[Giant and ulcerated juvenile xanthogranuloma: an atypical presentation in infants]. / Xantogranuloma juvenil gigante y ulcerado: una presentación atípica en lactantes.

Giant Juvenile Xanthogranuloma (GJXG) corresponds to an infrequent variant of Juvenile Xantho- granuloma (JXG) and is characterized by a lesion larger than 2 cm in diameter. It usually presents as a plaque but infrequently, presents as an ulcerated nodule. OBJECTIVE: To report two cases of atypical presentation of GJXG, highlighting the importance of considering them in the differential diagnosis of large, ulcerated tumors in infants. CLINICAL CASES: Case 1: A 4-month-old healthy male infant presented with a rapid and progressive growing left inguinal nodule, present since 2 months of age. At physical examination he presented with a 2.6 cm indurated erythematous nodule with central ulceration. Histological study of an incisional biopsy was compatible with JXG. Ophthalmologic involvement was ruled out. Because of functional impairment and parents worry complete surgical removal was performed. The patient had favorable evolution without local recurrence at 4 years of follow-up. Case 2: A 6-month-old healthy male infant presented with a 2.4 cm scapular crusted nodule of rapid and progressive growth, present since birth. Histological study of an incisional biopsy confirmed JXG. Ophthalmologic involvement was ruled out. After 18 months of periodic clinical follow-up, there was a progressive reduction in size of the lesion. CONCLUSIONS: The cases presented highlight the importance of considering JXG in the differential diagnosis of large, ulcerated tumors in infants. When encountered to atypical JXG presentations, histologic studies help to confirm the diagnosis. Given the favorable prognosis of this diagnosis, periodic clinical follow-up is advised; in exceptional cases, surgical or ablative treatments may be considered.

Tendencia secular de la lactancia materna en Santiago de Chile / Secular trend of breast-feeding in Santiago de Chile

Con el objetivo de caracterizar la evolución de la lactancia materna se estimó la prevalencia de esta práctica en Santiago, en los 19 bienios comprendidos entre 1951 y 1989. 1.143 mujeres con hijos residentes en Santiago durante su primer año de vida informaron sobre el tipo de lactancia de 180 recién nacidos por bienio (n total = 3.285). La iniciación de la lactancia materna se mantuvo estable en torno. En contrapartida, la duración de la práctica por al menos 60 y 90 días, mostró tendencia decreciente a partir de 1960, con máxima caída en los bienios 73/74 y 75/76, apreciándose tendencias ascendente a partir de 1976 y cierta inestabilidad posterior. La iniciación y duración de la lactancia materna mostró diferencias entre ambos estratos de escolaridad materna - utilizada como predictora de la situación socieconónica familiar- siendo más afectada en el estrato de escolaridad baja. Se concluye que la tendencia es concordante con la descrita en otras realidades y se discuten los méritos y desventajas de la metodología utilizada