Consuelo Moreno-Bonett

Cost-effectiveness study of oral hypoglycemic agents in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City

Introduction Worldwide, diabetes mellitus presents a high burden for individuals and society. In Latin America, many people with diabetes have limited access to health care, which means that indirect costs may exceed direct health care cost. Diabetes is Mexico’s leading cause of death. Purpose To evaluate the cost-effectiveness ratios of the most used oral hypoglycemic agents (OHA) in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City. Design A cross-sectional and analytic study was conducted in Mexico City. Methodology Twenty-seven adult outpatients with type 2 diabetes who were treated either with metformin or glibenclamide were included. Acarbose was used as an alternative strategy. The study was carried out from the perspective of Mexican society. Direct medical and nonmedical costs as well as indirect costs were evaluated using a structured questionnaire. Efficacies of all drug treatments were evaluated retrospectively. A systematic search was conducted to select published randomized clinical trials based on predetermined inclusion criteria, and treatment success was defined as glycosylated hemoglobin factor ≤ 7%. Efficacy data of each drug and/or combination were analyzed using meta-analysis. The Monte Carlo Markov model was used. Quality-adjusted life-years (QALY) were used as the unit of effectiveness; incremental and sensitive analyses were performed and a 5% discount rate was calculated. A hypothetical cohort of 10,000 patients was modeled. Results The odds ratios of the success of each drug treatment were obtained from the meta-analyses, and were the following: 5.82 (glibenclamide), 3.86 (metformin), 3.5 (acarbose), and 6.76 (metformin–glibenclamide). The cost-effectiveness ratios found were US

Evaluation of Completeness of Suspected Adverse Drug Reaction Reports Submitted to the Mexican National Pharmacovigilance Centre

272.63/QALY (glibenclamide), US

Propuesta de guía para instrumentar estancias estudiantiles en el sector laboral

296.48/QALY (metformin), and US

Macronutrient Composition of Giant Water Bug (Lethocerus sp.) Edible Insect in Mexico and Thailand

409.86/QALY (acarbose). Sensitivity analysis did not show changes for the most cost-effective therapy when the effectiveness probabilities or treatment costs were modified. Conclusion Glibenclamide is the most cost-effective treatment for the present study outpatient population diagnosed with type 2 diabetes in the early stages.

Determinación de metales pesados en el agua de un canal de Xochimilco (México, D.F.) como proyecto de Servicio Social

AbstractBackground: The Mexican National Centre of Pharmacovigilance (CNFV) receives suspected adverse drug reaction (ADR) reports from the pharmaceutical industry, Federal States Centre of Pharmacovigilance (CEFV) and Healthcare Institution Centres of Pharmacovigilance (CIFV). The completeness of these suspected ADR reports is particularly important for the proper evaluation of drug safety. Objective: The aim of the study was to evaluate the completeness of the information reported in a representative sample of suspected ADR reports submitted to the CNFV during 2007 and 2008, to evaluate the completeness of the suspected ADR reports submitted to the CNFV from different sources during these 2 years and to identify the therapeutic subgroups with the highest number of suspected ADR reports during the study years. Methods: A cross-sectional period-prevalence study was conducted at the CNFV. Only reports of suspected ADRs submitted by the CEFV, pharmaceutical industry and CIFV during 2007 and 2008 were included in the present study (reports related to vaccines were excluded). The sample sizes to be used for each year were determined using the formula for population rate at 95% significance level. The samples for each year were randomly selected from the reports related to synthetic drugs submitted that year. The suspected ADR reports were classified according to the standing Mexican Official Norm (Norma Oficial Mexicana [NOM]) guidelines, which were used to divide the reports into four categories (0, 1, 2 and 3) based on their completeness. The seriousness of the suspected ADRs reported was also evaluated; a suspected ADR was classified as ‘non-serious’ when signs and symptoms are likely to be tolerated, ‘moderate’ when ADR is not life threatening and needs pharmacological treatment, ‘erious’ when ADR is life threatening and leads to hospitalization and ‘fatal’ when ADR contributes directly or indirectly to the patient’s death. Results: A total sample size of 370 and 371suspected ADR reports from 2007 and 2008, respectively, were examined. Our analysis revealed that the pharmaceutical industry sent the highest number of suspected ADR reports for both years (58% and 63%, respectively). Results of the information completeness analysis by using the NOM categories showed that, in both study years, among the total suspected ADR reports about 32% (119) and 40% (148), respectively, were categorized as grade 0 (information insufficient to generate risk signals). Analyses of the seriousness of all suspected ADR reports revealed that 2% of reports were classified as fatal each year, whereas 6% and 5% were classified as serious and 25% and 29% were classified as moderate in 2007 and 2008, respectively. The therapeutic subgroups, according to the Anatomical Therapeutic Chemical classification, with the highest frequencies of suspected ADR reports in both study years were sex hormones and modulators of the genital system, antibacterial for systemic use, antiepileptics and psychoanaleptics, and antihypertensives. Conclusions: The completeness of the information provided in the suspected ADR reports submitted during the sample study years was incomplete and, in general, did not fulfil the requirements established by the NOM guidelines. Among the pharmaceutical industry, CEFV and CIFV, the suspected ADR reports were mainly provided by the pharmaceutical industry. It is necessary to improve the pharmacovigilance system in Mexico to achieve a high level of completeness of suspected ADR reports that totally fulfil the standing regulations.

Evaluation of completeness of suspected adverse drug reaction reports submitted to the mexican national pharmacovigilance centre: a cross-sectional period-prevalence study.

Las instituciones de educacion superior (IES) forman al estudiante en los aspectos tecnico y cientifico para enfrentarse a la realidad de su practica profesional al concluir su carrera. Sin embargo, ya que no puede reproducirse en su totalidad la estructura, organizacion y operacion de una empresa en las instalaciones de la universidad, se deben generar programas que vinculen al alumno con el sector laboral. Ademas un programa de esta naturaleza permite a las instituciones educativas involucrarse en un proceso de actualizacion constante de planes y programas de estudios de acuerdo con las necesidades del mercado ocupacional. En este trabajo se presenta una propuesta de guia de procedimientos para la instrumentacion de estancias estudiantiles en el sector productivo y de servicios. Se describen las etapas del programa y se hacen recomendaciones para la implementacion del mismo. Sin duda que esta guia debe ser modificada y adaptada a cada universidad y su entorno.

Las enfermedades "olvidadas" de América Latina y el Caribe: un problema de salud pública global

The health benefits of nutrients provided by edible insects are not properly studied, even though insect intake in Latin American and Asia is a cultural tradition since ancient times. Insects from the giant water bug (Belostomidae family) are consumed both in Mexico and Thailand, and are known as “Cucarachon de agua” (Lethocerus americanus) and “Mangda” (Lethocerus indicus), respectively. Raw samples of these insects were collected on 2014 at Xochimilco channels from Mexico and from Warorot night market in Chiang Mai, Thailand to further analyze nutrient composition of samples according to official methods of analysis (AOAC) techniques. The nutrient compositions were as following: proteins 60.12% and 53.11%; lipids 5.72% and 8.15%; minerals 5.46% and 6.75%; fiber 10.95 % and 12.23%; soluble carbohydrates 17.75% and 19.74%, for insects obtained from Mexico and Thailand, respectively. Giant water bug shows differences in nutrient composition. It may be the consequence of differences in the environment where they acquire the nutrients necessary for growth and reproduction. However, giant water bugs are available all year around and are a good source of proteins that could help people to obtain a cheaper source of this important macronutrient.

Estudio descriptivo de la participación de estudiantes y egresados en el Programa de Práctica Académica Integral a la licenciatura de QFB de la UAM-X, 2000, 2006, 2013

En este trabajo se presenta un proyecto de Servicio Social que permite que los alumnos se relacionen e interesen con la problematica de la contaminacion ambiental, en particular la del agua. Se eligio como zona de estudio un canal del lago de Xochimilco, Mexico D.F. Se hace la determinacion de algunos metales pesados (Mn, Cd, Cu y Pb) por Espectrofotometria de Absorcion Atomica. Con este proyecto se logra que los alumnos participantes se interesen por problemas reales de la comunidad y apliquen tecnicas de analisis aprendidas durante la licenciatura, reforzando asi sus conocimientos. Este proyecto de Servicio Social intenta sensibilizar sobre la importancia de la contaminacion del agua y abre la posibilidad de continuar con el estudio para comparar resultados en diferentes periodos.