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.

Nanoparticles Stokes radius assessment through permeability coefficient determination within a new stratified epithelium on-chip model.

Tissue barrier permeability plays a crucial role in determining the selective transport of substances across epithelial tissues, including drugs, cosmetic substances, and chemicals. The ability of these substances to cross through tissue barriers affects their absorption into the bloodstream and ultimately their effectiveness. Therefore, the determination of their permeability on these type of tissue barriers represents a useful tool for pharmaceutical and cosmetic industries as well as for toxicological studies.In this regard, microfluidic devices and organ-on-chip technologies are becoming more important to generate reliable data. We have designed and performed an alternative new stratified epithelia-on-chip model that allows to correlate the Stokes radius and the diffusion of molecules and/or nanoformulations through the in vitro generated barrier and establish a system suitable for the analysis of diffusion through stratified epithelium. Thus, extrapolating from experimental data we can predict the Stokes radius for unknown fluorescent labelled particles within a molecular size range, such as gold nanoparticles.

Prevalence of and factors associated with Helicobacter pylori infection in preschoolers in Havana, Cuba: A population-based study. / Prevalencia y factores asociados a infección por Helicobacter pylori en preescolares de La Habana, Cuba. Estudio de base poblacional.

INTRODUCTION: Helicobacter pylori (H. pylori) infection is usually acquired in childhood. In Cuba, its study in pediatric ages is a little explored field. AIM: To identify the prevalence of the infection and its associated risk factors in 3-year-old children in Havana. MATERIALS AND METHODS: An analytic, cross-sectional, epidemiologic analysis was conducted on 1,274 children belonging to the cohort of participants in the Natural History of Wheezing in Cuba study (HINASIC for its Spanish acronym) that were 3 years of age and provided a stool sample. H. pylori infection was identified by determining the H. pylori antigen (Ag) in stool, utilizing the commercial Spinreact kit, from Spain. The data were collected through a questionnaire applied by the researchers that included sociodemographic, environmental, and lifestyle variables, as well as infection from other parasites. Prevalence and the prevalence ratio with a 95% confidence interval were calculated and the dichotomous logistic regression analysis was employed. RESULTS: The prevalence of positive H. pylori Ag was 5%. Sleeping together was the risk factor found (PR:1.27; 95% CI: 1.03-1.50). Protective factors were drinking water from water delivery trucks (PR: 0.16; 95% CI: 0.04-0.72) and living in a nuclear family unit (PR: 0.94; 95% CI: 0.85-0.99). CONCLUSIONS: The prevalence of H. pylori infection in early childhood places Havana in an intermediate position at the international level. To control the infection, causal studies should be conducted and opportune interventions implemented.

Methyl-parathion decreases sperm function and fertilization capacity after targeting spermatocytes and maturing spermatozoa.

Paternal germline exposure to organophosphorous pesticides (OP) has been associated with reproductive failures and adverse effects in the offspring. Methyl-parathion (Me-Pa), a worldwide-used OP, has reproductive adverse effects and is genotoxic to sperm, possibly via oxidative damage. This study investigated the stages of spermatogenesis susceptible to be targeted by Me-Pa exposure that impact on spermatozoa function and their ability to fertilize. Male mice were exposed to Me-Pa (20 mg/kg bw, i.p.) and spermatozoa from epididymis-vas deferens were collected at 7 or 28 days post-treatment (dpt) to assess the effects on maturing spermatozoa and spermatocytes, respectively. Spermatozoa were examined for DNA damage by nick translation (NT-positive cells) and SCSA (%DFI), lipoperoxidation (LPO) by malondialdehyde production, sperm function by spontaneous- and induced-acrosome reactions (AR), mitochondrial membrane potential (MMP) by using the JC-1 fluorochrome, and fertilization ability by an in vitro assay and in vivo mating. Alterations on DNA integrity (%DFI and NT-positive cells) in spermatozoa collected at 7 and 28 dpt, and decreases in sperm quality and induced-AR were observed; reduced MMP and LPO were observed at 7 dpt only. Negative correlations between LPO and sperm alterations were found. Altered sperm functional parameters evaluated either in vitro or in vivo were associated with reduced fertilization rates at both times. These results show that Me-Pa exposure of maturing spermatozoa and spermatocytes affects many sperm functional parameters that result in a decreased fertilizing capacity. Oxidative stress seems to be a likely mechanism of the detrimental effects of Me-Pa exposure in male germ cells.

An experimental study of the mouse skin behaviour: damage and inelastic aspects.

Samples of male and female mice skin were tested under monotonic and cyclic loading to mechanically characterize the tissue for large deformations. Cyclic tests have shown a typical Mullins effect widely known for elastomers and other soft tissues. No statistical difference was found in the maximum stretch of the sample after the fifth loading cycle for male (1.26 +/- 0.035) and female (1.18 +/- 0.083). However, larger dispersion was obtained for the maximum stress for both genders, 0.61 +/- 0.16 MPa for male and 0.78 +/- 0.32 MPa for female. Results show the presence of inelastic strain and stress softening in the skin at large deformations. They also have shown how stress softening and residual strain change with the magnitude of the applied load. Good correlation was observed between the residual strain and the maximum strain previously attained by the sample during loading for all samples. However, the correlation was different between genders.

Dinámicas de producción y emisiones modeladas de gases de efecto invernadero en sistemas regionales de producción lechera de Honduras / Production dynamics and greenhouse gas modeled emissions from regional dairy production systems in Honduras

RESUMEN El objetivo del estudio fue la caracterización productiva y de emisiones modeladas de gases de efecto invernadero (GEI) en 61 sistemas lecheros localizados en cinco regiones de Honduras. Durante las fases inicial (FI) y final (FF), con encuestas aplicadas individualmente a los productores, se identificaron aspectos técnicos y de productividad. Variables numéricas expresadas en Microsoft Excel ® permitieron, con el modelo FAO de evaluación ambiental de la ganadería global-interactivo (GLEAM-i, por sus siglas en inglés) de ciclo de vida, estimar emisiones anuales de metano (CH4), óxido nitroso (N2O) y dióxido de carbono (CO2) en cada finca. Cálculos intermedios (GEI/animal) fueron derivados de la modelización GLEAM-i en Excel®. Durante la FI las fincas conjuntamente emitieron 25.038 t CO2 equivalente (CO2-eq), mientras que dichas emisiones fueron 10,5% menores en la FF. Emisiones de GEI/animal (2,85 ± 0,08 t CO2-eq) y de GEI/kg de proteína láctea (96,91 ± 4,50 kg CO2-eq) durante la FI fue-ron 13 y 21% menores en la FF, respectivamente. Valores de 52,82 ± 1,64 (CH4) y 2,66 ± 0,10 (N2O) kg/animal en la FI fueron 13% y 17% menores en la FF, respectivamente. La región Centro-Sur-Oriente emitió la menor cantidad de CH4 (42,95 ± 2,37 kg/animal) y N2O (1,82 ± 0,15 kg/animal, mientras las regiones Occidente y Norte experimentaron una reducción del 27% en GEI/kg proteína láctea entre la FI y FF. Se concluyó que la metodologia usada identificó los impactos productivos y medioambientales, derivados de alternativas técnicas implementadas en sistemas de producción lechera de Honduras.

ABSTRACT The study aimed to characterize production dynamics and greenhouse gas (GHG) emissions from 61 dairy farms in five regions in Honduras. Farm data were collected through individual surveys during the initial and final phases (IP; FP). Using Microsoft Excel, data was incorporated into the global livestock environmental assessment model-interactive (GLEAM-i, FAO) life cycle framework to estimate annual emissions of methane (CH4), nitrous oxide (N2O), and carbon dioxide (CO2) at the farm system level. Animal emissions (GHG/animal) were derived in Excel® from the GLEAM-i predictions. Together, farms during the IP emitted 25.038 t CO2 equivalent (CO2-eq) while these emissions were 10,5% lower in the FP. Emissions of GHG/animal (2,85 ± 0,08 t CO2-eq) and GHG/kg of milk protein (96,91 ± 4,50 kg CO2-eq) during the IP were 13% and 21% lower in the FP, respectively. Methane and N2O emission values (52,82 ± 1,64 vs. 2,66 ± 0,10 kg/animal) were 13% and 17% higher in the IP than in FP. The South-Central region emitted the lowest amount of CH4 and N2O (42,95 ± 2,37 kg/animal vs. 1,82 ± 0,15 kg/animal) while 27% lower GHG/kg milk protein was observed between the IP and FP of the Western and Northern regions. It was concluded that the used methodology identified productive and environmental impacts derived from implemented technical interventions in dairy production systems in Honduras.

Spermatozoa nucleus takes up lead during the epididymal maturation altering chromatin condensation.

Lead (Pb) alters sperm chromatin condensation (CC) and the mechanisms are investigated. During spermatogenesis, protamines replace histones and disulfide bonds formation during epididymal maturation condense the chromatin. We evaluated sperm Pb uptake in testis and epididymis and the effects on CC in mice (0.06% Pb(2+)/16 weeks/drinking water). Spermatozoa from caput epididymis (CP) and cauda epididymis-vas deferens (CE-VD) were obtained and CC was measured by SCSA. Lead levels in spermatozoa from CP were lower than those from CE-VD, and correlated with a decreased CC, while Pb in CE-VD spermatozoa correlated with an increased CC. Lead accumulation into the nucleus was observed and Pb binding to nuclear sulfhydryl groups decreased chromatin decondensation in vitro. Our results suggest that spermatozoa take up Pb during testicular development and epididymal transport and alter CC, depending of the timing of Pb incorporation into the sperm nucleus, which finally may interfere with the chromatin decondensation process after fertilization.

CROMqs: an infinitesimal successive refinement lossy compressor for the quality scores.

Massive amounts of sequencing data are being generated thanks to advances in sequencing technology and a dramatic drop in the sequencing cost. Much of the data are comprised of nucleotides and the corresponding quality scores that indicate their reliability. The latter are more difficult to compress and are themselves noisy. As a result, lossy compression of the quality scores has recently been proposed to alleviate the storage costs. Further, it has been shown that lossy compression, at some specific rates, can achieve a performance on variant calling similar to that achieved with the lossless compressed data. We propose CROMqs, a new lossy compressor for the quality scores with the property of "infinitesimal successive refinability". This property allows the decoder to decompress the data iteratively without the need of agreeing with the encoder on a specific rate prior to compression. This characteristic is particularly amenable in practice, as in most cases the appropriate rate at which the lossy compressor should operate can not be established prior to compression. Further, this property can be of interest in scenarios involving streaming of genomic data. CROMqs is the first infinitesimal successive refinement lossy compressor for the quality scores in the literature, and we show that it obtains a comparable rate-distortion performance to previously proposed algorithms. Moreover, we also show that CROMqs achieves a comparable performance on variant calling to that of the lossless compressed data.

Graphene oxide increases the viability of C2C12 myoblasts microencapsulated in alginate.

Cell microencapsulation represents a great promise for long-term drug delivery, but still several challenges need to be overcome before its translation into the clinic, such as the long term cell survival inside the capsules. On this regard, graphene oxide has shown to promote proliferation of different cell types either in two or three dimensions. Therefore, we planned to combine graphene oxide with the cell microencapsulation technology. We first studied the effect of this material on the stability of the capsules and next we analyzed the biocompatibility of this chemical compound with erythropoietin secreting C2C12 myoblasts within the microcapsule matrix. We produced 160 µm-diameter alginate microcapsules with increasing concentrations of graphene oxide and did not find modifications on the physicochemical parameters of traditional alginate microcapsules. Moreover, we observed that the viability of encapsulated cells within alginate microcapsules containing specific graphene oxide concentrations was enhanced. These results provide a relevant step for the future clinical application of graphene oxide on cell microencapsulation.

Neurotensin-SPDP-poly-L-lysine conjugate: a nonviral vector for targeted gene delivery to neural cells.

We report herein the synthesis of a novel DNA delivery system and in vitro evidence of its ability to transfect cell lines by binding to the high-affinity neurotensin receptor and subsequent internalization of ligand-receptor complexes. The targeting vehicle consisted of neurotensin crosslinked with poly-L-lysine via N-succinimidyl-3-(2-pyridyldithio) propionate (SPDP). The SPDP-derivatives with either neurotensin or poly-L-lysine were purified by gel filtration. The conjugate resulting of the reaction of neurotensin-SPDP with HS-SPDP-poly-L-lysine was purified through Biogel A 1.5. The neurotensin-SPDP-poly-L-lysine conjugate was able to bind plasmidic DNAs (pSV2cat and pGreen Lantern-1) at optimal molar ratios of 1:5 and 1:6 (DNA: conjugate), respectively. The conjugate internalized those plasmids in the cell lines (N1E-115 and HT-29) bearing the high-affinity neurotensin receptor. Expression of the plasmid products, chloramphenicol acetyltransferase and green fluorescent protein, was observed in such cell lines. Both internalization and expression of the plasmids transferred by the neurotensin-SPDP-poly-L-lysine conjugate were prevented by neurotensin (1 microM) and SR-48692 (100 nM), a specific antagonist of the high-affinity neurotensin receptor. The neurotensin-SPDP-poly-L-lysine conjugate was unable to transfect cell lines lacking the neurotensin receptor (COS-7 and L-929). In rat brain, the high-affinity neurotensin receptor is expressed by specific neurons such as those of the nigrostriatal and mesolimbic dopaminergic systems. Therefore, the neurotensin-SPDP-poly-L-lysine conjugate could be a useful tool for gene delivery to those neuronal systems.

[17-beta estradiol induces type III nitric oxide synthase expression in cultured endothelial cells]. / El 17-beta estradiol induce la expresión de la sintasa de óxido nítrico tipo III en células endoteliales en cultivo.

It has been suggested that the low incidence of cardiovascular diseases in premenopausal women, compared with that in men of the same age, is related to the interaction between the nitric oxide (NO) pathway and estrogens. The aim of the present work was to characterize the mechanism by which 17-beta estradiol produces an increment in NO release in cultured endothelial cells. Treatment of cells with 17-beta estradiol significantly increased the amount of nitrites delivered into the culture medium, compared with that from cells without estrogenic treatment. This effect was blocked by the antagonist of estrogen receptors, tamoxifen. By Western blot, it was shown that 17-beta estradiol significantly increased the amount of eNOS in treated cells, compared with that from their respective control cells. Moreover, the acetylcholine-induced release of nitrites in cells treated with 17-beta estradiol was higher than nitrite production induced by the same dose of acetylcholine in control cells. In conclusion, our data underline the physiological role of 17-beta estradiol, which promotes the increase in eNOS expression, potentiating the effects of vascular agonists that release nitric oxide, suggesting a cardiovascular protective role by estrogens.

Computational methodology to determine fluid related parameters of non regular three-dimensional scaffolds.

The application of three-dimensional (3D) biomaterials to facilitate the adhesion, proliferation, and differentiation of cells has been widely studied for tissue engineering purposes. The fabrication methods used to improve the mechanical response of the scaffold produce complex and non regular structures. Apart from the mechanical aspect, the fluid behavior in the inner part of the scaffold should also be considered. Parameters such as permeability (k) or wall shear stress (WSS) are important aspects in the provision of nutrients, the removal of metabolic waste products or the mechanically-induced differentiation of cells attached in the trabecular network of the scaffolds. Experimental measurements of these parameters are not available in all labs. However, fluid parameters should be known prior to other types of experiments. The present work compares an experimental study with a computational fluid dynamics (CFD) methodology to determine the related fluid parameters (k and WSS) of complex non regular poly(L-lactic acid) scaffolds based only on the treatment of microphotographic images obtained with a microCT (µCT). The CFD analysis shows similar tendencies and results with low relative difference compared to those of the experimental study, for high flow rates. For low flow rates the accuracy of this prediction reduces. The correlation between the computational and experimental results validates the robustness of the proposed methodology.

Biomimetic hydroxyapatite coating on pore walls improves osteointegration of poly(L-lactic acid) scaffolds.

Polymer-ceramic composites obtained as the result of a mineralization process hold great promise for the future of tissue engineering. Simulated body fluids (SBFs) are widely used for the mineralization of polymer scaffolds. In this work an exhaustive study with the aim of optimizing the mineralization process on a poly(L-lactic acid) (PLLA) macroporous scaffold has been performed. We observed that when an air plasma treatment is applied to the PLLA scaffold its hydroxyapatite nucleation ability is considerably improved. However, plasma treatment only allows apatite deposition on the surface of the scaffold but not in its interior. When a 5 wt % of synthetic hydroxyapatite (HAp) nanoparticles is mixed with PLLA a more abundant biomimetic hydroxyapatite layer grows inside the scaffold in SBF. The morphology, amount, and composition of the generated biomimetic hydroxyapatite layer on the pores' surface have been analyzed. Large mineralization times are harmful to pure PLLA as it rapidly degrades and its elastic compression modulus significantly decreases. Degradation is retarded in the composite scaffolds because of the faster and extensive biomimetic apatite deposition and the role of HAp to control the pH. Mineralized scaffolds, covered by an apatite layer in SBF, were implanted in osteochondral lesions performed in the medial femoral condyle of healthy sheep. We observed that the presence of biomimetic hydroxyapatite on the pore's surface of the composite scaffold produces a better integration in the subchondral bone, in comparison to bare PLLA scaffolds.

Natural enemies associated with Sirex noctilio (Hymenoptera: Siricidae) and S. nigricornis in Ontario, Canada.

Sirex noctilio F. is an exotic woodwasp now found in eastern North America where it shares natural enemies with native woodwasps of Pinus spp. To study the extent to which native hymenopteran parasitoids and parasitic nematodes could affect woodwasp populations, 60 Pinus trees with symptoms of S. noctilio attack were felled in 2007 and 2008 in Ontario, Canada. Each tree bole was cut into 1-m sections that were placed in individual rearing tubes; emergence was monitored from May to November of the year of felling. Female S. noctilio were dissected to assess parasitism by the nematode Deladenus siricidicola Bedding. Two species of Siricidae emerged from these trees; S. noctilio, which accounted for most of the specimens collected, and S. nigricornis F. Of the three species of parasitoid that emerged, Ibalia leucospoides (Hochenwarth) was the most abundant, accounting for an overall hypothetical Siricidae parasitism rate of almost 20%. This parasitoid emerged over a similar time period as S. noctilio-between early July and early September. Except in trees >15 m in height, parasitism by I. leucospoides generally appeared uniform throughout the bole. Parasitism rates did not vary between the 2 yr, but did between sites in 1 yr. Parasitic nematodes were found in the haemocoel of about one third of S. noctilio females dissected but were never found sterilizing the eggs; none were found in S. noctilio emerging from P. resinosa. These findings suggest that I. leucospoides is currently the primary invertebrate natural enemy of S. noctilio in Ontario.

PON1Q192R genetic polymorphism modifies organophosphorous pesticide effects on semen quality and DNA integrity in agricultural workers from southern Mexico.

Pesticide exposure, including organophosphorous (OP) insecticides, has been associated with poor semen quality, and paraoxonase (PON1), an enzyme involved in OP deactivation, may have a role on their susceptibility, due to PON1 polymorphisms. Our objective was to evaluate the role of PON1Q192R polymorphism on the susceptibility to OP toxicity on semen quality and DNA integrity in agricultural workers. A cross-sectional study was conducted in farmers with Mayan ascendancy from southeastern Mexico chronically exposed to pesticides; mostly OP. Fifty four agricultural workers (18-55 years old) were included, who provided semen and blood samples. Semen quality was evaluated according to WHO, sperm DNA damage by in situ-nick translation (NT-positive cells), PON1Q192R polymorphism by real-time PCR and serum PON1 activity by using phenylacetate and paraoxon. Two OP exposure indexes were created: at the month of sampling and during 3 months before sampling, representing the exposure to spermatids-spermatozoa and to cells at one spermatogenic cycle, respectively. PON1 192R and 192Q allele frequencies were 0.54 and 0.46, respectively. Significant associations were found between OP exposure at the month of sampling and NT-positive cells and sperm viability in homozygote 192RR subjects, and dose-effect relationships were observed between OP exposure during 3 months before sampling and sperm quality parameters and NT-positive cells in homozygote 192RR farmers. This suggests that cells at all stages of spermatogenesis are target of OP, and that there exists an interaction between OP exposure and PON1Q192R polymorphism on these effects; farmers featuring the 192RR genotype were more susceptible to develop reproductive toxic effects by OP exposure.

Consecuencias de incumplimiento terapéutico en paciente joven hipertenso / Consequences on therapeutic noncompliance in the young hypertensive patient

Exponemos el caso clínico de un paciente varón joven estudiado en el servicio de Nefrología por hipertensión arterial, que con tratamiento antihipertensivo supervisado logró un control óptimo de sus cifras de tensión arterial. Tras varios meses es traído al Servicio de Urgencias por un deterioro brusco de la consciencia secundario a una hemorragia intracerebral, con posterior fallecimiento. En la anamnesis realizada a sus familiares nos informan del incumplimiento absoluto del tratamiento pautado. El incumplimiento terapéutico conlleva una alta morbimortalidad y un elevado coste sociosanitario (AU)

We present the clinical case of a young male patient studied in the Nephrology service due to arterial hypertension. This patient achieved optimum control of his blood pressure level with supervised antihypertensive treatment. Months later, he came to the Emergency Service due to intracranial hemorrhaging, with subsequent death. Based on the anamnesis obtained from his family, they reported his total noncompliance regarding the prescribed treatment. Therapeutic non-compliance implies high morbidity-mortality and a social-health burden (AU)

Cervicalgia: la primera manifestación del mal de Pott / Neck pain: The first manifestation of Pott’s disease

Se presenta el caso clínico de un paciente varón de 78 años, que refería dolor cervical de intensidad moderada-severa y resistente al tratamiento conservador, junto con sintomatología general (pérdida de peso, hiporexia y astenia). La tomografía axial computarizada y la resonancia magnética nuclear cervical evidenciaron la reabsorción ósea de la odontoides y un absceso tuberculoso retrofaríngeo. Se trató con triple terapia tuberculostática e inmovilización cervical con ortesis tipo halo Jacket durante los 3 meses posteriores, y con tratamiento rehabilitador, con evolución clínica favorable (AU)

We present the case of a 78-year-old man who presented moderate-severe cervical pain, who did not respond conservative treatment, as well as general symptomology (weight loss, hyporexia and asthenia). The computed tomography (CT) scan and cervical magnetic resonance imaging (MRI) revealed odontoid bone reabsorption and retropharyngeal tuberculoid abscess. The patient received tuberculostatic triple therapy, underwent cervical immobilization with Halo Jacket cervical orthosis for 3 months and received rehabilitation treatment leading to a favorable clinical outcome (AU)

Ictus isquémico tras consumo de cannabis / Stroke after cannabis consumption

El uso del cannabis es un hábito muy extendido entre los jóvenes de las sociedades desarrolladas, y sin embargo sólo se han documentando 20 casos de ictus por consumo de cannabis. Las dificultades diagnósticas derivadas del uso de otras drogas y de la falta de especificidad clínica justifican el estudio de nuevos casos control. Un varón de 19 años acude a Urgencias por cefalea holocraneal y pérdida de fuerza en el hemicuerpo izquierdo después del consumo de cannabis. El TAC cerebral fue normal, y la RNM cerebral evidenció un infarto isquémico en la arteria cerebral posterior. En sangre y orina se detectó cannabis. A los catorce días se le dio el alta sin déficits neurológicos. Las características más relevantes de este caso incluyen: 1) diagnóstico etiológico nítido, por el consumo exclusivo de cannabis, 2) clínica inicial de migraña acompañada con TAC cerebral normal y 3) recuperación clínica total (AU)

Cannabis use is a widespread habit among the youth from well developed societies, however only 20 cases dealing with cannabis and stroke have been reported. Due to diagnostic difficulties linked to concomitant drug abuses and the lack of specific symptoms new cases should be studied. A 19-year-old male came to the Emergency Service reporting severe cephalgia and impairment in the left hemibody strenght after cannabis use. Brain CT was normal and the MRI revealed an ischemic infarct in the porterior cerebral artery. Cannabis was detected in the blood and in the urine analysis. After 14 days no neurologic deficits were found in the examination and the patient left the hospital. The most relevant issues in this case are: 1) clear etiologic diagnosis related to cannabis use, 2) initial migraine presentation with normal findings in the CT and 3) complete recovery (AU)

Prevención y tratamiento de la obesidad infantil / Prevention and treatment in child obesity

Objetivo: Conocer la situación actual del problema de la obesidad pediátrica para poder actuar en consecuencia.Resumen: Hemos realizado una revisión sobre la prevalencia y tratamiento de la obesidad infantil en los últimos cinco años, dado el aumento de prevalencia que ha experimentado en las últimas décadas y la importancia de sus consecuencias.Resultados: La obesidad infantil constituye un problema sanitario de primer orden en los países desarrollados, ante la dificultad del tratamiento una vez establecida es muy importante una actuación precoz mediante: educación nutricional fomentando unos buenos hábitos alimentarios sumados a actividad física regular, dirigido a niños y padres con el fin de conseguir disminuir la prevalencia de obesidad en el adulto y sus consecuencias. Como tratamiento es importante un programa multidisciplinario que combine la restricción dietética, el aumento de la actividad física, la educación nutricional y las modificaciones de la conducta.Conclusión. Es necesario concienciar a la población y al colectivo sanitario de la importancia del control de la obesidad como origen de presentes y futuros problemas sanitarios (AU)