This paper discusses the dual serotonergic-noradrenergic mechanism of action of venlafaxine, its indications for use, and dosage. Special attention was paid to the clinical application of higher doses of the drug, above 150 mg in the treatment of depression and anxiety disorders. Venlafaxine is one of the most effective antidepressants. The maximum recommended dose is 225 mg/day for anxiety disorders and 375 mg/day for major depression. The use of higher doses of the drug allows to take full advantage of its dual mechanism of action and improve its effectiveness.
{"title":"Wenlafaksyna XR, zastosowanie kliniczne większych dawek (> 150 mg)","authors":"Paweł Mierzejewski","doi":"10.5603/psych.2020.0014","DOIUrl":"https://doi.org/10.5603/psych.2020.0014","url":null,"abstract":"This paper discusses the dual serotonergic-noradrenergic mechanism of action of venlafaxine, its indications for use, and dosage. Special attention was paid to the clinical application of higher doses of the drug, above 150 mg in the treatment of depression and anxiety disorders. Venlafaxine is one of the most effective antidepressants. The maximum recommended dose is 225 mg/day for anxiety disorders and 375 mg/day for major depression. The use of higher doses of the drug allows to take full advantage of its dual mechanism of action and improve its effectiveness.","PeriodicalId":39960,"journal":{"name":"Psychiatria","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42648222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Shamsi, Reyhaneh Sadat Tohidi, M. Shamekhi, H. Amirifard, Alireza Ansarimoghadam
Introduction: Identification of effective factors in the quality of life (QOL) of patients with epilepsy is important in improving their quality of life. Regarding this, the present study aimed to investigate the relationship between personality characteristics and QOL in patients with epilepsy. Material and methods: This cross-sectional study was conducted on 100 epileptic patients referred to Neurology Clinic of Ali-ibn Abi Talib Hospital in Zahedan, Iran in 2015. The NEO Personality Inventory (NEO-PI) and Short Form Health Survey (SF-12) questionnaires were used to determine the personality characteristics and QOL scores, respectively. Results: The mean of QOL score was 28.94±4.58. Age, gender, marital status, education level, and duration of epilepsy had no significant correlation with the QOL. The QOL showed a negative correlation with openness to experience and neuroticism. However, this variable had a direct correlation with conscientiousness, agreeableness, and extraversion. There was a significant relationship between the predictor variables (extraversion and neuroticism) and the criterion variable (QOL). Therefore, extraversion and neuroticism can be considered as the predictors of the QOL. Conclusions: The extraversion and neuroticism seem to be two predictors of the QOL in the epileptic patients. Accordingly, whereas the patients with high levels of neuroticism had low QOL, this value was higher in those with high levels of extraversion.
引言：确定影响癫痫患者生活质量（QOL）的因素对提高他们的生活质量很重要。为此，本研究旨在探讨癫痫患者的人格特征与生活质量之间的关系。材料和方法：这项横断面研究是对2015年在伊朗扎黑丹Ali ibn Abi Talib医院神经科门诊就诊的100名癫痫患者进行的。NEO人格问卷（NEO-PI）和短期健康调查（SF-12）分别用于确定人格特征和生活质量分数。结果：生活质量评分平均值为28.94±4.58。年龄、性别、婚姻状况、文化程度和癫痫持续时间与生活质量无显著相关性。生活质量与体验开放性和神经质呈负相关。然而，这个变量与尽责性、宜人性和外向性有直接的相关性。预测变量（外向性和神经质）与标准变量（QOL）之间存在显著关系。因此，外向性和神经质可以被认为是生活质量的预测因素。结论：外向性和神经质似乎是癫痫患者生活质量的两个预测因素。因此，尽管具有高水平神经质的患者的生活质量较低，但在具有高水平外向性的患者中，这一值更高。
{"title":"The relationship between personality characteristics and the quality of life in patients with epilepsy","authors":"A. Shamsi, Reyhaneh Sadat Tohidi, M. Shamekhi, H. Amirifard, Alireza Ansarimoghadam","doi":"10.5603/psych.2020.0012","DOIUrl":"https://doi.org/10.5603/psych.2020.0012","url":null,"abstract":"Introduction: Identification of effective factors in the quality of life (QOL) of patients with epilepsy is important in \u0000improving their quality of life. Regarding this, the present study aimed to investigate the relationship between personality \u0000characteristics and QOL in patients with epilepsy. \u0000 Material and methods: This cross-sectional study was conducted on 100 epileptic patients referred to Neurology \u0000Clinic of Ali-ibn Abi Talib Hospital in Zahedan, Iran in 2015. The NEO Personality Inventory (NEO-PI) and Short Form \u0000Health Survey (SF-12) questionnaires were used to determine the personality characteristics and QOL scores, respectively. \u0000 Results: The mean of QOL score was 28.94±4.58. Age, gender, marital status, education level, and duration of epilepsy \u0000had no significant correlation with the QOL. The QOL showed a negative correlation with openness to experience and \u0000neuroticism. However, this variable had a direct correlation with conscientiousness, agreeableness, and extraversion. \u0000There was a significant relationship between the predictor variables (extraversion and neuroticism) and the criterion \u0000variable (QOL). Therefore, extraversion and neuroticism can be considered as the predictors of the QOL. \u0000 Conclusions: The extraversion and neuroticism seem to be two predictors of the QOL in the epileptic patients. Accordingly, \u0000whereas the patients with high levels of neuroticism had low QOL, this value was higher in those with high \u0000levels of extraversion.","PeriodicalId":39960,"journal":{"name":"Psychiatria","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41845647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marek Krzystanek, M. Matuszczyk, I. Krupka-Matuszczyk, A. Koźmin-Burzyńska, Seweryn Segiet, J. Przybyło
Telepsychiatry includes the medical services through modern digital media. On-line psychiatric and psychotherapeutic treatment is effective and safe as well as therapeutically equivalent compared to traditional off-line treatment. In times of epidemic crisis and restrictions on outpatient advice, telepsychiatry is an alternative and recommended method. The article presents recommendations on conducting online visits in psychiatric care prepared by the Scientific Section of Telepsychiatry of the Polish Psychiatric Association. The form and subject of conducting tele-visits were discussed, including reactive and somatic factors, and a psychiatric and somatic tele-visit scheme was also proposed.
{"title":"Telewizyta (e-wizyta) na czas kryzysu epidemicznego — rekomendacje w zakresie prowadzenia wizyt online w opiece psychiatrycznej","authors":"Marek Krzystanek, M. Matuszczyk, I. Krupka-Matuszczyk, A. Koźmin-Burzyńska, Seweryn Segiet, J. Przybyło","doi":"10.5603/psych.2020.0011","DOIUrl":"https://doi.org/10.5603/psych.2020.0011","url":null,"abstract":"Telepsychiatry includes the medical services through modern digital media. On-line psychiatric and psychotherapeutic treatment is effective and safe as well as therapeutically equivalent compared to traditional off-line treatment. In times of epidemic crisis and restrictions on outpatient advice, telepsychiatry is an alternative and recommended method. The article presents recommendations on conducting online visits in psychiatric care prepared by the Scientific Section of Telepsychiatry of the Polish Psychiatric Association. The form and subject of conducting tele-visits were discussed, including reactive and somatic factors, and a psychiatric and somatic tele-visit scheme was also proposed.","PeriodicalId":39960,"journal":{"name":"Psychiatria","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42617382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michał Wroński, Zuzanna Dukaczewska, J. Samochowiec
In this paper we share clinical observations and insights regarding the management and treatment of an uncooperative patient requiring an interdisciplinary approach due to diagnosis of delusional disorder, depressive symptoms, alcohol dependence syndrome, numerous complaints related to concomitant somatic diseases, and coronavirus infection (COVID-19). Our aim was to highlight the significance of a holistic approach to the patient, and scrupulous documentation of existing somatic diseases in psychiatric hospital discharge summary reports. Due to the common lack of compliance on the part of psychiatric patients, it proves utterly important to establish cooperation between healthcare providers and families of the mentally ill. Coronavirus infection (COVID-19) becomes another, additional complication in the management of psychiatric inpatients. We believe that the discussed interdisciplinary approach, together with increased family or institutional supervision can contribute to the improvement of psychiatric patients’ physical and mental health status as well as general functioning.
{"title":"Pacjent z rozpoznaniem organicznych zaburzeń urojeniowych z odczynem depresyjnym — podejście interdyscyplinarne oraz postępowanie w przypadku dodatniego wyniku COVID-19","authors":"Michał Wroński, Zuzanna Dukaczewska, J. Samochowiec","doi":"10.5603/psych.2020.0017","DOIUrl":"https://doi.org/10.5603/psych.2020.0017","url":null,"abstract":"In this paper we share clinical observations and insights regarding the management and treatment of an uncooperative patient requiring an interdisciplinary approach due to diagnosis of delusional disorder, depressive symptoms, alcohol dependence syndrome, numerous complaints related to concomitant somatic diseases, and coronavirus infection (COVID-19). Our aim was to highlight the significance of a holistic approach to the patient, and scrupulous documentation of existing somatic diseases in psychiatric hospital discharge summary reports. Due to the common lack of compliance on the part of psychiatric patients, it proves utterly important to establish cooperation between healthcare providers and families of the mentally ill. Coronavirus infection (COVID-19) becomes another, additional complication in the management of psychiatric inpatients. We believe that the discussed interdisciplinary approach, together with increased family or institutional supervision can contribute to the improvement of psychiatric patients’ physical and mental health status as well as general functioning.","PeriodicalId":39960,"journal":{"name":"Psychiatria","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43791393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The work presents a case report of a patient with symptoms classified as depression. An in-depth interview revealed a specific problem of this patient, as well as for many other people with similar constellations of psychological processes. On the one hand, high demands addressed to himself, that is expectation of the career level and achievements at worldwide importance. On the other hand, in a situation of confrontation with the requirements of studies and life circumstances, a sense of loss of self-esteem, a sense of lack of future, sense of lost life, self-destructive tendencies and active maintaining of inertness and self-destruction.
{"title":"„Odkochałem się w sobie” — uraz narcystyczny jako przyczyna pojawienia się objawów depresyjnych u młodych osób","authors":"Sławomir Murawiec","doi":"10.5603/psych.2020.0018","DOIUrl":"https://doi.org/10.5603/psych.2020.0018","url":null,"abstract":"The work presents a case report of a patient with symptoms classified as depression. An in-depth interview revealed a specific problem of this patient, as well as for many other people with similar constellations of psychological processes. On the one hand, high demands addressed to himself, that is expectation of the career level and achievements at worldwide importance. On the other hand, in a situation of confrontation with the requirements of studies and life circumstances, a sense of loss of self-esteem, a sense of lack of future, sense of lost life, self-destructive tendencies and active maintaining of inertness and self-destruction.","PeriodicalId":39960,"journal":{"name":"Psychiatria","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42654651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Approximately 46 million people worldwide have Alzheimer’s disease (AD). Treatments to prevent or slow down cognitive decline in AD remain an urgent therapeutic need. During the last decades the use of b secretase inhibitors as well as immunotherapy against Ab, antioxidants and anti-inflammatory agents as well as natural products and many others have been investigated. Although considerable efforts have been made to develop more effective therapeutic agents for AD therapy, clinical trials failed to reach efficacy endpoints in improving cognitive function in most cases to date or have been terminated due to adverse events. Current pharmacotherapy of AD is still limited to cholinesterase inhibitors and the N-methyl-D-aspartate antagonist memantine which were approved at the turn of the century. Despite critical opinions on the efficacy of acetylcholinesterase inhibitors and memantine, it should be said that these drugs improve memory and other cognitive functions throughout most of the duration of the disease. As Memantine, and the AChEIs target two different aspects of AD pathology their complementary mechanisms offer superior benefit as combination therapy. Moreover preclinical studies have shown that memantine and AChEIs have neuroprotective effects.
全世界约有4600万人患有阿尔茨海默病(AD)。预防或减缓阿尔茨海默病认知能力下降的治疗仍然是一项迫切的治疗需求。在过去的几十年里，对b分泌酶抑制剂的使用以及针对Ab的免疫疗法、抗氧化剂和抗炎剂以及天然产物和许多其他药物进行了研究。尽管已经做出了相当大的努力来开发更有效的阿尔茨海默病治疗药物，但迄今为止，在大多数病例中，临床试验未能达到改善认知功能的疗效终点，或者由于不良事件而终止。目前阿尔茨海默病的药物治疗仍然局限于胆碱酯酶抑制剂和n -甲基- d -天冬氨酸拮抗剂美金刚，这两种药物是在世纪之交批准的。尽管对乙酰胆碱酯酶抑制剂和美金刚的疗效持批评意见，但应该说这些药物在疾病的大部分时间内都能改善记忆和其他认知功能。Memantine和AChEIs针对AD病理的两个不同方面，它们的互补机制作为联合治疗提供了更好的益处。此外，临床前研究表明，美金刚和乙酰胆酸抑制剂具有神经保护作用。
{"title":"Farmakologiczne leczenie choroby Alzheimera — współczesne możliwości","authors":"L. Bidzan","doi":"10.5603/psych.2020.0016","DOIUrl":"https://doi.org/10.5603/psych.2020.0016","url":null,"abstract":"Approximately 46 million people worldwide have Alzheimer’s disease (AD). Treatments to prevent or slow down cognitive decline in AD remain an urgent therapeutic need. During the last decades the use of b secretase inhibitors as well as immunotherapy against Ab, antioxidants and anti-inflammatory agents as well as natural products and many others have been investigated. Although considerable efforts have been made to develop more effective therapeutic agents for AD therapy, clinical trials failed to reach efficacy endpoints in improving cognitive function in most cases to date or have been terminated due to adverse events. Current pharmacotherapy of AD is still limited to cholinesterase inhibitors and the N-methyl-D-aspartate antagonist memantine which were approved at the turn of the century. Despite critical opinions on the efficacy of acetylcholinesterase inhibitors and memantine, it should be said that these drugs improve memory and other cognitive functions throughout most of the duration of the disease. As Memantine, and the AChEIs target two different aspects of AD pathology their complementary mechanisms offer superior benefit as combination therapy. Moreover preclinical studies have shown that memantine and AChEIs have neuroprotective effects.","PeriodicalId":39960,"journal":{"name":"Psychiatria","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42845476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aripiprazole is an antipsychotic drug with unique pharmacological properties showing ago-antagonistic effects against the D2 receptor and is classified as a III generation antipsychotic. Clinical and preclinical studies indicate efficacy and safety of high doses of aripiprazole in selected patients, supporting the decision to use the drug at a maximum dose of 30 mg/day. This paper presents the mechanism of action of high doses of aripiprazole and discusses clinical situations when it is appropriate to use the drug at the maximum dose. The second part of the study presents arguments for beneficial effects of the combination of aripiprazole with olanzapine and other antipsychotic drugs of II generation.
{"title":"Arypiprazol w dawce maksymalnej 30 mg i w połączeniu z olanzapiną","authors":"Paweł Mierzejewski","doi":"10.5603/psych.2020.0013","DOIUrl":"https://doi.org/10.5603/psych.2020.0013","url":null,"abstract":"Aripiprazole is an antipsychotic drug with unique pharmacological properties showing ago-antagonistic effects against the D2 receptor and is classified as a III generation antipsychotic. Clinical and preclinical studies indicate efficacy and safety of high doses of aripiprazole in selected patients, supporting the decision to use the drug at a maximum dose of 30 mg/day. This paper presents the mechanism of action of high doses of aripiprazole and discusses clinical situations when it is appropriate to use the drug at the maximum dose. The second part of the study presents arguments for beneficial effects of the combination of aripiprazole with olanzapine and other antipsychotic drugs of II generation.","PeriodicalId":39960,"journal":{"name":"Psychiatria","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48266507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The article describes the possible consequences of using/abusing new technologies in the context of mental health. It is an attempt to reflect how smartphones, e-mail, computer games, social media affect our lives, things we can do to increase potential benefits and minimize the risks associated with these technologies. Through not only scientific but also personal perspective, the authors try to bring the conclusions from work to life practice.
{"title":"Nowe technologie a zdrowie psychiczne — szanse i trudności","authors":"Ł. Cichocki, M. Karbownik","doi":"10.5603/PSYCH.2020.0007","DOIUrl":"https://doi.org/10.5603/PSYCH.2020.0007","url":null,"abstract":"The article describes the possible consequences of using/abusing new technologies in the context of mental health. It is an attempt to reflect how smartphones, e-mail, computer games, social media affect our lives, things we can do to increase potential benefits and minimize the risks associated with these technologies. Through not only scientific but also personal perspective, the authors try to bring the conclusions from work to life practice.","PeriodicalId":39960,"journal":{"name":"Psychiatria","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41877749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Mosiołek, Jacek Gierus, Mateusz Margański, Katarzyna Margańska, A. Szulc
Wstep: Badanie mialo na celu ocene czestości zachowan agresywnych ze strony pacjentow z zaburzeniami psychicznymi oraz deklarowane sposoby radzenia sobie przez personel medyczny w celu unikniecia konsekwencji agresji. Material i metody: Badanie mialo charakter ankietowy, zostalo przeprowadzone jednorazowo, w 5 miastach w Polsce. Oceniono 102 ankiety wypelnione przez pracownikow medycznych pracujących w placowkach medycznych z pacjentami z zaburzeniami psychicznymi. Ankieta skladala sie z cześci demograficzno-opisowej oraz z 14 pytan dotyczących rodzajow agresji, czestości zachowan agresywnych, sposobow radzenia sobie z agresją oraz rodzaju szkod ponoszonych przez personel. Wyniki: Wiekszośc badanych osob doświadczyla agresji ze strony pacjentow o co najmniej umiarkowanym zasileniu, a u znacznej cześci badanych wskutek tych zdarzen wyksztalcilo sie wypalenie zawodowe lub szkody psychiczne. Glownym sposobem radzenia sobie ze skutkami agresji jest omawianie sytuacji w zespole, nieco rzadziej — stosowanie procedur. Wnioski: Poziom narazenia personelu na agresje nie spotyka sie z wystarczającymi środkami zapobiegawczymi. Autorzy rekomendują wdrazanie w placowkach ochrony zdrowia zarządzania ryzykiem klinicznym.
{"title":"Konsekwencje zachowań agresywnych ze strony pacjentów z zaburzeniami psychicznymi dla personelu medycznego","authors":"Anna Mosiołek, Jacek Gierus, Mateusz Margański, Katarzyna Margańska, A. Szulc","doi":"10.5603/PSYCH.2020.0004","DOIUrl":"https://doi.org/10.5603/PSYCH.2020.0004","url":null,"abstract":"Wstep: Badanie mialo na celu ocene czestości zachowan agresywnych ze strony pacjentow z zaburzeniami psychicznymi \u0000oraz deklarowane sposoby radzenia sobie przez personel medyczny w celu unikniecia konsekwencji agresji. \u0000 Material i metody: Badanie mialo charakter ankietowy, zostalo przeprowadzone jednorazowo, w 5 miastach w Polsce. \u0000Oceniono 102 ankiety wypelnione przez pracownikow medycznych pracujących w placowkach medycznych z pacjentami \u0000z zaburzeniami psychicznymi. Ankieta skladala sie z cześci demograficzno-opisowej oraz z 14 pytan dotyczących \u0000rodzajow agresji, czestości zachowan agresywnych, sposobow radzenia sobie z agresją oraz rodzaju szkod ponoszonych \u0000przez personel. \u0000 Wyniki: Wiekszośc badanych osob doświadczyla agresji ze strony pacjentow o co najmniej umiarkowanym zasileniu, \u0000a u znacznej cześci badanych wskutek tych zdarzen wyksztalcilo sie wypalenie zawodowe lub szkody psychiczne. Glownym \u0000sposobem radzenia sobie ze skutkami agresji jest omawianie sytuacji w zespole, nieco rzadziej — stosowanie procedur. \u0000 Wnioski: Poziom narazenia personelu na agresje nie spotyka sie z wystarczającymi środkami zapobiegawczymi. Autorzy \u0000rekomendują wdrazanie w placowkach ochrony zdrowia zarządzania ryzykiem klinicznym.","PeriodicalId":39960,"journal":{"name":"Psychiatria","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46345933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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