Effectiveness and Safety of Measures to Prevent Infections and Other Complications Associated With Peripheral Intravenous Catheters: A Systematic Review and Meta-analysis.

BACKGROUND: Peripheral intravenous catheters (PIVCs) contribute substantially to the global burden of infections. This systematic review assessed 24 infection prevention and control (IPC) interventions to prevent PIVC-associated infections and other complications. METHODS: We searched Ovid MEDLINE, Embase, Cochrane Library, WHO Global Index Medicus, CINAHL, and reference lists for controlled studies from 1 January 1980-16 March 2023. We dually selected studies, assessed risk of bias, extracted data, and rated the certainty of evidence (COE). For outcomes with 3 or more trials, we conducted Bayesian random-effects meta-analyses. RESULTS: 105 studies met our prespecified eligibility criteria, addressing 16 of the 24 research questions; no studies were identified for 8 research questions. Based on findings of low to high COE, wearing gloves reduced the risk of overall adverse events related to insertion compared with no gloves (1 non-randomized controlled trial [non-RCT]; adjusted risk ratio [RR], .52; 95% CI, .33-.85), and catheter removal based on defined schedules potentially resulted in a lower phlebitis/thrombophlebitis incidence (10 RCTs; RR, 0.74, 95% credible interval, .49-1.01) compared with clinically indicated removal in adults. In neonates, chlorhexidine reduced the phlebitis score compared with non-chlorhexidine-containing disinfection (1 RCT; 0.14 vs 0.68; P = .003). No statistically significant differences were found for other measures. CONCLUSIONS: Despite their frequent use and concern about PIVC-associated complications, this review underscores the urgent need for more high-quality studies on effective IPC methods regarding safe PIVC management. In the absence of valid evidence, adherence to standard precaution measures and documentation remain the most important principles to curb PIVC complications. CLINICAL TRIALS REGISTRATION: The protocol was registered in the Open Science Framework (https://osf.io/exdb4).

Pharmacovigilance practice among pediatric neurologists from Poland and Germany.

OBJECTIVES: To compare the pediatric neurologists' knowledge, practice, and barriers to the pharmacovigilance (PV) process in Poland and Germany. METHODS: The research tool was an online anonymous questionnaire on Google Forms e-mailed to pediatric neurologists from Poland and Germany. RESULTS: The questionnaires were handed out to 830 pediatric neurologists and 371 expressed their consent to participate in the study. Most of the neurologists were familiar with the definition of PV and adverse drug reactions (ADRs). Only 34.10% of pediatric neurologists from Poland, and 38.88% from Germany believe that many ADRs are preventable and almost most of them believe it is necessary to report ADRs from children with epilepsy. Unfortunately, in opposite to this knowledge, only 37.79% of respondents from Poland and 40.32% from Germany felt co-responsible for reporting ADRs. The main reason for the neurologists not to report ADRs was a conviction that reporting ADRs would be an additional burden generating extra work. CONCLUSION: There is no big difference between the practice of PV by pediatric neurologists in Poland and Germany. System-regulated PV stabilization in the country translates into the practice of maintaining PV. Monitoring the safety of pharmacotherapy and knowledge of risks associated with ADRs should be included in the curricula of academic neurologics courses.

Epilepsy is a chronic disorder characterized by episodic, gratuitous seizures. Most children with epilepsy (CWE) rely on antiepileptic drugs causing adverse drug reactions (ADRs). Many ADRs are preventable if physicians actively participate in pharmacovigilance (PV), which its pivotal role is to ensure the safety of pharmacotherapy by e.g. permanent control of ADRs. The study aimed to compare the pediatric neurologists' (PN) knowledge, practice, and barriers to the PV process in Poland and Germany. The research tool was an online anonymous questionnaire on Google Forms e-mailed to PN from Poland and Germany. Only 34.10% of PN from Poland and 38.88% from Germany believe that many ADRs are preventable and almost most of them believe it is necessary to report ADRs from CWE. Unfortunately, in opposite to this knowledge, only 37.79% of respondents from Poland and 40.32% from Germany felt co-responsible for reporting ADRs. The main reason for the neurologists not to report ADRs was a conviction that reporting ADRs would be an additional burden generating extra work. There is no big difference between the practice of PV by PN in Poland and Germany. System-regulated PV stabilization in the country translates into the practice of maintaining PV.

Impact of patient knowledge on hypertension treatment adherence and efficacy: A single-centre study in Poland.

Introduction: Recent studies show that treatment of arterial hypertension is unsuccessful. This is due to the patients' insufficient knowledge of about the therapeutic methods and the consequences of not treating arterial hypertension. Objectives: The aim of the study was to evaluate the patients' knowledge concerning therapeutic options, prophylaxis, and complications of arterial hypertension. The study also assessed the effect of such knowledge on hypertension treatment adherence and efficacy. Patients and Methods: The survey included 488 patients (250 female and 238 male), aged over 18 years, diagnosed with and treated in outpatient and inpatient settings at selected healthcare institutions in Poland. A custom-made questionnaire, based on references on this subject, was the key tool in the present study. Information about the course of the disease and evaluation of hypertension treatment efficacy was based on the patients' medical records. Results: The study found that 54.7% of the subjects had good knowledge about arterial hypertension, 40.0% had average knowledge, and 5.3% had poor knowledge. The extent of knowledge about the disease was significantly dependent on the level of education and the place of receiving medical care (p< 0.05). Good knowledge was significantly associated with controlled blood pressure, number of antihypertensive drugs used, frequency of hospitalization, as well as with medication adherence, and healthy lifestyle behaviours (p< 0.05). Conclusions: More than half of the patients presented good knowledge but a large group still had poor knowledge, especially patients with a low level of education and with hypertension treated at a general practitioner's clinic. The results of our study clearly show that knowledge about arterial hypertension affects medication adherence and healthy lifestyle behaviours and improves hypertension treatment efficacy.

A survey of pharmacists' knowledge, attitudes and barriers in pharmaceutical care concept in Poland.

BACKGROUND: The major goals of pharmaceutical care (PC) are to improve the patient's quality of life and ensure safety of pharmacotherapy. Inclusion of a pharmacist in the multidisciplinary team caring for the patient and integration of state-of-the-art pharmaceutical services with medical care and nursing are some of the most important challenges that the health care system in Poland is facing. OBJECTIVES: To evaluate the pharmacists attitudes towards practice in, and knowledge of PC in Poland and to identify the barriers in PC provision. METHODS: The study was designed as a multicenter study, conducted among Polish pharmacists. Random sampling technique was employed to select the study group. Face-to-face questionnaire method was used to interview the pharmacists, upon obtaining their prior verbal consent to participate in the study. The study was conducted between January 2017 and September 2019. RESULTS: Only 15% of the pharmacists have ever attended a training on PC. 72% believed PC provision was necessary to ensure pharmacotherapy safety. Only 63% of the pharmacists believed that preventing and solving health-related and drug therapy problems for patients were their responsibilities. The main reason for non-provision of PC by the pharmacists was the lack of time for such activities, lack of legal regulations, lack of organizational facilities. CONCLUSION: This study indicates that implementation of PC is expected in Poland. Educational programs in this respect are urgently needed. PC provision should be included in the curricula of academic pharmaceutical courses.

How current biologic therapies affect the risk of major adverse cardiovascular events in patients with plaque psoriasis? A systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: Concerns have been raised about an increased risk of major adverse cardiovascular events (MACEs) - stroke, myocardial infarction and sudden cardiac death - in patients with plaque psoriasis receiving biologic therapies. AIM: This review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the risk difference of MACEs between experimental and comparator interventions. MATERIAL AND METHODS: We searched MEDLINE database for suitable trials. Prior to that we identified the search strategy and eligibility criteria. Each RCT was double-blind, placebo controlled and scored five points in Jadad scale. We calculated risk difference (RD) with use of the Mantel-Haenszel fixed-effect method with 95% confidence intervals (CIs) and calculated i2 statistic to assess heterogeneity. A total of 43 RCTs were included, involving 19,161 patients. Overall, the risk of MACEs in the included studies was 0.1% (n = 21). RESULTS: There were no statistically significant risk differences in patients treated with biologic therapy vs. placebo (RD = 0.0; Z = 1.09; 95% CI: 0.0-0.0; p = 0.28); tumour necrosis inhibitors vs. placebo (RD = 0.0; Z = 0.47; 95% CI: -0.0-0.0; p = 0.64); anti-IL-17A agents vs. placebo (RD = 0.0; Z = 1.25; 95% CI: -0.0-0.01; p = 0.21); anti-IL-23 agents vs. placebo (RD = 0; Z = 0.36; 95% CI: -0.0-0.01; p = 0.72); anti-IL-12/23 agents vs. placebo (RD = 0.0; Z = 0.73; 95% CI: -0.0-0.0; p = 0.46). CONCLUSIONS: Further trials are needed, including longer follow-up and patients with an increased cardiovascular risk, to assess the risk of MACEs.

Safety of medicines-Pharmacists' knowledge, practice, and attitudes toward pharmacovigilance and adverse drug reactions reporting process.

PURPOSE: Patients' safety is a public concern in healthcare systems across the world and should be ensured, among others, by pharmacovigilance based on spontaneous reports of adverse drug reactions (ADRs). Spontaneous ADRs reporting is an important component of the pharmacovigilance system. The role of pharmacists in spontaneous ADRs reporting is crucial in the pharmacovigilance system since it helps to monitor the patients' treatment in real-life conditions. The aim of the study was to evaluate the pharmacists' attitudes to and knowledge on spontaneous ADRs reporting in Poland and to identify the reasons for underreporting of ADRs. METHODS: The study was conducted between January 2016 and January 2018. A self-administered questionnaire was designed and distributed to pharmacists. The pharmacists were randomly selected from the official database kept by the chief pharmaceutical inspectorate in Poland. RESULTS: Only 16% (n = 84) of the respondents have ever attended a training on pharmacovigilance. Eighty-one percent (N = 422) of pharmacists believe that not all synthetic drugs available on the market were safe. Twenty-eight percent (n = 146) of the respondents were certain about safety of drugs of natural origin, and 16% (n = 84) were of an opinion that adverse reactions following administration of such drugs should not be reported at all. CONCLUSIONS: To conclude, there is an increasing awareness of the need to develop pharmacovigilance practices. The current (not fully adhered to in practice) model of pharmacovigilance and its associated tools have been developed for synthetic drugs, and applying these methods to monitor safety of herbal medicines presents unique challenges.

Evaluation of the antidepressant, anxiolytic and memory-improving efficacy of aripiprazole and fluoxetine in ethanol-treated rats.

Some study results indicate a positive effect of aripiprazole (ARI) on impaired cognitive functions caused by brain damage resulting from chronic EtOH abuse. However, other research shows that to manifest itself, an ARI antidepressant effect requires a combined therapy with another selective serotonin reuptake inhibitor antidepressant, namely, fluoxetine (FLX). The aim of this article was to assess antidepressant and anxiolytic effects of ARI as well as its effect on spatial memory in ethanol-treated (alcoholized) rats. On the basis of alcohol consumption pattern, groups of (1) ethanol-preferring rats, with mean ethanol intake above 50%, and (2) ethanol-nonpreferring rats (EtNPRs), with mean ethanol intake below 50% of total daily fluid intake, were formed. The group of EtNPRs was used for this study, subdivided further into three groups administered ARI, FLX and a combination of both, respectively. Behavioral tests such as Porsolt's forced swimming test, the Morris water maze test and the two-compartment exploratory test were employed. Behavioral test results demonstrated (1) no antidepressant effect of ARI in EtNPRs in subchronic treatment and (2) no procognitive effect of ARI and FLX in EtNPRs in combined single administration. Combined administration of both drugs led to an anxiogenic effect and spatial memory deterioration in study animals. ARI had no antidepressant effect and failed to improve spatial memory in rats. However, potential antidepressant, anxiolytic and procognitive properties of the drug resulting from its mechanism of action encourage further research aimed at developing a dose of both ARI and FLX that will prove such effects in alcoholized EtNPRs.

Evaluation of antidepressant and memory-improving efficacy of aripiprazole and fluoxetine in alcohol-preferring rats.

INTRODUCTION AND AIMS: Dependence on ethanol increases the risk of depression in patients and leads to a damage and deficiencies of brain function, which manifest in cognitive functions impairment. Aripiprazole (ARI) is an atypical antipsychotic drug, which has also been shown to have a beneficial effect on cognitive function. Results of many studies show that, for ARI's antidepressant effect to manifest itself, it is necessary to use a combined therapy with a drug from the group of selective serotonin reuptake inhibitors (SSRIs). The aim of this paper was to assess the antidepressant and impact of ARI on spatial memory in alcohol-preferring rats (EtNPRs). DESIGN AND METHODS: In our study, we used Porsolt's forced swimming test (antidepressant effect) and Morris water maze test. The tests have been conducted upon administration of ARI (6 mg/kg i.p.), fluoxetine (FLX; 5 mg/kg p.o.) and combined administration of both drugs in alcohol-dependent rats. RESULTS: The results of behavioural tests carried out have shown a lack of antidepressant and procognitive effects of either ARI or FLX in EtPRs after acute and chronic treatment. Combined administration of both drugs would lead to spatial memory deterioration in the study animals. DISCUSSION AND CONCLUSIONS: Our results suggest that ARI applied in the experiment had no antidepressant effect and failed to improve spatial memory in study rats. Potential antidepressant and procognitive properties of this drug resulting from its mechanism of action encourage attempts (design) of further research aimed at developing a dose, which will show such effects in alcohol-preferring animals.

Clinical Factors Affecting Survival in Patients with Congenitally Corrected Transposition of the Great Arteries: A Systematic Review and Meta-Analysis.

Background: Congenitally corrected transposition of the great arteries (cc-TGA) is a defect characterized by arterio-ventricular and atrioventricular disconcordance. Most patients have co-existing cardiac abnormalities that warrant further treatment. Some patients do not require surgical intervention, but most undergo physiological repair or anatomical surgery, which enables them to reach adulthood. Aims: We aimed to evaluate mortality risk factors in patients with cc-TGA. Results: We searched the PubMed database and included 10 retrospective cohort studies with at least a 5-year follow-up time with an end-point of cardiovascular death a minimum of 30 days after surgery. We enrolled 532 patients, and 83 met the end-point of cardiovascular death or equivalent event. As a risk factor for long-term mortality, we identified New York Heart Association (NYHA) class ≥III/heart failure hospitalization (OR = 10.53; 95% CI, 3.17-34.98) and systemic ventricle dysfunction (SVD; OR = 4.95; 95% CI, 2.55-9.64). We did not show history of supraventricular arrhythmia (OR = 2.78; 95% CI, 0.94-8.24), systemic valve regurgitation ≥moderate (SVR; OR = 4.02; 95% Cl, 0.84-19.18), and pacemaker implantation (OR = 1.48; 95% Cl, 0.12-18.82) to affect the long-term survival. In operated patients only, SVD (OR = 4.69; 95% CI, 2.06-10.71) and SVR (OR = 3.85; 95% CI, 1.5-9.85) showed a statistically significant impact on survival. Conclusions: The risk factors for long-term mortality for the entire cc-TGA population are NYHA class ≥III/heart failure hospitalization and systemic ventricle dysfunction. In operated patients, systemic ventricle dysfunction and at least moderate systemic valve regurgitation were found to affect survival.

Analysis of Attitudes and Practices towards the Influenza Vaccine in High-Risk Adults in Poland.

This study aimed to understand Poles' attitudes and beliefs towards influenza vaccinations in the flu season of 2022-2023, especially among individuals at risk of flu complications. The cross-sectional survey-based study was carried out on a sample of 810 respondents. The questionnaire was disseminated electronically using social media and e-mail. The majority of respondents (71%) could identify "high-risk groups" recommended for influenza vaccination, and 52.01% of respondents reported receiving influenza vaccination at some point in the past, with 32.12% receiving it in the 2022-2023 flu season and 41.09% in the 2021-2022 season. The majority of respondents declaring acceptance of the vaccine for the 2022-2023 season were in the high-risk group. Only 17.28% of respondents declared receiving both influenza and SARS-CoV-2 vaccines in the 2022-2023 season, with the vast majority being respondents from the "high-risk group" (p < 0.0001). Only 26.12% of respondents declared their intention to continue influenza vaccination in the future. Of those expressing the intention to get vaccinated against the influenza virus in future seasons, 46.79% were from the "high-risk group" (p = 0.0087). Results suggest the need for further interaction and education with healthcare providers and targeted informational efforts for at-risk groups regarding the benefits of flu vaccination.

Medicines prices in International (Geary-Khamis) Dollar. The comparison between regulated and deregulated markets.

BACKGROUND: Affordability of medicines is key for effective healthcare. Thus, we compared medicine prices using International Dollar (I$), which allows confronting the values of different currencies. Besides, we intended to verify if pharmaceutical market deregulation leads to lower medicines prices. MATERIALS AND METHODS: We conducted the study between December 2019 and September 2022 collecting data from 21 countries. From the preliminary sampling of 30 medicines, we selected 10 brand names (5 Rx and 5 OTC brands) for the analysis. In each country, we collected price information from 3 pharmacies and then converted them to the I$ using the rates published by the International Monetary Fund. RESULTS: There were differences between regulated and deregulated markets in prices presented in I$. For instance, Aspirin C® (10 soluble pills) was on average I$ 5.41 in Finland (regulated market) and I$ 13.25 in Brazil. The most expensive Xarelto® 20 x 28 pills (I$ 538.40) was in Romania, which in the case of other medicines, was in the group of cheaper countries. There was no statistical significance in price comparison between regulated and deregulated markets. In some cases, however, regulated markets offered lower prices of the same medicine than deregulated markets. CONCLUSION: The analysis revealed differences in I$ prices between countries. Pharmaceutical market regulation does not mean higher prices of medicines. There is a need for affordable medicines. Hence, decision-makers should work on the medicines prices and adjust them to the local economies. I$ could be important in creating pharmaceuticals prices, and the conducted study should encourage other researchers to present their results using this currency.

The Growing Market for Natural Cosmetics in Poland: Consumer Preferences and Industry Trends.

Introduction: The cosmetics industry is one of the most dynamically developing sectors globally, and Europe has the largest share of that market. In Poland, the cosmetics industry is one of the most significant economic segments. Currently, natural cosmetics remain a strongly developing sector of the cosmetics industry. The increasing self-awareness of consumers and the omnipresent trend of being "eco" influence the increased interest in natural cosmetics. The development of the natural cosmetics market is confirmed by the increasing production and growing willingness of consumers to purchase this type of product. Purpose: The study analysed the purchase frequency and the type of cosmetic products consumers choose. The most recognised natural cosmetics brands and certificates confirming their naturalness were also analysed. Additionally, the purchase preferences of consumers choosing natural cosmetics and those not in this category were examined. The focus was on factors affecting the choice of different cosmetic products. Methods: The study was conducted as an anonymous survey of 24 questions (19 single-choice and five multiple-choice questions). Volunteers participated in the study regardless of gender, age, occupation, or income. The survey questionnaires were conducted using Google Forms through a shared link. The study was carried out from October 12, 2021, to January 6, 2022. A total of 807 surveys were collected, and the analysis included 807 completed forms that met the criteria for proper completion. The statistical analysis was performed based on the Pearson Chi2 coefficient with a significance level of p<0.05. Results: The results obtained in the study indicate that the natural cosmetics market is intensively developing, mainly because of consumers' increasing self-awareness and deepening knowledge of cosmetics. Moreover, the demand for natural cosmetics in Poland will continue to develop steadily in the coming years. Currently, the quality of a cosmetic is more important to consumers than its price. Internet sales channels are developing intensively, and Influencers and recommendations of products by friends and family are the most effective way of promotion. Conclusion: Significant changes in consumer attitudes toward the cosmetics market (after the COVID-19 pandemic outbreak) have been observed. From the manufacturers' perspective, it is advised to closely follow market trends and adapt to consumers' changing preferences and requirements. An adequate solution is to popularise and develop the segment of natural cosmetics using various forms of promotion and distribution of products. Further research is recommended to confirm the results regarding the significance of the fast-growing natural cosmetics market in Poland and other countries.

Directions of hyaluronic acid application in cosmetology.

BACKGROUND: Hyaluronic acid is a naturally occurring substance in the human body. It is a component of the intercellular matrix of the dermis and is often used as a raw material in cosmetology. This substance was isolated for the first time in the first half of the twentieth century, while cosmetology treatments and aesthetic medicine have been developing rapidly and gaining popularity. The same applies to companies producing cosmetic care products which contain hyaluronic acid. This is related to the growing desire of the society to improve the quality of the skin and maintain its vitality and firmness. AIMS: The study investigates different directions and possibilities of using hyaluronic acid in cosmetology. Moreover, the paper describes possible side effects observed after hyaluronic acid injections. PATIENTS/METHODS: The study was based on an anonymous questionnaire conducted between October 10, 2021, and February 21, 2022. 513 responses were collected. RESULTS: The awareness and level of knowledge in this field of cosmetology among potential beauty salon clients are on the rise. Hyaluronic acid is used in injections, as well as in care cosmetics, oral and vaginal preparations. Various areas of the face are injected, most often the lips. Face creams are among the most frequently purchased skincare products. CONCLUSIONS: The use of hyaluronic acid in cosmetology is multidirectional. It is mainly focused on skincare and specific anti-aging activities. Treatments of this type help preserve the skin's vitality, which translates into an improved quality of life due to the satisfaction of the need for attractiveness.

Clinical factors affecting survival in patients with D-transposition of the great arteries after atrial switch repair: A meta-analysis.

BACKGROUND: Atrial switch repair (AtrSR) was the initial operation method in patients with D-transposition of the great arteries (D-TGA) constituting the right ventricle as a systemic one. Currently, it has been replaced with arterial switch operation (ASO), but the cohort of adults after AtrSR is still large and requires strict cardiological management of late complications. For this reason, we aimed to evaluate potential long-term mortality risk factors in patients with D-TGA after AtrSR (either Mustard or Senning procedures) Methods: We searched the MEDLINE database for suitable trials. We included 22 retrospective and prospective cohort studies of patients with D-TGA with at least 5 years mean/median follow-up time after Mustard or Senning procedures, with an endpoint of non-sudden cardiac death (n-SCD) and sudden cardiac death (SCD) after at least 30 days following surgery. RESULTS: A total of 2912 patients were enrolled, of whom 351 met the combined endpoint of n-SCD/SCD. The long-term mortality risk factors were New York Heart Association (NYHA) class ≥III/heart failure hospitalization (odds ratio [OR], 7.25; 95% confidence interval [CI], 2.67-19.7), tricuspid valve regurgitation (OR, 4.64; 95% CI, 1.95-11.05), Mustard procedure (OR, 2.15; 95% CI, 1.37-3.35), complex D-TGA (OR, 2.41; 95% CI, 1.31-4.43), and right ventricular dysfunction (OR, 1.94; 95% CI, 0.99-3.79). Supraventricular arrhythmia (SVT; OR, 2.07; 95% CI, 0.88-4.85) and pacemaker implantation (OR, 2.37; 95% CI, 0.48-11.69) did not affect long-term survival in this group of patients. In an additional analysis, SVT showed a statistically significant impact on SCD (OR, 2.74; 95% CI, 1.36-5.53) but not on n-SCD (OR, 1.5; 95% CI, 0.37-6.0). CONCLUSIONS: This meta-analysis demonstrated that at least moderate tricuspid valve regurgitation, NYHA class ≥III/heart failure hospitalization, right ventricular dysfunction, complex D-TGA, and Mustard procedure are risk factors for long-term mortality in patients after AtrSR.

Full publication of preprint articles in prevention research: an analysis of publication proportions and results consistency.

There is concern that preprint articles will lead to an increase in the amount of scientifically invalid work available. The objectives of this study were to determine the proportion of prevention preprints published within 12 months, the consistency of the effect estimates and conclusions between preprint and published articles, and the reasons for the nonpublication of preprints. Of the 329 prevention preprints that met our eligibility criteria, almost half (48.9%) were published in a peer-reviewed journal within 12 months of being posted. While 16.8% published preprints showed some change in the magnitude of the primary outcome effect estimate, 4.4% were classified as having a major change. The style or wording of the conclusion changed in 42.2%, the content in 3.1%. Preprints on chemoprevention, with a cross-sectional design, and with public and noncommercial funding had the highest probabilities of publication. The main reasons for the nonpublication of preprints were journal rejection or lack of time. The reliability of preprint articles for evidence-based decision-making is questionable. Less than half of the preprint articles on prevention research are published in a peer-reviewed journal within 12 months, and significant changes in effect sizes and/or conclusions are still possible during the peer-review process.

Tozinameran (Pfizer, BioNTech) and Elasomeran (Moderna) Efficacy in COVID-19-A Systematic Review of Randomised Controlled Trial Studies.

Background: The objective of this research was to test the efficacy and safety profile of tozinameran (30 µg, BNT162b2, Pfizer, BioNTech) and elasomeran (100 µg, mRNA-1273, Moderna) in COVID-19 prevention in ≥16-year-old patients vaccinated with two doses. Methods: A meta-analysis of the literature was conducted using the MEDLINE and EMBASE databases, following inclusion and exclusion criteria. Eight RCTs have been selected. The results were presented using the risk ratio (RR) with a 95% confidence interval (CI). A fixed-effect model or random-effect model was applied based on the heterogeneity of the results. Results: BNT162b2 and mRNA-1273 vaccines are efficient in preventing COVID-19 in comparison to a placebo (MH, RR 0.08 [0.07, 0.09] p < 0.00001 (95% CI)). It was found that administering the vaccines BNT162b2 and mRNA-1273 was associated with a higher proportion of adverse events in comparison to the placebo (IV, RR 2.14 [1.99, 2.29] p < 0.00001 (95% CI)). Administering the vaccines BNT162b2 and mRNA-1273 was associated with a higher proportion of serious adverse events in comparison to the placebo (MH, RR 0.98 [0.89, 1.08] p = 0.68 (95% CI)). Conclusions: Tozinameran and elasomeran are effective and safe in preventing the occurrence of COVID-19.

Association between Compliance with COVID-19 Restrictions and the Risk of SARS-CoV-2 Infection in Poland.

During the coronavirus disease 19 (COVID-19) pandemic it has become very important to comply with preventive measures. We aimed to assess compliance with applicable restrictions and to explore the links between the level of compliance and the risk of COVID-19. This cross-sectional study included Polish adults who were asked to complete a validated questionnaire. The study period was from 1 November 2020 to 31 January 2021 and a computer-assisted web interview method was chosen to perform the survey. The study involved 562 women and 539 men. COVID-19 was reported in 11.26% of participants. A good level of compliance with the sanitary restrictions was reported for 38.87% of participants, an average level of compliance for 47.96%, and a low level of compliance for 13.17%. A reduced risk of COVID-19 was associated with the following preventive measures: regular use of protective masks, social and physical distancing in public places, regular use of hand sanitizers with high ethanol content, and the use of disposable gloves in public places. Our survey revealed satisfactory public compliance with the pandemic restrictions. Sanitary and epidemiologic measures to prevent the pandemic were shown to be adequate and effective.

The Mental Health of Poles during the COVID-19 Pandemic.

BACKGROUND: The SARS-Cov-2 pandemic has had a profound impact on all aspects of life in the global population, causing above other, psychological problems. AIMS: The objective of this study was to evaluate the mental health of the Poles during the COVID-19 pandemic. METHODS: A prospective, cross-sectional web-based survey design was adopted. The study horizon was from 1 June 2021, to 31 December 2021. An anonymous, standardized questionnaire was disseminated electronically by means of social media among Polish adults. The following tests were performed: Depression, Anxiety, and Stress Scale (DASS-21), and the Insomnia Severity Index (ISI). RESULTS: A total of 1306 individuals completed the survey. Of the participants, 77.79% were female at a mean age of 34.89 ± (14.79), 62.25% had higher education, and 56.43% were employed. The prevalence of depression, anxiety, stress, and sleep disturbances in this sample were as follows: 50.38%, 43.49%, 61.26%, and 44.74%, respectively. Poor self-estimated health status, the presence of comorbidities, and regular use of nicotine significantly increased the risk of any of the analyzed psychiatric symptoms and sleep disorders. The depression level was significantly associated with age, living alone, health status, and the use of nicotine. Moreover, the level of anxiety was significantly associated with age and health status. The level of stress depended on gender, age, health status, use of nicotine, and being vaccinated against SARS-CoV-2. Sleep disturbances depended on age, health status, the presence of comorbidities, and regular use of drugs. CONCLUSIONS: The Polish population manifested numerous psychological symptoms during the COVID-19 pandemic. There is a need to afford psychological support to them and ensure their mental health.

Psychotherapies for the treatment of borderline personality disorder: A systematic review.

OBJECTIVE: Borderline personality disorder (BPD) is the most common personality disorder, affecting 1.8% of the general population, 10% of psychiatric outpatients, and 15%-25% of psychiatric inpatients. Practice guidelines recommend psychotherapies as first-line treatments. However, psychotherapies commonly used for the treatment of BPD are numerous, and little is known about the comparative effectiveness of each individual psychotherapy versus treatment as usual (TAU) or other psychotherapies. To systematically assess the comparative effectiveness of commonly used psychotherapies versus TAU or versus other psychotherapies for BPD treatment. METHOD: We conducted systematic literature searches in MEDLINE, EMBASE, the Cochrane Library, and APA PsycINFO up to July 14, 2022, and searched reference lists of pertinent articles and reviews. Inclusion criteria were (a) patients 13 years or older with a diagnosis of BPD, (b) treatment with commonly used psychotherapies, (c) comparison with TAU or another psychotherapy, (d) assessment of relevant BPD-related health outcomes, and (e) randomized or nonrandomized trials or controlled observational studies. Two investigators independently screened abstracts and full-text articles and graded the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS: We found 25 psychotherapy studies meeting inclusion criteria with data on 2,545 participants. Seventeen studies compared nine psychotherapies with TAU and nine studies compared eight psychotherapies with another psychotherapy for the treatment of BPD. Overall, both TAU and included psychotherapies were effective in treating the severity and symptoms of BPD. Moderate certainty of evidence suggests that systems training for emotional predictability and problem solving is more effective than TAU for the treatment of BPD; low certainty of evidence suggests that dialectical behavior therapy, schema therapy, transference-focused psychotherapy, acceptance and commitment therapy, manual-assisted cognitive therapy, and cognitive behavioral therapy are more effective than TAU for treating BPD. We were unable to draw conclusions from head-to-head comparisons of psychotherapies, which were limited to single studies with very low to low certainty of evidence. CONCLUSIONS: All commonly used psychotherapies improve BPD severity, symptoms, and functioning. Our assessment found no strong evidence suggesting that any one psychotherapy is more beneficial than another. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Impact of the SARS-CoV-2 Vaccination Program on Presenteeism and Absenteeism among Healthcare Workers in Poland.

BACKGROUND: There is sufficient scientific literature on the effectiveness of registered vaccines in preventing SARS-CoV-2 infection, but research on the impact of the COVID-19 vaccination program on social and economic aspects is lacking. In connection with the above, this study aimed to assess the impact of vaccinations on presenteeism and absenteeism among healthcare professionals in the workplace caused by the COVID-19 pandemic. METHODS: A post-marketing, cross-sectional survey-based study was carried out on a sample of 736 actively employed healthcare professionals. Among them, 215 individuals (29.21%) were unvaccinated (control group). The study group consisted of 521 vaccinated respondents, with 52.97% being women and 47.03% men. A self-administered questionnaire was developed and delivered online to the target population group of healthcare workers. RESULTS: A significant association (p < 0.01) was observed between the number of doses of the COVID-19 vaccine received and presenteeism among the respondents. Among the unvaccinated respondents (2.30 ± 1.19) or those vaccinated with only one dose of the SARS-CoV-2 vaccine (2.16 ± 1.11), the COVID-19 pandemic had a significantly higher impact on work performance compared to individuals vaccinated with three doses of the vaccine (1.19 ± 1.11). Moreover, a significant association was found (p = 0.0265) between the number of workdays missed (over the last twelve months) due to COVID-19-related sick leave and the number of doses of the COVID-19 vaccine received. The number of workdays missed due to COVID-19 sick leave was lowest in the group vaccinated with three doses (2.00 ± 6.75) and highest in the unvaccinated group (5.32 ± 16.24). CONCLUSIONS: Our results clearly show that the widely implemented national COVID-19 vaccination program brings tangible benefits both in medical and economic terms. The extent of reducing absenteeism and presenteeism caused by the coronavirus disease depended on the number of vaccine doses administered.