BPD can be performed satisfactorily by laparoscopy. Avoiding the gastrectomy is an interesting option to reduce technical difficulties, the surgeon's stress, duration of the operation, the patient's stress, and, probably, postoperative morbidity and mortality. We consider an upper digestive endoscopy to be mandatory to determine, before operating, if the patient will need a gastrectomy, depending on its results.

In Ensenada Baja California, ships and vehicles produce particles with heavy metals. These particles are blown by the wind and deposited on the soil becoming urban dust. Heavy metals may affect the health of the population, so a quick diagnosis is required to find a solution to this problem. The aim of this study is to identify those areas of higher pollution within the city. A total of 86 urban dust samples were sampled on diferent substrates (soil, cement and asphalt). Heavy metals were analyzed by X-ray fluorescence. Differences among substrates were identified by analysis of variance. The analysis of ordinary Kriging interpolation was performed to estimate the spatial distribution of heavy metals. Asphalt contains higher concentration of Cr, Ni, Pb and Zn; cement contains higher concentrations of Cu and V; and soil contains higher concentrations of Rb. The map which includes the classes with higher concentration of heavy metals shows that the southwest area of the city is the most polluted area due to port and transpeninsular highway. ResumenE n Ensenada, Baja California, los barcos y vehículos emiten partículas con metales pesados. Las partículas se transportan con el viento y se depositan en el suelo, donde se mezclan con él dando lugar a los polvos urbanos. Los metales pesados pueden afectar la salud de la población, por lo que se requiere un diagnóstico rápido para encontrar soluciones. El objetivo de este trabajo fue identificar las zonas con mayor contaminación en la ciudad. Se tomaron 86 muestras de polvo urbano sobre diferentes sustratos (suelo, cemento y asfalto). Los metales se analizaron mediante fluorescencia de rayos X. Las diferencias entre los sustratos se identificaron mediante un análisis de varianza. Por otra parte, se hizo un análisis para conocer la distribución espacial de los metales pesados, utilizando la interpolación con kriging ordinario. El asfalto contiene las mayores concentraciones de Cr, Ni, Pb y Zn; el cemento contiene mayores concentracions de Cu y V; y el suelo es el que más Rb contiene. El mapa que integra las clases de mayor concentración de metales indica que la zona suroeste, donde se localiza el puerto y pasa la carretera transpeninsular, es la más contaminada.

The antimicrobial resistance of Pseudomonas aeruginosa to beta-lactams, aminoglycosides and ciprofloxacin was investigated in two Latin American hospitals, one in Venezuela and the other in Paraguay. The resistance of P. aeruginosa was investigated in 1,481 clinically isolated strains, 988 from Asunción and 493 from Caracas, collected between 1996 and 1999. Susceptibility was assessed by the disk diffusion method according to the National Committee for Clinical Laboratory Standards. 11.4% were resistant to cefoperazone, 11.4% to ceftazidime, 12.8% to piperacillin, 13.6% to amikacin, 18.2% to gentamicin, 11.1% to ciprofloxacin, and 6.7% to imipenem. There were significant differences in resistance patterns between isolates from Asunción and Caracas. Resistance was higher in Caracas. Despite similar antibiotic usage policies and other measures, differences in the resistance patterns of P. aeruginosa are evident in this study. The clinical and therapeutic implications of this resistance suggest the need to maintain surveillance in local settings, especially in developing countries such as Venezuela and Paraguay.

It has been proven that BPD can be performed satisfactorily using laparoscopy, but this technique requires a very skilled and experienced laparoscopic surgeon. Avoiding gastrectomy is a very interesting option in order to reduce technical difficulties, surgeon stress, duration of the operation, patient stress, and, probably, postoperative morbidity and mortality. Laparoscopic BPD with distal gastric preservation is a very promising bariatric procedure with potential advantages over laparoscopic BPD with gastrectomy or open BPD.

In our setting, cefepime is most active against strains of P. aeruginosa. In comparison with third-generation cephalosporins, cefepime may be less likely to induce resistance. Surveillance of antimicrobial activity should be done periodically to guide therapy of surgical infections.