New carbosilane polymers with interacting ferrocenes as support and bioelectrocatalysts of oxidases to develop versatile and specific amperometric biodevices.

In this work, the bioelectrocatalytical properties and kinetic characteristics of new oxidase amperometric biosensors based on two different ferrocene functionalized carbosilane polymers, polydiallylmethylsilane (PDAMS) and polymethyldiundecenylsilane (PMDUS) are described. In the development of these biodevices, glucose oxidase has been used as example of oxidase enzyme, and two different immobilization procedures have been studied. The polymer-modified electrodes act as efficient transducers for glucose sensing in anodic and cathodic aerobic conditions and also in anodic anaerobic conditions, and this fact turns them into useful devices for a wide field of applications. PMDUS has shown to be the bioelectrocatalyst with best kinetic and analytical properties in aerobic media while PDAMS was better in anaerobic conditions. The best aerobic biosensor developed displayed a strictly linear range from 0 to 3.0 mM, a detection limit of 7.8 µM and a response time less than 2 s in an ascorbate interference free work potential interval. The apparent Michaelis-Menten constant was calculated to be 1.36 mM according to the Lineweaver-Burk equation.

Cost-effectiveness of ambulatory blood pressure monitoring in the follow-up of hypertension.

AIMS: To study the cost of the follow-up of hypertension in primary care (PC) using clinical blood pressure (CBP) and ambulatory blood pressure monitoring (ABPM), and to analyse the cost-effectiveness (CE) of both methods. MAJOR FINDINGS AND PRINCIPAL CONCLUSION: Good control of hypertension was achieved in 8.3% with CBP (95% CI 4.8-11.8) and in 55.6% with ABPM (95% CI 49.3-61.9). The cost of one patient with good control of hypertension is almost four times higher with CBP than with ABPM (Euro 940 vs Euro 238). Reaching the gold standard (ABPM) involved an after-cost of Euro 115 per patient. The results for a 5% discount rate showed a saving of Euro 68,883 if ABPM was performed in all the patients included in the study (n = 241, Euro 285 per patient). An analysis of sensitivity, changing the discount rate and life expectancy indicated that ABPM provides a better CE ratio and a lower global cost. ABPM is more cost-effective than CBP. However, if we include the new treatment cost of poorly monitored patients, it is less cost-effective. Excellent control of hypertension is still an important challenge for all healthcare professionals, especially for those working in PC, where most monitoring of hypertensive patients takes place.