[PAPPS expert group: Lifestyle recommendations]. / Recomendaciones sobre el estilo de vida. Actualización PAPPS 2022.

We present the recommendations of the Preventive Activities and Health Promotion Programme (PAPPS) of the semFYC (Spanish Society of Family and Community Medicine) to promote healthy lifestyles using intervention methodology, and preventive actions against tobacco and alcohol use, healthy eating, physical activity in leisure time, prevention of traffic accidents, and child restraint systems. The recommendations have been updated, and new aspects highlighted, such as the definition of low-risk alcohol consumption, and the references have been updated. For the main recommendations, we include specific tables showing the quality of the evidence and the strength of the recommendation.

Using Copernicus Sentinel-2 and Sentinel-3 data to monitor harmful algal blooms in Southern Chile during the COVID-19 lockdown.

During the southern summer of 2020, large phytoplankton blooms were detected using satellite technology in Chile (western Patagonia), where intensive salmonid aquaculture is carried out. Some harvesting sites recorded massive fish mortalities, which were associated with the presence of the dinoflagellate species Cochlodinium sp. The bloom included other phytoplankton species, as Lepidodinium chlorophorum, which persistently changed the colour of the ocean to green. These blooms coincided with the government-managed emergency lockdown due to the COVID-19 pandemic. Local in situ sampling was slowed down. However, imagery from the Copernicus programme allowed operational monitoring. This study shows the benefits of both Sentinel-3 and Sentinel-2 satellites in terms of their spectral, spatial and temporal capabilities for improved algal bloom monitoring. These novel tools, which can foster optimal decision-making, are available for delivering early alerts in situations of natural catastrophes and blockages, such as those occurred during the global COVID-19 lockdown.

Control glucémico en pacientes diabéticos tipo 2 de edad avanzada. Intervención para evitar riesgos / Blood-glucose control in eldely patients with type 2 diabetes. Interventions to avoid risks

OBJETIVO: Evaluar el control glucémico de pacientes de edad avanzada, con diabetes mellitus tipo 2 (DM2), en tratamiento con varios antidiabéticos, y analizar el efecto de una intervención. MATERIAL Y MÉTODOS: Estudio descriptivo transversal y observacional de prevalencia que incluyó a pacientes ≥75 años con DM2, en tratamiento con 2 o más hipoglucemiantes. Se analizó la adecuación de los tratamientos siguiendo las recomendaciones actuales para este grupo poblacional, la prevalencia de complicaciones macro y microvasculares, demencia e hipoglucemias, los tratamientos empleados y la adherencia. Se realizó una intervención para optimizar la prescripción. RESULTADOS: Se incluyeron 215 pacientes. El 54,4% fueron mujeres, con edad media de 82,0±4,1 años, el 77,2% tenía complicaciones macro y/o microvasculares y el 7,4% demencia. En el 67,9% se detectó inadecuación por control glucémico demasiado intensivo (55,6% HbA1c<7,5%) o no estar ajustada la posología a su filtrado glomerular (51,0%). El 81,4% estaba en tratamiento con fármacos con riesgo de producir hipoglucemias; el 2,3% tenía algún episodio registrado. La HbA1c media fue mayor en los no adherentes (8,1±1,6% vs. 7,5±1,3%, p < 0,05). Tras la intervención disminuyó la intensidad del tratamiento hipoglucemiante en el 36,2% de los pacientes, y se adecuó la posología en el 23,1% de los fármacos que precisaban ajuste. El porcentaje de sobretratamiento se redujo al 40,0% (p < 0,01). CONCLUSIONES: Más de la mitad de los pacientes mayores, con DM2 e importantes comorbilidades, tenía un control glucémico demasiado estricto. La puesta en marcha de un programa de intervención ha permitido mejorar la seguridad y la adecuación de los tratamientos

OBJECTIVE: To evaluate blood-glucose control in elderly patients with type 2 diabetes mellitus (T2DM), who are receiving various anti-diabetic treatments, and to analyse the effect of an intervention. MATERIAL AND METHODS: Cross-sectional, descriptive, and observational study of prevalence that included patients who were ≥75 years old with T2DM and being treated with two or more antidiabetic drugs. The adequacy of treatments following current recommendations for this population group was analysed, together with the prevalence of macro- and micro-vascular complications, dementia, and hypoglycaemia, the treatments used, and adherence. An intervention was carried out to optimise prescription. RESULTS: A total of 215 patients were included, of which 54.4% were women. The mean age was 82.0±4.1, and 77.2% had micro- and/or macrovascular complications, and 7.4% had dementia. Inadequacy was detected in 67.9% due to an overly intensive blood glucose control (55.6% HbA1c<7.5%), or that the dosage was not adapted to glomerular filtration (51.0%). The large majority (81.4%) were being treated with drugs with a risk of producing hypoglycaemia (2.3% had recorded episodes). The HbA1c mean was higher in non-adherent patients (8.1±1.6% vs 7.5±1.3%, P<.05). After the intervention, the intensity of hypoglycaemic treatment was reduced in 36.2% of patients, and the dosage of drugs that required adjustment was corrected in 23.1%. The percentage of overtreatment decreased to 40.0% (P<.01). CONCLUSIONS: More than half of the elderly patients with T2DM and important comorbidities had an overly strict glycaemic control. The launch of an intervention programme has allowed for an improvement in safety and for the optimisation of treatments

[Blood-glucose control in eldely patients with type 2 diabetes. Interventions to avoid risks]. / Control glucémico en pacientes diabéticos tipo 2 de edad avanzada. Intervención para evitar riesgos.

OBJECTIVE: To evaluate blood-glucose control in elderly patients with type 2 diabetes mellitus (T2DM), who are receiving various anti-diabetic treatments, and to analyse the effect of an intervention. MATERIAL AND METHODS: Cross-sectional, descriptive, and observational study of prevalence that included patients who were ≥75 years old with T2DM and being treated with two or more antidiabetic drugs. The adequacy of treatments following current recommendations for this population group was analysed, together with the prevalence of macro- and micro-vascular complications, dementia, and hypoglycaemia, the treatments used, and adherence. An intervention was carried out to optimise prescription. RESULTS: A total of 215 patients were included, of which 54.4% were women. The mean age was 82.0±4.1, and 77.2% had micro- and/or macrovascular complications, and 7.4% had dementia. Inadequacy was detected in 67.9% due to an overly intensive blood glucose control (55.6% HbA1c<7.5%), or that the dosage was not adapted to glomerular filtration (51.0%). The large majority (81.4%) were being treated with drugs with a risk of producing hypoglycaemia (2.3% had recorded episodes). The HbA1c mean was higher in non-adherent patients (8.1±1.6% vs 7.5±1.3%, P<.05). After the intervention, the intensity of hypoglycaemic treatment was reduced in 36.2% of patients, and the dosage of drugs that required adjustment was corrected in 23.1%. The percentage of overtreatment decreased to 40.0% (P<.01). CONCLUSIONS: More than half of the elderly patients with T2DM and important comorbidities had an overly strict glycaemic control. The launch of an intervention programme has allowed for an improvement in safety and for the optimisation of treatments.

Mortality due to acute adverse drug reactions in Galicia: 1997-2011. / Mortalidad por reacción aguda tras consumo de drogas en Galicia: 1997-2011.

The aim of this research is to study all people who died in the Autonomous Community of Galicia from acute death after drugconsumption (ADR) in which there was judicial intervention during the period from 1997 to 2011, according to inclusion and exclusión criteria established by the National Drug Plan for the entire national territory. Sociodemographic and clinical characteristics of deceased subjects were studied, in order to identify key risk factors and/or vulnerable populations.A total of 805 deaths were recorded. The distribution by provinces and municipalities corresponds to the areas of greatest population, incidence of consumption and proximity to the coast. The average age of these patients was 34.34 years, with a gradual increase over years. Most of them were male (91.2%) and single (47.7). 43.5% of the deceased habitually used the parenteral route of administration and 36.4% had positive HIV serology. The most frequently-detected substances corresponded to opiates (heroin: 61.3%, methadone: 35.6%), followed by cocaine (53.7%), although the most common pattern was that of poly-consumption. ADR mortality figures remain relatively stable throughout the study period. The predominant pattern is that of males, opiates and a long history of consumption.

Se estudian todos los sujetos fallecidos en Galicia por reacción aguda tras consumo de drogas (RAD) en los que existe intervención judicial a lo largo del periodo 1997-2011, según los criterios establecidos por el Plan Nacional sobre Drogas para todo el territorio nacional. Se recogieron y analizaron variables sociodemográficas, clínicas y toxicológicas de cada uno de los casos. El objetivo fundamental es tratar de determinar los principales factores de riesgo y/o perfil de las poblaciones vulnerables, así como sugerir medidas preventivas. En total se registran 805 fallecimientos. La edad media de los fallecidos fue de 34,34 años, con un aumento progresivo a lo largo de los años. La mayoría eran varones (91,2%) y solteros (47,7%). El 43,5% de los fallecidos utilizaban la vía de administración parenteral y un 36,4% presentaban serología positiva frente al VIH. Las sustancias detectadas con más frecuencia correspondían a opiáceos (heroína: 61,3%, metadona: 35,6%), seguidos de cocaína (53,7 %), aunque el patrón más habitual era el policonsumo. Las cifras de mortalidad por RAD se mantienen relativamente estables a lo largo del periodo de estudio. El patrón predominante es el de varones, consumidores de opiáceos y con larga historia de consumo.

Mortalidad por reacción aguda tras consumo de drogas en Galicia: 1997-2011 / Mortality due to acute adverse drug reactions in Galicia; 1997-2011

Se estudian todos los sujetos fallecidos en Galicia por reacción aguda tras consumo de drogas (RAD) en los que existe intervención judicial a lo largo del periodo 1997-2011, según los criterios establecidos por el Plan Nacional sobre Drogas para todo el territorio nacional. Se recogieron y analizaron variables sociodemográficas, clínicas y toxicológicas de cada uno de los casos. El objetivo fundamental es tratar de determinar los principales factores de riesgo y/o perfil de las poblaciones vulnerables, así como sugerir medidas preventivas. En total se registran 805 fallecimientos. La edad media de los fallecidos fue de 34,34 años, con un aumento progresivo a lo largo de los años. La mayoría eran varones (91,2%) y solteros (47,7%). El 43,5% de los fallecidos utilizaban la vía de administración parenteral y un 36,4% presentaban serología positiva frente al VIH. Las sustancias detectadas con más frecuencia correspondían a opiáceos (heroína: 61,3%, metadona: 35,6%), seguidos de cocaína (53,7 %), aunque el patrón más habitual era el policonsumo. Las cifras de mortalidad por RAD se mantienen relativamente estables a lo largo del periodo de estudio. El patrón predominante es el de varones, consumidores de opiáceos y con larga historia de consumo

The aim of this research is to study all people who died in the Autonomous Community of Galicia from acute death after drug consumption (ADR) in which there was judicial intervention during the period from 1997 to 2011, according to inclusion and exclusion criteria established by the National Drug Plan for the entire national territory. Sociodemographic and clinical characteristics of deceased subjects were studied, in order to identify key risk factors and/or vulnerable populations. A total of 805 deaths were recorded. The distribution by provinces and municipalities corresponds to the areas of greatest population, incidence of consumption and proximity to the coast. The average age of these patients was 34.34 years, with a gradual increase over years. Most of them were male (91.2%) and single (47.7). 43.5% of the deceased habitually used the parenteral route of administration and 36.4% had positive HIV serology. The most frequently-detected substances corresponded to opiates (heroin: 61.3%, methadone: 35.6%), followed by cocaine (53.7%), although the most common pattern was that of poly-consumption. ADR mortality figures remain relatively stable throughout the study period. The predominant pattern is that of males, opiates and a long history of consumption

Cumplimiento con las guías nacionales en pacientes hospitalizados con neumonía adquirida en la comunidad: resultados del Estudio Capo en Venezuela / Adherence With National Guidelines in Hospitalized Patients With Community-acquired Pneumonia: Results From the CAPO Study in Venezuela

Introducción: La Organización de Neumonía adquirida en la Comunidad (CAPO, siglas en inglés: Community Acquired Pneumonia Organization) es un estudio observacional internacional en 130 hospitales de un total de 31 países, para evaluar la gestión actual de los pacientes hospitalizados con neumonía adquirida en la comunidad (NAC). Utilizando la base de datos centralizada de CAPO, se realizó este subestudio con el objetivo de evaluar el grado de cumplimiento con las guías nacionales en Venezuela, para definir en qué áreas se puede intervenir para mejorar la atención del paciente hospitalizado con NAC. Métodos: En este estudio retrospectivo observacional, se usaron indicadores de calidad para evaluar la atención de pacientes hospitalizados con NAC en 8 centros de Venezuela. El nivel de cumplimiento fue clasificado como óptimo (> 90%), intermedio (60-90%), y bajo (< 60%). Resultados: Se enrolaron 454 pacientes con NAC. El tratamiento empírico administrado dentro de las 8 horas de la admisión fue óptimo (96%), el resto de los indicadores mostraron un bajo nivel de cumplimiento (< 60%). Conclusiones: Podemos decir que existen muchas áreas en el manejo de las NAC en Venezuela que no se efectúan de acuerdo a las guías nacionales de la SOVETHORAX1. En todo proceso de mejora de calidad la primera etapa es la evaluación de la diferencia entre lo recomendado y lo que se efectúa en la práctica clínica diaria. Este estudio cumple con este primer paso, pero el desafío a futuro es implementar los procesos necesarios para mejorar el manejo de la NAC en Venezuela

Introduction: The Community-Acquired Pneumonia Organization (CAPO) is an international observational study in 130 hospitals, with a total of 31 countries, to assess the current management of hospitalized patients with community-acquired pneumonia (CAP). 2 Using the centralized database of CAPO was decided to conduct this study with the aim of evaluate the level of adherence with national guidelines in Venezuela, to define in which areas an intervention may be necessary to improve the quality of care of hospitalized patients with CAP. Methods: In this observational retrospective study quality indicators were used to evaluate the management of hospitalized patients with CAP in 8Venezuelan’s centers. The care ofthe patients was evaluated in the areas of: hospitalization, oxygen therapy, empiric antibiotic therapy, switch therapy, etiological studies, blood cultures indication, and prevention. The compliance was rated as good (> 90%), intermediate (60% to 90%), or low (< 60%). Results: Atotal of 454 patients withCAP were enrolled. The empiric treatment administered within8 hours of the patient arrival to the hospital was good (96%), but the rest of the indicators showed a low level of adherence (< 60%). Conclusion: We can say that there are many areas in the management of CAP in Venezuela that are not performed according to the national guidelines of SOVETHORAX.1 In any quality improvement processthe first step is to evaluate the difference between what is recommended and what is done in clinical practice. While this study meets this first step, the challenge for the future is to implement the processes necessary to improve the management of CAP in Venezuela

Distribution and growth of Vibrio parahaemolyticus in southern Chilean clams (Venus antiqua) and blue mussels (Mytilus chilensis).

We evaluated the distribution and growth of Vibrio parahaemolyticus in the inland sea of southern Chile, where the world's largest foodborne gastroenteritis outbreak by the pandemic strain O3:K6 occurred in 2005. Intertidal samples of Mytilus chilensis and Venus antiqua were collected around port towns between 41°28'S and 43°07'S, during April to May 2011 and January to March 2012. We used most probable number real-time polymerase chain reaction (MPN-PCR) for enumeration of the tlh, tdh, and trh genes in freshly harvested bivalves and after a controlled postharvest temperature abuse. Pathogenic markers (tdh+ or trh+) were not detected. Total V. parahaemolyticus (tlh+) in freshly harvested samples reached up to 0.38 and 3.66 log MPN/g in 2011 and 2012, respectively, with values close to or above 3 log MPN/g only near Puerto Montt (41°28'S, 72°55'W). Enrichments by temperature abuse (>2 log MPN/g) occurred mainly in the same zone, regardless of the year, suggesting that both natural or anthropogenic exposure to high temperatures were more critical. Lower salinity and higher sea surface temperature in Reloncaví Sound and Reloncaví Estuary were consistent with our observations and allowed confirmation of the existence of a high-risk zone near Puerto Montt. Based on the results, a strategy focused on risk management inside this defined hazard zone is recommended.

Adherence with national guidelines in hospitalized patients with community-acquired pneumonia: results from the CAPO study in Venezuela.

INTRODUCTION: The Community-Acquired Pneumonia Organization (CAPO) is an international observational study in 130 hospitals, with a total of 31 countries, to assess the current management of hospitalized patients with community-acquired pneumonia (CAP). 2 Using the centralized database of CAPO was decided to conduct this study with the aim of evaluate the level of adherence with national guidelines in Venezuela, to define in which areas an intervention may be necessary to improve the quality of care of hospitalized patients with CAP. METHODS: In this observational retrospective study quality indicators were used to evaluate the management of hospitalized patients with CAP in 8 Venezuelan's centers. The care of the patients was evaluated in the areas of: hospitalization, oxygen therapy, empiric antibiotic therapy, switch therapy, etiological studies, blood cultures indication, and prevention. The compliance was rated as good (>90%), intermediate (60% to 90%), or low (<60%). RESULTS: A total of 454 patients with CAP were enrolled. The empiric treatment administered within 8 hours of the patient arrival to the hospital was good (96%), but the rest of the indicators showed a low level of adherence (<60%). CONCLUSION: We can say that there are many areas in the management of CAP in Venezuela that are not performed according to the national guidelines of SOVETHORAX.1 In any quality improvement process the first step is to evaluate the difference between what is recommended and what is done in clinical practice. While this study meets this first step, the challenge for the future is to implement the processes necessary to improve the management of CAP in Venezuela.

Eficacia del método acupuntural en la disfunción sexual eréctil psicógena / Efficiency of acupuncture in psychogenic erectile sexual dysfunction

Se realizó un ensayo clínico fase II, en pacientes con disfunción sexual eréctil psicógena, atendidos en la consulta de psiquiatría del Hospital Clínico Quirúrgico Docente Dr Octavio de la Concepción y de la Pedraja, de Camagüey, desde Julio de 2001 a Junio de 2003, con el objetivo de demostrar la eficacia de este método en esta enfermedad. La muestra estuvo constituida por 68 pacientes con disfunción sexual eréctil psicógena y diagnóstico tradicional de síndrome de deficiencia. Se les aplicó tratamiento con acupuntura y moxibustión en puntos acupunturales previamente seleccionados. Se constató que la mayor aparición fue en edades avanzadas, predominó el grupo de edades de 51 a 60 años con el 54,41 por ciento; los síntomas más frecuentes fueron la depresión (67,65 por ciento) y el insomnio (57,35 por ciento). El mayor número de pacientes se presentó a la consulta con un tiempo de evolución de la enfermedad menor de un año y predominó la respuesta satisfactoria al tratamiento, los de más de cinco años tuvieron menor respuesta satisfactoria, las reacciones adversas que más se presentaron fueron el efecto postpuncional y el sangramiento en 17 y nueve pacientes respectivamente. La mayoría de los pacientes del grupo menores de un año de evolución presentaron respuestas satisfactorias. El tratamiento tuvo respuesta satisfactoria en el 83,82 por ciento. El método acupuntural fue eficaz en más de un 86 por ciento de los enfermos(AU)

Eficacia del método acupuntural en la disfunción sexual eréctil psicógena / Efficiency of acupuncture in psychogenic erectile sexual dysfunction

Se realizó un ensayo clínico fase II, en pacientes con disfunción sexual eréctil psicógena, atendidos en la consulta de psiquiatría del Hospital Clínico Quirúrgico Docente Dr Octavio de la Concepción y de la Pedraja, de Camagüey, desde Julio de 2001 a Junio de 2003, con el objetivo de demostrar la eficacia de este método en esta enfermedad. La muestra estuvo constituida por 68 pacientes con disfunción sexual eréctil psicógena y diagnóstico tradicional de síndrome de deficiencia. Se les aplicó tratamiento con acupuntura y moxibustión en puntos acupunturales previamente seleccionados. Se constató que la mayor aparición fue en edades avanzadas, predominó el grupo de edades de 51 a 60 años con el 54,41 por ciento; los síntomas más frecuentes fueron la depresión (67,65 por ciento) y el insomnio (57,35 por ciento). El mayor número de pacientes se presentó a la consulta con un tiempo de evolución de la enfermedad menor de un año y predominó la respuesta satisfactoria al tratamiento, los de más de cinco años tuvieron menor respuesta satisfactoria, las reacciones adversas que más se presentaron fueron el efecto postpuncional y el sangramiento en 17 y nueve pacientes respectivamente. La mayoría de los pacientes del grupo menores de un año de evolución presentaron respuestas satisfactorias. El tratamiento tuvo respuesta satisfactoria en el 83,82 por ciento. El método acupuntural fue eficaz en más de un 86 por ciento de los enfermos

Comparison of conventional nighttime with automatic or manual daytime CPAP titration in unselected sleep apnea patients: study of the usefulness of daytime titration studies.

Daytime CPAP titration studies with full polysomnography have been successfully performed in patients with severe sleep apnea-hypopnea syndrome (SAHS). The implementation of daytime studies in unselected SAHS patients could help to reduce the waiting lists for CPAP titrations. The main purpose of this study was to compare the effectiveness of conventional versus manual or automatic daytime CPAP titration in unselected patients with SAHS. Ninety-three consecutive patients with SAHS in whom CPAP was indicated were assigned to conventional titration or to manual or automatic (AutoSet) daytime CPAP titration, after sleep deprivation. The number of valid studies, sleep architecture, final pressure selected and mean pressure in the different sleep stages were compared. Changes in sleepiness (Epworth sleepiness score) and hours of CPAP use were assessed after 3 months of treatment. Four patients did not sleep (3 AutoSet, 1 conventional daytime groups). Sleep latency was shorter during automatic daytime titration whereas REM latency was shorter in daytime studies; the percentage of sleep stages was similar during all types of titration. CPAP requirements were significantly higher during REM sleep in conventional and manual daytime titrations while mean pressure was unchanged throughout sleep stages during AutoSet titration. CPAP pressure selected with conventional or daytime manual titration (7.5(2.2) cm H2O and 7.4(1.5) cm H2O, ns) were significantly lower (P< 0.001) than with AutoSet (9.4(1.6) cm H20. All groups showed similar decrease of sleepiness and hours of use of CPAP at 3 months of follow-up. Automatic and manual daytime PSG studies after sleep deprivation are useful for CPAP titration in unselected patients with SAHS. Pressure selected with AutoSet is significantly higher than with conventional daytime or nighttime titration, although not significant in terms of treatment compliance and symptom improvement.

Asthma induced by canary food mix.

A 42-year-old woman reported immediate rhinoconjunctivitis, asthma, and contact urticaria while handling bird food. Skin-prick tests were positive to Lolium, Cynodon, Phragmites, Cupressus sempervirens, Cupressus arizonica, Chenopodium, sunflower pollen and seed, mugwort, chamomile, Chrysanthemum, Taraxacum, canary seed, and black seed (Guizotia abyssinica). The patient's serum-specific immunoglobulin (IgE) to Taraxacum, black seed, and canary seed was positive. Enzyme-linked immunosorbent assay inhibition studies revealed a 97 and 27% IgE-binding inhibition of whole canary food IgE by black seed and Taraxacum pollen, respectively. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis immunoblotting showed two IgE-binding protein bands of 11 and 44 kDa in the G. abyssinica extract. These two bands were totally inhibited by sunflower seed, mugwort, and Taraxacum extracts. Specific bronchial challenge with black seed extract was positive. The patient was able to feed her canary with birdseeds after she removed black seeds. We report a case of asthma caused by black seed (G. abyssinica) used as canary food in a patient previously allergic to pollen (olea europaea, grass, and mugwort) and sunflower seeds.

Síndrome de pfiffer asociado a cráneo en trébol: primer caso descrito en Venezuela / Pfeiffer s syndrome associated to cloverleaf skull: first case described in Venezuela

En 1964, Pfeiffer describió un síndrome que consiste en craneosinostosis, pulgares anchos, primer ortejo grande y sindactilia cutánea parcial de manos y pies, por lo que se incluyó en el grupo de los síndromes de acrocefalosindactilia. Se describe un lactante menor, masculino, producto de VII gesta, embarazo simple, a término, no controlado, sin complicaciones, madre y padre sanos, no consanguíneos, de 32 y 50 años, respectivamente; quien llena los criterios diagnóstiscos y pronósticos de Síndrome de Pfeiffer, subtipo 2. Se discuten los aspectos clínicos, radiológicos, tomográficos y genéticos

Influence of N-acetylcysteine on the formation of biofilm by Staphylococcus epidermidis.

The influence of various concentrations (0.003-8 mg/mL) of N-acetylcysteine on the formation of biofilms by 15 strains of Staphylococcus epidermidis has been studied. A dose-related decrease in biofilm formation was observed, except with the lowest concentrations. The 'slime' index relative to the control was 63%, 55%, 46%, 34%, 26% and 26% in the presence of 0.25, 0.5, 1, 2, 4, and 8 mg/mL of N-acetylcysteine, respectively. These data are statistically significant. The inhibitory effect of 2 mg/mL of N-acetylcysteine on slime formation was also verified by electron microscopy.

Influence of the incubation atmosphere on the production of slime by Staphylococcus epidermidis.

The influence of various incubation atmospheres on the growth and slime production of 23 Staphylococcus epidermidis strains was studied. The atmospheres evaluated were aerobiosis (control), anaerobiosis, candle jar, 5% CO2 and 10% CO2. As compared to the aerobic control, growth was 55.7 +/- 19% (p < 0.01) in anaerobic incubation, 113.7 +/- 12% (p < 0.01) in 5% CO2, 112.8 +/- 13% (p < 0.01) in 10% CO2 and 106.4 +/- 7% (p > 0.1) in the candle jar. The slime production in relation to the aerobic control was 20.3 +/- 19% in anaerobiosis (p < 0.01), 22.3 +/- 27% (p < 0.01) in 5% CO2, 29.4 +/- 39% (p < 0.01) in 10% CO2 and 68.3 +/- 26% (p > 0.1) in the candle jar. The results of this study may explain the discrepancies which have been noted on occasion between slime formation data and pathogenicity.