Scientific management of Mediterranean coastal zone: a hybrid ocean forecasting system for oil spill and search and rescue operations.

The oil spill from Prestige tanker showed the importance of scientifically based protocols to minimize the impacts on the environment. In this work, we describe a new forecasting system to predict oil spill trajectories and their potential impacts on the coastal zone. The system is formed of three main interconnected modules that address different capabilities: (1) an operational circulation sub-system that includes nested models at different scales, data collection with near-real time assimilation, new tools for initialization or assimilation based on genetic algorithms and feature-oriented strategic sampling; (2) an oil spill coastal sub-system that allows simulation of the trajectories and fate of spilled oil together with evaluation of coastal zone vulnerability using environmental sensitivity indexes; (3) a risk management sub-system for decision support based on GIS technology. The system is applied to the Mediterranean Sea where surface currents are highly variable in space and time, and interactions between local, sub-basin and basin scale increase the non-linear interactions effects which need to be adequately resolved at each one of the intervening scales. Besides the Mediterranean Sea is a complex reduced scale ocean representing a real scientific and technological challenge for operational oceanography and particularly for oil spill response and search and rescue operations.

The etiology and natural history of sinus node disorders.

Two aspects of sinus node disorders currently seem to need emphasis--the etiology, which is still a difficult area, and the detailed structuring of the natural history of the sick sinus syndrome (SSS). The latter is becoming much clearer. The multifaceted influences of normal S-A nodal functions are reviewed. Degenerative fibrosis is the commonest abnormality, and coronary artery disease is not a major cause of the syndrome. The framework of the progressive natural history of the SSS in its usual sequential phases can now be constructed. Of course, not every feature of this progression is perceived in each patient. Gradually developing stages are reviewed, new data concerning behavior of rescue rhythms in S-A node disorders are presented, and a brief comment concerning the needs for and complications of pacing is included.

Preexcitation.

Recent increase in our knowledge of the basic features involved in ventricular preexcitation has moved it from being a somewhat rare curiosity for which there was no cure to an important medical condition requiring careful therapeutic planning. This review summarizes a body of information concerning mechanisms, various forms of preexcitation, embryologic features, electrophysiology and special testing maneuvers, treatment, prognosis and aviation plus insurance aspects of the syndrome. A new classification of the locations of the Kent bundles in the Wolff-Parkinson-White form of preexcitation is also offered.

[The bacteriological control of TPN mixtures at the Hospital de Bellvitge]. / Control bacteriológico de las mezclas de NPT en el Hospital de Bellvitge.

The complications of sepsis often make it necessary to suspend nutritional therapy. The origin of these is the nutritive mixture as well as the catheter connection and/or point where it has been inserted. The aim of this study is to show the need for bacteriological control of the whole process, in order to evaluate the effectiveness of the methods used, dilucidate the origin of the sepsis and establish an internal quality control. Study of different methods for bacteriological control of the nutritive mixtures, comparing them with the methods used in our Hospital, which is based on systematic culture of the mixtures, the collecting of samples after preparation and prior to perfusing the mixture through the patient, the performing of a further culture control and a bacteriological examination of the catheter. For this purpose, 28,501 nutritive mixtures were studied, corresponding to 1,782 patients. Of these, 185 samples were initially positive (0.65%) and only 59 samples showed positive cultures (0.21%). Of the 6 cases of sepsis discovered and confirmed by haemoculture, 5 corresponded to Enterobacter cloacae and 1 to Klebsiella pneumoniae.

[Bacteriologic control of total parenteral nutrition formulations at the Bellvitge Hospital]. / Control bacteriológico de las mezclas de NPT en el Hospital de Bellvitge.

Septic complications often lead to halting nutritional parenteral therapy. In general, the source of infection lies in the mixture, the connection and/or point of catheter insertion. The objective of this study is to show the need for bacteriological control throughout the parenteral nutrition process in order to assess the efficacy of the methods used, discover the source of infection and establish an in-house quality control. Different methods for bacteriological control of parenteral nutrition mixtures are studied and are compared with the method used at our hospital which is based on routine culture sampling after the mixture is prepared and before it is perfused, on repeating bacteriological control cultures and on performing bacteriological assessments of the catheter. In order to achieve this goal, 28.501 nutritional parenteral samples from 1,782 patients were studied. Only 185 (0.65%) samples were originally positive, and only 59 of them (0.21%) remained positive following a verification culture. Of the 6 culture-verified septic cases, 5 corresponded to Enterobacter cloacae and 1 to Klebsiella pneumoniae.