Ultrasound guidance for central venous catheterisation. A Colombian national survey.

QUALITY PROBLEM OR ISSUE: Ultrasound (US) is a widely propagated medical technology. Anaesthesiologists increase procedural safety by using US techniques, but training and availability are essential for its usage. Although its utility for central venous catheterisation (CVC) is well established, only a paucity of evidence is available regarding its use in low- and middle-income countries. This study is a nationwide survey of Colombian anaesthesiologists designed to explore the current use of US guidance for CVC. INITIAL ASSESSMENT AND IMPLEMENTATION: Web-based survey at National level. Anaesthesiologists registered in the Colombian Society of Anaesthesiology and Resuscitation database. CHOICE OF SOLUTION: Demographic variables (age and gender), anaesthesia expertise, years of anaesthesiology practice, US availability, use of US during CVC, reasons for not using US and training experience were collected. EVALUATION: Of 351 respondents (12.3% response rate), 45% reported using US sometimes and always for CVC (95% CI 39%-50%) (n = 157). Most anaesthesiologists obtained training in US through external courses (50.4%) or from colleagues (22.8%). Of the total respondents, 62.7% (n = 220) have US equipment available at all time and this factor was independently associated with the use of US for CVC (adjusted odds ratio [OR] = 38.6, P < 0.001). LESSONS LEARNED: US guidance is not a common technique used for CVC by Colombian anaesthesiologists; an important barrier for its use is lack of equipment.

[A microbiological analysis of the ethnopharmacological products used by the Misak people]. / Análisis microbiológico de la etnofarmacología empleada por el pueblo Misak.

OBJECTIVES: Evaluating microorganism presence, type and quantity in some of the most important ethnopharmacological products designed for oral administration currently being distributed by the Sierra Morena laboratory located in the Guambia Indian reservation (Cauca department, Colombia). MATERIALS AND METHODS: This was a cross-sectional descriptive study; it involved microbiological analysis using membrane filtration of six randomly-chosen samples which included the water being used by the laboratory and five of its ethnopharmacological products ready for commercial distribution and sale. RESULTS: The samples studied here were not microbiologically suitable for human consumption because they contained Escherichia coli and fecal coliforms. Colony forming unit (CFU) count/100 mL (reference 0 CFU/100 mL) was found to be up to 63,000 CFU/100 mL in water samples and 110 CFU/100 mL in ethnopharmacological samples. CONCLUSIONS: The quantitative results revealed the presence of pathogens, indicating failure in rural water supply and environmental sanitation infrastructure. On-going monitoring of water quality and an urgent intervention of the laboratory'’s ethnopharmacological production is necessary because of the contamination found there.

Análisis microbiológico de la etnofarmacología empleada por el pueblo Misak / A microbiological analysis of the ethnopharmacological products used by the Misak people

Objetivo Evaluar la presencia, tipo y cantidad de microorganismos en algunos de los principales productos etnofarmacológicos de administración oral, comercializados en el laboratorio Sierra Morena ubicado en el resguardo indígena de Guambia, en el Departamento del Cauca. Materiales y Métodos Se llevó a cabo un estudio observacional, descriptivo, de corte transversal. Se realizó un análisis microbiológico a través de la filtración por membrana de seis muestras escogidas de forma aleatoria que incluyeron el agua y cinco productos etnofarmacológicos listos para la distribución comercial. Resultados Las muestras tomadas fueron no aptas microbiológicamente para el consumo humano debido a la presencia de Escherichiacoli y coliformes. El recuento de UFC (Unidades Formadoras de Colonias)/100ml, (parámetro de referencia 0 UFC/100ml) llegó a ser de hasta 63.000 UFC/100ml en el caso del agua y de 110 UFC/100ml para los etnofármacos. Conclusiones Los resultados cuantitativos revelaron la presencia de organismos patógenos, lo que evidencia un fallo en la infraestructura del abastecimiento rural y purificación del agua. Es necesario un monitoreo continuo de la calidad del agua y una intervención urgente de la elaboración de los etnofármacos debido a que también se encuentran contaminados.(AU)

Objectives Evaluating microorganism presence, type and quantity in some of the most important ethnopharmacological products designed for oral administration currently being distributed by the Sierra Morena laboratory located in the Guambia Indian reservation (Cauca department, Colombia). Materials and Methods This was a cross-sectional descriptive study; it involved microbiological analysis using membrane filtration of six randomly-chosen samples which included the water being used by the laboratory and five of its ethnopharmacological products ready for commercial distribution and sale. Results The samples studied here were not microbiologically suitable for human consumption because they contained Escherichia coli and fecal coliforms. Colony forming unit (CFU) count/100 mL (reference 0 CFU/100 mL) was found to be up to 63,000 CFU/100 mL in water samples and 110 CFU/100 mL in ethnopharmacological samples. Conclusions The quantitative results revealed the presence of pathogens, indicating failure in rural water supply and environmental sanitation infrastructure. On-going monitoring of water quality and an urgent intervention of the laboratory’s ethnopharmacological production is necessary because of the contamination found there.(AU)