- MeSH
- lidé MeSH
- point of care testing * MeSH
- primární zdravotní péče MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- COVID-19 * MeSH
- lidé MeSH
- pandemie MeSH
- primární zdravotní péče MeSH
- šíření informací MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- demografie MeSH
- lidé MeSH
- primární zdravotní péče * statistika a číselné údaje MeSH
- ukazatele zdravotního stavu MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- grafy a diagramy MeSH
- tabulky MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- lidé MeSH
- náhlé příhody MeSH
- primární zdravotní péče * MeSH
- urgentní zdravotnické služby MeSH
- Check Tag
- lidé MeSH
- MeSH
- lidé MeSH
- nemoci štítné žlázy * diagnóza klasifikace terapie MeSH
- primární zdravotní péče * MeSH
- tyreoiditida diagnóza klasifikace terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
OBJECTIVES: To investigate if the effect of cardiac computed tomography (CT) vs. invasive coronary angiography (ICA) on cardiovascular events differs based on smoking status. MATERIALS AND METHODS: This pre-specified subgroup analysis of the pragmatic, prospective, multicentre, randomised DISCHARGE trial (NCT02400229) involved 3561 patients with suspected coronary artery disease (CAD). The primary endpoint was major adverse cardiovascular events (MACE: cardiovascular death, non-fatal myocardial infarction, or stroke). Secondary endpoints included an expanded MACE composite (MACE, transient ischaemic attack, or major procedure-related complications). RESULTS: Of 3445 randomised patients with smoking data (mean age 59.1 years + / - 9.7, 1151 men), at 3.5-year follow-up, the effect of CT vs. ICA on MACE was consistent across smoking groups (p for interaction = 0.98). The percutaneous coronary intervention rate was significantly lower with a CT-first strategy in smokers and former smokers (p = 0.01 for both). A CT-first strategy reduced the hazard of major procedure-related complications (HR: 0.21, 95% CI: 0.03, 0.81; p = 0.045) across smoking groups. In current smokers, the expanded MACE composite was lower in the CT- compared to the ICA-first strategy (2.3% (8) vs 6.0% (18), HR: 0.38; 95% CI: 0.17, 0.88). The rate of non-obstructive CAD was significantly higher in all three smoking groups in the CT-first strategy. CONCLUSION: For patients with stable chest pain referred for ICA, the clinical outcomes of CT were consistent across smoking status. The CT-first approach led to a higher detection rate of non-obstructive CAD and fewer major procedure-related complications in smokers. CLINICAL RELEVANCE STATEMENT: This pre-specified sub-analysis of the DISCHARGE trial confirms that a CT-first strategy in patients with stable chest pain referred for invasive coronary angiography with an intermediate pre-test probability of coronary artery disease is as effective as and safer than invasive coronary angiography, irrespective of smoking status. TRIAL REGISTRATION: ClinicalTrials.gov NCT02400229. KEY POINTS: • No randomised studies have assessed smoking status on CT effectiveness in symptomatic patients referred for invasive coronary angiography. • A CT-first strategy results in comparable adverse events, fewer complications, and increased coronary artery disease detection, irrespective of smoking status. • A CT-first strategy is safe and effective for stable chest pain patients with intermediate pre-test probability for CAD, including never smokers.
- MeSH
- koronární angiografie * metody MeSH
- kouření * škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci koronárních tepen * diagnostické zobrazování komplikace MeSH
- počítačová rentgenová tomografie * metody MeSH
- propuštění pacienta MeSH
- prospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pragmatická klinická studie MeSH
- randomizované kontrolované studie MeSH
INTRODUCTION: Existing advance care planning (ACP) definitional frameworks apply to individuals with decision-making capacity. We aimed to conceptualize ACP for dementia in terms of its definition and issues that deserve particular attention. METHODS: Delphi study with phases: (A) adaptation of a generic ACP framework by a task force of the European Association for Palliative Care (EAPC); (B) four online surveys by 107 experts from 33 countries, September 2021 to June 2022; (C) approval by the EAPC board. RESULTS: ACP in dementia was defined as a communication process adapted to the person's capacity, which includes, and is continued with, family if available. We identified pragmatic boundaries regarding participation and time (i.e., current or end-of-life care). Three interrelated issues that deserve particular attention were capacity, family, and engagement and communication. DISCUSSION: A communication and relationship-centered definitional framework of ACP in dementia evolved through international consensus supporting inclusiveness of persons with dementia and their family. HIGHLIGHTS: This article offers a consensus definitional framework of advance care planning in dementia. The definition covers all stages of capacity and includes family caregivers. Particularly important are (1) capacity, (2) family, (3) engagement, and communication. Fluctuating capacity was visualized in relation to roles and engaging stakeholders.
- MeSH
- delfská metoda MeSH
- demence * terapie MeSH
- konsensus MeSH
- lidé MeSH
- péče o umírající * MeSH
- předběžné plánování péče * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
1. vydání 46 stran : ilustrace ; 30 cm
Vysokoškolská učebnice, která se zaměřuje na intenzivní a resuscitační ošetřovatelskou péči, mimotělní membránovou oxygenaci a ošetřovatelské protokoly. Určeno i odborníkům v praxi.
- MeSH
- mimotělní membránová oxygenace MeSH
- ošetřovatelská péče o pacienty v kritickém stavu MeSH
- ošetřovatelské zhodnocení MeSH
- ošetřovatelství MeSH
- resuscitační péče MeSH
- Konspekt
- Patologie. Klinická medicína
- Učební osnovy. Vyučovací předměty. Učebnice
- NLK Obory
- ošetřovatelství
- anesteziologie a intenzivní lékařství
- NLK Publikační typ
- učebnice vysokých škol
