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This paper presents the results of experimental research using concrete produced by substituting part of the natural coarse aggregates with recycled aggregates from concrete demolition. The influence of the quality of the recycled aggregate (amount of declassified and source of aggregate), the percentage of replacement on the targeted quality of the concrete to be produced (strength and workability) has been evaluated. The granular structure of concrete and replacement criteria were analyzed in this study, factors which have not been analyzed in other studies. The following properties of recycled concretes were analyzed: density, absorption, compressive strength, elastic modulus, amount of occluded air, penetration of water under pressure and splitting tensile strength. A simplified test program was designed to control the costs of the testing while still producing sufficient data to develop reliable conclusions in order to make the number of tests viable whilst guaranteeing the reliability of the conclusions. Several factors were analyzed including the type of aggregate, the percentage of replacement, the type of sieve curve, the declassified content, the strength of concrete and workability of concrete and the replacement criteria. The type of aggregate and the percentage of replacement were the only factors that showed a clear influence on most of the properties. Compressive strength is clearly affected by the quality of recycled aggregates. If the water-cement ratio is kept constant and the loss of workability due to the effect of using recycled aggregate is compensated for with additives, the percentage of replacement of the recycled aggregate will not affect the compressive strength. The elastic modulus is affected by the percentage of replacement. If the percentage of replacement does not exceed 50%, the elastic modulus will only change slightly.

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Objetivo: La finalidad de este estudio es comparar la rentabilidad clínica de extracción de hemocultivos en medio para anerobios frente a un aumento del volumen de extracción en medio de cultivo, para gérmenes aerobios en bacteriemias de origen extrahospitalario diagnosticadas en urgencias, con intención de valorar y comparar la utilidad clínica de los medios de cultivo aerobios y anaerobios simultáneamente, frente a un volumen de extracción de sangre al menos similar procesado en medio sólo para aerobios. Métodos: Durante un mes se realizaron hemocultivos a todos los pacientes que por criterio médico lo precisaban en el servicio de urgencias, con intención de comparar clínicamente 30 ml de sangre procesados para aerobios y anaerobios (15 ml en cada medio), frente a 35 ml en medio sólo para aerobios. Se realizó el cálculo del índice Kappa de acuerdo entre ambos tipos de extracciones. Resultados: Se analizaron 152 pacientes (3 extracciones/paciente, con un volumen total de 50 ml por paciente). El número de bacteriemias verdaderas diagnosticadas con 35 ml de extracción por paciente procesados únicamente en medio de cultivo para aerobios fue de 27, mientras que ascendía a 31 si se procesaban en medio de aerobio y anaerobios simultáneamente (total 30 ml). La medida de acuerdo índice Kappa fue de 0,88, p=0,057. Analizados los crecimientos de microrganismos contaminantes, existe una disminución significativa de los mismos (p<0,05) si se mantienen los medios de cultivo para anaerobios, en lugar de aumentar y procesar los hemocultivos sólo en medio para aerobios. Conclusión: Con los resultados obtenidos, la recomendación de los autores es mantener sistemáticamente los medios de crecimiento para anaerobios en las sospechas de bacteriemias de origen extrahospitalario, en lugar de aumentar el volumen de extracción y procesamiento en medio de crecimiento para aerobios (AU)

Objectives: The objetive of this study is to compare the rentability of anaerobic hemocultures, with aerobic cultures increasing the total amount of extracted blood of patients suffering bacteremia, trying to analize and compare the clinical utility of the rentability of aerobic/ anaerobic cultures in front of a similar collection of blood cultures aerobic/aerobic. Methods: There were analized all the hemocultures taken by medical decision for one month in the emergency department of the hospital to compare 15 ml aerobic/15 ml anaerobic (total 30 ml) with 15 ml aerobic/ 20 ml aerobic (total 35 ml).The Kappa index was 0.88, p=0.057. Results: There were analyzed 152 hemocultures groups with a total volumen extraction of 50 ml by each group. The number of true bacteriemias diagnosticated with 35 ml of blood by each patient cultivated only in aerobic blood cultures were 27, but there were 31 if the 30 ml of blood by patient were cultivated in aerobic/anaerobic blood cultures. with signicant decrease (p<0.05) of the contaminants bacterias if there are used anaerobic bottles instead of a increasing volumen of blood for aerobic cultures. Conclusion: In the emergency department with extrahospitalary bacteremias the anaerobic blood cultures should sistematically be done instead of increasing blood extraction to aerobic blood cultures (AU)

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OBJECTIVE: To compare the rentability of anaerobic hemocultures with aerobic cultures in patients suffering bacteremia, trying to analyze the rentability of anaerobic cultures. METHODS: There were analyzed all the hemocultures taken by medical decision for one month. There were taken three extractions by patient in different venopunctures points. In each extraction was taken 10 ml (5 ml in aerobic bottle, and 5 ml in anaerobic bottle). There were compared microorganism isolated in aerobic bottles and anaerobic bottles. Three physician analyzed all the clinical dates of the patients with positive hemocultures and classified them as negatives, contaminants and significant. RESULTS: There were taken hemocultures of 180 patients. There were analyzed 152 hemocultures groups (3 extractions aerobic-anaerobic), without studying 28 owe to not following the study protocol 24 (13.3%) or because of not possibility of studying clinical story 4 (2.2%). Aerobic extractions: Negatives 91 (59.86%), contaminants 36 (23.68%), significant with or without contaminant 25 (16.44%). Anaerobic extractions: Negatives 127 (83.5%), contaminants 2 (1.31%); significant with or without contaminant 23 (15.13%). There are 6 (8.6%) significant positive isolated in anaerobic bottles, that were negative in aerobic bottles, and are: 3 E. coli, 1 K. pneumoniae, 1 Peptostreptococcus sp, 1 Bacteroides sp, and over the total significant isolated (31) are the 19.35%. Both anaerobic bacteremias were clinically suspected. Contaminant microorganism more frequently isolated in aerobic bottles was Staphylococcus sp, 25 cases (69.44% of all contaminants). Significant microorganism more frequently isolated was E. coli (in anaerobic bottles too) in 12 cases (38.70%) of all significant isolated, following by Streptococcus pneumoniae with 4 cases (12.9%). CONCLUSIONS: We recommend collection of one aerobic and one anaerobic blood culture bottle per blood culture set because the global rentability of hemocultures is increased significantly.

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Objetivo: Comparar rentabilidad de extracción de hemocultivos en medios para aerobios frente a anaerobios en bacteriemias diagnosticadas en urgencias, con intención de valorar la utilidad de los medios de cultivo para anaerobios. Metodología: Durante un mes se realizaron hemocultivos a todos los pacientes que por criterio médico lo precisaban. Tres extracciones por sujeto en sitios de venopunción diferentes. En cada extracción se obtenían 10 ml (distribuidos en 5 ml para frasco aerobios, 5 ml para frasco de aerobios). Posteriormente se compararon los frascos de aerobios frente a anaerobios. Se valoraron por tres clínicos todas las historias de los pacientes con hemocultivo positivo, clasificándolos como negativos, contaminantes o significativos. Resultados: Se obtuvieron hemocultivos de un total de 180 pacientes. Se analizaron 152 grupos de hemocultivos (3 extracciones aerobiosanaerobios), sin valorarse los 28 restantes por no seguir el protocolo de estudio 24 (13,3 por ciento); o por no haber podido analizar la historia clínica 4 (2,2 por ciento). Grupo de tres extracciones sólo aerobios: Negativos 91 (59,86 por ciento), contaminantes 36 (23,68 por ciento), verdadero positivo en por lo menos una de las tres con o sin contaminante 25 (16,44 por ciento). Grupo de tres extracciones sólo anaerobios: Negativos 127 (83,5 por ciento), contaminantes 2 (1,31 por ciento) ; verdadero positivo en por lo menos una de las tres con o sin contaminante 23 (15,13 por ciento). Existen 6 casos (8.6 por ciento) de verdaderos positivos en frasco de anaerobios que han sido negativos en los frascos de aerobios y que corresponden a los siguientes gérmenes: 3 E. coli; 1 K. pneumoniae; 1 Peptostreptococcus sp; 1 Bacteroides sp y sobre el total de verdaderos positivos (31) suponen el 19,35 por ciento. Las dos bacteriemias por anaerobios, fueron sospechadas clínicamente. El germen que con más frecuencia fue contaminante en medio de crecimiento para aerobios, es el Staphylococcus sp coagulasa negativo, 25 asos (69,44 por ciento de todos los contaminantes).El germen productor de bacteriemia verdadera más frecuente fue el E. coli (también en anaerobios) con 12 casos (38,70 por ciento de todas las verdaderas bacteriemias), seguido del Streptococcus pneumoniae, 4 casos (12,90 por ciento).Conclusiones: Nuestra recomendación es mantener los cultivos en frascos de anaerobios en las sospechas de bacteriemia puesto que la rentabilidad global de los hemocultivos aumenta de forma significativa (AU)

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The role of systemic lupus erythematosus (SLE) in the development of acute pancreatitis is a matter of controversy since, in many cases, this complication has been attributed to the drugs administered. In this study, we present a patient diagnosed as having SLE who developed acute pancreatitis with no apparent cause aside from her basic disease, and in whose necropsy was observed vascular damage consisting of severe intimal proliferation. Pancreatic vascular lesions in previously reported patients with lupus are reviewed.

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