Trends in the use and cost of human and analogue insulins in a Colombian population, 2011-2015.

OBJECTIVES: Diabetes mellitus is a common disease among the general population and imposes considerable costs on health care systems. Insulin is used to treat type 1 diabetes mellitus and as an adjuvant to oral agents in advanced stages of type 2 diabetes mellitus. The objective was to describe the trends in use and cost of human and analogue insulins for Colombian patients. STUDY DESIGN: Descriptive retrospective analysis of prescriptions of human and analogue insulins on a monthly basis for the period from July 1, 2011 to February 2, 2015. METHODS: Information was collected for the database population of two insurance companies. Frequencies and proportions were calculated; estimated economic impact was expressed as net cost and cost per thousand inhabitants per day. RESULTS: During the observation period, there was continuous growth in use of insulin, mainly in analogue forms (34.0% growth). At the start of the study, 10.4% of subjects were using an analogue insulin; this figure was 62.6% at the end of the study. In 2012, the average cost per 1000 inhabitants/day was US$1.7 for analogue and US$0.8 for human insulins. At the end of the observation period these costs had risen to US$9.2 for analogue (441.1% increase) and fallen to US$0.5 for human insulin (58.3% decrease). CONCLUSIONS: There has been an increase in the unit cost and frequency of use of insulin analogues for anti-diabetic therapy in Colombian patients. Moreover, there is controversy over whether insulin analogues are a more cost-effective treatment than human insulins for the general diabetic population.

Detection of specific anti-giardia serum antibody by an immunofluorescence test in children with clinical giardiasis.

In 50 of 100 children with clinical giardiasis studied, the presence of Giardia lamblia was proven by stool and/or duodenal aspirate examination; the presence of the parasite was not demonstrated in the rest. Serum antibodies to G. lamblia were investigated in all children by an indirect immunofluorescent test (IIF) with G. lamblia trophozoites as antigen. It was found that all the children with positive duodenal aspirate had positive serology (titers greater than or equal to 1/32). The best correlation between parasitological and serological procedures were in the 1-5-year-old age group, and there was an age dependent increase of the antibody titer. Most of the parasitologically negative children were serologically negative. Our results support the use of IIF as a useful diagnostic procedure in the diagnosis of giardiasis in children.

[Psychosurgery in behavior disorders]. / Psicocirurgia nos distúrbios do comportamento.

The results obtained in a casuistic of 170 patients with mental diseases and behavior disturbances treated by neurosurgical procedures are reported. The authors call attention to the advantages of the atraumatic stereotaxic psychosurgery over the major surgical procedures on the frontal lobes for the treatment of psychoses and intractable psychoneurosis.