Abstract: Various nanomaterials can be used as a drug delivery
vehicles in nanomedicine, called nanocarriers. They can either be
organic or inorganic, synthetic or natural-based. Although synthetic
nanocarriers are easier to produce, they can often be toxic for the
organism and thus not suitable for use in treatment. From naturalbased
nanocarriers, the most commonly used are protein cages or
viral capsids. In this work, virus bacteriophage λ was used for
delivery of different cytotoxic drugs (cisplatin, carboplatin,
oxaliplatin and doxorubicin). Large quantities of phage λ were
obtained from phage λ-producing strain of E. coli cultivated in
medium with 0.2% maltose. After killing of E. coli with chloroform
and its removal by centrifugation, the phage was concentrated by
ultracentrifugation at 130 000×g and 4°C for 3 h. The encapsulation
of the drugs was performed by infusion method and four different
concentrations of the drugs were encapsulated (200; 100; 50; 25
μg·mL-1). Free drug molecules were removed by filtration. The
encapsulation was verified using the absorbance for doxorubicin and
atomic absorption spectrometry for platinum cytostatics. The amount
of encapsulated drug linearly increased with the increasing
concentration of applied drug with the determination coefficient
R2=0.989 for doxorubicin; R2=0.967 for cisplatin; R2=0.989 for
carboplatin and R2=0.996 for oxaliplatin. The overall encapsulation
efficiency was calculated as 50% for doxorubicin; 8% for cisplatin;
6% for carboplatin and 10% for oxaliplatin.
Abstract: The main cause of Alzheimer disease (AD) was
believed to be mainly due to the accumulation of free radicals owing
to oxidative stress (OS) in brain tissue. The mechanism of the
neurotoxicity of Aluminum chloride (AlCl3) induced AD in
hippocampus Albino wister rat brain tissue, the curative & the
protective effects of Lipidium sativum group (LS) water extract were
assessed after 8 weeks by attenuated total reflection spectroscopy
ATR-IR and histologically by light microscope. ATR-IR results
revealed that the membrane phospholipid undergo free radical
attacks, mediated by AlCl3, primary affects the polyunsaturated fatty
acids indicated by the increased of the olefinic -C=CH sub-band area
around 3012 cm-1 from the curve fitting analysis. The narrowing in
the half band width (HBW) of the sνCH2 sub-band around 2852 cm-1
due to Al intoxication indicates the presence of trans form fatty acids
rather than gauch rotomer. The degradation of hydrocarbon chain to
shorter chain length, increasing in membrane fluidity, disorder, and
decreasing in lipid polarity in AlCl3 group indicated by the detected
changes in certain calculated area ratios compared to the control.
Administration of LS was greatly improved these parameters
compared to the AlCl3 group. Al influences the Aβ aggregation and
plaque formation, which in turn interferes to and disrupts the
membrane structure. The results also showed a marked increase in
the β-parallel and antiparallel structure, that characterize the Aβ
formation in Al-induced AD hippocampal brain tissue, indicated by
the detected increase in both amide I sub-bands around 1674, 1692
cm-1. This drastic increase in Aβ formation was greatly reduced in the
curative and protective groups compared to the AlCl3 group and
approached nearly the control values. These results supported too by
the light microscope. AlCl3 group showed significant marked
degenerative changes in hippocampal neurons. Most cells appeared
small, shrieked and deformed. Interestingly, the administration of LS
in curative and protective groups markedly decreases the amount of
degenerated cells compared to the non-treated group. In addition, the
intensity of congo red stained cells was decreased. Hippocampal
neurons looked more/or less similar to those of control. This study showed a promising therapeutic effect of Lipidium
sativum group (LS) on AD rat model that seriously overcome the
signs of oxidative stress on membrane lipid and restore the protein
Abstract: This paper describes the development of a DNA-based
nanobiosensor to detect the dengue virus in mosquito using
electrically active magnetic (EAM) nanoparticles as concentrator and
electrochemical transducer. The biosensor detection encompasses
two sets of oligonucleotide probes that are specific to the dengue
virus: the detector probe labeled with the EAM nanoparticles and the
biotinylated capture probe. The DNA targets are double hybridized to
the detector and the capture probes and concentrated from
nonspecific DNA fragments by applying a magnetic field.
Subsequently, the DNA sandwiched targets (EAM-detector probe–
DNA target–capture probe-biotin) are captured on streptavidin
modified screen printed carbon electrodes through the biotinylated
capture probes. Detection is achieved electrochemically by measuring
the oxidation–reduction signal of the EAM nanoparticles. Results
indicate that the biosensor is able to detect the redox signal of the
EAM nanoparticles at dengue DNA concentrations as low as 10
Abstract: This study evaluated the acute toxicity and tissue
distribution of intravenously administered gold nanoparticles
(AuNPs) in male rabbits. Rabbits were exposed to single dose of
AuNPs (300 μg/ kg). Toxic effects were assessed via general
behavior, hematological parameters, serum biochemical parameters,
and histopathological examination of various rabbits’ organs.
Inductively coupled plasma–mass spectrometry (ICP-MS) was used
to determine gold concentrations in tissue samples collected at
predetermined time intervals. After one week, AuNPs exerted no
obvious acute toxicity in rabbits. However, inflammatory reactions
were observed in liver, lungs and kidneys accompanied with mild
absolute neutrophilia and significant monocytosis. The highest gold
levels were found in the spleen and liver followed by lungs, and
kidneys. These results indicated that AuNPs could be distributed
extensively to various tissues in the body, but primarily in the spleen
Abstract: Objective: Acute coronary syndrome is a clinical
condition encompassing ST segments elevation myocardial
infraction, Non ST segment is elevation myocardial infraction and un
stable angina is characterized by ruptured coronary plaque, stress and
myocardial injury. Angina pectoris is a pressure like pain in the chest
that is induced by exertion or stress and relived with in the minute
after cessation of effort or using sublingual nitroglycerin. The present
research was undertaken to study the drug utilization pattern of
antiplatelet drugs for the ischemic heart disease in a tertiary care
hospital. Method: The present study is retrospective drug utilization
study and study period is 6months. The data is collected from the
discharge case sheet of general medicine department from medical
department Rajiv Gandhi institute of medical sciences, Kadapa. The
tentative sample size fixed was 250 patients. Out of 250 cases 19
cases was excluded because of unrelated data. Results: A total of 250
prescriptions were collected for the study according to the inclusion
criteria 233 prescriptions were diagnosed with ischemic heart disease
17 prescriptions were excluded due to unrelated information. out of
233 prescriptions 128 are male (54.9%) and 105 patients are were
female (45%). According to the gender distribution, the prevalence of
ischemic heart disease in males are 90 (70.31%) and females are 39
(37.1%). In the same way the prevalence of ischemic heart disease
along with cerebrovascular disease in males are 39 (29.6%) and
females are 66 (62.6%). Conclusion: We found that 94.8% of drug
utilization of antiplatelet drugs was achieved in the Rajiv Gandhi
institute of medical sciences, Kadapa from 2011-2012.
Abstract: Application of nanoscience in biomedical field has come across as a new era. This study involves the synthesis of nano drug carrier with antibiotic loading. Based on the founding that polydopamine (PDA) nanoparticles could be formed via self-polymerization of dopamine at alkaline pH, one-step synthesis of rifampicin coupled polydopamine (PDA-R) nanoparticles was achieved by adding rifampicin into the dopamine solution. The successful yield of PDA nanoparticles with or without the presence of rifampicin during the polymerization process was characterized by scanning electron microscopy, Fourier transform infrared spectroscopy, and Raman spectroscopy. Drug loading was monitored by UV-vis spectroscopy and the loading efficiency of rifampicin was calculated to be 76%. Such highly capacious nano-reservoir was found very stable with little drug leakage at pH 3.
Abstract: Yogurt capsule was made by mixing 14% w/v of
reconstitution of skim milk with 2% FOS. The mixture was
fermented by commercial yogurt starter comprising Lactobacillus
bulgaricus and Streptococcus thermophilus. These yogurts were
made as yogurt powder by freeze-dried. Yogurt powder was put into
capsule then stored for 28 days at 4oc. 8ml of commercial yogurt was
found to be the most suitable inoculum size in yogurt production.
After freeze-dried, the viability of L. bulgaricus and S. thermophilus
reduced from 109 to 107 cfu/g. The precence of sucrose cannot help to
protect cell from ice crystal formation in freeze-dried process, high
(20%) sucrose reduced L. bulgaricus and S. thermophilus growth
during fermentation of yogurt. The addition of FOS had reduced
slowly the viability of both L. bulgaricus and S. thermophilus similar
to control (without FOS) during 28 days of capsule storage. The
viable cell exhibited satisfactory viability level in capsule storage
(6.7x106cfu/g) during 21 days at 4oC.
Abstract: Cytotoxic platinum compounds play a major role in the chemotherapy of a large number of human cancers. However, due to the severe side effects for the patient and other problems associated with their use, there is a need for the development of more efficient drugs and new methods for their selective delivery to the tumours. One way to achieve the latter could be in the use of nanoparticular substrates that can adsorb or chemically bind the drug. In the cell, the drug is supposed to be slowly released, either by physical desorption or by dissolution of the particle framework. Ideally, the cytotoxic properties of the platinum drug unfold only then, in the cancer cell and over a longer period of time due to the gradual release. In this paper, we report on our first steps in this direction. The binding properties of a series of cytotoxic Pt(II) oxadiazoline compounds to mesoporous silica particles has been studied by NMR and UV/vis spectroscopy. High loadings were achieved when the Pt(II) compound was relatively polar, and has been dissolved in a relatively nonpolar solvent before the silica was added. Typically, 6-10 hours were required for complete equilibration, suggesting the adsorption did not only occur to the outer surface but also to the interior of the pores. The untreated and Pt(II) loaded particles were characterised by C, H, N combustion analysis, BET/BJH nitrogen sorption, electron microscopy (REM and TEM) and EDX. With the latter methods we were able to demonstrate the homogenous distribution of the Pt(II) compound on and in the silica particles, and no Pt(II) bulk precipitate had formed. The in vitro cytotoxicity in a human cancer cell line (HeLa) has been determined for one of the new platinum compounds adsorbed to mesoporous silica particles of different size, and compared with the corresponding compound in solution. The IC50 data are similar in all cases, suggesting that the release of the Pt(II) compound was relatively fast and possibly occurred before the particles reached the cells. Overall, the platinum drug is chemically stable on silica and retained its activity upon prolonged storage.
Abstract: Substandard and counterfeit antimalarials is a major problem in malaria endemic areas. The availability of counterfeit/ substandard medicines is not only decreasing the efficacy in patients, but it is also one of the contributing factors for developing antimalarial drug resistance. Owing to this, a pilot study was conducted to survey quality of drugs collected from different malaria endemic areas of India. Artesunate+Sulphadoxine-Pyrimethamine (AS+SP), Artemether-Lumefantrine (AL), Chloroquine (CQ) tablets were randomly picked from public health facilities in selected states of India. The quality of antimalarial drugs from these areas was assessed by using Global Pharma Health Fund Minilab test kit. This includes physical/visual inspection and disintegration test. Thin-layer chromatography (TLC) was carried out for semi-quantitative assessment of active pharmaceutical ingredients. A total of 45 brands, out of which 21 were for CQ, 14 for AL and 10 for AS+SP were tested from Uttar Pradesh (U.P.), Mizoram, Meghalaya and Gujrat states. One out of 45 samples showed variable disintegration and retension factor. The variable disintegration and retention factor which would have been due to substandard quality or other factors including storage. However, HPLC analysis confirms standard active pharmaceutical ingredient, but may be due to humid temperature and moisture in storage may account for the observed result.
Abstract: Niosomes were formulated with an aim of enhancing the oral bioavailability of losartan potassium and formulated in different molar ratios of surfactant, cholesterol and dicetyl phosphate. The formulated niosomes were found in range of 54.98 µm to 107.85 µm in size. Formulations with 1:1 ratio of surfactant and cholesterol have shown maximum entrapment efficiencies. Niosomes with sorbitan monostearate showed maximum drug release and zero order release kinetics, at the end of 24 hours. The in vivo study has shown the significant enhancement in oral bioavailability of losartan potassium in rats, after a dose of 10 mg/kg. The average relative bioavailability in relation with pure drug solution was found 2.56, indicates more than two fold increase in oral bioavailability. A significant increment in MRT reflects the release retarding ability of the vesicles. In conclusion, niosomes could be a promising delivery of losartan potassium with improved oral bioavailability and prolonged release profiles.
Abstract: Quantitative Structure Activity Relationship (QSAR) analysis has been developed to relate antifungal activity of novel substituted 1,3,4-oxadiazole against Candida albicans and Aspergillus niger using computer assisted multiple regression analysis. The study has shown the better relationship between antifungal activities with respect to various descriptors established by multiple regression analysis. The analysis has shown statistically significant correlation with R2 values 0.932 and 0.782 against Candida albicans and Aspergillus niger respectively. These derivatives were further subjected to molecular docking studies to investigate the interactions between the target compounds and amino acid residues present in the active site of glucosamine-6-phosphate synthase. All the synthesized compounds have better docking score as compared to standard fluconazole. Our results could be used for the further design as well as development of optimal and potential antifungal agents.
Abstract: Fluoroquinolones form the mainstay of therapy for the treatment of infections due to Salmonella enterica subsp. enterica. There is a complex interplay between several resistance mechanisms for quinolones and various fluoroquinolones discs, giving varying results, making detection and interpretation of fluoroquinolone resistance difficult. For detection of fluoroquinolone resistance in Salmonella ssp., we compared the use of pefloxacin and nalidixic acid discs as surrogate marker. Using MIC for ciprofloxacin as the gold standard, 43.5% of strains showed MIC as ≥1 μg/ml and were thus resistant to fluoroquinoloes. Based on the performance of nalidixic acid and pefloxacin discs as surrogate marker for ciprofloxacin resistance, both the discs could correctly detect all the resistant phenotypes; however, use of nalidixic acid disc showed false resistance in the majority of the sensitive phenotypes. We have also tested newer antimicrobial agents like cefixime, imipenem, tigecycline and azithromycin against Salmonella spp. Moreover, there was a comeback of susceptibility to older antimicrobials like ampicillin, chloramphenicol, and cotrimoxazole. We can also use cefixime, imipenem, tigecycline and azithromycin in the treatment of multidrug resistant S. typhi due to their high susceptibility.
Abstract: High reflectance of surgical instruments under bright
light hinders the visual clarity during laparoscopic surgical
procedures leading to loss of precision and device control and creates
strain and undesired difficulties to surgeons. Majority of the surgical
instruments are made of surgical grade steel. Instruments with a non
reflective surface can enhance the visual clarity during precision
surgeries. A conversion coating of black oxide has been successfully
developed 410 grade surgical stainless steel .The characteristics of
the developed coating suggests the application of this technique for
developing 410 grade surgical instruments with minimal reflectance.
Abstract: Natural preservatives have been used as alternatives to traditional chemical preservatives; however, a limited number have been commercially developed and many remain to be investigated as sources of safer and effective antimicrobials. In this study, we have been investigating the antimicrobial activity of an extract of Glycyrrhiza glabra (liquorice) that was provided as a waste material from the production of liquorice flavourings for the food industry, and to investigate if this retained the expected antimicrobial activity so it could be used as a natural preservative. Antibacterial activity of liquorice extract was screened for evidence of growth inhibition against eight species of Gram-negative and Gram-positive bacteria, including Listeria monocytogenes, Listeria innocua, Staphylococcus aureus, Enterococcus faecalis and Bacillus subtilis. The Gram-negative bacteria tested include Pseudomonas aeruginosa, Escherichia coli and Salmonella typhimurium but none of these were affected by the extract. In contrast, for all of the Gram-positive bacteria tested, growth was inhibited as monitored using optical density. However parallel studies using viable count indicated that the cells were not killed meaning that the extract was bacteriostatic rather than bacteriocidal. The Minimum Inhibitory Concentration [MIC] and Minimum Bactericidal Concentration [MBC] of the extract was also determined and a concentration of 50 µg ml-1 was found to have a strong bacteriostatic effect on Gram-positive bacteria. Microscopic analysis indicated that there were changes in cell shape suggesting the cell wall was affected. In addition, the use of a reporter strain of Listeria transformed with the bioluminescence genes luxABCDE indicated that cell energy levels were reduced when treated with either 12.5 or 50 µg ml-1 of the extract, with the reduction in light output being proportional to the concentration of the extract used. Together these results suggest that the extract is inhibiting the growth of Gram-positive bacteria only by damaging the cell wall and/or membrane.
Abstract: Tartrazine is an organic azo dyes food additive widely used in foods, drugs, and cosmetics. The present study aimed to investigate the toxic effects of tartrazine on kidneys and liver biomarkers in addition to the investigation of oxidative stress and change of histopathological structure of liver and kidneys in 30 male rats. Tartrazine was orally administrated daily at dose 200 mg/ kg bw (1/ 10 LD50) for sixty days. Serum and tissue samples were collected at the end of the experiment to investigate the underlying mechanism of tartrazine through assessment oxidative stress (Glutathione (GSH), Superoxide dismutase (SOD) and malondialdehyde (MDA) and biochemical markers (alanine aminotransferase (ALT), aspartate aminotransferase (AST), Total protein and Urea). Liver and kidneys tissue were collected and preserved in 10% formalin for histopathological examination. The obtained values were statistically analyzed by one way analysis of variance (ANOVA) followed by multiple comparison test. Biochemical analysis revealed that tartrazine induced significant increase in serum ALT, AST, total protein, urea level compared to control group. Tartrazine showed significant decrease in liver GSH and SOD where their values when compared to control group. Tartrazine induced increase in liver MDA compared to control group. Histopathology of the liver showed diffuse vacuolar degeneration in hepatic parenchyma, the portal area showed sever changes sever in hepatoportal blood vessels and in the bile ducts. The kidneys showed degenerated tubules at the cortex together with mononuclear leucocytes inflammatory cells infiltration. There is perivascular edema with inflammatory cell infiltration surrounding the congested and hyalinized vascular wall of blood vessel. The present study indicates that the subchronic effects of tartrazine have a toxic effect on the liver and kidneys together with induction of oxidative stress by formation of free radicals. Therefore, people should avoid the hazards of consuming tartrazine.
Abstract: Glycosmis pentaphylla is one of the medicinally important plants belonging to the family Rutaceae, commonly known as “Anam or Panal” in Tamil. Traditionally, leaves are useful in fever, hepatopathy, eczema, skin disease, helminthiasis, wounds, and erysipelas. The fruits are sweet and are useful in vitiated conditions of vata, kapha, cough, and bronchitis. The roots are good for facial inflammations, rheumatism, jaundice, and anemia. The preliminary phytochemical investigations indicated the presence of alkaloids, terpenoids, flavonoids, tannins, sugar, glycoside, and phenolic compounds. In the present study, the root part of Glycosmis pentaphylla was used, and the root was collected from Western Ghats of South India. The root was sun/shade dried and pulverized to powder in a mechanical grinder. The powder was successively extracted with various solvents, and the ethyl acetate extract of Glycosmis pentaphylla has been subjected to the GC-MS analysis. Amongst the 46 chemical constituents identified from this plant, three major phytoconstituents were reported for the first time. Marmesin, a furanocumarin compound with the chemical structure 7H-Furo (3,2-G) (1)Benzopyran-7-one,2,3–dihydro–2 - (1-Hydroxy-1methylethyl)-(s) is one of the three compounds identified for the first time at the concentration of 11-60% in ethyl acetate extract of Glycosmis pentaphylla. Others include, Beta.-Fagarine (4.71%) and Paverine (13.08%).
Abstract: Liposomes and pegylated liposomes were widely used as drug delivery system in pharmaceutical field since a long time. However, in the former time, polyethylene glycol (PEG) was connected into phospholipid after the liposomes were already prepared. In this paper, we intend to study the possibility of applying phospholipids which already connected with PEG and then they were used to prepare liposomes. The model drug resveratrol was used because it can be applied against different diseases. Cholesterol was applied to stabilize the membrane of liposomes. The thin film technique in a laboratory scale was a preparation method. The liposomes were then characterized by nanoparticle tracking analysis (NTA), photon correlation spectroscopy (PCS) and light microscopic techniques. The stable liposomes can be produced and the particle sizes after filtration were in nanometers. The 2- and 3-chains-PEG-phospholipid (PL) caused in smaller particle size than the 4-chains-PEG-PL. Liposomes from PL 90G and cholesterol were stable during storage at 8 °C of 56 days because the particle sizes measured by PCS were almost not changed. There was almost no leakage of resveratrol from liposomes PL 90G with cholesterol after diffusion test in dialysis tube for 28 days. All liposomes showed the sustained release during measuring time of 270 min. The maximum release amount of 16-20% was detected with liposomes from 2- and 3-chains-PEG-PL. The other liposomes gave max. release amount of resveratrol only of 10%. The release kinetic can be explained by Korsmeyer-Peppas equation.
Abstract: Superabsorbent polymers (SAPs) or hydrogels with three-dimensional hydrophilic network structure are high-performance water absorbent and retention materials. The in situ synthesis of metal nanoparticles within polymeric network as antibacterial agents for bio-applications is an approach that takes advantage of the existing free-space into networks, which not only acts as a template for nucleation of nanoparticles, but also provides long term stability and reduces their toxicity by delaying their oxidation and release. In this work, SAP/nanosilver nanocomposites were successfully developed by a unique green process at room temperature, which involves in situ formation of silver nanoparticles (AgNPs) within hydrogels as a template. The aim of this study is to investigate whether these AgNPs-loaded hydrogels are potential candidates for antimicrobial applications. Firstly, the superabsorbents were prepared through radical copolymerization via grafting and crosslinking of acrylamide (AAm) onto chitosan backbone (Cs) using potassium persulfate as initiator and N,N’-methylenebisacrylamide as the crosslinker. Then, they were hydrolyzed to achieve superabsorbents with ampholytic properties and uppermost swelling capacity. Lastly, the AgNPs were biosynthesized and entrapped into hydrogels through a simple, eco-friendly and cost-effective method using aqueous silver nitrate as a silver precursor and curcuma longa tuber-powder extracts as both reducing and stabilizing agent. The formed superabsorbents nanocomposites (Cs-g-PAAm)/AgNPs were characterized by X-ray Diffraction (XRD), UV-visible Spectroscopy, Attenuated Total reﬂectance Fourier Transform Infrared Spectroscopy (ATR-FTIR), Inductively Coupled Plasma (ICP), and Thermogravimetric Analysis (TGA). Microscopic surface structure analyzed by Transmission Electron Microscopy (TEM) has showed spherical shapes of AgNPs with size in the range of 3-15 nm. The extent of nanosilver loading was decreased by increasing Cs content into network. The silver-loaded hydrogel was thermally more stable than the unloaded dry hydrogel counterpart. The swelling equilibrium degree (Q) and centrifuge retention capacity (CRC) in deionized water were affected by both contents of Cs and the entrapped AgNPs. The nanosilver-embedded hydrogels exhibited antibacterial activity against Escherichia coli and Staphylococcus aureus bacteria. These comprehensive results suggest that the elaborated AgNPs-loaded nanomaterials could be used to produce valuable wound dressing.
Abstract: Background: Seborrheic dermatitis is a common chronic skin condition affecting the face, scalp, chest, and trunk. The cause of seborrheic dermatitis is still unknown. Sebum production, lipid composition, hormone levels, and Malassezia species have been suggested as important factors in the development of seborrheic dermatitis. Curcuma aeruginosa Roxb. extract-containing cream with anti-inflammatory and anti-androgenic properties may be beneficial for treating mild to moderate facial seborrheic dermatitis. Objectives: We evaluated the efficacy and safety of 2% C. aeruginosa Roxb. extract-containing cream in the treatment of mild to moderate seborrheic dermatitis. Methods: This was a prospective, open-label, and non-comparative study. Ten adult patients clinically diagnosed with mild to moderate seborrheic dermatitis were enrolled in a four-week study. The 2% C. aeruginosa Roxb. cream was applied twice daily to a lesional area on the face for four weeks. The Scoring Index (SI) ranking system on days 14 and 28 was compared with that at baseline to determine the efficacy of treatment. The adverse events (burning sensation and erythema) were evaluated on days 14 and 28 to determine the safety of the treatment. Results: Significant improvement was observed in the reduction of the mean SI at day 14 (2.9) and 28 (1.4) compared to that at baseline (4.9). An adverse reaction was observed on day 14 (mild erythema 20% and mild burning sensation 10%) and was resolved by the end of the study. Conclusion: This open-label pilot study has shown that there was a significant improvement in the severity in these seborrheic patients and most reported they were satisfied with it. Reported adverse events were all mild.
Abstract: The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.