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  Subjects -> BIOLOGY (Total: 3225 journals)
    - BIOCHEMISTRY (246 journals)
    - BIOENGINEERING (119 journals)
    - BIOLOGY (1543 journals)
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    - ZOOLOGY (141 journals)

BIOLOGY (1543 journals)                  1 2 3 4 5 6 7 8 | Last

Showing 1 - 200 of 1720 Journals sorted alphabetically
AAPS Journal     Hybrid Journal   (Followers: 25)
Achievements in the Life Sciences     Open Access   (Followers: 5)
ACS Synthetic Biology     Hybrid Journal   (Followers: 25)
Acta Biologica Colombiana     Open Access   (Followers: 7)
Acta Biologica Hungarica     Full-text available via subscription   (Followers: 4)
Acta Biologica Sibirica     Open Access   (Followers: 2)
Acta Biologica Turcica     Open Access  
Acta Biomaterialia     Hybrid Journal   (Followers: 28)
Acta Biotheoretica     Hybrid Journal   (Followers: 4)
Acta Chiropterologica     Full-text available via subscription   (Followers: 6)
acta ethologica     Hybrid Journal   (Followers: 4)
Acta Fytotechnica et Zootechnica     Open Access   (Followers: 1)
Acta Limnologica Brasiliensia     Open Access   (Followers: 3)
Acta Médica Costarricense     Open Access   (Followers: 2)
Acta Musei Silesiae, Scientiae Naturales     Open Access  
Acta Neurobiologiae Experimentalis     Open Access  
Acta Parasitologica     Hybrid Journal   (Followers: 11)
Acta Scientiarum. Biological Sciences     Open Access   (Followers: 2)
Acta Scientifica Naturalis     Open Access   (Followers: 2)
Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis     Open Access   (Followers: 1)
Actualidades Biológicas     Open Access   (Followers: 1)
Advanced Health Care Technologies     Open Access   (Followers: 4)
Advanced Journal of Graduate Research     Open Access  
Advanced Nonlinear Studies     Hybrid Journal  
Advanced Studies in Biology     Open Access  
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Bioinformatics     Open Access   (Followers: 17)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4)
Advances in Biology     Open Access   (Followers: 10)
Advances in Biosensors and Bioelectronics     Open Access   (Followers: 7)
Advances in Cell Biology/ Medical Journal of Cell Biology     Open Access   (Followers: 27)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 14)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 13)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 7)
Advances in Ecological Research     Full-text available via subscription   (Followers: 44)
Advances in Environmental Sciences - International Journal of the Bioflux Society     Open Access   (Followers: 16)
Advances in Enzyme Research     Open Access   (Followers: 11)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 8)
Advances in Genome Biology     Full-text available via subscription   (Followers: 10)
Advances in High Energy Physics     Open Access   (Followers: 19)
Advances in Human Biology     Open Access   (Followers: 4)
Advances in Life Science and Technology     Open Access   (Followers: 18)
Advances in Life Sciences     Open Access   (Followers: 6)
Advances in Marine Biology     Full-text available via subscription   (Followers: 18)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 23)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3)
Advances in Regenerative Biology     Open Access   (Followers: 1)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 6)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Tropical Biodiversity and Environmental Sciences     Open Access  
Advances in Virus Research     Full-text available via subscription   (Followers: 5)
African Journal of Range & Forage Science     Hybrid Journal   (Followers: 8)
AFRREV STECH : An International Journal of Science and Technology     Open Access   (Followers: 1)
Ageing Research Reviews     Hybrid Journal   (Followers: 11)
Aging Cell     Open Access   (Followers: 24)
Agrokémia és Talajtan     Full-text available via subscription   (Followers: 2)
Agrokreatif Jurnal Ilmiah Pengabdian kepada Masyarakat     Open Access  
AJP Cell Physiology     Hybrid Journal   (Followers: 18)
AJP Endocrinology and Metabolism     Hybrid Journal   (Followers: 24)
AJP Lung Cellular and Molecular Physiology     Hybrid Journal   (Followers: 3)
Al-Kauniyah : Jurnal Biologi     Open Access  
Alasbimn Journal     Open Access   (Followers: 1)
Alces : A Journal Devoted to the Biology and Management of Moose     Open Access  
AMB Express     Open Access   (Followers: 1)
Ambix     Hybrid Journal   (Followers: 3)
American Fern Journal     Full-text available via subscription   (Followers: 1)
American Journal of Agricultural and Biological Sciences     Open Access   (Followers: 8)
American Journal of Bioethics     Hybrid Journal   (Followers: 13)
American Journal of Human Biology     Hybrid Journal   (Followers: 15)
American Journal of Medical and Biological Research     Open Access   (Followers: 8)
American Journal of Plant Sciences     Open Access   (Followers: 19)
American Journal of Primatology     Hybrid Journal   (Followers: 16)
American Malacological Bulletin     Full-text available via subscription   (Followers: 3)
American Naturalist     Full-text available via subscription   (Followers: 76)
Amphibia-Reptilia     Hybrid Journal   (Followers: 6)
Anadol University Journal of Science and Technology B : Theoritical Sciences     Open Access  
Anadolu University Journal of Science and Technology : C Life Sciences and Biotechnology     Open Access  
Anaerobe     Hybrid Journal   (Followers: 4)
Analytical Methods     Full-text available via subscription   (Followers: 12)
Anatomical Science International     Hybrid Journal   (Followers: 3)
Animal Cells and Systems     Hybrid Journal   (Followers: 4)
Animal Models and Experimental Medicine     Open Access  
Annales de Limnologie - International Journal of Limnology     Hybrid Journal   (Followers: 1)
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale     Full-text available via subscription   (Followers: 3)
Annales Henri Poincaré     Hybrid Journal   (Followers: 3)
Annales Universitatis Mariae Curie-Sklodowska, sectio C – Biologia     Open Access   (Followers: 1)
Annals of Applied Biology     Hybrid Journal   (Followers: 7)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 17)
Annals of Human Biology     Hybrid Journal   (Followers: 5)
Annals of Science and Technology     Open Access  
Annual Review of Biomedical Engineering     Full-text available via subscription   (Followers: 13)
Annual Review of Biophysics     Full-text available via subscription   (Followers: 24)
Annual Review of Cancer Biology     Full-text available via subscription   (Followers: 1)
Annual Review of Cell and Developmental Biology     Full-text available via subscription   (Followers: 38)
Annual Review of Food Science and Technology     Full-text available via subscription   (Followers: 15)
Annual Review of Genomics and Human Genetics     Full-text available via subscription   (Followers: 25)
Annual Review of Phytopathology     Full-text available via subscription   (Followers: 12)
Anthropological Review     Open Access   (Followers: 23)
Antibiotics     Open Access   (Followers: 9)
Antioxidants     Open Access   (Followers: 4)
Antioxidants & Redox Signaling     Hybrid Journal   (Followers: 9)
Antonie van Leeuwenhoek     Hybrid Journal   (Followers: 5)
Anzeiger für Schädlingskunde     Hybrid Journal   (Followers: 1)
Apidologie     Hybrid Journal   (Followers: 4)
Apmis     Hybrid Journal   (Followers: 1)
APOPTOSIS     Hybrid Journal   (Followers: 9)
Applied Biology     Open Access  
Applied Bionics and Biomechanics     Open Access   (Followers: 7)
Applied Vegetation Science     Full-text available via subscription   (Followers: 10)
Aquaculture Environment Interactions     Open Access   (Followers: 4)
Aquaculture International     Hybrid Journal   (Followers: 26)
Aquaculture Reports     Open Access   (Followers: 3)
Aquaculture, Aquarium, Conservation & Legislation - International Journal of the Bioflux Society     Open Access   (Followers: 7)
Aquatic Biology     Open Access   (Followers: 6)
Aquatic Ecology     Hybrid Journal   (Followers: 37)
Aquatic Ecosystem Health & Management     Hybrid Journal   (Followers: 15)
Aquatic Science and Technology     Open Access   (Followers: 3)
Aquatic Toxicology     Hybrid Journal   (Followers: 23)
Archaea     Open Access   (Followers: 3)
Archiv für Molluskenkunde: International Journal of Malacology     Full-text available via subscription   (Followers: 3)
Archives of Biological Sciences     Open Access  
Archives of Microbiology     Hybrid Journal   (Followers: 9)
Archives of Natural History     Hybrid Journal   (Followers: 7)
Archives of Oral Biology     Hybrid Journal   (Followers: 3)
Archives of Virology     Hybrid Journal   (Followers: 5)
Archivum Immunologiae et Therapiae Experimentalis     Hybrid Journal   (Followers: 2)
Arid Ecosystems     Hybrid Journal   (Followers: 2)
Arquivos do Instituto Biológico     Open Access   (Followers: 1)
Arquivos do Museu Dinâmico Interdisciplinar     Open Access  
Arthropod Structure & Development     Hybrid Journal   (Followers: 2)
Arthropods     Open Access   (Followers: 1)
Artificial DNA: PNA & XNA     Hybrid Journal   (Followers: 3)
Asian Bioethics Review     Full-text available via subscription   (Followers: 3)
Asian Journal of Biodiversity     Open Access   (Followers: 4)
Asian Journal of Biological Sciences     Open Access   (Followers: 3)
Asian Journal of Cell Biology     Open Access   (Followers: 5)
Asian Journal of Developmental Biology     Open Access   (Followers: 2)
Asian Journal of Medical and Biological Research     Open Access   (Followers: 4)
Asian Journal of Nematology     Open Access   (Followers: 4)
Asian Journal of Poultry Science     Open Access   (Followers: 4)
Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche     Open Access  
Australian Life Scientist     Full-text available via subscription   (Followers: 2)
Australian Mammalogy     Hybrid Journal   (Followers: 7)
Autophagy     Hybrid Journal   (Followers: 4)
Avian Biology Research     Full-text available via subscription   (Followers: 4)
Avian Conservation and Ecology     Open Access   (Followers: 11)
Bacteriology Journal     Open Access   (Followers: 1)
Bacteriophage     Full-text available via subscription   (Followers: 3)
Bangladesh Journal of Bioethics     Open Access  
Bangladesh Journal of Plant Taxonomy     Open Access  
Bangladesh Journal of Scientific Research     Open Access   (Followers: 1)
Batman Üniversitesi Yaşam Bilimleri Dergisi     Open Access  
Berita Biologi     Open Access   (Followers: 1)
Between the Species     Open Access   (Followers: 1)
Bio Tribune Magazine     Hybrid Journal  
BIO Web of Conferences     Open Access  
BIO-Complexity     Open Access  
Bio-Grafía. Escritos sobre la Biología y su enseñanza     Open Access  
Bio-Lectura     Open Access  
Bioanalytical Reviews     Hybrid Journal   (Followers: 2)
Biocatalysis and Biotransformation     Hybrid Journal   (Followers: 6)
BioCentury Innovations     Full-text available via subscription   (Followers: 1)
Biochemistry and Cell Biology     Hybrid Journal   (Followers: 16)
Biochimie     Hybrid Journal   (Followers: 6)
BioControl     Hybrid Journal   (Followers: 6)
Biocontrol Science and Technology     Hybrid Journal   (Followers: 6)
Biodemography and Social Biology     Hybrid Journal  
BioDiscovery     Open Access   (Followers: 2)
Biodiversidade e Conservação Marinha : Revista CEPSUL     Open Access  
Biodiversitas : Journal of Biological Diversity     Open Access  
Biodiversity Data Journal     Open Access   (Followers: 4)
Biodiversity Informatics     Open Access   (Followers: 1)
Biodiversity Information Science and Standards     Open Access   (Followers: 1)
Biodiversity: Research and Conservation     Open Access   (Followers: 27)
Bioedukasi : Jurnal Pendidikan Biologi FKIP UM Metro     Open Access  
Bioeksperimen : Jurnal Penelitian Biologi     Open Access  
Bioelectrochemistry     Hybrid Journal   (Followers: 2)
Bioelectromagnetics     Hybrid Journal   (Followers: 1)
Bioenergy Research     Hybrid Journal   (Followers: 3)
Bioengineering and Bioscience     Open Access   (Followers: 1)
BioEssays     Hybrid Journal   (Followers: 10)
Bioethics     Hybrid Journal   (Followers: 15)
BioéthiqueOnline     Open Access  
Biofabrication     Hybrid Journal   (Followers: 5)
Biofilms     Full-text available via subscription   (Followers: 1)
Biogeosciences (BG)     Open Access   (Followers: 9)
Biogeosciences Discussions (BGD)     Open Access   (Followers: 2)
Bioinformatics     Hybrid Journal   (Followers: 342)
Bioinformatics and Biology Insights     Open Access   (Followers: 11)
Bioinspiration & Biomimetics     Hybrid Journal   (Followers: 7)
Biointerphases     Open Access   (Followers: 1)
Biojournal of Science and Technology     Open Access  
BioLink : Jurnal Biologi Lingkungan, Industri, Kesehatan     Open Access   (Followers: 1)
Biologia     Hybrid Journal  
Biologia on-line : Revista de divulgació de la Facultat de Biologia     Open Access  
Biological Bulletin     Partially Free   (Followers: 6)
Biological Control     Hybrid Journal   (Followers: 5)
Biological Invasions     Hybrid Journal   (Followers: 22)
Biological Journal of the Linnean Society     Hybrid Journal   (Followers: 18)

        1 2 3 4 5 6 7 8 | Last

Similar Journals
Journal Cover
Acta Médica Costarricense
Number of Followers: 2  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0001-6002
Published by SciELO Homepage  [716 journals]
  • El ser humano y su búsqueda de la felicidad

    •  
  • (Immunization in health care workers)

    • Abstract: Resumen Justificación: la inmunoprofilaxis del personal sanitario conlleva múltiples propósitos que engloban tanto la protección de los pacientes como de los funcionarios mismos, y redunda en un claro beneficio para el empleador. En particular, la protección de pacientes inmunocomprometidos y con bajo potencial de desarrollar respuestas vacunales efectivas es de suma importancia. Programas de inmunización sistemática del personal de salud pueden reducir el riesgo de enfermedad, minimizar el impacto de accidentes laborales con materiales infecciosos y mantener la fuerza de trabajo indemne en los centros médicos durante los brotes estacionales de algunas infecciones. Objetivos: concatenar los esquemas de vacunación recomendados actualmente para los funcionarios que laboran en centros de salud y ofrecer una guía adaptada a la realidad epidemiológica nacional. Métodos: se efectuó una revisión no sistemática de bibliografía médica publicada en Internet entre 1990 y 2018, concerniente a vacunación de empleados sanitarios. De igual manera, se compararon los respectivos esquemas de inmunización vigentes en América y Europa. Conclusiones: la trasmisión de enfermedades infecciosas en los centros sanitarios es un problema de salud pública frecuentemente no reconocido, pero sustancial, que pone en riesgo tanto a los usuarios como al personal de estas instituciones. La inmunización de los trabajadores sanitarios es una estrategia fundamental para prevenir y contener la diseminación de agentes infecciosos a nivel hospitalario. Esta medida puede crear “inmunidad de rebaño” para proteger a pacientes y funcionarios que no se hayan vacunado o no puedan generar inmunidad suficiente contra determinados patógenos. Además, la vacunación de los empleados de salud constituye un punto de referencia para motivar las inmunizaciones en los demás segmentos de la población. Background: Immune prophylaxis in health care personnel induces multiple positive effects that include protection for patients, as well as for employees and results with a clear benefit for the employers. Especially in immunological compromised patient groups and individuals who present a diminished potential to develop immunity to vaccination, contagion prevention is of highest importance. Systematic immunization programs can help to lower disease risks, minimize impact of occupational accidents related to handling of contagious materials and maintain the intactness of workforce in medical centers during periods of seasonal infection outbreaks. Objectives: this article resumes the present recommended schemes for vaccination of health care personnel and concludes them in a guideline adapted to the country´s epidemiologic reality. Methods: a non-systematic revision of medical literature related to immunization of health care personnel, published online between 1990 and 2018, was realized. In the same manner, a comparison of active vaccination schemes existing in Europe and the United States of America has been executed. Conclusion: the transmission of infectious diseases in health care installations represents a frequently ignored problem which substantially elevates the infection risk of patients as well as of health care personnel. The vaccination of health care personnel represents the easiest to imply and most effective strategy to inhibit this kind of transmission of infectious diseases. As well, this measure can create a “herd immunity” protecting patients and health care personnel who are not vaccinated or in conditions where they can not develop sufficient immunity against infectious agents. Furthermore, the immunization of the health care workers represents a reference and an example of motivation to other parts of the population.
       
  • (Acute pancreatitis: pathophysiology and initial management)

    • Abstract: Resumen La pancreatitis aguda es un trastorno intracelular del calcio en las células pancreáticas, el cual constituye la vía final común de múltiples estímulos etiopatogénicos y puede desencadenar cambios necroinflamatorios locales, efectos multisistémicos y compromiso en órganos distantes. Todo esto lleva a los pacientes a múltiples complicaciones por disfunción orgánica e infección. El diagnóstico adecuado y oportuno, el abordaje según severidad y la optimización de la terapia nutricional, así como una adecuada analgésica, reanimación hídroelectrolítica, detección de disfunción orgánica y de complicaciones locales e infecciosas, determinan el desenlace clínico de dicha patología. Se realizó una revisión narrativa incluyendo estudios clínicos, guías de manejo, protocolos y revisiones pertinentes, y se aporta un enfoque desde el punto de vista de medicina crítica para el abordaje inicial de esta patología. Acute pancreatitis is an intracellular calcium disorder in pancreatic cells, which constitutes the final common pathway of multiple etiopathogenic stimuli and can trigger local necroinflammatory changes, multisystemic effects and compromise distant organs. All of this leads to multiple complications due to organ dysfunction and infection in patients. The adequate and opportune diagnosis, the approach according to severity and the optimization of the nutritional therapy; as well as an adequate analgesic, hydroelectrolytic resuscitation, the detection of organic dysfunction and of local and infectious complications, determine the clinical outcome of this pathology. A narrative review was carried out including clinical studies, management guidelines, protocols and reviews. An initial approach for this pathology, from the critical medicine point of view, is provided.
       
  • (Measurement of the concordance in the selection of antidepressants
           between costarican psychiatrists that do not apply and apply the
           Psychopharmacological Reasoning Algorithm)

    • Abstract: Resumen Justificación: existe una alta comorbilidad entre las enfermedades médico-quirúrgicas y la depresión. No hay parámetros sistematizados que guíen la selección individualizada del tratamiento farmacológico en estas circunstancias. Objetivo: analizar la concordancia entre los psiquiatras costarricenses que no aplican y sí aplican el algoritmo de razonamiento psicofarmacológico para la elección de los antidepresivos, en 3 casos clínicos de pacientes deprimidos y con una enfermedad médico-quirúrgica. Metodología: se distribuyó de forma aleatoria en dos grupos a los participantes, y se les presentó tres casos clínicos reales y anónimos de personas deprimidas y con una enfermedad médico-quirúrgica. El grupo A eligió el antidepresivo según sus criterios personales, mientras que el grupo B realizó la elección del tratamiento basándose en la implementación del algoritmo de razonamiento psicofarmacológico. Resultados: no hubo concordancia respecto al fármaco entre los 22 psiquiatras del grupo que solo aplicó el criterio clínico (kappa= -0,0154, p= 0,3851), mientras que la concordancia sí fue estadísticamente significativa en el grupo de los 24 psiquiatras que aplicó el algoritmo de razonamiento psicofarmacológico (kappa=0,016, p<0,01). La concordancia entre ambos grupos fue del 25 % en el caso 1, el 16,67% en el caso 2 y el 20,83% en el caso 3. Los psiquiatras que emplearon el algoritmo de razonamiento psicofarmacológico lo consideran útil (87,50%), aplicable (83,33%) y con posible impacto clínico (91,67%). Conclusiones: el algoritmo de razonamiento psicofarmacológico aumentó la concordancia entre los psiquiatras para la selección de los antidepresivos en tres casos clínicos de pacientes deprimidos con enfermedades médico-quirúrgicas, en comparación con el criterio personal. La concordancia entre los grupos A y B fue muy baja. El algoritmo de razonamiento psicofarmacológico es una herramienta considerada útil, aplicable y de posible impacto en la práctica clínica. There is a high comorbidity between medical surgical diseases and depression. There is no current systematic approach to guide how to select an individualized treatment under these circumstances. Objective: to analyze the concordance between psychiatrist that do not use and those who use the Psychopharmacological Reasoning Algorithm to choose the treatment for 3 clinical cases of depression and medical surgical diseases. Methodology: Three case vignettes of anonymous real depressed patients with medical surgical diseases were presents to both groups. Group A made the selection of the antidepressant using their personal criteria; group B made the selection applying the Psychopharmacological Reasoning Algorithm. Results: There was no concordance on the drug among the 22 psychiatrists in the group that only applied the clinical criterion (kappa = -0.0154, p = 0.3851), whereas concordance was statistically significant in the group of 24 psychiatrists who applied the Psychopharmacological Reasoning Algorithm (kappa = 0.016, p <0.01). The concordance between groups A and B was 25% in the case 1, 16.67% in the case 2 and 20.83% in the case 3. The biggest majority of the psychiatrist that used the PPRA considers it useful (87.50%), applicable (83.33%) and with the possibility of impact the clinical practice (91.67%). Conclusion: The Psychopharmacological Reasoning Algorithm increased the concordance in the selection of antidepressants made by Costa Rican psychiatrists in 3 clinical vignettes of depressed patients with a medical surgical disease, when compared to personal criteria. The concordance in the selection of the antidepressants in the 3 cases between both groups is low. The Psychopharmacological Reasoning Algorithm is a tool considered useful, applicable and with a possible impact in clinical practice.
       
  • (Impact of the change of presentation of the trastuzumab for the Social
           Security of Costa Rica, cost minimization study)

    • Abstract: Resumen Objetivo: dado que en este momento está disponible a nivel de la Seguridad Social Costarricense tanto trastuzumab para administración intravenosa como para administración subcutánea, y que la presentación para administración subcutánea ha documentado ser no inferior a la intravenosa, resulta pertinente contar con un estudio de minimización de costes que permita documentar cuál de las formulaciones resulta más conveniente mantener en el sistema público de salud, con base en criterios de eficiencia de la intervención. Métodos: se desarrolló un estudio que evaluó desde la perspectiva financiera de la Seguridad Social de Costa Rica, dos opciones diferentes de aplicación del trastuzumab en pacientes con cáncer de mama. Los procedimientos relacionados fueron identificados y documentados para los dos tipos de aplicación del tratamiento intravenosa y subcutánea. Ambas opciones de tratamiento se basaron en esquemas de diecisiete dosis, con la estimación de los suministros y el tiempo del profesional sanitario para cada posibilidad. El análisis incluyó la evaluación desde la perspectiva del paciente. Resultados: la evaluación económica del procedimiento de administración para ambas alternativas evidenció que la opción subcutánea tenía un costo de aplicación de $ 78,6 y $ 467,34 para la opción intravenosa. Desde la perspectiva financiera, la opción subcutánea constituye la alternativa con un costo menor: $ 4000,00 por tratamiento por paciente, y desde la perspectiva de este, implica un 45,0 % menos de tiempo por sesión de tratamiento por paciente, que en la opción intravenosa. Conclusiones: la formulación de trastuzumab subcutánea evidenció una reducción sustancial de tiempo y costo en comparación con la presentación intravenosa en el sistema de Seguridad Social Costarricense. Objective: Given that at this time is available at the Costa Rican Social security both trastuzumab for intravenous as for subcutaneous administration, and that the presentation for subcutaneous administration has documented to be not inferior to the intravenous. It is relevant to have a study of cost minimization to investigate what formulation is more convenient to maintain in the public health system, based on criteria of efficiency of the intervention. Methods: A study was developed to evaluate, from the financial perspective of the Social Security of Costa Rica, two different options of application of trastuzumab in patients with breast cancer. The related procedures were identified and documented for the two types treatment application. Both treatment options were based on seventeen dose schemes, with the estimate of supplies and the time of the health professional for each possibility. The analysis also included the evaluation from the patient’s perspective. Results: The economic evaluation of the application procedure for both alternatives evidenced that the subcutaneous option had an application cost of $78.6 and $467.34 for the intravenous option. From the financial perspective the subcutaneous option constitutes the alternative with lower cost, with a cost around $4000.0 by treatment per patient, and from the patient perspective implies a 45.0% less time for session than then intravenous option. Conclusions: Trastuzumab subcutaneous formulation evidenced a substantial time and cost reduction in comparison with the intravenous formulation in the Costa Rican Social Security System.
       
  • (Quality indicators in colonoscopy)

    • Abstract: Resumen La colonoscopia se considera como la prueba de elección para el tamizaje del cáncer colorrectal. Su eficacia dependerá de múltiples factores entre los que se incluyen una preparación adecuada, una inspección meticulosa al realizar la exploración, apego a las recomendaciones de seguimiento y una capacitación óptima del colonoscopista. Para asegurar que los endoscopistas a nivel nacional brinden una colonoscopia de calidad, surge la iniciativa de establecer indicadores de calidad locales. A continuación, la Asociación Costarricense de Gastroenterología y Endoscopia Digestiva propone los indicadores de calidad para la realización de colonoscopias seguras y efectivas. Colonoscopy is considered as the gold standard study for colorectal cancer. The efficacy of colonoscopy depends on multiple factors, including a correct bowel preparation, careful inspection tecnique, close following of the screening guidelines and adecuate training of the colonoscopist. The initiative of establishing local quality indicatorsarise from the necessity to arise the quality of the colonospy delivered by Costarican endoscopists. On this document, the Costarican Society of Gastroenterology and Digestive Endoscopy establishes quality indicators for performing safe and effective colonoscopy.
       
  • (Chest pain, electrocardiogram and cardiac enzimes: a practical proposal
           for hospital management)

    • Abstract: Resumen La presentación clínica de la enfermedad arterioesclerótica coronaria abarca un espectro amplio: desde el paciente totalmente asintomático, a pesar de la existencia de lesiones obstructivas de grado variable en el árbol coronario, o bien, el paciente que refiere opresión precordial relacionada de manera exclusiva a esfuerzo físico, hasta el paciente que aqueja dolor precordial opresivo intenso de reposo, y acude a la sala de urgencias. En cada uno de estos contextos, existe una secuencia fisiopatológica distinta, a pesar de su origen común. Se presenta una propuesta práctica para el manejo del paciente con dolor torácico en la sala de urgencias, en diferentes contextos clínicos cuyo origen fisiopatológico es distinto; se comenta la utilidad y forma de interpretación del dosaje de las “enzimas cardiacas”. The clinical presentation of coronary arteriosclerotic disease covers a broad spectrum: from the patient totally asymptomatic, despite the existence of obstructive lesions of variable degree in the coronary tree, or the patient who refers precordial oppression related exclusively to physical activity, even the patient who suffers severe oppressive precordial pain at rest, and goes to the emergency room. In each of these contexts, there is a distinct physiopathological sequence, despite its common origin. A practical proposal for the management of patients with chest pain in the emergency room, in different clinical contexts with a different pathophysiology is presented. The usefulness and interpretation of the dosage of the “cardiac enzymes” is discussed.
       
 
 
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