Metal-Organic Framework-Based Antimicrobial Touch Surfaces to Prevent Cross-Contamination.

Infection diseases are a major threat to global public health, with nosocomial infections being of particular concern. In this context, antimicrobial coatings emerge as a promising prophylactic strategy to reduce the transmission of pathogens and control infections. Here, antimicrobial door handle covers to prevent cross-contamination are prepared by incorporating iodine-loaded UiO-66 microparticles into a potentially biodegradable polyurethane polymer (Baycusan eco E 1000). These covers incorporate MOF particles that serve as both storage reservoirs and delivery systems for the biocidal iodine. Under realistic touching conditions, the door handle covers completely inhibit the transmission of Gram-positive bacterial species (Staphylococcus aureus, and Enterococcus faecalis), Gram-negative bacterial species (Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii), and fungi (Candida albicans). The covers remain effective even after undergoing multiple contamination cycles, after being cleaned, and when tinted to improve discretion and usability. Furthermore, as the release of iodine from the door handle covers follow hindered Fickian diffusion, their antimicrobial lifetime is calculated to be as long as approximately two years. Together, these results demonstrate the potential of these antimicrobial door handle covers to prevent cross-contamination, and underline the efficacy of integrating MOFs into innovative technologies.

Digestive bleeding due to jejunal diverticula: diagnosis and management.

A jejunal diverticular haemorrhage is the second most common complication of jejunum diverticula. It can manifest clinically as acute upper gastrointestinal bleeding and is common to imitate acute rectal bleeding. Bleeding is usually associated with or without haemodynamic stability. Its diagnosis is challenging, requiring imaging examinations. Treatment is conservative management or surgery.

Fabrication of Oriented Polycrystalline MOF Superstructures.

The field of metal-organic frameworks (MOFs) has progressed beyond the design and exploration of powdery and single-crystalline materials. A current challenge is the fabrication of organized superstructures that can harness the directional properties of the individual constituent MOF crystals. To date, the progress in the fabrication methods of polycrystalline MOF superstructures has led to close-packed structures with defined crystalline orientation. By controlling the crystalline orientation, the MOF pore channels of the constituent crystals can be aligned along specific directions: these systems possess anisotropic properties including enhanced diffusion along specific directions, preferential orientation of guest species, and protection of functional guests. In this perspective, we discuss the current status of MOF research in the fabrication of oriented polycrystalline superstructures focusing on the specific crystalline directions of orientation. Three methods are examined in detail: the assembly from colloidal MOF solutions, the use of external fields for the alignment of MOF particles, and the heteroepitaxial ceramic-to-MOF growth. This perspective aims at promoting the progress of this field of research and inspiring the development of new protocols for the preparation of MOF systems with oriented pore channels, to enable advanced MOF-based devices with anisotropic properties.

Iatrogenic enterovesical fistula secondary to a permanent urinary catheter.

An enterovesical fistula is a rare entity resulting from inflammatory, neoplastic and iatrogenic processes. It can manifest clinically as pneumaturia and recurrent urinary tract infections. Its diagnosis is supported by imaging examinations and its treatment is primarily surgical.

Assembly of Covalent Organic Frameworks into Colloidal Photonic Crystals.

Self-assembly of colloidal particles into ordered superstructures is an important strategy to discover new materials, such as catalysts, plasmonic sensing materials, storage systems, and photonic crystals (PhCs). Here we show that porous covalent organic frameworks (COFs) can be used as colloidal building particles to fabricate porous PhCs with an underlying face-centered cubic (fcc) arrangement. We demonstrate that the Bragg reflection of these can be tuned by controlling the size of the COF particles and that species can be adsorbed within the pores of the COF particles, which in turn alters the Bragg reflection. Given the vast number of existing COFs, with their rich properties and broad modularity, we expect that our discovery will enable the development of colloidal PhCs with unprecedented functionality.

Self-assembly of colloidal metal-organic framework (MOF) particles.

Self-assembly of colloidal particles into ordered superstructures enables the development of novel advanced materials for diverse applications such as photonics, electronics, sensing, energy conversion, energy storage, diagnosis, drug or gene delivery, and catalysis. Recently, polyhedral metal-organic framework (MOF) particles have been proposed as promising colloidal particles to form ordered superstructures, based on their colloidal stability, size-tunability, rich polyhedral shapes, porosity and multifunctionality. In this review, we present a comprehensive overview of strategies for the self-assembly of colloidal MOF particles into ordered superstructures of different dimensionalities, highlighting some of their properties and applications, and sharing thoughts on the self-assembly of MOF particles.

Desenlaces clínicos y radiológicos del tratamiento quirúrgico de la cadera paralítica en pacientes con parálisis cerebral en Bogotá, Colombia / Clinical and radiological outcomes of surgical treatment for paralytic hip in cerebral palsy patients in Bogotá, Colombia

Introducción. La parálisis cerebral (PC) produce una alteración del tono y del balance muscular que puede generar luxación paralítica de cadera (LPC), especialmente en los pacientes más comprometidos Objetivo. Describir los desenlaces clínicos y radiológicos de los pacientes con PC que recibieron tratamiento quirúrgico de la LPC en el Instituto Roosevelt. Materiales y métodos. Estudio observacional retrospectivo realizado en 92 pacientes entre 4 y 18 años con PC y LPC operados entre 2010 y 2014. Se realizaron análisis bivariados para realizar comparaciones entre los hallazgos clínicos y radiológicos antes de la operación de corrección de la LPC y al finalizar el periodo posoperatorio mediante las pruebas de McNemar, T de student y U de- Mann-Whitney. Resultados. La media de edad fue 7,45 años, el 84,8% de los pacientes tenía PC espástica y el 59,8% fue clasificado en el nivel V del Gross motor function classification system. Se realizaron 155 cirugías en los 92 pacientes, los procedimientos más frecuentes fueron reducción cerrada y osteotomías pélvica, femoral varizante y femoral desrotadora. En el posoperatorio el dolor y la dificultad para realizar el aseo, sedestación y abducción de caderas disminuyeron significativamente (p<0,001). Además, hubo diferencias estadísticas en los índices y ángulos radiológicos pre y posoperatorios. Conclusión: Si bien se encontró una mejoría significativa en los desenlaces clínicos y radiológicos evaluados, los procedimientos reconstructivos y de salvamento predominaron, en detrimento de los preventivos, por lo que es necesario fortalecer los programas de seguimiento y prevención de la LPC y sus complicaciones en la institución para disminuir morbilidad en los pacientes con PC

Introduction: Cerebral palsy (CP) causes an alteration of muscle tone and balance that may lead to paralytic hip dislocation (PHD), especially in the most severely affected patients. Objective: To describe the clinical and radiological outcomes of patients with CP who underwent surgical treatment of PHD at the Instituto Roosevelt. Methodology: Retrospective observational study performed on 92 patients aged 4 to 18 years with CP and PHD operated on between 2010 and 2014. Bivariate analyses were performed to compare clinical and radiological findings before and after the surgery to correct PHD using McNemar's test, Student's t-test, and Mann-Whitney U-test. Results: The mean age was 7.45 years, 84.8% of the patients had spastic CP, and 59.8% were classified at level V of the Gross Motor Function Classification System. A total of 155 surgeries were performed in the 92 patients, the most frequent procedures being closed reduction and pelvic, femoral varus, and femoral derotation osteotomies. After surgery, pain, and difficulty in personal care, sitting and hip abduction decreased significantly (p<0.001). In addition, statistical differences were found between preoperative and postoperative radiological indices and angles. Conclusion: Although a significant improvement was found in the clinical and radiological outcomes evaluated, reconstructive and salvage procedures predominated over preventive ones, thus making it necessary to strengthen follow-up and prevention programs for PHD and its complications in the institution in order to reduce morbidity in patients with CP

Flexible amorphous metal-organic frameworks with π Lewis acidic pore surface for selective adsorptive separations.

Selective separation of light hydrocarbons (LHs) and adsorption of volatile organic compounds (VOCs) remain expensive and complex scientific challenges in the petrochemical industry. Shape-selective adsorbent materials can cost-effectively face these demands. Two new porous, dynamic and amorphous metal-organic frameworks (MOFs), NEU-3 [= Zn(PMDA)(Py)2] and NEU-4 [= Fe(PMDA)(Py)2] are disclosed. These MOFs along with NEU-1c [= Zn(BPDI)(Py)2] and NEU-2 [= Fe(BPDI)(Py)2] display an electron-deficient pore surface due to predesigned π-electron-deficient ligands. They are unique smart guest-responsive materials owing to their π Lewis acidic pore surface and presumably their framework flexibility. A variety of effective adsorptions and adsorptive separations is achieved by using beds of NEU-1c, NEU-2, NEU-3 and NEU-4. Promising for further investigations into the petrochemical industry, NEU-4 shows ultrahigh benzene adsorption, recognition capability, selectivity for benzene over its analogues, and high stability and regenerability.

Occupational Psychosocial Factors in Primary Care Continuing Care Staff.

This involves studying the psychosocial factors among the emergencies staff of primary care and seeing if there are differences with the primary health care staff at the Primary Care of the Integrated Care Management of Talavera de la Reina (Spain). Descriptive epidemiological study of type transversal. They have participated 51 emergencies staff of primary care and 50 primary health professionals from a sample of urban and rural health centres. The F-Psico 3.1 questionnaire has been used to evaluate the nine psychosocial risk factors. The emergencies staff quantify the psychosocial factors of working time (19.6 SD 5.7) and autonomy (69.8 SD 23.2) as a higher risk situation compared to the other health care staff with 3.7 SD 4, 7 and 52.1 SD 21.8, respectively (p < 0.05). In addition, the role performance is valued as a lower risk situation by the emergencies staff of primary care (p < 0.05). The workload assessment is the only difference between the emergencies staff of primary care in urban centres (61.5 SD 17.6) and rural (45.2 SD 18.4) (p < 0.05). Women have the highest workload (p < 0.05). It is necessary to apply preventive measures and policies applicable to women who work in emergencies, especially in urban areas to reduce their workload.

Morbilidad e indicadores hospitalarios en la Unidad de cuidados intensivos pediátricos de Bayamo, 2008-2018 / Morbidity and hospital indicators in the Bayamo Pediatric Intensive Care Unit, 2008-2018

Introducción: las terapias intensivas pediátricas son esenciales en el funcionamiento hospitalario, pues la asistencia al niño crítico es uno de sus objetivos prioritarios. Objetivo: caracterizar la morbilidad y los principales indicadores de calidad, establecidos por el Ministerio de Salud Pública (MINSAP), durante 11 años (2008-2018). Método: se realizó un estudio descriptivo, retrospectivo, epidemiológico en la UCIP Bayamo, con pacientes ingresados de 2008-2017, para estudiar el comportamiento de indicadores hospitalarios (ingresos directos, mortalidad neta y bruta, supervivencia general y del ventilado, promedio de estadía, índices ocupacional y tasa de infección asociada a la asistencia sanitaria) y de la morbilidad (ingresos, egresos, evaluación de los ingresos según grupos etarios, motivo de ingreso, tipo y estado nutricional). Resultados: de los ingresos: el 64.2 por ciento fue directos, de ellos el 63,6 por ciento procedió del cuerpo de guardia y de los intrahospitalarios el 49,3 por ciento fueron de gastro; el 50,1 por ciento menores de un año, el 18,2 por ciento desnutrido, el 14,2 por ciento quirúrgicos, en 61,3 por ciento por causa infecciosa. Entre los indicadores: tasa de mortalidad neta (2.7 por ciento) y la bruta (3.4 por ciento), promedio de estadía (5.6), índice ocupacional (77.7 por ciento) y tasa de infecciones asociadas a los cuidados sanitarios (5.3). La supervivencia general (96,5 por ciento), supervivencia del ventilado (86,1 por ciento) y en menores de un año de 96,8 por ciento y 85,0 por ciento, respectivamente. Conclusiones: se cumplen los indicadores hospitalarios con una elevada supervivencia general y en el paciente ventilado; hay un adecuado aprovechamiento de las camas y dentro de los ingresos predominaron los menores de un año, las causas infecciosas y los procedentes del cuerpo de guardia(AU)

Introduction: pediatric intensive therapies are essential in hospital operation, since the care of the critical child is one of their priority objectives. Objective: to characterize morbidity and the main quality indicators, established by the Ministry of Public Health (MINSAP), for 11 years (2008-2018). Method: a retrospective, epidemiological, descriptive study was carried out in the PICU Bayamo, with patients admitted from 2008-2017, to study the behavior of hospital indicators (direct admissions, net and gross mortality, general and ventilated survival, average stay, indices occupational and infection rate associated with health care) and morbidity (income, expenses, evaluation of income according to age groups, reason for admission, type and nutritional status). Results: of the admissions: 64.2 percent were direct, of them 63.6 percent came from the guardhouse and from the in-hospital 49.3 percent were from gastro; 50.1 percent under one year of age, 18.2 percent malnourished, 14.2 percent surgical, in 61.3 percent due to infectious causes. Among the indicators: net mortality rate (2.7 percent) and gross (3.4 percent), average length of stay (5.6), occupational index (77.7 percent) and rate of infections associated with health care (5.3). Overall survival (96.5 percent), ventilated survival (86.1 percent) and in children under one year of age of 96.8 percent and 85.0 percent, respectively. Conclusions: hospital indicators are met with a high overall survival and in the ventilated patient; there is an adequate use of the beds and within the income the minors of one year, the infectious causes and those coming from the body of the guard predominated(EU)

Morbilidad e indicadores hospitalarios en la Unidad de cuidados intensivos pediátricos de Bayamo, 2008-2018 / Morbidity and hospital indicators in the Bayamo Pediatric Intensive Care Unit, 2008-2018 / Indicadores de morbidade e hospitalares na Unidade de Terapia Intensiva Pediátrica de Bayamo, 2008-2018

RESUMEN Introducción: las terapias intensivas pediátricas son esenciales en el funcionamiento hospitalario, pues la asistencia al niño crítico es uno de sus objetivos prioritarios. Objetivo: caracterizar la morbilidad y los principales indicadores de calidad, establecidos por el Ministerio de Salud Pública (MISAP), durante 11 años (2008-2018). Método: se realizó un estudio descriptivo retrospectivo, epidemiológico en la UCIP Bayamo, con pacientes ingresados de 2008-2017, para estudiar el comportamiento de indicadores hospitalarios (ingresos directos, mortalidad neta y bruta, supervivencia general y del ventilado, promedio de estadía, índices ocupacional y tasa de infección asociada a la asistencia sanitaria) y de la morbilidad(ingresos, egresos, evaluación de los ingresos según grupos etarios, motivo de ingreso, tipo y estado nutricional). Resultados: de los ingresos: el 64.2% fue directos, de ellos el 63,6% procedió del cuerpo de guardia y de los intrahospitalarios el 49,3% fueron de gastro; el 50,1% menores de un año, el 18,2% desnutrido, el 14,2% quirúrgicos, en 61,3% por causa infecciosa. Entre los indicadores: tasa de mortalidad neta (2.7%) y la bruta (3.4%), promedio de estadía (5.6), índice ocupacional (77.7%) y tasa de infecciones asociadas a los cuidados sanitarios (5.3). La supervivencia general (96,5%), supervivencia del ventilado (86,1%) y en menores de un año de 96,8% y 85,0%, respectivamente. Conclusiones: se cumplen los indicadores hospitalarios con una elevada supervivencia general y en el paciente ventilado; hay un adecuado aprovechamiento de las camas y dentro de los ingresos predominaron los menores de un año, las causas infecciosas y los procedentes del cuerpo de guardia.

ABSTRACT Introduction: pediatric intensive therapies are essential in hospital operation, since the care of the critical child is one of their priority objectives. Objective: to characterize morbidity and the main quality indicators, established by the Ministry of Public Health (MISAP), for 11 years (2008-2018). Method: a retrospective, epidemiological descriptive study was carried out in the PICU Bayamo, with patients admitted from 2008-2017, to study the behavior of hospital indicators (direct admissions, net and gross mortality, general and ventilated survival, average stay, indices occupational and infection rate associated with health care) and morbidity (income, expenses, evaluation of income according to age groups, reason for admission, type and nutritional status). Results: of the admissions: 64.2% were direct, of them 63.6% came from the guardhouse and from the in-hospital 49.3% were from gastro; 50.1% under one year of age, 18.2% malnourished, 14.2% surgical, in 61.3% due to infectious causes. Among the indicators: net mortality rate (2.7%) and gross (3.4%), average length of stay (5.6), occupational index (77.7%) and rate of infections associated with health care (5.3). Overall survival (96.5%), ventilated survival (86.1%) and in children under one year of age of 96.8% and 85.0%, respectively. Conclusions: hospital indicators are met with a high overall survival and in the ventilated patient; there is an adequate use of the beds and within the income the minors of one year, the infectious causes and those coming from the body of the guard predominated.

RESUMO Introdução: as terapias intensivas pediátricas são essenciais na operação hospitalar, uma vez que o cuidado à criança crítica é um de seus objetivos prioritários. Objetivo: caracterizar a morbidade e os principais indicadores de qualidade, estabelecidos pelo Ministério da Saúde Pública (MISAP), por 11 anos (2008-2018). Método: estudo epidemiológico descritivo, retrospectivo, realizado na UTIP Bayamo, com pacientes internados de 2008 a 2017, para estudar o comportamento dos indicadores hospitalares (admissões diretas, mortalidade líquida e bruta, sobrevida geral e ventilada, permanênciamédia, índices taxa ocupacional e de infecção associada aos cuidados de saúde) e morbidade (renda, alta, avaliação de renda de acordó com a faixa etária, motivo da internação, tipo e estado nutricional). Resultados: das internações: 64,2% foram diretas, 63,6% vieram da guarita e do hospital, 49,3% foram gastro; 50,1% abaixo de um ano de idade, 18,2% desnutridos, 14,2% cirúrgicos, em 61,3% por causas infecciosas. Entre os indicadores: taxa de mortalida de líquida (2,7%) e bruta (3,4%), tempo médio de permanência (5,6), índice ocupacional (77,7%) e taxa de infecções associadas à assistência à saúde (5,3). Sobrevida global (96,5%), sobrevida ventilada (86,1%) e em crianças menores de um ano de 96,8% e 85,0%, respectivamente. Conclusões: os indicadores hospitalares são encontrados com alta sobrevida global e no paciente ventilado; existe um uso adequado dos leitos e, dentro da renda, predominaram os menores de um ano, as causas infecciosas e as provenientes do corpo da guarda.

Rational Synthesis of a Hierarchical Supramolecular Porous Material Created via Self-Assembly of Metal-Organic Framework Nanosheets.

Hierarchically porous materials with high stability and tailorable pore characters have potential for mass transfer applications, including bulky molecule capture and separation, heterogeneous catalysis, and drug delivery. The scope of functionalities can be notably broadened by employing metal-organic framework (MOF) sheets with tunable thickness as giant molecular building blocks for self-assembly into hierarchical supramolecular porous coordination materials. However, synthesizing MOF sheets with controllable bulkiness has proved challenging for scientists. We present a rational yet unprecedented bottom-up strategy to prepare a novel two-dimensional MOF sheet [Zn(BPDI)(Py)2] (BPDI = N,N'-bis(glycinyl)pyromellitic diimide; Py = pyridine) with unusual and highly desired tunable thickness. These sheets self-organize into a unique three-dimensional supramolecular coordination material (NEU-1) with tailorable porosity. To assess its technological relevance, NEU-1c is tested as a support of amine sorbent for CO2 capture. Multichannel porous NEU-1c solves the conventional trade-off suffered by supported amine carbon dioxide adsorbents between increasing amine content and decreasing access to amine sites. Our synthesis process opens the door to novel MOF nanosheets and unique hierarchical supramolecular porous materials with tailorable porosity.

Validation of a predictive model for successful vaginal birth after cesarean section.

INTRODUCTION: A strategy for reducing the number of cesarean sections is to allow vaginal delivery after cesarean section. OBJECTIVE: To validate two predictive models, Metz and Grobman, for successful vaginal delivery after a cesarean section. METHODS: Retrospective cohort study involving women with previous history of a previous segmental cesarean section, single pregnancy ≥37 weeks and cephalic presentation. The proportion of vaginal delivery in all pregnant women was determined, and it was compared with those (women) with successful delivery after cesarean section. Then, there were elaborated the models, and their predictive capacity was determined by curve-receiver-operator. RESULTS: The proportion of successful delivery in pregnant women with a previous cesarean section and indication of vaginal delivery was 85.64%. The observed proportion of birth for each decile predicted in the Grobman model was less than 15%, except for the 91-100% decile, where it was 64.09%; the area under the curve was 0.95. For the Metz model, the actual successful delivery rate was lower than predicted in scores between 4 and 14, and within expected for a score between 15 and 23; the area under the curve was 0.94. CONCLUSIONS: The vaginal delivery rate after cesarean was lower than expected according to the predictive models of Grobman and Metz. The implementation of these models in a prospective way can lead to a higher rate of successful birth.

INTRODUCCIÓN: Una estrategia de reducción del número de cesáreas es permitir el parto vaginal después de cesárea. OBJETIVO: Validar dos modelos predictivos, Metz y Grobman, para el parto vaginal exitoso después de una cesárea. MÉTODOS: Estudio de cohorte retrospectivo con mujeres con antecedente de una cesárea segmentaria previa, embarazo único ≥37 semanas y presentación cefálica . Se determinó la proporción de parto vaginal en todas las gestantes y se comparó con aquellas con parto exitoso después de cesárea, se elaboró los modelos y se determinó la capacidad predictiva de ellos mediante curva-receptor-operador. RESULTADOS: La proporción de parto exitoso en gestantes con cesárea previa e indicación de parto vaginal fue 85.64%. La proporción de parto observado para cada decil predicho en el modelo de Grobman fue inferior al 15%, excepto para el decil 91-100%, en el que fue 64.09%, el área bajo la curva fue 0.95. Para el modelo de Metz, la proporción de parto exitoso real fue menor a lo predicho en puntajes entre 4-14 y dentro de lo esperado para puntaje entre 15-23, con un área bajo la curva de 0.94. CONCLUSIONES: La tasa de parto vaginal después de cesárea fue menor a lo esperado de acuerdo a los modelos predictivos de Grobman y Metz. La implementación de estos modelos en forma prospectiva puede llevar una mayor tasa de parto exitoso.

Validation of a predictive model for successful vaginal birth after cesarean section / Validación de modelos predictivos para parto vaginal exitoso después de cesárea

Abstract Introduction: A strategy for reducing the number of cesarean sections is to allow vaginal delivery after cesarean section. Objective: To validate two predictive models, Metz and Grobman, for successful vaginal delivery after a cesarean section. Methods: Retrospective cohort study involving women with previous history of a previous segmental cesarean section, single pregnancy ≥37 weeks and cephalic presentation. The proportion of vaginal delivery in all pregnant women was determined, and it was compared with those (women) with successful delivery after cesarean section. Then, there were elaborated the models, and their predictive capacity was determined by curve-receiver-operator. Results: The proportion of successful delivery in pregnant women with a previous cesarean section and indication of vaginal delivery was 85.64%. The observed proportion of birth for each decile predicted in the Grobman model was less than 15%, except for the 91-100% decile, where it was 64.09%; the area under the curve was 0.95. For the Metz model, the actual successful delivery rate was lower than predicted in scores between 4 and 14, and within expected for a score between 15 and 23; the area under the curve was 0.94. Conclusions: The vaginal delivery rate after cesarean was lower than expected according to the predictive models of Grobman and Metz. The implementation of these models in a prospective way can lead to a higher rate of successful birth.

Resumen Introducción: Una estrategia de reducción del número de cesáreas es permitir el parto vaginal después de cesárea. Objetivo: Validar dos modelos predictivos, Metz y Grobman, para el parto vaginal exitoso después de una cesárea. Métodos: Estudio de cohorte retrospectivo con mujeres con antecedente de una cesárea segmentaria previa, embarazo único ≥37 semanas y presentación cefálica . Se determinó la proporción de parto vaginal en todas las gestantes y se comparó con aquellas con parto exitoso después de cesárea, se elaboró los modelos y se determinó la capacidad predictiva de ellos mediante curva-receptor-operador. Resultados: La proporción de parto exitoso en gestantes con cesárea previa e indicación de parto vaginal fue 85.64%. La proporción de parto observado para cada decil predicho en el modelo de Grobman fue inferior al 15%, excepto para el decil 91-100%, en el que fue 64.09%, el área bajo la curva fue 0.95. Para el modelo de Metz, la proporción de parto exitoso real fue menor a lo predicho en puntajes entre 4-14 y dentro de lo esperado para puntaje entre 15-23, con un área bajo la curva de 0.94. Conclusiones: La tasa de parto vaginal después de cesárea fue menor a lo esperado de acuerdo a los modelos predictivos de Grobman y Metz. La implementación de estos modelos en forma prospectiva puede llevar una mayor tasa de parto exitoso.

Actitud hacia el consumo, ahorro y endeudamiento en titulados de una universidad pública del sur de Chile / Attitudes toward purchase, saving and indebtedness in university graduates from a public university of southern Chile

La presente investigación tiene por objeto comparar las actitudes hacia el ahorro, consumo y endeudamiento en titulados de una universidad pública del sur de Chile, a partir de su género, nivel socioeconómico y facultad de procedencia. Cuenta con un diseño cuantitativo, no experimental, ex post facto, de alcance descriptivo-correlacional y de tipo transversal. Se administraron la Escala de Actitudes hacia el Endeudamiento, la Escala de Actitudes hacia el Ahorro, la Escala de Actitudes hacia la Compra y la Escala de Evaluación del Nivel Socioeconómico ESOMAR. Además, se aplicó un cuestionario de preguntas de clasificación sociodemográfica, que fue respondido por 120 titulados universitarios de una universidad pública del sur de Chile contactados mediante el método bola de nieve. Se realizaron análisis descriptivos, pruebas de comparación de medias y medianas para dos muestras independientes para las comparaciones según género, nivel socioeconómico y facultad de procedencia (pruebas t para muestras independientes y pruebas U de Mann-Whitney),y pruebas de correlación r de Pearson para identificar posibles asociaciones entre las distintas escalas y subescalas. Los resultados permiten concluir un perfil esperable en cuanto a actitudes hacia el ahorro, endeudamiento y la compra, en titulados universitarios. En relación a las comparaciones, si bien se encontraron algunas diferencias significativas en cuanto a género y nivel socioeconómico de los participantes, resultaron más bien bajas. Finalmente, se hallaron asociaciones entre actitudes hacia el ahorro con austeridad y con racionalidad en la compra. También se encontraron asociaciones entre compulsividad en la compra con austeridad (inversamente) y con impulsividad en la compra, lo que apunta a una coherencia teórica de los constructos y sus dimensiones. Limitaciones del estudio incluyen el uso de medidas de autorreporte, lo que restringe la extrapolación de resultados a contextos fuera del presente estudio. Otra limitación corresponde al método de muestreo utilizado (bola de nieve) y tamaño muestral, lo que no permitiría generalizar los resultados a la población. A partir de los hallazgos y limitaciones, se realizan sugerencias para futuras investigaciones en alfabetización económica.

Since the decade of 1970 onward in Chile, there has been a substantial change in terms of economic behaviour, which stems mainly from the installation of a neoliberal socioeconomic model. The profound consequences of this change for the Chilean society can be seen to this day, 40 years later, and these consequences include: broader access to goods and services for segments of the population that were previously excluded and/or that were a privilege of the economic elites; the assignation of new meanings to the concepts of purchase; and saving and indebtedness. These are all key concepts for the development and comprehension the neoliberal model. Complementary, the study of university graduates' behaviour is especially relevant in this area, considering that higher education is often thought to play a substantial role in social mobility. In the Chilean context, the transformations of the educational system have favoured the expansion of the admission numbers up to the point that seven of ten Chileans that pursue a graduate degree are the first members of their family to reach this educational level. Considering the above, the present study aims to compare attitudes towards purchase, saving and indebtedness in graduates from a university in southern Chile, by gender, socioeconomic level and faculty. The study follows a quantitative, cross-sectional, non-experimental, ex-post-facto design, with a descriptive-correlational scope. A questionnaire was completed by 120 participants contacted via snowball method. The questionnaire included: the Attitudes toward Indebtedness Scale; Attitudes toward Saving Scale; and Attitudes toward Purchase Scale, a scale that evaluates the participants' socioeconomic level and other sociodemographic information to help describe the sample. Descriptive analyses were carried out, along with mean and median comparisons for gender, socioeconomic level and faculty (t tests for independent samples and Mann-Whitney U tests). Finally, correlation tests with Pearson's r test were carried out to test associations between the scales and subscales. Results showed a profile that is desirable in university graduates in terms of attitudes towards saving, indebtedness and purchase, that is: favourable attitudes toward saving, austerity (a subscale of attitudes toward indebtedness) and rationality (a subscale of attitudes toward purchase), as well as negative attitudes toward hedonism (a subscale of attitudes toward indebtedness), and compulsivity and impulsivity (subscales of attitudes toward purchase). In terms of comparison, differences were found when comparing participants by gender in terms of attitudes toward compulsivity, and by their socioeconomic level by attitudes toward austerity in the indebtedness. Both these differences, although significant, were low when considering their effect size. No differences were found when comparing the faculty to which participants belonged in terms of attitudes toward saving, indebtedness and purchase. Finally, results showed associations between attitudes toward saving and austerity and with rationality, and between compulsivity and austerity (inversely) and with impulsivity. These results highlight the need to strengthen the attitudinal aspect in higher education environments where economic literacy is carried out, aiming to prepare students for their insertion into the workforce and their role as active citizens. Limitations of this study include the subjective self-report measurements used, which are susceptible to the effect of social desirability. This limitation hinders the extrapolation of the results in terms of attitudes into actual behaviour in the real world. Another limitation comes from the sampling method used (snowball) and sample size, which does not allow to generalize the results to the population. Drawing from both findings and limitations, suggestions for future research in the subject of economic literacy and related issues are outlined.

Validation of diagnostic tests for histologic chorioamnionitis: Systematic review and meta-analysis.

INTRODUCTION: The aim of this study was to determine the diagnostic performance of different diagnostic tests for histologic chorioamnionitis in patients at more than 20 weeks of gestation. METHODS: A systematic search was carried out through MEDLINE, EMBASE, LILACS, CENTRAL and unpublished literature. Observational studies included with pregnant women (>20 weeks) with chorioamnionitis. The reference standard was the histopathological study of the placenta, umbilical cord and fetal membranes. Two independent researchers extracted data and performed a meta-analysis of diagnostic tests. RESULTS: Twenty-nine articles were included. The studies provided evidence in the form of maternal clinical and serological tests; tests of vaginal fluid, amniotic fluid or the umbilical cord; fetal monitoring and ultrasound tests. To assess the performance of maternal serum CRP, 13 studies were included, showing a combined sensitivity of 68.7% (95%CI 58%-77%) and a combined specificity of 77.1% (95%CI 67%-84%). Maternal leukocytosis was evaluated in four publications, showing a combined sensitivity of 51% (95%CI 40%-62%) and a combined specificity of 65% (95%CI 50%-78%). CONCLUSIONS: CRP and maternal leukocytosis, showed a low sensitivity and specificity. The sonographic evaluation of the fetal thymus is also more sensitive for the diagnosis of histologic chorioamnionitis than the fetal biophysical profile.

Characteristics and mortality of elderly patients admitted to the Intensive Care Unit of a district hospital.

AIM: To study all the elderly patients (≥75 years) who were admitted in an Intensive Care Unit (ICU) of a Spanish hospital and identify factors associated with mortality. PATIENTS AND METHODS: A retrospective, observational data collected prospectively in patients ≥75 years recruited from the ICU in the period of January 2004 to December 2010. RESULTS: During the study period, 1661 patients were admitted to our unit, of whom 553 (33.3%) were older than 75 years. The mean age was 79.9 years, 317 (57.3%) were male, and the overall in-hospital mortality was 94 patients (17% confidence interval 14-20.3%). When comparing patients who survived to those who died, we found significant differences in mean age (P = 0.001), Acute Physiologic Assessment and Chronic Health Evaluation II and Simplified Acute Physiology Scoring II (SAPS II) on admission (P < 0.0001, postoperative patients (P = 0.001), and need for mechanical ventilation (P < 0.0001). Comparing age groups, we found statistically significant differences in SAPS II (P = 0.007), diagnosis of non-ST-segment elevation myocardial infarction (P = 0.014), complicated postoperative period (P = 0.001), and pacemaker (P = 0.034). Mortality between the groups was statistically significant (P = 0.004). The survival between the group of 65 and 74 years and patients >75 years was not significant (P = 0.1390). CONCLUSIONS: The percentage of elderly patients in our unit is high, with low mortality rates. The age itself is not the sole determinant for admission to the ICU and other factors should be taken into account.