Study of the distribution of active caspase-3-positive cells in turbot, Scophthalmus maximus (L.), enteromyxosis.

Enteromyxosis caused by Enteromyxum scophthalmi is one of the parasitizations with a higher economic impact on turbot, Scophthalmus maximus (L.), aquaculture. This myxosporean produces severe catarrhal enteritis with abundant inflammatory infiltrates in the lamina propria-submucosa (LP), epithelial detachment and leucocyte depletion of the lymphohaematopoietic organs. Some advances made on the pathogenesis pointed to a role of apoptosis in the enteromyxosis. Therefore, the main aim of this work was to employ the TUNEL assay and the anti-(active caspase-3) immunohistochemical assay to detect apoptotic cells in both healthy and E. scophthalmi-infected turbot in order to establish the presence and distribution of apoptotic cells during development of the disease. More apoptotic cells located within the gastrointestinal epithelium were observed in the initial stages of the infection in E. scophthalmi-infected turbot compared with non-infected turbot. As the infection progressed, a higher degree of apoptosis occurred in the epithelium of folds heavily parasitized. In the severely infected turbot, apoptosis was also found among the leucocytes of the intestinal inflammatory infiltrates. Moreover, the number of active caspase-3-positive cells in the lymphohaematopoietic organs tended to increase with disease severity. In view of the results, increased apoptosis in the epithelium may favour the scaling that occurs during enteromyxosis and cell death of leucocytes in the intestinal LP, contributing to leucocyte depletion in severe cases.

Evaluación económica de la vacunación rutinaria a niños de 15 meses de edad frente al virus de la varicela-zoster / Economic evaluation of routine vaccination of 15 month old children against chicken-pox-zoster

Fundamento. Se realiza una evaluación económica, coste-efectividad, comparando un programa hipotético de vacunación rutinaria y masiva frente al virus de la varicela-zoster en niños de 15 meses de edad de la Comunidad Foral de Navarra, frente a la actual estrategia de vacunación reducida a población de alto riesgo. Material y métodos. Se utilizan árboles de decisiones para calcular los costes de los cuidados sanitarios de los casos de infección y de los efectos del programa de vacunación apoyado en los modelos de Markov. La eficacia de la vacuna es del 90-95 por ciento y el escenario para la vacunación produce una inmunogenecidad de al menos diez años, con coberturas del 90 por ciento. Se han tenido en cuenta, tanto los costes directos de los cuidados sanitarios como los costes indirectos en pesetas constantes de 1995, debidos a la pérdida productiva a cargo de algún familiar y el punto de vista adoptado para la valoración del estudio ha sido el social. Resultados. El índice coste-efectividad refleja el coste o ahorro adicional por caso evitado de infección que supone vacunar rutinariamente a los niños respecto a vacular sólo a aquellas personas pertenecientes a las poblaciones de alto riesgo. El coste por caso evitado se sitúa entre las 3500 y las 4000 ptas. Por cada peseta invertida en el programa de vacunación se producirá un reembolso de 0'45 ptas. Conclusiones. El programa de vacunación rutinaria provoca un coste incremental. Sólo en el supuesto de reducir el precio de la vacuna en más de un 50 por ciento, podría el índice coste-efectividad ofrecer un beneficio social neto. (AU)

[Economic evaluation of routine vaccination of 15 month old children against chicken-pox-zoster]. / Evaluación económica de la vacunación rutinaria a niños de 15 meses de edad frente al virus de la varicela-zoster.

BACKGROUND: An economic, cost-effectiveness evaluation was carried out that compared a hypothetical program of routine mass vaccination against the chicken-pox-zoster virus in children aged 15 months in the Foral Community of Navarra against the present strategy of vaccination that is restricted to the high risk population. MATERIAL AND METHODS: Decision trees based on Markov models were used to calculate the costs of the health care of cases of infection and the costs of the effects of the vaccination program. The efficacy of the vaccination is 90-95%, and the scenario produces an immunogenicity of at least ten years, with a coverage of 90%. Account was taken of both the direct costs of health care and the indirect costs, with 1995 Pesetas taken as a constant, due to the loss in productivity of a family member, and a social view point was adopted for evaluating the study RESULTS: The index of cost-effectiveness reflects the additional cost or saving for each case of avoided infection brought about by vaccinating the children in comparison with vaccinating only those persons belonging to the high risk population sectors. The cost per avoided case is situated between 3,500 Ptas and 4,000 Ptas. For each Peseta invested in the vaccination program there would be a reimbursement of 0.45 Pesetas. CONCLUSIONS: The routine vaccination program produces an incremental cost. Only in the case of a reduction in the price of the vaccine by more than 50% would the cost-effectiveness index offer a net social profit.