[Geographic variability in prescribing antibiotics in the pediatric population of Castille and León during 2001-2005]. / Variabilidad geográfica de la prescripción de antibióticos en la población pediátrica de Castilla y León durante los años 2001 a 2005.

The aim of this study was to determine if there were differences in the antibiotic consumption among the pediatric population of the eleven Primary Health Care centers in the Community of Castilla Leon during the years 2001-2005 and to analyze the possible causes. Data of non-hospital antibiotic consumption in the pediatric population provided the amount of antibiotics billed in the Health Service of the area of Castilla and Leon (central region of Spain). The data was analyzed according to the Anatomic Therapeutic Chemical Classification System (ATC) and expressed as defined daily doses per 1000 inhabitants per day (DID). There were statistically significant differences in the use of antibiotics, varying 8.3 DID between the area with the highest rate (24.86 DID in Leon) and the area with the lowest rate (16.56 DID in Soria). The temporal fluctuations were great and varied especially in Segovia. The pattern of prescribing also varied. The use of penicillin in combination with beta-lacatamase inhibitors varied by a factor of almost three times between Burgos and Segovia. Segovia showed the best management in antibiotic prescriptions with data showing low consumption based on prescribing recommendations. Data from Soria showed low consumption but patterns of misuse in regard to protocols and prescribing. There was wide quantitative and qualitative variability of antibiotic use among the primary health care centers in the region of Castilla and Leon. More detailed studies by age groups, welfare pressure and indication are needed to better understand the determinants of antibiotic use in children.

Tratamiento fisioterápico de las alteraciones posturales y reflejos orales en la parálisis cerebral infantil, y otras alteraciones neurológicas. Ayudas técnicas para la alimentación / Physiotherapy treatment of the postural changes and oral reflexes in the children cerebral palsy and other neurological changes. Aids to feeding

En este trabajo se pretende describir las alteraciones posturales más frecuentes en la parálisis cerebral infantil (PCI), traumatismo craneoencefálico (TCE), y en la hemiplejia; y analizar cómo influyen éstas en las alteraciones orofaciales, presentes en la mayoría de estos pacientes. Se presenta una valoración de fisioterapia analítica de la disfunción orofacial, y se muestra un posible tratamiento de fisioterapia, adaptable a las diferentes alteraciones presentes en estos pacientes (AU)

Cosmic ray hits in the central nervous system at solar maximum.

It has been suggested that a manned mission to Mars be launched at solar maximum rather than at solar minimum to minimize the radiation exposure to galactic cosmic rays. It is true that the number of hits from highly ionizing particles to critical regions in the brain will be less at solar maximum, and it is of interest to estimate how much less. We present here calculations for several sites within the brain from iron ions (z = 26) and from particles with charge, z, greater than or equal to 15. The same shielding configurations and sites in the brain used in an earlier paper for solar minimum are employed so that direct comparison of results between the two solar activity conditions can be made. A simple pressure-vessel wall and an equipment room onboard a spacecraft are chosen as shielding examples. In the equipment room, typical results for the thalamus are that the probability of any particles with 7 greater than or equal to 15 and from 2.3 percent to 1.3 percent for iron ions. The extra shielding provided in the equipment room makes little difference in these numbers. We conclude that this decrease in hit frequency (less than a factor of two) does not provide a compelling reason to avoid solar minimum for a manned mission to Mars. This conclusion could be revised, however, if a very small number of hits is found to cause critical malfunction within the brain.

Cosmic ray hit frequencies in critical sites in the central nervous system.

One outstanding question to be addressed in assessing the risk of exposure to space travelers from galactic cosmic rays (GCR) outside the geomagnetosphere is to ascertain the effects of single heavy-ion hits on cells in critical regions of the central nervous system (CNS). As a first step toward this end, it is important to determine how many "hits" might be received by a neural cell in several critical CNS areas during an extended mission outside the confines of the earth's magnetic field. Critical sites in the CNS: the macula, and an interior brain point (typical of the genu, thalamus, hippocampus and nucleus basalis of Meynert) were chosen for the calculation of hit frequencies from galactic cosmic rays for a mission to Mars during solar minimum (i.e., at maximum cosmic-ray intensity). The shielding at a given position inside the body was obtained using the Computerized Anatomical Man (CAM) model, and a radiation transport code which includes nuclear fragmentation was used to calculate yearly fluences at the point of interest. Since the final Mars spacecraft shielding configuration has not yet been determined, we considered the minimum amount of aluminum required for pressure vessel-wall requirements in the living quarters of a spacecraft, and a typical duty area as a pressure vessel plus necessary equipment. The conclusions are: (1) variation of the position of the "target site" within the head plays only a small role in varying hit frequencies; (2) the average number of hits depends linearly on the cross section of the critical portion of the cell assumed in the calculation; (3) for a three-year mission to Mars at solar minimum (i.e., assuming the 1977 spectrum of galactic cosmic rays), 2% or 13% of the "critical sites" of cells in the CNS would be directly hit at least once by iron ions, depending on whether 60 micrometers2 or 471 micrometers2 is assumed as the critical cross sectional area; and (4) roughly 6 million out of some 43 million hippocampal cells and 55 thousand out of 1.8 million thalamus cell nuclei would be directly hit by iron ions at least once on such a mission for space travelers inside a simple pressure vessel. Also, roughly 20 million out of 43 million hippocampal cells and 230 thousand out of 1.8 million thalamus cell nuclei would be directly hit by one or more particles with z > or = 15 on such a mission.