INTRODUCTION:Sarcoidosis is a multisystem disorder of unknown etiology. Some cases are attributed to genetic factors, an inflammatory response by specific antigens including self-antigen, and autoimmune involvement. Ninety percent of patients with sarcoidosis have lung involvement, and a vast portion is asymptomatic. Most common initial symptoms are dry cough and dyspnea, however, manifestation can be unspecific and broad. Ocular manifestations like uveitis are a classical presentation. Cutaneous manifestations have also been associated with sarcoidosis but incidence is around 1.9 per 100,000 with a female predominance. Diagnosis can be performed from clinical, and radiological findings yet one of the most essential criteria is histopathological findings of non-caseating granulomas on a tissue biopsy. Here is a rare presentation of a Hispanic male with sarcoidosis after exposure to an unusual antigen.CASE PRESENTATION: A 32-year-old man came to the emergency department with dyspnea, dry cough, and bilateral eye redness of one week of evolution and ten days after the second dose of the SARS-CoV-2 vaccine. Before these symptoms, the patient experienced multiple desquamating tattoos and bilateral eye redness after the first dose of the vaccine, which presumed that resolved with tobramycin and dexamethasone eye drops. Physical examination was notable for tattoo peeling with surrounding erythematous papules and tenderness to palpation. Eye examination revealed an intact visual acuity bilaterally with hyperemia and conjunctival injection. Ophthalmology made the diagnosis of non-granulomatous bilateral anterior uveitis. Routine laboratories were unremarkable including angiotensin-converting enzyme levels except for erythrocyte sedimentation rate on 32mm/Hr and arterial blood gas with a partial pressure of oxygen of 72 mmHg. Chest radiograph revealed innumerable bilateral centrilobular nodules. Chest Computerized tomography showed bilateral centrilobular diffuse pulmonary nodules with associated mediastinal paratracheal and mediastinal lymphadenopathy. Skin biopsy revealed a nodular infiltrate of histiocytes with black foreign body deposits with non-caseating sarcoid granulomas. Treatment consisted of prednisone and azathioprine resulting in an improvement of symptoms the following days. DISCUSSION:The side effects of this novel ribonucleic acid vaccine are not well described yet, but our case raises the suspicion if the vaccine arouses or unmask autoimmune diseases like the one previously described.CONCLUSIONS: More studies and data are required on side effects to assess other possible complications, response to the vaccine, and which patients are at risk of developing autoimmune or serious health conditions.

The waste derived from Electrical and Electronic Equipment (WEEE) is of interest now worldwide, in some countries due to the rapid technological development and in others due to technological dependence through the acquisition of second hand equipment. Therefore it is necessary to implement strategies for the sustainable management of electrical and electronic equipment at the end of its useful life. This paper presents the results of an investigation that was conducted in a city located in the Northwest of Mexico, which seeks to understand the management practices of household WEEE generators. A survey was applied to a representative sample of the population with a confidence level of 90%. Six home appliances were quantified and it was found that approximately 21% of them are disposed directly as part of the household flow of Municipal Solid Waste (MSW), while 79% are storage for a latter sale, repair or reuse. The results obtained support the need to develop evaluations and to implement possible scenarios for the sustainable management of Electrical and Electronic Waste.

No abstract

Analizar nuevas guías 2015 de la Asociación Americana de Tiroides (ATA, por sus siglas en inglés) comparadas con las de 2009 y su impacto en extensión de tiroidectomía en pacientes con carcinoma papilar tiroideo. Material y métodos: Estudio retrospectivo de pacientes con cáncer papilar de tiroides operados en dos periodos distintos, 2013-2016 (grupo A) y 2017-2018 (grupo B), comparando número de hemitiroidectomías (HT) versus tiroidectomías totales (TT), realización o no disección ganglionar (DG), estancia hospitalaria y complicaciones perioperatorias. Resultados: Se estudiaron 108 pacientes, 54 en cada grupo, comparando grupo A con grupo B: no hubo diferencias en número de HT (tres versus dos) y TT (51 versus 52). Se realizó un número mayor de DG central (22 versus 32), y radical modificada siete versus nueve. No se encontró diferencia significativa en tiempo operatorio de HT (100.0 ± 29.4 versus 135.0 ± 15.0 min [p = 0.569]) ni en TT (114.0 ± 40.9 versus 127.9 ± 63.8 min [p = 0.877]), sangrado (28.5 ± 45.2 versus 28.9 ± 89.6 mL [p = 0.977]) y días de estancia hospitalaria (2.1 ± 1.3 versus 1.9 ± 0.9 [p = 0.374]). Conclusiones: Las recomendaciones de la extensión en cirugía no ha tenido impacto en la actitud quirúrgica. Las complicaciones fueron similares.