Antimicrobial potential of extracts from leaves and culms of an Amazonian native bamboo.

Antibiotics have shown less efficiency against resistance of pathogenic microorganisms. As a result, research centers have sought therapeutic alternatives against multidrug resistance of bacteria to antibiotics, one of which is using plant extracts. Bamboo extracts are used for several medicinal purposes. This study aimed to evaluate the antibacterial potential of hydroalcoholic extracts of culms and leaves of the species Guadua aff. lynnclarkiae on strains of Staphylococcus aureus, Streptococcus pneumoniae, and Klebsiella pneumoniae. We evaluated the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC). Only the leaves of G. aff. lynnclarkiae showed a bactericidal effect for all tested strains with MBC ranging from 1.55 mg ml-1 to 25 mg ml-1. The culms had bacteriostatic action with MIC ranging from 1.55 mg ml-1 to 6.25 mg ml-1, and bactericidal action at the concentration of 6.25 mg ml-1 only for S. aureus. This study provides bases for the use of this Amazonian native bamboo in bioprospecting.

Estudio coste-eficiencia de procedimientos quirúrgicos en cirugía menor con la utilización de un equipo quirúrgico de un solo uso / Cost-efficiency study on surgical procedures in minor ambulatory surgery with the utilization of single-use surgical set

Introducción: La situación económica actual condiciona que valoremos la eficiencia de los procesos de forma preeminente. Por tanto, pretendemos mantener una buena calidad asistencial al menor coste posible. Objetivo: Comparar el ahorro de tiempo y costes con la utilización de un equipo quirúrgico de un solo uso frente a material quirúrgico reutilizable. Material y método: Se realiza un estudio de coste-eficiencia de forma prospectiva en la Unidad de Cirugía Ambulatoria del Hospital de Mataró (Barcelona), para el tratamiento quirúrgico en cirugía menor de lesiones de partes blandas superficiales. Entran en estudio 128 pacientes consecutivos no aleatorizados. Se asignan a dos grupos de 64 pacientes cada uno según utilización de material quirúrgico reutilizable (Grupo 1) o material de un solo uso (Grupo 2, CombiSet®, Hartmann, Barcelona). Los pacientes se intervienen en sesiones de 10 procedimientos programados. Se divide el tiempo quirúrgico en cinco segmentos que posteriormente se compara entre grupos. Se realiza un análisis de costes de lavado y esterilización de material reutilizable. Resultados: El tiempo quirúrgico total se reduce un 30,6 % (44,4 y 30,6 minutos) en Grupo 2. Destaca una reducción de 41,7 % (11,7 vs. 6,8 minutos) en el tiempo desde la entrada del paciente en quirófano hasta la incisión. En una proyección de 910 procedimientos anuales y con un coste por equipo de un solo uso de 14,27 Euros , el coste total hubiera sido de 12.985,7 Euros. En el Grupo 1, el coste de lavado y esterilización, uso de instrumental reutilizable y material fungible sería de 17.792,3 Euros. Por tanto, la diferencia en el coste entre los dos grupos es de 4.986,6 Euros a favor del Grupo 2, lo que representa un ahorro del 28 %. Conclusiones: La utilización del equipo quirúrgico de un solo uso permite reducir los tiempos quirúrgicos, incrementando la actividad de una sesión (de 2 a 3 procedimientos más). Esta reducción se debe a una mayor rapidez en la preparación del proceso quirúrgico, una calidad siempre óptima y estándar de los materiales y la reducción de tiempo de recogida de materiales usados. Por otra parte, se produce un ahorro de costes por la ausencia de procesamiento del material reutilizable (AU)

Introduction: The current economic situation condition that we value preeminently the efficiency of processes. Therefore, our aim is keeping a good quality of care at the possible lower cost. Objective: To compare time and cost savings with the use of a surgical single-use set vs. reusable surgical material. Material and methods: A cost-efficiency study was prospectively carried out in the Ambulatory Surgery Unit of the Hospital de Mataro (Barcelona), for surgical treatment by office-based surgery of superficial soft tissue lesions. We considered non-randomized 128 consecutive patients for the study. Two groups of 64 patients each were allocated according to use of reusable surgical material (Group 1) or single-use material (Group 2, CombiSet®, Hartmann, Barcelona). Patients were scheduled and operated on in 10 surgical sessions. Surgical time was divided into five segments and subsequently a comparison between groups. An analysis of costs of washing and sterilization of reusable material is performed. Results: The total operating time is reduced 30.6 % (44.4 and 30.6 minutes) in group 2. We have to emphasize a reduction of 41.7 % (11.7 vs. 6.8 minutes) in the time from patient entry in the operating room until the surgical incision. In a projection of 910 annual procedures and a cost for single-use equipment of Euros 14.27, the total cost would have been Euros 12,985.7. In group 1, the cost of washing and sterilization, use of reusable instruments and consumables would be Euros 17,792.3. Therefore, the difference in cost between the two groups is Euros 4,986.6 for group 2, representing a saving of 28 %. Conclusions: The use of the surgical single-use set reduces surgical time, increasing the activity of a session (of 2-3 procedures more). This reduction is due to a faster preparation of the surgical procedure, and the optimal quality materials and time reduction collecting reusable materials. Moreover, a cost saving was noted from the absence of processing reusable material (AU)

Continuidad asistencial: rol de la enfermera de enlace / Continuity of care: role of the link nurse

Objetivo. Evaluar el programa de enfermera de enlace a los 2 años de funcionamiento. Diseño. Estudio descriptivo. Emplazamiento. Atención primaria de los municipios de Sant Boi de Llobregat y Sant Vicenç dels Horts (Barcelona) y el Hospital Comarcal de Sant Boi. Pacientes. Pacientes dados de alta del hospital (entre octubre de 2000 y octubre 2002) y que necesitaban cuidados de continuidad en el equipo de atención primaria o domicilio. Intervenciones. Visitas conjuntas entre la enfermera de enlace y la supervisora de la unidad hospitalaria para elaborar el plan de cuidados previo al alta hospitalaria. Se comunica al equipo de atención primaria del traspaso del enfermo y su plan de cuidados. Las visitas posteriores al domicilio las realiza la enfermera de enlace, el equipo de atención primaria, o conjuntamente. Resultados. Se ha estudiado a 854 pacientes (57,6% mujeres); media de edad en mujeres 69,82 ± 14,7 años y en varones de 61,7 ± 19,6 años (p < 0,0001). La enfermera de enlace ha realizado 2.241 visitas hospitalarias, 81 domiciliarias y 434 llamadas telefónicas. También se han hecho 636 coordinaciones. El diagnóstico de enfermería más frecuente ha sido trastorno de la movilidad física (61% de los pacientes). Conclusiones. Se ha creado un mecanismo que mejora la continuidad desde el alta hospitalaria hasta el contacto con el equipo de atención primaria. La enfermera de enlace coordina y gestiona los casos antes de que el paciente sea traspasado al ámbito de la atención primaria

Objective. To evaluate the link nurse programme after 2 years of operation. Design. Descriptive study. Setting. Primary vare in the towns of Sant Boi de Llobregat and Sant Vicenç dels Horts (Barcelona) and the County Hospital of Sant Boi, Spain. Patients. Patients discharged from the hospital (October 2000-October 2002) and who needed ongoing care in the primary care centre or at home. Interventions. Joint visits of the link nurse and the hospital unit's supervisor to work out the care plan before discharge. The PC team was informed of the transfer of the patient and his/her care plan. Subsequent home visits were by the link nurse, the primary care team or both together. Results. 854 patients (57.6% women) were studied. Women's mean age was 69.82 (SD, 4.7) and men's was 61.7 (SD, 9.6) (P<.0001). The link nurse made 2241 hospital visits, 81 home visits, and 434 phone calls. There were 636 co-ordinations. The most common nursing diagnosis made was physical mobility disorder (61% of patients). Conclusions. A mechanism was created to improve continuity from hospital discharge to contact with the PC team. The link nurse coordinates and manages patients before they are handed over to PC

[Continuity of care: role of the link nurse]. / Continuidad asistencial: rol de la enfermera de enlace.

OBJECTIVE: To evaluate the link nurse programme after 2 years of operation. DESIGN: Descriptive study. SETTING: Primary vare in the towns of Sant Boi de Llobregat and Sant Vicenç dels Horts (Barcelona) and the County Hospital of Sant Boi, Spain. PATIENTS: Patients discharged from the hospital (October 2000-October 2002) and who needed ongoing care in the primary care centre or at home. INTERVENTIONS: Joint visits of the link nurse and the hospital unit's supervisor to work out the care plan before discharge. The PC team was informed of the transfer of the patient and his/her care plan. Subsequent home visits were by the link nurse, the primary care team or both together. RESULTS: 854 patients (57.6% women) were studied. Women's mean age was 69.82 (SD, 4.7) and men's was 61.7 (SD, 9.6) (P<.0001). The link nurse made 2241 hospital visits, 81 home visits, and 434 phone calls. There were 636 co-ordinations. The most common nursing diagnosis made was physical mobility disorder (61% of patients). CONCLUSIONS: A mechanism was created to improve continuity from hospital discharge to contact with the PC team. The link nurse coordinates and manages patients before they are handed over to PC.

The EFQM excellence model is useful for primary health care teams.

BACKGROUND: Primary care teams are facing an increased need to develop quality programmes at local level. GPs must lead this process and promote a positive organizational culture if they want to achieve and maintain a continuous improvement of the service. OBJECTIVE: The aim of the present study was to test the applicability and reliability of the European Foundation for Quality Management (EFQM) excellence model self-assessment questionnaire in a primary health care organization. METHOD: A cross-sectional study was carried out of the EFQM questionnaire to compare the scores achieved by a primary health care team in Spain caring for 42 000 inhabitants using internal self-assessment with the scores achieved by professional management auditors through an external audit. RESULTS: The scores of each criterion achieved by self-evaluation are similar to or lower than those assessed by the external evaluation. There is agreement in the areas suitable for improvement. CONCLUSIONS: The experience proves the applicability of the EFQM excellence model for primary health care teams and its reliability, at least when the team undergoing self-assessment know they are going to be re-evaluated. There is high concordance in the identification of areas for improvement.

Antitumor and cytotoxic screen of 5,6,7-trisubstituted flavones from Gomphrena martiana.

An in vivo antitumor screening of extracts of Gomphrena martiana indicated positive activity in the petroleum ether extract, and its further bioactivity-directed fractionation resulted in a lipophilic flavonoid fraction. Upon inoculation of various doses of 5,6,7-trisubstituted flavones on two murine tumor lines, Sarcoma 180 and Ehrlich's carcinoma, a decrease of tumor growth was observed. An in vitro KB cultured cell screen indicated cytotoxicity.

Síntesis y control del MAG3 99mTc. Estudios comparativos con el hipurán 131I en seres humanos / Syntesis and control of Tc99m MAG3: comparative study with 131I hippuran in humans

La benzoilmercaptoacetiltriglicina (MAG,) se sintetizó de acuerdo con el método de A.R.Fritzberg y colaboradores. Se comprobó su pureza por punto de fusión, composición centesimal, cromatografía líquida de alta presión y resonancia magnética nuclear. Se realizaron estudios farmacológicos, esterilidad, apirogenicidad, toxicidad aguda y distribución biológica en animales. El producto (MAG,) marcado con tecnecio 99m, según la técnica de J.R.Coveney y M.S.Roblins, se controló por cromatografía en papel. Posteriormente, se inyectó en seres humanos (2,5-3 ,Ci) en normales y con patología renal (39 casos totales) realizándose el estudio comparativo con hipurán

Síntesis y control del MAG3 99mTc. Estudios comparativos con el hipurán 131I en seres humanos / Syntesis and control of Tc99m MAG3: comparative study with 131I hippuran in humans

La benzoilmercaptoacetiltriglicina (MAG,) se sintetizó de acuerdo con el método de A.R.Fritzberg y colaboradores. Se comprobó su pureza por punto de fusión, composición centesimal, cromatografía líquida de alta presión y resonancia magnética nuclear. Se realizaron estudios farmacológicos, esterilidad, apirogenicidad, toxicidad aguda y distribución biológica en animales. El producto (MAG,) marcado con tecnecio 99m, según la técnica de J.R.Coveney y M.S.Roblins, se controló por cromatografía en papel. Posteriormente, se inyectó en seres humanos (2,5-3 ,Ci) en normales y con patología renal (39 casos totales) realizándose el estudio comparativo con hipurán

Controlled clinical study of the efficacy of a new low molecular weight heparin administered subcutaneously to prevent post-operative deep venous thrombosis.

A double-blind, placebo-controlled study was carried out in 100 patients undergoing major surgery to investigate the efficacy of a new low molecular weight heparin (LMWH) preparation in the prevention of deep venous thrombosis. Patients were allocated at random to receive either placebo or LMWH (7500 AXaU) each day by subcutaneous injection (abdominal fold method), starting 2 hours before the operation and continuing for the following 7 days. Clinical and laboratory tests revealed deep venous thrombosis in 3 (6%) patients in the placebo group whereas no thrombotic episodes were observed in any of the patients treated with LMWH. Blood loss during the peri-operative and post-operative period and the number of blood units transfused were not significantly different in the two groups. Moreover, no side-effects were revealed in the LMWH group that could be attributed to the drug.

A humeral modular prostheses for bone tumour surgery: a study of 56 cases.

Fifty six humeral prostheses were inserted from 1974 to 1984 for primary bone tumours of the shoulder. In 40 patients a proximal humeral resection was performed and in the remaining 16 cases a Tikhoff-Linberg procedure was employed. The length of humeral resection ranged from 9 cm to 24 cm. A detailed analysis of the oncological and functional results was made. The resection was well clear in 42 patients (75%), marginal in 12 (21.5%), and through tumour in 2 (3.5%). Eight local recurrences were noted. The functional results were satisfactory, the patients having a wide range of active rotation and being able to do sedentary work. A new modified humeral modular prosthesis was introduced in 1984 and is presented.

[Radiologic studies in the diagnosis of biliary ileus]. / L'indagine radiologica nella diagnostica di ileo biliare.

The authors, after a short reference to considerations of general order, report 6 cases of gallstone-ileus. The number of cases, studied with the traditional X-ray procedure (with and without contrast means) are quite various for the occlusion at different levels of the small bowel, and exactly from the duodenal bulb to the Bowin valve, and for the X-ray symptomatology complete and incomplete. At last it must be underlined the high percentage where the stone of the gallbladder was ascertained, and which is to be considered responsible of intestinal occlusion; this ascertainment has been a very precious element to the right diagnosis of the gallstone-ileus.