Publications by authors named "Michal Maluchnik"

4 Publications

  • Page 1 of 1

Gender-Related Differences in Prodromal Multiple Sclerosis Characteristics: A 7-Year Observation Study.

J Clin Med 2021 Aug 26;10(17). Epub 2021 Aug 26.

Department of Neurology, Medical University of Lublin, 20-090 Lublin, Poland.

Increasing evidence supports the observation that multiple sclerosis (MS) has a preclinical period, with various prodromal signs and symptoms more frequently represented in patients with confirmed MS many years later. Considering the apparent gender differences in the incidence and clinical course of MS, it remains unclear whether it could be reflected in prodromal symptom features. This study aimed to compare a broad spectrum of prodromal signs and symptoms between males and females in the 7-year period before the definite diagnosis of MS. Data came from the central register of the national payer of services, financed under the public healthcare system in Poland. They covered a 7-year period of patient health record claims, from 2009 to 2016. The following groups of symptoms were significant with women: musculoskeletal ( < 0.001), ophthalmic ( < 0.001), laryngological ( < 0.001), digestive system ( < 0.001), urinary tract ( < 0.001), mental ( < 0.001), cardiovascular ( < 0.001), complaints and headaches ( < 0.001). There was also a weak correlation with head injuries ( = 0.03) while dermatological and reproductive system complaints did not appear to be significant ( < 0.05). For males, the following groups of symptoms were significant: musculoskeletal ( < 0.001), ophthalmic ( < 0.001), laryngological ( = 0.007), cardiovascular system symptoms ( < 0.001), and headaches ( < 0.001). Interestingly, reproductive system problems were overrepresented in the male population ( = 0.008). There was no significant correlation with MS risk for dermatological, digestive, urinary, and mental complaints. Similarly, head injuries were not significant. Our results shed more light on well-known differences in the epidemiological and clinical characteristics between sexes in multiple sclerosis, and show differences in prodromal complaints before MS onset.
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http://dx.doi.org/10.3390/jcm10173821DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432063PMC
August 2021

Multiple sclerosis incidence and prevalence in Poland: Data from administrative health claims.

Mult Scler Relat Disord 2021 Jul 22;55:103162. Epub 2021 Jul 22.

Department of Neurology, Jagiellonian University Medical College, Krakow, Poland; Department of Neurology, University Hospital in Krakow, Krakow, Poland.

Background: The detailed data concerning multiple sclerosis (MS) epidemiology in Poland are based on studies from few and less populated provinces. Therefore, we evaluated MS incidence and prevalence in Poland using electronic administrative health claims (AHCs) from the National Health Fund.

Methods: We retrospectively analyzed the AHC financial database collected from 2009 to 2019, encompassing all patients using public health resources. Three different algorithms for identification of MS cases were used: based on studies performed in German population (type 1), tested in the United States (type 2), and one created for the purpose of this study (type 3) that required at least 3 AHCs since 2009 with G35 ICD-10 diagnosis in outpatient specialist care, during hospitalization, and/or at rehabilitation service in any combination within maximally 3 years between the first and the last AHC, and provided that at least one AHC was either in neurological outpatient care or during hospitalization at a neurological ward or prescription of disease-modifying therapy. The American algorithm (type 2) required 3 AHCs within the analyzed year, while the German algorithm (type 1) required only one AHC in the analyzed year.

Results: According to the type 3 algorithm, age-adjusted MS incidence and prevalence in 2019 was 6.6 and 131.2 / 100,000 inhabitants, respectively. From 2014 to 2019, the significant trend in increasing prevalence and decreasing incidence of MS was observed (p<0.001). Median age of prevalent MS patients was 50 years (interquartile range, IQR 39-61) whereas median age of incident MS cases was 37 years (IQR 28-48). Female-to-male ratio in MS patients was 2.4. According to the type 1 algorithm, age-adjusted MS incidence and prevalence in 2019 was 11.6 and 244.9 / 100,000 inhabitants, respectively. Use of the type 2 algorithm resulted in estimated age-adjusted MS incidence and prevalence values in 2019 of 6.2 and 120.1 / 100,000 inhabitants, respectively.

Conclusions: Multiple sclerosis incidence and prevalence in Poland are higher than previously reported and similar to the numbers shown for central European countries.
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http://dx.doi.org/10.1016/j.msard.2021.103162DOI Listing
July 2021

Decreasing access to cancer diagnosis and treatment during the COVID-19 pandemic in Poland.

Acta Oncol 2021 Jan 26;60(1):28-31. Epub 2020 Oct 26.

Warsaw School of Economics, National Health Fund, Warsaw, Poland.

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http://dx.doi.org/10.1080/0284186X.2020.1837392DOI Listing
January 2021

Differences in acute ischaemic stroke care in Poland: analysis of claims database of National Health Fund in 2017.

Neurol Neurochir Pol 2020 4;54(5):449-455. Epub 2020 Sep 4.

Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland.

Selected and basic indicators of acute ischaemic stroke care in Poland are reported cross-regionally based on the analysis of claims data of the National Health Fund (NFZ) in 2017, the most reliable source of healthcare funding in the country, being a single public payer. For research purposes, a selection algorithm based on the diagnosis coded as I63 according to the International Classification of Diseases (ICD-10) was used to identify all ischaemic stroke patients in the claims database provided by the NFZ. Stroke units and other centres providing treatment for acute ischaemic stroke patients were examined. The analysis showed marked differences between provinces in terms of stroke unit treatment availability. The crude and standardised rates of acute ischaemic stroke admissions to stroke units varied between provinces. Moreover, substantial differences were observed for the thrombolysis implementation rate, access to rehabilitation, hospital stay and early prognosis. As the leading cause of disability and the second leading cause of death in developed countries, stroke requires a well-organised, evidence-based healthcare system provided for both acute treatment and rehabilitation. Continuous monitoring of healthcare is crucial to identify weaknesses and areas for improvement.
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http://dx.doi.org/10.5603/PJNNS.a2020.0066DOI Listing
November 2020
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