Resumen La alogenosis iatrogénica es la enfermedad causada por la aplicación de biopolímeros con fines estéticos. Sus manifestaciones clínicas pueden presentarse entre las seis horas y los 30 años posteriores a la aplicación, con síntomas locales o sistémicos. El principal rasgo de la histopatología es la presencia de granulomas por cuerpo extraño con reacción de tipo sarcoideo, la cual es difícil de Interpretar por su asociación con la sarcoidosis. Se reporta aquí el caso de una paciente con lesiones granulomatosas de tipo sarcoideo por reacción a cuerpo extraño, secundaria a la aplicación de múltiples sustancias desconocidas en cara y glúteos.

Abstract Iatrogenic allogenosis is a disease caused by the injection of biopolymers with esthetic purposes. Clinical manifestations can occur between six hours and 30 years after the procedure with local and/or systemic symptoms. The pathological findings are characterized by the presence of foreign body granulomas with a sarcoid-like reaction. Its Interpretation Is difficult given Its association with sarcoidosis. We report the clinical case of a female patient with granulomatous lesions In reaction to a foreign body secondary to the multiple application of unknown substances on the face and buttocks.

Abstract Introduction: psoriasis is a systemic, inflammatory, and chronic disease with a global prevalence between 0.6-6.5 %. It is related to multiple comorbidities and generates a significant decrease in quality of life. Objective: to characterize sociodemographic, clinical, pharmacological, and quality of life variables in a population of patients with moderate-severe psoriasis. Methods: descriptive observational study the patients with a diagnosis of severe-moderate psoriasis treated in the Clínica Integral de Psoriasis-CLIPSO between May 2018 - June 2020. A collection format was designed for defined variables and a univariate analysis was performed. Results: 948 patients were identified with a median age of 50 years (IQR: 38-60) of which 51.0 % were women. 23.6 % were incidents with a median treatment time of 114 days (IQR: 98-127) and 73.9 % were prevalent with a median treatment time of 228 days (IQR: 160-371). The type of therapy used was mainly non-biological systemic and 90.9 % of the patients were adherent to the treatment. The clinical variables were similar for both groups and the most common phenotype was psoriasis vulgaris (57.1 %). The health-related quality of life in both groups was greater than 60 points and the affected dimensions were physical and psychological health. 27.3 % of the patients had comorbidities associated with cardiovascular risk and 44.7 % were overweight. Conclusion: knowing the sociodemographic, clinical, pharmacological, and quality of life characteristics of patients with moderate-severe psoriasis allows the identification of risk factors and comprehensive management of the disease.

Resumen Introducción: la psoriasis es una enfermedad sistémica, inflamatoria y crónica con una prevalencia global entre 0,6-6,5 %. Está relacionada con múltiples comorbilidades y genera una disminución significativa en la calidad de vida. Objetivo: caracterización sociodemográfica, clínica, farmacológica y calidad de vida de un grupo de pacientes con psoriasis moderada-severa. Métodos: estudio observacional descriptivo en pacientes con diagnóstico de psoriasis moderada-severa atendidos en la Clínica Integral de Psoriasis (CLIPSO) entre mayo 2018 y junio 2020. Se diseñó un formato para la recolección de las variables definidas y se realizó un análisis univariado. Resultados: se identificaron 948 pacientes con una mediana de edad de 50 años (RIC:38-60) de los cuales el 51 % eran mujeres. El 23,6 % eran incidentes, con una mediana en tiempo de tratamiento de 114 días (RIC:98-127) y 73,9 % eran prevalentes, con una mediana de tiempo de tratamiento de 228 días (RIC:160-371). El tipo de terapia utilizada fue principalmente sistémica no biológica y el 90,9 % de los pacientes eran adherentes al tratamiento. Las variables clínicas fueron similares en los incidentes y los prevalentes y el fenotipo más común fue psoriasis vulgar (57,1 %). La calidad de vida en ambos grupos fue mayor a 60 puntos y las dimensiones más afectadas en la calidad de vida fueron la salud física y la psicológica. El 27,3 % presentaban comorbilidades asociadas a riesgo cardiovascular y 44,7 % presentaban sobrepeso. Conclusión: conocer las características sociodemográficas, clínicas, farmacológicas y calidad de vida de los pacientes con psoriasis moderada-severa permite la identificación de factores de riesgo y un manejo integral de la enfermedad.

ABSTRACT The work environment, the "air that is breathed" within organizations, is largely linked to the perception formed by its members and has to do with the set of favorable and unfavorable feelings and emotions, which are reflected in the assessment that the collaborators give to their work; And given that it directly influences productivity, it is essential that institutions take care of creating an environment conducive to employees perceiving that they work in a pleasant environment. The general objective of the research was: Analyze the level of the work environment that exists in public and private companies in the city of Asunción. The Specific Objectives were: Identify the levels of general satisfaction of the work environment; and list the levels of job satisfaction in the 10 factors identified. The research had a non-experimental design, descriptive in scope, cross-sectional and quantitative approach. For data collection, the Work Environment Questionnaire (AT-ARG), created by Alex Sívori Ruíz Gómez, in 2009, was used. 104 people participated, collaborators from public and private institutions in Asunción. The level of general job satisfaction with their work environment was distributed as follows: 47% very favorable; 48% favorable, and only 5% expressed an average level of satisfaction with their work environment.

RESUMEN El clima laboral, el "aire que se respira" dentro de las organizaciones, está ampliamente ligada a la percepción que se forman sus miembros y tiene que ver con el conjunto de sentimientos y emociones favorables y desfavorables que se reflejan en la valoración que los colaboradores le dan a su trabajo; y dado que influye directamente sobre la productividad, es fundamental que las instituciones se ocupen de generar un ambiente propicio para que los colaboradores perciban que trabajan en un ambiente agradable. El Objetivo general de la investigación fue: Analizar en nivel del clima laboral que se vive en empresas públicas y privadas de la ciudad de Asunción. Los Objetivos Específicos fueron: Identificar los niveles de satisfacción general del ambiente de trabajo; y listar los niveles de satisfacción laboral en los 10 factores identificados. La investigación tuvo un diseño no experimental, de alcance descriptivo, de corte transversal y enfoque cuantitativo. Para la recolección de datos se utilizó el Cuestionario de ambiente de trabajo (AT-ARG), creado por Alex Sívori Ruíz Gómez, en el año 2009. Participaron 104 personas, colaboradoras de instituciones públicas y privadas de Asunción. El nivel de satisfacción laboral general con su ambiente laboral se distribuyó de la siguiente manera: 47 % muy favorable; 48 % favorable, y tan solo el 5 % manifestó un nivel medio de satisfacción con su ambiente laboral.

Resumen Introducción: Aunque el proceso de paz colombiano produjo una reducción en la cantidad de minas antipersona en el país, no hay estimativos sobre el efecto de este fenómeno en los desenlaces de los pacientes víctimas de estos artefactos. Objetivo: Nuestro objetivo fue evaluar la mortalidad por minas antipersona antes y durante la negociación del proceso de paz en Colombia. Además, exploramos posibles asociaciones entre las negociaciones de paz y la mortalidad. Métodos: Para este estudio utilizamos los datos del "Registro de víctimas colombianas de lesiones de minas antipersona" (base de datos MAP / MUSE) de 2002 a 2018. Este registro fue lanzado en 2001 por el gobierno de Colombia con el objetivo de recolectar información de manera prospectiva y sistemática de los casos de trauma por minas antipersona en el país. Clasificamos el período comprendido entre 2002 y 2012 como el período previo a la negociación (período de guerra), el comprendido entre 2014 y 2018 como el período de negociaciones de paz y el año 2013 como período de "depuración". Se utilizaron modelos de regresión logística multivariados para explorar las asociaciones entre las negociaciones de paz y la mortalidad. Resultados: Se registraron un total de 10306 casos de lesiones por minas antipersona. De estos, 1180 (11.4%) ocurrieron en el período de negociación de paz. La mortalidad fue significativamente menor durante el período de negociaciones de paz. El análisis de regresión logística multivariado determinó que el período de negociación de paz se asoció con una menor probabilidad de mortalidad después de sufrir una lesión por minas antipersona (OR = 0,6, IC 95%, 0,5-0,7; p <0,001). Conclusiones: Nuestros hallazgos sugieren una asociación entre el período de negociación de paz y una menor probabilidad de mortalidad entre las víctimas de las minas antipersona.

Abstract Introduction: Although the peace process in Colombia resulted in a significant reduction in the number of anti-personnel mines across the country, there are no reliable data on the effects of this phenomenon on outcomes for patients who were victims of these devices. Objective: The objective of this study was to assess mortality from landmine injuries before and during the Colombian peace process. Furthermore possible associations between peace negotiations and mortality were explored. Methods: For this study, we used the "Colombian Victims of Antipersonnel Mines Injuries registry" (MAP/MUSE database) data from 2002 to 2018. This registry was launched in 2001 by the government of Colombia with the aim of prospectively and systematically collect information on all the cases of anti-personnel mine injuries in the country. The period between 2002-2012 was classified as the pre-negotiation period (período de guerra), and 2014-2018 as the peace negotiations period, with 2013 classified as a washout year. Multivariate logistic regression was used to explore the association between peace negotiations and mortality among anti-personnel landmine injured individuals. Results: A total of 10306 landmine injury cases were registered. Of these, 1180 (11.4%) occurred in the peace-negotiation period. Mortality was significantly lower during the period of peace negotiations. After adjusting for sex, age group, race, active duty soldier status, rural area, and geographic Departamentos case volumes, the peace negotiation period was found to be associated with lower risk-adjusted odds of mortality after suffering a landmine injury (OR= 0.6, 95% CI, 0.5-0.7; p<0.001). Conclusions: Our findings suggest an association between the period of peace negotiation and a lower likelihood of mortality among victims of anti-personnel landmines.

Resumen La pigmentación exógena por nitrato de plata es una enfermedad poco frecuente, cuyas manifestaciones clínicas pueden aparecer años después del contacto, lo que en ocasiones dificulta su diagnóstico. Se caracteriza por la presencia de máculas o placas azul-grisáceas en la piel o las mucosas de la zona de contacto que, en ocasiones, son muy similares a las lesiones melanocíticas y al melanoma, sus principales diagnósticos diferenciales. Se reporta el caso de un paciente de Medellín, Colombia, con antecedentes familiares de melanoma y presencia de estas lesiones en todo el cuerpo.

Abstract Exogenous pigmentation by silver nitrate is a rare disease whose clinical manifestations appear even years after the contact, making its diagnosis difficult on occasions. It is characterized by the presence of blue-gray macules or plaques on the skin or mucosa in the contact area, sometimes very similar to melanocytic lesions and melanoma, which constitute the main differential diagnosis. We report the case of a male patient from Medellín, Colombia, with a family history of melanoma and the presence of these lesions throughout his body.

ABSTRACT Ion exchange resin poly(4-vinylbenzyl) trimethylammonium chloride(P(ClVBTA)) was synthesized and its removal properties toward vanadium(V) and molybdenum(VI) were evaluated and compared with those of the Amberlite IRA-402 commercial resin. The resin was characterized by FT-IR spectroscopy, TGA, and SEM. The water absorption capacity, pH effect, Langmuir and Freundlich adsorption isotherms, and kinetic model parameters were determined. All studies were conducted through a batch equilibrium procedure. Thermodynamic parameters, including enthalpy, entropy, and free energy, were determined. The P(ClVBTA) resin showed faster and higher capacity for the removal of V(V) and Mo(VI) from a water solution than the Amberlite IRA-402 commercial resin with the same ammonium salt functional group. The higher capacity of the P(ClVBTA) resin was attributed to the higher degree of swelling, the exfoliation in the monolayer, and the small particle size.

Abstract: This article reviews the intellectual beginnings of Florestan Fernandes, trying to identify the bases of his thinking and presenting evidence about the peculiar articulation of two facets that characterize his trajectory: academical and political. The article is organized around four key aspects of his vital experience, which dictate, in our point of view, his most important positions: the markers of his social origin; his political participation in the Partido Socialista Revolucionario; liberal reformism and education as a trench against authoritarianism; and the essay of national interpretation and the reception of worldwide sociology.

Resumen: El artículo revisa los inicios de la formación intelectual del autor con el objeto de identificar las bases de su pensamiento y evidenciar la peculiar articulación de las dos facetas que caracterizaron la trayectoria de Fernandes: académica y militante. La exposición se organiza a partir de cuatro núcleos de experiencia vital desde donde se construyen, a nuestro juicio, sus posicionamientos más importantes: las marcas del origen social, la miltancia política en el Partido Socialista Revolucionario, el reformismo liberal y la educación como trinchera contra el autoritarismo, el ensayo de interpretación nacional y la recepción de la sociología mundial.

Abstract Since its inception, the life course approach has been widely used in the socio-demographic research and sociological studies. The use of this perspective in health research has spread for some years, although its use in pediatrics has been limited. This work presents the main concepts of the life course approach and some methodological principles for the development of research from this perspective. In addition, a series of research projects that have used this approach as a conceptual basis in their design and implementation are included, as well as some sources of information that can be used for the development of research since this conceptualization in Mexico.

Resumen Desde su concepción, el enfoque del curso de vida se ha utilizado ampliamente en la investigación sociodemográfica y en los estudios sociológicos. El empleo de esta perspectiva se ha difundido desde hace algunos años en la investigación en salud. Sin embargo, su uso ha sido muy limitado en pediatría. Este trabajo presenta una exposición de los principales conceptos del enfoque del curso de vida y algunos principios metodológicos para el desarrollo de investigaciones desde esta perspectiva. Además, se incluyen una serie de proyectos de investigación que se han valido de este enfoque como fundamentación conceptual en su diseño e implementación y algunas fuentes de información que pueden ser utilizadas para el desarrollo de investigaciones desde esta conceptualización en México.

ABSTRACT The solvent impregnated resin (SIR) was prepared by using Diaion HP-2MG as a hydrophilic polymer adsorbent and commercial Aliquat 336 as extractant for hexavalent chromium Cr(VI) removal from aqueous solution. The resulting SIRs were stabilized by coating using poly(vinyl alcohol) (PVA) and divinylsulfone as crosslinking reagent with different amounts. In order to predict the mechanism involved in the adsorption process, several kinetic models were used. Among them, the sorption kinetics was usually described by pseudo-first or pseudo-second order models. The kinetic behavior of stabilized SIRs was investigated as a function of amount of crosslinking reagent by batch adsorption equilibrium. Uncoated resins exhibited a faster kinetics than coated ones. It was possible to improve the kinetic performance of crosslinked resins with conditioning by using NaOH-NaCl mixture. The breakthrough profiles of SIRs were also influenced by amount of cross linking reagent.

ABSTRACT Ion exchange resins based on the water-insoluble polymers poly(acrylamide-co-styrene sodium sulfonate) (P(AAm-co-ESS)), poly(2-acrylamide-2-methyl-1-propanesulfonic acid-co-acrylicacid) (P(APSA-co-AAc)),poly(2-acrylamidoglycolic acid-co-2-acrylamide-2-methyl-1-propane sulfonic acid) (P(AAGA-co-APSA)), and poly(2-acrylamidoglycolic acid-co-4-styrene sodium sulfonate) (P(AAGA-co-ESS)) were synthesized by radical polymerization. These polymers were employed to remove Cr(III) from an aqueous solution. The optimum sorption parameters of amount of resin and sorption time were obtained through batch-mode sorption tests. Following batch elution tests to identify the best eluting agent. Finally, the column-mode sorption/elution behaviors of ion exchange resins were studied. The ion exchange resins exhibited excellent removal of Cr(III). The P(AAGA-co-APSA) resin exhibited 89.4% removal, while P(AAGA-co-ESS) displayed 88.3%, P(AAm-co-ESS) 86.8%, and P(APSA-co-AAc) 89.3%. The column-mode was studied by the P(AAGA-co-APSA) resingave a breakthrough capacity of 1.5 mg Cr(III)/mL resin in the first cycle. The elution efficiency was almost 100%. The breakthrough capacity was 1.2 mg Cr(III)/mL resin in the second cycle. The elution efficiency was 90.2% in the second cycle.

The water-insoluble polymers poly(acrylamide-co-styrene sodium sulfonate) (P(AAm-co-ESS)) and poly(2-acrylamide-2-methyl-1-propanesulfonic acid-co-acrylic acid) (P(APSA-co-AAc)) were synthesized by radical polymerization. Parameters including the water sorption capacity, effect of the pH and reaction time, maximum retention capacity of the metal ions, elution, regeneration, and selectivity were studied. The commercial resin Amberlite IRP-64 was used for comparative purposes. Laboratory tests showed that both of the resins had better capacities to remove Pb(II), Cd(II), Zn(II), and Hg(II) from an aqueous solution by the batch method. P(AAm-co-ESS) and P(APSA-co-AAc) resins remove the metal ions faster and had better regeneration than commercial Amberlite IRP-64 resin.

Austrocedrus chilensis forests suffer a widespread mortality locally known as «mal del ciprés» (cypress disease) whose cause remains controversial. Previous studies suggested Phytophthora austrocedrae as the biotic cause; however, the origin of the mortality is still being studied since there are affected areas not connected with Phytophthora. The soil was proved to be an important factor affecting the disease. The purpose of this article was to study soil chemical properties related to A. chilensis disease. Four sampling sites with A. chilensis dense forests developed on different types of soils were selected in the 16 de Octubre Valley (Chubut province, Argentine). In each of them, pairs of plots that differed in disease symptoms were established. Each pair included a plot with an advanced degree of disease (diseased plot) and another that did not exhibit symptoms (asymptomatic plot). Eight plots were included in the control forests, where the disease was totally absent. In each plot, a soil sample from the A horizon was collected for chemical analyses. This study showed high soil chemical fertility in all the forest soils, with high contents of organic matter, nitrogen, exchangeable cations and high cation exchange capacity. Differences between diseased forests and control forests were found for the following properties: sum of bases, base saturation, calcium, pH NaF and phosphorus. These differences could be associated with the drainage conditions and may also be associated to the presence of Phytophthora.

Los bosques de Austrocedrus chilensis sufren un proceso de mortalidad conocido como «mal del ciprés», cuya causa es aún discutida. Estudios previos sugieren la presencia de Phytophthora austrocedrae como agente causal de la mortalidad; sin embargo, el origen de la enfermedad continúa en estudio, dado que existen áreas afectadas no vinculadas con Phytophthora. El suelo, principalmente a través de sus características físicas y morfológicas, fue evidenciado como un factor asociado con la aparición y desarrollo de la enfermedad. En este trabajo, se evaluó la fertilidad química del suelo en relación al «mal del ciprés». Se seleccionaron cuatro sectores ubicados en el Valle «16 de Octubre» de la provincia del Chubut correspondientes a bosques puros y densos de A. chilensis. En cada sector se instalaron parcelas en áreas del bosque con síntomas severos de la enfermedad y en áreas sin síntomas. A su vez se incorporaron al estudio ocho parcelas control, ubicadas en bosques completamente sanos. Se tomaron muestras del horizonte A y se caracterizaron las propiedades químicas del suelo. No se encontraron deficiencias nutricionales y se observó un buen estado nutricional en todos los suelos analizados, aún en los bosques afectados, reflejándose en valores adecuados de materia orgánica, nitrógeno, bases y capacidad de intercambio catiónico. Se manifestaron diferencias entre los suelos bajo bosque afectado y suelos bajo bosques control en los contenidos de suma de bases, saturación de bases, calcio, pH NaF y fósforo. Estas diferencias podrían estar asociadas tanto a las condiciones de drenaje como a la presencia de Phytophthora.

INTRODUÇÃO: A aplicação de ventilação por dois níveis de pressão positiva (BiPAP®) associada à fisioterapia respiratória convencional (FRC) no pós-operatório (PO) imediato de cirurgia cardíaca pode contribuir para a diminuição das complicações pulmonares. OBJETIVO: Avaliar a segurança e a adesão da aplicação preventiva do BiPAP® associado a FRC no PO imediato de revascularização do miocárdio. MÉTODOS: Vinte e seis pacientes submetidos a revascularização do miocárdio foram aleatoriamente alocados. O Grupo Controle (GC) foi tratado com FRC, o Grupo BiPAP (GB) foi submetido a 30 minutos de BiPAP®, duas vezes ao dia, associado à FRC. A FRC foi realizada em ambos os grupos, duas vezes ao dia. Todos os pacientes foram avaliados quanto: capacidade vital, permeabilidade das vias aéreas, pressões respiratórias máximas, saturação de oxigênio, frequência cardíaca, frequência respiratória, volume minuto, volume corrente, pressões arteriais sistólica e diastólica. As avaliações foram realizadas durante a internação no pré-operatório, imediatamente após a extubação, e na 24ª e 48ª horas após extubação. RESULTADOS: No GC, 61,5% dos pacientes tiveram algum grau de atelectasias, no GB, 54% (P=0,691). A capacidade vital foi estatisticamente maior no GB no PO (P<0,015). Todos os outros parâmetros de ventilometria, gasometria, manovacuometria e hemodinâmicos foram semelhantes entre os grupos. CONCLUSÃO: A cirurgia de revascularização do miocárdio leva à degradação da função respiratória no PO, e a aplicação da ventilação com pressão positiva (BiPAP®) pode ser benéfica para reestabelecer a função pulmonar mais rapidamente, principalmente a capacidade vital, de forma segura, sendo bem aceita pelos paciente, devido ao maior conforto em relação à sensação de dor durante a execução da fisioterapia respiratória.

INTRODUCTION: The application of two levels of ventilation by positive pressure (BiPAP®) associated with conventional respiratory therapy (CRT) in postoperative periord of cardiac surgery may contribute to reduction of pulmonary complications. OBJECTIVES: To evaluate the safety and compliance of preventive application of BiPAP® CRT associated with immediate postoperative myocardial revascularization. METHODS: 26 patients undergoing coronary artery bypass grafting were randomly allocated in one of the groups. Patients of the Control Group (CG) were treated only with conventional respiratory therapy, compared to BiPAP group (BG) (in addition to conventional respiratory therapy the patients were subjected to 30 minutes of ventilation by two levels twice a day). The conventional respiratory therapy was held in both groups, twice a day. All patients were evaluated for vital capacity, airway permeability, maximal respiratory pressures, oxygen saturation, heart rate, respiratory frequency, Volume Minute, tidal volume, systolic and diastolic blood pressure. Evaluations were performed during hospitalization preoperatively, immediately after extubation, 24h and 48h after extubation. RESULTS: In CG 61.5% of patients had some degree of atelectasias, in comparison to 54% of BG (P=0.691). The vital capacity was higher in the GB postoperatively (P<0.015). All the other ventilometric, gasometric, hemodynamic and manometric parameters were similar between groups. CONCLUSION: Coronary artery bypass grafting leads to deterioration of respiratory function postoperatively, and the application of positive pressure ventilation (BiPAP®) may be beneficial to restore lung function more quickly, especially vital capacity, safely, and well accepted by patients due to greater comfort with the sensation of pain during the execution of respiratory therapy.