Manager's leadership is the main skill for ambulatory health care plan success.

To demonstrate effectiveness of ambulatory health care plan implementation among institutions and variables associated with the differences observed. Randomized selection of primary health care (PHC) centers was done. Leadership ability of the plan manager was explored. Univariate/bivariate analyses were performed to observe correlation between variables. Two groups of PHC centers were established according to the efficacy of plan implementation: high and low performance. Differences between groups were observed (592%-1023% more efficacy in controls and practices; P < .001). Leadership was responsible for the main differences observed. Leadership of manager for implementation of the health care plan was the major important variable to reach the best efficacy standards.

Healthcare model based on personalised attention: impact on maternal mortality and health system quality.

BACKGROUND: Latin America's public healthcare model has traditionally offered health services on demand including provision for the most deprived inhabitants. However, this care model has not provided the expected improvement in health conditions or equity for the indigent population. AIM: To compare maternal health indicators between previous services and a new healthcare model based on personalised care and a named healthcare worker. METHODS: Pregnant women in La Plata, Argentina were observed during two periods: a control period using a historical model and an intervention period where a new healthcare model was provided, each period lasting 12 months. Indicators of the quality of antenatal care services were measured, including mortality rate, number of pregnancy related consultations, vaccination coverage, gestational age at delivery, newborn weight, laboratory and scan monitoring, early pregnancy detection and type of delivery. RESULTS: The number of patients undergoing antenatal surveillance increased almost five-fold during the period of the new healthcare model. Also the rate of early detection of pregnancy, average number of health consultations and vaccination coverage were significantly higher with the new model compared with previous care. Maternal gestation at delivery increased from 37.4±3.8% to 39.3±2.5% weeks (P<0.001) and neonatal weight increased from 3048 AE 612 g to 3301 AE 580 g (P=0.003). There were no maternal deaths in the intervention group compared with seven deaths in the control group. Child mortality rate was 13.7 and 11.8 per 1000 for control and intervention groups respectively (P=0.039). CONCLUSIONS: A named responsible health worker and personalised care helped contribute to improvements in quality of antenatal care in the health system.

Obtención de ADN polimerasa de Thermus aquaticus en un laboratorio de mediana complejidad / Thermus aquaticus polymerase DNA's production in a medium complexity laboratory

La PCR (reaccion en cadena de la polimerasa) es una técnica de diagnóstico molecular muy sensible, capaz de revelar tan sólo una copia de ADN en una mexcla compleja del mismo. El punto central para la difusión de esta metodología fue el descubrimiento de una ADN polimerasa estable al calor aislada de Thermus aquaticus (taq ADN pol), lo cual permitió automatizar el proceso de PCR usando un ciclador térmico, sin la necesidad de una adición continua de ADN polimerasa fresca. El objetivo del trabajo fue adaptar un método para la obtención de taq ADN pol en un laboratorio hospitalario de mediana complejidad usando el equipamiento y los medios de cultivo disponibles. Con este mètodo se consiguió producir un extracto crudo de 10.000 unidades de enzima, de fácil purificación, que mostró tener muy buena actividad enzimática por lo cual es posible utilizarla en una amplia variedad de aplicaciones (PCR clásica, PCR anidada, PCR transcriptasa reversa). La actividad enzimática para estos casos fue comparable con la de la taq polimerasa que se adquiere en el mercado.