Electron density and temperature measurements in a magnetized expanding hydrogen plasma.

We report measurements of electron densities, n_{e}, and temperatures, T_{e}, in a magnetized expanding hydrogen plasma performed using Thomson scattering. The effects of applying an axial magnetic field and changing the background pressure in the plasma vessel on n_{e} and T_{e} along the expansion axis are reported. Magnetic field strengths (B field) up to 170 mT were applied, which are one order of magnitude larger than previously reported. The main effect of the applied B field is the plasma confinement, which leads to higher n_{e}. At B fields larger than 88 mT the electron density along the expansion axis does not depend strongly on the magnetic field strength. However, T_{e} is susceptible to the B field and reaches at 170 mT a maximum of 2.5 eV at a distance of 1.5 cm from the exit of the cascaded arc. To determine also the effect of the arc current through the arc, measurements were performed with arc currents of 45, 60, and 75 A at background pressures of 9.7 and 88.3 Pa. At constant magnetic field n_{e} decreases from the exit of the arc along the expansion axis when the arc current is decreased. At 88.3 Pa n_{e} shows a higher value close to the exit of the arc, but a faster decay along the expansion axis with respect to the 9.7 Pa case. T_{e} is overall higher at lower pressure reaching a maximum of 3.2 eV at the lower arc current of 45 A. The results of this study complement our understanding and the characterization of expanding hydrogen plasmas.

[Modification of specialised care prescriptions by Primary Healthcare physicians]. / Modificación de la prescripción procedente del segundo nivel de asistencia por parte del médico de Atención Primaria.

OBJECTIVE: To determine the percentage of new Specialist Healthcare prescriptions received and modified by Primary Healthcare physicians. DESIGN: Descriptive, cross-sectional and multi-centre study with the participation of Primary Healthcare physicians from one Madrid Health Area during 2 months. A method was established for registering the origin of the new prescriptions in the Computerised Medical Record System. In order to register new prescriptions without any change from Specialist Healthcare, the «second level¼ option was marked when the prescription was issued. A protocol was prepared and was available on the Computerized Medical Record System, so for those cases where there was a new Specialist Healthcare prescription, the Primary Healthcare physician would not issue any prescription or issue a prescription with changes as regards the original one. RESULTS: A total of 69 Primary Healthcare physicians from 15 Primary Healthcare centres registered 46,512 new prescriptions, 3,893 (8.4%) from Specialist Healthcare. From this number, 3,544 prescriptions (91.0% 95% CI: 90.1-91.9) were issued without changes, and 298 prescriptions were modified (7.7% 95% CI: 7.0-8.7). In 46 cases (1.2% 95% CI: 0.8-1.5) no prescription was issued. Some prescriptions were changed by 51% of Primary Healthcare physicians, and the median of prescriptions changed or not issued was 3. The main reason for the modification was replacement with generics. CONCLUSIONS: A high percentage of new Specialist Healthcare prescriptions are issued without any changes being made by Primary Healthcare physicians. Modifications are concentrated in half of the participating physicians. Therefore, these data suggest that this practice is not generally adopted by the professionals.

Implementación de un programa de educación terapéutica mínimo para pacientes diabéticos hospitalizados que inician tratamiento con insulina / Implementation of a minimum therapeutic education program for in-hospital diabetic patients initiating insulin treatment

La educación terapéutica que acompaña a la insulinización se realiza en el momento del diagnóstico en la diabetes tipo 1 y en caso de grave deterioro del control glucémico en la diabetes tipo 2, coincidiendo con el diagnóstico o si fracasa el tratamiento previo con agentes orales. Con frecuencia estos pacientes ingresan en el hospital por otras patologías, junto a una hiperglucemia no controlada. En estos casos será necesario iniciar tratamiento con insulina, de carácter provisional o definitivo, acompañado de una educación terapéutica mínima o de supervivencia. El objetivo de este programa será la adquisición de los conocimientos, habilidades y actitudes mínimos para que el paciente y/o sus familiares puedan continuar, encaso necesario, el tratamiento con insulina de forma ambulatoria, se familiaricen con la técnica de la inyección y puedan prevenir y tratar las posibles hipoglucemias. Diversas sociedades científicas avalan la necesidad de contar con programas estructurados de educación en los hospitales y un equipo interdisciplinario coordinado, para mejorar la calidad asistencial de los pacientes diabéticos hospitalizados(AU)

Therapeutic education related to initiation of insulin therapy should be administered from the time of diagnosis in type 1 diabetes or in case of severe deterioration of glycemic control in type 2 diabetes, either at diagnosis or when failing previous treatment with oral agents. Frequently, these patients were admitted to the hospital due to other diseases, although generally associated to non-controlled hyperglycemia. In these cases, it will be necessary initiate insulintherapy, either in a provisional or permanent manner, besides a simplified therapeutic education or for survival. The program objective is to acquire as aminimum knowledge, skills and attitudes for patients and/or its relatives to continue, when necessary, insulin therapy at home, to learn appropriately the injection technique, and to prevent or treat possible hypoglycemic episodes. Several scientific societies support the need to have education structured programs in hospitals and a coordinated interdisciplinary team for improving quality of care of in-hospital diabetic patients(AU)

Balmer-beta line asymmetry characteristics in a high pressure, microwave-produced argon plasma.

This paper presents a study on the asymmetry of the Balmer H(beta) profile in plasmas produced by microwaves at high pressure with the help of some functions of asymmetry for the whole profile, as well as by means of some specific parameters characterizing only its central dip. The study shows how this asymmetry--very low in our case--depends on the electron density and flux of gases and how the existence of inhomogeneities in the plasma can affect the shape and symmetry of this line. Also, limitations on the determination of the asymmetry are pointed out and the use of this profile for plasma diagnosis is discussed.

[Intervention of a pharmacy department following the 11-M terrorist attack]. / Actuación de un servicio de farmacia en el atentado terrorista del 11-M.

OBJECTIVE: To describe the intervention of a pharmacy department, as well as medication requirements, in the healthcare emergency situation brought about by the terrorist attack of March 11, 2004 in Madrid. To compare this intervention with other similar experiences reported in the medical literature. METHOD: A compilation of actions carried out by pharmacists directly involved in the management of this incident. A literature search of Medline, Cochrane Library, and Spanish Index Medicus databases. RESULTS: The pharmacy department acted to ensure the availability of all medication needed in the management of casualties by placing urgent orders in pharmaceutical laboratories, simplifying distribution networks, and staying in permanent contact with the medical and nursing staff of the emergency department, as well as with people in charge of emergency coordination. Most commonly used medications included plasma expanders, fluid therapy, blood-derived products, pain killers, antiseptics, peripheral myorelaxants, and antibiotics, which are consistent with those employed by other Madrid hospitals for this same attack. CONCLUSIONS: The pharmacy department, as any other department in a hospital, should be ready to rapidly and effectively cope with any emergency situation. Having a protocol available including major intervention guidelines is advisable to reduce reaction times, anticipate potential complications, and effectively solve such situations.

[Evidence for glutamatergic neurotransmission in the geniculo-cortical pathway in the rat]. / Evidencias de la participación del ácido glutámico en la neurotransmisión de la vía genículo-cortical en la rata.

PURPOSE: To investigate the possible participation of glutamate in the neurotransmission of the rat geniculo-cortical pathway. METHODS: In a first set of experiments, we studied the effects of microiontophoresis of kynurenate, a broad spectrum antagonist of glutamate receptors, on the excitation evoked in visual cortex cells by electrical stimulation of the dorsal lateral geniculate nucleus and the optic tract. Cell activity was determined by extracellular unit recordings. In a second set of experiments, we studied the effects of electrical stimulation of the dorsal lateral geniculate nucleus and the optic tract on the release of glutamate and aspartate in the visual cortex in vivo. Push pull perfusions were made in the visual cortex and the amino acids contents of the perfusates were analysed by high performance liquid chromatography. RESULTS: Microiontophoresis of kynureate in area 17 cells selectively supressed the excitatory response to dorsal geniculate nucleus and optic tract stimulation. On the other hand, stimulation of these structures significantly increased glutamate, but not aspartate, release in area 17. CONCLUSIONS: These results demonstrate that glutamate is the neurotransmitter of the geniculo-cortical pathway in the rat.

Atypical thyroiditis in Huelva, Spain.

OBJECTIVE: To report an epidemic of atypical thyroiditis that occurred in southwestern Europe during 1995. METHODS: We present the clinical, laboratory, morphologic, and histologic features of 672 cases of thyroiditis and describe the results of treatment. RESULTS: During 1995, atypical thyroiditis was diagnosed in 672 of 725 patients with thyroid disorders encountered at our medical center in Huelva, Spain. Of these patients, 98% were women with normal ovarian function. The clinical findings were acute or subacute manifestation of diffuse nodular enlargement of the thyroid and spontaneous, severe pain on deglutition and palpation of the gland. Initial hematology and serum biochemistry studies, free triiodothyronine, free thyroxine, thyrotropin, and thyroid-stimulating immunoglobulins were in the normal range, but after the second week, the thyrotropin level began to increase. Thyroid antibodies (thyroglobulin and thyroid peroxidase) increased up to 300 times the high-normal level. Ultrasonography exhibited diffuse nodular enlargement of the thyroid gland, with irregular hypoechoic, normal, and hyperechoic zones. Fine-needle aspiration biopsy showed abundant lymphocytic infiltration. The best treatment results were obtained with the combination of levothyroxine and deflazacort. Because the epidemic appeared after a severe drought of 5-year duration (1991 to 1995) and affected women with normal ovarian function, our etiopathogenetic hypothesis was that an estrogen-like chemical substance polluted the area swamps. The high concentration of the pollutant was attributable to diminished water levels (8% of their capacity at the end of the drought period), and this situation may have affected the population through tap water used for human consumption. CONCLUSION: We describe an atypical autoimmune thyroiditis that affected primarily women of reproductive age, after a severe drought. The main features were a very painful, diffuse nodular enlargement of the thyroid gland, substantially increased thyroid antibodies, good response to levothyroxine and deflazacort combination treatment, and a benign evolution to chronic thyroiditis. Pollutants from various sources should be considered when atypical thyroiditis occurs in any community.

Electrophysiological and neurochemical study of the rat geniculo-cortical pathway. Evidence for glutamatergic neurotransmission.

The projection from the dorsal lateral geniculate nucleus to the primary visual cortex of the rat was studied electrophysiologically. Electrical stimulation of the dorsal lateral geniculate nucleus and the optic tract produced three types of responses on neurons of area 17: excitation followed by inhibition, excitation and inhibition. These results extend and confirm, in adult rats, previous studies done in rat geniculate-visual cortex cocultures preparations in vitro. The role of glutamate in the neurotransmission of the rat geniculo-cortical pathway was also investigated. In a first set of experiments, the effects of kynurenate, an antagonist of glutamate receptors, on visual cortex neurons with a monosynaptic excitatory response to dorsal lateral geniculate nucleus stimulation were studied. Microiontophoresis of kynurenate in area 17 neurons selectively suppressed the excitatory response to dorsal lateral geniculate nucleus and optic tract stimulation. In a second set of experiments, the effects of electrical stimulation of the dorsal lateral geniculate nucleus and the optic tract on the release of amino acids in the rat visual cortex in vivo were studied. Using the push-pull method, we perfused a discrete region of the visual cortex with artificial cerebrospinal fluid (CSF), and the amino acid content of the perfusates was analysed by high performance liquid chromatography (HPLC). Stimulation of either the dorsal lateral geniculate nucleus or the optic tract significantly increased glutamate release in area 17. The rest of the amino acids studied did not show significant changes. The results provide evidence for the participation of glutamate in the neurotransmission of the geniculo-cortical pathway in the rat.