8 research outputs found
Ichthyofauna of Trancas Departament (Salà river basin, Tucumán, Argentina)
The ichthyofauna of the upper Salà river is described from material collected through seasonal sampling. Considering highland and piain zones rivers, there were identified 25 species, including 16 new reports for this area and 4 new species for Tucumán province. The data were analized using association coefficients and cluster analysis. The species maximun density registered at each waterbody, ranges between 7 species at de Abajo river, and 14 at Salà river. The presence of Eigenmannia virescens adds to the endorreic basins of Argentina, a taxa belonging to a new reported order with Paranensean distribution.Facultad de Ciencias Naturales y Muse
Ichthyofauna of Trancas Departament (Salà river basin, Tucumán, Argentina)
The ichthyofauna of the upper Salà river is described from material collected through seasonal sampling. Considering highland and piain zones rivers, there were identified 25 species, including 16 new reports for this area and 4 new species for Tucumán province. The data were analized using association coefficients and cluster analysis. The species maximun density registered at each waterbody, ranges between 7 species at de Abajo river, and 14 at Salà river. The presence of Eigenmannia virescens adds to the endorreic basins of Argentina, a taxa belonging to a new reported order with Paranensean distribution.Facultad de Ciencias Naturales y Muse
Increasing and sustaining blood-borne virus screening in Spain and Portugal throughout the COVID-19 pandemic: a multi-center quality improvement intervention
BackgroundAround 57,000 people in Spain and Portugal currently living with HIV or chronic hepatitis C are unaware of their infection. The COVID-19 pandemic severely disrupted screening efforts for these infections. We designed an intervention to increase and sustain opportunistic blood-borne virus (BBV) screening and linkage to care (SLTC) by implementing the TEST model.MethodsThe Plan Do Study Act (PDSA) method of quality improvement (QI) was implemented in 8 healthcare organizations (HCOs), including four hospitals, two clusters of community health centers, and two community-based organizations (CBOs). Baseline assessment included a review of BBV SLTC practices, testing volume, and results 12 months before the intervention. Changes in BBV testing rates over time were measured before, during, and after the COVID-19 lockdowns in 2020. A mixed ANOVA model was used to analyze the possible effect on testing volumes among HCOs over the three study periods.InterventionBBV testing was integrated into normal clinical flow in all HCOs using existing clinical infrastructure and staff. Electronic health record (EHR) systems were modified whenever possible to streamline screening processes, implement systemic institutional policy changes, and promote QI.ResultsTwo years after the launch of the intervention in screening practices, testing volumes increased by 116%, with formal healthcare settings recording larger increases than CBOs. The start of the COVID-19 lockdowns was accompanied by a global 60% decrease in testing in all HCOs. Screening emergency department patients or using EHR systems to automate screening showed the highest resilience and lowest reduction in testing. HCOs recovered 77% of their testing volume once the lockdowns were lifted, with CBOs making the fullest recovery. Globally, enhanced screening techniques enabled HCOs to diagnose a total of 1,860 individuals over the research period.ConclusionsImplementation of the TEST model enabled HCOs to increase and sustain BBV screening, even during COVID-19 lockdowns. Although improvement in screening was noted in all HCOs, additional work is needed to develop strong patient linkage to care models in challenging times, such as global pandemics
Cost-effectiveness analysis of therapeutic strategies for patients with chronic hepatitis C previously non-responders to interferon.
Background: The efficacy of combination therapy in previous non responders to
interferon (IFN) monotherapy with chronic hepatitis C is lower than in naĂŻve patients,
and there has been no economic evaluation in this population.
Aim: To develop a cost-effectiveness analysis of therapeutic regimens with IFN
alpha and ribavirin in previous interferon non-responders.
Methods: A Markov simulation model was used to project the clinical and
economic outcomes of five different therapeutic strategies including a “no treatment”
alternative using the health care system perspective. The effectiveness data for the
different doses and durations was obtained from a previously performed meta-analysis.
A sensitivity analysis was performed to test robustness of the model, analysing changes
in different variables.
Results: Applying a 3% discount rate, the standard patient on combination
therapy for 12 months showed an increase of 0.80 years and 1.55 quality adjusted life
years (QALYs), when comparing combination therapy for 12 months vs. “no treatment”
strategy. This option led to an incremental cost-effectiveness ratio of 11,767 euros per
year of life gained and 6,073 euros per QALY.
Conclusions: Combination therapy with interferon plus ribavirin in previous
interferon non-responders shows an incremental cost-effectiveness ratio within the
range of some well accepted medical interventions in our health care system.Hepatitis C; Interferon; Markov model; Non-responders; ribavirin.
Table_1_Increasing and sustaining blood-borne virus screening in Spain and Portugal throughout the COVID-19 pandemic: a multi-center quality improvement intervention.DOCX
BackgroundAround 57,000 people in Spain and Portugal currently living with HIV or chronic hepatitis C are unaware of their infection. The COVID-19 pandemic severely disrupted screening efforts for these infections. We designed an intervention to increase and sustain opportunistic blood-borne virus (BBV) screening and linkage to care (SLTC) by implementing the TEST model.MethodsThe Plan Do Study Act (PDSA) method of quality improvement (QI) was implemented in 8 healthcare organizations (HCOs), including four hospitals, two clusters of community health centers, and two community-based organizations (CBOs). Baseline assessment included a review of BBV SLTC practices, testing volume, and results 12 months before the intervention. Changes in BBV testing rates over time were measured before, during, and after the COVID-19 lockdowns in 2020. A mixed ANOVA model was used to analyze the possible effect on testing volumes among HCOs over the three study periods.InterventionBBV testing was integrated into normal clinical flow in all HCOs using existing clinical infrastructure and staff. Electronic health record (EHR) systems were modified whenever possible to streamline screening processes, implement systemic institutional policy changes, and promote QI.ResultsTwo years after the launch of the intervention in screening practices, testing volumes increased by 116%, with formal healthcare settings recording larger increases than CBOs. The start of the COVID-19 lockdowns was accompanied by a global 60% decrease in testing in all HCOs. Screening emergency department patients or using EHR systems to automate screening showed the highest resilience and lowest reduction in testing. HCOs recovered 77% of their testing volume once the lockdowns were lifted, with CBOs making the fullest recovery. Globally, enhanced screening techniques enabled HCOs to diagnose a total of 1,860 individuals over the research period.ConclusionsImplementation of the TEST model enabled HCOs to increase and sustain BBV screening, even during COVID-19 lockdowns. Although improvement in screening was noted in all HCOs, additional work is needed to develop strong patient linkage to care models in challenging times, such as global pandemics.</p