1
|
Ostrowska A, Wojciechowska W, Rajzer M, Weber T, Bursztyn M, Persu A, Stergiou G, Kiełbasa G, Chrostowska M, Doumas M, Parati G, Bilo G, Grassi G, Mancia G, Januszewicz A, Kreutz R. The impact of the COVID-19 Pandemic on hypertension phenotypes (ESH ABPM COVID-19 study). Eur J Intern Med 2024:S0953-6205(24)00376-5. [PMID: 39261181 DOI: 10.1016/j.ejim.2024.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 08/29/2024] [Accepted: 08/31/2024] [Indexed: 09/13/2024]
Abstract
OBJECTIVE The COVID-19 pandemic had a major impact on medical care. This study evaluated the influence of the pandemic on blood pressure (BP) control and hypertension phenotypes as assessed by office and 24-hour ambulatory BP monitoring (ABPM). DESIGN AND METHODS Data were collected from 33 centers including Excellence Centers of the European Society of Hypertension. Two groups of patients with treated hypertension were compared. Pandemic group: including participants who had ABPM twice - at visit 2 during the COVID-19 pandemic and visit 1 performed 9-15 months prior to visit 2. Pre-pandemic group: had ABPM at two visits, performed before the pandemic within 9-15 months interval. We determined the following hypertension phenotypes: masked hypertension, white coat hypertension, sustained controlled hypertension (SCH) and sustained uncontrolled hypertension (SUCH). We analyzed the prevalence of phenotypes and their changes between visits. RESULTS Data of 1419 patients, 616 (43 %) in the pandemic group and 803 (57 %) in the pre-pandemic group, were analyzed. At baseline (visit 1), the prevalence of hypertension phenotypes did not differ between groups. In the pandemic group, the change in hypertension phenotypes between two visits was not significant (p = 0.08). In contrast, in the pre-pandemic group, the prevalence of SCH increased during follow-up (28.8 % vs 38.4 %, p < 0.01) while the prevalence of SUCH decreased (34.2 % vs 27.8 %, p < 0.01). In multivariable adjusted analysis, the only factor influencing negative changes of hypertension phenotypes was the COVID-19 pandemic period. CONCLUSION These results indicate a negative impact of the COVID-19 pandemic on BP control assessed by hypertension phenotypes.
Collapse
Affiliation(s)
- Aleksandra Ostrowska
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Wiktoria Wojciechowska
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland.
| | - Marek Rajzer
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Thomas Weber
- Cardiology Department Klinikum Wels-Grieskirchen, Wels, Austria
| | - Michael Bursztyn
- Hypertension Clinic, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, and Faculty of Medicine, Hadassah-Hebrew University, School of Medicine, Jerusalem, Israel
| | - Alexandre Persu
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique and Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - George Stergiou
- Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Grzegorz Kiełbasa
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Marzena Chrostowska
- Hypertension Unit, Department of Hypertension and Diabetology, Medical University of, Gdansk, Poland
| | - Michaelis Doumas
- 2nd Prop Department of Internal Medicine, Aristotle University, Thessaloniki, Greece
| | - Gianfranco Parati
- Department of Cardiology, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Grzegorz Bilo
- Department of Cardiology, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Guido Grassi
- Clinica Medica, S. Gerardo dei Tintori Hospital, University Milano-Bicocca, Monza, Italy
| | - Giuseppe Mancia
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Andrzej Januszewicz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland
| | - Reinhold Kreutz
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Berlin, Germany
| |
Collapse
|
2
|
Wall J, Gadsby‐Davis K, Mistry K, Levell NJ, Venables ZC. Impact of the COVID-19 pandemic on international cutaneous squamous cell carcinoma incidence: A systematic review and meta-analysis. SKIN HEALTH AND DISEASE 2024; 4:e405. [PMID: 39104659 PMCID: PMC11297431 DOI: 10.1002/ski2.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/09/2024] [Accepted: 06/04/2024] [Indexed: 08/07/2024]
Abstract
Background Non-melanoma skin cancer (NMSC) is the most common cancer globally in white ethinicity populations, and cutaneous squamous cell carcinoma (cSCC) is the second most common subtype. The COVID-19 pandemic severely impacted public and private healthcare systems. Many studies have reported reduced cancer diagnoses during the pandemic. The impact of the COVID-19 pandemic on global cSCC and NMSC incidence is poorly reported. Objectives The aim was to conduct a systematic review and meta-analysis to assess the impact of the COVID-19 pandemic on global cSCC and NMSC incidence rates, compared with 2019 incidence rates. Two primary outcome measures were used: crude incidence rate ratios (CIRR) and age-standardised incidence rate ratios (ASIRR). Methods A structured search was undertaken on 23 March 2023 using grey literature and four electronic databases: MEDLINE, CINAHL, EMBASE and Web of Science. Studies published before January 2020 were excluded. A quality assessment was undertaken using A. Lomas quality assessment tool. CIRR outcomes were synthesised in a meta-analysis, while ASIRR outcomes were narratively synthesised. Results Fourteen cancer registries were included, capturing data from 13 countries across Europe. Variation was observed in NMSC and cSCC incidence across the cancer registries. Pooled cSCC crude incidence rates in 2020 were equal to crude incidence rates in 2019 (cSCC-CIRR 1.00 (95% confidence interval (CI) 0.94-1.06). In 2021, the pooled result indicated a non-significant 8% increase in cSCC crude incidence rates, compared with 2019 (cSCC-CIRR 1.08 (95% CI 0.98-1.19). Significant reductions were reported in NMSC incidence across all meta-analyses in 2020 and 2021 compared with 2019. Heterogeneity was observed across most pooled estimates (I 2>75%). Conclusion There was a lack of high quality data on cSCC incidence rates recorded during the pandemic outside of Europe. The COVID-19 pandemic resulted in no significant changes in cSCC incidence across Europe. By contrast, NMSC incidence fell across Europe following the pandemic. Significant reductions in pooled NMSC incidence rates may reflect a delay in basal cell carcinoma presentation, diagnosis and treatment. Although annual incidence rates for cSCC were not affected by the pandemic, delays in treatment may still have occurred, which may result in poorer outcomes yet to be fully understood.
Collapse
Affiliation(s)
- James Wall
- University of East AngliaNorwich Medical SchoolNorwichUK
| | | | - Khaylen Mistry
- University of East AngliaNorwich Medical SchoolNorwichUK
- DermatologyNorfolk and Norwich University Hospitals NHS Foundation TrustNorwichUK
| | - Nick J. Levell
- University of East AngliaNorwich Medical SchoolNorwichUK
- DermatologyNorfolk and Norwich University Hospitals NHS Foundation TrustNorwichUK
| | - Zoe C. Venables
- University of East AngliaNorwich Medical SchoolNorwichUK
- DermatologyNorfolk and Norwich University Hospitals NHS Foundation TrustNorwichUK
| |
Collapse
|
3
|
Trojanowski M, Radomyski P, Kycler W, Michalek IM. The impact of the COVID-19 pandemic on incidence gap in screen-detectable cancers: a cohort study in Greater Poland, Poland. Rep Pract Oncol Radiother 2024; 29:131-140. [PMID: 39143965 PMCID: PMC11321766 DOI: 10.5603/rpor.99354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/05/2024] [Indexed: 08/16/2024] Open
Abstract
Background The global COVID-19 pandemic has had a significant impact on healthcare systems. This study aimed to assess the incidence gap in screening-detectable cancers in the Greater Poland (Poland) in 2020. Materials and methods Data on breast, cervix uteri, and colorectal cancer cases diagnosed from 2010 to 2020 were obtained from the regional cancer registry. Standardized incidence ratios (SIR) and incidence rate differences (IRD) were calculated to estimate the change in incident cancer cases during the pandemic. The number of observed cases was extracted from the registry database. Simple linear regression analysis was used to predict the expected number of incident cancer cases in 2020 and the age-standardized incidence rate based on registry data from the preceding ten years (2010-2019). Results In 2020, the registered number of incident female breast cancer cases decreased by 12% [SIR 0.88, 95% confidence interval (CI): 0.88-0.92, observed: 1,848, expected: 2,101], resulting in an IRD of -6.3 per 100 K. The number of registered cervical cancers decreased by 15% (SIR 0.85, 95% CI: 0.73-0.98, observed: 181, expected: 213), with an IRD of -0.8 per 100 K. For colorectal cancer, there was a 16% decrease in new cases among females (SIR 0.84, 95% CI: 0.78-0.90) and a 15% decrease among males (SIR 0.85, 95% CI: 0.80-0.91), resulting in IRDs of -3.04 and -5.29 per 100K, respectively. Conclusions The COVID-19 pandemic led to a significant, 15% decrease in newly diagnosed screening-detectable cancer cases in 2020. Further studies are needed to investigate the impact of delayed cancer diagnoses on stage at diagnosis and survival rates.
Collapse
Affiliation(s)
- Maciej Trojanowski
- Greater Poland Cancer Registry, Greater Poland Cancer Centre, Poznan, Poland
| | - Piotr Radomyski
- Radiology Department, Greater Poland Cancer Centre, Poznan, Poland
- Electroradiology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - Witold Kycler
- Gastrointestinal Surgical Oncology Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Irmina Maria Michalek
- Department of Cancer Pathology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCI), Warsaw, Poland
| |
Collapse
|
4
|
Pszczółkowska D, Bojarczuk S, Duszczyk M, Matuszczyk K, Szyszkowska E. Did Covid-19 make things worse? The pandemic as a push factor stimulating the emigration intentions of junior doctors from Poland: A mixed methods study. PLoS One 2024; 19:e0301757. [PMID: 38626047 PMCID: PMC11020858 DOI: 10.1371/journal.pone.0301757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 03/21/2024] [Indexed: 04/18/2024] Open
Abstract
Covid-19 has challenged health systems around the world and increased the global competition for medical professionals. This article investigates if the pandemic and its management became an important push factor influencing the migration intentions of medical students and junior doctors and how this factor compared in importance to others. A mixed methods study-a survey and in-depth interviews-was conducted with final-year students at public medical universities in Poland, a country already suffering from a significant emigration of medical staff. The research demonstrated that the difficulties of the Polish healthcare system in dealing with Covid-19 were a factor that slightly positively influenced the emigration intentions of medical students and junior doctors. Nevertheless, the pandemic's influence was not decisive. Factors such as the socio-political situation in Poland (.440**) (including hate speech directed at doctors by politicians and patients), the participants' family situation (.397**), healthcare system organization (.376**), or the opportunity of pursuing a planned career path (.368**) proved more influential. Salary is still important but did not turn out to be among the decisive factors. This allows us to conclude that migration decisions of medical students have a very well-established basis that does not fundamentally change even under the influence of such dramatic situations as the pandemic. This conclusion has important implications for healthcare management and the ongoing discussion in migration studies on the evolution of push and pull factors in place and time.
Collapse
Affiliation(s)
- Dominika Pszczółkowska
- Centre of Migration Research, University of Warsaw, Warszawa, Poland
- Faculty of Political Science and International Studies, University of Warsaw, Warszawa, Poland
| | - Sara Bojarczuk
- Centre of Migration Research, University of Warsaw, Warszawa, Poland
| | - Maciej Duszczyk
- Centre of Migration Research, University of Warsaw, Warszawa, Poland
- Faculty of Political Science and International Studies, University of Warsaw, Warszawa, Poland
| | - Kamil Matuszczyk
- Centre of Migration Research, University of Warsaw, Warszawa, Poland
- Faculty of Political Science and International Studies, University of Warsaw, Warszawa, Poland
| | - Emilia Szyszkowska
- Centre of Migration Research, University of Warsaw and Warsaw School of Economics, Warszawa, Poland
| |
Collapse
|
5
|
Stadnik-Zawalska K, Tomys-Składowska J, Zawalski P, Buczkowski K, Migdalski A. The impact of the first and the second wave of the COVID-19 pandemic on vascular surgery practice in the leading regional center: a comparative, retrospective study. Eur J Med Res 2024; 29:127. [PMID: 38365805 PMCID: PMC10870438 DOI: 10.1186/s40001-024-01720-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 02/08/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND We conducted an analysis of the vascular surgery regional center reorganization in response to the first and the second wave of the coronavirus disease-2019 (COVID-19) pandemic to see what lessons we learned from the first wave. METHODS The study included a total of 632 patients admitted to the vascular surgery department in three periods: March-May 2020, October-December 2020, and October-December 2019 as a control period. RESULTS In the pandemic periods the number of admitted patients decreased in relation to the control period. There was a reduction in performed procedures. We observed an increase in the ratio of less invasive procedures. There was a significant decline in hospitalization time in comparison to the control period. CONCLUSIONS The reduction of scheduled admissions and procedures affected vascular centers all over the world. Minimally invasive procedures were more willingly performed to shorten the hospitalization time and reduce the patient's exposure to hospital infection. It allowed us to treat more patients during the second wave. Nevertheless, an increased number of vascular patients should be expected in the future, which will result from the failure to perform elective procedures during the pandemic.
Collapse
Affiliation(s)
- Katarzyna Stadnik-Zawalska
- Department of Vascular Surgery and Angiology, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland
| | | | - Patryk Zawalski
- Jan Biziel University Hospital No. 2 in Bydgoszcz, 85-168, Bydgoszcz, Poland
| | - Krzysztof Buczkowski
- Department of Family Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland
| | - Arkadiusz Migdalski
- Department of Vascular Surgery and Angiology, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland.
| |
Collapse
|
6
|
Njuguna C, Tola HH, Maina BN, Magambo KN, Phoebe N, Mgamb EA, Tibananuka E, Turyashemererwa FM, Rubangakene M, Richard K, Opong G, Richard S, Opesen C, Mateeba T, Muyingo E, George U, Namukose S, Woldemariam YT. Perceived barriers of access to health and nutrition services under drought and food insecurity emergency in north-east Uganda: a qualitative study. BMC Public Health 2024; 24:390. [PMID: 38321413 PMCID: PMC10848454 DOI: 10.1186/s12889-024-17830-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/20/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND In the face of drought and food insecurity emergency, evidence on access to health and nutrition services is important. Karamoja is one of the regions that have experienced extreme drought and food insecurity emergency in Uganda. As a part of the drought and food insecurity emergency response, World Health Organization (WHO) with Ministry of Health (MoH) has designed and implemented a qualitative study in 15 districts that have experienced drought and food insecurity emergency in north-east Uganda. Thus, we aimed to explore the barriers of access to health and nutrition services in drought and food insecurity emergency affected districts in north-east Uganda. METHODS We employed a descriptive qualitative study design. We interviewed 30 patients and 20 Village Health Teams (VHT) from 15 districts. We employed an in-depth interview with semi-structured questions to collect data until information saturation reached. We used thematic data analysis approach by ATLAS.ti version 7.5.1.8 software. RESULTS Of the 30 interviewed subjects, 15 were female, and the median age of the subjects was 29 years with interquartile range (IQR) of 23 to 37 years. Majority (68.8%) of subjects reported that access to health and nutrition services was harder to them. Four themes: sociocultural and economic; environmental; health system, and individual related factors were identified as the barriers of access to health and nutrition services. CONCLUSION The present study identified several modifiable barriers that hinder access to health and nutrition services in drought and food insecurity affected districts. Comprehensive interventions aimed at addressing sociocultural, economic, environmental, health system and subject related challenges are required to improve access to health and nutrition services in drought and food insecurity affected setups.
Collapse
Affiliation(s)
- Charles Njuguna
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda.
| | - Habteyes Hailu Tola
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| | - Benson Ngugi Maina
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| | - Kwikiriza Nicholas Magambo
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| | - Nabunya Phoebe
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| | - Elizabeth Adhiambo Mgamb
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| | - Evelyne Tibananuka
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| | - Florence M Turyashemererwa
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| | - Moses Rubangakene
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| | - Kisubika Richard
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| | - George Opong
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| | - Ssekitoleko Richard
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| | - Chris Opesen
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| | - Tim Mateeba
- Ministry of Health of Uganda, Kampala, Uganda
| | | | | | | | - Yonas Tegegn Woldemariam
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kampala, Kololo, P. O. Box: 24578, Uganda
| |
Collapse
|
7
|
Mrożek-Gąsiorowska M, Tambor M. How COVID-19 has changed the utilization of different health care services in Poland. BMC Health Serv Res 2024; 24:105. [PMID: 38238694 PMCID: PMC10797947 DOI: 10.1186/s12913-024-10554-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected health care systems in many ways, including access to and the use of non-COVID services. The aim of the study was to assess the impact of the pandemic on the utilization of different public health care services in Poland. METHODS The aggregated data on health care users and provided services for the years 2015/2016-2021 were used to analyse the changes in health care utilization during the pandemic and deviations from pre-pandemic utilization trends. Quantitative analysis was complemented with qualitative descriptions of the changes in principles of health care provision during the pandemic. RESULTS The results show a considerable drop in the provision of most health care services in 2020 that in some cases disturbed pre-pandemic utilization trends and was not made up for in 2021. The most significant decrease has been observed in the field of preventive and public health services, as well as rehabilitation. The provision of these services was put on hold during the pandemic. CONCLUSIONS The accumulated COVID-19-related "health debt" urgently calls for government actions to strengthen disease prevention and health promotion in Poland.
Collapse
Affiliation(s)
- Magdalena Mrożek-Gąsiorowska
- Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawinska Street, 31-066, Krakow, Poland.
| | - Marzena Tambor
- Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawinska Street, 31-066, Krakow, Poland
| |
Collapse
|
8
|
Trojanowski M, Radomyski P, Kycler W, Michalek IM. Decrease in the number of new cancer diagnoses during the first year of the COVID-19 pandemic - cohort study of 3.5 million individuals in western Poland. Front Oncol 2023; 13:1230289. [PMID: 38179170 PMCID: PMC10765942 DOI: 10.3389/fonc.2023.1230289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/13/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction The COVID-19 pandemic has considerably affected healthcare systems worldwide and is expected to influence cancer incidence, mortality, stage at diagnosis, and survival. This study aimed to assess COVID-19-related changes in cancer incidence observed in 2020 in the Greater Poland region. Materials and methods Data from the Greater Poland Cancer Registry on cancer patients diagnosed between 2010 and 2020 were analysed. To quantify the change in the number of incident cancer cases during the COVID-19 pandemic, we calculated the standardized incidence ratio (SIR) and the incidence rate difference (IRD) to assume the pandemic-attributable gap in cancer incidence. Results In 2020, in Greater Poland, the expected number of new cancer cases was 18 154 (9 226 among males and 8 927 among females), while the observed number was 14 770 (7 336 among males and 7 434 among females). The registered number of cancer cases decreased in 2020 by 20% (SIR 0·80, 95% CI 0·78 to 0·81) and 17% (SIR 0·83, 95% CI 0·81 to 0·85) in males and females, respectively. Among men, the most significant difference was reported for myeloma (SIR 0·59, 95% CI 0·45 to 0·77), among women for bone cancer (SIR 0·47, 95% CI 0·20 to 0·93). In females the observed incidence was higher than expected for cancer of an unspecified site (SIR 1·19, 95% CI 1·01 to 1·38). In our study, the decrease in new cancer cases was greater in males than in females. Discussion The observed incidence was affected in most cancer sites, with the most significant deviation from the expected number in the case of myeloma. An increase in the observed incidence was reported only in women diagnosed with cancer of an unspecified site, which might reflect shortages in access to oncological diagnostics.
Collapse
Affiliation(s)
- Maciej Trojanowski
- Greater Poland Cancer Registry, Greater Poland Cancer Centre, Poznan, Poland
| | - Piotr Radomyski
- Radiology Department, Greater Poland Cancer Centre, Poznan, Poland
- Electroradiology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - Witold Kycler
- Gastrointestinal Surgical Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Irmina Maria Michalek
- Cancer Epidemiology and Primary Prevention Department, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| |
Collapse
|
9
|
Płatek P, Daniel N, Cieplak K, Sarzyński M, Siemiński P, Sadownik B, Andruszkiewicz P, Wróblewski Ł. 3D Printing in the Fight Against Covid-19. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2023; 16:167-182. [PMID: 37435359 PMCID: PMC10332420 DOI: 10.2147/mder.s406757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 05/16/2023] [Indexed: 07/13/2023] Open
Abstract
Purpose The paper describes the design concept and findings from technological and initial clinical trials conducted to develop a helmet for non-invasive oxygen therapy using positive pressure, known as hCPAP (Helmet Continuous Positive Airway Pressure). Methods The study utilized PET-G filament, a recommended material for medical applications, along with the FFF 3D printing technique. Additional technological investigations were performed for the production of fitting components. The authors proposed a parameter identification method for 3D printing, which reduced the time and cost of the study while ensuring high mechanical strength and quality of the manufactured elements. Results The proposed 3D printing technique facilitated the rapid development of an ad hoc hCPAP device, which was utilized in preclinical testing and treatment of Covid-19 patients, and yielded positive results. Based on the promising outcomes of the preliminary tests, further development of the hCPAP device's current version was pursued. Conclusion The proposed approach offered a crucial benefit by significantly reducing the time and costs involved in developing customized solutions to aid in the fight against the Covid-19 pandemic.
Collapse
Affiliation(s)
- Paweł Płatek
- Faculty of Mechatronics, Armament and Aviation, Military University of Technology, Warsaw, Poland
| | - Natalia Daniel
- Faculty of Mechatronics, Armament and Aviation, Military University of Technology, Warsaw, Poland
| | - Kamil Cieplak
- Faculty of Mechatronics, Armament and Aviation, Military University of Technology, Warsaw, Poland
| | - Marcin Sarzyński
- Faculty of Mechatronics, Armament and Aviation, Military University of Technology, Warsaw, Poland
| | - Przemysław Siemiński
- Faculty of Automotive and Construction Machinery Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Bartosz Sadownik
- 2nd Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Central Teaching Hospital, Central Teaching Hospital, Warsaw, Poland
- Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Andruszkiewicz
- 2nd Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Central Teaching Hospital, Central Teaching Hospital, Warsaw, Poland
| | - Łukasz Wróblewski
- 2nd Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Central Teaching Hospital, Central Teaching Hospital, Warsaw, Poland
| |
Collapse
|
10
|
Moryson W, Kalinowski P, Kotecki P, Stawińska-Witoszyńska B. Changes in the Level of Premature Mortality in the Polish Population Due to Selected Groups of Cardiovascular Diseases before and during the Pandemic of COVID-19. J Clin Med 2023; 12:jcm12082913. [PMID: 37109249 PMCID: PMC10144974 DOI: 10.3390/jcm12082913] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND In the years 2020 and 2021, the COVID-19 pandemic disrupted Poland's health care system and caused a high number of excess deaths. After nearly 30 years of continuous dynamic increase in the life expectancy of the Polish population and a decrease in premature mortality that led to a reduction in the health gap between Poland and Western European countries, regrettably, a decline in life expectancy was recorded. For males, the decline amounted to 2.3 years and, for females, to 2.1 years. AIM The aim of this study was to assess changes in the level of premature mortality due to selected cardiovascular diseases in Poland before and during the COVID-19 pandemic. METHOD Time trends of deaths of patients under the age of 65 due to ischemic heart disease, cerebrovascular disease and aortic aneurysm were analyzed by gender and age groups. The joinpoint model was used in determining time trends. RESULTS Premature mortality due to all of the cardiovascular diseases analyzed had been declining steadily by about 5% per year since 2008. However, at the end of the second decade of the 21st century, a significant change in the dynamics of the trend was observed, particularly with regard to deaths from ischemic heart disease, which since 2018 caused premature mortality increases of 10% per year in the female population. In the male population, an increase of nearly 20% per year has been observed since 2019. The changes also affected premature mortality due to cerebrovascular disease. CONCLUSIONS After nearly three decades of significant decline in premature mortality from cardiovascular diseases in Poland, there was a reversal in the trend, in particular as regards ischemic heart disease. The unfavorable changes intensified in the subsequent two years. The simultaneous increase in the number of cardiovascular incidents ending in death and the decline in access to prompt diagnosis and effective treatment may explain the unfavorable changes in the deaths caused by cardiovascular disease and the increase in premature mortality due to cardiovascular disease.
Collapse
Affiliation(s)
- Wacław Moryson
- Department of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | - Paweł Kalinowski
- Department of Hygiene and Epidemiology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Paweł Kotecki
- Department of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | - Barbara Stawińska-Witoszyńska
- Department of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| |
Collapse
|
11
|
Fragkiadakis GF, Tsatinian A. Evaluation of Outpatient Access to the Greek Health System Considering the Constraints of the COVID-19 Pandemic. Cureus 2023; 15:e36704. [PMID: 37113361 PMCID: PMC10129045 DOI: 10.7759/cureus.36704] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 03/29/2023] Open
Abstract
Background The COVID-19 pandemic fundamentally changed the way healthcare is delivered in most healthcare systems around the world. It is now known that, in addition to the medical and economic impact of the pandemic on societies, there is another unmet medical need due to the difficulties and barriers that have existed and may still exist in the provision of health services at the primary care level in public hospitals. In Greece, there appears to have been a similar problem in citizens' access to health care in the country's public hospitals, which negatively affected the satisfaction of outpatients and significantly prevented them from receiving the medical care they needed. Methods This study relied on two international questionnaires; the Visit Specific Satisfaction (VSQ-9), an instrument measuring patients' satisfaction with their visit to the physician, and the Patient Satisfaction Questionnaire Short-Form (PSQ-18), consisting of 18 questions measuring both satisfaction and dissatisfaction. The questionnaires were collected electronically between 01.03.22 and 20.03.22 from two hundred and three outpatient residents of the region of Eastern Macedonia and Thrace in Greece. Results The results of the study show that satisfaction of hospital outpatient department users is positively influenced by both access to medical care after the last visit (p=0.008 < 0.05) and frequency of visits (Pearson correlation coefficient=0.178, p=0.012). In addition, lower satisfaction with access to care was found among participants with the lowest income (p=0.010) and those with a chronic illness (p=0.002), which was attributed to pandemic limitations in access to health care services in public hospital outpatient departments. Regarding the overall satisfaction of participants, 40.9% were dissatisfied, and 32.5% were dissatisfied with specific hospital services. Conclusions It was found that patients were hindered from accessing medical care in the hospital due to the restrictions caused by the pandemic. This seemed to cause problems both in accessing a specialist and in making appointments. Half of the outpatients in the sample reported having difficulty communicating with the hospital to make an appointment or to access medical services in general. A relationship was also found between patient satisfaction and the quality of services provided, in terms of medical services offered, such as their availability, and patient satisfaction with the appropriate information they receive from physicians during the pandemic period. The study also found that long-term care hospitals need to improve patient satisfaction with existing medical services.
Collapse
|
12
|
Della Polla G, Miraglia del Giudice G, Napoli A, Folcarelli L, Angelillo IF. COVID-19 Vaccination among a Population Experiencing Homelessness: A Survey in Italy. Vaccines (Basel) 2022; 10:vaccines10122118. [PMID: 36560528 PMCID: PMC9785287 DOI: 10.3390/vaccines10122118] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/04/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
The purposes of this cross-sectional study were to determine the knowledge, attitudes, and behaviors about COVID-19 and its vaccination among 313 individuals experiencing homelessness in Italy and to identify the associated factors. A total of 20.5% identified the virus as a causative agent for COVID-19 and 44.2% identified how the SARS-CoV-2 infection wastransmitted. Those living in homeless shelters were more likely to have this knowledge. Concerns about the safety of the COVID-19 vaccine werehigher in those who were younger, with secondary school as the highest level of education, who practiced Christianity, and who did not believe that COVID-19 was a severe disease. A total of 83.9% received the vaccination. Those who were older, who had correct knowledge, whoperceived to be at a higher risk of getting the disease, and who had a lower concern about the vaccine side effects were more likely to have received the vaccination. The primary reasons for accepting the COVID-19 vaccine were that it wasa preventive measure and that it wasmandatory; those unvaccinated indicated, as the main reasons, a fear of side effects and that it wasnot useful. A relationship and communication between healthcare professionals and this hard-to-reach population are needed, with the implementation of educational and information programs.
Collapse
Affiliation(s)
- Giorgia Della Polla
- Department of Public Health and Laboratory Services, Teaching Hospital of the University of Campania “Luigi Vanvitelli”, Via Luciano Armanni 5, 80138 Naples, Italy
| | - Grazia Miraglia del Giudice
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via Luciano Armanni 5, 80138 Naples, Italy
| | - Annalisa Napoli
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via Luciano Armanni 5, 80138 Naples, Italy
| | - Lucio Folcarelli
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via Luciano Armanni 5, 80138 Naples, Italy
| | - Italo Francesco Angelillo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via Luciano Armanni 5, 80138 Naples, Italy
- Correspondence: ; Tel.: +39-081-566-7717
| |
Collapse
|
13
|
Płaciszewski K, Wierzba W, Ostrowski J, Pinkas J, Jankowski M. Use of the Internet for Health Purposes-A National Web-Based Cross-Sectional Survey among Adults in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16315. [PMID: 36498389 PMCID: PMC9736358 DOI: 10.3390/ijerph192316315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
The Internet is one of the most popular information sources. This study aimed to assess the public attitudes towards the use of the Internet for health purposes as well as to identify factors associated with the use of the Internet for health purposes among adults in Poland. A web-based cross-sectional survey was carried out between 9 and 12 September 2022 on a nationwide random-quota sample of 1092 adults in Poland. The study questionnaire included 10 questions on Internet use for health purposes. The most common reason for the use of the Internet for health purposes was searching for information on drugs and their effects (69.9%). Almost two-thirds of participants used the Internet for searching for health information (64.9%), for doctors/medical services (63.4%), or for medical facilities (65.3%). Over half of the participants used the Internet for checking online reviews of doctors (55.2%) and 43.5% of the participants ordered drugs or dietary supplements online. Out of 9 different socioeconomic factors analyzed in this study, having higher education, being female, as well as living in cities from 100,000 to 499,999 residents were the most important factors (p < 0.05) associated with the use of the Internet for health purposes. This study confirmed a high level of adoption of medical Internet in Poland.
Collapse
Affiliation(s)
- Krzysztof Płaciszewski
- Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 02-507 Warsaw, Poland
| | - Waldemar Wierzba
- Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 02-507 Warsaw, Poland
| | - Janusz Ostrowski
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
| | - Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
| |
Collapse
|
14
|
Zdziarski K, Karakiewicz-Krawczyk K, Awad MS, Qumsieh N, Landowska A, Karakiewicz B. Feelings of Polish and Palestinian Students after Receiving Vaccinations against COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13692. [PMID: 36294268 PMCID: PMC9603528 DOI: 10.3390/ijerph192013692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has limited human freedom in many areas. Developing a COVID-19 vaccine has been a key task to contain the spread of the virus. In many countries, there is increasing concern about anti-vaccines due to complications after receiving the vaccine. The research problem concerns the opinions of Polish and Palestinian students after receiving vaccinations against COVID-19. This study involved 657 respondents (332 from Poland and 325 from Palestine) who completed the original questionnaire online. The respondents present two different cultures, embedded in different existential conditions, also in terms of health care, and especially the availability of vaccines. The obtained data indicate that almost 50% of research participants from both countries believe that vaccines are an effective antidote to the pandemic situation. Respondents in both populations believed that it was their personal choice to undergo vaccinations. The social motivation for vaccination in both groups was the desire to participate in public life, and the possibility of free travel for Poles, and the fear of infecting other people for Palestinians. The most common side effect reported after vaccination was pain at the site of the infection. Medical assistance was more often sought by respondents from Palestine. From an existential, psychosocial and health perspective, vaccines contributed to strengthening the vital forces in a large part of the population, allowed rebuilding social interactions and gave a sense of security in the daily functioning of a person.
Collapse
Affiliation(s)
- Krzysztof Zdziarski
- Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | | | - Mariam S. Awad
- Faculty of Nursing and Health Sciences, Bethlehem University, Bethlehem 92248, Palestine
| | - Narmeen Qumsieh
- Faculty of Nursing and Health Sciences, Bethlehem University, Bethlehem 92248, Palestine
| | - Anna Landowska
- Faculty of Economics, Finance and Management, University of Szczecin, 71-101 Szczecin, Poland
| | - Beata Karakiewicz
- Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| |
Collapse
|