Cross section for inelastic neutron scattering from 193Ir at 6 MeV.

Two samples, one of natural iridium and the other of enriched 193Ir, were irradiated with a monoenergetic neutron beam of energy 6.0 MeV at the Triangle Universities Nuclear Laboratory. The product of the 193Ir [Formula: see text] Ir reaction was determined by means of measuring X-rays following electron conversion of the isomeric state at 80.2 keV in 193Ir. The cross section for inelastic neutron scattering is reported disagreeing with the literature data.

[Influence of a program of physical activity in children and obese adolescents with sleep apnea; study protocol]. / Influencia de un programa de actividad física en niños y adolescentes obesos con apnea del sueño; protocolo de estudio.

Recent studies show an alarming increase in the rate of overweight / obesity among the infant - juvenile population. Obesity in childhood is associated with a significant number of complications, such as sleep apnea syndrome, insulin resistance and type 2 diabetes, hypertension, cardiovascular disease and some cancers. It is estimated that the prevalence of sleep apnea in children is 2-3% in the general population, while in obese adolescents, varies between 13% and 66%, according to various studies. It is associated with impairment of neurocognitive function, behavior, cardiovascular system, metabolic disorders and growth. Sleep apnea is a serious public health problem that increases when children and adolescents are overweight or obese. We hypothesize that aerobic endurance exercise can be an effective treatment for obesity and apnea at the same time. The aim of this study was to determine the influence of physical activity in children and adolescents with overweight / obesity in sleep apnea. An observational, descriptive, prospective, longitudinal study will be carried out in children with sleep apnea and obesity. The universe will be made up of 60 children and adolescents aged between 10 and 18 years, attending the endocrinology service for suffering of obesity in the Hospital Clinico San Cecilio of Granada during the period September 2012-September 2013. The smple will consist of children and adolescents that meet these characteristics and to whom their parents/tutors have authorized through the informed consent. Sleep apnea in children wil be measured by polysomnography and sleep quality questionnaire. There will also be a nutritional assessment by a food frequency questionnaire and an anthropometric assessment. Among the expected results are the lower overweight and obesity in children through the physical activity program. To reduce apnea and to improve sleep quality.

Estudios recientes muestran un incremento alarmante en la tasa de sobrepeso/obesidad entre la población infanto - juvenil. La obesidad en la infancia se asocia con un importante número de complicaciones, como síndrome de apnea del sueño insulinorresistencia y diabetes tipo 2, hipertensión, enfermedad cardiovascular, algunos tipos de cáncer. Se estima que la prevalencia de apnea en niños es de un 2-3% en la población general, mientras que, en adolescentes obesos, varía entre el 13% y el 66%, según distintos estudios. Se asocia con la afectación de la función neurocognitiva, comportamiento, sistema cardiovascular, alteraciones metabólicas y del crecimiento. La apnea del sueño es un grave problema de salud pública que aumenta cuando los niños y adolescentes padecen sobrepeso y obesidad. Se postula el ejercicio de resistencia aeróbica como un tratamiento efectivo para la obesidad y la apnea de forma conjunta. El objetivo de este estudio es conocer si la actividad física en niños con sobrepeso/obesidad disminuye la apnea del sueño. Se realizará un estudio observacional, descriptivo, prospectivo, longitudinal con niños que padecen apnea del sueño y obesidad. El universo estará constituido por 60 niños y adolescentes con edades comprendidas entre 10 y 18 años que acudan a la consulta de endocrinología por tener obesidad en el Hospital Clínico San Cecilio de Granada durante el período de septiembre 2012-septiembre 2013. La muestra estará formada por niños y adolescentes que cumplan estas características y que sus padres/tutores hayan autorizado a través del consentimiento informado. La apnea del sueño se medirá en los niños mediante una polisomnografía y un cuestionario de calidad del sueño. También se hará una valoración nutricional a través de un cuestionario de frecuencia de consumo alimentario y una valoración antropométrica. De entre los resultados esperados están el bajar el sobrepeso y obesidad en los niños mediante el programa de actividad física. Disminuir la apnea y mejorar la calidad del sueño.

Influencia de un programa de actividad física en niños y adolescentes obesos con apnea del sueño; protocolo de estudio / Influence of a program of physical activity in children and adolescents obese with sleep apnea; study protocol

Estudios recientes muestran un incremento alarmante en la tasa de sobrepeso/obesidad entre la población infanto-juvenil. La obesidad en la infancia se asocia con un importante número de complicaciones, como síndrome de apnea del sueño insulinorresistencia y diabetes tipo 2, hipertensión, enfermedad cardiovascular, algunos tipos de cáncer. Se estima que la prevalencia de apnea en niños es de un 2-3% en la población general, mientras que, en adolescentes obesos, varía entre el 13% y el 66%, según distintos estudios. Se asocia con la afectación de la función neurocognitiva, comportamiento, sistema cardiovascular, alteraciones metabólicas y del crecimiento. La apnea del sueño es un grave problema de salud pública que aumenta cuando los niños y adolescentes padecen sobrepeso y obesidad. Se postula el ejercicio de resistencia aeróbica como un tratamiento efectivo para la obesidad y la apnea de forma conjunta. El objetivo de este estudio es conocer si la actividad física en niños con sobrepeso/obesidad disminuye la apnea del sueño. Se realizará un estudio observacional, descriptivo, prospectivo, longitudinal con niños que padecen apnea del sueño y obesidad. El universo estará constituido por 60 niños y adolescentes con edades comprendidas entre 10 y 18 años que acudan a la consulta de endocrinología por tener obesidad en el Hospital Clínico San Cecilio de Granada durante el período de septiembre 2012-septiembre 2013. La muestra estará formada por niños y adolescentes que cumplan estas características y que sus padres/tutores hayan autorizado a través del consentimiento informado. La apnea del sueño se medirá en los niños mediante una polisomnografía y un cuestionario de calidad del sueño. También se hará una valoración nutricional a través de un cuestionario de frecuencia de consumo alimentario y una valoración antropométrica. De entre los resultados esperados están el bajar el sobrepeso y obesidad en los niños mediante el programa de actividad física. Disminuir la apnea y mejorar la calidad del sueño (AU)

Recent studies show an alarming increase in the rate of overweight / obesity among the infant - juvenile population. Obesity in childhood is associated with a significant number of complications, such as sleep apnea syndrome, insulin resistance and type 2 diabetes, hypertension, cardiovascular disease and some cancers. It is estimated that the prevalence of sleep apnea in children is 2-3% in the general population, while in obese adolescents, varies between 13% and 66%, according to various studies. It is associated with impairment of neurocognitive function, behavior, cardiovascular system, metabolic disorders and growth. Sleep apnea is a serious public health problem that increases when children and adolescents are overweight or obese. We hypothesize that aerobic endurance exercise can be an effective treatment for obesity and apnea at the same time. The aim of this study was to determine the influence of physical activity in children and adolescents with overweight / obesity in sleep apnea. An observational, descriptive, prospective, longitudinal study will be carried out in children with sleep apnea and obesity. The universe will be made up of 60 children and adolescents aged between 10 and 18 years, attending the endocrinology service for suffering of obesity in the Hospital Clinico San Cecilio of Granada during the period September 2012-September 2013. The smple will consist of children and adolescents that meet these characteristics and to whom their parents/tutors have authorized through the informed consent. Sleep apnea in children wil be measured by polysomnography and sleep quality questionnaire. There will also be a nutritional assessment by a food frequency questionnaire and an anthropometric assessment. Among the expected results are the lower overweight and obesity in children through the physical activity program. To reduce apnea and to improve sleep quality (AU)

[Clinicoepidemiological characteristics of community-acquired pneumonia in children aged less than 6 years old]. / Características clínico-epidemiológicas de la neumonía adquirida en la comunidad en niños menores de 6 años.

INTRODUCTION: Acute respiratory infections are an important cause of consultations in primary care and hospitals. Most published epidemiological studies have analyzed pneumonia in hospitals and very few include information on primary care. MATERIAL AND METHODS: We performed a multicenter, prospective, epidemiological study in 17 primary care centers and four hospital pediatric emergency rooms. All children under 6 years of age with a clinical diagnosis of pneumonia were included. RESULTS: There were 311 patients with a mean age of 32.2 months. The incidence of community-acquired pneumonia was 3,600 cases/100,000 children/year under 6 years old in primary care centers. Of these, 136 were diagnosed in hospitals (43.7 %). The most common clinical signs and symptoms were fever (95.4 %), cough (94.4 %), tachypnea (58.2 %), and auscultation abnormalities (90.2 %). Antibiotic therapy was started in 298 patients (98 %). The most frequent antibiotic was amoxicillin-clavulanate (39.5 %), followed by cefuroxime (32.7 %) and clarithromycin (8.3 %). The most frequently isolated microorganism was respiratory syncytial virus followed by Streptococcus pneumoniae. Hospital admission was required in 15.6 % of patients. Only 24.6 % of the patients had been vaccinated with the heptavalent pneumococcal conjugate vaccine and 12.7 % of the children with underlying respiratory diseases had been vaccinated with the influenza virus vaccine. CONCLUSIONS: In our milieu, the diagnosis and treatment of community-acquired pneumonia is usually carried out in primary care and the incidence is high. Although most patients do not require hospitalization, etiological diagnosis of community-acquired pneumonia and optimal antibiotic therapy remain difficult goals to achieve.

Características clínico-epidemiológicas de la neumonía adquirida en la comunidad en niños menores de 6 años / Clinicoepidemiological characteristics of community-acquired pneumonia in children aged less than 6 years old

Introducción. Las infecciones respiratorias agudas representan una importante causa de consulta a nivel de atención primaria y hospitalaria. La mayoría de estudios epidemiológicos publicados analizan las neumonías a nivel hospitalario, siendo escasos los que incluyen el nivel de atención primaria. Material y métodos. Estudio epidemiológico, prospectivo y multicéntrico realizado en Centros de Atención Primaria y Servicios de Urgencia Hospitalaria Pediátrica. Se han incluido en el estudio todos los niños menores de 6 años con diagnóstico clínico de neumonía. Resultados. Se incluyeron 311 pacientes con una media de edad de 32,2 meses. La incidencia de neumonía adquirida en la comunidad (NAC) fue de 3.600 casos/100.000 niños/año en menores de 6 años en centros de atención primaria. De los casos, 136 fueron diagnosticados en el hospital (43,7 %). Los síntomas y signos clínicos más comunes fueron: fiebre (95,4 %), tos (94,4 %), taquipnea (58,2 %) y alteraciones en la auscultación (90,2 %). Se instauró tratamiento antibiótico en 298 pacientes (98 %). La amoxicilina-ácido clavulánico fue el antibiótico más utilizado (39,5 %), seguido de cefuroxima (32,7 %) y claritromicina (8,3 %). El microorganismo más frecuentemente aislado fue el virus respiratorio sincitial seguido de Streptococcus pneumoniae. Requirieron ingreso hospitalario el 15,6 % de los casos. Solamente un 24,6 % de los niños menores de 2 años estaban vacunados con la vacuna antineumocócica conjugada heptavalente y un 12,7 % de niños con patología respiratoria de base estaban vacunados frente al virus de la gripe. Conclusiones. En nuestro medio, el diagnóstico y tratamiento de las neumonías adquiridas en la comunidad se realiza en el ámbito de atención primaria en la mayoría de los casos, presentando una alta tasa de incidencia. Aunque la mayoría de los casos no precisan atención hospitalaria, el diagnóstico etiológico de la NAC y la optimización del tratamiento antibiótico continúa siendo todavía un reto difícil de alcanzar

Introduction. Acute respiratory infections are an important cause of consultations in primary care and hospitals. Most published epidemiological studies have analyzed pneumonia in hospitals and very few include information on primary care. Material and methods. We performed a multicenter, prospective, epidemiological study in 17 primary care centers and four hospital pediatric emergency rooms. All children under 6 years of age with a clinical diagnosis of pneumonia were included. Results. There were 311 patients with a mean age of 32.2 months. The incidence of community-acquired pneumonia was 3,600 cases/100,000 children/year under 6 years old in primary care centers. Of these, 136 were diagnosed in hospitals (43.7 %). The most common clinical signs and symptoms were fever (95.4 %), cough (94.4 %), tachypnea (58.2 %), and auscultation abnormalities (90.2 %). Antibiotic therapy was started in 298 patients (98 %). The most frequent antibiotic was amoxicillin-clavulanate (39.5 %), followed by cefuroxime (32.7 %) and clarithromycin (8.3 %). The most frequently isolated microorganism was respiratory syncytial virus followed by Streptococcus pneumoniae. Hospital admission was required in 15.6 % of patients. Only 24.6 % of the patients had been vaccinated with the heptavalent pneumococcal conjugate vaccine and 12.7 % of the children with underlying respiratory diseases had been vaccinated with the influenza virus vaccine. Conclusions. In our milieu, the diagnosis and treatment of community-acquired pneumonia is usually carried out in primary care and the incidence is high. Although most patients do not require hospitalization, etiological diagnosis of community-acquired pneumonia and optimal antibiotic therapy remain difficult goals to achieve

Variables del comportamiento en la anorexia infantil: propuesta de una escala de valoración / Variables in the behaviour of infant anorexia: Proposal for a scale of evaluations

Objetivo: Determinar los factores asociados conla anorexia infantil y construir un instrumento de valoraciónde fácil aplicación para su discriminación.Material y método: Se estudiaron 220 niños deedades entre 2 y 4 años, 30 con trastorno grave dela conducta alimentaria, 40 con trastorno leve y 150sanos. Se elaboró una escala compuesta por 91items agrupados en 16 subescalas, valorándoseconducta alimentaria y factores del comportamientodel niño, actitud de los padres ante la alimentacióndel niño y aspectos relacionales y emocionales entreambos.Resultados: La consistencia interna de las subescalasosciló entre 0,63 y 0,90, con unas correlacionesentre clases de 0,95-0,99. El análisis factorialeliminó 12 items; los 79 items restantes quedarondistribuidos en 27 nuevas subescalas, las cuales establecíandiferencias entre los tres grupos. Mediantela discriminación lineal de Fisher la escala quedó reducidaa 22 items, consiguiéndose un nivel muy altode clasificaciones correctas.Conclusión: Se propone una escala de fácil aplicaciónpara detectar precozmente la anorexia infantil

Objetive: To determine de factors related to infantanorexia, to construct an instrument of evaluationseasy to apply and which would facilitate the discriminationthereof.Material and method: 220 children between 2and 4 years were examined, 30 of which had seriousdisorder of eating habits, 40 with slight disorder and150 were completely sane. A scale composed of 91items was produced and assembled into 16 subscales,in which the following was evaluated: eating habits,factors in the behaviour of the child, parents´actitude towards the nourishment of the child andthe emotional aspects and relationship betweenboth.Results: The internal consistency on the subscalesranged from 0,63 to 0,90, with correlations betweenclasses of 0,95-0,99. The factorial analysis eliminated12 items, the remaining 79 items were distributedinto 27 new subscales, which set up the differencesbetween the groups. By means of Fisher´slineal discrimination, the scale was reduced to 22items obtaining thus a high level of correct classifications.Conclusion: A scale which is easy to apply is hereproposed in order to detect infant anorexia at anearly stage (AU)

[Epidemic outbreak of tuberculosis in a primary and secondary school in Granada (Spain)]. / Brote epidémico de tuberculosis en un colegio de Granada.

OBJECTIVE: To describe the diagnosis and early treatment of an epidemic outbreak of tuberculosis and determine the utility of polymerase chain reaction (PCR) compared with routine culture in gastric juice. MATERIAL AND METHODS: A computer studies teacher, with clinical features suggestive of tuberculosis and caverns on X-ray, was diagnosed with bacilliferous tuberculosis. Primary health care services carried out a Mantoux test on the school's 387 students as well as on teachers and other staff. The children with a positive Mantoux test underwent laboratory, radiological, and microbiological investigations for one week in the Pediatric Respiratory Unit of Hospital Clínico in Granada. In the teaching and non-teaching staff, active tuberculosis was ruled out through bacilloscopy of sputum samples, Mantoux test, and chest X-ray. RESULTS: In the first screening, the Mantoux test was positive in 67 children. Of these, 7 children were diagnosed with tuberculosis and 60 were found to be infected. Of the 7 children with tuberculosis, five presented positive gastric juice culture in Lowenstein medium while Roche COBAS PCR was negative. In the second screening, 9 children became tuberculin positive. Of these, 8 were diagnosed with tuberculosis and one was infected. Cultures were positive in 3 and PCR was negative. In 77.6 % of the children (59/76), the Mantoux induration was equal to or higher than 18 mm. All of the 15 children with tuberculosis were aged between 9 and 14 years old, except one who was 5 years old. CONCLUSIONS: The Mantoux test remains a basic screening method in diagnosis and epidemiological research, whereas the results of microbiological investigation remain poor and in our study the results DNA were disappointing. The screening of tuberculosis and of other infectious diseases should be more closely monitored in professional groups, such as teachers, that are in contact with large numbers of children. This would identify infected adults and prevent epidemics such as that described in the present study.

Brote epidémico de tuberculosis en un colegio de Granada / Epidemic outbreak of tuberculosis in a primary and secondary school in Granada (Spain)

Objetivo: El diagnóstico y tratamiento precoz del brote epidémico de tuberculosis y comprobar la relevancia de la reacción en cadena de la polimerasa (PCR) frente a cultivos específicos habituales en el jugo gástrico en ayunas. Material y métodos: Tras diagnosticar a un profesor de informática de tuberculosis bacilífera, con sintomatología indicativa y radiología de caverna, se realizó Mantoux en los servicios de atención primaria, a la totalidad del colegio, que componían 387 escolares y personal docente y no docente del colegio. Los niños con Mantoux positivo fueron estudiados, en una semana, en el Servicio de Neumología Pediátrica del Hospital Clínico de Granada, mediante pruebas analíticas, radiológicas y microbiológicas. El resto del personal docente y no docente, se descartó que tuvieran una tuberculosis activa mediante baciloscopia en esputo, Mantoux y radiografía de tórax. Resultados; En el primer cribado en los 387 alumnos, 67 niños fueron Mantoux positivo, de los cuales siete se diagnosticaron de enfermedad tuberculosa y 60 de infección latente. De los 7 pacientes, cinco presentaron positividad en jugo gástrico en medio de Löwenstein, mientras que la PCR tipo Cobas de la empresa Roche fue negativa. En el segundo cribado, 9 niños experimentaron viraje tuberculínico; de ellos, ocho fueron diagnosticados de enfermedad y uno de infección, y se encontraron cultivos positivos en tres de ellos y PCR negativa en todos. La induración del Mantoux fue igual o superior a 18 mm en el 77,6 por ciento de los niños (59/76). Los 15 enfermos tenían entre 9 y 14 años, excepto uno con 5 años. Conclusiones: El Mantoux sigue siendo un método básico de detección en el diagnóstico e investigación epidemiológica, mientras que el rendimiento del estudio microbiológico sigue siendo pobre y la amplificación genómica de ADN en nuestro caso fue descorazonadora. Pensamos que el cribado de tuberculosis y otras enfermedades infecciosas debería ser más vigilado en grupos de profesionales que se relacionan con grandes comunidades infantiles, como la docente, lo que permitiría detectar adultos bacilíferos y evitar casos epidémicos como los reseñados en este trabajo (AU)

Quiste de colédoco asociado a pancreatitis aguda. Diagnóstico preoperatorio mediante colangiopancreatografía-RM / Choledochal cyst associated with acute pancreatitis, preoperative evaluation with magnetic resonance cholangiopancreatography

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An anti-smoking project instituted by senior nursing students in a rural community.

The Health Council of Hawkins County, Tennessee, received a State Tobacco Prevention grant to institute an anti-smoking program in the county schools. The program chosen was called TarWars and encompasses a prohealth tobacco-free program curriculum. The goal was to discourage tobacco use among the nation's youth by focusing on tobacco's short-term ill effects. Because the program encourages community involvement, nursing students from East Tennessee State University, Johnson City, identified volunteers from the Hawkins County Retired Teachers Association to develop a teaching program for use in the first year of the program and as well as in subsequent years of the TarWars curriculum. A pretest and posttest were given to the students to assess the program's success. The objectives of the grant were that 80% of the students would be able to name three negative effects associated with tobacco use and three positive effects of not using tobacco. The goal was met when 91% could identify negative effects and 89% could identify three positive effects of not using tobacco.