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Introduction: Maternal mortality remains a significant challenge for public health globally, particularly in developing areas such as Ica, Peru. This study aims to analyze the risk factors contributing to maternal mortality in reference hospitals in Ica during the period of 2010 to 2020.

Methods: A case-control study was conducted, including 49 cases of maternal deaths and 98 controls, applying multivariate logistic regression to analyze data collected from hospital records.

Results: The absence of a partner (adjusted OR: 12.3; 95% CI: 2.6 to 58.8), history of anemia (adjusted OR: 5.8; 95% CI: 1.5 to 21.3), delays of more than two hours in accessing medical care (adjusted OR: 10.2; 95% CI: 2.0 to 51.1), and lack of knowledge of warning signs such as unrecognized vaginal bleeding by companions (adjusted OR: 7.4; 95% CI: 1.2 to 46.7) were associated with an increased risk of maternal mortality.

Conclusions: The identification of these factors highlights the urgent need to develop comprehensive strategies that optimize access to maternal health services and strengthen education on warning signs. To reduce preventable maternal mortality, it is essential to collaborate between the Ministry of Health of Peru and regional governments, aiming to expand coverage and improve the quality of prenatal care. Additionally, awareness should be increased and transportation availability ensured 24 hours a day for women experiencing obstetric complications. The main limitation of this study is the generalization of results due to the regional focus and exclusive use of hospital data.

Introduction: Shortage of medicines in Peruvian healthcare facilities is a significant public health issue that may affect patient satisfaction.

Objective: To estimate the association between access to medicines and the level of satisfaction with the received care from users of healthcare facilities in Peru during 2016.

Methods: An analytical cross-sectional study was conducted using data from the 2016 National Survey of User Satisfaction in Health (ENSUSALUD). Access to medicines at the healthcare facilities' pharmacy and patient satisfaction were measured using self-report questions. Crude and adjusted ordinal logistic regression models were used to estimate Odds ratios with 95% confidence intervals. The complex sample design of the 2016 National Health User Satisfaction Survey was considered in all calculations.

Results: Data from 10 386 healthcare facility users were included. After receiving medical care, 19.6% had partial access to medications, 6.8% had no access, and 6% were dissatisfied with the care received. Users with partial access to drugs had 87% higher odds of dissatisfaction (Odds ratio: 1.87; 95% confidence interval: 1.56 to 2.23), while users without access to medications had 51% higher odds of dissatisfaction (OR: 1.51; 95% CI: 1.06 to 2.16), compared to users with full access to drugs, adjusted for confounding variables.

Conclusions: Patients with limited access to medicine at pharmacies in Peruvian healthcare facilities reported higher dissatisfaction with the care received.

Health economics is an area of study that has critical tools for evidence-based healthcare decision making, among which are economic evaluations. These tools allow us to weigh the costs incurred for a given intervention in relation to its health outcomes. The main utility of these studies lies in accomplishing decision-making in healthcare and the formulation of public policies. This article is the first of two reviews on whose main purpose is to address fundamental theoretical concepts of health economic evaluations to facilitate their understanding and critical analysis. The text is part of a methodological series on clinical epidemiology, biostatistics and research methodology conducted by the Evidence-based Medicine team at the School of Medicine of the University of Valparaíso, Chile.

The partogram is a graphic tool used to monitor labor progression. This article reviews the recent literature on the use of the partogram, aiming to evaluate whether its implementation reduces cesarean section rates and to determine which model is more appropriate. Studies that compared using the partogram with not using it were analyzed, as well as studies that contrasted different partogram models. The results indicate that partogram use is not associated with a significant reduction in cesarean section rate, particularly in countries with low cesarean section rates. However, the modified World Health Organization partogram, which eliminates the latent phase, appears to have advantages over the classic 1994 model, with significantly lower cesarean section rates. Although the partogram has not shown significant benefits in reducing cesarean sections, it is still a useful tool for graphically documenting the progress of labor, which could improve clinical decision-making. In Chile, the high cesarean section rates, close to 45%, suggest that implementing the WHO 2000 partogram could be beneficial. However, local studies are needed to confirm the potential benefits of reducing cesarean sections.

Introduction: Candida albicans infection shows a wide range of patterns on chest computed tomography, including ground glass opacities and consolidation, with the miliary pattern being the least frequent. The miliary pattern is not exclusive to tuberculosis. Fungal lung infections are rare and potentially fatal. Colonization by Candida albicans, associated with impaired immunity, requires early empirical antifungal therapy to improve survival.

Case report: 48-year-old male patient with persistent productive cough, mucopurulent expectoration, dyspnea on moderate exertion, night sweats, elevated temperature, and weight loss. Chest tomography revealed miliary interstitial lung disease, and he was prescribed antituberculosis treatment. The pathologic result of the biopsy concluded the presence of moderately differentiated keratinized infiltrating squamous cell carcinoma. The patient died.

Dicussion: The miliary tomographic pattern requires a broader approach for accurate diagnosis. The reported case presented with oral candidiasis and impaired immunity. Previous colonization associated with impaired immunity is the most important factor found for disseminated candidiasis.

Conclusion: The miliary radiological pattern is not exclusive to tuberculosis, warranting a more precise diagnostic approach. It is important to diagnose disseminated candidiasis in order to initiate early antifungal therapy and thus improve survival.

The article analyzes the arrival of attending physicians in the province of Coquimbo between 1840 and 1870. Through communication with the physicians assigned to the San Juan de Dios Hospital of La Serena, the modernization of the medical practice in a local space is confirmed, characterized by the gradual installation of sanitary taxation. The study's methodology was based on direct research in documents from the National Historical Archive of Chile. Thus, it was found that in the context of a mining export boom, it was necessary to modernize an infrastructure that would accompany the welfare policies before consolidating the republic. Based on the evidence, it is postulated that the political authorities and the physicians in charge of the hospital tended to control and eradicate the informal practice of medicine and pharmacology. Finally, we note the intention of the physicians to generate an orderly public healthcare system.

Qualitative research plays an essential role in health sciences, aiming to achieve a deep understanding of phenomena, experiences, perceptions, and behaviors in their natural contexts. In this article, we outline essential aspects to consider when conducting qualitative research, starting from formulating the research question to analyzing and reporting the obtained data. We present the main qualitative design methods and sampling techniques, emphasizing the importance of reaching data saturation and the data production methods. This article offers a roadmap for conducting qualitative research in health care, contributing to a more humanized and evidence-based clinical practice.

Introduction: The Long Coronavirus Disease (COVID) Symptom and Impact Tools (ST and IT) were published in English in 2022 to monitor the symptoms and impact of persistent COVID-19. ST includes 53 symptoms selected by the patient. IT includes six aspects of life that the patient must rate from 1 to 10 points. We aim to report the results of the cultural adaptation of both instruments for the Chilean population, together with the content validity of the adapted instrument.

Methods: The cultural adaptation was carried out in five steps: 1) translation from English to Spanish, 2) synthesis, 3) back-translation, 4) review by the editorial board, and 5) testing the questionnaire with ten patients; they answered both questionnaires and seven questions assessing their understanding of the TI and their opinion on whether the instrument reflected the impact of prolonged COVID-19 on their lives. The content validity of the final version of the IT was assessed by 14 experts.

Results: The main outcome is the two final questionnaires adapted for use in Chile. Most patients responded with the best concept or approval for all items. Content validity showed acceptable results, with an average content validity index of 0.9 and Aiken's V for the relevance of the questionnaire in general of 0.83 (95% CI 0.69 to 0.92). For one item, Aiken's V was less than 0.7 (95% CI 0.5 to 0.8).

Conclusions: This study provides Chilean health authorities and health providers with an instrument for assessing the impact of prolonged COVID-19 on core aspects of people's lives.

Forensic medicine is of enormous importance in the functioning of contemporary justice systems worldwide. Therefore, in order to characterize the current state of medicolegal and forensic activity in Chile, a non-systematic review of the biomedical and legal literature on the subject was carried out. An analysis of open sources of information was also incorporated, including the National Registry of Individual Health Care Providers, the latest public accounts of the Forensic Medical Service, relevant background information available on the active transparency portal of that institution, exempt resolutions included in the "Chile Law" database (of the Department of Legislative and Documentary Services of the Library of the National Congress) and the lists of judicial experts appointed by the Courts of Appeals of the country for the biennium 2024 to 2025. We note that Chile maintains an unacceptable historical debt in terms of academic development and training of qualified professionals in forensic matters. Likewise, national scientific productivity in this field is practically null. Currently, forensic medicine is the medical specialty with the deepest shortage of professionals nationwide. Consequently, as in the early part of the last century, medical expert opinions are frequently performed by professionals untrained in forensic medicine. This scenario, taking into account the attitudes of certain lawyers and judges (detailed in the article), increases the risk of a miscarriage of justice. National public policies must take urgent action to address the deficits and provide solutions.

Introduction: The rapid emergence of COVID-19 urged policy responses worldwide, focusing on vaccination and mobility restrictions. Chile represents a unique scenario for analyzing personal preventive measures amid intensive communication and vaccination campaigns. This study aims to explore changes in population adherence to non-pharmacological preventive measures during the pandemic and the factors that explain this adherence each year.

Methods: 386 individuals who participated in two population-based studies (2021 and 2022) were considered. An interview was conducted to measure adherence to self-care practices, and case and contact tracing by the health authorities. The Wilcoxon signed-rank test was performed to measure change between 2021 and 2022, bivariate analysis, and a linear regression model for each year were performed.

Results: Mask-wearing in public places was the most commonly used measure (95.9% in 2021, 89.9% in 2022). Follow-up of cases and cases contacts by the health authority had high coverage in 2021 (94.3% and 83% respectively). A greater decrease was observed in contact tracing in 2022 totaling 33.3%. An increase in the score of adherence to preventive practices was observed in 2022 (p < 0.00). The regression model showed in 2021 that women were more likely to adopt preventive behaviors (95% confidence interval: 0.27 to 1.13) and the overweight/obese had higher adherence compared to normal body mass index (95% confidence interval: 0.06 to 0.98). In 2022 being a young adult (30 to 49 years) predicted the adoption of behavioral precautions (95% confidence interval: 0.00 to 1.32).

Conclusions: Adherence to preventive measures increased even with high vaccination coverage, likely due to the epidemiological situation with the Omicron variant circulating in 2022.