Článek popisuje vývoj stigmatizujícího postoje veřejnosti k elektrokonvulzivní terapii. Elektrokonvulzivní terapie (EKT) je vysoce účinná metoda léčby závažných duševních poruch. V psychiatrii se používá přes 80 let a v některých léčebných indikacích je dosud obtížně nahraditelná. Modernizace metody vedla k výrazné minimalizaci nežádoucích účinků léčby. Navzdory bezpečnosti metody a subjektivní spokojenosti vyléčených pacientů je elektrokonvulzivní terapie stále vnímána běžnou společností spíše negativně. V článku autoři rozebírají podrobně zdroje přetrvávající stigmatizace. Záporně ovlivnilo pohled na EKT především filmové zpracování, negativní pohled je udržován také prostřednictvím nových médií.
The article describes the evolution of the stigmatizing public view on electroconvulsive therapy (ECT). ECT is a highly effective method of treatment of serious mental illnesses. It has been in use for over 80 years and in some indications, its efficacy has yet to be surpassed by alternative methods. Modernization of the method led to significant minimalization of adverse effects. Despite this, ECT is still perceived negatively by the public. In the article, the authors describe the sources of this stigmatization. ECT has been influenced negatively especially by its portrayal in the movie industry, but also in the new media.
- MeSH
- duševní poruchy terapie MeSH
- elektrokonvulzívní terapie * škodlivé účinky etiologie MeSH
- film jako téma MeSH
- hudba MeSH
- komunikační média MeSH
- lidé MeSH
- literatura MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Functional connectivity analysis is a common approach to the characterization of brain function. While studies of functional connectivity have predominantly focused on resting-state fMRI, naturalistic paradigms, such as movie watching, are increasingly being used. This ecologically valid, yet relatively unconstrained acquisition state has been shown to improve subject compliance and, potentially, enhance individual differences. However, unlike the reliability of resting-state functional connectivity, the reliability of functional connectivity during naturalistic viewing has not yet been fully established. The current study investigates the intra-session reliability of functional connectivity during naturalistic viewing sessions to extend its understanding. Using fMRI data of 24 subjects measured at rest as well as during six naturalistic viewing conditions, we quantified the split-half reliability of each condition, as well as cross-condition reliabilities. We find that intra-session reliability is relatively high for all conditions. While cross-condition reliabilities are higher for pairings of two naturalistic viewing conditions, split-half reliability is highest for the resting state. Potential sources of variability across the conditions, as well as the strengths and limitations of using intra-session reliability as a measure in naturalistic viewing, are discussed.
BACKGROUND: The European Association for Endoscopic Surgery Bariatric Guidelines Group identified a gap in bariatric surgery recommendations with a structured, contextualized consideration of multiple bariatric interventions. OBJECTIVE: To provide evidence-informed, transparent and trustworthy recommendations on the use of sleeve gastrectomy, Roux-en-Y gastric bypass, adjustable gastric banding, gastric plication, biliopancreatic diversion with duodenal switch, one anastomosis gastric bypass, and single anastomosis duodeno-ileal bypass with sleeve gastrectomy in patients with severe obesity and metabolic diseases. Only laparoscopic procedures in adults were considered. METHODS: A European interdisciplinary panel including general surgeons, obesity physicians, anesthetists, a psychologist and a patient representative informed outcome importance and minimal important differences. We conducted a systematic review and frequentist fixed and random-effects network meta-analysis of randomized-controlled trials (RCTs) using the graph theory approach for each outcome. We calculated the odds ratio or the (standardized) mean differences with 95% confidence intervals for binary and continuous outcomes, respectively. We assessed the certainty of evidence using the CINeMA and GRADE methodologies. We considered the risk/benefit outcomes within a GRADE evidence to decision framework to arrive at recommendations, which were validated through an anonymous Delphi process of the panel. RESULTS: We identified 43 records reporting on 24 RCTs. Most network information surrounded sleeve gastrectomy and Roux-en-Y gastric bypass. Under consideration of the certainty of the evidence and evidence to decision parameters, we suggest sleeve gastrectomy or laparoscopic Roux-en-Y gastric bypass over adjustable gastric banding, biliopancreatic diversion with duodenal switch and gastric plication for the management of severe obesity and associated metabolic diseases. One anastomosis gastric bypass and single anastomosis duodeno-ileal bypass with sleeve gastrectomy are suggested as alternatives, although evidence on benefits and harms, and specific selection criteria is limited compared to sleeve gastrectomy and Roux-en-Y gastric bypass. The guideline, with recommendations, evidence summaries and decision aids in user friendly formats can also be accessed in MAGICapp: https://app.magicapp.org/#/guideline/Lpv2kE CONCLUSIONS: This rapid guideline provides evidence-informed, pertinent recommendations on the use of bariatric and metabolic surgery for the management of severe obesity and metabolic diseases. The guideline replaces relevant recommendations published in the EAES Bariatric Guidelines 2020.
- MeSH
- bariatrická chirurgie * metody MeSH
- dospělí MeSH
- film jako téma MeSH
- gastrektomie metody MeSH
- konsensus MeSH
- laparoskopie * metody MeSH
- lidé MeSH
- morbidní obezita * chirurgie MeSH
- síťová metaanalýza MeSH
- systém GRADE MeSH
- výsledek terapie MeSH
- žaludeční bypass * metody MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- směrnice pro lékařskou praxi MeSH
- MeSH
- film jako téma MeSH
- komunikace MeSH
- lékařská etika MeSH
- lidé MeSH
- paliativní péče * MeSH
- vztahy mezi lékařem a pacientem MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
- recenze MeSH
The tear film at the ocular surface is covered by a thin layer of lipids. This oily phase stabilizes the film by decreasing its surface tension and improving its viscoelastic properties. Clinically, destabilization and rupture of the tear film are related to dry eye disease and are accompanied by changes in the quality and quantity of tear film lipids. In dry eye, eye drops containing oil-in-water emulsions are used for the supplementation of lipids and surface-active components to the tear film. We explore in detail the biophysical aspects of interactions of specific surface-active compounds, cetalkonium chloride and poloxamer 188, which are present in oil-in-water emulsions, with tear lipids. The aim is to better understand the macroscopically observed eye drops-tear film interactions by rationalizing them at the molecular level. To this end, we employ a multi-scale approach combining experiments on human meibomian lipid extracts, measurements using synthetic lipid films, and in silico molecular dynamics simulations. By combining these methods, we demonstrate that the studied compounds specifically interact with the tear lipid film enhancing its structure, surfactant properties, and elasticity. The observed effects are cooperative and can be further modulated by material packing at the tear-air interface.
- MeSH
- film jako téma * MeSH
- fluorescenční mikroskopie metody MeSH
- kvartérní amoniové sloučeniny chemie MeSH
- lidé MeSH
- lipidy chemie MeSH
- mastné alkoholy chemie MeSH
- meibomské žlázky metabolismus MeSH
- poloxamer chemie MeSH
- simulace molekulární dynamiky * MeSH
- teoretické modely MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Polyelectrolyte layer-by-layer (LbL) films that disintegrate under physiological conditions are intensively studied as coatings to enable the release of bioactive components. Herein, we report on the interactions and pH-stability of LbL films composed of chitosan (CH) or N-(2-hydroxypropyl)-3-trimethylammonium chitosan chloride (CMCH) and tannic acid (TA), employed to guarantee the film disintegration. The self-assembly of TA with CH and CMCH at pH 5 and with CMCH at pH 7.4 were proven by turbidimetric, surface plasmon resonance and UV-Vis analyses. The LbL films exhibited pH-dependent properties; CMCH/TA films prepared at pH 7.4 showed exponential growth as well as a higher layer thickness and surface roughness, whereas films prepared at pH 5 grew linearly and were smoother. The film stability varied with the pH used for film assembly; CH/TA films assembled at pH 5 were unstable at pH 8.5, whereas CMCH/TA films assembled at pH 7.4 disintegrated at pH 4. All films exhibited a similar disassembly at pH 7.4. The coatings reduced the adhesion of E. coli and S. aureus by approximately 80%. CMCH-terminated CMCH/TA films were more resistant to bacterial adhesion, whereas CH-terminated CH/TA films demonstrated stronger killing activity. The prepared pH-triggered decomposable LbL films could be used as degradable coatings that allow the release of therapeutics for biomedical applications and also prevent bacterial adhesion.
- MeSH
- antibakteriální látky farmakologie MeSH
- biokompatibilní materiály chemie farmakologie MeSH
- chitosan chemie MeSH
- Escherichia coli účinky léků MeSH
- film jako téma MeSH
- koncentrace vodíkových iontů MeSH
- Staphylococcus aureus účinky léků MeSH
- taniny chemie MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- chybná zdravotní péče * MeSH
- film jako téma MeSH
- zanedbání povinné péče MeSH
- Publikační typ
- novinové články MeSH
- MeSH
- chybná zdravotní péče * MeSH
- dítě MeSH
- film jako téma MeSH
- kóma MeSH
- lidé MeSH
- pooperační krvácení MeSH
- tonzilektomie škodlivé účinky MeSH
- zanedbání povinné péče MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- novinové články MeSH
- MeSH
- duševní zdraví * MeSH
- film jako téma MeSH
- zdravotní výchova MeSH
- Publikační typ
- zprávy MeSH
