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Objective Lung disease (LD) is an increasingly recognized complication of systemic juvenile idiopathic arthritis (sJIA). As there are no currently available guidelines for pulmonary screening in sJIA, we sought to develop such an algorithm at our institution. Methods A multidisciplinary workgroup was convened, including members representing rheumatology, pulmonary, stem cell transplantation, and patient families. The workgroup leaders drafted an initial algorithm based on published literature and experience at our center. A modified Delphi approach was used to achieve agreement through three rounds of anonymous, asynchronous voting and a consensus meeting. Statements approved by the workgroup were rated as appropriate with moderate or high levels of consensus. These statements were organized into the final approved screening algorithm for LD in sJIA. Results The workgroup ultimately rated 20 statements as appropriate with a moderate or high level of consensus. The approved algorithm recommends pulmonary screening for newly diagnosed patients with sJIA with clinical features that the workgroup agreed may confer increased risk for LD. These “red flag features” include baseline characteristics (young age of sJIA onset, human leukocyte antigen type, trisomy 21), high disease activity (macrophage activation syndrome [MAS], sJIA‐related ICU admission, elevated MAS biomarkers), respiratory symptoms or abnormal pulmonary examination findings, and features of drug hypersensitivity‐like reactions (eosinophilia, atypical rash, anaphylaxis). The workgroup achieved consensus on the recommended pulmonary work‐up and monitoring guidelines. Conclusion We developed a pulmonary screening algorithm for sJIA‐LD through a multidisciplinary consensus‐building process, which will be revised as our understanding of sJIA‐LD continues to evolve.

La literatura producida por las US Latina Writers, como los casos que se analizarán a continuación, de cubanas y dominicanas, constituyen un esfuerzo de representación de las situaciones provocadas por identidades fragmentadas que se recrean entre dos culturas en sociedades fragmentadas. Analizaremos el proceso de re-creación de identidades en el exilio en la novela De cómo las chicas García perdieron el acento (1992), de la escritora dominicano-americana Julia Álvarez, y en Soñar en cubano (1992), de la escritora cubano-americana Cristina García. Ambas novelas están estructuradas sobre la memoria de los integrantes de la familia, la americanización de los personajes femeninos y las pérdidas del lenguaje y cultura de su país natal. De este modo, el foco de nuestro análisis estará, principalmente, en el lenguaje, junto con el efecto de las dinámicas sociales, tales como género, etnia y clase. El resultado es la recreación de identidades híbridas con múltiples peculiaridades lingüísticas, sociales y culturales.