Generation of vector Bessel beams with diffractive phase elements based on the Jacobi-Anger expansion.

We report the design and optimization of a diffractive phase element whose phase modulation is derived from the Jacobi-Anger relation, which allows the simultaneous generation of multiple scalar Bessel beams of different integer orders. In addition, by the appropriate treatment of a couple of such Bessel beams, we generate a vector Bessel beam of arbitrary order m. This beam is constructed by the collinear superposition of the scalar Bessel beam modes of orders m-1 and m+1, with circular orthogonal polarizations. We demonstrate experimentally both the simultaneous generation of the multiple scalar Bessel beams and the generation of vector Bessel beams of orders m=0 and m=1. These tasks are performed in an optical setup based on a pixelated liquid-crystal spatial light modulator.

Desempenho, frequência de diarreia, produção de fezes e custos de dietas com teores crescentes de farelo de abacaxi para leitões desmamados / Performance, diarrhea frequency, feces production and costs of diets with increasing levels of pineapple byproducts in weaned piglets

Esta pesquisa objetivou avaliar dietas com teores crescentes de farelo de abacaxi na alimentação de leitões desmamados. Foram utilizados 56 leitões, no intervalo de 21 a 63 dias de idade, que receberam dietas compostas principalmente por milho, farelo de soja e produtos lácteos, com adição de farelo de abacaxi em 0%, 3,4%, 6,8% e 10,2%. Foram avaliados o desempenho zootécnico; a incidência de diarreia; as excreções nas fezes, totais e por unidade de peso vivo ganho, de matérias seca (MS), mineral (MM) e orgânica (MO), nitrogênio (N) e fósforo (P); os custos relativos ao ganho de peso dos animais e os índices de eficiência econômica e de custo. As avaliações foram efetuadas dos 21 aos 35 dias; dos 21 aos 49 dias; e dos 21 aos 63 dias de idade dos leitões. Adotou-se delineamento em blocos ao acaso, de acordo com os pesos dos animais no início do experimento, com quatro tratamentos e sete repetições. Dos 21 aos 49 dias os animais submetidos às dietas com 3,4 e 6,8% de farelo de abacaxi consumiram mais ração (P<0.05) do que os alimentados com a dieta controle, e dos 21 aos 63 dias verificou-se maior ganho de peso (P<0.05) somente dos animais que receberam a dieta com 3,4% de farelo de abacaxi em relação aos leitões controle. Dos 21 aos 63 dias os animais que receberam as dietas com farelo de abacaxi apresentaram excreções de MS, MM, MO e N superiores (P<0.05) às dos animais controle. Contudo, ao se verificarem as excreções destes componentes nas fezes por unidade de peso vivo ganho neste mesmo período, foi constatado que não houve diferença (P>0.05) entre os leitões que receberam as dietas sem farelo de abacaxi e os que consumiram a dieta com 3,4% do produto. Portanto, a inclusão do farelo de abacaxi em dietas para leitões desmamados em 3,4% é viável, por não interferir negativamente nas excreções por unidade de peso vivo ganho e nos índices de custos das dietas e por proporcionar melhor ganho de peso aos leitões em relação àqueles que não consumiram farelo de abacaxi.(AU)

This research aimed to evaluate diets with growing levels of pineapple meal in weaned piglets feeding. Fifty-six piglets, from 21 to 63 days old, were fed diets composed mainly of corn, soybean meal, and dairy products, with the addition of pineapple byproduct in 0%, 3.4%, 6.8% and 10.2%. The parameters evaluated were: growth performance; diarrhea incidence; excretion in feces, total and per unit of weight gain, of dry (DM), mineral (MM) and organic (OM) matters, nitrogen (N) and phosphorous (P); diet costs related to weight gain, index of economic efficiency and of costs. The evaluations were performed from 21 to 35 days; from 21 to 49 days; and from 21 to 63 days of age. A complete randomized block design was adopted, according to the animal's weight in the beginning of the trial, with four treatments and seven repetitions. From day 21 to 49 the animals fed diets with 3.4 and 6.8% of pineapple meal consumed more feed (P<0.05) than those fed the control diet, and from day 21 to 63 only the animals that received the diet with 3.4% of pineapple presented a higher weight gain (P<0.05) than control piglets. From day 21 to 63 animals fed diets with pineapple meal presented higher (P<0.05) excretions of DM, MM, OM, and N than the control animals. However, checking the excretions of these components in the feces per unit of live weight gain in the same period, it was found that there was no difference (P>0.05) among the piglets fed diets without pineapple meal and those who consumed the diet with 3.4% of the product. Thus, the inclusion of pineapple meal in weaned piglet's diets at 3.4% is feasible, because it did not interfere negatively on excretions per unit of live weight gain and in diet cost indices, and provided better weight gain to the animals, as compared with pigs who did not consume pineapple meal.(AU)

Trapping and manipulation of microparticles using laser-induced convection currents and photophoresis.

In this work we demonstrate optical trapping and manipulation of microparticles suspended in water due to laser-induced convection currents. Convection currents are generated due to laser light absorption in an hydrogenated amorphous silicon (a:Si-H) thin film. The particles are dragged towards the beam's center by the convection currents (Stokes drag force) allowing trapping with powers as low as 0.8 mW. However, for powers >3 mW trapped particles form a ring around the beam due to two competing forces: Stokes drag and thermo-photophoretic forces. Additionally, we show that dynamic beam shaping can be used to trap and manipulate multiple particles by photophotophoresis without the need of lithographically created resistive heaters.

Fate of non O157 Shigatoxigenic Escherichia coli in ovine manure composting / Eliminação de Escherichia coli Shigatoxigênica não O157 em compostagem de esterco ovino

Livestock manure may contain pathogenic microorganisms which pose a risk to the health of animal or humans if the manure is not adequately treated or disposed of. To determine the fate of Shiga toxigenic Escherichia coli (STEC) non O157 in composted manure from naturally colonized sheep, fresh manure was obtained from animals carrying bacterial cells with stx1/ stx2 genes. Two composting systems were used, aerated and non-aerated, and the experiments were done in Dracena city, São Paulo State. Every week, for seven weeks, one manure sample from six different points in both systems was collected and cultured to determine the presence of E. coli, the presence of the virulence genes in the cells, and also the susceptibility to 10 antimicrobial drugs. The temperature was verified at each sampling. STEC non-O157 survived for 49 days in both composting systems. E. coli non-STEC showing a high degree of antibiotic resistance was recovered all long the composting period. No relationship was established between the presence of virulence genes and antibiotic resistance. The presence of virulence genes and multiple antibiotic resistances in E. coli implicates a potential risk for these genes spread in the human food chain, which is a reason for concern...

Esterco de animais de criação pode conter microrganismos patogênicos, o que representa um risco para a saúde animal e a humana se o esterco não for adequadamente tratado ou descartado. Determinou-se o tempo necessário para a eliminação de Escherichia coli Shiga toxigenica (STEC) não O157 em esterco ovino composto, obtido de fezes frescas de ovelhas naturalmente colonizadas com cepas STEC não O157 que apresentavam os genes stx1/ stx2. Foram utilizados dois sistemas de compostagem, aerado e não aerado, em experimentos realizados na cidade de Dracena, estado de São Paulo. Todas as semanas, durante sete semanas, uma amostra de compostagem proveniente de seis pontos diferentes na leira, nos dois sistemas, foi coletada e semeada para a determinação da presença de E. coli, da presença de genes de virulência nas células, bem como da sensibilidade dessas células a 10 drogas antimicrobianas. Em cada amostragem, a temperatura da leira foi analisada. Células de STEC não O157 sobreviveram por 49 dias nos dois sistemas de compostagem. E. coli não STEC com um alto grau de resistência a antibióticos foi recuperada ao longo de todo o período de compostagem. Não foi possível estabelecer relação entre a presença de genes de virulência e a resistência a antibióticos. A presença de genes de virulência e a resistência a múltiplos antibióticos em E. coli representam um risco potencial para o espalhamento desses genes na cadeia alimentar humana, o que é motivo de grande preocupação...

Polarization holograms allow highly efficient generation of complex light beams.

We report a viable method to generate complex beams, such as the non-diffracting Bessel and Weber beams, which relies on the encoding of amplitude information, in addition to phase and polarization, using polarization holography. The holograms are recorded in polarization sensitive films by the interference of a reference plane wave with a tailored complex beam, having orthogonal circular polarizations. The high efficiency, the intrinsic achromaticity and the simplicity of use of the polarization holograms make them competitive with respect to existing methods and attractive for several applications. Theoretical analysis, based on the Jones formalism, and experimental results are shown.

Qualidade da carne de fêmeas suínas alimentadas com diferentes concentrações de ractopamina na dieta / Meat quality of gilts fed different ractopamine concentrations in diet

Analisaram-se as qualidades física, química e sensorial, bem como o perfil de ácidos graxos da carne de fêmeas suínas alimentadas com dietas com concentrações crescentes de ractopamina. Foram utilizadas 468 fêmeas, com peso inicial de 84,77±7,20kg, alojadas em 36 baias e alimentadas com dietas contendo 0, 5, 10 ou 15mg de ractopamina/kg. Após o período de 28 dias, dois animais de cada baia, depois de passarem por 15 horas de jejum sólido, foram abatidos. Uma amostra do músculo Longissimus da meia carcaça direita foi colhida para se avaliar as características de qualidade da carne. Não houve efeito (P>0,05) da adição de ractopamina às dietas sobre o pH, capacidade de retenção de água, força de cisalhamento, cor e oxidação lipídica da carne. Observou-se efeito quadrático (P<0,05) para perdas por cocção da carne, e não foi observada diferença (P>0,05) na análise sensorial da carne. Também não foi observado efeito (P>0,05) sobre a composição em ácidos graxos e sobre a relação entre ácidos graxos saturados:insaturados. A adição de até 15mg de ractopamina/kg de dieta não altera as características físicas, sensoriais e o perfil de ácidos graxos da carne de fêmeas suínas abatidas com 110kg de peso.

A study was conducted to evaluate the physical, chemical and sensorial quality and fat acids profile of meat from gilts fed diets containing increasing concentration of ractopamine. A total of 468 gilts with initial weight of 84.77±7.20kg were allotted into 36 pens and fed diets containing 0, 5, 10 or 15mg of ractopamine/kg. After an experimental period of 28 days, two animals from each pen were chosen and slaughtered after 15 hours of fasting. A sample of the Longissimus muscle was collected to evaluate the quality of the pork meat. There was no effect (P>0.05) of ractopamine inclusion in pH, water holding capacity, shear force, color and lipid oxidation. However, a quadratic trend was observed (P<0.05) for cooking loss by increasing concentration of ractopamine in diets. For sensorial analysis of the Longissimus muscle, no differences were noted (P>0.05). No effects were observed (P>0.05) for fat acids profile and saturated and unsaturated fat acids ratio. In conclusion, the increase of up to 15mg of ractopamine/kg concentration in the diet does not change the physical and sensorial characteristics and the fat acids profile of meat from gilts slaughtered at 110kg of body weight.

Nutrient digestibility of degermed, dehulled corn, citrus pulp, and soy protein concentrate by barrows.

This study was carried out to determine apparent ileal digestibility (AID) and apparent total tract digestibility (ATTD) of DM, CP, GE, and their respective digestible content of degermed dehulled corn (Zea mays), citrus pulp, and soy (Glycine max) protein concentrate by pigs using the difference method. Thirty-two barrows (28.1 ± 1.6 kg of BW) were fed a corn-soybean meal basal diet or 1 of 3 diets formulated by replacing 30% of the basal diet with 30% of 1 of the test feedstuffs for 11 d. Chromic oxide (0.3%) was included in the diets. Feces were collected from days 7 to 11 by grab sampling and ileal digesta were collected after pigs were slaughtered on day 12. The AID of DM and AID and ATTD of GE of degermed corn (77.4, 88.7, and 77.7%) were greater (P < 0.05) than those observed in citrus pulp (50.3, 86.5, and 55.8%) and in soy protein concentrate (63.5, 85.1, and 59.4%), which did not differ (P > 0.05). The ATTD of CP, total digestible CP, and total DE of soy protein concentrate (87.5%, 500 g/kg, and 3739 kcal/kg) were higher (P < 0.05) than the values in degermed corn (81.7%, 57.5 g/kg, and 3330 kcal/kg), which were greater (P < 0.05) than those in citrus pulp (60.5%, 39.5 g/kg, and 3223 kcal/kg). Total and ileal digestible DM, AID of CP, and ileal DE of degermed corn (782 g/kg, 673 g/kg, 70.7%, and 2913 kcal/kg) and soy protein concentrate (778 g/kg, 570 g/kg, 78.7%, and 2878 kcal/kg) were similar (P > 0.05) and greater (P < 0.05) than those in citrus pulp (737 g/kg, 436 g/kg, 50.6%, and 2081 kcal/kg). Ileal digestible CP of degermed corn (49.8 g/kg) and citrus pulp (33.0 g/kg) did not differ (P > 0.05) but were smaller (P < 0.05) than the value found in soy protein concentrate (434 g/kg). The DM and energy from degermed corn are more efficiently digested by the pig than those from soy protein concentrate and citrus pulp. Soy protein concentrate was the best protein source evaluated in this study.

Avaliação econômica da utilização de diferentes níveis de polpa cítrica com ou sem adição de complexo enzimático nas dietas de suínos / Economic evaluation of the use of different levels of citrus pulp with or without the addition of enzyme complex in the diets of pigs

Avaliou-se economicamente o efeito da inclusãode 0, 5, 10 e 15 por cento de polpa cítrica (PC), com ou sem adição do complexo enzimático, sobre o desempenho de 72 suínos, dos 25,71±7,51 aos 98,81±10,64kg de peso. Com este peso final, os animais foram abatidos, e dos valores (R$) da carcaça, incluindo os índices de bonificação, foram descontados o valor de compra dos animais e os custos com alimentação, de acordo com cada tratamento. Para os custos com alimentação, foi observado aumento linear (P=0,0190), enquanto para as receitas bruta (P=0,0328) e líquida (P=0,0013) parciais foram encontradas reduções lineares em função das porcentagens de PC com ou sem a adição do complexo enzimático. Considerando-se a evolução dos preços do milho, farelo de soja e do suíno durante o ano de 2008, foram determinados 12 cenários diferentes para a receita líquida parcial e, em todos eles, foi observada redução linear em função da inclusão da PC, com ou sem adição do complexo enzimático. Conclui-se que a utilização de PC, com ou sem adição do complexo enzimático, não reduziu os custos com alimentação, não sendo economicamente viável sua inclusão nas rações de suínos em crescimento e terminação.

An economic evaluation was done in order to evaluate the effect of the inclusion of 0, 5, 10 and 15 percent of citrus pulp (PC), with or without the addition of the enzyme complex, on the performance of 72 pigs from 25.71±7.51 to 98.81±10.64kg of body weight. The animals were slaughtered when they reached 98.81kg. The purchase value of the animals and feed costs (R$) were discounted from the carcass value, including subsidy rates (R$). A linear increase (P= 0.0190) was observed, while linear reductions were observed for the gross receipts (P=0.0328) and net (P = 0.0013) partials, due to the inclusion of PC in the diet with or without the enzyme complex. Considering the evolution of corn, soybean meal and pig prices during 2008, there were some 12 different scenarios for partial and net income determined and in all of them, linear reductions were observed due to the inclusion of PC in the diet with or without the enzyme complex. The use of PC with or without the addition of the enzyme complex was unable to reduce the costs of feed.

Carcass characteristics and meat quality of heavy swine fed different citrus pulp levels / Características de carcaça e qualidade da carne de suínos com elevado peso de abate, alimentados com dietas contendo diferentes níveis de polpa cítrica

An assay with 36 swine initially weighting 83.7±5.1kg body weight (BW) was carried out to evaluate the effects of the use of different dietary citrus pulp levels, 0, 10 percent, 20 percent, and 30 percent, upon digestive organs weights, carcass characteristics, and meat quality of animals subjected to qualitative feed restriction program, and slaughtered at 130kg BW. Linear response (P<0.05) on the weight of stomach, colon, and liver were observed. Negative linear responses (P<0.05) on final BW and carcass yield relative to citrus pulp addition to the diet were observed. Although a negative linear effect (P<0.05) of increasing dietary levels of citrus pulp had been observed on ham weight, yield of this by product was not affected (P>0.05). Higher levels of citrus pulp neither decreased backfat thickness nor increased amount of lean meat, indicative that qualitative feed restriction was not efficient. Positive linear effect (P<0.05) on pH measured 24 hours after slaughter and negative linear effect (P<0.05) on color characteristics as function of citrus pulp dietary levels were verified. Citrus pulp addition in qualitative feed restriction program may not be effective. As no deleterious effects upon meat qualities were observed, citrus pulp can be used as an alternative feedstuff for finishing swine.

Foi realizado um ensaio utilizando 36 suínos machos castrados, com peso inicial de 83,7±5,1kg, para avaliar o efeito da inclusão de polpa cítrica, 0, 10, 20 e 30 por cento, em um programa de restrição alimentar qualitativa para suínos abatidos aos 130kg de peso, sobre o peso dos órgãos do sistema digestório e sobre características da carcaça e da qualidade da carne. A inclusão de polpa cítrica proporcionou aumento linear (P<0,05) nos pesos do estômago, cólon e fígado, e efeito quadrático (P<0,05) no peso do ceco. Foi observada redução linear (P<0,05) no peso, no rendimento da carcaça e no peso do pernil, porém não houve efeito (P>0,05) sobre o rendimento do pernil. Maior inclusão de polpa cítrica não foi suficiente para reduzir a espessura do toucinho e aumentar a quantidade de carne magra na carcaça, mostrando que a restrição alimentar qualitativa não foi eficiente. Foi observado aumento linear (P<0,05) do pH da carcaça resfriada e linear negativo (P<0,05) sobre as variáveis indicativas de cor da carne em função da inclusão da polpa cítrica nas dietas. A adição de polpa cítrica em programas de restrição alimentar qualitativa não foi eficiente. Por não promover nenhum efeito deletério sobre as características da carne, a polpa cítrica pode ser utilizada como ingrediente alternativo para suínos em terminação.

Qualitative feed restriction for heavy swines: effect on digestibility and weight of organs of digestive tract, and environmental impact of feces / Restrição alimentar qualitativa para suínos pesados: efeito sobre digestibilidade e peso dos órgãos do trato digestório e impacto ambiental das fezes

A total of 50 barrows were used to evaluate qualitative feed restriction on digestibility of dietary components, weight of organs of digestive tract, and composition and production of feces. Five experimental diets, with increasing levels of qualitative feed restriction of 0, 5, 10, 15, and 20 percent were used. There was linear reduction (P<0.001) of all digestibility coefficients on the levels of qualitative feed restriction, except for acid detergent fiber, which presented a quadratic response (P<0.05). Contents of total solids (P<0.01), volatile solids (P<0.05), and total minerals (P<0.001) in the feces augmented with increasing levels of qualitative feed restriction, whereas the levels of K (P<0.05), Cu (P<0.01), N, P, Na, Ca, Mg, Fe, and Zn (P<0.001) presented a quadratic response. Daily feces excretion; and contents of total solids, volatile solids, total minerals, and levels of N, P, K, Mn, and Cu (P<0.001) and Ca, Na, Mg, and Fe (P<0.05) presented a clear increase in function of the qualitative feed restriction level. Qualitative feed restriction can be an alternative for the disposal of agribusiness waste, providing good crop-fertilizing by the use of swine feces.

Foram utilizados 50 suínos machos castrados para avaliar o efeito da restrição alimentar qualitativa sobre a digestibilidade dos componentes dietéticos, os órgãos do trato digestório, a composição e a produção fecal. Foram utilizadas cinco dietas experimentais, com níveis de restrição qualitativa de 0, 5, 10, 15 e 20 por cento. Houve redução linear (P<0,001) para todos os coeficientes de digestibilidade, com exceção da fibra em detergente ácido, que apresentou resposta quadrática (P<0,05). Os teores de sólidos totais (P<0,01) e voláteis (P<0,05), e minerais totais (P<0,001) nas fezes aumentaram com os níveis de restrição alimentar, enquanto os níveis de K (P<0,05), Cu (P<0,01) e de N, P, Na, Ca, Mg, Fe e Zn (P<0,001), apresentaram resposta quadrática. A excreção diária de fezes, sólidos totais e voláteis, minerais totais, N, P, K, Mn e Cu (P<0,001), Ca, Na, Mg e Fe (P<0,05) apresentaram aumento em função do nível da restrição alimentar qualitativa. A restrição qualitativa pode ser alternativa para destinação de resíduos da agroindústria, conferindo boas propriedades às fezes suínas, no que diz respeito à utilização para adubação de culturas.

Zero order synthetic hologram with a sinusoidal phase carrier for generation of multiple beams.

We discuss a phase synthetic hologram, for encoding arbitrary complex fields, whose design is based on a sinusoidal phase grating with a spatially modulated phase depth. An important feature of the hologram is that it encodes the complex field at the zero diffraction order of the carrier grating. The smoothness of this sinusoidal carrier grating facilitates the implementation of the hologram with a pixelated spatial light modulator. We take advantage of the hologram reconstruction at the zero-diffraction order for the simultaneous generation of a collection of complex beams.

Receitas bruta e líquida parcial e custo de dietas contendo polpa cítrica para suínos abatidos com 130kg de peso / Gross and partial net incomes and feeding cost of diets containing citrus pulp for pigs slaughtered with 130kg of weight

Avaliou-se o custo de inclusão da polpa cítrica em programa de restrição alimentar qualitativa, utilizando dados de desempenho de 36 suínos da linhagem Topigs, dos 83,7±5,1kg aos 129,8±1,9kg de peso, alimentados com dietas contendo porcentagens crescentes (0, 10, 20 e 30 por cento) de polpa cítrica. Os animais foram abatidos aos 130kg e dos valores (R$) da carcaça foram descontados o valor de compra dos animais e o custo com alimentação, de acordo com cada tratamento. Não houve efeito (P>0,05) da inclusão da polpa cítrica sobre o custo com ração e receita bruta, porém houve efeito linear negativo (P<0,05) sobre o rendimento líquido parcial com o aumento da participação da polpa cítrica nas dietas. A queda no rendimento líquido parcial foi causada pelo menor peso da carcaça obtida de animais alimentados com porcentagem mais elevada de polpa cítrica. Considerando a evolução dos preços do milho, do farelo de soja e do suíno entre junho de 2005 e maio de 2006, foram determinados 12 diferentes cenários para o rendimento líquido parcial. Em todos esses cenários, foi observada redução linear da receita líquida parcial em função da inclusão da polpa cítrica, mostrando que esse ingrediente não foi eficiente em promover melhora no rendimento (R$) ao produtor.

The cost of inclusion of citrus pulp was evaluated in a qualitative feed restriction program using performance data of 36 pigs of Topigs lineage (from 83.7±5.1kg to 129.8±1.9kg) fed with crescent levels of citrus pulp (0, 10, 20, and 30 percent). The animals were slaughtered when they reached 130kg. The value paid for animal and its feeding cost were discounted from the carcass value (R$), according to each treatment. No effect (P>0.05) of the inclusion of citrus pulp on ration cost and gross income was observed. A negative linear effect (<0.05) on partial net income with the increasing participation of the citrus pulp in diets was found. The decreasing trend in the partial net income was caused by the reduction on carcass weight of animals fed on crescent levels of citrus pulp. Considering the increase on corn, soybean, and swine prices from June 2005 to May 2006, 12 different sceneries were determined for partial net income analysis. In all situations, linear reductions on partial net income were observed as a function of citrus pulp inclusion, evidencing that the ingredient was not efficient in promoting profits for producers.

Accreditation trends in Spain.

The profound political changes that followed the Spanish Constitution of 1978 have had a major influence in the healthcare offered to the Spanish population. The healthcare provision once centred in a single government agency, the Instituto Nacional de la Salud (INSALUD), is now being decentralized to the 17 autonomous regions established by the Constitution. Existing Spanish legislation, traditional accountability and established professional roles are determinant factors in defining the boundaries amongst the main stakeholders in the healthcare accreditation issue. Hospital accreditation has been traditionally understood by the central government agency as a way to assure regulated standards for licensing the operations of healthcare facilities. However, recent public concern over the quality of healthcare, health departments' accountability and health professional technical knowledge are now creating the search for a common approach to accreditation in Spain.

Implementing total quality management in the Spanish health care system.

A Total Quality Management Programme for the Spanish Health Care System was set in motion in 1986. The first phase of the programme covers three areas: (1) information sources, (2) training, (3) Total Quality activities, through a cascade of four coordinated projects. The first one defines a basic nucleus of patient information and established two national standards: (a) a minimum basic data set, (b) the use of an ICD-9-CM Spanish translation for codification of diagnoses and procedures. The second is an open demonstration project implementing these two standards in National Health Service hospitals and carrying out intensive training on ICD-9-CM codifiers. The third project encompasses two pilot studies on case-mix measurements systems and cost analysis framework. Through the fourth project concepts, methods and tools for Total Quality Management are developed, setting up specific working groups on clinical and organizational indicators for hospitals and primary health care.

Hospital comparisons using a Euro Health Data Base for resource management and strategic planning.

A European approach for resource management and strategic planning has been implemented in the HOSCOM project of AIM by defining information standards needed across countries, as well as a methodology to measure resources and costs at the institutional and interinstitutional level. A Euro Health Data Base (EHDB) has been obtained in order to test data availability and comparability as well as to validate models through macrocomparisons using case-mix (DRG's, refined grouping, disease staging) and microcomparisons based on three diseases (cardiac valve replacement, diabetes mellitus and hip fracture). The EHDB's presently based on 274 164 medical record summaries sampled from 7 countries allowed us to build prototypes (using Clipper, Prolog and SQL) in order to export uniform aggregates in the different countries, with standard software tools for statistical comparisons. It showed the present feasibility of using case-mix based on the European Minimum Basic Data Set (MBDS) and the difficulty of obtaining uniform data on resources and costs other than length of stay across countries. Medical data confidentiality was assured but not yet population-based representativity. Given the present state of the EHDB, problems have been clearly identified in order to be solved by international research and development projects in the near future.

[Congenital fibrosarcoma. Apropos of 2 cases]. / Fibrosarcoma congénito. A propósito de dos casos.

Two cases of congenital fibrosarcoma are presented. Both tumors showed histological features of malignancy, but were successful treated with simple resections. Recurrent tumor does not seem to predispose to metastatic disease. Local excision is the initial treatment of choice for lesions occurring in newborns and infants.

[Follow-up of essential fatty acids in parenteral nutrition in which a fat preparation is included]. / Seguimiento de los ácidos grasos esenciales a lo largo de la alimentación parenteral, en la que se incluye un preparado graso.

Changes in essential fatty acids of twenty two patients during parenteral nutrition are studied. Two populations (neonatal and others) were differencied. In the neonatal group a percentual decrease in arachidonic acid was showed. In both groups a percentual increase of linoleic acid was observed. Possible implications of these findings are discussed.

[Localized pulmonary interstitial emphysema. Therapeutic management of 3 cases]. / Enfisema pulmonar intersticial localizado. Actitud terapéutica a propósito de tres casos.

Persistent localized interstitial emphysema (PLIE) is a severe complication of assisted ventilation in the neonatal period. From january 1980 to may 1982, 156 cases of IRDS where treated in our Intensive Care Unit. Three of these patients developed this type of emphysema. The initial management was conservative. In two cases, when high ventilatory pressures, and oxygen concentrations were needed to maintain normal blood gases, lobectomy was performed. In both of them mechanical ventilation could be withdrawn shortly after surgery. The third case was managed with conservative medical therapy, and the patient died. In conclusion, when PLIE is diagnosed and does not resolve with medical therapy, the patient needs increasingly higher oxygen concentrations and ventilatory pressures, or mechanical ventilation can not be withdrawn, lobectomy should be performed as long as the process is well localized.