Cherenkov Light Emission in Pure Cherenkov Emitters for Prompt Gamma Imaging.

Proton range verification (PRV) in proton therapy by means of prompt-gamma detection is a promising but challenging approach. High count rates, energies ranging between 1 MeV and 7 MeV, and a strong background complicate the detection of such particles. In this work, the Cherenkov light generated by prompt-gammas in the pure Cherenkov emitters TlBr, TlCl and PbF2 was studied. Cherenkov light in these crystals can provide a very fast timing signal with the potential to achieve very high count rates and to discern between prompt-gammas and background signals. Crystals of 1×1 cm2 and thicknesses of 1 cm, 2 cm, 3 cm and 4 cm were simulated. Different photodetector configurations were studied for 2.3 MeV, 4.4 MeV, and 6.1 MeV prompt-gammas. TlCl achieved the greatest number of detected Cherenkov photons for all energies, detector dimensions, and photodetector efficiency modeling. For the highest prompt-gamma energy simulated, TlCl yielded approximately 250 Cherenkov detected photons, using a hypothetical high-performance photodetector. Results show the crystal blocks of 1 cm × 1 cm × 1 cm have greater prompt-gamma detection efficiency per volume and a comparable average number of detected Cherenkov photons per event.

El farmacéutico comunitario y la legalización del consumo del cannabis medicinal / Community pharmacists and the legalisation of medical cannabis use

JUSTIFICACIÓN: el consumo de cannabis con fines medicinales está autorizado en algunos países desarrollados, y hay muchos otros en los que se está abriendo el debate sobre su legalización. El farmacéutico comunitario, como experto en el medicamento y como agente sanitario encargado de la prevención de enfermedades y promoción de la salud, puede y debe participar de este debate.OBJETIVO: revisión bibliográfica para evaluar la evidencia sobre eficacia y seguridad del cannabis usado con fines medicinales como alternativa a otros tratamientos medicamentosos autorizados y valorar la conveniencia de su legalización en España.MÉTODOS: 10 Miembros SEFAC de los Grupos de Trabajo Dolor, Respiratorio y Tabaquismo y Seguridad del paciente se han coordinado para recopilar la evidencia científica actual sobre el uso terapéutico y “recreativo” de cannabis, realizando búsquedas en fuentes como PubMed, Cochrane, Ministerio de Sanidad o Bibliotecas de Sociedades anti-tabaco. Se han empleado herramientas como Dropbox y Google Drive para generar carpetas y documentos compartidos donde los miembros pue dieran aportar los datos de sus revisiones de manera efectiva y sencilla.RESULTADOS: en toda la Unión Europea ningún país que autoriza el uso médico de preparados de cannabis permite su uso inhalado. La única evidencia terapéutica sólida del cannabis terapéutico que represente una mejora con respecto a otras alternativas terapéuticas para la misma situación se refiere a la náusea y el vómito en preparado para solución bucal. En cuanto al dolor los meta análisis no reflejan diferencias significativas en sus resultados de cannabis frente a placebo. (AU)

Análisis de cumplimentación de las recetas médicas en soporte papel / Analysis of completion of medical prescriptions on paper

Dentro de las políticas farmacéuticas, el Estado se ha interesado por la receta médica como documento legal de prescripción y de dispensación de medicamentos y productos sanitarios, contribuyendo a la mejora en la seguridad del paciente. Con el objetivo de medir la cumplimentación de las recetas que llegan a la farmacia comunitaria se realizó un estudio observacional transversal, durante dos meses de 2019, revisando todas las recetas en soporte papel presentadas para su dispensación en cinco farmacias. En ese intervalo se recibieron un total de 33.463 recetas, 30.085 (89,90 %) eran electrónicas y 3.378 (10,10 %) en papel. De estas, 841 (25 %) eran del Sistema Nacional de Salud (SNS), 931 (27 %) de MUFACE, 362 (11 %) de ISFAS, 28 (1 %) de MUGEJU, 201 (6 %) de otras mutuas y 1.015 (30 %) de asistencia sanitaria privada. Cuando se analizó el número y porcentaje de recetas en papel que podían ser dispensadas legalmente, se observó que sólo 130 (65 %) recetas de otras mutuas, 30 (4 %) recetas del SNS y 34 (3 %) recetas privadas estaban correctamente cumplimentadas. Por tanto, sólo 194 de las 3.378 recetas en papel analizadas (6 %) que se han recibido durante dos meses en las cinco farmacias podían ser dispensadas de acuerdo con la ley actual. Cuando las recetas no están correctamente cumplimentadas, con los datos básicos obligatorios, indispensables para la validez de la receta médica, la seguridad del paciente puede verse comprometida y los profesionales sanitarios que prescriben y los que dispensan los medicamentos se exponen a sanciones

Within the pharmaceutical policies, the State has been interested in the medical prescription as a legal document of prescription and dispensing medicines and health products contributing to the improvement in patient safety. To measure the degree of compliance of the prescriptions that arrive at the community pharmacy, a cross-sectional observational study was conducted for two months of 2019 to review all the prescriptions on paper presented for dispensing in five pharmacies. Within this period, a total of 33463 prescriptions were received 30085 (89.90%) were electronic and 3378 (10.10%) were on paper. Of these, 841 (25%) came from the public health system, 931 (27%) from MUFACE, 362 (11%) from ISFAS, 28 (1%) from MUGEJU, 201 (6%) other organizations and 1015 (30%) from private healthcare. When the number and percentage of paper prescriptions that could be legally dispensed was analysed, it was observed that only 130 (65%) prescriptions of other organizations, 30 (4%) of the public health system and 34 (3%) of private healthcare were correctly completed. Therefore, only 194 of the 3,378 paper prescriptions (6%) received during two months in the five community pharmacies could be dispensed according to current law. When the prescriptions are not correctly filled, with the mandatory basic data, indispensable for the validity of the medical prescription, the patient's safety can be compromised and the prescribing health professionals and those who dispense the medications are exposed to sanctions

A Proinflammatory Immune Response Might Determine Toxoplasma gondii Vertical Transmission and Severity of Clinical Features in Congenitally Infected Newborns.

Toxoplasma gondii is the etiological agent of toxoplasmosis. Mother-to-child transmission of this parasite can occur during pregnancy. Newborns with congenital toxoplasmosis may develop central nervous system impairment, with severity ranging from subclinical manifestations to death. A proinflammatory/regulated specific immune profile is crucial in the defense against the parasite; nevertheless, its role in the infected pregnant women and the congenitally infected offspring has been poorly explored, and there is still no consensus about its relation to parasite vertical transmission or to severity and dissemination in the congenitally infected newborns. This work aimed to characterize these relations by means of principal component and principal factor analyses. For this purpose, we determined the specific production of the four immunoglobulin G antibody subclasses, cytokines, and lymphocyte proliferation in the T. gondii-infected pregnant women-10 who transmitted the infection to their offspring and seven who did not-as well as in 11 newborns congenitally infected and grouped according to disease severity (five mild and six moderate/severe) and dissemination (four local and seven disseminated). We found that the immune response of nontransmitter women differed from that of the transmitters, the latter having a stronger proinflammatory response, supporting a previous report. We also found that newborns who developed moderate/severe disease presented higher levels of lymphocyte proliferation, particularly of CD8+ and CD19+ cells, a high proportion of tumor necrosis factor α producers, and reduced expression of the immune modulator transforming growth factor ß, as opposed to children who developed mild clinical complications. Our results suggest that a distinctive, not regulated, proinflammatory immune response might favor T. gondii vertical transmission and the development of severe clinical manifestations in congenitally infected newborns.

Prevalence of active infection by herpes simplex virus type 2 in patients with high-risk human papillomavirus infection: A cross-sectional study.

The aim is to determine the prevalence of active infection by herpes simplex virus type 2 (HSV-2) among Mexican women with high-risk human papillomavirus (HR-HPV) cervical infection, recruited from public gynecology and colposcopy services. In a cross-sectional study, HSV-2 antibodies, HSV-2 DNA, and HR-HPV DNA were quantified. Significant differences in HSV-2 seroprevalence and HSV-2 active infection rates were found between negative and positive HR-HPV cases. HSV-2 seroprevalence was 28.15% and 16.1% (P = .0001), while HSV-2 active infection rates were 6.83% and 0.62% (P = .001) for positive and negative HR-HPV groups, respectively. The risk of HSV-2 seropositivity was 1.7 times greater for HR-HPV-positive cases (P = .02). Similarly, HR-HPV-positive cases were nine times more likely to have an HSV-2 active infection than HR-HPV-negative cases (P = .03). High HSV-2/h-HPV coinfection rates were observed among women recruited from public gynecology and colposcopy services. The main factors related to an HSV-2 active infection are a history of risky sexual behavior and HR-HPV infection. The prevalence of HSV-2 active infection among positive HR-HPV subjects indicate that these infections constitute an important group of STIs in Mexico.

18 F-sodium fluoride positron emission tomography of the racing Thoroughbred fetlock: Validation and comparison with other imaging modalities in nine horses.

BACKGROUND: Early and accurate detection of stress remodelling in racehorses is of utmost importance to prevent catastrophic injuries. Current imaging techniques have limitations in assessing early changes predisposing to catastrophic breakdowns. Positron emission tomography (PET) using 18 F-sodium fluoride (18 F-NaF) is a sensitive method for the detection of early bone turnover and may improve early recognition of subtle injuries. OBJECTIVES: To validate the clinical use of 18 F-NaF PET in Thoroughbred racehorses, to assess the value of PET in the detection of bone lesions and to compare PET results with findings of other advanced imaging modalities, clinical examination and pathology. STUDY DESIGN: Experimental exploratory study. METHODS: Twenty fetlocks from nine Thoroughbred racehorses were imaged using 18 F-NaF PET, computed tomography (CT) and scintigraphy. Five fetlocks were also imaged with magnetic resonance imaging and four fetlocks were also examined histologically. Imaging findings were independently reviewed by three board certified radiologists. Imaging, clinical and histopathological findings were correlated. RESULTS: PET imaging was well-tolerated by all horses. PET detected focal areas of 18 F-NaF uptake in instances where other imaging modalities did not identify abnormalities, in particular in the proximal sesamoid bones. Maximal standardised uptake values could be measured to quantify the activity of lesions. Areas of 18 F-NaF uptake corresponded to regions of increased vascularity and increased osteoblastic activity. MAIN LIMITATIONS: Limited number of cases. CONCLUSIONS: 18 F-NaF PET imaging of the Thoroughbred fetlock is feasible and compares favourably with other imaging modalities in detecting stress remodelling in Thoroughbred racehorses. PET appears to be a beneficial imaging modality when used for early detection of stress remodelling in an effort to prevent catastrophic musculoskeletal injuries in this population of horses.

Cadmium and cadmium-tolerant soil bacteria in cacao crops from northeastern Colombia.

AIMS: This research aims to assess total-cadmium soil content and microbiological aspects to understand the dynamics of culturable cadmium-tolerant bacteria (CdtB) in cacao soils from northeastern Colombia. METHODS AND RESULTS: An integration of inverted dish plating, Cd determination and a microcalorimetry assay (IMC) was carried out. A farm in Boyacá showed the highest level of total soil Cd (3·74 mg kg-1 ) followed by farms in Santander and Arauca (2·76 and 1·16 mg kg-1 , respectively). Coefficient of determination between total soil Cd and CFU of CdtB was high (R2  = 0·83) for the farm in Boyacá. Moreover, a pool of 129 CdtB was isolated, and phylogeny of 21 CdtB was discussed. Among CdtB strains isolated, Enterobacter sp. CdDB41 showed major Cd immobilization capacity (Qmax of 2·21 and 2·32 J at 6 and 24 mg l-1 of CdCl2 ), with an immobilization rate of 0·220 mg kg-1  h-1 . CONCLUSIONS: Among CdtB strains isolated, Enterobacter sp. CdDB41 showed major Cd immobilization capacity (Qmax of 2·21 and 2·32 J at 6 and 24 mg l-1 of CdCl2 ), with an immobilization rate of 0·220 mg kg-1  h-1 . SIGNIFICANCE AND IMPACT OF THE STUDY: Nothing is known about soil CdtB in cacao. Our data showed that CdtB such as Enterobacter sp. has high immobilization capacity. Furthermore, the otavite found in situ might be mineralized due to the bacterial metabolic activity of CdtB.

Rationale and design of the PLACID study: a randomised trial comparing the efficacy and safety of inhaled loxapine versus IM aripiprazole in acutely agitated patients with schizophrenia or bipolar disorder.

BACKGROUND: The management of acute agitation manifesting in patients with schizophrenia or bipolar disorder requires swift pharmacological intervention to provide rapid symptomatic relief and prevent escalation to aggression and violence. Antipsychotic medications are widely used in this setting and the availability of an inhaled formulation with deep lung absorption of the antipsychotic loxapine has the potential to deliver a faster onset of therapeutic effect than the available intramuscular formulations of antipsychotics. METHODS: The efficacy of inhaled loxapine and the alternative antipsychotic aripiprazole delivered via intramuscular (IM) injection will be compared in the Phase IIIb PLACID study. Adults (18-65 years) with a confirmed diagnosis of schizophrenia or bipolar I disorder presenting with acute agitation will be randomly assigned to open-label treatment in a 1:1 ratio. Clinical evaluation will be conducted by raters blinded to treatment assignment. The primary efficacy endpoint is time to response (defined as a Clinical Global Impression of Improvement [CGI-I] score of 1 [very much improved] or 2 [much improved]). Secondary endpoints will include the percentage of responders at different time points after dosing; the proportion of patients who receive 1 or 2 doses of study drug; time to second dose; time to rescue medication; satisfaction with study drug (evaluated using Item 14 of the Treatment Satisfaction Questionnaire for Medication); and safety and tolerability. Approximately 360 patients will be recruited with an interim analysis conducted once 180 patients have completed the study to decide whether to stop for futility or continue with or without an increase in the sample size up to additional 288 patients. DISCUSSION: The PLACID trial will assess the efficacy and safety of inhaled loxapine with deep lung absorption compared with the IM antipsychotic, aripiprazole, in acutely agitated patients with schizophrenia or bipolar disorder. In the event that the median time to response of inhaled loxapine is significantly shorter than that of the intramuscular aripiprazole, the PLACID study has the potential to support the inhaled antipsychotic therapy as the standard of care in this setting. TRIAL REGISTRATION: The study protocol was registered with the European Clinical Trials Database on the 31 October 2014 (EudraCT number 2014-000456-29 ).

Risk allelic load in Th2 and Th3 cytokines genes as biomarker of susceptibility to HPV-16 positive cervical cancer: a case control study.

BACKGROUND: Alterations in the host cellular immune response allow persistent infections with High-Risk Human Papillomavirus (HR-HPV) and development of premalignant cervical lesions and cervical cancer (CC). Variations of immunosuppressive cytokine levels in cervix are associated with the natural history of CC. To assess the potential role of genetic host immunity and cytokines serum levels in the risk of developing CC, we conducted a case-control study paired by age. METHODS: Peripheral blood samples from patients with CC (n = 200) and hospital controls (n = 200), were used to evaluate nine biallelic SNPs of six cytokine genes of the adaptive immune system by allelic discrimination and cytokines serum levels by ELISA. RESULTS: After analyzing the SNP association by multivariate logistic regression adjusted by age, CC history and smoking history, three Th2 cytokines (IL-4, IL-6 and IL-10) and one Th3 (TGFB1) cytokine were significantly associated with CC. Individuals with at least one copy of the following risk alleles: T of SNP (-590C > T IL-4), C of SNP (-573G > C IL-6), A of SNP (-592C > A IL-10), T of SNP (-819C > T IL-10) and T of SNP (-509C > T TGFB1), had an adjusted odds ratio (OR) of 2.08 (95 % CI 1.475-2.934, p = 0.0001), an OR of 1.70 (95 % CI 1.208-2.404, p = 0.002), an OR of 1.87 (95 % CI 1.332-2.630, p = 0.0001), an OR of 1.67 (95 % CI 1.192-2.353, p = 0.003) and an OR of 1.91 (95 % CI 1.354-2.701, p = 0.0001), respectively, for CC. The burden of carrying two or more of these risk alleles was found to have an additive effect on the risk of CC (p trend = 0.0001). Finally, the serum levels of Th2 and Th3 cytokines were higher in CC cases than the controls; whereas IFNG levels, a Th1 cytokine, were higher in controls than CC cases. CONCLUSION: The significant associations of five SNPs with CC indicate that these polymorphisms are potential candidates for predicting the risk of development of CC, representing a risk allelic load for CC and can be used as a biomarker of susceptibility to this disease.

Cytostatic and genotoxic effect of temephos in human lymphocytes and HepG2 cells.

Temephos is an organophosphorus pesticide that is used in control campaigns against Aedes aegypti mosquitoes, which transmit dengue. In spite of the widespread use of temephos, few studies have examined its genotoxic potential. The aim of this study was to evaluate the cytotoxic, cytostatic and genotoxic effects of temephos in human lymphocytes and hepatoma cells (HepG2). The cytotoxicity was evaluated with simultaneous staining (FDA/EtBr). The cytostatic and genotoxic effects were evaluated using comet assays and the micronucleus technique. We found that temephos was not cytotoxic in either lymphocytes or HepG2 cells. Regarding the cytostatic effect in human lymphocytes, temephos (10 µM) caused a significant decrease in the percentage of binucleated cells and in the nuclear division index as well as an increase in the apoptotic cell frequency, which was not the case for HepG2 cells. The comet assay showed that temephos increased the DNA damage levels in human lymphocytes, but it did not increase the MN frequency. In contrast, in HepG2 cells, temephos increased the tail length, tail moment and MN frequency in HepG2 cells compared to control cells. In conclusion, temephos causes stable DNA damage in HepG2 cells but not in human lymphocytes. These findings suggest the importance of temephos biotransformation in its genotoxic effect.

Measurement of mobility and lifetime of electrons and holes in a Schottky CdTe diode.

We report on the measurement of drift properties of electrons and holes in a CdTe diode grown by the travelling heating method (THM). Mobility and lifetime of both charge carriers has been measured independently at room temperature and fixed bias voltage using charge integration readout electronics. Both electrode sides of the detector have been exposed to a 241Am source in order to obtain events with full contributions of either electrons or holes. The drift time has been measured to obtain the mobility for each charge carrier. The Hecht equation has been employed to evaluate the lifetime. The measured values for µτe/h (mobility-lifetime product) are in agreement with earlier published data.

[Anterior cruciate ligament lesions]. / Lesiones del ligamento cruzado anterior.

A bibliographic review was conducted on the current status of ACL ligamentoplasties including their anatomical and functional bases and surgical treatment.

[Chronic lateral ankle instability treated with a minimally invasive approach with lateral peroneus brevis tendon]. / Inestabilidad lateral crónica de tobillo con tratamiento mínimo invasivo con peroneo lateral corto.

This study assessed the results obtained with a minimally invasive surgical technique developed by the authors to treat chronic lateral ankle instability. This is an observational, prospective, longitudinal, open, follow-up study of patients with a diagnosis of chronic lateral ankle instability seen at "Lomas Verdes" IMSS Traumatology and Orthopedics Hospital in 2009-2010.

Consenso médico de biopsia por aspiración con aguja fina de tiroides. reporte de citología tiroidea basado en el sistema de bethesda / Medical consensus of fine-needle aspiration biopsy of the thyroid. bethesda system for reporting thyroid cytopathology

En este artículo se presenta un consenso médico basado en el sistema de Bethesda del Instituto Nacionalde Cáncer (Estados Unidos) para el uso de la biopsia por aspiración con aguja fina en el manejo de nódulos tiroideos, realizado en conjunto con patólogos, radiólogos, endocrinólogos y otras especialidades médicas de Colombia, España, Chile, Venezuela, Estados Unidos y Panamá. En este trabajo se describen las indicaciones de la biopsia por aspiración con aguja fina de tiroides, requisitos previos, entrenamiento, acreditación, técnicas, terminología diagnóstica, pruebas complementarias y opciones de tratamiento. El objetivo del actual artículo es presentar ante la comunidad médica la clasificación de los reportes citológicos, el reporte de ecografía que propone usar el sistema de datos y el reporte de imágenes tiroideas (TIRADS, del inglés The Thyroid Imaging Reporting and Data System), el uso de la medición de tiroglobulina en biopsia por aspiración con aguja fina y técnicas de citología líquida;...

This article presents a medical consensus based on the Bethesda system of the National Cancer Institute (USA) for the use of fine needle aspiration biopsy in the management of thyroid nodules. This consensus was performed in conjunction with pathologists, radiologists, endocrinologists, and other medical specialties of Colombia, Spain, Chile, Venezuela, United States, and Panama. In this work was described the indications for fine needle aspiration biopsy of thyroid, prerequisites, training, accreditation, techniques, diagnostic terminology, additional tests and treatment options. The aim of this article is present to the medical community the classification of cytological report, ultrasound report using the data system, and the thyroid imaging reporting and data system (TIRADS); as well as, the use of thyroglobulin measurement in fine needle aspiration biopsy, and liquid-based cytology techniques...

Feline aortic thromboembolism: first case reported in Colombia / Tromboembolismo aórtico felino: primer caso reportado en Colombia / Tromboembolismo aórtico felino: relato do primeiro caso na Colômbia

Anamnesis and treatment approach: a cross-breed tomcat, 5 years old, with bilateral pelvic limb paresis was treated with saline solution hydration (20 drops/in), tramadol (2 mg/kg IV every 8 h), methylprednisolone succinate (18 mg, every 6 h), dimethyl sulphoxyde (0.36 mg diluted in sodium chloride, twice a day, IV) and ketoprofen (2 mg/kg, every 24 h) with no response to this treatment schedule. Clinical and laboratory findings: according to results of thorax and abdomen radiological tests, coldness in pelvic limbs and lack of bleeding after a deep nail cutting, clinical diagnosis of feline aortic thromboembolism was established and the cat was subjected to euthanasia after informed consent. A hypertrophic cardiomyopathy and thrombus in the lumbar abdominal aorta were found at necropsy. Conclusion: the first case of feline aortic thromboembolism in Colombia is reported and the most relevant findings and treatment schedule are discussed.

Anamnesis y aproximación terapéutica: un felino mestizo de 5 años de edad, con cuadro neurológico fue tratado con solución salina (20 gotas/min), tramadol (2 mg/kg i.v. cada 8 horas), succinato de metilprednisolona (18 mg totales cada 6 horas), dimetilsulfoxido (0.36 mg diluidos en cloruro de sodio cada 12 horas e.v.) y ketoprofeno (2 mg/kg cada 24 horas), sin responder al tratamiento. Hallazgos clinicos y de laboratorio: ante los resultados de las radiografìas de tórax y el abdomen, las extremidades pelvianas frías y el no sangrado ante corte profundo de uña, se estableció el diagnóstico de tromboembolismo aórtico felino. El gato fue sometido a eutanasia previo consentimiento informado. A la necropsia fue hallada una cardiomiopatía hipertrófica y un coágulo en la porción lumbar de la aorta abdominal. Conclusiones: este es el primer reporte de un caso de tromboembolismo felino en Colombia, se discuten los hallazgos clínicos y el esquema de tratamiento más relevante.

Anamnese e abordagem de tratamento: um felino mestiço de 5 anos de idade com quadro neurológico foi tratado com solução salina (20 gotas / min), tramadol (2 mg / kg iv c / 8 horas), succinato de metilprednisolona (18 mg c total / 6 h), sulfóxido de dimetilo (0.36 mg de cloreto de sódio diluído em q12h ev) e cetoprofeno (2 mg / kg C/24 h), não respondendo ao tratamento. Achados clínicos e laboratoriais: com os resultados do exame radiológico de tórax e abdôme, membros pelvianas frios e falta de sangramento ao corte profundo da unha, foi diagnosticado com tromboembolismo aórtico felino. O gato foi eutanasiado prévio consentimento informado. Na necropsia foi encontrada cardiomiopatia hipertrófica e um coágulo na porção lombar da aorta abdominal. Conclusões: Este é o primeiro reporte de tromboembolismo felino na Colômbia, neste artigo se discutem os achados clínicos e o cronograma de tratamento mais relevante.

[Treatment of unrecent patellar tendon tear with semitendinous and gracilis tendons]. / Tratamiento de la rotura no reciente del tendón patelar con tendones semitendinoso y gracilis.

The patellar tendon lesion is very important due to the role of this tendon on the conformation of the extensor mechanism of the quadriceps. When the terminal end of this mechanism is injured, the extensor function of the knee is completely lost and thus the functional capability of the involved limb is completely disrupted.

Cannabis use and age at onset of psychosis: further evidence of interaction with COMT Val158Met polymorphism.

OBJECTIVE: To examine, in a sample of young psychiatric patients, (n = 157, mean age 17.01 years (SD = 3.6)) whether i) age at first cannabis use and age at emergence of psychiatric disorders are related and ii) such a relationship is modulated by the Val158Met polymorphism in the COMT gene. METHOD: Cannabis use profiles and COMT Val158Met genotypes were obtained from 80 inpatients with schizophrenia-spectrum disorders and 77 inpatients with other non-psychotic disorders. RESULTS: First, age at first cannabis use correlates with age at onset in both schizophrenia-spectrum and other psychiatric disorder groups: those who started using cannabis earlier had an earlier age at onset of psychiatric disorders. Second, the distribution of the Val158Met genotypes was not different either between diagnosis groups or between cannabis users and non-users. Third, an interaction between Val158Met genotypes and cannabis use was observed specifically on age at emergence of psychotic disorders, with Val/Val genotype carriers showing an earlier age at onset than Met carriers. CONCLUSION: Our results suggest the importance of brain maturation timing in which exposure to cannabis occurs. The COMT Val158Met genotype seems to modulate the association between cannabis and age at onset of psychotic disorders. These results are consistent with previous studies.

[Description of an arthroscopic and percutaneous technique to repair posterolateral corner knee lesions]. / Descripción de una técnica artroscópica y percutánea para la reparación de lesiones de esquina posterolateral de rodilla.

Posterolateral corner knee lesions are infrequent and very disabling. They usually occur with other ligament lesions, so historically different techniques have been used to reconstruct this kind of lesions. Most of them involve open surgery, with the Clancy procedure as one of the most popular ones. After thorough preoperative planning taking into account the patient's activities, we propose a new arthroscopic and percutaneous technique based on Clancy's procedure, using a calcaneal tendon or quadriceps allograft.

Choque cardiogénico: historia, fisiopatología e implicaciones terapeúticas: parte II / Cardiogenic shock: history, pathophysiology and therapeutical implications. Part II

El choque cardiogénico es la principal causa de muerte entre los pacientes que presentan un síndrome coronario agudo. Después de la revisión histórica y de los conceptos fisiológicos y fisiopatológicos de esta condición clínica expuesta en la primera parte, se revisa su abordaje terapéutico, principalmente la revascularización de emergencia con angioplastía o cirugía.