[Consistency and validity of the evaluation of the clinical chart]. / Consistencia y validez en la evaluación del expediente clínico.

OBJECTIVE: Assess the degree of external consistency and validity of the EXP CLIN instrument has for measuring the quality information contained in medical charts. MATERIAL AND METHODS: In a transverse comparative study, two hundred and twelve clinical charts were randomly selected belonging to patients seen at a pediatric hospital. The charts were assessed using the EXP-CLIN for phases: 1) internal assessment: by hospital personnel of the pediatric hospital, and, II) external assessment: by personnel from other hospitals. The results were analyzed using the concordance method. RESULTS: The concordance percentages were found to be 76% for medical charts and medical notes related with the process of diagnosis-treatment, as well as the general characteristics of the clinical chart. The concordance percentages average was 88%, supporting the idea that when the EXP-CLIN instrument is applied twice to the same chart, good concordance is obtained between the two measures. CONCLUSIONS: Given that the application of the instrument documented a good level of external consistency, its use is justified for assessing the quality of the information contained in the charts of the patients seen at our unit.

[Mercury poisoning caused by a homeopathic drug]. / Intoxicación mercurial causada por un medicamento homeopático.

We report an infant with diaper dermatitis and mild respiratory and enteral infections, treated with a homeopathic mercurial medicine: Mercurius 6a (cinnabar dilute 1 x 10(6)), who thereafter became seriously ill with exacerbation and dissemination of the dermatitis as well as irritability and albuminuria. Mercury urine levels were 60 micrograms/L (reference less than 10 micrograms/L). The homeopathic medicine was suspended but symptoms persisted. Therefore the chelating agent D-penicillamine was administered per os (50 mg/kg/day during 10 days). The clinical conditions improved and urinary levels of mercury decreased to normal values. We concluded that homeopathic medicaments should be recognised as potentially harmful substances.

"Asarcon", una causa mas de intoxicacion por plomo. / \"Asarcon\", one more cause of lead intoxication

Existen diversas fuentes de exposicion al plomo que pueden originar intoxicacion por este metal en los ninos. Una mas es la ingestion de "asarcon", polvo rojo empleado en medicina folklorica para el tratamiento de diversos padecimientos gastrointestinales conocidos popularmente como "empachos" Se informa del caso de una nina de dos anos que sufrio intoxicacion aguda por plomo causada por ingestion de este polvo y que, ademas, durante su atencion medica presento intoxicacion yatrogena por fenobarbital. La oportunidad en el diagnostico y en el tratamiento permitio su curacion, aparentemente sin secuelas. El analisis quimico del "asarcon" demostro que contenia 97 por ciento de plomo, que se identifico como tetroxico de plomo

Intoxicacion por Solanum pseudocapsicum ("manzanita del amor"). / Poisoning by Solanum pseudocapsicum (\"manzanita del amor\")

Solanum pseudocapsicum es un arbusto utilizado en Mexico como planta de ornato. La ingestion de sus frutos causa efectos toxicos neurologicos y cardiovasculares. Se informa del caso de un nino de cinco anos que murio despues de la ingestion de frutos de esta planta, con manifestaciones de depresion neurologica y trastornos irreversibles del ritmo cardiaco. Dada la toxicidad de esta planta y el peligro potencial de que que sea ingerida por ninos, se concluye necesidad de que las autoridades sanitarias controlen su venta y uso sin criterio