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The major finding of the present study is that the ultrastructural organization of the neuromuscular synapse can be modified by a small, 4-week-long, physiological increase in the locomotor activity of the extensor digitorum longus muscle of normal adult rats trained to walk. This study measures these plastic adaptations using several synaptic morphological parameters. The observed changes in neuromuscular junctions affect both pre- and postsynaptic membranes. In particular, the presynaptic membrane densities in the active zones and the postsynaptic adaxonal membrane densities become larger, which shows that in the normal adult mammal neuromuscular junction, there is an activity-dependent modulation of the neurotransmission-related structures in response to slight physiologic functional demands. The nature and magnitude of these changes are discussed.

Intervertebral disc protrusions are rare in children and adolescents, and we report our experience of 9 cases, all of whom were girls. Diagnostic problems are common and objective findings dominate the clinical picture at this age. Eight patients were treated by operation; no spinal fusions were carried out. Six patients with a follow up of from 6 to 15 years were reviewed. There were no recurrences, but episodes of low back did occur. Radiographs showed a variable diminution in the height of the disc in every case.

Objective: This Case Study describes the experience of Rovira i Virgili University School of Medicine (URV) with the early introduction of pre-clinical skills learning in the undergraduate medical curricula to monitor and assessing these competencies as a prerequisite for medical students accessing their training in clinical settings.Course Development: A PRE-CLINICAL SKILLS course has been developed to guarantee medical student's performance in managing clinically relevant basic medical sciences to interpret clinical scenarios, to develop technical communication skills and to value professional behavior throughout the first two years of medical education. The set of pre-clinical competencies evaluated in this course as well as the corresponding assessment methods have been established according to an international reference standards review work in collaboration with the regional quality assurance agency. An integrated formative assessment is being used. Course Advantages, Added Values and Outcome Measures:Since the academic year 2009-2010 about 130 students from second-year of Medicine follows this integrated trunk-course while being enrolled in parallel in other core courses as Physiology, Anatomy, and Histology. The program doesn't include lectures but only learning activities to train and monitor the successful achievement of the pre-clinical skills by medical students. A good majority of the participants achieve readiness for start training in clinical settings. As a whole, this course is useful ensuring patient's safety by identifying weaknesses acquisition of pre-clinical skills and predicting medical students who will have difficulty during their clinical training. Conclusions:Reflecting on our experience, we believe that the named course "PRE-CLINICAL SKILLS" Fenoll-Brunet M, Piera V, Sánchez D, Lanuza M, García N, Cobos P MedEdPublish https://doi.org/10. 15694/mep.2017.000110 Page | 2 overcomes the disadvantages of the traditional teaching methods. Helping students to conceptualize rather than memorize and encouraging them to integrate clinically relevant basic medical sciences concepts and principles by training pre-clinical skills in this competence-based assessment course prior entering into clinical settings.