A scale without anthropometric measurements can be used to identify low weight-for-age in children less than five years old.

Malnutrition and morbidity have a synergistic association that often leads to death. However, malnutrition in children who die is largely underreported, because anthropometry of the deceased child is rarely known. This study had two purposes: i) to develop a scale that would help determine if a child had low weight-for-age (w/a), in the absence of anthropometric measures; and ii) to select an appropriate cut-off that would give the best sensitivity (Se) and specificity (Sp) of the proposed scale when contrasted with actual w/a measurement.

[Biomedical papers written by Chilean authors published in international journals in 1997. A review of MEDLINE].

Background: Many Chilean biomedical investigators publish the results of their research in international journals, not easily accessible to fellow physicians of the country.

Aim: To assess the amount and quality of papers published by Chilean authors in international journals.

Data Source And Methods: Using MEDLINE databases from January to August, 1997, all papers in which Chile appeared in the field "AD" (Address of author) were selected.

[Mortality for diarrheic disease in Mexico: problem of accessibility or quality of care?].

Objective: To evaluate the access to health services and the process of care provided to children under five years old who died from acute diarrhea (AD).

Material And Methods: In four states of Mexico, a cross-sectional study was carried out. Deaths from AD that occurred in the lapse of one year were included.

[Is the methodology of our original articles essentially inferior to similar papers published in English-speaking journals?].

Randomised controlled trials reported in languages other than English are generally excluded from systematic reviews. This exclusion is often based in the biased opinion that the strictness of methodology and the quality of assessment of the results are essentially inferior to similar articles reported in English. A study published in 1996 in The Lancet compared completeness of reporting, design characteristics, and analytical approaches of 229 randomised controlled trials published in English, French, German, Italian or Spanish, between 1989 and 1994.

[The "impact factor" and the impact of medical journals].

Original articles published in scientific journals are important parameters for committees when they evaluate academic promotions or research grant applications. The analysis usually tries to give each paper a qualitative/quantitative assessment. An article's citation by others is accepted as a fair estimate of the value assigned to its originality and importance.

Characterization of acellular dermal matrices (ADMs) prepared by two different methods.

The efficacy of acellular dermal matrix (ADM) in the treatment of full-thickness skin injuries as a dermal substitute depends on its low antigenicity, capacity for rapid vascularization, and stability as a dermal template. These properties will be determined largely by the final composition of the ADM. We have treated human skin with either Dispase followed by Triton X-100 detergent or NaCl followed by SDS detergent, cryosectioned the resulting ADMs, and then characterized them immunohistochemically.

[Improving the editing of medical journals and the World Association of Medical Editors (WAME)].

Medical journal editing is a task with many facets. The role of the editors includes organizing and evaluating a peer-review system as a main tool for their decision making in selecting manuscripts to be published. The International Congress on Biomedical Peer Review and Global Communications was held in September, 1997, in Prague, Czech Republic, organized by JAMA, the BMJ and Project HOPE, and sponsored by several other organizations.

Cryptococcal rib osteomyelitis in a pediatric patient.

A case of cryptococcal rib osteomyelitis in a pediatric patient is described. Isolated cryptococcal osteomyelitis in pediatric patients is a rare entity, and only 10 cases have been reported in the literature. The radiological findings are reviewed to include chest films, nuclear bone scan, and computed tomographic imaging scan.

[Characteristics associated with under-registration of children's deaths in the state of Guerrero, Mexico].

Objective: To estimate the frequency of under-registered children deaths in rural areas and to identify associated characteristics.

Material And Methods: The study was conducted in three stages. In the first, three strata of communities were formed according to the number of inhabitants; then a representative number of villages was randomly selected from each stratum.

Effects of ursodeoxycholic acid on conjugated bile acids and progesterone metabolites in serum and urine of patients with intrahepatic cholestasis of pregnancy.

Background/aims And Methods: The mechanism(s) behind the effects of ursodeoxycholic acid on serum steroid sulphate profiles in patients with intrahepatic cholestasis of pregnancy is not clear. Conjugated progesterone metabolites and bile acids have therefore been analysed in serum and urine of patients with intrahepatic cholestasis of pregnancy before and during treatment with ursodeoxycholic acid using chromatographic and mass spectrometric methods.

Results: The concentration of glycine-/taurine-conjugated bile acids decreased from 8.

Ursodeoxycholic acid in the treatment of cholestasis of pregnancy: a randomized, double-blind study controlled with placebo.

Background/aims: Intense pruritus and the risk of stillbirths and premature deliveries justify the search for an effective pharmacologic treatment of intrahepatic cholestasis of pregnancy. This study was designed to test the efficacy of ursodeoxycholic acid in maternal pruritus, the biochemical abnormalities and the outcome of pregnancy, in patients with intrahepatic cholestasis of pregnancy of early onset.

Methods: Pregnant patients hospitalized in a secondary case-referral center with intense pruritus and abnormal serum levels of bile salts and aminotransferases, detected before week 33 of pregnancy, were randomly assigned to receive ursodeoxycholic acid, 1 g per day orally, or an identical placebo, until delivery, in a double-blind study.

Progesterone metabolites and bile acids in serum of patients with intrahepatic cholestasis of pregnancy: effect of ursodeoxycholic acid therapy.

The concentrations in serum of sulfated metabolites of progesterone are known to be elevated in patients with intrahepatic cholestasis of pregnancy (ICP). The profiles of these metabolites and conjugated bile acids were analyzed in serum from 11 patients with ICP before and during administration of ursodeoxycholic acid (UDCA) (8 patients) or placebo (3 patients). The clinical condition of 7 of the patients given UDCA improved markedly, and 1 patient given placebo had a spontaneous remission of the disease.

Antibiotic noncompliance and waste in upper respiratory infections and acute diarrhea.

A prospective cohort study was conducted to analyze factors associated with antibiotic noncompliance and waste among patients suffering acute respiratory infection (ARI) and acute diarrhea (AD). The study took place in four primary health care clinics in Mexico City, two belonging to the Ministry of Health (MoH) and two to the Mexican Social Security Institute (IMSS). Two hundred twenty-two patients with ARI and 155 with AD were included.

Infant mortality due to acute respiratory infections: the influence of primary care processes.

A population-based case control study was conducted to ascertain whether the process of primary care can be a determinant of infant mortality due to Acute Respiratory Infection (ARI). Cases were 118 infants who died from ARI, individually matched with 118 infants who suffered an ARI episode and recovered. Information was gathered through interviewing mothers.

Profiles of bile acids and progesterone metabolites in the urine and serum of women with intrahepatic cholestasis of pregnancy.

Background/aims And Methods: The etiology of intrahepatic cholestasis of pregnancy (JCP) is unknown. We have performed comprehensive chromatographic and mass spectrometric analyses of progesterone metabolites and bile acids in serum and urine of six patients in order to characterize changes that might be of importance for the development of the disease.

Results: Conjugated bile acids were increased in serum and urine of patients with ICP while the levels of unconjugated bile acids were similar in healthy pregnancies and ICP.

[A tribute to Germán Schneider, MD, first editor of Revista Médica de Chile].

Germán Schneider was born in 1820 in Magdeburg, Germany, and graduated as M.D. at the University of Bonn.

Effect of quality of care on preventable perinatal mortality.

This study assessed and quantified the effect of quality of care on death preventability, independent of social and biological variables. One hundred and eighty-one avoidable perinatal deaths (cases) were compared to 341 non-avoidable ones (controls). Judgement criteria on death preventability were based predominantly on compliance with explicit hospital medical care standards, determined by peer review.

Review: intrahepatic cholestasis. A puzzling disorder of pregnancy.

Intrahepatic cholestasis of pregnancy is characterized by skin pruritus and a biochemical cholestasis of mild to moderate severity appearing during pregnancy (mainly in the third trimester) and disappearing after delivery. It recurs in 40-60% of future pregnancies. The intensity of pruritus and the laboratory alterations (increased serum bile salts and transaminases in almost all patients, hyperbilirubinaemia in 20% of patients) fluctuate during one pregnancy and also vary in subsequent affected pregnancies.

Antineoplastic activity of BCG: location of antineoplastic glycans in the cellular integument of Mycobacterium bovis, BCG vaccine, Connaught substrain.

The polysaccharidic integument surrounding growing cells of attenuated Mycobacterium bovis Bacillus Calmette-Guérin (BCG) vaccine, Connaught substrain, can be removed with non-specific proteases. After 5 weeks incubation at 37 degrees C in Middlebrook 7H-9 medium, the collected cells were incubated with pronase and the integument and cells separated by centrifugation in a Ficoll-Histopaque preparation. After washing and drying, the detached integument accounted for 65% w/w of the original dried cell mass.

[The Editorial Advisory Committee].

Since 1970, Revista Médica de Chile applies the peer review system as a main step in the selection and improvement of the manuscripts to be published. Over 150 experts participate in this process annually, reviewing up to 5 manuscripts per year. The final decision with regards to to the acceptability of a manuscript remains a responsibility of the Editor.

Chemical and ultrastructural investigations of Mycobacterium bovis BCG: implications for the molecular structure of the mycobacterial cell envelope.

The mycobacterial cell wall visualized by transmission electron microscopy (TEM) of thin sections of resin-embedded specimens is generally believed to consist of an electron-dense peptidoglycan, an electron-transparent arabinogalactanmycolate layer and an electron-dense outer layer (OL). In addition, a pseudocapsule known as the 'electron-transparent zone' (ETZ) has been observed after phagocytosis of mycobacteria by macrophages. TEM of thin sections of Mycobacterium bovis BCG, Tice substrain, revealed an OL bilayer, each of which measured 2-4 nm in diameter.