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Montevideo, Uruguay

Objective: A literature review on the pharmacoeconomic evaluation for the National Health Systems of Cuba was performed, in order to assess the economic and social value to improve efficiency. Methods: A literature review was carried out to search for international and national information to support the incorporation of pharmacoeconomics in the health system of Cuba. Results: Thus, the required levels of pharmacoeconomics efficiency justifying the use of drugs in the health budgets were considered. For this reason, pharmacoeconomics applied to pharmacotherapy is considered to be an additional element contributing to improve rational prescription, which leads to the efficient use of health resources. Conclusions: As shown by the literature review, pharmacoeconomics had a very special place in the topic of drug efficiency. Using pharmacoeconomic techniques we can define the research lines based not only on effectiveness but also on efficiency, and improve the efficiency within the National Health System of Cuba. Adis © 2012 Springer International Publishing AG.

Giglio J.,Catedra de Radioquimica | Fernandez S.,Catedra de Radioquimica | Pietzsch H.-J.,Helmholtz Center Dresden | Dematteis S.,Catedra de Inmunologia | And 3 more authors.
Nuclear Medicine and Biology | Year: 2012

The evaluation of oxygenation status of solid tumors is an important field of radiopharmaceutical research. With the aim to develop new potential 99mTc-radiopharmaceuticals for imaging hypoxia, we have synthesized two novel isocyanide derivatives of metronidazole, which has demonstrated high affinity for hypoxic tumors in vitro and in vivo. Methods: Metronidazole derivatives 4-isocyano-N-[2-(2-methyl-5-nitro-1H-imidazol-1-yl)ethyl]butanamide (M1) and 1-(4-isocyanobutanoyl)-4-[2-(2-methyl-5-nitro-1H-imidazol-1-yl)ethyl]piperazine (M2) were synthesized, and labeling was performed through preparation of their corresponding 99mTc-(4+1) complexes, 99mTc-NS3M1 and 99mTc-NS3M2. The structure of the technetium complexes was corroborated by preparation and characterization of the corresponding rhenium complexes. We have studied the main physicochemical properties (stability, lipophilicity and plasma protein binding). Biological behavior in HCT-15 cells both in oxia and in hypoxia was assessed. Biodistribution in normal mice and in animals bearing induced 3LL Lewis murine lung carcinoma was also studied. Results: Metronidazole derivatives were successfully synthesized. Labeling with high radiochemical purity was achieved for both ligands. 99mTc complexes were stable in labeling milieu and human plasma. However, presence of the piperazine linker in M2 resulted in higher lipophilicity and protein binding. Although cell uptake in hypoxic conditions was observed for both radiotracers, 99mTc-NS3M2 biodistribution was considered unsuitable for a potential radiopharmaceutical due to high liver uptake and poor blood clearance. However, 99mTc-NS3M1 demonstrated a very favorable in vivo profile both in normal mice and in mice bearing induced tumors. Conclusion: Selective uptake and retention in tumor together with favorable tumor/muscle ratio make 99mTc-NS3M1 a promising candidate for further evaluation as potential hypoxia imaging agent in tumors. © 2012 Elsevier Inc..

Alonso E.D.,Instituto Nacional Of Endocrinologia Inen | Jo A.S.,Institute Higiene | Galan Y.,Instituto Nacional Of Oncologia Y Radiobiologia Inor
Revista Cubana de Salud Publica | Year: 2011

Objectives To identify differences in the integral burden (combined mortality and morbidity) associated to lung cancer between sexes and among provinces, and to describe the evolution in 1990, 1995, 2000 and 2002. Methods The Potential Years of Life Lost due to mortality were calculated on the basis of estimated Life Expectancy for quinquennial groups of age. The Potential Years of Life Lost were calculated per death as an average. The Potential Years of Life Lost due to morbidity were estimated on the basis of severity, incidence and average duration. Results The rate of potential years of life lost due to premature mortality increased for both sexes in the 1990-2002 period; it was 6.07 to 7.45 per 1 000 inhabitants in males and 2.52 to 4.21 per 1 000 inhabitants in females. The provinces with the highest rates for males in 1990 and 2002 were Ciudad de La Habana, Matanzas, La Habana and Isla de la Juventus whereas the highest rates for females were found in Pinar del Río, Villa Clara, Ciudad de La Habana, Isla de la Juventud and Ciego de Avila provinces in the same years. There was found an increase in the rate of Potential Years of Life Lost due to morbidity for both sexes from 1990 to 2002; it was 0.42 to 0.52 and 0.19 to 0.28 per 1 000 inhabitants in males and females respectively. The rate of Disability Adjusted Years of Life also showed unfavourable evolution in both sexes. The highest figures were seen in La Habana, Ciudad de La Habana and Villa Clara for both sexes. The males were more affected in terms of mortality and morbidity. Conclusions The impact of lung cancer in healthy years of life lost had unfavourable evolution in Cuba in the selected years of the 1990-2002 period.

Seuc A.H.,Institute Higiene | Dominguez E.,Instituto Nacional Of Endocrinologia
Cadernos de Saude Publica | Year: 2010

The objective of this study was to estimate the evolution of the burden of disease in Cuba for 20 major causes at five year intervals from 1990 to 2005, in terms of mortality and years of life lost due to premature death (YLL), using national mortality registries. Six summary measures were computed for each of the 20 major causes of death which characterized the evolution of the disease burden over the period studied. The 20 causes were then grouped according to their behaviour in these summary measures; hierarchical cluster analysis was used to support this grouping process. We compute YLL results with and without age-weighting and time discounting (3%). The 20 major causes were grouped into 12 subgroups, each with a particular pattern. The burden of disease in Cuba during the period 1990-2005 has a peculiar pattern that does not reproduce the one characteristic of other low- and middle-income countries. The approach used in this study supports a better description of mortality and YLL trends for major causes, for identifying possible explanations, and for supporting public health policy making. It seems convenient to reproduce this analysis using shorter time intervals, e.g. annually.

Brower C.S.,California Institute of Technology | Veiga L.,California Institute of Technology | Veiga L.,Institute Higiene | Jones R.H.,California Institute of Technology | And 2 more authors.
Journal of Biological Chemistry | Year: 2010

Our study of the mouse Ate1 arginyltransferase, a component of the N-end rule pathway, has shown that Ate1 pre-mRNA is produced from a bidirectional promoter that also expresses, in the opposite direction, a previously uncharacterized gene (Hu, R. G., Brower, C. S., Wang, H., Davydov, I. V., Sheng, J., Zhou, J., Kwon, Y. T., and Varshavsky, A. (2006) J. Biol. Chem. 281, 32559-32573). In this work, we began analyzing this gene, termed Dfa (divergent from Ate1). Mouse Dfa was found to be transcribed from both the bidirectional PAte1/Dfa promoter and other nearby promoters. The resulting transcripts are alternatively spliced, yielding a complex set of Dfa mRNAs that are present largely, although not exclusively, in the testis. A specific Dfa mRNA encodes, via its 3′-terminal exon, a 217-residue protein termed DfaA. Other Dfa mRNAs also contain this exon. DfaA is sequelogous (similar in sequence) to a region of the human/mouse HTEX4 protein, whose physiological function is unknown. We produced an affinity-purified antibody to recombinant mouse DfaA that detected a 35-kDa protein in the mouse testis and in several cell lines. Experiments in which RNA interference was used to down-regulate Dfa indicated that the 35-kDa protein was indeed DfaA. Furthermore, DfaA was present in the interchromatin granule clusters and was also found to bind to the Ggnbp1 gametogenetin-binding protein-1 and to the Abt1 activator of basal transcription that interacts with the TATA-binding protein. Given these results, RNA interference was used to probe the influence of Dfa levels in luciferase reporter assays. We found that DfaA acts as a repressor of TATA-box transcriptional promoters. © 2010 by The American Society for Biochemistry and Molecular Biology, Inc.

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