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Secondary extraction factories in the oil olive production are subjected to high pressures each year due to the treatment of large quantities of olive mill wastes. In return, this sector achieves a biomass by-product and olive pomace oil. Furthermore, these facilities remove a serious environmental problem. To help improve and optimize the drying process of these wastes, we have carried out a study of mass transfer in a convective dryer using the drying conditions in rotary dryers. A design of experiments based on a central composite design in two dimensions, drying air temperature (between 100 °C and 425 °C) and drying air velocity (between 1 m/s and 7 m/s), was used to determine the drying rate and effective diffusivity coefficients. These variables were calculated from the experimental data obtained in isothermal drying test. Polynomial surface models, obtained by the linear least-squares fitting method, allowed to calculate these variables as a function of other such as drying air temperature, drying air velocity and moisture ratio. Drying rate and effective diffusivity values were found between 0.00001915 and 0.028 kgwater/kgsolid·s and 1.917·10−8 and 10.02·10−8 m2/s, respectively. These parameters will contribute to solve the heat and mass transfer phenomena in rotary dryers.

Livestock and their ectoparasites are involved in the epidemiology of several zoonotic diseases. Studies regarding the molecular detection of infectious agents in ticks from Northwestern Algeria are scarce. Thus, the presence of spotted fever group Rickettsia spp., Anaplasmataceae microorganisms and Coxiella burnetii was investigated in ticks collected from ruminants in Sidi Bel Abbes and Saida provinces. Rickettsia aeschlimannii was detected in one Hyalomma excavatum pool and one H. marginatum pool. Moreover, 'Candidatus Rickettsia barbariae' was found in one H. excavatum and six Rhipicephalus bursa pools. Lastly, Coxiella burnetii was amplified in two H. excavatum and two R. bursa pools. No Anaplasmataceae bacterium was detected. This study demonstrates the presence of the tick-associated microorganism 'Candidatus R. barbariae' in the North of Africa, and corroborates the presence of the zoonotic pathogens R. aeschlimannii and C. burnetii in Algeria.

Resumen Objetivo Analizar los datos epidemiologicos de las infecciones del tracto urinario relacionadas con sonda uretral (ITU-SU) en pacientes criticos ingresados en UCI espanolas para evaluar la necesidad de aplicar un programa de intervencion a nivel nacional para disminuir dichas infecciones. Diseno Analisis retrospectivo, no intervencionista, de prevalencia de periodo anual. Ambito UCI participantes en el registro multicentrico ENVIN-UCI entre los anos 2007-2016. Pacientes Pacientes criticos ingresados en UCI con ITU-SU. Variables principales Tasa de incidencia por 1.000 dias de utilizacion de SU; ratio de uso de SU; proporcion de ITU-SU con respecto del total de infecciones relacionadas con asistencia sanitaria (IRAS) controladas en el registro. Resultados Se han incluido 187.100 pacientes de los que 137.654 (73,6%) utilizaron SU durante 1.215.673 dias (84,4% de los dias de estancia en UCI). En 4.539 (3,3%) pacientes sondados se han diagnosticado 4.977 ITU-SU (3,6 episodios por 100 pacientes con SU). La tasa de incidencia de ITU-SU ha disminuido entre los anos 2007 y 2016 un 19% (4,69 a 3,8 episodios por 1.000 dias de SU), aunque se ha mantenido la ratio de uso de SU (0,84 [0,82-0,86]). La proporcion de las ITU-SU ha aumentado desde el 23,3% al 31,9% del total de IRAS controladas. Conclusiones Aunque han disminuido las tasas de ITU-SU estas infecciones han pasado a ser, proporcionalmente, la primera de las IRAS en UCI. Persiste una elevada ratio de utilizacion de SU en UCI espanolas. Existe un espacio de mejora, por lo que un proyecto ITU-ZERO podria ser util en nuestro pais.

Objective To analyze epidemiological data of catheter-associated urinary tract infection (CAUTI) in critically ill patients admitted to Spanish ICUs in order to assess the need of implementing a nationwide intervention program to reduce these infections. Design Non-intervention retrospective annual period prevalence analysis. Setting Participating ICUs in the ENVIN-UCI multicenter registry between the years 2007 and 2016. Patients Critically ill patients admitted to the ICU with catheter-associated urinary tract infection (CAUTI). Main variables Incidence rates per 1000 catheter-days; urinary catheter utilization ratio; proportion of CAUTIs in relation to total health care-associated infections (HAIs). Results A total of 187,100 patients, 137,654 (73.6%) of whom had a urinary catheter in place during 1,215,673 days (84% of days of ICU stay) were included. In 4539 (3.3%) patients with urinary catheter, 4977 CAUTIs were diagnosed (3.6 episodes per 100 patients with urinary catheter). The CAUTI incidence rate showed a 19% decrease between 2007 and 2016 (4.69–3.8 episodes per 1000 catheter-days), although a sustained urinary catheter utilization ratio was observed (0.84 [0.82–0.86]). The proportion of CAUTI increased from 23.3% to 31.9% of all HAIs controlled in the ICU. Conclusions Although CAUTI rates have declined in recent years, these infections have become proportionally the first HAIs in the ICU. The urinary catheter utilization ratio remains high in Spanish ICUs. There is room for improvement, so that a CAUTI-ZERO project in our country could be useful.

Nowadays, the design, control and development of rotary dryers are based on the study of the complete equipment. Rotary dryers are treated as a black box where only inlet and outlet parameters are known. This implies the need to know the main interactions of mass, energy and exergy throughout the trommel to help improve the drying process. In this paper, we carried out an analysis of energy and exergy during drying of olive stone from finites control volumes in an experimental rotary dryer. Mass, energy and exergy balances are applied to each control volume in the drying air. The design of experiments is based on three initial drying air temperatures (210 °C, 180 °C and 150 °C) and three drying air flows (576 kg/h, 425 kg/h and 280 kg/h), with a by-product mass flow of 40 kg/h and a rotational speed of 5.5 rpm. The results indicated that olive stone moisture content was reduced to less than half in the first third of the trommel where a big thermal shock is produced due to the interaction between the by-product and the drying air flow at high moisture contents and high temperatures, respectively. This fact led to the highest exergy destruction values, thereby diminishing the flow exergies for the following control volumes. Heat losses were considerable in all equipment, especially in the first two control volumes. Furthermore, drying process was analyzed from the enersgetic, exergetic and drying efficiencies and the unit energy consumption.

Introduction Crimean-Congo hemorrhagic fever (CCHF) is a viral disease, mainly transmitted through tick bite, of great importance in Public Health. In Spain, Crimean-Congo hemorrhagic fever virus (CCHFV) was detected for the first time in 2010 in Hyalomma lusitanicum ticks collected from deer in Caceres. The aim of this study was to investigate the presence of CCHFV in ticks from Caceres, and from other Spanish areas, and to evaluate the presence of antibodies against the virus in individuals exposed to tick bites. Methods A total of 2053 ticks (1333 Hyalomma marginatum , 680 H. lusitanicum and 40 Rhipicephalus bursa ) were analyzed using molecular biology techniques (PCR) for CCHFV detection. The determination of specific IgG antibodies against CCHFV in 228 serum samples from humans with regular contact with ticks (at risk of acquiring the infection) was performed by indirect immunofluorescence assay. Results The CCHFV was not amplified in ticks, nor were antibodies against the virus found in the serum samples analyzed. Conclusion The absence of the CCHFV in the ticks studied and the lack of antibodies against the virus in individuals exposed to tick bites would seem to suggest a low risk of acquisition of human infection by CCHFV in Spain.

Since 1991, the main by-product obtained in the olive oil extraction process is the two-phase olive-oil mill waste. To remove it, the main treatment is the drying in rotary dryers placed on secondary extraction factories. Andalusia has 39 of the 63 industrial plants in Spain. Drying of this by-product is vital for sustainable development of olive sector which eliminates a serious environmental problem, obtains the olive pomace oil and generates a biofuel called dry de-oiled pomace. This article develops a methodology to study and analyze the drying behavior in an industrial olive-oil mill waste rotary dryer. The results are compared to design parameters related to the drying of three-phase olive-oil mill waste or olive pomace in past years and for which rotary dryers were designed. After evaluating the results, the main problems are identified and several solutions and future proposals are commented.

Crimean-Congo hemorrhagic fever virus (CCHFV) was detected in Spain in 2010. The presence of CCHFV in Hyalomma marginatum ticks from migratory birds passing through Morocco during the spring migration strengthened the hypothesis of the arrival of infected ticks transported by birds to the Iberian Peninsula. Furthermore, Hyalomma species are vectors of bacterial infections such as spotted fever rickettsioses. CCHFV and Rickettsia were screened in Hyalomma ticks from Spain attached to patients (n=12) and birds (n=149). In addition, Rickettsia was investigated in 52 Hyalomma ticks from Morocco (previously reported as CCHFV-infected). No sample collected in Spain showed an infection with CCHFV. Two ticks removed from patients (16.7%), as well as 47 (31.5%) and 4 (7.7%) from birds, collected in Spain and Morocco respectively, were infected with Rickettsia aeschlimannii. Rickettsia sibirica subsp. mongolitimonae was also found in 2 ticks from birds collected in Spain (1.3%). The risk of CCHFV-infected ticks attached to migratory birds to reach the North of Spain is low. This study corroborates the presence of R. aeschlimannii in Spain and Morocco, and supports that H. marginatum can be a potential vector of R. sibirica subsp. mongolitimonae in the Iberian Peninsula.

This work presents a fast and practical method to determine a characteristic function that predicts a local ground response of vertical ground heat exchangers (GHE) in a short term, which is mandatory when intermittent operation modes are modelled. It expands the use of a Thermal Response Test (TRT) that is recommended previous to the design of a borehole field into a vertical Ground Source Heat Pump (GSHP). These tests are used to provide some ground thermal characteristics, such as ground conductivity or borehole effective thermal resistance. The same device can also be used to measure the undisturbed ground temperature along depth. From the measurements, it has been determined a temperature response factor function that characterizes the ground behavior in a short term as a consequence of a heat pulse. This function is then included into a finite line-source model to simulate the average temperature of the fluid that flows into the borehole pipes along time. In order to validate this method, several additional tests have been performed by the same device used for TRT’s, with intermittent operation modes. For each test, both experimental and simulated average fluid temperatures have been compared. Results present an excellent accuracy; thus, they demonstrate de effectiveness of the method, as well as other advantages: i) fast and accurate; ii) prevents high precomputing times; iii) several uncertainties from measurements disappear when it is used.

Drying of clean olive stone (free of olive pulp) means a revaluation as biofuel especially used for thermal processes. This work has studied the time-dependent effective moisture diffusivity from isothermal drying experiments in a convective dryer. A new method, based on a modification of the simplified method, has been established to calculate this coefficient. A comparison between this method and the slope method has been carried out and similar results have been obtained. Modified simplified method requires fewer calculations than the slope method. The dependence between the effective moisture diffusivity, the temperature and the moisture ratio was analyzed by multiple regression analysis from a second order multivariate polynomial model and the mechanisms of moisture transport were exposed. Finally, the activation energy was analyzed and its values were shown with respect to the moisture ratio and the sample thickness.

Highlights • First in vitro culture system for Anaplasma centrale. • A. centrale infected and grew in two out of 32 tick cell lines tested. • Potential for safer and more ethical bovine anaplasmosis vaccine., Anaplasma centrale has been used in cattle as a live blood vaccine against the more pathogenic Anaplasma marginale for over 100 years. While A. marginale can be propagated in vitro in tick cell lines, facilitating studies on antigen production, immunisation and vector-pathogen interaction, to date there has been no in vitro culture system for A. centrale. In the present study, 25 cell lines derived from 13 ixodid tick species were inoculated with the Israeli vaccine strain of A. centrale and monitored for at least 12 weeks by microscopic examination of Giemsa-stained cytocentrifuge smears. Infection of 19 tick cell lines was subsequently attempted by transfer of cell-free supernate from vaccine-inoculated tick cells. In two separate experiments, rickettsial inclusions were detected in cultures of the Rhipicephalus appendiculatus cell line RAE25 28–32 days following inoculation with the vaccine. Presence of A. centrale in the RAE25 cells was confirmed by PCR assays targeting the 16S rRNA, groEL and msp4 genes; sequenced PCR products were 100% identical to published sequences of the respective genes in the Israeli vaccine strain of A. centrale. A. centrale was taken through three subcultures in RAE25 cells over a 30 week period. In a single experiment, the Dermacentor variabilis cell line DVE1 was also detectably infected with A. centrale 11 weeks after inoculation with the vaccine. Availability of an in vitro culture system for A. centrale in tick cells opens up the possibility of generating a safer and more ethical vaccine for bovine anaplasmosis.

Resumen Objetivo Describir el case-mix de los pacientes medicos y quirurgicos ingresados en UCI y comparar ambas poblaciones. Diseno Analisis de datos de pacientes ingresados en UCI entre 2006 y 2011, extraidos del registro ENVIN-HELICS. Estudio observacional, prospectivo, multicentrico y de participacion voluntaria. Ambito Ciento ochenta y ocho Unidades de Cuidados Intensivos espanolas. Participantes Pacientes ingresados durante mas de 24 h. Variables de interes principales Datos demograficos, causa de ingreso, escalas de gravedad, tiempo de estancia y mortalidad. Resultados Se analiza a 138.999 pacientes. El motivo de ingreso era medico no coronario en 65.467 (47,1%), coronario en 27.785 (20,0%), postoperatorio de cirugia programada en 28.044 (20,2%) y urgente en 17.613 (12,7%). Los pacientes quirurgicos urgentes precisan mayor utilizacion de dispositivos y presentan mas infecciones nosocomiales y por patogenos multirresistentes. La mediana de estancia en UCI es mas prolongada en estos pacientes (5 dias; rango intercuartilico: 2-11), asi como la media de APACHE II y SAPS II. La mortalidad global es superior en pacientes medicos no coronarios (16,6%). Categorizando a los pacientes segun el valor APACHE II, la mortalidad es mayor para todos los niveles en los pacientes quirurgicos urgentes que en los programados, dandose la mayor diferencia en aquellos con APACHE II entre 6 y 10: el 3 y el 0,9%, respectivamente; OR: 2,141 (IC del 95%, 1,825-2,513); p Conclusiones Los pacientes medicos no coronarios presentan mayor mortalidad, pero son los quirurgicos urgentes los que precisan mayor uso de recursos por paciente. La escala APACHE II infraestima la mortalidad en pacientes quirurgicos urgentes.

Resumen La presencia de una infeccion fungica respiratoria en un paciente critico se asocia con una elevada morbimortalidad. Objetivos Determinar la incidencia de infeccion respiratoria por Aspergillus spp. en pacientes ingresados en UCI espanolas, independientemente del origen de la misma, asi como describir las tasas, caracteristicas, evolucion y factores pronostico de los pacientes con dicha infeccion. Material y metodo Estudio retrospectivo, abierto, observacional y multicentrico que analiza la cohorte de pacientes con infeccion respiratoria por Aspergillus spp. ingresados en UCI espanolas entre los anos 2006-2012 (meses de abril, mayo y junio), incluidos en el registro nacional ENVIN-HELICS (108.244 pacientes y 825.797 dias de estancia-UCI). Las variables relacionadas de forma independiente con mortalidad hospitalaria se han identificado mediante analisis de regresion logistica multiple. Resultados Se han incluido 267 pacientes en 79 de las 198 UCI participantes (2,46 casos por 1.000 pacientes ingresados en UCI y de 3,23 episodios por 10.000 dias de estancia en UCI). Las infecciones se clasificaron desde un punto de vista clinico como neumonia relacionada con ventilacion mecanica en 93 (34,8%) casos, neumonia no relacionada con ventilacion mecanica en 120 (44,9%) y traqueobronquitis en 54 (20,2%). Se trata de pacientes de edad avanzada (64,8 ± 17,1 anos), con un elevado nivel de gravedad (APACHE II: 22,03 ± 7,7), con enfermedad medica (64,8%), estancia prolongada en el hospital previa a la identificacion del Aspergillus spp. (mediana 11 dias), procedencia de salas de hospitalizacion (58,1%) y elevada mortalidad intra-UCI (57,3%) y hospitalaria (59,6%), con importantes diferencias dependiendo del tipo de infeccion. Los factores con riesgo independiente de mortalidad han sido: ingreso previo en una unidad de hospitalizacion (OR: 7,08; IC 95%: 3,18-15,76), antecedente de inmunosupresion (OR: 2,52; IC 95%: 1,24-5,13) y presencia de sepsis grave o shock septico (OR: 8,91; IC 95%: 4,24-18,76). Conclusiones La tasa de infeccion respiratoria por Aspergillus spp. en pacientes criticos ingresados en UCI en Espana es baja, afectando a un grupo muy seleccionado de pacientes, cuya mortalidad hospitalaria es elevada y condicionada por factores no modificables.

Olive-oil mill waste rotary dryers play an important role in the environmental protection and sustainable development in the olive sector. Drying of these wastes is vital for three main reasons: the extraction of olive oil contained in them (olive pomace oil) by the use of solvents, the obtaining of a biomass fuel called dry de-oiled pomace and the elimination of a highly polluting by-product due to its high biological oxygen demand (BOD). However, because of the transition from three-phase system to two-phase system, their drying presents serious problems due to high moisture contents and their nature and composition. The main objective of this work is to study and analyze the research carried out on drying kinetics of olive-oil mill wastes, which is vital to understanding the drying phenomenon, and on the main models of heat and mass transfer in the olive-oil mill waste rotary dryers, based mainly on the trommel and furnace. The synergy between these two general studies will serve as a starting point for improving the design and optimization of the drying process in this type of dryers.

Spent coffee grounds are being consolidated as one of the most abundant bioresources in the world for use as green energy. Biodiesel, bioethanol, bio-oil and fuel pellet are biofuels derived of this waste. To get them, spent coffee grounds need to be dried due to their high moisture content. This work analyzes their drying kinetics from isothermal drying experiments in a convective dryer at different temperatures: 100, 150, 200 and 250 °C, and sample thicknesses: 5, 10, 15 and 20 mm. Drying curves were fitted with the main mathematical models in the drying of agricultural products where the Two Term Gaussian model got the best results of fit. Drying rate was calculated and analyzed. Effective moisture diffusivities were calculated in a range between 1.29 · 10 − 9 to 28.8 · 10 − 9 m 2 /s. Activation energies were 12.29, 12.78, 15.18 and 16.87 kJ/mol for each sample thickness: 5, 10, 15, and 20 mm, respectively.

Drying operations are common in food industries. One of the main components in a drying system is the furnace. The furnace operation involves heat–mass transfer and combustion, thus it demands a complex mathematic representation. Since autoregressive methods are simple, and help to simulate rapidly a system, we model a drying furnace of olive pomace via an auto-regression with exogenous variables (ARXs) method. A neural network of radial basic functions (RBFs) defines the ARX experimental relation between the amounts of dry pomace (moisture content of 15%) used like fuel and the temperature of outlet gases. A real industrial furnace is studied to validate the proposed model, which can help to control the drying process.

To assess potential differences in epidemiology and management of patients admitted with influenza infection in the intensive care unit (ICU) during the first post-pandemic influenza period. Observational prospective study comparing September 2009–January 2010 with September 2010–January 2011. Variables captured: demographics, co-morbidities, physiological parameters, outcomes and management. Analysis was performed using SPSS v. 13.0; significance was set at p 0.5. Data from 53 patients, 38 adults (age, median 41.5 years; interquartile range (IQR) 32.8–51.3) and 15 children (age, median 2 years, IQR 0.5–9) are presented. Vaccination rates were 0% and 4.3% during the first and second periods, respectively. Differences postpandemic were: 100% of episodes developed after December compared with 16.7% in the 2009 season. Younger children were affected (median age 0.8 years (IQR 0.3–4.8) vs 7 years (IQR 1.25–11.5), p 0.05) and influenza B caused 8.7% of ICU admissions. Influenza A (H1N1) 2009 and respiratory syncytial virus epidemics occurred simultaneously (42.8% of children) and bacterial co-infections doubled (from 10% to 21.7%); the prevalence of co-infections (viral or bacterial) increased from 10% to 39.1% (OR 5.8, 95% CI 1.3–24.8). Respiratory syndromes without chest X-ray opacities reflecting exacerbation of asthma or chronic obstructive pulmonary disease, bronchitis or bronchiolitis increased (from 6.9% to 39.1%, p

A novel enzyme entrapment approach based on an electropolymerization process utilizing multi-walled carbon nanotubes (MWCNT), β-cyclodextrin (β-CD) and glucose oxidase (GOx) is shown. Dopamine (DA) quantification is presented using a screen-printed electrode modified by electropolymerization of cyclodextrin with glucose oxidase, SPE/MWCNT/β-CD-GOx. In order to show the relevance of the enzyme entrapment strategy controlled by electropolymerization to develop a specific and efficient biosensor, the various parts composing the electrode: SPE, SPE/β-CD, SPE/GOx, SPE/β-CD/GOx, SPE/MWCNT/β-CD, SPE/MWCNT/GOx and SPE/MWCNT/β-CD/GOx were tested separately. It was shown that although DA determination can be achieved with all of them, the electrodes modified with MWCNT presented better analytical features that those built without MWCNT, the best being the one including all components. This biosensor displayed good reproducibility, repeatability, and prolonged life-time under cold storage conditions. Its DA limit of detection (LOD) was 0.48 ± 0.02 μA in a linear range of 10–50 μM with a sensitivity of 0.0302 ± 0.0003 μA μM−1 that makes it comparable or even better than many other electrodes reported in the literature. Moreover, it was also shown that using this electrode, DA quantification can be done in the presence of interfering agents such as ascorbic and uric acid. These findings demonstrate that the approach employed is feasible for enzyme entrapment and may find applications in other biosensing systems, where better sensitivity, stability and fast response are required.

Cystic ovarian disease (COD) is an important cause of infertility that affects cattle. Alterations in the ovarian micro-environment of females with follicular cysts could alter the normal processes of proliferation and programmed cell death in ovarian cells. Thus, the objective in the present study was to evaluate apoptosis and proliferation in induced ovarian cystic follicles in cows to investigate the follicular persistence. Stage of estrous cycle was synchronized in 10 heifers and 5 were then subjected to the induction of COD by administration of ACTH. After the ovariectomy number of in situ apoptotic cells by TUNEL assay, active caspase-3, FAS/FASLG and members of the BCL2 family were compared by immunohistochemistry and multiplex PCR and cell proliferation by evaluation of Ki-67 protein and cyclin D1 and E mRNA. Significantly (p

Summary Cystic ovarian disease (COD) is one of the most common reproductive disorders of cattle and is considered to have multifactorial aetiology. An accepted hypothesis involves neuroendocrinological dysfunction of the hypothalamic–pituitary–gonadal axis; however, the role of growth factors in COD has not been extensively investigated. The present study examines the potential role of members of the insulin-like growth factor (IGF) family in COD. Expression of genes encoding IGF-II and insulin-like growth factor-binding proteins (IGFBPs) was examined and the distribution of IGF-II within the follicular wall was assessed immunohistochemically. Finally, the concentration of IGF-II protein was determined in follicular fluid. There was increased IGF-II mRNA in the wall of cystic follicles, mainly associated with granulosa cells. Additionally, there was significantly more IGF-II protein in granulosa and theca cells in cystic follicles, but no change in the concentration of IGF-II in follicular fluid. Total IGFBPs, assessed by western blotting, were similar in different structures. However, by discriminating each IGFBP a decrease was detected in IGFBP-2 expression in cystic follicles that may be related to the observed higher expression of IGF-II. In summary, the present study provides evidence to suggest that COD in cattle is associated with modifications in the IGF-II system.

Objective: In recent years there has been an increase in infections caused by gram-positive cocci in critical patients, together with a rapid development of resistance to the antibiotics which are normally used to treat them. The objective is to prepare an antibiotic treatment guide for the most common infections caused by gram positive cocci in critical patients. This guide will help in the decision-making process regarding the care of such patients. Method: Experts from two scientific societies worked together to prepare a consensus document. They were members of the Study Group on Infections in Critical Patients (GEIPC), which is part of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), and the Infectious Diseases Working Group (GTEI), belonging to the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC). There was a systematic review of the literature published up to September 2006 regarding this type of infections and the antibiotic treatments marketed to that date. An evidence grading system was applied according to the strength of the recommendation (categories A, B or C) and the level of evidence (categories I, II or III). Recommendations were given if there was consensus among the experts from both societies. Results: The antibiotic regimens recommended for treating infections caused by gram-positive cocci were presented in the form of tables, showing the recommendation grade. Alternatives were given for allergic patients. The scientific basis supporting the aforementioned recommendations is explained within the text and the references upon which they are based are cited. Conclusions: A summary of an evidence-based practical guide for the treatment of infections caused by gram-positive cocci in critical patients is presented.

An evaluation of corrosion resistance of boride coatings in AISI 304 steel was carried out. Formation of iron boride layers (FeB and Fe 2 B) at the material surface was obtained by paste boriding process. Boron paste thicknesses of 4 and 5 mm were applied to the steel surface. A thermochemical treatment, for each boron potential, was carried out at temperatures of 1173, 1223 and 1273 K; with exposure times of 4 and 6 h. Corrosion resistance of the borided samples was evaluated by the electrochemical techniques of open circuit and polarization resistance with a 0.1 M solution of NaCl. Dependence between the polarization resistance and the experimental parameters is observed. The results show that the corrosion resistance is maximized with a treatment time of 4 h and a boron paste thickness of 4 mm.

Objetivo Identificar las tasas nacionales de las infecciones hospitalarias adquiridas en Unidades de Cuidados Intensivos (UCI) relacionadas con instrumentalizacion, correspondientes al ano 2002, asi como conocer sus etiologias y la evolucion de las resistencias de aquellos microorganismos mas prevalentes. Diseno Estudio de serie de casos, observacional y prospectivo. Ambito 85 UCI, servicios o unidades de Cuidados Intensivos u otras unidades en donde se ingresan pacientes criticos, pertenecientes a 80 hospitales distintos. Pacientes y metodos Se han incluido de forma continuada los pacientes ingresados durante mas de 24 horas en las UCI participantes, que fueron seguidos hasta su alta de UCI o hasta un maximo de 30 dias. Las infecciones objeto de vigilancia han sido: neumonias relacionadas con ventilacion mecanica (N-VM), infecciones urinarias relacionadas con sonda uretral (IU-SU), bacteriemias primarias (BP) y relacionadas con cateteres vasculares (B-CVC) y bacteriemias secundarias. Resultados Se han incluido 6.868 pacientes. En 684 (10%) pacientes se han detectado 1.019 infecciones, 445 N-VM (43,7%), 229 IU-SU (22,5%), 100 BP (9,8%), 135 B-CVC (13,2%) y 110 bacteriemias secundarias (10,8%). Las densidades de incidencia en relacion con los dias de exposicion al factor de riesgo han sido 18,0 N-VM por 1.000 dias de ventilacion mecanica, 6,0 IU-SU por 1.000 dias de sonda uretral y 4,5 BP-CVC por 1.000 dias de cateter venoso central. La etiologia predominante en las N-VM precoces ha sido Staphylococcus aureus sensible a meticilina y Haemophilus influenzae y en las N-VM tardias Pseudomonas aeruginosa y Acinetobacter baumannii. Las IU-SU han estado originadas predominantemente por Escherichia coli y Enterococcus faecalis y las BP-CVC por Staphylococcus epidermidis y Staphylococcus coagulasa negativo. Entre los marcadores de resistencia destacan por su frecuencia: P. aeruginosa resistente a imipenem-cilastatina (34,7%) y a ceftazidima (29,5%), S. aureus resistente a meticilina (35,3%), A. baumannii resistente a imipenem (33,9%) y E. coli resistente a ciprofloxacino (20,0%). No se ha detectado ninguna cepa de Enterococcus spp. o de Staphylococcus aureus resistente a vancomicina. Conclusiones Se han identificado, para el ano 2002, las tasas nacionales de las infecciones nosocomiales relacionadas con ventilacion mecanica, sonda uretral y cateter venoso central, asi como los agentes patogenos que predominan en cada una de ellas y el estado de los marcadores de multirresistencia.

Fundamento Analizar la incidencia de infeccion nosocomial (IN) en una UCI polivalente de nivel II, y evaluar el efecto de la utilizacion de sucralfato y la aplicacion de medidas estrictas de asepsia sobre las distintas tasas de IN. Material y metodos Se ha llevado a cabo un estudio prospectivo de cohortes, de 2 anos de duracion, sobre 400 pacientes distribuidos en dos grupos, grupo A (n = 200), observacional, y grupo B (n = 200), en el que se aplicaron medidas de mejora basadas en la administracion de sucralfato, cumplimiento de la profilaxis antibiotica posquirurgica y medidas estrictas de asepsia en las distintas instrumentalizaciones. Se han comparado las tasas de IN asociada a ventilacion mecanica (NAVM), infeccion urinaria relacionada con sonda uretral, bacteriemia vinculada a infeccion de cateter venoso central e infeccion de herida quirurgica entre ambos grupos, asi como la mortalidad intra-UCI. Resultados En el grupo A, 29 pacientes desarrollaron una o mas IN frente a 18 en el grupo B (p = 0,06). No apreciamos diferencias en la mortalidad global intra-UCI entre ambos grupos (10,5 frente a 10%; p = 0,89), aunque si en la mortalidad de los pacientes con diagnostico de IN (57,1 frente a 25%; p = 0,03). En aquellos que desarrollaron una NAVM, observamos una reduccion no significativa de la tasa de mortalidad (60 frente a 50%; grupo A y B). A pesar de la reduccion lograda en los indicadores de IN, el nivel de incumplimientos del protocolo de intervenciones de mejora propuesto para el control de la IN fue elevado. Conclusiones Nuestros resultados se situan en un nivel aceptable dentro del contexto de los estandares admitidos sobre IN en UCI. La instauracion de un sistema de vigilancia y la aplicacion de medidas de mejora han logrado reducir tanto la incidencia como la mortalidad de la IN, no asi la mortalidad global intra-UCI.

Resumen Se presenta el caso clinico de un paciente que radiograficamente tenia un patron intersticial difuso. La anatomia patologica de estas alteraciones fue informada como alveolitis fibrosante. Ademas el enfermo tenia una anemia hemolitica autoinmune. Esta asociacion ha sido referida unicamente en dos ocasiones anteriormente. Las alveolitis fibrosantes se inician en ocasiones por el deposito de complejos inmunes en las membranas de los alveolos, cosa que no ocurriria en la anemia hemolitica, ya que los complejos inmunes circulantes no se formarian. En los comentarios del caso clinico se exponen los posibles mecanismos que se han senalado en la literatura mundial para explicar las alteraciones a nivel pulmonar.

Two cases of fracture of the penis occurring during intercourse were treated with immediate surgical exploration and primary repair. Functional recovery was excellent. The pathophysiology, diagnosis, and treatment are reviewed. Although not common, penile fracture is an entity which may be seen and must be recognized in the emergency department.