OBJECTIVES: To determine whether selected single nucleotide polymorphisms (SNPs) of genes encoding proteins responsible for the activation, transport, or metabolism of dabigatran and apixaban might be associated with a risk of gastrointestinal bleeding in a cohort of adult patients treated with these drugs. No previous study has focused specifically on the association with gastrointestinal bleeding. MATERIALS AND METHODS: Ninety-one patients treated with dabigatran or apixaban were genotyped for selected polymorphisms. The following polymorphisms were studied: ABCB1 gene rs1045642, rs4148738, rs1128503 and rs2032582; CES1 gene rs2244613, rs8192935 and rs2244614; and SULT1A1 gene rs9282861 and SULT1A2 gene rs1136703. Two groups divided by particular drugs and genotypes were compared in terms of the presence (bleeding group) or absence (nonbleeding group) of gastrointestinal bleeding. The genotype distribution was expressed via dominant and recessive models. RESULTS: In patients treated either with dabigatran or with apixaban, no evidence was found to support the association of gastrointestinal bleeding with any genotype for any of the studied SNPs. CONCLUSION: In both dabigatran- and apixaban-treated patients, no associations between the selected polymorphisms and gastrointestinal bleeding risk were found, however the results should be interpreted with caution because of the small cohort size.
- MeSH
- antithrombiny škodlivé účinky terapeutické užití MeSH
- dabigatran * škodlivé účinky MeSH
- dospělí MeSH
- farmakogenetika MeSH
- gastrointestinální krvácení * genetika chemicky indukované MeSH
- genotyp MeSH
- inhibitory faktoru Xa škodlivé účinky terapeutické užití MeSH
- jednonukleotidový polymorfismus * MeSH
- lidé středního věku MeSH
- lidé MeSH
- P-glykoproteiny MeSH
- pyrazoly * škodlivé účinky terapeutické užití MeSH
- pyridony * škodlivé účinky terapeutické užití MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Drift is a phenomenon that can occur in cognitive-behavioral supervision, where core components of supervision are omitted, avoided, or deprioritized. This narrative review explores the signs, reasons, and impact of supervisory drift at the experiential, cognitive, and emotional levels for both the supervisor and the supervisee. Additionally, the article presents potential solutions for preventing and addressing supervisory drift, such as staying on track, anticipating problems before they arise, adapting supervision to the supervisee's needs, using active supervision methods to understand drift better, engaging in Supervision of Supervision (SoS), and using alliance measures. Through the use of case vignettes, we illustrate the potential solutions. We aim to provide a comprehensive understanding of supervisory drift and offer practical strategies for its prevention and management.
- MeSH
- kognitivně behaviorální terapie * organizace a řízení MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: An in-depth study of neurological symptoms and complications of influenza in elderly patients. This population group is more susceptible to complications of the disease and these complications are more likely to end in death. METHODS: A retrospective analysis of patient data was performed. All patients aged 65 years and older were included in the study. The study period was from the 1st of January , 2018 to 31st of December, 2021. All symptoms and complications of influenza were analyzed. Especially neurological and general symptoms were analyzed. Data were extracted from the complete medical records of the patients. RESULTS: The most common symptoms of influenza in the elderly were fever in 218 cases (83.52%), cough in 189 patients (72.41%), general weakness in 182 (69.73%) and fatigue in 166 patients (63.6%). Myalgias were experienced by 106 patients (40.61%) and arthralgias by 101 patients (38.7%). Headache occurred in only 21 patients (8.06%). Encephalopathy was observed in 7 elderly patients (2.68%) during hospitalization. Influenza encephalitis was noted in 2 cases. CONCLUSION: The most common neurological symptoms of influenza in more than half of the elderly are general weakness and increased fatigue. Myalgias are common, headache less often. Nausea is not uncommon. Of the complications, encephalopathy is the most common. Cases of influenza encephalitis have also been reported. We have not encountered a stroke. Concerning other complications, bacterial pneumonia was the most common.
- MeSH
- bolesti hlavy etiologie epidemiologie MeSH
- chřipka lidská * komplikace epidemiologie MeSH
- horečka etiologie MeSH
- kašel etiologie MeSH
- lidé MeSH
- myalgie etiologie epidemiologie MeSH
- nemoci nervového systému epidemiologie etiologie MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- svalová slabost etiologie epidemiologie MeSH
- únava etiologie epidemiologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Telerehabilitation is a practical option for individuals with multiple sclerosis (MS) to engage in sustained physical activity without -visiting a rehabilitation facility. The aim of this systematic review was to evaluate the feasibility, effectiveness, safety, and adherence of exercise-based telerehabilitation as compared with usual care for MS patients. METHODS: A comprehensive literature search adhering to PRISMA guidelines was conducted, focusing on studies published in English since 2000. The systematic review protocol was registered in PROSPERO. The selection process involved strict criteria, including studies focusing on people with MS, telerehabilitation centred on regular exercise, a control group receiving usual care, valid exercise testing, and adherence to randomized controlled trial principles. Methodological quality was assessed using the TESTEX tool, ensuring rigour in study design and reporting. RESULTS: Among the 281 records screened, 10 studies met the criteria. Telerehabilitation interventions varied in format and outcomes were assessed using diverse exercise tests and questionnaires. Despite variations, the studies collectively demonstrated promising feasibility and safety, with minimal withdrawals and minor adverse events. Effectiveness varied, with 5 out of 10 studies showing significant improvements in the intervention group. Adherence rates ranged from 38% to 100%. CONCLUSION: In most of the assessed aspects, telerehabilitation is comparable to regular centre-based rehabilitation.
- MeSH
- adherence pacienta MeSH
- cvičení * MeSH
- lidé MeSH
- roztroušená skleróza * rehabilitace MeSH
- telerehabilitace * MeSH
- terapie cvičením * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- systematický přehled MeSH
BACKGROUND: Ethics is an inherent part of psychotherapy that protects the interests and rights of all parties engaged in the therapeutic relationship. This article focuses on ethical issues and dilemmas that may arise when using schema therapy. METHOD: We created a narrative review by searching the databases PubMed, Web of Science, and Scopus with the keywords "psychotherapy", "schema therapy", "therapeutic relationship", "ethics", "ethical questions", and "ethical dilemmas". In addition, we focused on the clinical experience of therapists, training instructors, and supervisors. RESULTS: Ethical psychotherapy requires adherence to ethical codes and standards. Among the most important ethical principles are confidentiality, informed consent, boundaries of the therapeutic relationship, and dual relationships. Understanding transference, countertransference, and one's modes and schemas is essential to ethical reflection in schema therapy. The article presents examples of ethical dilemmas in schema therapy and suggests possible solutions. At the same time, we point out the need for further research in this field. CONCLUSION: Similarly to other psychotherapeutic approaches, one of the schema therapist's core competencies is following the profession's ethical principles and productively finding solutions to the occasional ethical dilemmas. Ethics is a prominent part of all psychotherapeutic sessions. Still, it becomes even more central when working with challenging issues such as personality disorders that schema therapy routinely treats. More research on the topic is needed.
- MeSH
- důvěrnost informací etika MeSH
- informovaný souhlas pacienta etika MeSH
- lidé MeSH
- psychoterapie * etika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
AIM: The paper describes the characteristics of relationship obsessive-compulsive disorder (R-OCD), including the types of obsessions and compulsions, the common triggers and the impact on psychological well-being and relationship functioning. It also offers basic cognitive-behavioural strategies to help patients change their attitudes towards obsessive thoughts and reduce compulsive behaviours. METHODS: This article is a narrative review of the literature and case studies on R-OCD. To search for relevant sources, we used PubMed, PsycINFO and Web of Science databases with the keywords "relationship obsessive compulsive disorder", "R-OCD", "relationship OCD" and "partner-focused OCD". We included only studies published in English from January 1990 to June 2023. The paper provides examples of how basic cognitive-behavioural strategies help individuals with R-OCD. RESULTS: People with R-OCD experience intrusive thoughts about whether they have the right feelings for their partner, whether their partner loves them, whether the relationship is suitable or whether their partner has flaws. These thoughts trigger the urge to perform various rituals to alleviate anxiety, such as repeated checking, reassurance or comparison. However, this behaviour leads to disruption of the relationship and long-term maintenance of the anxiety. Examples of basic cognitive-behavioural strategies can be applied in clinical practice to help individuals change their attitudes towards relational obsessive thoughts and reduce compulsive behaviours.
OBJECTIVES: Patients are the most common source of violence against EMS personnel. This study aims at elucidating specific clinical features in patients with mental alteration and aggressive behaviour increasing risk of violence. MATERIAL AND METHODS: This consecutive cross-sectional retrospective study analysed consecutive patients treated for prespecified list of primary diagnoses by one EMS provider in the Czech Republic between 1 January 2021 and 31 December 2023. The effect of individual features of medical history and present symptoms on the occurrence of violence, need for the Police assistance and use of restraints was evaluated, using linear regression model. RESULTS: 410 patients were evaluated. Verbal and brachial violence was present in 21.5 and 12.9 %, respectively. Police assistance was needed in 48.3 %, restraints were used in 4.6 %. The most significant predictor for violence, need for Police or restraints was agitation (OR 7.02, CI 4.14 - 11.90; OR 2.60, CI 1.60 - 4.24, OR 11.02, CI 3.49 - 34.80 respectively). Other predictors of violence included history of acute psychotic attacks and psychotic disorders, or outpatient psychiatry care. Among other predictors for Police assistance was presence of delusions, paranoia and history of outpatient psychiatry care. CONCLUSION: Prehospital care for patients with mental status alteration and aggressive behaviour is complex. Some clinical features seem to increase the risk of violence. Future research in the evaluation of agitated and violent patients is warranted to find strategies of risk mitigation for EMS personnel.
- MeSH
- agrese * psychologie MeSH
- dospělí MeSH
- duševní poruchy epidemiologie terapie MeSH
- fyzické omezení statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- násilí statistika a číselné údaje psychologie MeSH
- policie MeSH
- průřezové studie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- urgentní zdravotnické služby * statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
BackgroundCOVID-19 remains a major infectious disease with substantial implications for individual and public health including the risk of a post-infection syndrome, long COVID. The continuous changes in dominant variants of SARS-CoV-2 necessitate a careful study of the effect of preventative strategies.AimWe aimed to estimate the effectiveness of post-vaccination, post-infection and hybrid immunity against severe cases requiring oxygen support caused by infections with SARS-CoV-2 variants BA1/2 and BA4/5+, and against long COVID in the infected population and their changes over time.MethodsWe used a Cox regression analysis with time-varying covariates and calendar time and logistic regression applied to national-level data from Czechia from December 2021 until August 2023.ResultsRecently boosted vaccination, post-infection and hybrid immunity provide significant protection against a severe course of COVID-19, while unboosted vaccination more than 10 months ago has a negligible protective effect. The post-vaccination immunity against the BA1/2 or BA4/5+ variants, especially based on the original vaccine types, appears to wane rapidly compared with post-infection and hybrid immunity. Once infected, however, previous immunity plays only a small protective role against long COVID.ConclusionVaccination remains an effective preventative measure against a severe course of COVID-19 but its effectiveness wanes over time thus highlighting the importance of booster doses. Once infected, vaccines may have a small protective effect against the development of long COVID.
- MeSH
- COVID-19 * imunologie prevence a kontrola epidemiologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- postakutní syndrom COVID-19 MeSH
- SARS-CoV-2 * imunologie MeSH
- sekundární imunizace MeSH
- senioři MeSH
- vakcinace MeSH
- vakcíny proti COVID-19 * imunologie aplikace a dávkování MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
During the summer of 2023, the European Region experienced a limited resurgence of mpox cases following the substantial outbreak in 2022. This increase was characterised by asynchronous and bimodal increases, with countries experiencing peaks at different times. The demographic profile of cases during the resurgence was largely consistent with those reported previously. All available sequences from the European Region belonged to clade IIb. Sustained efforts are crucial to control and eventually eliminate mpox in the European Region.
- MeSH
- dítě MeSH
- dospělí MeSH
- epidemický výskyt choroby * MeSH
- fylogeneze * MeSH
- incidence MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předškolní dítě MeSH
- senioři MeSH
- surveillance populace MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
The purpose of supervision is to ensure that clients' needs are met and to monitor the effectiveness of therapeutic interventions and the therapeutic relationship. Cognitive behavioural therapy (CBT) supervision is the systematic cooperation of the supervisee with the supervisor, which aims at increasing the therapists' competencies when working with specific clients. The advantage of supervision is the possibility to shape and develop the therapist's practical skills through specific techniques. This paper aims to review currently available CBT supervision strategies that boost the development of therapists' skills and provide possible examples. Various techniques are discussed, including behavioural, cognitive, imagery and psychodrama methods that facilitate supervisors in enhancing therapists' skills. In addition, complementary approaches are discussed, such as role-playing, modelling, chaining, or imitation to present at a particular moment of the therapy, increase the insight into the client's perspective or the treatment itself, and search for an alternative approach to improve the therapeutic outcomes for the client. Overall, the article describes the supervisor's need to have a flexible variety of skills and know which learning methods might be most effective for boosting the supervisee's skill level and needs with a particular client.
- MeSH
- behaviorální terapie * výchova MeSH
- klinické kompetence * MeSH
- kognitivně behaviorální terapie * metody MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
