Differentiating multi-MeV, multi-ion spectra with CR-39 solid-state nuclear track detectors.

The development of high intensity petawatt lasers has created new possibilities for ion acceleration and nuclear fusion using solid targets. In such laser-matter interaction, multiple ion species are accelerated with broad spectra up to hundreds of MeV. To measure ion yields and for species identification, CR-39 solid-state nuclear track detectors are frequently used. However, these detectors are limited in their applicability for multi-ion spectra differentiation as standard image recognition algorithms can lead to a misinterpretation of data, there is no unique relation between track diameter and particle energy, and there are overlapping pit diameter relationships for multiple particle species. In this report, we address these issues by first developing an algorithm to overcome user bias during image processing. Second, we use calibration of the detector response for protons, carbon and helium ions (alpha particles) from 0.1 to above 10 MeV and measurements of statistical energy loss fluctuations in a forward-fitting procedure utilizing multiple, differently filtered CR-39, altogether enabling high-sensitivity, multi-species particle spectroscopy. To validate this capability, we show that inferred CR-39 spectra match Thomson parabola ion spectrometer data from the same experiment. Filtered CR-39 spectrometers were used to detect, within a background of ~ 2 × 1011 sr-1 J-1 protons and carbons, (1.3 ± 0.7) × 108 sr-1 J-1 alpha particles from laser-driven proton-boron fusion reactions.

Electrocardiograma y evaluación predeportiva en el niño que practica deporte / Electrocardiogram and pre-sports evaluation in the child who practices sports

Introducción: existe consenso en la necesidad de realizar un cribado predeportivo, aunque con enormes diferencias en cuanto a protocolos. El objetivo de nuestro estudio es conocer el estado de los reconocimientos predeportivos en niños, conocer la prevalencia de anomalías cardiovasculares y valorar la utilidad del electrocardiograma (ECG). Pacientes y métodos: estudio descriptivo transversal. Durante dos años se realizó el reconocimiento médico propuesto por la Guía Clínica de Evaluación Cardiovascular previa a la práctica deportiva en Pediatría en las revisiones de niños mayores de seis años, incluyendo anamnesis, exploración física y electrocardiograma. Resultados: se incluyeron 691 niños. El 62,5% realizaba deporte extraescolar con una mediana de 3 horas por semana (2-4,5). El 52,2% de los niños estaban federados. Existen diferencias en las horas de práctica deportiva y la edad entre niños federados y no federados (p <0,001). En los federados se realizó reconocimiento en el 68,1% y un ECG en el 19%, existiendo diferencias significativas entre los distintos tipos de deportes (p <0,001). El 13% de los niños estudiados presentaban antecedentes familiares de cardiopatía. El 3,5% de los ECG realizados fueron patológicos precisando valoración por Cardiología Pediátrica. El 6,6% de los niños con antecedentes familiares de cardiopatía y el 3% de los niños sin antecedentes necesitaron seguimiento cardiológico. Conclusiones: en la mayoría de los reconocimientos deportivos de nuestro medio no se incluye ECG. Investigar en profundidad los antecedentes familiares de cardiopatía es importante (AU)

Introduction: there is consensus on the need to perform pre-sport screening, although with enormous differences in terms of protocols. The objective of our study is to know the status of pre-sport screenings in children, to know the prevalence of cardiovascular abnormalities and to assess the usefulness of the electrocardiogram (ECG).Patients and methods: descriptive cross-sectional study. For two years, the medical screening proposed by the Clinical Guide for Cardiovascular Evaluation prior to sports practice in pediatrics was carried out in the check-ups of children older than 6 years, including anamnesis, physical examination and electrocardiogram.Results: 691 children were included. 62.5% did extracurricular sports with a median of 3 hours per week (2-4.5). 52.2% of the children were federated. There are differences in the hours of sports practice and age between federated and non-federated children (p <0.001). In federated, recognition was performed in 68.1% and ECG in 19%, with significant differences between the different types of sports (p <0.001). 13% of the children studied had a family history of heart disease. 3.5% of the ECGs performed were pathological, requiring evaluation by pediatric cardiology. 6.6% of the children with a family history of heart disease and 3% of the children without a history required cardiac follow-up.Conclusions: ECG is not included in most of the sports examinations in our environment. Investigating family history of heart disease is important. (AU)

Hipertensión pulmonar: uno entre un millón / Pulmonary hypertension: one in a million

Introducción. La hipertensión pulmonar en pediatríasuele presentarse con una clínica inespecífica que hace difícilsu sospecha diagnóstica, siendo hasta en el 30% de los casosde etiología multifactorial.Caso clínico. Presentamos el caso de una lactante de2 meses de edad que comienza con clínica inespecífica(vómitos, rechazo de tomas, irritabilidad), presentando unempeoramiento progresivo que termina en varias paradascardiorrespiratorias abortadas. En el estudio diagnósticoúnicamente se encuentra una hipertensión pulmonar grave que no responde a tratamiento vasodilatador agresivo.Además, muestra hiperecogenicidad periventricular condesarrollo de edema cerebral progresivo, que termina conla vida de la paciente. El estudio metabólico muestra elevación de glicina en líquidos biológicos; y el estudio genético confirma una variante patogénica en homocigosis en elgen NFU1 (NM_001002755.3:c.622G>T, p.Gly208Cys), por loque se diagnostica de síndrome de disfunción mitocondrialmúltiple tipo 1.Conclusiones. El síndrome de disfunción mitocondrialmúltiple tipo 1 es una enfermedad autosómica recesiva conuna prevalencia <1/1.000.000, que afecta al metabolismomitocondrial por alteración del gen NFU1. La clínica comienza en las primeras etapas de la vida por síntomas inespecíficos, neurológicos e hipertensión pulmonar, con un cursomortal a los pocos meses de edad. Destaca un aumento deglicina y lactato en líquidos biológicos; una leucoencefalopatía periventricular con degeneración quística, cavitacionesy/o necrosis. El diagnóstico de las enfermedades metabólicasprecisa de una alta sospecha clínica. El curso rápidamenteprogresivo y refractario al tratamiento de una hipertensiónpulmonar que asocia clínica encefalopática, debe hacernossospechar una alteración en el metabolismo mitocondrial. (AU)

Introduction. Pulmonary hypertension in children usually presents with non-specific symptoms that makes thesuspicion difficult, being up to 30% of cases of multifactorialetiology.Clinical case. We present the case of a 2-month-old infantwho began with nonspecific symptoms, presenting a progressive worsening that results in aborted cardiorespiratoryarrest. The diagnostic work-up only shows a severe pulmonary hypertension that does not respond to aggressivevasodilator therapy. In addition, the patient has periventricular hyperechogenicity with progressive cerebral edema,causing the patient’s death. The metabolic study shows elevation of glycine in biological fluids; and the genetic study confirmed a homozygous pathogenic variant in the NFU1gene (NM_001002755.3:c.622G>T, p.Gly208Cys), leading tothe diagnosis of type 1 multiple mitochondrial dysfunctionsyndrome.Conclusion. Multiple mitochondrial dysfunction syndrome type 1 is an autosomal recessive disease with a prevalence <1/1,000,000, which affects mitochondrial metabolismdue to alterations in the NFU1 gene. The clinic begins in theearly stages of life presenting with nonspecific symptoms,neurological symptoms and pulmonary hypertension; witha fatal course in all cases. An increase in glycine and lactate in biological fluids is characteristic; it is also typical tofind a periventricular leukoencephalopathy with chemicaldegeneration, cavitations and/or necrosis. The diagnosisof metabolic disorders requires a high clinical suspicion. Asevere pulmonary hypertension associated with encephalopathy should lead us to suspect an alteration in mitochondrial metabolism (AU)

High order mode structure of intense light fields generated via a laser-driven relativistic plasma aperture.

The spatio-temporal and polarisation properties of intense light is important in wide-ranging topics at the forefront of extreme light-matter interactions, including ultrafast laser-driven particle acceleration, attosecond pulse generation, plasma photonics, high-field physics and laboratory astrophysics. Here, we experimentally demonstrate modifications to the polarisation and temporal properties of intense light measured at the rear of an ultrathin target foil irradiated by a relativistically intense laser pulse. The changes are shown to result from a superposition of coherent radiation, generated by a directly accelerated bipolar electron distribution, and the light transmitted due to the onset of relativistic self-induced transparency. Simulations show that the generated light has a high-order transverse electromagnetic mode structure in both the first and second laser harmonics that can evolve on intra-pulse time-scales. The mode structure and polarisation state vary with the interaction parameters, opening up the possibility of developing this approach to achieve dynamic control of structured light fields at ultrahigh intensities.

An optically multiplexed single-shot time-resolved probe of laser-plasma dynamics.

We introduce a new approach to temporally resolve ultrafast micron-scale processes via the use of a multi-channel optical probe. We demonstrate that this technique enables highly precise time-resolved, two-dimensional spatial imaging of intense laser pulse propagation dynamics, plasma formation and laser beam filamentation within a single pulse over four distinct time frames. The design, development and optimization of the optical probe system is presented, as are representative experimental results from the first implementation of the multi-channel probe with a high-power laser pulse interaction with a helium gas jet target.

Valoración subjetiva de los padres en el manejo de las bronquiolitis / Subjective assessment of parents on the management of bronchiolitis

Introducción: Numerosos estudios concluyen que no hay diferencias significativas entre los distintos aerosoles utilizados en el tratamiento de las bronquiolitis. Sin embargo, en protocolos recientes, la adrenalina ha demostrado mayor eficacia que el placebo y los beta-2 agonistas a corto plazo, con una mejoría en los síntomas en los primeros 60 minutos. Objetivos: Demostrar que el uso de adrenalina nebulizada en los pacientes ingresados por bronquiolitis produce una mejoría subjetiva percibida por los cuidadores (en calidad del sueño, ingesta y estado general) e interfiere en los días de ingreso, respecto al uso de suero salino fisiológico (SSF). Pacientes y métodos: Estudio experimental, prospectivo, aleatorizado y simple ciego, en el que se incluyeron lactantes menores de 12 meses ingresados en nuestro hospital entre el 15 de octubre de 2015 y el 31 de marzo de 2016. Resultados: La muestra final fue de 58 niños, un 62% varones. La mediana de edad al ingreso fue de 2 meses (rango intercuartílico: 3), el 62% recibió adrenalina y el 38% SSF. No se hallaron diferencias en el número de días de oxigenoterapia ni en el de días de ingreso entre ambos grupos. Respecto a la apreciación de los padres sobre la ingesta, el sueño y el estado general, no encontramos diferencias estadísticamente significativas entre ambos aerosoles. Conclusiones: El uso de adrenalina no produce una mejoría subjetiva percibida por los cuidadores frente al uso de SS

Introduction: Several studies have concluded that there are no significant differences between the different aerosols used in the treatment of bronchiolitis. However, in recent protocols epinephrine has shown more short-term efficiency than the placebo and beta2-agonists, with an improvement of symptoms within the first 60 minutes. Objectives: To prove that the use of nebulized epinephrine in patients admitted with bronchiolitis leads to a subjective improvement as perceived by caregivers (regarding quality of sleep, food intake and general state of health) and that it affects the days of hospitalization, compared with the use of physiological saline solution (PSS). Patients and methods: Experimental, prospective, randomized, single-blind study. It includes breastfed babies <12 months old who were admitted in our hospital from 15th October 2015 to 31st March 2016. Results: 58 patients, 62% male in total. The median age at admission was 2 months (interquartile range 3). 62% received epinephrine and 38% were given PSS. No differences were found regarding the days of oxygen therapy or the days of admission between both groups. With regard to the parents' assessment of food intake, sleeping and general state of health, we did not find statistically significant differences between different aerosols. Conclusions: The use of epinephrine does not lead to a subjective improvement perceived by the caregivers compared with the use of PSS

Annular fast electron transport in silicon arising from low-temperature resistivity.

Fast electron transport in Si, driven by ultraintense laser pulses, is investigated experimentally and via 3D hybrid particle-in-cell simulations. A transition from a Gaussian-like to an annular fast electron beam profile is demonstrated and explained by resistively generated magnetic fields. The results highlight the potential to completely transform the beam transport pattern by tailoring the resistivity-temperature profile at temperatures as low as a few eV.

Platanus pollen allergen, Pla a 1: quantification in the atmosphere and influence on a sensitizing population.

BACKGROUND: The allergic response in susceptible patients does not always coincide with the presence and magnitude of airborne pollen counts. The prevalence of allergy to Platanus is currently moderate, although the percentage of monosensitized patients is low. This hinders accurate interpretation of the relationship between the amount of pollen inhaled and the patient's symptoms. OBJECTIVE: This study aims to investigate the relationship between the atmospheric concentration pattern of Pla a 1 aeroallergen and the Platanus pollen. METHODS: The pollen sampling was carried out using a Hirst-type volumetric trap (Burkard(©) ) for pollen grains and a Burkard Cyclone sampler (Burkard(©) ) for Pla a 1 allergen. Serum-specific IgE levels to Acer sp., Artemisia vulgaris, Betula alba, Chenopodium album, Cupressus arizonica, Cynodon dactylon, Fraxinus excelsior, Lolium perenne, Pinus sp., Plantago lanceolata, Platanus acerifolia, Populus sp., Quercus ilex and Taraxacum officinale allergens were determined using the EAST System (Hytec specific IgE EIA kit; Hycor Biomedical, Kassel, Germany). RESULTS: The aerobiological dynamics of Platanus pollen grains and Pla a 1 differed considerably, particularly during the Platanus pollination period. Of the 118 subjects tested, sera from 34 contained specific IgE to Platanus pollen and all of them had specific IgE to other pollen types. CONCLUSIONS: The presence of the aeroallergen Pla a 1 in the atmosphere appears to be independent of Platanus pollen counts over the same period, which may be contributing to allergic symptoms and sensitization. The number of polysensitized patients displaying allergy to Platanus suggested that allergic symptoms were caused by co-sensitization or cross-reactivity involving a number of allergenic particles.

Manejo de la vía aérea con remifentanilo en el síndrome de Pterigium múltiple (Enfermedad de Escobar) / No disponible

No disponible

[Anesthetic management for left ventricular epicardial lead implantation with minimally invasive thoracoscopic guidance]. / Manejo anestésico para la implantación de electrodos epicáirdicos en el ventrículo izquierdo, mediante cirugía mínimamente invasiva asistida.

Medical treatment for left ventricular (LV) systolic dysfunction and congestive heart failure has improved quality of life for patients but mortality rates have remained unaffected. For a subgroup of such patients with interventricular conduction delays and ventricular contraction dyssynchrony, cardiac resynchronization by placement of a LV epicardial lead is a new approach to management. We report 3 cases in which such electrodes were implanted under the guidance of minimally invasive thoracoscopy. In the first 2 cases it was decided to place the LV electrode using thoracoscopic guidance because of complications or technical difficulties in the percutaneous procedure. In the third case thoracoscopy was used because of deterioration of the patient's condition after implantation of a double-chamber pacemaker and shifting of the lead to the right ventricle. The literature on the anesthetic management of such patients is scarce. Although sedation with general anesthesia and single-lung ventilation is indicated for percutaneous procedures, that technique also proved adequate for the thoracoscopic procedures.

Mascarilla laríngea Proseal / Proseal laryngeal mask

La mascarilla laríngea Proseal está introducida en lapráctica clínica desde el año 2000. Son muchos los artículosque se han publicado en este tiempo sobre su utilización,generalmente en casos clínicos concretos. En estetrabajo se presenta una revisión del dispositivo y susposibles indicaciones, contraindicaciones, técnicas deinserción, complicaciones de uso; así como una comparacióncon la mascarilla laríngea clásica o convencional.Para ello hemos revisado la literatura médica existentehasta octubre del 2005 mediante búsqueda en MEDLINE,utilizando los términos de búsqueda “ProSeal laryngealmask airway, anaesthesia”

The Proseal laryngeal mask was introduced into clinicalpractice in 2000. Since then, many publications,most of them case reports, have discussed the use of thismask. This review considers the possible indications andcontraindications for use of this device, techniques forinsertion, and complications. The Proseal is comparedwith the conventional laryngeal mask. We reviewed theliterature indexed on MEDLINE through October 2005using the search terms Proseal laryngeal mask, airway,and anesthesia

[Clinical and radiologic assessment of vertebroplasty]. / Valoración clínico-radiológica de las vertebroplastias.

INTRODUCTION: Percutaneous vertebroplasty consists of the injection of acrylic cement into weakened vertebral bodies to achieve pain relief and mechanical stability of the spine. OBJECTIVE: To evaluate the characteristics and effectiveness of the vertebroplasties performed at the Hospital Universitario Miguel Servet in Zaragoza. PATIENTS AND METHODS: This is a retrospective study of 147 vertebroplasties performed in 95 patients (60 women and 35 men; age range: 19 to 84 years). The oblique transpedicular approach, which achieves adequate cement injection with a single puncture, is currently used. A visual analogue scale (VAS) was used to evaluate pain before and after the procedure. RESULTS: The osseous lesion most often treated by vertebroplasty is fracture secondary to osteoporosis, accounting for 65% of the cases in this series, followed by hemangiomas (23%), and osteolytic metastases, traumatic fractures, lymphomas, and myelomas. Prior to vertebroplasty, the mean VAS score was 8.88 versus 2.78 after the treatment. Only 7.3% of the patients had symptomatic complications. CONCLUSION: Vertebroplasty is safe and efficacious; it is the treatment of choice for vertebral pain refractory to medication. It enables patients to return to their habitual lifestyle quickly and thus helps reduce hospital stays and costs.

Manejo anestésico para la implantación de electrodos epicárdicos en el ventrículo izquierdo, mediante cirugía mínimamente invasiva asistida / Anesthetic management for left ventricular epicardial lead implantation with minimally invasive thoracoscopic guidance

El tratamiento médico de los pacientes con disfunciónsistólica del ventrículo izquierdo (VI) y afectos de insuficienciacardiaca congestiva (ICC), ha mejorado su calidadde vida pero no así la mortalidad. Existe un subgrupode estos pacientes, con alteraciones en laconducción interventricular y asincronía de la contracciónventricular, en los que la terapia de resincronizacióncardiaca (TRC), se consideró una nueva alternativaen su manejo mediante implantación de un electrodoepicárdico en VI. Se exponen tres casos en los que seprocedió a su implantación mediante cirugía mínimamenteasistida. En los dos primeros casos se decidió laimplantación del electrodo epicárdico a VI, mediantecirugía mínimamente invasiva, por complicaciones odificultad técnica del procedimiento percutáneo y en eltercer caso por deterioro clínico del paciente, tras lacolocación de marcapasos bicameral, y desplazamientode electrodo epicárdico a ventrículo derecho.La literatura es escasa en el manejo anestésico deestos pacientes. Si bien para técnicas percutáneas serecurrió a la sedación, con anestesia general medianteventilación unipulmonar, se logró un manejo adecuadoen el procedimiento asistido por toracoscopia

Medical treatment for left ventricular (LV) systolicdysfunction and congestive heart failure has improvedquality of life for patients but mortality rates haveremained unaffected. For a subgroup of such patientswith interventricular conduction delays and ventricularcontraction dyssynchrony, cardiac resynchronization byplacement of a LV epicardial lead is a new approach tomanagement. We report 3 cases in which such electrodeswere implanted under the guidance of minimally invasivethoracoscopy. In the first 2 cases it was decided toplace the LV electrode using thoracoscopic guidancebecause of complications or technical difficulties in thepercutaneous procedure. In the third case thoracoscopywas used because of deterioration of the patient's conditionafter implantation of a double-chamber pacemakerand shifting of the lead to the right ventricle.The literature on the anesthetic management of suchpatients is scarce. Although sedation with general anesthesiaand single-lung ventilation is indicated for percutaneousprocedures, that technique also proved adequatefor the thoracoscopic procedures

Valoración clínico-radiológica de las vertebroplastias / Clinical and radiologic assessment of vertebroplasty

Introducción. La vertebroplastia percutánea consiste en la inyección de cemento acrílico en los cuerpos vertebrales debilitados, con el fin de obtener un efecto analgésico y la estabilización mecánica de la columna vertebral. Objetivo. Valorar las características y efectividad de las vertebroplastias realizadas en el Hospital Universitario Miguel Servet de Zaragoza. Pacientes y métodos. Se han estudiado, de forma retrospectiva, 147 vertebroplastias efectuadas entre 1994 y 2003, a 95 pacientes (60 mujeres y 35 hombres), con un rango de edad entre 19 y 84 años. La vía de abordaje utilizada actualmente es la transpedicular oblicua, que con una sola punción consigue una buena expansión del cemento dentro del cuerpo vertebral. Resultados. La lesión ósea más frecuentemente tratada con vertebroplastia es la fractura secundaria a osteoporosis, con un 65% de los casos, le sigue con un 23% los hemangiomas y, en menor proporción, las metástasis osteolíticas, fracturas traumáticas, linfomas y mielomas. Para valorar la reducción del dolor empleamos la escala analógica visual (VAS), pasando de un VAS previo a la vertebroplastia de 8,88 a un VAS de 2,78 después del tratamiento. Solamente el 7,4% de los pacientes tuvieron complicaciones sintomáticas. Conclusión. La vertebroplastia es un procedimiento seguro y eficaz, de elección en el tratamiento del dolor vertebral refractario a la medicación, que permite una rápida incorporación del paciente a su vida habitual y una reducción de los costes hospitalarios

Introduction. Percutaneous vertebroplasty consists of the injection of acrylic cement into weakened vertebral bodies to achieve pain relief and mechanical stability of the spine. Objective. To evaluate the characteristics and effectiveness of the vertebroplasties performed at the Hospital Universitario Miguel Servet in Zaragoza. Patients and methods. This is a retrospective study of 147 vertebroplasties performed in 95 patients (60 women and 35 men; age range: 19 to 84 years). The oblique transpedicular approach, which achieves adequate cement injection with a single puncture, is currently used. A visual analogue scale (VAS) was used to evaluate pain before and after the procedure. Results. The osseous lesion most often treated by vertebroplasty is fracture secondary to osteoporosis, accounting for 65% of the cases in this series, followed by hemangiomas (23%), and osteolytic metastases, traumatic fractures, lymphomas, and myelomas. Prior to vertebroplasty, the mean VAS score was 8.88 versus 2.78 after the treatment. Only 7.3% of the patients had symptomatic complications. Conclusion. Vertebroplasty is safe and efficacious; it is the treatment of choice for vertebral pain refractory to medication. It enables patients to return to their habitual lifestyle quickly and thus helps reduce hospital stays and costs

[Proseal laryngeal mask]. / Mascarilla laríngea Proseal.

The Proseal laryngeal mask was introduced into clinical practice in 2000. Since then, many publications, most of them case reports, have discussed the use of this mask. This review considers the possible indications and contraindications for use of this device, techniques for insertion, and complications. The Proseal is compared with the conventional laryngeal mask. We reviewed the literature indexed on MEDLINE through October 2005 using the search terms Proseal laryngeal mask, airway, and anesthesia.

[Hypothalamic-infundibular histiocytosis: magnetic resonance findings]. / Histiocitosis hipotálamo-infundibular: hallazgos en resonancia magnética.

INTRODUCTION: We report the magnetic resonance imaging (MRI) of a case of Langerhans cell histiocytosis in the pituitary. Isolated central nervous system involvement is uncommon. CASE REPORT: An eighteen-years old female patient who had an acute onset of central diabetes insipidus because of the Langerhans cell histiocytosis. The MRI evidenced a lesion in the hypothalamic-pituitary axis. The hyperintensity in the posterior pituitary lobe, which is seen in normal subjects on T1-weighted images, was absent. The pituitary stalk was thickened and enhanced homogeneously following contrast administration. During the follow-up, the infundibullar lesion extended to the hypothalamic region and other systemic manifestations appeared. Diagnosis of Langerhans cell histiocytosis was confirmed by lung biopsy. After radiotherapy and chemotherapy, MRI showed regression of the hypothalamic-pituitary lesion. CONCLUSION: The combination of these findings, although nonspecific of Langerhans cell histiocytosis, should nevertheless prompt further studies, including chest films, bone scanning and temporal bone computerized tomography in order to narrow the differential diagnosis.