Public health impact and return on investment of the pediatric immunization program in Poland.

BACKGROUND: This study aims to evaluate the epidemiological impact and return on investment of the pediatric immunization program (PIP) in Poland from the healthcare-sector and societal perspectives. RESEARCH DESIGN AND METHODS: A health-economic model was developed focusing on the nine vaccines, targeting 11 pathogens, recommended by the public health authorities for children aged 0-6 years in Poland. The 2019 birth cohort (388,178) was followed over their lifetime, with the model estimating discounted health outcomes, life-years gained, quality-adjusted life-years, and direct and indirect costs with and without the PIP based on current and pre-vaccine - era disease incidence estimates, respectively. RESULTS: Across 11 targeted pathogens, the Polish PIP prevented more than 452,300 cases of disease, 1,600 deaths, 37,900 life-years lost, and 38,800 quality-adjusted life-years lost. The PIP was associated with vaccination costs of €54 million. Pediatric immunization averted €65 million from a healthcare-sector perspective (benefit-cost ratio [BCR], 2.2) and averted €358 million from a societal perspective (BCR, 7.6). The BCRs from both perspectives remained >1.0 in scenario analyses. CONCLUSIONS: The Polish PIP, which has not previously been systematically assessed, brings large-scale prevention of disease-related morbidity, premature mortality, and associated costs. This analysis highlights the value of continued investment in pediatric immunization in Poland.

Strength Parameters of Clay Brick Walls with Various Directions of Force.

The study analyzes the anisotropy effect for ceramic masonry based on experimental tests of samples made of 25 × 12 × 6.5 cm3 solid brick elements with compressive strength fb = 44.1 MPa and cement mortar with compressive strength fm = 10.9 MPa. The samples were loaded in a single plane with a joint angle that varied from the horizontal plane. The load was applied in a vertical direction. The samples were loaded at angles of 90°, 67.5°, 45°, 22.5°, and 0° toward the bed joints. The most unfavourable cases were determined. It was observed that the anisotropy of the masonry significantly influences the load-bearing capacity of the walls depending on the angle of the compressive stresses trajectory. Approximation curves and equations for compressive strength, Young's modulus, and Poisson's coefficient were proposed. It was observed that Young's modulus and Poisson's ratio will also change depending on the trajectory of compressive stresses as a function of the joint angle. Experimental tests allowed to determine the failure mechanism in prepared specimens. The study allowed to estimate the masonry strength with the load acting at different angles toward the bed joints.

Costs of management of patients with coronary artery disease in Poland: the multicenter RECENT study.

INTRODUCTION: Treatment of coronary artery disease (CAD) generates the major part of public health expenditure in the developed countries. OBJECTIVES: The aim of the study was to estimate costs associated with the diagnosis and treatment of patients with CAD in Poland. PATIENTS AND METHODS: Costs were estimated in a representative sample of 2593 patients with CAD receiving general practitioner (n = 1977) or specialist care (n = 616) in 2005 (the multicenter RECENT study). Data from the National Health Fund, Social Insurance Institution, Central Statistical Office, and current literature were used. RESULTS: The total annual cost of CAD reached €2254.17 per patient, with 48% accounting for direct medical costs (drugs, medical consultations, laboratory tests, diagnostic procedures, invasive treatment, hospitalizations, emergency care) and 52% for indirect costs (related to absence at work and disability). Eighty-one percent of total direct medical costs were covered by the public payer (including 30% of pharmacological treatment costs). Direct medical costs covered by the public payer were higher in men and in patients with more severe angina symptoms (both P <0.05). In the model based on the lowest prevalence of CAD (estimated based on the real population of patients treated in 2005), direct medical costs covered by the public payer reached €617.6 million, i.e., around 7% of the total public health expenditure in Poland in 2005. CONCLUSIONS: Modern management of CAD imposes enormous economic burden on the public health system in Poland. There is a need to develop and implement strategies that would optimize health care costs associated with the treatment of CAD.

Rilmenidine--its antihypertensive efficacy, safety and impact on quality of life in perimenopausal women with mild to moderate essential hypertension.

OBJECTIVES: A prospective, open-labeled study to assess the antihypertensive effect of monotherapy with rilmenidine and its impact on quality of life (QoL), as well as on biochemical parameters in perimenopausal women with essential hypertension. DESIGN AND METHODS: Fifty-five perimenopausal women with mild to moderate essential hypertension (mean age 51.4+/-2.4 years) were enrolled. At baseline and after 12-week monotherapy with rilmenidine, we assessed: systolic (SBP) and diastolic (DBP) blood pressure (BP), heart rate (HR), fasting glucose, serum creatinine and total cholesterol levels. QoL was also assessed at baseline and at 12 weeks by two standardized questionnaires: the Short Form - 36 (SF-36) and the Subjective Symptoms Assessment Profile (SSAP). Statistical analysis was performed using Student's t-test to compare changes in BP, QoL and biochemical parameters during therapy with rilmenidine. RESULTS: After 12 weeks of therapy, there was a significant decrease in BP and HR. Normalization of BP was observed in 46 (84%) women. Rilmenidine did not influence serum creatinine, fasting glucose and lipid profile. Treatment was very well tolerated by the patients and no side-effects were noted. Both the SF-36 and the SSAP demonstrated improvement in general QoL. We observed a significant improvement in all SF-36 subscales. In the SSAP, a similar significant improvement was found, except dizziness subscale. Improvement in QoL was not related to reduction of BP. CONCLUSIONS: Monotherapy with rilmenidine is safe and effective in BP treatment and significantly improves QoL in perimenopausal women with essential hypertension.