Sanidad Militar - Ministerio de Defensa

Sanidad Militar
Revista de Sanidad de las Fuerzas Armadas de España
Sanid. Mil. Volumen 68, número 1. ISSN: 1887-8571 Enero-marzo 2012
CONTENTS
EDITORIAL
7 Spanish Medical Advisors in Kampala
Alsina Álvarez J.
ORIGINAL ARTICLE
8 Analgesia in the management of the combat casualty. Experience of the Spanish Medical Service
Navarro Suay R., Castillejo Pérez S.
SUMMARY: Antecedents and Objectives: the analgesia of the wounded has played a vital role in military medicine. Nowadays
it still is a medical, tactical and logistical challenge in the integral management of the combat casualty. The objective of this
study is to evaluate the homogeneity of the analgesic drugs used, starting point of the treatment, number and type of administration
routes, as well as the type of anesthesia used in gunshot or explosive device casualties in the Spanish Role 2 in Herat
(Afghanistan) between 2005 and 2008, in accordance with an anatomical injury severity score (NISS) of the injuries. Material
and Methods: we carried out an observational, retrospective study with a sample of 256 patients. Results: the drugs most
commonly used were the NSAIDs (73%) followed by major morphine derivatives (44%), adjuvants (29%) minor morphine
derivatives (21%) and ketamine (12%). In 61 % of the cases the analgesia was administered in the prehospital setting and in 31
% in the hospital. The most common administration route was intravenous (79%). In 75% of the cases only one administration
route was obtained for analgesia. General anesthesia was the most common anesthetic procedure (32%). Conclusions: analgesic
treatment of the combat casualties studied was homogeneous in terms of drugs used and number and types of administration
routes. However it was heterogeneous in reference to the chosen type of NSAIDs and initiation of analgesic drug administration.
KEY WORDS: Analgesia, Combat, Pain, Spanish Medical Service, Afghanistan.
17 Beta-hemolytic streptococci in school children
Miranda García MC.
SUMMARY: Introduction: Streptococci are responsible for different infectious diseases in the community; some of them with
serious consequences as rheumatic fever, endocarditis, glomerulonefritis, alopecia or scarlet fever, and have the potential to cause
outbreaks in closed communities like school children. Objectives: the objective of this study was to determine the frequency
and variability of the different groups of beta-hemolytic streptococci in carrier school children (12-18 years old) in different
schools in the town of San Fernando, as well as their antimicrobial susceptibilities. Material and Methods: samples taken from
160 school children of both sexes were cultured and incubated for 48 hours. Gram stains, catalase tests and bacitracin sensitivity
tests were carried out. Serogroups were identified by agglutination tests using the Oxoid kit. Antimicrobial susceptibility was
determined with Becton-Dickinson discs with different antibiotics. Results: from 34 positive samples we isolated 6 group A
beta hemolytic streptococci strains (3,75%), 2 group B strains, 5 group C, 10 group F, 6 group G and 5 non-groupables (considered
important due to the abundance of colonies on the plate). Although not significant we found a higher frequency of groups
A and G streptococci in males and groups C and F in females. Conclusions: the frequency of the isolated groups B, C, F, G and
non-groupable beta hemolytic streptococci represents a higher percentage in comparison with studies carried out in other cities.
As for the strains of S. Pyogenes we found antimicrobial susceptibility and resistance rates similar to those of other cities, but
lower than that of the Valencia study in 2002.
KEY WORDS: beta hemolytic streptococci, carrier school children, susceptibility.
22 Development and validation of a method for simultaneous determination of pseudouridine and creatinine in human
urine. Evaluation’s Index Pseudouridona /Creatinine in smokers and no-smokers
Montenegro Álvarez de Tejera P., Chamorro Merino G., Cabanes Mariscal MªA., Sánchez López P., Medina Font J.
SUMMARY: Introduction: The excretion of pseudouridine is increased in inflammatory processes related to loss of muscle
mass found in patients with pulmonary involvement. Material and Methods: A rapid and sensitive method for quantitative and
simultaneous determination of pseudouridine, a breakdown product of tRNA, and creatinine in human urine via HPLC was
developed and validated. The mobile phase was 0.01 mol phosphate buffer (pH 6.1) containing 3 mmol octanesulphonic acid as
ion pairing agent. Sample preparation is based on dilution and filtration. A LiCHros-pher ® 100 RP-18 (5 µm) LiCHroCART ®
250-4 (Merck) column with precolumn LiCHrospher ® 100 RP-18 (5 µm) LiCHroCART ® 50-4 (Merck) were used, flow rate of
Sanid. mil. 2012; 68 (1) 3