INTRODUCTION: Nosocomial pneumonia associated with use of mechanical ventilators is one of the greatest challenges confronted by intensivists worldwide. The literature associates several bacteria with this type of infection; most common in intensive care units are Acinetobacter baumannii, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus and some of the Enterobacteriaceae family. OBJECTIVES: To identify the causal agents of nosocomial ventilatorassociated pneumonia in patients receiving mechanical ventilation in the intensive care units of Havana's Hermanos Ameijeiras Clinical-Surgical Teaching Hospital in 2011, and to characterize their antibiotic resistance. METHODS: A cross-sectional descriptive study was conducted using hospital administrative data of quantitative cultures from positive tracheal aspirates for January through December, 2011. Records were analyzed from 77 intensive care unit patients who developed nosocomial ventilator-associated pneumonia. Variables examined were age and sex, and pathogens identified from culture of tracheal aspirate and related antibiotic susceptibility. RESULTS: Species most frequently isolated were: Acinetobacter baumannii in 53 patients (68.8%), Pseudomonas aeruginosa in 34 patients (44.2%), other species of Pseudomonas in 15 patients (19.5%), and Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli in 12 patients each (15.6%). Some patients presented more than one pathogen in concurrent or successive infections. Antimicrobial susceptibility testing found high percentages of resistance to antibiotics in all these pathogens. Least resistance was found to colistin. CONCLUSIONS: The prevalence of antibiotic resistance in bacteria causing nosocomial ventilator-associated pneumonia is of concern. Colistin is the drug of choice among the antibiotics reviewed, but sensitivity to other antibiotics should be assessed to search for more appropriate broad-spectrum antibiotics for treating nosocomial ventilator-associated pneumonia. Our results also suggest the need to strengthen infection control efforts, particularly in intensive care units, and to reassess compliance with quality control procedures. Multidisciplinary research involving microbiologists, epidemiologists, internists and intensivists is needed to fully understand the etiological and resistance patterns observed.

The knowledge management is one of the essential aspects in the formation of the New Basic General Doctor. An adequate knowledge management in an academic institution has vital importance for the correct functioning of the university. The New Doctor's Formation Program does not escape to this reality. It is presented how are applied some components of the knowledge management, such as the teaching structure, the preparation of students and teachers and the use of the Information and Communication Technologies in the context of The New Doctor's Formation Program.

La gestión del conocimiento constituye uno de los aspectos imprescindibles para la formación del nuevo Médico General Básico. Una adecuada gestión del conocimiento en una institución académica es de vital importancia para el buen funcionamiento del centro universitario en cuestión. El Nuevo Programa de Formación de Médicos no escapa a esta realidad. Se presenta la manera en que se aplican algunos componentes de la Gestión del Conocimiento tales como la estructura docente de los Policlínicos Facultades, la preparación de estudiantes y profesores y el uso de las Tecnologías de la Información y la Comunicación en el contexto del Nuevo Programa de Formación de Médicos.

One concept that decisively influences over the learning process in the university polyclinics is the information literacy, which is the set of skills required by people to realize when information is needed and how to locate, assess and use it efficiently. It makes emphasis on the contents, the communication, the analysis, the search, the evaluation and the use of information. The literate people in information are those who have learned the way of getting knowledge. Attaining skilled and information literate students is rapidly becoming a fundamental objective for many counties. The new University Polyclinics do not ignore this reality.

Un concepto que influye determinantemente en el proceso de aprendizaje en los Policlínicos Universitarios es el concepto de la alfabetización en información (ALFIN). La ALFIN no es más que el conjunto de habilidades que requieren las personas para reconocer cuándo necesitan información, cómo localizarla, evaluarla y utilizarla eficazmente. Enfatiza en el contenido, la comunicación, el análisis, la búsqueda, evaluación y uso de la información. Las personas alfabetizadas en información son aquellas que han aprendido cómo aprender. Lograr ciudadanos educados, alfabetizados en información, se ha convertido rápidamente en un objetivo importante para muchos países. Los nuevos Policlínicos Universitarios no escapan a esta realidad.

Objectives: to compare the prevalence of atherogenic factors in two groups of elderlies, one with atherosclerosis complications and the other without it. Methods: a comparative, retrospective and descriptive study was conducted in patients seen in six family physicians consulting rooms from the "19 de Abril" Polyclinic during 2007 and 2008. Each group included 80 elderlies seen in the consulting room or at home. Ethical requirements of a research were taken into account. Results: smoking was the only risk factor present with a great prevalence in involved men compared with those non-involved. High blood pressure was the only factor observed with a higher prevalence in women than in men. In involved men predominated two risk factors and in women only one. Conclusions: the more frequent risk factors are observe in elderlies with some atherosclerosis complication in male sex.

Objetivos: comparar la prevalencia de factores de riesgo aterogénicos en dos grupos de adultos mayores, uno con complicaciones ateroscleróticas y el otro sin ellas. Métodos: estudio descriptivo retrospectivo y comparativo en seis consultorios del médico de la familia del policlínico "19 de Abril" en los años 2007 y 2008. Cada grupo estuvo formado por 80 adultos mayores, los que fueron vistos en consulta o en terreno. Se tuvieron en cuenta los requerimientos éticos de una investigación. Resultados: el tabaquismo fue el único factor de riesgo que se observó con mayor prevalencia en los hombres no complicados en relación con los complicados. La hipertensión arterial fue el único factor que se observó con mayor prevalencia en mujeres que en hombres. En los hombres complicados primó la presencia de dos factores de riesgo y solo uno en las mujeres. Conclusiones: los factores de riesgo se observan con mayor frecuencia en los adultos mayores que han sufrido alguna complicación ateroscleróticas y de ellos, en el sexo masculino.

The assessment of clinical competences in the New Program of Physician Training Program (NPPT) is dilemma from its onset. The Structural Clinical Assessment by OBJECTIVE (SCAA) solves this problem in this new educational context. Considering all advantages of this method, it was applied in «José Maceo Grajales» Faculty Polyclinic like a usual practical examination of Clinic I as subject. For design of this assessment we took into account different phases (planning, prior day, the present day, and the day after examination). We explain how each phase of the previous ones was carried out.

La evaluación de las competencias clínicas en el Nuevo Programa de Formación de Médicos (NPFM) ha constituido un dilema desde los inicios de este programa. La Evaluación Clínica Estructurada por Objetivos (ECOE) viene a dar solución a esta problemática en este nuevo contexto educacional. Teniendo en cuenta todas las ventajas de este método se aplicó en el Policlínico Facultad José Maceo Grajales como examen práctico ordinario de la asignatura Clínica I. Para el diseño de esta evaluación se tuvieron en cuenta distintas fases (Planificación, el día previo al examen, el día del examen y el día después del examen). Se explica cómo se llevo a cabo cada fase de las anteriores.