Deprese v dětském a adolescentním věku je ovlivněna vývojovým stadiem. Děti a dospívající, stejně jako dospělí, mohou pociťovat smutek, trpět nespavostí, mít sníženou chuť k jídlu, mít sebevražedné myšlenky. Často se u nich projevují somatické obtíže nebo poruchy chování. S depresí je také spojeno suicidální jednání, kdy zejména pro adolescentní věk je typický suicidální pokus. Narůstajícím problémem je sebepoškozování, u kterého není úmysl zemřít, je však rizikovým faktorem pro sebevražedný pokus nebo dokonané suicidium. Depresivní symptomatika může být přítomna jako komorbidní při dalších psychických poruchách, jako jsou poruchy příjmu potravy, psychotické poruchy a poruchy aktivity a pozornosti. Léčba vyžaduje přístupy psychofarmakologické i psychoterapeutické, důležitá je práce s rodinou.
Depression in childhood and adolescence is determined by the developmental stage of child. Children and adolescents, like adults, may experience sadness, suffer from insomnia, have a decreased appetite, or have suicidal thoughts. They often develop somatic or behavioural difficulties. Suicidal behavior is also associated with depression, with suicide attempts being typical, particularly in adolescence. Self harm is a growing problem, in which there is no intention to die, but it is a risk factor for suicide attempt or completed suicide. Depressive symptoma- tology may be present as a comorbidity in other psychiatric disorders such as eating disorders, psychotic disorders, and activity and attention disorders. Treatment requires psychopharmacological and psychotherapeutic approaches, such as family therapy
BACKGROUND: Longitudinal investigation of the association between mobile health (mHealth) app use and attitudes toward one's body during adolescence is scarce. mHealth apps might shape adolescents' body image perceptions by influencing their attitudes toward their bodies. Adolescents might also use mHealth apps based on how they feel and think about their bodies. OBJECTIVE: This prospective study examined the longitudinal within-person associations between mHealth app use, body dissatisfaction, and physical self-worth during adolescence. METHODS: The data were gathered from a nationally representative sample of Czech adolescents aged between 11 and 16 years (N=2500; n=1250, 50% girls; mean age 13.43, SD 1.69 years) in 3 waves with 6-month intervals. Participants completed online questionnaires assessing their mHealth app use, physical self-worth, and body dissatisfaction at each wave. The mHealth app use was determined by the frequency of using sports, weight management, and nutritional intake apps. Physical self-worth was assessed using the physical self-worth subscale of the Physical Self Inventory-Short Form. Body dissatisfaction was measured with the items from the body dissatisfaction subscale of the Eating Disorder Inventory-3. The random intercept cross-lagged panel model examined longitudinal within-person associations between the variables. A multigroup design was used to compare genders. Due to the missing values, the final analyses used data from 2232 adolescents (n=1089, 48.8% girls; mean age 13.43, SD 1.69 years). RESULTS: The results revealed a positive within-person effect of mHealth app use on the physical self-worth of girls: increased mHealth app use predicted higher physical self-worth 6 months later (β=.199, P=.04). However, this effect was not consistent from the 6th to the 12th month: a within-person increase in using apps in the 6th month did not predict changes in girls' physical self-worth in the 12th month (β=.161, P=.07). Regardless of gender, the within-person changes in the frequency of using apps did not influence adolescents' body dissatisfaction. In addition, neither body dissatisfaction nor physical self-worth predicted app use frequency at the within-person level. CONCLUSIONS: This study highlighted that within-person changes in using mHealth apps were differentially associated with adolescents' body-related attitudes. While increased use of mHealth apps did not influence body dissatisfaction across genders, it significantly predicted higher physical self-worth in adolescent girls 6 months later. A similar association was not observed among boys after 6 months. These findings indicate that using mHealth apps is unlikely to have a detrimental impact on adolescents' body dissatisfaction and physical self-worth; instead, they may have a positive influence, particularly in boosting the physical self-worth of adolescent girls.
- MeSH
- Child MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Adolescent MeSH
- Mobile Applications * MeSH
- Body Dissatisfaction * psychology MeSH
- Personal Satisfaction MeSH
- Body Image psychology MeSH
- Prospective Studies MeSH
- Surveys and Questionnaires MeSH
- Self Concept * MeSH
- Telemedicine * MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
AIMS: Tailored education is recommended for cardiac patients, yet little is known about information needs in areas of the world where it is most needed. This study aims to assess (i) the measurement properties of the Information Needs in Cardiac Rehabilitation short version (INCR-S) scale and (ii) patient's information needs globally. METHODS AND RESULTS: In this cross-sectional study, English, simplified Chinese, Portuguese, or Korean versions of the INCR-S were administered to in- or out-patients via Qualtrics (January 2022-November 2023). Members of the International Council of Cardiovascular Prevention and Rehabilitation community facilitated recruitment. Importance and knowledge sufficiency of 36 items were rated. Links to evidence-based lay education were provided where warranted. A total of 1601 patients from 19 middle- and high-income countries across the world participated. Structural validity was supported upon factor analysis, with five subscales extracted: symptom response/medication, heart diseases/diagnostic tests/treatments, exercise and return-to-life roles/programmes to support, risk factors, and healthy eating/psychosocial management. Cronbach's alpha was 0.97. Construct validity was supported through significantly higher knowledge sufficiency ratings for all items and information importance ratings for all subscales in cardiac rehabilitation (CR) enrolees vs. non-enrolees (all P < 0.001). All items were rated as very important-particularly regarding cardiac events, nutrition, exercise benefits, medications, symptom response, risk factor control, and CR-but more so in high-income countries in the Americas and Western Pacific. Knowledge sufficiency ranged from 30.0 to 67.4%, varying by region and income class. Ratings were highest for medications and lowest for support groups, resistance training, and alternative medicine. CONCLUSION: Identification of information needs using the valid and reliable INCR-S can inform educational approaches to optimize patients' health outcomes across the globe.
- MeSH
- Adult MeSH
- Cardiac Rehabilitation * standards methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Heart Diseases rehabilitation diagnosis psychology MeSH
- Needs Assessment * MeSH
- Cross-Sectional Studies MeSH
- Surveys and Questionnaires MeSH
- Psychometrics * MeSH
- Reproducibility of Results MeSH
- Aged MeSH
- Patient Education as Topic * MeSH
- Health Knowledge, Attitudes, Practice * MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Validation Study MeSH
- Keywords
- záměrná kompenzovaná vazoplegie, steatotické jaterní onemocnění spojené s metabolickou dysfunkcí, DCV, MASLD,
- MeSH
- beta Lactam Antibiotics therapeutic use MeSH
- Blood Vessels MeSH
- Endocrine Surgical Procedures MeSH
- Enterobacteriaceae Infections drug therapy MeSH
- Pheochromocytoma surgery MeSH
- Clinical Studies as Topic * MeSH
- Humans MeSH
- Blood Pressure Determination methods MeSH
- Metabolic Syndrome complications MeSH
- Intraoperative Care methods MeSH
- Intermittent Fasting MeSH
- Pseudomonas Infections drug therapy MeSH
- Fatty Liver diet therapy etiology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Overall MeSH
Cíle: Od prosince roku 2022 je pozorován v České republice zvýšený výskyt invazivního onemocnění způsobeného Streptococcus pyogenes s posunem klinické prezentace a věkové hranice postižených osob. Invazivní onemocnění se projevují ve srovnání s předchozími roky častěji u dětí do 18 let věku a dosud zdravých dospělých středního věku. Zvýšil se počet izolátů S. pyogenes získaných z primárně sterilních míst, jako je hemokultura, mozkomíšní mok, pleurální výpotek, kloubní punktát a sekční materiál. Rutinním stanovováním typu genu emm bylo zjištěno, že převažujícím emm typem S. pyogenes je emm1. V období od ledna 2023 do července 2023 46 % všech izolátů S. pyogenes z invazivních onemocnění odpovídalo typu emm1. Globálně rozšířená sublinie M1UK je charakterizována ve srovnání s historickými kmeny iGAS typu emm1 odlišnou expresí sedmi genů, mezi které patří i gen streptokokového pyrogenního toxinu A (speA). Cílem studie je stanovit, zda ve větší míře toxigenní sublinie M1UK je spojena se zvýšeným výskytem invazivního onemocnění v České republice. Metody: Celogenomová sekvenace 41 izolátů S. pyogenes izolovaných v České republice v letech 2018 a 2019 a od prosince 2022 do května 2023 od pacientů s invazivním onemocněním byla provedena přístrojem MiSeq (Illumina). Bioinformatická analýza byla provedena volně dostupnými online nástroji Bacterial and Viral Bioinformatics Resource Center. Výsledky: Na základě dat celogenomové sekvenace 41 izolátů S. pyogenes typu emm1 izolovaných od pacientů s invazivním infekčním onemocněním v období let 2018 a 2019 a od prosince 2022 do května 2023 bylo zjištěno, že mezi invazivními kmeny S. pyogenes typu emm1 převládá od prosince 2022 do května 2023 v České republice sublinie M1UK. Závěr: Důvod rozšíření sublinie M1UK v České republice na konci roku 2022 a v první polovině roku 2023 není zcela zřejmý, ale může být spojen se sníženou imunitou v souvislosti s omezeným přenosem GAS během lockdownů, zvláště u dětí. Dalším faktorem, který mohl přispět k vysokému výskytu invazivních infekčních onemocnění, je sezonní cirkulace respiračních virů.
Aims: Since December 2022, an increase in invasive disease caused by Streptococcus pyogenes has been observed in the Czech Republic, with a shift in the clinical presentation and age of patients. Unlike in previous years, invasive disease is more common in children and adolescents under 18 years of age and in previously healthy middle-aged adults. An increase has been noticed in the number of S. pyogenes isolates from primarily sterile sites such as haemoculture, cerebrospinal fluid, pleural effusion fluid, joint fluid, and postmortem specimens. Routine emm gene typing revealed emm1 to be the predominant emm type of S. pyogenes. Between January 2023 and July 2023, 46% of all S. pyogenes isolates from invasive cases were assigned to the emm1 type. The globally spread M1UK sublineage is characterized by differences in the expression of seven genes, including the streptococcal pyrogenic toxin A (speA) gene, compared to historical emm1 iGAS strains. The aim of this study is to determine whether the more toxigenic M1UK sublineage is associated with the increase in invasive disease in the Czech Republic. Methods: Whole genome sequencing of 41 S. pyogenes isolates from patients with invasive disease recovered in the Czech Republic in 2018 and 2019 and from December 2022 to May 2023 was performed using the MiSeq instrument (Illumina). Bioinformatics analysis was performed using freely available online tools the Bacterial and Viral Bioinformatics Resource Center. Results: Based on whole genome sequencing data of 41 emm1 isolates of S. pyogenes from patients with invasive infectious disease recovered in 2018 and 2019 and from December 2022 to May 2023, the M1UK sublineage was found to be predominant from December 2022 to May 2023. Conclusion: The reason for the spread of the M1UK sublineage in the Czech Republic late in 2022 and in the first half of 2023 is not entirely clear, but it may be related to reduced immunity due to limited GAS transmission during lockdowns, especially in children. Another factor that may have contributed to the high incidence of invasive infectious diseases is the seasonal circulation of respiratory viruses.
- MeSH
- Antigens, Bacterial MeSH
- Bacterial Proteins genetics isolation & purification MeSH
- Exotoxins MeSH
- Humans MeSH
- Bacterial Outer Membrane Proteins genetics MeSH
- Whole Genome Sequencing MeSH
- Streptococcus pyogenes genetics isolation & purification MeSH
- Streptococcal Infections * epidemiology microbiology MeSH
- Superantigens MeSH
- Check Tag
- Humans MeSH
- Geographicals
- Czech Republic MeSH
Ve světle současných znalostí o biologické podstatě obezity a jako nemoci s naprosto zásadním genetickým vkladem je nezbytné přijmout fakt, že obezitu je třeba léčit trvale a doživotně. Mozek řídí stravovací návyky a chuť k jídlu. Hmotnost je určována a regulována unikátním třívrstvým systémem. Jedná se o homeostatický okruh na úrovni hypothalamu a hédonický okruh, kdy je zapojen limbický systém a kůra mozková. Preferujeme kombinační léčbu obezity, tedy konzervativní léčbu nutriční a pohybovou, spolu s psychologickými přístupy kognitivně behaviorální terapie, doplněnou o farmakoterapii a bariatricko-metabolické operace. V ideálním případě se tyto postupy prolínají a vzájemně na sebe opakovaně navazují.
In the light of current knowledge about the biological nature of obesity and as a disease with an absolutely essential genetic contribution, it is essential to accept that obesity needs to be treated permanently and for life. The brain controls eating habits and appetite. Weight is determined and regulated by a unique three-layered system. These are the homeostatic circuit at the level of the hypothalamus and the hedonic circuit where the limbic system and the cortex are involved. We prefer a combination treatment of obesity, i.e. conservative treatment of nutrition and exercise, together with psychological approaches of cognitive behavioural therapy, complemented by pharmacotherapy and bariatric-metabolic surgery. Ideally, these approaches are intertwined and interact repeatedly.
- Keywords
- emoční jezení,
- MeSH
- Precision Medicine methods MeSH
- Combined Modality Therapy methods MeSH
- Anti-Obesity Agents * economics classification adverse effects therapeutic use MeSH
- Humans MeSH
- Obesity * surgery diet therapy drug therapy metabolism MeSH
- Retreatment MeSH
- Motor Activity MeSH
- Psychotherapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Background: The regularity of eating, together with other nutritional factors, is one of the important determinants of health. According to previous studies, it is not clear if a greater fluctuation in energy intake is associated with higher body fat and weight gain, or if the weight of people is stable despite these fluctuations in the energy intake. The aim of the study was to verify if a higher variability in the energy intake each day of the week is related to the amount of body fat and other anthropometric parameters. Methods: A total of 220 (151 women, 69 men) individuals of Czech Caucasian origin with a BMI of 18.3-58 kg/m2, aged 21.7-79.7 were included in the study. Selected anthropometric characteristics were measured using a bioelectrical impedance analysis. 7-day food records were completed and analyzed using nutritional software. The measured values were statistically evaluated by multiple linear regression analysis. Results: The results of the multiple linear regression showed the statistically significant dependence of the percentage of body fat (p<0.01), BMI (p<0.01), and waist circumference (p<0.05) on the relative variability of the daily energy intake. Conclusions: The results of our study suggest that people with more regular energy intake also have better anthropometric parameters related to their cardiometabolic health.
- MeSH
- Adult MeSH
- Electric Impedance MeSH
- Energy Intake * physiology MeSH
- Body Mass Index * MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Waist Circumference MeSH
- Aged MeSH
- Body Composition * physiology MeSH
- Adipose Tissue MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
PURPOSE: The CD47 molecule, often referred to as the "do not eat me" signal, is frequently overexpressed in tumor cells. This signaling pathway limits phagocytosis by macrophages. Our objective was to determine CD47 abundance in various soft tissue sarcomas (STS) to investigate whether it could serve as a potential evasion mechanism for tumor cells. Additionally, we aimed to assess the prognostic value of CD47 expression by examining its association with different clinicopathological factors. This study aimed to elucidate the significance of CD47 in the context of emerging anti-tumor targeting approaches. METHODS: In this retrospective study, formalin-fixed paraffine-embedded (FFPE) tumor tissues of 55 treatment-naïve patients were evaluated by immunohistochemistry for the abundance of CD47 molecule on tumor cells. The categorization of CD47 positivity was as follows: 0 (no staining of tumor cells), 1 + (less than 1/3 of tumor area positive), 2 + (between 1/3 and 2/3 of tumor area positive), and 3 + (more than 2/3 of tumor area positive for CD47). Next, we compared CD47 abundance between different tumor grades (G1-3). We used Kaplan-Meier survival curves with log-rank test to analyze the differences in survival between patients with different CD47 expression. Moreover, we performed Cox proportional hazards regression model to evaluate the clinical significance of CD47. RESULTS: CD47 is widely prevalent across distinct STS subtypes. More than 80% of high grade undifferentiated pleiomorphic sarcoma (UPS), 70% of myxofibrosarcoma (MFS) and more than 60% of liposarcoma (LPS) samples displayed a pattern of moderate-to-diffuse positivity. This phenomenon remains consistent regardless of the tumor grade. However, there was a tendency for higher CD47 expression levels in the G3 group compared to the combined G1 + G2 groups when all LPS, MFS, and UPS were analyzed together. No significant associations were observed between CD47 abundance, death, and metastatic status. Additionally, high CD47 expression was associated with a statistically significant increase in progression-free survival in the studied cohort of patients. CONCLUSION: This study highlights the potential of the CD47 molecule as a promising immunotherapeutic target in STS, particularly given its elevated expression levels in diverse sarcoma types. Our data showed a notable trend linking CD47 expression to tumor grade, while also suggesting an interesting correlation between enhanced abundance of CD47 expression and a reduced hazard risk of disease progression. Although these findings shed light on different roles of CD47 in STS, further research is crucial to assess its potential in clinical settings.
- MeSH
- CD47 Antigen metabolism MeSH
- Adult MeSH
- Humans MeSH
- Lipopolysaccharides MeSH
- Macrophages pathology MeSH
- Soft Tissue Neoplasms * pathology MeSH
- Prognosis MeSH
- Retrospective Studies MeSH
- Sarcoma * therapy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
Rearing common bed bugs (Cimex lectularius L.) and other hematophagous insects is essential for basic, medical, and pest-control research. Logistically, acquiring fresh blood can be a challenge, while biologically, the eventual effects of different rearing and blood preparation protocols on bed bug genotype and phenotype pose a risk of biased research results. Using bed bug populations that are either bat- (BL) or human-related (HL), we tested the short- and long-term effects of rearing bugs on live bats or human volunteers, or artificially on CPDA (citrate phosphate dextrose, adenine)-treated blood, measuring meal size, body size, and fertility. We found that artificial feeding did not affect meal size compared with feeding on natural hosts. Long-term rearing across many generations of HL on CPDA-preserved blood led to reduced body size and fertility compared with populations reared on human volunteers. Blood preservatives increased the proportion of sterile eggs even after a single feed. Finally, our results indicated that laboratory reared bed bugs were smaller, regardless of the blood source, than wild bugs. Similar effects of artificial feeding or laboratory rearing alone should be considered in future studies using bed bug cultures to choose an appropriate rearing protocol. With regard to switching between bat and human hosts, HL took smaller meals and BL had lower fertility when fed on bats than when fed on humans. We attribute these results to methodological constrains, specifically the inconsistency of bat feeding, rather than to host specialization. Nevertheless, BL can be easily reared using human blood and artificial feeding systems.
- MeSH
- Chiroptera * MeSH
- Fertility MeSH
- Heteroptera * MeSH
- Humans MeSH
- Bedbugs * MeSH
- Feeding Behavior MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH