The insignificant and short-term changes in knowledge, attitudes and self-medication demonstrate that interventions need to be implemented for a longer period of time, at a large scale, with active health providers' engagement, and accompanied by inspections to promote appropriate use of antibiotics and discourage self-medication.

Abstract:Fruit spirits contain a large array of volatile compounds among which the important role from toxicological aspect besides ethanol has methanol, aliphatic esters and fusel alcohols. This study evaluates the content of ethanol, ethyl acetate, methanol, isopropyl alcohol (2-propanol), n-propyl alcohol (propan-l-ol), isobutyl alcohol (2-methylpropan-1-ol), n-butyl alcohol (1-butanol), isoamyl alcohol (3-methyl-1-butanol) and n-amyl alcohol (pentan-1-ol) in different grapes and plum brandies industrially produced at Republic of Macedonia. Gas chromatography (GC) with flame ionization detection (FID) was applied for the characterization of all investigated volatile compounds. The obtained results revealed that the highest methanol content was present in the samples of plum brandy, which is mainly due to the higher content of pectin in the raw material. The most important higher alcohols of grape and plum brandies were found to be: n-propyl alcohol, isobutyl alcohol and isoamyl alcohol. In all the analyzed samples of grape and plum brandies, the most abundant was isoamyl alcohol which content ranged from 50.3 to 290.7 mg/100 mL a.a. Comparing the results with the data from the literature, it can be concluded that the concentrations of all investigated volatile compounds in the samples of grape and plum brandies are commonly acceptable.

Objectives: The aim of the study was to compare the access of patients with rare diseases (RDs) to biotechnological drugs in several Central and Eastern European countries (CEECs). We focused on the legislative pricing and reimbursement requirements, availability of biotechnological orphan medicinal products (BOMPs) for RDs, and reimbursement expenditures.Methods: A questionnaire-based survey was conducted among experts from 10 CEECs: Bulgaria, Croatia, Estonia, Greece, Hungary, Poland, Romania, Slovakia, Serbia, and Macedonia. The legal requirements for reimbursement and pricing of BOMPs were collected. All BOMPs and medicines without prior orphan designations were extracted from the European list of orphan medicinal products, 2017. The reimbursement status of these medicinal products in 2017 in the public coverage of the included CEECs as well as the share of their costs in relation to the total public pharmaceutical spending for the period from 2014 to 2016 were defined.Results: Our survey revealed that some differences in the legal requirements for pricing and reimbursement of BOMPs amongst the countries included in the study. All European Union countries have developed and implemented pharmacoeconomic guidelines with or without some specific reimbursement requirements for orphan medicinal products. Cost-effectiveness analysis, cost-utility analysis, Markov models, meta-analysis, and discount levels of costs and results were required only in Bulgaria, Poland and Hungary. The number of reimbursed BOMPs and biotechnological medicinal products for RDs without prior orphan designation was the highest in Hungary (17 and 40, respectively). Patient-based reimbursement schemes were available only in Hungary for 11 out of 17 BOMPs. Poland and Greece have the highest pharmaceutical expenditure of reimbursed BOMPs with are ~214 million and 180 million EUR, respectively in the observed period from 2014 to 2016. High proportion of the pharmaceutical expenditure on the reimbursed biotechnological medicinal products for RDs for the observed period 2014–2016 is presented in Bulgaria and Slovakia.Conclusions: The non-European Union CEECs face a significant delay in the legal implementation of pharmacoeconomic guideline for assessment of BOMPs. The access to BOMPs is similar among the observed CEECs and the countries with the best access are Hungary and Greece. The influence of BOMP expenditures on the budget in the individual countries is significant.

Faculty of Natural and Technical Sciences and Faculty of Medical Sciences starting from December 2012, launched joint study in order to investigate personal noise exposure and associated health effects in general school teachers population, starting from kindergartens up to high schools in Stip, Macedonia.In order to determine workplace associated noise exposure and associated health effects in this specific profession, a full shift noise exposure of 40 teachers from 1 kindergarten, 2 primary and 2 high schools were measured in real conditions using noise dosimeters.A-weighted equivalent-continuous sound pressure levels (LAeq) of each teacher were recorded during single activities (classes). Normalized 8-hours exposure, termed the noise exposure level (L ex,8 h ) was also computed. Daily noise dose is another descriptor for noise exposure that was determined as a measure of the total sound energy to which workers have been exposed, as a result of working in the varying noise levels.Health effects were assessed trough a full scale epidemiological study which included 231 teachers from the same schools. Specific questionnaire was used to extract information about subject's perception on occupational noise exposure, as well as theirs occupational and medical history.

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