Trauma characteristics and its management is influenced by socioeconomic context. Cardiac trauma constitutes a challenge for surgeons, and outcomes depend on multiple factors including initial care, characteristics of the wounds, and surgical management. This is a retrospective cross-sectional case series of patients with penetrating cardiac injuries (PCI) from January 1999 to October 2009 who underwent surgery in a trauma referral center in Bogotá, Colombia. Demographic variables, trauma characteristics, treatment, and outcomes were analyzed. The study included 240 cases: 96.2% males, mean age of 27.8 years. Overall mortality was 14.6%: 11.7% from stab wounds and 41.2% from gunshot wounds. Upon admission, 44% had a normal hemodynamic status and 67% had cardiac tamponade. About 32% had Grade II injuries and 29% Grade IV injuries. In 85% of the cases, there were ventricular compromise and 55% of patients had associated lesions. In 150 cases, a pericardial window was performed. Highest mortality occurred in wounds to the right atrium. In tamponade patients, mortality was 20% being higher for gunshot wounds (54.5%) than for stab wounds (18%) (p = 0.0120). The study evidenced predominance of stab wounds. Based on characteristics of the trauma, patients, and survival rate, there is most likely a high pre-hospitalization mortality rate. The difference in mortality due to stab wounds and those produced by gunshots was more related to technical difficulties of the surgical repair than with the type of injury established by the Injury Grading Scale. Mortality was higher in patients with cardiac tamponade. Surgical management was satisfactory using pericardial window as the diagnostic method and sternotomy as the surgical approach.

Diagnosing dengue in endemic areas remains problematic because of the low specificity of the symptoms and lack of accurate diagnostic tests. This study aimed to develop and prospectively validate, under routine care, dengue diagnostic clinical algorithms. The study was carried out in two phases. First, diagnostic algorithms were developed using a database of 1,130 dengue and 918 non-dengue patients, expert opinion, and literature review. Algorithms with > 70% sensitivity were prospectively validated in a single-group quasi-experimental trial with an adaptive Bayesian design. In the first phase, the algorithms that were developed with the continuous Bayes formula and included leukocytes and platelet counts, in addition to selected signs and symptoms, showed the highest sensitivities (> 80%). In the second phase, the algorithms were applied on admission to 1,039 consecutive febrile subjects in three endemic areas in Colombia of whom 25 were laboratory-confirmed dengue, 307 non-dengue, 514 probable dengue, and 193 undetermined. Including parameters of the hemogram consistently improved specificity without affecting sensitivity. In the final analysis, considering only confirmed dengue and non-dengue cases, an algorithm with a sensitivity and specificity of 65.4% (95% credibility interval 50–83) and 40.1% (34.7–45.7) was identified. All tested algorithms had likelihood ratios close to 1, and hence, they are not useful to confirm or rule out dengue in endemic areas. The findings support the use of hemograms to aid dengue diagnosis and highlight the challenges of clinical diagnosis of dengue.

Introducción: La evidencia actual sobre la relación entre los estilos de vida y las principales problemáticas de salud mundial es amplia, dando cuenta del aumento en las cifras de comportamientos de riesgo y de sus impactos en la salud de la población. Objetivo: Identificar agrupaciones entre los jóvenes matriculados en una universidad privada de Cali, a partir de ocho dimensiones relacionadas con sus estilos de vida. Materiales y métodos: Se aplicó el Cuestionario de Estilos de Vida de Jóvenes Universitarios, que permitió clasificar las prácticas de los jóvenes en saludables y no saludables a 370 estudiantes con edades entre 18 y 25 años. Se utilizaron modelos de regresión para respuesta binaria y una combinación de métodos factoriales con análisis de conglomerados para obtener tipificación de estilos de vida. Se trabajó con ayuda de los paquetes Stats para los modelos de regresión y FactoClass para el análisis multivariado con el software R. Resultados: Fue posible establecer tres conformaciones tipológicas: 1) hombres sin pareja, que no trabajan, con prácticas no saludables en actividad física; 2) mujeres sin pareja, que no trabajan, con prácticas no saludables de actividad física y alto nivel de estrés; 3) mujeres sin pareja, que no trabajan, con prácticas no saludables de actividad física. Conclusiones: Las tipologías encontradas permitirán a la universidad realizar intervenciones focalizadas que consideren las características propias de diferentes tipos de jóvenes, logrando mejores resultados y optimizando los recursos disponibles. Abstract Introduction: The current evidence on the relationship between lifestyles and the main health problems in the world is wide, taking into account the increase in the numbers of behaviors of risk and their impacts on the health of the population Objetive: The aim of the study was to describe life styles of private college youth from Cali, according to their practices in eight dimensions, and to identify clustering of them. Materials and methods: The study sample consisted of 370 youth with ages between 18 and 25 years, who answered the Lifestyle Questionnaire for University Students - CEVJU-R2, which classifies healthy and unhealthy practices. Regression models for binary response factor and a combination of cluster analysis methods were used. The stats packages for the regression models and FactoClass (10) for multivariate analysis with the R software were used. Results: With binary regression models and combination of multivariate methods, it was possible to find three clusters: 1) men, without couple, not working, with unhealthy physical activity practices; 2) women, without couple, not working, with unhealthy physical activity practices and high level of stress; and 3) women, without couple, not working, with unhealthy physical activity practices. Conclusions: Typologies found will allow the university to make targeted interventions that consider the characteristics of different types of youth, achieving better results and optimizing the available resources.

Copula functions have been extensively used in applied statistics, becoming a good alternative for modeling the dependence of multivariate data. Each copula function has a different dependence structure. An important issue in these applications is the choice of an appropriate copula function model for each one; thus common classical or Bayesian discrimination methods might not be appropriate for determining the best copula. Considering only the special case of bivariate data, we propose a procedure obtained from a recently introduced dependence measure for selecting an appropriate copula for the statistical data analyses.

In this paper, we introduce bivariate lifetime models derived from copula functions considering two copula functions, the Farlie Gumbel Morgenstern (FGM) commonly used to model very weak linear dependences and the Gumbel-Barnett copula which models v

En este artículo se propone una aproximación heurística para medir el nivel de preocupación y un modelo que predice la probabilidad de aprobar el primer curso de matemáticas en la universidad. Se utilizó una La metodología cuantitativa centrada en el uso de estadística inferencial. Se aplicó un instrumento tipo encuesta con preguntas cerradas a 502 estudiantes de primer semestre matriculados en diferentes carreras de una universidad privada en Cali-Colombia. Los resultados permiten contar con un indicador que aproxima los niveles de preocupación frente a la asignatura de matemáticas que presentan los estudiantes de carreras diferentes a la de matemáticas cuando van a tomar su primer curso de esta disciplina en la universidad. La probabilidad de reprobar el curso aumenta con el incremento de los niveles de preocupación y cuando se ha dejado transcurrir mucho tiempo entre la salida del colegio y el ingreso a la universidad. Se concluye que los niveles de preocupación inicial frente al curso pueden ser funcionales, pero no necesariamente patológicos. El modelo de probabilidad propuesto puede ser una herramienta útil para que los profesores identifiquen las condiciones iniciales en las que llegan los estudiantes al curso y usen esta información como insumo para su planificación.