[Use of Digital Health Records and "WebMovil" corporate service in the communication management of critical results of Microbiology, in the context of a primary health care area]. / Utilización de la Historia Digital de Salud y la aplicación "WebMovil" corporativa en la gestión de la comunicación de resultados críticos de Microbiología, en el ámbito de Atención Primaria de un Área Sanitaria.

INTRODUCTION: The objective was to describe and evaluate a new communication protocol of reporting critical results applied to Microbiology in a health area of Andalusia. MATERIAL AND METHODS: The size and type of the critical values of Microbiology are analyzed for primary care patients. A new computerized reporting system was analyzed, in real time, through Diraya Digital Health Records, which integrates the analytical test module (MPA). The protocol is complemented, in collaboration with the Information Technology (IT), with the Junta de Andalucía short message service (SMS) "WebMovil". RESULTS: The total number of notices of critical results by the new protocol in 2012 was 817. The number of critical values for primary care was 570, of which 90 were for Microbiology. The most frequent notice was by isolation in the stool culture (n = 51; 56.67%). The prevalence of the critical values of Microbiology in primary care was 0.45/100. The average time of notifications was 13 minutes. The success rate of notifications was 97.7% and 0% obtained in the number of withdrawals. In 99.93% of cases the contact with the patient was stated and in 98.55% the medical intervention was also confirmed. CONCLUSIONS: Communication by a computerized system linked to the SMS technology showed a reduction in the time of notification, and produced additional benefits, such as eliminating the risk of error when there is no repetition of information from the recipient received by the laboratory. Furthermore, the use of SMS messages ensures that doctors on duty always receive information immediately.

[Evaluation of hepatic encephalopathy using computerized electroencephalography]. / Evaluación de la encefalopatía hepática mediante electroencefalografía computarizada.

Spectral EEG analysis techniques were used to evaluate the degree of hepatic encephalopathy in a group of 69 cirrhotic patients, as compared to the results obtained in a group of healthy controls. With respect to controls, the cirrhotics had stronger delta and theta bands, and a weaker alpha band, as well as a reaction of the alpha band to opening the eyes. The use of strength ratios between different bands of frequency increments the sensitivity and diagnostic reliability of this technique, particularly the delta/alpha and theta/alpha indices, and permits the detection of cases with subclinical encephalopathy, which is particularly useful for clinical follow-up and for the evaluation of different therapeutic regimens.

[Evaluation of the therapeutic effect of flumazenil in hepatic encephalopathy using cerebral cartography]. / Evaluación del efecto terapéutico del flumazenil en la encefalopatía hepática mediante cartografía cerebral.

We investigated the therapeutic effect of flumanezil on acute and chronic hepatic encephalopathy in a group of cirrhotics; its efficacy was evaluated using clinical data and neurophysiologic examination, e.g. brain mapping. Flumazenil was not found to induce significant changes in the clinical status or in maps of the cerebral activity of patients with chronic encephalopathy. In acute encephalopathy, flumazenil improved clinical status, as was confirmed neurophysiologically by improved cerebral activity on brain mapping.