International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module.

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN.

Péptidos natriuréticos: ¿una nueva era en el manejo de la insuficiencia cardiaca? / Peptides natriuréticos: a new one was in the management of the cardiac shortage?

Los Péptidos Natriuréticos (PN) son hormonas de naturaleza proteica liberadas principalmente por las células miocárdicas de los atrios y ventrículos en respuesta a una sobrecarga de volumen o al aumento de las presiones intracavitarias. Tienen propiedades diuréticas y vasodilatadoras. Se hace una revisión de los antecedentes, papel fisiológico, formas de cuantificar los PN y valores de referencia, utilidad clínica de la determinación del PNB y NT-proPNB en la insuficiencia cardíaca (IC) y se concluye que las concentraciones de PNB caen rápidamente después de un tratamiento farmacológico efectivo en pacientes con IC. Las concentraciones elevadas de PNB deberían alertar al clínico hacia la descompensación. La monitorización regular del PNB puede también ayudar a estratificar el intervalo de seguimiento para un plan más racional de alta o revisión clínica. La administración adicional de PNA (Nesiritida, Anaritida) o fármacos que inhiben diversas metalopeptidasas aumentando así el tiempo de vida media de los PN y potenciando su acción es efectiva en los pacientes con IC(AU)

The Peptides Natriuréticos (PN) are hormones of protean nature freed chiefly by the cells miocárdicas of the atria and ventricles in answer to an overload of volume or to the increase of the pressures intracavitarias. They have vasodilator and diuretic properties. A review of the antecedents is done, physiological role, forms to quantify the PN and values of reference, clinical utility of the decision of the PNB and NT-proPNB in the heart failure (IC) and is concluded that the concentrations of PNB fall quickly after an effective pharmacological processing in patients with IC. The high concentrations of PNB should alert to the clinical one toward the descompensación. The monitoring to regulate of the PNB can also help to stratify the interval of monitoring for a rationaler plan of high or clinical review. The additional administration of PNA (Nesiritida, Anaritida) or medicines that inhibit diverse metalopeptidasas enlarging thus the time of average life of the PN and promoting its action is cash in the patients with IC(AU)