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Rajkovic J, Peric M, Stanisic J, Gostimirovic M, Novakovic R, Djokic V, Tepavcevic S, Rakocevic J, Labudovic-Borovic M, Gojkovic-Bukarica L. Effect of Type-2 Diabetes Mellitus on the Expression and Function of Smooth Muscle ATP-Sensitive Potassium Channels in Human Internal Mammary Artery Grafts. Pharmaceuticals (Basel) 2024; 17:857. [PMID: 39065708 PMCID: PMC11280115 DOI: 10.3390/ph17070857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 06/10/2024] [Accepted: 06/27/2024] [Indexed: 07/28/2024] Open
Abstract
Here we have shown for the first time altered expression of the vascular smooth muscle (VSM) KATP channel subunits in segments of the human internal mammary artery (HIMA) in patients with type-2 diabetes mellitus (T2DM). Functional properties of vascular KATP channels in the presence of T2DM, and the interaction between its subunits and endogenous ligands known to relax this vessel, were tested using the potassium (K) channels opener, pinacidil. HIMA is the most commonly used vascular graft in cardiac surgery. Previously it was shown that pinacidil relaxes HIMA segments through interaction with KATP (SUR2B/Kir6.1) vascular channels, but it is unknown whether pinacidil sensitivity is changed in the presence of T2DM, considering diabetes-induced vascular complications commonly seen in patients undergoing coronary artery bypass graft surgery (CABG). KATP subunits were detected in HIMA segments using Western blot and immunohistochemistry analyses. An organ bath system was used to interrogate endothelium-independent vasorelaxation caused by pinacidil. In pharmacological experiments, pinacidil was able to relax HIMA from patients with T2DM, with sensitivity comparable to our previous results. All three KATP subunits (SUR2B, Kir6.1 and Kir6.2) were observed in HIMA from patients with and without T2DM. There were no differences in the expression of the SUR2B subunit. The expression of the Kir6.1 subunit was lower in HIMA from T2DM patients. In the same group, the expression of the Kir6.2 subunit was higher. Therefore, KATP channels might not be the only method of pinacidil-induced dilatation of T2DM HIMA. T2DM may decrease the level of Kir6.1, a dominant subunit in VSM of HIMA, altering the interaction between pinacidil and those channels.
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Affiliation(s)
- Jovana Rajkovic
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.G.); (L.G.-B.)
| | - Miodrag Peric
- Dedinje Cardiovascular Institute, 11000 Belgrade, Serbia;
| | - Jelena Stanisic
- Laboratory for Molecular Biology and Endocrinology, Vinca Institute of Nuclear Sciences, University of Belgrade, 11000 Belgrade, Serbia; (J.S.); (S.T.)
| | - Milos Gostimirovic
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.G.); (L.G.-B.)
| | - Radmila Novakovic
- Center for Genome Sequencing and Bioinformatics, Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, 11000 Belgrade, Serbia;
| | - Vladimir Djokic
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA;
| | - Snezana Tepavcevic
- Laboratory for Molecular Biology and Endocrinology, Vinca Institute of Nuclear Sciences, University of Belgrade, 11000 Belgrade, Serbia; (J.S.); (S.T.)
| | - Jelena Rakocevic
- Institute of Histology and Embryology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (J.R.); (M.L.-B.)
| | - Milica Labudovic-Borovic
- Institute of Histology and Embryology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (J.R.); (M.L.-B.)
| | - Ljiljana Gojkovic-Bukarica
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.G.); (L.G.-B.)
- Dedinje Cardiovascular Institute, 11000 Belgrade, Serbia;
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Vuković M, Jovičić Bata J, Todorović N, Puača G, Vesković D, Čanji Panić J, Dugandžija T, Lalić-Popović M. Diabetes management, dietary supplements use and the effect of coronavirus pandemic on diabetes patients in Serbia: a cross-sectional study. Curr Med Res Opin 2024; 40:165-174. [PMID: 38112408 DOI: 10.1080/03007995.2023.2296963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/15/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES Diabetes mellitus (DM) is a significant public health challenge in Serbia, mirroring the situation in other European middle-income countries. The aims of this study were to examine the disease-related characteristics and management of diabetes, as well as the prevalence of use of dietary supplements (DS) among diabetes patients in Serbia, and to analyze the effects of the coronavirus pandemic on DM patients in Serbia. METHODS The study was carried out as an online, observational, cross-sectional study involving 422 adult diabetes type 1 (DM1) and type 2 (DM2) patients residing in Serbia. RESULTS DM1 patients were more likely than DM2 patients to self-control glucose levels (p < 0.001). Almost one-third of DM2 patients (31.4%) did not know their HbA1c value. Polypharmacy has been reported by 9.7% of DM1 patients and 23.5% of DM2 patients. During the coronavirus pandemic increased anxiety levels for one-third of respondents was noticed. The prevalence of DS use among DM patients was very high (95.3%), with vitamin C, zinc, vitamin D and magnesium being the most commonly used. Women were more likely to use vitamin D (p = 0.001) and magnesium DS (p = 0.005) than men. Most patients (76.9%) faced limited access to healthcare services during the coronavirus pandemic with, sometimes, detrimental consequences. A significant portion of respondents (41.2%) consulted a pharmacist more often in 2021 than in previous years. CONCLUSIONS Special caution is needed regarding the potential interactions of DS with chronic therapy. To enhance diabetes care, Serbia needs more accessible mental health support, improved diabetes education, expanded CGM availability, and carefully planned emergency healthcare measures for chronic patients.
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Affiliation(s)
- Milana Vuković
- Department of Pharmacy, University of Novi Sad, Novi Sad, Serbia
| | | | | | - Gorana Puača
- Department of Pharmacy, University of Novi Sad, Novi Sad, Serbia
| | - Dunja Vesković
- Clinic for Dermatology, Clinical Center of Vojvodina, Novi Sad, Serbia
- Department of Dermatovenereology, University of Novi Sad, Novi Sad, Serbia
| | | | - Tihomir Dugandžija
- Department of Epidemiology, University of Novi Sad, Novi Sad, Serbia
- Department of Epidemiology, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
| | - Mladena Lalić-Popović
- Department of Pharmacy, University of Novi Sad, Novi Sad, Serbia
- Centre for Medical and Pharmaceutical Investigations and Quality Control (CEMPhIC), University of Novi Sad, Novi Sad, Serbia
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Marjanović M, Bralić Lang V, Đido V. Total and partial clinical inertia of general physicians with type 2 diabetes mellitus patients in Central Bosnia Canton. Prim Care Diabetes 2020; 14:622-627. [PMID: 32173293 DOI: 10.1016/j.pcd.2020.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/07/2020] [Accepted: 02/25/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The goal of this study was to determine the frequency and predictive factors of partial (PCI) and total clinical inertia (TCI) of general physicians (GPs) in Central Bosnia Canton in the care of type 2 diabetes mellitus patients. MATERIAL AND METHODS A longitudinal study was conducted with a prospective data collection. Total of 541 subjects of over 40 years of age with type 2 diabetes mellitus of both genders were included in the study. Total of 532 subjects completed the study. Questionnaires for physicians and patients and the Perceived Stress Scale were used, as well as anthropometric measurements and measurements of the glucose level in plasma, HbA1c, triglycerides, AST, ALT, creatinine and eGFR, which were examined on the day of study entry, after 6 months and after one year. RESULTS TCI was 5.8% and PCI was 25.6%. Patients with poorly regulated glycaemia and elevated triglyceride levels had the highest probability of PCI and TCI. Patients with an unaccomplished targeted level of blood pressure were more likely to experience PCI. Patients treated by both an internist and a general physician were more likely to have TCI as compared to patients treated only by an internist. CONCLUSIONS Patients with poor glycemic control experience PCI and TCI more often. In our study, referring to a diabetologist was observed as a non-inert procedure, which resulted in lower PCI and TCI, compared to studies where clinical inertia was defined only as non-intensification of medication therapy.
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Affiliation(s)
- Marijan Marjanović
- Faculty of Health Care, University "Vitez "in Vitez, Bosnia and Herzegovina.
| | - Valerija Bralić Lang
- Private Family Physician Office affiliated to University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Vedran Đido
- Faculty of Health Studies, University of Sarajevo, Bosnia and Herzegovina
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Morgovan C, Cosma SA, Valeanu M, Juncan AM, Rus LL, Gligor FG, Butuca A, Tit DM, Bungau S, Ghibu S. An Exploratory Research of 18 Years on the Economic Burden of Diabetes for the Romanian National Health Insurance System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4456. [PMID: 32575853 PMCID: PMC7344799 DOI: 10.3390/ijerph17124456] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/11/2020] [Accepted: 06/18/2020] [Indexed: 01/12/2023]
Abstract
The prevalence of diabetes mellitus (DM) rises constantly each year worldwide. Because of that, the funds allocated for the DM treatment have increased over time. Regarding the number of DM cases, Romania is among the top ten countries in Europe. Based on the National Diabetes Programme (NDP), antidiabetic drugs and other expenditures (Self-monitoring blood glucose (SMBG) test, HbA1c, insulin pumps/insulin pumps supplies) are free of charge. This programme has undergone many changes in drugs supply, in the last two decades: re-organizing the NDP, authorization of new molecules with high prices (e.g., SGLT-2 inhibitors, etc.) or new devices (e.g., insulin pumps, etc.) The main purpose of this study is to identify and analyse the impact of the DM costs on the Romanian health budget and to highlight the evolution of these costs. A retrospective longitudinal research on the official data regarding the DM costs from 2000 to 2017 was performed. The DM funds (DMF) were adjusted with the inflation rate. In this period, the average share of DMF in the total funds allocated for health programmes was 21.3 ± 3.4%, and DMF average growth rate was 25.4% (r = 0.488, p = 0.047). On the other hand, the DMF increased more than 14 times, in spite of the patients' number having increased only about 2.5 times. Referring to the structure of DMF, the mean value of the antidiabetic drugs cost was of 96,045 ± 67,889 thousand EUR while for other expenditures it was of 11,530 ± 7922 thousand EUR (r = 0.945, p < 0.001). Between 2008 and 2017, the total DMF was 181,252 ± 74,278 thousand EUR/year. Moreover, the average patients' number was 667,384 ± 94,938 (r = 0.73, p = 0.016), and the cost of treatment was 215 ± 36 EUR/patient/year. Even if the cost is rising, the correct and optimal treatment is a main condition for the diabetic patient's health and for the prevention of its complications, which have multiple socio-economic repercussions.
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Affiliation(s)
- Claudiu Morgovan
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (C.M.); (A.M.J.); (L.L.R.); (F.G.G.); (A.B.)
| | - Smaranda Adina Cosma
- Department of Hospitality Services, Faculty of Business, “Babeș-Bolyai” University, 7 Horea St., 400174 Cluj-Napoca, Romania;
| | - Madalina Valeanu
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, “Iuliu Haţieganu” University Medicine and Pharmacy, 4 Louis Pasteur St., 400349 Cluj-Napoca, Romania
| | - Anca Maria Juncan
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (C.M.); (A.M.J.); (L.L.R.); (F.G.G.); (A.B.)
| | - Luca Liviu Rus
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (C.M.); (A.M.J.); (L.L.R.); (F.G.G.); (A.B.)
| | - Felicia Gabriela Gligor
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (C.M.); (A.M.J.); (L.L.R.); (F.G.G.); (A.B.)
| | - Anca Butuca
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (C.M.); (A.M.J.); (L.L.R.); (F.G.G.); (A.B.)
| | - Delia Mirela Tit
- Department of Pharmacy, University of Oradea, 29 Nicolae Jiga St., 410028 Oradea, Romania; (D.M.T.); (S.B.)
| | - Simona Bungau
- Department of Pharmacy, University of Oradea, 29 Nicolae Jiga St., 410028 Oradea, Romania; (D.M.T.); (S.B.)
| | - Steliana Ghibu
- Department of Pharmacology, Physiology and Pathophysiology, Faculty of Pharmacy, “Iuliu Haţieganu” University Medicine and Pharmacy, 4 Louis Pasteur St., 400349 Cluj-Napoca, Romania
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Lee CW, Wu SH, Chiu WC, Tsai ST, Lan TY. The medications and health care utilization of patients newly diagnosed with type 2 diabetes mellitus: A nationwide population-based cohort study. J Formos Med Assoc 2020; 120:130-136. [PMID: 32249109 DOI: 10.1016/j.jfma.2020.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/06/2020] [Accepted: 03/03/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND/PURPOSE The prevalence of young-onset diabetes (YOD) is increasing in Asia, but little is known about the metabolic control, associated complications, or medical behavior in this population. Our aim was to assess the prevalence of young-onset and late-onset type 2 diabetes mellitus (T2DM) and their associated risk factors and medical behaviors in Taiwan. METHODS Data were collected from the National Health Insurance Research Database of Taiwan on 11,244 patients from 2008 to 2013. We classified patients with young-onset diabetes if they were diagnosed before 40 years of age and late-onset diabetes (LOD) if diagnosed at 40 years of age or older. We analyzed the prevalence, medication, and medical behaviors between these groups. RESULTS We enrolled 2556 newly diagnosed T2DM patients in 2012. Demographics and comorbidities were recorded from YOD (n = 311) and LOD (n = 2245) patients. Most newly diagnosed patients started with monotherapy and almost half of them with sulfonylurea. The prevalence of YOD in Taiwan is up to 12%. In terms of treatment, 42% of T2DM patients are treated in clinics, 58% in hospital, and 25.2% by an endocrinologist. CONCLUSION Our study highlights the rising trend of YOD in Taiwan. National endeavors are urgently needed for early diagnosis, effective management, and primary prevention of diabetes.
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Affiliation(s)
- Chun-Wei Lee
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, MacKay Medical College, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Shu-Hao Wu
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, MacKay Medical College, New Taipei City, Taiwan
| | - Wen-Chi Chiu
- Family Medicine Department, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
| | - Shih-Tzer Tsai
- Department of Internal Medicine, Cheng Hsin General Hospital, Taipei, Taiwan.
| | - Tzuo-Yun Lan
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
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Russel-Szymczyk M, Valov V, Savova A, Manova M. Cost-effectiveness of insulin degludec versus insulin glargine U100 in adults with type 1 and type 2 diabetes mellitus in Bulgaria. BMC Endocr Disord 2019; 19:132. [PMID: 31796048 PMCID: PMC6891960 DOI: 10.1186/s12902-019-0460-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 11/22/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND This analysis evaluates the cost-effectiveness of insulin degludec (degludec) versus biosimilar insulin glargine U100 (glargine U100) in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in Bulgaria. METHODS A simple, short-term model was used to compare the treatment costs and outcomes associated with hypoglycaemic events with degludec versus glargine U100 in patients with T1DM and T2DM from the perspective of the Bulgarian National Health Insurance Fund. Cost-effectiveness was analysed over a 1-year time horizon using data from clinical trials. The incremental cost-effectiveness ratio (ICER) was the main outcome measure. RESULTS In Bulgaria, degludec was highly cost-effective versus glargine U100 in people with T1DM and T2DM. The ICERs were estimated to be 4493.68 BGN/quality-adjusted life year (QALY) in T1DM, 399.11 BGN/QALY in T2DM on basal oral therapy (T2DMBOT) and 7365.22 BGN/QALY in T2DM on basal bolus therapy (T2DMB/B), which are below the cost-effectiveness threshold of 39,619 BGN in Bulgaria. Degludec was associated with higher insulin costs in all three patient groups; however, savings from a reduction in hypoglycaemic events with degludec versus glargine U100 partially offset these costs. Sensitivity analysis demonstrated that the results were robust and largely insensitive to variations in input parameters. At a willingness-to-pay threshold of 39,619 BGN/QALY, the probability of degludec being cost-effective versus glargine U100 was 60.0% in T1DM, 99.4% in T2DMBOT and 91.3% in T2DMB/B. CONCLUSION Degludec is a cost-effective alternative to biosimilar glargine U100 for patients with T1DM and T2DM in Bulgaria. Degludec could be of particular benefit to those patients suffering recurrent hypoglycaemia and those who require additional flexibility in the dosing of insulin.
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Affiliation(s)
| | | | | | - Manoela Manova
- Faculty of Pharmacy, Medical University Sofia, Sofia, Bulgaria
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Škrlec I, Milić J, Cilenšek I, Petrovič D, Wagner J, Peterlin B. Circadian clock genes and myocardial infarction in patients with type 2 diabetes mellitus. Gene 2019; 701:98-103. [PMID: 30905809 DOI: 10.1016/j.gene.2019.03.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 03/15/2019] [Accepted: 03/19/2019] [Indexed: 02/07/2023]
Abstract
Disruption of circadian clock may trigger the onset of diabetes mellitus and myocardial infarction. Type 2 diabetes mellitus (T2DM) is well-known risk factors for cardiovascular diseases and myocardial infarction. We performed a case-control study, where we explored the possible association between single nucleotide polymorphisms in three circadian rhythm genes (ARNTL, CLOCK, and PER2) and myocardial infarction in 657 patients with T2DM. The study group consisted of 231 patients with myocardial infarction and T2DM and a control group of 426 T2DM patients. We hypothesized that variations in the circadian rhythm genes in patients with T2DM could be an additional risk factor for myocardial infarction. The statistically significant difference was found in allelic (p = 1.1 × 10-5) and genotype distribution (p = 1.42 × 10-4) between two groups of the rs12363415 at the ARNTL gene locus. We provide evidence that genetic variability in the ARNTL gene might be associated with myocardial infarction in patients with T2DM.
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Affiliation(s)
- Ivana Škrlec
- Department of Biology, Faculty of Dental Medicine and Health, J. J. Strossmayer University of Osijek, Croatia; Faculty of Medicine, J. J. Strossmayer University of Osijek, Croatia.
| | - Jakov Milić
- Faculty of Medicine, J. J. Strossmayer University of Osijek, Croatia
| | - Ines Cilenšek
- Institute of Histology and Embryology, Faculty of Medicine, University Ljubljana, Ljubljana, Slovenia
| | - Daniel Petrovič
- Institute of Histology and Embryology, Faculty of Medicine, University Ljubljana, Ljubljana, Slovenia
| | - Jasenka Wagner
- Faculty of Medicine, J. J. Strossmayer University of Osijek, Croatia
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Center Ljubljana, Slovenia
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Tachkov K, Mitov K, Mitkova Z, Kamusheva M, Dimitrova M, Petkova V, Savova A, Doneva M, Tcarukciev D, Valov V, Angelova G, Manova M, Petrova G. Improved quality of diabetes control reduces complication costs in Bulgaria. BIOTECHNOL BIOTEC EQ 2019. [DOI: 10.1080/13102818.2019.1604160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Konstantin Tachkov
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Konstantin Mitov
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Zornitsa Mitkova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Maria Kamusheva
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Maria Dimitrova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Valentina Petkova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Alexandra Savova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Miglena Doneva
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Dimitar Tcarukciev
- University Endocrinology Hospital “Ivan Penchev”, Medical University of Sofia, Sofia, Bulgaria
| | | | - Galia Angelova
- Linguistic Modelling and Knowledge Processing Department, Institute of Information and Communication Technologies, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Manoela Manova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Guenka Petrova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
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