Abstract Background: The appearance and spread of carbapenems-resistant Enterobacterales have generated a major impact on health care-associated infections worldwide. Recently, a Klebsiella pneumoniae outbreak expressing OXA-48 like-carbapenemases was detected in Chile, the first reported cases corresponded to hospitalized patients mainly from northern Chile. Aim: To characterize the phenotypic and genotypic profiles of antimicrobial susceptibility of 16 clinical isolates referred during May 2021 from Antofagasta and Metropolitan regions to the Reference Laboratory of Instituto de Salud Publica. Methods: Antimicrobial susceptibility of all strains was analyzed using traditional (Kirby-Bauer and epsilometry) and automated methods, and complemented with colorimetric, immunochromatographic and molecular (PCR and PFGE) techniques. Results: As a result of the genetic characterization, blaoxa-48 and blaoxa-232 genes were detected, showing the isolates an unusual resistance profile to both carbapenems (ertapenem, imipenem, and meropenem) and cephalosporins (cefepime, cefotaxime, and ceftazidine), as well as piperacillin/ tazobactam and temocillin. Two subtypes were detected by PFGE, with a predominant clone CL-Kpn-Spe-329 (93.8%), with two resistance mechanisms identified: carbapenemase and extended-spectrum β-lactamase (ESBL). Conclusion: Due to this epidemiological alert, it is essential the establishment of national guidelines for early detection, surveillance, and control of future outbreaks of OXA-48 like carbapenemases isolates.

Resumen Introducción: La aparición y diseminación de Enterobacterales resistentes a carbapenémicos ha generado un gran impacto en las infecciones asociadas a la atención de salud en el mundo. Recientemente, en Chile se detectó un brote por Klebsiella pneumoniae productora de carbapenemasas tipo oxacilinasas (OXA) de la subfamilia tipo OXA-48, reportándose los primeros casos en pacientes hospitalizados mayoritariamente en la zona norte del país. Objetivo: Determinar los perfiles fenotípicos, genotípicos y de susceptibilidad antimicrobiana de 16 cepas referidas durante mayo del año 2021 desde las regiones de Antofagasta y Metropolitana al Laboratorio de Referencia del Instituto de Salud Pública. Metodología: Las cepas provenientes de muestras clínicas fueron analizadas mediante técnicas tradicionales (Kirby-Bauer y epsilometría) y automatizadas, además de técnicas colorimétricas, inmunocromatográficas y moleculares (RPC y PFGE). Resultados: Se detectó la presencia de los genes blaoxa-48 y blaoxa-232 con una resistencia inusual, tanto a carbapenémicos (ertapenem, imipenem y meropenem) como a cefalosporinas (cefepime, cefotaxima y ceftazidima), además de piperacilina/tazobactam y temocilina. Se detectaron dos subtipos por PFGE, siendo predominante el clon CL-Kpn-Spe-329 (93,8%) con dos mecanismos de resistencia identificados: carbapenemasa y β-lactamasa de espectro extendido (BLEE). Conclusión: Ante esta alerta epidemiológica es necesario unificar criterios existentes en la red asistencial nacional para la oportuna detección, vigilancia y control de posibles brotes de cepas productores de oxacilinasa tipo OXA-48.

Abstract Leprosy or Hansen’s disease is one of the classic neglected diseases that still persists in Peru. The infection is caused by Mycobacterium leprae. The disease varies in a wide range of manifestations from tuberculoid (paucibacillary) to lepromatous (multibacillary) leprosy. We present the case of a 55-year-old man, farmer and wood extractor, from the Peruvian Amazon with old infiltrating cutaneous lesions on the face, neck, thorax, abdomen and extremities. The smear and biopsy examinations confirm the presence of acid-alcohol-resistant bacilli compatible with leprosy. It is concluded, with a long delay, it was a case of nodular lepromatous leprosy. He received therapy with rifampicin, dapsone and clofamizine for two years with slow progressive improvement; however, he presented an erythema nodosum leprosum (type 2 reaction) with response to corticosteroids and thalidomide.

Resumen La lepra o enfermedad de Hansen es una de las clásicas enfermedades olvidadas que aún persiste en Perú. La infección es ocasionada por Mycobacterium leprae. La enfermedad varía en un amplio rango de manifestaciones desde la lepra tuberculoide (paucibacilar) hasta la lepromatosa (multibacilar). Se presenta el caso de un varón de 55 años, agricultor y extractor de madera, procedente de la Amazonia peruana, con lesiones cutáneas antiguas infiltrantes en la cara, cuello, tórax, abdomen y extremidades. La baciloscopia y estudio histológico de una biopsia de piel confirmaron la presencia de bacilos ácido-alcohol resistentes. Se concluyó, en forma tardía, que fue un caso de lepra lepromatosa nodular. Recibió terapia con rifampicina, dapsona y clofamizina por dos años con una lenta mejoría; no obstante, cursó con un eritema nodoso leproso (reacción tipo 2) con buena respuesta a corticoesteroides y talidomida.

ABSTRACT In today's Western society, philosophy begins to recognize some of the representative features of romantic thought, especially concerning the breakdown of the relationship linking man with his natural environment, also to the search for a purpose beyond the productive aims of the market, and to the renewed interest in the transcendental. With this motivation, this article proposes an analytical reading of Romanticism's influence in the novel The Black Corsair - The Revenge of Emilio Salgari. The analysis, based on the proposal of Domínguez Caparrós, includes the exposition of the author's environment, and the romantic movement demonstrating the influences of Romanticism on the style and structure of the story.

RESUMEN En la sociedad occidental actual, la filosofía empieza a reconocer algunos de los elementos representativos del pensamiento romántico, sobre todo en lo concerniente al quebranto de las relaciones que vinculan al hombre con su entorno natural, a la búsqueda de propósito más allá de las miras productivas del mercado y al renovado interés por lo trascendental. Con esa motivación, el presente artículo propone una lectura en clave analítica de la influencia del romanticismo en la novela El corsario negro - La venganza de Emilio Salgari. El análisis, a partir de la propuesta de Domínguez Caparrós, comprende la exposición del entorno del autor, de la corriente romántica y demuestra la presencia de influencias del romanticismo en el estilo y la estructura del relato.

ABSTRACT Objective To determine the frequency and antifungal susceptibility of Candida spp. (other than C. albicans) isolated from samples of patients admitted to critical care units of a third-level hospital in northern Peru. Materials and methods A cross-sectional study was conducted between February 2018 and May 2019 in 232 samples of patients admitted to critical care units of the Hospital Regional Lambayeque (HRL). Candida spp. (other than C. albicans) were identified using phenotypic tests. The antifungal susceptibility to fluconazole and voriconazole was determined according to the epidemiological cut-off values of CLSI document M44-A2. Results Two hundred thirty-two (232) samples were analyzed. The frequency of Candida spp. (other than C. albicans) was 19.82 % (46/232) and C. albicans was 11.20 % (26/232). Candida spp. (other than C. albicans) were the following: C. tropicalis (67.39 %, 31/46), C. glabrata (17.39 %, 8/46), C. parapsilosis (10.86 %, 5/46) and C. krusei (4.34 %, 2/46). Patients from whom Candida spp. (other than C. albicans) were isolated were mostly females (56.52 %), had a history of antimicrobial drugs consumption (67.39 %) and were 60 years of age and older (36.95 %). Most microorganisms were isolated from urine samples (45.65 %). Regarding the antifungal susceptibility of Candida spp. (other than C. albicans), 19.56 % and 21.73 % were resistant to fluconazole and voriconazole, respectively. Conclusions The high incidence and prevalence of Candida spp. (other than C. albicans) in patients admitted to critical care units of a third-level hospital in Chiclayo, together with resistance to fluconazole and voriconazole, are significant in the morbidity and mortality of these patients.

RESUMEN Objetivo Determinar la frecuencia y susceptibilidad antifúngica de Candida spp. (no C. albicans) aisladas de muestras de pacientes en cuidados críticos de un hospital de tercer nivel del norte del Perú. Materiales y métodos Se realizó un estudio transversal entre febrero del 2018 y mayo del 2019 en 232 muestras de pacientes hospitalizados en unidades de cuidados críticos del Hospital Regional Lambayeque (HRL). Candida ssp. (no C. albicans) fue identificada mediante las pruebas fenotípicas. La susceptibilidad antifúngica al fluconazol y voriconazol se determinó según la interpretación de los puntos de corte del documento M44-A2 del CLSI (por sus siglas en inglés, Clinical and Laboratory Standards Institute). Resultados Se estudiaron 232 muestras. La frecuencia de Candida spp. (no C. albicans) fue de 19,82 % (46) y C. albicans de 11,20 % (26). Las especies de Candida spp. (no C. albicans) fueron las siguientes: Treintaiuna de C. tropicalis (67,39 %), ocho de C. glabrata (17,39 %), cinco de C. parapsilosis (10,86 %) y dos de C. krusei (4,34 %). Los pacientes en quienes se aisló Candida spp. (no C. albicans) se caracterizaron por ser, en su mayoría, mujeres (56,52 %), que previamente habían usado antimicrobianos (67,39 %), y de 60 años a más (36,95 %). La muestra en la que se aisló en microorganismo con mayor frecuencia fue la orina (45,65 %). Respecto a la susceptibilidad antifúngica de las especies de Candida spp. (no C. albicans), encontramos resistencia a fluconazol (19,56 %) y a voriconazol (21,73 %). Conclusiones La alta frecuencia y predominio de especies de Candida spp. (no C. albicans) en pacientes de unidades de cuidados críticos de un hospital de tercer nivel en Chiclayo, y la resistencia que muestran a la acción de fluconazol y voriconazol son características de gran importancia en la morbilidad y mortalidad en estos pacientes.

Resumo A identificação dos objetos a partir de sua forma é uma tarefa que realizamos cotidianamente sem maiores dificuldades e sem nos perguntarmos de que modo a identidade surge da forma. A semiótica asume a tarefa de descrever esse proceso a partir do momento em que a identidade do objeto, sua caracterização, é concebida em termos de significação. Sem dúvida, ao abordar essa tarefa encontra-se imediatamente a dificuldade de descrever mediante um método geral a diversidade das formas que o homem enfrenta. Aquí é proposto fazer a descrição das formas tridimensionais a partir de imagens bidimensionais e com a ajuda de uma análise qualitativa em termos de pontos de referência inscritos na grade posicional. O artigo justifica a pertinência semiótica do método adotado e ilustra sua aplicação por meio de um estudo de recipientes maias prehispânicos.

Abstract The identification of objects based on their form is a task that we carry out on a daily basis without much difficulties and without asking ourselves how the identity comes to the form. Semiotics assumes the task of describing this process from the moment in which the identity of the object, its categorization, is conceived in terms of meaning. However, a difficulty immediately arises of describing by a general method the diversity of forms that man faces. Here it is proposed to carry out the description of three-dimensional shapes from two-dimensional images and with the help of a qualitative analysis in terms of reference points, inscribed on a positional grid. The paper justifies the semiotic relevance of the adopted method and illustrates its application through a study of pre-Hispanic Mayan vessels.

Resumen La identificación de los objetos a partir de su forma es una tarea que realizamos cotidianamente sin mayores dificultades y sin preguntarnos mayormente el modo en la identidad adviene a la forma. La semiótica asume la tarea de describir ese proceso desde el momento en que la identidad del objeto, su categorización, es concebida en términos de significación. Sin embargo, al abordar dicha empresa, surge inmediatamente la dificultad de describir mediante un método general la diversidad de formas a las que el hombre se enfrenta. Aquí se propone, realizar la descripción de formas tridimensionales a partir de imágenes bidimensionales y con ayuda de un análisis cualitativo en términos de puntos de referencia inscritos en una rejilla posicional. El artículo justifica la pertinencia semiótica del método adoptado e ilustra su aplicación mediante un estudio de recipientes mayas prehispánicos.

Abstract This project provides a compilation, classification, and examination of diverse sources related to the Chilean fonts that are currently globally commercialized throughout the Internet. This research aims to become a first step in the elaboration of a state of the art of the Chilean font market, and a contribution to the development, understanding and valuation of the discipline in the region. Most of the data in this study was extracted directly from MyFonts, which is today the most important distributor of fonts in the world. The registry was executed between 2011 and 2018, and it compiled records such as the complete list of Chilean fonts available for sale in this platform, their respective designers and foundries, the numbers of font styles of each one and other similar details. In addition, we have incorporated some points of analysis, such as the presence or absence of serifs or the stylistic classification of each alphabet. The results are expressed through tables and graphs that summarize the data and shows the information in an organized and systematic way, so everyone can get to know the dimensions and main characteristics of the “Chilean font market”. Some key details which can be found here are: the intense productive progression of the Chilean fonts in the last three years, the ascending participation of women, the low production of fonts for continuous text or the predominance of the humanist sans style, among others. Finally, it is important to mention that the categories of information that have been created increase constantly, and as they do, data crossing and relationships are established in a way that supports a better understanding of the phenomenon studied. From this research it is possible to extract the opportunity of continuing publishing the progresses.

Resumen Este proyecto consiste en un registro, clasificación y examen de diversos antecedentes vinculados a las fuentes chilenas que actualmente se comercializan a nivel global a través de internet. Busca constituirse como un primer apronte para la elaboración de un estado del arte del mercado de la tipografía chilena, como un paso más, para el desarrollo, comprensión y valoración de la disciplina en la región. La mayor parte de los datos que conforman este estudio, fueron extraídos directamente de MyFonts, que es hoy, la distribuidora de fuentes más importante del mundo. El registro se ha ejecutado entre los años 2011 y 2018, recopilando antecedentes tales como el listado completo de fuentes chilenas que están a la venta en la plataforma, sus respectivos autores y fundiciones, la cantidad de variantes que posee cada fuente y otros detalles similares. Sumado a esto, se han incorporado algunos puntos de análisis propios, como la presencia o ausencia de serifas o la clasificación estilística de cada alfabeto. Los resultados se expresan a través de tablas y gráficos que resumen los datos y los visualizan de forma ordenada y sistémica, para que cualquier persona pueda conocer cuáles son las dimensiones y principales características de este “mercado tipográfico chileno”. Algunos detalles clave que se pueden encontrar son: la intensa progresión productiva en los últimos tres años, la ascendente participación de las mujeres, la baja producción de fuentes para texto continuo o la predominancia del estilo humanista sans, entre otros. Por último, es importante mencionar que las categorías de información que se han ido creando siguen en aumento, a medida que lo hacen, se van estableciendo cruces y relaciones que ayudan a comprender mejor el fenómeno estudiado, dando así la posibilidad de continuar publicando los avances.

ABSTRACT Objective: Communicate the first report of Klebsiella pneumoniae producing carbapenemases. The study: Microbiological diagnosis using phenotypic methods: double disc synergy, modified Hodge test, immunochromatography and carbapenemic inactivation. Findings: Four isolates (urine 3 and blood 1) of carbapenemase-producing K. pneumoniae were confirmed, which also presented a MIC of 4 and> = 8 for ertapenem and> = 16 µg / mL at imipenem and meropenem. Conclusion: Standardized phenotypic methods are useful in the confirmation of carbapenemases and with it an alternative for the best taking of therapeutic options and epidemiological surveillance.

RESUMEN Objetivo: Comunicar el primer reporte de Klebsiella pneumoniae productora de carbapenemasas. El estudio: Diagnóstico microbiológico empleando métodos fenotípicos: sinergia del doble disco, Test de Hodge modificado, inmunocromatografia y la inactivación del carbapenémico. Hallazgos: Se confirmaron cuatro aislamientos (orinas 3 y sangre 1) de K. pneumoniae productoras de carbapenemasas que además presentaron una CMI de 4 y > = 8 para el ertapenem y > = 16 µg/mL a imipenem y meropenem. Conclusiones: los métodos fenotípicos estandarizados son de utilidad en la confirmación de carbapenemasas y con ello una alternativa para la mejor toma de opciones terapéuticas y vigilancia epidemiológica.

Abstract This paper analyses the relationship between the gratuity policy implemented in Chile and measures of student academic performance from a higher vocational education and training institution. The research contributes evidence in a little explored field, especially regarding vocational education and training. Through the use of lineal and logistic regression models, it is possible to conclude that gratuity had an effect on reducing the number of dropouts and improving academic progress. The most significant effect is observed with students who in its absence, would have had to make a co-payment, since the financial aid they received would not have covered all expenses. However, if gratuity beneficiaries are compared to those that would not have had to pay, because their scholarships and loans covered all expenses, the results show that the gratuity policy is less effective in terms of the two academic indicators analyzed.

Resumen Esta investigación analiza la relación entre la política de gratuidad implementada en Chile y medidas de desempeño académico en estudiantes de una institución de educación superior técnico-profesional (TP). Se aporta evidencia a un ámbito poco abordado en el país, especialmente en este subsector. Mediante la utilización de modelos de regresión lineal y logística, se puede concluir que la gratuidad efectivamente tuvo un efecto de disminuir la deserción y aumentar el rendimiento. Pero esto fue resultado de que benefició a muchos estudiantes que antes debían efectuar un nivel de pago, dado que sus ayudas no cubrían el arancel total cobrado. Si se contrasta a beneficiarios de gratuidad con quienes no debieron copagar por contar con becas y créditos juntos, los resultados muestran que la gratuidad es menos eficiente en término de los dos indicadores académicos analizados.

Abstract Background Adherence to antihypertensive medication is a major challenge in the management of hypertension, and non-adherence is an important barrier to effective management of hypertension. Objectives To determine the adherence rate to hypertensive drug treatment and the factors that influence non-adherence in a cohort of the Argentinean population. Methods A multicenter cross-sectional study was conducted in eight cities of Argentina. Consecutive hypertensive patients seen in general practice offices, receiving pharmacological treatment for at least six months were included. Blood pressure measurements were performed by physicians during the patient visit. The level of adherence was assessed using the Morisky questionnaire, and patients were divided into non-adherent and adherent. Continuous variables were compared using independent t-test. Categorical variables were compared using the χ2 test. To identify the variables independently associated with non-adherence, a forward stepwise binary regression logistic model was performed, and the results expressed as odds ratio (OR) with 95% of confidence interval. All tests were two-tailed, and p-values < 0.05 were considered statistically significant. Results A total of 852 individuals (52% women, 62 ± 13 years) were included. The main reason for lack of adherence was forgetfulness of medication intake and errors in the time of intake (~ 40% in both). Individuals with more cardiovascular risk factors (smoking, diabetes, dyslipidemia and previous cardiovascular events) had lower adherence to antihypertensive treatment, and considerably younger (~ five years younger). Conclusions Adherence rate to antihypertensive drug treatment in our study group was higher than the one reported in previous studies, and the main reason for non-adherence was forgetfulness of medication intake. (Int J Cardiovasc Sci. 2020; 33(3):272-277)

ABSTRACT The inclusion of aquaculture in household agriculture has been related as an opportunity of product and income diversification as wells as to increase food security for farmers. Small-scale fish production has increased in Brazil, even in regions with a pronounced dry season. However, there is no information about the characteristics and technical and economic viability of aquaculture under these conditions. This study was carried out with the objective to characterize the production of tambatinga (♀Colossoma macropomum × ♂Piaractus brachypomus) in water deficit conditions in Tocantins State, Brazil. The study revealed that it is technically possible and economically feasible to produce tambatinga in seasonal ponds. Worth noting was the adaptability of the hybrids which showed a suitable growth and tolerance to the poor water quality conditions. However, in order to achieve production success and financial returns, the adoption of the following procedures are suggested: a) fish stocking as soon as the rainy period starts, b) use of larger juveniles to achieve a higher final weight, c) adoption of pond liming and fertilizing practices previous to stocking, d) water quality monitoring, e) evaluate fish growing performance, f) partial harvesting during the production cycle, and g) total harvesting at the end of the rainy season.