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Legal access to medications: a threat to Brazil's public health system?

BackgroundIn Brazil, health is fundamental human right guaranteed by the Constitution of 1988, which created the Brazilian Universal Health System (Sistema Único de Saúde - SUS). The SUS provides medications for outpatient care via policy of pharmaceutical assistance (PA) programmes. Despite the advances in PA policies which include the improvement in access to medications, there has been a significant increase in lawsuits related to health products and services. This study aimed to characterize the medication processes filed between 2010 and 2014 against the Secretary of State for Health of S

End-stage kidney disease and rationing of kidney replacement therapy in the free state province, South Africa: a retrospective study.

BackgroundEnd-stage kidney disease (ESKD) and the required kidney replacement therapy (KRT) are significant public health challenges for low-and-middle-income countries. The South African government adopted a KRT rationing policy to balance the growing need for KRT and scarce resources. We aimed to describe the epidemiology and KRT access in patients with ESKD referred to the main public sector hospital in the Free State Province, South Africa.MethodsA retrospective study of adult patients with ESKD admitted to Universitas Academic Hospital for KRT, was conducted between 1 January 2016 and 31

European Code Against Cancer, 5th edition - occupational exposures and cancer.

Occupational exposure to cancer-causing agents is a major, yet preventable, contributor to cancer in Europe and globally. In the European Union (EU), cancer is responsible for nearly half of all work-related deaths, underscoring the critical need for prevention measures. Effective strategies typically involve regulatory and workplace measures aimed at reducing or eliminating exposure risks. Raising awareness of hazardous workplace exposures is essential to empower individuals, foster a culture of prevention, and support effective regulation. The 5th edition of the European Code Against Cancer

A Rebalancing of Financial Valuations and Expectations Moving Forward in the Telehealth Sector as the United States Moves Toward a Post-COVID-19 Reality.

The telehealth sector of health care delivery experienced significant growth at the start of the pandemic as web-based care quickly became essential for the ongoing safety of patients and health care providers, such as clinicians and other health care professionals. After vaccines were introduced, however, telehealth companies lost value as the need for web-based care appeared to lessen. Presently, both existing telehealth companies and new entrants to the space are seeking ways to innovate, gain investor and customer buy-in, and overcome competitors. New companies are hoping to be seen not as

Design and development of the Australian and New Zealand (ANZ) myeloma and related diseases registry.

BACKGROUND: Plasma cell dyscrasias (PCD) are a spectrum of disorders resulting from the clonal expansion of plasma cells, ranging from the pre-malignant condition monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma (MM). MM generates a significant burden of disease on the community and it is predicted that it will increase in both incidence and prevalence owing to an ageing population and longer survival secondary to new therapeutic options. Robust and comprehensive clinical data are currently lacking but are required to define current diagnostic, investigational and

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… A truly population-based registry requires as close as possible to 100 % coverage of all sites that manage PCD in ANZ, both in the public and private sector. … However, to improve the inclusiveness and clinical usefulness of data, under-represented areas including non-Victorian, rural and private sector sites are now prioritised. …

Epidemiology of multiple myeloma in Poland in the years 2008-2017.

IntroductionMultiple myeloma is the third most common blood cancer in Europe and accounts for approx. 10-15% of these cancers. The objective of this study was to determine the incidence, prevalence, mortality and survival in multiple myeloma (ICD code: C90.0) patients in Poland in the years 2008-2017.Material and methodsThe analysis used the data on healthcare services provided to patients with multiple myeloma defined with the ICD-10 (International Statistical Classification of Diseases and Related Health Problems) code C90.0 and reported by healthcare entities to the National Health Fund (NF

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… The Polish NFZ database contains only the data on services provided in the public healthcare system and lacks data from the private medical sector; however, due to the scope of services required for treatment, usually unavailable in the private sector, the percentage of such patients seems to be minimal …

Оптимизация многочисленных методов лечения миэломы в условиях ограниченности ресурсов: нынешние перспективы и проблемы.

Множественная миелома (ММ) представляет собой серьезную глобальную проблему в области здравоохранения, и за последние десятилетия уровень ее распространенности и смертности неуклонно возрастал. В настоящем обзоре содержится критический анализ нынешнего положения дел в области управления ММ с особым упором на ограниченные ресурсами условия, в которых наиболее заметны различия в диагностических возможностях и вариантах лечения. Комплексный поиск литературы был проведен с использованием многочисленных баз данных, включая рецензированные статьи, клинические руководящие принципы и резюме конференци

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… Establishing specialised centers and fostering partnerships between the public and private sectors could mitigate many of the current limitations. …

The health and economic impact and cost effectiveness of interventions for the prevention and control of overweight and obesity in Kenya: a stakeholder engaged modelling study.

BackgroundThe global increase in mean body mass index has resulted in a substantial increase of non-communicable diseases (NCDs), including in many low- and middle-income countries such as Kenya. This paper assesses four interventions for the prevention and control of overweight and obesity in Kenya to determine their potential health and economic impact and cost effectiveness.MethodsWe reviewed the literature to identify evidence of effect, determine the intervention costs, disease costs and total healthcare costs. We used a proportional multistate life table model to quantify the potential i

Факторы, связанные с задержкой диагностики множественных склерозов в Замбии.

Задержки с диагностикой множественных склерозов (МС) в странах Африки к югу от Сахары в значительной степени неизвестны. В этом исследовании используется количественный подход для определения факторов, независимо связанных с задержками с диагностированием среди замбийской группы лиц, имеющих MS. В рамках этого перекрестного исследования люди получили подтвержденный диагноз MS в государственной амбулаторной неврологической клинике в Лусаке, Замбия. Проводились стандартизированные обследования. Диагностическая задержка была классифицирована как задержка пациента, задержка системы здравоохранения

Sociodemographic and health factors associated with the risk of financial catastrophe when informal care for patients with haematological neoplasms is replaced by formal care.

BackgroundCancer is one of the diseases with the highest incidence and mortality in the world, and one that requires greater care (formal and informal). At present, the traditional informal caregiver is disappearing. The objective is to analyse the sociodemographic and health factors associated with the possible catastrophic financial effect on households of replacing informal care by formal care for patients with blood cancer, during the different stages of treatment in Spain.MethodsA total of 139 patients with haematological neoplasm who underwent stem cell transplantation completed a longit

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… Formal care refers to services that are contracted and paid for, and provided by care professionals working either for public institutions or in the private sector [ 26 , 27 ]. This form of care provision may be home-based, community-based (via day/night care centres) or residential [ 26 , 28 ]. …

Consideration for Health Disparities in Value Assessment Frameworks.

BackgroundCost-effectiveness analysis (CEA) compares interventions based on relative value and is an integral part of value assessment. Despite recommendations for economists to consider disparities in CEAs that impact health-care resource allocation decisions, the perception held by stakeholders is that value assessment frameworks are inconsistent in practice.MethodsWe reviewed value assessment reports produced by a United States (US)-based value assessment organization to identify how patients and caregiver input may contribute to how the organization considers health disparities. We purpose

A cross-sectional study of the socio-demographic and epidemiological factors associated with childhood cancer in Cali, Colombia.

This study investigates the occurrence of childhood cancer between the years 2015 and 2016 in the city of Cali, Colombia, with respect to: a) sociodemographic characteristics, b) type of cancer, c) epidemiological weeks of cancer and d) comparative survival according to health system affiliation by consolidating the records notified to the municipal health secretariat. Statistically significant differences were found between the groups analysed in relation to the variables related to the type of cancer (p = 0.006). With respect to the proportion of cancer mortality between the years 2015-2016

Treatment Decision Making at Diagnosis for Children Presenting With Advanced Cancer in Low- and Middle-Income Countries.

PurposeAlthough most children diagnosed with cancer live in low- and middle-income countries (LMICs), research exploring decision making in these settings remains sparse. When children present with advanced cancer in LMICs, local centers may lack resources to provide treatment required to achieve cure. Existing treatment guidelines often do not account for contextual and resource variations influencing decision making. This qualitative study sought to understand physician approaches to treatment decision making for children presenting with advanced cancer at diagnosis in LMICs.MethodsSemistruc

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… It took one and a half years for the child to be diagnosed in the private sector. So, it was a late referral to us, at which time he had metastasis everywhere, […] we talked to the family and we gave them an extensive explanation about the disease, what to expect and the cure rate. … [Some may go to] a hospital in the private sector, who may tell them [the cancer] could be cured. …

Assessment of adherence to the guidelines for the management of nausea and vomiting induced by chemotherapy.

ObjectiveTo assess adherence of the prescribing physicians in a private cancer care center to the American Society of Clinical Oncology guideline for antiemetic prophylaxis, in the first cycle of antineoplastic chemotherapy.MethodsA total of 139 chemotherapy regimens, of 105 patients, were evaluated retrospectively from 2011 to 2013.ResultsWe observed 78% of non-adherence to the guideline rate. The main disagreements with the directive were the prescription of higher doses of dexamethasone and excessive use of 5-HT3 antagonist for low risk emetogenic chemotherapy regimens. On univariate analys

Attitudinal, regional and sex related vulnerabilities to COVID-19: Considerations for early flattening of curve in Nigeria.

Background: In Nigeria, the policies and interventions due to the COVID-19 pandemic are majorly directed at businesses and relief. There are no clear plans to identify individuals with comorbidities associated with high morbidity and fatality rates. This paper identifies comorbidities associated with high morbidity and fatalities of COVID-19 across countries and vulnerable groups in Nigeria. Methods: Peer-reviewed articles published between 2010 and 2020 retrieved from Google scholar, African Journal Online, EMBASE, Scopus, and MEDLINE/PubMed (central) were systematically reviewed. Results: Th

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… For example, in NWN, the awareness of PHSs is approximately 93% and 89% among public and private sector workers but only 44% and 42% of such workers utilize the services, respectively. The awareness is lower in males (39%) than in females (61%) ( 9 ). …

Comprehensive update on cancer scenario of Bangladesh.

Bangladesh, at 142 million people, is the ninth most populous country in the world. There are 13 to 15 lakh cancer patients in Bangladesh, with about two lakh patients newly diagnosed with cancer each year. As an overview, lung cancer and mouth-oropharynx cancer rank as the top two prevalent cancers in males. Other types of cancers are esophagus cancer and stomach cancer. In women, cancer cervix uteri and breast cancer are most prevalent. Other cancer types, which affect women, are mouth and oropharynx cancer, lung cancer, and esophagus cancer. There are around 150 qualified clinical oncologis

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… However, in Bangladesh there are 17 radiotherapy centers in public and private sector; only one is situated in a rural area. …

Awareness About Medication-Related Osteonecrosis of the Jaw Among Dental Professionals: A Multicentre Study.

PURPOSE: Bisphosphonates and non-bisphosphonate antiangiogenic and antiresorptive agents are widely used in the management of bone diseases and cancer. A subset of patients receiving these drugs can manifest with medication-related osteonecrosis of the jaw (MRONJ) and it is one of the major complications faced in dental practice. Dentoalveolar and periodontal surgery are the major risk factors associated with it. Therefore, a dentist must have adequate knowledge to promptly identify patients at risk and efficiently manage the condition. This multicentre study was designed with an aim to assess

Neuropsychiatric disorders in adults undergoing chimeric antigen receptor T cells therapy for aggressive lymphomas and acute lymphoblastic leukemia.

ObjectiveTo evaluate risk factors for neuropsychiatric disorders (NPD) in recipients of CART therapy.MethodsPatients ≥ 18 years with acute lymphoblastic leukemia (ALL), and aggressive B-cell lymphomas who received CART in 2018 were evaluated. Patients with and without NPD were compared.ResultsNPD was diagnosed in 31.2% of patients. Compared to patients without NPD, patients with NPD were likely to be females (P = 0.035) and have ALL (P = 0.039). NPD was significantly associated with female gender (OR = 2.03) and diagnosis of ALL (OR = 2.76). No association between NPD and outcomes.ConclusionsF

Multiple myeloma in Latin America: A systematic review.

The incidence of multiple myeloma (MM) has surged globally, particularly in Latin American countries, and is attributable to an aging population and increased life expectancy. This systematic review analyzes the epidemiology, patient characteristics, and treatment outcomes for MM in selected Latin American countries: Brazil, Mexico, Colombia, Argentina, Chile, Peru, and Uruguay. PubMed and the Latin American and Caribbean Health Sciences Literature (LILACS), conference abstracts (between June 2019 and June 2022), and GLOBOCAN registry (January 2010 to June 2022) were electronically searched. Q

Impact of payment source, referral site, and place of residence on outcomes after allogeneic transplantation in Mexico.

BackgroundThe impact of social determinants of health in allogeneic transplant recipients in low- and middle-income countries is poorly described. This observational study analyzes the impact of place of residence, referring institution, and transplant cost coverage (out-of-pocket vs government-funded vs private insurance) on outcomes after allogeneic hematopoietic stem cell transplantation (alloHSCT) in two of Mexico's largest public and private institutions.AimTo evaluate the impact of social determinants of health and their relationship with outcomes among allogeneic transplant recipients i

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… The Mexican health system consists of three main components: (1)‎ Employment-based healthcare (40.4%); (2)‎ public assistance services for the uninsured (43.5%); and (3)‎ a private sector composed of out-of-pocket payments from patients and private insurance companies. …