ABSTRACT
BACKGROUND: The Learning Environment (LE) influences the performance of students, learning, social life, mental health, and the future of work. AIM: To assess the learning environment (LE) among medical residents of 64 specialties. MATERIAL AND METHODS: Two validated instruments "Postgraduate Hospital Education Environment Measure" (PHEEM) and "Ambulatory Care Learning Educational Environment" (ACLEEM), and open questions were answered online by 1259 residents from 15 universities. A descriptive and analytical statistical analysis and semantic deductive-inductive analyses of open questions were performed. RESULTS: LE was positive rather than negative (PHEEM of 100.5 points (79-116) and ACLEEM of 138.5 points (120-157)). An age over 32 years, male sex, studying in a private university, being in first year of residence and being in a non-surgical specialty were associated with a better PHEEM score (p < 0.05). For ACLEEM, the first year of specialty, a non-surgical specialty and studying in a private university were associated with better scores (p < 0.05). Two programs had excellent LE (Pathological Anatomy and Ophthalmology) and no specialty had a very poor performance or many problems. Aspects of teaching, clinical activities, and teachers were strengths reported by students. Aspects to improve were teaching, protected times and clinical activities. CONCLUSIONS: LE among medical specialties had more positive than negative features, but with areas that should be improved.
Subject(s)
Internship and Residency , Medicine , Adult , Chile , Education, Medical, Graduate , Hospitals, Teaching , Humans , Male , Perception , Surveys and Questionnaires , UniversitiesABSTRACT
BACKGROUND: This study aimed to assess the efficacy of ceftolozane-tazobactam (C/T) for treating infections due to Pseudomonas aeruginosa (P. aeruginosa) in critically ill patients. PATIENTS AND METHODS: A multicenter, retrospective and observational study was conducted in critically ill patients receiving different C/T dosages and antibiotic combinations for P. aeruginosa infections. Demographic data, localisation and severity of infection, clinical and microbiological outcome, and mortality were evaluated. RESULTS: Ninety-five patients received C/T for P. aeruginosa serious infections. The main infections were nosocomial pneumonia (56.2%), intra-abdominal infection (10.5%), tracheobronchitis (8.4%), and urinary tract infection (6.3%). Most infections were complicated with sepsis (49.5%) or septic shock (45.3%), and bacteraemia (10.5%). Forty-six episodes were treated with high-dose C/T (3 g every 8 hours) and 38 episodes were treated with standard dosage (1.5 g every 8 hours). Almost half (44.2%) of the patients were treated with C/T monotherapy, and the remaining group received combination therapy with other antibiotics. Sixty-eight (71.6%) patients presented a favourable clinical response. Microbiological eradication was documented in 42.1% (40/95) of the episodes. The global ICU mortality was 36.5%. Univariate analysis showed that 30-day mortality was significantly associated (P < 0.05) with Charlson Index at ICU admission and the need of life-supporting therapies. CONCLUSIONS: C/T appeared to be an effective therapy for severe infections due to P. aeruginosa in critically ill patients. Mortality was mainly related to the severity of the infection. No benefit was observed with high-dose C/T or combination therapy with other antibiotics.
Subject(s)
Cephalosporins/therapeutic use , Pseudomonas Infections/drug therapy , Pseudomonas Infections/mortality , Pseudomonas aeruginosa/drug effects , Tazobactam/therapeutic use , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Critical Illness , Cross Infection/drug therapy , Cross Infection/mortality , Dose-Response Relationship, Drug , Drug Resistance, Multiple, Bacterial , Female , Humans , Intensive Care Units , Male , Microbial Sensitivity Tests , Middle Aged , Pseudomonas aeruginosa/isolation & purification , Retrospective Studies , Spain , Treatment OutcomeABSTRACT
BACKGROUND: The Learning Environment (LE) influences the performance of students, learning, social life, mental health, and the future of work. Aim: To assess the learning environment (LE) among medical residents of 64 specialties. MATERIAL AND METHODS: Two validated instruments "Postgraduate Hospital Education Environment Measure" (PHEEM) and "Ambulatory Care Learning Educational Environment" (ACLEEM), and open questions were answered online by 1259 residents from 15 universities. A descriptive and analytical statistical analysis and semantic deductive-inductive analyses of open questions were performed. Results: LE was positive rather than negative (PHEEM of 100.5 points (79-116) and ACLEEM of 138.5 points (120-157)). An age over 32 years, male sex, studying in a private university, being in first year of residence and being in a non-surgical specialty were associated with a better PHEEM score (p < 0.05). For ACLEEM, the first year of specialty, a non-surgical specialty and studying in a private university were associated with better scores (p < 0.05). Two programs had excellent LE (Pathological Anatomy and Ophthalmology) and no specialty had a very poor performance or many problems. Aspects of teaching, clinical activities, and teachers were strengths reported by students. Aspects to improve were teaching, protected times and clinical activities. CONCLUSIONS: LE among medical specialties had more positive than negative features, but with areas that should be improved.
Subject(s)
Humans , Male , Adult , Internship and Residency , Medicine , Perception , Universities , Chile , Surveys and Questionnaires , Education, Medical, Graduate , Hospitals, TeachingABSTRACT
A rare case of abdominal pregnancy, diagnosed by ultrasound at 14 weeks' gestation, was managed conservatively resulting in the delivery of a viable infant at 32 weeks who survived. Details of the natural history, subsequent pregnancy course and perinatal and maternal outcomes in this case are presented.
Subject(s)
Live Birth , Pregnancy, Abdominal/diagnostic imaging , Adult , Female , Humans , Infant, Newborn , Infant, Premature , Infant, Small for Gestational Age , Pregnancy , UltrasonographyABSTRACT
El presente estudio correlacional, cuantitativo y no experimental, tiene por objeto determinar si existe relación entre el Desarrollo Psicomotor y el Rendimiento Escolar de niños de primer año básico pertenecientes a escuelas municipalizadas de la Región Metropolitana. Se evaluó una muestra de 106 niños a través del Manual de Observación Psicomotriz de Vitor da Fonseca, para determinar el desarrollo psicomotor, por otra parte, para establecer el Rendimiento Escolar se enfocó en las asignaturas de Lenguaje y Matemáticas, evaluadas a través de cuatro procedimientos: Prueba de Funciones Básicas (PFB) e Índice Lenguaje (IL) (notas-simce) para Lenguaje y Prueba de Precálculo (PPC) e Índice Matemáticas (IM) (notas-simce) para Matemáticas. Los resultados muestran una correlación ordinal estadísticamente significativa (p<0,01) entre el Desarrollo Psicomotor y cada una de las cuatro evaluaciones del Rendimiento Escolar, según el coeficiente de Spearman y la Prueba de t de Student. Además, se buscaron asociaciones significativas entre cada una de las áreas del Desarrollo Psicomotor y ambas pruebas Rendimiento Escolar. Los resultados indican que para la Prueba de Funciones Básicas sólo existe una asociación significativa estadísticamente, con el área de Praxia Fina (p<0,01), mientras que la Prueba de Precálculo se asocia significativamente con las áreas de Estructuración Temporo-Espacial (p<0,01), Praxia Global (p<0,05) y Praxia Fina (p<0,05). En conclusión, existe una correlación ordinal significativa entre el Desarrollo Psicomotor y el Rendimiento Escolar en niños de primer año básico.