RESUMO
BACKGROUND: Strokes are a group of heterogeneous conditions that can cause lasting brain damage, long-term disability, or even death. In Morocco, the management of this disease generates important expenses and increases the financial burden on health care. In order to rationalize the expenses and to direct the budgetary policy in healthcare, we aimed to estimate the cost of ischemic stroke (IS) management in Morocco through this study. METHODS: A cost-of-illness study was conducted between March 2018 and March 2019 at the neurology department of the Hassan II University Hospital, Fez. We included all patients who were admitted, during this period, to the department for IS. The collected data included sociodemographic information, and all details regarding the patient's medical management (diagnosis, treatment, etc.). The cost was estimated using a "bottom-up micro-costing" approach with a societal perspective. RESULTS: A total of 267 individuals were included in this study with a female predominance (56.6%); the mean age was 66.93 ± 14.83 years. The total cost of ischemic stroke management per patient per year was estimated at $3674.32 ± 1340.81, with a high share related to hospitalization at $1415.06 ± 1015.53. A statistically significant association was found between total cost and age (p=0.014), National Institutes of Health Stroke Scale (NIHSS) score (p≤0.001), and length of hospitalization (p≤0.001); however, no association was found with other factors (sex, complication, Rankin score, etc.). CONCLUSION: Ischemic strokes are relatively frequent in Morocco. Their management generates an important cost, which is influenced by several factors such as severity of the disease and the duration of hospitalization. This cost can be decreased by rationalizing the expenses and acting on various risk factors of ischemic strokes.
RESUMO
During the Covid-19 pandemic, healthcare workers were extremely vulnerable to infection with the virus and needed continuous protection. One of the most effective and widely used means of protection was the FFP2 respirator. Unfortunately, this crisis created a shortage of these masks, prompting hospitals to explore opportunities to reuse them after decontamination. An approach for assessing the filtration efficiency of decontaminated FFP2 masks has been proposed and applied to evaluate the possibilities of their safe reuse. The decontamination processes adopted are those based on moist heat or hydrogen peroxide. The approach introduces efficiency measures that define the filtration and protection capacity of the masks, which characterize both chemical and structural changes, and encompasses many techniques including scanning electron microscopy (SEM), Fourier transforms infrared spectroscopy (FTIR), and thermogravimetric analysis (TGA). The test protocol was applied to mask samples that had endured different decontamination cycles and the results of their efficiency measures were compared to brand-new masks performances. The main result was that chemical and structural characterization of the decontaminated masks have shown no substantial change or deformation of their filter media structures. Indeed, the respiratory resistance test has shown that the results of both the FFP2 masks that have undergone a hydrogen peroxide disinfection cycle or a steam autoclave cycle remained constant with a small variation of 10 Pa from the EN149 standard. The chemical characterization, on the other hand, has shown that the filter media of the decontaminated masks remains unchanged, with no detectable chemical derivatives in its constituents.
