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Objective Orthopaedic procedures performed in Day Surgery Units provide important advantages which disappear when patients require admission when postoperative recovery is not as expected. The aim of this study was to analyse the reasons for unplanned hospital admissions after orthopaedic procedures in a Day Surgery Unit and their relationship between variables such as patient age, anaesthetic risk and technique, procedure or duration. Methods Ambispective cohort study of 5085 patients who underwent surgical orthopaedic procedures between 1995 and 2017. Thirty-nine variables provided by the Unit’s database were analysed. The database was opened on the day of admission and closed the 30th postoperative day. Results Of the patients, 98.2 % were discharged from the Unit. Seventy- four, 1.5 % required overnight admission. This percentage showed significant differences in relation to the type of procedure, type of anaesthesia and duration, which conditioned overnight admission due to inadequate postoperative pain management, nausea or wound complications. Seventeen patients, .3 %, required readmission after discharge due to complications that arose at home, such as wound infection, which was the most common. Conclusions Unplanned admissions are more frequently related to general anaesthesia, lengthy surgeries and procedures such as arthroscopy, hallux valgus corrections or removal of osteosynthesis material. The major reasons for unplanned admissions were inadequate postoperative pain management for overnight admissions and wound infection for admissions after discharge.

Resumen Objetivo Los procedimientos de cirugia ortopedica y traumatologia realizados en unidades de cirugia mayor ambulatoria ofrecen importantes ventajas que desaparecen cuando la recuperacion postoperatoria no es la esperada y los pacientes precisan ingresar. El objetivo de este estudio es analizar las causas de ingresos no deseados tras intervenciones quirurgicas de cirugia ortopedica y traumatologia en una unidad de cirugia mayor ambulatoria en relacion con variables como edad, riesgo anestesico, tipo de anestesia, procedimiento o duracion. Metodos Estudio de cohorte ambispectivo sobre 5.085 pacientes intervenidos desde 1995 a 2017. Se analizaron 39 variables proporcionadas por la base de datos de la unidad que se abre al ingreso en la misma y se cierra el dia 30 postoperatorio. Resultados El 98,2% de los pacientes fueron dados de alta de la unidad. Precisaron ingresar 74 (1,5%). Este porcentaje demostro diferencias significativas en relacion con el tipo de procedimiento, el tipo de anestesia y la duracion, que condicionaron el ingreso inmediato por mal control del dolor agudo postoperatorio, nauseas o alteraciones de la herida. Diecisiete pacientes (0,3%) precisaron un ingreso diferido por complicaciones surgidas en el domicilio, siendo la mas frecuente la infeccion de la herida. Conclusiones Los ingresos no deseados se relacionan con mayor frecuencia con el empleo de anestesia general, con operaciones de mayor duracion y con procedimientos como la cirugia artroscopica, las correcciones de hallux valgus o las retiradas de material de osteosintesis, siendo las causas de ingreso mas importantes el mal control del dolor agudo postoperatorio en los inmediatos y la infeccion de la herida en los diferidos.

Orthopaedic procedures performed in Day Surgery Units provide important advantages which disappear when patients require admission when postoperative recovery is not as expected. The aim of this study was to analyse the reasons for unplanned hospital admissions after orthopaedic procedures in a Day Surgery Unit and their relationship between variables such as patient age, anaesthetic risk and technique, procedure or duration.Ambispective cohort study of 5,085 patients who underwent surgical orthopaedic procedures between 1995 and 2017. Thirty-nine variables provided by the Unit's database were analysed. The database was opened on the day of admission and closed the 30th postoperative day.Of the patients, 98.2% were discharged from the Unit. Seventy-four (1.5%) required overnight admission. This percentage showed significant differences in relation to the type of procedure, type of anaesthesia and duration, which conditioned overnight admission due to inadequate postoperative pain management, nausea or wound complications. Seventeen patients (0.3%) required readmission after discharge due to complications that arose at home, such as wound infection, which was the most common.Unplanned admissions are more frequently related to general anaesthesia, lengthy surgeries and procedures such as arthroscopy, hallux valgus corrections or removal of osteosynthesis material. The major reasons for unplanned admissions were inadequate postoperative pain management for overnight admissions and wound infection for admissions after discharge.

This research tries to know how the political interaction of the citizens from the center of Ecuador is on the Internet. Every day more people use new technologies in order to learn about political issues. Virtual media allow different forms of citizen participation, making the traditional ones such as television, radio o written press to be obsolete. Through an online questionnaire, people were asked about the use of the political information in the different channels, and especially, about their participation in the last election campaign of 2017. The results show different patterns according to factors such as gender, age or occupation, confirming a panorama of transition between offline and online media.

The crystal structure of the title complex, fluorene-1,3,5-trinitrobenzene (1.5/2) (1.5C 13 H 10 .2C 6 H 3 N 3 O 6 ) has been determined at room temperature. The molecule crystallizes in a triclinic cell and in the P1 space group. One of the three fluorene molecules in the unit cell is located at a special position and adopts two different orientations that are related by an inversion center. Therefore, the asymmetric unit contains 1.5 fluorene molecules and two molecules of 1,3,5-trinitrobenzene. Acceptor and donor molecules are arranged in mixed stacks, one with 1:1 and the other with 2:1 trinitrobenzene:fluorene stoichiometries. This mixed arrangement and the composition of the asymmetric unit explains the global 4:3 stoichiometry. These two independent stacking directions are parallel to the c and a axes, respectively.

Discussions of the ultraviolet and visible spectra of the picrates of polycyclic aromatic hydrocarbons and other organic compounds (aromatic heterocycles, phenols, aromatic amines, etc.) and their characteristics are not found in the literature, at least in a systematic way. In this paper the ultraviolet and visible spectra of the picrates of polycyclic aromatic hydrocarbons [naphthalene (I), β-methylnaphthalene (II), anthracene (III), phenanthrene (IV), chrysene (V), pyrene (VI), fluorene (VII), and acenaphthene (VIII)] and other representative organic compounds [dibenzofuran (IX), β-naphtol (X), and β-naphthylamine (XI)] are reported and analyzed, wit the recognition that they have been regarded as charge transfer complexes. Furthermore, the above-mentioned spectra offer a convenient basis for the identification of these compounds (I-XI).

From the petroleum ether extract of the aereal part of Condalia microphylla Cav, hydrocarbons, sterols, alcohols, and fatty acids were isolated. From fruits of the same plant anthocyanins were also isolated and characterized by chromatographic and spectroscopic methods.

Depression in the medically ill is underdiagnosed and undertreated. Fluoxetine would appear promising in this population because of its efficacy and benign side effect profile, but it has not been systematically studied in the medically ill.The authors report the cases of three seriously medically ill patients, seen in psychiatric consultation while patients on a general medical service, who were treated with fluoxetine for depression. Each was an elderly white female with pulmonary disease and atrial arrhythmias, including atrial fibrillation, and each was prescribed diuretics, nitrates, and other cardiac and/or pulmonary agents.Each patient died within 10 days of beginning fluoxetine treatment, from unexplained causes.The authors hypothesize that direct cardiac effects mediated by fluoxetine, or other factors, may have been contributory. The effects of fluoxetine on electrolytes, fluoxetine's possible effects on drug levels, and serotonin's effect on the pulmonary system are examined. Other antidepressant agents should be considered in this particular population until further data are available.

In a previous paper, a study of ultraviolet and visible spectra of the picrates of polycyclic aromatic hydrocarbons and other representative organic compounds was reported. In the present paper, a similar study of 1,3,5-trinitrobenzolates derivatives is described.

To determine the relationship of gonadotropin excretion to spermarche, 26 boys ranging in age from 10.3 to 17.5 years each provided ten overnight urine samples. Microscopic observation of sperm was found in 33 (13%) of the 260 samples, with 50% of the boys exhibiting sperm in at least one specimen. No further cumulative gain in detecting spermaturia occurred after the seventh urine collection. The median age of spermarche was computed by logistic regression analysis to be 14 years. Three urine collections from each boy were assessed for gonadotropin levels. At age 14 years mean follicule-stimulating hormone and luteinizing hormone excretion were, respectively, 857 and 503 mIU/h, into the reported adult daytime range. Spermarche is a midpubertal event associated with age-appropriate gonadotropin production.