Alteplase deemed life saving and cost effective - GUSTO data

1995 ◽  
Vol 29 (1) ◽  
pp. 3-4
Author(s):  
Tracey Langsdale ◽  
Carlene Todd
Keyword(s):  
Cost Effective ◽  
Life Saving

scholarly journals Immunisation financing and programme performance in the Middle East and North Africa, 2010 to 2017

2019 ◽  
Vol 4 (2) ◽  
pp. e001248
Author(s):  
Helen Saxenian ◽  
Nahad Sadr-Azodi ◽  
Miloud Kaddar ◽  
Kamel Senouci
Keyword(s):  
Economic Growth ◽  
Middle East ◽  
North Africa ◽  
Low Income ◽  
Health Sector ◽  
Cost Effective ◽  
Middle Income ◽  
Middle Income Countries ◽  
Life Saving ◽  
Fiscal Space

Immunisation is a cornerstone to primary health care and is an exceptionally good value. The 14 low-income and middle-income countries in the Middle East and North Africa region make up 88% of the region’s population and 92% of its births. Many of these countries have maintained high immunisation coverage even during periods of low or negative economic growth. However, coverage has sharply deteriorated in countries directly impacted by conflict and political unrest. Approximately 1.3 million children were not completely vaccinated in 2017, as measured by third dose of diphtheria–pertussis–tetanus vaccine. Most of the countries have been slow to adopt the newer, more expensive life-saving vaccines mainly because of financial constraints and the socioeconomic context. Apart from the three countries that have had long-standing assistance from Gavi, the Vaccine Alliance, most countries have not benefited appreciably from donor and partner activities in supporting their health sector and in achieving their national and subnational immunisation targets. Looking forward, development partners will have an important role in helping reconstruct health systems in conflict-affected countries. They can also help with generating evidence and strategic advocacy for high-priority and cost-effective services, including immunisation. Governments and ministries of health would ensure important benefits to their populations by investing further in their immunisation programmes. Where possible, the health system can create and expand fiscal space from efficiency gains in harmonising vaccine procurement mechanisms and service integration; broader revenue generation from economic growth; and reallocation of government budgets to health, and from within health, to immunization.

scholarly journals Identification and Characterization of a Small-Molecule Rabies Virus Entry Inhibitor

2020 ◽  
Vol 94 (13) ◽  
Author(s):  
Venice Du Pont ◽  
Christoph Wirblich ◽  
Jeong-Joong Yoon ◽  
Robert M. Cox ◽  
Matthias J. Schnell ◽  
...  
Keyword(s):  
G Protein ◽  
Small Molecule ◽  
High Throughput ◽  
Viral Entry ◽  
Cost Effective ◽  
Molecular Probe ◽  
Entry Inhibitor ◽  
Protein Fusion ◽  
Life Saving

ABSTRACT Rabies virus (RABV) causes a severe and fatal neurological disease, but morbidity is vaccine preventable and treatable prior to the onset of clinical symptoms. However, immunoglobulin (IgG)-based rabies postexposure prophylaxis (PEP) is expensive, restricting access to life-saving treatment, especially for patients in low-income countries where the clinical need is greatest, and does not confer cross-protection against newly emerging phylogroup II lyssaviruses. Toward identifying a cost-effective replacement for the IgG component of rabies PEP, we developed and implemented a high-throughput screening protocol utilizing a single-cycle RABV reporter strain. A large-scale screen and subsequent direct and orthogonal counterscreens identified a first-in-class direct-acting RABV inhibitor, GRP-60367, with a specificity index (SI) of >100,000. Mechanistic characterization through time-of-addition studies, transient cell-to-cell fusion assays, and chimeric vesicular stomatitis virus (VSV) recombinants expressing the RABV glycoprotein (G) demonstrated that GRP-60367 inhibits entry of a subset of RABV strains. Resistance profiling of the chemotype revealed hot spots in conserved hydrophobic positions of the RABV G protein fusion loop that were confirmed in transient cell-to-cell fusion assays. Transfer of RABV G genes with signature resistance mutations into a recombinant VSV backbone resulted in the recovery of replication-competent virions with low susceptibility to the inhibitor. This work outlines a tangible strategy for mechanistic characterization and resistance profiling of RABV drug candidates and identified a novel, well-behaved molecular probe chemotype that specifically targets the RABV G protein and prevents G-mediated viral entry. IMPORTANCE Rabies PEP depends on anti-RABV IgG, which is expensive and in limited supply in geographical areas with the highest disease burden. Replacing the IgG component with a cost-effective and shelf-stable small-molecule antiviral could address this unmet clinical need by expanding access to life-saving medication. This study has established a robust protocol for high-throughput anti-RABV drug screens and identified a chemically well-behaved, first-in-class hit with nanomolar anti-RABV potency that blocks RABV G protein-mediated viral entry. Resistance mapping revealed a druggable site formed by the G protein fusion loops that has not previously emerged as a target for neutralizing antibodies. Discovery of this RABV entry inhibitor establishes a new molecular probe to advance further mechanistic and structural characterization of RABV G that may aid in the design of a next-generation clinical candidate against RABV.

scholarly journals Teaching Helping Babies Breathe via Telehealth: A New Application in Rural Guatemala

2019 ◽  
Vol 4 (3) ◽  
pp. 1-6
Author(s):  
Caitlin Jones-Bamman ◽  
Susan Niermeyer ◽  
Kelly McConnell ◽  
John F. Thomas ◽  
Christina Olson
Keyword(s):  
Nursing Students ◽  
Neonatal Resuscitation ◽  
Cost Effective ◽  
Helping Babies Breathe ◽  
Life Saving ◽  
Percent Improvement ◽  
Hands On ◽  
Post Test ◽  
Course Material ◽  
Passing Scores

Background: Helping Babies Breathe (HBB) is a neonatal resuscitation curriculum that teaches life-saving interventions utilized in the first minutes after birth, reducing morbidity and mortality. Traditionally, it requires in-person facilitators for didactic and hands-on training. Objectives: The aim of this study was to offer HBB to nurses and nursing students in Guatemala, with the lead facilitator presenting concepts via telehealth and in-person facilitators providing hands-on demonstration. Methods: Learners completed pre- and post-tests that included the standard HBB knowledge check, as well as an assessment of the course teaching model. Learners also completed the standard Objective Structured Clinical Evaluations (OSCEs). Results: Eighteen learners were included in the analysis. All but one learner (94%) passed the course, and the average percent improvement from the pre- to post-test was 12%. All learners achieved passing scores on the OSCEs. Learners responded positively to questions regarding the technology, connection with the instructor, and ability to ask questions. Ninety-four percent of the learners agreed with the statement “this lecture was as good via telehealth as in person.” A cost analysis demonstrated approximately USD 3,979.00 in savings using telehealth compared to a standard in-person course. Conclusions: The telehealth model was successful in delivering course material to the learners and was well received. This model represents a cost-effective way to improve access to HBB. This study may not be generalizable to other populations, and the ability to use telehealth requires reliable internet connectivity, which may not be available in all settings. Further study and expansion of this pilot are needed to assess success in other settings.

User-Managed Inventory: An Approach to Forward-Deployment of Urgently Needed Medical Countermeasures for Mass-Casualty and Terrorism Incidents

2012 ◽  
Vol 6 (4) ◽  
pp. 408-414 ◽  
Author(s):  
C. Norman Coleman ◽  
Chad Hrdina ◽  
Rocco Casagrande ◽  
Kenneth D. Cliffer ◽  
Monique K. Mansoura ◽  
...  
Keyword(s):  
Cost Effective ◽  
Distribution Networks ◽  
The United States ◽  
Mass Casualty ◽  
Life Saving ◽  
Medical Facilities ◽  
Response Capacity ◽  
Regional Medical ◽  
Federal Response ◽  
Medical Countermeasures

ABSTRACTThe user-managed inventory (UMI) is an emerging idea for enhancing the current distribution and maintenance system for emergency medical countermeasures (MCMs). It increases current capabilities for the dispensing and distribution of MCMs and enhances local/regional preparedness and resilience. In the UMI, critical MCMs, especially those in routine medical use (“dual utility”) and those that must be administered soon after an incident before outside supplies can arrive, are stored at multiple medical facilities (including medical supply or distribution networks) across the United States. The medical facilities store a sufficient cache to meet part of the surge needs but not so much that the resources expire before they would be used in the normal course of business. In an emergency, these extra supplies can be used locally to treat casualties, including evacuees from incidents in other localities. This system, which is at the interface of local/regional and federal response, provides response capacity before the arrival of supplies from the Strategic National Stockpile (SNS) and thus enhances the local/regional medical responders' ability to provide life-saving MCMs that otherwise would be delayed. The UMI can be more cost-effective than stockpiling by avoiding costs due to drug expiration, disposal of expired stockpiled supplies, and repurchase for replacement.(Disaster Med Public Health Preparedness. 2012;6:408-414)

scholarly journals Selecting Micronutrient Intervention Programs to Save Lives: Evidence From Cameroon

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 693-693
Author(s):  
Stephen Vosti ◽  
Katherine Adams ◽  
Aleksandr Michuda ◽  
Hanqi Luo ◽  
Demewoz Woldegebreal ◽  
...  
Keyword(s):  
Vitamin A ◽  
Wheat Flour ◽  
Edible Oils ◽  
Cost Effective ◽  
Reproductive Age ◽  
Economic Optimization ◽  
Adequate Intake ◽  
Life Saving ◽  
Program Costs ◽  
Gates Foundation

Abstract Objectives We use the Micronutrient Intervention Modeling (MINIMOD) tool to identify and compare economically optimal sets of micronutrient (MN) programs that focus on two objectives: increasing the number of individuals achieving adequate intake of specific life-saving MNs, and saving children's lives using sets of MNs. Methods We used 24-hour dietary intake data from Cameroon to estimate usual intake of zinc and vitamin A for children 1–5 y (n = 872) and of folate for women of reproductive age (WRA) (n = 902), as well as the prevalence of inadequate intake (below the Estimated Average Requirement) for each. We simulated the effects on inadequate MN intake of single or combined fortification of wheat flour, oil, and/or bouillon cubes, as well as two delivery platforms for vitamin A supplementation (VAS). The Lives Saved Tool (LiST) was used to estimate the number of lives saved by each program, and by all combinations of them. We estimated program costs for each scenario, nationally and subnationally, over a 10-year planning time horizon. The economic optimization model was run twice to identify the most cost-effective combination of programs based on two objectives achieving adequate intake for each MN, and increasing lives saved by all MNs. Results When the policy focus is on adequate intake of specific life-saving MNs, the following national and subnational programs are most cost-effective: wheat flour fortified with zinc (95 ppm, at target level), edible oils (9 mg/kg, 75% of target) and bouillon cubes (80 ppm) both fortified with vitamin A, and VAS provided to children in the northern part of Cameroon via Child Health Days. For meeting the folate needs of WRA, wheat flour fortified with folic acid (5 mg/kg, 33% of standard) is the most cost-effective option. When the primary focus is saving lives, a very similar set of economically optimal programs emerges, which saves over 26,000 lives over 10 years. Conclusions Policymakers in Cameroon who promote mortality-reducing MN programs using adequate intake and economic efficiency as their guides can expect to save child lives in a cost-effective way. Funding Sources This work was funded by a grant from the Bill & Melinda Gates Foundation to the UC Davis, and by a gift from Mars Inc. to UC Davis to support interdisciplinary research and training in economics and nutrition.

scholarly journals A thousand words about cardiac mobile health

2014 ◽  
Vol 83 (2) ◽  
pp. 194-199
Author(s):  
Vincent Noori ◽  
Przemysław Guzik
Keyword(s):  
Mobile Health ◽  
Lifestyle Modification ◽  
Cost Effective ◽  
Self Management ◽  
Personal Health ◽  
Innovative Method ◽  
Life Saving ◽  
Effective Manner ◽  
Medical Advances ◽  
Potential Use

Cardiac mHealth (mobile health) is an innovative method of integrating technological and medical advances to provide healthcare in a convenient and cost effective manner in cardiology. While still considered an experimental and upcoming technology, its potential use in cardiology is feasible and may soon replace some standard medical practices. From basic encouragement of lifestyle modification to chronic disease self-management, mHealth can be a personal “pocket-doc”. It can provide personal health benefits and immediate life-saving interventions to those who are unable to access medical care. mHealth’s potential has much to offer to both physicians and patients.

scholarly journals Rational design of a nanoparticle platform for oral prophylactic immunotherapy to prevent immunogenicity of therapeutic proteins

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nhan H. Nguyen ◽  
Fiona Y. Glassman ◽  
Robert K. Dingman ◽  
Gautam N. Shenoy ◽  
Elizabeth A. Wohlfert ◽  
...  
Keyword(s):  
Immune Response ◽  
Rational Design ◽  
Therapeutic Proteins ◽  
Cost Effective ◽  
Therapeutic Protein ◽  
Safety And Efficacy ◽  
Life Saving ◽  
Pre Treatment ◽  
Design And Testing

AbstractThe safety and efficacy of several life-saving therapeutic proteins are compromised due to their immunogenicity. Once a sustained immune response against a protein-based therapy is established, clinical options that are safe and cost-effective become limited. Prevention of immunogenicity of therapeutic proteins prior to their initial use is critical as it is often difficult to reverse an established immune response. Here, we discuss a rational design and testing of a phosphatidylserine-containing nanoparticle platform for novel oral prophylactic reverse vaccination approach, i.e., pre-treatment of a therapeutic protein in the presence of nanoparticles to prevent immunogenicity of protein therapies.

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