Gastric outlet obstruction due to an intragastric balloon in a patient returning from the Caribbean.

Key Clinical Message: Gastric outlet obstruction can be a dangerous complication of intragastric balloons, as it can result in severe metabolic alkalosis. As weight loss procedures and medical tourism become more popular, physicians should have a high index of suspicion for complications of invasive procedures, particularly in returning travelers. Abstract: Intragastric balloons for weight loss have decreased in frequency in the United States. However, they are still frequent in low- and middle-income countries. Severe complications occur in less than 3% of patients who undergo this procedure. Herein, we present a case of gastric outlet obstruction, severe metabolic alkalosis, and refeeding syndrome in a patient returning from the Dominican Republic. She presented with 2 weeks of emesis and obstipation, followed by a pre-syncope and altered mental status. An intragastric mass was observed on computerized tomography, which was characterized as an intragastric balloon and retrieved endoscopically. All metabolic derangements were corrected, and the patient improved without sequelae. As weight loss procedures and medical tourism become more popular, physicians should have a high index of suspicion for complications of invasive procedures, particularly in returning travelers.

[Psychostimulants consumption for neuroenhancement among medical students from National University of Córdoba]. / Consumo de psicoestimulantes como potenciadores cognitivos por estudiantes de Medicina de Universidad Nacional de Córdoba.

Objectives: To determine prevalence of psychostimulants (PS) consumption among medical students of National University of Córdoba (UNC) trying to improve their concentration and alertness when studying as well as potentially related factors. Methods: Methods: urvey was designed. Absolute and relative frequency was calculated for qualitative variables; and mead, median, mode and range were obtained for quantitative ones. InfoStat software was used and Chi-square and Student t tests were applied when appropriate. Results: 99,15% consumed a PS, being coffee predominant in 93,05%, mate 91,02%, tea 74,75%, chocolate 70%, soft drinks 58,64%, energy drinks 37,97%, tobacco 22,71%, Cafiaspirina® 13%, Arriba!quenotebochen® 9%, coca leaves 8%. 8,3% referred modafinil and methylphenidate consumption and 45% of them perceived an improvement of their academic performance after this. Consuming these drugs was associated to masculine sex (p=0,0275), older age, (p˂0,0001), not professing any religion (p=0,0004), higher courses (p˂0,0001), more academic difficulty (p˂0,0001), delay in the degree (p=0,0009), less than 4 hours of sleep before and exam (p=0,0002), psychological or psychiatric diagnosis (p=0,0017), anxiety disorder (p=0,0068), depressive disorder (p=0,0275) and higher consumption level of caffeine (p˂0,0268). No association was found with working, practicing sports or living with their families. Conclusion: PS consumption to improve academic performance is a usual practice among the students who integrated the sample.

Objetivos: Determinar prevalencia del consumo de psicoestimulantes (PS) por estudiantes de Medicina de la Universidad Nacional de Córdoba (UNC) buscando mejorar su concentración y nivel de alerta al estudiar, y potenciales factores asociados. Métodos: Estudio epidemiológico observacional, analítico, prospectivo, de corte transversal con abordaje cuali-cuantitativo. La población estuvo conformada por todos los estudiantes de Medicina de la UNC de 2018. Se elaboró una encuesta anónima de 23 preguntas. Se determinó frecuencia absoluta y porcentual para las variables cualitativas y para las cuantitativas se obtuvo media, moda, mediana y rango. Se empleó el programa InfoStat y se aplicaron las pruebas Chi-cuadrado y t de Student según correspondiera. Resultados: El 99,15% consumió algún PS con predominio de café en el 93,05%, mate 91,02%, té 74,75%, chocolate 70%, gaseosas colas 58,64%, bebidas energizantes 37,97%, tabaco 22,71%, Cafiaspirina® 13%, Arriba!quenotebochen® 9%, hojas de coca 8%. El 8,3% refirió consumo de modafinilo y/o metilfenidato y el 45% de estos percibió que sus resultados académicos mejoraron tras el consumo. El consumo de estos fármacos se asoció con sexo masculino (p=0,0275), mayor edad (p˂0,0001), no practicar ninguna religión (p=0,0004), mayor avance en la carrera (p˂0,0001), mayor dificultad académica (p˂0,0001), atraso en la carrera (p=0,0009), menos de 4 horas de sueño pre-examen (p=0,0002), diagnóstico psicológico o psiquiátrico (p=0,0017), trastorno ansioso (p=0,0068), trastorno depresivo (p=0,0275) y mayor consumo de cafeína (p˂0,0268). No se encontró asociación con trabajo, deporte o convivientes. Conclusiones: El consumo de PS como potenciadores cognitivos es una práctica habitual entre los estudiantes que conformaron la muestra.