bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic and social burden of cystic fibrosis in Poland. Estimates based on patients - reported data
Authors: Bator Magdalena , Ameljańczyk Tomasz
Published: July 2023

Cystic fibrosis (CF) is a genetic disease inherited as an autosomal recessive disorder. With an incidence of 1:2500 to 1:3000 in white race population it can be regarded as the most common rare disease. Taking into account clinical characteristics of patients, CF may place a substantial burden on a population both from social and economic point of view. The aim of the study was to estimate the cost of CF treatment in Poland with a special emphasis on outpatient treatment. Selected medical and social aspects were also investigated. Survey study was conducted on the sample of 100 children and adolescents patients. Indirect costs linked to lost productivity and a cost of care could be 4 fold higher then direct costs. Medication and diet costs are main components of direct costs. Life satisfaction is deteriorated in the vast majority of studied CF patients.
Opinion of patients on analgesics drugs used in the process of self-medication
Authors: Drozd Mariola , Olejniczak-Rabinek Magdalena
Published: July 2023

The surveyed group was divided by age, education, place of purchase of the medicine, place of residence. The study surveyed the understanding of a medicine leaflet. 97% of respondents buy analgesics from a pharmacy, 9 % in a hypermarket and 5% in a grocery store, 4% at a petrol station. Education defines the comprehension of a leaflet. 79% with the tertiary education people understand the leaflet and 38% with the primary education people understand the leaflet. Overall men do not read medicine leaflets and most frequently misuse medicines. The education, sex and place of residence have an important influence on the purchase and the way of medicine administration by patients in Poland.
Health technology assessment in reimbursement policy of the Slovak Republic
Authors: Tesar Tomas
Published: July 2023

Evidence suggests that availability of medicines on the Slovak market is both comprehensive and prompt. The low co-payment rate of reimbursed products results in easy access to highly priced patented products. There is always at least one treatment available in determined therapeutic classes with no co-payment. Evidence suggests that Slovak pharmaceutical expenditures do not result in the most cost effective outcomes. The use of HTA in the decision-making process is vague.
The impact of the modification of the composition and the quantity of extemporaneous preparation on its price value
Authors: Kuriata Elżbieta
Published: July 2023

Background: The aim of this study is the analysis and estimation of the impact of the modification of the composition of extemporaneous preparation dispensed by the community pharmacy on their price value. The modification of ointment base, dosage form, active ingredient and excipient concentration, prescribing two separate preparations instead of double quantity of extemporaneous preparation, prices of the ingredients and packaging have been evaluated. Material and method: 1407 prescriptions have been prescribed by 330 doctors providing their practice in 212 medical institutions. On the basis of these prescriptions five community pharmacies situated in Olsztyn, Elblag, Paslek and Ilawa in Warmian-Masurian Voivodeship made 1407 extemporaneous preparations in 2011. The information contained in prescriptions has become a foundation for creating a database using MS Excel tool. Statistical analysis and arithmetic mean have been applied. Results: The average price value of the extemporaneous preparations in the test material amounts to PLN 34.05. The price value of 90% of the extemporaneous preparations is within PLN 15.89 – PLN 50.00 . The price value of 10% is above PLN 50.00 including 1% over PLN 100.00. The modification of the ointment base has triggered, on average, a 38% increase of the price value, the modification of dosage form - 37%, prescribing two separate preparations instead of double quantity of the extemporaneous preparation - 32%, modification of active ingredient concentration - 23%, modification of excipient concentration - 14%. The purchase prices of ingredients and packaging have not been uniform.
Do we need real world data? Polish ISPOR Chapter Therapeutic Programs, Pharmaceutical Care and Pharmaceutical Law Section (TPPCPL) initial discussion
Authors: Szkultecka-Dębek Monika
Published: July 2023

Objective: to discuss potential areas for use and sources of real world data in relation to medical treatment. Methods: we performed Pub-Med and an internet based search in literature for definitions, sources and examples of real world data use. Results: we identified 13 publications fitting our search criteria and we found that there are not many full publications related to real world data even if they can provide significant additional information regarding patient related outcomes, resources use, costs and the effect of therapies in a non-controlled environment and on broader populations than those from randomized clinical trials. Conclusion: Real world data can provide additional information in relation to medical treatments however there is a need to focus attention on methodology of data collection, data quality, potential sources of data and ensure proper legal environment for data collection. Unfortunately, despite large number of publications identified in PubMed database, there are only few available in a form of full text papers, the majority of publications are only abstracts from scientific conferences. In the future in order to share RWD experience it will be of benefit to encourage authors to work on full publications and not to limit their work only to abstracts.
The overview of Agency for Health Technology Assessment recommendations in 2012, and their impact on reimbursement decisions
Authors: Prząda-Machno Patrycja
Published: July 2023

An introduction of the Reimbursement Act in Poland, which took effect on 1st January 2012, was one of the most important reforms implemented in the Polish healthcare system over the past few years, affecting significantly the pharmaceutical market and its stakeholders. Objective: The aim of this study was to analyse the market access of new, innovative therapies for the Polish patients, after the Reimbursement Act being in force for over one year. Methods: The analysis was based on the Overview of the Minister of Health Orders, published on the Polish Agency for Health Technology Assessment (AHTAPol) website. The AHTAPol President and Council for Transparency’s recommendations were divided into the positive and negative ones, and they were further divided into their corresponding reimbursement categories: the register of reimbursed medicines, drug programs and the chemotherapy catalogue. The issued recommendations were than compared with the final reimbursement decisions made by the Minister of Health. Results: In the analysed period AHTAPol issued 46 positive / positive subject to conditions recommendations of which: 31 (69%) concerned the medicines available in drug programs, 10 (22%) concerned the medicines available on prescription in pharmacy, and 4 (9%) concerned the products available in chemotherapy catalogue. Most medicines that had been positively recommended were reimbursed from public funds and made available for the Polish patients. Conclusions: Most positively recommended by AHTAPol technologies received positive reimbursement decisions. Receiving a negative recommendation did not imply the negative reimbursement decision.
Ebola viral hemorrhagic fever
Authors: Płusa Tadeusz
Published: July 2023

Pathogens causing transmissible viral hemorrhagic fevers are therefore classified internationally at the most dangerous hazard level. Most of them may be transmitted through the respiratory tract into human being. For this reason aerosol dissemination of viral pathogens may be considered as biological weapon. The clinical presentation of Ebola virus-infected patients is difficult to distinguish from other infections in the first steps of disease. A rash develops in 25–52% of patients in the first week and hemorrhagic manifestations are noted in some patients after a few days of illness. Tetherin/BST-2 has been identified as an effective cellular factor that prevents Ebola virus hemorrhagic fever as similarly the newly introduced Zmapp. Two proposals vaccines - cAd3-EboV (cAd3) produced by GlaxoSmithKline, and the US National Institute of Allergy and Infectious Diseases and rVSVΔG-EboV-GP (rVSV) produced by NewLink Genetics and Public Health Agency of Canada – were discussed in the last period as effective in prevention of Ebola virus hemorrhagic fever.
Can We Determine the Optimal Cycle Length for Which Half-Cycle Correction Should Always Be Applied?
Authors: Drzał Robert , Parker Mark , Plisko Robert , Władysiuk Magdalena
Published: July 2023

Objective: The aim of the study is to measure the influence of cycle length and progression rates on differences between final results obtained using different approaches concerning time of transition to another state in Markov models (at the beginning, at the end of the cycle or half-cycle correction – HCC) and to estimate an optimal cycle length for which HCC should always be applied. Methods: A hypothetical, two-state Markov model was built. Assuming different progression rates, four methods concerning time of transition were compared. For each rate, the threshold values were determined, i.e. the maximal cycle length for which the difference between HCC/ ‘life-table’ (LT) method and ’beginning’/‘end’ methods were not greater than 5%. Cycles longer than the estimated threshold are assumed to imply the application of HCC/LT. Results: Under few assumptions, the threshold cycle length for annual progression of 0.05 was 1 year or 2 years, for 5% and 0% discount rate, respectively. The threshold cycle lengths became shorter for lower progression rates (2 weeks for 0.90 rate). The results obtained for single intervention cannot be easily repeated for incremental outcomes; however, some general relationships can be determined. Conclusions: Choice of the time of transitions in the model may have a significant impact on the findings of economic evaluations. For cycles shorter than 2 weeks, HCC/LT does not appear necessary. However, it should be applied for cycles longer than 1 year. We were unable to make a recommendation for cycles between 2 weeks and 1 year.
Pharmacoeconomic evaluation of fixed-dose triple combination for antihypertensive therapy in Ukraine
Authors: Adonkina Viktoriya , Mishchenko Oksana
Published: July 2023

In Ukraine, the efficacy of treatment of arterial hypertension is only 19% in urban areas and 8 % in rural populations. The most important reasons of low efficiency of antihypertensive therapy (AHT) are a wrong choice of tactics of the patient management and low adherence of patients to treatment. The latter decreases with increasing amounts of prescribed drugs. One possible way to increase patients’ compliance to treatment and the effectiveness of therapy is to use fixed-dose combinations (FDCs) of antihypertensive drugs (AHDs). The share of FDCs consumption (in terms of DDDs/1000/day) in Ukraine in the total structure of AHDs consumption is 25%, which is significantly less than the proportion of patients (60%), requiring combined AHDs. This is an indirect evidence of low compliance of Ukrainian patients to HD treatment and the need of pharmacoeconomic study of benefits of antihypertensive therapy using FDCs. As a result of pharmacoeconomic cost-effectiveness analysis it has been found that antihypertensive therapy in patients with moderate and severe AH using triple FDC Val+Aml+HCTZ compared with three dual FDC: Val+HCTZ, Val+Aml, Aml+HCTZ provides greater clinical efficacy (the number of patients with the achieved target level of blood pressure). This triple FDC Val+Aml+HCTZ has pharmacoeconomic benefits (greater cost efficiency), compared with only one dual FDC Val+HCTZ. This gives the opportunity to save money, presents additional advantages in efficiency and justifies benefits from its use by hypertensive patients in need of appointing the third AHD CCB amlodipine in addition to the existing dual one using valsartan and hydrochlorothiazide.
Mammography screening in the OECD and its impact on health and health system related indicators
Authors: Wilde Sandra , Zoellner York
Published: July 2023

Background: Mammography screening, with its primary aim of breast cancer mortality reduction, is well implemented in most OECD member states. Overdiagnosis and overtreatment are often controversially discussed as potential consequences of screening. The objective of this study was to examine whether high mammography screening rates are associated with (a) higher incidence of and (b) lower mortality rates from breast cancer, and (c) higher inpatient mastectomy rates in OECD countries. Methods: For this investigation, an ecological study design was chosen. Data of mammography screening rates, standardized incidence and mortality rates of breast cancer and inpatient mastectomy rates were derived from the database OECD.Stat Extracts for 2008 (or nearest year). Bar charts and scatter plots with associated R² were produced. Results: Mammography screening rates showed a broad distribution among OECD states. Specific health indicators were, on average, less favorable in those countries where more women were screened. A high degree of variance explained by screening rates could be found for incidence rates of breast cancer and mastectomy rates (R²=0.522 and R²=0.258, respectively). For mortality rates, this was lower, but of medium size (R²=0.227). Conclusion: Due to the ecological nature of the data, international variations in treatment guidelines and documentation of health indicators, the results must be interpreted with caution. However, the findings are in line with the contemporary literature. In the light of the observed correlation between mammography screening and less favorable health indicators, the role – whether explanatory or confounding – of potential overdiagnosis, overtreatment, and the time point of screening implementation remain controversial.
Pharmaceutical system in Ukraine: current and prospective issues
Authors: Zaliska Olha , Maksymovych Nataliia , Sichkoriz Orest , Tolubaiev Viacheslav
Published: July 2023

Introduction: To review the current pharmaceutical system in the private and public sectors in Ukraine in terms of the availability and affordability of medicines, to explore and analyze national health system reforms started to be introduced in 2015. Methods: The captured data was analyzed using the predetermined themes of financing, pricing, reimbursement, reforms and market analysis in Ukraine. We also examined the prices and volumes of medicines in 2013-2015. Results: This analysis showed the dynamics of key indicators of the pharmaceutical market of Ukraine for 2013-2015. We used data from the MOH, market research analytical system “PharmXplorer”, “Pharmstandard” company “Proxima Research”. Conclusions: The analysis of retail sales of drugs on the pharmaceutical market of Ukraine for the last 3 years indicates a decreasing sales trend in number of packages and dollar values. The current structure of market is characterized by the inadequate consumption of drugs, a high use of medicines for symptomatic treatment, increasing the average drug cost, medical devices, generic drugs dominance and lack of legislative regulation of pricing for the original drugs. Importantly, positive results of reimbursement of medicines for hypertension indicated an urgent need to introduce mechanisms for reimbursement of other medicines for the treatment of diabetes and some socially important diseases. In Ukraine the capacity building and educational programs on HTA for pharmacists have already started. That is necessary to implement the requirements to health technology assessment to prioritize the procurements of medicines and their financing by government according to the developed scientific methodology.
Medical registries in perspective of the new EU’s legal framework of personal data protection - selected issues
Authors: Krasińska Monika
Published: July 2023

Keeping medical registries is inextricably linked with the processing of personal data, which often belong to the most sensitive sphere of privacy of every individual. Creating a comprehensive and complete legislation in this area is a guarantee of proper protection of the privacy and dignity of the patient, and is a part of the optimal model of protection of personal data representing the content of the registers, which is guaranteed both at the level of constitutional and international law. The creation of appropriate legal mechanisms must also be accompanied by a friendly technical and organizational environment. Lack of financial resources to ensure the security of data stored in the medical records may result in the risk of data leaks, unauthorized access to data, or using data for the wrongpurposes. In view of the reform of the EU data protection law the above-mentioned circumstances must be a subject of in-depth analysis.
Treatment and prevention of bleeding in adult hemophilia A patients with inhibitor – economic analysis.
Authors: Jędrzejczak Wiesław , Olszyńska Anna
Published: July 2023

Hemophilia A is caused by an absence or deficiency of coagulation factor VIII. Patients with hemophilia may experience recurrent spontaneous hemarthroses or internal bleeding. Following the treatment with factor VIII concentrates, patients with hemophilia A may develop alloantibodies to factor VIII, evidence of which is critical to diagnose hemophilia with inhibitor. The primary goal of treatment in patients with hemophilia with inhibitor is a durable inhibitor elimination and the interim goal is to stop the bleeding. The aim of this paper is to compare the effectiveness and costs of on-demand therapy and prophylaxis in patients with hemophilia A with or without inhibitor. We conducted a review of studies. The outcomes of the studies included in the review suggested that the difference in annual bleeding rate (ABR) between prophylaxis and on-demand therapy is less pronounced in patients with inhibitor. Furthermore, one study found no statistically significant difference in ABR between prophylaxis and on-demand therapy in patients aged ≥ 40, although the consumption of coagulation factor was significantly higher in the prophylaxis group. Treatment of patients with hemophilia A is associated with high costs of coagulation factor concentrates and frequent, stressful and painful injections. Therefore, while considering the introduction of prophylaxis in adult patients, it appears advisable to select groups of patients depending on the frequency of bleeding episodes and to determine adequate treatment strategy.
Cost-effectiveness study of diagnosis strategies of acute viral infections in Ukraine
Authors: Soloviov Serhii , Zaliska Olha , Piniazhko Oresta , Dediuk Svitlana
Published: July 2023

Background: Efficient and accurate laboratory diagnosis of viral pathogens is of primary importance for clinical care in terms of health care system reforms. The methodological approach of cost-effectiveness analysis of laboratory diagnosis tests for viral infections from payer’s perspective was presented. We argue on an expository software-based technique for assessing the costs of newer laboratory tests. Methods: We applied decision tree modeling techniques to compare expected costs and effectiveness of strategies for the diagnosis of viral infections. We conducted univariate and Monte-Carlo method based multivariate sensitivity analysis. Results: Operating characteristics of diagnostic methods have been described. The analytical modeling, based on the cost-effectiveness method for the detection of human viruses were conducted. We considered three strategies: the use of only rapid tests for detection of one pathogen – adenoviruses; multiplexed PCR for 12 viruses, including adenoviruses; and combined strategy with confirmation of negative result of rapid test via use of PCR method. Univariative analysis showed that the cost savings achieved by use of PCR were 45% less per unit of effectiveness than the cost per effectiveness unit of rapid tests. Moreover multivariate probabilistic analysis, taking into account uncertainty of all operating characteristics, showed similar results for PCR method. Conclusions: Acceptability and usability of the applied cost-effectiveness methodology was outlined and provided in computer application for the analysis of diagnosis strategies of acute viral infections. Feasibility of study results implementation by managers was discussed to improve laboratory services and to support patient management and disease control in Ukraine.
Pharmaceutical Policies under Economic Crisis: The Greek case
Authors: Yfantopoulos Nick , Yfantopoulos John
Published: July 2023

Introduction: The purpose of this paper is to critically assess the Pharmaceutical reforms implemented in Greece before and during the economic crisis. The effects of the crisis are multiple in terms of GDP reduction, severe cuts of health and pharmaceutical expenditures and the deterioration of the health status of the population. However, the crisis has been a “window opportunity” to implement the long anticipated reforms in the health sector. Methods: The analysis is based on Time series data from the OECD Health data source covering the period 1970-2014. Double Logarithmic models are explored to estimate income elasticity for pharmaceutical expenditures. The value of the income elasticity in the Pre-crisis period is 1.72 the highest in Europe. The average annual growth of Pharmaceutical expenditure in the pre-crisis period was 12.3% i.e. the highest among the EU-28 countries and during the crisis this rate dropped to -8.5% the lowest among the EU-28. Results: The evolution of thePharmaceutical policies and reforms are discussed with reference to HTA, Co-payments, Claw-back and the E-Prescribing. The mixture of both demand and supply side measures resulted in a substantial reduction of pharmaceutical expenditures from 5,6 bil. Euros in 2009 to 2 bil. Euros in 2016. One of the main contributing factors to cost containment policies is the effective launching of E-prescribing. Exclusion and deprivation of citizens of effective and innovative medicinal treatments should be avoided and their access to health services and medicines should be assured. The new strategy in medicinal products should ensure good quality at affordable prices. The Greek Government, in an attempt to reach the Memorandum objective of 1 percent of GDP on pharmaceutical spending should develop incentives to promote the use of generic medicines and the cost-effective use of medicines in general Conclusions: With all its pros and cons, Greece appears to be an interesting case study to assess the success and failures of the various pharmaceutical reforms implemented.
Visualisation of the results of sequence analysis with the use of Sankey diagrams, based on prevalence analysis of selected medical problems in the years 2013-2015 in Poland
Authors: Śliwczyński Andrzej , Kozierkiewicz Adam , Wierzba Waldemar , Marczak Michał
Published: July 2023

Introduction. The goal of the study is to assess the usefulness of Sankey model in the analysis of healthcare phenomena. Material and methods. Sequence analysis and Sankey model generation was based on the data provided to the National Health Fund in the years 2013-2015 for the following diseases defined by the following ICD-10 codes: C50.% – malignant neoplasm of breast; G35 – multiple sclerosis; B18.2, B17.1 – chronic hepatitis C. The reported data concerned all types of services provided by the public payer. Results. The analysis was conducted for: C50.% – 3.26 million data records, for 236.6 thousand patients; G35 – 110 thousand data records, for 23.9 thousand patients; B18.2, B17.1 – 1,1 million data records, for 100 thousand patients. Sequence analysis and the generated Sankey diagrams indicate that paths taken by patients in the health care system are varied and are strictly conditional on the medical problem. Conclusion. Sequence analysis, and in particular the diagram-based visualisation of its results enables the assessment of event sequences and their size (number). The analysis of data obtained from actual clinical practice enables obtaining more credible results which may form the correct basis for decision-making.
Reimbursement and value assessment frameworks: ensuring patients’ access to asthma medicines in Ukraine
Authors: Zaliska Olha , Ilyk Roman , Irynchyn Hryhoriy
Published: July 2023

Background. Health technology assessment (HTA) introduction and implementation for development of the National List of Essential Medicines (NLEM) took place in Ukraine in 2016 in the context of National Drug Policy until 2025. The study aimed to outline the reimbursement of medicines for asthma treatment, market access for innovative medicines, main steps of HTA development in the decision making process in Ukraine in line with the international requirements and future directions. Methods. Literature review was conducted examining legislation database and scientific publications on the study issues in Ukraine: epidemiology of asthma, reimbursement programs, HTA development, affordability of innovative medicines for asthma treatment, market analysis. The study was performed to investigate the practices, processes and policies of value assessment and their impact in Ukraine. Results. In 2016 a legal framework was developed for the elaboration of NLEM and procedures for reference pricing and reimbursement programs. HTA is used for the inclusion medicines on the list based on the applied evidence of quality, efficacy, effectiveness, safety and economic evaluations adhering to the Order of Ministry of Health (MoH). HTA implementation in 2016 consisted of legislation, HTA training for experts of Expert committee of MoH and development of NLEM. Reimbursement programs for cardiovascular diseases, type 2 diabetes (T2D), asthma have started in April 2017 due to the adopted regulations. Conclusions. HTA use in the decision-making in Ukraine will provide an access to innovative medicines for patients and transparent, consistent decision making process in assessing the health technologies for inclusion on regulatory lists and reimbursement programs.
Indirect costs of pneumococcal diseases in Poland: estimation based on the data of the Social Insurance Institution (ZUS) regarding sickness absence
Authors: Golicki Dominik , Jaśkowiak Katarzyna , Dobrowolska Iwona , Niewada Maciej
Published: July 2023

Background: The study aimed to estimate the indirect costs of pneumococcal diseases in Poland based on the data of the Social Insurance Institution (ZUS) regarding sickness absence. Methods: The study included the following diseases, which may be caused by Streptococcus pneumoniae: meningitis, sepsis, pneumonia and otitis media (OM). Indirect costs resulting from adults’ sick leave for their own sickness or for caring for a sick child were taken into account. The ZUS data concerning all diagnoses of the analysed diseases, regardless of the aetiology, was used. The data was corrected for the share of cases caused by S. pneumoniae, determined based on epidemiological data found in the literature. Epidemiological data were searched in the following databases: MEDLINE, Polska Bibliografia Lekarska and on the NIZP-PZH website. The unit cost of lost productivity was estimated based on the methodology recommended by AOTMiT HTA guidelines (2016), including methods suggested in the EY (2013) and INFARMA (2014) reports. Results: Total absenteeism due to pneumococcal diseases amounted to approx. 302,000 days, of which 156,000 days were absences due to own illness and 146,000 days because of child care. The total indirect costs of absenteeism due to diseases caused by S. pneumoniae amounted to approx. PLN 95.5 million, of which PLN 49.4 million were the costs of diseases in the adult population (including 90% of pneumococcal pneumonia), and 46.1 PLN million costs resulting from children's diseases (in 57% and 42%, respectively, costs of OM and pneumonia). Conclusions: Diseases with pneumococcal aetiology are the cause of a significant number of sickness absence and indirect costs arising from them are at a level similar to the costs of purchasing vaccines for the universal pneumococcal vaccination program.
Accessibility and effectiveness of mechanical thrombectomy for ischaemic stroke in Latin American countries: a rapid review of the literature
Authors: Gonzales-Aquines Alejandro , Bochenek Tomasz
Published: July 2023

Introduction. Stroke constitutes a major cause of death and disability in Latin America. Although the number of stroke survivors has increased in recent decades, a small proportion receives the appropriate treatment. Mechanical thrombectomy (MT) revolutionised stroke management by treating patients within a 24-hour window period, compared to the usual 4.5 hours with intravenous recombinant tissue plasminogen activator (IV rtPA). Objective. To evaluate the current status of mechanical thrombectomy in Latin American countries regarding availability, accessibility, effectiveness, and cost-utility. Methods. A rapid review of the literature was performed by identifying papers published in MEDLINE in English or Spanish from 2015 to current. Reference list search complemented the database research. Included studies were randomised controlled trials and observational studies. Data extraction was performed by one reviewer, and data synthesis was performed following the SWIM guidelines. Results. 10 studies were included. Only one study was a randomised controlled trial. Studies reported that MT is available in Latin American countries. The proportion of treated patients varied from 3% to 19.9%. Recanalisation rates were above 69% in all studies, while functional independence (mRS 0-2) varied from 25% to 50%. Financial barriers were considered as the main limiting factor to access MT. No study realised a cost-utility analysis. Conclusion. Evidence of the efficacy and effectiveness of MT and its main barriers to access is consistent among Latin American countries. Further research is needed, mainly from a robust economic analysis, to evaluate the economic impact of MT.
The impact of the SARS-CoV-2 virus pandemic on the hygiene habits of the Poles
Authors: Skwierawska Justyna , Ciećko Weronika , Bandurska Ewa
Published: July 2023

Background The objective of the study was to learn about and evaluate the hygienic habits of the Poles. There were also specific objectives defined, related to the change of the habits during the pandemic: 1. 1. perform basic hygiene activities and those aimed at reducing the risk of contracting COVID-19, 2. 2. use of hygiene utensils. Material and methods The study was conducted in two editions. The first edition took place at the beginning of the pandemic in Poland (April 2020) and the second one after another 8 months (November 2020). A total of 549 people took part in the study, including 412 women and 137 men. In the study (survey) a specifically designed questionnaire consisting of 14 closed questions was used. The questions concerned three subject areas: 1. 1. Possession and use of hygienic utensils, 2. 2. Habits and activities related to COVID-19 pandemic, 3. 3. Basic activities of personal hygiene. Within each part, the existence of a correlation between the first edition and the second round of the study was examined. Results Most of the respondents had personal hygiene equipment, in the second edition they also had a toothbrush (p=0.0367). The habits of the respondents regarding the additional activities related to oral hygiene changed significantly (p=0.0315), the percentage of people using only dental floss increased along with decreasing percentage of people using mouthwash solely. There was also a significant decrease in the percentage of respondents using chewing gum (p=0.0044). In addition, it was found that the frequency of hand washing during the pandemic increased and the time of using antibacterial fluids lengthened significantly (p=0.000). Along with the course of the pandemic, the subjects stopped adhering to the recommendations related to the manner of sneezing and coughing. The number of people sneezing in their elbow decreased significantly (p=0.0016), while the number of people sneezing in their hands increased simultaneously (p=0.000). Along with the course of the pandemic, the number of people who do not take their bath every day has also decreased (p=0.0023), which may be related to the prolonged period of social isolation. Conclusions In the light of the obtained results, it can be noticed that the respondents do not fully comply with the requirements of the sanitary regime and they apply the guidelines selectively and for a short time. The behavioural patterns that may be identified by the subjects as related to their personal epidemic safety seem to be more persistent. These behavioural patterns indicate the need for more frequent and systematic educational campaigns on epidemiological safety and hygiene.
The economic burden of advanced breast cancer
Authors: Tabor Bernadetta , Bojanic Lovro , Zawodnik Szymon , Bojkow Sebastian , Chahoud Lamis , Sweeney Nyree , Benkovic Vanesa , Christodoulou Christos , Dimitrova Maria , Liepina Elina , Ondrusova Martina , Pana Adrian , Petrova Guenka , Petrovica Marija , Ulici Angela , Niewada Maciej
Published: July 2023

Background Breast cancer is the most frequently diagnosed and leading cause of death amongst cancers in women. Understanding its burden is important in healthcare management. We assessed direct medical and indirect costs of advanced breast cancer (ABC) in selected countries: Bulgaria, Croatia, Czech Republic, Estonia, Greece, Israel, Latvia, Poland, Romania, and Slovak Republic. Methods The data were collected in individual countries with a unified questionnaire (covering epidemiology, mortality, treatment patterns, and economic aspects) based on databases/registries, published studies, or experts’ opinions in the absence of published data. International scope allowed for consistency checks and missing data imputing. Results The total annual costs of ABC per 100,000 women varied from 1 million EUR in Romania to 3.4 million EUR in Slovak Republic with the differences partially related to data availability. The direct costs resulted mainly from the costs of treatment (covering surgery, breast reconstruction, external breast prosthesis, chemotherapy, radiation, hormonal and targeted therapy). The indirect costs (lost productivity due to premature mortality and reduced employment rate) constitute a large part (>50%) of the total costs. The average (for all countries) total annual costs per 100,000 women amounts to 1.8 million EUR. Conclusion ABC is associated with substantial healthcare costs and imposes a significant societal burden, as indicated by high indirect costs. Early detection, timely intervention, and effective treatment of early stage BC hold potential to decrease burden of ABC. Our findings may be used in informing decisions on resource allocation, improving cancer policies and supporting national cancer plans. Highlights · Advanced breast cancer costs between 1 and 3.4 million euro per 100,000 women in studied countries; lost productivity (from societal perspective) accounts for most of the cost. · The data availability is still limited; comparisons between countries reveal some gaps, but collecting more information, e.g. in registries, is crucial for improved decision making. · The results of our study may be used in cost-effectiveness modelling of diagnostic or treatment technologies.
The use of a systematic review to verify the completeness of the PharmGKB database based on the search for genetic variant related side effects during ovarian cancer treatment with platinum compounds
Authors: Kościółek Michał
Published: July 2023

PharmGKB (The Pharmacogenomics Knowledgebase) contains information on the correlation between genetic variability and response to pharmacotherapy. The authors of PharmGKB indicate that the database does not include all the knowledge gathered in PubMed. This paper aimed to obtain variants from the PharmGKB and determine whether additional variants related to adverse drug reactions (ADR) during the treatment of ovarian cancer with platinum compounds have been discovered to verify PharmGKB completeness. For this purpose, a systematic review was carried out. Methods First, all variants related to ADR risk in patients with ovarian cancer treated with platinum compounds (in monotherapy or with paclitaxel or docetaxel) were identified in the PharmGKB. In the second stage, a systematic search of PubMed and Embase was carried out to identify variants not indexed in the PharmGKB and thus verify its completeness. Results As a result of the systematic review, three publications describing four new variants were found, which completed the pool of 10 variants found in PharmGKB. A correlation between rs363717, rs12762549 and a reduction in the odds of grade III-IV anaemia was described in publications. Variant rs1695 reduced the odds of grade I–IV thrombocytopenia and grade III-IV anaemia and increased the odds of grade II anaemia. Rs11615 was proved to be associated with an increased odds of grade III-IV anaemia. Conclusion In the search for pharmacogenetic data, until the introduction of fully automated indexing in the PharmGKB, a systematic review should be performed.
Comparative analysis of the understanding the "ten-star pharmacist" concept by pharmaceutical specialists and pharmacy students of medical universities of Ukraine and Poland
Authors: Kremin Yuliia , Kus Krzysztof , Hromovyk Bohdan
Published: July 2023

Introduction The aim of our study was to conduct a comparative analysis of the opinions of pharmaceutical professionals and senior students of pharmaceutical faculties of Ukraine and Poland on awareness of the "ten-star pharmacist" concept. Methods An anonymous survey was conducted among Ukrainian and Polish pharmaceutical workers (n = 614 and n = 209) and students (n = 516 and n = 475). The analyzed period in Ukraine was February-April 2020, in Poland - June-September 2020. Results This study revealed differences of opinion between the respondents and a lack of proper knowledge about the above concept. On the one hand, they have a high level of awareness of some professional roles, but on the other part, the rest of them cause hesitation and lack of affirmative opinion. Conclusions Inadequate awareness of professional roles indicates the need to create effective mechanisms for implementing the "ten-star pharmacist" concept in the practical and educational systems of both countries.
Analysis of national health prevention programs based on implemented actions aimed at reducing tobacco use in Poland
Authors: Szymański Jakub , Krzych-Falta Edyta
Published: July 2023

Objective The aim of this study is to compare selected national health prevention programs regarding their proposed actions aimed to reduce the use of tobacco products in Poland and to assess their performance indicators. Methods Twelve national health prevention programs coordinated by the Ministry of Health were analyzed, all relating to the reduction of tobacco use. We analyzed the websites and publications by the Ministry of Health and the subordinate agencies responsible for the implementation of each program. Three programs were selected for the final analysis: · the Prevention of tobacco-related disorders program (including COPD); · the National Oncology Strategy, · the National Health Program. Results The public administration agency responsible for the implementation of public national anti-smoking prevention programs in Poland is the Ministry of Health. The legal basis for the operation of the national campaigns is usually the regulations of the Council of Ministers. In the three analyzed programs, the proposed strategic objectives for anti-smoking prevention may be considered the same. The programs are primarily focused on providing counseling to smokers and training medical staff on how to support patients in their efforts to quit smoking. Conclusions The lack of a single comprehensive anti-smoking program leads to proposed actions being reiterated several times. There is currently no institution that coordinates anti-smoking actions. Because anti-smoking measures are multidisciplinary, it is difficult to identify the direct impact of a single health program on i.e. reduced incidence of tobacco-related disorders. It is, therefore, appropriate to maintain the overall performance indicators without setting specific targets.
Contact Tracing /Filiation Cost for COVID-19 in Türkiye
Authors: Enes Gökler Mehmet , Metintas Selma , Emre Bulut Yunus
Published: July 2023

Aim: Aim of this study is to estimate direct and indirect cost of COVID-19 contact tracing (CT) for capital city of Türkiye. Materials and Methods: This is an economic study to estimate the cost for COVID-19 CT program from March 11, 2020 to March 11, 2021. This study was conducted in Pursaklar district of Ankara city. Direct and indirect cost were estimated for national level, the direct costs include fixture, salary of the team, consumption and car while indirect costs include nutritıon, transportation, communication, PPE, Food and others. Results: total direct cost was estimated as $ 69108,3; the highest cost was related to salary ($ 42204,0) followed by consumption ($15560,9), transportation ($5481,0) and fixture ($98,8) while indirect cost was estimated as $5763,6; the highest mean cost was related to transportation ($98,3) followed by shoes-clothes ($91,5), Vitamin-like supplement food ($65,7), food ($43,7), PPE ($34,1) and communication ($17,3) annually. Conclusion: The total cost for COVID-19 contact tracing program for the district was estimated to be $ 69108,3 of which, 91,7% ($ 63344,7) were due to direct cost while 8,3% ($ 5763,6) were generated by indirect cost. The annual national cost for CT team for 2020 was estimated to be 106,288,565.4 $.
COVID-19 in patients with inborn errors of immunity - the current state of knowledge, diagnostic and therapeutic dilemmas
Authors: Kołtan Sylwia
Published: July 2023

Patients with inborn errors of immunity (IEI) are at risk of contracting the SARS CoV2 virus, as are all humans. The risk of a serious course of COVID-19 related to the type of IEI concerns patients with combined immunodeficiencies, immune dysregulation syndromes, and certain inborn immunity defects, including type I interferon defects. Adult patients with severe humoral immunodeficiency are also at the increased risk (for example CVID or agammaglobulinemia). The additional risk results from the frequent occurrence of many comorbidities and the treatment used. Vaccination is the most effective way to prevent a severe course of COVID-19. An additional dose is required in the selected patients with IEI. The vaccine response in selected IEI groups may be ineffective. Therefore, the pre-exposure prophylaxis with the use of long-acting monoclonal antibodies is justified. With regard to the Omicron variant, there are no recommendations for the post-exposure prophylaxis - no effective preparations. Treatment of COVID-19 in patients with IEI, especially those at risk of severe disease, should be started not later than 5-10 days after the infection. It is advisable to use in paralel,the antiviral drugs and monoclonal antibodies, effective for the currently dominant variants of the virus. It is important to continue treatment of the inbornerrors of immunity, especially human immunoglobulin replacement therapy.
Huntingtin recruits KIF1A to transport synaptic vesicle precursors along the mouse axon to support synaptic transmission and motor skill learning
Authors: Vitet Hélène , Bruyère Julie , Xu Hao , Séris Claire , Brocard Jacques , Abada Yah-Sé , Delatour Benoît , Scaramuzzino Chiara , Venance Laurent , Saudou Frédéric
Published: July 2023

Neurotransmitters are released at synapses by synaptic vesicles (SVs), which originate from SV precursors (SVPs) that have traveled along the axon. Because each synapse maintains a pool of SVs, only a small fraction of which are released, it has been thought that axonal transport of SVPs does not affect synaptic function. Here, studying the corticostriatal network both in microfluidic devices and in mice, we find that phosphorylation of the Huntingtin protein (HTT) increases axonal transport of SVPs and synaptic glutamate release by recruiting the kinesin motor KIF1A. In mice, constitutive HTT phosphorylation causes SV over-accumulation at synapses, increases the probability of SV release, and impairs motor skill learning on the rotating rod. Silencing KIF1A in these mice restored SV transport and motor skill learning to wild-type levels. Axonal SVP transport within the corticostriatal network thus influences synaptic plasticity and motor skill learning.
Dopamine signaling regulates predator-driven changes in Caenorhabditis elegans’ egg laying behavior
Authors: Pribadi Amy , Rieger Michael A , Rosales Kaila , Reddy Kirthi C , Chalasani Sreekanth H
Published: July 2023

Prey respond to predators by altering their behavior to optimize their own fitness and survival. Specifically, prey are known to avoid predator-occupied territories to reduce their risk of harm or injury to themselves and their progeny. We probe the interactions between Caenorhabditis elegans and its naturally cohabiting predator Pristionchus uniformis to reveal the pathways driving changes in prey behavior. While C. elegans prefers to lay its eggs on a bacteria food lawn, the presence of a predator inside a lawn induces C. elegans to lay more eggs away from that lawn. We confirm that this change in egg laying is in response to bites from predators, rather than to predatory secretions. Moreover, predator-exposed prey continue to lay their eggs away from the dense lawn even after the predator is removed, indicating a form of learning. Next, we find that mutants in dopamine synthesis significantly reduce egg laying behavior off the lawn in both predator-free and predator-inhabited lawns, which we can rescue by transgenic complementation or supplementation with exogenous dopamine. Moreover, we find that dopamine is likely released from multiple dopaminergic neurons and requires combinations of both D1- (DOP-1) and D2-like (DOP-2 and DOP-3) dopamine receptors to alter predator-induced egg laying behavior, whereas other combinations modify baseline levels of egg laying behavior. Together, we show that dopamine signaling can alter both predator-free and predator-induced foraging strategies, suggesting a role for this pathway in defensive behaviors.