Abstract: Regarding judicial settlements, the Chilean justice system is subject to contradiction. On the one hand, in civil justice matters judicial settlements are statistically insignificant, while in labor and family matters their use is prevalent. On the other hand, comparative procedural law shows that judicial settlements progressively are having a more relevant role, generating an important discussion regarding settlement culture. None of the above hap- pens in Chile’s civil procedure law, still this has not prevented the Chilean lawmakers to recently reform the civil procedure code, introducing new rule 3 bis, which ignoring this lack of discussion established a general duty for all legal actors to promote negotiated alternatives to procedure, placing the Chilean civil justice system in the same track as other legal systems. In this article we wonder to which degree Chile’s justice system is fo- llowing these international tendencies and which obstacles may lie ahead to this new legal rule. Our reflection is built on the examination of the per- formance of judicial settlements at the civil courts in contrast to its perfor- mance at the reformed procedural systems, alongside the developments in comparative law. Finally, we identify some of different challenges that may prevent that Chile’s legal systems follows this international tendency properly.

Resumen: En materia de conciliación el sistema de justicia chileno es de contrastes. Por un lado, en el funcionamiento de la justicia civil la conciliación cumple un rol prácticamente insignificante en términos estadísticos, lo que la diferencia de los sistemas reformados en materia laboral y de familia, donde su uso es masivo. Por otro lado, el derecho procesal comparado muestra como las salidas negociadas en el proceso civil -destacando, entre ellas, la conciliación judicial- tienen un rol cada vez más relevante, generando una profunda discusión acerca de una cultura de los acuerdos. Nada de esto ocurre en nuestro derecho procesal civil. Sin embargo, una reciente reforma al Código de Procedimiento Civil incorporó el artículo 3 bis, que estableció un deber general de todos los actores de promover las salidas autocompositivas, posicionando al sistema de justicia civil chileno en la misma dirección que el derecho comparado. En este artículo nos preguntamos hasta qué punto nuestro sistema de justicia sigue las tendencias comparadas en materia de métodos alternativos/apropiados de solución de conflictos, y, en particular, qué obstáculos puede enfrentar la implementación y aplicación del art. 3 bis del Código de Procedimiento Civil. Esta reflexión se construye contrastando el funcionamiento de la conciliación en los tribunales civiles, con su funcionamiento en los procedimientos reformados, el desarrollo de este asunto en la experiencia comparada y algunos de los diversos desafíos que debería sortear nuestro país para sumarse adecuadamente a esta tendencia transversal.

ABSTRACT Perennial ryegrass is one of the most important food sources in animal production. However, several pests affect this crop, and one of the primary control strategies is the symbiotic relationships between ryegrass endophyte fungi. This fungus produces alkaloids that exhibit toxic activity against arthropods. Furthermore, the effect of fungi may extend to higher trophic levels, including predators (spiders and/or insects), decreasing their abundance and diversity. Given the importance of spiders and insects as predators, whether the symbiotic interaction between perennial ryegrass and endophyte fungus reduces the abundance and diversity of predators pose an important question. To address this question, natural enemies in perennial ryegrass were collected and analyzed over a year, and the percentage of endophyte fungus was evaluated by the presence of hyphae from two ryegrass cultivars, Jumbo (E-) and Alto AR1 (E+). We observed an 80% endophyte infection rate for (E+) and 0% for (E-). Moreover, 222 individual spiders corresponding to 10 families were identified in both perennial ryegrasses, including 209 individuals for (E-) and 13 for (E+). The most abundant spider family was Lycosidae, representing 71.17% of the total spiders. In addition, 65 insects were collected, corresponding to 6 families, with Carabidae being the most abundant. Furthermore, the Simpson index indicated the dominance of the family Lycosidae. Overall, spider and insect abundance and diversity were reduced in (E+), suggesting a negative effect of the endophyte on predator populations.

Los síndromes coronaries crónicos son infrecuentes en mujeres jóvenes, quienes suelen presentar una lenta progresión de enfermedad coronaria aterosclerótica, tienen presentación clínica atípica y son menos sujetas a exploración diagnostica. Se deben considerar causas no ateroscleróticas de enfermedad coronaria en mujeres jóvenes con angina. Informamos una paciente de 25 años que consultó por cinco meses de angina con esfuerzos moderados. Al examen físico presentaba un soplo carotideo derecho y pulsos asimétricos de extremidades superiores. La exploración de laboratorio inicial y posterior evaluación multimodal permitió evidenciar la presencia de aortitis y estenosis de ambos ostium coronarios, concordante con el diagnóstico de una arteritis de Takayasu. Inició terapia medica con respuesta clínica aparentemente favorable. No obstante, la evaluación cardiológica no invasiva en el seguimiento permitió corroborar la persistencia de isquemia significativa y necesidad de revascularización miocárdica. Se realizó una intervención coronaria percutánea de ambos ostium, con una evolución favorable.

Chronic coronary syndromes are usually considered uncommon in young women, related to slower progression of atherosclerotic coronary artery disease, have atypical clinical presentations, and experience less diagnostic investigation. Non-atherosclerotic causes of coronary artery disease should be considered in young women experiencing angina. We report a 25-year-old woman who consulted for five months of moderate exertion angina. Physical examination revealed a right carotid bruit and asymmetrical upper extremity peripheral pulses. Initial work-up and imaging allowed to diagnose aortitis with bilateral coronary ostial stenosis secondary to Takayasu's arteritis. The patient experienced an apparent clinical response to initial medical therapy. However, follow-up evaluation revealed persistence of significant ischemia and requirement for myocardial revascularization. A percutaneous coronary intervention was performed.

ABSTRACT: In Chilean procedural scholarship the dominant framework used to study, analyze, and criticize the procedural reform experiences, such as family and the still pending civil procedure reform, has been the formative principles of procedure, especially orality and documentation. This article challenges the real usefulness of such perspective, claiming that the way they have been used has carried the debate about procedural reforms towards abstract issues, such as their supposed advantages and disadvantages, debating about their “excesses” and “trends”, reducing the debate to a somewhat contest between them. Likewise, it proposes three new and compatible frameworks to analyze such procedural reforms, all of which highlight new and important dimensions of these procedural transformations, identifying their different characteristics and complexities by distinguishing between “fine-tunning” and “radical reforms”, and focusing on the transformative process itself, by examining new variables related to the sources of the procedural transformation, the stakeholders behind it, their process of implementation and the different type of obstacles that impact their success or failure.

RESUMEN: La perspectiva dominante desde la cual la doctrina procesal chilena ha estudiado, analizado y criticado las experiencias nacionales de reforma procesal, como la de familia y la aún pendiente reforma civil, han sido los principios formativos del procedimiento, particularmente la oralidad y la escrituración. El presente artículo cuestiona la utilidad de este enfoque para la finalidad antes dicha, postulando que genera una serie de inconvenientes vinculados al uso que se les ha dado, llevando la discusión en materia de reformas procesales a cuestiones mayormente abstractas, tales como las supuestas ventajas y desventajas teóricas de los mismos, hablándose de los “excesos” y “las modas” a su respecto, reduciendo la discusión a una suerte de competencia entre ambos. Asimismo, se proponen tres novedosas y complementarias formas de aproximarse al estudio de las reformas procesales, las cuales se estima iluminan nuevas e importantes dimensiones de estas, identificando sus distintas características y complejidades según se trate de reformas de “sintonía fina” o de reformas “radicales” y colocando atención en el mismo proceso de cambio procesal, examinando nuevas variables de análisis como las fuentes del cambio, los agentes detrás del mismo, su proceso de implementación y los distintos tipos de obstáculos que inciden en su éxito o fracaso.

Abstract The aim of this study was to develop a Preventive Oral Health Exam for Elderly People (EDePAM), using the e-Delphi technique, to diagnose oral health problems in people 65 or older. The e-Delphi technique was used with experts in multiple stages, and in a final workshop, where an agreement on an examination protocol was reached for diagnosing dental caries, oral mucosa lesions, periodontal diseases, and masticatory function disorders. Quantitative analyses of all the rounds of the e-Delphi method were conducted. It was agreed that the International Caries Detection and Assessment System (ICDAS) should be used together with a modified version of the Nyvad criteria to detect and assess caries lesions. It was also agreed that an assessment was needed of the different factors involved in determining caries risk, namely socioeconomic level, access to fluoride, level of dependence/functionality, salivary flow, history of head and neck cancer treatment, use of medications that decrease salivary flow, diet, use of removable dental prostheses, exposure of root surfaces, and caries history. Furthermore, patients would be required to undergo an examination of the oral mucosa, where any existing lesion should be described in terms of its clinical appearance, location, and risk potential. It was also agreed that an assessment of masticatory function should be performed using the Leake index, together with chewing-gum combined with a color scale to categorize masticatory performance. The number of pairs of occluding antagonist teeth was considered as the best predictor of masticatory function. The 2018 classification by the American Academy of Periodontology (AAP) / European Federation of Periodontology (EFP) was accepted as the standard to assess periodontal status, and it was agreed that this assessment should include an evaluation of clinical attachment loss and bleeding on probing. The novel EDePAM was considered as appropriate for conducting a functional assessment of oral health by providing a comprehensive diagnosis of oral diseases.

RESUMO Este artigo estuda a oferta programática sobre a questão indígena, analisando as plataformas programáticas dos candidatos presidenciais para o período 1989-2017 no caso do Chile. Interrogamo-nos se existem diferenças entre as coligações e se as mudanças são observadas ao longo do tempo. Utilizando o Manifesto Research on Political Representation como ponto de partida teórica, neste artigo se assinala que, devido às características da questão indígena, não é conveniente restringirmo-nos à dicotomia “assimilação/multiculturalismo” oferecida por essa estratégia de análise. É aqui apresentado um quadro conceitual e metodológico que analisa de forma mais abrangente as posições programáticas dos partidos, a fim de distinguir posições assimiladoras, multiculturalistas e plurinacionais. Estudando empiricamente o caso do Chile, é dada uma contribuição teórica e metodológica, mostrando a existência de posições políticas mais complexas do que o esperado e que também evoluem ao longo do tempo.

ABSTRACT This article studies the political stands of the main coalitions in Chile concerning indigenous rights, analyzing Presidential programatic manifestos between 1989 and 2017. The main inquiries are related to the differences within coalitions concerning indigenous rights and changes in position overtime. Using the Comparative Manifesto Project literature as a point of theoretical departure, this article addresses the limitation of such framework as it mainly astresses the traditional cleavage “assimilation/multiculturalism”. This article proposes a different conceptual framework that considers the ideological debate concerning assimilation, multiculturalism and plurinationalism. Studing the case of Chile, this paper makes a theoretical as well as methodological contribution suggesting the existence of mixed ideological position as well as relevant shifts over time.

RESUMEN Este artículo estudia la oferta programática sobre el tema indígena, analizando las plataformas programáticas de candidaturas presidenciales para el período 1989-2017 en caso de Chile. Nos preguntamos si existen diferencias entre coaliciones y si se observan cambios a través del tiempo. Utilizando el Manifesto Research on Political Representation como punto de partida teórica, en este artículo se señala que por las características de la temática indígena, no es conveniente restringirse a la dicotomía “asimilación/multiculturalismo” ofrecida por esa estrategia de análisis. Se presenta aquí un marco conceptual y metodológico que considera más comprehensivamente las posturas programáticas de los partidos para distinguir posturas asimilacionistas, multiculturalistas y plurinacionales. Estudiando empíricamente el caso de Chile, se realiza una contribución teórica y metodológica al mostrar la existencia de posiciones políticas más complejas de las esperadas y que además evolucionan en el tiempo.

RÉSUMÉ Cet article étudie l’offre programmatique sur la question indigène, en analysant les plateformes programmatiques des candidatures présidentielles pour la période 1989-2017 dans le cas du Chili. On se demande s’il y a des différences entre les coalitions et si des changements sont observés dans le temps. Utilisant le Manifesto Research on Political Representation comme point de départ théorique, cet article souligne qu’en raison des caractéristiques des thémes indigènes, il n’est pas opportun de se limiter à la dichotomie « assimilation/multiculturalisme » offerte par cette stratégie d’analyse. On présent ici un cadre conceptuel et méthodologique qui considère plus globalement les positions programmatiques des partis pour distinguer les positions assimilationnistes, multiculturalistes et plurinationales. En étudiant empiriquement le cas du Chili, on apporte une contribution théorique et méthodologique en montrant l’existence de positions politiques plus complexes que prévu et qui évoluent également dans le temps.

RESUMO O artigo compara duas experiências de surgimento e consolidação de atores armados não estatais no Rio de Janeiro, no Brasil, e Michoacán, no México, constatando a emergência dos grupos, seu funcionamento, sua relação com o Estado e seu envolvimento em novas formas de governabilidade no controle territorial, na regulamentação populacional e na obtenção de lucros. Esses fenômenos fariam parte de uma transformação mais ampla, referente a mutações políticas que descentralizam o Estado e geram formas subjetivas específicas que modificam a relação entre o indivíduo, o social, o Estado e o mercado.

ABSTRACT The article compares two important experiences of the emergence and consolidation of armed non-state actors in Rio de Janeiro, Brazil, and Michoacán, Mexico, noting the rise of the groups, their functioning, relationship with the state and involvement in new forms of governance in territorial control, population regulation and profit-making. These phenomena are part of a broader transformation related to political mutations that decentralize the state and generate specific subjective forms that modify the relationships between the individual, the social, the state, and the market.

Abstract Polyhydroxyalkanoates (PHA) are biodegradable biopolymers of microbial origin that can be alternative materials to decrease the extensive use of plastics of petrochemical or synthetic origin. Thus, the selection of microorganisms with potential for PHA production from unexplored natural sources is a strategy to find bacterial species of high value. In the current study, 55 microbial strains related to bacteria were isolated from agricultural soils from Cascas, Peru. Initially, 4 strains were selected by Sudan Black B staining and Nile blue A fluorescence methods, subsequently, they were screened to examine its production capacity of PHA. Bacillus thuringiensis SP7-1 strain was selected based on its high production of PHA at 0.54 ± 0.16 g/L with an accumulation of 19 % by weight of cell biomass, during 72 h at 30 ºC. The isolate was characterized by its morphology, biochemical and molecular tests through the 16S rRNA gene. The extracted PHA was characterized quantitatively by HPLC and qualitatively by FT-IR. Its thermal properties were determined by TGA and DSC, revealing a thermal degradation temperature of up to 270-303 ºC and a melting temperature of 166.88 °C. Therefore, Bacillus thuringiensis SP7-1 can be used as a model system for the production of PHA with efficient thermal stability, and optimize its performance in future research, as well as being applied in obtaining of molded bioplastics.

Resumo A hiperuricemia é comum na doença renal crônica (DRC) e pode estar presente em até 50% dos pacientes que se apresentam para diálise. A hiperuricemia pode ser secundária ao comprometimento da taxa de filtração glomerular (TFG) que ocorre na DRC. No entanto, ela também pode preceder o desenvolvimento da doença renal e mesmo prever uma DRC incidente. Estudos experimentais de modelos hiperuricêmicos descobriram que tanto o ácido úrico solúvel quanto o cristalino podem causar danos renais significativos, caracterizados por isquemia, fibrose tubulointersticial e inflamação. Entretanto, a maioria dos estudos de randomização Mendeliana falhou em demonstrar uma relação causal entre o ácido úrico e a DRC, e os ensaios clínicos têm apresentado resultados variáveis. Aqui sugerimos explicações potenciais para os achados clínicos e genéticos negativos, incluindo o papel do ácido úrico cristalino, do ácido úrico intracelular e da atividade da xantina oxidase na lesão renal mediada por ácido úrico. Propomos ensaios clínicos futuros, bem como um algoritmo para o tratamento de hiperuricemia em pacientes com DRC.

Abstract Hyperuricemia is common in chronic kidney disease (CKD) and may be present in 50% of patients presenting for dialysis. Hyperuricemia can be secondary to impaired glomerular filtration rate (GFR) that occurs in CKD. However, hyperuricemia can also precede the development of kidney disease and predict incident CKD. Experimental studies of hyperuricemic models have found that both soluble and crystalline uric acid can cause significant kidney damage, characterized by ischemia, tubulointerstitial fibrosis, and inflammation. However, most Mendelian randomization studies failed to demonstrate a causal relationship between uric acid and CKD, and clinical trials have had variable results. Here we suggest potential explanations for the negative clinical and genetic findings, including the role of crystalline uric acid, intracellular uric acid, and xanthine oxidase activity in uric acid-mediated kidney injury. We propose future clinical trials as well as an algorithm for treatment of hyperuricemia in patients with CKD.

ABSTRACT Microalgae hold great potential for producing purified high-value products (e.g. pigments and polyunsaturated fatty acids) and represent a source of bioavailable nutrients in aquaculture feeds; however, its production is limited by the high costs of harvesting. Recently, microalgae autoflocculation has been considered a useful solution due to the easy recovery of cell aggregates and natural increase in pH that prevents cell lysis. This work evaluates some cultivation conditions that could contribute to autoflocculation, such as natural pH increase and precipitate formation over the productivity and flocculation of 16 microalgae consortia. Results showed a biomass production of 1.4 to 4.4 dry weight (g L-1) and high flocculation of 81 to ~100%, probably due to Ca3(PO4)2 formation. Moreover, the alkaline pH could have facilitated the assimilation of CO2 and explained the increase of inorganic carbon in the solution obtained. Likewise, results showed a marked descent in electrical conductivity (EC) in solution and high mineral content in the biomass (21.4-35.9%). Finally, this study suggests that the studied culture conditions facilitated microalgae harvest, and the resulting biomass could be a source of bioavailable dietary minerals. Therefore, some of these results might be addressed in future studies with individual microalgae species.

ABSTRACT Although planktonic diatoms are one of the most abundant taxonomic groups in coastal wetlands, their assemblages have not been used to determine the environmental health of these ecosystems. Studies of ecosystem environmental health have been based on other taxonomic groups; we propose that diatom genera diversity represents a viable alternative for this purpose. Thus, our aim was to determine the alpha and beta diversities of the planktonic diatom assemblage present in Caulín Bay, Chiloé Island (41° 49’S; 73° 38’W), southern Chile, during the austral winter and spring of the years 2012 and 2014. Caulín Bay is an important site for aquatic bird observation and conservation, hunting is prohibited on a national scale and, internationally, the site has been declared an Important Bird and Biodiversity Area (IBA). Our results indicate different diversities between sampling stations, but not between the years studied. In total, we recorded 53 diatom genera, of which the most abundant were Coscinodiscus (21.99%) and Cocconeis (16.23%). The study area presented high genera diversity (i.e., H’(log2) >3.74) and beta diversity indicated that Caulín presents a low level of heterogeneity and is a low genera replacement environment. Consequently, we infer that Caulín Bay is a productive and environmentally stable ecosystem. This leads us to conclude that diatom diversity determination is a viable alternative to establish aquatic ecosystem environmental health and we recommend that future conservation strategies be established for Caulín Bay.

RESUMEN Si bien las diatomeas planctónicas son uno de los grupos taxonómicos más abundantes de los humedales costeros, sus ensambles no se han utilizado para determinar el estado ambiental de estos ecosistemas. Aunque se han realizado estudios de la salud ambiental de un ecosistema utilizando otros grupos taxonómicos, nosotros proponemos que la diversidad de géneros de diatomeas representa una alternativa viable. Por lo tanto, el objetivo de este estudio fue determinar las diversidades alfa y beta del ensamble de diatomeas planctónicas presentes en la Bahía de Caulín, Isla de Chiloé (41° 49’S; 73° 38’O), sur de Chile, durante las temporadas de invierno y primavera austral de los años 2012 y 2014. Bahía Caulín es un sitio importante para la observación y conservación de aves acuáticas por lo que a nivel nacional se ha prohibido la caza y a nivel internacional fue decretada un Área Importante para la Conservación de Aves, AICA. Los resultados de este estudio indicaron diferencias en las diversidades entre las estaciones de muestreo, pero no entre los años estudiados. En total, se identificaron 53 géneros de diatomeas; los más abundantes fueron Coscinodiscus (21,99%) y Cocconeis (16,23%). El área de estudio presentó una alta diversidad de géneros (i.e., H’(log2) >3,74) y la diversidad beta indicó que Caulín presentó bajo nivel de heterogeneidad y es un entorno con bajo reemplazo de géneros. Así, inferimos que Bahía Caulín es un ecosistema productivo y ambientalmente estable, por lo cual concluimos que la determinación de las diversidades de diatomeas es una alternativa viable para establecer la salud ambiental de los ecosistemas acuáticos y recomendamos establecer futuras estrategias de conservación para Bahía Caulín.

ABSTRACT: The social and political demands that fall up on the Justice systems and the problems they must deal with in specific moments in time determine the answer they provide to the crucial issue about who controls and guides the civil proceedings. From this standpoint this article succinctly describes the justice system’s contemporary demands and challenges which have generated a new paradigm regarding the control of the judicial proceedings, to which the legal scholarship and comparative procedural law have termed case management or judicial case management. Alongside the presentation of the main features of this new paradigm, the paper shows how it overcomes the judge as director of the proceedings paradigm.

RESUMEN: Las exigencias sociales y políticas que recaen sobre los sistemas de justicia y los desafíos que estos deben enfrentar en una época específica determinan la respuesta al crucial problema de la conducción del proceso civil. En esta perspectiva, este trabajo describe someramente aquellas exigencias y desafíos contemporáneos de los sistemas de justicia que han generado un nuevo paradigma en la conducción de los procedimientos, que la doctrina y el derecho procesal comparado denominan case management o judicial case management. Junto con esbozar los rasgos centrales de este nuevo paradigma, se demuestra cómo sus alcances implican la superación del paradigma del juez director del proceso.

Introduction: Idiopathic pulmonary fibrosis is the most common idiopathic interstitial pneumonia, with incidence and prevalence figures varying worldwide because of the inconsistent way of collecting cases in different studies. There are no published figures on the epidemiology of IPF in Chile or Latin America. It is relevant to know them because of the health burden of patients with IPF and the recent approval for treatment purposes of high cost antifibrotic drugs. The objective of this study was to develop a clinical registry of patients with IPF treated by Chilean pulmonologists from different regions of the country, using the diagnostic means they usually use in real life. Patients and Methods: An online electronic survey was designed by the group of diffuse pulmonary diseases of the “Instituto Nacional del Tórax” to register patients with diagnosis of IPF from June 2015 to June 2017 according to ATS/ERS/JRS/ALAT criteria. Results: 40 of the 200 invited pulmonologists sent IPF cases from the country’s 13 regions, completing a total of 700 patients. 2/3 were old cases, a similar number of men and women, 73% had definitive UIP pattern in CT, the majority were patients over 60 years old and in only 16% biopsy was requested for diagnosis. Conclusions: A register of 700 cases represents a very important number of patients with IPF in Chile that allows us to approach the characterization of the cohort and to strengthen a network of specialists dedicated to the care of these patients and their families.

Resumen Introducción: La FPI es la neumonía intersticial idiopática más común, con cifras de incidencia y prevalencia que varían en el mundo por la poco uniforme manera de recolectar casos en los diferentes estudios. No hay cifras publicadas sobre la epidemiología de la FPI en Chile ni Latinoamérica. Se hace relevante conocerlas por la carga sanitaria que representan los pacientes con FPI y por la aprobación reciente de drogas antifibróticas de alto costo. El objetivo de este estudio fue realizar un registro de pacientes con FPI atendidos por neumólogos chilenos de diversos regiones del país, con los medios diagnósticos que habitualmente utilizan en la vida real. Pacientes y Métodos: Se utilizó una encuesta electrónica en línea diseñada por el grupo de enfermedades pulmonares difusas del Instituto Nacional del Tórax para registro de pacientes con diagnóstico de FPI según criterios ATS/ERS/JRS/ALAT desde junio de 2015 a junio de 2017. Resultados: 40 de los 200 neumólogos invitados enviaron casos de FPI de las 13 regiones del país, completando un total de 700 pacientes. 2/3 eran casos antiguos, un número similar de hombres y mujeres, 73% tienen patrón definitivo de UIP (Usual Interstitial Pneumonia) en tomografía axial computarizada, la mayoría eran pacientes sobre 60 años y en solo 16% se solicitó biopsia para diagnóstico. Conclusiones: Un registro de 700 casos representa un número muy importante de pacientes con FPI en Chile que nos permite acercarnos a la caracterización de la cohorte y a fortalecer una red de especialistas dedicados al cuidado de estos pacientes y sus familias.

ABSTRACT Introduction: The objective of the study is to describe the clinical, pathological, virological and genetic characteristics of the immune response of patients diagnosed with SARS-CoV-2 infection and its relationship with the unfavorable course of the disease. Methods: Descriptive, relational, longitudinal and retrospective study based on the review of medical records, taking post-mortem tru-cut biopsies of the lung and liver, taking blood samples and naso-oropharyngeal swab or endotracheal tube aspirate. In the first phase, the biopsies will be processed and studied with conventional and immunohistochemical histology in the Pathological Anatomy service of the Carlos Seguín Escobedo National Hospital in Arequipa, Peru. Results: Advanced mean age, male sex, and the presence of comorbidities were predominant in deceased patients. Lung biopsies showed predominantly the exudative and partially proliferative phases of diffuse and focal alveolar damage, and acute organizational and fibrinoid pneumonia, associated primarily with intraalveolar macrophage hyperplasia with accumulation within the alveolar space-resembling desquamative pneumonia, as well as binucleated intraalveolar pneumocytes and atypical, with eosinophilic nucleoli (similar to virocytes) in some cases. In the vast majority of cases, intravascular fibrin deposits associated with the accumulation of inflammatory cells composed of neutrophils and monocytes, representing microthrombosis, were observed. Liver biopsies showed predominantly macrovesicular steatosis and in two cases microvesicular steatosis was observed. Additionally, varying degrees of necrosis and mild portal and lobular inflammation were observed. Conclusion: The clinical and pathological findings in this first report are consistent with previous publications and confirm the pattern of diffuse alveolar damage associated with aggregates of intraalveolar macrophages and microthrombosis in addition, macro and microvesicular hepatocytic steatosis, together with variable degrees of necrosis.

RESUMEN Introducción: El objetivo del estudio es describir las características clínicas, patológicas, virológicas y genéticas de la respuesta inmune de los pacientes diagnosticados con infección por SARS-CoV-2 y su relación con el curso desfavorable de la enfermedad. Métodos: Estudio descriptivo, relacional, longitudinal y retrospectivo basado en la revisión de historias clínicas, toma de biopsias tru-cut post-mortem de pulmón e hígado, toma de muestras de sangre e hisopado naso-orofaríngeo o de aspirado del tubo endotraqueal. En la primera fase las biopsias serán procesadas y estudiadas con histología convencional e inmunohistoquímica en el servicio de Anatomía Patológica del hospital Nacional Carlos Seguín Escobedo de Arequipa, Perú. Resultados: La edad media avanzada, el sexo masculino y la presencia de comorbilidades fue predominante en los pacientes fallecidos. Las biopsias pulmonares mostraron predominantemente las fases exudativa y parcialmente proliferativa del daño alveolar difuso y focal, y neumonía organizativa y fibrinoide aguda, asociada principalmente a una hiperplasia de macrófagos intraalveolares con acumulación dentro del espacio alveolar, semejando una neumonía descamativa, así como neumocitos intraalveolares binucleados y atípicos, con nucléolos eosinofílicos (semejante a virocitos) en algunos casos. En la gran mayoría de casos se observaron depósitos de fibrina intravascular asociada al acúmulo de células inflamatorias compuestas por neutrófilos y monocitos, representando microtrombosis. Las biopsias de hígado mostraron esteatosis predominantemente macrovesicular y en dos casos se observó esteatosis microvesicular. Adicionalmente, se observaron diversos grados de necrosis e inflamación portal y lobular leve. Conclusión: Los hallazgos clínicos y patológicos en este primer reporte son consistentes con publicaciones previas y confirman el patrón de daño alveolar difuso asociado a agregados de macrofagos intraalveolares y microtrombosis; ademas esteatosis macro y microvesicular hepatocitica, junto a grados variables de necrosis.