[Audit of deaths due to cervical cancer in a health service of Santiago. A preliminary analysis]. / Auditoría de muertes por cáncer cérvico-uterino, servicio de salud metropolitano Sur-oriente, 1995. Análisis preliminar.

BACKGROUND: Despite the epidemiological importance and the surveillance programs to detect cervix uterine cancer in Chile, its mortality continues to be high. AIM: To perform an audit of all deaths due to cervix uterine cancer, that occurred in a health service of Santiago during 1995. MATERIAL AND METHODS: The clinical records and pathological studies of 46 women, whose death certificates indicated cervix uterine cancer as the cause of death, were audited. RESULTS: In six women, the audit revealed that the cause of death was not a cervix uterine cancer, and they were discarded from further analyses. The higher mortality rate (36/100,000) occurred in women over 64 years old, those living in the poorest community and with less Papanicolaou vaginal smears coverage (La Pintana). The evolution prior to diagnosis was registered in only four women and was of less than one year. Most women consulted in advanced stages of the disease and only 48% were subjected to some sort of treatment (surgery, radiotherapy or chemotherapy). Mean survival was 3 years and mean age at death was 55.5 years old. There was a great lack of clinical and epidemiological information. In only 13 women information about previous Pap smears was registered. CONCLUSIONS: Audit of deaths should be an important component of preventive programs for cervix uterine cancer, and the coverage of Pap smears should be improved.

[Assessment of the use of statistical methods in health research]. / Evaluación de utilización de los métodos estadísticos en la investigación en salud.

BACKGROUND: Computer use has lead to a great development of statistical methods. AIM: To assess the use of statistical methods in Chilean medical literature. METHODS: Two hundred sixty four papers appeared in Revista Médica de Chile and Revista Chilena de Pediatría between 1983 and 1993 were reviewed. RESULTS: Student's "t", Fisher's, and chi 2 test are the most frequently used statistical methods in 67% of papers. Correlation coefficients are used in 10% of papers. Multivariate methods are seldom used. CONCLUSIONS: Statistical analysis of papers published in Chilean medical journals is restricted to very few methods.

[Epidemiological profile of liver cirrhosis in Chile 1970-1992]. / Perfil epidemiológico de la cirrosis hepática en Chile 1970-1992.

BACKGROUND: Liver cirrhosis is an important public health problem in Chile. AIM: To review the main epidemiological features of liver cirrhosis in Chile in the last 22 years. METHODS: Review of yearbooks of mortality and causes of death of the Ministry of Health and Instituto Nacional de Estadísticas, review of hospital discharges and review of international statistics published by the World Health Organization. RESULTS: The mortality rate of liver cirrhosis in 1992 was 17.9/100,000 inhabitants and represented 3.3% of all deaths. The risk of cirrhosis is higher among men and in people over 64 years of age. In the last decade, death rates of young adults (15-44 years old) and children decreased dramatically. Hospital discharge rates for cirrhosis have decreased from 46.7 in 1970 to 40.4 in 1992. The men/women ratio in 1991 was 2.1/1 for hospital discharges and 2.8/1 for mortality. Mortality was higher in large urban areas (Santiago, Valparaíso and Concepción). A correlation of +0.17 was found between death rates for cirrhosis and wine production per capita. CONCLUSIONS: Cirrhosis continues to be a highly prevalent disease in Chile.

[Malum perforans diabeticorum: treatment with controlled circulatory blockade and regional intravenous administration of antibiotics]. / Malum perforans diabeticorum: Behandlung mit der kontrollierten Kreislaufsperre und der regionalen intravenösen Anwendung von Antibiotika.

Orthopedic deformations of the feet play an important role in the etiology of the foot ulcers of diabetic patients, together with neuropathy and vascular impairment. The employment of new techniques in the treatment of diabetic foot has considerably improved its prognosis. These are the transient circulatory blockade (TCB) and the regional intravenous antibiotic administration (RAA). This paper reports on the usage of these techniques in the treatment of 24 diabetic patients, 8 women with ages between 41 and 75 (mean 54.7) years, and 16 men with ages between 41 and 75 (mean 59.3) years who were operated on 29 opportunities because of foot ulcer. Most of the patients had different grades of foot infection. Neuropathy was present in all cases and a distal type of arterial occlusion was diagnosed in 8 cases. Foot surgery was performed under regional i.v. anesthesia associated with regional i.v. injection of 1 g Cefotaxine (Calaforan) in 250 ml saline solution which was administered through the same butterfly needle used for the regional anesthesia. The drainage of the foot infection was performed simultaneously with the orthopedic correction of the foot deformities. All patients healed without complications attributable to the bone surgery. Patients operated upon while complicated with foot phlegmons remained longer (31 days) in the hospital than those without infection (18 days). After a follow-up period of 4.7 (1 to 8) years there were 2 recurrencies and 3 patients developed new foot ulcers. All patients were using a normal, soft shoe. We conclude that the TCB and the RAA facilitate orthopedic surgery in diabetic patients with foot ulcers improving their life quality and prognosis.