Performance in Kahoot! activities as predictive of exam performance.

BACKGROUND: Game-based learning (GBL) is effective for increasing participation, creativity, and student motivation. However, the discriminative value of GBL for knowledge acquisition has not yet been proven. The aim of this study is to assess the value of Kahoot! as a discriminative tool for formative assessment in medical education in two different subjects. METHODS: A prospective experimental study was conducted on a sample of 173 students enrolled in neuroanatomy (2021-2022). One hundred twenty-five students individually completed the Kahoot! prior to the final exam. In addition, students enrolled in human histology during two academic courses were included in the study. The control group course (2018-2019) received a traditional teaching methodology (N = 211), while Kahoot! was implemented during 2020-2021 (N = 200). All students completed similar final exams for neuroanatomy and human histology based on theory tests and image exams. RESULTS: The correlation between the Kahoot score and the final grade was analyzed for all students enrolled in neuroanatomy who completed both exercises. The correlation between the Kahoot exercise and the theory test, image exam and final grade was significantly positive in all cases (r = 0.334 p < 0.001, r = 0.278 p = 0.002 and r = 0.355 p < 0.001, respectively). Moreover, students who completed the Kahoot! exercise obtained significantly higher grades in all parts of the exam. Regarding human histology, the theory tests, image exams and final grades were significantly higher when using Kahoot! versus the "traditional" methodology (p < 0.001, p < 0.001 and p = 0.014, respectively). CONCLUSIONS: Our study demonstrates for the first time that Kahoot! can be used to improve and predict the final grade in medical education subjects.

Sección de Perinatología. Servicio de Pediatría del Hospital Universitario Cruces / Perinatology section: pediatrics department of the Hospital Universitario Cruces

En este artículo se presenta la organización, la actividad asistencial, docente y de investigación y los índices de calidad de la Sección de Perinarología del Hospital Universitario Cruces (HU Cruces). Se trata de un proceso multidisciplinar que tiene como principal objetívo contribuir a mantener y, si es posible, mejorar la calidad de la atención sanitaria del recién nacido (RN) y su madre, contando con la implicación y participación de todo e! personal sanitario de la Sección y en coordinación con otras áreas asistenciales (Unidad de Medicina Perinatal, Unidad de Medicina Fetal y Unidad Neonatal) y especialistas. Se describirá nuestra actual Cartera de Servicios y las estrategias de mejora para favorecer la información prenatal, la asistencia especializada a partos de riesgo y e! control posnatal, tanto de los RN aparentemente sanos, como de los que requieran una adaptación especial o un control multidisciplinar postnatal, promocionando y favoreciendo la inseparabilidad de la madre y su hijo de manera segura y la lactancia materna (LM) (AU)

This paper presents the Organization, the Quality Indexes and the Health Care, Teaching and Research activities of the Perinatology Section at Cruces University Hospital. The paper holds a multidisciplinary perspective and its main objective is to help to maintain and, if possible, improve newborns and mothers' health care quality, relying on the participation of all the health care workers in the Section and on the coordination with other care areas (Unit of Perinatal Medicine, Fetal Medicine Unit and Neonatal Unit) and specialists. Our current service portfolio will be presented together with suggestions of improvement strategies leading to the following objectives: prenatal information improvement, specialized care for risk births, postnatal control, related both to apparently healthy newborns and to those requiring special adaptation or a multidisciplinary postnatal control, and the encouragement of safe mother-child inseparability and breastfeeding (AU)

Study of perfusion changes in the optic disc of patients with fibromyalgia syndrome using new colorimetric analysis software.

PURPOSE: We measured the amount of hemoglobin at the optic nerve head of fibromyalgia (FM) patients using new colorimetric analysis software. We also investigated whether perfusion defects of the optic nerve head in patients with FM lead to tissue atrophy and corresponding retinal nerve fiber layer (RNFL) thinning measured by optical coherence tomography (OCT). METHODS: We recruited for this cross-sectional study 118 FM patients and 76 sex- and age-matched healthy controls. All subjects underwent a complete neuro-ophthalmologic examination, which also included visual field testing using the Spark strategy in an Easyfield perimeter, and OCT examinations using the Spectralis. One photograph of the optic disc was obtained using a Cirrus™ Photo 800 multi-modality imager. We analyzed fundus photographs using Laguna ONhE software, a new method that allows hemoglobin levels to be measured at the optic nerve head. We compared hemoglobin percentages in different sectors of the nerve head and RNFL thicknesses between the two groups. RESULTS: Mean hemoglobin percentages and hemoglobin content in all optic nerve head sectors calculated by the Laguna ONhE program were significantly lower in FM patients than in healthy controls, and the main differences were detected in the outer ring, which corresponds with the neuroretinal rim. However, only the differences in the superotemporal RNFL were statistically significant. Correlations between the RNFL thickness and the percentage of hemoglobin in the different sectors were weak. CONCLUSION: Optic disc perfusion was decreased in patients with FM, especially within the neuroretinal rim, without clear involvement in the RNFL.

Aesthetic and functional rehabilitation of child using mock-up combined with stratified technique.

BACKGROUND: The loss of the vertical dimension of occlusion in children with quickly progressing early childhood caries hinders the aesthetic rehabilitation of primary incisors. Minimally invasive restorations using chemical-mechanical caries removal methods preserve sound dental tissue and maintains the health of the pulp. This is the treatment of choice for children and allows crown reconstruction of the primary incisors without the need for endodontic treatment. The resources employed in the rehabilitation process range from biological restorations to direct and indirect crowns with or without the aid of a celluloid matrix. CASE REPORT: The aim of this study was to describe a case of maxillary incisor rehabilitation in a female patient aged two years five months using a mock-up combined with the stratified technique and Planas' direct tracks. After a 26-month follow-up period only a little fracture of the reconstructed incisor had occurred. CLINICAL IMPLICATIONS: In the case described, neuro-occlusal and functional rehabilitation enabled the establishment of satisfactory aesthetics in the primary incisors.

Estudio de la repercusión del estrés oxidativo sobre la fluidez de membrana en un modelo animal de la esclerosis lateral amiotrófica / No disponible

No disponible

Células madre satélite musculares en el modelo de ELA murino hSOD-1G93A / No disponible

No disponible

Síndromes canaliculares en los músicos / Canalicular síndromes in musicians

El desarrollo de la actividad profesional del músico condiciona la aparición de diversas patologías por sobrecarga que limitan, en ocasiones, la posibilidad de mantener el ritmo de trabajo preciso. Pretendemos dar un repaso a un grupo de patologías frecuentes en los músicos, que presentan dificultades a la hora del diagnóstico en ocasiones, pudiendo condicionar no sólo una dificultad en el desarrollo de su trabajo de forma temporal, sino también a veces el abandono precoz de la actividad por la incapacidad que conlleva. El objeto de este artículo es revisar los síndromes canaliculares más frecuentes que pueden relacionarse con la práctica musical, valorando únicamente los vinculados con las extremidades superiores, ya que los síndromes canaliculares de extremidades inferiores son excepcionales en este ámbito

The professional activities carried out by a musician condition the apparition of injuries caused by overcharging, which limits on occasions the possibility to maintain the rhythm needed in this work. We seek to look at a group of frequent injuries found in musicians which present difficulties at the time of diagnosis. They cause not only temporary problems in the realization of their work but sometimes can result in having to abandon the activity prematurely as a consequence of the injury caused. The object of this article is to revise the most frequently found syndromes related to musical practice concentrating on the arm area, as syndromes in the leg area in this case are exceptional

Grepafloxacin concentration in ocular tissues after intravenous infusion in rabbits with intraocular inflammation.

PURPOSE: To determine the penetration of grepafloxacin into ocular tissues during experimental ocular inflammation. METHODS: 10 albino and 10 pigmented rabbits underwent a continuous intravenous infusion of the drug 24 h after injecting Salmonella typhimurium toxin intravitreously, creating ocular inflammation. The animals were killed and grepafloxacin levels were determined in plasma and ocular tissues using high performance liquid chromatography. RESULTS: Grepafloxacin levels achieved a steady-state plasma concentration of 1.5 microg/ml. The drug diffused more towards vascularized tissues (chorioretina and iris) in both albino and pigmented rabbits with a tissue/serum ratio higher than 1. Grepafloxacin showed more affinity to pigmented tissue, rising levels of 40,000-50,000 ng/g in the chorioretina and iris in pigmented animals. After inflammation, grepafloxacin intraocular penetration increased in albino animals with levels exceeding the minimum inhibitory concentration for the most common ocular pathogens. CONCLUSION: Grepafloxacin intraocular penetration is higher in pigmented tissues. Ocular inflammation increases the drug penetration into the vitreous.

Terapia fotodinámica en neovascularización coroidea / Photodynamic therapy for treatment of choroidal neovaoscularization

Objetivo: Valorar la eficacia de la terapia fotodinámica (TFD) en el tratamiento de neovascularización subretiniana (NVSR) causada por DMAE (degeneración macular asociada a la edad) y miopía. Material y método: Se estudiaron 102 pacientes con neovascularización coroidea yuxta o subfoveolar tratados con TFD en los que se valoró: Agudeza visual (AV), examen oftalmoscópico y angiografía fluoresceínica. El retratamiento se realizó cuando fue necesario cada tres meses. Resultados: La etiología de la neovascularización coroidea fue: 75,5% por DMAE y 24,5% miópica. El tiempo de seguimiento medio fue de 15,94 meses (9-33). Un 88% de las NVSR eran angiográficamente clásicas en los miopes y un 40% en las DMAE. La supervivencia de la membrana resultó significativa en función del tipo de NVSR, presentando una mejor evolución en los pacientes miopes (p=0,0018). La AV mejoró en 48% de los pacientes miopes y en 28,6% de las DMAE. No se objetivaron complicaciones severas atribuibles al tratamiento. Conclusiones: La TFD es un tratamiento moderadamente efectivo y sin complicaciones para el tratamiento de la NVSR sub/yuxta foveolar(AU)

Purpose: To evaluate the efficacy of photodynamic therapy with photodynamic therapy (PDT) in the management of choroidal neovascularization (CNV) in age-related macular degeneration (AMD) and myopia. Methods: 102 eyes with subfoveal or yuxtafoveal CNV underwent visual acuity (VA) testing, ophthalmic examination, and fluorescein angiography. Retreatment of persistent CNV was done after three months. Results: CNV was caused by AMD in 75.5% of patients, pathologic myopia in 24.5%. Follow up ranged from 9 to 33 months (mean: 15.94 months). 88% of CNV caused by pathologic myopia was classic and 40% was in lesions caused by AMD. CNV survival was shorter in lesions caused by pathologic myopia with a significant difference (p=0.0018). VA improved in 48% of lesions caused by pathologic myopia and in 28.6% of lesions caused by AMD. We did not observe any severe complication caused by PDT. Conclusion: PDT is a moderately effective treatment without complications in treating subfoveal CNV(AU)

C) Estrés oxidativo en la hipertensión: de los SNPs al fenotipo clínico / No disponible

No disponible

[Idiopathic polypoidal choroidal vasculopathy]. / Vasculopatía coroidea polipoidal idiopática.

PURPOSE: To evaluate the incidence, clinical features and evolution of polypoidal choroidal vasculopathy (PCV) in our population. METHODS: Retrospective study of patients diagnosed with exudative and/or hemorrhagic maculopathy including age-related macular degeneration in the last two years and who have undergone a complete ophthalmologic exploration and videoangiography with fluorescein and indocyanine green. RESULTS: 250 patients were included in the study, 8 patients (3.2%) had clinical and angiographic criteria of PCV. The mean age was 68 years-old, 62.5% were men and 85.7% were caucasian. Ninety percent of cases presented clinically as a predominantly hemorrhagic macular detachment. The initial clinical diagnosis before indocyanine green angiography was exudative age-related macular degeneration in 90% of cases. The mean visual acuity was 0.2 at baseline and after follow-up. Laser treatment was performed in 4 eyes, achieving good anatomic and visual acuity results in 2 of them; both eyes of one patient were treated by photodynamic therapy with poor angiographic and functional outcome. CONCLUSIONS: Polypoidal choroidal vasculopathy is a clinical entity which is relatively frequent among patients previously diagnosed with exudative maculopathy. Indocyanine green angiography increases the number of correct diagnoses. Treatment must be individualized depending on the location of the lesions and the severity of the disease.

[Serpiginous choroiditis: clinical course and treatment]. / Coroiditis serpiginosa: evolución clínica y tratamiento.

PURPOSE: To evaluate the clinical evolution and treatment of serpiginous choroiditis in 11 diagnosed patients. METHODS: Retrospective study of 11 cases diagnosed with serpiginous choroiditis in our area, from 1980 to the present. We analyzed age at onset of symptoms, systemic diseases, ophthalmological symptoms at presentation, the location of lesions, initial and final visual acuity, recurrences, treatment régime and development of subretinal neovascularization. A complete ophthalmological examination and fluorescein angiograms were performed in all of them. RESULTS: The mean period of follow-up was 4 years. Average age was 56 years, predominantly in men (10/1). Five patients had known ischemic cardiopathy and systemic hypertension, one patient underwent a kidney transplant. All of them were treated with oral prednisone (1-1.5 mg/kg/daily) in the active stages. Three patients received triple therapy (prednisone, cyclosporine and azathioprine) that did not prevent the recurrences. Five patients developed a subretinal neovascularization, bilateral in three of them. CONCLUSIONS: The serpiginous choroiditis is a rare entity and the visual outcome prognosis is determined by the macular involvement. Men are predominantly affected in our series and corticosteroid treatment is effective in acute inflammatory episodes. Recurrences could not be prevented by triple therapy with immunosuppressive agents in our three patients.

[Photodynamic therapy for treatment of choroidal neovascularization]. / Terapia fotodinámica en neovascularización coroidea.

PURPOSE: To evaluate the efficacy of photodynamic therapy with photodynamic therapy (PDT) in the management of choroidal neovascularization (CNV) in age-related macular degeneration (AMD) and myopia. METHODS: 102 eyes with subfoveal or yuxtafoveal CNV underwent visual acuity (VA) testing, ophthalmic examination, and fluorescein angiography. Retreatment of persistent CNV was done after three months. RESULTS: CNV was caused by AMD in 75.5% of patients, pathologic myopia in 24.5%. Follow up ranged from 9 to 33 months (mean: 15.94 months). 88% of CNV caused by pathologic myopia was classic and 40% was in lesions caused by AMD. CNV survival was shorter in lesions caused by pathologic myopia with a significant difference (p=0.0018). VA improved in 48% of lesions caused by pathologic myopia and in 28.6% of lesions caused by AMD. We did not observe any severe complication caused by PDT. CONCLUSION: PDT is a moderately effective treatment without complications in treating subfoveal CNV.

Histological toxicity of grepafloxacin after intravitreal injection.

PURPOSE: To determine the intravitreal levels of grepafloxacin after intravitreal injection of 80 microg and to evaluate the retinal toxicity after intravitreal injection of different doses of grepafloxacin in rabbit eyes. METHODS: Fifteen female New Zealand white rabbits and 15 female pigmented 'Gigantes de España' rabbits were injected with 80 microg of grepafloxacin into the vitreous cavity. The grepafloxacin concentration was determined with HPLC after 2, 4, 8, 12 and 24 h. Eighteen female rabbits (9 New Zealand white rabbits and 9 pigmented 'Gigantes de España' rabbits) were used for a study of toxicity. The rabbits were divided into 6 treatment groups: group 1 (3 pigmented rabbits) received an intravitreal injection of 80 microg of grepafloxacin in 0.1 ml of saline solution, group 2 (3 white rabbits) 80 microg of grepafloxacin in 0.1 ml, group 3 (3 pigmented rabbits) 800 microg of grepafloxacin, group 4 (3 white rabbits) 800 microg of grepafloxacin, group 5 (3 pigmented rabbits) and group 6 (3 white rabbits) 0.1 ml of saline solution. Clinical examination was performed prior to injection and 24 h and 10 days after surgery. The animals were sacrificed 10 days after the injection, and the eyes were enucleated and fixed for histopathology. The specimens were stained with hematoxylin-eosin and toluidine blue. RESULTS: No relevant complications were found during the clinical follow-up. All the eyes showed no abnormalities in the histologic evaluation. CONCLUSION: Grepafloxacin can be considered as a safe alternative for intravitreal injection for the treatment of intraocular infections.

[Photodynamic therapy for choroidal neovascularization not caused by age related macular degeneration or pathologic myopia]. / Terapia fotodinámica en membrana neovascular subretiniana no relacionada con degeneración macular asociada a la edad o miopía patológica.

PURPOSE: To assess the effects of photodynamic therapy (PDT) with verteporfin on visual acuity (VA) and fluorescein angiography, in patients with subfoveal choroidal neovascularization (CNV) not secondary to age related macular degeneration (AMD) or pathologic myopia. METHODS: 113 eyes from 104 patients underwent PDT due to subfoveal CNV from July 2001 to June 2002. In this study only those patients with CNV not related to AMD or pathologic myopia were included. Fluorescein angiography and visual acuity were evaluated. RESULTS: 9 eyes from 8 patients (8.03%) showed distinct causes of CNV: 3 were idiopathic cases, 1 suffered angioid streaks, 1 was secondary to laser photocoagulation due to diabetic retinopathy, 2 had polypoidal choroidal vasculopathy and 2 central serous choroiditis. Regarding VA results, 77.7% improved or mantained the previous VA. Angiography resolution was observed in 55.5% of the cases (80% with just one PDT session). Average follow up was 10.5 months. Systemic or local complications were not observed. CONCLUSION: PDT may be useful in the treatment of different types of CNV due to causes other than AMD or high myopia.

Terapia fotodinámica en membrana neovascular subretiniana no relacionada con degeneración macular asociada a la edad o miopía patológica / Photodynamic therapy for choroidal neovascularization not caused by age related macular degeneration or pathologic myopia

Objetivo: Valorar los efectos de la terapia fotodinámica (TFD) en la agudeza visual (AV) y la angiografía en pacientes con neovascularización subretiniana (NVSR) foveal no debida ni a degeneración macular asociada a la edad (DMAE) ni a miopía patológica. Material y Métodos: Se evaluaron de un total de 104 pacientes (113 ojos) a los que se les realizó TFD por NVSR foveal, desde julio de 2001 a junio de 2002, aquellos cuya causa no era DMAE o miopía patológica. Se valoró la evolución angiográfica y de la agudeza visual (AV). Resultados: 9 ojos de 8 pacientes presentaban otras causas de NVSR (8,03 por ciento): 3 idiopáticas, 1 en estrías angioides, 1 secundaria a fotocoagulación láser en retinopatía diabética, 2 en vasculopatia coroidea polipoidal y 2 en coroiditis serosa central. El 77,7 por ciento presentó estabilización o mejoría en su AV y el 55,5 por ciento presentó resolución angiográfica, el 80 por ciento de ellos con una sola sesión de TFD. El tiempo de seguimiento medio fue de 10,5 meses. No se objetivaron complicaciones ni a nivel local ni sistémico. Conclusión: La TFD puede ser de utilidad en NVSR no debidas a DMAE o miopía patológica (AU)

Purpose: To assess the effects of photodynamic therapy (PDT) with verteporfin on visual acuity (VA) and fluorescein angiography, in patients with subfoveal choroidal neovascularization (CNV) not secondary to age related macular degeneration (AMD) or pathologic myopia. Methods: 113 eyes from 104 patients underwent PDT due to subfoveal CNV from July 2001 to June 2002. In this study only those patients with CNV not related to AMD or pathologic myopia were included. Fluorescein angiography and visual acuity were evaluated. Results: 9 eyes from 8 patients (8.03%) showed distinct causes of CNV: 3 were idiopathic cases, 1 suffered angioid streaks, 1 was secondary to laser photocoagulation due to diabetic retinopathy, 2 had polypoidal choroidal vasculopathy and 2 central serous choroiditis. Regarding VA results, 77.7% improved or mantained the previous VA. Angiography resolution was observed in 55.5% of the cases (80% with just one PDT session). Average follow up was 10.5 months. Systemic or local complications were not observed. Conclusion: PDT may be useful in the treatment of different types of CNV due to causes other than AMD or high myopia (AU)

[Topical versus contact anaesthesia in conventional trabeculectomy. Prospective randomised study]. / Anestesia tópica versus anestesia de contacto en la trabeculectomía convencional. Estudio prospectivo aleatorizado.

PURPOSE: To compare the pain rates, comfort levels and safety between conventional topical anaesthesia and the application of a long lasting lidocaine soaked film or contact anaesthesia. METHODS: Fifty patients undergoing conventional trabeculectomy with or without Mitomycin-C were included. One half received topical anaesthesia and the other half contact anaesthesia in a random fashion. Pain and discomfort rates before, during and after surgery were evaluated on a scale from 0 to 5, also, surgeon subjective stress and complications observed were included in the clinical protocol. RESULTS: Significant differences were found between both groups regarding pain rates, during and after surgery, and surgeon stress level. Sedation and change of anesthesic method were required more frequently by the patients included in the topical anaesthesia group. CONCLUSIONS: Topical anaesthesia provides sufficient level of anaesthesia for performing a trabeculectomy. Nevertheless pain rate differences between contact and conventional topical anaesthesia were patent during and after surgery. Contact anaesthesia appears to be a valid and practical alternative in a wide range of patients undergoing glaucoma surgery.