R Gálvez Vargas

Contamination on fresh vegetables during cultivation and marketing

Abstract A total of 345 samples of vegetable from farms, a wholesale market, supermarkets and small shops in Granada were examined between February, 1981 and March, 1983. The vegetables consisted of the green leaves of beet, artichoke, cerely, cardoon, escarole, cabbage, Brussels sprouts, cauliflower, endive, asparagus, spinach, lettuce and parsley. The results obtained indicated a high degree of faecal contamination. Escherichia coli was detected in 86.1% of the samples, and salmonellae were isolated from 7.5%. The serotype most frequently isolated was Salmonella typhimurium .

Bacterial contamination of enteral feeds as a possible risk of nosocomial infection

Abstract The degree of microbiological contamination in enteral diets was studied and the possible infectious complications that could arise in the patient after administration of an enteral feed were evaluated. Of the 208 diets studied, 56 (26·9%) were contaminated and 152 (73·1%) were sterile. Of the 56 contaminated diets, 11 could be used as delivered, but the other 45 required further medication. Of the patients who had received enteral feeding, 43 developed gastrointestinal symptoms in the first 24 h (fever, vomiting, abdominal pain and diarrhoea). Twenty-nine (67·4%) had received a contaminated diet and 14 (32·6%) an uncontaminated one. We conclude that contamination of enteral feeds may constitute a risk factor for nosocomial infection, and consider it necessary to carry out epidemiological surveillance in order to control the factors which may lead to contamination of enteral diets.

Preoperative stay as a risk factor for nosocomial infection

To evaluate the relationship between duration of preoperative stay and the risk of nosocomial infection, we studied 449 patients who underwent surgery at the University Hospital of Granada during the first six months of 1986. Patients were chosen from two cross-sectional surveys. Nosocomial infection was studied throughout each patients hospital stay. Other variables included preoperative stay, age, severity and total length of stay. The data were analyzed by comparing nosocomial infection for different lengths of preoperative hospitalization, age and severity by calculating the Odds Ratio. The effects of age and severity were studied by stratifying patients by duration of preoperative stay. Two multivariate regression models were used to confirm the results of the stratified analysis. The results suggest that lengthening the preoperative stay may increase the risk of nosocomial infection in surgical wounds and in other sites, and may simultaneously potentiate the effects of other risk factors such as age and severity of the patients condition, whose influence on susceptibility to infection increases with the duration of preoperative stay.

Evolución de la mortalidad por accidentes de tráfico en España, 1962-1994

Resumen Objetivo Estudiar la evolucion de la tasa de mortalidad por accidentes de trafico en Espana desde 1962 hasta 1994 y la capacidad explicativa que sobre ella tienen sus cuatro componentes teoricos: la motorizacion (vehiculos/habitantes), la accidentabilidad (accidentes/vehiculos), la lesividad (victimas/ accidentes), y la letalidad (defunciones/victimas). Metodos A partir de los Censos de la Poblacion Espanola y de los Boletines de la Direccion General de Trafico se han obtenido los datos necesarios para calcular las variables antes referidas, para todos los anos del periodo en estudio, globales, en carretera y en zona urbana. Se han obtenido los coeficientes de correlacion de Pearson simple y parcial entre cada indicador y la tasa de mortalidad, y se han aplicado modelos de regresion de Poisson. Resultados La tasa de mortalidad poblacional muestra una tendencia ascendente durante el periodo estudiado, y destaca el fuerte incremento de sus valores entre 1982 y 1989, que afecto fundamentalmente a poblacion joven, seguido de un descenso posterior. Los cuatro componentes antes citados se asocian positivamente con la magnitud de la tasa de mortalidad. En el analisis de correlacion parcial destaca su asociacion con los indices de motorizacion y de lesividad globales y en carretera, mientras que en zona urbana es la letalidad el factor mas estrechamente asociado con ella. El papel de la accidentabilidad parece relativamente menor. Conclusiones Ya que la tasa de exposicion es creciente en nuestro pais y escapa a una estrategia de control, es necesario potenciar las medidas que tiendan a disminuir los otros tres componentes de la mortalidad poblacional, especificamente las relacionadas con la lesividad y la letalidad.

Influence of driver nationality on the risk of causing vehicle collisions in Spain.

Study objective: To estimate the association between driver nationality and the risk of causing a collision between vehicles in motion. Design: Retrospective, matched by collision, case-control study. Setting: Collisions that occurred in Spain during the period from 1990 to 1999 were studied. Participants: Responsible (case) and non-responsible (control) drivers identified in the databases of the Dirección General de Tráfico (General Traffic Directorate) who were involved in a collisions between two or more four wheeled vehicles in motion, in which only one of the drivers had committed a traffic violation. Main results: Crude odds ratios (ORs) for the effect of driver nationality on the risk of causing a collision were significantly higher for foreign drivers than for Spanish drivers, and ranged from a minimum of 1.19 (95% CI 1.09 to 1.29) for Portuguese drivers to a maximum of 2.06 (1.88 to 2.27) for British drivers. Corresponding adjusted ORs were slightly lower, but were still significantly higher than 1 for all nationalities except Italian, Belgian, and American (USA). Adjusted ORs were usually higher for collisions that occurred in urban areas than on open roads. Conclusions: Authorities responsible for traffic safety, and drivers in general, should consider foreign drivers in Spain at particularly high risk for causing collisions, especially in urban areas.

Variabilidad geográfica de la gravedad de los accidentes de tráfico en España

Resumen Objetivo Cuantificar la variabilidad interprovincial de la gravedad de los accidentes de trafico en Espana, en el periodo 1985–1994, y comparar la distribucion de diversos indicadores de gravedad. Metodos Para el periodo en estudio se han obtenido los valores provinciales medios de tres indicadores de severidad: el indice de mortalidad (defunciones por 1.000 accidentes), la tasa de lesividad (victimas por 1.000 accidentes) y la tasa de letalidad (defunciones por 1.000 victimas), asi como el indice de motorizacion (vehiculos por 1.000 habitantes) y la densidad de poblacion. Para cada uno se obtuvieron sus correspondientes medidas de dispersion y se clasificaron las 50 provincias en terciles. Se calcularon los coeficientes de correlacion entre las cinco variables y se obtuvieron modelos de regresion de Poisson, tomando los indicadores de gravedad como variables dependientes. Resultados y conclusiones Se observa una importante variabilidad interprovincial en los valores del indice de mortalidad y de la tasa de letalidad. Para todos los indicadores de gravedad, los valores tienden a ser menores en las provincias con elevada densidad de poblacion y grandes concentraciones urbanas. La lesividad y la letalidad aportan componentes explicativos diferentes a la magnitud del indice de mortalidad.

Klebsiella ozaenae in relation to atrophic rhinitis in granada (Spain)

We foundKlebsiella ozaenae in only six women of 30 patients (20 females, ten males) suffering from atrophic rhinitis. These isolates were confirmed three times at intervals of 15 days. In the remaining 24 patients a wide variety of microorganisms were isolated,Proteus mirabilis having the highest incidence. Wir fandenKlebsiella ozaenae nur bei sechs Frauen von insgesamt 30 Fällen (20 Frauen, zehn Männer) mit atrophischer Rhinitis. Diese Isolate wurden in Abständen von 15 Tagen dreimal bestätigt. Bei den verbleibenden 24 Patienten wurde eine breite Vielfalt von Mikroorganismen isoliert, dabei warProteus mirabilis am häufigsten.

Prevalence of dental caries in schoolchildren of the province of Granada (Spain)

A sample of 3,347 students between 5 and 14 years of age was selected from the entire student population in the province of Granada (Spain) to study the prevalence of dental caries and several risk factors for the disease. Decay was ascertained in the study population by mean of the following indices: df, DMF, and DMFS. Risk factors considered were the level of oral hygiene, number of between-meal sugar-containing food, and flouride concentration in drinking water. The indices mentioned showed a clear relationship to the age of the participants in the study. The level of oral hygiene did not show a clear association with dental caries measured through the df and DMF indices. Curiously, a higher correlation was noted between the disease in deciduous teeth and fluoride concentration than between the disease in permanent teeth and the latter factor.A sample of 3,347 students between 5 and 14 years of age was selected from the entire student population in the province of Granada (Spain) to study the prevalence of dental caries and several risk factors for the disease. Decay was ascertained in the study population by mean of the following indices: df, DMF, and DMFS. Risk factors considered were the level of oral hygiene, number of between-meal sugar-containing food, and flouride concentration in drinking water. The indices mentioned showed a clear relationship to the age of the participants in the study. The level of oral hygiene did not show a clear association with dental caries measured through the df and DMF indices. Curiously, a higher correlation was noted between the disease in deciduous teeth and fluoride concentration than between the disease in permanent teeth and the latter factor.

Possibility of using purified pyocins for typing Pseudomonas aeruginosa: purification of pyocins and sensitivity of P. aeruginosa in different tests.

Summary Two types of pyocins were simultaneously found in Pseudomonas aeruginosa strains HCP2. According to their structures, they belonged to the types classified as R and F, respectively, and were named HCP2-R and HCP2-F. The sensitivity of 87 strains of P. aeruginosa of clinical origin to pyocins of strain HCP2 was compared in different types of tests. Results indicated that the use of the purified pyocins for the typing of P. aeruginosa provides data which are easier to control and interpret.

Análisis de un taller de trabajo sobre atención primaria de salud

Resumen Se realiza la evaluacion de un taller de trabajo sobre atencion primarla de salud de 32 horas de duracion. El metodo de trabajo de participacion activa, constaba de: a) prueba anonima de evaluacion de conocimientos, b) trabajo en equipos de 5–6 miembros para resolver supuestos practicos, c) exposicion conjunta y sintesis y d) nueva evaluacion anonima de la misma prueba inicial asi como una valoracion anonima de la utilidad del taller y su metodologia. Se presentan los resultados sobre la modificacion de conocimientos de los 237 alumnos que lo realizaron (96,2% los mejoran), la utilidad del taller (91,1% lo estiman util) y la valoracion de la metodologia. Este tipo de ensenanza es util por estimular la capacidad critica de los alumnos, mejorando sus conocimientos. ( Gac Sanit 1989; 3 (11): 377–9).