The economic benefits of increasing breastfeeding rates in Spain.

BACKGROUND: Interventions aimed at promoting breastfeeding rates are among the most effective possible health policies available, with an estimated return of US$35 per dollar invested. Indeed, some authors found that a 10% increase in exclusive breastfeeding rates in the first two years of life led to a reduction in treatment costs of US$312 million in the US, US$7.8 million in the UK, US$30 million in China, and US$1.8 million in Brazil. Among high-income countries, Spain stands out for its low breastfeeding rate. METHODS: We calculated the savings that the Spanish National Health System would have benefited from had breastfeeding rates been higher in Spain, both from the time of hospital discharge and at 6 months postpartum. We followed the methods used in similar studies carried out in the US, Italy, Australia, the Netherlands, and the UK, to conservatively estimate these potential savings by considering only the lower thresholds in all our estimates. Here we approximated the benefits of having increased exclusive breastfeeding rates based on the lower incidence of infantile pathologies among exclusively breastfed infants. Robust evidence indicates that among breastfed infants there is a lower prevalence of otitis media, gastroenteritis, respiratory infections, and necrotising enterocolitis. We obtained the estimated monetary cost of these diseases by combining their prevalences with data about their economic costs for diagnosis-related groups. RESULTS: The estimated effects we calculated imply that the Spanish National Health System could have saved more than €5.6 million for every percentage point increase in exclusive breastfeeding rates in Spain during 2014. CONCLUSIONS: Breastfeeding is essential both for the health of mothers and the health and development of newborns but is rarely considered as an economic issue and remains economically invisible. In addition to the improved wellbeing of mothers and their infants, breastfeeding can positively impact society as a whole and should therefore be better defined in public policies. Thus, strategies aimed at increasing exclusive breastfeeding rates would likely contribute to lowering the fiscal burden of the Spanish National Health System. Moreover, the magnitude of these potential benefits suggests that such policies would likely be socially cost-effective.

Genotoxicity and cytotoxicity of sevoflurane in two human cell lines in vitro with ionizing radiation.

OBJECTIVE: To determine the in vitro toxicity of different concentrations of sevoflurane in cells exposed to X-ray. METHODS: The genotoxic effects of sevofluorane were studied by means of the micronucleus test in cytokinesis-blocked cells of irradiated human lymphocytes. Subsequently, its cytotoxic effects on PNT2 (normal prostate) cells was determined using the cell viability test (MTT) and compared with those induced by different doses of X-rays. RESULTS: A dose- and time-dependent cytotoxic effect of sevofluorane on PNT2 cells was determined (p >0.001) and a dose-dependent genotoxic effect of sevofluorane was established (p >0.001). However, at volumes lower than 30 µL of sevofluorane at 100%, a non-toxic effect on PNT2 cells was shown. CONCLUSION: Sevofluorane demonstrates a genotoxic capacity as determined in vitro by micronucleus test in cytokinesis-blocked cells of irradiated human lymphocytes.

OBJETIVO: Determinar la capacidad genotóxica del anestésico sevofluorano en en células expuestas a radiación ionizante. MÉTODOS: La genotoxicidad del sevofluorane se determinó mediante el test del bloqueo citocinético de linfocitos humanos irradiados bloqueados con citochalasina. La capacidad citotóxica se determino mediante el test de viabilidad celular e inhibición del crecimiento celular (MTT) en células PNT2 (epiteliales de próstata), comparando sus resultados con los inducidos por diferentes dosis de rayos X. RESULTADOS: Se ha determinado un efecto citotóxico del sevofluorane sobre las células PNT2 que presenta correlación con la dosis administrada y el tiempo de estudio utilizado (p >0.001), así como un efecto genotóxico con características dosis-dependientes (p >0.001). Sin embargo, con volúmenes de sevofluorane puro inferiores a 30 µL no encontramos efecto citotóxico sobre las células PNT2. CONCLUSIÓN: Sevofluorane muestra una significativa capacidad genotóxica in vitro determinada mediante el test de micronúcleos en linfocitos humanos irradiados con bloqueados citocinético mediante citochalsina.