Prognostic value of gasometric parameters of carbon dioxide in resuscitation of septic patients. A bibliography review.

The anaerobic metabolism is the cornerstone in physiopathology of septic shock. Nowadays we have both the central or mixed venous oxygen saturation and lactate levels to monitoring the metabolism in septic patients. Some studies have shown that normalization of systemic hemodynamic and oxygen metabolism variables not prevent progression to multiorgan damage and death. Recently has been proposed the venous-to-arterial carbon dioxide difference (ΔpvaCO2) as an alternative marker of tissue hypoperfusion, like Cardiac Index. High ΔpvaCO2 predicts adverse outcomes. Also has been proposed both, the ratio between the ΔpvaCO2 and arterial-to-venous oxygen content difference (ΔCavO2): ΔpvaCO2/ΔCavO2; and, the ratio between venous-to-arterial carbon dioxide difference (ΔCvaCO2) and ΔCavO2: ΔCvaCO2/ΔCavO2, as markers of anaerobic metabolism. Both of high ratios are related to high levels of lactate and worse prognosis. Therefore in patients with sepsis the combination of markers of resuscitation could be important to improve the outcomes.

[In vitro sensitivity of Mycobacterium chelonae strains to various antimicrobial agents]. / Sensibilidad in vitro de cepas de Mycobacterium chelonae frente a diversos antimicrobianos.

The in vitro susceptibility of 32 Mycobacterium chelonae strains to 10 antimicrobial agents was determined. The sources of the different strains were: clinical samples from patients treated at the Hospital Universitario de Canarias and Hospital del Tórax (General and Chest facilities) and from environmental sources (water supply, sewage, swimming pools and the sea). The susceptibility tests were performed by a broth microdilution method (Mueller-Hinton Broth). The results showed amikacin as the most effective antimicrobial agent against M. chelonae isolates, then ofloxacin and cefoxitin. However no statistical difference was detected among them. The least effective was imipenem, followed by ciprofloxacin and norfloxacin.

[A microbiological and physicochemical analysis of the water in swimming pools on the island of Tenerife]. / Análisis microbiológico y fisicoquímico del agua de piscinas de la isla de Tenerife.

BACKGROUND: A microbiological and physiochemical analysis has been made from 60 samples of water from two swimming pools in Santa Cruz de Tenerife in order to know the hygienic condition and to establish the most adequate microbiological indicators. The water of the two swimming pools has a different origin: sea water (Swimming pool B) and public supply (Swimming pool A), and so, different processings are used. METHODS: The analytical methodology was based on the Spanish current day regulations for the control of drinkable waters for public use, as well as on the methods the American Public Health Association recommends. RESULTS: There have been found differences between one swimming pool and the other, depending basically on the water characteristics and the processings used to treat it; there exists a greater microbiological contamination in the samples from the swimming pool B. It has been proved that medium R2A is better than medium P.C.A. to recount total mesophilic aerobes in both swimming pools. CONCLUSIONS: The isolation of St. aureus species in samples from the swimming pool B makes of it a possible microbiological indicator for the hygienic control of swimming pool waters of marine origin. Likewise, the presence of mycobacterium species in samples of the swimming pool A confirms its resistance to concentrations of growth inhibitors of free chlorine.

[Health instruction in adult education as instrument for community participation. Analysis of an experiment in La Nora (Murcia)]. / La formación sanitaria en la educación de adultos como instrumento para la participación comunitaria. Análisis de una experiencia en La Nora (Murcia).

AIM: The main aim of this work is to demonstrate the possibility of establishing stable contacts between the PC study and citizens' groups, in order to promote Health Education. The experience of Adult Education in a Health Centre, initiated by its Consejo de Salud (Health Council), was analysed. DESIGN: The study's methodology is of Participatory Research based on an earlier descriptive analysis, which had followed the educational input. PLACE: It takes place in a PCC and is a Community-based activity. PARTICIPANTS: The PC study, Adult Education teachers, the Social Health Department of the Faculty of Medicine and 136 adult students from nine villages in the rural area of La Nora (Murcia), took part in the study. ACTIVITIES: Essentially to develop a programme of Health Instruction within Adult Education, in order to encourage Community Participation. RESULTS: They focus on checking the effect of the programme on all the groups concerned and analysing the characteristics of the adult student body. CONCLUSIONS: The most important have been the generally positive feelings about the experiment and thus the possibility of tackling new ones. It was important that the study had been the fruit of a programme of Community Participation, with the Health Centre as the point of reference.