Abstract A trial was conducted with 414 newborn calves randomly divided by riskblocks of developing omphalitis or omphalophlebitis: low; medium, and high. The treatments were applied by stump-dipping daily for three days, with either iodine-polyvinylpyrrolidone (I-PVP) (n = 205), or with an alginate gel containing 0.5 % enrofloxacin hydrochloride dehydrate (enro-C) (n = 209). Results showed that only one death occurred in the enro-C group, which was attributable to internal hemorrhage not linked with the treatment. After four days, we recorded six other cases as stump fibrosis, but these were inconsequential. In the I-PVP group, 44 calves developed cord infection and were considered treatment failures (13 high-risk; 11 medium-risk, and 20 low-risk) (P < 0.0435 in the three risk grades). The umbilical stump involution was evident in the enro-C-treated animals on day one as most stumps were noticeably dried. Stump detachment occurred within an average of nearly 30 days, and the umbilical scars did not present infection in any case. Conversely, in the remaining calves of the I-PVP group, stump drying was observable after 72 h, and it detached within an average of 32 days (P < 0.05). In stumps treated with enro-C, dirt stuck less, and the gel formed an apparently protecting layer around the umbilical scar when stump was either absent or too short. These results show that enro-C is a successful preventive treatment that allows rapid umbilical stump involution in newborn calves.

Respiratory virus epidemics had highlighted the importance of the Intensive Care Unit (ICU) to save life of severe cases. ICU functioning and outcomes depends on infrastructure and trained healthcare personnel. In Chiapas, a Southern state in Mexico,an area to care for severe H1N1 cases on respiratory distress during the second H1N1-2009 outbreak, had to be habilitated.This had to be done without sufficient equipment and ICU un-experienced healthcare workers. It was possible to improve its performance through training and standardizing attention care processes for critically ill patients. In preparation for the next pandemic it is essential to designate hospitals with preexistent ICU where to refer severe cases and avoid improvisations.The experience in Chiapas showed that standardization of medical care processes are clue and in case of an overwhelming emergency it is possible to habilitate an ICU although it is imperative to take advantage from installed facilities in each city with the official authority.

Las epidemias de virus respiratorios en la era moderna han destacado la importancia de las unidades de terapia intensiva (UTI) para salvar la vida de pacientes graves. El desempeño de la UTI depende mucho del equipamiento y del personal capacitado. En Chiapas, durante el segundo brote de influenza H1N1-2009, se habilitó un área para atender enfermos graves con insuficiente equipamiento y con personal sin experiencia en UTI. Se logró mejorar su desempeño con una capacitación para estandarizar los procesos de atención del paciente en estado crítico.En la preparación para una próxima pandemia es esencial identificar anticipadamente los hospitales con UTI donde referir los casos graves y evitar improvisaciones. La experiencia en Chiapas demuestra que la estandarización de los procesos de atención es clave,y que en caso de una emergencia avasalladora es posible habilitar unidades sin dejar de lado la importancia de aprovechar la infraestructura instalada de cada ciudad con una decisión de autoridad.

Respiratory virus epidemics had highlighted the importance of the Intensive Care Unit (ICU) to save life of severe cases. ICU functioning and outcomes depends on infrastructure and trained healthcare personnel. In Chiapas, a Southern state in Mexico,an area to care for severe H1N1 cases on respiratory distress during the second H1N1-2009 outbreak, had to be habilitated.This had to be done without sufficient equipment and ICU un-experienced healthcare workers. It was possible to improve its performance through training and standardizing attention care processes for critically ill patients. In preparation for the next pandemic it is essential to designate hospitals with preexistent ICU where to refer severe cases and avoid improvisations.The experience in Chiapas showed that standardization of medical care processes are clue and in case of an overwhelming emergency it is possible to habilitate an ICU although it is imperative to take advantage from installed facilities in each city with the official authority.

Las epidemias de virus respiratorios en la era moderna han destacado la importancia de las unidades de terapia intensiva (UTI) para salvar la vida de pacientes graves. El desempeño de la UTI depende mucho del equipamiento y del personal capacitado. En Chiapas, durante el segundo brote de influenza H1N1-2009, se habilitó un área para atender enfermos graves con insuficiente equipamiento y con personal sin experiencia en UTI. Se logró mejorar su desempeño con una capacitación para estandarizar los procesos de atención del paciente en estado crítico.En la preparación para una próxima pandemia es esencial identificar anticipadamente los hospitales con UTI donde referir los casos graves y evitar improvisaciones. La experiencia en Chiapas demuestra que la estandarización de los procesos de atención es clave,y que en caso de una emergencia avasalladora es posible habilitar unidades sin dejar de lado la importancia de aprovechar la infraestructura instalada de cada ciudad con una decisión de autoridad.