Abstract Objective: To analyze medication errors reported in 2018 in a highly complex Chilean public hospital. Methodology: Quantitative, retrospective, descriptive and correlational study. The variables sex and age of the patient, month of the incident, type of error, service, stage of the medication process and contributing factors were analyzed. Results: The incidents were more frequent in summer months, in female patients over 60 years of age. The most commonly reported errors were incorrect dose, medication and patient. The highest number of notifications were registered in the pharmacy. Errors occurred more frequently in the administration and dispensing stages. Among the contributing factors are inefficient check-up, attrition or work overload, overconfidence, lack of training, and patient confusion. Conclusion: Vacation periods concentrate the highest number of medication errors, associated with work overload and lack of training for replacement professionals, whose training must be reinforced.

Resumen Objetivo: Analizar errores de medicación notificados en 2018 en un hospital público de alta complejidad chileno. Metodología: Estudio cuantitativo, retrospectivo, descriptivo y correlacional. Se analizaron las variables sexo y edad del paciente, mes del incidente, tipo de error, servicio, etapa del proceso de medicación y factores contribuyentes. Resultados: Los incidentes fueron más frecuentes en meses estivales, en pacientes mayores de 60 años y de sexo femenino. Los errores más notificados fueron dosis, medicamento y paciente incorrecto. En farmacia se registraron el mayor número de notificaciones. Los errores ocurrieron con mayor frecuencia en las etapas de administración y dispensación. Entre los factores contribuyentes destacan chequeo ineficiente, desgaste o sobrecarga laboral, exceso de confianza, falta de capacitación y confusión del paciente. Conclusión: Los periodos vacacionales concentran el mayor número de errores de medicación, asociados a la sobrecarga laboral y falta de capacitación de los profesionales de reemplazo, cuya formación debe ser reforzada.

ABSTRACT Introduction: hypertension as obesity is considered a health problem worldwide. In recent years, this situation has increased in childhood. There is a close inverse correlation between the dietary intake of magnesium, or in its supplementation, and blood pressure levels. In hypertension, there is a presence of reactive oxygen species, as well as, antioxidant defenses may be affected. Objectives: to evaluate the manifestation of magnesium concentrations in pre-hypertensive, hypertensive and obese school-age children. Methods: a cross-sectional descriptive study was carried out. The sample consisted of 501 infants (8-11 years old), which were classified according to: blood pressure values at rest, gender, skin color and body mass index. The determinations of magnesium were made using flame atomic absorption spectrometry. Mann-Whitney U and Student's T Tests were used to compare groups with a significance level of p <0.05. Results: there were no differences in magnesium concentrations in the total group of children. Female pre-hypertensive and hypertensive white children aged 9 years showed a significant decrease in magnesium concentrations. Normal-weight hypertensive males had a significant difference in magnesium concentrations in relation to normotensive ones. No significant difference in magnesium concentrations was found when studying the body mass index. Conclusions: magnesium concentrations were decreased in pre-hypertensive, hypertensive or obese children for certain age groups, gender and skin color.

RESUMEN Introducción: la hipertensión, al igual que la obesidad, es un problema de salud a nivel mundial. En los últimos años esta situación ha aumentado en la edad infantil. Existe una estrecha relación inversa entre la ingestión del magnesio en la dieta, o en su suplementación, y los niveles de presión sanguínea. En la hipertensión hay presencia de las especies reactivas del oxígeno y las defensas antioxidantes pudieran estar afectadas. Objetivos: evaluar el comportamiento de las concentraciones del magnesio en niños pre-hipertensos, hipertensos y obesos en edad escolar. Métodos: se realizó un estudio descriptivo transversal. La muestra estuvo constituida por 501 infantes (8-11 años), los cuales se clasificaron según: los valores de presión arterial en reposo, sexo, color de la piel e índice de masa corporal. Las determinaciones del magnesio se realizaron por el método de absorción atómica con llama. Se utilizaron las pruebas: T student y U de Mann-Whinney, en la comparación de los grupos con un nivel de significación p< 0,05. Resultados: en el grupo total de niños no hubo diferencias en las concentraciones del magnesio. Los niños pre-hipertensos e hipertensos, del sexo femenino y piel blanca, de 9 años, presentaron disminución significativa de las concentraciones de magnesio. Los varones hipertensos normopesos presentaron diferencia significativa del magnesio en relación con los normotensos. No se encontró diferencia significativa en las concentraciones de magnesio al estudiar el índice de masa corporal. Conclusiones: las concentraciones de magnesio estuvieron disminuidas en los niños pre-hipertensos, hipertensos u obesos para determinados grupos de edad, sexo y color de la piel.

ABSTRACT Introduction: Frequently the medical information on a certain clinical aspect is so unclear and contradictory, that health professional does not have the time or guidance to be able to analyze it in its entirety, and thus be able to take advantage of it in its real magnitude. Objective: To review the existing methodology and systems to perform meta-analysis of clinical trials. Methods: The process of analyzing this knowledge, called meta-analysis, has been reviewed; this is a systematic, qualitative and quantitative study of a group of reports or research articles, generally focused on the analysis of a clinical aspect. Results: In this review article, we show how the meta-analysis is designed, executed and reported, as well as the steps to carry out the meta-analysis. Discussion: The systems most used to perform meta-analysis are summarized and compared. Conclusions: With this work we know that the analysis of sensitivity, accumulated and publication bias cannot be missing for a meta-analysis, as well as the systems where each of these analyzes can be performed.

RESUMEN Introducción: Frecuentemente la información médica sobre determinado aspecto clínico, es tan poco clara y contradictoria, que en ocasiones el profesional de la salud no tiene el tiempo o la orientación para poder analizarla en su totalidad, y poder así aprovecharla en su real magnitud. Objetivo: Revisar la metodología y los sistemas que existen para realizar meta-análisis de ensayos clínico. Métodos: Se ha revisado el proceso de análisis de esos conocimientos, llamado meta-análisis; éste es un estudio sistemático, cualitativo y cuantitativo de un grupo de informes o artículos de investigación, generalmente enfocado al análisis de un aspecto clínico. Resultados: En este artículo de revisión, se muestra cómo se diseña, se ejecuta y reporta el meta-análisis, así como los pasos para la realización del meta-análisis. Discusión: Se resumen y se comparan los sistemas que más se utilizan para realizar meta-análisis. Conclusiones: Con este trabajo se conocen que los análisis de sensibilidad, acumulado y de sesgo de publicación no pueden faltar para un meta-análisis, así los sistemas donde poder realizar cada uno de estos análisis.

Marco contextual: La educación en enfermería en esta última década ha iniciado importantes cambios curriculares basados en la formación en competencias, por lo que implica un reto para la disciplina, el definir qué competencias son relevantes a desarrollar en los estudiantes. Objetivo: Comprender las experiencias vividas por los (as) estudiantes de la Universidad Católica del Maule acerca de la formación basada en competencias. Metodología: Se enmarca bajo el paradigma cualitativo, descriptivo e interpretativo, se realizaron 17 entrevistas semiestructuradas. En el análisis se utilizó el enfoque holístico de Van Manen. Resultados: Emergen temas como sentimientos experimentados con la innovación curricular, la implementación de competencias es difícil, el cambio es profundo, y una buena docencia, valoran el acompañamiento y la experiencia clínica del docente. Conclusión: El estudio permitió conocer el significado que tiene la innovación curricular desde la perspectiva de los estudiantes, aporta información relevante para el rediseño curricular y permite reflexionar acerca del proceso formativo de los currículos por competencias en el espacio latinoamericano.

Enquadramento: A educação em enfermagem, nesta última década, tem iniciado importantes mudanças curriculares com base na formação de competências, promovendo um desafio para a disciplina de definir quais as competências relevantes para que os estudantes desenvolvam. Objetivo: Compreender as experiências dos(as) estudantes da Universidade Católica de Maule sobre formação baseada em competências. Metodologia: Estudo descritivo e interpretativo de natureza qualitativa, por meio de 17 entrevistas semiestruturadas. Para a análise, utilizou-se a abordagem holística de Van Manen. Resultados: Os temas emergentes foram sentimentos vivenciados com a inovação curricular, dificuldades na implementação de competências, o facto de a mudança ser profunda e uma boa docência valorizam o acompanhamento e a experiência clínica do professor. Conclusão: O estudo permitiu conhecer o significado que tem a inovação curricular na perspectiva dos estudantes, forneceu informações relevantes para o redesenho curricular e permitiu refletir sobre o processo formativo dos currículos baseados em competências no espaço latino-americano.

Background: In the past decade, nursing education has initiated important curricular changes based on competency training. The discipline faces the challenge of defining the most relevant competencies for students to acquire. Objective: To understand the experiences of students from the Catholic University of the Maule, Chile about competency-based education. Methodology: A qualitative, descriptive and interpretative study was conducted. A total of 17 semi-structured interviews were performed. Van Manen's holistic approach was used in the analysis. Results: The emergent themes were feelings experienced regarding curricular innovation; the difficult implementation of competencies; the profound changes; and a good teaching. Conclusion: The study allowed us to understand the meaning of curricular innovation from the students' perspective and provided relevant information for curricular redesign. It allowed us to reflect on the teaching/learning process of competency-based curricula in Latin-America.

Background: Decreased antiretroviral therapy persistence is associated with increased rates of virologic failure, development of antiretroviral resistance, and increased morbidity and mortality. Different therapeutic strategies, such as single-tablet regimens (STR) and less-drug regimens (LDR), have been developed in order to simplify antiretroviral therapy (ART) and increase persistence. Objectives: The primary objective was to compare antiretroviral persistence among patients receiving STRs and patients receiving LDRs. A secondary objective was to identify factors associated with non-persistence. Methods: This was a retrospective study that included treatment-experienced HIV-infected patients who received ART based on STR or LDR. Baseline patient characteristics collected included demographic information, HIV risk transmission, substance abuse during the therapy, presence of psychiatric disorder and hepatitis B or C virus infection. Kaplan-Meier analysis and Log rank was utilized to compare persistence to STR and LDR. To identify independent predictors of non-persistence we developed a multivariate Cox regression analysis. Results: A total of 244 patients were included, 176 with STR and 68 with LDR. 60 (34.1%) patients discontinued in the STR group and 13 (19.1%) in the LDR group. The Cox regression model showed that the only variable associated with higher risk of non-persistence was the substance abuse (HR = 2.59; p = 0.005). Adverse events were the main reason for ART discontinuation in the STR group and virologic failure in the LDR group. Conclusions: Persistence to STR and LDR seems to be similar in pretreated HIV-infected patients. Drug abuse was the only factor identified with a higher risk of non-persistence.

Objetivos: Analizar y comparar la persistencia entre las estrategias basadas en Single-Tablet Régimen (STR) y Less Drug Régimen (LDR) en pacientes VIH+. El objetivo secundario del estudio fue determinar factores predictores de persistencia. Material y métodos: Estudio observacional retrospectivo que incluyó los siguientes criterios: pacientes VIH+ con tratamiento antirretroviral (TAR) con un régimen basado en STR o LDR. Se recogieron variables demográficas, factores de riesgo de adquisición, consumo de drogas, presencia de algún trastorno psiquiátrico y coinfección por el virus de la hepatitis B o C. Para comparar la persistencia entre ambas estrategias se realizó un análisis de supervivencia de Kaplan-Meir y se aplicó el método de log-rank. Se realizó un análisis de regresión de Cox para identificar los factores predictores de persistencia. Resultados: Se incluyeron 244 pacientes, 176 con STR y 68 con LDR. El 34,1% (n = 60) de los pacientes que recibieron un régimen STR abandonaron y en el LDR el 19,1% (n = 13). Los efectos adversos fueron la principal causa de abandono del tratamiento en los pacientes que recibieron STR y el fallo virológico en el régimen LDR. La persistencia de las estrategias STR y LDR fue similar, no encontrándose diferencias estadísticamente significativas entre ambas. El consumo de drogas fue el único factor predictivo asociado con una menor persistencia (HR = 2,59; p = 0,005). Conclusiones: La persistencia entre los regímenes STR y LDR fue similar, no detectándose diferencias significativas entre ambos. El consumo de drogas fue el único factor independiente asociado con una menor persistencia del tratamiento antirretroviral.

Se evaluó la estructura de talla, la relación talla peso y la tasa de crecimiento y mortalidad de la ostra de mangle Crassostrea rhizophorae en la zona de La Tortuga, laguna de La Restinga, durante el período marzo 2012 - febrero 2013. Para ello se realizaron muestreos mensuales y aleatorios de las ostras. La composición anual de talla estuvo integrada por organismos de 15 a 95 mm de longitud total, con un mayor número de individuos en el intervalo de 45 y 60 mm. La relación talla-peso presentó un coeficiente de correlación r = 0,66 y una pendiente b = 1,80, señalando que la especie tiene un crecimiento alométrico minorante. El modelo de crecimiento en longitud estuvo representado por la ecuación Lt = 103,41 [1 - exp (-1,59 (t-0,31))], mostrando un crecimiento acelerado alcanzando a los 6 meses la talla comercial (60 mm), con una longevidad máxima estimada de 2 años.

The size structure, height - weight relationship and growth rate and mortality of the mangrove oyster Crassostrea rhizophorae were evaluated in the area La Tortuga, La Restinga Lagoon, during the period march 2012 - february 2013. Monthly ramdom samples of oysters were taken. The annual size composition consisted of individuals between 15 and 95 mm in length, with a larger number of individuals in the range 45 to 60 mm. The length-weight relationship showed a positive relationship, with a correlation coefficient r = 0.66 and a slope b = 1.80, indicating that the species has a negative allometric growth. The model of growth in length was represented by the equation Lt = 103.41 [1 - exp (-1.59 (t-0, 31))], showing a fast growth which allows the oyster to reach commercial size (60 mm ) at 6 months, with a maximum estimated longevity of 2 years.

Este estudo objetivou avaliar a qualidade do sêmen de carneiros da raça Santa Inês, alimentados com dietas contendo diferentes níveis de caroço de algodão integral (CAI). Foram utilizados 20 carneiros distribuídos em quatro dietas e alimentados com 0, 20, 30, 40% do caroço de algodão integral. Para este estudo realizou-se a coleta de sêmen dos animais pelo método da eletroejaculação e durante nove meses procedeu-se o exame andrológico mensal. As variáveis analisadas foram: circunferência escrotal (CE); volume, aspecto e cor do ejaculado, motilidade progressiva (MP), vigor, movimento de massa (MM), concentração espermática total (spzX10(9)), morfologia espermática (ME) e hematócritos sanguíneos. A CE não variou entre as dietas com média de 31,83 cm. Os animais que receberam (CAI) tiveram ingestão média de 9,16 mg de gossipol kg-1 PV, e tenderam a apresentar o sêmen de coloração esverdeada, com aspecto variando de cremoso fino a aquoso. Nas características microscópicas a MP decresceu linearmente com aumento do nível de CAI, enquanto o vigor mostrou comportamento quadrático. Os defeitos totais tiveram efeito linear crescente em relação aos valores de referência descritos na literatura. O CAI não influenciou os níveis de hematócritos, porém afetou a motilidade progressiva e o vigor dos espermatozoides, não devendo ser usado em dietas de animais destinados à reprodução.

This study evaluated the semen quality of Santa Ines sheep fed diets containing different levels of whole cottonseed (WCS). Twenty sheep were distributed into four groups that were given diets with 0; 20; 30; 40% of WCS. For this study the semen was collected by electroejaculation, and a monthly andrological examination was performed during nine months. The analyzed variables were: scrotal circumference (SC), appearance and color of the ejaculate, progressive motility (PM), vigor, mass movement (MM), total sperm concentration (spzX10(9)), sperm morphology (SM) and blood hematocrit. The SC had no difference among diets, with mean 31.83 cm. The animals fed diets with WCS, presented mean intake of 9.16 mg gossypol kg BW, and were prone to present greenish semen, and appearance ranging from thin creamy to watery. The PM decreased linearly (p < 0.05) with increasing level of WCS, while the vigor had a quadratic trend. The total defects increased linearly in relation to reference values described in literature. The WSC had no influence on hematocrit levels, but did affect the PM and vigor of spermatozoa, thus not recommended to diets of animals for breeding.

A medicina diagnóstica é, hoje, um conglomerado de especialidades direcionadas à realização de exames complementares no auxílio ao diagnóstico. A maior competitividade do mercado fez com que os gestores realizassem os denominados trade offs entre diferentes fatores estratégicos de produção - qualidade, confiabilidade, flexibilidade, velocidade e custo -, com o objetivo de definir o posicionamento ante a contribuição da área de produção para a organização. A determinação dos fatores escolhidos, diante das expectativas dos clientes e de um benchmarking com a concorrência, analisados de forma sistemática, define o posicionamento estratégico da organização. Para sedimentar os conceitos defendidos neste artigo, uma simulação de um caso de definição da estratégia da área de produção é apresentada.

Diagnostic Medicine is currently a pool of medical specialties oriented to conduct complementary tests for clinical diagnostics. The higher market competitiveness has led management teams to make trade offs among strategic factors such as quality, reliability, flexibility, velocity and costs with the aim to define the contribution of the production area to the company. The determination of these factors based on clients' expectations, benchmarking and subject to systematical analysis define the company strategy. The simulation of a production area strategy planning is presented to demonstrate the concepts discussed in this article.

Direct Agglutination (DA) techniques, both, using dry blood samples in filter paper and serum samples, were compared with the ELISA test in order to detect antibodies against Toxoplasma gondii. The results show the validity of the dry blood samples in filter paper for detecting antitoxoplasma antibodies with a DA test. Our results would confirm their usefulness in field epidemiological surveys.

Se compara la técnica de Aglutinación Directa (AD) utilizando muestras de sangre total desecada en papel de filtro, con la técnica de ELISA y la misma AD utilizando muestras de suero de los mismos pacientes, para la detección de anticuerpos antitoxoplasma. Los resultados muestran la validez del método de la sangre desecada en papel de filtro para la detección de anticuerpos antitoxoplasma con la técnica de AD, y se considera su utilidad en los estudios epidemiológicos de campo.