RESUMEN

OBJECTIVES: To identify the availability, types and quantity of anti-tuberculosis drugs in the public and private sectors from 2007 to 2011 in the Philippines. METHODS: Analysis of the procurement of and sales data on anti-tuberculosis drugs from both the public and private sectors from 2007 to 2011. RESULTS: Publicly procured anti-tuberculosis drugs were sufficient to treat all reported new tuberculosis (TB) cases from 2007 to 2011 in the Philippines. Nevertheless, the volume of anti-tuberculosis drugs in the private sector would have sufficed for the intensive phase of treatment for an additional 250 000 TB patients annually, assuming compliance with national treatment guidelines. Fixed-dose combination drugs comprised the main bulk (81%) of private market sales, while sales of loose drugs decreased over the years. Combining public and private sales in 2011, 484 725 new TB patients, i.e., 2.4 times the number of notified cases, could have been placed on treatment and treated for at least the intensive phase. Key second-line drugs are not available in the private market, making it impossible to design an adequate treatment regimen for multidrug-resistant TB (MDR-TB) in the private sector. CONCLUSION: An enormous quantity of anti-tuberculosis drugs was channelled through the private market outside the purview of the Philippine National Tuberculosis Control Program, suggesting significant out-of-pocket expenditure, severe underreporting of TB cases and/or misuse of drugs due to overdiagnosis and overtreatment.

Asunto(s)

Asunto(s)

RESUMEN

The aim of this study was to investigate the effects of known papillotoxins using cultures of human renal interstital medullary cells (hRMIC). The culture of hMIC was based on the primary culture of human renal medullary explants, selective detachment of interstitial cells and selective overgrowth of these cells in a serum-rich medium after dilution cloning. The homogeneous population of cells obtained exhibited the characteristic morphological and functional characteristics of Type I interstitial cells, viz. stellate-shaped cells demonstrating numerous lipid droplets, abundant endoplasmic reticulum and mitochondria, fine filaments underlying the cell membrane and the production of extracellular matrix. Cytotoxicity studies using hMIC and known papillotoxins clearly demonstrated a reduction in cell viability that varied with bath exposure time and type of agent tested. While only phenylbutazone and mefenamic acid produced significant cytotoxicity after a 24 h incubation period, cell viability assessed using the MTT assay was only profoundly reduced by aspirin and paracetamol following sub-chronic exposure for 7 days. The rank order of cytotoxicity observed in hMIC was phenylbutazone > mefenamic acid > aspirin > paracetamol. The results demonstrate the potential of hMIC for investigating and defining the early cellular events in the pathogenesis of analgesic nephropathy.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Many people could define with ease the job of a cardiologist, a paediatrician or an obstetrician. However, only a few would have any clear idea of how a clinical pharmacologist might fill a day. Indeed, within the medical profession, and often within the scientific community, there has been a sneaking suspicion that clinical pharmacologists are themselves unsure of their remit. This article describes the possible role for clinical pharmacologists and different areas where they can make significant contributions to medical services.

Asunto(s)

RESUMEN

OBJECTIVES: To assess the prescribing patterns for the use of antithrombotics in the management of atrial fibrillation. DESIGN: A descriptive cross sectional study. SETTING: Parirenyatwa Hospital, Harare, Zimbabwe. SUBJECTS: The outpatient records of 200 outpatients attending the cardiac clinic (with a documented history of an irregular pulse) between January and August 1999 at Parirenyatwa Hospital, Harare, Zimbabwe were reviewed. MAIN OUTCOME MEASURES: In addition to antithrombotic therapy prescribed at the time of review, patient information (rural or urban), relative contra-indications to antithrombotic therapy, and risk factors for stroke were identified. RESULTS: Patients were similar in terms of age, sex, and risk factors for stroke. At least one stroke risk factor was noted in 79% of urban and 83% of rural patients. Two risk factors were noted in 26% of patients. It was noted that urban patients were more likely to have a relative contra-indication to antithrombotic therapy compared with rural patients (24% vs 10%, p = 0.028) but received antithrombotic therapy more often (38% vs 19%, p = 0.025). CONCLUSIONS: Patients with atrial fibrillation are being inappropriately managed in terms of their major prognostic risk factor. Rural patients with atrial fibrillation receive antithrombotic therapy less frequently than urban patients despite having a similar high risk profile and fewer relative contra-indications.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

The renal medullary interstitial cell (RMIC) is a unique lipid containing cell found mainly in the renal medulla between the tubular and vascular structures (1). These highly specialized fibroblast-like cells are abundant in the inner medulla and papilla (2), and are thought to be responsible for the production of both collagenous and noncollagenous extracellular matrix, secretion of vasoactive prostaglandins, and also for degradation of certain components of extracellular material, such as hyaluronic acid (3). The lipid droplets of these cells contain polyunsaturated fatty acids, which can serve as precursors for prostaglandins and other lipid-derived hormones (4) Ultrastructural studies show that, compared with cortical fibroblasts, the renal medullary interstitial cells are highly differentiated, with abundant rough endoplasmatic reticulum, free ribosomes, and a characteristic mitochondrial profile, suggesting an active secretory function.