Is there a rationale for the continuous infusion of cefepime? A multidisciplinary approach

This review is the fruit of multidisciplinary discussions concerning the continuous administration of β-lactams, with a special focus on cefepime. Pooling of the analyses and viewpoints of all members of the group, based on a review of the literature on this subject, has made it possible to test the hypothesis concerning the applicability of this method of administering cefepime. Cefepime is a cephalosporin for injection which exhibits a broader spectrum of activity than that of older, third-generation cephalosporins for injection (cefotaxime, ceftriaxone, ceftazidime). The specific activity of cefepime is based on its more rapid penetration (probably due to its zwitterionic structure, this molecule being both positively and negatively charged) through the outer membrane of Gram-negative bacteria, its greater affinity for penicillin-binding proteins, its weak affinity for β-lactamases, and its stability versus certain β-lactamases, particularly derepressed cephalosporinases. The stability of cefepime in various solutions intended for parenteral administration has been studied, and the results obtained demonstrated the good compatibility of cefepime with these different solutions. These results thus permit the administration of cefepime in a continuous infusion over a 24-h period, using two consecutive syringes

Mapping socio-environmental vulnerability and environmental health promotion in a rural community of Lamarão, Federal District, Brazil, 2011

Objetivo: realizar atividade de ensino e extensão com alunos de graduação para construção de diagnóstico participativo sobre as condições de vida, ambiente e trabalho em núcleo populacional rural, visando subsidiar ações de promoção da saúde pela equipe de agentes comunitários da Estratégia Saúde da Família. Métodos: trabalho realizado no Núcleo Rural do Lamarão, no Distrito Federal, de outubro/2010 a janeiro/2011. Alunos, conjuntamente com agentes comunitários de saúde, por meio de entrevistas, visitas e oficinas, aplicaram instrumentos de Estimativa Participativa Rápida e de construção de mapa de vulnerabilidade socioambiental e de contextos de promoção da saúde ambiental. Resultados: identificaram-se como promotores da vida na comunidade: diversidade de produção de alimentos, liberdade e segurança, união e organização da comunidade, geração de empregos e natureza. Foram considerados ameaçadores à vida: cultura alimentar, uso inadequado de agrotóxicos, uso incorreto de equipamentos de proteção individual, pulverização aérea, falta de lazer, falta de transporte, uso de drogas lícitas e ilícitas. Conclusão: a partir do diagnóstico, será construído um projeto de intervenção participativo que incorporará características de ensino, pesquisa e extensão na relação Saúde, Trabalho, Ambiente e Nutrição.Objective: To involve undergraduate students in an extension activity aimed at conducting a participatory diagnosis on life, environment, and work conditions in a rural settlement, with the purpose of raising goals for future health promotion actions performed by community health agents of the Family Health Strategy. Methods: The study was held between October 2010 and January 2011 in the rural community of Lamarão, located in the Federal District in Brazil. By means of interviews, visits, and workshops, students and community health agentes used Participatory Rapid Appraisal instruments as well as tools for mapping socio-environmental vulnerability and health promotion related issues. Results: The following were identified as life promotion factors in the community: food production diversity, freedom and safety, unity and community organization, job generation, and nature. Considered as threatening to life were: food culture, improper use of pesticides, inadequate use of personal protective equipment, aerial spraying, lack of leisure, lack of transportation, use of licit and illicit drugs. Conclusion: A participatory intervention project will be developed, which will incorporate teaching, research and extension activities regarding Health, Work, Environment, and Nutrition