Descriptive, Longitudinal Study Results Applied to Statistical Models to Assess the Impact of Early Microbiological Cultures on the Economic Burden of Treatment for Infected Diabetic Foot Ulcers at a Mexican Public Health Facility.

Infection plays a critical role in health care and impacts the cost of the treatment of diabetic foot ulcers (DFU). To examine the cost reduction associated with the multidisciplinary treatment of infected DFU (IDFU) by obtaining early (ie, within 48 hours of admission) microbiological culture results, a descriptive, longitudinal study was conducted. Data were collected prospectively from patient medical charts of a cohort of 67 patients (mean age, 56.14 ± 12.3 years; mean duration of diabetes, 14.95 ± 8 years) with IDFU treated at a Mexican public health facility from January 1 to April 30, 2010. Information included demographic data (age, gender, marital status, time elapsed since first diagnosis of diabetes mellitus type 2 [DM2]), and the following clinical records: Wagner classification, bacterium type, antimicrobial resistance, length of hospital stay, and the antibiotic schedule utilized, as well as number and type of laboratory tests, medications, intravenous therapy, surgical and supportive treatment, type and number of specialists, and clinical outcome. Microcosting was used to calculate the unit cost of each medical treatment element. Using the Monte Carlo and Markov predictive simulation economical models, cost reduction associated with early identification of the specific microorganism through bacterial culture in IDFU was estimated. Based on the statistical results, differences between real and estimated costs when including early microbiological culture were identified and the number and type of most common species of infectious bacteria were detected. The total cost observed in the patient cohort was $502 438.04 USD, mean cost per patient was $7177.69 ± $5043.51 USD, and 72.75% of the total cost was associated with the hospital stay length. The cost of the entire treatment including antibiotics was $359 196.16 USD; based on the simulation of early microbiological culture, the model results showed cost could be reduced by 10% to 25% (in this study, the cost could be as low as $304 624.63 USD). The use of early microbiological cultures on IDFU to determine the appropriate antibiotic can reduce treatment costs by >30% if hospital stay is part of the consideration.

Bases para el uso combinado de los interferones y de los retinoides en oncología clínica / Basis for the combined use of interferon and retinoid in clinical oncology

El acido retinoico y el interferón alfa tienen actividad limitada en el tratamiento de cáncer avanzado. La información obtenida de los cultivos celulares indican que, en combinación, estos agentes tienen incremento de la actividad biológica modulando el crecimiento y la diferenciación en un número de tipos celulares malignos. Trabajos clínicos recientes sobre el tratamiento de algunos carcinomas avanzados de células escamosas informan actividad terapéutica con este régimen. Este artículo revisa los datos preclínicos obtenidos al evaluar el ácido retinoico en combinación con interferones

Método simples de preparaçäo de soro bovino fetal para uso em laboratório de cultura de tecidos de países em desenvolvimento / Simple Method for Preparing Fetal Bovine Serum for Use in Tissue Culture Laboratories of Developing Countries

O presente trabalho relata a experiência do laboratório de cultura de tecidos do Instituto Evandro Chagas, Fundaçäo SESP, Ministério da Saúde, Belem-Pará, Brasil, na preparaçäo de soro bovino fetal (SBF) obtido de sangue colhido diretamente no matadouro local. Os procedimentos adotados säo simples e compatíveis com os recursos de laboratórios pequenos, que fazem uso das culturas celulares para diagnósticos, vigilância epidemiológica e pesquisa virológica. Cada uma das etapas de elaboraçäo do trabalho - coleta e transporte do sangue, separaçäo do soro, filtraçäo e esterilizaçäo física e os testes para detecçäo de agentes bacterianos e PPLO - visa a obtençäo de um produto final, o tanto quanto possível, livre de contaminantes, toxicidade e hemólise. Levando-se em conta o alto custo do produto comercializado, o empreemdimento é viável e os resultados satisfatórios