An education and motivation intervention to change clinical management of the third stage of labor - the GIRMMAHP Initiative.

Background: Hemorrhage and hypertensive disorders are major contributors to death after delivery in developing countries. The GIRMMAHP Initiative was designed to describe the actual delivery care in five Latin American countries and to educate and motivate clinical staff at 17 hospitals with the purpose of implementing their own clinical practice guidelines to prevent postpartum hemorrhage.

Methods: A multicountry education intervention was developed in four consecutive stages, using two analyses: (a) an observational study of the clinical records in eight teaching and nine nonteaching hospitals and (b) a study of the long-term changes measured 12 months after completion of an education intervention and writing a local clinical guideline.

[Prediction of serotypes of dengue virus by response to IgM antibodies].

A study of 4 groups of serum samples from Cuba, Costa Rica, Nicaragua and Panama was made to determine the serotypes of dengue virus causing epidemics or outbreaks by using IgM antibody-capture ELISA(MAC-ELISA). Dengue-IgM diagnostic kit was independently used in each of the serotypes and an index value was calculated (optical density of the sample/cut-off value) in each case, with which two statistical analyses were made: Fisher's variances and Litter significant difference (LSD) calculation. Such calculations allowed determining that in Cuba and Panama, serotype 2 circulated whereas in Costa Rica, serotype 1 prevailed.

Health needs, drug registration and control in less developed countries--the Peruvian case.

A number of factors influence how medicines are used in each community, but drug registration is the initial and usually necessary step. In the course of an external advisory consultation, the list of approved medicines in Peru in 1998 was examined. Of 1672 newly approved forms, 119 were of 49 new chemical entities.