Essential Medicines at the National Level : The Global Asthma Network's Essential Asthma Medicines Survey 2014

Patients with asthma need uninterrupted supplies of affordable, quality-assured essential medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013-2020 sets an 80% target for essential NCD medicines' availability. Poor access is partly due to medicines not being included on the national Essential Medicines Lists (EML) and/or National Reimbursement Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how many countries have essential asthma medicines on their EML and NRL, which essential asthma medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013-2015 of Global Asthma Network principal investigators generated 111/120 (93%) responses41 high-income countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML or NRL. Technical guidance and advocacy for policy change is required. Improving access to these medicines will improve the health system's capacity to address NCDs.Peer reviewe

The Labeled-Leukocyte Scan in the Study of Abdominal Abscesses

The purpose of the present paper was to review the literature over the last 30 years to assess the value of radionuclide imaging, particularly labeled leukocyte scan, as compared to other imaging modalities in the management of abdominal abscesses. A systematic review of the published studies in humans cited in PubMed written in English, French, German, Italian, and Spanish was made. Ultrasound (US) has lower sensitivity than leukocyte scan (LS), particularly in patients without localizing signs, while CT has higher sensitivity than US, but less than LS. On the other hand, CT had higher specificity than both LS and US. LS is the more sensitive method to localize abdominal abscesses and may guide dedicated US and CT investigations to improve their diagnostic potential. Further diagnostic evolution is expected from the routine use of hybrid SPECT/CT systems