OBJECTIVE: To determine the relationships between psilocybin dose, psychedelic experiences, and therapeutic outcome in treatment-resistant depression. METHODS: For treatment-resistant depression, 233 participants received a single dose of 25, 10, or 1 mg of COMP360 psilocybin (a proprietary, pharmaceutical-grade synthesized psilocybin formulation, developed by the sponsor, Compass Pathfinder Ltd.) with psychological support. The resulting psychedelic experience (Five-Dimensional Altered States of Consciousness questionnaire [5D-ASC] and Emotional Breakthrough Inventory [EBI]) were measured. These proximal variables and outcome 3 weeks post-administration (change in Montgomery-Åsberg Depression Rating Scale [MADRS]) were explored using correlation analysis. RESULTS: The mean intensity of psychedelic effects was dose-related, but distributions of scores for different doses overlapped considerably. Depression response correlated with select aspects of the psychedelic experience overall and for individual doses. At the 25 mg dose, 5D-ASC dimensions Oceanic Boundlessness (Pearson correlation coefficient r = -0.508) and Visual Restructuralization (r = -0.516), and EBI (r = -0·637) were the variables with the strongest correlation to the Week 3 change from Baseline in MADRS score. LIMITATIONS: The existence of correlation does not establish causation and exploratory findings require further replication, preferably in larger independent samples. CONCLUSIONS: The intensity of psychedelic experience overlaps widely across doses and mitigates the risk of unblinding to dose. Correlations between psychedelic experience and outcome suggest specificity in psilocybin's mechanism of action. Quality and intensity of psychedelic experience may be a measure of pharmacodynamic effect and reveal an effective dose response phenomenon for single oral doses.
- MeSH
- deprese nereagující na léčbu * farmakoterapie MeSH
- depresivní porucha unipolární farmakoterapie MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- halucinogeny * aplikace a dávkování farmakologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- psilocybin * farmakologie aplikace a dávkování MeSH
- psychiatrické posuzovací škály MeSH
- výsledek terapie MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
PURPOSE: Obesity and its related severe comorbidities are increasing rapidly. The duodenal-jejunal bypass is an endoscopically implanted device (mimicking the Roux-en-Y gastric bypass) developed to support weight reduction and improve type 2 diabetes control. MATERIALS AND METHODS: Retrospective data analysis of consecutive patients undergoing duodenal-jejunal bypass (EndoBarrier®, DJB) implantation between 2013 and 2017 was performed to evaluate safety as well as short- and long-term efficacy. RESULTS: One hundred and twenty-one patients (mean BMI of 43.1 ± 7.2 kg/m2 and weight of 138.2 ± 28.6 kg) underwent DJB implantation. The mean dwelling time was 15.5 months, the mean total body weight loss (%TBWL) after explantation was 10.3% ± 7.9% (14.2 kg, p < 0.0001), and the mean BMI was 39.5 ± 7.3 kg/m2 (p < 0.0001). There was no significant weight gain 24 months after the explantation. Seventy-seven patients had type 2 diabetes mellitus (T2DM) with a mean HbA1c before implantation of 5.6% (n = 52). The mean HbA1c after explantation was 5.1% (p = 0.0001). Significant reductions in transaminase and lipid levels before and after explantation were observed. One complication occurred during implantation and another during explantation. In 16 patients, the device had to be extracted earlier than expected (7 for severe adverse events and 9 for adverse events; 13.2%). CONCLUSION: Despite an evident rate of adverse events, the DJB shows promise as a weight-loss procedure. Our results show that some patients implanted with the device maintained reduced weight even 24 months after explantation, while many improved T2DM control.
- MeSH
- diabetes mellitus 2. typu * chirurgie komplikace MeSH
- duodenum chirurgie MeSH
- glykovaný hemoglobin MeSH
- hmotnostní úbytek MeSH
- jejunum chirurgie MeSH
- lidé MeSH
- morbidní obezita * chirurgie MeSH
- obezita chirurgie komplikace MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- žaludeční bypass * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Cíl: Prezentovat zkušenosti našeho pracoviště s perkutánní nefrolitotomií v modifikované supinační poloze. Materiál a metody: Ve sledovaném období od 1. 1. 2020 do 31. 5. 2023 bylo provedeno 93 perkutánních nefrolitotomií v modifikované supi- nační poloze u 80 pacientů. Retrospektivně byla provedena analýza dat. Mezi sledované faktory byly zařazeny velikost litiázy, Guy’s stone skóre, operační čas, stone free rate, komplikace, doba skiaskopie, využití trypse a nutnost hemosubstituce po výkonu. Výsledky: Průměrná velikost řešené litiázy byla 261 mm2 , v 31 případech jsme řešili vícečetnou litiá- zu, částečně odlitkovou litiázu (Guy’s stone skóre 3) v 17 případech a kompletně odlitkovou litiázu ve 4 případech (Guy’s stone skóre 4). Stone free rate byla v našem souboru 78 %. Trypse litiázy byla nutná v 59 případech (63 %). Komplikace II. stupně Clavien-Dindovy klasifikace jsme zaznamenali ve 2 případech (2 %), stupeň IIIa v 1 případu (1 %) a stupeň IIIb v 8 případech (9 %). Průměrný operační čas byl 44 minut, průměrná doba skiaskopie 2 minuty 33 vteřin. Hemosubstituci po výkonu si vyžádaly 2 případy (2 %). Závěr: Perkutánní nefrolitotomie v modifikované supinační poloze je bezpečná a účinná metoda v řešení nefrolitiázy, její výhodou je zkrácení operačního času díky stacionární poloze pacienta v průběhu výkonu.
Aim: To present our department's experience with percutaneous nephrolithotomy in a modified supine position. Materials and Methods: During the observed period from January 1, 2020, to May 31, 2023, 93 percutaneous nephrolithotomies were performed in a modified supine position on 80 patients. A retrospective data analysis was conducted. The factors studied included stone size, Guy's stone score, operative time, stone-free rate, complications, fluoroscopy time, use of lithotripsy, and the need for blood transfusion after the procedure. Result: The average size of the treated stone was 261 mm2. In 31 cases, we dealt with multiple stones, partially cast stones (Guy's stone score 3) in 17 cases, and completely cast stones in 4 cases (Guy's stone score 4). The stone-free rate in our cohort was 78%. Lithotripsy of the stone was necessary in 59 cases (63%). Complications of grade II according to the Clavien-Dindo classification were recorded in 2 cases (2%), grade IIIa in 1 case (1%), and grade IIIb in 8 cases (9%). The average operative time was 44 minutes, and the average fluoroscopy time was 2 minutes and 33 seconds. Blood transfusion after the procedure was required in 2 cases (2%). Conclusion: Percutaneous nephrolithotomy in a modified supine position is a safe and effective method for treating nephrolithiasis, with the advantage of reduced operative time due to the stationary position of the patient during the procedure.
Ateroskleróza je hlavnou prí činou kardiovaskulá rnych ochorení a významne prispieva k celosvetovej úmrtnosti. Stá le rastúci počet dôkazov naznačuje, že črevný mikrobióm môže zohrá vať kľúčovú úlohu v patogenéze tohto ochorenia. Črevný mikrobióm pozostá va z biliónov mikroorganizmov, ktoré nielen podporujú trá venie a metabolizmus, ale tiež ovplyvňujú imunitnú odpoveď hostiteľa. Zmeny v zložení črevného mikrobiómu boli spojené s rôznymi chronickými ochoreniami, vrá tane obezity, cukrovky a aterosklerózy. Tento člá nok poskytuje stručný prehľad zloženia črevného mikrobiómu u pacientov s koroná rnou chorobu srdca a sumarizuje možné zá kladné mechanizmy vplyvu na rozvoj aterosklerózy. Zloženie črevného mikrobiómu u pacientov s aterosklerózou sa líš i od zdravých jedincov. Identifiká cia a pochopenie týchto rozdielov poskytuje nové možnosti pre diagnostiku a liečbu aterosklerózy.
Atherosclerosis is a major cause of cardiovascular diseases and significantly contributes to global mortality. An increasing body of evidence suggests that the gut microbiome may play a key role in the pathogenesis of this disease. The gut microbiome consists of trillions of microorganisms that not only support digestion and metabolism but also influence the host's immune response. Alterations in the composition of the gut microbiome have been associated with various chronic diseases, including obesity, diabetes, and atherosclerosis. This article provides a brief overview of the gut microbiome composition in patients with coronary artery disease and summarizes the potential underlying mechanisms influencing the development of atherosclerosis. The composition of the gut microbiome in patients with atherosclerosis differs from that in healthy individuals. Identifying and understanding these differences offers new opportunities for the diagnosis and treatment of atherosclerosis.
- MeSH
- arterioskleróza * etiologie prevence a kontrola MeSH
- lidé MeSH
- střevní mikroflóra * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
BACKGROUND: MUC1 and UMOD pathogenic variants cause autosomal dominant tubulointerstitial kidney disease (ADTKD). MUC1 is expressed in kidney, nasal mucosa and respiratory tract, while UMOD is expressed only in kidney. Due to haplo-insufficiency ADTKD-MUC1 patients produce approximately 50% of normal mucin-1. METHODS: To determine whether decreased mucin-1 production was associated with an increased COVID-19 risk, we sent a survey to members of an ADTKD registry in September 2021, after the initial, severe wave of COVID-19. We linked results to previously obtained ADTKD genotype and plasma CA15-3 (mucin-1) levels and created a longitudinal registry of COVID-19 related deaths. RESULTS: Surveys were emailed to 637 individuals, with responses from 89 ADTKD-MUC1 and 132 ADTKD-UMOD individuals. 19/83 (23%) ADTKD-MUC1 survey respondents reported a prior COVID-19 infection vs. 14/125 (11%) ADTKD-UMOD respondents (odds ratio (OR) 2.35 (95%CI 1.60-3.11, P = 0.0260). Including additional familial cases reported from survey respondents, 10/41 (24%) ADTKD-MUC1 individuals died of COVID-19 vs. 1/30 (3%) with ADTKD-UMOD, with OR 9.21 (95%CI 1.22-69.32), P = 0.03. The mean plasma mucin-1 level prior to infection in 14 infected and 27 uninfected ADTKD-MUC1 individuals was 7.06 ± 4.12 vs. 10.21 ± 4.02 U/mL (P = 0.035). Over three years duration, our longitudinal registry identified 19 COVID-19 deaths in 360 ADTKD-MUC1 individuals (5%) vs. 3 deaths in 478 ADTKD-UMOD individuals (0.6%) (P = 0.0007). Multivariate logistic regression revealed the following odds ratios (95% confidence interval) for COVID-19 deaths: ADTKD-MUC1 8.4 (2.9-29.5), kidney transplant 5.5 (1.6-9.1), body mass index (kg/m2) 1.1 (1.0-1.2), age (y) 1.04 (1.0-1.1). CONCLUSIONS: Individuals with ADTKD-MUC1 are at an eight-fold increased risk of COVID-19 mortality vs. ADTKD-UMOD individuals. Haplo-insufficient production of mucin-1 may be responsible.
- MeSH
- COVID-19 * mortalita genetika MeSH
- dospělí MeSH
- intersticiální nefritida genetika MeSH
- lidé středního věku MeSH
- lidé MeSH
- mucin 1 * krev MeSH
- mutace * MeSH
- registrace MeSH
- SARS-CoV-2 genetika MeSH
- senioři MeSH
- uromodulin MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
Introduction: The aim of this study was to investigate health science students' perceptions of poverty and health inequality to gain insight into the perspectives of future healthcare workers. Design: A descriptive cross-sectional study. Methods: Data was collected via an online survey that was developed based on a thorough literature review. Participants were students (n = 106) from undergraduate nursing and applied kinesiology programmes. Statistical analyses were conducted with IBM SPSS Statistics 29.0. using bivariate statistical analysis. The significance level was set at p < 0.05. Results: 28.3% of students cited lack of opportunity as the main cause of poverty. There were significant differences in perception between nursing and kinesiology students (p < 0.05), particularly in relation to personal responsibility for poverty. On average, students scored 58/85, indicating a moderate yet significant awareness of social determinants of health. Conclusion: The findings illustrate how different disciplines influence perceptions of poverty and emphasise the inclusion of empathy in health education. While views on the roots of poverty vary, a common nuanced understanding points to a move towards empathic, socially conscious healthcare education. The study highlights the importance of an education system that emphasises social determinants of health and empowers students to engage with the complexities of poverty and health inequality.
- MeSH
- analýza dat MeSH
- chudoba MeSH
- dospělí MeSH
- lidé MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- sociální determinanty zdraví MeSH
- studenti ošetřovatelství psychologie statistika a číselné údaje MeSH
- studenti zdravotnických povolání * psychologie statistika a číselné údaje MeSH
- zdravotní nespravedlnost * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
This study examines the challenges vulnerable populations in Albania face in accessing healthcare, focusing on structural, access-related, and socio-cultural barriers. Using a qualitative approach, it involved 13 focus group discussions (FGDs) with 118 participants from diverse backgrounds, including individuals with disabilities and members of the Roma and Egyptian communities. Data were collected between 2019 and 2020 as part of the "Health Vulnerability Study in Albania", commissioned by the "Health for All Project" (HAP) and approved by the Albanian Committee of Medical Ethics. Oral consent was obtained, and discussions were recorded to explore participants' experiences and perspectives in-depth. Key findings highlight limited healthcare infrastructure, negative perceptions of the health insurance system, and discrimination, which erode trust in healthcare providers. Vulnerable groups included socio-economically disadvantaged individuals, older adults, the LGBT community, and women facing domestic violence or unemployment. The study calls for reforms in healthcare infrastructure, health insurance, and cultural competence training for providers to address disparities.
- MeSH
- dostupnost zdravotnických služeb * statistika a číselné údaje MeSH
- lidé MeSH
- sexuální a genderové menšiny MeSH
- sociální diskriminace statistika a číselné údaje MeSH
- zajištění kvality zdravotní péče metody MeSH
- zdravotní péče - kvalita, dosažitelnost a hodnocení MeSH
- zranitelné populace * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- klinická studie MeSH
- Geografické názvy
- Albánie MeSH
