Official Database Research Articles

Cost Analysis of Epilepsy Healthcare in Adults: A Direct Cost Estimate From a Colombian Perspective.

To estimate the direct healthcare costs related to outpatient care and hospital stays for adults with epilepsy in the context of the Colombian healthcare system. A cost analysis was conducted from a base case, which included direct medical costs related to diagnosis, follow-up, pharmacological and surgical treatment, and in-hospital care for status epilepticus. A Delphi panel was carried out to identify and quantify cost-generating events. The monetary valuation was estimated using official databases and tariff manuals available in Colombia. The cost distribution was obtained using the bootstrapping method. Two one-way deterministic sensitivity analyses were performed. The total annual cost of an adult patient with epilepsy without including hospital stays is US dollars $2416.31. If at least 1 intensive care unit stay (8-day average) is included to treat a patient with status epilepticus, the total annual cost increases to $61 567.72. The total cost of resective surgery is $14 894.44, and the vagus nerve stimulation implant costs $26 565.86. Epilepsy in adults represents a significant economic burden for the Colombian healthcare system, comparable to that of other upper-middle-income countries. The majority of expenditure is attributed to intensive care unit stays, less financial resources would be required if patients achieve better control of the disease.

Pharmacophore, syndrome de Noé, tire-veine, and other newcomers in medical terminology. Analysis of official medical neologisms in FranceTerme

The article deals with formal and semantic neological terms in the field of medicine as a domain with a dynamically developing interdisciplinary terminology. The official French terminological database FranceTerme, available online, has been used as a corpus: namely a closed group of the 175 terms that have been added since 2011 under the heading Health and Medicine. The analysis of formal terminogenic means deals with derivation, composition, abbreviation, syntactic formation, and borrowing, which are commented upon and complemented via relevant examples. The article further deals with semantic neology, manifesting itself as terminologization of words from everyday language and their figurative use. The metaphors detected in the corpus are based both on analogies of form and function, and the most frequently occurring metonymies are based on a cause–effect relationship. The analysis is mainly qualitative, as the variability and multiplicity of terminological means involved in term formation constitute the principal limiting factors for a deeper quantitative analysis.

Public Health Threat: Detection of Undeclared Dexamethasone and Paracetamol in Jamu Marketed in Kudus, Indonesia

Jamu, Indonesia's traditional herbal medicine, holds significant cultural and medicinal value. However, the adulteration of jamu with undeclared synthetic drugs like dexamethasone and paracetamol poses a severe public health risk. This study aimed to qualitatively identify these drugs in jamu products circulating in Kudus City, Indonesia. Ten jamu samples, representing various brands and forms (powder, capsules), were purchased from local depots in Kudus. Samples were selected based on their indication for pain relief or anti-inflammatory properties, lack of BPOM (Indonesia's Food and Drug Authority) registration, or discrepancies between the registration number on the packaging and the BPOM database. Organoleptic analysis (odor, taste, color, form) was performed, followed by microscopic analysis to identify natural ingredients using their characteristic fragments. Finally, infrared spectroscopy was employed to detect the presence of dexamethasone and paracetamol. Nine out of ten samples displayed BPOM registration numbers that were not verifiable in the official BPOM database, while one sample lacked any registration number. Organoleptic analysis revealed that six samples exhibited distinct herbal odors, often associated with bitter-tasting jamu. Microscopic analysis confirmed the presence of 1-4 natural ingredients in each sample. Notably, infrared spectroscopy identified paracetamol in one sample. In conclusion, the study revealed a concerning trend of unregistered jamu products and adulteration with undeclared paracetamol in Kudus City. This highlights the need for stricter regulatory measures, enhanced surveillance, and public awareness campaigns to ensure the safety and efficacy of jamu.

German-Turkish Commodities Trade in Contrast to the Decline in German Foreign Trade

The article examines the specifics of Germany's trade with Turkey in comparison with the characteristics of all-German foreign trade. The author shows the successful development of the Turkish direction of German foreign trade after 2010, the roles of Turkey and Germany as trading partners, and examines in detail the structure of bilateral trade. Structural changes are analysed on the basis of the electronic database of German Federal Statistical Office, which allows to use the statistics in three profiles – four product groups, thirty branches and 248 product items. Particular attention is paid to the changes that occurred in 2023. The unit costs of exports and imports by product groups are calculated and a significant difference in favor of Germany is revealed for the main product group – finished products. The main branches of export and import are identified and compared with analogous branches of all-German trade flows. Based on this comparison, the peculiar features of the Turkish export market (increased role of the automotive, mechanical engineering and chemical industries, the growing importance of the production of vehicles other than cars) and the import source (increased focus on the automotive, clothing and engineering industries) are formulated. Both the most important and the most promising individual commodity items in bilateral trade are identified (the first include aircraft for export and outerwear for import, the second include auto components and cars for import). The conclusions about the likely increase in the importance of imports from Turkey and the imminent entry of this country into the top ten trading partners of Germany are substantiated.

Competitividad del sector manufacturero en México, Estados Unidos y Canadá 2006-2022: ventajas, desventajas y tendencias

This research seeks to analyze the competitiveness of the manufacturing sector in Mexico compared to the United States and Canada from 2006 to 2022 in the different industries that make it up to identify the advantages, disadvantages and trends. Official databases were consulted to correlate the information through statistics; specialists in the sector (Organization for Economic Cooperation and Development, Mexican Institute of Competitiveness, World Bank, Statistics Canada and the U.S. Bureau of Labor Statistics); reports and studies. The most productive sectors for Mexico compared to the United States and Canada are: food, beverages, tobacco, paper, non-metallic products and transport equipment. The least productive: leather and leather, furniture, textiles and automotive. And the stable ones: wood, metal products, machinery and basic metals. The main advantages: Nearshoring, geographical location, logistics and labor. The disadvantages for Mexico are high dependence on the United States, disruption, technology transfer and inflation. And trends: wage increases, sustainability, turning suppliers into partners, new technologies (cloud, 5G and AI), redesigning work and work culture.

Citizen science platforms can effectively support early detection of invasive alien species according to species traits

Abstract Early detection and rapid response are essential to deal effectively with new introductions of invasive alien species (IAS). Citizen science platforms for opportunistic recording of species are increasingly popular, and there is potential to harvest their data for early detection of IAS, but this has not been tested. We evaluated the potential of data from existing citizen science platforms for early detection of IAS by obtaining 687 first records of species from 30 European countries where there was both an official first record (i.e. published in scientific literature or by a government agency) and a record in a citizen science platform. We tested how the difference between the two (time lag) was related to species traits, popularity in citizen science platforms, public and research attention and regulatory status. We found that for 50% of the time lag records, citizen science platforms reported IAS earlier than or in the same year as the official databases. Although we cannot determine causality (the first official record could have been from a citizen science platform, or contemporaneous with it), this demonstrates that citizen science platforms are effective for IAS early detection. Time lags were largely affected by species traits. Compared with official records, vertebrates were more likely to have earlier records on citizen science platforms, than plants or invertebrates. Greater popularity of the IAS in citizen science platforms and its observation in neighbouring countries resulted in earlier citizen science reporting. In contrast, inclusion in the EU priority list resulted in earlier official recording, reflecting the efficacy of targeted surveillance programmes. However, time lags were not affected by the overall activity of citizen platforms per country. Synthesis and applications. Multi‐species citizen science platforms for reporting nature sightings are a valuable source of information on early detection of IAS even though they are not specifically designed for this purpose. We recommend that IAS surveillance programmes should be better connected with citizen science platforms, including greater acknowledgement of the role of citizen scientists and better data flow from smaller citizen science initiatives into global databases, to support efficient early detection. Read the free Plain Language Summary for this article on the Journal blog.

Impact of gut microbiota on the central nervous system relevance in neurodegenerative and psychiatric diseases

Introduction: The gut microbiota plays an important role in regulating the function of the gut-brain axis. Incorrect dietary habits promote the development of metabolic syndrome, which negatively affects the biodiversity of the microbiome. The aim of the study was to determine the influence of the gut microbiota on the function of the gut-brain axis and the development of mental and neurodegenerative diseases. Material and methods: A review of available literature was performed by searching the official databases PubMed and Google Scholar using the following keywords: metabolic syndrome, gut microbiome, metabolic microbiome, mental illness, neurodegenerative diseases with reference to original papers, meta-analyses and reviews in Polish, Ukrainian and English published in scientific journals and articles. Results: Studies evaluating the role of gut microbiota in the pathogenesis of psychiatric and neurodegenerative diseases show promising results, suggesting that gut microbiota influences brain function by modulating the gut-brain axis, the immune system, and neurotransmitter production. Despite the growing evidence implicating microbiota in the development of diseases such as depression, schizophrenia, Alzheimer's disease, and Parkinson's disease, study results often remain inconsistent, which may be due to methodological differences, heterogeneity of study populations, and sample size limitations. Conclusions: Further research on the influence of gut microbiota on the development of psychiatric and neurodegenerative diseases may contribute to a better understanding of the pathophysiology of these disorders and the discovery of new strategies for their treatment and prevention. Further research in this direction is needed to better understand the influence of gut microbiota on psychiatric and neurodegenerative disorders. Keywords: metabolic syndrome, mental illness, neurodegenerative diseases, gut microbiome, metabolic microbiome Abbreviations: International Diabetes Federation (IDF), short-chain fatty acids (SCFA), peptide YY (PYY), glucagon-like peptide-1 agonist (GLP-1), adenosine triphosphate (ATP), blood-brain barrier (BBB), central nervous system (CNS), Alzheimer's disease (AD), pathogen-associated molecular patterns (PAMPs), Toll-like receptors (TLRs), autism spectrum disorder (ASD), social anxiety disorder (SAD), bipolar disorder (BD), Young's Mania Rating Scale (YMRS), World Health Organization (WHO), Parkinson’s disease (PD), attention deficit hyperactivity disorder (ADHD)

Implementation Prospects of Investment Process For The Investors

The article covers the formation and development of the accumulative pension fund, its influence on the development of capital investment in production activities. Specific factors that can narrow the fund's participation in investment projects are given. Specific proposals are given to activate the investment of the fund's capital in the company's activities. This study explores the development and challenges of institutional investment processes in Uzbekistan, focusing on the accumulative pension fund (APF) as a key player in the country’s investment landscape. Utilizing both quantitative and qualitative research methodologies, data from official Uzbek databases were analyzed statistically. The results highlight significant limitations in the current investment climate, including underdeveloped financial infrastructure, narrow investment portfolios, and regulatory constraints on fund activities. Despite these challenges, the APF has the potential to catalyze market growth through strategic investments in securities and corporate bonds. The study concludes that creating a favorable investment environment, coupled with improved management practices and broader financial instruments, could transform institutional investors into vital contributors to Uzbekistan’s economic growth and industrial development

Validation Of Matching Nik, Npwp And Assistance In Filling Out Annual Tax Returns With Ibi Kosgoro Tax Volunteers For 2024 Term Of Service

Matching of Population Identification Numbers (NIK) and Taxpayer Identification Numbers (NPWP), as well as assistance in filling out the Annual Tax Return (SPT). Validation of NIK and NPWP is a critical step in identifying and ensuring the validity of individual and company data in various administrative processes, especially those related to tax obligations. NIK validation involves matching a person's personal identity data with an official government database, while NPWP validation verifies the existence and validity of a company's tax identification number. These two processes support the accuracy of information used in various financial transactions and reporting. Apart from validation, assistance in filling out the Annual Tax Return is also important to ensure that the tax documents submitted comply with applicable tax regulations. This assistance can take the form of technical assistance in filling out SPT forms, consultation regarding income classification and processing tax deductions, as well as interpretation of the latest applicable regulations. Validation of NIK and NPWP as well as assistance in filling out the Annual SPT plays an important role in supporting administrative efficiency and tax compliance. By optimizing these processes, it is hoped that it can improve tax compliance, reduce the risk of administrative errors, and increase transparency and accountability in data management and financial reporting.

Trends and Characteristics of the Whole-Grain Diet.

Whole-grain foods are good choices for a nutritious diet and play an important role in lowering the risk of chronic diseases. China is a large cereal-consuming country that is experiencing rapid economic growth and an increased burden of noncommunicable diseases. Studies have shown that insufficient intake of whole grains has increased the burden on public health to some extent. Therefore, we aimed to analyze the characteristics and trends of whole-grain consumption in China to contribute to the development of a healthy Chinese population. We searched for important policies, standards, and dietary recommendations related to whole grains through the official websites of the China State Council and its affiliated ministries. Official and public databases, such as the National Bureau of Statistics and the China Health and Nutrition Survey (CHNS), were utilized to obtain data on whole grains and different foods. This approach was employed to gain insight into changes in whole-grain intake levels and dietary structure. Since 2010, the development of whole grains in China has received significant attention. Supportive policies have been continuously introduced on both the supply and demand sides. Numerous whole-grain standards have been developed, and terms and definitions related to whole grains have been preliminarily defined. The consumption of whole grains has fluctuated among Chinese residents since 2000, with a downward trend from 2000 to 2009, followed by an upward trend from 2009 to 2018. However, despite this increasing trend, the whole-grain intake of 80% of the adult residents was still lower than the minimum recommended dietary intake (50[Formula: see text]g/day). Furthermore, the dietary structure of Chinese residents has undergone a significant transformation, characterized by high consumption of high-fat foods, excessive consumption of meat, low intake of dietary fiber, and insufficient consumption of whole grains. These findings highlight the need for further monitoring of whole-grain intake in China. In addition, a sound whole-grain standardization system should be established, and the availability and consumer awareness of whole grains should be improved, with the goal of increasing the intake of whole grains.

Evaluation of Changes in Land Use and Their Influence on Ecological Stability of a Selected Area of the Dolný Spiš Region (Slovakia)

In this study, the landscape and ecological stability of the Dolný Spiš region are investigated, focusing on human-induced changes and land use patterns. The purpose is to assess the impact of industrial, agricultural, and social activities on the landscape structure, using current and historical data. Field mapping and data from the DATAcube (Database of the Slovak Statistical Office) and CORINE Land Cover databases (Landscape cover layer for the whole territory of Europe) were used to evaluate land use, with ecological stability measured through the coefficient of ecological stability (CES). Three methodologies—Míchal, Löw, and Miklós—were applied and adjusted for local conditions. The study area, predominantly covered by forests (over 80%), was classified as highly stable based on CES values, with forested areas contributing significantly to this classification. Additionally, the non-forested areas were analyzed to assess the full scope of anthropic influence, revealing low-intensity human activity, as indicated by the coefficient of anthropic influence (CAI), ranging from 0 to 0.45. The results demonstrate that the landscape’s ability to resist disruptive elements is strong, particularly in forested regions. Overall, in this study, the critical role of forests is highlighted in maintaining the ecological stability in the region and suggests that the landscape structure remains resilient despite ongoing changes in agricultural land use.

Financial Framework for Non-Resource Exports to Foster the Dynamic Growth of the Russian Economy

The relevance of the article is rooted in the critical role of the non-resource sector in the Russian economy, particularly in the face of increasing sanctions.The purpose of the article is to propose a comprehensive framework for financial assistance to non-resource exports, fostering the sustained growth of the Russian economy in the current context.Methods: the research methodology is based on general and special methods of cognition; analysis of reports of international organizations, official databases of statistical data, normative documents, monographs and scientific publications.Scientific novelty: Drawing on the analysis of successful international approaches, we have developed a holistic framework for financial assistance to non-traditional exports in Russia. This framework is designed to complement the national project “International Cooperation and Export”, which is focused on implementing the Strategy for the Development of Foreign Economic Activity of the Russian Federation until 2030.Research results: The article explores the global experience of comprehensive export support systems and suggests financial measures to help Russian manufacturers of industrial products.Practical significance of the article lies in the fact that the financial instruments developed for non-primary non-energy exports can be used in the implementation of the Federal National Project “International Cooperation and Export”.

Epidemiological insights and geographic clusters for COVID-19 in Taiwan using a mixture scan statistic

The COVID-19 pandemic has posed unprecedented public health challenges worldwide, necessitating a comprehensive understanding of its transmission dynamics. This study examines the correlation between COVID-19 transmission and various risk factors, focusing on the impact of population structure and socio-economic conditions in Taiwan. By analyzing official government databases, we explore how factors such as population density, dependency ratios, and socio-economic environment influence the spread of COVID-19. Our findings highlight that densely populated areas, along with regions characterized by higher child dependency ratios and a significant number of low- and middle-income households, exhibit higher transmission rates. This research underscores the importance of considering socio-economic disparities and healthcare access in developing effective public health strategies. Furthermore, we utilize a mixture scan statistic to identify disease hotspots, taking into account spatial correlation and covariate effects. This approach can detect clusters based on known risk factors and help to assess possible unknown geographic risks, facilitating targeted interventions and resource allocation. Our study contributes to the broader understanding of COVID-19 transmission dynamics, offering insights into the importance of integrating socio-economic factors and spatial analysis in pandemic response efforts.

Will the COVID-19 infection affect the performance of top basketball players? A data-driven analysis.

To investigate the changes in the game performance of high-level basketball players in NBA league before and after the COVID-19 infection. Athletic statistics were collected from official database for 68 players (19 forwards, 29 guards, 20 centers; mean age 27.14 ± 3.65 years) in the NBA league for 10 games before and after infection with COVID-19. We used a the Kruskal-Wallis analysis of variance to examine the impact caused by COVID-19. Among all 68 players, a statistically significant decrease in plus/minus (Z = -2.392, p = 0.017) and free throw shooting (FT% Z = -2.153, p = 0.031), occurred compared to the pre-infection with COVID-19. Among the interior players, we found a statistically significant decrease in free throw shooting FT% (Z = 2.674, p = 0.021), Plus/Minus (Z = -2.371, p = 0.018). Among centers and forwards, there was no statistically significant change. The impact of COVID-19 on players' fatigue and cardiorespiratory and muscular endurance may have contributed to the decline in performance, and the impact of detraining due to isolation should not be ignored.

A prediction model of PTSD in the Israeli population in the aftermath of october 7th, 2023, terrorist attack and the Israel–Hamas war

BackgroundOn October 7th, 2023, a mass terror attack was launched by Hamas militants, which was followed by the Israel-Hamas war. These events constitute a nationwide trauma with major ramifications for public mental health. This article presents an evidence-based model for the prediction of the prevalence of posttraumatic stress disorder (PTSD) related to the terrorist attack and the war.Main body: The creation of the model consisted of several steps. Firstly, the Israeli population was divided into six groups based on the intensity, context, and type of traumatic exposure (direct exposure to terror, close proximity to terror, soldiers in combat and support units, intense exposure to rocket attacks, moderate exposure to rocket attacks, and indirectly affected communities), and the population size of each group was assessed using official national databases. Secondly, an estimation of the expected prevalence of PTSD in each of the exposure groups was based on a review of the relevant literature. A random-effects meta-analysis of the prevalence rates was conducted separately per each exposure group. Finally, the predicted number of PTSD causalities in the population was calculated by multiplying the group size and the PTSD prevalence estimation. Based on population size and estimated PTSD prevalence within each exposure category, the model predicts that approximately 5.3% (N = 519,923) of the Israeli population (95% confidence interval, 1.64–9%), may develop PTSD as a result of the terrorist attack and the war.ConclusionsThe predicted number of individuals with PTSD following mass trauma is expected to be considerable. The presented model can assist policymakers, clinicians, and researchers in preparing and devising adequate interventions for the mental health needs of large populations. Moreover, this model can be applied in other instances of mass-trauma exposure.

Study on access to social protection policies by homeless people during the COVID-19 pandemic

Abstract The study analyzed the access of homeless people (HP) to health and social protection policies, including emergency measures, during the COVID-19 pandemic in Belo Horizonte (BH), capital of the state of Minas Gerais, Brazil. Its main objective was to provide data on the profile of HP in the municipality, in addition to evaluating existing public policies focused on HP, based on the time frame of the health emergency. Study with mixed methods design with triangulation of quantitative and qualitative data. It used official databases in parallel with document analysis, interviews and focus groups. As a result, the cartography showed that in the first months of the pandemic the municipality had difficulty reorganizing the health system, which underwent constant protocol updates, consolidating, however, over the months. Important emergency interventions in the municipality of BH involved activities that facilitated HP’s access to the provision of services, including intersectorality between health services, social assistance and the third sector. The temporary offer of various intersectoral services, simultaneously with the offer of daytime shelters by organized civil society, was considered a key factor for the expansion and intensification of care networks for HP during the emergency phase. Itinerant services were among those with the greatest positive evidence of service to HP, with emphasis on the ‘Consultório na Rua’. The study concluded that understanding the profile of homeless people in BH and the intersectoral variables that impact HP contributes to better directing investments in interventions for these individuals and increasing the effectiveness of health and social protection systems, in line with with the work carried out by the third sector. Key messages • Understanding the inter-sector variables that impact Homeless People contributes to better targeting of investments in interventions in protection social. • Knowing the profile of the homeless population makes it possible to organize more effective health care and social assistance.

National trends of left ventricular assist device therapy in Germany

Abstract Background The prevalence of advanced heart failure (HF) is increasing and prognosis remains poor. Although heart transplantation is still considered to be the gold standard for the treatment of advanced HF in selected patients, its use is limited by organ donor shortage and a growing burden of cormorbidities among potential recipients. The 2021 European Society of Cardiology (ESC) guidelines recommend consideration of long-term mechanical circulatory support with a left ventricular assist device (LVAD) in eligible patients with advanced heart failure (HF) who are refractory to medical/device therapy. Purpose The purpose of this study was to evaluate the national trends of LVAD in Germany. The main hypothesis was that LVAD therapy is still underutilized. Methods From the national database of the German Federal Statistical Office (DESTATIS), we identified all patients who underwent LVAD implantation in Germany between January 2011 and December 2022 (n = 9,232). We compared temporal trends and in-hospital outcomes. Results From 2011 to 2022, number of LVAD implantation was highest in the year 2017 (n = 914) and steadily decreased over the following years (2022: n = 617). Mean age of LVAD recipients was 56.2 years (2011-2015) and increased to 58.4 years (2020-2022). The majority of LVAD recipients are male (84,8 %), and this trend has been stable during the entire time period. In-hospital mortality after LVAD remains high, but has been decreasing (25.8% during 2011-2015 compared to 20.2% during 2020-2022). Conclusion Although LVAD is recommended in eligible patients with advanced HF, our study suggests an underutilization of LVAD in this patient population and especially in female patients.

Approach to Mental Disorders in Dental Education in a Brazilian State

Oral diseases present higher prevalence in people with mental disorders, which makes dental care a possible means for screening and referral to mental health specialized care. Because some dental conditions can be caused by or associated with mental disorders, dentists can identify patients’ mental health care needs. However, they have shown low confidence and a lack of training in dealing with mental health patients, which may indicate a deficiency in the approach to mental disorders in dental education. This study aimed to verify whether undergraduate Dentistry courses in a Brazilian state introduce knowledge about adult mental disorders into their curriculum content. The courses operating in the state of Minas Gerais, Brazil, were assessed by information available at the e-MEC system, the official database of courses and Higher Education Institutions in Brazil, and at institutions’ websites. Two researchers independently assessed pedagogical projects, curriculum matrices, syllabi, and teaching plans. Psychology disciplines Applied Psychology and Psychology-related were identified, and their syllabi and teaching plans were screened, searching for themes related to mental disorders and/or psychopathology. Of the 73 courses included, 34 were evaluated, and only five courses presented disciplines with some approach to mental disorders and/or psychopathology. The results showed that a large part of undergraduate Dentistry courses assessed do not address knowledge about adult mental disorders as part of dental education. Considering the impact of mental disorders on oral and systemic health, it is important to reflect on the role of dentists in mental health care and on the responsibility of Higher Education Institutions regarding the development of skills and competencies of these professionals. The results of this study draw attention to the need to address adult mental disorders in dental education, reinforcing mental health as an important aspect of patients’ general health.

Effect of the Covid-19 pandemic on hospitalizations for non-Covid-19-pneumonia and exacerbations of chronic obstructive pulmonary diseases in Switzerland: comparison of national data between 2020/2021 and 2015–2019

BackgroundProtective measures applied during the Covid-19 pandemic had a marked impact on the incidence of pneumonia. However, systematic data are lacking for hospitalizations for pneumonia and acute exacerbations of chronic obstructive lung diseases (AECOPD) not caused by SARS-CoV-2 in Switzerland. We aimed to compare the incidences of hospitalization for these entities between 2020/2021 and prepandemic years.MethodsThis retrospective study examined all nationwide hospitalizations for non-Covid-19-pneumonia and AECOPD listed as primary diagnoses based on ICD-10 codes between 2015 and 2021 in a publicly available hospitalization database of the Swiss Federal Statistical Office. Hospitalizations for acute coronary syndrome (ACS) and stroke were used as controls. Changes of monthly incidences of hospitalizations, length of stay (LOS) and mortality were compared between 2020/2021 and the average of 2015–2019.ResultsThe incidences of hospitalizations for AECOPD and for pneumonia showed seasonal variations from 2015 to 2019 followed by significant and almost identical decreases in 2020/2021 (incidence rate ratio [IRR] 0.59, 95% CI: 0.45–0.77, p < 0.001, and IRR: 0.62, 95% CI: 0.52–0.74, p < 0.001, respectively). Hospital-mortality was slightly higher in 2020/2021 for AECOPD (2015–2019: 3.8%; 2020/2021: 4.2%, odds ratio [OR] 1.24, 95% CI: 1.07–1.44, p = 0.004) and for pneumonia (2015–2019: 4.5%, 2020/2021: 4.6%, odds ratio [OR] 1.17, 95% CI: 1.07–1.28, p < 0.001). Median LOS slightly decreased for AECOPD (2015–2019: 8 [IQR: 5–14] days; 2020/2021: 7 [IQR: 4–13] days, Wilcoxon test: p < 0.001) but slightly increased for pneumonia (2015–2019: 7 [IQR: 4–11] days; 2020/2021: 7 [IQR: 4–13] days, Wilcoxon test: p < 0.001). Throughout 2020/2021, there were no significant fluctuations observed in the incidences of ACS and stroke. (IRR: 0.98, 95% CI: 0.83–1.16, p = 0.810, IRR: 0.96, 95% CI: 0.81–1.14, p = 0.636, respectively).ConclusionThe first two years of the Covid-19 pandemic showed a marked decrease in incidences in AECOPD and non-Covid-19 pneumonia hospitalizations in Switzerland. It is likely that this effect is associated with the society-based, at first vigorous, social distancing measures.

A cost-utility analysis of single maintenance and reliever (SMART) therapy as compared to step 3 fixed-dose therapy in patients aged 12 years or more with uncontrolled asthma.

A significant percentage of patients with asthma appear to benefit from the addition of long-acting β2-agonists (LABAs) to ICS to achieve better control of their disease. The aim of the present study was to determine the cost-utility of single inhaler combination inhaled ICS/LABAs as both maintenance and reliever (SMART) versus remaining at the same treatment step with fixed-dose ICS-LABA maintenance with a short-acting β2-agonist (SABA) as reliever in patients aged 12 years or more with uncontrolled asthma. A Markov-type model was developed to estimate the costs and health outcomes of a simulated cohort of patients aged 12 years or more with uncontrolled asthma treated for 12 months. The effectiveness data and transition probabilities were obtained from a recent meta-analysis. Cost data were obtained from official databases provided by the Colombian Ministry of Health. The main outcome was the variable "quality-adjusted life-years" (QALYs). The base-case analysis showed that compared with remaining at the same GINA treatment step with ICS/LABA maintenance plus SABA reliever, ICS/LABAs as SMART was associated with lower costs, US$2,906.92 versus $4,462.02 average cost per patient, and the greatest gain in QALYs, 0.8540 versus 0.8258 QALYs on average per patient, thus leading to dominance. Compared with remaining at the same GINA treatment step with ICS/LABA maintenance plus SABA reliever, ICS/LABAs as SMART is more cost-effective in patients aged 12 years or more with uncontrolled asthma. This is because ICS/LABAs as SMART showed a greater gain in QALYs at lower total treatment costs.