ABSTRACT Oral myiasis is a rare parasitic disease that requires immediate treatment once diagnosed. However, no standard treatment protocol can be found in the literature. Through a clinical-surgical report, we present the case of an 82-year-old man with lesions extending through the vestibule and alveolar ridge of the maxilla on both sides, in addition to occupying a large part of the palate, with a considerable number of larvae. The patient was initially treated with a single dose of systemic ivermectin (6 mg orally) and topical application of a tampon soaked in ether. The larvae were then surgically removed and debridement of the wound was performed. A crushed tablet of ivermectin 6 mg was applied topically for 2 days, the remaining larvae were again mechanically removed, and the patient received intravenous antimicrobial therapy. Treatment with systemic and topical ivermectin combined with antibiotic therapy and debridement proved to be effective in treating oral myiasis.

ABSTRACT Simple liver cysts (SLC) are the most common liver tumors. They are usually asymptomatic but large cysts may produce symptoms. The aim of this article is to report a rare complication of SLC. We report the case of a 61-year-old woman with a history of multiple SLCs who sought medical care due to sudden abdominal pain not associated with trauma. A probable diagnosis of spontaneous rupture was made, and the patient underwent computed tomography (CT) scan of the abdomen which confirmed the suspicion. Conservative treatment was decided, with favorable outcome. After the acute episode the patient underwent surgery and the cysts were unroofed. Rupture of SLC is a rare complication that usually presents with abdominal pain. There is no standard of care due to the low incidence of this complication. The conservative approach is a good option in patients without signs of peritonitis, while emergency surgery is indicated in patients with acute abdomen.

RESUMEN Los quistes hepáticos simples (QHS) son las lesiones hepáticas más frecuentes. Cursan habitualmente asintomáticas, aunque cuando alcanzan gran tamaño pueden causar síntomas. El objetivo del presente artículo es presentar una complicación excepcional de los QHS. Presentamos a una mujer de 61 años con historia de QHS múltiples que acude a Urgencias por dolor abdominal brusco sin antecedente traumático. Ante la sospecha de rotura quística espontánea, se realiza tomografía computarizada (TC) abdominal que confirma el diagnóstico. Se decide tratamiento conservador con buena evolución. Tras el episodio agudo es intervenida quirúrgicamente realizándose destechamiento de los quistes. a rotura de los QHS es una complicación excepcional que habitualmente cursa con dolor abdominal. Debido a su baja frecuencia no existe un tratamiento estándar. Se acepta que el tratamiento conservador es una buena opción en pacientes sin signos de peritonitis, mientras que la cirugía urgente está indicada en pacientes con abdomen agudo.

Objectives: Golimumab is approved for patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis. However, data from our region are scarce. The aim of this study was to evaluate the efficacy, safety, and cumulative survival of golimumab in real-life patients with RA, PsA and axial spondyloarthritis (axSpa) from different rheumatology centers in Argentina. Material and methods: We performed a longitudinal study of consecutive adults with RA (ACR/EULAR 2010 criteria), PsA (CASPAR criteria) and axSpa (ASAS 2009 criteria), who have started treatment with golimumab according to medical indication. Data was obtained by review of medical records. Sociodemographic and clinical data, musculoskeletal manifestations, comorbidities and previous treatments were recorded. In reference to golimumab treatment, start date, route of administration and concomitant treatments were identified. Disease activity was assessed using DAS28 for RA patients, DAPSA and MDA for PsA and BASDAI for axSpa. The presence of adverse events was recorded. If golimumab was stopped, date and cause was documented. Patients were followed up until golimumab discontinuation, loss of follow-up, death, or study completion (November 30, 2020). Results: In total 182 patients were included, 116 with a diagnosis of RA, 30 with PsA and 36 with axSpa. Most of them (70.9%) were female with a median (m) age of 55 years (IQR 43.8-64) and m disease duration of 7 years (IQR 4-12.7) at treatment initiation. Al least one prior biological (-b) and/or targeted synthetic (-ts) disease modifying antirheumatic drug (DMARD) was received by 63 patients (34.6%). Total follow-up was 318.1 patients/year. Golimumab treatment showed clinical improvement in all three groups of patients. The incidence of AE was 6.6 per 100 patients/year, being infections the most frequents ones. During follow-up, 50 patients (27.5%) discontinued golimumab, the most frequent cause was treatment failure (68%), followed by lack of health insurance (16%) and adverse events (10%). Golimumab persistence was 76% and 68% at 12 and 24 months, respectively. Treatment survival was 50.2 months (95% CI 44.4-55.9). Patients who had received prior treatment with b- or ts-DMARDs showed lower survival (HR 2.41, 95% CI 1.3-4.4). Conclusions: Golimumab treatment in real life patients in Argentina has shown good efficacy and safety. Drug survival was over 4 years and almost 80% were still using golimumab after one year. Prior treatment with other b- or ts-DMARDs was associated with lower treatment survival.

Objetivos: Golimumab ha sido aprobado para el tratamiento de pacientes con artritis reumatoidea (AR), artritis psoriásica (APs) y espondiloartritis axial. Sin embargo, los datos provenientes de nuestra región son escasos. El objetivo de este estudio fue evaluar la eficacia, seguridad y sobrevida acumulada de golimumab en pacientes de la vida real con AR, APs y espondilitis anquilosante (EA) de diferentes centros de Argentina. Material y métodos: Se llevó a cabo un estudio longitudinal, en el que se incluyeron pacientes consecutivos mayores de 18 años con diagnóstico de AR (criterios ACR/EULAR 2010), APs (criterios CASPAR) y Espax (criterios ASAS 2009), que hayan iniciado tratamiento con golimumab de acuerdo a la indicación médica. Se obtuvieron los datos por revisión de historias clínicas. Se consignaron características sociodemográficas, clínicas, comorbilidades y tratamientos previos. Con respecto al golimumab, se registraron fecha de inicio, vía de administración y tratamientos concomitantes. Se determinó la actividad de la enfermedad mediante DAS28 en el caso de la AR, por DAPSA y MDA para APs y por BASDAI en el caso de Espax. Se consignó la presencia de eventos adversos (EA). En el caso de suspensión del tratamiento, se identificaron la fecha y motivo del mismo. Los pacientes fueron seguidos hasta la suspensión del golimumab, pérdida de seguimiento, muerte, o finalización del estudio (30 de noviembre de 2020). Resultados: Se incluyeron 182 pacientes, 116 con diagnóstico de AR, 30 con APs y 36 con Espax. La mayoría de ellos (70.9%) eran mujeres con una edad mediana (m) de 55 años (RIC 43.8-64) y una duración de la enfermedad m de 7 años (RIC 4-12.7) al inicio del tratamiento. El 34.6% de los mismos habían recibido al menos una droga modificadora de la enfermedad (DME) biológica (-b) o sintética dirigida (-sd) previamente. El seguimiento total fue de 318.1 pacientes/año. El tratamiento con golimumab mostró mejoría clínica en los tres grupos de pacientes. La incidencia de eventos adversos fue de 6.6 por 100 pacientes/año, siendo las infecciones las más frecuentes. Durante el seguimiento, 50 pacientes (27.5%) suspendieron golimumab, la causa más frecuente fue el fracaso del tratamiento (68%), seguida de la falta de cobertura (16%) y el desarrollo de eventos adversos (10%). La persistencia de golimumab fue del 76% y 68% a los 12 y 24 meses, respectivamente. Se registró una sobrevida de 50.2 meses (IC 95% 44.4-55.9). Los pacientes que habían recibido tratamiento previo con DME-b y/o -sd mostraron una menor sobrevida (HR 2.4, IC 95% 1.3-4.4). Conclusiones: El tratamiento con golimumab en pacientes de la vida real en Argentina ha demostrado una buena eficacia y seguridad. La sobrevida del fármaco fue de más de 4 años y casi el 80% seguía usando golimumab después de un año. El tratamiento previo con otros DME-b o -sd se asoció con una menor sobrevida al tratamiento.

Abstract Objective: The objective was to measure the incidence of surgical site infection (SSI) and identify risk factors, in patients undergoing elective surgery of the colon and rectum. Materials and methods: A prospective cohort study was performed from January 2017 to December 2018. Results: A total of 130 patients were studied. The cumulative incidence of SSI was 12.3%. The 56.25% were superficial wound infections and the 31.25%, organ-space infection. The risk factors significantly associated with SSI were the non-administration of pre-operative oral nutrition, diabetes mellitus, heart disease, symptomatic state at the diagnosis of colorectal cancer (CRC), and ≥ 2 altered nutritional biochemical parameters at diagnosis. After multivariate , risk factors associated with SSI were: non-administration of preoperative enteral nutrition (odds ratio [OR] = 0.27; 95% confidence interval [CI]: 0.07-1.0), DM (OR = 3.0; 95% CI: 0.9-9.9), the heart disease (OR = 4.6; 95% CI: 1.1-18.6), and laparoscopic surgery (OR = 0.28; 95% CI: 0.08-0.97). The average stay was higher in patients with a diagnosis of SSI (11.9 vs. 9.2 days). Conclusions: Independent risk factors for SSI in CRC were the non-administration of pre-operative enteral nutrition, the existence of heart disease, and open surgery.

Resumen Objetivo: Estudiar la incidencia de infección del sitio quirúrgico y evaluar sus factores de riesgo en pacientes intervenidos de cirugía colorrectal electiva. Método: Se realizó un estudio de cohortes prospectivo desde enero de 2017 hasta diciembre de 2018. Resultados: Se incluyeron 130 pacientes. La incidencia acumulada de infección del sitio quirúrgico fue del 12,3% (n = 16), siendo el 56,25% infecciones de herida y el 31,25% infecciones órgano-espacio. Los factores de riesgo asociados a infección del sitio quirúrgico con significación estadística fueron la no administración de nutrición oral preoperatoria, la diabetes mellitus, la enfermedad cardiaca, la presencia de síntomas en el momento del diagnóstico de cáncer colorrectal y tener al menos dos parámetros bioquímicos nutricionales alterados. Tras el análisis multivariante se asociaron la no administración de nutrición enteral preoperatoria (odds ratio [OR] = 0,27; intervalo de confianza del 95% [IC95%]: 0,07-1,0), la diabetes mellitus (OR = 3,0; IC95%: 0,9-9,9), la enfermedad cardiaca (OR = 4,6; IC95%: 1,1-18,6) y la cirugía laparoscópica (OR = 0,28; IC95%: 0,08-0,97). La estancia media fue mayor en los pacientes con diagnóstico de infección del sitio quirúrgico (11,9 frente a 9,2 días). Conclusiones: Los factores de riesgo independientes para el desarrollo de infección del sitio quirúrgico en los pacientes con cáncer colorrectal fueron la no administración de nutrición oral preoperatoria, la enfermedad cardiaca y la cirugía abierta.

Abstract % We show that codimension one distributions with at most isolated singularities on certain smooth projective threefolds with Picard rank one have stable tangent sheaves. The ideas in the proof of this fact are then applied to the characterization of certain irreducible components of the moduli space of stable rank 2 reflexive sheaves on $\p3$, and to the construction of stable rank 2 reflexive sheaves with prescribed Chern classes on general threefolds. We also prove that if $\sG$ is a subfoliation of a codimension one distribution $\sF$ with isolated singularities, then $\sing(\sG)$ is a curve. As a consequence, we give a criterion to decide whether $\sG$ is globally given as the intersection of $\sF$ with another codimension one distribution. Turning our attention to codimension one distributions with non isolated singularities, we determine the number of connected components of the pure 1-dimensional component of the singular scheme.

COVID-19 dramatically impacted social vulnerable regions at the periphery of large Brazilian cities. Besides, low testing capacity resulted in the lack of proper control measures due inconsistent information on the disease behave. Objectives: to estimate seroprevalence of SARS-CoV-2 antibodies among Baixada Santista Metropolitan Region (RMBS) population and the impacts of social vulnerability and public policies implemented within an iniquity environment. Methods: a quantitative, cross-sectional study, through a serial serological survey and the application of a questionnaire in stratified population sampling and home drew, in nine municipalities of RMBS. Conclusions: Seroprevalence was 1.4% in the first and 2.2% in the second phase, allowing estimating 15 infected people for each case notified in the first phase, and 10 in the following. Lethality was recalculated to 0.40% and 0.48% in each phase, approaching the international rates. Social vulnerable people were the most affected by the pandemic. Informal work, low income, self-reported skin color as black or brown and ambivalent information regarding prevention should be considered as risk factors. Our results reinforce the relevance of social isolation and the adoption of protective economic and social measures especially for social vulnerable populations

A COVID-19 chegou rapidamente na periferia das grandes cidades brasileiras, socialmente mais vulnerável. A baixa capacidade de testagem resulta na adoção de medidas sem informações consistentes sobre o comportamento da doença e interfere na adoção de ações de controle. Objetivos: estimar a prevalência de infecção por SARS-CoV-2 na população da Região Metropolitana da Baixada Santista (RMBS) e analisar impactos da vulnerabilidade social e de políticas públicas implementadas em contextos de desigualdades. Métodos: estudo de caráter quantitativo, transversal, através de inquérito sorológico seriado e aplicação de questionário em amostragem populacional estratificada e coleta domiciliar, nos nove municípios da RMBS. Conclusões: A soroprevalência medida foi de 1,4% na primeira fase e de 2,2 % na segunda permitindo estimar 15 pessoas infectadas para cada caso notificado na primeira fase, e 10 na seguinte. A letalidade foi recalculada para 0,40% e 0,48 % em cada fase, aproximando-se da casuística internacional. Pessoas mais vulneráveis são as mais atingidas pela pandemia, devendo ser consideradas: a informalidade no trabalho, baixa renda, cor da pele auto referida como preta ou parda e informações ambivalentes quanto à prevenção. Os resultados reforçam a importância do isolamento social e de adoção de medidas econômicas e sociais protetivas destinadas às populações vulneráveis.

RESUMO A Covid-19 chegou rapidamente à periferia das grandes cidades brasileiras, a qual é socialmente mais vulnerável. A baixa capacidade de testagem resulta na adoção de medidas sem informações consistentes sobre o comportamento da doença e interfere na adoção de ações de controle. Objetivou-se estimar a prevalência de infecção por SARS-CoV-2 na população da Região Metropolitana da Baixada Santista (RMBS) e analisar impactos da vulnerabilidade social e de políticas públicas implementadas em contextos de desigualdades. Estudo de caráter quantitativo, transversal, mediante inquérito sorológico seriado e aplicação de questionário em amostragem populacional estratificada e coleta domiciliar, nos nove municípios da RMBS. Conclui-se que a soroprevalência medida foi de 1,4% na primeira fase, e de 2,2% na segunda; permitindo estimar 15 pessoas infectadas para cada caso notificado na primeira fase, e 10 na seguinte. A letalidade foi recalculada para 0,40% e 0,48% em cada fase, aproximando-se da casuística internacional. Pessoas mais vulneráveis são as mais atingidas pela pandemia, devendo ser consideradas: informalidade no trabalho, baixa renda, cor da pele autorreferida como preta ou parda e informações ambivalentes quanto à prevenção. Os resultados reforçam a importância do isolamento social e da adoção de medidas econômicas e sociais protetivas destinadas às populações vulneráveis.

ABSTRACT Covid-19 dramatically impacted socially vulnerable regions at the outskirts of large Brazilian cities. Besides, low testing capacity resulted in the lack of proper control measures due to inconsistent information on the disease’s behavior. This study aimed to estimate prevalence of SARS-CoV-2 antibodies among the Baixada Santista Metropolitan Region (RMBS) population and the impacts of social vulnerability and public policies implemented within an environment of inequality. A quantitative, cross-sectional study, through a serial serological survey and the application of a questionnaire in stratified population sampling and home drew, in nine municipalities of RMBS. Seroprevalence was 1.4% in the first and 2.2% in the second phase, allowing to estimate 15 infected people for each case notified in the first phase, and 10 in the following. Lethality was recalculated to 0.40% and 0.48% in each phase, approaching the international rates. Socially vulnerable people were the most affected by the pandemic. Informal work, low income, self-reported skin color as black or brown, and ambivalent information regarding prevention should be considered as risk factors. Our results reinforce the relevance of social isolation and the adoption of protective economic and social measures, especially for socially vulnerable populations.

RESUMO A Covid-19 chegou rapidamente à periferia das grandes cidades brasileiras, a qual é socialmente mais vulnerável. A baixa capacidade de testagem resulta na adoção de medidas sem informações consistentes sobre o comportamento da doença e interfere na adoção de ações de controle. Objetivou-se estimar a prevalência de infecção por SARS-CoV-2 na população da Região Metropolitana da Baixada Santista (RMBS) e analisar impactos da vulnerabilidade social e de políticas públicas implementadas em contextos de desigualdades. Estudo de caráter quantitativo, transversal, mediante inquérito sorológico seriado e aplicação de questionário em amostragem populacional estratificada e coleta domiciliar, nos nove municípios da RMBS. Conclui-se que a soroprevalência medida foi de 1,4% na primeira fase, e de 2,2% na segunda; permitindo estimar 15 pessoas infectadas para cada caso notificado na primeira fase, e 10 na seguinte. A letalidade foi recalculada para 0,40% e 0,48% em cada fase, aproximando-se da casuística internacional. Pessoas mais vulneráveis são as mais atingidas pela pandemia, devendo ser consideradas: informalidade no trabalho, baixa renda, cor da pele autorreferida como preta ou parda e informações ambivalentes quanto à prevenção. Os resultados reforçam a importância do isolamento social e da adoção de medidas econômicas e sociais protetivas destinadas às populações vulneráveis.

ABSTRACT Covid-19 dramatically impacted socially vulnerable regions at the outskirts of large Brazilian cities. Besides, low testing capacity resulted in the lack of proper control measures due to inconsistent information on the disease’s behavior. This study aimed to estimate prevalence of SARS-CoV-2 antibodies among the Baixada Santista Metropolitan Region (RMBS) population and the impacts of social vulnerability and public policies implemented within an environment of inequality. A quantitative, cross-sectional study, through a serial serological survey and the application of a questionnaire in stratified population sampling and home drew, in nine municipalities of RMBS. Seroprevalence was 1.4% in the first and 2.2% in the second phase, allowing to estimate 15 infected people for each case notified in the first phase, and 10 in the following. Lethality was recalculated to 0.40% and 0.48% in each phase, approaching the international rates. Socially vulnerable people were the most affected by the pandemic. Informal work, low income, self-reported skin color as black or brown, and ambivalent information regarding prevention should be considered as risk factors. Our results reinforce the relevance of social isolation and the adoption of protective economic and social measures, especially for socially vulnerable populations.

RESUMO Em 2007, o Ministério da Saúde, com o objetivo de desenvolver ações de apoio às equipes de atenção básica por meio da educação permanente e de tecnologias virtuais, instituiu o Programa Telessaúde Brasil, mais tarde denominado Telessaúde Brasil Redes. Inicialmente, no projetopiloto, foram constituídos nove Núcleos de Telessaúde no Brasil, sendo um deles em Santa Catarina, vinculado à Universidade Federal de Santa Catarina e posteriormente com parceria da Secretaria Estadual de Saúde (SES). Um dos serviços ofertados pelo Núcleo de Telessaúde de Santa Catarina é a teleconsultoria, que se trata de consulta registrada e solicitada por profissionais de saúde com o fim de esclarecer dúvidas sobre procedimentos clínicos, de gestão e processo de trabalho, realizada por meio de telecomunicação bidirecional à distância. Embora o serviço esteja disponível desde sua implantação, seu uso sempre foi numericamente pequeno, ao passo que há grande quantidade de encaminhamentos desnecessários à atenção especializada com possibilidade de manejo na atenção básica. Este trabalho relata a experiência da implantação de fluxo compulsório de teleconsultoria antes do encaminhamento às especialidades, ocorrida no Núcleo de Telessaúde de Santa Catarina. O estabelecimento do fluxo compulsório demonstrou que grande parte dos casos apresenta sugestão de manejo na atenção básica, com diminuição importante do número de encaminhamentos às especialidades envolvidas e consequente diminuição do tempo de espera para consulta com o especialista. Além disso, nestes casos de sugestão de encaminhamento, a teleconsultoria possibilita a classificação de risco, a solicitação prévia de exames e o manejo compartilhado, qualificando, desta forma, o acesso à especialidade e o próprio cuidado ao usuário. A teleconsultoria potencializa ainda a qualidade da comunicação entre os pontos de atenção, pois ela passa a ser estratégica na definição do fluxo do usuário, tanto para a referência, quanto para a contrarreferência, com aprendizado mútuo e funcionamento que de fato caracteriza uma rede de cuidados. Quanto à compulsoriedade da teleconsultoria, ainda que cause alguns desconfortos no início do processo, o uso incipiente do serviço quando da modalidade espontânea, o número de encaminhamentos desnecessários às especialidades e a quantidade de teleconsultorias com possibilidade de manejo na atenção básica justificam a decisão como propósito de gestão. Esse conjunto de aspectos tem impacto positivo no cuidado do usuário, que tem suas necessidades atendidas e acompanhadas, seja na atenção básica ou na atenção especializada, em tempo, situação e local oportunos.

ABSTRACT In 2007, with the aim of developing actions to support primary health care teams through the use of permanent education and virtual technologies, the Health Ministry established the Telehealth Program Brazil, later named the Brazil Telehealth Networks. The pilot project initially involved the establishment of nine Telehealth Centers in Brazil, one of which is in Santa Catarina, and linked to the Federal University of Santa Catarina, and later formed a partnership with the State Health Department (SES). One of the services offered by the Santa Catarina Telehealth Center is teleconsulting, which involves registering and requesting consultation by health professionals in order to clarify questions about clinical procedures, work process and management, by means of two-way remote telecommunication. Despite the service being made available from its implantation, it has always been relatively underused, whereas there is a disproportionally high amount of unnecessary referrals to specialized care that could be managed within Primary Care. This paper reports on the experience of implementing a forced flow through teleconsulting prior to referral to specialists, at the Telehealth Center of Santa Catarina. The established forced flow demonstrated that for most the cases there were possible solutions within Primary Care, resulting in a considerable reduction in the number of referrals to the specialties involved, and a consequently reduced waiting time for consultations with specialists. Furthermore, in these cases where referral was suggested, the teleconsulting allowed for risk assessment, prior request for tests or scans and shared management, thus qualifying the access to the specialist and the actual care of the the patient. Teleconsulting also enhances the quality of communication between the points of care, as it takes on a strategic role in defining the user flow, both for referrals and counter-referrals, with mutual learning and functioning which effectively characterizes a care network. As regards to the compulsory imposition of teleconsulting, although causing some initial discomfort, incipient use of the service implemented spontaneously, coupled with the number of unnecessary referrals to specialties and the quantity of remote consultations that can be handled within primary care justify the decision as a management objective. This combination of factors has a positive impact on the care for whose needs are met and followed up, whether in Primary Care or Specialized Care, in a timely manner and suitable location.

En la actualidad, uno de los principales obstáculos de las organizaciones de desarrollo de software en la implementacion del Modelo CMMI-Dev es como iniciar su implementación y aumentar la probabilidad de éxito en una evaluación SCAMPI. Este método de evaluación permite validar, establecer e identificar las oportunidades de mejora de procesos para obtener un nivel de madurez. Sin embargo, el método de evaluación SCAMPI no garantiza una evaluación exitosa, debido a que el proceso de evaluación es empírico basado en la experiencia del equipo auditor experto en Mejora de Procesos de Software con respecto a este modelo. Este artículo propone la identificacion de alternativas de caminos a traves de una herramienta para lograr una efectiva implementación en el modelo CMMI-DEV Nivel 2, considerando sus objetivos de negocio de la organización

One of the main obstacles of software development organizations in the implementation of the CMMI-Dev Model is how to start its implementation and increase the probability of success in a SCAMPI evaluation. This evaluation method allows to validate, establish and identify opportunities for process improvement to obtain a level of maturity in this model. However, the SCAMPI evaluation method does not guarantee a successful evaluation, because the evaluation process is empirical based on the experience of the expert audit team in Software Process Improvement with respect to this model. This article proposes the identification of paths alternatives through a tool to achieve an effective implementation in the CMMI-DEV v1.3 Level 2 model, considering its business objectives of the organization

Resumen Este artículo presenta los aportes teóricos y metodológicos de Evelyn H. Davison a partir del texto Trabajo social de casos. La revisión de los aportes de Davison tiene un valor y significado fundamentales, puesto que permite reflexionar sobre los avances, las continuidades y las rupturas que en el ejercicio y en la teorización del Trabajo Social se han generado con el pasar de los años, los cambios socioculturales y el surgimiento de marcos teóricos y conceptuales diferentes a los de los periodos en los que la profesión tuvo origen.

Abstract The article discusses Evelyn H. Davison's theoretical and methodological contributions to the field on the basis of her book Social Casework. The review of Davison's contributions is of fundamental importance since it facilitates reflection on the advances, continuities, and breaks in the theorization of Social Work over the years, as well as on the socio-cultural changes and the appearance of theoretical and conceptual frameworks that differ from those prevailing at the time the profession arose.

Resumo Este artigo apresenta as contribuições teóricas e metodológicas de Evelyn H. Davison a partir do texto Social Casework. A revisão das contribuições de Davison tem um valor e significado fundamentais visto que permite refletir sobre o progresso, a continuidade e as rupturas que, no exercício e na teorização do Serviço Social, vêm sendo gerados com o passar dos anos, com as mudanças socioculturais e com o surgimento de referenciais teóricos e conceituais diferentes aos dos periodos nos quais a profissão teve origem.

RESUMO Myracrodruon urundeuva, mais conhecida no Brasil como “Aroeira”, é uma espécie arbórea altamente utilizada por seu valor comercial e farmacológico. Apesar do alto valor comercial no mercado, esta espécie carece de estudos sobre o tempo de recuperação e crescimento em diferentes estágios de sucessão nas florestas secas tropicais brasileiras. O principal objetivo deste estudo foi determinar as taxas de crescimento diamétrico das árvores em três estágios sucessionais da floresta tropical seca no Parque Estadual Mata Seca, em Minas Gerais, Brasil. Nós medimos todos os indivíduos (≥5cm de DAP) anualmente em 18 parcelas permanentes em estágios sucessionais inicial, intermediário e tardio durante um período de 8 anos (2006-2014). Calculamos os incrementos anuais de diâmetro para cada indivíduo desta espécie, para cada estágio sucessional e por classe diamétrica. Foram obtidos os seguintes incrementos médios anuais por estágio sucessional: inicial (10,53 mm/ano), intermediário (2,09 mm/ano) e tardio (2,90 mm/ano). As taxas de incremento foram semelhantes entre os estágios sucessionais intermediário e tardio. O maior aumento incremental de diâmetro foi obtido nas classes de diâmetro 5-15 cm e 15-25 cm no estágio inicial, e para o estágio intermediário, incrementos máximos foram encontrados na classe de 5-15 cm de diâmetro e na classe de 35-45 cm no estágio tardio. Os resultados deste estudo permitem concluir que esta árvore não é apenas uma espécie pioneira, mas que também tolera as condições de estágios sucessionais avançados. Tendo em conta os incrementos diametrais rápidos e elevados observados no estágio inicial de sucessão e nas classes de diâmetro menores, esta espécie demonstra grande potencial para o manejo silvicultural.

ABSTRACT Myracrodruon urundeuva, better known in Brazil as “Aroeira”, is an arboreal species highly used for its commercial and pharmacological value. Despite the high commercial value in the timber market, this species lacks studies analyzing the recovery time and growth in different stages of succession in the Brazilian tropical dry forests. The main objective of this study was to determine growth rates of this species in three successional stages of a tropical dry forest in Mata Seca State Park, in Minas Gerais, Brazil. We measured all individuals (≥5cm of DBH) annually in 18 permanent plots in early, intermediate, and late successional stages over a period of 8 years (2006-2014). We calculated the annual diameter increments for each individual of this species, for each successional stage and by diameter class. We obtained the following mean annual increments by successional stage: early (10.53 mm/yr), intermediate (2.09 mm/yr), and late (2.90 mm/yr). Increment growth rates were similar between the intermediate and late successional stages. The highest incremental increase in diameter was obtained in the diameter classes 5-15 cm and 15-25 cm in the early stage, and for the intermediate stage, maximum increments were found in the 5-15 cm diameter class and 35-45 cm class for the late stage. Results from this study support the conclusion that this tree is not only a pioneering species but that it also tolerates the conditions of advanced successional stages. Given the fast and high diametric increments observed in the early stage of succession and the smaller diametric classes, this species demonstrates great potential for silvicultural management.

The ductus venosus agnesis is not infrequent. It has two forms of presentation, each with different prognosis each. In the absence of the ductus venosus, the flow needs to find new pathways. There are two options. The first is by an extrahepatic shunt or portosystemic bypass, and the other by an intrahepatic shunt that drains to the portal system. The last one has a better prognosis. In both cases, It is especially important to look for associated structural and chromosomal anomalies, as to determine prognosis. It is especially important is to explore the biliary venous system. In this article, we present two clinical cases, with each one of the variants, without association to chromosomal diseases.

La agenesia del ductus venoso (ADV) no es infrecuente. Tiene dos manifestaciones clínicas que presentan diferentes pronósticos. En la ausencia del ductus venoso, el flujo venoso empleará caminos alternativos. Hay dos posibilidades. En una de ellas habrá un shunt extrahepático, y se caracterizará por sobrecarga de volumen sistémico y tendencia a la insuficiencia cardiaca y en otra habrá un shunt intrahepático, con drenaje al seno portal, que presenta mejor pronóstico. Es necesario descartar anomalías estructurales asociadas y cromosopatías, ya que de ello depende el pronóstico. Especialmente importante es analizar el sistema venoso biliar. Presentamos dos casos clínicos con cada una de estas variantes, ninguna de la cuales tuvo asociación a cromosopatías.

La secuenciación de los procesos de la Biblioteca de Infraestructura de Tecnologías de Información (ITIL) en cuanto a su orden de implementación es un aspecto no abordado en sus libros. Otros marcos de trabajo y modelos de proceso relativos a la gestión de servicios (p.ej., COBIT, COSO y CMMI-SVC) son suficientemente explicados en la literatura y en sus libros guía. Sin embargo, la identificación del primer proceso a implementar no ha sido analizada en produndidad en los marcos de trabajo y modelos anteriores, y es también una pregunta difícil de contestar por las organizaciones, especialmente por las pequeñas y medianas empresas (PYMEs). Las PYMEs son organizaciones que tienen una abrumadora presencia en la economía mundial; los datos oficiales del Directorio Central de Empresas muestran que su rango de presencia en diferentes países alrededor del mundo es entre el 93% y el 99% del total de empresas legalmente registradas, y el promedio de contribución al empleo es alrededor del 60%. En consecuencia, la mejora de la gestión de servicios de tecnología de la información en este tipo de empresas es un asunto imperativo de lograr. Esta investigación se ha enfocado en dos estudios cuyo objetivo es ayudar a las PYMEs a seleccionar el proceso de ITIL por el que podrían comenzar a implementar ITIL. En el primer estudio, los datos fueron recogidos mediante una encuesta aplicada a PYMEs registradas en la Comunidad Autónoma de Madrid. El segundo obtuvo datos de empresas y expertos de países como España, Ecuador, Luxemburgo, Chile, Colombia, Noruega, El Salvador y Venezuela. Finalmente, los resultados de ambos estudios muestran que la tendencia para iniciar una implementación ITIL en las PYMEs apunta a uno de los procesos incluidos en la Operación del Servicio.

Sequencing of Information Technology Infrastructure Library (ITIL) processes related to their order of implementation is one of the pending issues in the ITIL handbooks. Other frameworks and process models related to service management (e.g., COBIT, COSO and CMMI-SVC) are quite well described in the literature and their handbooks. However, the identification of the first process to be implemented has not been deeply analysed in the previous frameworks and models, and it is also a complex question to answer for organizations, especially Small and Medium Enterprises (SMEs). Moreover, SMEs are the organizations that have the largest presence in the world economy; official data of General Business Directory, show that their range of presence in different countries around the world is between 93% and 99%, and the average of employment contribution is around 60%. Consequently, the improvement of information technology service management is of vital importance to accomplish in this type of enterprises. This research has focused on two surveys that aim at helping SMEs to select the ITIL process by which starting the implementation of ITIL. In the first survey, data were gathered through a questionnaire to SMEs registered in the region of Madrid. The second survey obtained data from experts and enterprises in countries as Spain, Ecuador, Chile, Luxembourg, Colombia, Norway, El Salvador, and Venezuela. Finally, the results of both surveys show that the tendency for starting an ITIL implementation in SMEs points to one of the processes included in the Service Operation.

Debido al gran crecimiento que han tenido hoy en día los servicios de Tecnologías de la Información (TI), las industrias necesitan algún tipo de marco y/o normas para la gestión de sus servicios, especialmente los servicios de TI, por lo que se hace necesario e imprescindible definir y adoptar un conjunto de buenas prácticas para proveer y gestionar de forma eficaz la tecnología y los servicios ofrecidos a lo largo de todo su ciclo de vida. Actualmente, la gestión de aplicaciones y servicios de TI se vuelve más compleja, predecir y controlar los problemas relacionados con el rendimiento del sistema y planificación de la capacidad se ha convertido en una tarea difícil. Para grandes proyectos de TI, generalmente los costes relativos al ajuste del rendimiento, gestión del rendimiento y planificación de capacidad, resultan ser los más grandes y los más incontrolables. En los últimos años han surgido una serie de marcos de trabajo enfocados a cubrir ciertos aspectos de la gestión de servicios de TI. Uno de estos aspectos es la gestión de la capacidad de servicios de TI. En este artículo, presentaremos una comparación de los modelos y estándares más usados en la actualidad con respecto a la gestión de la capacidad. El resultado es una comparación con las debilidades y fortalezas de cada uno de los modelos/estándares respecto a la gestión de la capacidad, de forma que pueda guiar a las organizaciones a seleccionar el modelo que mejor se ajuste a sus necesidades.

Due to the recent and significant growth of the information technology (IT) services, industries need some sort of framework and / or standards for the management of their services, especially IT services. So, it becomes necessary and essential to define and adopt a set of best practices for providing and effectively managing the technology and services offered throughout its life cycle. Currently, the management of IT applications and services becomes more complex. Predicting and controlling the problems associated with system performance and capacity planning has become a difficult task. For large IT projects, the costs related to performance tuning, performance management and capacity planning, generally turn out to be the biggest and the most uncontrollable costs. In recent years, a number of frameworks aimed at covering certain issues of IT service management have been developed. One of these issues is the IT service capability management. In this paper, a comparison between the models and standards used today regarding capacity management are presented. A comparison of the strengths and weaknesses of each of the models/standards on the capacity management is presented, so that it can guide organizations to select the model/standard that best suits their needs.