2312-3893 2312-3893 S2312-38932018000100009 10.18004/rvspmi/2312-3893/2018.05(01)09-011 Paraguay 00 03 2018 00 03 2018 5 1 9 11 1 2017 S0735-1097 17 17 41519-1 2 2003 42 6 6 1206-52. 3 2018 5 1 1 12-24 4 2016 3 2 2 11-57