PURPOSE: To evaluate treatment outcomes and toxicity in patients with stage T1-3N0M0 oral cancer treated with surgery followed by high-dose-rate brachytherapy (HDR-BT). METHODS AND MATERIALS: Retrospective study of 50 patients with stage T1-T3N0 tongue and floor-of-mouth cancer who underwent tumour excision (+ elective neck dissection) followed by postoperative HDR-BT due to the presence of negative prognostic factors (close or positive resection margins, lymphovascular and/or perineural invasion, deep invasion). The plastic tube technique (dose: 18 x 3 Gy b.i.d.) was used. Survival outcomes, toxicity, and prognostic factors were evaluated. RESULTS: At a median follow-up of 81 months (range, 4-121), actuarial 5-year local control (LC), nodal control (NC) and progression-free survival (PFS) rates were 79%, 69%, and 64%. After salvage treatment (surgery + external beam radiotherapy), LC, NC, and PFS increased to 87%, 77%, and 72.3%, respectively. Five-year overall survival and cancer-specific survival (CSS) rates were 73% and 77%. Treatmentrelated toxicity included two cases of mandibular osteoradionecrosis and five cases of small soft tissue necrosis. T stage was significantly correlated with nodal control (p=0.02) and CSS (p=0.04). Tumour grade correlated with DFS (p=0.01). CONCLUSION: Postoperative HDR-BT 18 x 3 Gy b.i.d. seems to be an effective method in patients with T1-3N0M0 oral cancer with negative prognostic factors after tumour resection.
- Klíčová slova
- Brachytherapy, Early oral cancer, Postoperative treatment,
- MeSH
- brachyterapie * metody škodlivé účinky MeSH
- celková dávka radioterapie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory úst * radioterapie chirurgie patologie mortalita MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- staging nádorů MeSH
- výsledek terapie 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
INTRODUCTION AND OBJECTIVES: With increases in obesity and metabolic syndrome because of lifestyle-related factors, the prevalence of non-alcoholic fatty liver disease (NAFLD) also is increasing worldwide. In a subset of patients with NAFLD, an inflammatory process arises in the steatotic liver, known as non-alcoholic steatohepatitis, that leads to liver fibrosis and liver cirrhosis. In selected patients with obesity, bariatric surgery, and bariatric endoscopy are important therapeutic options. MATERIALS AND METHODS: This prospective interventional pilot study was conducted to investigate two types of intragastric balloons (IGB). The IGBs were the Orbera and the Spatz3. Liver fibrosis changes were monitored non-invasively using point and 2D shear wave ultrasound elastography (SWE) and transient elastography that allowed for quantification of liver steatosis using the controlled attenuation parameter (CAP). Patients were followed for 12 months. RESULTS: Of 34 patients implanted with an IGB, 30 completed follow-up at month 12; results for one patient were excluded because of initiation of obesity pharmacotherapy. Fifteen patients received the Orbera IGB, and nineteen patients received the Spatz3 type. In month 12, total and excess weight loss was 7.88 % and 30.13 %. Elastography values decreased from baseline (3.88 kPa) to 3.61 kPa at month 12 (p 0.024). 2D SWE values decreased from baseline (5.42 kPa) to a value of 4.91 kPa at month twelve (p 0.135). Transient elastography values decreased from baseline (5.62 kPa) to a value of 4.17 kPa at month twelve (p 0.009). CONCLUSIONS: Bariatric endoscopy in the form of IGB implantation leads to weight reduction and improvement of liver fibrosis and steatosis. GOV REGISTRATION: NCT04895943.
- Klíčová slova
- Elastography, Intragastric balloon, Liver fibrosis, Non-alcoholic fatty liver disease, Obesity,
- MeSH
- bariatrická chirurgie * MeSH
- časové faktory MeSH
- design vybavení MeSH
- dospělí MeSH
- elastografie MeSH
- hmotnostní úbytek MeSH
- jaterní cirhóza * etiologie diagnostické zobrazování diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- nealkoholová steatóza jater * diagnostické zobrazování diagnóza etiologie MeSH
- obezita * komplikace chirurgie diagnóza MeSH
- pilotní projekty MeSH
- prospektivní studie MeSH
- výsledek terapie MeSH
- žaludeční balónek * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
INTRODUCTION: This study aimed to assess the impact of midline lumbar fusion with cortical bone trajectory screws (MIDLF/CBT) on the multifidus muscles, focusing on the evaluation of their postoperative atrophy. CLINICAL RATIONALE FOR THE STUDY: MIDLF/CBT is a relatively new technique increasingly used to treat spinal instability. Despite its reduced invasiveness compared to traditional posterior lumbar interbody fusion with traditional pedicle screws (PLIF/TP), concerns remain about potential damage to the multifidus muscles that are crucial for spinal stability. Understanding the extent of muscular atrophy post-MIDLF/CBT is vital for improving surgical outcomes, and potentially patient rehabilitation strategies. MATERIAL AND METHODS: This study retrospectively analysed preoperative and postoperative MRI scans of patients who underwent MIDLF/CBT for degenerative segmental spondylolisthesis. The bilateral width of the multifidus muscles at the operated segment and adjacent segments was measured using axial T2-weighted MRI scans. Statistical comparisons were made using a paired t test, with significance set at p < 0.05. RESULTS: The study included 16 patients with an average age of 57 ± 10 years, 10 of whom (62.5%) were women, and featured a mean follow-up period of 37 ± 25 months. Postoperative measurements showed a significant reduction in the width of the multifidus muscles at the operated segment (mean difference -3.3mm, p = 0.02) and the inferior adjacent segment (-7.4 mm, p < 0.01). A decrease in muscle width at the superior adjacent segment was also observed, although this was not statistically significant. CONCLUSIONS AND CLINICAL IMPLICATIONS: Our study concluded that MIDLF/CBT results in significant multifidus muscle atrophy at and below the operated segment, potentially impacting postoperative rehabilitation and recovery. These findings highlight the need for further research comparing MIDLF/CBT to other spinal stabilisation techniques. Additionally, incorporating functional electromyographic assessments of paraspinal muscles could provide deeper insights into the long-term consequences of spinal surgeries and helpdevelop new approaches and strategies to mitigate paravertebral muscles atrophy, thus enhancing patient outcomes.
- Klíčová slova
- cortical bone trajectory, midline lumbar fusion, multifidus muscles, spinal fusion, spinal instability, spinal stabilisation,
- MeSH
- bederní obratle * chirurgie MeSH
- dospělí MeSH
- fúze páteře * škodlivé účinky metody MeSH
- hluboké zádové svaly * diagnostické zobrazování patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- pedikulární šrouby škodlivé účinky MeSH
- retrospektivní studie MeSH
- senioři MeSH
- spondylolistéza * chirurgie MeSH
- svalová atrofie * etiologie diagnostické zobrazování MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: MRI-only adaptive brachytherapy (MRI-ABT) is the state-of-the-art for treating locally advanced cervical cancer (LACC) in combination with concurrent chemoradiotherapy. We aimed to evaluate the pattern of pelvic recurrence after the treatment. MATERIAL AND METHODS: A total of one hundred LACC patients were treated between January 2017 and December 2023 with concurrent chemoradiotherapy of 45 Gy in 25 fractions ± boost to lymphadenopathy (up to a maximum dose of 60 Gy in 25 fractions) with concurrent weekly cisplatin chemotherapy at the dose of 40 mg/m2/week, and MR-ABT. RESULTS: At a median follow-up of 30.2 months, there were 2 local recurrences (2%) and 9 regional pelvic recurrences (9%). The median time to local/regional recurrence was 11 months (range 6-21). For all stages, the 3-year local control was 97.66%, and the 3-year pelvic control was 89.45%. Twenty-four patients died during follow-up; the 3-year overall survival was 75.11%, and the 3-year disease-free survival was 70.97%. CONCLUSION: MRI-ABT combined with external beam radiotherapy and concurrent chemotherapy for LACC demonstrates excellent local and regional pelvic control. Most local/regional recurrences occur inside or at the edge of the external-beam irradiated field. Recurrences inside the field of brachytherapy are rare. Distant recurrences are the predominant cause of death in LACC patients treated with definitive CRT and MRI-ABT.
- Klíčová slova
- Adaptive brachytherapy, Cervical cancer, MRI-only brachytherapy, Recurrence,
- MeSH
- brachyterapie * metody MeSH
- chemoradioterapie metody MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru * MeSH
- magnetická rezonanční tomografie * metody MeSH
- nádory děložního čípku * patologie radioterapie diagnostické zobrazování terapie mortalita MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: It is hypothesized that systemically administered antibiotics penetrate wound sites more effectively during negative pressure wound therapy (NPWT). However, there is a lack of clinical data from patients who receive NPWT for deep sternal wound infection (DSWI) after open-heart surgery. Here, we evaluated vancomycin penetration into exudate in this patient group. PATIENTS AND METHODS: For this prospective observational study, we enrolled 10 consecutive patients treated with NPWT for post-sternotomy DSWI. On the first sampling day, serum and exudate samples were synchronously collected at 0 (pre-dose), 0.5, 1, 2, 3 and 6 h after vancomycin administration. On the following three consecutive days, additional samples were collected, only before vancomycin administration. RESULTS: The ratio of average vancomycin concentration in wound exudate to in serum was higher for free (unbound) (1.51 ± 0.53) than for total (bound + unbound) (0.91 ± 0.29) concentration (p = 0.049). The percentage of free vancomycin was higher in wound exudate than serum (0.79 ± 0.19 vs. 0.46 ± 0.16; p = 0.04). Good vancomycin wound penetration was maintained on the following three days (vancomycin trough exudate-to-serum concentration ratio > 1). The total hospital stay was significantly longer in patients with DSWI (46 ± 11.6 days) versus without DSWI (14 ± 11.7 days) (p < 0.001). There was no in-hospital or 90-day mortality. Two patients experienced late DSWI recurrence. All-cause mortality was 4.8% during a median follow-up of 2.5 years. CONCLUSION: Vancomycin effectively penetrates wound exudate in patients receiving NPWT for DSWI after open-heart surgery.The protocol for this study was registered at ClinicalTrials.gov on July 16, 2024 (NCT06506032).
Vancomycin effectively penetrates into wound exudate in patients receiving NPWT to treat post-sternotomy DSWI after open-heart surgery.NPWT promotes the penetration of vancomycin into the infection site.
- Klíčová slova
- Deep sternal wound infection, exudate, negative pressure wound therapy, open-heart surgery, vancomycin, wound penetration,
- MeSH
- antibakteriální látky * farmakokinetika aplikace a dávkování MeSH
- exsudáty a transsudáty metabolismus mikrobiologie MeSH
- infekce chirurgické rány * MeSH
- kardiochirurgické výkony * škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- prospektivní studie MeSH
- senioři MeSH
- sternotomie * škodlivé účinky MeSH
- sternum chirurgie MeSH
- terapie ran pomocí řízeného podtlaku * metody MeSH
- vankomycin * aplikace a dávkování farmakokinetika MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Názvy látek
- antibakteriální látky * MeSH
- vankomycin * MeSH
AIMS: To assess perceptions, motivations and barriers to treatment adherence depending on emotional, lifestyle, medical and non-adherence risk profiles in hypertensive patients. METHODS AND RESULTS: Cross-sectional data were obtained using an online anonymous survey. Four distinct global risk scores (medical, lifestyle, emotional and quality of life (QoL) and non-adherence risk scores) were calculated based on the responses to specific groups of questions. A total of 2615 treated hypertensive patients (≥18 years of age) from 5 European countries completed the questionnaire. Mean (SD) age was 69.6 years (5.8); 54% males. Overall, antihypertensive therapy represented a low burden in patients' daily life (2.9/10 in the Likert scale). Perfect self-reported adherence was claimed by 59.8% of participants. Reporting of non-adherence episodes to physicians was low (13% always/often). Participants with a high non-adherence risk score had a greater number of associated diseases (obesity, sleep disturbances, depression and cardiac complications), a higher treatment-associated burden on daily life, a greater stress level and more antihypertensive pills per day (p < 0.001 for all). No correlation was found between the clinical and lifestyle risk scores and the risk of non-adherence. The emotional score correlated significantly with the non-adherence risk score (p < 0.001). Comparing patients with a low/middle risk to those with a high risk of non-adherence, female gender and age >65 years were associated with a lower odd ratio of non-adherence whereas depression, stress, family hardships, negative information on drugs and poor information were associated with higher odds of non-adherence. CONCLUSIONS: This large survey reveals several underestimated issues regarding patients' perspective in hypertension. It highlights the impact of emotions, exposure to family hardships, and stress on the risk of non-adherence. Non-adherence is underreported by patients; hence it remains mostly unrecognised.
A good knowledge of patients’ perception, beliefs, motivations and barriers to antihypertensive treatment adherence is essential to improve blood pressure (BP) control in the population.In this large survey conducted in five European countries, we assessed patients according to their medical, emotional, lifestyle and non-adherence risk profiles.Results show that emotional aspects and exposure to family hardships have a significant impact on the risk of non-adherence.Moreover, a poor adherence to medications remains often unknown because patients do not report their difficulties to their physicians.
- Klíčová slova
- Adherence, emotion, medication, patient perspective, quality of life, stress,
- MeSH
- adherence k farmakoterapii * psychologie MeSH
- antihypertenziva * terapeutické užití MeSH
- hypertenze * farmakoterapie psychologie epidemiologie MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- motivace * MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- životní styl MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
- Názvy látek
- antihypertenziva * MeSH
The aim of the study here was to evaluate the association between expression of CD23 molecule on B-lymphocytes and the level of specific IgE to molecular components of birch, Bermuda grass, hazel pollen, timothy, and rye grass in atopic dermatitis (AD) patients (with and without dupilumab therapy). A total of 46 patients suffering from AD were included: 26 without dupilumab treatment and 20 with dupilumab treatment. Serum levels of specific IgE were measured by the components resolved diagnostic assay ALEX2 Allergy Xplorer, the expression of CD23 molecule on B-lymphocytes was evaluated with flow cytometry. For the statistical analysis, the Spearman's rank correlation coefficient was used. In patients treated with dupilumab, the higher association was observed between the expression of CD23 on B-lymphocytes and specific IgE to molecular components Bet v 1, Cor a 1.0103, Cor a 1.0401, and Phl p 1. This study demonstrated that the relationship between CD23 expression on B-lymphocytes and specific IgE to pollen molecular components varies depending on whether the patient was treated with dupilumab and the type of molecular component involved.
What is already known about this topic?It is not yet known whether the expression of molecule CD23 on B lymphocytes is related to the level of allergen-specific IgE antibodies in AD patients. It is also not yet known what role dupilumab may have on this receptor.What does this article add to our knowledge?The study investigated the relationship between CD23 expression on B lymphocytes and specific IgE levels to various pollen molecular components in patients with atopic dermatitis (AD), both with and without dupilumab treatment.How does this study impact current management guidelines?The study provides insights into how dupilumab influences IgE interactions and allergic inflammation, potentially guiding more targeted treatments for AD patients.The findings suggest that dupilumab therapy may be more effective in AD patients sensitized to specific molecular components like Bet v 1, Cor a 1.0103, Cor a 1.0401, and Phl p 1, due to its role in reducing inflammatory responses.
- Klíčová slova
- Atopic dermatitis, B lymphocytes, CD23 molecule, dupilumab, molecular components, specific IgE,
- MeSH
- alergeny imunologie MeSH
- atopická dermatitida * imunologie farmakoterapie MeSH
- B-lymfocyty * imunologie MeSH
- dospělí MeSH
- humanizované monoklonální protilátky * terapeutické užití MeSH
- imunoglobulin E * krev imunologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- pyl * imunologie MeSH
- receptory IgE * metabolismus imunologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- alergeny MeSH
- dupilumab MeSH Prohlížeč
- humanizované monoklonální protilátky * MeSH
- imunoglobulin E * MeSH
- receptory IgE * MeSH
Inflammatory changes in perivascular adipose tissue are associated with atherosclerotic lesions in the adjacent artery and can also be used as a marker in patient workup. While adipocyte size is known to be closely related to adipose tissue dysfunction and inflammation, it has not been widely studied in perivascular adipose tissue obtained from healthy human subjects without clinical atherosclerosis. In this cross-sectional study, we addressed this issue by measuring adipocyte size and defining its relationship to cardiovascular risk factors in a healthy cohort of living kidney donors. The presence of cardiovascular risk factors was established by a standardized questionnaire, clinical measurements and body composition analyses. Adipocyte size was measured in the perivascular depot. The proportions of various macrophage subtypes were determined by flow cytometry. To confirm the results, the proportion of CD68 + macrophages was additionally assessed by immunohistochemistry. A correlation and principal component analyses were performed to explore associations. Adipocyte size in perivascular adipose tissue correlated with markers of lipid metabolism, inflammation, and glucose metabolism. Further, the positive correlation with the pro-inflammatory subpopulation of macrophages suggests a strong local effect of perivascular adipose tissue. Perivascular adipocyte size was associated with cardiovascular risk factors and markers of inflammation in a healthy cohort of living kidney donors. This further supports the local role of adipose tissue dysfunction and inflammation in early atherosclerosis development and detection.
- Klíčová slova
- Perivascular adipose tissue, adipocyte size, cardiovascular risk factors, inflammation, macrophages,
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- lipidy * MeSH
- makrofágy metabolismus MeSH
- metabolismus lipidů MeSH
- průřezové studie MeSH
- tuková tkáň metabolismus MeSH
- tukové buňky * metabolismus cytologie MeSH
- velikost buňky MeSH
- zánět * metabolismus patologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- lipidy * MeSH
OBJECTIVES: This cross-sectional analysis from the CZecking Heart Failure in patients with advanced Chronic Kidney Disease trial (ISRCTN18275480) examined pulmonary hypertension and right ventricular-pulmonary arterial coupling in patients on chronic hemodialysis. The aims of this analysis were: 1. To analyze relations between pulmonary hypertension and right ventricular-pulmonary arterial coupling with dialysis access flow and current hydration; 2. To analyze structural heart changes associated with right ventricular-pulmonary arterial uncoupling; 3. To reveal the prevalence, etiology and severity of pulmonary hypertension in the Czech hemodialysis population. METHODS: We performed expert echocardiography, vascular access flow measurements, bioimpedance analysis, and laboratory testing in 336 hemodialysis patients. RESULTS: Pulmonary hypertension was present in 34% (114/336) patients and right ventricular-pulmonary arterial uncoupling was present in 25% of patients with pulmonary hypertension. Only weak associations between the flow of the dialysis arteriovenous access and estimated pulmonary arterial systolic pressure and right ventricular-pulmonary arterial coupling was proved. There was a strong association between hydration status assessed by estimated central venous pressure with pulmonary arterial systolic pressure (Rho 0.6, p < 0.0001) and right ventricular-pulmonary arterial coupling (Rho -0.52, p < 0.0001) and association between overhydration to extracellular water ratio with pulmonary arterial systolic pressure (Rho 0.31, p = 0.0001) and right ventricular-pulmonary arterial coupling (Rho -0.29, p = 0.002). The prevalence of heart failure was significantly higher in patients with right ventricular-pulmonary arterial uncoupling (88% vs. 52%, p = 0.0003). CONCLUSION: These findings suggest that optimizing volume status and treating heart failure should be prioritized in hemodialysis patients to prevent pulmonary hypertension progression and right ventricular-pulmonary arterial uncoupling.
- Klíčová slova
- Right ventricular-pulmonary arterial coupling, arteriovenous access flow, chronic hemodialysis, fluid overload, heart failure, pulmonary hypertension,
- MeSH
- arteria pulmonalis * patofyziologie diagnostické zobrazování MeSH
- chronické selhání ledvin * terapie komplikace MeSH
- dialýza ledvin * škodlivé účinky MeSH
- echokardiografie MeSH
- lidé středního věku MeSH
- lidé MeSH
- plicní hypertenze * patofyziologie epidemiologie etiologie MeSH
- prevalence MeSH
- průřezové studie MeSH
- senioři MeSH
- srdeční komory * patofyziologie diagnostické zobrazování MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
ABSTRACTBackground: European health care workers recently experienced serious challenges to their mental health. Following the extremely stressful experience of the COVID-19 pandemic, the war in Ukraine caused a humanitarian influx of refugees in need of social and healthcare. We aimed to explore: (1) how working with refugees has affected the mental well-being of health care workers in the context of the COVID-19 pandemic, and (2) the nature of health care workers' emotional strain related to the refugee situation and the war in Ukraine.Methods: We used a combination of quantitative regression analyses and qualitative content analysis to assess data collected by an online questionnaire in 2022. The study included 1121 health care workers from the Czech arm of the international HEROES Study.Results: Quantitative findings did not indicate that working with Ukrainian refugees was reliably associated with a greater occurrence of symptoms of depression, anxiety, distress, or burnout. Qualitative analysis revealed five categories of emotional strain: impacts on working conditions, emotional reactions to refugees and the war, comparisons with the COVID-19 pandemic, and coping strategies.Conclusions: This study highlights the resilience of health care workers but also points to the need for ongoing support to address the complex emotional challenges they face during health crises.
Although we did not find a significant association between working with refugees and mental health issues, health professionals encountered emotionally challenging situations.Emotionally challenging situations involved reactions to the war and refugees, worsening working conditions, and higher subjective strain than during the COVID-19 pandemic.When comparing health workers caring for with refugees and COVID-19 patients, we found differences in their mental health issues.
- Klíčová slova
- COVID-19 pandemic, Migración, Migration, Russian-Ukrainian war, emotional strain, guerra ruso-ucraniana, malestar psicológico, pandemia de COVID-19, psychological distress,
- MeSH
- adaptace psychologická MeSH
- COVID-19 * psychologie epidemiologie MeSH
- deprese psychologie epidemiologie MeSH
- dospělí MeSH
- duševní zdraví * MeSH
- lidé středního věku MeSH
- lidé MeSH
- pandemie MeSH
- profesionální vyhoření * psychologie epidemiologie MeSH
- průzkumy a dotazníky MeSH
- psychický stres * psychologie MeSH
- SARS-CoV-2 MeSH
- uprchlíci * psychologie MeSH
- úzkost psychologie epidemiologie MeSH
- zdravotnický personál * psychologie statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Ukrajina etnologie MeSH