Unlike the case in Mediterranean countries, where olive oil consumption is driven by habit or tradition, in a population where olive oil consumption rates are considerably low, it appears reasonable to suppose that the initial decision to buy a fairly expensive product—as is the case with olive oil in the Uruguayan market—may result from an individual’s overall interest in health-related issues and/or their acquaintance with relevant nutritional properties of the particular product—in this case, olive oil. Consumer subjective and objective knowledge, interest in health-related issues, and demographic variables were studied for their potential relationship (explanatory capacity) with olive oil consumption frequency, using a sample of 256 inhabitants of Montevideo (Uruguay). Several of the studied variables were found to relate to olive oil consumption, such as subjective and objective knowledge, age, education level, marital status, and interest in health-related issues. Subjective knowledge was found to have the highest explanatory capacity. An increase in subjective knowledge is therefore expected to lead to an increase in consumption frequency among regular olive oil consumers, while it may also encourage less frequent or non-consumers to purchase olive oil and become acquainted with the product.

Introduction: Widespread use of ten-valent (Synflorix TM , GSK) or 13-valent (Prevenar 13 TM ; Pfizer) conjugate vaccination programs has effectively reduced invasive pneumococcal disease (IPD) globally. However, IPD caused by serotypes not contained within the respective vaccines continues to increase, notably serotypes 3, 6A, and 19A in countries using lower-valent vaccines. Our objective was to estimate the clinical and economic benefit of replacing PCV10 with PCV13 in Colombia, Finland, and The Netherlands. Methods: Country-specific databases, supplemented with published and unpublished data, informed the historical incidence of pneumococcal disease as well as direct and indirect medical costs. A decision-analytic forecasting model was applied, and both costs and outcomes were discounted. The observed invasive pneumococcal disease (IPD) trends from each country were used to forecast the future number of IPD cases given a PCV13 or PCV10 program. Results: Over a 5-year time horizon, a switch to a PCV13 program was estimated to reduce overall IPD among 0-2 year olds by an incremental-37.6% in Colombia,-32.9% in Finland, and-26% in The Netherlands, respectively, over PCV10. Adults [ 65 years experienced a comparable incremental decrease in overall IPD in Colombia (-32.2%), Finland (-15%), and The Netherlands (-3.7%). Serotypes 3, 6A, and 19A drove the incremental decrease in disease for PCV13 over PCV10 in both age groups. A PCV13 program was dominant in Colombia and Finland and cost-effective in The Netherlands at 1 9 GDP per capita (€34,054/QALY). Conclusion: In Colombia, Finland, and The Netherlands, countries with diverse epidemiologic and population distributions, switching from a PCV10 to PCV13 program would Enhanced digital features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11778303.

LF. Sarcoidosis y carcinoma fibrolamelar del hígado. AnMed Interna (Madrid) 2007; 24: 431-434. RESUMENSe presenta el caso de una paciente de 20 años de edad con el diagnóstico de sarcoidosis asociada a carcinoma hepático fibrolamelar. Se exponen algunos aspectos clínicos de estas dos enfermedades, así como la conducta diagnóstica y terapéutica seguida. Se resaltan las opiniones de diferentes investigadores sobre la posible relación de la sarcoidosis con las enfermedades neoplásicas, las cuales hasta el momento actual son contradictorias. Se concluye que esta asociación es supremamente rara y debe tenerse en cuenta en el estudio de pacientes jóvenes con sintomatología compatible. INTRODUCCIÓNLa sarcoidosis es una enfermedad de etiología desconocida que se caracteriza por la acumulación en los tejidos afectos de linfocitos CD4+ y monocitos, así como la presencia de granulomas no caseificantes que conducen a la alteración de la arquitectura tisular normal (1). Aunque suele existir anergia cutánea y disminución de los procesos de inmunidad celular en sangre, en los lugares afectados la sarcoidosis se caracteriza por un aumento de la actividad inmunitaria en la que intervienen los linfocitos T colaboradores (TH1) (1). El HLA-DRB1 se señala como un factor de riesgo para esta enfermedad (2).Esta entidad puede afectar cualquier parte del organismo, siendo más frecuente en el pulmón, ganglios, piel, ojos, así como en el hígado y en el bazo. Se ha señalado la asociación de sarcoidosis con enfermedades inmunes (3), neoplasias (4) e infecciones (5).El hepatocarcinoma fibrolamelar (HF) fue primeramente reportado por Edmonson en 1956, es un tipo especial de hepatocarcinoma, dado que la mayoría de los casos ocurren en ausencia de cirrosis del hígado y pueden ser resecables (6); este tumor es muy raro, y lo es más aún en América Latina, donde sólo se han reportado hasta el 2002, 12 casos (7), y en la literatura revisada a nivel mundial, entre 1980 y 1999 se habían informado solamente 165 casos (7).El objetivo de este trabajo es la presentación de una paciente con sarcoidosis asociada a un HF, asociación que no hemos encontrado reportada en la literatura médica después de un profundo rastreo bibliográfico, y que además constituye el primer caso expuesto en nuestro pais. CASO APORTADOPaciente femenina, negra, de 20 años de edad, estudiante, soltera, sin hábitos tóxicos, ni antecedentes patológicos familiares de interés, refiere que desde los 12 años sufría de bronquitis recurrentes, por lo que fue asistida desde la niñez en consulta de alergología, recibiendo tratamiento con antihistamínicos, esteroides inhalados, y vacunas

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5% discount rate was used. The number of expected cases was calculated from the single national register of members of the Colombian health system (BDUA). Additionally a prevalence of 0.52% was used and we assumed that 30% of patients were refractory to initial treatment with non-biologic DMARDs. The costs of drugs were used current price regulation and the official database of purchase and sale of drugs (SISMED). The market share was estimated based on SISMED and the projected demand validated by expert physician. RESULTS: As the use of tofacitinib is increased from 0.9% (current scenario) to 15.3% (projected for three years) total spending is reduced in USD $ 80,345,510 equivalent to 5% of total expenditure of this pathology in Colombia. CONCLUSIONS: The use of tofacitinib in patients who have an inadequate response to methotrexate, decreases total costs of care for the health system in Colombia.

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using the narrative analysis approach. Results: 17 publications met the inclusion criteria (8 randomized controlled trials, 1 case-controlled trial, 6 qualitative and 2 economic evaluation studies of moderate to high quality), which represented 10 studies. Disease activity was the most common measure of effectiveness with NLC being superior (n= 3) or equal (n= 3) to comparator. Acceptability was assessed in 6 studies; patients were more (n= 4) or equally (n= 1) satisfied with NLC compared to single-provider care and less satisfied compared to team care (n= 1). NLC was found to be safe (n= 2), with no difference in blood tests and disease activity. With regard to efficiency, mixed data on cost of NLC was reported with NLC being equivalent or less costly than traditional models (n= 3). Quantitative measures of accessibility and appropriateness were not found. Although in qualitative studies patients found NLC provided improved continuity of care (n= 3) and education and support (n= 4). ConClusions: NLC for RA patients is effective, acceptable, and safe. More information regarding accessibility, appropriateness and efficiency of this model, including its cost-effectiveness and the impact on patient flow, is needed.