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Katarzyna Orlewska

Bio: Katarzyna Orlewska is an academic researcher from Medical University of Warsaw. The author has contributed to research in topics: Medicine & Years of potential life lost. The author has an hindex of 5, co-authored 12 publications receiving 32 citations.

Papers
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Journal ArticleDOI
TL;DR: The positive correlation between DCI and both mortality and case fatality suggests that DCI could be considered as an indirect indicator of healthcare burden, compared to incidence rate alone.
Abstract: Introduction: An attempt to assess basic epidemiological data was made two months after confirming the first case of SARS-CoV-2 in Poland (March 4th, 2020). The aim of the study was to examine which indicators related to epidemiology, population characteristics and health care quality affect COVID-19 incidence, mortality and case fatality in Poland. Material and methods: The study was based on national data as of May 4th, 2020. For each voivodeship incidence rates, mortality rates, case fatality rates and daily cumulative index (DCI) were calculated. The correlations were examined using Pearson’s and Spearman’s rank correlation coefficient, with a significance level of p < 0.05 (2-tailed tests). Results: The overall COVID-19 incidence rate was 3.65 per 10,000 population, mortality rate 0.18 per 10,000 population and case fatality rate 5%. All three disease indicators were positively correlated with DCI and negatively correlated with the number of hospital beds in infectious diseases wards per 10,000 population. Both incidence and mortality rates were positively correlated with population density and number of cases per COVID-19 designated hospital. Conclusions: The positive correlation between DCI and both mortality and case fatality suggests that DCI could be considered as an indirect indicator of healthcare burden, compared to incidence rate alone. Our analysis confirms the role of social distancing in reducing viral transmission. The results could be useful for policymakers to plan ahead in order to relieve the risk of healthcare system overload during the current and future epidemics.

10 citations

Journal ArticleDOI
05 Jun 2017-PLOS ONE
TL;DR: The observed tendencies correspond to the evidence-based HTA recommendations, and the increase in antidiabetic medications costs over the analysed period of time was mainly caused by the increased use of insulin analogues.
Abstract: Aim to investigate the drug-class-specific changes in the volume and cost of antidiabetic medications in Poland in 2012–2015. Methods This retrospective analysis was conducted based on the National Health Fund database covering an entire Polish population. The volume of antidiabetic medications is reported according to ATC/DDD methodology, costs—in current international dollars, based on purchasing power parity. Results During a 4-year observational period the number of patients, consumption of antidiabetic drugs and costs increased by 17%, 21% and 20%, respectively. Biguanides are the basic diabetes medication with a 39% market share. The insulin market is still dominated by human insulins, new antidiabetics (incretins, thiazolidinediones) are practically absent. Insulins had the largest share in diabetes medications expenditures (67% in 2015). The increase in antidiabetic medications costs over the analysed period of time was mainly caused by the increased use of insulin analogues. Conclusions The observed tendencies correspond to the evidence-based HTA recommendations. The reimbursement status, the ratio of cost to clinical outcomes and data on the long-term safety have a deciding impact on how a drug is used.

8 citations

Journal ArticleDOI
TL;DR: The findings provide quantitative evidence on the burden of suicide and suggest LEYLLs and premature mortality costs estimated according to national guidelines have the potential to be useful for local public health policymakers.
Abstract: Objectives The aim of our study was to estimate the health-related and economic burden of suicide in Poland in 2012 and to demonstrate the effects of using different assumptions on the disease burden estimation.

8 citations

Journal ArticleDOI
TL;DR: The results of cost-effectiveness analyses suggest that preoperative medical therapy with SSAs may be highly cost-effective in acromegalic patients with macroadenoma and indicate that in some countries pasireotide and pegvisomant appeared to be cost- effective or even dominant strategies in comparison to first-generation SSAs.
Abstract: Introduction Somatostatin analogues (SSAs) are the largest contributor to the direct medical cost of acromegaly management worldwide. The aim of this review was to identify and report available evidence on the cost-effectiveness of SSAs in the treatment of acromegaly. Areas covered A literature search on relevant papers published up to April 2018 was performed. A total of 22 eligible studies (10 full-text articles and 12 conference abstracts) conducted in 14 countries were included in the analysis. In majority of studies, modelling technique was the principal research method. Expert commentary The results of cost-effectiveness analyses: 1) support published recommendations where SSAs are indicated as first-line medical treatment for patients with persistent disease after surgery or who are not eligible for surgery; 2) suggest that preoperative medical therapy with SSAs may be highly cost-effective in acromegalic patients with macroadenoma, in centres without optimal surgical results 3) indicate that in some countries pasireotide and pegvisomant appeared to be cost-effective or even dominant strategies in comparison to first-generation SSAs. The main limitation of economic evaluations was the lack of high-quality studies designed to directly compare various treatment strategies in acromegaly.

8 citations

Journal ArticleDOI
TL;DR: The findings of this cross-sectional ecological study support public health concerns over the implication of socioeconomic environment for cancer.
Abstract: To assess the link between the risks of most frequent cancer sites in Poland and selected socioeconomic variables that potentially affect health outcomes throughout the life course. This is a cross-sectional ecological study. Incidence of lung, breast, and colon cancer by voivodeships in 2014 was calculated based on Polish National Cancer Registry. Socioeconomic variables in individual voivodeships were assessed based on Polish Social Cohesion Survey for 2015. Spearman’s rank correlation coefficient was used to test the association of incidence rates and socioeconomic variables. The significance level was set at p < 0.05 (two-tailed tests). Statistically significant negative correlation exists between: (1) friend-/neighbour-based social capital and colon and breast cancer, (2) association-based social capital and lung cancer, (3) high religiousness and lung and breast cancer, and (4) income poverty and breast cancer. Statistically significant positive correlation exists between: (1) social isolation, living conditions poverty, poverty resulting from the lack of budget balance, and lung cancer; (2) low/no involvement in religious activity and lung and breast cancer. Our findings support public health concerns over the implication of socioeconomic environment for cancer.

6 citations


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01 Jan 2020
TL;DR: Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
Abstract: Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

4,408 citations

Journal Article
TL;DR: Decrease in soft-tissue swelling and weight loss, and improved vitality, performance, carbohydrate metabolism, and cardiovascular function, facilitated anesthetic and surgical management; tumor removal was easy in virtually all cases.
Abstract: The aim of this study was to determine the role of octreotide administration in acromegalic patients as a preparation for selective adenomectomy using transsphenoidal route. Octreotide was administered for 3 to 6 weeks before surgery in 12 patients and for 4 to 39 months in 25 patients. The clinical response was judged as excellent or good in 10 of 12 patients from group I and in 23 of 25 patients from group II. Marked reduction (ie, greater than 50% of initial values) in serum growth hormone (GH) levels was seen in all patients, with levels to less than 5 micrograms/L in 68% of patients and less than 2 micrograms/L in 27%. Insulin-like growth factor 1 (IGF-1) levels decreased to within normal limits in half the cases. During long-term treatment, an escape phenomenon could be seen. Varying degrees of tumor shrinkage were seen in more than 50% of cases. During surgery, with regard to the relative ease or difficulty in removing the tumor, the consistency of the tumor and the separation of normal from pathological tissue, no significant difference was observed between patients given octreotide and those from control series. Morphological changes in adenomatous tissue were rather small. The surgical outcome was similar in the pretreated series as in the control series, except in enclosed adenomas, which showed a tendency to a higher success rate. Since octreotide improves both the clinical condition and hormonal parameters and induces varying degrees of tumor shrinkage, it is potentially useful as an adjunct to surgery. Morphological data suggest that octreotide exercises a functional inhibitory effect on GH release.

148 citations

Journal ArticleDOI
TL;DR: Loneliness and SI were independently associated with a diagnosis of CVD and T2D within a 5 year follow-up period and were fully explained by baseline psychological and behavioral factors.
Abstract: Background Research suggests that loneliness and social isolation (SI) are serious public health concerns. However, our knowledge of the associations of loneliness and SI with specific chronic diseases is limited. Purpose The present prospective cohort study investigated (a) the longitudinal associations of loneliness and SI with four chronic diseases (cardiovascular disease [CVD], chronic obstructive pulmonary disease [COPD], diabetes mellitus Type 2 [T2D], and cancer), (b) the synergistic association of loneliness and SI with chronic disease, and (c) baseline psychological and behavioral explanatory factors. Methods Self-reported data from the 2013 Danish "How are you?" survey (N = 24,687) were combined with individual-level data from the National Danish Patient Registry on diagnoses in a 5 year follow-up period (2013-2018). Results Cox proportional hazard regression analyses showed that loneliness and SI were independently associated with CVD (loneliness: adjusted hazard ratio (AHR) = 1.20, 95% confidence interval [CI; 1.03, 1.40]; SI: AHR = 1.23, 95% CI [1.04, 146]) and T2D (loneliness: AHR =1.90, 95% CI [1.42, 2.55]; SI: AHR = 1.59, 95% CI [1.15, 2.21]). No significant associations were found between loneliness or SI and COPD and cancer, respectively. Likewise, loneliness and SI did not demonstrate a synergistic effect on chronic disease. Multiple mediation analysis indicated that loneliness and SI had an indirect effect on CVD and T2D through both baseline psychological and behavioral factors. Conclusion Loneliness and SI were independently associated with a diagnosis of CVD and T2D within a 5 year follow-up period. The associations of loneliness and SI with CVD and T2D were fully explained by baseline psychological and behavioral factors.

36 citations

Journal ArticleDOI
TL;DR: The need to focus attention on ensuring access for individuals to essential medicines is stressed, with an increasing burden of disease and changing patterns of medicines in the market.
Abstract: The purpose of this review is to highlight the key issues with regard to the value, affordability, and availability of diabetes treatments. Many of the medicines needed to manage diabetes are available as generics and, if purchased appropriately, can be made affordable to many individuals and systems. With new treatments for diabetes, additional costs to individuals and systems need to be assessed in terms of added clinical benefit and financial impact. As healthcare finances are limited, increased spending on diabetes medicines means fewer resources for other areas of diabetes care or for the population as a whole. This increased expenditure is driven by rising prevalence as well as the cost of newer treatments. With an increasing burden of disease and changing patterns of medicines in the market, we stress the need to focus attention on ensuring access for individuals to essential medicines. Universal health care offers unique opportunity to address the issue of access to medicines and the wider issues surrounding access to diabetes care, but this will require concerted action bringing together governments, civil society and the private sector.

33 citations

Journal ArticleDOI
TL;DR: A long-run relationship between the suicide rate and long-term unemployment emerged, though statistically weaker, and a specific "flexicurity” system (intended as a combination of high employment protection, job satisfaction and labour-market policies) may have a positive impact on health.
Abstract: From the mid-1990s on, the suicide rate in Italy declined steadily, then apparently rose again after the onset of the Great Recession, along with a sharp increase in unemployment. The aim of this study is to test the association between the suicide rate and unemployment (i.e., the unemployment rate for males and females in the period 1977-2015, and the long-term unemployment rate in the period 1983-2012) in Italy, by means of cointegration techniques. The analysis was adjusted for public unemployment spending (referring to the period 1980-2012). The study identified a long-run relationship between the suicide rate and long-term unemployment. On the other hand, an association between suicide and unemployment rate emerged, though statistically weaker. A 1% increase in long-term unemployment increases the suicide rate by 0.83%, with a long-term effect lasting up to 18 years. Public unemployment spending (as percentage of the Italian gross domestic product) may mitigate this association: when its annual growth rate is higher than 0.18%, no impact of unemployment on suicide in detectable. A decrease in the suicide rate is expected for higher amounts of social spending, which may be able to compensate for the reduced level of social integration resulting from unemployment, helping the individual to continue to integrate into society. A corollary of this is that austerity in times of economic recession may exacerbate the impact of the economic downturn on mental health. However, a specific "flexicurity" system (intended as a combination of high employment protection, job satisfaction and labour-market policies) may have a positive impact on health.

24 citations