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biological therapy in inflammatory bowel diseases:Access in Central and Eastern Europe

World Journal of Gastroenterology 2015年第6期21卷 1728-1737页

作者： Fanni Rencz Márta Péntek Martin bortlik Edyta Zagorowicz Tibor Hlavaty Andrzej Sliwczyński Mihai M Diculescu Limas Kupcinskas krisztina b gecse László Gulácsi Peter L Lakatos Department of Health Economics Corvinus University of Budapest Semmelweis University Doctoral School of Clinical Medicine IbD Clinical and Research Centre ISCARE a.s.1~(st) Faculty of Medicine Charles University Department of Gastroenterology The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology and Medical Center for Postgraduate Education Gastroenterology Unit Department of Internal Medicine V University Hospital Bratislava Public Health Department Health Sciences Faculty Medical University in ?ód? and National Health Fund Department of Gastroenterology and Hepatology Carol Davila University Department of Gastroenterology Medical Academy Lithuanian University of Health Sciences 1~(st) Department of Medicine Semmelweis University

biological drugs opened up new horizons in the management of inflammatory bowel diseases(IbD).This study focuses on access to biological therapy in IbD patients across 9 selected Central and Eastern European(CEE)countries,namely bulgaria,the Czech Republic,Estonia,Hungary,Latvia,Lithuania,Poland,Romania and *** data on the epidemiology and disease burden of IbD in CEE countries was systematically ***,we provide an estimation on prevalence of IbD as well as biological treatment *** all countries with the exception of Romania,lower biological treatment rates were observed in ulcerative colitis(UC)compared to Crohn’s disease despite the higher prevalence of *** heterogeneity(up to 96-fold)was found in access to biologicals across the CEE ***,bulgaria,Romania and the baltic States are lagging behind Hungary,Slovakia and the Czech Republic in their access to *** of reimbursement policy may be one of the factors explaining the differences to a certain extent in bulgaria,Latvia,Lithuania,and Poland,but association with other possible determinants(differences in prevalence and incidence,price of biologicals,total expenditure on health,geographical access,and cost-effectiveness results)was not *** assume,nevertheless,that healthdeterioration linked to IbD might be valued differently against other systemic inflammatory conditions in distinct countries and which may contribute to the immense diversity in the utilization of biological drugs for *** conclusion,access to biologicals varies widely among CEE countries and this difference cannot be explained by epidemiological factors,drug prices or total health *** in reimbursement policy could contribute to better access to biologicals in some countries.

关键词： Inflammatory bowel diseases Ulcerative colitis bio

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burden of Clostridium difficile infection between 2010 and 2013:Trends and outcomes from an academic center in Eastern Europe

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World Journal of Gastroenterology 2015年第21期21卷 6728-6735页

作者： Zsuzsanna Kurti barbara D Lovasz Michael D Mandel Zoltan Csima Petra A Golovics bence D Csako Anna Mohas Lorant Gnczi krisztina b gecse Lajos S Kiss Miklos Szathmari Peter L Lakatos 1~(st) Department of Medicine Semmelweis University Institute of Health Care Development and Clinical Methodology Semmelweis University

AIM:To analyze the incidence and possible risk factors in hospitalized patients treated with Clostridium difficile infection(CDI).METHODS:A total of 11751 patients were admitted to our clinic between 1 January 2010 and 1 *** hundred and forty-seven inpatients were prospectively diagnosed with *** the risk analysis a 1:3 matching was *** of 732 patients matched for age,sex,and inpatient care period and unit were compared to those of the CDI *** records were collected from an electronic hospital database and comprehensively ***:Incidence of CDI was 21.0/1000 admissions(2.1%of all-cause hospitalizations and 4.45%of total inpatient days).The incidence of severe CDI was 12.6%(2.63/1000 of all-cause hospitalizations).Distribution of CDI cases was different according to the unit type,with highest incidence rates in hematology,gastroenterology and nephrology units(32.9,25 and24.6/1000 admissions,respectively) and lowest rates in 1.4%(33/2312) in endocrinology and general internal medicine(14.2 and 16.9/1000 admissions)*** of CDI was 11.3%within 12 wk after *** of hospital stay was longer in patients with CDI compared to controls(17.6 ± 10.8d vs 12.4 ± 7.71 d).CDI accounted for 6.3%of allinpatient deaths,and 30-d mortality rate was 21.9%(54/247 cases).Risk factors for CDI were antibiotic therapy[including third-generation cephalosporins or fluoroquinolones,odds ratio(OR) = 4.559;P bitors(OR = 2.082,Pbetes mellitus was associated with a decreased risk for CDI(OR = 0.484;Pbination(P biotic therapy duration was longer(P < 0.02).Severity,mortality and outcome of primary infections and relapsing

关键词： Clostridium difficile infection Hospitalization Antibiotics Proton pump inhibitors

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