of collaborative technologies in science classes has made visible the cultural diversity in the classroom, helping students and teachers recognize themselves as active agents in the construction of common knowledge and in sharing their\ud knowledge. This experience also shows the importance of ICTs as technologies of expression that reinforce individual and collective identity in intercultural contexts

A Case of Chronic Inflammatory Demyelinating Polyneuropathy after Pfizer COVID-19 Vaccination

Background: Chronic inflammatory demyelinating polyneuropathy is an immune-mediated polyneuropathy characterized by peripheral demyelination, resulting in symmetrical sensory loss and distal and proximal muscle weakness. While CIDP has been reported after influenza, tetanus, and other common vaccinations, this is the first reported case of CIDP after COVID-19 vaccination to our knowledge. Case Presentation: A 34-year-old right-handed male with an unremarkable past medical history presented with bilateral distal paresthesias, proximal and distal muscle weakness, and fine motor difficulties. Symptoms initially manifested with toe numbness, approximately two weeks after receiving the first dose of the Pfizer COVID-19 vaccine. Paresthesias gradually progressed from lower extremities to upper extremities. Two months after the initial COVID-19 vaccine, symptoms worsen with decreased muscle strength, difficulties with fine motor activities, difficulties climbing stairs, and lifting objects above his head. Neurologic evaluation revealed 4/5 strength in upper and lower extremities, generalized hyporeflexia, decreased vibration, and proprioception. MRI of the brain and spine revealed no abnormalities. Nerve conduction studies were consistent with demyelination and cerebral spinal fluid analysis revealed albuminocytologic dissociation. The patient was diagnosed with CIDP and began steroids after poor response to a four-day treatment course of IVIG 2g/kg which resulted in partial improvement of strength. The patient continues to follow up with long-term prednisone therapy. Conclusion: Demyelinating polyneuropathies are a rare complication of vaccination. While the benefits outweigh the risks of immunization, we aim to inform of this potential complication

Toxoplasmosis gondii: An Atypical Presentation of Optic Neuritis

Toxoplasmosis gondii is a parasite whose natural host is the cat. Ocular toxoplasmosis can be categorized into two forms of infections: congenital, where an infant is infected in utero; and acquired, where an individual is typically infected by ingesting food contaminated with T. Gondii oocytes. Although acquired infections are rare in the United States, they can occur and toxoplasmosis should be in the differential diagnosis of an infectious optic neuritis. The typical manifestation of toxoplasmosis is a retinochoroiditis, with a “headlight in the fog” appearance, due to dense inflammation of the vitreous; consequently, the diagnosis is often made clinically. This case describes a healthy 36-year-old Hispanic male who had an atypical presentation, with minimal vitritis and papillomacular involvement; thus serology was necessary for a definitive diagnosis. Treatment led to a rapid improvement in vision and ultimately a good prognosis

Full Recovery From Cocaine-Induced Toxic Leukoencephalopathy: Emphasizing the Role of Neuroinflammation and Brain Edema

Toxic leukoencephalopathy (TL) is characterized by white matter disease on magnetic resonance imaging (MRI) and evidence of exposure to a neurotoxic agent. We describe a case of cocaine-induced TL in which extensive white matter disease did not preclude full recovery. A 57-year-old man with substance abuse disorder presented with a 5-day history of strange behavior. On admission, he was alert but had difficulty concentrating, psychomotor retardation, and diffuse hyperreflexia. Brain MRI revealed confluent subcortical white matter hyperintensities with restricted diffusion in some but not in other areas. Electroencephalography (EEG) showed mild diffuse slowing. Blood tests were normal except for mild hyperammonemia. Urine screen was positive for cocaine and benzodiazepine but quantitative analysis was significant only for cocaine. Prednisone 60-mg qd was initiated on day 4, tapered over a 5-day period, and discontinued on day 9. He was discharged after 3 weeks. Cognitive function returned to normal 2 weeks after discharge. Five months later, neurologic exam and EEG were normal and MRI showed near-100% resolution of white matter lesions. TL has been attributed to white matter ischemia/hypoxia resulting in demyelination/axonal injury. The clinical, EEG, and MRI findings and time course of recovery of our patient suggest that cocaine-induced inflammation/edema resulted in TL but not in ischemic/hypoxic injury. While inflammation/edema may have regressed when cocaine was discontinued, we cannot exclude a role for prednisone in protecting the patient from the ischemic/hypoxic sequelae of inflammation/edema. MRI is indispensable for diagnosing TL but EEG may provide additional useful diagnostic and prognostic information

Horner\u27s syndrome secondary to neuroblastoma

Horner’s syndrome is classically characterized by a triad of miosis, partial ptosis and anhidrosis. The etiology is due to an interruption in the sympathetic innervation to the eye. A prompt diagnosis is crucial, given that Horner’s syndrome could be a manifestation of a life-threatening condition. A thorough case history and clinical evaluation must be employed to arrive at the diagnosis. An important means for confirming Horner’s syndrome is pharmacological testing, which is also used to localize the level where the sympathetic chain is compromised. Following the diagnosis and localization of the lesion, an algorithm should be followed to determine the testing indicated, in order to ascertain the underlying cause of the condition. There is a known association between mediastinal neuroblastoma and preganglionic Horner’s syndrome. We present a case of a seven-year-old boy with a history of excision of a mediastinal neuroblastoma at age two, who soon after presented with signs and symptoms associated with a residual Horner’s syndrome

Intracranial Hypertension Secondary to Eosinophilic Meningitis Caused by Angiostrongylus Cantonensis

Angiostrongylus Cantonensis, a nematode, is a well-known cause of eosinophilic meningitis in endemic areas such as Southeast Asia, the Pacific Islands, and Hawaii. Nevertheless, an increasing number of cases in the southeast of the U.S. have been documented recently, specifically in Louisiana, Texas, and Florida. Infection is acquired after ingesting undercooked fresh water snails, mollusks, or undercooked vegetables contaminated by the slime from infected snails or slugs. Typical signs and symptoms include fever, general malaise, meningeal signs, headaches, photophobia, nausea and vomiting. Here we present a 23 year-old woman who presented to our emergency department with signs and symptoms consistent with intracranial hypertension, malaise, mild photophobia, and without fever, or meningeal signs. We also provide a review of the most recent literature regarding eosinophilic meningitis secondary to A. cantonensis

A Case Report of Subacute Combined Degeneration Due to Nitrous Oxide-Induced Vitamin B12 Deficiency

Nitrous oxide, also known as “laughing gas,” is a naturally occurring gas that is colorless, odorless, nonflammable, and nontoxic. It has been used as an inhalant anesthetic in the medical field for more than 150 years for dental and surgical procedures. Due to its wide availability and ability to cause euphoria, its recreational use is on the rise. We present a case of subacute combined degeneration (SCD) due to nitrous oxide-induced vitamin B12 deficiency. The patient presented with bilateral lower extremity paresthesia, weakness, and ataxic gait. The patient was found to have vitamin B12 deficiency. An MRI of the cervical spine revealed an abnormal T2 signal within the cervical spinal cord extending from the level of C2-C6 affecting only the posterior column. On the fifth day of hospitalization, the patient reported that he had been inhaling nitric oxide from whipped cream cans for recreational use. According to his clinical presentation and laboratory and imaging findings, we concluded that the patient had SCD. The patient slowly improved after receiving vitamin B12 supplementation therapy. Patients presenting with paresthesia, weakness, and laboratory studies indicating vitamin B12 deficiency should be questioned about nitrous oxide recreational use since the incidence is increasing