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During platelet activation, arachidonic acid (AA) is released from membrane phospholipids and metabolized to thromboxane A2 (TXA2) through the actions of cyclooxygenase-1 (COX-1) and TXA2 synthase. Note, TXA2 binds to the platelet TXA2 receptor, causing shape change, secretion and platelet aggregation.1 Also, COX-1 (599aa; 70 kDa) has cyclooxygenase and peroxidase activities and it is functionally active as a homodimer, with each COX-1 monomer consisting of four highly conserved domains: an N-terminal signal peptide, a dimerization domain, a membrane-binding domain (MBD) and a large C-terminal catalytic domain2 (Figure 1A). Irreversible COX-1 inhibition by aspirin is a widely established anti-platelet therapy in cardiovascular disease., Fundación Mutua Madrileña, Grant/Award Number: AP172142019; Fundación Séneca, Grant/Award Number: 19873/GERM/15; Gerencia Regional de Salud, Grant/Award Numbers: 1647/A/17, 2061A/19; Instituto de Salud Carlos III (ISCIII) & Feder, Grant/Award Numbers: CB15/00055, PI17/01966, PI18/00598, PI20/00926, PI17/01311; Junta de Castilla y León; British Heart Foundation, Grant/Award Number: PG/17/40/33028; Ayuda a Grupos de Trabajo en Patología Hemorrágica; Premio López Borrasca 2019; Sociedad Española de Trombosis y Hemostasia.

According to reports from the literature,1,2 depending on the location where cavernomas appear, range from the very common locations to unusual. Cavernous malformations arising from the optic nerve and chiasm are rare, with only few cases reported to date.3-5 We present a case of a 28-yr-old man who suddenly started with sever visual loss in the right eye and homonymous lateral hemianopia in the left eye. Because of the acute symptomatology, a brain MRI was immediately performed in order to diagnose the etiology. The MRI showed a chiasmatic mass with right extension, heterogeneous on T1 and T2 sequences, without enhancement after gadolinium. The surgery was carried out a week after the diagnosis. A right pterional transsylvian approach was performed and the cavernoma was resected with microsurgical maneuvers, preserving the optic nerve fibers, chiasm, and optic tract. The patient evolved favorably, improving the visual deficit in the postoperative period as can be observed in the postoperative visual field study 7 mo after the surgery. The patient signed an informed consent for the procedure and agreed with the use of his images and surgical video for research and academic purposes. Our surgical case emphasizes the importance of a prompt diagnosis and surgery for chiasmatic cavernomas3 associated to visual loss, providing early decompression of the optic apparatus and improvement of the visual field defects after surgery.

Background: Acute myeloid leukemia (AML) remains a major clinical challenge due to poor overall survival, which is even more dramatic in elderly patients. TIGIT, an inhibitory receptor that interacts with CD155 and CD112 molecules, is considered as a checkpoint in T and NK cell activation. This receptor shares ligands with the co-stimulatory receptor DNAM-1 and with TACTILE. The aim of this work was to analyze the expression of DNAM-1, TIGIT and TACTILE in NK cells and T cell subsets in AML patients. Methods: We have studied 36 patients at the time of diagnosis of AML and 20 healthy volunteers. The expression of DNAM-1, TIGIT and TACTILE in NK cells and T cells, according to the expression of CD3 and CD56, was performed by flow cytometry. Results: NK cells, CD56&minus, T cells and CD56+ T (NKT-like) cells from AML patients presented a reduced expression of DNAM-1 compared with healthy volunteers. An increased expression of TIGIT was observed in mainstream CD56&minus, T cells. No differences were observed in the expression of TACTILE. Simplified presentation of incredibly complex evaluations (SPICE) analysis of the co-expression of DNAM-1, TIGIT and TACTILE showed an increase in NK and T cells lacking DNAM-1 and co-expressing TIGIT and TACTILE. Low percentages of DNAM-1&minus, TIGIT+TACTILE+ NK cells and DNAM-1&minus, TIGIT+TACTILE+ CD56&minus, T cells were associated with a better survival of AML patients. Conclusions: The expression of DNAM-1 is reduced in NK cells and in CD4+ and CD8+ T cells from AML patients compared with those from healthy volunteers. An increased percentage of NK and T cells lacking DNAM-1 and co-expressing TIGIT and TACTILE is associated with patient survival, supporting the role of TIGIT as a novel candidate for checkpoint blockade.

Epilepsy is a common symptom in patients with primary central nervous system (CNS) tumors. Seizures are reported in 15–95% of patients with brain tumors, depending on the type of tumor [1]. Seizures are the presenting symptom in 15–50% of patients with gliomas, and up to 75% will have at least one seizure at some point in the disease course [2]. The recognition and classification of epileptic seizures and providing effective treatment are essential to preserve the quality of life of patients with glial tumors. In a previous study, we found that 63% of patients with glial tumors experienced seizures at some point in the disease course. Sixty two percent of seizures were focal onset, while 38% were generalized onset seizures [3]. However, considering the tumor etiology of seizures, we were unable to verify the results. Therefore, the goal of this study was to present the results of a larger cohort of patients with primary glial tumors and epilepsy based on a more rigorous examination approach. The primary objectives of this study were to classify and quantify epileptic seizures as a symptom of onset or later in the course of the disease and the correlation between ILAE 1981 and 2017 classifications [5,6]. The secondary objectives were to quantify: 1) the cases in which epileptic seizures were reclassified; 2) patients who received antiepileptic drugs (AEDs) as monotherapy; 3) patients whose antiepileptic treatment on admission was modified; and (4) patients whose seizures were controlled with the prescribed AEDs.

Resumen Introduccion El infarto isquemico secundario a anomalia del desarrollo venoso es infrecuente y su fisiopatologia no se conoce con certeza. Caso clinico Presentamos el caso de un paciente con antecedente de adenocarcinoma de prostata, quien durante el posoperatorio mediato presento cefalea intensa y crisis generalizadas tonico-clonicas. El resultado de la tomografia de cerebro inicial fue interpretado como metastasis. La resonancia magnetica y la tomografia computarizada evidenciaron una anomalia del desarrollo venoso e isquemia periferica a la malformacion. Conclusion Es importante evitar el sesgo diagnostico de los hallazgos en las neuroimagenes de pacientes oncologicos y, asi, plantear los diagnosticos diferenciales, incluso los infrecuentes.

Resumen Introduccion Los meningiomas son los tumores primarios mas frecuentes del sistema nervioso central y son de consulta frecuente en neurooncologia. Metodos Se realizo una revision bibliografica extensa y actualizada con el objetivo de favorecer el mejor abordaje de esta patologia. Resultados Los meningiomas son tumores extraaxiales originados a partir de las celulas de la aracnoides y representan el 36,4% de los tumores primarios intracraneanos. Los meningiomas pueden ser incidentales, pequenos y de lento crecimiento, o masas extensas y/o de crecimiento progresivo. La primera alteracion genetica descripta fue la perdida del cromosoma 22; en los ultimos anos se han descripto diversas mutaciones geneticas, tales como las mutaciones del promotor de transcriptasa reversa de la telomerasa (TERT), implicadas en la progresion maligna. Las neuroimagenes suelen tener caracteristicas distintivas en la tomografia computarizada y la resonancia magnetica. Por anatomia patologica se los clasifica en grados i , ii y iii de la Organizacion Mundial de la Salud y existen diversos subtipos con diferentes caracteristicas, evolucion y pronostico. La neurocirugia y el grado de reseccion son el pilar del tratamiento y el predictor de progresion. En pacientes seleccionados se podria considerar la embolizacion prequirurgica. La radioterapia puede ser adyuvante o como tratamiento unico en los irresecables; al igual que en los grados ii y anaplasicos. En relacion con la terapia farmacologica, solo bevacizumab, sunitinib y vatalinib han mostrado una potencial actividad clinica. Conclusiones Describimos en detalle las caracteristicas mas relevantes, la evaluacion y las opciones terapeuticas disponibles para pacientes con meningiomas.

BACKGROUND AND OBJECTIVES: Chemosensitization using plerixafor combined with FLAG-IDA (PLERIFLAG regimen) showed promising results (48% CR/CRi) in a phase 2 trial for primary refractory and early relapsed (duration of first CR Patients: Of the 540 patients in the data base we analysed 300 patients relapsed or resistant to induction therapy, which had all data available. 241 patients were treated with FLAG-IDA, 41 with FLAGO-Ida, and 42 with PLERIFLAG. Differences between treatment cohorts were tested using Fisher exact test. Treatment cohorts (PLERIFLAG vs FLAG-IDA vs FLAGO-IDA) were similar in Age (p=0.5), Sex (p=0.5), FLT3-ITD mutated (p=0.5), EPI/HOVON cytogenetics score (p=0.5) and previous myelodisplasia (p=0.2). The three cohorts differed in time to relapse (p=0.001), previous stem cell transplantation (0.001), HOVON score (p=0.03) and SALFLAGE score (0.001). RESULTS There were no differences in terms of CR+CRi between the three types of treatment adjusted by Hovon risk score (Pleriflag: 48%, FLAG-IDA: 50% or FLAGO-IDA: 58%; Chrochan Maentel-Haenszel test, p=0.466) or SALFLAGE score (Chrochan-Maentel-Haenszel test, p=0.23). More patients were allografted in the PLERIFLAG (61%) group even not achieving CR/Cri, as compared to FLAG-IDA (38%) or FLAGO-Ida (61% vs 38% vs. 18%, p=0.0001). To compare PLERIFLAG against the other two types of salvage treatment we performed a Propensity Score in a proportion 1:3. We adjust variables like age, previous allogeneic transplant, time to relapse (refractory, 12 months), karyotype using MRC, and FLT3-ITD status. Karyotype risk was considered by HOVON criteria (inv16, t(8;21) vs others), and SALFLAGE (inv 16, intermediate risk, and unfavourable risk by MRC risk plus t(8;21)). The propensity score analyses showed that Compared to FLAG-IDA, PLERIFLAG was associated to increased survival (median OS 10.56 months vs. 5.6, p=0.03), but not improved EFS (2.83 months vs 1.41 months, p=0.8). The benefit in OS but not in EFS could be explained in part by frequent use of Allo SCT in patients who had not achieve CR/CRi in the PLERIFLAG cohort. In conclusion, our historical control study show that PLERIFLAG regimen is an acceptable therapeutic option for first relapsed/refractory adult AML patients. Disclosures Esteve: Jazz Pharmaceuticals: Consultancy; Amgen: Consultancy; Pfizer: Consultancy; Novartis: Consultancy, Research Funding, Speakers Bureau; Celgene: Consultancy, Speakers Bureau; Daiichi Sankyo: Consultancy; Roche: Consultancy; Astellas: Consultancy, Speakers Bureau. Salamero:Novartis: Honoraria; Pfizer: Honoraria; Celgene: Honoraria; Daichii Sankyo: Honoraria. Perez Encinas:CELGENE: Consultancy; JANSSEN: Consultancy; GILEAD SCIENCES: Research Funding. Montesinos:Incyte: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Research support, Speakers Bureau; Pfizer: Membership on an entity's Board of Directors or advisory committees, Other: Research support, Research Funding, Speakers Bureau; Janssen: Membership on an entity's Board of Directors or advisory committees, Other: Research support, Research Funding, Speakers Bureau; Daiichi Sankyo: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Research support, Speakers Bureau; Abbvie: Membership on an entity's Board of Directors or advisory committees; Karyopharm: Membership on an entity's Board of Directors or advisory committees, Other: Research support; Novartis: Membership on an entity's Board of Directors or advisory committees, Other: Research support, Research Funding, Speakers Bureau; Teva: Membership on an entity's Board of Directors or advisory committees, Other: Research support, Research Funding, Speakers Bureau.

Resumen El tratamiento quirurgico de los tumores gliales del sistema nervioso central es un marcador pronostico y uno de los pilares respecto del tiempo libre de progresion y sobrevida del paciente. Sin embargo, el riesgo de secuelas neurologicas posquirurgicas aumenta con el grado de reseccion y localizacion del tumor. Basandonos en las caracteristicas de las neuroimagenes tumorales y posquirurgicas, confeccionamos esta guia para la planificacion prequirurgica, incluyendo algunos comentarios del acto quirurgico y el seguimiento posquirurgico, con el objetivo de clasificar y definir porcentajes de reseccion adecuadamente.

Background: Fabry disease (FD) is an underdiagnosed cause of stroke in youngadults, but the frequency of this association is largely unknown. We estimatedthe prevalence of FD in a nationwide cohort of young adults who had stroke andtransient ischemic attack (TIA) in Argentina. Methods: This was a prospective, multicenterstudy of stroke and FD in young adults (18-55 years) conducted in Argentinabetween 2011 and 2015. Patients were enrolled if they had had a TIA or an ischemicor hemorrhagic stroke within the previous 180 days. FD was diagnosed bymeasuring α-galactosidase A activity (males) and through genetic studies (females).Results: We enrolled 311 patients (54% men, mean age: 41 years). Ischemic eventsoccurred in 89% of patients (80% infarcts, 9% TIA) and hemorrhagic strokes in11%. One female (.3% of the total group, 1% of the cryptogenic ischemic strokes)had the pathogenic mutation c.888G>A/p.Met296Ile /Exon 6 on the GAL gene.Her only other manifestation of FD was angiokeratoma. Eighteen females hadnonpathogenic intronic variations: c.-10C>T, c.-12G>A, or both. Two patients hadthe nonpathogenic mutation D313Y, while a third had the likely benign mutationS126G. Conclusions: FD was identified in 1 patient (.3%) in this first LatinAmerican study. The patient presented with a late-onset oligo-symptomatic formof the disease. A large number of nonpathogenic mutations were present in ourcohort, and it is essential that they not be mistaken for pathogenic mutations to avoid unnecessary enzyme replacement treatment. Fil: Reisin, Ricardo C.. Hospital Británico de Buenos Aires; Argentina Fil: Mazziotti, Julieta. Hospital Británico de Buenos Aires; Argentina Fil: León Cejas, Luciana. Hospital Británico de Buenos Aires; Argentina Fil: Zinnerman, Alberto. Hospital Posadas; Argentina Fil: Bonardo, Pablo. Hospital Británico de Buenos Aires; Argentina Fil: Fernandez Pardal, M.. Hospital Británico de Buenos Aires; Argentina Fil: Martinez, A.. Hospital Posadas; Argentina Fil: Riccio, Patricia. Fundación Favaloro; Argentina Fil: Ameriso, Sebastián. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina Fil: Bendersky, Eduardo. INAREPS; Argentina Fil: Nofal, Pedro. Sanatorio Parque Tucumán; Argentina Fil: Cairola, Patricia. CEMIC; Argentina Fil: Jure, Lorena. Sanatorio Parque Rosario; Argentina Fil: Sotelo, Andrea. Sanatorio Adventista del Plata; Argentina Fil: Rozenfeld, Paula Adriana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Estudios Inmunológicos y Fisiopatológicos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Estudios Inmunológicos y Fisiopatológicos; Argentina Fil: Ceci, Romina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Estudios Inmunológicos y Fisiopatológicos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Estudios Inmunológicos y Fisiopatológicos; Argentina Fil: Casas Parera, Ignacio Faustino. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; Argentina Fil: Sánchez Luceros, Analía Gabriela. Academia de Medicina; Argentina

Resumen Introduccion La prevalencia de embarazos en la poblacion con tumores gliales es desconocida. Casos clinicos Este es un estudio descriptivo, observacional, retrospectivo sobre 140 pacientes con tumores gliales diagnosticados entre enero de 2002 y septiembre de 2011; 49 fueron mujeres, 28 en edad fertil. Solo se registraron 3 embarazos. Dos fueron primigestas. Solamente un embarazo fue planificado. Todas se encontraban en tratamiento por epilepsia secundaria. Solo una paciente presento una crisis parcial motora durante el embarazo. Una paciente recibio temozolomida durante el primer mes de embarazo. Todos los embarazos llegaron a termino. Un parto fue vaginal. Un recien nacido presento sindrome de Down, y uno pie Bot y retraso madurativo. Conclusiones Los resultados de esta experiencia amplian los conocimientos sobre la maternidad en pacientes neurooncologicas.

With funding provided by Microsoft Research, the Inter-American Development Bank and selected universities from the region, the LACCIR Federation promotes collaborative research in ICT and computer science within Latin America and the Caribbean (LAC). The focus is on applications for social and economic needs that are common throughout the LAC region. LACCIR aims to generate leverage between research teams and validate and generalize the research outcomes and their transfer to the society at large. This scientific collaboration allows researchers to address common problems and opportunities for the region. Thus, regional scientific collaboration becomes a possible source of solutions for its own social and economic needs. This paper describes the LACCIR organization, its main activities and some selected on-going research initiatives.

Introduction: Multiple Myeloma (MM) is an incurable disease. In young patients, autologous bone marrow transplantation (ABMT) remains a cornerstone treatment after induction therapy. Induction therapy has varied during time, from alkylating polychemotherapy (VBAD,VCMP) or VAD chemotherapy (AVAD) to Velcade-Dexametasone based regimens (VD). We present results of follow-up of a large cohort of patients treated with ABMT. We described overall survival (OS; from transplant to death by any cause) and progression free survival (PFS; from transplant to death by any case or progressive disease defined by reappearance by inmunofixation, or duplication of monoclonal peak after ABMT) , and the impact of induction therapy regiments. Patients: 183 patients transplanted from 2002 to 2017. The median age of the patients was 59 years (33-72). Before 2008 all the patients were treated in alkylating based chemotherapy (42 patients). After 2008 patients were treated with VD based regimens (141patients). Only 12 patients received maintenance therapy based in PETHEMA trials 2005 and 2012. No one patient received a planed second transplant; only 32 patients received a second transplant after relapse as consolidation therapy. Results: Median follow-up of patients still alive is 3.65 years (0.15-14.77). Median OS of all patients was 9.12 years (95% confidence interval (CI): 6.28-NR); Median PFS was 3.02 years(95% CI: 2.46-3.76). At 13 years only 2% of patients remains progression free (CI: 0.00-17%). There were significant differences between patients treated before and after VD regimens. The median OS of patients treated with APVAD was significantly shorter compared to VD (6.22 years, CI[3.39-12] vs. NR, CI[6.28-NR], p=0.025) (HR=0.49, p=0.01). Conclusions: VD schemes of induction before ABMT have improved remarkably OS inpatients with Myeloma; nonetheless, plateau is not observed in EFS. Further analysis must address if EFS could represent a strong indicator of OS, mainly due to novel effective salvage therapies after relapse/refractoriness could be a confounding factor. Figure. Figure. Disclosures No relevant conflicts of interest to declare.

Resumen Introduccion En los ultimos anos se sucedieron cambios en la neurooncologia que mejoraron la calidad de vida y sobrevida de pacientes con tumores primarios (TP) del SNC. Objetivos Presentar las caracteristicas clinicas de una cohorte de pacientes con TP de SNC de la serie glial. Material y metodos Entre los anos 2002-2009 se realizo el seguimiento de 148 pacientes con TP de SNC. Se analizaron solo los tumores de la serie glial intracraneanos. Este es un estudio descriptivo. Resultados Setenta y nueve pacientes (52 varones y 27 mujeres) presentaron tumores de la serie glial. El mayor numero de casos se presentaron en la cuarta decada. Segun la histopatologia: 34 glioblastomas multiformes (GBM), 6 astrocitomas GIII, 9 astrocitomas GII, 5 astrocitomas GI, 3 gliomas de tronco, 1 glioma cordoide, 16 oligodendrogliomas GII y 5 oligodendrogliomas GIII. La localizacion mas frecuente fue en el lobulo frontal. Los sintomas de inicio, en orden de frecuencia, fueron: crisis comiciales, cefalea, afasias, deficits cognitivos, motores o sensitivos, patologia de pares y sindrome de hipertension endocraneana. En 27 pacientes el tratamiento fue quirurgico/radioterapia/quimioterapia (Qx/Rt/Qt), 20 Rt/Qt, 6 Qx, 6 Qt, 5 Rt, 5 Qx/Qt, 4 Qx/Rt, y 6 pacientes no realizaron tratamiento. El 51% de los pacientes tuvieron reseccion parcial o completa del tumor. Las crisis epilepticas (parciales [62%] y generalizadas [38%]) fueron controladas completamente en el 66% de los casos con monoterapia. Conclusiones El GBM fue el tumor mas frecuente y el lobulo frontal el mas comprometido. El sintoma prevalente fueron las crisis epilepticas. Obtuvimos un porcentaje bajo de pacientes con reseccion parcial o completa del tumor.

Introduction Camptocormia is characterized by an abnormal posture of the trunk with marked forward flexion of the thoracolumbar spine, which accentuates during standing and walking and abates in the recumbent position. Material/methods Case report. Results We describe a 62-year-old woman with L1 vertebral body collapse and partial compression of the cauda equine underwent surgery decompression and stabilization with instrumentation technique. She was discharged 5 days later with ambulation preserved but with camptocormia. Electromyography of lumbar and lower thoracic paraspinal muscles showed denervation. Discussion A pathophysiological mechanism triggered by surgery with instrumentation technique resulted in denervation and atrophy of paraspinal muscles.

The objective of the study was to assess the cost of multiple sclerosis (MS) patients in Argentina categorized by disease severity using a societal perspective.Method:Cross-sectional study including MS patients from 21 MS centers in 12 cities of Argentina. Patients were stratified by disease severity using the expanded disability status scale (EDSS) (group 1 with EDSS score between 0 and 3; group 2 with EDSS >3 and 3 and 3 y 3 y

It is well-known that physical activities contribute to keep the people healthy. However, the modern life style impacts negatively on the amount of physical activity that we do during the day. Many times the people do not perform enough exercise because they are not aware of the amount of physical activity that they have done. In order to make the persons aware of this aspect of his life, this article presents a mobile application that monitors the amount of exercise they do every day and it informs properly to the user. The system, named AMOPA, allows caregivers or doctors monitoring particular patients, to access this information remotely in order to support the person being monitored. The system was evaluated using laboratory tests, and the results indicate a good performance and accuracy in the detection of the people physical activities. Moreover, the monitored process has a low impact on the energy consumption of the devices used to capture and process the information.

We analyzed the value of new NCCN-IPI index in patients affected of Large B cell lymphoma (LBCL) treated with DA-EPOCH-R in order to assess the validity of this index in patients treated homogenously with dose adjusted R-EPOCH. Patients and protocol: We analyzed the use of NCCN-IPI (Zhou et al, 2014) index in a retrospective cohort of 98 DLBCL patients treated with -EPOCH. These patients were included in DA-EPOCH using IPI(Shipp M.A., 1993) as criteria of inclusion, including only patients (95 patients, 96%)with suspected bad prognosis based in IPI (2-5) and 3 patients with primary mediastinal large B cell lymphoma (PMLBCL). R-EPOCH was administered as reported previously(Wilson et al, 2013). Only 10 patients (10%) were Ann Arbor stage I or II. Results: The median age of the cohort was 57,13(15-82), 47 woman, 75 patients alived. The median follow-up of the patients alive is 6,7 years (1,3-11). Ann Arbor stage was IVB in 44 patients, and IVA in 21. Responses during treatment: Complete response (CR): 81 (82%), refractory during treatment: 7 (7%), death during treatment: 7 (7%). The number of patients who relapsed after treatment was 19 (20%). The median overall (OS) survival of all patients was not reached, (at 5 years, 0.669, CI: 0.562-0.798). The progression free survival (PFS) at 5 years is 0.62, CI: 0.483-0.795. We classify by the new NCCN-IPI the patients in Low-Intermediate risk (L-I)(3 patients, 3%), High-Intermediate risk (H-I)(38, 44%) and High risk (HR) (45, 52%). The OS at 5 years in H-I is 0.839 (CI: 0.73-0.96) and HR was 0.56 (CI: 0.421-0.754), p=0.025. The PFS at 5 years in H-I is 0.65 (CI: 0.518-0.826) and HR is 0.57 (CI: 0.43-0.755), p=0.4. Conclusions: NCCN-IPI discriminates well prognosis between HR/H-I patients with DLBCNHL treated with DA-EPOCH-R. The results of this retrospective analysis of high and intermediate high-risk patients compares better than the published in patients treated with R-CHOP. PFS were similar in H-I and HR; differences in OS could be explain by differences in outcome after salvage treatment with autologous stem cell Disclosures No relevant conflicts of interest to declare.

IMPLICATIONS We describe a technique of one-lung high-frequency jet ventilation surgery with continuous monitoring of airway pressures that achieves satisfactory operating conditions with less complications than other similar approaches.

MCT-LAC - a Math Cognitive Tutor System - consists of a teaching-learning strategy based on "learning by doing", which is enhanced by the use of an interactive software tool that adapts itself to the student's interactions and responses. It is a system in the sense that includes both teaching-learning strategies and an interactive-adaptable technology. The strategy uses both an individual approach (in the computer lab) and a collaborative approach (in the classroom). The MCT-LAC software tools provide progress feedback to students and teachers, both in an individualized and a group format. As a side effect, the MCT-LAC system also serves as an excellent tool for teachers to re-enforce their math knowledge and associated teaching strategies. In this paper we describe the strategy and tools of the MCT-LAC system, the implementation of a pilot experience in several Latin American countries and some preliminary assessment results.

BACKGROUND: Pressure-controlled ventilation (PCV) has been suggested as a tool to improve oxygenation during one-lung ventilation (OLV) for patients undergoing thoracic surgery. In this study we investigated whether PCV results in improved arterial oxygenation compared with volume-controlled ventilation (VCV) during OLV. METHODS: Fifty-eight patients with good preoperative pulmonary function scheduled for thoracic surgery were prospectively randomized into two groups. Those in group A underwent OLV initially with VCV for 30 min followed by PCV for a similar period of time. Those in group B underwent OLV initially with PCV for 30 min followed by VCV for a similar duration. Airway pressures and arterial blood gases were obtained during OLV at the end of each ventilatory mode. RESULTS: There were no differences during OLV in arterial oxygenation between VCV (Pao 2 , 206.1 ± 62.4 mm Hg) and PCV (Pao 2 , 202.1 ± 56.4 mm Hg; P = 0.534). Peak airway pressure was lower with PCV than with VCV (24.43 ± 3.42 cm H 2 O vs. 34.16 ± 5.21 cm H 2 O; P < 0.001). CONCLUSIONS: The use of PCV during OLV does not lead to improved oxygenation during OLV compared with VCV for patients with good preoperative pulmonary function, but PCV did lead to lower peak airway pressures. Further study is needed for patients with severe obstructive or restrictive pulmonary disease.

El diagnostico clinico de los tumores cardiacos es, a menudo, dificil. Presentamos el caso de un paciente de 17 anos en el que se diagnostico un tumor del ventriculo izquierdo a partir del estudio de un sincope. El estudio anatomopatologico confirmo el diagnostico de mixoma. Clinical diagnosis of cardiac tumours is often difficult. We present the case of a 17 year-old boy inwhom a left ventricular tumour was discovered duringon diagnostic work-up for a syncope. The tumourwas removed and histology confirmed thediagnosis of myxoma.

Los procesos de enseñanza-aprendizaje (E/A) en las universidades pueden ser potenciados por ambientes TEL (Technology Enhanced Learning). Considerando que estos ambientes buscan provocar cambios para mejorar la efectividad educacional, es fundamental incorporar mecanismos de evaluación que provean retroalimentación respecto de su impacto en la educación. Creemos que el desarrollo de un DSS (Decision Support System), cuyos elementos de decisión estén sustentados por el análisis de múltiples fuentes de datos provenientes del propio ambiente TEL, aportará a resolver este problema. Exponemos la implementación OLAP (OnLine Analytic Processing) de CCPR_R, un metamodelo para la evaluación de ambientes TEL y el desarrollo de un modelo experimental. Concluimos que CCPR_R puede ser parte de un DSS para la evaluación de ambientes TEL, que incentiva el desarrollo de indicadores de gestión. University teaching-learning (T/L) processes can be enhanced by TEL (Technology Enhanced Learning) environments. Considering that these environments goal is to provoke changes in order to improve educational effectiveness, the incorporation of evaluation tools that provide feedback is fundamental. We believe that the development of a DSS (Decision Support System), whose decision elements are supported by the analysis of a variety of sources of data that come from the TEL system itself, will contribute to the solution of this problem. We propose an OLAP (OnLine Analytic Processing) implementation of CCPR_R, a meta-model for the evaluation of TEL systems, as well as the development of an experimental model. We conclude that CCPR_R can be part of a DSS for the evaluation of TEL environments, thus promoting the development of management indicators.

We describe the case of a 20-year-old male who developed right-arm choreic movements secondary to a giant unruptured aneurysm impinging upon the left thalamus, putamen, globus pallidus, cerebral peduncle, midbrain, and subthalamic nucleus. The aneurysm was treated successfully with coils and a supraclinoid balloon. Abnormal movements initially failed to ameliorate, but within a few months, it was possible to discontinue symptomatic haloperidol therapy, with only mild residual abnormal movements.

Anticoagulation for cardiopulmonary bypass in the infrequent clinical setting of thrombocytopenia associated with the use of unfractionated heparin is a very serious problem. We describe a case in which a low-molecular-weight heparin (tedelparin) was selected for this purpose based on a platelet aggregation test, permitting adequate anticoagulation during cardiopulmonary bypass for valve replacement. This case report might help establish an adequate anticoagulation protocol when faced with a patient suffering from this condition.

Every day more and more undergraduate and graduate students use their mobile computing devices during lectures. This situation has been identified by several researchers as a distracting factor. This article presents and discuses two CSCL activities that help delivering the knowledge in engineering courses, at two traditional Chilean universities. These activities have also been used during the last years to deal with the problem of students’ distraction, caused by laptop usage during lectures. The results obtained could represent good alternatives to deal with the stated problem. © 2010 Elsevier Ltd. All rights reserved.

We describe a patient who developed bilateral cavernous sinus septic thrombosis secondary to a suppurative lesion on the left cheek. Despite clinical improvement, left oculomotor symptoms recurred suddenly. A carotid artery aneurysm within the cavernous sinus was diagnosed by means of magnetic resonance imaging and confirmed by digital angiography. Follow-up angiograms showed an initial decrease in the aneurysm size, with subsequent enlargement. A latex contrast-filled balloon was successfully placed within the aneurysm, preserving the carotid parent artery blood flow. Our case illustrates the usefulness of the detachable balloon technique in the treatment of bacterial aneurysms of the cavernous sinus as an alternative treatment to carotid artery ligation.

Cinnarizine and flunarizine are selective calcium blockers that have been used to treat and prevent vertigo. We studied 15 patients who had extrapyramidal syndromes after taking these drugs. Eleven patients had parkinsonism, one with persistent akathisia as well; one had an orofacial tremor; one, acute akathisia alone; and one an acute dystonic reaction. All but one improved when the drug therapy was discontinued. Seven patients were also depressed during treatment. Cinnarizine and flunarizine must therefore be added to the list of potentially risky drugs known to induce extrapyramidal reactions and depression.

Over the last few years, cases of movement disorders induced by flunarizine and cinnarizine have been increasingly reported. We describe a series of 101 patients, whose ages ranged from 37 to 84 years (mean 69.1), developing abnormal movements frequently associated with depression, secondary to treatment with either or both drugs. Symptoms closely resembled those induced by neuroleptic drugs and remitted on drug discontinuance in all but five cases after 5-22 months' follow-up. Whether or not such undesirable side effects are attributable to calcium antagonism and/or dopamine receptor blockade, long-term treatment with flunarizine or cinnarizine should be discouraged, particularly in the elderly.