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INTRODUCTION: COVID-19, the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to grow all over the world since december of 2019. Although the main clinical manifestation is pulmonary disease, neurological manifestations are a prominent and increasingly recognized feature of the disease. The Acute Disseminated Encephalomyelitis (ADEM) is a rare autoimmune disorder, most commonly triggered by a viral infection. There are a few case reports of ADEM associated with COVID-19, almost all of them associated pulmonary disease. We report the case of a young patient with diagnosis of ADEM with SARS-CoV-2 infection without clinical respiratory symptoms. CASE REPORT: A 20-year-old woman with no relevant medical history was brought to the emergency department with a progressive confusional state lasted for 7 days. Family reported the development of smell and taste deficit since two weeks before the onset of neurological symptoms. There were no complaints of pulmonary symptoms. At admission, she was drowsy and disoriented. Left homonymous hemianopsia and an ipsilateral Babinski sign was identified. A brain magnetic resonance image was done showing multiple hyperintense bilateral, asymmetric patchy and poorly marginated lesions with gadolinium enhancement. She was SARS-CoV-2 PCR positive on nasopharyngeal swab. Intravenous high-dose glucocorticoids were administered with marked clinical improvement. CONCLUSION: ADEM is an extremely uncommon complication of SARS-CoV-2infection. Acute disseminated encephalomyelitis should be considered a potentially treatable cause of encephalopathy or multifocal neurological deficits in COVID-19 patients, even in the absence of respiratory symptoms.

TITLE: Encefalomielitis aguda diseminada asociada a infección por el SARS-CoV-2 sin afectación respiratoria.Introducción. COVID-19 (coronavirus disease-2019) es la enfermedad secundaria a la infección por el coronavirus de tipo 2 o SARS-CoV-2 (severe acute respiratory syndrome coronavirus type 2), que se ha constituido como pandemia desde diciembre de 2019. Si bien la afectación más frecuente y grave es la pulmonar, las complicaciones neurológicas secundarias a la COVID-19 son cada vez más reconocidas. La encefalomielitis aguda diseminada (EMAD) es una enfermedad autoinmune poco frecuente, clásicamente secundaria a una infección viral previa o concomitante. Existen informes de EMAD asociada a la COVID-19, casi todos con afectación respiratoria asociada. Presentamos el caso de una mujer joven diagnosticada con EMAD secundaria a la infección por el SARS-CoV-2 sin afectación respiratoria. Caso clínico. Mujer de 20 años que consultó por cuadro de desorientación y alteración conductual de una semana de evolución. Destaca en la historia la presencia de anosmia y sensación febril dos semanas antes del inicio de los síntomas neurológicos. En el examen físico destacó somnolencia, desorientación, hemianopsia homónima izquierda y síndrome piramidal ipsilateral. Se realizó una resonancia magnética encefálica que mostró múltiples lesiones inflamatorias desmielinizantes bihemisféricas de la sustancia blanca sugerentes de EMAD. La reacción en cadena de la polimerasa del SARS-CoV-2 en aspirado nasofaríngeo resultó positiva. Se descartaron otras causas de lesiones inflamatorias. Recibió esteroides con excelente respuesta. Conclusión. La EMAD es una complicación extremadamente rara en pacientes con COVID-19 que debe considerarse como una causa tratable de encefalopatía y/o déficits neurológicos multifocales en pacientes con infección activa o reciente por SARS-CoV-2 con o sin manifestaciones respiratorias.

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Coccidiosis negatively impacts health and productive performance in broilers. Anticoccidial resistance has prompted alternatives to prevent and control this disease. Therefore, the objective of this study was to evaluate a plant feed additive consisting of Acacia concinna containing saponins (Peptasan®) and compare its effectiveness with salinomycin in terms of performance of broilers challenged with Eimeria. In the first experiment, 300 Ross chicks (1 day old) were randomly distributed into a negative (uninfected and untreated), and positive control group (infected and untreated), and three levels of dietary Peptasan® (500, 750 and 1000 ppm). In the second experiment, the same number of chicks were distributed in two control groups (negative and positive), two levels of Peptasan® (500 and 750 ppm) and one level of salinomycin (550 ppm). In both experiments chicks were challenged at day 21 of age with 100,000 oocysts of Eimeria acervulina, 50,000 oocysts of Eimeria maxima and 50,000 oocysts of Eimeria tenella. Dietary Peptasan® improved productive performance, reduced mortality and the number of oocysts in feces, as well as increased yellow pigmentation of the skin of challenged chickens. The plant feed additive Peptasan® containing Acacia concinna can be effectively used for preventing coccidiosis in broilers.

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Coccidiosis negatively impacts health and productive performance in broilers. Anticoccidial resistance has prompted alternatives to prevent and control this disease. Therefore, the objective of this study was to evaluate a plant feed additive consisting of Acacia concinna containing saponins (Peptasan®) and compare its effectiveness with salinomycin in terms of performance of broilers challenged with Eimeria. In the first experiment, 300 Ross chicks (1 day old) were randomly distributed into a negative (uninfected and untreated), and positive control group (infected and untreated), and three levels of dietary Peptasan® (500, 750 and 1000 ppm). In the second experiment, the same number of chicks were distributed in two control groups (negative and positive), two levels of Peptasan® (500 and 750 ppm) and one level of salinomycin (550 ppm). In both experiments chicks were challenged at day 21 of age with 100,000 oocysts of Eimeria acervulina, 50,000 oocysts of Eimeria maxima and 50,000 oocysts of Eimeria tenella. Dietary Peptasan® improved productive performance, reduced mortality and the number of oocysts in feces, as well as increased yellow pigmentation of the skin of challenged chickens. The plant feed additive Peptasan® containing Acacia concinna can be effectively used for preventing coccidiosis in broilers.(AU)

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Myxinoids in Chile are represented by the subfamilies Eptatretinae and Myxininae, with a total of 14 species, the identification is complex due to the low level of morphological differentiation that characterizes this taxonomic group. Worldwide, hagfish are species of commercial value, and in Chile many attempts have been reported to initiate small-scale fisheries. The aim of the present study is describe the hagfish species caught in an incipient fishery of the Magellan Strait. Samples were collected in the Magellan Strait during eight fishing expeditions from June 2009 to October 2010 in Bahía Lomas (5348`S; 70°46'W) and Agua Fresca (5323`S; 70°45'W). The samples were taken at two depths, 0-70 meters and 71-140 meters. Taxonomic keys were used to identify the species. All specimens were individuals from the Myxininae subfamily. From a total of 3946 hagfishes, 99 % (n=3905) were the species Myxine affinis and the remaining 1 % were Notomyxine tridentiger, both reported for Chilean and Argentinean Patagonia. The range of variation for meristic variables recorded in this research was wider than those reported in the literature. This could be explained by differences in sample size between the present study and those previously published. Body proportions and meristic variables were not species specific in Myxine sp, so there is a large overlap of ranges between species, which makes their diagnostic use not applicable. This research updates the information and extends the meristic ranges for both species. The esophageocutaneous duct (in N. tridentiger) and the number of fused teeth (bicuspid in M. affinis and tricuspid in N. tridentiger) are the morphological characters that allow a clear identification in the field of the two species.

Los Myxinoideos en Chile están representados por las subfamilias Eptatretinae y Myxininae, con un total de 14 especies, cuya identificación resulta compleja debido al bajo nivel de diferenciación morfológica que caracteriza a este grupo taxonómico. A nivel mundial las anguilas babosas constituyen especies de valor comercial, y en Chile se reportan varios intentos para iniciar pesquerías de pequeña escala. El presente estudio tuvo como propósito la descripción de las especies de anguila babosa capturadas en una pesquería incipiente del Estrecho de Magallanes. Los ejemplares fueron colectados durante ocho expediciones de pesca, desde junio de 2009 a octubre de 2010 en Bahía Lomas (5348`S; 70°46'W) y Agua Fresca (5323`S; 70°45'W). Las muestras fueron tomadas en dos rangos de profundidad, 0-70 metros y 71-140 metros. Todos los especímenes fueron pertenecientes a la subfamilia Myxininae. De un total de 3946 anguilas el 99 % (n=3905) pertenecieron a la especie Myxine affinis y el restante 1 % a la especie Notomyxine tridentiger, ambas reportadas para Chile y la Patagonia Argentina. El rango de variación para las variables merísticas, registradas en esta investigación, fue mayor a los reportados en literatura. Esto puede ser explicado por las diferencias en el tamaño de muestra entre el presente estudio y aquellos publicados previamente. Las proporciones corporales y las variables merísticas no fueron especie-específica en Myxine sp, por lo que existe una gran sobre posición de los rangos entre las especies, lo que hace que su uso como diagnóstico no sea aplicable. Esta investigación actualiza la información y extiende los rangos merísticos para ambas especies. El conducto esofágico-cutáneo (en N. tridentiger) y el número de dientes fusionados (bicúspide en M. affinis y tricúspide en N. tridentiger), son los caracteres morfológicos que permiten una identificación clara de ambas especies.

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Ovarian cancer is the leading cause of death due to gynecological cancer and the 5th cause of death for cancer in women in Europe. Optimal management of patients with ovarian cancer needs the participation of a well-trained multidisciplinary team. In the last few years, we have observed a significant improvement in the knowledge of the molecular biology of the different histotypes of ovarian cancer that will probably change our standard of care in the forthcoming years. In this Guideline, we summarize the most current evidence for the medical management of ovarian cancer.

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In 2006, under the auspices of The Spanish Research Group for Ovarian Cancer (Spanish initials GEICO), the first "Treatment Guidelines in Ovarian Cancer" were developed and then published in Clinical and Translational Oncology by Poveda Velasco et al. (Clin Transl Oncol 9(5):308-316, 2007). Almost 6 years have elapsed and over this time, we have seen some important developments in the treatment of ovarian cancer. Significant changes were also introduced after the GCIG-sponsored 4th Consensus Conference on Ovarian Cancer by Stuart et al. (Int J Gynecol Cancer 21:750-755, 2011). So we decided to update the treatment guidelines in ovarian cancer and, with this objective, a group of investigators of the GEICO group met in February 2012. This study summarizes the presentations, discussions and evidence that were reviewed during the meeting and during further discussions of the manuscript.

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Immunization is one of the most successful and cost-effective health interventions ever. Immunization have been helping to reduce child mortality, improving maternal health and combating infectious diseases. In spite of its, undisputed past success and promising future, however, immunization remains an unfinished agenda because of them inadequate coverage. Several factors have been largely responsible of a difficulty to attain immunization coverage and have been recognized as a problems of current vaccines, such as: the number of dose, excessive use of parenteral route, a small number of adjuvants approve for use in human, higher reactogenicity and unavailability against intracellular pathogens, infected or altered cells and scanty feasibility to combined more than one antigen in the same formulation. For bacterial meningitis WHO estimates that 1,2 million cases occur annually and Neisseria meningitidis is the etiological agent in more than 40 percent of these cases although some meningococcal vaccines are available. To bear in mind these principals problems, a novel protocol for vaccination against N meningitidis called Single Time Vaccination Strategy (SinTimVaS) is proposed. Using female BALB/c mice, we induce systemic and mucosal immune responses against N meningitidis with only one parenteral and one mucosal dose at the same time, employing the Finlay Adjuvants derivate from N meningitidis, AFPL1 and AFCo1, respectively. In conclusion, SinTimVaS could increase the vaccination coverage and reduce the time-cost of vaccine campaigns, adding the possibility to increase the herd immunity by mucosal specific response induction(AU)

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Meningococcal B strains accounts for some 72 percent and 28 percent of meningococcal diseases in infants and toddlers in Europe and the USA, respectively. Nevertheless, meningococcal diseases are rare in Cuba owing to the wide spread program on antimeningococcal vaccination in the country. Finlay Institute is one of the pioneering organizations in Neisseria Vaccinology mainly by its contribution to N. meningitidis serogroup B outer membrane-based bivalent vaccine, VA-MENGOC-BC™. This vaccine was given intramuscularly in more than 60 million doses corresponding 10,7 millions of them to Cuban young adults, children, and infants. However, most dangerous or commensally Neisseria strains enter and establish in the mucosa, where the secretory (S) IgA is the main specific guardian and is mainly induced by mucosal routes. However, few mucosal vaccines exist principally due to the absent of mucosal adjuvants. We develop a Finlay Adjuvant (AF) platform based in outer membrane vesicles (Proteoliposome, PL) and its derivate Cochleate (Co). AFPL1 derived from serogroup B N meningitidis is a potent Th1/CTL driving parenteral adjuvant. AFCo1 is a potent mucosal adjuvant. Therefore, we sought to go deeper in the possible mucosal cross recognition between N. meningitidis serogroups and Neisseria species and explore a concurrent mucosal and parenteral immunization strategy (SinTimVaS) in order to develop suitable mucosal vaccines. Experiments were conducted in Balb/c or C57Bl6 mice with mucosal and systemic immunization using AFCo1 and AFPL1. Human sera and saliva were also analyzed for cross cognition. Mucosal cross recognition at SIgA level in human saliva between N. meningitidis serogroups B, A, C, Y, and W135 were observed. This SIgA cross recognition response was also observed between pathogenic (N meningitidis serogroup B, N gonorrhoeae) and non-pathogenic strains (N flava, N lactamica). The possible influence of meningococcal vaccination ...(AU)

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Neisseria meningitidis B proteoliposome (AFPL1 when used as adjuvant) and its derivative-Cochleate (AFCo1) contain immunopotentiating and immunomodulating properties and delivery system capacities required for a good adjuvant. Additionally, they contain meningococcal protective antigens and permit packaging of other antigens and pathogen-associated molecular patterns (PAMP). Consequently, we hypothesized that they would function as good vaccine adjuvants for their own antigens and also for non-related antigens. AFPL1 is a detergent-extracted outer membrane vesicle of N. meningitidis B transformed into AFCo1 in calcium environment. Both are produced at Finlay Institute under good manufacture practices (GMP) conditions. We show their exceptional characteristics: combining in the same structure, the potentiator activity, polarizing agents and delivery system capacities; presenting multimeric protein copies; containing multiprotein composition and multi and synergistic PAMP components; acting with incorporated or co-administrated antigens; inducing type I IFN-gamma and IL-12 cytokines suggesting the stimulation of human plasmocytoid precursor and conventional dendritic cells, respectively, inducing a preferential Th1 immune response with TCD4(+), TCD8(+), cross-presentation and cytotoxic T-lymphocyte (CTL) in vivo responses; and functioning by parenteral and mucosal routes. AFPL1-AFCo1 protective protein constitutions permit per se their function as a vaccine. In addition to Phase IV Men BC vaccine, AFPL1 has ended the preclinical stage in an allergy vaccine and is concluding the preclinical stage of a nasal meningococcal vaccine. In conclusion, AFPL1 and AFCo1 induced signal 1, 2 and 3 polarizing to a Th1 (including CTL) response when they acted directly as vaccines or were used as adjuvants with incorporated or co-administered antigens by parenteral or mucosal routes. Both are very promising adjuvants.

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Ovarian and cervical cancers are significant health problems. This article provides an update in selected management topics. Paclitaxel and platinum derivatives are the first-line treatment for patients with advanced disease. In selected patients, intraperitoneal chemotherapy has been associated with improved survival but the broad applicability of this strategy is limited by issues of toxicity and feasibility. Management of patients with recurrent disease is based on a number of factors and includes surgery in selected cases, platinum-based chemotherapy for patients with platinum-sensitive disease and other agents such as topotecan and pegylated liposomal formulation of doxorubicin for patients with platinum-resistant disease. In cervical cancer, the most significant issue/event is the demonstration of superior survival with topotecan and cisplatin compared to cisplatin alone. Finally, new agents such as epidermal growth factor receptor inhibitors and antiangiogenic agents are being currently tested in these settings.

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Polycrystalline Nd(1-x)Eu(x)NiO(3) (0≤x≤0.5) compounds were synthesized in order to investigate the character of the metal-insulator (MI) phase transition in this series. Samples were prepared through the sol-gel route and subjected to heat treatments at ∼1000 °C under oxygen pressures as high as 80 bar. X-ray diffraction (XRD) and neutron powder diffraction (NPD), electrical resistivity ρ(T), and magnetization M(T) measurements were performed on these compounds. The NPD and XRD results indicated that the samples crystallize in an orthorhombic distorted perovskite structure, space group Pbnm. The analysis of the structural parameters revealed a sudden and small expansion of ∼0.2% of the unit cell volume when electronic localization occurs. This expansion was attributed to a small increase of ∼0.003 Å of the average Ni-O distance and a simultaneous decrease of ∼-0.5° of the Ni-O-Ni superexchange angle. The ρ(T) measurements revealed a MI transition occurring at temperatures ranging from T(MI)∼193 to 336 K for samples with x = 0 and 0.50, respectively. These measurements also show a large thermal hysteresis in NdNiO(3) during heating and cooling processes, suggesting a first-order character of the phase transition at T(MI). The width of this thermal hysteresis was found to decrease appreciably for the sample Nd(0.7)Eu(0.3)NiO(3). The results indicate that cation disorder associated with increasing substitution of Nd by Eu is responsible for changing the first-order character of the transition in NdNiO(3).

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Abnormalities in gas exchange during general anaesthesia are caused partly by atelectasis. Inspiratory pressures of approximately 40 cm H2O are required to fully re-expand healthy but collapsed alveoli. However, without PEEP these re-expanded alveoli tend to collapse again. We hypothesized that an initial increase in pressure would open collapsed alveoli; if this inspiratory recruitment is combined with sufficient end-expiratory pressure, alveoli will remain open during general anaesthesia. We tested the effect of an 'alveolar recruitment strategy' on arterial oxygenation and lung mechanics in a prospective, controlled study of 30 ASA II or III patients aged more than 60 yr allocated to one of three groups. Group ZEEP received no PEEP. The second group received an initial control period without PEEP, and then PEEP 5 cm H2O was applied. The third group received an increase in PEEP and tidal volumes until a PEEP of 15 cm H2O and a tidal volume of 18 ml kg-1 or a peak inspiratory pressure of 40 cm H2O was reached. PEEP 5 cm H2O was then maintained. There was a significant increase in median PaO2 values obtained at baseline (20.4 kPa) and those obtained after the recruitment manoeuvre (24.4 kPa) at 40 min. This latter value was also significantly higher than PaO2 measured in the PEEP (16.2 kPa) and ZEEP (18.7 kPa) groups. Application of PEEP also had a significant effect on oxygenation; no such intra-group difference was observed in the ZEEP group. No complications occurred. We conclude that during general anaesthesia, the alveolar recruitment strategy was an efficient way to improve arterial oxygenation.

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Objetivo: La ventilación mecánica (VM) ha demostrado ser una terapeútica útil en pacientes con compromiso de la función respiratoria. Son múltiples las complicaciones asociadas a los modos convencionales de VM. Están en desarrollo técnicas para disminuir la incidencia de efectos adversos. El objetivo del trabajo es evaluar la técnica ventilatoria denominada APERTURA PULMONAR (AP). (Open Lung Concept. Intens Care Med. 18:319-321, 1992). Pacientes y métodos: Se incorporaron en forma prospectiva y randomizada los pacientes que requirieron VM. Se usaron Siemmens Servo 300 y 900C. Se utilizaron tres modos ventilatorios: Presión Control (PC), Volumen Control (VC), y AP (con parámetros iniciales VT 7-10 ml/kg, PEEP/Presión Inspiratoria Pico (PIP) de 5/25, e incrementos progresivos de 5 cm H20 hasta alcanzar 15/60 e inmediato descenso, posteriormente éste grupo fue ventilado en modo PC con los parámetros de PEEP/PIP de 5-10/25-30, VT 7-10 ml/kg, I:E de 1:1.3, con frec. resp. entre 10-15. La AP se repitió según criterio del equipo médico. Se usó la escala de Murray al ingreso para estratificar las muestras. Se efectuaron registros seriados de monitoreo respiratorio y gasométrico. Se compararon los valores de Pao2/Fio2 entre los diferentes modos ventilatorios. Resultados: Ingresaron 42 pacientes. Se efectuaron 505 monitoreos. En la tabla se observan las comparaciones de los valores de las Pao2/Fio2 generales entre los grupos y las Pao2/Fio2 según horas de VM y según valor de Murray. Conclusiones: el modo AP tuvo mejores índices de oxigenación, siendo más evidente con el transcurso del tiempo y en los pacientes con mayor injuria pulmonar (AU)

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Objetivo: La ventilación mecánica (VM) ha demostrado ser una terapeútica útil en pacientes con compromiso de la función respiratoria. Son múltiples las complicaciones asociadas a los modos convencionales de VM. Están en desarrollo técnicas para disminuir la incidencia de efectos adversos. El objetivo del trabajo es evaluar la técnica ventilatoria denominada APERTURA PULMONAR (AP). (Open Lung Concept. Intens Care Med. 18:319-321, 1992). Pacientes y métodos: Se incorporaron en forma prospectiva y randomizada los pacientes que requirieron VM. Se usaron Siemmens Servo 300 y 900C. Se utilizaron tres modos ventilatorios: Presión Control (PC), Volumen Control (VC), y AP (con parámetros iniciales VT 7-10 ml/kg, PEEP/Presión Inspiratoria Pico (PIP) de 5/25, e incrementos progresivos de 5 cm H20 hasta alcanzar 15/60 e inmediato descenso, posteriormente éste grupo fue ventilado en modo PC con los parámetros de PEEP/PIP de 5-10/25-30, VT 7-10 ml/kg, I:E de 1:1.3, con frec. resp. entre 10-15. La AP se repitió según criterio del equipo médico. Se usó la escala de Murray al ingreso para estratificar las muestras. Se efectuaron registros seriados de monitoreo respiratorio y gasométrico. Se compararon los valores de Pao2/Fio2 entre los diferentes modos ventilatorios. Resultados: Ingresaron 42 pacientes. Se efectuaron 505 monitoreos. En la tabla se observan las comparaciones de los valores de las Pao2/Fio2 generales entre los grupos y las Pao2/Fio2 según horas de VM y según valor de Murray. Conclusiones: el modo AP tuvo mejores índices de oxigenación, siendo más evidente con el transcurso del tiempo y en los pacientes con mayor injuria pulmonar

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The goal of this program was to identify problems in patients with symptomatic malignant terminal disease relating to the improvement of their care at home. A program was developed consisting of guidelines and instructions which built on the previous training of the family members assuming their care. Patient needs assessment was performed to identify the major problems afflicting patients. Problems were described by nursing diagnoses using the classification system of altered functional patterns. Based on their problems, family members were trained so that they could offer patients more adequate care and attention in their homes. The effectiveness of the program was evaluated, as was its impact on the patients themselves and their families.

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Distintos autores describen los beneficios de la autopsia, sin embargo ésta practica se practica con una frecuencia cada vez menor. Una alternativa para aumentar el interés es convocar al internista a presenciar el examen macroscópico (EMAC) de sus pacientes. El objetivo del presente trabajo es demostrar que el EMAC genera datos suficientes para justificar esta convocatoria. Se revisaron 33 autopsias del período 1988-89. Se definieron dos tipos de error diagnóstico (EI, EII). EI: entidad cuyo tratamiento hubiera mejorado la sobrevida. EII: entidad que pudo contribuir a la muerte o que no tenía tratamiento. Se compararon los diagnósticos del EMAC vs los microscópicos. Se evaluó la capacidad del EMAC para resolver la enfermedad principal (Enf Ppal), evolución, causa de muerte y EI y/i EII. Resultados: Población: 27 hombres, 6 mujeres. Edad: 53 ñ 17. Casos con diagn. de enf. ppal. n24,. Error= 0,5 por caso (EI 65%; EII 35%). Casos sin díagn. de enf. ppal. n9, Error=2,33 por caso (EI 52%; EII 48%). Clasificación de diag.: EMAC 270 (exclusivos 40). Microscópicos confirmatorios de EMAC 176, micr.nuevos 92. Conclusiones: 1) El EMAC junto a la historia clínica explicó la enf. ppal., evolución y causa de muerte en el 92%, el EI en el 69% y el EII en el 80% de los casos. 2) El error diag. fue de mayor frecuencia en los casos con error de enf. ppal. 3) Los nuevos diag. micr. cambiaron la orientación diag. primitivo en el 8% de los casos. 4) El internista devbe recuperar el hábito perdido de presenciar el EMAC de sus pacientes (AU)

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Distintos autores describen los beneficios de la autopsia, sin embargo ésta practica se practica con una frecuencia cada vez menor. Una alternativa para aumentar el interés es convocar al internista a presenciar el examen macroscópico (EMAC) de sus pacientes. El objetivo del presente trabajo es demostrar que el EMAC genera datos suficientes para justificar esta convocatoria. Se revisaron 33 autopsias del período 1988-89. Se definieron dos tipos de error diagnóstico (EI, EII). EI: entidad cuyo tratamiento hubiera mejorado la sobrevida. EII: entidad que pudo contribuir a la muerte o que no tenía tratamiento. Se compararon los diagnósticos del EMAC vs los microscópicos. Se evaluó la capacidad del EMAC para resolver la enfermedad principal (Enf Ppal), evolución, causa de muerte y EI y/i EII. Resultados: Población: 27 hombres, 6 mujeres. Edad: 53 ñ 17. Casos con diagn. de enf. ppal. n24,. Error= 0,5 por caso (EI 65%; EII 35%). Casos sin díagn. de enf. ppal. n9, Error=2,33 por caso (EI 52%; EII 48%). Clasificación de diag.: EMAC 270 (exclusivos 40). Microscópicos confirmatorios de EMAC 176, micr.nuevos 92. Conclusiones: 1) El EMAC junto a la historia clínica explicó la enf. ppal., evolución y causa de muerte en el 92%, el EI en el 69% y el EII en el 80% de los casos. 2) El error diag. fue de mayor frecuencia en los casos con error de enf. ppal. 3) Los nuevos diag. micr. cambiaron la orientación diag. primitivo en el 8% de los casos. 4) El internista devbe recuperar el hábito perdido de presenciar el EMAC de sus pacientes

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Se hace referencia a un caso de dermatitis ampollar mucosinequiante y atrofiante de Lortat Jacob en una mujer de 76 anos que evoluciona clinicamente con lesiones de comienzo ampollar, no dolorosas, de aspecto irregular, superficie brillante y tamano variable. Distribuida en piel de hipogastrio, en mucosa oral y ocular con secuelas de simblefaron y opacidad corneal

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Se hace referencia a un caso de dermatitis ampollar mucosinequiante y atrofiante de Lortat Jacob en una mujer de 76 anos que evoluciona clinicamente con lesiones de comienzo ampollar, no dolorosas, de aspecto irregular, superficie brillante y tamano variable. Distribuida en piel de hipogastrio, en mucosa oral y ocular con secuelas de simblefaron y opacidad corneal

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