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Background: Polypharmacy or the concomitant use of three or more medications, may increase the complexity of health care and its costs., Aim: To determine the costs of polypharmacy in patients with Type 2 Diabetes Mellitus in a Mexican population sample., Patients and Methods: Analysis of health care costs in 257 patients with Type 2 Diabetes Mellitus from two family care facilities, who had at least five consultations during one year. The cost of professional care by family physicians, pharmacological care and medications were considered to calculate the total expenses. The price of medications and the number of units consumed in one year were used to determine pharmacological expenses. Medications were grouped to determine costs derived from complications and concomitant diseases. Costs were calculated in US dollars (USD)., Results: The mean cost derived from family physician fees was USD 82.32 and from pharmacy fees USD 29.37. The mean cost of medications for diabetes treatment was USD 33.31, for the management of complications USD 13.9 and for management of concomitant diseases USD 23.7, rendering a total cost of USD 70.92. Thus, the total annual care cost of a diabetic patient was USD 182.61., Conclusions: Medications represent less than 50% of total expenses of diabetic patients with polypharmacy.

Background: Social representations are value systems. Social stereotypes are a social consensus of traits associated with a specific group. Stereotypes about older subjects, generally have negative connotations., Aim: To assess the prevalence of negative stereotypes towards older subjects among health care personnel., Material and Methods: A questionnaire about stereotypes towards old age, with Likert type questions that included health, social motivations and personality-character domains, was applied to 52 doctors, 12 residents, 80 general nurses, 36 auxiliary nurses, four social workers and 10 medical assistants, working at a general hospital., Results: The mean age of the professionals who answered the questionnaire was 38 years (95% confidence intervals (CI) 37-39 years) and 78% were women. The prevalence of a Global negative stereotype was 65.0%(95% CI: 59.5-70.5). The figure for the health domain was 64.5% (IC95%; 59.0-70.0), for the social motivation domain was 60%(5%CI: 54.3-65.7) and for the character personality domain was 64% (95%CI: 58.4-69.6)., Conclusions: There is a high prevalence of a negative stereotype towards old age among health care personnel.

The expression of exoprotein synthesis of Staphylococcus aureus Sae mutant RC121 and its parental strain was studied under in vivo growth conditions. Cultures of both strains were inoculated into dialysis sacs implanted in sheep peritoneum. Results indicated that similar to in vitro grown mutant cells, Sae mutant RC121 shows diminished synthesis of alpha- and beta-hemolysin, coagulase, DNase and protein A. However, in vitro and in vivo grown mutant cultures showed different exoprotein profiles in SDS-PAGE; some bands from in vivo mutant cultures were diminished or missing and others appeared as more concentrated, when compared with the pattern of the in vivo grown parental strain, while all the exoprotein bands from the in vitro cultures of the mutant were diminished or missing as compared to the in vitro grown parental strain. The virulence of the Sae mutant, assayed by intraperitoneal injection in mice, was lower than that of the parental strain after both in vivo and in vitro growth conditions.

A pleiotropic transpositional mutant derived from Staphylococcus aureus strain RC46, from bovine origin, was isolated and characterized. This mutant showed decreased production of several exoproteins such as alpha- and beta-hemolysins, DNase, coagulase and extracellular protein A. The production of cell-bound protein A, proteases and delta-hemolysin was not affected. The pleiotrophy of this mutant, designated sae (for S. aureus exoprotein expression), is due to a single insertion of transposon Tn917, as indicated by Southern blot hybridization. The sae mutant showed decreased virulence since its LD50 determined by intraperitoneal injection in mice was 32 times higher than that of the parental strain RC46.

An insertional mutant was isolated from a bovine Staphylococcus aureus strain after membrane-mating with a Streptococcus faecalis strain carrying conjugative plasmid pCF10::Tn925. This mutant, designated RC128, showed enhanced production of alpha-hemolysin and proteases and decreased production of coagulase, extracellular protein A, DNase, lipase and delta-hemolysin. No difference was found in the production of beta-hemolysin. Both, Southern blot analysis and transfer of the pleiotropic mutant phenotype by transduction, indicated that the mutation was originated from a single insertion of transposon Tn925. The LD50 determined by intraperitoneal administration in mice showed that mutant RC128 was slightly less virulent than its parental strain.