Wednesday, 11 January 2023

Croatian Doctors Simultaneously Transplant Heart and Liver

January 11, 2023 - Incredible success of Croatian doctors from KBC Zagreb - a few days ago, they transplanted a man's heart and liver simultaneously.

As Index writes, Hrvoje Gašparović, head of the Clinic for Cardiac Surgery at KBC Zagreb, commented on the venture for Nova TV. More than 30 people participated in the operation, and the patient is recovering very well.

"Heart transplantation, liver transplantation, in fact, transplantation of all solid organs, is always a race against time. There is a rigid time frame within which the transplantation procedure must be started and completed. When we disconnect the heart from circulation, we usually disconnect it in another country so that we would re-incorporate it into circulation in the Republic of Croatia. We want to do that within four hours. Sometimes we lose more than two hours just for transportation," explained Gašparović.

A complex operation

He pointed out that it is a complex procedure in which four surgical teams participate, which must be carefully coordinated to perform the transplant in the correct sequence.

"The heart transplant happens first, after which the colleagues from abdominal surgery continued the operation and successfully performed their part of the liver transplant," Gašparović pointed out.

Professor Gašparović's team transplanted lungs to a child for the first time in Croatia. "Lung transplantation is a program that has been stable for the past few years," he said, adding that the child received the lungs of an adult.

106 transplants last year

He pointed out that a total of 106 solid organ transplants were performed last year - 27 heart transplants, 26 liver transplants, 43 kidney transplants, and 10 lung transplants.

"It is a comprehensive transplant program that we can be proud of. Transplantation of solid organs in this country is the backbone of our medicine. Hats off to everyone participating, including our transplant coordinators from the Ministry. It is difficult to count all the people who participate in this process", he concluded.

"Regarding the transplantation of solid organs, especially hearts, we are extremely good at the global level. For example, everyone remembers that in 2018 Croatia beat England 2:1, but not many people know that Croatia beat that same England, and Germany too, 9:3 in the number of transplants we do per million inhabitants. Therefore, we have nothing to be ashamed of," said Gašparović.

For more, make sure to check out our dedicated Lifestyle section.

Friday, 18 November 2022

City of Split to Co-Finance Medically Assisted Reproduction

November the 18th, 2022 - The City of Split is set to co-finance medically assisted reproduction in order to attempt to raise the birthrate in that part of Central Dalmatia.

As Poslovni Dnevnik writes, the City of Split will co-finance medically assisted fertilisation from 2023 onwards, writes Vecernji list, stating that such a pronatal measure has already been introduced by the Eastern Croatian city of Osijek, as well as by the municipality of Gradac in the Makarska littoral.

Many couples try to become parents even after several failed fertility procedures, when they no longer have the right to the procedure of medically assisted reproduction at the expense of the Croatian Institute for Health Insurance, which is a big blow to any normal bank account, so, in an effort to improve the devastating demographic trends in Dalmatia, the city will cover part of the costs of such interventions.

When it comes to demographics in the city and the wider area, the situation is truly alarming. Split has lost 10,100 inhabitants in the last ten years along, and as for the ratio of births and deaths, in the same period, about 3,000 more people died were born.

''We've agreed with Mayor Ivica Puljak that from 2023 on, the City of Split will receive a fund for subsidising medically assisted reproduction. The fund will amount to 600,000 kuna. We will further harmonise the regulations with the mayor before announcing the tender. Otherwise, HZZO covers the costs of four procedures, for women up to 42 years of age. I propose that the City of Split co-finance procedures for women living in Split until the age of 44 or 45, but also to co-finance procedures for couples who have already used all of the procedures financially covered by HZZO, of which there are unfortunately many,'' said Davor Matijevic, a Split city councilor from SDP.

He explained that HZZO pays out in full for four procedures if they are performed at KBC Split (Split Hospital). If those procedures either don't work or result in loss, people seeking such treatments then have to pay for them alone, which is either incredibly difficult or in some cases simply not possible.

For the additional three procedures, the City of Split will co-finance 80 percent of the total costs if the procedure is performed at Split Hospital, 60 percent if the procedure is performed in one of the private institutions in the wider area, and 40 percent (up to 7,500 kuna) for procedures performed in another healthcare institution located on the territory of the Republic of Croatia or even in another European Union member state.

For more, make sure to check out our dedicated news section.

Saturday, 29 October 2022

Roadmap to Cholesterol: Croatia Among First to Implement New Global Project

October 29, 2022 - Croatia is very successful in the treatment of cardiovascular diseases but urgently needs to improve prevention - we are among the first to start implementing the new global Roadmap for Cholesterol, which was just presented in Zagreb, as well as other projects to improve the nation's cardiovascular health.

Although Croatians have the highest obesity rate amongst the citizens of the EU and insufficiently recognize and treat other key cardiovascular risk factors, Croatia went from the group of so-called very high-risk countries to the group of countries with a high risk of cardiovascular diseases. This is confirmation of the good practice of domestic experts in cardiovascular health, but the key next step is the National Plan for the Suppression of Cardiovascular Diseases with the aim of transforming into a group of countries with low cardiovascular risk – the most developed countries in Europe and the world.



The symposium named Use your brain chose your heart, organized by the World Heart Federation and the Croatian Cardiac Society in Zagreb and under the chairmanship of academician Davor Miličić, brought together the leading domestic experts in cardiovascular health. Just after the world premiere, got acquainted with the new Roadmap for Cholesterol 2022. It is a comprehensive document aimed at improving health outcomes and survival in patients with increased cardiovascular risk, with an emphasis on the importance of comprehensive prevention, early and high-quality diagnostics, and screening of risk groups from an early age. It was presented by the president of the European Society for Atherosclerosis and one of the world's leading authorities on cardiovascular diseases, prof. Kausik Ray. As the host of the symposium, academician Davor Miličić asserted that with more than 22,000 deaths from cardiovascular diseases per year, Croatia is among the countries with higher mortality rates than the EU average and is classified as one of the countries with a high cardiovascular risk in Europe. In Croatia, there is already a consensus on the need for the urgent adoption of the National Plan for the Suppression of Cardiovascular Diseases, which has the support of the Ministry of Health. Academician Miličić also pointed out that cardiology is a very successful field of Croatian medicine, within which a number of new diagnostic and therapeutic achievements have been introduced into routine practice, such as the primary network of interventional treatment in acute coronary syndrome and other most complex interventional procedures in diseases of the heart, aorta and peripheral vessels. Great progress was also made in arithmology and electrostimulation, and of course, in heart transplantation and the use of mechanical circulation pumps, which is why Croatian cardiology is internationally recognized and acknowledged. Therefore, our cardiology patients, even the most difficult ones, can receive high-quality and comprehensive cardiology care in Croatia.



"In order to bring Croatia closer to countries with the lower mortality rates from cardiovascular diseases,  it is necessary to simultaneously work on six key challenges – comprehensive primary prevention targeted active and systematic detection of high-risk patients who do not yet have an established diagnosis, such as those with familial hyperlipoproteinemia, reduction of obesity and cardiometabolic risk, public health campaigns, the introduction of new therapies in accordance with the guidelines of the European Society of Cardiology and, of course, the consistent and steady implementation of a comprehensive National Plan for the suppression of cardiovascular diseases"  concluded academician Miličić.

Academician Miličić also pointed out screening for familial hyperlipoproteinemia among preschool children as one of the future major public health projects, whereby Croatia would be one of the first countries with this type of screening that exposes children with an extremely high cardiovascular risk, but also their parents and siblings. This enables the start of effective treatment and prevents cardiovascular disease and mortality, which without treatment can be expected in adolescence or young adulthood. Academician Željko Reiner reminded it is a congenital disease where patients have a lifelong high value of LDL cholesterol, which needs to be effectively and permanently controlled.




"It is estimated that about 20,000 people in Croatia suffer from such a hereditary form of high cholesterol, of which only one percent has been recognized. Due to long-term imperceptible exposure to high values of bad LDL-cholesterol, these people have a 20 times higher risk of developing cardiovascular diseases than the rest of the population. In this procedure, after identifying a child with familial hypercholesterolemia, the cooperation of a family medicine doctor, but also of the whole family, which would be covered by screening and the possibility of effective, timely treatment, is needed," added academician Reiner, president of the Croatian Society for Atherosclerosis.

The Ministry of Health strongly supports the proposals and conclusions of the Symposium, pointed out the representative of the Ministry, Dr. Ivana Portolan Pajić. "The upcoming healthcare reform is making a big turn towards primary prevention, early disease detection, and the implementation of screening for familial hypercholesterolemia in preschool children, which will begin in 2023," she concluded.




Academician Bojan Jelaković, president of the Croatian Society for Hypertension, reminded me of the importance of reduced salt intake. "In the last 12 years, we have recorded a significant decrease in salt intake, both among citizens and through cooperation with the food industry, as well as a decrease in blood pressure values. But we still have to work systematically to highlight the danger that excessive salt consumption poses to human health,"  added academician Jelaković. With this Symposium, Croatia hosted the World Heart Federation for the first time, which is the representative of the global cardiovascular community, and gathers more than 200 member organizations in more than hundreds of countries.

Thursday, 8 September 2022

Dubrovnik Hosts Digitalisation in Healthcare, Health Tourism Conference

September the 8th, 2022 - The City of Dubrovnik hosted a recent conference on digitalisation in healthcare, and the potential of health tourism.

As Morski writes, the global health and wellness tourism market is worth more than 900 billion US dollars and is the fastest growing segment of tourism with annual growth of 15 to 20 percent. Croatia can do more in this than it does currently, and this was among the main messages from this week's conference "Digitalisation in healthcare and the potential of health tourism 365'', held in Dubrovnik.

The conference was organised by the Dubrovnik County Chamber of Commerce, bringing together experts from the fields of digitisation, innovation, healthcare and tourism.

The global data on the value of that market presented at the conference are actually estimates by the World Tourism Organisation (UNWTO), according to which the largest part of the total estimated value of the global market, or about 800 billion dollars, refers to wellness, while the value of health tourism is estimated to stand at about 125 billion dollars.

With regard to the growing market value, which also stimulates the increase in demand for healthcare and wellness tourism services, as well as the growing life expectancy of the world's population, it was pointed out at the conference that these are opportunities for further development of that market, including right here in Croatia.

The global report on the health and medical tourism market confirms that there are opportunities for growth and predicts that revenues in this market will grow by 30 percent annually from 2021 to 2026, and everything was additionally accelerated by the global coronavirus pandemic, which resulted in a significantly increased interest in healthcare and wellness tourism. Croatia also has a great opportunity due to its natural benefits, professional staff and excellent offer.

What it lacks, and what is happening more and more in the world, is that this growing demand is accompanied by increased investments in healthcare infrastructure, which in recent years also includes significant investments in the areas of digital transformation and innovation, robotics and artificial intelligence. Nevertheless, the European Centre for Digitisation and Innovation in Healthcare was established right here in the Republic of Croatia, which provides strong support to the business sector in the segment of project application support, research, testing, and the marketing of new products and services, and therefore this centre is designated as a possible reference point for the development of that sector.

The participants of the Dubrovnik conference agreed that Croatia has the potential for developing digital processes, including the digital transformation of the healthcare system, but with the assumption that speeding up all administrative processes is paramount. Croatia is a very attractive destination, it is especially strong in the fields of dental, aesthetic surgery and ophthalmology. In addition, work can be done to attract significant investments in this segment of the tourist offer and the clear marketing communication of Croatia as a destination for year-round health tourism, which would begin to solve the problems of seasonality.

For more, make sure to check out our dedicated lifestyle section.

Sunday, 26 June 2022

Four Croatian Healthcare Innovation Projects Selected for EU Funding

ZAGREB, 26 June 2022 - As many as four Croatian healthcare innovation projects are included among 20 projects from central, eastern and southern Europe selected for financing by the European Institute of Innovation and Technology (EIT) under the Regional Innovation Scheme.

Eighty projects have applied for funding, and four Croatian ones have been selected, more than from any other country in the region, the Večernji List (VL) daily said on Sunday.

The EIT Health Regional Innovation Scheme supports the development of  innovation in healthcare in the countries of central, eastern and southern Europe. The consortia behind the selected innovations will be granted up to €75,000 for further development of products or solutions, mentoring, a place at a bootcamp, and access to potential investors and partners through EIT Health, a network of top healthcare innovators in Europe.

The selected Croatian projects are: MEGI, PsyFlux, StressLyft and the Human-Machine Interface.

MEGI aims to develop an AI-enabled virtual cardiovascular health assistant that uses personalised protocols to remind patients to take medication and measure their blood pressure at home.

The PsyFlux consortium is developing a telemetric intracranial pressure monitoring device that can be used outside the hospital without infection risks, allowing the patient to partake in everyday activities.

StressLyft is an educational course about workplace stress and stress relief skills, based on interactive video content, which companies provide for their employees to prevent work-related stress.

The gesture-based human machine interface for guided orthopaedic surgery aims to develop novel medical devices that help surgeons to make millimetre-precision measurements during hip replacement surgery and possibly other types of operations.

"Our aim is to find the best ideas and early-stage innovations in the region and encourage players from business and academia to build consortia and turn their concepts into realities," Mónika Tóth, EIT Health InnoStars RIS Programme Manager, was quoted as saying.

For more, check out our politics section.

Sunday, 19 June 2022

Health Ministry Decides on New Croatian Immunology Institute Location

June the 19th, 2022 - The much-talked-about Croatian Immunology Institute is one step closer to coming to fruition now that the involved ministries have chosen a location for the future facility.

As Poslovni Dnevnik/Marija Crnjak writes, through the joint efforts of the Ministry of Health, the Ministry of Physical Planning, Construction and State Property and the Immunology Institute, a solution was reached by which the Rugvica business zone near Zagreb will become the permanent home of the new Croatian Immunology Institute, the Ministry of Health reported recently.

''In the context of legal challenges we faced with the previous chosen location, we've made a significant step forward in continuing this strategic project and have shown the strong will and determination of the Croatian Government, the Ministry of Health and the Croatian Immunology Institute to remain committed to revitalising the Immunology Institute as an important institution in this country,'' said Health Minister Beros on the occasion of this decision.

With this decision, the Municipality of Rugvica, as the owner, donates to the Croatian Immunological Institute, land in the Rugvica working zone - north, 69,761 m2 with a potential minimum minimum size of 20,000 m3 for the construction of an entire biological drug factory, the construction of a separate plant for antitoxins, and plants for the production of animal immunosera intended for both human and animal use with the primary purpose of producing antitoxins for the venom of European snakes.

This Decision was preceded by a statement from the State Attorney's Office of the Republic of Croatia, the Ministry of the Economy and Sustainable Development, and the Ministry of Physical Planning, Construction and State Property found no legal obstacles in terms of Article 391 of the Property and Other Real Rights Act.

The construction of the entire factory will begin in no later than two years time, while the estimated construction time to the stage of functionality is nine months from the positive completion of the public tender, ie the selection of all of the contractors by tender. The method of construction of the production plant will be prefabricated modular segments of clean rooms designed and built outside the building and connected and formed inside the building, preceded by a series of preliminary works, from obtaining the necessary permits, evaluating the conceptual design and final design of the main project.

At the same time, a public tender has been prepared for publication for the construction of a new biopharmaceutical plant for the production of animal immunosera, ie drugs intended for both human and veterinary use with the primary purpose of producing antitoxins for European snake venom.

As the Croatian Immunology Institute has permits for animal testing, as well as breeding permits, there are some basic preconditions for building a plant for processing hyperimmune equine (horse) plasma within the new factory, as a complete unit in one location, where the processing, filling and equipping would take place. The existing resources on the farm in Sveta Nedelja will be used for all of the above.

"The Croatian Immunology Institute is the flagship of our science and deserves all possible interdepartmental efforts. The easiest thing in the world to do is to simply declare the end and throw in the towel at the first sign of any obstacles that understandably appeared due to the complexity of this project. We've chosen a harder but more correct way of going about things, we've taken an additional step forward and together we've found a solution to continue the revitalisation of the Croatian Immunology Institute.

In order to restore its reputation and further position it on the international map of leading manufacturers of vaccines for various purposes, as well as other products in demand in this market segment, in the first phase, vaccines against measles and rubella will be produced, as these are products needed by both the Croatian and world markets,'' concluded Minister Vili Beros, adding that this country now the opportunity to meet the preconditions for its own production of antitoxins, which would make Croatia self-sufficient in the production of snake antidote, which is especially in demand during the summer tourist season when bites are more common.

For more, make sure to check out our dedicated lifestyle section.

Sunday, 15 May 2022

Minister Comments on Strike, Says Won't Tolerate Patients Being Denied Healthcare

ZAGREB, 15 May 2022 - Health Minister Vili Beroš said on Sunday, ahead of a strike of non-emergency ambulance drivers set for Monday, that he supports any protest that is in line with the law but that he will not tolerate patients being denied the right to health care.

Some of the non-emergency ambulance drivers have announced a strike for Monday, to last until their demands are met and a regulation is adopted that would make their wages even throughout the country as currently they differ up to HRK 1,500, depending on the county where they work.

The minister said a solution was being defined with all the relevant stakeholders, recalling that last year the government and the health ministry launched dialogue with unions and showed the will to resolve the problem.

He added that there was therefore no reason to strike or take action that would be to the detriment of patients and that he expected local clinics and non-emergency ambulance drivers to continue providing regular services so that a solution to their problem could be found in a constructive and peaceful atmosphere.

For more, make sure to check out our lifestyle section.

Wednesday, 4 May 2022

Health Ministry: Pregnancy Termination Possible After Week 10 for Medical Reasons

ZAGREB, 4 May 2022 - It should be possible for every woman in Croatia to terminate pregnancy even after ten weeks if there are medical reasons for that, the Health Ministry said on Wednesday after the media reported on the case of a 39-year-old woman whose second child in the womb has an aggressive brain tumour.

The ministry called on all health institutions to timely and accurately inform their patients of their rights and possibilities that exist in Croatia.

Mirela Čavajda, whose second child got an aggressive brain tumour in the womb, told the Index web portal, which was the first to publish her story, that all hospitals in Zagreb she contacted had refused to do a termination of pregnancy despite the fact that doctors told her that the tumour was so big the child most likely would not live long, and even if it did, it would never have a normal life.

The doctors she talked to convinced her they would be happy to help her, but they said it was illegal in Croatia to do an abortion after week ten, Index wrote.

The parent tried to seek help in all Zagreb hospitals that could do a termination of pregnancy -- Sveti Duh, Merkur, Vinogradska, and last Friday they sent a request to hospitals to establish a committee which should by law approve a termination of pregnancy, but they still have not received a response.

Čavajda added that she therefore launched a procedure in Slovenia, where she was told after an examination that the diagnosis was very bad, that there was nothing disputable about her case and that the decision was up to the parents, announcing that an ethics committee would make a decision on the request next Tuesday.

In a reaction to that case, the Croatian Ministry of Health said that a termination of pregnancy was possible after week ten with an approval of the committee and with the consent, that is, at the request of the pregnant woman, in cases where there are medical indications, or when the conception occurred as a result of rape, intercourse with an incapacitated person, intercourse by abuse of position, intercourse with a child or incest.

In order to ensure the woman's right, the Ministry of Health has enabled the establishment of a second-instance committee at the KBC Zagreb Hospital, in case the first-instance committee denies her request, it was said.

For more, make sure to check out our dedicated lifestyle section.

Sunday, 17 April 2022

Faster HZZO Medicine Listing Would Save Another Billion for Healthcare System

April the 17th, 2022 - The much more rapid and efficient listing of HZZO medicine could end up saving the already enfeebled Croatian healthcare system another billion kuna.

As Poslovni Dnevnik/Marija Crnjak writes, the Croatian healthcare system could save an additional one billion kuna per year if the policy of putting generic and biologically similar drugs on the lists of the Croatian Health Insurance Institute (HZZO) was improved and accelerated, according to Croatian pharmaceutical generic companies within the Croatian Employers' Association (HUP).

Currently, the system saves about 300 million kuna a year with the use of this HZZO medicine, but the potential is significantly higher, said Jerko Jaksic, president of the Association of Drug Manufacturers at HUP, at a briefing for journalists which took place on Thursday.

According to data from back in 2019, 61 percent of the volume of prescription drugs in the Republic of Croatia is made up of generic drugs, which is slightly lower than the EU average of 67 percent. The situation with biosimilars is much worse, they accounted for a modest 13 percent of the market in total consumption of biological drugs.

Although further growth is expected in the coming years, in addition to education, it's necessary to accelerate their application when they are registered with the European Medicines Agency and the Croatian Medicines Agency.

As the manufacturers have explained, the HZZO procedure for listing a drug, which is purely administration and paperwork, takes an average of four to six months, during which time money is directly lost that could be saved by using generic instead of innovative therapy.

“So-called drug penetration into the system should be significantly quicker, which is even more significant when it comes to biological drugs, as biological drugs are very expensive. We have announcements from the Croatian Health Insurance Fund that this process could be accelerated, and we're very happy about that. There's no reason why a drug shouldn't automatically be on the list immediately after its registration, and it would be very good if the new procedure comes to life by the middle of this year because patents for some drugs expire soon,'' Jaksic said.

In particular, these are diabetes related drugs, and the potential for savings is 30 percent for the healthcare system, with the release of patient participation. With proper application, in 2023, 15 percent more patients could be treated for the same cost in this segment alone, HUP pointed out. The data also shows that biosimilars have increased the availability of biologic therapy.

For example, in the immunology segment, 67 percent more patients were treated for only 19 percent more. Back in 2021, 2.5 times more patients were treated with the chemotherapy mitigation drug than in 2019 for approximately the same total cost. In 2020 alone, biosimilars provided savings of 200 million kuna. However, the biggest shortcoming in the drug policy in Croatia is still poor cost control, due to insufficient therapeutic guidelines and measuring the effectiveness of therapies, they added from HUP.

Patient registries exist only for a small number of diagnoses and a large role in this is played by patient associations, which are as such fighting for the better availability of some drugs, but for most patients and diagnoses, not all treatment parameters are systematically monitored.

For more, check out our lifestyle section.

Sunday, 3 April 2022

Croatia's Acute Myeloid Leukemia Survival Rate 5% Below EU Average

ZAGREB, 3 April 2022 - About 150 people in Croatia are annually diagnosed with acute myeloid leukemia (AML), and the survival rate is about 5% below the EU average, a round table on the treatment and quality of life of AML patients heard earlier this week.

"In Croatia, every week three persons are told they have AML, which is 156 annually, according to data from the Cancer Register for 2019. The five-year survival rate is 12.6%, compared to the EU average of 17.2%, which shows that there is considerable room for improving treatment", the participating doctors and patients said at the round table.

AML is the most common type of acute leukemia in adulthood and the most frequent age at diagnosis is 65 years, with increasing incidence after 65 years of age. It has the lowest survival rate compared to other types of leukemia and is treatable in about 40 per cent of patients aged under 60 years, most frequently by bone marrow transplantation from an unrelated donor.

"In Croatia, we have 70,000 bone marrow samples and we can find an unrelated donor relatively quickly, which is why nearly every patient in Croatia has a chance to get a transplant and be cured. The number of transplantations has reached one hundred annually, which is within the European average," haematologist Radovan Vrhovac said.

For more, check out our dedicated lifestyle section.

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