Interhospital Sepsis Code in Catalonia (Spain): Territorial model for initial care of patients with sepsis. / Código Sepsis Interhospitalario en Catalunya: modelo organizativo territorial para la atención inicial al paciente con sepsis.

Sepsis is a syndromic entity with high prevalence and mortality. The management of sepsis is standardized and exhibits time-dependent efficiency. However, the management of patients with sepsis is complex. The heterogeneity of the forms of presentation can make it difficult to detect and manage such cases, in the same way as differences in training, professional competences or the availability of health resources. The Advisory Commission for Patient Care with Sepsis (CAAPAS), comprising 7 scientific societies, the Emergency Medical System (SEM) and the Catalan Health Service (CatSalut), have developed the Interhospital Sepsis Code (CSI) in Catalonia (Spain). The general objective of the CSI is to increase awareness, promote early detection and facilitate initial care and interhospital coordination to attend septic patients in a homogeneous manner throughout Catalonia.

Comparison between exclusively school teacher-based and mixed school teacher and healthcare provider-based programme on basic cardiopulmonary resuscitation for secondary schools.

OBJECTIVE: To compare two teaching methodologies for PROCES (a basic cardiopulmonary resuscitation (b-CPR) programme for secondary school students): one exclusively performed by school teachers (study group) and another by a mixed team of school teachers and healthcare providers (control group). METHODS: According to their preferences, teachers chose either method and students were consequently assigned to the control or study group. All participants took a 10 multiple-choice question exam regarding b-CPR skills twice: immediately after PROCES and one year later. Eight or more correct answers was considered satisfactory learning. Results between groups were compared. Associations between satisfactory learning and some student characteristics were analysed. RESULTS: Immediately after PROCES, 442 students (219 in the study group and 223 in the control group) took the exam. The percentage of satisfactory learning was not different: 67.1% in the study group and 64.6% in the control group. Immediate satisfactory learning was related to the absence of pending subjects in the control (odds ratio (OR) 2.31, 95% CI 1.16 to 4.64) and study (OR 5.87, 95% CI 1.22 to 28.20) groups. One year later, a greater percentage of retention of b-CRP skills was detected in the study group (57.1% vs 40.6%; p = 0.01). The absence of any pending subject (OR 6.86, 95% CI 1.83 to 25.66) was independently associated with better retention in the study group, but not the control group. CONCLUSIONS: Secondary school teachers, previously trained in b-CPR, can teach these skills effectively to 14-16-year-old students using PROCES. The retention of b-CPR skills is greater with this methodology compared with a more standardised programme.

[Intraparotid lymphoepithelial cysts and the human immunodeficiency virus]. / Quistes linfoepiteliales intraparotídeos y virus de la inmunodeficiencia humana.

Lymphoepithelial lesions in the parotid gland are an uncommon benign entity, with an increasing incidence since 1980 due to the involvement of HIV infected patients. We report here three cases recorded at the ORL service in Viladecans Hospital, with cytologic investigation with echo-guided fine needle aspiration. A discussion follows on the theory that these cysts are part, together with persistent polyadenopathies, of the immune response to HIV infection. The course towards malignancy is exceptional and conservative management is most accepted.

[The prevalence of infection by the hepatitis B, C and human immunodeficiency viruses in drug users]. / Prevalencia de la infección por los virus de la hepatitis B, C e inmunodeficiencia humana en usuarios de drogas.

OBJECTIVE: Estimate the prevalence of the hepatitis B (HBV) infection, hepatitis C (HCV) and human immunodeficiency virus (HIV) and its coexistence in intravenous drug users, in order to start afterwards a vaccination and sanitary training programmes. PATIENTS AND METHODS: Intravenous drug users attended in a health centre and in the drugs addition deshabitation centre of reference located in a marginal urban quarter. Patients were detected from the health centre. During one year (June 1995-1996) facts were collected. The age, sex, consumption, type, administration mechanism and also the described serologies were analysed. It has been carried out descriptive statistics and applied the chi-square [correction of square-ji] test. RESULTS: A study of 355 patients, 295 (83.1%) males and 60 (16.9%) females was carried out. The average age was 28.6 years (SD = 6.5). All serologies in 113 (31.8%) were available. The positive serologies for HIV, 64.6% for HBV and 64.4% had 71.1% for HCV. The three of them coexisted in a 35.4% between HIV, 39.1% of them were VHB and 88% VHC. 49.1% were VHB and VHC. The infection from any of the three virus was related with intravenous administration mechanism, but not with sex or drug type. CONCLUSION: The infection caused from the virus above mentioned is frequent in drug users. A not negligible percentage of patients could benefit from the hepatitis B vaccine administration (67.6%) or other preventive measures.