Prescripción antibiótica en infecciones respiratorias agudas en atención primaria / Antibiotic prescribing in acute respiratory tract infections in general practice

Introducción: La resistencia a antimicrobianos representa una amenaza para la salud pública mundial. Las infecciones respiratorias agudas son el principal motivo de prescripción antibiótica en la población pediátrica española. El objetivo del estudio fue describir la frecuencia de prescripción y el patrón de utilización de antibióticos en infecciones respiratorias agudas, diagnosticadas en atención primaria, en la población pediátrica de Aragón. Material y método: Se incluyeron los episodios de otitis aguda, faringoamigdalitis aguda, infección respiratoria superior inespecífica y bronquitis aguda, registrados durante un año, en niños de 0-14 años. Se calculó la proporción de episodios que recibieron antibiótico, por diagnóstico y grupo de edad, y describió el patrón prescriptor. Resultados: El 50% de los niños fueron diagnosticados de infección respiratoria aguda durante el periodo de estudio, siendo la infección respiratoria superior inespecífica la más frecuente. Se prescribió un antibiótico en el 75% de las faringoamigdalitis, 72% de otitis, 27% de bronquitis y 16% de infecciones respiratorias superiores inespecíficas. Los antibióticos más prescritos fueron los de amplio espectro, principalmente amoxicilina y amoxicilina-clavulánico. Conclusiones: El uso de antibióticos en infecciones respiratorias agudas pediátricas fue, en general, elevado, y la elección del tipo de antibiótico podría ser inadecuada en un porcentaje elevado de casos. Se considera necesaria una mejora en la práctica prescriptora de antibióticos en niños (AU)

Introduction: Antimicrobial resistance is a worldwide threat to public health. Acute respiratory tract infections are the main reason for antibiotic prescribing in the Spanish paediatric population. The aim of the study was to describe the frequency of antibiotic prescription and their pattern of use in acute respiratory tract infections diagnosed in children in Primary Care in Aragón (Spain). Methodology: A study was conducted over a 1-year period on children between 0 and 14 years-old, recording all episodes of acute otitis, acute pharyngotonsillitis, non-specific upper respiratory infection, and acute bronchitis. The proportion of episodes within each diagnosis receiving an antibiotic prescription was calculated, and the prescribing pattern was determined. Results: Half (50%) of the children in Aragón were diagnosed with a respiratory tract infection during the study period. Non-specific upper respiratory infection was the most frequent diagnosis. An antibiotic was prescribed in 75% of pharyngotonsillitis episodes, 72% of otitis, 27% of bronchitis, and 16% of non-specific upper respiratory infections. Broad spectrum antibiotics, mainly amoxicillin and amoxicillin-clavulanic, were predominantly prescribed. Conclusions: Antibiotic prescribing in respiratory tract infections in children was generally high, and the choice of antibiotics was probably inappropriate in a high percentage of cases. Therefore an improvement in antibiotic prescribing in children appears to be needed (AU)

[Antibiotic prescribing in acute respiratory tract infections in general practice]. / Prescripción antibiótica en infecciones respiratorias agudas en atención primaria.

INTRODUCTION: Antimicrobial resistance is a worldwide threat to public health. Acute respiratory tract infections are the main reason for antibiotic prescribing in the Spanish paediatric population. The aim of the study was to describe the frequency of antibiotic prescription and their pattern of use in acute respiratory tract infections diagnosed in children in Primary Care in Aragón (Spain). METHODOLOGY: A study was conducted over a 1-year period on children between 0 and 14 years-old, recording all episodes of acute otitis, acute pharyngotonsillitis, non-specific upper respiratory infection, and acute bronchitis. The proportion of episodes within each diagnosis receiving an antibiotic prescription was calculated, and the prescribing pattern was determined. RESULTS: Half (50%) of the children in Aragón were diagnosed with a respiratory tract infection during the study period. Non-specific upper respiratory infection was the most frequent diagnosis. An antibiotic was prescribed in 75% of pharyngotonsillitis episodes, 72% of otitis, 27% of bronchitis, and 16% of non-specific upper respiratory infections. Broad spectrum antibiotics, mainly amoxicillin and amoxicillin-clavulanic, were predominantly prescribed. CONCLUSIONS: Antibiotic prescribing in respiratory tract infections in children was generally high, and the choice of antibiotics was probably inappropriate in a high percentage of cases. Therefore an improvement in antibiotic prescribing in children appears to be needed.

The modulated structure of the calcium aluminate Ca6(AlO2)12·Bi2O3.

Bismuth calcium aluminate, Bi(2)Ca(6)Al(12)O(27), has been prepared as a ceramic and a single crystal. Analysis of reciprocal space using both electron and X-ray diffraction show an R-centred hexagonal unit cell: a = b = 17.3892 (4), c = 6.986 (1) Å. Additional weak reflections are observed; they require the introduction of a modulation wavevector q = 0.0453 (2)c* for indexing. The modulated structure has been solved using the superspace formalism [superspace group X3(00γ)0]. A framework of corner-sharing AlO(4) tetrahedra forms corrugated sixfold rings and uncommon triple rings. The Ca(2+) cations exhibit an eightfold coordination sphere; edge-sharing CaO(8) polyhedra form intertwinned zigzagging rows along c creating a three-dimensional net. Bi atoms are located in large hexagonal tunnels parallel to c and form Bi(2)O(3) pairs, which adopt a trigonal bipyramidal configuration. The 6s(2) lone-electron pairs (Lp) point along c, in the opposite direction to the three Bi-O strong bonds to form two BiO(3)Lp tetrahedra with a common base. Different orientations of the Bi(2)O(3)Lp(2) pairs, rotated by 60° around c, are observed. Their stacking modes in each of the hexagonal tunnels are described. The sequence of the stacking varies along c in each of the tunnels.

Structural, magnetic, and transport properties of the SrTi1-xCoxO3-delta perovskite (0 < or = x < or = 0.9).

The series of the SrTi(1-x)Co(x)O(3-delta) polycrystalline samples has been prepared via solid-state reaction in air. The structural study shows that a solid solution exists for all compositions, such as 0 < or = x < or = 0.9, which discards the presence of ferromagnetic and metallic cobalt clusters for the low level of cobalt substitution. The existence of systematic extra peaks on the electron diffraction patterns for x > 0.5 indicates that the oxygen vacancy ordering is responsible for the superstructures (2a(p) x 2a(p) x 4a(p), where the subscript "p" refers to the perovskite subcell). The oxygen nonstoichiometry is confirmed by thermogravimetric analysis. The magnetic properties reveal a maximum in the magnetic moment per mole of cobalt for x approximately 0.10. However, the clear lack of strong ferromagnetism does not suggest that a diluted magnetic semiconductor (DMS)-type behavior is induced in SrTiO(3) as Co is substituted for Ti. The transport properties along the SrTi(1-x)Co(x)O(3-delta) line are explained by considering the substitution of a Co(3+)/Co(4+) mixed valency, which decreases the room-temperature resistivity by at least 5 orders of magnitude as one goes from SrTi(0.9)Co(0.1)O(3-delta) to SrTi(0.1)Co(0.9)O(3-delta).

A multidisciplinary study of the 'yips' phenomenon in golf: An exploratory analysis.

BACKGROUND: The 'yips' is a psychoneuromuscular impediment affecting execution of the putting stroke in golf. Yips symptoms of jerks, tremors and freezing often occur during tournament golf and may cause performance problems. Yips-affected golfers add approximately 4.7 strokes to their scores for 18 holes of golf, and have more forearm electromyogram activity and higher competitive anxiety than nonaffected golfers in both high and low anxiety putting conditions. The aetiology of the yips is not clear. OBJECTIVE: To determine whether the yips is a neurological problem exacerbated by anxiety, or whether the behaviour is initiated by anxiety and results in a permanent neuromuscular impediment. METHODS: In phase I, golf professionals assisted investigators in developing a yips questionnaire that was sent to tournament players (<12 handicap) to establish the prevalence and characteristics of the yips. Phase II measured putting behaviour in scenarios that contribute to the yips response. Four self-reported yips and 3 nonaffected golfers putted 3 scenarios using an uncorrected grip and a standard length putter. Heart rate was superimposed on the videotape and the putter grip was instrumented with strain gauges to measure grip force. Electromyograms and relative putting performance were also measured. RESULTS: The questionnaire was sent to 2,630 tournament players, of whom 1,031 (39%) responded (986 men and 45 women). Of these, 541 (52%) perceived they experienced the yips compared with 490 (48%) who did not. Yips-affected golfers reported that the most troublesome putts were 3, 4 and 2 feet (0.9, 1.2 and 0.6 metres) from the hole. Fast, downhill, left-to-right breaking putts and tournament play also elicited the yips response. Golfers affected by the yips had a faster mean heart rate, increased electromyogram activity patterns and exerted more grip force than nonrffected golfers and had a poorer putting performance. CONCLUSIONS: For <10 handicap male golfers and <12 handicap female golfers, the prevalence of the yips is between 32.5% and 47.7%, a high proportion of serious golfers. This high prevalence suggests that medical practitioners need to understand the aetiology of the yips phenomenon so that interventions can be identified and tested for effectiveness in alleviating symptoms. Although previous investigators concluded that the yips is a neuromuscular impediment aggravated but not caused by anxiety, we believe the yips represents a continuum on which 'choking' (anxiety-related) and dystonia symptoms anchor the extremes. The aetiology may well be an interaction of psychoneuromuscular influences. Future research to test the effect of medications such as beta-blockers should assist in better identifying the contributions these factors make to the yips phenomenon.

Sport injury and illness: elite skiers describe their experiences.

Injury and illness pose significant physical and psychological challenges for competitive athletes. The present study examined the psychological processes associated with injury and illness among elite skiers. Twelve members of the Canadian Alpine Ski Team who had recovered from a serious sport injury or debilitating illness were interviewed for the study. Inductive analyses of interview transcripts revealed that the experience of sport injury and athlete illness spanned three distinct phases, namely, the injury-illness phase, the rehabilitation-recovery phase, and the return to full activity phase. In addition, it was found that each phase was marked by a series of events that caused the skiers varying degrees of distress. This article traces the skiers' psychological journey from injury and illness through recovery, with an emphasis on factors contributing to stress and the strategies used to manage stress.

[Self concept patterns according to the Tennessee self concept scale in vasectomized men and their partners]. / Patrones de autoconcepto según la escala Tennessee en hombres vasectomizados y sus parejas.

PIP: This study investigates 40 couples whose male partners had voluntarily undergone vasectomy as a permanent contraceptive method. The Tennessee self concept scale test was used to examine changes, if any, in personality characteristics. The only changes were in self-perception of conflict and identity, while adjustment-disadjustment patterns, and psychosis and neurosis patterns remained identical to those tested before vasectomy. The typical negative characteristics of Mexican men and women, i.e., confusion regarding self-perception, passivity, dependence, social insecurity, and the positive ones, such as ability to socially communicate, and emotional perception, were not changed, as was unchanged the conflict as to sexual identity which often prevents Mexicans to fully enjoy sexual gratification. Changes in intellectual capacity were measured, before and after vasectomy, with the Beta test. Both men and women showed an increased capacity in intellectual performance.^ieng

Electrocardiographic and vectocardiographic findings in Friedreich's ataxia.

Electrocardiographic and vectocardiographic changes are frequent in Friedreich's ataxia. In one of 35 patients both tests were normal. The vectocardiogram is more explicit in demonstrating the severity of the QRS changes with a right ventricular hypertrophy pattern present in 60% of cases. Serial examination of ECG tracings are recommended to monitor the cardiomyopathy in this progressive neurological disorder, in order to detect the onset of congestive heart failure, significant tachyarrythmias, or obstructive cardiomypathy.