ABSTRACT Objective. To determine the prevalence of arterial hypertension and cardiovascular risk factors (CRF) in a rural population exposed to arsenic (As) in drinking water in the province of Tucumán, Argentina. Materials and methods. A total of 352 adult inhabitants participated. Consumption of arsenic in drinking water was measured. Blood pressure, smoking, risk and harmful alcohol consumption, salt intake, physical activity, body mass index, glycemia and dyslipidemia were evaluated. Cardiovascular risk was calculated using the Framingham score. Results. The population was divided into Exposed Group (EG) n=90 and Non-Exposed Group (NEG) n=262. The prevalence of hypertension was 48.9 and 51.1% in each group, respectively; for smoking it was 31.1 and 39.7%; for risky alcohol consumption, 22.2 and 17.9%; for harmful alcohol consumption, 36.6 and 36.6%; for salt intake, 100 and 100%; for physical activity, 16.7 and 18.7%; for being overweight, 43.3 and 43.9%; for obesity, 25.5 and 25.6%; for diabetes, 24.4 and 32.8%; and for dyslipidemia, 58.9 and 66.4%. The scores for low, moderate, or high-risk were 50; 21.1; and 28.9% in the EG, and 54.6; 19.1 and 26.3% in the NEG, respectively. Conclusions. Exposure to As does not affect the prevalence of CRFs. We identified a rural population in a vulnerable condition with high CRFs. The National Risk Factor Survey does not reflect what happens in rural areas. The Framingham scale is consistent with the found CRFs. The implementation of health promotion policies is required to improve the prognosis of suffering cardiovascular events in the short and medium term.

RESUMEN Objetivos. Determinar la prevalencia de hipertensión arterial y factores de riesgo cardiovascular (FRC) en una población rural expuesta al arsénico (As) en el agua de consumo en la provincia de Tucumán, Argentina. Materiales y métodos. Participaron 352 habitantes adultos. Se midió el consumo de arsénico en agua de bebida y se evaluó la presión arterial, el tabaquismo, el consumo de alcohol de riesgo y perjudicial, la ingesta de sal, la actividad física, el índice de masa corporal, la glucemia y la dislipidemia. El riesgo cardiovascular fue calculado usando el score de Framingham. Resultados. Se dividió la población en Grupo Expuesto (GE) n=90 y Grupo No Expuesto (GNE) n=262. La prevalencia de hipertensión fue 48,9 y 51,1%; tabaquismo 31,1 y 39,7%; consumo de alcohol de riesgo 22,2 y 17,9%; perjudicial 36,6 y 36,6%; ingesta de sal 100 y 100%; actividad física 16,7 y 18,7%; sobrepeso 43,3 y 43,9%; obesidad 25,5 y 25,6%; diabetes 24,4 y 32,8%; y dislipidemia 58,9 y 66,4%. El score de riesgo bajo, moderado o alto fue 50; 21,1; y 28,9% para GE, y 54,6; 19,1 y 26,3% para GNE, respectivamente. Conclusiones. La exposición al As no afecta la prevalencia de FRC. Se identifica una población rural en situación de vulnerabilidad con elevados FRC. La Encuesta Nacional de Factores de Riesgo no refleja lo que ocurre en zonas rurales. La escala de Framingham concuerda con los FRC encontrados. Se requiere la implementación de políticas de promoción de salud que permita mejorar el pronóstico de sufrir eventos cardiovasculares a corto y mediano plazo.

ABSTRACT Objective. To determine the prevalence of arterial hypertension and cardiovascular risk factors (CRF) in a rural population exposed to arsenic (As) in drinking water in the province of Tucumán, Argentina. Materials and methods. A total of 352 adult inhabitants participated. Consumption of arsenic in drinking water was measured. Blood pressure, smoking, risk and harmful alcohol consumption, salt intake, physical activity, body mass index, glycemia and dyslipidemia were evaluated. Cardiovascular risk was calculated using the Framingham score. Results. The population was divided into Exposed Group (EG) n=90 and Non-Exposed Group (NEG) n=262. The prevalence of hypertension was 48.9 and 51.1% in each group, respectively; for smoking it was 31.1 and 39.7%; for risky alcohol consumption, 22.2 and 17.9%; for harmful alcohol consumption, 36.6 and 36.6%; for salt intake, 100 and 100%; for physical activity, 16.7 and 18.7%; for being overweight, 43.3 and 43.9%; for obesity, 25.5 and 25.6%; for diabetes, 24.4 and 32.8%; and for dyslipidemia, 58.9 and 66.4%. The scores for low, moderate, or high-risk were 50; 21.1; and 28.9% in the EG, and 54.6; 19.1 and 26.3% in the NEG, respectively. Conclusions. Exposure to As does not affect the prevalence of CRFs. We identified a rural population in a vulnerable condition with high CRFs. The National Risk Factor Survey does not reflect what happens in rural areas. The Framingham scale is consistent with the found CRFs. The implementation of health promotion policies is required to improve the prognosis of suffering cardiovascular events in the short and medium term.

RESUMEN Objetivos. Determinar la prevalencia de hipertensión arterial y factores de riesgo cardiovascular (FRC) en una población rural expuesta al arsénico (As) en el agua de consumo en la provincia de Tucumán, Argentina. Materiales y métodos. Participaron 352 habitantes adultos. Se midió el consumo de arsénico en agua de bebida y se evaluó la presión arterial, el tabaquismo, el consumo de alcohol de riesgo y perjudicial, la ingesta de sal, la actividad física, el índice de masa corporal, la glucemia y la dislipidemia. El riesgo cardiovascular fue calculado usando el score de Framingham. Resultados. Se dividió la población en Grupo Expuesto (GE) n=90 y Grupo No Expuesto (GNE) n=262. La prevalencia de hipertensión fue 48,9 y 51,1%; tabaquismo 31,1 y 39,7%; consumo de alcohol de riesgo 22,2 y 17,9%; perjudicial 36,6 y 36,6%; ingesta de sal 100 y 100%; actividad física 16,7 y 18,7%; sobrepeso 43,3 y 43,9%; obesidad 25,5 y 25,6%; diabetes 24,4 y 32,8%; y dislipidemia 58,9 y 66,4%. El score de riesgo bajo, moderado o alto fue 50; 21,1; y 28,9% para GE, y 54,6; 19,1 y 26,3% para GNE, respectivamente. Conclusiones. La exposición al As no afecta la prevalencia de FRC. Se identifica una población rural en situación de vulnerabilidad con elevados FRC. La Encuesta Nacional de Factores de Riesgo no refleja lo que ocurre en zonas rurales. La escala de Framingham concuerda con los FRC encontrados. Se requiere la implementación de políticas de promoción de salud que permita mejorar el pronóstico de sufrir eventos cardiovasculares a corto y mediano plazo.

ABSTRACT Background: Intrauterine growth restriction is an abnormal fetal development characterized by a fetal growth rate lower than the potential genetic growth for the gestational age. This condition represents a major burden for public health systems, as it increases short and long-term morbidity and mortality in the offspring, particularly because of its association with the development of cardiovascular and metabolic disease in adult life. Objectives: The aim of the present study was to identify possible cardinal genes involved in intrauterine growth restriction associated with the development of obesity, hypertension and metabolic syndrome using bioinformatics tools. Methods: A total of 343 genes involved in the phenotypes of interest were obtained and 20 genes were identified as significantly relevant in the interaction network analysis. Specifically, four of these identified genes encode for growth factors or their receptors, VEGFA, PDGFRB, IGF1R and EGFR. We also identified genes related to insulin and cardiovascular homeostasis as CTNNB1, APP, MYC and MDMD2. Cluster analysis provided the most significant gene ontology terms, including those related to the biological processes of proliferation and programmed cell death, intercellular communication, protein metabolism and development of the cardiovascular system. Conclusions: The genes found in this study could be useful as putative biomarkers for the presence of cardiovascular and metabolic disorders associated with intrauterine growth restriction, or as potential therapeutic targets for treatment strategies directed to the patient’s genotype.

RESUMEN Introducción: La restricción del crecimiento intrauterino es una alteración del desarrollo fetal que se caracteriza por una tasa de crecimiento durante la etapa fetal que es menor al potencial genético de crecimiento para la edad gestacional. Esta condición plantea una carga importante para la salud pública, ya que aumenta la morbimortalidad de la descendencia, a corto y a largo plazo, particularmente, por asociarse al desarrollo de enfermedad cardiovascular y metabólica en la vida adulta. Objetivos: Mediante el uso de herramientas bioinformáticas nos propusimos identificar posibles genes cardinales involucrados en la restricción del crecimiento intrauterino asociados al desarrollo de obesidad, hipertensión arterial y síndrome metabólico. Material y métodos: Obtuvimos un total de 343 genes involucrados en los fenotipos de interés e identificamos 20 genes que resultaron significativamente relevantes en el análisis de la red de interacción. Particularmente, cuatro de estos genes identificados codifican para factores de crecimiento o sus receptores, VEGFA, PDGFRB, IGF1R y EGFR. Además, identificamos genes relacionados con la insulina y el control de la homeostasis cardiovascular, como son el CTNNB1, APP, MYC y MDMD2. Por otra parte, el análisis de clústeres permitió reconocer los términos de ontología genética más significativos, entre los que se destacan aquellos relacionados con procesos biológicos de proliferación y muerte celular programada, de comunicación intercelular, del metabolismo proteico, y de desarrollo del sistema cardiovascular. Conclusiones: Los genes hallados en este estudio podrían ser de utilidad como biomarcadores putativos de la presencia de alteraciones cardiovasculares y metabólicas asociadas a la restricción del crecimiento intrauterino o potenciales blancos terapéuticos de estrategias de tratamiento orientadas al genotipo del paciente.

Abstract Arsenic contamination in the environment and groundwater is a major global public health problem. Several researchers suggest that the toxicity of arsenic could be related to oral cancer development, usually resulting from potentially malignant lesions. During pathological processes, salivary proteins suffer modifications, which could lead to the discovery of new biomarkers. Objective To analyze the protein profile in human saliva samples from a rural population exposed to high levels of arsenic in drinking water and its association with potentially malignant lesions. Methodology This observational, analytic and cross-sectional design included 121 patients from the state of Graneros (Tucumán, Argentina). Arsenic concentration in drinking water was determined and, according to the values obtained, individuals were divided into 2 groups: exposed group and non-exposed group. Saliva samples were obtained, and total protein concentration was measured by Bradford method. Finally, Laemmli SDS-polyacrylamide gel electrophoresis was conducted to obtain the protein profile. Results Total protein concentration in saliva was lower in the exposed group than in the non-exposed group. Average areas of 20 and 42 KDa bands were significantly lower in exposed group than non-exposed group. Conclusion Chronic intake of high arsenic concentrations in drinking water produces changes in the salivary protein profile, which is associated with the presence of potentially malignant lesions.

RESUMEN Se realizó un estudio etnobotánico y se calculó el índice de confianza de las especies medicinales empleadas por los usuarios de la Unidad de Salud Familiar (USF) del Departamento de Caaguazú, Paraguay, buscando incorporar esta medicina al sistema nacional de salud. El estudio fue observacional, descriptivo. El método utilizado fue la entrevista, se empleó el cuestionario semiestructurado a usuarios de las USF, quienes proveyeron las muestras de plantas que reportaban como medicinales. Estas entrevistas se realizaron durante seis meses, entre los años 2015 y 2016. Para el análisis de confianza se empleó el método Uso Significativo TRAMIL (UST). Se identificaron 54 familias botánicas, que corresponden a 93 géneros y 116 especies, siendo Asteraceae la mejor representada con 17 Géneros y 21 especies. El órgano vegetal más frecuentemente empleado fue la hoja, seguido de la parte aérea y la planta entera, existiendo algunas especies de las cuales se emplean más de un órgano vegetal. El índice UST demuestra que las especies con mayor índice de consenso son las introducidas como Artemisia absinthium ajenjo, Mentha x piperita menta, Moringa oleifera moringa. La especie nativa con mayor índice de consenso fue Lippia alba salvia-rá. Las afecciones tratadas con estas especies fueron preferentemente los dolores estomacales y las enfermedades no trasmisibles como colesterol alto, ácido úrico, y estados de ansiedad. Se espera que estos datos sirvan para continuar los estudios hasta la validación farmacológica de las especies que permita el uso de plantas medicinales en atención primaria de salud.

ABSTRACT An ethnobotanical study was carried out and the confidence index of the medicinal species used by the users of the Family Health Unit (USF) of the Department of Caaguazu, Paraguay was calculated, seeking the incorporation of this medicine into the national health system. The study was observational, descriptive. The method used was the interview, the semi-structured questionnaire was used to USF users, who provided the samples of plants they reported as medicinal. These interviews were conducted during six months between 2015 and 2016. For the confidence analysis, the method Significant Use TRAMIL (UST) was used. 54 botanical families were identified, corresponding to 93 genera and 116 species, Asteraceae was the better represented family with 17 genera and 21 species. The most frequently used plant organ was the leaf, followed by the aerial part and the entire plant, and some species of which more than one plant organ is used. The UST index demonstrates that the species with the highest consensus index are those introduced as follows: Artemisia absinthium wormwood, Mentha x piperita mint, and Moringa oleifera moringa. The native species with the highest consensus index was Lippia alba sage-ra. The conditions treated with these species were preferably stomach pains and non-communicable diseases such as high cholesterol, uric acid, and anxiety states. It is expected that these data will serve to continue studies until the pharmacological validation of the species that allow the use of medicinal plants in primary health care.

RESUMEN El artículo utiliza la categoría trabajo sucio en el análisis de la identidad de sepultadores y de agentes funerarios (transporte y preparación de cadáveres), así como identifica técnicas y prácticas de manipulación de los estigmas profesionales. Analiza el papel de los tipos de mácula en la naturaleza de la relación de estos trabajadores con el trabajo sucio y la influencia de elementos contextuales. La investigación, que integra los métodos cuantitativo y cualitativo, emplea escalas del trabajo y entrevistas semi-estructuradas. Se concluye que la presencia de mácula moral en los agentes funerários (transporte y preparación de cadáveres) influye para una mayor cohesión del grupo y que elementos como el estrato social y la raza están en la construcción social de estos trabajos desprestigiados y operan en la producción de las identidades maculadas.

ABSTRACT This article uses the category dirty work in the analysis of the identity of morticians and funeral directors, as well as it identifies techniques and practices to deal with professional stigma. The article analyzes the role of the types of stains in the nature of these workers’ relationships with their dirty job, and the influence of context elements. This research, which integrates quantitative and qualitative methods, uses scales pertaining to this job and semi-structured interviews. It is concluded that the presence of moral stains in funeral directors brings the group together more solidly, and that elements such as class and race inhabit in the social construction of these discredited jobs and operate in the production of stained identities.

RESUMO O artigo utiliza a categoria trabalho sujo na análise da identidade de sepultadores e motoristas paramentadores, bem como identifica técnicas e práticas de manipulação dos estigmas profissionais. Analisa o papel dos tipos de mácula na natureza da relação desses trabalhadores com o trabalho sujo e a influência de elementos contextuais. Esta pesquisa, que integra os métodos quantitativo e qualitativo, utiliza escalas do trabalho e entrevistas semiestruturadas. Conclui-se que a presença de mácula moral nos motoristas paramentadores influencia para a maior coesão do grupo, e que elementos como a classe e a raça estão na construção social desses trabalhos desprestigiados e operam na produção das identidades maculadas.

Resumo Neste artigo se discute o quadro metropolitano dos homicídios em 2010 em um município do Entorno de Brasília, Águas Lindas de Goiás (GO). As externalidades negativas da metropolização de Brasília, em interface com a estrutura e organização da segurança pública e a fragilidade das ações da assistência social no município, esclarecem a dinâmica dos homicídios e os fatores estruturais que influenciam para a sua ocorrência. A pesquisa baseia-se em dados socioeconômicos secundários e em entrevistas realizadas junto aos atores da segurança pública e da assistência social. Os resultados apontam para a segregação socioespacial e a exclusão social no processo de urbanização do município, o alto grau de interação econômica e social deste último com o Distrito Federal, isto é, a polarização que o Distrito Federal exerce na oferta ao mercado de trabalho e de serviços básicos de educação e saúde. Neste quadro, e em face da alta taxa de homicídios no município, o artigo indica a necessidade de políticas cooperadas entre os diferentes entes da Federação envolvidos (União, estados, Distrito Federal e municípios) na área econômica e social e das políticas de segurança pública.

Abstract This work brings out the metropolitan context of homicides in Brasília, in 2010, specifically the town of Aguas Lindas de Goias. The paper highlights some features of the Brasilia metropolitan area, that interfaces with the structure and organization of public security, the deficit of health care activities in the municipality and also the dynamics of homicides. The research work was carried out on secondary socioeconomic data and semi-structured interviews with the actors involved with development of public safety and welfare programmes and policies. The results indicate to the socio-spatial segregation and social exclusion as the core features of the process of metropolization of the Brasilia. The high level of economic dependence and social interaction, between Aguas Lindas de Goias and Brasilia, is demonstrated throughout the offering of vacancies within the Brasilia's labor market and basic health services. In this context, and considering the high rate of homicides in the town, the paper indicates the need for cooperative policies between the different level of government involved (federal, state and municipalities) in economic and social sectors and public safety policies.

Resumo No Brasil, a maior parte das pesquisas sobre o cuidado de pessoas idosas provém de áreas como geriatria, gerontologia, enfermagem e saúde pública. Este artigo objetiva propor um conceito sociológico para analisar o trabalho de cuidado de mulheres idosas residentes em Instituições de Longa Permanência para Idosos (ILPIs). A construção desse conceito resultou da experiência em pesquisa sobre o trabalho de cuidado de pessoas idosas em ILPIs do Distrito Federal e de Goiás. Essa experiência possibilitou a elaboração de um conceito situacional e multidimensional do trabalho de cuidado, considerado uma técnica do corpo recriada por cuidadoras em Instituições Totais e que comporta as dimensões afetiva, cognitiva, moral e de poder.

Abstract In Brazil, most of the research on care for the elderly comes from areas such as geriatrics, gerontology, nursing and public health. This paper proposes to discuss a sociological concept to study the work of caring for elderly women living in Long Term Care Institutions for the Elderly (LTCIEs). Such concept has been forged out of research experiences in caring for the elderly in LTCIEs located in the Federal District and the state of Goiás. The experience allowed the construction of a situational and multidimensional concept of care, considering a body technique re-created by female caregivers in Total Institutions; it includes affective, cognitive, moral and power-related aspects.

Gingival fibromatosis is a rare disease characterized by progressive enlargement of the gingiva caused by an increase in submucosal connective tissue. The enlargement may potentially cover the exposed tooth surfaces. Idiopathic gingival fibromatosis (IGF) is a heterogeneous group of disorders with no definite cause. The aim of this study is to present a 13-year-old female patient with unusual clinical forms of Unilateral FGI with a complete analysis of the features of the clinical diagnosis, treatment and follow-up for four years. Intraoral examination revealed severe gingival overgrowth involving both the upper arch and the lower arch, affecting on the left side. The right side of the mouth was unaffected. There was no significant pain. The lesion was diffuse, firm and fibrotic. Her medical and family history was also non-contributory. The patient was not receiving any antiepileptic, antihypertensive, or immunosuppressive medications that could contribute to the gingival enlargement. Histopathological examination showed hyperparakeratinized stratified squamous epithelium, presence of a thickened acanthotic epithelium and focal hyperplasia. Underlying connective tissue stroma was collagenous with numerous lymphoplasmacytic infiltrate. Unusual findings include the presence of calcified particles. Bevel gingivectomy was taken to remove gingival overgrowth. This case is thus a rare and atypical presentation of gingival fibromatosis. The patient was advised to maintain good oral hygiene to minimize the effect of inflammation on fibroblasts. In our case, even after four years of follow-up, no recurrence of gingival overgrowth was observed. Unilateral IGF is a relatively rare condition with poorly understood etiopathogenesis and recurrence rates. The cases should be treated with a multidisciplinary management. Treatment appreciably improved the patient's psychological, aesthetics and masticatory competence.

La fibromatosis gingival es una enfermedad rara que se caracteriza por aumento del tejido gingival por proliferación fibrosa, es de crecimiento lento, cubriendo en algunos casos la totalidad de los dientes comprometidos. Esta nosología comprende un grupo heterogéneo de patologías de causas no determinadas. El objetivo de este trabajo es presentar un caso clínico de una paciente de 13 años con FGI Unilateral, su diagnóstico, tratamiento y seguimiento durante cuatro años. Presenta al examen clínico intraoral, agrandamiento anormal de su encía tanto superior como inferior, afectando solamente los hemiarcos del sector izquierdo. A la palpación es indolora y de consistencia fibrosa. No se encontraron factores locales que justifiquen dicho aumento. El examen físico elimina la posibilidad de otras patologías asociadas, no refiriendo recibir medicaciones inmunosupresivas, antiepilépticos o antihipertensivas. No tiene antecedentes familiares. La paciente fue sometida a extirpación quirúrgica del tejido hiperplasiado y el material obtenido enviado a estudio histopatológico. Después del tratamiento quirúrgico y una buena higiene oral con exámenes de control efectuados durante cuatro años no se observó recurrencia. A pesar de ser una patología poco frecuente el odontólogo debe conocer la fisiopatología y comprender que el manejo de ésta enfermedad es a través de un equipo multidisciplinario. El diagnóstico precoz y el tratamiento oportuno logran la recuperación psicológica, estética y funcional de los pacientes.

Background: There is an association between arsenic exposure and prostatic cancer mortality. Aim: To analyze and to compare the serum levels of total prostatic specific antigen (TPSA) in asymptomatic men of a rural zone, exposed and not exposed to high concentrations of arsenic (As) in drinking water. Material and Methods: The study included 161 men that were subjected to a clinical evaluation, serum TPSA determination and a trans rectal ultrasonography. Exposed and non-exposed subjects were divided in groups GA, GB and GC according to TPSA levels (<4 ng/ml, 4.1-10 ng/ml and >10.1 ng/ml respectively). Results: Exposed and non-exposed subjects had similar TPSA levels. Among exposed subjects, 88.2, 8,8 and 3% were ascribed to groups GA, GB and GC respectively. The figures for non-exposed subjects were 90. 6, 6,3 and 3,1%. The area under the receiver operating characteristic (ROC) curve for TPSA in exposed and non-exposed subjects was 0.64 (95% confidence intervals (CI) 0.40-0.9) and 0.71 (95% CI 0.6-0.8) respectively. Conclusions: No differences in TPSA levels between subjects exposed and non-exposed to arsenic were observed in this study.

Este artigo discute a mercantilização da vida íntima, isto é, o cuidado de pessoas idosas em Instituições de Longa Permanência para Idosos (ILPIs) realizado por cuidadoras, em troca de um salário, no Brasil. O estudo, baseado em etnografias, observação participante, entrevistas com cuidadoras, pessoas idosas e dirigentes de ILPIs do Distrito Federal, focou no trabalho das cuidadoras abordado em seus dinâmicas internas, ou seja, nas interações com as pessoas idosas e na sociabilidade das mulheres, tradicionalmente construída nas famílias. Analisa o habitus feminino de cuidado, enquanto disposições afetivas (emoções e sentimentos) e morais adquiridas pelas mulheres nas famílias e recriadas nas interações entre as cuidadoras e os idosos, observando as suas especificidades nas instituições asilares. O estudo apontou que a imposição de uma ordem do trabalho de cuidado taylorizada nas instituições estudadas instrumentaliza as atividades das mulheres cuidadoras, limitando a realização do cuidado adequado, que não se resume na competência técnica da cuidadora, mas exige um complemento de afetividade e moralidade.

This article discusses the commodification of intimate life that is the care of elderly people performed by salaried caregivers in the Long Term Institutions in Brazil. The study used ethnographies, participant observation, interviews with caregivers, with elderly people and with the leaders of the institutions in the Federal District. It focused on the work of caregivers and on their interactions with the elderly people. It examines the "feminine habitus of care" as a set of affective and moral dispositions acquired by women in the family group. In their work caregivers recreate these dispositions, during their interactions with the elderly in the Long Term Institutions. The study found that the imposition of a taylorist work organization in the institutions prevents the realization of the care work. Care work requires caregiver´s technical competence and further more a complement of emotions and morality.

Histoplasmosis is an endemic deep mycosis produced by Histoplasma capsulatum, a dimorphic fungus. It penetrates into the organism by inhalation and spreads by lymphatic or hematic route. We report a 57-year-old immunocompetent male presenting with an enlargement of the tongue that also exhibited white pseudomembranes. There were also nodular lesions in the dorsum of the tongue, separated by deep grooves. The pathological study revealed a chronic infammatory process with granulomas. The microbiological examination with the Giemsa technique showed multiple yeasts of 4-5 mm of diameter with a clear halo inside macrophages and epithelial cells, compatible with the parasitic phase of Histoplasma capsulatum. Serology was positive for the histoplasmine antigen. The patient was treated with Itraconazole 200 mg/day, experiencing 40% remission of lesions during the frst month of treatment.

The aim of this study was to investígate the relationship between the levels of serum sialic acid (S) and hepatic enzymes in individuáis who drink As contaminated water. Two hundred individuáis were selected: 85 were the control group, 32 presented hepatomegaly (I with H) and 83 did not present hepatomegaly (I without H) who had consumed drinking water containing As levels higher than O.Ol mg/L. Blood samples were collected for the determination of S and hepatic enzymes in serum: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (FAL), gamma glutamil transpeptidase (GGT), direct (BD) and total bilirrubin (BT), lactate deshydrogenase (LDH) and 5'nucleotldase (5'Nu). The populatlon exposed to As in drinking water presented high levels of S, FAL, GGT, LDH and GGT, LDH were increased in I with H and I without H respectively. No significant changes were observed in the other parameters studied. Prevalence of hepatomegaly was not significantly higher and the hepatic biochemical changes were related with the presence of cholestasis in As-exposed people. These data show that people with high As level intake would have an increased sialoprotein replacement which could be an marker with other one of the alterations caused by arsenic.

El objetivo de esta investigación fue evaluar los niveles del ácido siálico (S) y enzimas hepáticas en individuos que consumieron agua con arsénico (As) relacionándolos con la presencia ("I con H") o no de hepatomegalia ("I sin H"). Se incluyeron 200 individuos, 85 correspondieron al Grupo Control (GC), 32 "I con H" y 83 "I sin H" quienes habían consumido agua con niveles mayores a 0,01 mg/L. Se les tomó una muestra de sangre venosa y se les realizó el dosaje del S y de las enzimas alaninaninotransferasa (ALT), aspartatoaminotransferasa (AST), fosfatasa alcalina (FAL), gamma glutamil transferasa (GGT), bilirrubina directa (BD) y total (BT), lactato deshidrogenasa (LDH) y 5' nucleotidasa (5'Nu). En los individuos que consumieron agua contaminada se encontró un aumento de los niveles del S. En el grupo "I con H", la FAL, la GGT y la LDH se encontraron aumentadas. En el grupo "I sin H", la GGT y la LDH tuvieron niveles elevados. En los individuos expuestos al As, no se encontraron alteraciones en los otros parámetros bioquímicos estudiados y la prevalencia de hepatomegalia no fue significativa. Los cambios bioquímicos encontrados fueron compatibles con la presencia de un patrón colestásico. Estos datos muestran que la concentración del S sérico podría servir como un indicador de exposición al arsénico que podría ser utilizado en forma conjunta con otros marcadores.

Este artigo analisa o problema da produção do controle e da ordem em prisões brasileiras, utilizando as perspectivas histórica e sociológica, e levanta a hipóteses de que, no Brasil, convivem duas modalidades de construção da ordem e do controle nas prisões. Uma delas, minoritária, baseia-se na prerrogativa do Estado na gestão do dia a dia prisional. A outra é relativa à negociação da pacificação do presídio entre o Estado e as lideranças dos presos. Embora, no primeiro caso, a prerrogativa do Estado possa ser vinculada às condições institucionais adequadas e, no segundo (negociação entre o estado e as lideranças dos presos) às condições precárias dos presídios, como superlotação, número reduzido de agentes penitenciários, entre outros, a análise apontou que ambas as modalidades traduzem formas de relacionamentos e interações sociais historicamente produzidas entre o Estado e a sociedade, que remetem à fundação da República, recriadas através do habitus dos atores sociais, não se restringindo exclusivamente ao espaço social das prisões.

This paper analyzes the problem of the order and control production in Brazilian prisons, using the historical and sociological perspectives, and brings the hypotheses that, in Brazil, two modalities of construction of order and control in the prisons happen together. One of them, minoritary, is based on the State's prerogative of daily prisional administration. The other regards the negotiation of the prison pacification between the State and the prisoners' leaderships. Although, in the first case, the prerogative of the State can be linked to the appropriate institutional conditions and, in the second (negotiation between the State and the prisoners' leaderships) to such precarious conditions of the prisons, as overcrowding, reduced number of penitentiary agents, the analysis pointed out that both modalities translate forms of relationships and social interactions historically produced among the State and society, that go to the foundation of the Republic, recreated through the social actors' habitus, not limiting exclusively to the social space of the prisons.

Ce travail analyse le problème de la production du contrôle et de l'ordre dans les prisons brésiliennes en tenant compte des perspectives historique et sociologique et soulève l'hypothèse selon laquelle, au Brésil, il y a deux manières de construire l'ordre et le contrôle dans les prisons. L'une d'elles, minoritaire, est basée sur la prérogative de l'Etat pour la gestion quotidienne des prisons. L'autre est relative à la négociation de la pacification de la prison entre l'Etat et les leaders des prisonniers. Même si, dans le premier cas, la prérogative de l'Etat peut être liée aux conditions institutionnelles adéquates et, dans le deuxième cas (négociation entre l'état et les leaders des prisonniers), aux conditions précaires des prisons - telles que la surpopulation, le nombre réduit d'agents pénitentiaires, entre autres -, l'analyse montre que les deux modalités sont le reflet des formes de relations et d'interactions sociales historiquement produites entre l'Etat et la société qui remontent à la fondation de la République et qui sont recréées par l'intermédiaire de l'habitus des acteurs sociaux mais qui ne se limitent pas exclusivement à l'espace social des prisons.

The aim of this work was to investigate the contamination with Arsenic (As) in drinking water in Leales (L) and Graneros (G) (Tucumán), the relationship between the level of pollution and the depth of the wells, and the presence of cutaneous signs. The determination of As was made by the quantitative method of modified Gutzei. A hundred and twenty-two individuals were selected. A total of 9.3% and 34.7% of 140 samples of L and 95 of G respectively have allowed levels.The average concentrations in L were 0.112; 0.087 and 0.096 mg/L for depths lower than 10; 11 to 25 meters, and higher than 25 meters respectively. No difference was found between the different depths. The average concentrations in G were 0.163; 0.045; 0.405; 0.056 mg/L for the wells lower than 10; 11 to 25: meters with concentrations moderately and markedly raised, and higher than 25 meters respectively. Differences were found between the concentrations of As and the depth of the wells. A total of 12.4% of 89 of L and 39.4% of 33 individuals examined of G showed cutaneous signs. This pathology is of high importance in depressed areas of the Argentina, is linked to an inadequate provision of water.

Se determinó la contaminación con Arsénico (As) en agua de bebida en Leales (L) y Graneros (G) (Tucumán), y se relacionó el nivel de contaminación con la profundidad de los pozos y la presencia de signos dermatológicos. La determinación de As fue realizada por el método cuantitativo de Gutzei modificado. Se entrevistaron 122 individuos, se evaluaron los signos dermatológicos de arsenicismo. El 9,3% y 34,7% de 140 muestras de L y 95 de G respectivamente tienen niveles permitidos. Las concentraciones promedios en L fueron 0,112; 0,087 y 0,096 mg/L para la profundidad menor a 10; 11 a 25 y mayor a 25 metros respectivamente. No se encontró diferencia entre las distintas profundidades. Las concentraciones promedios en Graneros fueron 0,163; 0,045; 0,405; 0,056 mg/L para los pozos menor a 10; 11 a 25 con concentraciones moderadamente y marcadamente elevadas, y mayor a 25 metros respectivamente. Se encontraron diferencias entre las concentraciones de As y la profundidad de los pozos. El 12,4% de los 89 individuos examinados de L y el 39,4% de los 33 individuos de G presentaron signos dermatológicos. Es una patología de alta prevalencia en áreas deprimidas del noroeste argentino, se vincula a una inadecuada provisión de agua, es un problema de alta importancia socio-sanitaria por su magnitud; su severidad real y potencial y su evitabilidad.