Akutní antidepresivní efekt racemického ketaminu je na úrovni elektrokonvulzivní léčby a není nižší ve srovnání s esketaminem. K udržení antidepresivního, anxiolytického i antisuicidálního efektu akutní léčby racemickým ketaminem je nezbytná pokračovací a udržovací léčba ketaminem nebo ketaminem asistovaná psychoterapie. Dosud byly publikovány zahraniční retrospektivní a prospektivní studie pokračovací a udržovací léčby racemického ketaminu s aplikací intravenózní, intramuskulární, subkutánní, intranazální, sublingvální i orální. V nich je ketamin podáván dle potřeby a snášenlivosti 3× týdně až 1× za 12 týdnů. Dosud nebyla publikována placebem či komparátorem kontrolovaná dlouhodobá studie udržovací léčby ketaminem u pacientů s depresivní poruchou rezistentní na léčbu. Chybí tak přímé srovnání efektivity ketaminu s jinými intervencemi. Prozatímní pozorování udržovací léčby ketaminem přesahující 1 rok nepřinášejí informace o jiných nežádoucích účincích, než jsou popsány při akutní léčbě ketaminem. Určitá obezřetnost je na místě ohledně rozvoje závislosti. Pokud byl pacientům poskytnut ketamin do domácího užívání, byla u některých jedinců zaznamenána tendence ke zvyšování dávek, což je jeden ze signálů možné závislosti.

The acute antidepressant effect of racemic ketamine is at the level of electroconvulsive treatment and is not inferior compared to esketamine. Maitenance ketamine treatment or ketamine-assisted psychotherapy are indispensable to sustain the antidepressant, anxiolytic and antisuicidal effects of prior acute treatment with racemic ketamine. Several international retrospective and prospective studies have focused on maintenance treatment with racemic ketamine by intravenous, intramuscular, subcutaneous, intranasal, sublingual and oral administration. In these studies, ketamine has been administered from 3 times weekly to once every 12 weeks, depending on the effect and tolerance. No placebo- or comparator-controlled long-term study on ketamine maintenance therapy in patients with treatment-resistant depressive disorder has been published to date. Thus, a direct comparison of the effectiveness of ketamine with other interventions is lacking. Interim observations beyond 1 year do not provide information on adverse effects, other than those described during acute ketamine treatment. Some caution has been raised regarding the dependence development, considering a tendency to increase doses in some self-administrating patients, who had been given ketamine home.

• MeSH
• Depressive Disorder, Treatment-Resistant * drug therapy   prevention & control   MeSH
• Ketamine * administration & dosage   adverse effects   therapeutic use   MeSH
• Consolidation Chemotherapy methods   MeSH
• Humans MeSH
• Meta-Analysis as Topic MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Randomized Controlled Trials as Topic MeSH
• Retrospective Studies MeSH
• Maintenance Chemotherapy methods   MeSH
• Drug Administration Routes MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Cíl: Cílem této studie je prozkoumat vliv sociodemografických a klinických dat na míru deprese a úzkosti u pacientek s karcinomem podstupujících radioterapii. Materiál a metody: Do této studie bylo zahrnuto 111 pacientek s karcinomem prsu léčených na oddělení radiační onkologie nemocnice Kayseri City Education and Research Hospital. Studie byla plánována prospektivně jako studie založená na průzkumu. Byl získán souhlas etické komise. Po získání potřebného souhlasu s dobrovolnou účastí ve studii byly s pacientkami vedeny individuální („face-to-face“) rozhovory. Průzkum zahrnoval škálu Hospital Anxiety and Depression Scale (HADS) a také demografické a klinické informace. U shromážděných dat byla provedena statistická analýza. Výsledky: Podle výsledků analýzy rozptylu opakovaných měření byl zjištěn statisticky významný průměrný rozdíl mezi hodnotami na škále deprese zjištěnými po 3 a 6 měsících a hodnotami získanými v první den radioterapie (p < 0,001). V případě úzkosti byly zjištěny statisticky významné průměrné rozdíly u proměnných jako je věk a rodinný stav a v případě deprese u proměnných jako je věk, dosažené vzdělání, rodinný stav, zaměstnání, výskyt rakoviny v rodinné anamnéze, menopauza, operace, chemoterapie a hormonální terapie. Když byla zkoumána změna ve výskytu (škála deprese > 10) nebo absenci (škála deprese < 10) deprese ve třech různých časech radioterapie (první den, 3 měsíce a 6 měsíců), mezi hodnotami na škále deprese u pacientek léčených radioterapií zjištěných první den radioterapie a 3 a 6 měsíců po radioterapii byl zjištěn statisticky významný rozdíl (p < 0,05). Závěr: Podle výsledků naší studie bylo psychické zdraví žen s karcinomem prsu ovlivněno během radioterapie i po ní. U pacientek, u kterých se během léčby karcinomu prsu vyskytne úzkost nebo deprese, by tedy mělo být zváženo začlenění psychiatrického poradenství do léčby.

Purpose: The aim of this study is to investigate the effects of sociodemographic and clinical data on depression and anxiety levels in patients who undergoing radiotherapy for breast cancer. Materials and methods: A total of 111 patients with breast cancer treated in the Radiation Oncology Department of Kayseri City Education and Research Hospital were included in this study. The study was planned prospectively as a survey research based study. Ethics committee approval was obtained. After obtaining the necessary consent for voluntary participation, patients were interviewed face-to-face. The research survey included the Hospital Anxiety and Depression Scale (HADS), as well as demographic and clinical information. Statistical analysis was performed with the collected data. Results: According to the results of repeated measures analysis of variance, the mean difference between the 3-month and 6-month measurements of the depression scale values on the first day of radiotherapy was statistically significant (P < 0.001). Mean differences were statistically notable for age and marital status variables in anxiety and for age, education level, marital status, employment status, family history of cancer, menopause, surgery, chemotherapy and hormone therapy variables in depression. When the change in the presence (> 10 depression scale) or absence (< 10 depression scale) of depression at three different times of radiotherapy (first day, 3 and 6 months) was examined, a statistically notable difference was found between the depression scale values of patients receiving radiotherapy on the first day, 3 months after radiotherapy and 6 months after radiotherapy (P < 0.05). Conclusion: According to the results of our study, the psychological health of women with breast cancer was affected during and after radiotherapy. As a response, psychiatric counseling should be considered as a part of the treatment for depression and anxiety that occur during and after treatment in breast cancer patients.

• MeSH
• Data Analysis MeSH
• Demography statistics & numerical data   MeSH
• Depression * etiology   psychology   MeSH
• Humans MeSH
• Breast Neoplasms * psychology   therapy   MeSH
• Prospective Studies MeSH
• Surveys and Questionnaires MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Radiotherapy psychology   MeSH
• Anxiety etiology   psychology   MeSH
• Check Tag
• Humans MeSH

OBJECTIVE: We aimed to examine whether demographic characteristics (i.e., sex, age and education) correlate with total scores of the Czech version of the Beck Depression Inventory (BDI-II), understand the factorial structure of this scale, compare our results with findings of studies conducted in other countries and provide preliminary normative data for use in clinical practice. METHODS: Data of 450 participants were analysed using correlation analysis, non-parametric tests and confirmatory factor analysis (CFA). RESULTS: Women, and participants with lower education, tended to score higher than men, and participants with higher education. There was no significant relationship between age and total scores. CFA confirmed two factors: cognitive-affective and somatic. Czech participants scored lower than participants in other studies. Preliminary normative data are presented in the form of percentile values for the whole sample and stratified according to gender and education level. CONCLUSIONS: We recommend the usage of the BDI-II total score while taking into account also the cognitive-affective and somatic factor subscores. The comparison of our results with other foreign findings shows the need for the development of locally specific normative values for self-reported depression scales. KEY POINTS Women scored higher in the BDI-II than men. Participants with lower education scored higher in the BDI-II than participants with higher education. CFA confirmed two factors: cognitive-affective and somatic. Preliminary normative data for the Czech version of the BDI-II are stratified according to gender and education.

• MeSH
• Depression diagnosis   MeSH
• Depressive Disorder diagnosis   MeSH
• Adult MeSH
• Factor Analysis, Statistical MeSH
• Middle Aged MeSH
• Humans MeSH
• Psychiatric Status Rating Scales standards   statistics & numerical data   MeSH
• Psychometrics standards   statistics & numerical data   MeSH
• Sex Factors MeSH
• Educational Status MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

Cílem této studie bylo zhodnocení léčebného účinku psychoterapeutického přístupu k pacientům s diagnózou psychotického spektra v rámci programu denního stacionáře. Jedná se o eklektický terapeutický přístup s kombinací psychoterapeutických metod a technik a jejich aplikaci na základě našich praktických zkušeností při léčbě psychóz a nejnovějších poznatků výzkumu v této oblasti. Efekt léčebné intervence je klinicky hodnocen z hlediska aktuální psychopatologie, úrovně a typu dosažené remise a subjektivního hodnocení vývoje psychického stavu. Ke klinickému hodnocení slouží objektivní a subjektivní psychometrické škály PANSS, CGI‑S, PSP a WHOQOL‑Bref. Data jsou zpracována neparametrickými i parametrickými statistickými testy včetně posouzení korelací mezi škálami.

The aim of this study was to evaluate the psychotherapeutic approach to patients diagnosed with the psychotic spectrum within the day care center. There is an eclectic therapeutic approach with a combination of psychotherapeutic methods and techniques and their application based on our practical experience in the treatment of psychosis and the latest research findings in this field. Effective intervention is clinically evaluated from the perspective of current psychopathology, degree and type of remission achieved and subjective evaluation of the development of mental state. The clinical evaluation is based on objective and subjective psychometric scales PANSS, CGI-S, PSP and WHOQOL-Bref. The data are processed by non-parametric and parametric statistical tests, including assessment of correlations between scales. The outcome of the study is a desirable improvement in symptomatic remission indicators despite its sufficient entry level, extension of the functional occupational social status accompanied by adequate adjustment of subjective status above the population standards. The results obtained are clinical and statistical results with limited sample size and strong tests. The conclusions of this pilot study serve to modify the design for the long-term study, in particular by widening the scope of the selection, creating a control file and including more sensitive scaling and software tools.

• MeSH
• Day Care, Medical * methods   psychology   statistics & numerical data   MeSH
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Psychotherapy methods   statistics & numerical data   MeSH
• Psychotic Disorders * psychology   therapy   MeSH
• Psychotherapy, Group methods   statistics & numerical data   MeSH
• Statistics as Topic MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Publication type
• Clinical Trial MeSH
• Research Support, Non-U.S. Gov't MeSH

INTRODUCTION: Measuring early-life psychosocial stress is complicated by methodological challenges. This paper compares three survey instruments for the assessment of life in pregnancy/postpartum and investigates the effects of the timing of early-life stress for emotional/behavioral difficulties (EBD) of offspring during mid/late childhood and adolescence. METHODS: Observational data were obtained from the European Longitudinal Cohort Study of Pregnancy and Childhood (ELSPAC-CZ), which included 4811 pregnancies in two Czech metropolitan areas. We used data collected between 1991 and 2010 at 20 weeks of pregnancy (T1), after delivery (T2), at 6 months postpartum (T3), and at child's age of 7 years (T4), 11 years (T5), 15 years (T6), and 18 years (T7). Life stress was assessed with (1) the Edinburgh Postnatal Depression Scale (EPDS), (2) a stressful life events (SLE) count based on 42-item inventory, and (3) the SLE measure weighted by perceived stressfulness (PS). Each stress measure was administered at T1, T2, and T3. Child's EBD were assessed with the Strengths and Difficulties Questionnaire at T4, T5, T6, and T7. RESULTS: Each stress measure independently predicted long-term EBD. The best data fit was obtained in a model combining EPDS and SLE. Effect sizes for SLEs decreased between the first half of pregnancy and postpartum, while the effect of EPDS increased. DISCUSSION: SLE-based methods capture an aspect of perinatal stress not adequately assessed by EPDS. Combination of psychological distress measures and SLE-based measures is optimal in predicting EBD of the child. Stress measures based on SLE are suitable for early pregnancy, while self-reports of depressive symptoms may perform better in postpartum.

• MeSH
• Behavioral Symptoms epidemiology   etiology   MeSH
• Child MeSH
• Adult MeSH
• Cohort Studies MeSH
• Pregnancy Complications psychology   MeSH
• Humans MeSH
• Adolescent MeSH
• Infant, Newborn MeSH
• Depression, Postpartum diagnosis   epidemiology   MeSH
• Postpartum Period MeSH
• Prospective Studies MeSH
• Surveys and Questionnaires MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Stress, Psychological * MeSH
• Risk Factors MeSH
• Pregnancy MeSH
• Pregnancy Trimesters psychology   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Infant, Newborn MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Comparative Study MeSH

Záměr studie: Cílem studie bylo na podkladě údajů od pacientů s diagnózou schizofrenie ověřit v českém kontextu: (a) strukturu a vnitřní konzistenci dotazníku Kvalita prožívání radosti a spokojenosti ze života (Q-LES-Q-SF), (b) míru závislosti úrovně kvality života na pohlaví, věku, délce trvání choroby, celkovém klinickém dojmu a spokojeností s léčbou a (c) vypracovat lokální percentilové normy pro pacienty s diagnózou schizofrenie. Metoda: Konsekutivní soubor pacientů s diagnózou schizofrenního okruhu (N = 726) byl vyšetřen 126 ambulantními psychiatry. Lékaři zaznamenali pacientův věk, pohlaví, délku choroby, globální klinický dojem; pacienti vyplnili dotazník Q-LES-Q-SF. Výsledky: Nálezy přinesly podklad pro (a) existenci jednodimenzionální struktury nástroje, (b) vnitřní konzistenci inventáře, (c) symetrickou distribuci hodnot a absenci podlahového i stropního efektu, (d) vztah mezi současným klinickým stavem pacienta, spokojeností s léčbou a kvalitou života nezávisle na věku, pohlaví a délce choroby. Závěr: Nástroj je možné akceptovat jako spolehlivý instrument pro odhad kvality života českých pacientů s diagnózou schizofrenie.

Objectives: The purpose of this paper is to test on responses from patients with schizophrenia (a) dimenzionality and internal consistency of the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form questionnaire (Q-LES-Q-SF), (b) effect of gender, age, duration of illness, satisfaction with medication, Clinical Global Impression on patients´ wellbeing, and (c) develop local percentile norms for patients with schizophrenia. Methods: Consecutive patients with schizophrenia (N = 726) were interviewed by 126 outpatient care psychiatrists. The physicians recorded patients´ gender, age, duration of illness, the CGI- Clinical Global Impression scale, and patients filled up the Q-LES-Q-SF quality of life questionnaire. Results: The findings plausibly established (a) the instrument unidimensionality; (b) acceptable internal consistency; (c) symmetrical distribution of the questionnaire values and absence of floor and ceiling effect; (d) association of present clinical state of patients, satisfaction with medication and quality of life without the effect of age, gender, and duration of illness. Conclusion: The instrument appears to be a reliable instrument for assessment of wellbeing among Czech patients with schizophrenia.

• MeSH
• Persons with Psychiatric Disorders psychology   statistics & numerical data   MeSH
• Data Interpretation, Statistical MeSH
• Quality of Life * psychology   MeSH
• Humans MeSH
• Surveys and Questionnaires statistics & numerical data   MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Psychometrics * methods   MeSH
• Schizophrenia * MeSH
• Patient Satisfaction statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Evaluation Study MeSH

INTRODUCTION: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method. METHODS: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed. RESULTS: Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients. DISCUSSION: This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.

• MeSH
• Adult MeSH
• Factor Analysis, Statistical MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Disease Progression * MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Schizophrenia classification   diagnosis   physiopathology   MeSH
• Sotos Syndrome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe MeSH
• Nigeria MeSH

Statistical theory indicates that hierarchical clustering by interviewers or raters needs to be considered to avoid incorrect inferences when performing any analyses including regression, factor analysis (FA) or item response theory (IRT) modelling of binary or ordinal data. We use simulated Positive and Negative Syndrome Scale (PANSS) data to show the consequences (in terms of bias, variance and mean square error) of using an analysis ignoring clustering on confirmatory factor analysis (CFA) estimates. Our investigation includes the performance of different estimators, such as maximum likelihood, weighted least squares and Markov Chain Monte Carlo (MCMC). Our simulation results suggest that ignoring clustering may lead to serious bias of the estimated factor loadings, item thresholds, and corresponding standard errors in CFAs for ordinal item response data typical of that commonly encountered in psychiatric research. In addition, fit indices tend to show a poor fit for the hypothesized structural model. MCMC estimation may be more robust against clustering than maximum likelihood and weighted least squares approaches but further investigation of these issues is warranted in future simulation studies of other datasets. Copyright © 2015 John Wiley & Sons, Ltd.

• MeSH
• Factor Analysis, Statistical * MeSH
• Data Interpretation, Statistical * MeSH
• Humans MeSH
• Computer Simulation MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

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• Keywords
• Social Cognition and Object Relations Scale (SCORS),
• MeSH
• Adult MeSH
• Interpersonal Relations MeSH
• Cognition * classification   MeSH
• Middle Aged MeSH
• Humans MeSH
• Schizophrenia, Paranoid psychology   MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Schizophrenic Psychology * MeSH
• Social Cognition MeSH
• Thematic Apperception Test MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

Úvod: Delirium jako projev mozkové dysfunkce je častá komplikace u kriticky nemocných. Kritické onemocnění představuje nezávislý rizikový faktor pro výskyt delirantních stavů. Prevalence deliria se u kriticky nemocných pohybuje mezi 11 a 87 %. Delirium je poddiagnostikováno, ačkoli významně zhoršuje prognózu. Cílem naší práce je podpořit zavedení skríningového testu deliria CAM‑ICU (The Confusion Assessment Method for the Intensive Care Unit) do běžné praxe a tím umožnit jeho včasnou diagnostiku, prevenci a léčbu.> Metody: Prospektivní hodnocení incidence deliria a rizikových faktorů jeho rozvoje u pacientů přijatých na šestilůžkovou JIP v období únor až červen 2014. Delirium bylo vyšetřováno metodou CAM‑ICU. Použili jsme českou verzi testu brněnské skupiny autorů. U všech pacientů jsme hodnotili rizikové faktory (preexistující a precipitující). Ke zhodnocení jsme použili Fisherův exaktní test (u kategoriálních znaků) a dvouvýběrový Wilcoxonův pořadový test (u numerických znaků). U všech testů byla použita hladina významnosti p = 0,05. Závěr: Ze 142 pacientů bylo delirium hodnotitelné u 125 pacientů. Pro nemožnost vyšetření deliria CAM‑ICU testem vzhledem k perzistujícímu kómatu a jednou pro jazykovou bariéru bylo vyloučeno 17 pacientů. Incidence deliria dosáhla 31,2 %. Šlo o smíšenou populaci pacientů traumatologických, chirurgických a interních s mediánem APACHE II (Acute Physiology And Chronic Health Evaluation) rovným 12. Vyšší riziko rozvoje deliria je u pacientů s primárně interním onemocněním a po traumatu ve srovnání s pacienty chirurgickými. Výskyt deliria ovlivňuje tíha onemocnění (APACHE II), užití analgosedace, vazopresorů. Delirantní pacienti pobývali na JIP déle, rovněž potřeba umělé plicní ventilace byla vyšší. Klíčová slova: delirium – diagnostické testy – jednotka intenzivní péče – rizikové faktory preexistující – rizikové faktory precipitující – preventivní přístup

Introduction: Delirium, as a manifestation of acute brain dysfunction, is a frequent complication in critical care patients. Any critical disorder is an independent risk factor for development of delirium. The prevalence of delirium in critically ill patients has been reported between 11 and 87%. Delirium is under-diagnosed even though it significantly worsens patient prognosis. The aim of our study was to support regular use of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), in order to facilitate early diagnostics, prevention and treatment of delirium. Method: A prospective study of the incidence of delirium as well as risk factors for its development in patients admitted to six-bed ICU from February to June 2014. All patients were assessed for predisposing and precipitating risk factors using the Czech version of CAM-ICU. Fisher’s Exact Test and Wilcoxon Rank-Sum were performed with the significance level of 0.05. Results: Delirium was diagnosed in 125 of the overall group of 142 patients. Seventeen patients were excluded from the study as they could not be assessed (16 due to prolonged coma, one due to language barrier). The incidence of delirium reached 31.2%. Within the study group consisting of surgical, medical and trauma patients with the median APACHE II score of 12, medical and trauma patients were more likely to develop delirium than surgical ones. Development of delirium was associated with the severity of the disease (APACHE II score), use of sedatives, analgesics and vasopressors. Delirious patients stayed longer at the ICU and they showed higher need for artificial ventilation. Key words: delirium – diagnostic tests – intensive care units – predisposing risk factors – precipitating risk factors – prevention The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

• MeSH
• Antipsychotic Agents therapeutic use   MeSH
• Delirium * diagnosis   epidemiology   prevention & control   MeSH
• Diagnostic Techniques and Procedures utilization   MeSH
• Intensive Care Units * organization & administration   trends   utilization   MeSH
• Humans MeSH
• Interdisciplinary Communication MeSH
• Critical Care * methods   psychology   utilization   MeSH
• Preventive Medicine methods   trends   MeSH
• Prognosis MeSH
• Prospective Studies MeSH
• Psychiatric Status Rating Scales standards   statistics & numerical data   MeSH
• Rehabilitation methods   trends   MeSH
• Risk Factors MeSH
• Statistics as Topic MeSH
• Emergency Nursing methods   trends   MeSH
• Check Tag
• Humans MeSH