OBJECTIVES: The provision of primary health care was not interrupted during the coronavirus disease 2019 (COVID-19) pandemic in Czechia, although the capacity and resources of providers changed. We examined how the pandemic affected individual general practices throughout 2017-2021, focusing on differences between urban and rural practices. METHODS: We analysed data from the largest health insurance company in Czechia, which provides care to 4.5 million people (60% of the population). We evaluated the prescription volume, diabetes care procedures, and faecal immunochemical test (FIT) in preventive care and new pandemic-related procedures (remote consultations, testing, and vaccinations). For the spatial distribution of practices, we adapted the Organisation for Economic Cooperation and Development typology. RESULTS: We observed minimal declines in 2020 in the rate of prescribing (-1.0%) and diabetes care (-5.1%), with a rapid resumption in 2021, but a substantial decline in FIT (-17.8% in 2020) with slow resumption. Remote consultations were used by 94% of all practices regardless of location, with testing and vaccinations more commonly performed by rural general practitioners (GPs). CONCLUSIONS: Primary care in Czechia rose to the challenge of the COVID-19 pandemic, as shown by the finding that the volume of healthcare services provided through primary care did not decrease across most of the monitored parameters. This study also confirmed that rural GPs provide more care in-house, both in terms of prescribing and procedures performed in their practices. Future studies will need to focus on preventive care, which the pandemic has dampened in GP practices in Czechia.
- MeSH
- časná detekce nádoru * statistika a číselné údaje MeSH
- COVID-19 * epidemiologie prevence a kontrola MeSH
- diabetes mellitus * epidemiologie MeSH
- kolorektální nádory * diagnóza epidemiologie MeSH
- lékařská praxe - způsoby provádění * statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- odborná praxe - umístění statistika a číselné údaje MeSH
- pandemie prevence a kontrola MeSH
- praktičtí lékaři statistika a číselné údaje MeSH
- primární zdravotní péče MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
SARS-CoV-2 infection, which causes the respiratory disease COVID-19, has spread rapidly from Wuhan, China, since 2019, causing nearly 7 million deaths worldwide in three years. In addition to clinical risk factors such as diabetes, hypertension, and obesity, genetic variability is an important predictor of disease severity and susceptibility. We analyzed common polymorphisms within the LZTFL1 (rs11385942) and ABCA3 (rs13332514) genes in 519 SARS-CoV-2-positive subjects (164 asymptomatic, 246 symptomatic, and 109 hospitalized COVID-19 survivors) and a population-based control group (N?=?2,592; COVID-19 status unknown). Rare ABCA3 AA homozygotes (but not A allele carriers) may be at a significantly increased risk of SARS-CoV-2 infection [P?=?0.003; OR (95 % CI); 3.66 (1.47-9.15)]. We also observed a borderline significant difference in the genotype distribution of the LZTFL1 rs11385942 polymorphism (P?=?0.04) between the population sample and SARS-CoV-2-positive subjects. In agreement with previous studies, a nonsignificantly higher frequency of minor allele carriers was detected among hospitalized COVID-19 subjects. We conclude that a common polymorphism in the ABCA3 gene may be a significant predictor of susceptibility to SARS-CoV-2 infection.
- MeSH
- ABC transportéry genetika MeSH
- COVID-19 * diagnóza epidemiologie genetika MeSH
- genotyp MeSH
- lidé MeSH
- polymorfismus genetický MeSH
- SARS-CoV-2 MeSH
- transkripční faktory genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Publikační typ
- abstrakt z konference MeSH
Úvod: Správně dimenzovaná síť školitelů je klíčová pro přípravu mladých lékařů v primární péči, kde umístění praxe školitele ovlivňuje mladé lékaře v úvahách o lokaci vlastní praxe. Tato práce popisuje počty školitelů podle krajů Česka, zahrnuje i jejich prostorovou charakteristiku a vývojové trendy. Metody: Na základě dat největší zdravotní pojišťovny v Česku jsme analyzovali školící praxe všeobecných praktických lékařů v letech 2017–2021, jak dle krajů, tak i prostorové lokace, pro kterou jsme použili vlastní typologii, aplikovanou opakovaně v předchozím výzkumu. Výsledky: Nejvyšší relativní počet školitelů působil ve Středočeském kraji, největšího nadhodnocení dosahovala školící činnost v Praze. Naopak nejnižší relativní počty školitelů vykazoval Ústecký kraj, nejrychlejší pokles Liberecký kraj. Kraje s nejnižší hustotou sítě školitelů měly zároveň nejnižší podíl venkovských školitelů. Závěry: Síť školitelů v Česku není rovnoměrná a ve sledovaném období vykazovala řadu odlišných trendů. Domníváme se, že v některých regionech je nedostatečná, a nelze sem proto alokovat potřebnou výši prostředků na vzdělávání.
Objectives: A properly sized network of trainers is crucial for the training of young doctors in primary care, where the location of the trainer’s practice influences young doctors’ considerations about the location of their own practice. This paper describes the number of trainers by region of the country, and includes their spatial characteristics and trends. Methods: Based on data from the largest health insurance company in Czechia, we analysed the training practices of general practitioners in 2017–2021, both by region and by spatial location, for which we used our own typology, applied repeatedly in previous research. Results: The highest relative number of trainers was in the Central Bohemia Region, with the highest overestimation of training activity in Prague. On the other hand, the lowest relative number of trainers was in the Ústí Region, while the fastest decline was in the Liberec Region. The regions with the lowest density of trainers also had the lowest proportion of rural trainers. Conclusions: The network of trainers in Czechia is not uniform and showed a number of different trends in the period under review. We believe that in some regions it is insufficient and therefore the necessary amount of resources for training cannot be allocated here.
- MeSH
- dostupnost zdravotnických služeb MeSH
- lidé MeSH
- primární zdravotní péče * MeSH
- školitelé MeSH
- zdravotnické služby pro venkov MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Česká republika MeSH
A 2021 in silico study highlighted an association between the CD14 polymorphism rs2569190 and increased susceptibility to SARS-CoV-2, which causes coronavirus disease 2019 (COVID-19). The aim of our study was to confirm this finding. We analysed the CD14 polymorphism (C→T; rs2569190) in 516 individuals who tested positive for SARS-CoV-2, with differing disease severity (164 asymptomatic, 245 symptomatic, and 107 hospitalized). We then compared these patients with a sample from the general population consisting of 3,037 individuals using a case-control study design. In comparison with carriers of the C allele, TT homozygotes accounted for 21.7 % of controls and 20.5 % in SARS-CoV-2-positive individuals (P = 0.48; OR; 95 % CI - 0.92; 0.73-1.16). No significant differences in the distribution of genotypes were found when considering co-dominant and recessive genetic models or various between-group comparisons. The CD14 polymorphism is unlikely to be an important predictor of COVID-19 in the Caucasian population in Central Europe.
- MeSH
- COVID-19 * genetika MeSH
- genetická predispozice k nemoci MeSH
- jednonukleotidový polymorfismus * genetika MeSH
- lidé MeSH
- SARS-CoV-2 genetika MeSH
- studie případů a kontrol MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: While the role of physiotherapy as part of a comprehensive inpatient rehabilitation is indisputable, clear evidence concerning the effectiveness of different rehabilitation managements [interdisciplinary implementing the International Classification of Functioning, disability and health (ICF) vs. multidisciplinary model] and physiotherapy categories (neuroproprioceptive "facilitation, inhibition" vs. motor/skill acquisitions using technologies) are still lacking. In this study, four kinds of comprehensive inpatient rehabilitation with different management and content of physical therapy will be compared. Moreover, focus will be placed on the identification of novel biological molecules reflective of effective rehabilitation. Long non-coding RNAs (lncRNAs) are transcripts (>200 bps) of limited coding potential, which have recently been recognized as key factors in neuronal signaling pathways in ischemic stroke and as such, may provide a valuable readout of patient recovery and neuroprotection during therapeutic progression. METHODS AND ANALYSIS: Adults after the first ischemic stroke in an early sub-acute phase with motor disability will be randomly assigned to one of four groups and undergo a 3 weeks comprehensive inpatient rehabilitation of different types: interdisciplinary team work using ICF model as a guide; multidisciplinary teamwork implementing neuroproprioceptive "facilitation and inhibition" physiotherapy; multidisciplinary teamwork implementing technology-based physiotherapy; and standard multidisciplinary teamwork. Primary (the Goal Attainment Scale, the Patient-Reported Outcomes Measurement Information System, and the World Health Organization Disability Assessment Schedule) and secondary (motor, cognitive, psychological, speech and swallowing functions, functional independence) outcomes will be measured. A blood sample will be obtained upon consent (20 mls; representing pre-rehabilitation molecular) before and after the inpatient program. Primary outcomes will be followed up again 3 and 12 months after the end of the program. The overarching aim of this study is to determine the effectiveness of various rehabilitation managements and physiotherapeutic categories implemented by patients post ischemic stroke via analysis of primary, secondary and long non-coding RNA readouts. This clinical trial will offer an innovative approach not previously tested and will provide new complex analysis along with public assessable molecular biological evidence of various rehabilitation methodology for the alleviation of the effects of ischemic stroke. CLINICAL TRIAL REGISTRATION: NCT05323916, https://clinicaltrials.gov/ct2/show/NCT05323916.
- Publikační typ
- časopisecké články MeSH
