Plan de patrocinio de la Academia de Futbol Fair Play

En el presente documento podrá observar el trabajo realizado a lo largo del curso de Especialización en gestión y administración deportiva, durante el año 2021. Adquiriendo conocimiento sobre la gestión de empresas, enfocándonos en el área deportiva, especificándonos en 4 puntos principales: 1. Como primer punto podemos mencionar la importancia de crear un plan de marketing para tener éxito en el proyecto deportivo que se desee construir, esto permitirá promocionar la marca al mayor número de público posible, además de enfocar los recursos en el mercado que deseamos alcanzar, como, por ejemplo, en el caso de la academia de futbol Fair Play se buscan estudiantes cuyas familias pertenezcan a clase media, ¿por qué? Porque los costos de mensualidad, matricula, costos de uniformes, etc. Están dirigidos a un público que pueda prestar sus servicios. 2. Además como punto numero dos tenemos los diferentes instrumentos que se deben de utilizar para conocer el grado de satisfacción que tienen los clientes y colaboradores, estos instrumentos son muy importantes para conocer la opinión de los padres de familia, los niños y el personal, además como punto número tres: los métodos de autoevaluación nos permiten saber si los objetivos se están alcanzando. Finalizando con el punto número cuatro: el plan de patrocinio, todos estos puntos se desarrollaron y presentaron a la academia de Futbol Fair Play empresa deportiva con la cual trabajamos durante el transcurso de la especialización. Se desarrollaron los siguientes módulos: Módulo 1. Plan de marketing; Módulo 2. Encuesta de satisfacción; Módulo 3. Autoevaluación EFQM; Módulo 4. Plan de patrocinio. PALABRAS CLAVE: Administración ; Gestión ; Evaluación ; Marketing ; Plan ; Formación

Pediatric Hospitalizations Associated with 2009 Pandemic Influenza A (H1N1) in Argentina

Fil: Libster, Romina. Fundación Infant, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Bugna, Jimena. Fundación Infant, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Coviello, Silvina. Fundación Infant, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Hijano, Diego R. Hospital De Niños Sor María Ludovica, La Plata; Argentina.Fil: Dunaiewsky, Mariana. Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Reynoso, Natalia. Hospital Municipal Materno Infantil de San Isidro; Argentina.Fil: Cavalieri, Maria L. Hospital Eva Perón, Benito Juárez, Buenos Aires; ArgentinaFil: Guglielmo, Maria C. Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Areso, M. Soledad. Hospital Eva Perón, Benito Juárez, Buenos Aires; ArgentinaFil: Gilligan, Tomas. Hospital General de Agudos Carlos G. Durand, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Santucho, Fernanda. Hospital General de Agudos Carlos G. Durand, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Cabral, Graciela. Hospital Nacional Profesor Alejandro Posadas, El Palomar, Buenos Aires; Argentina.Fil: Gregorio, Gabriela L. Hospital Nacional Profesor Alejandro Posadas, El Palomar, Buenos Aires; Argentina.Fil: Moreno, Rina. Hospital Nacional Profesor Alejandro Posadas, El Palomar, Buenos Aires; Argentina.Fil: Lutz, Maria I. Hospital Nacional Profesor Alejandro Posadas, El Palomar, Buenos Aires; Argentina.Fil: Panigasi, Alicia L. Hospital Nacional Profesor Alejandro Posadas, El Palomar, Buenos Aires; Argentina.Fil: Saligari, Liliana. Hospital Nacional Profesor Alejandro Posadas, El Palomar, Buenos Aires; Argentina.Fil: Caballero, Mauricio T. Hospital De Niños Sor María Ludovica, La Plata; Argentina.Fil: Egües Almeida, Rodrigo M. Hospital De Niños Sor María Ludovica, La Plata; Argentina.Fil: Gutierrez Meyer, Maria E. Hospital De Niños Sor María Ludovica, La Plata; Argentina.Fil: Neder, Maria D. Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Davenport, Maria C. Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Del Valle, Maria P. Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Santidrian, Valeria S. Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Mosca, Guillermina. Ministerio de Ciencia, Técnica e Innovación. Fundación Infant, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Alvarez, Liliana. Hospital General de Agudos Carlos G. Durand, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Landa, Patricia. Hospital General de Agudos Carlos G. Durand, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Pota, Ana. Hospital General de Agudos Carlos G. Durand, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Boloñati, Norma. Hospital General de Agudos Carlos G. Durand, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Dalamon, Ricardo. Hospital General de Agudos Carlos G. Durand, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Sanchez Mercol, Victoria I. Hospital Eva Perón, Benito Juárez, Buenos Aires; Argentina.Fil: Espinoza, Marco. Fundación Infant, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Peuchot, Juan Carlos. Hospital Eva Perón, Benito Juárez, Buenos Aires; Argentina.Fil: Karolinski, Ariel. Hospital General de Agudos Carlos G. Durand, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Bruno, Miriam. Hospital General de Agudos Carlos G. Durand, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Borsa, Ana. Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Ferrero, Fernando. Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Bonina, Angel. Hospital De Niños Sor María Ludovica, La Plata; Argentina.Fil: Ramonet, Margarita. Hospital Nacional Profesor Alejandro Posadas, El Palomar, Buenos Aires; Argentina.Fil: Albano, Lidia C. Hospital Nacional Profesor Alejandro Posadas, El Palomar, Buenos Aires; Argentina.Fil: Luedicke, Nora. Ministerio de Ciencia, Técnica e Innovación. Fundación Infant, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Alterman, Elias. Fundación Infant, Ciudad Autónoma de Buenos Aires; Argentina.Fil: Savy, Vilma L. ANLIS Dr.C.G.Malbrán. Instituto de Enfermedades Infecciosas; Argentina.Fil: Baumeister, Elsa. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas. Departamento de Virología. Servicio de Virosis Respiratoria; Argentina.Fil: Chappell, James D. Vanderbilt University. Pathology, Nashville, Tennessee; Estados Unidos.Fil: Edwards, Kathryn M. Vanderbilt University. Departments of Pediatrics, Nashville, Tennessee; Estados Unidos.Fil: Melendi, Guillermina A. Vanderbilt University. Departments of Pediatrics, Nashville, Tennessee; Estados Unidos.Fil: Polack, Fernando P. Vanderbilt University. Departments of Pediatrics, Nashville, Tennessee; Estados Unidos.Background: While the Northern Hemisphere experiences the effects of the 2009 pandemic influenza A (H1N1) virus, data from the recent influenza season in the Southern Hemisphere can provide important information on the burden of disease in children. Methods: We conducted a retrospective case series involving children with acute infection of the lower respiratory tract or fever in whom 2009 H1N1 influenza was diagnosed on reverse-transcriptase polymerase-chain-reaction assay and who were admitted to one of six pediatric hospitals serving a catchment area of 1.2 million children. We compared rates of admission and death with those among age-matched children who had been infected with seasonal influenza strains in previous years. Results: Between May and July 2009, a total of 251 children were hospitalized with 2009 H1N1 influenza. Rates of hospitalization were double those for seasonal influenza in 2008. Of the children who were hospitalized, 47 (19%) were admitted to an intensive care unit, 42 (17%) required mechanical ventilation, and 13 (5%) died. The overall rate of death was 1.1 per 100,000 children, as compared with 0.1 per 100,000 children for seasonal influenza in 2007. (No pediatric deaths associated with seasonal influenza were reported in 2008.) Most deaths were caused by refractory hypoxemia in infants under 1 year of age (death rate, 7.6 per 100,000). Conclusions: Pandemic 2009 H1N1 influenza was associated with pediatric death rates that were 10 times the rates for seasonal influenza in previous years

Laparotomía por peritonitis secundaria

Secondary peritonitis (PS) results from direct contamination of the peritoneum by effusion of the digestive tract or urogenital tract or associated solid organs. Appendicitis is considered the main and most common cause of this pathology. The objec- tive pursued when developing this research is based on generating a contribution of current content that, in general, serves to strengthen and expand knowledge about laparotomy in case of secondary peritonitis, and in turn, as a contribution to health professionals in the face of the constant need to update regarding the medico-scientific contents of interest, without prejudice to the learning that any person interested in this subject can acquire with this same material. The research meth- odology is based on a bibliographic design and a review method. The results, presented as evidence, refer to the opinions and criteria that some experts have expressed through their own studies, which refer especially to laparotomy treatment of secondary peritonitis, and other general aspects associated with the complication. In conclusion, according to the data sources used in this study, it is possible to dare to infer that, although there are, more and more, studies that support the special indication of laparotomy as a therapeutic modality of PS, it turns out that it does not It is the only way for its effective treatment, given that, even with clear advances in antimicrobial therapy and in supportive care in intensive care units (ICU), as well as in the technique and implementation of new surgical materials; This type of invasive intervention still reports high risks that are associated with high morbidity and mortality rates, a situation that, by the way, is still equally supported by sufficient evidence and that maintains its real feasibility in discussion for the majority of patients diagnosed with PS.La peritonitis secundaria (PS) resulta de la contaminación directa del peritoneo por derrame del tubo digestivo o del aparato urogenital o los órganos sólidos asociados. La apendicitis se considera la causa principal y más común de esta patología. El objetivo que se persigue al desarrollar la presente investigación se basa en generar un aporte de contenido vigente que, en general, sirva para el fortalecimiento y ampliación de los conocimientos en torno a la laparotomía en caso de peritonitis secundaria, y a su vez, como contribución a los profesionales de la salud ante la constante necesidad de ac- tualización respecto a los contenidos medicocientíficos de interés, sin menoscabo del aprendizaje que pueda adquirir con este mismo material cualquier persona interesada en la presente temática. La metodología investigativa se fundamenta en un diseño bibliográfico y un método de revisión. Los resultados, presentados como evidencia, refieren las opiniones y criterios que algunos los expertos han expresado mediante sus propios estudios, que aluden especialmente al tratamiento por laparotomía de la peritonitis secundaria, y otros aspectos generales asociados a la complicación. En conclusión, de acuerdo a las fuentes de datos utilizadas en este estudio, es posible atreverse a inferir que, si bien existen, cada vez más, estudios que sostienen la especial indicación de la laparotomía como modalidad terapéutica de la PS, resulta ser que no es la única vía para su tratamiento efectivo, dado que, aun evidenciándose claros avances en la terapia antimicrobiana y en los cuidados de sostenimiento en las unidades de cuidados intensivos (UCI), así como también en la técnica e im- plementación de nuevos materiales quirúrgicos; este tipo de intervención invasiva todavía reporta elevados riesgos que se asocian a altas de tasa de morbilidad y mortalidad, situación que por cierto aún se encuentra igualmente sustentada con evidencia suficiente y que mantiene en discusión su factibilidad real para la mayoría de los pacientes diagnosticados con PS

Incidencia del parasitismo intestinal en la provincia del Azuay

Los diferentes tipos de parásitos reciben los nombres de ectoparásitos a los que viven fuera del cuerpo del huésped y los endoparásitos aquellos que viven dentro del huésped. Los parásitos intestinales son endoparásitos entre estos estan las amebas que se mueven por la tornación de seudópodos que son prolongaciones protoplasmáticas, se multiplican por la fisión binaria y suelen tener una fase quística. Otro tipo de parásitos los nematelmintos tienen un cuerpo cilíndrico y alargado, no son segmentados, entre este grupo se encuentra el Ascaris lumbrincoides el cual al ser eliminado tiene un color blanco amarillento, su propagación se hace por vectores como las moscas que se posan sobre las excretas y luego contaminan alimentosDoctor en Bioquímica y FarmaciaCuenc

Stressor interaction networks suggest antibiotic resistance co-opted from stress responses to temperature.

Environmental factors like temperature, pressure, and pH partly shaped the evolution of life. As life progressed, new stressors (e.g., poisons and antibiotics) arose as part of an arms race among organisms. Here we ask if cells co-opted existing mechanisms to respond to new stressors, or whether new responses evolved de novo. We use a network-clustering approach based purely on phenotypic growth measurements and interactions among the effects of stressors on population growth. We apply this method to two types of stressors-temperature and antibiotics-to discover the extent to which their cellular responses overlap in Escherichia coli. Our clustering reveals that responses to low and high temperatures are clearly separated, and each is grouped with responses to antibiotics that have similar effects to cold or heat, respectively. As further support, we use a library of transcriptional fluorescent reporters to confirm heat-shock and cold-shock genes are induced by antibiotics. We also show strains evolved at high temperatures are more sensitive to antibiotics that mimic the effects of cold. Taken together, our results strongly suggest that temperature stress responses have been co-opted to deal with antibiotic stress

Parkinsonismo secundario a mielinolisis extrapontina: reporte de caso

Parkinsonism is a syndrome characterized by hypokinetic extrapiramidal motor manifestations, it can be divided into idiopathic or secondary accordingly. The most common cause is the idiopathic Parkinson’s diseases. The secondary causes are less common and they do not usually respond to dopaminergic substitutive therapy, among the causes is the osmotic demyelination syndrome characterized by pontine and extrapontine myelinolysis caused by abrupt changes in the osmolarity in the central nervous system; This condition can be developed in patients with hydro-electrolyte imbalances like hyponatremia with a rapid correction of sodium. 47-year-old male that presented acute parkinsonism secondary to osmotic demyelination syndrome, posterior to a rapid sodium correction; he was treated with levodopa. Secondary parkinsonism caused by osmotic damage triggered by hydro-electrolyte imbalance is an uncommon complication with a variable therapeutic response; with an ongoing acute or subacute presentation and bilateral clinical manifestations of a parkinsonian motor syndrome, an exhaustive approach must be done to study a secondary cause because the dopaminergic substitutive therapy response differs from idiopathic Parkinson diseases.El parkinsonismo es un síndrome caracterizado por manifestaciones motoras extrapiramidales hipokinéticas en el cual las causas pueden ser primarias o secundarias. La causa más común es la enfermedad idiopática de Parkinson, un proceso neurodegenerativo. Las causas secundarias son menos frecuentes y no suelen responder a la terapia sustitutiva dopaminérgica, entre ellas se encuentra el síndrome de desmielinizacion osmótica caracterizado por mielinolisis pontina y extrapontina provocada por cambios abruptos de osmolaridad en el sistema nervioso central; Este puede presentarse en pacientes con trastornos hidroelectrolíticos como la hiponatremia con reposición rápida de sodio. Reportamos el caso de un paciente masculino de 47 años que presentó parkinsonismo secundario a síndrome de desmielinizacion osmótica, posterior a corrección rápida de sodio; recibió manejo terapéutico con levodopa. El Parkinsonismo secundario, como consecuencia de una injuria osmótica por desbalance electrolítico, es una complicación poco frecuente la cual tiene una respuesta terapéutica variable. Ante una presentación aguda o subaguda y con manifestaciones clínicas bilaterales de un síndrome motor Parkinsoniano se debe hacer un abordaje exhaustivo en busca de una causa secundaria ya que la respuesta a la terapia sustitutiva dopaminérgica difiere en comparación a la enfermedad de Parkinson idiopática

Presentation 1209-083: Soluble FMS-Like Tyrosine Kinase-1 (Sflt-1) is Associated with Subclinical and Clinical ASCVD: The Dallas Heart Study

Background Soluble Fms-like tyrosine kinase-1 (sFlt-1) plays a role in angiogenesis, atherogenesis, and preeclampsia but associations with subclinical atherosclerosis and clinical events in healthy adults are unknown. Methods Participants from the Dallas Heart Study with sFlt-1 measured were included (n=3932). Abdominal aortic atherosclerosis was measured by MRI and coronary artery calcium (CAC) by CT. The cohort was followed for subsequent atherosclerotic cardiovascular disease (ASCVD) events (CV death, MI, stroke, revascularization). Multivariable linear and logistic regression and Cox regression analyses were performed for sFlt-1, analyzed by quartile (Q4 vs. Q1), adjusting for demographics and traditional risk factors. Results sFlt-1 levels were higher in older individuals, males, and African Americans and tracked with traditional cardiac risk factors. sFlt-1 was significantly associated with aortic wall thickness and plaque area (p\u3c0.05). sFlt-1 independently associated with prevalent aortic plaque [OR 1.32, 1.02–1.72] but not CAC. There were 336 ASCVD events over 12 years of follow-up. Higher sFlt-1 levels associated with increased ASCVD events in unadjusted (16.7% vs. 8.8%, p\u3c0.001) (Figure) and adjusted analyses [HR 1.58, 1.14–2.18]. Findings were unchanged when excluding those with prior ASCVD. Download FigureDownload PowerPoint Conclusion sFlt-1 is associated with subclinical aortic atherosclerosis and clinical ASCVD events. Future studies are warranted on sFlt-1 as a potential therapeutic target. Footnotes Poster Contributions Posters Hall_Hall A Saturday, March 28, 2020, 3:45 p.m.-4:30 p.m. Session Title: Prevention: Clinical 3 Abstract Category: 32. Prevention: Clinical Presentation Number: 1209-08

Identifying a low-flow phenotype in heart failure with preserved ejection fraction: a secondary analysis of the RELAX trial.

AimsThe relationship between resting stroke volume (SV) and prognostic markers in heart failure with preserved ejection fraction (HFpEF) is not well established. We evaluated the association of SV index (SVI) at rest with exercise capacity and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in stable patients with HFpEF.Methods and resultsParticipants enrolled in the Phosphodiesterase-5 Inhibition to Improve Clinical Status and Exercise Capacity in Diastolic Heart Failure (RELAX) trial with available data on SVI by the Doppler method were included in this analysis (n = 185). A low-flow state defined by resting SVI < 35 mL/m2 was present in 37% of study participants. Multivariable adjusted linear regression analysis suggested that higher resting heart rate, higher body weight, prevalent atrial fibrillation, and smaller left ventricular (LV) end-diastolic dimension were each independently associated with lower SVI. Patients with low-flow HFpEF had lower systolic blood pressure and smaller LV end-diastolic dimension. In multivariable adjusted linear regression models, lower SVI was significantly associated with lower peak oxygen consumption (peak VO2 ) and higher NT-proBNP levels at baseline, and greater decline in peak VO2 at 6 month follow-up independent of other confounders. Resting LV ejection fraction was not associated with peak VO2 and NT-proBNP levels.ConclusionsThere is heterogeneity in the resting SVI distribution among patients with stable HFpEF, with more than one-third of patients identified with the low-flow HFpEF phenotype (SVI < 35 mL/m2 ). Lower SVI was independently associated with lower peak VO2 , higher NT-proBNP levels, and greater decline in peak VO2 . These findings highlight the potential prognostic utility of SVI assessment in the management of patients with HFpEF

Identifying a low-flow phenotype in heart failure with preserved ejection fraction: a secondary analysis of the RELAX trial.

AimsThe relationship between resting stroke volume (SV) and prognostic markers in heart failure with preserved ejection fraction (HFpEF) is not well established. We evaluated the association of SV index (SVI) at rest with exercise capacity and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in stable patients with HFpEF.Methods and resultsParticipants enrolled in the Phosphodiesterase-5 Inhibition to Improve Clinical Status and Exercise Capacity in Diastolic Heart Failure (RELAX) trial with available data on SVI by the Doppler method were included in this analysis (n = 185). A low-flow state defined by resting SVI < 35 mL/m2 was present in 37% of study participants. Multivariable adjusted linear regression analysis suggested that higher resting heart rate, higher body weight, prevalent atrial fibrillation, and smaller left ventricular (LV) end-diastolic dimension were each independently associated with lower SVI. Patients with low-flow HFpEF had lower systolic blood pressure and smaller LV end-diastolic dimension. In multivariable adjusted linear regression models, lower SVI was significantly associated with lower peak oxygen consumption (peak VO2 ) and higher NT-proBNP levels at baseline, and greater decline in peak VO2 at 6 month follow-up independent of other confounders. Resting LV ejection fraction was not associated with peak VO2 and NT-proBNP levels.ConclusionsThere is heterogeneity in the resting SVI distribution among patients with stable HFpEF, with more than one-third of patients identified with the low-flow HFpEF phenotype (SVI < 35 mL/m2 ). Lower SVI was independently associated with lower peak VO2 , higher NT-proBNP levels, and greater decline in peak VO2 . These findings highlight the potential prognostic utility of SVI assessment in the management of patients with HFpEF

Variante atípica aguda de esclerosis múltiple con lesiones pseudotumorales: reporte de caso

Multiple sclerosis that appears with a magnetic resonance image similar to a tumor in appearance has been considered a relatively rare condition: 1-2/1000 cases of multiple sclerosis or around 3 cases per million habitants per year. The demyelinating diseases of the central nervous system include a broad spectrum of different etiologies, with multiple sclerosis being the most frequent one. Multiple sclerosis is a chronic demyelinating disease, autoimmune and inflammatory that affects all the central nervous system. The diagnostic criteria require magnetic resonance imaging in which demyelinating areas can be appreciated. Occasionally atypical lesions of multiple sclerosis are identified, showing a size, morphology and pattern of unusual contrast enhancement. Pseudotumoral lesions represent one of these atypical forms of lesions in multiple sclerosis. The treatment of pseudotumoral forms of multiple sclerosis is not well defined. In cases reported in literature corticoid therapy is the one that is used the most. We present the case of a 24 year old female patient, without vascular risk who presented with rapidly progressive right hemiparesis accompanied by mutism. Image studies show multifocal white matter lesions predominantly in the fronto-parietal region, with pseudotumoral demyelinating features, compatible with demyelinating disease, confirmed by biopsy for which corticoid treatment was started with satisfactory outcome. The acute variants of multiple sclerosis must be taken into consideration in all cases of pseudotumoral lesions with symptoms pertinent to multiple sclerosis, in spite of it being a rare variant, it´s course is usually acute and fulminant, and so, a timely detection and management is essential.La aparición de esclerosis múltiple con imagen de resonancia magnética similar a un tumor en apariencia ha sido considerada una condición relativamente rara: 1-2/1000 casos de esclerosis múltiple o alrededor de 3 casos por millón de habitantes por año. Las enfermedades desmielinizantes del sistema nervioso central incluyen un vasto espectro de distintas etiologías siendo la más frecuente la esclerosis múltiple. La esclerosis múltiple es una enfermedad desmielinizante crónica, autoinmune e inflamatoria que afecta a todo el sistema nervioso central. Los criterios diagnósticos exigen imágenes por resonancia magnética en las que se aprecien áreas de desmielinización. Ocasionalmente lesiones atípicas de esclerosis múltiple son identificadas, mostrando un tamaño, morfología o patrón de captación de contraste inusual. Las lesiones pseudotumorales representan una de estas formas atípicas de lesiones de esclerosis múltiple. El tratamiento de las formas pseudotumorales de esclerosis múltiple no está bien definida. La terapia corticoesteroide es la más usada en casos reportados en la literatura. Presentamos el caso de una paciente de 24 años, sin riesgo vascular, quien presenta hemiparesia derecha rápidamente progresiva acompañado de mutismo. Los estudios de imagen muestran lesiones multifocales de substancia blanca de predominio fronto-parietal y de aspecto pseudotumoral desmielinizante, compatible con patología desmielinizante, confirmada por biopsia, por lo que se inicia tratamiento con corticoesteroides con resultado satisfactorio. Se deben tener en consideración las variantes agudas de esclerosis múltiple en todo caso de lesiones pseudotumorales con sintomatología pertinente a esclerosis múltiple, a pesar de ser una variante rara, su curso es usualmente agudo y fulminante, por lo que su detección y manejo oportuno es imprescindible