[Hospital infections at an oncology hospital]

During 23 months, the authors analyzed 8122 records of cancer patients admitted to the National Institute of Cancer of Rio de Janeiro, Brazil. The rate of hospital infection was of 18.4 infection episodes per 100 admissions. Hospital infections were detected in 556 patients (57.7%) of the surgical department. The overall rate of purulence seen in 4194 surgeries was 10.1%, and among 2153 clean surgeries, the authors found 95 (4.4%) suppurated surgeries. The surgical wound (28.2%), the respiratory tract (19.2%), and the urinary tract (18.7%) were the major sites involved during infections episodes. Of the 319 ICU patients evaluated, 154 acquired infection after the first 72 hours, with a mortality rate of 48.7%. The hospital microbial flora was made-up mostly of gram-negative aerobic bacteria, with a high incidence of micro-organisms that resist to major antibiotics of hospital use. The percentage of positive results in blood culture tests requested was of 23.7%, with a predominance of gram-negative bacteria (50.9%) and a high percentage of gentamicin-resistant micro-organisms. Antibiotics of greater use in surgical interventions were amikacin, first generation cephalosporins, and chloramphenicol, whereas amikacin, carbenicillin, and first and third generation cephalosporins prevailed in nonsurgical treatments. The authors' experience and findings re-emphasize the need and the importance of a broad multidisciplinary understanding and suggest the need of strict action for an effective control and prevention in hospitals of developing countries.

Surgical significance of persistent cholecystohepatic ducts

Anatomical variations of the biliary tract occur frequently enough so as to worry the general surgeon dealing with this problem. Generally speaking, these anatomical variations are not identified prior to surgery. Anomalous drainage of the common hepatic duct into the gall bladder was identified while performing a cholecystectomy. The common bile duct proximal to the cystic duct was atretic. The problem described above was successfully managed by hepatico-jejunostomy.

Local languages, the succesor method, and a step towards a general methodology for the inference of regular grammars

A methodology is proposed for the inference of regular grammars from positive samples of their languages. It is mainly based on the generative mechanism associated with local languages, which allows us to obtain arbitrary regular languages by applying morphic operators to local languages. The actual inference procedure of this methodology consists of obtaining a local language associated with the given positive sample. This procedure, which is very simple, is always the same, regardless of the problem considered, while the task-dependent features that are desired for the inferred languages, are specified through the definition of certain task-appropriate symbol renaming functions (morphisms).

[Idiopathic cyclic edema in Klinefelter syndrome (author's transl)]

After a minor abdominal traumatism, M. B., 53 years of age, presents a sudden and acute edematous syndrome. Cardiac, renal, hepatic, nutritional and thyroid etiologies ares rapidly eliminated. A cavography and lymphography reveal the integrity of the drainage pathways. The idiopatic cyclic edematous syndrome is therefore evoked by few clinical details (diurnal weight gain, diurnal oliguria...). Exploration of the renin - angiotensin - aldosterone system, the Landis test and the marked radioactive serum albumin test attest to the exaggeration of capillary permeability. Likewise, it was discovered in this patient, a Klinefelter syndrome which was, until now, unknown. This case poses interesting pathogenic problems since the idiopathic cyclic edematous syndrome is a predominantly feminine disease. Only a few cases were described in the masculine sex and, to our knowledge, this syndrome has never been associated with Klinefelter syndrome.