The cost of type 2 diabetes in Brazil: evaluation of a diabetes care center in the city of São Paulo, Brazil

Background: the worldwide increase of diabetes, a long duration, slow progression disease, impacts health care costs. the aim of this study was to estimate, from the society's perspective, the annual cost per patient with Type 2 Diabetes (T2DM) at a specialized, outpatient center in the city of São Paulo, capital of São Paulo state, Brazil.Methods: Data from 209 patients were collected during the years 2009 and 2010 in a São Paulo diabetes care center which is part of the tertiary sector of SUS, Brazil's National Health Care System. Data were collected by means of interviews and reviews of medical charts, and the quality of life was appraised using the SF36-v2 questionnaire. Direct medical costs were divided in five categories: 1) medication; 2) laboratory tests; 3) hospitalizations and procedures; 4) reactive strips for capillary blood glucose monitoring; and 5) medical consultations. Direct non-medical costs referred to transportation of patient and companion for treatment. Indirect costs included early retirements, sick leave and absenteeism in the workplace. Statistical analysis of the data was performed by the SPSS software, version 17.0.Results: Our sample comprised 122 women (58%) and 87 men (42%), with mean age of 63 years and average diabetes duration of 13 years. the mean annual cost was US$1,844 per patient, out of which US$ 1,012 corresponded to direct costs (55%) and US$831 to indirect costs (45$ 466 in 2010 (World Health Statistics 2013 96-104 2013). Taking into account the high prevalence of the disease (IDF Diabetes Atlas. 5th edition. 29-48 2012), this survey recommends the enforcement of policies for the prevention of diabetes and its complications, and urges for better allocation of healthcare resources.Universidade Federal de São Paulo, Ctr Diabet, BR-04022001 São Paulo, BrazilUniversidade Federal de São Paulo, Ctr Diabet, BR-04022001 São Paulo, BrazilWeb of Scienc

Quantifying the loading capacity of a carrier-based DPI formulation and its dependence on the blending process

Abstract Non-segregating ordered powder mixtures constituted by a coarse carrier fraction and finer components are at the basis of dry powders for inhalation pharmaceuticas. The estimation of the loading capacity, i.e. how many fines can be hosted on each carrier particle, is crucial to grant the product quality through a reproducible and affordable manufacturing process. We propose an approach based on the combination of sieve analysis, optical microscopy and powder bed permeability to quantify the loading capacity and understand the fines behavior, the impact of the mixing process was also investigated. We tested the method on model binary mixtures composed only of a coarse lactose carrier and micronized lactose fines as a surrogate of a real active pharmaceutical ingredient. The results provided by the different methods are consistent, the approach proved to be accurate and reproducible. The effect of different mixing parameters and equipment on the loading capacity is also discussed

Crystal structure and ferroelectric properties of ϵ-Ga2O3 films grown on (0001)-sapphire

The crystal structure and ferroelectric properties of ϵ-Ga2O3 deposited by low-temperature MOCVD on (0001)-sapphire were investigated by single-crystal X-ray diffraction and the dynamic hysteresis measurement technique. A thorough investigation of this relatively unknown polymorph of Ga2O3 showed that it is composed of layers of both octahedrally and tetrahedrally coordinated Ga3+ sites, which appear to be occupied with a 66% probability. The refinement of the crystal structure in the noncentrosymmetric space group P63mc pointed out the presence of uncompensated electrical dipoles suggesting ferroelectric properties, which were finally demonstrated by independent measurements of the ferroelectric hysteresis. A clear epitaxial relation is observed with respect to the c-oriented sapphire substrate, with the Ga2O3 [10-10] direction being parallel to the Al2O3 direction [11-20], yielding a lattice mismatch of about 4.1%