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Background: Anatomical reduction of posterior malleolar fracture is a key goal in achieving good functional outcomes in patients with ankle fractures. Although there are many approaches for managing this type of fracture, no studies have shown reduction quality of posterior malleolar fracture in postoperative CT scan using the modified posteromedial ankle approach. Methods: A retrospective case series of 66 patients of 2 health centers with type 2, 3, and 4 posterior malleolar fractures according to Bartonicek classification treated using the modified posteromedial ankle approach was performed. The postoperative CT scan was used to assess syndesmotic reduction and articular step-off and residual gap in posterior malleolus reduction. Results: Reduction of posterior malleolus fracture was determined to be 2 mm in 4 cases. Syndesmotic reduction quality was considered to be anatomical in 61 patients. Four patients showed mild anterior fibular translation in the axial plane and were not reoperated. One syndesmotic malreduction was considered poor. Conclusion: In this study, we found that 92% (61 of 66) of patients with posterior malleolar fracture were reduced with

Objectives: Describe the epidemiology of cuboid fracture, the mechanisms of injury and associated injuries, the progression to osteoarthritis, and propose a surgical management algorithm. Methods: A retrospective and descriptive study of patients with cuboid fractures operated on between 2009 and 2014. The variables analyzed were age, sex, mechanism of injury, classification, associated fractures, and osteoarthritis changes, among others. Results: Twenty-seven patients were included: 19 men and eight women. The mean age was 41.3 years (range 25 - 62). The mean followup was 3.3 years. The mechanisms of injury were motor vehicle accidents and falls from height. Among the patients, 44.4% had lateral column shortening, and 81.5% involved calcaneal cuboid articular surface. Cuboid locking plates were used in 15 patients, and single screw fixation was used in four patients. Three patients required a bone graft. Degenerative changes were observed in calcaneocuboid and cuboid-metatarsal joints. Conclusions: Cuboid fracture is an uncommon injury. In general, the injuries are caused by high-energy accidents. In our study, 40.7% of patients had an injury to the medial column. It is recommended the use of a cuboid locking plate for comminuted fractures, screw fixation for simple fractures, and a bridging plate or external fixation can be considered for most complex cases. Level of Evidence IV; Retrospective Case Series.

IntroductionHypoxia is defined as a critically low-oxygen condition of water, which, if prolonged, can be harmful to fish and many other aquatic species. In the context of ocean salmon fish farming, early detection of hypoxia events is critical for farm managers to mitigate these events to reduce fish stress, however in complex natural systems accurate forecasting tools are limited. The goal of this research is to use a machine learning approach to forecast oxygen concentration and predict hypoxia events in marine net-pen salmon farms.MethodsThe developed model is based on gradient boosting and works in two stages. First, we apply auto-regression to build a forecasting model that predicts oxygen concentration levels within a cage. We take a global forecasting approach by building a model using the historical data provided by sensors at several marine fish farms located in eastern Canada. Then, the forecasts are transformed into binary probabilities that indicate the likelihood of a low-oxygen event. We leverage the cumulative distribution function to compute these probabilities.Results and discussionWe tested our model in a case study that included several cages across 14 fish farms. The experiments suggest that the model can detect future hypoxic events with a commercially acceptable false alarm rate. The resulting probabilistic predictions and oxygen concentration forecasts can help salmon farmers to prioritize resources, and reduce harm to crops.

Abstract The CIMAR program (Marine Research Cruises to Remote Areas) run by the Chilean Navy through the National Oceanographic Committee has been developed since 1995, focused on Chilean fjord and channel zones (~41–56°S; “CIMAR-Fjords”) and Chilean remote islands (“CIMAR-Islands”). Samples and data was collected on biotic and abiotic variables on all these cruises, both from the water column and benthos. Our work standardizes, compiles, and summarizes the published information on benthic organisms for twenty-one CIMAR-Fjords cruises developed in the first 25 years of the program, plus the Southern Ice Fields Cruise 1995 (precursor of the CIMAR program), which includes the distribution, abundance and geographic location of cruises sampling stations. The data set includes 8,854 records from 880 different localities, corresponding to 1,225 species from 24 different phyla (four kingdoms) and more than 150,000 individuals. Only two cruises did not record any benthic sampling. The fjords and channels of Chilean Patagonia have high biodiversity, so we hope that our data set will serve as a baseline for ecological studies and ecosystem conservation.

Introducción: La dermatitis atópica es una enfermedad crónica, sistémica, reincidente, con manifestaciones dermatológicas, que impone una alta carga a los pacientes, las familias y los sistemas de salud, y tiene repercusión psicológica, social y económica, y en la calidad de vida de los pacientes. Afecta principalmente a la población pediátrica y con menor frecuencia a la adulta. Las manifestaciones clínicas varían según la edad y evolución de la enfermedad, y en la actualidad se dispone de múltiples opciones farmacológicas y no farmacológicas para el tratamiento de los pacientes. Objetivo: Presentar un algoritmo de tratamiento de la dermatitis atópica, propuesto con una serie de recomendaciones acerca del diagnóstico, tratamiento y seguimiento de los pacientes. Métodos: Se llevó a cabo un consenso de expertos, utilizando la técnica del grupo nominal. La metodología se desarrolló en 7 fases que incluyeron: planteamiento de las preguntas de investigación, búsqueda de la bibliografía, propuesta inicial de las recomendaciones, elaboración de las recomendaciones finales y del algoritmo de tratamiento con tres ciclos de votación. Se estableció el consenso con un 80% de favorabilidad. Resultados y conclusiones: El resultado del consenso fue un algoritmo de tratamiento de pacientes con dermatitis atópica leve, moderada-grave, derivado de las recomendaciones de expertos. En el algoritmo se establecen criterios diagnósticos y de tratamiento, y se aportan recomendaciones actualizadas que incluyen las alternativas disponibles en Perú.

Introduction: Balamuthia mandrillaris, a free-living amoeba, causes an uncommon infection that is characterized by cutaneous and neurological involvement, which carries a poor prognosis. Methods: This is a retrospective observational study including patients with clinical suspicion of cutaneous balamuthiasis, their skin biopsies, and/or a positive direct immunofluorescence test. The data were collected from the Dermatology and Pathology service of the Hospital Cayetano Heredia and the Instituto Tropical Alexander von Humboldt, Lima, Peru, from January 1985 to June 2007. We identified 60 biopsies from 35 patients, from which clinical data were available in 30. Results: Twenty-two (73%) patients had centrofacial lesions, mostly located on the nose. The classical lesion was an asymptomatic, erythematous, or violaceous infiltrated plaque. Twenty-two (73%) patients had neurologic involvement. Fifty (83%) biopsies showed granulomatous dermatitis and 75% showed ill-defined tuberculoid granulomas without caseous necrosis. Multinucleated giant cells were observed in 52 (87%) biopsies. Trophozoite forms were identified in the biopsies of 25 (71%) patients. Direct immunofluorescence was positive in 25 (71%) patients. Conclusion: B. mandrillaris is a pathogen that is capable of inducing a characteristic skin lesion with a reaction pattern of ill-defined tuberculoid granulomas and many giant cells.

Background: Intramedullary nailing of the fibula (FN) is a method of fixation that has proven to be useful for treating distal fibular fractures (DFs). FN minimizes soft tissue complications and provides similar stability to plating, with fewer hardware-related symptoms. Nevertheless, FN has been associated with syndesmotic malreduction and the incapacity of restoring length and rotation of the fibula. We aimed to evaluate the fibular position and syndesmotic reduction after fixation with FN compared with the uninjured ankle in the immediate postoperative period. Methods: Prospective cohort study. Patients with DF fractures treated with IN between January 2017 and January 2020 were included. Immediate postoperative bilateral ankle CT was obtained in all cases. Fibular rotation, length, and translation as well as syndesmotic diastasis were measured on both ankles and compared by 3 independent observers. Results: Twenty-eight patients were included (16 women). The mean age was 46 years (range 16-91). Fracture type distribution according to AO/ASIF classification included 19 patients with 44.B (67.9%), 8 patients with 44.C (28.6%), and 1 patient with a 44.A fracture (3.6%). No significant differences were identified considering fibular rotation ( P = .661), syndesmotic diastasis ( P = .147), and fibular length ( P = .115) between the injured and uninjured ankle. Fibular translation had statistical differences ( P = .01) compared with the uninjured ankle. The intraclass correlation coefficient showed an excellent concordance between observers except for fibular translation on the injured ankle. Conclusion: In this cohort, fixation of DF fractures with FN allows restoration of anatomical parameters of the ankle in terms of fibular rotation, length, and syndesmotic diastasis. However, fibular translation had significant differences compared with the uninjured ankle based on bilateral CT scan evaluation. Level of Evidence: Level II, prospective cohort study.

This paper investigates the relationship between audit committee financial expertise, particularly considering specific accounting financial expertise, and the readability of management reports. Additionally, this study also examines whether the effect of financial experts is moderated by the intensity of the audit committee’s activity. The dataset for directors’ characteristics is hand-collected as are the management reports. The sample is composed of Spanish listed firms for the period 2013-2015. The results show a negative association between financial expertise, especially accounting financial expertise, and the readability of management reports. In addition, this association is accentuated with higher number of audit committees’ meetings. This evidence stimulates the debate on the advantages of having members with financial expertise in the audit committee. Otherwise, the use of contextual approaches in further studies regarding the role of directors is recommended. In addition, this could help regulators and professionals to guide their requirements and recommendations about directors’ qualifications.

Down syndrome (DS) is a genetic disorder caused by a trisomy of the human chromosome 21 (Hsa21). Overexpression of Hsa21 genes that encode proteins and non-coding RNAs (ncRNAs) can disrupt several cellular functions and biological processes, especially in the heart. Congenital heart defects (CHDs) are present in 45–50% of individuals with DS. Here, we describe the genetic background of this condition (Hsa21 and non-Hsa21 genes), including the role of ncRNAs, and the relevance of these new players in the study of the pathophysiology of DS heart diseases. Additionally, we discuss several distinct pathways in cardiomyocytes which help maintain a functional heart, but that might trigger hypertrophy and oxidative stress when altered. Moreover, we highlight the importance of investigating how mitochondrial and lysosomal dysfunction could eventually contribute to understanding impaired heart function and development in subjects with the Hsa21 trisomy. Altogether, this review focuses on the newest insights about the gene expression, molecular pathways, and organelle alterations involved in the cardiac phenotype of DS.

Polymers have had an enormous impact on science and technology, and their interest relating to the development of new macromolecular materials has exponentially increased. Polymer nanocomposites, materials based on a polymeric matrix covalently coupled to reinforcement, display properties of both components. In the aerospace industry, polymer nanocomposites are attractive due to their promising characteristics, among which lightness, mechanical and thermal resistance, radiation and corrosion resistance, and conductive and magnetic properties stand out. The use of them, instead of metal-based materials, has allowed the optimization of design processes and applications in order to provide safer, faster, and eventually cheaper transportation in the future. This comparative review collects the most relevant and prominent advances in the development of polymer nanocomposites with aerospace applications starting from basic aspects such as the definition of polymer nanocomposite to more specialized details such as synthesis, characterization, and applications, in addition to proposing new research branches related to this topic.

Nanocomposite materials have acquired great importance, as have similar composite materials on a macroscopic scale, because the reinforcement complements the defects in the properties of the matrix, thus obtaining materials with better mechanical, thermal, and electrical properties, among others. At the same time, the importance and research of polymeric nanocomposites reinforced with nanoparticles of various types have grown. Among those that have stood out the most in the electronics industry are polymeric matrices reinforced with nanoparticles that present dual behavior, that is, both magnetic and semiconductor. This property has been very well used in developing electronic devices such as televisions, computers, and smartphones, which are part of everyday life. In this sense, this review presents a compilation of the synthetic methods to produce polymer nanocomposites with dual magnetic and semiconductor behavior and their potential applications within electronic fields and new relevant trends.

El síndrome SAPHO es una enfermedad inflamatoria de origen multifactorial que incluye una asociación entre manifestaciones dermatológicas y osteoarticulares. La presencia de osteítis e hiperostosis definen la enfermedad. No existe un tratamiento estándar, pero se usan AINES como primera línea. Se presenta el caso de un varón de 18 años con acné severo en dorso, pecho, barbilla y zona retroauricular, asociado a fiebre alta y placas eritematosas en ambas piernas. La gammagrafía presenta hipercaptación en tibia derecha, con relación a osteítis no infecciosa. Tuvo evolución favorable con antibióticos y corticoide oral.

Translation by Silvia Regina Barros da Cunha. Taking as a general hypothesis that the ethics of the Philebus is an ethics of the good life or an eudaimonics, I aim to demonstrate in this article that it is also, as the Aristotelian one, a pluralistic or inclusive ethics. My main arguments for this conclusion may be enounced as follows: 1) the open attitude of Socrates and Protarchus, the main speakers of the dialogue, in contrast with the Philebus’ dogmatic one, 2) the method that Plato sets going for the construction of his Philebian ethics, 3) the ontological principles he sets up as a basis of such an ethics, 4) the elements that the main speakers finally include in the mixed good that the ἀνθρώπινων ἀγαθόν (anthrôpinon agathón) is. I maintain moreover that a close analysis of these arguments helps, as Gadamer would say, to better understand the Aristotelian ethics.

Abstract: Gnathostomiasis is a parasitic infection caused by the third larval stage of nematodes of the genus Gnathostoma. The disease is endemic in some countries around the world. In the American continent, the majority of cases is concentrated in Mexico, Ecuador, and Peru. However, due to increasing traveling either at the intercontinental or intracontinental level, the disease is seen each time more frequently in tourists. Furthermore, countries, such as Brazil, that have never been considered endemic are reporting autochthonous cases. The disease usually presents as a deep-seated or slightly superficial migratory nodule in patients with history of eating raw fish, in the form of ceviche, sushi, or sashimi. Along with the clinical presentation, diagnostic criteria include either blood or tissue eosinophilia. In most instances, these criteria are enough for the attending physician to institute therapy. Chances of finding the parasite are low, unless the biopsy is taken from a very specific area that develops after antiparasitic treatment is started. The potential of other organ involvement with more serious consequences should always be kept in mind.

The purpose of this paper is to investigate whether forward-looking disclosures and corporate reputation lead to a reduction in stock return volatility. This study measures financial forward-looking information, by conducting a content analysis of annual reports for a sample of US companies. Since every annual report was manually examined and coded, the study is therefore restricted to the companies listed in Standard and Poor's 100. Results show that financial forward-looking information has significant effects on capital markets. This study contributes to the current literature on voluntary disclosure, by examining the link between the disclosure of financial forward-looking information and stock return volatility. Since stock volatility is linked to information asymmetries and to a higher risk of a company, this analysis implies certain practical implications for both managers and regulators regarding the importance of specific disclosure strategy in capital markets. Moreover, results indicate that forward-looking information disclosed by companies of a higher reputation has a greater effect on stock return volatility. This is the first study that demonstrates that corporate reputation moderates the effects of forward-looking information in capital markets. In addition to the level of disclosed information, the interpretation and the effectiveness of forward-looking information depends on the reputation of a company.

El presente trabajo analiza diferentes cuestiones relacionadas con la probabilidad de quiebra de las empresas españolas cotizadas. En primer lugar, se ha analizado el riesgo de quiebra de estas empresas en el año 2015 en base al índice Z-Score diseñado por Altman (1968). En segundo lugar, se realiza una comparación de los resultados procedentes del cálculo del indicador Z-score con los resultados obtenidos al utilizar un indicador de la probabilidad de quiebra adaptado para las empresas españolas. Finalmente, se analiza la posible relación existente entre la probabilidad de quiebra y la calidad de la información voluntaria publicada de las empresas españolas, cuestión importante para mejorar la eficiencia de los mercados de capitales. La evidencia encontrada puede tener implicaciones directas tanto para empresas como para reguladores.

Electrochemical sensors appear as low-cost, rapid, easy to use, and in situ devices for determination of diverse analytes in a liquid solution. In that context, conducting polymers are much-explored sensor building materials because of their semiconductivity, structural versatility, multiple synthetic pathways, and stability in environmental conditions. In this state-of-the-art review, synthetic processes, morphological characterization, and nanostructure formation are analyzed for relevant literature about electrochemical sensors based on conducting polymers for the determination of molecules that (i) have a fundamental role in the human body function regulation, and (ii) are considered as water emergent pollutants. Special focus is put on the different types of micro- and nanostructures generated for the polymer itself or the combination with different materials in a composite, and how the rough morphology of the conducting polymers based electrochemical sensors affect their limit of detection. Polypyrroles, polyanilines, and polythiophenes appear as the most recurrent conducting polymers for the construction of electrochemical sensors. These conducting polymers are usually built starting from bifunctional precursor monomers resulting in linear and branched polymer structures; however, opportunities for sensitivity enhancement in electrochemical sensors have been recently reported by using conjugated microporous polymers synthesized from multifunctional monomers.

El rol oncogénico de los virus en las neoplasias cutáneas es conocido por el hombre desde hace más de un siglo, cuando se atribuía el origen de la verruga vulgar al virus papiloma humano (VPH). En la actualidad, las neoplasias inducidas por virus pueden agruparse en tumores sólidos y procesos linfoproliferativos. Destacan entre los primeros el VPH, del cual ahora conocemos numerosos serotipos, cada uno vinculado a una neoplasia específica, el herpesvirus humano tipo 8 que produce el sarcoma de Kaposi y el poliomavirus vinculado al carcinoma de Merkel. Entre los procesos linfoproliferativos debemos mencionar al virus linfotrópico de células T humanas tipo 1 (HTLV-1) responsable de los linfomas de células T, en los cuales el compromiso cutáneo es inespecífico, con un amplio espectro de presentaciones clínicas y, que por consiguiente, plantean un reto para el diagnóstico diferencial. En este grupo también se encuentra el virus Epstein Barr vinculado a los linfomas nasales de Células NK/T y a los linfomas tipo Hidroa, de reciente descripción. En esta era en la que lo genético y lo molecular priman en las investigaciones en cáncer, no podemos dejar de lado el concepto de neoplasia como resultado de la infección por un agente viral, lo que abre una nueva veta de posibilidades de tratamiento anticanceroso basado en medicamentos antiviralesThe oncogenic role of viruses in cutaneous neoplasms has been known by humankind for more than a century, when the origin of the common wart, or verruca vulgaris, was attributed to the human papilloma virus (HPV). Currently, virus-induced cutaneous neoplasms may be grouped into solid tumors and lymphoproliferative disorders. HPV, from which various serotypes are now known, each being linked to a specific neoplasm, the human herpes virus type 8 producing Kaposi sarcoma, and the Merkel cell polyomavirus, highlight among the first group. Regarding the lymphoproliferative disorders, we should mention the human T-lymphotropic virus type I (HTLV-1), which is responsible for the T-cell lymphomas, in which the cutaneous manifestations are non-specific and have a wide spectrum, thus posing a challenge for differential diagnosis. The Epstein Barr virus, linked to nasal lymphomas of NK/T-cells and Hydroa-like cutaneous lymphomas, is also part of this group. In an era in which the genetic and molecular aspects of cancer research prevail, we may not leave behind the concept of neoplasms as a result an infection with a viral agent, which opens a wide array of new possibilities for cancer treatment based on antiviral drugs

Numerosas recomendaciones académicas e institucionales abogan por una mejora en la información divulgada por las compañías, bajo la hipótesis de que un aumento de la transparencia informativa mejora la eficiencia en los mercados. En particular, alrededor del año 2000 se publicaron diversas recomendaciones de organismos internacionales que sugerían un incremento en la información previsional divulgada por las empresas, dados los beneficios asociados al suministro de esta información. El objetivo de este trabajo es estudiar el efecto de estas recomendaciones en las estrategias de divulgación de información llevadas a cabo por las empresas. Para ello, se examina empíricamente la evolución de la información previsional divulgada por las empresas desde distintos puntos de vista, empleando diversas medidas de la información: de cantidad, de cobertura y de riqueza. Los resultados muestran que, aunque las empresas estudiadas aumentan la cantidad de información proporcionada, su cobertura y principalmente su riqueza no se incrementan de la misma manera. Las implicaciones del estudio son especialmente importantes para mejorar la eficacia de futuras medidas reguladoras, que deberán asegurarse de cubrir todas las dimensiones de la divulgación de información.

Diffuse multibacillary leprosy of Lucio and Latapí is mainly reported in Mexico and Central America. We report a case in a 65-year-old man in Peru. He also had Lucio’s phenomenon, characterized by vascular thrombosis and invasion of blood vessel walls by leprosy bacilli, causing extensive skin ulcers.

Objetivos: Determinar la frecuencia de infección por el virus linfotrópico humano tipo 1 (HTLV-1) y VIH en pacientes con herpes zoster. Material y métodos: Estudio prospectivo observacional realizado entre agosto de 2005 y agosto de 2006. Se incluyeron pacientes adultos con diagnóstico de herpes zoster atendidos en los diferentes servicios del Hospital Nacional Cayetano Heredia. Un cuestionario de características clínicas y factores de riesgo asociados con infección por HTLV-1 y VIH fue completado previo a la toma de muestra. Se excluyeron los pacientes con resultados positivos previos para HTLV-1 y HIV. Resultados: Se incluyeron 44 pacientes, la edad promedio fue 48,1 ± 19,5; 24/44 (55%) fueron mujeres. Infección solo por VIH se encontró en 4/44 (9%) pacientes, todos menores de 35 años, mientras que infección solo por HTLV-1 se encontró en 2/44 (5%) pacientes, todas mujeres mayores de 50 años. Un caso de infección dual fue encontrado en una mujer de 56 años. La tasa de infección por HTLV-1 fue 25% (3/12) en mujeres mayores de 50 años con compromiso de múltiples dermatomas. Conclusiones: En nuestro escenario, la infección por HTLV-1 es ligeramente mas frecuente en mujeres mayores de 50 años con herpes zoster. Por ello, el despistaje de HTLV-1 debe ser recomendado en este grupo etario, mientras que el despistaje de VIH es aún particularmente importante en pacientes jóvenes.(Rev Med Hered 2011;22:98-102).

To determine human herpesvirus 8 (HHV-8) K1 genotypes in patients with Kaposi sarcoma (KS) from Peru, we characterized HHV-8 in 25 KS biopsy samples. Our findings of 8 A, 1 B, 14 C, and 2 E subtypes showed high HHV-8 diversity in these patients and association between E genotype and KS development.

El análisis de esta obra me ha permitido resaltar algunos de sus méritos y poner en evidencia el estímulo que ella constituye para los investigadores de la filosofía griega. Pero también me ha dejado señalar las que considero algunas de sus hipótesis discutibles. Sugiero, por ejemplo, la conveniencia (¿o la necesidad?) de rastrear el "surgimiento de la phantasía" -o lo que Diels-Kranz (III, 451) llaman la "Entstehung der phantasía"- en Demócrito aún antes que en la phantasía protagórica en tanto objeto de la crítica platónica y aristotélica. En ambos casos, saludo este maduro fruto del esfuerzo por mejor entender y mejor apropiarse de la herencia de los griegos.The analysis of this work has enabled me to throw into relief some of its merits and make evident the stimulus that it means for researchers in Greek Philosophy. But it has also allowed me to point out some hypothesis seemingly debatable. I suggest, for instance, the convenience (or perhaps the necessity?) of tracking down the "emergence of fantasy" -or it that Diels-Kranz (III, 451) name the "Entstehung der phantasía"- in Demokritus even before the Protagorean phantasía as an object of Plato's and Aristotle's criticism. In both cases, I welcome this mature fruit of an effort aiming at a better understanding and a deeper appropriation of Greek inheritance.

Measurement of information disclosed by companies is a complex task. Accounting research usually relies on disclosure indices to obtain a proxy for the information disclosed by companies. However, there is no consensus about the best design for these indices. The purpose of this paper is to investigate if there are significant differences among the indices that are used in disclosure studies. Three indices that measure disclosure of forward-looking information are compared: A “quality index” of a multidimensional nature; a “scope index” designed specifically to measure the scope of information, and a “quantity index” that measures information disclosed exclusively in terms of quantity. Results of the empirical analysis indicate that although the indices are correlated, they have a big impact in the rankings of companies. Evidence against the idea of the irrelevance of the particular index chosen is provided.La medición de la información divulgada por las empresas es una tarea compleja. La investigación contable normalmente se apoya en índices de revelación para obtener una aproximación cuantitativa a la información divulgada por las compañías. Sin embargo, no hay consenso sobre el diseño de estos índices. El objetivo del trabajo es investigar si hay diferencias significativas entre los índices empleados en los estudios sobre divulgación de información. Se comparan tres índices que miden la revelación de información previsional: un índice de calidad, de naturaleza multidimensional; un índice de alcance, diseñado específicamente para medir la cobertura de la información; y un índice de cantidad que mide la información divulgada exclusivamente en términos de cantidad. Los resultados del análisis empírico indican que aunque los índices están correlacionados, tienen un gran impacto en los rankings de las compañías. El análisis proporciona evidencia en contra de la irrelevancia del diseño de un índice en particular.

Eight adult patients (ages 18–58, 5 women) with Buruli ulcer (BU) confirmed by at least 2 diagnostic methods were seen in a 10-year period. Attempts to culture Mycobacterium ulcerans failed. Five patients came from jungle areas, and 3 from the swampy northern coast of Peru. The patients had 1–5 lesions, most of which were on the lower extremities. One patient had 5 clustered gluteal lesions; another patient had 2 lesions on a finger. Three patients were lost to follow-up. All 5 remaining patients had moderate disease. Diverse treatments (antituberculous drugs, World Health Organization [WHO] recommended antimicrobial drug treatment for BU, and for 3 patients, excision surgery) were successful. Only 1 patient (patient 7) received the specific drug treatment recommended by WHO. BU is endemic in Peru, although apparently infrequent. Education of populations and training of health workers are first needed to evaluate and understand the full extent of BU in Peru.

Outbreaks of rapidly growing mycobacteria have been occasionally described. The article reports an outbreak of cutaneous abscesses due to Mycobacterium chelonae following mesotherapy in Lima, Peru. From December 2004 through January 2005, 35 subjects who had participated in mesotherapy training sessions presented with persistent cutaneous abscesses. Thirteen (37%) of these suspected cases consented to underwent clinical examination. Skin punch-biopsies were collected from suspicious lesions and substances injected during mesotherapy were analyzed. Suspected cases were mainly young women and lesions included subcutaneous nodules, abscesses and ulcers. Mycobacterium chelonae was isolated from four patients and from a procaine vial. In conclusion, it is important to consider mesotherapy as a potential source of rapidly growing mycobacteria infections.Surtos de micobactérias de crescimento rápido têm sido relatados ocasionalmente. O estudo relata um surto de abscessos cutâneos por Mycobacterium chelonae após sessões de mesoterapia em Lima, Peru. De dezembro de 2004 a janeiro de 2005, 35 pessoas que haviam passado por sessões de mesoterapia apresentaram esses abscessos cutâneos. Treze (37%) desses casos suspeitos concordaram em realizar exames clínicos. Foram realizadas biópsias de punção de pele de lesões suspeitas e examinadas substâncias injetadas durante a mesoterapia. Os casos suspeitos eram predominantemente mulheres jovens e as lesões incluíram nódulos subcutâneos, abscessos e úlceras. Mycobacterium chelonae foi isolada de quatro pacientes e de um frasco de procaína. Em conclusão, é importante considerar a mesoterapia como fonte potencial de infecções de micobactérias de crescimento rápido.

Objetivo: Determinar la frecuencia de demodicidosis y sus características clínicas en pacientes con rosácea. Materiales y métodos: Estudio de casos y controles en 42 pacientes con rosácea y 42 controles para describir la presencia y densidad de D. folliculorum. El estudio se realizó en el Hospital Nacional Cayetano Heredia entre marzo y setiembre del 2004, utilizándose la técnica de Tello. Resultados: Demodex folliculorum fue encontrado en los 42 pacientes con rosácea (100%) y en 13 (31,0%) del grupo control, (p= 0,000). La exposición a gatos, la crianza de roedores y cerdos, la seborrea y el uso de corticoides tópicos fueron mas frecuentes en los pacientes con rosácea. Conclusiones: La presencia de Demodex folliculorum fue más frecuente en los pacientes con rosácea. (Rev Med Hered 2007;18:15-21).

Objetivo: Evaluar la frecuencia de infección por VIH en pacientes que consultan por episodio agudo de herpes zoster. Material y Métodos: Se incluyeron a todos los pacientes entre 18 y 49 años, atendidos entre setiembre del 2001 y enero del 2003 en el Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas del Hospital Nacional Cayetano Heredia, por un cuadro agudo de herpes zoster, diagnosticado clínicamente. Los criterios de inclusión fueron: status VIH desconocido tanto del paciente como de su pareja; que no presentaran alguna complicación neurológica o presentación atípica de zoster y que no tuvieran signos ni síntomas compatibles con infección por VIH (muguet oral, diarrea crónica, síndrome de desgaste, etc.). Previa firma de consentimiento informado, se tomó muestra de sangre para prueba de ELISA para VIH1. A todos los pacientes con resultado positivo se les realizó western blot. Resultados: Veintiún pacientes cumplieron los criterios del estudio, 14 varones y 7 mujeres. Cinco pacientes (23,8%) fueron VIH positivos. De éstos, 4 fueron varones (4/14) y 1 mujer (1/7). No se encontró diferencias significativas en cuanto a la conducta sexual de riesgo. Conclusiones: Se encuentra un porcentaje elevado de infección por VIH en adultos jóvenes que consultan en un hospital general por un cuadro agudo de herpes zoster, sin ningún otro signo ni síntoma de inmunosupresión, independientemente de conductas sexuales de riesgo. Nuestro hallazgo justifica un despistaje de VIH en adultos jóvenes con herpes zoster.

Review of Fernando Muniz, Potência da aparência. Um estudo sobre o prazer e a sensação nos Diálogos de Platão, São Paulo, Annablume Ed., 2011, ISBN: 978-85-391-0288-4, 338p.

Introducción: varias revisiones y guías de manejo de Micosis Fungoides (MF) y Síndrome Sézary(SS) han sido publicados. Sin embargo, estrategias terapeúticas para esta entidad varían entre instituciones y países. Existen pocos estudios fase III que permitan tomar decisiones en el tratamiento de MF/SS. Por tanto éste es frecuentemente determinado por las experiencias institucionales. Objetivo: con el objeto de sumarizar la evidencia disponible y revisar las mejores prácticas, es que se realizó un Consenso Peruano llevado a cabo en Setiembre 2008 para establecer guías de diagnóstico y tratamiento de MF/SS. Resultados: este artículo revisa los criterios clínicos, histopatológicos y terapéuticos de MF/SS.

En este artículo intento responder a la pregunta de si son –o al menos pueden ser– pluralistas las éticas de la vida buena. Por tales se entienden las éticas teleológicas, centradas en el fin último o bien supremo del individuo humano. ¿Pueden, pese a su aparente individualismo, ser éticas pluralistas? Para responder, me circunscribo al Filebo de Platón, en que el autor, superando las visiones que identifican el bien humano con la vida de placer o con la vida del conocimiento, lo identifica con una vida mixta, que es una mezcla de las dos. Desarrolla, pues, a mi modo de ver, una ética estructuralmente pluralista: (1) por la actitud, eminentemente dialógica, de sus interlocutores; (2) por el método de la división que emplea, el cual va de la pluralidad indefinida a la unidad, y de esta a una pluralidad definida; (3) por el principio ontológico de lo Uno-Múltiple en que se funda; (4) por el contenido que asigna al bien de la existencia humana. Sobre todo por este contenido –esencialmente inclusivo– la ética del Filebo ha ejercido una influencia decisiva en la filosofía moral igualmente pluralista de la Ética a Nicómaco.