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El objetivo de este trabajo es evaluar el uso del recurso guanaco por parte de las poblaciones humanas que habitaron los diferentes ambientes del norte de la Isla Grande de Tierra del Fuego, particularmente para establecer una comparación diacrónica. Para ello, se recopila información zooarqueológica publicada de 61 contextos de 42 sitios arqueológicos, analizada por diferentes equipos de investigación. Se presenta el estudio de la composición de conjuntos zooarqueológicos en términos espaciales y temporales, combinando el uso de un entorno SIG (Sistema de Información Geográfica) y las herramientas estándar del análisis zooarqueológico. Los resultados indican 1) claro patrón geográfico en la ubicuidad de Lama guanicoe como especie objetivo, 2) con un aumento en la proporción de este taxón en los sitios más alejados de las costas, 3) variaciones temporales con un aumento en el consumo de esta especie a lo largo del tiempo.

Diversas especies de roedores se encuentran con frecuencia en los sitios arqueológicos del norte de Tierra del Fuego. Sin embargo, discriminar las vías de incorporación en los contextos arqueofaunísticos y su potencialidad resulta una tarea ardua. La identificación de aquellos restos que ingresaron por acción antrópica o por agentes naturales resulta necesaria para poder inferir el rol que tuvieron en la subsistencia humana. En este trabajo se estudian los restos de roedores del sitio arqueológico Las Vueltas 1 (Isla Grande de Tierra del Fuego, Argentina), donde representan el segundo taxón más abundante en la muestra. Se identificaron un total de 2191 elementos esqueletarios; 1488 corresponden al caviomorfo Ctenomys magellanicus y 703 a representantes de la familia Cricetidae, con al menos 4 especies. La interpretación tafonómica efectuada sugiere un origen múltiple; buena parte del material parece haber ingresado por la acción acumuladora de aves rapaces y cánidos y también por incorporación natural a través de muerte en madrigueras. No obstante y aunque en menor grado, hay evidencias de consumo y descarte antrópico en C. magellanicus.

This article presents a review in relation to the object of study: Communications Management as an important factor in the management of projects. The review includes the most relevant and most renowned authors in the field of project management, focusing on telecommunications projects, which lets you define a communications management model.

En este trabajo se presenta el análisis tafonómico de los restos arqueofaunísticos y bioarqueológicos recuperados en el sitio La Arcillosa 2 (Tierra del Fuego). El mismo es un sitio multicomponente con fechados radiocarbónicos del Holoceno medio. Se discuten las características de estos dos conjuntos de huesos en particular y se comparan los resultados con datos tafonómicos generados en otros sitios arqueológicos de la isla. La evaluación del efecto de los factores de formación del registro es fundamental para una correcta interpretación de las actividades llevadas a cabo por los cazadores-recolectores en el sitio.In this paper, the tafonomic analysis of the archaeofaunal and bioarchaeological remains recovered from the La Arcillosa 2 site, Tierra del Fuego, is reported. This is a multicomponent site, radiocarbon dated to the middle Holocene. The characteristics of these two bone assemblages are discussed and compared with taphonomic data generated at other archaeological sites on the island. An evaluation of the effect of the record's formation processes is fundamental for an accurate interpretation of the activities carried out by the hunter-gatherers at the site.

Se presentan en este trabajo los resultados de un análisis zooarqueológico en el cual se abordó el estudio de variables paleoclimáticas, tafonómicas y arqueológicas de los roedores del sitio Cerro Aguará, ubicado en el nordeste de la provincia de Santa Fe. Los roedores tuvieron una importancia clave en la subsistencia de los grupos humanos que habitaron la llanura aluvial del Paraná, al menos en el Holoceno tardío, hace ca. 1000 años AP. Este análisis, además, permitió establecer los diferentes agentes tafonómicos que intervinieron en la formación del conjunto muestreado.In this article the results of a zooarchaeological analysis are presented in which palaeoclimatic, taphonomic and archaeological variables of the rodents of the site Cerro Aguará were studied. Located in the northeast of Santa Fe province, the rodents were central to the subsistence of the human groups that inhabited the alluvial plain of Paraná at least during the late Holocene, ca. 1000 BP. In addition, this analysis enabled the different taphonomic agents that took part in the formation of the survey set to be established.

Resumen: Introducción: La enfermedad por coronavirus-2019 (COVID-19) se ha expandido con gran rapidez en todo el mundo. Las alteraciones del olfato o gusto han emergido como un síntoma muy frecuente a medida que la enfermedad se propagó en Europa. Uno de los países con mayor número de contagios en este continente ha sido España. Objetivo: Investigar la evolución clínica de los trastornos del olfato y el gusto en la enfermedad leve por COVID-19 en pacientes españoles. Métodos: Se realizó un estudio transversal a través de encuesta on-line, en pacientes que presentaron afección súbita del olfato o el gusto, durante los 2 meses de confinamiento total por COVID-19 en España. Resultados: El 91,18% de los sujetos con afectación del olfato o el gusto, que tuvieron acceso a la realización de PCR, fueron positivos para COVID-19. El 6,5% presentó anosmia y ageusia de forma aislada. El 93,5% manifestó otros síntomas leves asociados: cefalea (51,6%), tos (51,6%), mialgias (45,2%), astenia (38,7%), congestión nasal o rinorrea (35,5%), fiebre (41,9%), febrícula (29,0%), odinofagia (25,8%) y diarrea (6,5%). La duración media de la anosmia fue de 8,33 días, posteriormente los pacientes manifestaron hiposmia, con resolución completa en 17,79 días de media. En el 22,6% de los pacientes el déficit olfatorio persistió. Todos los sujetos recuperaron el sentido del gusto. Conclusiones: Los trastornos olfativos y gustativos son síntomas prevalentes en la infección leve por COVID-19. Gran parte de los pacientes no presentan congestión nasal o rinorrea asociada y un grupo reducido de pacientes los presentan de forma aislada. Abstract: Introduction: Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world. Smell and/or taste disorders have emerged as a very frequent symptom as the disease has spread in Europe. Spain is one of the European countries with the highest number of infections. Objective: This study aimed to investigate the clinical progression of smell and taste disorders in Spanish patients with mild COVID-19. Methods: An online survey was used to conduct a cross-sectional study of patients who presented sudden smell and/or taste disorders during the 2 months of total lockdown due to COVID-19 in Spain. Results: In our sample, 91.18% of respondents with impaired smell and/or taste and who were able to undergo PCR testing were positive for SARS-CoV-2 infection. Anosmia and ageusia presented in isolation in 6.5% of participants. The remaining 93.5% presented other mild symptoms: headache (51.6%), cough (51.6%), myalgia (45.2%), asthaenia (38.7%), nasal congestion or rhinorrhoea (35.5%), fever (41.9%), low-grade fever (29.0%), odynophagia (25.8%), or diarrhoea (6.5%). The mean duration of anosmia was 8.33 days, with patients subsequently manifesting hyposmia; complete resolution occurred after a mean of 17.79 days. In 22.6% of respondents, olfactory deficits persisted. All participants recovered their sense of taste. Conclusions: Olfactory and gustatory disorders are prevalent symptoms in mild COVID-19. Most patients do not present associated nasal congestion or rhinorrhoea and a small group of patients present these alterations in isolation.

Este artículo aborda el desarrollo humano en Sonora, Baja California y Baja California Sur. Se estimaron los valores de cuatro índices: desarrollo humano con producto interno bruto, desarrollo humano con servicios, con género e inequidad; además de curvas de calidad estatal y municipal.Aunque los valores ubican a Baja California Sur en la mejor posición de los indicadores de desarrollo humano y después a Sonora; Baja California ocupa el mejor sitio en equidad en el país.

En este trabajo se compila información zooarqueológica proveniente de 97 contextos correspondientes a 75 sitios arqueológicos emplazados en distintas regiones del archipiélago fueguino, con cronologías que abarcan desde el Holoceno temprano hasta el contacto con la sociedad occidental. Por medio de la utilización de SIG (Sistemas de información geográfica) e índices de abundancia económica se suman los NISP de conjuntos de un espacio determinado, lapso o cultura y se calcula un nuevo índice de abundancia. De esta manera se generan valores promediados de consumo de fauna para una región o para un momento en particular del pasado. En este trabajo se utiliza una escala supraregional para comprender de modo no convencional como se estructuran los distintos conjuntos zooarqueológicos en su contexto natural y cultural.

Introduction: Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world. Smell and/or taste disorders have emerged as a very frequent symptom as the disease has spread in Europe. Spain is one of the European countries with the highest number of infections., Objective: This study aimed to investigate the clinical progression of smell and taste disorders in Spanish patients with mild COVID-19., Methods: An online survey was used to conduct a cross-sectional study of patients who presented sudden smell and/or taste disorders during the 2 months of total lockdown due to COVID-19 in Spain., Results: In our sample, 91.18% of respondents with impaired smell and/or taste and who were able to undergo PCR testing were positive for SARS-CoV-2 infection. Anosmia and ageusia presented in isolation in 6.5% of participants. The remaining 93.5% presented other mild symptoms: headache (51.6%), cough (51.6%), myalgia (45.2%), asthaenia (38.7%), nasal congestion or rhinorrhoea (35.5%), fever (41.9%), low-grade fever (29.0%), odynophagia (25.8%), or diarrhoea (6.5%). The mean duration of anosmia was 8.33 days, with patients subsequently manifesting hyposmia; complete resolution occurred after a mean of 17.79 days. In 22.6% of respondents, olfactory deficits persisted. All participants recovered their sense of taste., Conclusions: Olfactory and gustatory disorders are prevalent symptoms in mild COVID-19. Most patients do not present associated nasal congestion or rhinorrhoea and a small group of patients present these alterations in isolation., (Copyright © 2020 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Cigarette smoking is a major risk factor in the development of chronic obstructive pulmonary disease (COPD). Serotonin levels have been associated with COPD and smoking has been as a significant modulator. Elevated levels of serotonin are responsible for bronchoconstriction and pulmonary vasoconstriction and also nicotine dependence, thus serotonin response could be affected by genetic polymorphisms in transporters and receptors of serotonin., Objectives: The aim of the current study was to analyze the effect of SLC6A4 (5HTT_LPR) (rs25531) and HTR2A-1438G/A (rs6311) genetic polymorphisms on the relation between smoking habits and COPD., Methods: The association between SLC6A4 (5HTT_LPR) (rs25531), HTR2A-1438G/A (rs6311), smoking degree and COPD was analyzed in a total of 77 COPD patients (active smokers) and 90 control subjects (active healthy smokers). The DNA was extracted of peripheral leukocytes samples and genotyping was performed using an allele specific polymerase chain reaction., Results: The distribution of SLC6A4 genotypes did not vary between healthy smokers and COPD patients (P=0.758). On the other hand, the A allele of HTR2A (rs6311) was significantly associated with COPD incidence in the trend model (P=0.02; 1.80 [1.04-3.11]). Among all smokers, this allele was also associated with the number of pack years smoked (P=0.02) and also, we observed a marginal association with FEV1/FVC values (P=0.06)., Conclusion: Our results point a possible role of the A allele of HTR2A (rs6311) in COPD pathogenesis, suggesting that this effect depends partly on tobacco consumption due to a gene-by-environment interaction., (Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background and Objective: Ghrelin is a gastrointestinal peptide involved in regulation of body weight and energy balance. However, its behavior after bariatric surgery and its relationship to insulin resistance are still controversial. A simultaneous assessment was made of the association between changes in ghrelin levels and different variables after three types of bariatric surgery., Patients and Methods: Ghrelin levels were measured in 103 morbidly obese subjects before and 6 months after bariatric surgery (Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion of Scopinaro (BPD), and sleeve gastrectomy (SG)), and in 21 non-obese subjects., Results: Ghrelin levels increased after RYGB (p<0.05), were unchanged after BPD, and decreased after SG (p<0.05). The percent change in ghrelin levels (Δ-ghrelin) was associated to the type of surgery in a multiple linear regression model (p=0.017). When the same analysis was only performed in subjects in whom the gastric fundus was maintained (RYGB and BPD), Δ-ghrelin was negatively associated to Δ-HOMA-IR (p=0.001). In morbidly obese subjects who underwent RYGB and BPD, the odds ratio of a lower Δ-HOMA-IR in patients with Δ-ghrelin in the Q1 quartile versus those with Δ-ghrelin in the Q4 quartile was 8.74 (1.73-44.06) (p=0.009)., Conclusions: Changes in ghrelin levels after bariatric surgery are associated to the presence or absence of the gastric fundus. After bariatric surgery, the decrease in insulin resistance was associated to increased ghrelin levels in procedures in which the fundus is not excluded., (Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Burnout syndrome is a three-dimensional clinical syndrome caused by stress at work. It is frequent in professions which require direct contact with people. In Mexico, the presence of Burnout Syndrome in doctors and medical students, is characterized as a threat to their health, quality of life and professional performance., Objectives: To evaluate the prevalence of burnout syndrome in students of years 1 through 6 of medical school at a private university in northern Mexico., Methods: Cross-sectional study in the Escuela de Medicina Campus Laguna de la Universidad Autónoma de Durango. The one-dimensional scale of Burnout Student (EUBE) and the Maslach Burnout Inventory (MBI) were applied to the participants. SPSS 19 was used to analyze the data., Results: Of the 344 students, 255 participated; 153 from years 1 to 3 (group 1); and 72 from years 4 to 6 (group 2). We found that 94.1% of the students of group 1 had mild burnout syndrome, and 2.8% had moderate burnout syndrome. In Group 2, 27.8% had moderate burnout syndrome, and 8.3% had severe burnout syndrome. The prevalence of severe burnout syndrome was higher in group 2 than in group 1 (p=0.02)., Conclusions: Burnout syndrome affects medical students across all stages of their studies, and develops in a progressive way. In our study, external factors have no influence on the development of burnout syndrome.

Neurogenic stunned myocardium is an unusual clinical entity. It mimics an acute coronary syndrome with electrocardiographic abnormalities, cardiac dysfunction and elevated cardiac enzymes with absence of obstructive coronary disease. It may occur after a neurosurgical procedure. A case is presented of neurogenic stunned myocardium occurring in a child after removal of a posterior fossa medulloblastoma. The patient developed nodal tachycardia with hemodynamic impairment. The clinical course was satisfactory due to antiarrhythmic therapy, with biochemical, echocardiographic, and clinical improvement within a week., (Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)

Autoimmune diseases are a cluster of disorders characterized by a failure of the immune tolerance and a hyperactivation of the immune system that leads to a chronic inflammation state and the damage of several organs. The medications currently used to treat these diseases usually consist of immunosuppressive drugs that have significant systemic toxic effects and are associated with an increased risk of opportunistic infections. Recently, several studies have demonstrated that mesenchymal stem cells have immunomodulatory properties, a feature that make them candidates to be used in the treatment of autoimmune diseases. In the present study, we reviewed the role of this therapy in the treatment of systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis, Crohn's disease and multiple sclerosis, as well as the potential risks associated with its use., (Copyright © 2013 Elsevier España, S.L.U. All rights reserved.)

Objectives: To calculate cardiovascular risk according to the American Framingham Coronary Risk Score (FCRS) and the European Systematic Coronary Risk Evaluation (SCORE) methods. To correlate the results with the presence of meta-bolic syndrome (glycemia, triglyceridemia, cholesterolemia, abdominal circumference and blood pressure) and with serum levels of three emerging biomarkers [ultrasensitive reactive C protein (PCRus), homocysteine (Hcy) and lipoproteín (a) (lp (a)]., Methods: Data were gathered during routine medical surveillance of mostly white collar workers in FREMAP Alcobendas from 2004 to 2006 (n=248).We followed standardized health surveillance protocols as established by the Spanish Health Ministry, along with inclusion of an additional blood sample and measurement of the abdominal circumference., Results: None of the 248 workers included in our sample was classified as having high or very high risk according to FCRS in contrast to 44.8 % according to SCORE.We observed a strong correlation (r=0.78, p<0.001) between both predictive methods.We also found associations between both methods and metabolic syndrome (p=0.043), and between the FCRS and PCRus (p=0.021) and Hcy (p=0.036)., Conclusions: Our results suggest that the inclusion of risk predictions based on FCRS and/or SCORE could be recommended for the primary prevention of cardiovascular disease, because of their excellent cost-benefit relationship. However, we do not recommend routine measurement of the biological markers included in this study., (Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.)

Introduction: The objective of this investigation is to determine whether bispectral index (BIS®) monitoring during intravenous anaesthesia with spontaneous breathing for upper gastrointestinal endoscopy (UGE) in a pediatric population is useful for: a) decreasing the amount of drug, b) decreasing the time for awakening, and c) improving patient safety., Patients and Method: A quasi-experimental case-control prospective study was conducted in the setting of a second level hospital pediatric intensive care unit., Patients: Children aged 1-13 years., Case: ASA I patient who needed a diagnostic UGE; eligible, 36, participants, 30., Control: historical cohort of patients who needed UGE (years 2008-2010): 50 patients., Intervention: UGE performed with anaesthetic protocol, vital signs monitoring, sedation level (Ramsay scale) and BIS monitoring., Variables of Interest: propofol total dose (mg/kg), induction time, time in performing the UGE, awakening time (min); initial BIS (iBIS), and BIS during the UGE; adverse effects., Results: There were no significant differences in sex, age or weight between case (B) and control (C) population. No significant differences in total propofol doses: (B 4.9 ± 1.4 mg/kg; C 5.2 ± 1.6 mg/kg, P=.492), awakening time (B 12.2 ± 4.6 min; C 12.8 ± 4.4 min, P=.402), time for execution of UGE (B 9.5 ± 4.8 min; C 11.3 ± 6.5 min, P=.335) and induction time (B 11.1 ± 2.6 min; C 10.1 ± 4.2 min, P=.059), iBIS 55.4 ± 6.9. There were no significant differences in adverse effects: 2 patients suffered from mild desaturation in the control group., Conclusions: BIS monitoring for diagnostic UGE in spontaneous breathing in a pediatric population is feasible, but does not appear to decrease awakening time or the amount of propofol needed. Furthermore, there was no statistically significant decrease in the number of adverse effects., (Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.)

Acute peritoneal dialysis (APD) is still a useful tool in the critical pediatric patient. Acute kidney failure due to septic shock often requires invasive depuration procedures and although hemofiltration is very effective, not all pediatric Intensive Care Units have the equipment necessary to establish it. Pediatric APD is generally initiated with short dwell times, every hour exchanges and 10-20 ml/kg filling volumes. We present the evolution of two critical patients with kidney failure on APD who benefited from the measurement of dialysate-to-plasma (D/P) ratios for creatinine and urea, and dialysate-to-solution ratio for glucose (Dt/Do) to optimize APD prescription.

Introduction and Objectives: The predictive value of ECG abnormalities in patients with type-2 diabetes mellitus (DM2) has not been fully studied. Our objective was to assess the prognostic value of ECG abnormalities in patients with DM2 but without known cardiovascular disease., Methods: Overall, 412 patients with DM2 were identified at two primary care centers in the same city. Two hundred and twenty one patients younger 80 years without known cardiovascular disease were included in the study. An ECG was recorded at baseline and annually during follow-up. The ECGs were evaluated using a system based on the Minnesota code. The main study end-point during follow-up was the occurrence of a cardiovascular event, as defined in the Framingham study., Results: The mean follow-up duration was 5.9 years (1.1-8.5 years). At the beginning of the study, 24.9% of patients had ECG abnormalities; at the end, 44.3% had abnormalities. Cardiovascular events occurred in 65 patients (29.4%). The relative risk (RR) of a cardiovascular event in a patient with an ECG abnormality was 8.28 (95% confidence interval [CI], 3.36-20.42). Only hypertension (RR = 2.29; 95% CI, 1.24-4.22) and age were significantly related to the occurrence of a cardiovascular event. Multiple regression analysis that included classical risk factors and ECG findings showed that an ECG abnormality was a significant independent predictor, with adjusted RR = 5.95 (95% CI, 2.29-15.47)., Conclusions: The presence of an ECG abnormality can predict the occurrence of a future cardiovascular event in patients with DM2 more accurately than risk factors alone. This finding could be helpful in selecting subgroups of high-risk diabetic patients.

Introduction: The subjective experience of psychotic patients with neuroleptics has been the purpose of many studies, considering its importance in treatment adherence, quality of life and outcome. Many authors have developed measurement instruments applicable in everyday clinical practice. The scale objectives defer in hues, but have the subjective perspective in common., Method: Questionnaires designed for evaluating subjective experience with antipsychotics, appearing in PUBMED during the last 40 years, have been collected., Results: Ten scales for evaluating the subjective experience with antipsychotics: NDS, DRI, DAI-30, DAI-10, ROMI, SWN, SWN (short version), MARS, ANT and PETiT, were found. Their advantages and limitations have been analyzed., Conclusions: We have checked out that the contents of each scale do not overlap. It is proposed to differentiate between ((dysphoria response to neuroleptics)) as an acute effect and the ((subjective experience)) as complex effect of long term compliance.

Utility of inhaled nitric oxide in the treatment of acute respiratory distress syndrome (ARDS) with pulmonary hypertension (PHT) is controversial and there are few studies in the literature that evaluate its effects during prolonged administration. We analyze the case of a 45 day old male patient with un-operated Fallot's tetralogy who developed ARDS and PHT with non-cardiac cause, that required prolonged mechanical ventilation (30 days) and administration of inhaled nitric oxide (INO). Before the INO, the oxygenation index was 19, and at a few minutes of its application it decreased to 15. The patient developed a dependence on INO, tolerating its gradual weaning. Administration could be interrupted at 27 days on onset. We did not observe toxic effects during the administration of INO.

Objective: Analyze the frequencies of genetic mutation in alcohol dehydrogenase (ADH), aldehyde dehydrogenase (ALDH) and cytochrome P450 2E1 (CYP2E1) and establish their possible association with the development of acute alcoholic hepatitis (AAH)., Methodology: Case-control study in a total of 85 Spanish patients. We distinguish three groups (one case group and two control groups) based on hepatic histological lesion and alcohol consumption: controls (group 1: teetotalers; group 2: drinkers without AAH; cases: group 3: drinkers with AAH). Case diagnosis was established based on the presence of polymorphonuclear leukocyte infiltrate in histological study. We analyzed the presence of the genetic mutations R47H and R369C (ADH2), E487K (ALDH2) and mutation Rsa I of CYP2E1 (allele c2) by polymerase chain reaction (PCR) and capillary electrophoresis., Results: The allele c2 of CYP2E1 was found in 10%, 16% and 50% of the groups 1, 2 and 3 patients, respectively. Presence of the mutation Rsa I showed influence on the development of AAH (odds ratio [OR]: 3.63; confidence interval (95% [CI]: 0.88-15.02)., Conclusions: The data suggest a possible association between the presence of the Rsa I of CYP2E1 and the development of AAH in patients with chronic alcohol consumption.

Background: The total cancer prevalence falls within the range of 2%-3% of the population. Some data suggests differences in terms of whether the environment is urban or rural, other geographical factors and in the area surrounding nuclear power plants. This study is aimed at ascertaining said prevalences and the distribution thereof in the different geographical areas of the Guadalajara Healthcare District., Methods: Point prevalence study in 1999 based on a systematic review of cases at primary and secondary sources in the Guadalajara Health District, including invasive malignant tumors among individuals over age 14. The overall and specific distribution in terms of the place of residence, region and proximity to nuclear power plants is analyzed, raw and adjusted prevalences/100,000 inhabitants and CI 95% prevalence index., Results: A total of 2,717 cases were detected (raw prevalence: 2034.6/10(5)), there being a 50%-50% ratio between the urban and rural environments. The adjusted prevalence (worldwide population) is 1295.2/10(5), being greater in the urban environment (1479.9/10(5)) than in the rural environment (1136.3/10(5)). With regard to the geographic regions, solely thyroid cancer is more prevalent among women in the most depressed, mountainous areas, although involving a low-level casuistic., Conclusions: The cancer prevalences found are similar to those published and, following an age-based adjustment, are greater in the urban than in the rural environment. The differences among regions are related to the demographic and geographical characteristics and to the environment being urban.

This is the case of a young woman, 16-year-old, calling to our Department because of the appearance, in the floor of the mouth, of a mass progressively growing until about 5 cm diameter. Through fine needle biopsy was diagnosed of epidermoid cyst. Despite its size and infrahyoid site was removed successfully. Perusal review of last years bibliography and its variants.

Nowadays, it is known that platelets are the main agents involved in the pathogenesis of acute coronary syndromes, and the fact that aspirin is a weak antiplatelet agent has led to an intensive research in antiplatelet drugs in the last years. The medical literature from the last decade contains many studies on the use of platelet IIb/IIIa receptor blockers in different clinical settings. Agents that block the IIb/IIIa platelet receptor have shown to be useful in improving prognosis of patients with acute coronary syndromes (ACS), especially in those studies of percutaneous coronary revascularization procedures. However, their potential risk of causing bleeding and high cost have prevented applied universal and routine application. There are some aspects, such as correct dosage, optimal duration of treatment, and direct comparison of the efficacy of different types of IIb/IIIa blockers, that not have not been resolved yet. On the other hand, oral IIb/IIIa antagonists have not exceeded the efficacy of aspirin. Finally, it is necessary to identify those patients that will obtain the most benefit from this treatment to avoid unnecessary risks and costs. Therefore, it is very important, for the nurse to have the necessary knowledge on the therapeutic effect and use of this antiplatelets therapy, to be able to identify in time any complication that night increase the risk and in danger the patient's life.

Pilomatrixial carcinoma is the malignant variety of pilomatrixoma. It is a malignant lesion, locally aggressive that can reappear, specially if not completely removed. Scanty are the number of cases listed in the literature (2). Although metastases are uncommon one or twice references can be found in the writings (1). We report 2 cases of pilomatrixial carcinoma located in the middle canthal and malar zones, which were treated surgically: excision of the tumor and reconstruction by means of a local rotation flap.

Subacute sclerosing panencephalitis is an infrequent central nervous system viral disease and is a late manifestation of persistent infection by a mutant form of measles virus. Since it affects mainly children and teenagers, the diagnosis in older ages is difficult. Its main clinical symptoms are cognitive impairment, behavioral disturbances and myoclonia. We report two males, aged 21 and 22 years old, presenting with the disease with atypical manifestations. One had a catatonic syndrome and the other, amaurosis. The recognition of the different presentation forms of the disease, endemic in developing countries, allows an earlier diagnosis and a more efficient treatment, when available.

Introduction: Vigabatrin (VGB) was specifically synthesized to enhance inhibitory GABAergic transmission by elevating GABA levels via irreversible inhibition of GABA transaminase., Material and Methods: This study was conducted to determine the efficacy of VGB introduced as monotherapy in 26 children fulfilled the criteria for diagnosis of West syndrome. Duration of follow-up was 24 months., Results: Following the introduction of VGB, 13 patients became seizure free, a special efficacy in one case of tuberous sclerosis. Relapses of infantile spasms occurred in 8 infants, generalized seizures developed in 4 infants, and partial seizures in 3, of whom 2 were eventually rendered seizure-free by increasing the dose. EEG features and age affecting the response rate. VGB has been well tolerated in children with agitation being the most commonly reported side effects, and one case required discontinuation of therapy., Conclusions: VGB seems to be an effective an safe antiepileptic drug as primary monotherapy for West syndrome.