RESUMEN
Background: As blood is a scarce and expensive resource, irrational blood usage places huge burden on health expenditures. In response to this challenge, governments and health care providers are developing different strategies to optimize blood utilization. Among these strategies is trying to raise the public awareness on the actual costs of the blood production and changing the cost recovery systems of blood and blood components.
Aims: This study aims to compare cost recovery and financing systems of blood and blood products in different countries.
Methods: This research was an email-based survey of 30 countries from four HDI categories. All related literature was reviewed.
Results: Out of 28 countries, 19 have blood and blood products that are provided totally free of charge to the patients. In nine countries blood and blood products are totally or partially chargeable to the patients.
Conclusions: In countries with low and lower-middle income economies, total or partial costs of blood and blood products are recovered directly from the patients. While countries in which blood and blood products are 'free of charge' for patients are mostly categorized in upper-middle- or high-income economies with well-developed healthcare and insurance systems. There is no clear relation between blood usage and the type of cost recovery system. However, having an efficient cost recovery system will help blood establishments to sustain their service delivery
RESUMEN
Objective: Hemoglobin F [HbF] augmentation is considered a clinically beneficial phenomenon in beta-hemoglobinopathies. Prevention of gamma-globin gene silencing, inspired by the hereditary persistence of fetal hemoglobin, may be a suitable strategy to upregulate HbF expression in these patients. Therefore, our objective was to assess the potential feasibility of induced -117 G?A substitution in HBG promoter in prevention of transcriptional silencing of the gamma-globin
Materials and Methods: In this experimental study, human peripheral blood-derived hematopoietic stem cells [HSCs] and the K562 cell line were differentiated to erythroid cells. Erythroid maturation was examined using cell morphology parameters and flow cytometry analysis of CD235a expression. A synthesised chimeraplast was transfected to differentiating cells. The efficiency of chimeraplast delivery into target cells was assessed by flow cytometry. Restriction-fragment length polymorphism and DNA sequencing verified oligonucleotide-directed mutagenesis. Gene conversion frequency and globin genes expression was quantified through Allele specific-quantitaive polymerase chain reaction [AS-qPCR] and quantitative-PCR respectively
Results: Increase in CD235a-expressing cells along with observations made for different stages of erythroid maturation confirmed erythroid differentiation in HSCs and K562 cells. gamma to beta-globin gene switching was estimated to be on days 18-21 of HSC differentiation. Flow cytometry analysis showed that more than 70% of erythroid progenitor cells [EPCs] were transfected with the chimeraplast. The highest gene conversion efficiency was 7.2 and 11.1% in EPCs and K562 cells respectively. The induced mutation led to a 1.97-fold decrease in beta/gamma-globin gene expression in transfected EPCs at the experimental end point [day 28] whereas, due to the absence of beta-globin gene expression following K562 differentiation, this rate was not evaluable
Conclusion: Our results suggest the effectiveness of chimeraplasty in induction of the mutation of interest in both EPCs and K562 cells. We also demonstrate that the single nucleotide promoter variant was able to significantly inhibit gamma-globin gene silencing during erythroid differentiation