Propuesta de cesación del tabaco para la Atención Primaria de Salud (APS) en Chile, bajo un enfoque costo-beneficio / Smoking cessation proposal for Primary Health Care (PHC) in Chile, under a cost-benefit approach

Objetivo. El propósito de esta investigación fue realizar una evaluación económica costo-beneficio ex ante (evaluación previa) de un programa piloto integral de prevención y tratamiento de cesación tabáquica en los centros de salud familiar (CESFAM) de la Atención Primaria de Salud (APS) de la comuna de Peñalolén, ubicada en el área oriente de Santiago de Chile. Pacientes y método. El estudio corresponde a la evaluación económica del programa piloto integral de prevención y cesación tabáquica, considerando los costos y beneficios que generará el programa, contra la realidad actual de ausencia de programa de cesación tabáquica, incluyéndose a 100 adultos de ambos sexos de 25 a 65 años. Los cálculos se realizaron en un horizonte temporal de 33,77 años con una abstinencia esperada del 30%. Se consideró como costes el uso de espacios en los recintos de salud, gestión del programa, capacitación universal, selectiva e intensiva a los funcionarios de los centros de salud, así como, medicamentos y honorarios profesionales de médicos, psicólogos, kinesiólogos y nutricionistas más utilización de plataforma on-line y aplicaciones en móviles. Resultados. La evaluación social del Programa fue positiva, obteniendo un valor actual neto (VAN) social de 1.113.304 Euros. La sociedad se beneficia con un ahorro de 2.226.873 Euros, siendo el ahorro en gasto de tabaco para los abstinentes, el mayor componente 1.235.978 Euros. Este Programa tiene un beneficio-coste de 14,34, es decir, por cada 1 Euros invertido en el programa se ahorran 4,16 Euros en el sistema de salud y un ahorro personal de 7,96 Euros. Conclusiones. La evaluación económica costo-beneficio del 'Programa de Prevención y Tratamiento Integral de Tabaquismo RespiraLibre' demuestra que este logra liberar recursos en el sistema de salud, en la productividad de las empresas y produce un importante ahorro a quienes dejan de fumar. Sería una ganancia para la comunidad y la red asistencial, al optimizar su uso. Esta investigación aporta evidencia para la realización y posterior expansión de esta estrategia de cesación en la APS en Chile (AU)

Objective. The purpose of the research was to make an ex ante cost-benefit economic evaluation of a comprehensive pilot program of prevention and treatment of smoking cessation in the family health centers (CESFAM) of the Primary Health Care (PHC) of the Peñalolen district, located in the East area of Santiago de Chile. Patients and method. The study corresponds to the economic evaluation of the comprehensive pilot program of smoking prevention and cessation, considering the costs and benefits that the program will generate compared to the current reality of an absence of a smoking cessation program. It includes 100 adults of both genders, aged 25 to 65 years. The calculations were performed in a time frame of 33.77 years with expected abstinence of 30%. Costs were considered as the use of spaces in the health care premises, program management, universal, selective and intensive training of the public employees of the health care centers as well as medications and professional fees of the physicians, psychologists, kinesiologists, and nutritionists used most of the on-line platform and cell phone applications. Results. The social evaluation of the Program was positive, obtaining a social net present value (NPS) of 1,113,304 Euros. The society benefits with a savings of 2,226,873 Euros, the savings being in costs of tobacco for the abstinent, the largest component being 1,235,978 Euros. This program has a cost-benefit of 14.34, that is for every 1 Euros invested in the program, 4.16 Euros was saved in the health care system and a personal savings of 7,96 Euros. Conclusions. The cost-benefit economic evaluation of the 'Comprehensive smoking prevention and Treatment RespiraLibre Program' shows that this is successful in freeing resources in the health care system, in the productivity of companies and produces a significant savings for those who quit smoking. It would be a gain for the community and care network, by optimizing its use. This research provides evidence for the performance and subsequent expansion of this cessation strategy in the PHC in Chile (AU)

Microbial Community Dynamics and Response to Plant Growth-Promoting Microorganisms in the Rhizosphere of Four Common Food Crops Cultivated in Hydroponics.

Plant growth promoting microorganisms (PGPMs) of the plant root zone microbiome have received limited attention in hydroponic cultivation systems. In the framework of a project aimed at the development of a biological life support system for manned missions in space, we investigated the effects of PGPMs on four common food crops (durum and bread wheat, potato and soybean) cultivated in recirculating hydroponic systems for a whole life cycle. Each crop was inoculated with a commercial PGPM mixture and the composition of the microbial communities associated with their root rhizosphere, rhizoplane/endosphere and with the recirculating nutrient solution was characterised through 16S- and ITS-targeted Illumina MiSeq sequencing. PGPM addition was shown to induce changes in the composition of these communities, though these changes varied both between crops and over time. Microbial communities of PGPM-treated plants were shown to be more stable over time. Though additional development is required, this study highlights the potential benefits that PGPMs may confer to plants grown in hydroponic systems, particularly when cultivated in extreme environments such as space.

Influence of the type of management system on corticosterone transfer into eggs in laying hens.

The effect of free-range versus cage management system on corticosterone transfer into the eggs was studied in laying hens. Hungarian Yellow laying hens (age: 21 weeks, body weight: 2.0 +/- 0.5 kg) were divided into two groups in the spring: Group I, free-range keeping (n=15 layers, density: > 0.5 bird/m2) in outdoor runs, with continuous access to a commercial layer feed; Group II, hens kept in battery cages (n=17 layers, density: 2 birds/m2, natural light, continuous access to feed and water). Eggs were collected after a one-week adaptation period on days 2, 7 and 16. Corticosterone (CST) was extracted from homogenised egg samples using an ASE-200 Accelerated Solvent Extractor and then assayed by liquid chromatography linked with tandem mass spectrometry (LC-MS/MS) [Thermo Quest Surveyor high-performance liquid chromatography (HPLC) interfaced via Atmospheric Pressure Chemical Ionisation (APCI) ion source to Finnigan/Thermo Quest LCQ Deca MS/MS] using dexamethasone as internal standard with positive APCI ionisation. CST concentrations of whole eggs laid by free-range hens on days 2, 7 and 16 were 0.370 +/- 0.218, 0.259 +/- 0.066 and 0.915 +/- 0.745 ng x g(-1), respectively, while those of eggs laid by caged hens were 0.206 +/- 0.157, 0.223 +/- 0.165 and 0.184 +/- 0.110 ng x g(-1) at the above sampling times. It is concluded that in free-range laying hens the sharp changes of environmental weather conditions significantly increased the corticosterone content of eggs, while the environmentally controlled and closed battery cage management technology resulted in relatively uniform corticosterone concentrations in the whole eggs.

Radionuclide monitoring strategy for food-chain in Hungary.

Annually about 3000 samples including foodstuff, feeding material, environmental samples, among them bioindicators are examined by the Radiological Monitoring Network of the Ministry of Agriculture and Regional Development. Environmental monitoring strategy and major properties of the network are described. The median value of specific activity of (137)Cs in all kinds of foodstuff produced in Hungary is below 0.1B q/kg fresh weight, based on regular countrywide survey. The committed effective dose due to ingestion for adults was estimated to be 0.6 microSv for (90)Sr and 0.3 microSv for (137)Cs in 2004 according to a conservative estimation. It is shown how (137)Cs contamination due to the accidental release from the steel mill in Algeciras, Spain in 1998 could be detected by a county station of the network making use of the database of the whole network.

Efficient method for (lyso)phospholipid class separation by high-performance liquid chromatography using an evaporative light-scattering detector.

A simple high-performance liquid chromatography method with evaporative light-scattering detection has been devised in order to separate and quantify the major phospholipid and lysophospholipid classes. HPLC analyses were performed with a diol-silica column and ternary gradient elution. Standard curves were drawn up for each of the (lyso)phospholipids involved.

Contribution to the pathobiochemistry of furazolidone-induced oxidative toxicity in chickens.

Furazolidone (F) and its 5-nitrofuran derivatives, occasionally used in veterinary and human medicine, are active against some microorganisms. This drug is considered to be mutagenic in special bacterial test systems. For public health reasons, the presence of F and other 5-nitrofuran residues in edible mammalian and poultry tissues is strictly prohibited. One-month-old experimental chickens (n = 2 x 25) were fed 300 mg.kg-1 furazolidone for 3 days. A separate subgroup (n = 11) was used for monitoring the kinetics of F in the blood plasma. Liver, lung and blood plasma samples taken from the experimental and control chickens after treatment were tested for glutathione-peroxidase (GSH-Px), glutathione reductase (GSH-R), catalase (CAT), superoxide dismutase (SOD) activities, reduced and oxidized glutathione (GSH and GSSG), malondialdehyde (MDA), alpha-tocopherol (vE), selenium (Se) and F concentrations. On post-treatment day 2, SOD activity was significantly lowered in the liver only. GSH-Px did not show any characteristic change in any of the tissues. CAT and GSH-R activities were significantly reduced in both organs until post-treatment day 5. At the same time, a significant decrease of GSH accompanied by an increase in GSSG concentration, was found in both tissues. Oral F treatment produced a transient increase in lipid peroxidation levels measured by the formation of MDA. Alpha-tocopherol content significantly decreased in both organs by post-treatment day 2. Se concentrations showed an insignificant rate of decrease. F concentration in the blood plasma reached its peak already 30 min after treatment. In the liver and lungs, F decreased sharply, reaching the detection limit between days 2-5 after treatment. Furazolidone administered per os was found to alter the in vivo antioxidative enzymatic defense mechanisms. Increased lipid peroxidation and the concomitant oxidative stress may affect the functional integrity of the tissues.

Secondary copper deficiency in cattle caused by molybdenum contamination of fodder: a case history.

In a herd of cattle located in central Hungary, illness and subsequent death of cows was observed. The cause of these losses was molybdenum-induced secondary copper deficiency. The origin of the environmental molybdenum was used motor oil containing molybdenum bisulfide as an additive. This split motor oil polluted the cow's pasture located on the side of a railway bed near the farm. Before the illnesses and deaths, the animals were grazing for at least 2 weeks in the contaminated area. The ill animals were recumbent and unable to rise. There was no response to treatment with 10 g calcium gluconate iv. Cows which died showed no specific lesions on necropsy. The clinical chemistry investigations showed anemia, minimal caeruloplasmin activity in the blood, and high molybdenum concentrations in the rumen contents, liver and kidney. Copper concentrations were low in liver, kidney and blood serum. The seriously ill cows died in spite of 100 mg copper glycinate injections, but the asymptomatic animals remained alive. Molybdenum pollution can cause acute clinical disease and subsequent death by interfering with copper metabolism.

Effect of acute stress on the absorption and distribution of zinc and on Zn-metallothionein production in the liver of the chick.

A study has been made of the effects of chloroform inhalation, Escherichia coli endotoxin injection and hydrocortisone injection on the absorption of a single intragastric dose of 65Zn by the chick. Injection of hydrocortisone increased the absorption of the 65Zn by 30-55% in both Zn-deficient and Zn-supplemented chicks. The influence of chloroform and endotoxin was less consistent; the former treatment only increased 65Zn absorption and endotoxin was less consistent; the former treatment only increased 65Zn absorption in Zn-supplemented chicks fed ad libitum whereas endotoxin only increased that in Zn-supplemented chicks on a restricted food intake. Injection of endotoxin increased the hepatic uptake of the absorbed 65Zn in both Zn-deficient and Zn-supplemented chicks, whereas hydrocortisone had a similar effect in the Zn-supplemented birds only. Chloroform inhalation increased hepatic 65Zn uptake in Zn-deficient chicks only. The increase in hepatic Zn concentrations in the stressed chicks was mainly associated with a protein in the cytosol identified as metallothionein. Both endotoxin and hydrocortisone decreased total plasma Zn concentrations in Zn-supplemented and Zn-deficient chicks; chloroform decreased plasma 65Zn content only.