1H-NMR glycoprotein analysis: An Advanced approach for inflammatory diseases diagnosis

La inflamació és una resposta biològica complexa d'un organisme davant d'estímuls de diversa etiologia. Durant la resposta inflamatòria es produeix una variació en les concentracions de certes proteïnes presents en plasma anomenades “proteïnes de fase aguda”. La majoria d'aquestes proteïnes són proteïnes glicadas. El procés de glicosilació de proteïnes augmenta en resposta a citocines proinflamatòries i es caracteritza per la unió d'un o diversos monosacàrids (com són GlcNAc, GalNAC i Neu5Ac, entre d'altres) a la cadena d'aminoàcids de la proteïna. Actualment hi ha un interès creixent en el descobriment de nous biomarcadors capaços d'avaluar el grau d'inflamació sistèmica degut, en part, a la gran variabilitat intraindividual que presenten els marcadors actualment utilitzats en clínica, com és la PCR. Durant els últims anys la tecnologia d'alt rendiment RMN s'ha convertit en una eina cada vegada més utilitzada en la pràctica clínica a causa dels seus grans avantatges. Un exemple d'això són els tests avançats de lipoproteïnes (ex. Liposcale a Biosfer Teslab o Lipoprofile en Labcorp). En aquesta tesi presentem un mètode de quantificació de glicoproteïnes basat en RMN amb la finalitat de determinar el seu interès clínic. A diferència d'altres mètodes de RMN descrits en la literatura que quantifiquen GlycA i GlycB, corresponents a la concentració dels grups acetil dels residus GlcNAc, GalNac i Neu5AC, nosaltres vam presentar nous paràmetres no descrits anteriorment com són GlycF i les ràtios H / W de GlycA i GlycB, que han demostrat estar fortament associats al grau d'inflamació. Els resultats obtinguts en els estudis presentats en aquesta tesi són prometedors des del punt de vista clínic i metodològic. El perfilat de glicoproteïnes a través de 1H-NMR llança un nou paradigma encoratjador per a la seva futura incorporació al diagnòstic clínic.La inflamación es una respuesta biológica compleja de un organismo frente a estímulos de diversa etiología. Durante la respuesta inflamatoria se produce una variación en las concentraciones de ciertas proteínas presentes en plasma llamadas proteínas de fase aguda. La mayoría de estas proteínas son proteínas glicadas. El proceso de glicosilación de proteínas aumenta en respuesta a citoquinas proinflamatorias y se caracteriza por la unión de uno o varios monosacáricos (como son GlcNAc, GalNAC y Neu5Ac, entre otros) a la cadena de aminoácidos de la proteína. Actualmente existe un creciente interés en el descubrimiento de nuevos biomarcadores capaces de evaluar el grado de inflamación sistémica debido en parte a la gran variabilidad intraindividual que presentan los marcadores actualmente utilizados en clínica como es la PCR. Durante los últimos años la tecnología de alto rendimiento RMN se ha convertido en una herramienta cada vez más utilizada en la práctica clínica debido a sus grandes ventajas. Un ejemplo de ello son los test avanzados de lipoproteínas (ej. Liposcale en Biosfer Teslab o Lipoprofile en Labcorp). En esta tesis presentamos un método de cuantificación de glicoproteínas basado en RMN con el fin de determinar su interés clínico. A diferencia de otros métodos de RMN descritos en la literatura que cuantifican GlycA y GlycB, correspondientes a la concentración de los grupos acetilo de los residuos GlcNAc, GalNac y Neu5AC, nosotros presentamos nuevos parámetros no descritos anteriormente como son GlycF y los ratios H/W de GlycA y GlycB, que han demostrado estar fuertemente asociados al grado de inflamación. Los resultados obtenidos en los estudios presentados en esta tesis son prometedores desde el punto de vista clínico y metodológico. El perfilado de glicoproteínas a través de 1H-NMR, lanza un nuevo paradigma alentador para su futura incorporación en el diagnostico clínicoInflammation is a complex biological response of an organism to a stimulus of diverse aetiology. During the inflammatory response there is a variation in the concentrations of certain proteins present in plasma called acute phase proteins. Most of these proteins are glycated proteins. The process of protein glycation increases in response to pro-inflammatory cytokines and is characterized by the binding of one or more monosaccharides (such as GlcNAc, GalNAC and Neu5Ac, among others) to the amino acid chain of the protein. Currently there is a growing interest in the discovery of new biomarkers capable of evaluating the degree of systemic inflammation due in part to the great intra-individual variability that present the markers currently used in clinical such as CRP. In recent years, high-performance NMR technology has become an increasingly used tool in clinical practice due to its great advantages. An example of this are the advanced lipoprotein tests (e.g. Liposcale in Biosfer Teslab or Lipoprofile in Labcorp). In this thesis we present a method of quantification of glycoproteins based on NMR in order to determine their clinical interest. Unlike other NMR methods described in the literature that quantify GlycA and GlycB, corresponding to the concentration of the acetyl groups of GlcNAc, GalNac and Neu5AC residues, we present new parameters not previously described such as GlycF and the H/W ratios of GlycA and GlycB, which have been shown to be strongly associated with the degree of inflammation. The results obtained in the studies presented in this thesis are promising from a clinical and methodological point of view. The profiling of glycoproteins through 1H-NMR, launches an encouraging new paradigm for its future incorporation in clinical diagnosis

Análisis de las competencias del docente para la identificación del alumnado con altas capacidades

Hoy día, las altas capacidades es un tema muy relevante en las escuelas, ya que un gran número de docentes debe hacer frente a la detección de estos alumnos. La elección de nuestro tema viene dada por la necesidad de concienciar a los docentes sobre las necesidades de este tipo de alumnado pudiendo ofrecer actuaciones adaptadas a sus características. Nuestro trabajo de investigación trata sobre la formación docente para la detección del alumnado con altas capacidades, ya que consideramos que la mayoría de docentes no tienen los conocimientos para poder hacerlo. Este trabajo de investigación tiene como propósito analizar la formación del docente en altas capacidades. Además, se exponen aclaraciones sobre los conceptos, las características, teorías y falsas creencias en relación a este alumnado junto con aspectos relacionados con la detección y las respuestas educativas que se debe dar ante un alumnado con altas capacidades. Para ello, nos hemos centrado en docentes de diferentes colegios de carácter público, concertado y privado, situados en diferentes zonas de la provincia de Sevilla. La metodología utilizada ha sido mixta, fortaleciendo ambos tipos de investigación, mediante entrevistas y cuestionarios. Una vez obtenidos los resultados, los hemos analizado, consiguiendo dar respuesta a los problemas planteados.Nowadays, high capacities is a very important issue in schools, because a large number of teachers must deal with the detection of students with high abilities. The choice of our theme is given by the need to educate teachers about the needs of this type of student so that performances adapted to their characteristics are offered. Our research work is about teacher training for the detection of students with high abilities, since we believe that most teachers do not have the knowledge to do so. The purpose of this research work is to analyze the teacher's training regarding high abilities. In addition, clarifications are provided on the concepts, characteristics, theories and false beliefs in relation to these students along with aspects related to detection and educational responses that should be given to students with high intellectual abilities. For this, we have focused on teachers from different schools of a public, concerted and private, located in different areas of the province of Seville. The methodology used has been mixed, strengthening both types of research, through interviews and questionnaires. Once the results have been obtained, we have analyzed them, managing to respond to the problems posed. Thanks to this research work, we have been able to know the training and check if the teachers have the knowledge to work with students who have the high capacities in early childhood education, knowing the importance of early detection.Universidad de Sevilla.Grado en Educación Infanti

Detection of AI-created images using pixel-wise feature extraction and convolutional neural networks

Generative AI has gained enormous interest nowadays due to new applications like ChatGPT, DALL E, Stable Diffusion, and Deepfake. In particular, DALL E, Stable Diffusion, and others (Adobe Firefly, ImagineArt, etc.) can create images from a text prompt and are even able to create photorealistic images. Due to this fact, intense research has been performed to create new image forensics applications able to distinguish between real captured images and videos and artificial ones. Detecting forgeries made with Deepfake is one of the most researched issues. This paper is about another kind of forgery detection. The purpose of this research is to detect photorealistic AI-created images versus real photos coming from a physical camera. Id est, making a binary decision over an image, asking whether it is artificially or naturally created. Artificial images do not need to try to represent any real object, person, or place. For this purpose, techniques that perform a pixel-level feature extraction are used. The first one is Photo Response Non-Uniformity (PRNU). PRNU is a special noise due to imperfections on the camera sensor that is used for source camera identification. The underlying idea is that AI images will have a different PRNU pattern. The second one is error level analysis (ELA). This is another type of feature extraction traditionally used for detecting image editing. ELA is being used nowadays by photographers for the manual detection of AI-created images. Both kinds of features are used to train convolutional neural networks to differentiate between AI images and real photographs. Good results are obtained, achieving accuracy rates of over 95%. Both extraction methods are carefully assessed by computing precision/recall and F1-score measurements

Efectividad cualitativa del ganado caprino en la dispersión de especies de frutos secos y carnosos

[ES] mediterráneo: Cistus salviifolius, C. libanotis, Halimum halimifolium H. calycinum, Myrtus communis, Phillyrea angustifolia, Pistacia lentiscus y Rhamnus lycioides. Frutos de estas especies fueron ofrecidos a seis cabras estabuladas individualmente. Tras la ingestión, se procedió a recoger las heces a intervalos de 24 horas. En las heces recuperadas, se determinó el porcentaje de pérdida de semillas (masticación y digestión), distribución de la recuperación de las semillas en el tiempo y la eficacia germinativa tras el paso por el tracto digestivo. Menos del 30% de las semillas ingeridas fueron recuperadas, con diferencias significativas entre las especies. C. salviifolius presentó el mayor porcentaje de recuperación (casi 30%) y P. lentiscus el menor (0%). Esta tasa de recuperación estuvo significativamente relacionada positivamente con la dureza de las semillas. En la mayoría de las especies, la máxima tasa de recuperación se dio entre las 24-72 horas tras la ingestión. El paso por el intestino de las cabras aumentó significativamente la germinación de C. salviifolius, H. halimifolium, H. calycinum y P. angustifolia. Los resultados de este estudio pusieron de manifiesto que el ganado caprino puede favorecer la dispersión de la mayoría de las semillas de especies cistáceas estudiadas e inhibir la dispersión de semillas de frutos carnosos. El conocimiento de los mecanismos de dispersión por ungulados generalistas son aspectos importantes a tener en cuenta en los planes de gestión, restauración y conservación de los ecosistemas Mediterráneos[EN] We evaluated the role of domestic goats as seed dispersers of eight representative Mediterranean shrub species (Cistus salviifolius, C. libanotis, Halimum halimifolium, H. calycinum, Myrtus communis, Phillyrea angustifolia, Pistacia lentiscus and Rhamnus lycioides). Six female goats of similar size and age were fed with fruits of study species. Following fruits ingestion by goats, total faeces were collected at 24-h intervals. The seeds retrieved were tested for germination and viability, along with seeds not eaten by the goats. Less than 30% of the seeds eaten were retrieved from the dung, with significant differences between species. C. salviifolius showing the maximum recovery percentage (30%), and P. lentiscus the minimum (0%). Seed recovery was significantly related to seed hardness. In most species, the maximum amount of seeds recovered occurred 24-72 h after ingestion. The passage through the goat gut significantly increased seed germination in C. salviifolius, H. halimifolium, H. calycinum and P. angustifolia. The results of this study show that goats can potentially favour (Cistaceae) or inhibit (fleshy fruits) seed dispersal of browsed Mediterranean shrub species. Therefore, these results should be considered when developing conservation and restoration plans of natural vegetation in Mediterranean areasPeer reviewe

Nuevo hospedador y distribución del parásito de mosquitos Strelkovimermis spiculatus

Strelkovimermis spiculatus, Poinar and Camino 1986 (Nematoda: Mermithidae) was found parasitizing some mosquito genera like Aedes (Ochlerotatus), Culex and Psorophora. In a mosquito distribution project in Buenos Aires, Argentina, we found nematodes infecting mosquito larvae in natural breeding sites in the outskirts of Mar del Plata city. The aim of this work was to identify this parasite in this distribution area and determine the mosquito species host. COI and 18S rRNA-ITS1-5.8S rRNA-ITS2-28S rRNA fragment genes were described and were used for molecular identification of this nematode, confirming the morphological diagnostic traits. In this report a new host of S. spiculatus, the mosquito larvae of Culex eduardoi was detected, expanding the southeastern distribution.Fil: Lopez, Rocio de la Paz. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones En Biodiversidad y Biotecnología; Argentina. Fundación para Investigaciones Biológicas Aplicadas; ArgentinaFil: Díaz Nieto, Leonardo Martín. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones En Biodiversidad y Biotecnología; Argentina. Fundación para Investigaciones Biológicas Aplicadas; ArgentinaFil: Berón, Corina Marta. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones En Biodiversidad y Biotecnología; Argentina. Fundación para Investigaciones Biológicas Aplicadas; Argentin

The Efficacy of Therapeutic Respiratory Muscle Training Interventions in People with Bronchiectasis: A Systematic Review and Meta-Analysis

Background: Respiratory muscle dysfunction is an important health problem with high morbidity and mortality and associated costs in patients with bronchiectasis (BC). The aim of this study was to analyse the effects of therapeutic respiratory muscle training (RMT) interventions on improving sputum clearance, ventilator function, muscle strength and functional capacity in BC. Methods: Systematic review and meta-analysis were conducted following PRISMA guidelines. Two independent investigators searched using several electronic databases. The methodological quality of nine studies was assessed using the PEDro scale. Study selection/eligibility criteria: The following were included: randomised controlled trials, randomised crossover trials and pilot studies of patients with BC that used the intervention as RMT (inspiratory/expiratory) and evaluations of respiratory muscle strength (maximal expiratory pressure/maximal inspiratory pressure). This systematic review was registered in PROSPERO (CRD42017075101). Nine studies were included, five of which obtained an A recommendation grade, three with B, and one with C. Study quality was poor to good (mean PEDro Score of 6.375 out of 10). Studies had small sample sizes (8-98). Results show improvements on PImax in favour of therapeutic respiratory muscle training intervention (MD = 6.08; 95% CI = 1.38, 10.77; p < 0.01; I-2 = 92%). However, high heterogeneity was identified on meta-analysis

Environmental Pollutant Hexachlorobenzene Induces Hypertension In a Rat Model

Hexachlorobenzene (HCB) is a dioxin-like environmental pollutant, widely distributed in the environment. New research links exposure to high levels of persistent organic environmental toxicants to cardiovascular disease, however little is known about the effect of HCB on vascular function and on blood pressure. The purpose of the present study was to evaluate biochemical and cardiovascular changes resulting from subchronic HCB exposure. Adult female Sprague-Dawley rats were treated with vehicle or HCB (5 or 500 mg/kg b.w) for 45 days. Systolic blood pressure (BP), recorded by tail cuff plethysmography, was significantly increased at 35, 40 and 45 days of 500 mg/kg HCB-treatment. HCB (500 mg/kg) increased arterial thickness, while both 5 and 500 mg/kg HCB decreased proliferating cell nuclear antigen (PCNA) protein levels and cellular nuclei in abdominal aortas indicating a hypertrophic process. Also, aortas from both groups of HCB-treated rats presented higher sensitivity to noradrenalin (NA) and a significant decrease in maximum contractile response. Arteries from 500 mg/kg HCB-treated rats showed a significant increase in the levels of transforming growth factor-β1 (TGF-β1) mRNA and angiotensin II type1 receptor (AT1), and a significant decrease in estrogen receptor alpha (ERα), endothelial nitric oxidide synthase (eNOS) protein expression and deiodinase II (DII) mRNA levels. In conclusion, we have demonstrated for the first time that subchronic HCB administration significantly increases BP and alters associated cardiovascular parameters in rats. In addition, HCB alters the expression of key vascular tissue molecules involved in BP regulation, such as TGF-β1, AT1, ERα, eNOS and DII.Fil: Castilla Lozano, Maria del Rocio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Cardiológicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas; ArgentinaFil: Asuaje, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Estudios Inmunológicos y Fisiopatológicos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Estudios Inmunológicos y Fisiopatológicos; ArgentinaFil: Riviere, Stephanie. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Cardiológicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas; ArgentinaFil: Romero, Caimi Giselle. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Bioquímica Humana; ArgentinaFil: Martín, Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Estudios Inmunológicos y Fisiopatológicos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Estudios Inmunológicos y Fisiopatológicos; ArgentinaFil: Cao, Gabriel Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Cardiológicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas; ArgentinaFil: Kleiman, Diana Leonor. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Bioquímica Humana; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Milesi, Verónica. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Estudios Inmunológicos y Fisiopatológicos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Estudios Inmunológicos y Fisiopatológicos; ArgentinaFil: Alvarez, Laura. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Bioquímica Humana; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Frailty prevalence and slow walking speed in persons age 65 and older: Implications for primary care

Background: Frailty in the elderly increases their vulnerability and leads to a greater risk of adverse events. According to various studies, the prevalence of the frailty syndrome in persons age 65 and over ranges between 3% and 37%, depending on age and sex. Walking speed in itself is considered a simple indicator of health status and of survival in older persons. Detecting frailty in primary care consultations can help improve care of the elderly, and walking speed may be an indicator that could facilitate the early diagnosis of frailty in primary care. The objective of this work was to estimate frailty-syndrome prevalence and walking speed in an urban population aged 65 years and over, and to analyze the relationship between the two indicators from the perspective of early diagnosis of frailty in the primary care setting. Methods: Population cohort of persons age 65 and over from two urban neighborhoods in northern Madrid (Spain). Cross-sectional analysis. Bivariate and multivariate analysis with binary logistic regression to study the variables associated with frailty. Different cut-off points between 0.4 and 1.4 m/s were used to study walking speed in this population. The relationship between frailty and walking speed was analyzed using likelihood ratios. Results: The study sample comprised 1,327 individuals age 65 and older with mean age 75.41 ± 7.41 years; 53.4% were women. Estimated frailty in the study population was 10.5% [95% CI: 8.9-12.3]. Frailty increased with age (OR = 1.14; 95% CI: 1.10-1.19) and was associated with poor self-rated health (OR = 2.52; 95% CI: 1.43-4.44), number of drugs prescribed (OR = 1.17; 95% CI: 1.08-1.26) and disability (OR = 6.58; 95% CI: 3.92-11.05). Walking speed less than 0.8 m/s was found in 42.6% of cases and in 56.4% of persons age 75 and over. Walking speed greater than 0.9 m/s ruled out frailty in the study sample. Persons age 75 and older with walking speed <0.8 m/s are at particularly high risk of frailty (32.1%). Conclusions: Frailty-syndrome prevalence is high in persons aged 75 and over. Detection of walking speed <0.8 m/s is a simple approach to the diagnosis of frailty in the primary care settingThis project is partially funded with a grant from the Ministry of Health, Instituto de Salud Carlos III (FIS: PI 09/2143) and RETICEF (Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad, RD 06/0013/101

Diversity of Potassium Channels in Human Umbilical Artery Smooth Muscle Cells: A Review of Their Roles in Human Umbilical Artery Contraction

Through their control of cell membrane potential, potassium (K(+)) channels are among the best known regulators of vascular tone. This article discusses the expression and function of K(+) channels in human umbilical artery smooth muscle cells (HUASMCs). We review the bibliographic reports and also present single-channel data recorded in freshly isolated cells. Electrophysiological properties of big conductance, voltage- and Ca(2+)-sensitive K(+) channel and voltage-dependent K(+) channels are clearly established in this vessel, where they are involved in contractile state regulation. Their role in the maintenance of membrane potential is an important control mechanism in the determination of the vessel diameter. Additionally, small conductance Ca(2+)-sensitive K(+) channels, 2-pore domains K(+) channels and inward rectifier K(+) channels also appear to be present in HUASMCs, while intermediate conductance Ca(2+)-sensitive K(+) channels and ATP-sensitive K(+) channels could not be identified. In both cases, additional investigation is necessary to reach conclusive evidence of their expression and/or functional role in HUASMCs. Finally, we discuss the role of K(+) channels in pregnancy-related pathologies like gestational diabetes and preeclampsia.Fil: Martín, Pedro. Universidad Nacional de la Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas. Grupo de Investigación en Fisiología Vascular; ArgentinaFil: Rebolledo, Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de la Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas. Grupo de Investigación en Fisiología Vascular; ArgentinaFil: Roldan Palomo, Ana Rocio. Universidad Nacional de la Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas. Grupo de Investigación en Fisiología Vascular; ArgentinaFil: Moncada, Melisa. Universidad Nacional de la Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas. Grupo de Investigación en Fisiología Vascular; ArgentinaFil: Piccinini, Luciano. Universidad Nacional de la Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas. Grupo de Investigación en Fisiología Vascular; ArgentinaFil: Milesi, Verónica. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de la Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas. Grupo de Investigación en Fisiología Vascular; Argentin

¿Crisis convulsiva o maltrato infantil? Seizure or child abuse?

More child abuse cases are reported in Peru every year; however, there is no official report that describes the actual incidence, especially of the most vulnerable population such as infants. Signs of physical abuse generally involve brain injury and constitute shaken baby syndrome or pediatric abusive head trauma, which is a challenging diagnostic challenge.&nbsp;A 3-month-old infant is admitted to the emergency room for 30-minute generalized tonic-clonic seizures. On physical examination, the presence of a bony callus on the right clavicle was striking. A brain tomography and magnetic resonance imaging were performed, showing hyperintense lesions in the white matter, non-contrast enhancers, limited diffusion, and a bilateral subdural collection. Together, a bone survey was taken, which revealed multiple fractures in different areas of the body and suspecting the case of child abuse, so the relevant authorities (medical and judicial) were notified. Currently, the infant is in the custody of the Child Protection Unit, pending the definition of her final custody.Cada año se informan más casos de maltrato infantil en el Perú, sin embargo, no hay un reporte oficial que describa la incidencia real, en especial de la población más vulnerable como son los lactantes. Los signos de abuso físico generalmente implican lesiones cerebrales y constituyen el síndrome del bebé sacudido o traumatismo craneal abusivo pediátrico, que representa todo un desafío diagnóstico.&nbsp;Lactante de 3 meses ingresa a emergencia por convulsiones tónico clónicas generalizadas de 30 minutos de duración. En el examen físico llamó la atención la presencia de un callo óseo en la clavícula derecha. Se realizó una tomografía y una resonancia magnética cerebral, que muestran lesiones hiperintensas en la sustancia blanca, no captadoras de contraste, con difusión limitada y una colección subdural bilateral. Conjuntamente, se tomó un survey óseo donde se evidencia múltiples fracturas en distintas áreas corporales. Ante la sospecha del caso de maltrato infantil, se comunicó a las autoridades pertinentes (médicas y judiciales). Actualmente, la lactante se encuentra bajo custodia de la Unidad de Protección al Menor a la espera de la definición de su custodia final