Correction to: A case of intracoronary and endovenous levosimendan as a rescue therapy for refractory cardiac arrest.

After publication of this supplement [1], it was brought to our attention that the author 'L. Vegnuti' has been erroneously omitted from the author list of the following abstract.

Assessment of children exposed to adult pulmonary tuberculosis in Cali, Colombia.

BACKGROUND: There is a lack of uniform criteria for the diagnosis and management of tuberculosis (TB) in children in Cali, Colombia. Addressing TB in children is a challenge in this setting, under both programmatic and research conditions. OBJECTIVES: To facilitate the diagnostic assessment of TB in a paediatric cohort of TB household contacts. METHODS: A diagnostic and management algorithm (DMA) was used to assess children exposed to adult TB cases, according to clinical and epidemiological findings and under programmatic conditions. On the basis of diagnostic tests, cases were classified as TB exposure, TB infection, suspected TB, possible TB or confirmed TB and then submitted to a management plan. This was a prospective pilot study nested within a national cohort study of the transmission dynamics of Mycobacterium tuberculosis, undertaken in Colombia during 2005-2008. RESULTS: During 24 months of follow-up, 54 of 217 children met the criteria for assessment by DMA, 18 of whom (33%) were considered to be TB incident cases (new TB cases among household contacts). The main clinical findings were failure to thrive and cough lasting >21 days. Only one case was smear-positive and culture-confirmed TB. TB treatment was given to 16 children and they demonstrated clinical and radiographic resolution at follow-up. Conducting the study under programmatic conditions demonstrated barriers to accessing competent radiological evaluation, correct interpretation of the tuberculin skin test, and proper specimen collection. CONCLUSION: Structured assessment using DMA facilitated the detection of incident TB cases. The study identified potential barriers to addressing childhood TB in Cali.

Análisis del impacto presupuestario para el Sistema Nacional de Salud de la combinación fija de amlodipino 5 o 10mg y atorvastatina 10mg / Analysis of the budget impact for the Spanish National Health System of the fixed combination of amlodipine 5 or 10mg and atorvastatin 10mg

Objetivo Realizar un análisis de impacto presupuestario (AIP) de la introducción en la prestación sanitaria del sistema nacional de salud (SNS) de la combinación fija (CF) de amlodipino 5 o 10mg y atorvastatina 10mg en la indicación aprobada. Material y métodos El AIP se ha realizado desde la perspectiva del SNS para un periodo de 3 años (2009–2011). Se ha diseñado un modelo de decisión tipo árbol (árbol de pacientes) construido a partir de datos epidemiológicos y la literatura científica para estimar la población hipertensa susceptible de tratamiento con la CF. El AIP, por año y en total, se ha calculado imputando el coste a PVP-IVA de la CF al número de pacientes a tratar, del que se sustrae el coste del tratamiento antihipertensivo que se sustituye y el coste por paciente promedio actualizado de los eventos cardiovasculares prevenidos para el SNS por el uso de la CF en el periodo de referencia. Resultados La población susceptible de tratamiento con la CF es de 51.104 pacientes (1.er año), con una tasa de crecimiento entre 1–2% en los sucesivos años, lo que supone un coste (€) anual de 15,9M (2009), 19,9M (2010) y 24,1M (2011), totalizando 60,0M. El AIP se ve compensado mostrando valores de impacto negativo para el SNS cuando se descuentan los costes del tratamiento antihipertensivo sustituido y eventos cardiovasculares prevenidos, mostrando un ahorro de 69,9M € en 3 años. Conclusión El AIP de la CF de atorvastatina y amlodipino muestra que su uso en la indicación aprobada podría generar ahorros netos para el SNS en el periodo 2009–2011 de 9,9M (AU)

Objective To carry out a Budget Impact Analysis (BIA) of the inclusion of the administration, within the Spanish National Health System (SNS), of the fixed combination (FC) of amlodipine 5 or 10mg and atorvastatin 10mg for approved indications. Materials and Methods A BIA was carried out from the SNS perspective for a 3 year period (2009–2011). A tree type decision model was designed (tree of patients), based on epidemiological data and scientific literature, to estimate the hypertensive population that could be treated with a FC. The total per annum BIA was calculated by attributing the retail price- VAT of the FC to the number of patients to be treated, and deducting the cost of the treatment for hypertension that was replaced and the updated average cost per patient of cardiovascular events (CVEs) prevented by the use of the FC by the SNS during the period of study. Results The patient population susceptible to treatment with the FC was 51,104 patients (1st year), with a growth rate of between 1–2% over the following years, which means an annual cost (€) of 15.9M (2009), 19.9M (2010) and 24.1M (2011), with a total of 60.0M. The BIA was compensated showing negative impact values for the SNS when the cost of replaced antihypertensive treatment and prevented CVEs was deducted, with savings of €69.9M over 3 years. Conclusion The BIA of a FC of atorvastatin and amlodipine shows that the use of this medication for approved indications could generate net savings for the SNS of €9.9M for the period 2009–2011 (AU)

[Analysis of the budget impact for the Spanish National Health System of the fixed combination of amlodipine 5 or 10mg and atorvastatin 10mg]. / Análisis del impacto presupuestario para el Sistema Nacional de Salud de la combinación fija de amlodipino 5 o 10mg y atorvastatina 10mg.

OBJECTIVE: To carry out a Budget Impact Analysis (BIA) of the inclusion of the administration, within the Spanish National Health System (SNS), of the fixed combination (FC) of amlodipine 5 or 10mg and atorvastatin 10mg for approved indications. MATERIALS AND METHODS: A BIA was carried out from the SNS perspective for a 3 year period (2009-2011). A tree type decision model was designed (tree of patients), based on epidemiological data and scientific literature, to estimate the hypertensive population that could be treated with a FC. The total per annum BIA was calculated by attributing the retail price- VAT of the FC to the number of patients to be treated, and deducting the cost of the treatment for hypertension that was replaced and the updated average cost per patient of cardiovascular events (CVEs) prevented by the use of the FC by the SNS during the period of study. RESULTS: The patient population susceptible to treatment with the FC was 51,104 patients (1(st) year), with a growth rate of between 1-2% over the following years, which means an annual cost (euro) of 15.9M (2009), 19.9M (2010) and 24.1M (2011), with a total of 60.0M. The BIA was compensated showing negative impact values for the SNS when the cost of replaced antihypertensive treatment and prevented CVEs was deducted, with savings of euro69.9M over 3 years. CONCLUSION: The BIA of a FC of atorvastatin and amlodipine shows that the use of this medication for approved indications could generate net savings for the SNS of euro9.9M for the period 2009-2011.

Umbilical flow waveforms versus fetal biophysical profile in hypertensive pregnancies.

The pulsatility index (PI) of the umbilical arteries was measured in 40 hypertensive pregnancies. Doppler-velocimetric data were kept unknown to the clinical staff. An abnormal PI was found in 79% of cases in which an abnormal fetal growth in utero had been diagnosed by ultrasonographic measurements. Serial PI findings showed worsening figures in most of the cases with an abnormal fetal growth, irrespective of the last absolute value. Amniotic fluid estimation and PI data were significantly correlated. PI values were markedly abnormal in fetuses with non-reactive heart-rate tracings. A high sensitivity and an optimal specificity were found for umbilical PI versus the diagnosis of fetal growth retardation made by the coexistence of different biophysical criteria. However, false normal results may occur. 62% of the newborns weighed below the 5th percentile. The sensitivity of abnormal PI values to detect these light fetuses resulted to be only 67%. However the prevalence of neonatal morbidity in fetuses with abnormal PI values was 74%, while morbidity occurred only in 14% of cases with normal PI values. In hypertensive pregnancies, this simple velocimetric parameter proved to correlate with abnormal biophysical monitoring and complicated neonatal outcomes.