ABSTRACT. Neurodegenerative diseases pose significant challenges due to their impact on brain structure, function, and cognition. As life expectancy rises, the prevalence of these disorders is rapidly increasing, resulting in substantial personal, familial, and societal burdens. Efforts have been made to optimize the diagnostic and therapeutic processes, primarily focusing on clinical, cognitive, and imaging characterization. However, the emergence of non-invasive brain stimulation techniques, specifically transcranial magnetic stimulation (TMS), offers unique functional insights and diagnostic potential. TMS allows direct evaluation of brain function, providing valuable information inaccessible through other methods. This review aims to summarize the current and potential diagnostic utility of TMS in investigating neurodegenerative diseases, highlighting its relevance to the field of cognitive neuroscience. The findings presented herein contribute to the growing body of research focused on improving our understanding and management of these debilitating conditions, particularly in regions with limited resources and a pressing need for innovative approaches.

RESUMO. As doenças neurodegenerativas representam desafio significativo por seu impacto na estrutura cerebral, função e cognição. À medida que a expectativa de vida aumenta, a prevalência dessas doenças cresce rapidamente, resultando em substanciais encargos pessoais, familiares e sociais. Esforços têm sido feitos para otimizar os processos diagnósticos e terapêuticos, com foco principal na caracterização clínica, cognitiva e de imagem. No entanto, o surgimento de técnicas de estimulação cerebral não invasivas, especificamente a estimulação magnética transcraniana (EMT), oferece compreensão funcional e potencial diagnóstico únicos. A TMS permite a avaliação direta da função cerebral, fornecendo informações valiosas inacessíveis por outros métodos. Esta revisão teve como objetivo resumir a utilidade diagnóstica atual e potencial da EMT na investigação de doenças neurodegenerativas, destacando sua relevância para o campo da neurociência cognitiva. As conclusões aqui apresentadas contribuem para o crescente corpo de investigação centrado na melhoria da nossa compreensão e gestão dessas condições debilitantes, particularmente em regiões com recursos limitados e necessidade premente de abordagens inovadoras.

Resumen El presente trabajo forma parte del programa de estudios actualísticos que estamos desarrollando en el marco de nuestras investigaciones arqueológicas en el NE del Macizo del Deseado (Santa Cruz, Argentina). Tiene por objetivo identificar los distintos agentes y procesos tafonómicos que actúan modificando los restos óseos depositados en las distintas unidades geomorfológicas del Parque Nacional Bosques Petrificados de Jaramillo (PNBPJ), para evaluar cuáles de estos microambientes ofrecen condiciones extremas de preservación (buenas vs. malas). Para alcanzar el objetivo llevamos adelante el relevamiento sistemático por transectas de restos de vertebrados modernos distribuidos en distintas unidades geomorfológicas, previamente definidas. Las tendencias obtenidas se discuten con aquellas generadas a partir de la misma metodología en los sectores de Los Toldos, La Huella y Laguna Sierras Blancas, ubicados al noroccidente del PNBPJ. Los resultados indican que en el PNBPJ las mesetas altas son la unidad geomorfológica donde hay menos preservación del registro óseo y que las mesetas intermedias corresponden a las unidades donde existen más posibilidades de localización de contextos en estratigrafía a cielo abierto. Las observaciones realizadas, coinciden con las realizadas previamente en el sector norte del macizo acerca del potencial destructivo de las mesetas altas, y aportan al conocimiento de los procesos de preservación y destrucción del registro óseo que operan en los distintos microambientes del sector. Los resultados obtenidos son de utilidad para el avance de las investigaciones arqueológicas en el área de estudio.

Abstract This work is part of the actualistic study program that we are developing within the framework of our archaeological research in the NW of the Deseado Massif (Santa Cruz, Argentina). Its objective is to identify the different agents and taphonomic processes that act modifying the bone remains deposited in the different geomorphological units of the Jaramillo Petrified Forests National Park (PNBPJ), to evaluate which of these microenvironments offer extreme preservation conditions (good vs. bad). To achieve the objective, we carry out the systematic survey by transects and register the remains of modern vertebrates distributed in different geomorphological units, previously defined. The trends obtained are discussed with those generated from the same methodology in the Los Toldos, La Huella and Laguna Sierras Blancas sectors, located to the northwest of the PNBPJ. The results indicate that in the PNBPJ the high plateaus are the geomorphological unit where there is less preservation of the bone record, and that the intermediate plateaus correspond to the units where there are more possibilities of locating contexts in open-pit stratigraphy. The observations made coincide with those previously made in the northern sector of the massif about the destructive potential of the high plateaus and contribute to the knowledge of the processes of preservation and destruction of the bone record that operate in the different microenvironments of the sector. The results obtained are useful for the advancement of archaeological research in the study area.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that mainly affects the motor system, resulting in progressive weakness and muscle wasting. Despite the tremendous advances in physiopathological and clinical characterization, we do not have a curative treatment yet. The progressive and fatal course of ALS makes its management particularly complex and challenging given the diversity of symptoms presenting during the disease progression. The main goal in the treatment of ALS patients is to minimize morbidity and maximize the quality of life. Currently, a series of therapeutic interventions improve the quality of life and prolong survival, including multidisciplinary care, respiratory management, and disease-modifying therapy. Within the supportive interventions, weight maintenance through nutritional and metabolic support is critical. In addition, the management of neuropsychiatric manifestations and preservation of communicative capacity before speech loss are also crucial. Lastly, early palliative care intervention is essential to optimize symptomatic management. Anticipatory guidelines to face the inevitable patient deterioration should be devised. This article updates the main therapeutic strategies used in these patients, including evolving clinical trials with promising novel therapies.

Fasciculations and cramps originate in the motor unit, a functional unit that includes the lower motor neuron and their innervated muscle fibres. Both are common complaints in outpatient practice. These symptoms can be secondary to neurological or medical pathology, presenting a broad differential diagnosis and a complex approach. Recent neurophysiological studies have increased the knowledge of their origin mainly in amyotrophic lateral sclerosis. The symptomatic management of fasciculations and cramps depends on their etiology and includes pharmacological and non-pharmacological treatments. This article aims to present an updated review of the most relevant aspects of physiopathology, clinical approach, and differential diagnosis of both phenomena.

Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of acquired immune-mediated diseases, which typically involve the striated muscle with a variable involvement of the skin and other organs. Clinically, they are characterized by proximal muscle weakness, elevation of muscle enzymes, myopathic changes on electromyography and an abnormal muscle biopsy. The different IIM have been classified according to their distinctive histopathologic features in dermatomyositis (DM), polymyositis (PM), inclusion body myositis (IBM) and immune-mediated necrotizing myopathy (IMNM). Several myositis-specific antibodies are associated with the different phenotypes, as well as with different risk of neoplastic disease and systemic complications. The basis for the treatment of DM, PM, and IMNM is immunosuppression. For IBM there are only symptomatic treatments. Steroids, associated or not with other immunosuppressant drugs, are the first line of treatment. Biologic drugs will allow future individualized therapies. The 10-year survival of DM, PM and IMNM is 62 to 90%. The leading causes of death are neoplastic, lung and cardiac complications. IBM does not impair survival, although it affects the quality of life.

EL USO DE LA TERAPIA CON ANTICOAGULANTES ORALES es cada vez más frecuente. Hay evidencia creciente de la mejoría de resultados cuando la anticoagulación es manejada por servicios o clínicas de anticoagulación. Este manejo sistemático se traduce en optimización del rango terapéutico y disminución de hemorragias, de trombosis y del uso de recursos médicos. El Hospital San Vicente de Paúl (HUSVP) cuenta con una clínica de anticoagulación desde hace más o menos veinte años pero se desconoce su rendimiento. Nuestro objetivo es describir las características demográficas, las indicaciones y el comportamiento de la terapia antitrombótica de los pacientes inscritos y activos en la clínica de anticoagulación del HUSVP hasta diciembre de 2002. Se estudiaron 139 pacientes, 57,6% mujeres y 42,2% hombres; el promedio de edad fue de 64 años; el régimen de cobertura en salud fue: vinculado en el 55,4%, subsidiado en el 26,6% y contributivo en el 18%. Las Indicaciones de anticoagulación más comunes fueron: fibrilación auricular (40%), enfermedad cerebro vascular (26%) y estados de hipercoagulabilidad (20%). Los pacientes inscritos en la clínica de anticoagulación tuvieron un tiempo en el rango terapéutico de 41% con un promedio de controles al año de 4,5 veces. Las complicaciones se presentaron en 16% de los pacientes. Nuestro estudio caracterizó la clínica de anticoagulación del HUSVP en sus variables demográficas, indicaciones de pertenencia y enfermedades concomitantes asociadas y evaluó parámetros objetivos para compararla con otras clínicas en el mundo.

THE USE OF ORAL ANTICOAGULATION therapy is more common every day. There is increasing evidence of better outcome in patients when anticoagulation is handled by anticoagulation clinics or services. This systemic managing has proved in that therapeutical range results in clinical improvement and decrease of hemorrhage, thrombosis and the use of medical resources. Even more, there are less hospitalizations and visits to the Emergency Department. The San Vicente of Paúl Hospital (HUSVP for it’s initials in Spanish) has an anticoagulation clinic functioning for over twenty years, but until now, there has been no work concerning it’s results and benefits. Our task is to describe the demographic characteristics, indications and behavior of the antithrombotic therapy of those patients adscript and active in the clinic of the mentioned Hospital until December 2002. 139 patients were found, 57.6% were women and 42.2% men; the average age was 64 years; and the health system coverage was entail in 55.4% of the patients, subsided in 26.6% and contributive 18%. The most common anticoagulation indications were atrial fibrillation (40%), stroke (26%) y hypercoagulability states (20%). The registered patients had a therapeutical range time of 41% with an annual control average of 4.5 times. Complications were present in 16% of the patients. This study was able to characterize the HUSVP anticoagulation clinic in its demographic variables, relevancy indications and co-morbid associated diseases. As well, some standardized parameters were evaluated in order to be compared with other clinics in the world.