[Budget impact analysis of the implementation of a bone tissue bank in a Chilean health service]. / Análisis de impacto presupuestario de un banco de tejido óseo en un servicio de salud de Chile.

This research aimed to analyze the costs of bone grafting through a bone tissue bank in a Chilean regional health service. Methods: First, we developed a preliminary epidemiological study to obtain the necessary data for the analysis, specifically on bone graft procedures in a local health service (Servicio Salud Concepción). Next, we performed a budget impact analysis. Results: We analyzed a total of 6,252 cc of bone grafts, with a total cost of USD$156,000 per year. We found a potential recovering capacity of 302 ± 16 femoral heads per year from the total hip replacement procedures. Based on these results, bone tissue banks could save USD$145,000 hospital costs annually. Studying a representative health service from Chile, this analysis revealed a dependency on imported bone substitutes and autografts. These requirements can be supplied sustainably by a bone tissue bank based on donations of femoral heads under the current legislation of the Chilean health authority.

Current concepts for tissue transplant services for developing countries.

The transplantation of tissues can save lives and re-establish vital functions, where no alternatives of comparable effectiveness exist. This has led to establishment of tissue transplantation as a successful practice worldwide; however, a great variability between countries remains in terms of donation levels, safety, quality of grafts and their efficacy. Tissue transplantation requires coordination of different agencies involved in the implementation of procurement, processing, storage and distribution of tissues and cells from different hospital units that perform surgical procedures with graft-type input requirements. This biomaterial-like requirement has led to the constant development of the area and today these graft products of human origin can be the starting point for new and more advanced biotechnological products. For long-term sustainability and successful transplantation units, a process management comparable to the pharmaceutical industry in terms of quality management systems must be established to produce safe and high-quality human-derived products. This review aims to update the current concepts of tissue transplant services for its application for developing countries using the current Chilean scenario as a case study. We summarize our findings proposing a set of guidelines/actions that should be followed to ensure smooth tissue transplant services implementations with high efficiency and safe use.

DNA damage triggers squamous metaplasia in human lung and mammary cells via mitotic checkpoints.

Epithelial transdifferentiation is frequent in tissue hyperplasia and contributes to disease in various degrees. Squamous metaplasia (SQM) precedes epidermoid lung cancer, an aggressive and frequent malignancy, but it is rare in the epithelium of the mammary gland. The mechanisms leading to SQM in the lung have been very poorly investigated. We have studied this issue on human freshly isolated cells and organoids. Here we show that human lung or mammary cells strikingly undergo SQM with polyploidisation when they are exposed to genotoxic or mitotic drugs, such as Doxorubicin or the cigarette carcinogen DMBA, Nocodazole, Taxol or inhibitors of Aurora-B kinase or Polo-like kinase. To note, the epidermoid response was attenuated when DNA repair was enhanced by Enoxacin or when mitotic checkpoints where abrogated by inhibition of Chk1 and Chk2. The results show that DNA damage has the potential to drive SQM via mitotic checkpoints, thus providing novel molecular candidate targets to tackle lung SCC. Our findings might also explain why SCC is frequent in the lung, but not in the mammary gland and why chemotherapy often causes complicating skin toxicity.

Análisis de impacto presupuestario de un banco de tejido óseo en un servicio de salud de Chile / Budget impact analysis of the implementation of a bone tissue bank in a Chilean health service

El objetivo de la presente investigación fue el realizar un análisis de impacto presupuestario del injerto óseo en un servicio regional de salud chileno en base a un banco de tejido óseo. Se realizó un estudio epidemiológico preliminar para obtener los datos necesarios para el análisis, específicamente sobre procedimientos de injerto óseo en un servicio de salud local del Servicio Salud Concepción (SSC). Esta búsqueda evidenció un total de 6.252 cc de injertos óseos con un costo total de USD $156.000 por año. Se encontró una capacidad potencial de 302 ± 16 cabezas femorales recuperadas por año de los procedimientos de reemplazo total de cadera y que un banco de tejido óseo puede generar un ahorro de USD $145.000 en los costos hospitalarios por año. Este análisis evidenció que en un servicio de salud representativo de Chile existe una dependencia de sustitutos óseos importados y autoinjertos que pueden ser suplidos de manera sustentable con un banco de tejido óseo basado en donaciones de cabezas femorales bajo la legislación vigente de la autoridad sanitaria chilena.

This research aimed to analyze the costs of bone grafting through a bone tissue bank in a Chilean regional health service. Methods: First, we developed a preliminary epidemiological study to obtain the necessary data for the analysis, specifically on bone graft procedures in a local health service (Servicio Salud Concepción). Next, we performed a budget impact analysis. Results: We analyzed a total of 6,252 cc of bone grafts, with a total cost of USD$156,000 per year. We found a potential recovering capacity of 302 ± 16 femoral heads per year from the total hip replacement procedures. Based on these results, bone tissue banks could save USD$145,000 hospital costs annually. Studying a representative health service from Chile, this analysis revealed a dependency on imported bone substitutes and autografts. These requirements can be supplied sustainably by a bone tissue bank based on donations of femoral heads under the current legislation of the Chilean health authority.