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Data revealing the phase and chemical compositions of natural black sands from "El Ostional" beach, located in the northern Ecuadorian Pacific coast have been presented. The samples were collected from six points over the shore area of approximately 500 × 40 m2. The data on crystalline phases (iron titanium oxide, orthoclase feldspar and zircon) were determined by X-ray powder diffraction (XRPD), while semi-quantitative chemical analyses of major (Fe and Ti) and trace elements were obtained by X-ray fluorescence spectroscopy (XRF). The phase composition was verified by scanning electron microscopy (SEM), using backscattered electron (BSE) mode and energy dispersive spectroscopy (EDS). These comprehensive data are a contribution to valorize ilmenite-hematite solid solutions from natural resources towards the identification of novel technological applications.

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Abstract Throughout this paper, the theoretical and clinical approaches of D.W. Winnicott are reviewed in order to reread the written production of Sándor Ferenczi. Winnicott's clinical and theoretical concepts allow returning to Ferenczi and rescuing aspects of his work that had been silenced in the psychoanalytic community. Ferenczi, in turn, is one that holds his presence in Winnicott's thought. Even though there are few times in which he cites Ferenczi in his work, it is possible to draw clear relationships between both theories. Three main issues are addressed: the role of the environment as active; the primitive traumatic event in which there is no one that has experience of it, and psychoanalysis as the place to experience that which happened in the first months of life for the first time; and, finally, severe pathologies and psychoses: technical innovations in Winnicott and Ferenczi for the treatment of psychotic and borderline patients. It is concluded that the theoretical and technical developments of Winnicott serve to illuminate a retrospective reading of Ferenczi.

Resumen A través de este trabajo, se retoman los planteamientos teóricos y clínicos de D.W. Winnicott para releer la producción escrita de Sándor Ferenczi. Los conceptos teóricos y clínicos de Winnicott permiten volver a Ferenczi y rescatar aspectos de su obra que habían quedado silenciados en la comunidad psicoanalítica. Ferenczi, a su vez, conserva su presencia en limítrofe el pensamiento de Winnicott. Si bien son escasas las veces que cita a Ferenczi en su obra, es posible trazar claros puntos de encuentro entre ambas teorías. Se abordan tres puntos principales: el papel del medio como activo, la vivencia traumática primitiva en la cual no hay un alguien que haga experiencia de ello y el psicoanálisis como el lugar para hacer experiencia por primera vez de eso que ocurrió en los primeros meses de vida y, por último, las enfermedades graves y la psicosis: innovaciones técnicas en Winnicott y Ferenczi para el tratamiento de pacientes psicóticos y borderline. Se concluye que los desarrollos teóricos y técnicos de Winnicott sirven para iluminar una lectura retrospectiva de Ferenczi.

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Throughout this paper, the theoretical and clinical approaches of D.W. Winnicott are reviewed in order to reread the written production of Sándor Ferenczi. Winnicott's clinical and theoretical concepts allow returning to Ferenczi and rescuing aspects of his work that had been silenced in the psychoanalytic community. Ferenczi, in turn, is one that holds his presence in Winnicott's thought. Even though there are few times in which he cites Ferenczi in his work, it is possible to draw clear relationships between both theories. Three main issues are addressed: the role of the environment as active; the primitive traumatic event in which there is no one that has experience of it, and psychoanalysis as the place to experience that which happened in the first months of life for the first time; and, finally, severe pathologies and psychoses: technical innovations in Winnicott and Ferenczi for the treatment of psychotic and borderline patients. It is concluded that the theoretical and technical developments of Winnicott serve to illuminate a retrospective reading of Ferenczi.

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Infective endocarditis is a severe condition, with a mortality that fluctuates between 16 and 25 percent in the Metropolitan area of Chile. Aim: To perform a prospective assessment of clinical and microbiological features of patients with infective endocarditis in Chile. Material and methods: Collaborative study of regional hospitals in the whole country and teaching hospitals in Santiago. Patients with a possible or definitive infective endocarditis, according to Duke's criteria, were included in the protocol and a structured data entry form was completed. Results: Three hundred twenty one patients (65 percent male, mean age 49ñ16.5 years) were studied. According Duke's criteria, 89 percent had a definitive and 11 percent a possible endocarditis. The subacute form occurred in 64 percent of patients. The most frequent predisposing cardiopathies were rheumatic in 25 percent, prosthetic valves in 15 percent and congenital in 13 percent. There was no evidence of cardiopathy in 20 percent. Twenty percent of patients were on hemodialysis, 11 percent were diabetic and only one patient abused intravenous drugs. The most frequent complication was cardiac failure in 59 percent of cases, followed by renal failure in 32 percent and embolism in 28 percent. The most frequent causing organism was coagulase positive Staphylococcus in 35 percent. Blood cultures were negative in 28 percent of cases from the metropolitan region, in 56 percent of cases from the north and 38 percent of cases from the south. Echocardiographic diagnosis was done in 92 percent of cases. Aortic valve was involved in 42 percent and mitral valve in 29 percent. Successful antimicrobial treatment was achieved in 59 percent of patients. Thirty five percent of patients were subjected to surgical procedures with a 78 percent survival. Overall mortality was 29 percent. Univariate analysis identified sepsis, an age over 60 years and the presence of cardiac or renal failure as prognostic indicators of mortality. On multivariate analysis, the identified prognostic indicators were the presence of sepsis, renal failure, mitroaortic involvement associated to combined surgery and failure of antimicrobial treatment not associated to surgery. Conclusions: Subacute form is the most common presentation of infective endocarditis and rheumatic valve disease is the most common underlying cardiac lesion. The most frequent causing agent is coagulase positive Staphylococcus...

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Lejos de disminuir su frecuencia, la endocarditis infecciosa se está presentando en la actualidad en nuevos escenarios clínicos. Destaca su presentación en grupos etarios mayores y en relación a nuevas condiciones predisponentes, siendo hoy en día una patología frecuente en cualquier población hospitalaria. Los notables avances en los métodos de diagnóstico no han permitido aun reducir drásticamente las complicaciones de la enfermedad, determinantes de su todavía elevada morbimortalidad. La sistematización de los hallazgos clínicos y de laboratorio siguiendo los criterios de Duke, ha permitido ordenar y homogeneizar las distintas variables que apoyan el diagnóstico. Sin embargo, el amplio espectro de formas de su presentación clínica y las dificultades para contar con parámetros absolutamente específicos de la enfermedad, representan limitaciones a su reconocimiento oportuno. La forma de no retardar o equivocar el diagnóstico, con serias consecuencias en el pronóstico, es mantener siempre un alto índice de sospecha clínica que permita realizar a tiempo los exámenes adecuados para confirmar, rechazar o establecer el grado de certeza de la hipótesis diagnóstica

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El objetivo de esta guía es apoyar el desarrollo de la cultura gerencial de los servicios públicos de salud mediante la aplicación de metolología para el control de costos desde el nivel local, a fin de contribuir al mejoramiento de dichos servicios

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