Suchergebnisse

<i>Objective:</i> Gaucher disease (GD) is a genetic disease caused by glucocerebrosidase deficiency. GD is treated by enzyme replacement therapy (ERT) with imiglucerase, a high-cost drug provided by the Brazilian Ministry of Health (BMH). This study reports the implementation of the BMH guidelines for GD in the southernmost state of the country. <i>Methods:</i> We review the clinical and laboratorial data for patients seen at the reference center for GD from Rio Grande do Sul, Brazil (July 2003 to June 2006). <i>Results:</i> Twenty-five patients were included in this study. At baseline, 19/20 were on ERT (mean dosage of imiglucerase = 51.8 U/kg/infusion), 3/17 presented anemia, and 5/16 thrombocytopenia. The amount of imiglucerase prescribed to these patients was adjusted according to the guidelines in July 2003; out of them, 18 were receiving ERT in the reference center at month 36 (mean dosage of imiglucerase = 27.5 U/kg/infusion), 2/18 presented anemia, and 4/18 presented thrombocytopenia. The analysis of the liver, spleen, and bone data presented some limitations, but the available information suggests that patients did not deteriorate. GD patients who initiated ERT after July 2003 (n = 5) received lower dosage of imiglucerase since the beginning of the treatment; most of them demonstrated clinical and laboratorial response. From baseline to month 36, the consumption of imiglucerase by the reference center showed a significant reduction, which represented savings of USD 3 million to the public health system. <i>Conclusions:</i> The model of care of GD patients suggested by the BMH guidelines appears to be cost-effective and could be an example for management of rare diseases in underdeveloped countries.

In the european political field, the challenge consists in organizing a political debate on the scale of the Union whereas the citizens of this one do not speak the same language, ignore the Community institutions, live in different institutional systems and, during nearly 50 years, lived Wall on both sides, in opposite ideological universes. Television can help to take up this challenge in condition of being put in perspective in its right place: neither obsolete and diabolic object manipulating the masses, nor democratic fairy bringing the rational light to the individuals

In the european political field, the challenge consists in organizing a political debate on the scale of the Union whereas the citizens of this one do not speak the same language, ignore the Community institutions, live in different institutional systems and, during nearly 50 years, lived Wall on both sides, in opposite ideological universes. Television can help to take up this challenge in condition of being put in perspective in its right place: neither obsolete and diabolic object manipulating the masses, nor democratic fairy bringing the rational light to the individuals

In the european political field, the challenge consists in organizing a political debate on the scale of the Union whereas the citizens of this one do not speak the same language, ignore the Community institutions, live in different institutional systems and, during nearly 50 years, lived Wall on both sides, in opposite ideological universes. Television can help to take up this challenge in condition of being put in perspective in its right place: neither obsolete and diabolic object manipulating the masses, nor democratic fairy bringing the rational light to the individuals

In the european political field, the challenge consists in organizing a political debate on the scale of the Union whereas the citizens of this one do not speak the same language, ignore the Community institutions, live in different institutional systems and, during nearly 50 years, lived Wall on both sides, in opposite ideological universes. Television can help to take up this challenge in condition of being put in perspective in its right place: neither obsolete and diabolic object manipulating the masses, nor democratic fairy bringing the rational light to the individuals

In the european political field, the challenge consists in organizing a political debate on the scale of the Union whereas the citizens of this one do not speak the same language, ignore the Community institutions, live in different institutional systems and, during nearly 50 years, lived Wall on both sides, in opposite ideological universes. Television can help to take up this challenge in condition of being put in perspective in its right place: neither obsolete and diabolic object manipulating the masses, nor democratic fairy bringing the rational light to the individuals

In the european political field, the challenge consists in organizing a political debate on the scale of the Union whereas the citizens of this one do not speak the same language, ignore the Community institutions, live in different institutional systems and, during nearly 50 years, lived Wall on both sides, in opposite ideological universes. Television can help to take up this challenge in condition of being put in perspective in its right place: neither obsolete and diabolic object manipulating the masses, nor democratic fairy bringing the rational light to the individuals

The SARS-CoV-2 global pandemic will disproportionately impact countries with weak economies and vulnerable populations including people with dementia. Latin American and Caribbean countries (LACs) are burdened with unstable economic development, fragile health systems, massive economic disparities, and a high prevalence of dementia. Here, we underscore the selective impact of SARS-CoV- 2 on dementia among LACs, the specific strain on health systems devoted to dementia, and the subsequent effect of increasing inequalities among those with dementia in the region. Implementation of best practices for mitigation and containment faces particularly steep challenges in LACs. Based upon our consideration of these issues, we urgently call for a coordinated action plan, including the development of inexpensive mass testing and multilevel regional coordination for dementia care and related actions. Brain health diplomacy should lead to a shared and escalated response across the region, coordinating leadership and triangulation between governments and international multilateral networks.