Currently there is increasingly closer interaction between the importance of environmental protection and efficient promoting of scientific and technological progress in the field of waste incineration. Waste is not only undesirable source of pollution, but if it is effectively used it also has great economic importance. In the Czech Republic 34.5 million tonnes of all wastes was produced in 2017, of which 5.7 million tonnes of municipal waste. 50% of the produced municipal waste was used, 38% of which was used for the material and 12% for energy utilization. 45% of municipal waste was deposited in the landfills. The method of waste incineration is among the major tools to reduce the landfill waste. The use or processing of the product which the process of incineration of municipal and hazardous waste generated can be considered as an obstacle to the favorable reception of this process. Apart from flammable components, waste also contains certain amount of dangerous particles. This is especially the sulfur chlorides, fluorine, PCBs and other heavy decomposable organic substances and heavy metals. This fact puts high demands on the gas cleaning processes followed by neutralization of other products that the incinerator leaves, in which these substances can be contained in higher concentrations than in the original waste. For this reason subsequent stabilization of these toxic substances is necessary to ensure new environmental burdens are avoided when not used properly. The major part of the waste combustion process is made up of ash and slag. One of the most common ways of dealing with these solid residues is disposing them to avoid creating new hazardous waste landfills. Other filtering waste also passes hazardous waste stabilization process before landfilling. Currently there is intensive search for new possibilities for utilization of solid residues from incineration. Nowadays there is emphasis on process control of their pretreatment for the production of draft procedure with its management. Appropriate procedures may minimize the instances of improper use.
- MeSH
- nebezpečný odpad MeSH
- odpadky - odstraňování * MeSH
- popel uhelný MeSH
- skládková zařízení MeSH
- spalování odpadů MeSH
- těžké kovy * MeSH
- tuhý odpad MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Direct oral anticoagulants (DOACs) have gradually entered the Czech market as alternatives to vitamin K antagonists and parenteral anticoagulants since 2008. Considering the eventual changes, the aim was to evaluate drug use and expenditure patterns on anticoagulants in the Czech Republic. A retrospective utilization study was conducted retrieving data from the State Institute for Drug Control database, including reports on drug supplies from distributors with anatomical therapeutic chemical classification (ATC) codes B01AA, B01AB, B01AE, B01AF, and B01AX. The utilization on national level was expressed as the ratio of the number of defined daily doses per 1000 inhabitants per day (DDD/TID). Expenditures on all anticoagulants were also assessed. Data was analyzed using PASW (version 18.0). Between January 2007 and December 2017, the national anticoagulant utilization rate increased continuously from 14.15 to 27.67 DDD/TID. The use of DOACs was 0.002 DDD/TID in 2008, increased to 6.04 DDD/TID in 2017. Warfarin utilization, after a small decrease in 2008, has shown nearly stable levels in the recent years (70.9% of all anticoagulants; mean 11.55 DDD/TID over the last 5 years), while its increase was halted by the spread of DOACs utilization (p < 0.05). In 2017, over half of the expenditures (51.1%) were due to oral anticoagulants, whereof 47.6% was related to DOACs. The results reflected a growing utilization and increasing costs of all anticoagulants, especially in DOACs at the expense of warfarin. Still, additional information regarding patient persistence and prescribing patterns is needed for a better understanding of oral anticoagulant utilization.
- MeSH
- antikoagulancia aplikace a dávkování ekonomika MeSH
- aplikace orální MeSH
- časové faktory MeSH
- databáze faktografické MeSH
- hodnocení spotřeby léčiv trendy MeSH
- lékařská praxe - způsoby provádění ekonomika trendy MeSH
- lékové předpisy MeSH
- lidé MeSH
- náklady na léky trendy MeSH
- retrospektivní studie MeSH
- výdaje na zdravotnictví trendy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
WHAT IS KNOWN AND OBJECTIVE: Polypharmacy has a significant impact on patients' health with overall expenditure on over-the-counter (OTC) medicines representing a substantial burden in terms of cost of treatment. The aim of this study, which was conducted within the framework of a European Project funded by the European Union under the Seventh Framework Programme and was entitled OTC-SOCIOMED, was to report on possible determinants of patient behaviour regarding the consumption of medicines, and particularly OTCs, in the context of primary care. METHODS: A multicentre, cross-sectional study was designed and implemented in well-defined primary healthcare settings in Cyprus, the Czech Republic, France, Greece, Malta and Turkey. Patients completed a questionnaire constructed on the basis of the theory of planned behaviour (TPB), which was administered via face-to-face interviews. RESULTS AND DISCUSSION: The percentage of patients who had consumed prescribed medicines over a 6-month period was consistently high, ranging from 79% in the Czech Republic and 82% in Turkey to 97% in Malta and 100% in Cyprus. Reported non-prescribed medicine consumption ranged from 33% in Turkey to 92% in the Czech Republic and 97% in Cyprus. TPB behavioural antecedents explained 43% of the variability of patients' intention to consume medicines in Malta and 24% in Greece, but only 3% in Turkey. Subjective norm was a significant predictor of the intention to consume medicines in all three countries (Greece, Malta and Turkey), whereas attitude towards consumption was a significant predictor of the expectation to consume medicines, if needed. WHAT IS NEW AND CONCLUSION: This study shows that parameters such as patients' beliefs and influence from family and friends could be determining factors in explaining the high rates of medicine consumption. Factors that affect patients' behavioural intention towards medicine consumption may assist in the formulation of evidence-based policy proposals and inform initiatives and interventions aimed at increasing the appropriate use of medicines.
- MeSH
- dospělí MeSH
- lékařská praxe - způsoby provádění statistika a číselné údaje MeSH
- lékařství statistika a číselné údaje MeSH
- léky bez předpisu terapeutické užití MeSH
- léky na předpis terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- primární zdravotní péče statistika a číselné údaje MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- úmysl MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- Geografické názvy
- Evropa MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
Despite the fact that biological treatments are very promising, classical immunosuppressants, antimalarial drugs and glucocorticosteroids are still very important and widely used in practice. Although drug interactions can have fatal consequences, few studies have reviewed drug interactions of these classical drugs used in rheumatology, and very few guidelines are available on this subject. Therefore, this report summarizes important interactions of immunosuppressants, antimalarial drugs and glucocorticosteroids with drugs commonly used in internal medicine. In the present study, more than 300 interactions were retrieved from the Micromedex ® database. The selection was reduced to the interactions rated as moderate, major or contraindicated. The selected interactions were further checked against PubMed ®, MEDLINE ®, InfoPharm Compendium of Drug Interactions and Summaries of Product Characteristics. For each interaction, its nature, mechanism, onset and clinical severity were indicated, documentation quality was rated and recommendations for clinical practice were formulated. Twenty significant interactions that we rated as moderate, severe and very severe were identified. Interacting drugs were warfarin, fluoroquinolones, azole antifungals, co-trimoxazole, proton pump inhibitors, amiodarone, cholestyramine, activated carbon, allopurinol, angiotensin-converting enzyme inhibitors, statins, digoxin, iron, aluminium and magnesium salts, and hepatotoxic and nephrotoxic agents.
- MeSH
- antimalarika škodlivé účinky terapeutické užití MeSH
- glukokortikoidy škodlivé účinky terapeutické užití MeSH
- imunosupresiva škodlivé účinky terapeutické užití MeSH
- lékové interakce MeSH
- lidé MeSH
- revmatické nemoci farmakoterapie MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
