Conclusión: Nuestra conclusión es que los conectores fueron efi caces en la prevención de las bacteriemias ya que redujeron notablemente nuestros, ya bajos, índices de las mismas. PALABRAS CLAVE: -CATÉTER VENOSO CENTRAL TUNELIZADO -BACTERIEMIA -BIOCONECTORES -HEMODIÁLISISBioconnectors: Are they really effective in reducing bacteraemia related to permanent catheters for haemodialysis? AbstractOne of the greatest problems presented by tunnelled central venous catheters for haemodialysis is infections, on account of their seriousness and the high costs they generate. Prevention is therefore important because, in addition, the number of catheters has increased considerably in recent years. Objectives:We carried out this study in our unit to analyse:• Effi cacy of closed-system connectors (TEGO®) in the prevention of catheter-related bacteraemia. Bioconectores: ¿Son realmente efi caces en la reducción de las bacteriemias relacionadas con el catéter permanente para hemodiálisis?• Incidence of Staphylococcus aureus and most frequent infection-causing germs. Material and method:A transversal retrospective comparative study was carried out over 800 days, which we divided into two equal periods. In the fi rst 400 days, the unit protocol was applied to 24 patients and in the next 400 days the same protocol was applied plus the above-mentioned connectors to 25 patients. In both periods, 19 of the patients were the same.Results: In the fi rst period, 4 infections were counted in 7062 catheter days and in the second period, 2 infections in 8622 catheter days.Bacteraemia index in each period: 0.56/1000 and 0.23/1000 respectively.No Staphylococcus aureus infection occurred, the most frequent germ being Coagulase-negative Staphylococcus .Conclusion: Our conclusion is that the connectors were effective in preventing bacteraemia as they notably reduced our already low indices.

Introduction:We looked at the reasons why fluorescent cholangiography (FC) should be used routinely in laparoscopic cholecystectomy (LC). Method: A single dose of 0.05 mg/kg of Indocyanin Green (ICG) was administered intravenously one hour prior to the surgery to perform fluorescent cholangiograhy. Results: FC could be performed in all 45 (100%) patients whereas intra-operative cholangiography (IOC) could be performed in 42 out of 45 (93%) patients (p < 0.078). Individual median cost of performing FC was cheaper than IOC (13.97 ± 4.3 vs 778.43 ± 0.4 US dollars per patient, p = 0.0001). The mean operative time was 64.95 ± 17.43 minutes. FC was faster than IOC (0.71 ± 0.26 vs 7.15 ± 3.76 minutes, p < 0.0001). The cystic duct was identified by FC in 44 out of 45 patients (97.77 %). The residents were able to identify the extrahepatic structures in all 45 cases (100%) with FC. No complications were detected related to surgery and the use of FC. Learning curve was not necessary to identify structures using FC. X-ray leads were only used for IOC. FC could be performed by all residents at different level of training in 100% of the cases. Smooth dissection, transection and resection could be safely performed in 45 cases (100%). Conclusion: Fluorescent cholangiography seems to be feasible, cheap, expeditious, useful, an effective teaching tool, safe, no learning curve is necessary, does not require x-ray and easy to perform. It can be used for real time surgery to delineate the extrahepatic biliary structures.Background: Objective of this study is to compare rates of pancreatic fistulas and complications following the Whipple operation between pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG).Methods: 98 patients undergoing Whipple resection were randomized to either PG (48) or PJ (50) reconstruction. T-test and Chi-square tests were used for intention to treat data analysis. Logistic regression was used to measure the influence of surgical technique, preoperative ASA score and soft pancreatic gland on overall complications, severe post operative complications and overall fistula rates. Results: The rate of pancreatic fistula formation was 18% (Grade A = 6%, B = 10%, C = 2%) in the PJ arm and 25% (Grade A = 8%, B = 13%, C = 4%) in the PG arm, p = 0.399. The rate of postoperative complications was 48% (Clavien 1 = 14%, 2 = 36%, 3 = 10%, 4 = 0%, 5 = 2%) in the PJ and 58% (Clavien 1 = 21%, 2 = 38%, 3 = 25%, 4 = 6%, 5 = 4%) in the PG arm, p = 0.306. There was a significant difference in severe complications (Clavien 3-5) with 12% in the PJ and 31% in the PG arm, p = 0.02. In the multivariate analysis randomization (together with ASA) was only predictive of severe complications (OR 0.10, p < 0.005 for randomization to PJ reconstruction; OR 11.58, p < 0.05 for ASA 2 and OR 30.89, p < 0.05 for ASA 3 compared to ASA 1). Conclusion: Results of the study suggest that while there are no overall differences in rates of pancreatic leak/fistula and overall complications between PG and PJ arms, pancreaticogastrostomy is associ...

We report the development of a human monoclonal antibody to cytomegalovirus (CMV) produced from a human X human hybridoma. This hybrid was developed by fusion of an EBV-transformed cell line making antibody to CMV and a human lymphoblastoid cell line WI-L2. The antibody is directed to a CMV-specific antigen primarily in the nucleus of CMV-infected human fibroblasts. It cross-reacts with at least 10 different strains of CMV and may provide a method for the rapid in vitro diagnosis of CMV infections. The production of CMV-specific human man monoclonal antibodies from human-human hybridomas for future therapeutic use is now technically feasible with this specific method of production.

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