[The skin flora: a source of the contamination of central venous catheters?]

The authors studied the incidence of catheter related infection in 24 central venous catheter at the Departamento de Cirurgia da Faculdade de Ciências Médicas da Santa Casa de São Paulo. Skin and blood cultures were done in the first and fifth days and when the catheter were discharged. There were correlation between skin and catheter cultures in 33%. The results suggest that the skin flora is an important source of catheter related infection.

[Effects of food restriction on the protein and electrolyte composition in the liver and muscles of rats]

Protein and electrolyte disturbances in hepatic and muscle tissues are related to trauma, sepsis, or short term starvation or semistarvation. The consequences of a prolonged semistarvation are poorly understood. For five weeks, male adult rats were offered 50% of the diet until they had a weight loss of 40%, after which protein and electrolyte (Ca++, Mg++, Zn++, Na+, K+) changes in the liver and soleus and extensorum digitorum longus muscles were analyzed. There was a significant weight loss after 5 weeks of semistarvation. Hepatic protein and serum albumin were not changed, but the authors observed a significant muscle protein depletion. A fall in Zn++ levels in the blood was accompanied by a rise in muscle and liver concentrations. The rise in Ca++ and Mg++ concentration in blood and in the muscles might be related to the enhanced proteolysis. Results suggest that the early changes of protein and electrolyte metabolism at tissue level with semistarvation impair muscular and hepatic functions as they delay adequate response to trauma and infection.

[Severe acute pancreatitis, laparotomies, and planned reoperation]

Of 111 cases of acute pancreatitis studied, 13 (11.7%) patients had severe pancreatitis with infection and were submitted to planned reoperation or to open peritoneal drainage. Twelve patients were male, ages ranging from 20 to 56. The etiology was biliary in 4 patients, traumatic in 1 patient, and alcoholic in 8 patients. Early treatment included clinical support at the intensive care unit and surgical intervention was performed after the first week based on clinical signs and on ultrasound and CT scan findings. A total of 42 surgeries was performed (mean of 3.23 operations per patient). Mortality rate was 46% due to systemic complications and to multiple organ failure.