Italian regional health service costs for diagnosis and 1-year treatment of ADHD in children and adolescents

The main aim of this study was to estimate the costs associated with diagnostic assessment and 1-year therapy in children and adolescents enrolled in 18 ADHD reference centres. Data concerning 1887 children and adolescents from the mandatory ADHD registry database during the 2012-2014 period were analysed. The overall diagnostic and treatment costs per patient amounts to \u20ac574 and \u20ac830, respectively. The ADHD centre, the school as sender, and the time to diagnosis constitute cost drivers. Non-pharmacological therapy resulted as being more expensive for patients concomitantly treated with drugs (\u20ac929) compared to those treated with psychological interventions alone (\u20ac590; p=0.006). This study gives the first and reliable estimate of the costs associated with both diagnosis and treatment of ADHD in Italy. Although costs associated with mental disorders are difficult to estimate, continuing efforts are need to define costs and resources to guarantee appropriate care, also for ADHD

Mus musculus lesions inoculated with Mycobacterium phlei, Mycobacterium kansasii and Mycobacterium fortuitum isolated from soil of La Pampa Province (R. Argentina)

The study objective was to determine the capacity of originate macroscopic and microscopic lesions of nine atypical mycobacteria inoculated in albino rats. The mycobacteria were isolated from farms soil samples at different places from La Pampa province (Argentina). It was investigated the three most frequent species (M. fortuitum, M. phlei and M. kansasii). The animals were endovenously inoculated with 1 mg of bacteria/ml-1 of fresh culture and kept in a restricted area during 60 days. After euthanasia, samples from different organs, for bacteriologic and histopathologic studies, were collected. M. phlei and M. kansasii showed lesions resemble to that produced by M. tuberculosis or M. bovis, whereas M. fortuitum did not show lesions in the animal model descript in this study. It is necessary to value other atypical mycobacterium isolated from soil and other inoculation ways in order to assist in clarifying the differential diagnosis in tuberculosis and other granulomatose diseases.Fil: Oriani, D.S. Universidad Nacional de La Pampa. Facultad de Ciencias Veterinarias. Departamento de Epizootiología y Salud Pública. La Pampa, ArgentinaFil: Sagardoy, M.A. Universidad Nacional del Sur. Departamento de Agronomía. Buenos Aires, ArgentinaEl objetivo de este trabajo fue determinar la capacidad para producir lesiones macro y microscópicas de nueve aislamientos de micobacterias no tuberculosas (MNT) cuando eran inoculadas en ratones albinos (Mus musculus). Las micobacterias fueron aisladas de muestras de suelos destinados a la agricultura y ganadería de la provincia de La Pampa, Argentina. Se investigaron tres especies ambientales (M. fortuitum, M. phlei y M. kansasii) que eran dominantes en los suelos estudiados. Los animales fueron inoculados por vía endovenosa, con una suspensión de cultivos frescos de MNT, equivalente a 1 mg de bacterias mL1. Los animales se mantuvieron en un área restringida durante 60 días, en ese momento se les efectuó la eutanasia y la necropsia, recolectando órganos para realizar estudios bacteriológicos e histopatológicos. Las cepas de M. phlei y M. kansasii inoculadas produjeron lesiones en los ratones similares a las producidas por M. tuberculosis y/o bovis, mientras que M. fortuitum no desarrollo patogenicidad en el modelo animal utilizado bajo las condiciones en que se realizó este estudio. Es necesario continuar valorando otras micobacterias ambientales aisladas de suelos y otras vías de inoculación contribuyendo a colaborar en el diagnostico diferencial de la tuberculosis y las enfermedades granulomatosas

Susceptibility of Mycobacterium fortuitum, Mycobacterium phlei and Mycobacterium kansasii to three different germicide solutions

An investigation was carried out to measure the in vitro susceptibility of opportunistic mycobacteria to three antimicrobial agents. Field strains of nontuberculous mycobacteria were obtained of soil samples from La Pampa province (Argentina). Strains of the following species were tested: Mycobacterium fortuitum, M. phlei and M. kansasii. The antimicrobial agents were: 2% and 4% formaldehyde solutions, 3% and 5% phenol solutions and 70% alcohol solution. At 20o C, suspensions of the test strains were exposed to the germicides and samples were taken at defined intervals (25 min and 45 min) to determine the concentration of survivors. From these data, the decimal reduction times (D) were calculated for each test strain. The results obtained indicated that the nontuberculous mycobacteria were resistant to formaldehyde 2% during 25 min. The D values found revealed considerable differences in the chemical susceptibilities of the test strains. However, all the tested strains were susceptible to formaldehyde 4%, phenol solutions, and alcohol solution 70%. It is necessary to continue evaluating other germicide agents and their effects on Mycobacterium bovis in order to find effective disinfectants for animal waters and field facilities, thus contributing to the control of tuberculosis in cattle.Fil: Oriani, D.S. Universidad Nacional de La Pampa. Facultad de Ciencias Veterinarias. Departamento de Epizootiología y Salud Pública. La Pampa, ArgentinaFil: Sagardoy, M.A. Universidad Nacional del Sur. Departamento de Agronomía. Buenos Aires, ArgentinaEl objetivo de este trabajo fue evaluar la susceptibilidad in vitro de nueve micobacterias no tuberculosas frente a tres agentes antimicrobianos de amplio uso. Las micobacterias fueron aisladas de muestras de suelos de la provincia de La Pampa (Argentina). Se utilizaron tres especies ambientales (Mycobacterium fortuitum, M. phlei y M. kansasii), tres agentes químicos (formaldehído 2% y 4 %, fenol 3% y 5% y alcohol 70%) y dos tiempos de exposición (25 min y 45 min). Las micobacterias eran sólo resistentes al formaldehído 2% después de 25 min de exposición. Los valores de reducción decimal (D) calculados con ese tratamiento mostraron que las cepas tenían grandes diferencias de susceptibilidad al formaldehído 2%. Sin embargo, todas las micobacterias fueron eliminadas cuando se usó formaldehído 4%, fenol 3% y 5 % y alcohol 70% (25 min). Es necesario continuar valorando otros agentes germicidas y sus efectos frente a Mycobacterium bovis con el objeto de encontrar desinfectantes efectivos para instalaciones y aguadas, contribuyendo de esta forma en el control de la tuberculosis de los rodeos