Mariana De Santis

Accessibility as a conditioning factor in treatment for exudative age-related macular degeneration

Purpose Ranibizumab and bevacizumab coexist as the main therapeutic strategies for the treatment of neovascular age-related macular degeneration (NV-AMD). In Argentina, the access pathways to the drugs are different. Patients with different pathways and gatekeepers to access may experience different outcomes. The purpose of this work was to estimate the impact on therapeutic effects and visual outcome of the different accessibilities to NV-AMD treatment. Methods A retrospective analysis of the charts of 78 patients with previously untreated exudative AMD, who were treated with ranibizumab or bevacizumab between January 2009 and December 2011, was conducted. The main outcomes measured included time delay and change in mean best-corrected visual acuity (BCVA) between diagnosis and treatment and mean BCVA change at 1-year follow-ups. Results The delay between diagnosis and treatment and decrease in visual acuity over this time was significantly higher for patients treated with ranibizumab. At 1 year after the initiation of treatment, BCVA had a mean increase from baseline of 0.11 letters in the bevacizumab group with a mean of 4.71 injections, compared with a decrease of 8.87 letters with a mean of 2.98 injections in the ranibizumab group. Conclusions Access to treatment can be a key factor for success of therapy. Waiting times and availability of doses are crucial in the treatment of NV-AMD. Solving the problems related to delayed initiation of therapy and the difficulties in the maintenance phase are more important than define whether bevacizumab or ranibizumab is used.

Economic and Social Status, Health and Subjective Well-Being - The Case of Argentina in 1995 and 2006

In this study the probability of being happy and have good health are jointly estimated controlling by the effect of economic, social and demographic characteristics. A bivariate probit model is estimated using data from the World Values Survey for Argentina in 1995 and 2006. The results show that the probability of having good health increases with the socioeconomic status of individuals and the confidence level in institutions (cognitive dimension of individual social capital). In addition, the probability of being happy is positively affected by better socioeconomic status, greater confidence level in institutions, and is greater for married people and men. It also can be concluded that variables associated with financial satisfaction such as number of children and being unemployed present a negative impact on subjective well-being. The results confirm that there is a positive correlation between being happy and being healthy and suggest that it is possible to positively affect the health and well-being of people in social and economic disadvantages encouraging and promoting policies to foster the strengthening of social capital.