Erythropoietin treatment in chronic renal failure anaemia-biosimilar option in the rational use of medicine process in order to reduced public health economic burden

Biopharmaceuticals innovation molecules have changed the course of a large number of chronic diseases. Many of these molecules became Gold Standards in oncology, rheumatology and other illness. However, their cost makes these drugs unattainable for most patients, and often put the health systems’ budgets at risk. This study takes the anaemia due to Chronic Renal Failure disease (CRFD) as an example to a rational selection of treatment with erythropoietin (EPO) and compares the trade brand mark of this drug with biosimilars option. Prescriptions of EPO in 394 patients with CRFD were submitted to a protocol of rational selection based in efficacy/risk ratio demonstration. This protocol was able to reduce that initial number to 91 cases that could really benefited with EPO treatment. These patients were included in a cohort study that compared EPO trade mark with biosimilars option. The experience demonstrated equal clinical outcomes in both groups but a reduction to half the original cost when biosimilars were dispensed. Biosimilars demonstrated to be a cheap and safe option to increase medicine access for anaemia associated to CRFD.Fil: Marin, Gustavo Horacio. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Departamento de Articulación de Ciencias Básicas y Clínicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Marin, Lupe. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Departamento de Articulación de Ciencias Básicas y Clínicas; Argentina. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas; ArgentinaFil: Haag, Griselda Octavia. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Departamento de Articulación de Ciencias Básicas y Clínicas; ArgentinaFil: Risso, Paula. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Departamento de Articulación de Ciencias Básicas y Clínicas; ArgentinaFil: Errecalde, Jorge Oscar. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Departamento de Articulación de Ciencias Básicas y Clínicas; Argentin

Climate Long-Term Trends Impacting Wheat Production Systems in Kansas

Winter wheat production is of major importance in Kansas. The purpose of the study was to verify the evidence of climate change in a long-term weather data series from Wellington and Parsons, KS, to understand whether climate change has been affecting yield production

Barriers to Health Service Access: A Study on Conditioning Factors of Self-Health and Illness Perception in Argentina

Aims: To determine self-health image and illness perception as potential barriers to health services access among inhabitants of La Plata, Buenos Aires, Argentina. Methods: A cross-sectional study, where survey, “Brief Illness- Perception Questionnaire” and basic medical examination were performed on 2430 participants at homes. Results: Although men showed a better concept of their state of health, they perceived their illness worse and belatedly. Only 45% of participants perceived symptoms disease, and from them, 48% finally decided to consult to the health system. Hence, from every 100 sick people, only 21 had access to a health institution. Higher level of education achieved, better socio-economic conditions or holding health insurance were significantly associated with appropriate health seeking, and access to health service. Conclusions: Self-health image and disease perception affected people’s access to health services. Participants of this study showed suboptimal disease perception, manifested as meager and delayed demand for care. These results demonstrate the weakness of current health care model based on people’s spontaneous demand. It is necessary to adopt a new health system for the entire population, regardless of the self-awareness that people may have about their own health/disease status. It would be a more inclusive, effective and efficient healthcare model.Facultad de Ciencias Médica

Quantification of residual enrofloxacin and ciprofloxacin in feathers of broiler chickens by high-performance liquid chromatography-fluorescence after oral administration of the drugs

Enrofloxacin (ENR) and ciprofloxacin (CIP) are drugs used in poultry feeding. In general, feathers that are incorporated in the food chain as a protein source for animal feed, have residues of these drugs. In order to study the pharmacokinetic of ENR/CIP residues in feathers of broiler chickens, to calculate the waiting times for these drugs, before human consumption, we developed the present research. Feathers of broiler chickens were enriched with ENR/CIP. After adding acetone, the mix was agitated and centrifuged and supernatant evaporated under nitrogen. The dry residue was suspended in a tetrahydrofuran solution and the supernatant was injected into the chromatographic system for analysis. Animals showed high levels of ENR/CIP in their feathers after administration of 10 mg/kg enrofloxacin dissolved in drinking water for 5 days. Both compounds were detected in feathers during 9 days. The analytical method developed in this paper to determine ENR and CIP in feathers of broiler chicken showed good linearity, selectivity, accuracy and precision in the analysis conditions. This technique could have important applications in the studies on residues of ENR/CIP in feathers, since the effect of this component in animal diets has not been considered yet.Fil: Haag, Griselda Octavia. Universidad Nacional de La Plata; ArgentinaFil: Marin, Gustavo Horacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata; ArgentinaFil: Errecalde, Jorge Oscar. Universidad Nacional de La Plata; Argentin

Molecular Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with a Large Cholera Outbreak in Ghana in 2014

BACKGROUND:Ghana is affected by regular cholera epidemics and an annual average of 3,066 cases since 2000. In 2014, Ghana experienced one of its largest cholera outbreaks within a decade with more than 20,000 notified infections. In order to attribute this rise in cases to a newly emerging strain or to multiple simultaneous outbreaks involving multi-clonal strains, outbreak isolates were characterized, subtyped and compared to previous epidemics in 2011 and 2012. METHODOLOGY/PRINCIPAL FINDINGS:Serotypes, biotypes, antibiotic susceptibilities were determined for 92 Vibrio cholerae isolates collected in 2011, 2012 and 2014 from Southern Ghana. For a subgroup of 45 isolates pulsed-field gel electrophoresis, multilocus sequence typing and multilocus-variable tandem repeat analysis (MLVA) were performed. Eighty-nine isolates (97%) were identified as ctxB (classical type) positive V. cholerae O1 biotype El Tor and three (3%) isolates were cholera toxin negative non-O1/non-O139 V. cholerae. Among the selected isolates only sulfamethoxazole/trimethoprim resistance was detectable in 2011, while 95% of all 2014 isolates showed resistance towards sulfamethoxazole/trimethoprim, ampicillin and reduced susceptibility to ciprofloxacin. MLVA achieved the highest subtype discrimination, revealing 22 genotypes with one major outbreak cluster in each of the three outbreak years. Apart from those clusters genetically distant genotypes circulate during each annual epidemic. CONCLUSIONS/SIGNIFICANCE:This analysis suggests different endemic reservoirs of V. cholerae in Ghana with distinct annual outbreak clusters accompanied by the occurrence of genetically distant genotypes. Preventive measures for cholera transmission should focus on aquatic reservoirs. Rapidly emerging multidrug resistance must be monitored closely