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Concern exists about the risk of nephrotoxicity using tenofovir (TDF) in HIV-infected patients. We performed a retrospective case-control study including 122 consecutive TDF-naive patients who started treatment with TDF-containing regimens and 194 patients receiving antiretroviral therapy with other antiretroviral drugs. During a 12-month observation period 5 (4.1%) patients in the TDF group versus 1 (0.5%) in the control group developed grade 1 or higher serum creatinine elevations (p = 0.018). Only 2 (1.6%) patients discontinued TDF treatment as a result of serum creatinine level elevations. In 4 of the 5 patients developing creatinine elevations TDF was combined with lopinavir-ritonavir. The use of TDF in clinical practice during a 12-month period is associated with low risk of mild renal failure. Further studies to assess long-term renal safety of this drug are needed.

Purpose. To report a case of hemiretinal artery occlusion in a child with dextrocardia, visceral heterotaxia, and secondary polycythemia. Methods. Complete clinical examination, fundus photography, and retinal fluorescein angiography were performed. Laboratory testing included complete blood cell count, homocysteine, protein c, protein s, activated protein s, methyltetrahydrofolate and homocysteine activator genes, factor leiden V gene, antithrombin III, and activated protein c resistance. In addition, transthoracic and transesophageal echocardiogram and cardiac catheterism were performed. Results. We report an 11-year-old boy with a sudden, painless visual loss in his right eye. His past medical history is remarkable for a congenital cardiac disease. He presented with vision of light perception in the right eye and a relative afferent pupillary defect. Fundus findings included a macular cherry-red spot and inferior hemiretinal whitening consistent with hemiretinal artery occlusion. Laboratory testing showed increased red blood cell (RBC) count, hemoglobin, and hematocrit. The patient was treated with four phlebotomies with improvement of RBC count and after one month reperfusion of the retina and a visual acuity of 20/200 were observed. Thrombophilia and cardiac screening were negative, except for secondary polycythemia. Conclusion. Hemiretinal artery occlusion is extremely rare in children and is often associated with congenital cardiac disease and hypercoagulative states.

El presente artículo muestra la implementación de la plataforma educativa Classroom, aplicada a la educación, para ofrecer a los estudiantes de educación superior herramientas que empleen alternativas de aprendizaje, portabilidad y  colaboración en las actividades escolares. En este trabajo se reflejan las ventajas y  características de Classroom plataforma, utilizada como recurso tecnológico vinculado al curso presencial de Introducción a la Computación en el Centro Universitario de los Lagos de la Universidad de Guadalajara. Pretendiendo reforzar en los estudiantes el uso y empleo de las nuevas tecnologías; donde los docentes de manera particular podrán evaluar las ventajas de esta plataforma (Classroom) sobre Moodle que de igual manera proporciona a educadores, administradores y estudiantes un sistema integrado para crear ambientes de aprendizaje personalizados. PALABRAS CLAVE: plataformas educativas; desarrollo de habilidades tecnológicas; educación superior. EDUCATION 4.0: APPROACHING A NEW WAY TO LEARN WITH ONLINE TOOLS ABSTRACT This article shows the implementation of the Classroom educational platform, applied to education to offer students of university education tools that employ alternatives of learning,  portability and collaboration in school activities. This work reflects the advantages and characteristics of Classroom platform, used as a technological resource linked to the classroom course of Introduction to Computing in the Centro Universitario de los Lagos. Intending to reinforce in students the use it and use of new technologies; Where teachers in a particular way, will be able to evaluate the advantages of Classroom vs Moodle that equally provides educators, administrators and students an integrated system to create customized learning environments. KEYWORDS: educational platforms; development of technological skills; higher education.