La concentración en el sector farmacéutico peruano y su impacto económico

La investigación se centra en determinar si la concentración en el sector farmacéutico peruano tiene impacto económico en los consumidores y pacientes, enfocado en realizar un análisis interno y externo, marco regulatorio, opinión de stakeholders, oferta y demanda, considerando el periodo de enero 2014 a octubre 2019. Para lograr el objetivo se realizaron entrevistas a expertos, además, se establecieron tres escenarios de estudio, donde se analizaron los precios de los medicamentos del Observatorio de DIGEMID frente a los precios y volumen de ventas de los laboratorios obtenido del IMS Health. El análisis demuestra que el sector retail se encuentra altamente concentrado, que existe quiebre estructural en la tendencia de precios de medicamentos y se corrobora que si existe un daño económico al paciente, donde el paciente crónico es el que recibe el mayor daño. Adicionalmente, se encuentra una brecha considerable entre el precio de venta del laboratorio a las farmacias y el de las farmacias al consumidor final. El margen bruto de las cadenas origina un gran impacto en el sector farmacéutico, en donde éstas cuentan con mayor participación, liderado por InRetail, el cual proyectado al 2022 llegaría a valores dos veces más que lo conseguido en el acumulado 2018

Pre diabetes and arterial stiffness: its identification and posible pathogenesis

Introducción: antecedentes: en el estadio de prediabetes (PreD) aparecen marcadores de lesión vascular que indican la necesidad de identificación precoz y tratamiento oportuno. Objetivos: evaluar los indicadores de rigidez arterial en personas con PreD y su posible patogenia.Introduction: background: in the prediabetes stage (PreD), vascular lesion markers appear indicating the need for early identification and timely treatment. Aims: To evaluate arterial stiffness indicators in people with prediabetes (PreD) and its possible pathogenesis.Publicado en Revista de la Sociedad Argentina de Diabetes, vol. 54, no. 3, Sup.Centro de Endocrinología Experimental y Aplicad

COMPARISON BETWEEN TWO METHODS OF STAINING FOR ASSESSMENT OF MORPHOLOGY AND ACROSOME IN DOMESTIC CAT (Felis catus) SPERMATOZOA COMPARAÇÃO ENTRE DOIS MÉTODOS DE COLORAÇÃO PARA ANÁLISE MORFOLÓGICA E ACROSSOMAL DE ESPERMATOZÓIDES DE GATO DOMÉSTICO (Felis catus).

<span><font size="3"><font face="Times New Roman"><span><p align="justify">The objective of this study was to evaluate the efficiency of the modified Karras staining technique (KA) to analyze domestic cat sperm morphology by comparing it with the Fast Green FCF/ Rose Bengal staining (FR), previously used for this species. Four adult cats were used, from which sperm samples were collected four times in alternate days for each tom using an artificial vagina (n=16 ejaculates). Both staining techniques were performed for each ejaculate. For the FR staining technique, the semen <em>in natura</em> was diluted in 2.9% sodium citrate and, afterwards, in the staining solution. After 70 seconds, smears were made onto slide and dried at 37ºC. For the KA staining technique, previously made and formol saline fixed slides were sequentially immersed in Rose Bengal solution, Tannin<font size="2" color="#ff0000"><font size="3" color="#ff0000"> </font></font><font size="3">solution, and Victoria Blue B solution, and dried at room temperature. For sperm evaluation, 200 sperm cells were assessed for each staining technique in all ejaculate samples using a bright field microscope at 1000X magnification. Statistical <span>analysis used the non-parametric Wilcoxon test, establishing significance at p<0.05. For the KA staining technique, higher percentage of distal cytoplasmic droplets and lower percentage of sperm head defects were obtained when compared to the FR staining technique. This way, both staining techniques were not totally efficient for the assessment of morphological defects found in the domestic cat <em>in natura </em>spermatozoa.</span></font></p><font size="3"><span><span><p align="justify">KEY WORDS: Acrosome, domestic cat, spermatozoa, sperm morphology, staining.</p></span></span></font></span></font></font></span><p> </p> <font size="3"><font face="Times New Roman"><span style="color: black"><span><p align="justify">O objetivo do estudo foi avaliar a eficiência do método de coloração Karras modificado (KA) para a análise da morfologia espermática no gato doméstico através da comparação com a coloração Fast Green FCF/Rosa Bengala (FR), previamente utilizada para esta espécie. Utilizaram-se quatro gatos adultos, colhendo-se quatro vezes amostras de sêmen em dias alternados para cada animal através de vagina artificial (n=16 ejaculados). Para cada ejaculado, realizaram-se duas colorações. Para a coloração FR, o sêmen <em>in natura</em> foi diluído em citrato de sódio 2,9% e, posteriormente, em solução de coloração. Após setenta segundos, procedeu-se a esfregaços em lâminas, as quais foram secas a 37ºC. Para a coloração KA, os esfregaços previamente confeccionados e fixados em formol salino foram imersos seqüencialmente nas soluções de Rosa Bengala, Tanino e Azul Vitória e secas em temperatura ambiente. Avaliaram-se duzentas células para cada tipo de coloração em todos os ejaculados, usando-se microscópio de luz em aumento de 1.000X. Efetuou-se análise estatística mediante o teste não-paramétrico de Wilcoxon, estabelecendo diferença significativa quando p<0,05. Para a coloração de KA, obtiveram-se maior porcentagem de gota citoplasmática distal e menor porcentagem de defeitos de cabeça quando comparada à coloração FR. Assim, nenhuma das colorações mostrou-se totalmente eficiente na identificação dos defeitos de morfologia encontrados na avaliação do sêmen <em>in natura</em> de gatos domésticos.</p><span><p align="justify">PALAVRAS-CHAVES: Acrossomo, coloração, espermatozóide, gato doméstico, morfologia espermática.</p></span></span></span></font></font><p> </p&gt

High incidence of 'Dag-like' sperm defect in the domestic cat

The occurrence of a high incidence of sperm tail defects in a male domestic cat resembling the known 'Dag-like' defect is reported. Sperm analyses were performed in ejaculated samples collected by an artificial vagina and in testicular and epididymal sperm cells after castration. The following alterations were observed using transmission electron microscope: heavily coiled sperm tails containing several axonemal units enclosed in the same common cell membrane; aberrations in the axonemal main structure; and swollen and unevenly distributed mitochondria in the midpiece. Abnormal modifications in the mitochondrial sheath were also found in sperm cells retrieved from testes and epididymides. Considering these findings, we can conclude that this is the Dag-like defect, described previously in other domestic species and a testicular origin may be involved. © ISFM and AAFP 2012

Nonpregnant and pregnant adult female rats affected by maternal diabetes environment

Maternal diabetes-mediated fetal programming is widely discussed, however, it is important to define the extent to which intrauterine hyperglycemia interferes with the health of female pups, along with determining whether these changes can be perpetuated across generations. This study aimed to evaluate the effects of maternal diabetes on fetal programming and the repercussions on the metabolism of pregnant and nonpregnant female pups. Diabetes status was induced (diabetic group—D) using streptozotocin (a beta cell cytotoxic drug) on the fifth postnatal day of female rats, while controls received a citrate buffer (Control—C). In adulthood, the rats were mated to obtain their female pups. At 90 days of age, half of the female pups were mated (preg) and the other half continued virgin (Npreg). Furthermore, they were distributed into four groups: OC/Npreg and OC/preg—female pups from control mothers; OD/Npreg and OD/preg—female pups from diabetic mothers. At 115 days of life and/or 17 days of pregnancy, the oral glucose tolerance test (OGTT) was performed with blood collection for insulin measurement. At 120 days of life and/or 21 days of pregnancy, the rats were anesthetized and euthanized to determine their blood oxidative stress status. The OD/Npreg group showed glucose intolerance during OGTT (p p p = 0.0027). An increase in homeostatic model assessment β was shown in the pregnant groups, regardless of maternal diabetes (p p p = 0.0005) and decreased superoxide dismutase activity (p = 0.0063). Additionally, small fetuses for gestational age (p < 0.0001) were found in these rats. In conclusion, exposure to maternal hyperglycemia compromises the glycemic metabolism of female pups before and during pregnancy and causes oxidative stress, IR, and impaired fetal growth during pregnancy.</p

Cryoprotective effect of different glycerol concentrations on domestic cat spermatozoa

Cryopreservation of spermatozoa is a pivotal tool in assisted reproduction, and studies aiming to establish optimal freezing/thawing protocols are essential to enhance sperm survival. The objectives of the present study were to (1) compare the cryoprotective efficiency of three different glycerol concentrations (3%, 5%, and 7%) on the basis of post-thaw sperm quality and (2) investigate whether the incidence of morphologically abnormal sperm in fresh samples is related to cryodamage sensitivity. Semen was collected from six tomcats using an artificial vagina (total 18 ejaculates). Each ejaculate was diluted using Tris-egg yolk-based extender (TEY), evaluated, equally divided into three aliquots, and rediluted using TEY with and without glycerol to achieve final concentrations of 3%, 5%, and 7%. Samples were loaded into 0.25 mL straws, equilibrated for 60 minutes at 5 °C, frozen, and then thawed at 46 °C for 12 seconds. Fresh and frozen-thawed samples were evaluated for sperm motion parameters (computer-assisted sperm analysis), plasma membrane integrity (PMI; propidium iodide and carboxyfluorescein diacetate), and DNA integrity (acridine orange). Plasma and acrosomal membrane integrity were assessed by flow cytometry (propidium iodide and fluorescein isothiocyanate-conjugated pea (Pisum sativum) agglutinin) immediately after thawing. Sperm motion parameters were also evaluated at 30 and 60 minutes of postincubation. For all treatment groups, cryopreservation significantly impaired the PMI and sperm motion parameters, except for straightness and amplitude of lateral head displacement. DNA integrity showed a slight reduction (P < 0.05) when 3% glycerol was used. The percentage of total motility, progressive motility, and rapid spermatozoa were significantly lower immediately after thawing and up to 60 minutes of incubation for the 3% glycerol group when compared with 5% and 7%. No difference (P > 0.05) was found for PMI, acrosome integrity, and DNA integrity among post-thaw groups. However, higher (P < 0.05) incidence of viable cells with reacted acrosome and dead cells with intact acrosome were observed with 7% and 3% glycerol, respectively. Percentage of morphologically abnormal spermatozoa in fresh sample was positively correlated with PMI only in the 3% glycerol group and negatively correlated with sperm motility in the 5% and 7% groups. In conclusion, the final concentration of 5% glycerol offered better cryoprotective effect for ejaculated cat sperm, and the relationship found between prefreezing sperm morphology and post-thaw sperm quality showed to be dependent on final glycerol concentration. © 2013 Elsevier Inc

Identification of phospholipase C zeta in normospermic and teratospermic domestic cat sperm

In mammalian species, oocyte activation is initiated by oscillations in the intracellular concentration of free calcium ([Ca2+]i), which are also essential to allow embryonic development. To date, evidence supporting the hypothesis that a sperm factor is responsible for initiating oocyte activation has been presented in various mammalian species. Among the possible candidates to be the active sperm factor is the novel sperm-specific phospholipase C ζ (PLCζ), which besides its testis-specific expression is capable of initiating [Ca2+]i oscillations. In this study, we investigated the presence of PLCζ in the sperm of the domestic cat and whether normospermic and teratospermic cats differ in their PLCζ expression. Immunoblotting with anti-PLCζ antibodies confirmed the presence of an immunoreactive band of ~70 kDa in whole sperm lysates of domestic cat as well as in both soluble and insoluble fractions from this sperm. Additional immunoreactive bands, probably C- and N-terminal truncated versions of PLCζ, were also visualized in the soluble sperm fractions. Interestingly, immunoreactivity of PLCζ was detectable in teratospermic sperm, although with slightly less intensity than in normospermic sperm. In conclusion, domestic cat sperm express PLCζ in both cytosolic and high-pH fractions, which is consistent with data in other mammals. Sperm from teratospermic cats also express PLCζ, albeit at reduced concentrations, which may affect the fertility of these males. © 2013 Elsevier Inc.

Hypertension arising after 20 weeks of gestation: gestational hypertension or chronic masked hypertension?

Introducción: Los trastornos hipertensivos del embarazo han sido divididos en hipertensión arterial (HA) crónica vs HA gestacional. El monitoreo ambulatorio de la presión arterial (MAPA) podría modificar esta clasificación pues una proporción de las pacientes con HA gestacional pueden tener HA enmascarada. Objetivo: determinar la proporción de embarazadas con HA gestacional que tienen HA crónica enmascarada y el riesgo de desarrollar PE Material y Métodos: 227 embarazadas de alto riesgo (edad 32 ± 6 años) fueron evaluadas antes de la semana 20 de gestación con MAPA. Las normotensas que desarrollaron HA gestacional fueron reclasificadas de acuerdo al MAPA basal en HA gestacional verdadera (MAPA normal) y pseudo HA gestacional (MAPA con hipertensión enmascarada). Los riesgos de PE fueron estimados con regresión logística. Resultados: La prevalencia de HA crónica fue 29,5%. De las 160 embarazadas sin HA crónica, 39 desarrollaron HA gestacional (16 HA gestacional verdadera y 23 pseudo HA gestacional). Desarrollaron PE el 23,3% de la cohorte. Los riesgos absolutos de PE fueron 15,7%, 12,5%, 43,5% y 32,8% para normotensión, HA gestacional verdadera, pseudo HA gestacional verdadera e HA crónica, respectivamente. Comparadas con normotensión, la HA gestacional verdadera no incrementó el riesgo de desarrollar PE (OR 0,76, IC95% 0,16-6,65) mientras que la pseudo HA gestacional aumentó > 4 veces (0R 4,13 IC 1,58-10,77). Conclusión: 59% de las embarazadas clasificadas como HA gestacional, tenían HA crónica enmascarada. Este subgrupo tiene más de cuatro veces de incremento del riesgo de desarrollar PE, mientras que las verdaderas HA gestacionales no mostraron mayor riesgoObjectives: the aims were 1- to evaluate the prevalence of masked chronic hypertension in pregnant women classified as gestational hypertension 2- to compare the risks of developing preeclampsia in true gestational hypertension vs those women classified as having gestational hypertension but who had had masked hypertension in the first half of pregnancy. Methods: We performed a cohort study in consecutive high-risk pregnancies and evaluated before 20 weeks of gestation. Women who developed hypertension (office BP ≥ 140/90 mmHg and/or antihypertensive treatment) after 20 weeks of gestation was classified, according to the ABPM performed before 20 weeks of gestation, as having “true” gestational hypertension (if their ABPM before 20 weeks of gestation was normal) or “pseudo” gestational hypertension (if there had chronic masked hypertension). Risks for preeclampsia (PE) were estimated and compared with normotensive women. Results: Before 20 weeks of gestation, 227 were analyzed (age 32 ± 6 years, median gestation age 15 weeks); 67 had chronic hypertension (29.5%). Of the remaining 160, 39 developed gestational hypertension (16 had true gestational and 23 pseudo gestational hypertension, because they had masked hypertension in the first half of pregnancy). Compared normotensive pregnant women, true gestational hypertension did not increase the risk of developing PE (OR=0.76, 95%CI=0.16-6.65). Conversely, pseudo gestational hypertension increased the risk for PE more than 4 times (0R=4.47 CI=1.16-12.63). Risk estimation did not change substantially after adjustment for multiple possible confounders. Conclusion: 59% of women diagnosticated as gestational hypertension had indeed chronic masked hypertension and a very risk for developed PE.Facultad de Ciencias Médica