Policy dialogue on financing options for rare diseases

A rare disease is a disease that occurs infrequently or rarely in the general population. In order to be considered as rare, each specific disease cannot affect more than a limited number of people out of the whole population, defined in Chile as 0.18 in 10,000 citizens (Minister of Health draft of the law on rare diseases). This figure can also be expressed as 18 patients with rare diseases out of 1 million citizens. While 0.18 out of 10,000 seems very few, in a total population of 17 million citizens this could mean as many as 306 individuals for each rare disease. It is important to underline that the number of patients with rare disease varies considerably from disease to disease, and that most people represented by the statistics in this field suffer from even rarer diseases, affecting only one in 100,000 people or less. Some rare diseases do only affect a couple of dozens patients. These very rare diseases make patients and their families particularly isolated and vulnerable.

[Color-Doppler sonographic mapping for the choice of treatment in variceal disease]. / Il mappaggio eco-color-Doppler nella scelta del trattamento della malattia varicosa.

The Authors, after having reported Huch's classification concerning both large and small saphenas varixes, make a short historical excursus about the most significant operative methods. Then they start explaining how a correct therapeutic approach can't be done without a careful hemodynamic study. After having given data about their case-report, they conclude affirming how today the duplex-scanner permits to obtain an excellent radicality also with not very invasive techniques.

[Regional initiative on health care reform in Latin America and the Caribbean]. / Iniciativa Regional de Reforma del Sector de la Salud en América Latina y el Caribe.

Many countries throughout Latin America and the Caribbean are introducing reforms that can profoundly influence how health services are provided and who receives them. Governments in the region identified the need for a network to support health reform by building capacity in analysis and training, both at the Summit of the Americas in 1994 and at the Special Meeting on Health Sector Reform, which was convened in 1995 by an interagency committee of the Pan American Health Organization/World Health Organization, the Inter-American Development Bank, the World Bank, and other multilateral and bilateral agencies. In response, in 1997 the Pan American Health Organization and the United States Agency for the International Development launched the Latin America and Caribbean Regional Health Sector Reform Initiative. The Initiative has approximately US$ 10 million in funding through the year 2002 to support activities in Bolivia, Brazil, the Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Paraguay, and Peru. Now in its third year of implementation, the Initiative supports regional activities seeking to promote more equitable and effective delivery of basic health services.

[Reflections on mesenteric infarct]. / Riflessioni sull'infarto mesenterico.

The authors relate their statistic about mesenteric infarction in the last five years and they get out the starting point in order to check the characteristics of a disease, which is today distinguished by an infaust prognosis. After few mentions about etiopathology and pathologic anatomy they keep their attention on clinic manifestations of disease and on diagnostic research. After dealing with medical and surgical therapy they declare how more refined diagnostic technique could help early diagnosis and consequently decrease morbidity and morbidity, which are completely unacceptable.