<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1816-8949</journal-id>
<journal-title><![CDATA[Anales de la Facultad de Ciencias Médicas (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[An. Fac. Cienc. Méd. (Asunción)]]></abbrev-journal-title>
<issn>1816-8949</issn>
<publisher>
<publisher-name><![CDATA[EFACIM. Editorial de la Facultad de Ciencias Médicas - Universidad Nacional de Asunción]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1816-89492019000300111</article-id>
<article-id pub-id-type="doi">10.18004/anales/2019.052.03.111-116</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Tres casos consecutivos de gangrena seca en invierno]]></article-title>
<article-title xml:lang="en"><![CDATA[Three consecutive cases of dry gangrene in winter]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Real]]></surname>
<given-names><![CDATA[Raúl Emilio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bogado]]></surname>
<given-names><![CDATA[Luis María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sierra]]></surname>
<given-names><![CDATA[María Amanda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Dávalos]]></surname>
<given-names><![CDATA[José Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Holzberger]]></surname>
<given-names><![CDATA[Sandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Paredes]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Real]]></surname>
<given-names><![CDATA[Nicolás Emilio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Hospital Nacional Medicina Interna]]></institution>
<addr-line><![CDATA[Itauguá ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional de Itapúa Hospital Nacional, Facultad de Medicina Postgrado en Medicina Interna]]></institution>
<addr-line><![CDATA[Itauguá ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad del Pacífico Facultad de Ciencias Médicas ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<volume>52</volume>
<numero>3</numero>
<fpage>111</fpage>
<lpage>116</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1816-89492019000300111&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1816-89492019000300111&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1816-89492019000300111&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Se presentan tres casos de gangrena seca ocurridos en el invierno austral del 2018. El primero corresponde a un varón de 37 años, portador de vasculitis por crioglobulinemia y enfermedad celiaca silente, que desarrolla gangrena seca en manos y pies. El segundo es una mujer de 40 años que consulta por gangrena seca de manos y pies, sin etiología demostrable. El tercero es un varón de 38 años que ingresa por choque séptico de origen neumónico que requiere tratamiento con vasopresores desarrollando gangrena seca de manos y pies. A pesar que los tres casos tienen etiología diferente, coincidieron con temperaturas muy frías (media 6° C), inusuales para el clima tropical del Paraguay.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT We present three cases of dry gangrene occurred in the southern winter of 2018. The first corresponds to a 37-year-old man, carrier of vasculitis due to cryoglobulinemia and silent celiac disease, which develops dry gangrene in hands and feet. The second is a 40-year-old woman who consults for dry gangrene of hands and feet, without demonstrable etiology. The third is a 38-year-old male admitted for septic shock of pulmonary origin that requires treatment with vasopressors developing dry gangrene of the hands and feet. Although the three cases have a different etiology, they coincided with very cold temperatures (average 6 °C), unusual for the tropical climate of Paraguay.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[gangrena]]></kwd>
<kwd lng="es"><![CDATA[vasculitis]]></kwd>
<kwd lng="es"><![CDATA[enfermedad celiaca]]></kwd>
<kwd lng="es"><![CDATA[vasopresores]]></kwd>
<kwd lng="es"><![CDATA[lesión por frío.]]></kwd>
<kwd lng="en"><![CDATA[gangrene]]></kwd>
<kwd lng="en"><![CDATA[vasculitis]]></kwd>
<kwd lng="en"><![CDATA[celiac disease]]></kwd>
<kwd lng="en"><![CDATA[vasopressors]]></kwd>
<kwd lng="en"><![CDATA[cold injury.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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