scholarly journals Drug Response Diversity: A Hidden Bacterium?

2021 ◽  
Vol 11 (5) ◽  
pp. 345
Author(s):  
Nadji Hannachi ◽  
Laurence Camoin-Jau
Keyword(s):  
Drug Response ◽  
Public Health Problem ◽  
Response To Treatment ◽  
Research Teams ◽  
Response Diversity ◽  
Drug Molecules ◽  
New Information ◽  
Genetic Level ◽  
Set Up ◽  
The Cost

Interindividual heterogeneity in response to treatment is a real public health problem. It is a factor that can be responsible not only for ineffectiveness or fatal toxicity but also for hospitalization due to iatrogenic effects, thus increasing the cost of patient care. Several research teams have been interested in what may be at the origin of these phenomena, particularly at the genetic level and the basal activity of organs dedicated to the inactivation and elimination of drug molecules. Today, a new branch is being set up, explaining the enigmatic part that could not be explained before. Pharmacomicrobiomics attempts to investigate the interactions between bacteria, especially those in the gut, and drug response. In this review, we provide a state of the art on what this field has brought as new information and discuss the challenges that lie ahead to see the real application in clinical practice.

Rares Diseases and Handicap: State of the Medical, Social and Health Policy in Developing Countries. Cameroon case: about One Case: Cushing Disease

2019 ◽  
Author(s):  
Carolle Laure Kpoumie
Keyword(s):  
Developing Countries ◽  
Health System ◽  
Public Health Problem ◽  
Industrialized Countries ◽  
Cushing Disease ◽  
Poor Countries ◽  
The Social ◽  
Set Up ◽  
The Cost

Rare’s diseases and orphan’s diseases, disability (orhandicap) are a reality throughout the world and a real public health problem in developing countries. The great precariousness in which the populations live increases their impact and their gravity by the absence of information, technical platform, means of detection, actual presence of research and clinical studies on these territories, lack of awareness of the detection, diagnosis, without forgetting that the means of care and prevention are sometimes in existent or little known and especially expensive in countries where the populations are poor, without mutual or social security as in industrialized countries .This work will focus on a patient case presenting a rare disease: Cushing's disease. A case that occurred in Cameroon in order to establish in a practical way this major and yet ignored, neglected issue in a health system with poor specialized structures, technical platforms, and without the support of the pharmaceutical laboratories that could with the health system of these poor countries set up a system of refueling in the sense of the social view the cost that requires the monitoring of these long pathologies that make autonomous living almost impossible, also life-threatening.In Cameroon, there have been difficulties in the care and monitoring of this young patient since childhood through the phase of the pubertal transition, adolescence, to adulthood. It is therefore important to organize the follow-up of these patients, by developing specific programs of medical follow-up, psychological care, and social integration programs. Health policies should invest in better support.

Personalized Medicine: Boon or Budget-Buster?

2009 ◽  
Vol 43 (5) ◽  
pp. 958-962 ◽  
Author(s):  
Charles E Dean
Keyword(s):  
Drug Response ◽  
Genetic Factors ◽  
Current Approach ◽  
Molecular Medicine ◽  
Genetic Profile ◽  
Epigenetic Variation ◽  
Noncoding Regions ◽  
New Information ◽  
Current Economic Crisis ◽  
The Cost

While the development of personalized or molecular medicine is a laudable goal, there remain multiple barriers to its implementation. For example, little is known about the functions of noncoding regions of DNA, as well as the interplay of drug response, environmental factors, and the patient's genetic profile. In addition, there is a constant influx of new information on genetic factors such as epigenetic variation that could further complicate the development of medications based on the genetic profile, as well as the cost of profiling. However, assuming that clinically relevant genetic factors will be discovered and that drugs can be developed based on the molecular changes induced by those genetic factors, I suggest that the costs involved may substantially exceed the savings brought about by abandoning our current “one drug fits all” approach. While there is no doubt that our current approach is inefficient and expensive, remarkably little attention has been paid to the potential costs of molecular medicine. Given the current economic crisis, the time is ripe for a debate on this issue.

scholarly journals Multiple Sclerosis Biomarker Discoveries by Proteomics and Metabolomics Approaches

2021 ◽  
Vol 16 ◽  
pp. 117727192110133
Author(s):  
Ameneh Jafari ◽  
Amirhesam Babajani ◽  
Mostafa Rezaei-Tavirani
Keyword(s):  
Multiple Sclerosis ◽  
Complex Disease ◽  
Biomarker Discovery ◽  
Response To Treatment ◽  
Inflammatory Disorder ◽  
Protein Marker ◽  
Complex Disorders ◽  
New Information ◽  
The Central Nervous System ◽  
Monitoring Treatment

Multiple sclerosis (MS) is an autoimmune inflammatory disorder of the central nervous system (CNS) resulting in demyelination and axonal loss in the brain and spinal cord. The precise pathogenesis and etiology of this complex disease are still a mystery. Despite many studies that have been aimed to identify biomarkers, no protein marker has yet been approved for MS. There is urgently needed for biomarkers, which could clarify pathology, monitor disease progression, response to treatment, and prognosis in MS. Proteomics and metabolomics analysis are powerful tools to identify putative and novel candidate biomarkers. Different human compartments analysis using proteomics, metabolomics, and bioinformatics approaches has generated new information for further clarification of MS pathology, elucidating the mechanisms of the disease, finding new targets, and monitoring treatment response. Overall, omics approaches can develop different therapeutic and diagnostic aspects of complex disorders such as multiple sclerosis, from biomarker discovery to personalized medicine.

scholarly journals A Systematic Review and Meta-Analysis of Pharmacogenetic Studies in Patients with Chronic Kidney Disease

2021 ◽  
Vol 22 (9) ◽  
pp. 4480
Author(s):  
Maria Tziastoudi ◽  
Georgios Pissas ◽  
Georgios Raptis ◽  
Christos Cholevas ◽  
Theodoros Eleftheriadis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Response To Treatment ◽  
Genotype Distribution ◽  
Global Public Health ◽  
High Prevalence ◽  
Additive Inheritance

Chronic kidney disease (CKD) is an important global public health problem due to its high prevalence and morbidity. Although the treatment of nephrology patients has changed considerably, ineffectiveness and side effects of medications represent a major issue. In an effort to elucidate the contribution of genetic variants located in several genes in the response to treatment of patients with CKD, we performed a systematic review and meta-analysis of all available pharmacogenetics studies. The association between genotype distribution and response to medication was examined using the dominant, recessive, and additive inheritance models. Subgroup analysis based on ethnicity was also performed. In total, 29 studies were included in the meta-analysis, which examined the association of 11 genes (16 polymorphisms) with the response to treatment regarding CKD. Among the 29 studies, 18 studies included patients with renal transplantation, 8 involved patients with nephrotic syndrome, and 3 studies included patients with lupus nephritis. The present meta-analysis provides strong evidence for the contribution of variants harbored in the ABCB1, IL-10, ITPA, MIF, and TNF genes that creates some genetic predisposition that reduces effectiveness or is associated with adverse events of medications used in CKD.

The Mitigation of the French Nuclear Option: New Industrial Realism and Technical Democracy

2002 ◽  
Vol 13 (2) ◽  
pp. 263-279 ◽  
Author(s):  
Dominique Finon
Keyword(s):  
Waste Management ◽  
Electricity Markets ◽  
Social Preferences ◽  
Public Inquiry ◽  
The Future ◽  
Parliamentary Committee ◽  
Set Up ◽  
The Stability ◽  
The Cost ◽  
Phase Out

Nuclear phase-out policies and the European obligation to liberalise electricity markets could put the French nuclear option dramatically at risk by influencing social preferences or by constraining power producers' investment choices in the future. So far, the particular institutional set-up which has allowed the efficient build-up and operation of several series of standardised reactors preserves the stability of the main elements of the option. However, important adaptations to the evolving industrial and political environment occur and contribute to changing the option. Some institutional changes (such as local public inquiry, creation of a Parliamentary committee, independence of safety authorities) and divergence between industrial interests already allow debates on internal options such as reprocessing, type of waste management deposits, ordering of an advanced PWR. These changes improve the cost transparency, even if internalisation of nuclear externalities (cost of insurance, provisions for waste management) is still incomplete. However, when effective, this internalisation would not affect definitively the competitive position of the nuclear production because of the parallel internalisation of CO2 externalities from fossil fuel power generation in the official rationale. Consequently the real issue for the future of the nuclear option in France remains the preservation of social acceptability in the perception of nuclear risks.

Design for Variety: A Methodology for Understanding the Costs of Product Proliferation

1996 ◽  
Author(s):  
Mark V. Martin ◽  
Kosuke Ishii
Keyword(s):  
Indirect Costs ◽  
Product Line ◽  
Decision Makers ◽  
Profit Margins ◽  
Design For Variety ◽  
Set Up ◽  
Market Coverage ◽  
Product Proliferation ◽  
The Cost

Abstract This paper further develops the previously introduced concept of Design for Variety (DFV). Our study seeks a tool that enables product managers to estimate the cost of introducing variety into their product line. This will help them to maximize market coverage while maintaining required profit margins. Variety incurs many indirect costs that are not always well understood or are difficult to capture. These costs are often not considered by people making the decision about introducing variety. Our DFV model attempts to capture these indirect costs through the measurement of three indices: commonality, differentiation point, and set-up cost. These indices will allow the decision makers to estimate some of the generally unmeasurable costs of providing variety. We conclude this paper by discussing our validation plans for testing the model in industry.

scholarly journals Underwater Power Kites

2017 ◽  
Vol 139 (06) ◽  
pp. 38-43
Author(s):  
David J. Olinger
Keyword(s):  
Low Cost ◽  
Power Grid ◽  
Offshore Wind ◽  
Turbine Generator ◽  
Research Teams ◽  
Offshore Wind Turbines ◽  
Hydrokinetic Turbines ◽  
Available Technology ◽  
Economic Analyses ◽  
The Cost

This article discusses different features of underwater kites and its advantages in the turbine industry. The underwater kite moves fastest when it slaloms through the current in this way, much like a water skier. Electricity generated by the mounted turbine generator is transmitted along the tether to a moored, floating buoy, and then onto the power grid. This concept, now known as the Tethered Undersea Kite (TUSK), was first conceived by Magnus Landberg, a researcher in Sweden, in 2007. Underwater kites look to be feasible to build using commercial available technology. According to economic analyses conducted by other research teams, TUSK systems may be able to produce electricity at about half the current cost for fixed hydrokinetic turbines, and a bit below the cost of the power produced by offshore wind turbines. Those researchers attribute the lower costs to improved power-to-weight ratios derived from replacing the inner blades and support tower of a traditional turbine with a lightweight, low-cost tether.

OP116 Cost-Effectiveness Of Sacubitril/Valsartan In Heart Failure

2017 ◽  
Vol 33 (S1) ◽  
pp. 52-53
Author(s):  
Liang Lin ◽  
Mohamed Ismail Abdul Aziz ◽  
David Bin-Chia Wu ◽  
Kwong Ng
Keyword(s):  
Heart Failure ◽  
Cost Effectiveness ◽  
Public Health Problem ◽  
Cardiovascular Death ◽  
Sensitivity Analyses ◽  
Major Public Health Problem ◽  
Old Patients ◽  
Asian Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
The Cost

INTRODUCTION:Heart failure (HF) is a major public health problem worldwide and in Asia. Sacubitril/valsartan reduces cardiovascular death and hospitalizations for HF. However, decision makers need to determine whether its benefits are worth the additional costs, given the low-cost generic status of current standard of care.METHODS:Using a Markov model, we projected lifetime clinical and economic outcomes of sacubitril/valsartan versus enalapril for 66-year-old patients with HF in Singapore. Key health states included New York Heart Association (NYHA) classes; patients in each state incurred a monthly risk of hospitalization for HF and cardiovascular death. Probabilities of events were based on the PARADIGM-HF trial. The uncertain treatment effect of sacubtril/valsartan in Asian patients was modelled using a hazard ratio (HR) of 1 as upper limit in sensitivity analyses. Utilities were obtained from published literature. Local national epidemiological and cost data were applied. Analyses were conducted from the Singapore healthcare payer's perspective. Both one-way and Probabilistic Sensitivity Analyses (PSA) based on 10,000 Monte Carlo simulations were performed.RESULTS:Compared to enalapril, sacubitril/valsartan was associated with an incremental cost-effectiveness ratio (ICER) of SGD74k (USD52k) per quality-adjusted life year (QALY) gained. The cost-effectiveness of sacubitril/valsartan was highly dependent on its effectiveness in reducing the risk of cardiovascular death. However, this was uncertain, particularly in the Asian subgroup, where results were not statistically significant. In sensitivity analyses using results from Asian patients, the ICERs ranged from SGD41k (USD30k) to SGD1.3 million (USD 0.94 million) per QALY gained. PSA showed the probability of sacubitril/valsartan being cost-effective was below 1 percent, 12 percent and 71 percent at thresholds of SGD20k (USD14k), SGD50k (USD36k) and SGD100k (USD 72k) per QALY gained, respectively.CONCLUSIONS:Given the uncertain ICER, sacubtril/valsartan may not provide good value for money compared to enalapril in reducing cardiovascular morbidity and mortality in patients with HF at the current daily cost. Our study highlights the cost-benefit trade-off that healthcare professionals and patients face when considering HF therapy.

Balqis restaurant: how to move on?

2017 ◽  
Vol 7 (3) ◽  
pp. 1-19
Author(s):  
Farzana Quoquab ◽  
Shazwani Binti Ahmad ◽  
Wan Nurul Syazwani Binti Wan Danial ◽  
Jihad Mohammad
Keyword(s):  
Subject Area ◽  
Marketing Mix ◽  
Business Success ◽  
Strategic Decisions ◽  
Gradual Improvement ◽  
Content Type ◽  
To Come ◽  
Set Up ◽  
The Right ◽  
The Cost

Subject area This case can be used in marketing management as well as consumer behaviour courses. Study level/applicability This case is suitable to use in advanced undergraduate levels, MBA and MSc in marketing courses that cover topics related to market segmentation and marketing mix strategies. Case overview This case highlights the dilemma of an entrepreneur and a manager of a restaurant who were to take a decision about the sustainability of their restaurant business. Balqis Restaurant was owned by Danny who was a retiree from Telekom Malaysia. He wanted to open a restaurant business after he came back from his long holiday trip. He conducted market research to find a suitable place to open his Arabic restaurant. He assigned Waleed Masood Abdullah as the manager of Balqis Restaurant. Finally, in June 2010, he opened his long awaited restaurant at Gombak, Kuala Lumpur. The restaurant was known as Qasar before the name was changed to Balqis in 2015 because of copyright issues related to Saba’ restaurant at Cyberjaya. The restaurant was well managed under Danny’s supervision for 4 years and successfully won customers’ hearts and loyalty before he decided to give full responsibility to Waleed in March 2014. Danny trusted Waleed because he taught and trained him. However, under Waleed’s management, Balqis started to lose its customers. Waleed also started to branch out the restaurant to different places in different states; one in Ipoh, and the other in Perak. He invested much money on renovation for all three branches, but one of the restaurants closed down in September 2014. This is because of the fact that they could no longer bear the cost of operations for the restaurant. However, he failed to learn from the mistake; they set up another restaurant, which was in Kuantan, in the same month. The sales were not that encouraging but it did show gradual improvement; yet, they once again sold it to another Arab businessman. Waleed realized his failure in managing the restaurant business in August 2015. He again opted to open another new branch which was questioned by Danny. He was in a rush to open it by the end of December 2015 to ensure that the additional profits from the current restaurants could cover the variables costs if the new restaurants were launched. Based on that, the owner had to make a decision about whether a new branch should be opened or whether they should just retain their restaurant in Gombak. Expected learning outcomes The learning objectives of using this case are as follows. 1. Knowledge enhancement: to help students in understanding the problems faced by a restaurant in expanding its market; to make students aware that a properly blended marketing mix is the key to business success and to broaden students’ views and understanding in targeting the proper market segment in formulating an effective marketing strategy. 2. Skills building: to be able to identify the best marketing strategic decisions to manage the restaurant business for its survival and to develop students’ ability to analyse the existing situation to come up with a viable and effective solution. 3. Attitudinal: to help the students to have intellectual openness in accepting different ways of finding solutions for a particular problem and to assist students in making the right move at the right time. Supplementary materials Teaching Notes are available for educators only. Please contact your library to gain login details or email [email protected] to request teaching notes. Subject code CSS 8: Marketing.

Severity and costs associated with hospitalization for dengue in public and private hospitals of Surat city, Gujarat, India, 2017–2018

2019 ◽  
Vol 113 (11) ◽  
pp. 661-669 ◽  
Author(s):  
Viral R Bajwala ◽  
Denny John ◽  
T Daniel Rajasekar ◽  
Manoj V Murhekar
Keyword(s):  
Urban Areas ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Warning Signs ◽  
World Health ◽  
Severe Dengue ◽  
Major Public Health Problem ◽  
Private Hospitals ◽  
Government Hospitals ◽  
The Cost

Abstract Background Dengue is major public health problem in India, especially in urban areas. We conducted a study to estimate the severity and costs of treatment among hospitalized dengue patients in Surat city, Gujarat, India. Methods We reviewed the medical records of dengue patients hospitalized in five tertiary care facilities (private [n=2], semi-government [n=2] and government [n=1]) between April 2017 and March 2018. We used the World Health Organization 2009 classification to classify the severity of dengue. A resource utilization approach was used to estimate the cost of illness in US dollars (US$) (inflation adjusted to 2018) from a quasi-societal perspective (excluding non-medical cost) for dengue hospitalization. Results Of the 732 hospitalized dengue patients, 44.7% had no warning symptoms, 39.5% had warning signs and 15.8% had severe dengue. The mean cost of hospitalization was US$86.9±170.7. The cost of hospitalization was 28.8 times higher in private hospitals compared with government hospitals. Consultant charges in private hospitals, laboratory investigations in semi-government hospitals and registration with admission charges in government hospitals accounted for 27.3%, 39.4% and 53% of the direct cost in these facilities, respectively. Conclusions A better triage system for hospitalization, subsidizing costs in the public sector and cost capping in the private sector can help to reduce the cost of hospitalization due to dengue so as to ensure affordability for larger portion of the society for universal health coverage.

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