José Quero Jiménez

Prospective study of infection, colonization and carriage of methicillin-resistant Staphylococcus aureus in an outbreak affecting 990 patients.

In the three years between November 1989 and October 1992, an outbreak of methicillin-resistantStaphylococcus aureus (MRSA) affected 990 patients at a university hospital. The distribution of patients with carriage, colonization or infection was investigated prospectively. Nosocomial acquisition was confirmed in at least 928 patients, 525 of whom were identified from clinical specimens as being infected (n=418) or colonized (n=107) by MRSA. An additional 403 patients were identified from screening specimens, of whom 58 subsequently became infected and 18 colonized. Screening of the nose, throat and perineum detected 98 % of all carriers. Of the 580 infections in 476 patients, surgical wound, urinary tract and skin infections accounted for 58 % of the infections. Of the 476 infected patients, death was attributable to MRSA infection in 13 %. Colonization with MRSA was found in 127 patients and 42 % of 165 colonized sites were the skin. Auto-infection from nasal carriage or cross-infection, probably via staff hands, seemed to be the most common mode of acquisition of MRSA infections.

Seudohipoaldosteronismo tipo I múltiple: presentación neonatal y seguimiento

El seudohipoaldosteronismo (PHA) tipo I multiple es un sindrome de resistencia mineralocorticoide, de herencia autosomica recesiva, que afecta a tubulo renal, glandulas salivales y sudoriparas y mucosa del colon. Caso 1 Recien nacida con hermana que fallecio a los 10 dias de vida con hiperpotasemia. A los 7 dias de vida presenta deshidratacion, hiponatremia, hiperpotasemia, acidosis metabolica e hipernatriuria. El diagnostico se baso en la presencia de aldosterona en plasma, actividad de renina plasmatica (ARP) y eliminacion de sal en sudor muy elevadas. Preciso rehidratacion y tratamiento con sal, bicarbonato, resinas de intercambio ionico y dieta pobre en potasio. Durante el primer ano de vida requirio hospitalizacion por descompensaciones repetidas. Tras 7 anos de evolucion, aun precisa suplementos de sal y bicarbonate y resinas de intercambio ionico. El desarrollo psicomotor y el crecimiento son adecuados. Caso 2 Recien nacida de 8 dias con antecedente de consanguinidad en la familia materna. Al ingreso presenta deshidratacion severa con hiponatremia, hiperpotasemia, acidosis metabolica e hipernatriuria, con aldosterona, ARP y sal en sudor muy elevados. Precisa rehidratacion, suplementos de sal y bicarbonato y resinas de intercambio ionico. Permanece ingresada durante 6 meses por descompensaciones multiples, siendo posible posteriormente control ambulatorio. Al ano de edad, la curva de peso y el desarrollo psicomotor son adecuados. Conclusiones Se debe sospechar PHA I multiple en recien nacidos con sindrome pierdesal e hiperpotasemia, sin virilizacion, hiperpigmentacion ni deficit glucocorticoide, que no responde al tratamiento con mineralocorticoides. La labilidad en el primer ano de vida obliga al ingreso hospitalario prolongado. A edades posteriores es susceptible de control ambulatorio.

Design and Implementation of a Modular Optical System of Perimeter Activity Detection for Military Posts of the Colombian National Army - Phanton Fox

The Colombian National Army conducts military operations against armed groups aimed at defending sovereignty, independence and territorial integrity. One of the armed groups strategies involved the creation of groups called “pisa-softs”, whose mission was to infiltrate the patrols and kill the sentinels. Various responses were developed to stop this type of attacks; One of them makes use of technological tools with programmable electronic devices and the use of sensors. A review of perimeter activity detection devices to detect intruders with systems applicable to hostile environments to define the most practical technology for building an effective device usable in the military posts. Subsequently, the functional modules of the device were defined, including a PIC microcontroller, a module with four infrared sensors, a receiving module and a tablet under Android for enhanced Tablet can be used for its construction. The result is a tool capable of generating a tactical advantage to military posts with a data reception at 60 ± 5 m and high sensitivity of 80% to 90% for intrusion detection.