RESUMEN
Multiple-pass ultrahigh pressure homogenization (UHPH) was used for reducing microbial population of both indigenous spoilage microflora in whole raw milk and a baroresistant pathogen (Staphylococcus aureus) inoculated in whole sterile milk to define pasteurization-like processing conditions. Response surface methodology was followed and multiple response optimization of UHPH operating pressure (OP) (100, 175, 250 MPa) and number of passes (N) (1-5) was conducted through overlaid contour plot analysis. Increasing OP and N had a significant effect (P < 0·05) on microbial reduction of both spoilage microflora and Staph. aureus in milk. Optimized UHPH processes (five 202-MPa passes; four 232-MPa passes) defined a region where a 5-log(10) reduction of total bacterial count of milk and a baroresistant pathogen are attainable, as a requisite parameter for establishing an alternative method of pasteurization. Multiple-pass UHPH optimized conditions might help in producing safe milk without the detrimental effects associated with thermal pasteurization.
Asunto(s)
Manipulación de Alimentos/métodos , Microbiología de Alimentos/métodos , Leche/microbiología , Pasteurización/métodos , Presión , Staphylococcus aureus/fisiología , Animales , Recuento de Colonia Microbiana , Modelos Teóricos , TemperaturaRESUMEN
During a period of 42 months, we studied the prevalence of epilepsy in a specific health district, composing by four towns with 98,405 inhabitants older than 10 years. This has been accomplished by a two-phase cross-sectional study. The prevalence rate observed was 4.12/1000 inhabitants for all types of epilepsy. No significant differences were found between the sexes. Sixty-three per cent of affected individuals had partial seizures, with a confirmed cause in 45%. Fifty-five patients with single unprovoked seizures, were also identified but not included in the prevalence rate.
Asunto(s)
Epilepsia/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Estudios Transversales , Epilepsias Parciales/epidemiología , Epilepsias Parciales/etiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Prevalencia , España/epidemiologíaRESUMEN
The problems posed by health care are related to health service structure and development. The transformation of a three level care structure into one of just two levels, primary care and specialized care, plays its part. With the aim of analyzing the importance these factors might have in present-day health care, we carried out an aleatoric study of all those patients who attended our neurological service in the years 1992 and 1993. We obtained two sample groups consisting of 921 and 849 patients respectively through interconsultatory requests from practitioners within a limited health care area. We studied the patient's background, the requesting practitioner, diagnosis obtained and complementary tests used. Patients from individual practitioners varied in number from 4 to 38, with some 20% of all patients having been referred by just six practitioners. 20% of the patients we studied showed no neurological pathology. Complementary tests used in all diagnoses sent to us amounted to less than half the number of patients studied. We analyzed the importance these factors have in the present delay in health care services.
Asunto(s)
Administración de los Servicios de Salud , Neurología , Encefalopatías/fisiopatología , Femenino , Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Atención Primaria de Salud/organización & administración , Atención Primaria de Salud/estadística & datos numéricos , Estudios Retrospectivos , EspañaRESUMEN
Spontaneous post-anesthetic tremor that resembles shivering is common during recovery from anesthesia. Risks to postoperative patients include an increase in metabolic rate of up to 400%, hypoxemia, wound dehiscence, dental damage, and disruption of delicate surgical repairs. The etiology of spontaneous post-anesthetic tremor is most commonly attributed to normal thermoregulatory shivering in response to intraoperative hypothermia. However, the mechanism of this tremor remains unknown, hampering prevention and treatment. The present study was designed to determine whether mechanisms other than thermoregulation contribute to the tremor. The electromyograms (EMGs) of eight muscles were observed in nine women during recovery from isoflurane anesthesia. Signals from each muscle were compared to those of pathologic clonus induced by plantar flexion in unanesthetized patients with spinal cord transections and to those of cold-induced shivering in normal, unanesthetized subjects. Two distinct EMG patterns were identified: 1) regular, bursting signals of 5-7 Hz similar to those produced by pathologic clonus in patients with spinal cord transections; and 2) tonic, irregular signals of 5-15 Hz which had poorly defined bursts that did not demonstrate the synchronous 4-8-cycle/min waxing and waning pattern typical of normal shivering. EMG activity occurred most often at expired isoflurane concentrations of 0.1-0.19%, and was not related to rectal temperature. During the later part of recovery when isoflurane concentrations were less than or equal to 0.1%, hypothermic patients frequently demonstrated no clinical or EMG evidence of muscular activity.(ABSTRACT TRUNCATED AT 250 WORDS)