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BACKGROUND: Adverse effects of medications are an important cause of morbidity and hospital admissions. Errors in prescription or preparation of medications by pharmacy personnel are a factor that may influence these occurrence of the adverse effects Aim: To assess the frequency and type of errors in prescriptions and in their preparation at the pharmacy unit of a regional public hospital. MATERIAL AND METHODS: Prescriptions received by ambulatory patients and those being discharged from the hospital, were reviewed using a 12-item checklist. The preparation of such prescriptions at the pharmacy unit was also reviewed using a seven item checklist. RESULTS: Seventy two percent of prescriptions had at least one error. The most common mistake was the impossibility of determining the concentration of the prescribed drug. Prescriptions for patients being discharged from the hospital had the higher number of errors. When a prescription had more than two drugs, the risk of error increased 2.4 times. Twenty four percent of prescription preparations had at least one error. The most common mistake was the labeling of drugs with incomplete medical indications. When a preparation included more than three drugs, the risk of preparation error increased 1.8 times. CONCLUSIONS: Prescription and preparation of medication delivered to patients had frequent errors. The most important risk factor for errors was the number of drugs prescribed.

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Background: Adverse effects of medications are an important cause of morbidity and hospital admissions. Errors in prescription or preparation of medications by pharmacy personnel are a factor that may influence these occurrence of the adverse effects Aim: To assess the frequency and type of errors in prescriptions and in their preparation at the pharmacy unit of a regional public hospital. Material and Methods: Prescriptions received by ambulatory patients and those being discharged from the hospital, were reviewed using a 12-item checklist. The preparation of such prescriptions at the pharmacy unit was also reviewed using a seven item checklist. Results: Seventy two percent of prescriptions had at least one error. The most common mistake was the impossibility of determining the concentration of the prescribed drug. Prescriptions for patients being discharged from the hospital had the higher number of errors. When a prescription had more than two drugs, the risk of error increased 2.4 times. Twenty four percent of prescription preparations had at least one error. The most common mistake was the labeling of drugs with incomplete medical indications. When a preparation included more than three drugs, the risk of preparation error increased 1.8 times. Conclusions: Prescription and preparation of medication delivered to patients had frequent errors. The most important risk factor for errors was the number of drugs prescribed.

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Background: Adverse effects of medications are an important source of morbidity. Prescription and dispensing errors are an important cause of these adverse effects. Aim: To adapt and validate two checklists, one to measure errors in handwritten prescriptions and other to detected errors in the medication dispensing process of hospital pharmacies for outpatient care. Material and Methods: The study was conducted in three stages. First, checklists for medication errors developed elsewhere were adapted. Afterwards, the checklists were reviewed by experts. Finally, the inter and intra-observer reliability of each checklist was assessed, testing them in 32 occasions by two independent observers. Results: The checklists for medication prescription and dispensing were composed by 12 and seven items, respectively. They were corrected according to experts’ opinions. The intraclass correlations of the results of each tester were 0.68 and 0.82 for the prescription and dispensing error checklists, respectively. Conclusions: The developed checklists for the detection of errors in prescription and dispensing of medications are reliable en can be applied in future studies.

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ANTECEDENTES: La valoración nutricional de la madre y el recién nacido es un criterio ampliamente usado con fines pronósticos y de manejo clínico. En el ámbito obstétrico materno y neonatal se utiliza índice de masa corporal e índice ponderal neonatal respectivamente. OBJETIVO: Construir tablas bidimensionales que en la clínica práctica faciliten la obtención de estos índices. MÉTODO: Los índices antropométricos que relacionan el peso y la talla, fueron calculados mediante sus fórmulas respectivas: peso dividido por talla al cuadrado o al cubo según se trate de índice de masa corporal o índice ponderal neonatal. Para la categorización posterior del estado nutricional tanto materno como neonatal, los índices obtenidos han de ser valorados con gráficas en función de la edad gestacional. Recomendamos para ello los estándares de referencia nacional. RESULTADOS: Se conformaron dos tablas bidimensionales para el cálculo de índices, las cuales fueron acotadas de acuerdo a valores antropométricos promedios de nuestra población. CONCLUSIÓN: Estas tablas facilitarán al clínico la obtención de índices antropométricos y el diagnóstico de la condición nutricional de la embarazada y recién nacido.

BACKGROUND: Nutritional assessment is a widely used criterion for prognostic purposes and clinical management. In obstetrics, maternal and neonatal body mass Índex and neonatal ponderal Índex, respectively, are used. OBJECTIVE: To construct bidimensional tables to facilítate indexes obtaining process in clinical practice, moreover, graphs also are recommend for nutritional categorize using this indexes. METHODS: The anthro-pometric indexes that associate weight with height were calculated by their respectively formulas: weight divided by height squared or cubed, depending if body mass index or neonatal ponderal index is needed. For the subsequently categorization of both maternal and neonatal nutritional status, these indexes have to be judged in terms of gestational age graphics. For this process, we recommend national standard references. RESULTS: Two bidimensional tables were built to calcúlate the indexes and were delimited according to anthropometric averages of our population. CONCLUSION: These tables will facilítate the obtaining of indexes by the clinicians and, at the same time, the nutritional status diagnosis of pregnant women and their newborn.

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The (co)variance components of BW at weaning (WW) were estimated for a Colombian multibreed beef cattle population. A single-trait animal model was used. The model included the fixed effect of contemporary group (sex, season, and year), and covariates including age of calf at weaning, age of cow, individual and maternal heterozygosity proportions, and breed percentage. Direct genetic, maternal genetic, permanent environmental, and residual effects were included as random effects. Direct, maternal, and total heritabilities were 0.23 +/- 0.047, 0.15 +/- 0.041, and 0.19, respectively. The genetic correlation between direct and maternal effects was -0.42 +/- 0.131, indicating that there may be antagonism among genes for growth and genes for maternal ability, which in turn suggests that improving WW by direct and maternal EPD may be difficult. A greater value for the direct heterosis effect compared with the maternal heterosis effect was found. Furthermore, the greater the proportion of Angus, Romosinuano, and Blanco Orejinegro breeds, the less the WW.

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Background: Studies done in Santiago, Chile show that menses return before the sixth month of puerperium in 50 percent of lactating women, even in those that continue with exclusive breast feeding. Aim: To study the length of lactational amenorrhea in a group of women living in Southern Chile. Material and methods: One hundred fourteen women giving exclusive breast feeding, were followed from the third postpartum month, to determine the length of lactational amenorrhea. Its relationship with general characteristics of the mothers and children and breast feeding pattern was also studied. Results: Sixty six women (58 percent) recovered their menses before the 6th postpartum month and their length of lactational amenorrhea was 101 ñ 5 days. In the rest of the sample, the length was 277 ñ 10 days. No differences in characteristics of the mothers and children or breast feeding pattern, were observed between these two groups. Conclusions: A short lactational amenorrhea is common in the Chilean population. Clinical characteristics or pattern of breast feeding do not explain the length of LA in this population

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STUDY OBJECTIVES: To describe the clinical features and laboratory abnormalities of 16 adults with confirmed Hantavirus pulmonary syndrome (HPS) due to Andes virus in Temuco, Chile. DESIGN: A retrospective chart review abstracting clinical, radiologic, laboratory, and epidemiologic data. SETTING: ICU of the university teaching hospital in Temuco, Chile. PATIENTS: Sixteen patients with HPS treated between 1997 and 1999. RESULTS: Patients were aged from 19 to 45 years, 82% were men, and 88% were farm or timber workers with occupational acquisition of HPS. After an incubation period ranging from 5 to 25 days, a prodromal influenza-like phase frequently was accompanied by abdominal symptoms. From 1 to 7 days later, respiratory insufficiency and hemodynamic instability suddenly appeared. In 81%, hemorrhage was evident; in 63%, moderate-to-severe bleeding occurred. The most prominent laboratory abnormalities were hemoconcentration, leukocytosis, thrombocytopenia, altered partial thromboplastin time (PTT), creatine kinase, transaminases, and hyponatremia. Creatinine elevation was common, with clinical importance in two patients. All patients had severe hypoxemia and pulmonary edema. Fifteen patients received supportive treatment, and 5 patients were treated with corticosteroids. The mortality rate was 43.8%. CONCLUSIONS: Bad prognostic factors appeared to be severe hypotension, lower PaO(2)/fraction of inspired oxygen values, prolonged PTT, hemorrhage, greater volume load, and profuse bronchorrhea. The effects of treatment with corticosteroids could not be determined. Hemorrhage and renal involvement were common in our patients, features not often described in the North American literature of Sin Nombre virus HPS.

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All clinical S. pneumoniae specimens isolated from patients with invasive or sterile-site infections admitted to one regional general hospital in southern Chile were collected during a 5-year period (February 1994 to September 1999). A total of 247 strains belonging to 50 serotypes were isolated in this survey: 69 in patients under 5 years of age, 129 in patients 5 to 64 years old, and 49 from patients 65 years and older. Eight serotypes were identified in all age groups, while all other serotypes were found exclusively in one age group or in patients over 4 years of age. Serotype 3 was never found in patients under 5 years old, and serotype 14 was not found in patients >64 years of age. There was no difference in the serotypes causing infection in each one of the 5 years of the survey. Our results suggest that both bacterial virulence factors and host factors play an important role in the selection of S. pneumoniae serotypes causing invasive infection. Possible host factors include age-related differences in the immune response. Comparative studies with other areas of the world may help to further understanding of our observations in southern Chile.

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The adult coffee berry borer (Hypothenemus hampei Ferrari [Coleoptera: Scolytidae]), a major insect pest of coffee, has two major digestive alpha-amylases that can be separated by isoelectric focusing. The alpha-amylase activity has a broad pH optimum between 4.0 and 7.0. Using pH indicators, the pH of the midgut was determined to be between 4.5 and 5.2. At pH 5.0, the coffee berry borer alpha-amylase activity is inhibited substantially (80%) by relatively low levels of the amylase inhibitor (alphaAI-1) from the common bean, Phaseolus vulgaris L., and much less so by the amylase inhibitor from Amaranthus. We used an in-gel zymogram assay to demonstrate that seed extracts can be screened to find suitable inhibitors of amylases. The prospect of using the genes that encode these inhibitors to make coffee resistant to the coffee berry borer via genetic engineering is discussed.

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We compared the incidence of nasopharyngeal colonization by Streptococcus pneumoniae, the serotypes causing mucosal and invasive diseases, and the antibiotic resistance of these strains in patients admitted to three large hospitals and children attending day care centers in two Chilean cities (Santiago and Temuco). The populations in both cities were similar in ethnic background, socioeconomic status, family size, and access to medical care. Significant differences in nasopharyngeal colonization rates, in serotypes causing infections, and in antibiotic resistance were found between the two cities. In children 0 to 2 years of age, 42% were colonized with S. pneumoniae in Santiago compared to 14% in Temuco. A total of 41 serotypes were identified in both Chilean cities studied. Six serotypes were found only in Santiago; 14 serotypes were found only in Temuco. Antibiotic-resistant serotypes 6A, 6B, 14, 19F, and 23F were detected only in Santiago. We show that important differences in the incidence of nasopharyngeal carriage, infection, and S. pneumoniae serotypes can exist in similar populations in different areas of the same country. Our findings are relevant for prevention strategies, antibiotic usage, and vaccine design.

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Streptococcus pneumoniae is a most important patogen in respiratory and meningeal infections. It is also a relevant agent of septic arthritis, pericarditis, acute endocarditis and spontaneous peritonitis in cirrhotic patients with ascites. It is less well known as a cause of infections in many other sites, including abdominal organs and soft tissues, which may be very severe. In this report, we describe three fatal cases (phlegmonous gastritis, cellulitis and primary peritonitis without pre-existing ascites) due to Streptococcus pneumoniae. In the last years it has become clear that this agent can cause infections at almost any body level, which is worth remembering. We review the literature and discuss some clinical aspects of two rare infectious syndromes, like primary peritonitis without previous ascites and phlegmonous gastritis.

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En Temuco, Chile, se estudiaron 114 mujeres en lactancia exclusiva de acuerdo a la duración con la amenorrea de lactancia y su relación con los niveles de estradiol plásmático al tercer mes postparto. Sesenta y seis madres (58 por ciento ) recuperaron la menstruación antes del sexto mes postparto. La duración de la amenorrea de lactancia fue de 100,7+ - 5,28 y 277,9 + - 10,5 días para aquellas con menstruación y amenorrea respectivamente. Los niveles de estradiol fueron 99 pmol/l mayores en las mujeres con corta duración de amenorrea de lactancia (p=0,0001). Este estudio confirma la corta duración de amenorrea de lactancia descrita en población chilena. La diferencia en los niveles de estradiol puede ser un indicador de la recuperación precoz de la fertilidad postparto

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Se estudiaron 45 mujeres en lactancia exclusiva, para explorar la relación entre: los niveles de prolactina (PRL) basal y postsucción con la duración de la amenorrea postparto. Muestras de sangre para medición de PRL se tomaron al tercer mes postparto, antes de un episodio de succión y 30 minutos después de iniciado el episodio. El nivel de PRL basal fue de 1053 ñ 113 mlU/L (X ñ SE). Las mujeres con largos períodos de amenorrea tenían aumento de PRL basal en 632 mlU/L (x) con respecto a aquellas con menstruación antes de 180 días postparto (p ñ 0,036). Los niveles de PRL postsucción fueron mayores en mujeres con amenorreas largas (p = 0,06). No se encontró relación entre el estado menstrual al 6- mes postparto y el incremento de PRL postsucción (delta PRL). Este estudio encuentra que los niveles de PRL basal tiene relación con la duración de la amenorrea en mujeres con lactancia exclusiva

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We evaluated immunofluorescence techniques to investigate the presence of S pneumoniae, N meningitidis, H influenzae types a and b and L monocytogenes in 85 samples of CSF fluid: 60 were taken from patients suffering meningitis and 25 from a control group. Results were compared to conventional bacteriologic methods. There were no false positive results in the control group. In patients with meningitis, 28 were positive by both methods. Nine additional patients were positive only to immunofluorescence which allowed identification of S pneumoniae in 6, N meningitidis in 2 and H influenzae in 1. 37 samples were positive by immunofluorescence and 28 of them were positive to conventional bacteriology. There was only 1 case of Group B streptococcus identified by bacteriology which was not diagnosed by immunofluorescence. Thus, immunofluorescence increases the ability to make a bacteriologic diagnosis in patients with meningitis.

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