INTRODUCTION: In a previously published randomised, placebo-controlled trial, 800 mg/day of pharmaceutical-grade chondroitin sulfate (CS) was shown to be superior to placebo in reducing pain and improving function over 6 months in patients with symptomatic knee osteoarthritis (OA). The aim of the current post hoc analyses was to evaluate the cost-effectiveness of CS compared with placebo in a European perspective using individual patient data from this clinical trial. METHODS: Patients with knee OA randomised to CS or placebo were followed up at 1, 3 and 6 months. The algo-functional Lequesne index was used to derive the EuroQol Five-Dimension Five-Level (EQ-5D-5L) score based on a validated formula. The EQ-5D-5L scores at each time point were used to calculate the changes in quality-adjusted life years (QALYs) with the area under the curve method. Costs were assessed using the average price of CS in the countries where the original study took place and where CS is currently marketed. The costs of CS in three countries were then used (i.e. the Czech Republic, Italy and Switzerland). The incremental cost-effectiveness ratio (ICER) threshold for CS to be considered cost-effective was set at 91,870 EUR per QALY (equivalent to the usually recommended threshold of US $100,000). The study used an intention-to-treat population, i.e. patients who received one dose of the study drug, and imputed missing values using the basal observation carried forward method. RESULTS: No significant differences in baseline characteristics were observed between the CS group (N = 199) and the placebo group (N = 205). The mean cost of CS for 6 months of treatment was 194.74 EUR. After 6 months of treatment, CS showed a mean ICER of 33,462 (95% CI 5130-61,794) EUR per QALY gained, indicating cost-effectiveness compared with placebo. The acceptability curve for cost-effectiveness shows that the CS treatment is likely to be cost-effective compared with placebo, with a 93% probability when the ceiling ratio is set at 91,870 EUR per QALY gained. CONCLUSIONS: These results highlight the role of CS as a cost-effective therapeutic option in the management of OA. However, further studies taking into account the use of other healthcare resources are warranted for a more complete understanding.

• MeSH
• analýza nákladové efektivity MeSH
• analýza nákladů a výnosů * MeSH
• artróza kolenních kloubů * farmakoterapie   ekonomika   MeSH
• chondroitinsulfáty * terapeutické užití   ekonomika   MeSH
• kvalitativně upravené roky života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Česká republika MeSH
• Itálie MeSH
• Švýcarsko MeSH

Conflict deeply affects human experiences, frequently testing individual resilience to its breaking point and leaving enduring psychological and societal wounds. The current conflict in Ukraine, initiated by Russia's invasion in 2022, illustrates this phenomenon by altering regional relationships and triggering a major humanitarian crisis marked by extensive displacement, loss of life, and emotional turmoil. This study explores the factors influencing hope and distress in Ukraine alongside six nearby European countries during the ongoing conflict. A cross-sectional survey collected data primarily via internet panel samples from the Czech Republic, Georgia, Lithuania, Poland, Romania, Slovakia, and Ukraine in the second year since the war's initiation. The current study utilised validated instruments, collecting data on levels of hope, distress, individual resilience, community resilience, societal resilience, morale, sense of danger, perceived security threats, and demographic characteristics. Hope and distress levels differ across countries, with Ukraine exhibiting the highest levels of both (3.74 ± 1.02 and 2.89 ± 0.87, respectively). Overall, average scores of hope were higher than average distress levels. Across the regression models for the seven countries, hope showed strong associations with individual (between β = 0.089 and β = 0.327) and societal resilience (between β = 0.206 and β = 0.514), while morale (between β = -0.104 and β = -0.479) and individual resilience (between β = -0.077 and β = -0.335) displayed a protective relationship against distress (all β values were significant, p < 0.01). Monitoring hope and distress is crucial during the Russian-Ukrainian war and other adversities, as these factors give insight into the current and future psychological states of affected populations. The results offer valuable information that can guide the development of tailored strategies to enhance hope and buffer distress in war-impacted countries, as well as those experiencing its broader effects. Fostering individual and societal resilience, alongside enhancing morale, may strengthen hope and mitigate distress amid adversity. Developing targeted interventions that address each population's unique needs, as well as their sociocultural and geopolitical contexts can enhance efficacy.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• naděje * MeSH
• ozbrojené konflikty * psychologie   MeSH
• průřezové studie MeSH
• psychická odolnost * MeSH
• psychický distres * MeSH
• psychický stres * psychologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Rusko MeSH
• Ukrajina MeSH

OBJECTIVES: Our objective was to assess morbidity trends in Europe and to classify European countries based on population ageing theories: the compression, expansion and dynamic equilibrium of morbidity. METHODS: The proportions of healthy life years were calculated for 31 European countries for the period 2005-2019 based on life expectancy values and healthy life years at age 65 years adopted from the Eurostat database. European countries were classified according to morbidity patterns applying the standard deviation distance from the average of relative change method between the selected years. RESULTS: A large degree of variation in terms of life expectancy and healthy life years at age 65 years was determined between 2005 and 2019. While the life expectancy differences between men and women were consistent across all the European countries, the gender gap concerning healthy life years was more diverse. Approximately one-third of the countries fell into the expansion, compression and dynamic equilibrium categories, respectively. CONCLUSION: Significant variations were identified in healthy life year trends across European countries, which underscores the need for preventive strategies.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• morbidita trendy   MeSH
• naděje dožití * trendy   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND: The COVID-19 pandemic posed severe challenges to delivery of services at Primary Care level and for achieving follow-up of patients with chronic diseases. OBJECTIVES: We analysed data from the PRICOV-19 study to explore determinants of active follow-up for chronic disease patients in seven Central and Eastern European (CEE) countries during the pandemic. METHODS: Pricov-19 was a cross-sectional study conducted within PC (Primary Care) practices in 37 European countries. We analysed data from 7 CEE countries (Bulgaria, Czech Republic, Hungary, Poland, Moldova, Romania, Ukraine) collected between November 2020 and December 2021. Practices were recruited through random or convenience sampling and participation of practices was voluntary. We performed descriptive statistics to identify the level of follow-up of chronic disease and what health system and practice-specific factors were associated with better follow-up. We used logistic regression and meta-analysis techniques to explore associations and heterogeneity between countries. RESULTS: 67.8% out of 978 practices reported actively following up chronic patients. Positive associations were found between active follow-up and such as having more GPs (aOR = 1.18, p-value = 0.005), an above-average chronic patient population (aOR = 3.13, p-value = 0.006), adequate government support (aOR = 2.35, p-value = 0.001), and GPs having time for guideline reading (aOR = 0.008, p-value = 1.71). CONCLUSIONS: Patient follow-up, was influenced by different health system and practice-specific factors. The implications suggest the need for government support to enhance PC practice organisation during crises and solutions to decrease GP workload and provide tailored care for patients with chronic disease.

• MeSH
• chronická nemoc MeSH
• COVID-19 * epidemiologie   MeSH
• lidé MeSH
• primární zdravotní péče * organizace a řízení   statistika a číselné údaje   MeSH
• průřezové studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH
• východní Evropa MeSH

OBJECTIVES: This study aimed to determine trend in polyphenol consumption in the Czech Republic during the last three decades. Additionally, it provides a brief overview of the beneficial effects of polyphenols in several body systems. METHODS: Data from the Phenol-Explorer 3.6, a specialized database of polyphenolic substances, were assigned to the resources of the Czech Statistical Office on the consumption of food and beverages in the Czech Republic for the years 1989-2022. The average daily intake of polyphenols was determined by multiplying the average annual consumption of each type of food by the polyphenol content obtained from the database; results were given in milligrams of polyphenols per inhabitant and day. Since the food items in the data sources are not identical, it was necessary to create an extensive model of food categories. RESULTS: The current value of polyphenol intake is 1,673 mg per day per inhabitant; however, this level most likely reflects methodological underestimation. The favourable increase in dietary polyphenol intake in the Czech population - doubling, to be precise - which we observed from 1989 to 2007, has been replaced by the opposite trend in the last 15 years. The current intake of polyphenols corresponds to the level that was already achieved in 2004. Hydroxycinnamic acids (from the group of phenolic acids) are the most prevalent dietary polyphenols, followed by flavanols (from the group of flavonoids). The most frequent source of polyphenols in the Czech population are non-alcoholic beverages such as coffee, tea and juices, followed by fruits, cereals, and vegetables, respectively. CONCLUSION: Current trend of dietary polyphenol intake in the Czech population is slightly decreasing. This tendency, lasting since 2008, is indisputably negative. Plant polyphenols offer opportunities for inexpensive interventions in health promotion.

• MeSH
• dieta statistika a číselné údaje   MeSH
• lidé MeSH
• polyfenoly * aplikace a dávkování   analýza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Background: Psoriasis is a common, T-cell-mediated inflammatory and immune-mediated skin disease. Numerous studies confirmed that patients with psoriasis have a significant frequency of cardiovascular (CV) risk factors and CV diseases (CVDs). Risk stratification is helpful in light of the elevated risk of CVD in psoriasis patients. SCORE2 and SCORE2-OP, a new algorithm derived, calibrated and validated to predict the 10-year risk of first-onset CVD in European populations, enhances the identification of individuals at higher risk of developing CVD across Europe. Objective: Using the SCORE2 and SCORE2-OP scoring systems, the current study objective was to evaluate CV risk in Slovak psoriasis patients and the relationship between CV risk and psoriasis features in a real-world setting. Results: A case-control study was conducted involving 115 outpatients with plaque psoriasis and 66 age- and gender-matched controls with skin conditions other than psoriasis. Patients with psoriasis had significantly higher mean SCORE2 values. In the age group up to 50 years, more psoriasis patients were classified as moderate risk than controls (33.8% vs. 13.6%, p = 0.010); the high-risk category was dominated by psoriasis patients. Analysing the relationship between CV risk and selected variables, we determined, using linear regression, the dependence of the SCORE2 risk score on gender in the age group up to 50 years, on age in both age groups, on waist circumference (WC) in the category up to 50 years and on the duration and severity of psoriasis in both age groups using linear regression. For individuals older than 70, we estimated the SCORE2-OP risk score, with the average risk score being 19.5 ± 4.95. We did not observe controls with a high risk score. Psoriasis patients were more likely to be smokers and had significantly higher mean values for body mass index (BMI), WC, total cholesterol (TC), low-density lipoprotein (LDL) and systolic blood pressure (BP). Conclusions: Because CV risk factors and psoriasis are strongly related, the importance of CV risk stratification is growing, and initiating preventive lifestyle changes or therapeutic interventions in patients with psoriasis is warranted.

• Publikační typ
• časopisecké články MeSH

BACKGROUND: New methods to identify patients who benefit from a primary prophylactic implantable cardioverter-defibrillator (ICD) are needed. T-wave alternans (TWA) has been shown to associate with arrhythmogenesis of the heart and sudden cardiac death. We hypothesized that TWA might be associated with benefit from ICD implantation in primary prevention. METHODS AND RESULTS: In the EU-CERT-ICD (European Comparative Effectiveness Research to Assess the Use of Primary Prophylactic Implantable Cardioverter-Defibrillators) study, we prospectively enrolled 2327 candidates for primary prophylactic ICD. A 24-hour Holter monitor reading was taken from all recruited patients at enrollment. TWA was assessed from Holter monitoring using the modified moving average method. Study outcomes were all-cause death, appropriate shock, and survival benefit. TWA was assessed both as a contiguous variable and as a dichotomized variable with cutoff points <47 μV and <60 μV. The final cohort included 1734 valid T-wave alternans samples, 1211 patients with ICD, and 523 control patients with conservative treatment, with a mean follow-up time of 2.3 years. TWA ≥60 μV was a predicter for a higher all-cause death in patients with an ICD on the basis of a univariate Cox regression model (hazard ratio, 1.484 [95% CI, 1.024-2.151]; P=0.0374; concordance statistic, 0.51). In multivariable models, TWA was not prognostic of death or appropriate shocks in patients with an ICD. In addition, TWA was not prognostic of death in control patients. In a propensity score-adjusted Cox regression model, TWA was not a predictor of ICD benefit. CONCLUSIONS: T-wave alternans is poorly prognostic in patients with a primary prophylactic ICD. Although it may be prognostic of life-threatening arrhythmias and sudden cardiac death in several patient populations, it does not seem to be useful in assessing benefit from ICD therapy in primary prevention among patients with an ejection fraction of ≤35%.

• MeSH
• časové faktory MeSH
• defibrilátory implantabilní * MeSH
• elektrická defibrilace přístrojové vybavení   škodlivé účinky   MeSH
• elektrokardiografie ambulantní * metody   MeSH
• hodnocení rizik metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhlá srdeční smrt * prevence a kontrola   etiologie   MeSH
• prediktivní hodnota testů MeSH
• primární prevence * metody   MeSH
• prognóza MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• srdeční arytmie terapie   patofyziologie   diagnóza   prevence a kontrola   mortalita   MeSH
• srdeční frekvence fyziologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa MeSH

COVID-19 vaccine uptake varied across countries, in part due to vaccine hesitancy fueled by a lack of trustworthy information. To help health workers provide evidence-based answers to common questions about COVID-19 vaccines and vaccination, and thereby, assist individuals ́ decisions on vaccine acceptance, COVID-19 InfoVaccines, a joint WHO-EU project, was launched in February 2021 to support COVID-19 vaccine rollout in 6 Eastern European countries. COVID-19 InfoVaccines was made available in seven languages and shared on social media networks. A total of 262,592 users accessed COVID-19 InfoVaccines.com between February 11, 2021, and January 31st, 2023. The users were most interested in: general questions; vaccine efficacy and duration of protection; vaccine safety; vaccine co-administration, and dose-interval and interchangeability; though the interest in a specific theme varied in function of the epidemiological situation. A total of 118,510 (45.1%) and 46,644 (17.7%) users scrolled up to 35% and 75% of the COVID-19 InfoVaccines webpage, respectively. The average engagement rate was 71.61%. The users accessed COVID-19 InfoVaccines from 231 countries and territories, but the majority were in Ukraine (N = 38,404; 14.6%), Spain (N = 23,327; 8.9%), and Argentina (N = 21,167; 8.1%). Older Facebook users were more interested in COVID-19 information than younger individuals (X2 p-value < .0001). Two hundred twenty-eight videos were shared on YouTube. The average Click-Through-Rate on Facebook was 7.82%, and that on YouTube was 4.4%, with 60 videos having a Click-Through-Rate >5%, falling in the range of average YouTube video Click-Through-Rate (2% - 10%). As misinformation about vaccines and vaccination spreads easily and can negatively impact health-related decisions, initiatives like COVID-19 InfoVaccines are crucial to facilitate access to reliable information.

• MeSH
• COVID-19 * prevence a kontrola   epidemiologie   MeSH
• dospělí MeSH
• lidé MeSH
• odkládání očkování statistika a číselné údaje   MeSH
• SARS-CoV-2 imunologie   MeSH
• sociální média * MeSH
• Světová zdravotnická organizace MeSH
• vakcinace * statistika a číselné údaje   psychologie   MeSH
• vakcíny proti COVID-19 * aplikace a dávkování   MeSH
• zdravotní výchova metody   MeSH
• zdravotnický personál statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: Urinary incontinence is an extremely stressful and often debilitating disease, increasing morbidity in society. The aim of the work is to point out the problems of the management of incontinent patients - seniors in the context of their quality of life as well as treatment costs to find ways to make the widest possible public awareness of the fact that in most cases incontinence is solvable in terms of improving the quality of life. METHODS: The group consisted of 100 patients with urinary incontinence who were treated with conservative medical procedures at the urological outpatient clinic of the Railway Hospital in Košice. The research was conducted in the period from September 2018 to February 2019. The extended standardized Urinary Incontinence Quality of Life Measure (I-QOL) questionnaire was used to evaluate the quality of life. The SPSS program - version 16.0 was used for statistical analysis of the file and hypotheses, and the chi-square test and the McNemar test for analysis of non-parametric data distribution. RESULTS: The average value of the total social I-QOL score was 14.15 ± 5.03, which means that this area contributes significantly to the reduction of the quality of life. The average value of the total I-QOL score of the group studied was 63.86 ± 19.29, which indicates that urinary incontinence has a significant impact on the quality of life of seniors. Respondents considered the frequent urge to urinate and the absence of a toilet in a reachable place to be a negative factor. Feeling of the state of a certain form of inferiority and obsession was the most serious. Patients expressed approximately equal concerns about feeling out of control of their bladder and concerns about urinating as well as concerns about worsening incontinence due to aging. CONCLUSION: Based on the presented results, participants achieved the highest average score in the psychological domain of quality of life (27.81 ± 7.54) and the lowest in the social domain (14.15 ± 5.03). Social support programmes aimed at reducing stigma and enhancing social engagement for individuals dealing with incontinence could help improve the social quality of life. Physical health interventions, such as pelvic floor exercises could support physical well-being.

• MeSH
• inkontinence moči * terapie   psychologie   MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: An occupational disease (OD) is a disorder or health condition which arises due to work related activities and tasks or is caused by work environment. The impact of ODs on medical and social system may be considered as a very important in relation to mortality, morbidity, and invalidity. The most common ODs in the European Union are musculoskeletal disorders (58% of all ODs in 2015). The aim of the study was to determine the differences in the incidence of occupational diseases between the Slovak Republic (SK) and the Czech Republic (CZ). METHODS: Data were obtained from the Health Statistics Yearbooks of the National Health Information Centre of the Slovak Republic and in CZ from the Institute of Health Information and Statistics of the Czech Republic. We worked with records from 2009 to 2019. The average incidence rates (aIR) per 100,000 labourers were calculated based on the number of workers in a given year. All data were calculated separately for SK and CZ, and for males and females. P < 0.05 was considered a significant value. RESULTS: In SK, the number of ODs diagnosed from 2009 to 2019 amounted to 2,351 cases in males and 1,605 cases in females. In CZ, the amount of ODs diagnosed from 2009 to 2019 reached 6,616 cases in males and 5,513 cases in females. In SK, from 2009 to 2019, the incidence of ODs decreased significantly from 7.3 to 4.8 cases per 100,000 labourers (rs = -0.76; p = 0.006). Diseases from one-sided excessive load were the most common ODs in SK (aIR = 7.6 ± 2.2) and in CZ (aIR = 8.2 ± 3.5), followed by ODs caused by vibration. Occupational diseases due to noise, vibrations and SiO2 inhalation were considerably more common among males. Diseases due to long-term excessive one-sided load, skin and infectious diseases were more prevalent in females. Occupational hearing damage due to noise was more frequent in SK and silicosis, asthma bronchiale, respiratory allergies, dermatoses, and infectious diseases were remarkably more frequent in CZ. CONCLUSION: Regarding the main goal, we found a significantly higher aIR of ODs caused by noise in SK than in CZ. In CZ, there was a markedly higher presence of ODs caused by SiO2 inhalation, asthma and respiratory allergy, ODs of skin and infectious and parasitic ODs when compared to SK. In both countries different principles for discontinuance in work are applied when a risk factor occurs. It is necessary to enhance surveillance data and reporting of ODs and increase investments in occupational safety, health education and research for the future.

• MeSH
• dospělí MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci z povolání * epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH
• Slovenská republika MeSH