The KEB represents an equation for calculating the fictitious average number of ATP molecules produced in the CSF compartment from one molecule of glucose, and we used it successfully as a new parameter for evaluating energy metabolism status in the CSF.
Background: Prevalence rates of complementary and alternative medicine (CAM) use are still missing for some European countries, especially in the East. Thus, we measured patterns and determinants of CAM use among a representative sample of the general population in the Czech Republic. Methods: A cross-sectional survey was conducted. A sex-, age- and region-stratified sample of citizens aged 15 and older were randomly selected from voter registration lists (n = 8,639,375). Results: Overall, 76.0% (n = 1,365) of the respondents reported use of one or more CAM modalities during the past 30 days. The top five CAM modalities used were vitamins/minerals (54.6%), herbal remedies (47.8%), massage (19.9%), relaxation techniques (9.5%), and dietary supplements excluding vitamins/minerals (9.2%). Prevention (82.0%) was the primary reason for CAM use. Only 15.9% of CAM users employed it for therapeutic purposes. The most commonly treated ailments were respiratory (35.0%) and musculoskeletal (33.6%) disorders. Conclusion: The prevalence of CAM use in the Czech Republic is high, especially among people who apply CAM for self-treatment prior to seeing a doctor. Half of the study population combined CAM with conventional medical treatment, which may result in potential harm to the patient. Healthcare providers as well as the public should be educated about effective and safe use of CAM.
Brain ischemia after central nervous system (CNS) bleeding significantly influences the final outcome of patients. Catalytic activities of aspartate aminotransferase (AST) in the cerebrospinal fluid (CSF) to detect brain ischemia were determined in this study. The principal aim of our study was to compare the dynamics of AST in 1956 CSF samples collected from 215 patients within a 3-week period after CNS hemorrhage. We compared concentrations of the AST catalytic activities in the CSF of two patient groups: survivors (Glasgow Outcome Score (GOS) 5–3) and patients in a vegetative state or dead (GOS 2–1). All statistical evaluations were performed using mixed models and the F-test adjusted by Kenward and Roger and the Bonferroni adjustment for multiple tests. The significantly higher catalytic activities of AST in the CSF from patients with the GOS of 2–1 when compared to those who survived (GOS 5–3, p = 0.001) were found immediately after CNS haemorrhage. In the further course of time, the difference even increased (p < 0.001). This study confirmed the key association between early signs of brain damage evidenced as an elevated AST activity and the prediction of the final patient’s clinical outcome. The study showed that the level of AST in the CSF could be the relevant diagnostic biomarker of the presence and intensity of brain tissue damage.
Background: The prevalence of complementary and alternative medicine (CAM) ranges between 0.3% and 86% in most highly developed countries. In the Czech Republic, CAM is used by 76% of the general population. Our aim was to examine patterns in CAM use among a representative sample of the general population in the Czech Republic, for 2011 and 2014. Material and Methods: A cross-sectional survey was conducted. A sex-, age- and region-stratified sample of citizens aged 15 years and older was randomly selected from the 2014 voter registration lists (n = 8,395,132). A comparative analysis of data collected in 2011 and 2014 was performed. Results: Overall, 76.0% (N = 1,365) versus 87.0% (N = 1,565) of the respondents reported use of 1 or more CAM modalities during the past 30 days, in 2011 and 2014, respectively (p < 0.001). In both years, the top 4 CAM modalities used were vitamins/minerals, herbal teas, massage, and relaxation. Yoga replaced dietary supplements excluding vitamins/minerals in the 5th position. Nevertheless, only herbal teas (48.0% vs. 53.0%, p = 0.002), massage (20.0% vs. 26.0%, p < 0.001), relaxation (10.0% vs. 19.0%, p < 0.001), and yoga (3.7% vs. 7.1%, p < 0.001) showed a significant increase in use. Conclusions: The prevalence of CAM use in the Czech Republic is increasing, especially among people who use biological, body- and mind-based CAM therapies. There is a great need to educate students and health care professionals about the efficacy and safety of CAM in order to meet the patients' demands on CAM.
Purpose
The COVID‐19 pandemic had an impact on health care, with disruption to routine clinical care. Our aim was to describe changes in prescription drugs dispensing in the primary and outpatient sectors during the first year of the pandemic across Europe.
Methods
We used routine administrative data on dispensed medicines in eight European countries (five whole countries, three represented by one region each) from January 2017 to March 2021 to compare the first year of the COVID‐19 pandemic with the preceding 3 years.
Results
In the 10 therapeutic subgroups with the highest dispensed volumes across all countries/regions the relative changes between the COVID‐19 period and the year before were mostly of a magnitude similar to changes between previous periods. However, for drugs for obstructive airway diseases the changes in the COVID‐19 period were stronger in several countries/regions. In all countries/regions a decrease in dispensed DDDs of antibiotics for systemic use (from −39.4% in Romagna to −14.2% in Scotland) and nasal preparations (from −34.4% in Lithuania to −5.7% in Sweden) was observed. We observed a stockpiling effect in the total market in March 2020 in six countries/regions. In Czechia the observed increase was not significant and in Slovenia volumes increased only after the end of the first lockdown. We found an increase in average therapeutic quantity per pack dispensed, which, however, exceeded 5% only in Slovenia, Germany, and Czechia.
Conclusions
The findings from this first European cross‐national comparison show a substantial decrease in dispensed volumes of antibiotics for systemic use in all countries/regions. The results also indicate that the provision of medicines for common chronic conditions was mostly resilient to challenges faced during the pandemic. However, there were notable differences between the countries/regions for some therapeutic areas.
Preliminary findings suggest that adding a CLMP to standard care in patients with bronchial asthma offers greater clinical benefit than standard care alone and also suggest that conducting a large randomized clinical trial is feasible.
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