Smart central venous port for early detection of bacterial biofilm related infections.

Central venous catheters (CVC) are commonly used in clinical practice to improve a patient's quality of life. Unfortunately, there is an intrinsic risk of acquiring an infection related to microbial biofilm formation inside the catheter lumen. It has been estimated that 80 % of all human bacterial infections are biofilm-associated. Additionally, 50 % of all nosocomial infections are associated with indwelling devices. Bloodstream infections account for 30-40 % of all cases of severe sepsis and septic shock, and are major causes of morbidity and mortality. Diagnosis of bloodstream infections must be performed promptly so that adequate antimicrobial therapy can be started and patient outcome improved. An ideal diagnostic technology would identify the infecting organism(s) in a timely manner, so that appropriate pathogen-driven therapy could begin promptly. Unfortunately, despite the essential information it provides, blood culture, the gold standard, largely fails in this purpose because time is lost waiting for bacterial or fungal growth. This work presents a new design of a venous access port that allows the monitoring of the inner reservoir surface by means of an impedimetric biosensor. An ad-hoc electronic system was designed to manage the sensor and to allow communication with the external receiver. Historic data recorded and stored in the device was used as the reference value for the detection of bacterial biofilm. The RF communication system sends an alarm signal to the external receiver when a microbial colonization of the port occurs. The successful in vitro analysis of the biosensor, the electronics and the antenna of the new indwelling device prototype are shown. The experimental conditions were selected in each case as the closest to the clinical working conditions for the smart central venous catheter (SCVC) testing. The results of this work allow a new generation of this kind of device that could potentially provide more efficient treatments for catheter-related infections.

A 24-h inpatient detoxification treatment for heroin addicts: a preliminary investigation.

The present study describes a detoxification method which takes only 4 h to complete. Eleven polydrug users addicted to opiates were detoxified 12 h after their last dose of heroin, in an intensive care unit. The detoxification was carried out using naltrexone, after sedation with midazolan. After detoxification (12 h) patients were discharged without withdrawal symptoms. This procedure offers a rapid detoxification procedure which seems to be widely accepted by the addicts themselves.

Prevalence estimates of pathological gambling in Seville (Spain).

Pathological gambling is becoming an increasing concern for the Spanish population. Governmental figures from 1989 show that in the Autonomic Region of Andalucia, with a population of 7 million inhabitants, more than three hundred billion pesetas (approximately UK pounds 1,500 million) were spent during 1988 gambling in casinos, slot machines and at bingo. These figures represent an increase of 15% over the figures of the previous year and suggest that gambling may have come a very important problem in Spain. This paper presents the first epidemiological study carried out in Spain on gambling and the estimated prevalence of pathological gambling in Seville, political capital of Andalucia. A sample of 598 individuals were interviewed with an adapted screening instrument. The results suggest that further epidemiological studies are required at a national level. They also indicate that preventive and treatment measures should also be taken urgently.

[Mentally deficient patients and infection caused by hepatitis B virus. Prevalence in our area]. / Los deficientes mentales y la infección por el virus de la hepatitis B. Prevalencia en nuestro medio.

To assess the prevalence of hepatitis B virus (HBV) infection in medium level mentally impaired patients (MIP), 620 MIP were evaluated; 181 of them had Down's syndrome and were active inmated of open institutions. At the time of the study, 28.7% had some positive serum marker of HBV infection, and 5.8% were virus carriers. The highest rate of seropositive individuals (48%) was found in male MIP with Down's syndrome. The rate of seropositive individuals was higher among those MIP who had attended special education centers than in those who had not. The tendency to remain as HBV carrier was higher in males with Down's syndrome. Our results confirm the need for prophylaxis in this population.