Ivermectin is a broad spectrum antiparasitic veterinary drug introduced in human medicine in 1987. It is considered the drug of choice in onchocerciasis and strongyloidiasis infections, and remains as a therapeutic option for mass treatment in lymphatic filariasis, for which it has widely proved its efficacy. While research continued for human use, new therapeutic targets for ivermectin have emerged. It is currently the better therapeutic option in the treatment of gnathostomiasis and crusted scabies, and could be an alternative option in ascariasis and Mansonella infections. Although these uses are already included in clinical guidelines, more trials are needed to increase their grade of evidence and to obtain their official approval. Concerning other minor uses such as the treatment of enterobiasis or against Trichuris trichiura, more research is still needed in order to test the real activity of ivermectin. The use of ivermectin in human medicine has shown an outstanding low rate of adverse reactions, with the exception of treatment of loiasis and onchocerciasis, where the death of a high microfilarial load may cause severe encephalopathy. However special attention must be paid to the emergence of the first documented cases of resistance in treatment of scabies.

causadas a las personas en distintas circunstancias: accidentes de tráfico, accidentes laborales, agresiones físicas… La utilización de pruebas complementarias ha sido, es y seguirá siendo un pilar fundamental para la valoración objetiva de las consecuencias que estas lesiones tienen en quien las sufre. Nuestros informes periciales deben aportar las pruebas necesarias con el fin de justificar la sintomatología residual referida por los lesionados. Uno de los puntos más polémicos es la objetivación del dolor referido por los lesionados. En este sentido, la termografía infrarroja (TIR) se ha convertido en una herramienta complementaria muy útil para la evaluación de los procesos dolorosos, permitiendo identificar alteraciones fisiopatológicas del medio interno que justifican la clínica dolorosa manifestada por los pacientes. Sus aplicaciones médicas son múltiples y actualmente su uso se encuentra regulado y estandarizado por sociedades científicas que velan por el control de la calidad de los estudios. Con el fin de introducir y divulgar la utilización de esta prueba complementaria en el ámbito médico legal, exponemos un caso en que la TIR permitió la identificación de alteraciones en el equilibrio térmico de los músculos masticatorios en una paciente que refería dolor en la articulación temporomandibular derecha tras un traumatismo craneoencefálico moderado-grave. Palabras clave: Termografía infrarroja. Disfunción temporomandibular. Medicina forense. Valoración del daño corporal.

We developed and implemented a completely paperless and on-line obstetric record in the high-risk obstetric clinics at Columbia Presbyterian Medical Center. Patient care and interactions are input directly into the computer by the health care providers. Laboratory information is transferred automatically from the Laboratory Tnfortnation Servicc into the computerired prenatal record. The system has been in continuous operation for 2 years and is highly regarded. Problems such as illegible handwriting, missing records, and missing laboratory data have disappeared. Research and data query capabilities have been facilitated. The feasibility and applicability of a computerized record replacing the paper record has been demonstrated.

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