• MeSH
• Diabetes Mellitus, Type 2 drug therapy   MeSH
• Diabetes Mellitus * drug therapy   metabolism   therapy   MeSH
• Insulin, Long-Acting pharmacology   therapeutic use   MeSH
• Endocrinology methods   trends   MeSH
• Dipeptidyl-Peptidase IV Inhibitors * administration & dosage   metabolism   therapeutic use   MeSH
• Clinical Studies as Topic utilization   MeSH
• Insulin, Short-Acting pharmacology   therapeutic use   MeSH
• Langerhans Cells * enzymology   metabolism   secretion   MeSH
• Humans MeSH
• Evidence-Based Medicine methods   trends   MeSH
• Meta-Analysis as Topic MeSH
• Infusions, Subcutaneous methods   trends   utilization   MeSH
• Education methods   trends   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Interview MeSH

Úvod: Prognózu nemocných s chronickou obstrukční plicní nemocí (CHOPN) ovlivňuje četnost a tíže akutních exacerbací (AE). V léčbě těžkých AE CHOPN je využívána mechanická ventilace, preferován je neinvazivní způsob. Nemocní léčení invazivní mechanickou ventilací (IMV) mají vysoké riziko úmrtí a nízké jednoroční přežívání. Dle našich předchozích zkušeností asi 40 % nemocných na ventilátoru umírá a rovněž asi 40 % přežívá jeden rok od intubace („pravidlo 40 %“). Metodika: Do studie byli zařazeni nemocní s AE CHOPN léčení na Jednotce intenzivní respirační péče Pneumologické kliniky 2. LF UK a FN Motol pomocí IMV v letech 2009-2014. Sledován byl výsledek IMV (úmrtí či odpojení od ventilátoru) a aktuální hospitalizace (propuštění do ambulantní péče či úmrtí) a dále doba strávená na IMV a celková doba přežití od intubace. Rovněž byly hodnoceny potenciální prediktory výsledku IMV a jednoročního přežití od intubace. Výsledky: Do studie bylo zařazeno 47 pacientů (25 mužů) s mediánem (IQR) věku 67,3 (62,7-76,9) roku. Na IMV zemřelo 15 nemocných (32 %). Z nemocných odpojených od ventilátoru během následujících hospitalizací zemřelo dalších 10 osob (21 %) a do ambulantní péče bylo propuštěno 22 pacientů (47 %). V regresní analýze s adjustací na pohlaví a věk byla přítomnost dlouhodobé domácí oxygenoterapie (DDOT) nezávislým prediktorem úmrtí na IMV (p=0,049). Medián (IQR) doby IMV byl 20 (10-43) dnů a medián (IQR) přežití od okamžiku intubace činil 0,51 (0,12-1,85) roku. Jeden rok od intubace přežívalo 19 (40 %) pacientů. Závěr: Prognóza nemocných s AE CHOPN s nutností léčby pomocí IMV je nepříznivá. Na ventilátoru umírá 32 % a jednoročního přežití dosahuje 40 % nemocných. Přítomnost DDOT je nezávislým prediktorem úmrtí na IMV.

Introduction: The prognosis of patients with chronic obstructive pulmonary disease (COPD) is affected by the frequency and severity of acute exacerbations (AEs). In the treatment of severe AEs of COPD, mechanical ventilation is used, with the non-invasive approach being preferred. Patients treated with invasive mechanical ventilation (IMV) have a high risk of death and low one-year survival. According to our previous experience, about 40 % of patients die on the ventilator and about 40 % survive one year after intubation (a "40 percent rule"). Methods: Included in the study were patients with AEs of COPD treated with IMV at the Respiratory Intensive Care Unit of the Department of Pneumology, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol between 2009 and 2014. Outcomes of IMV (weaning from the ventilator or death) and subsequent hospital stay (discharge to outpatient care or death) as well as the time spent on IMV and overall survival time from intubation were analyzed. Potential predictors of IMV outcomes and one-year survival from intubation were also evaluated. Results: The study comprised 47 patients 125 males) with a median (IQR) age of 67.3 (62.7-76.9) years. Fifteen patients (32 %) died during IMV. Among those weaned from the ventilator, another 10 patients (21 %) died during their subsequent hospital stay and only 22 (47 %) persons were discharged from the hospital. In regression analysis with adjustment for age and sex, the presence of long-term oxygen therapy (LTOT) was an independent predictor of death during IMV (p = 0.049). The median (IQR) duration of IMV was 20 (10-43) days and the median (IQR) survival time from intubation was 0.51 (0.12-1.85) years. Nineteen (40 %) patients survived one year after intubation. Conclusions: The prognosis of patients with AEs of COPD requiring treatment with IMV is unfavorable. As many as 32 % of patients die during IMV and one-year survival is 40 %. The presence of LTOT is an independent predictor of death during IMV.

• Keywords
• invazivní mechanická ventilace, pravidlo 40%,
• MeSH
• Acute Disease therapy   MeSH
• Survival Analysis MeSH
• Pulmonary Disease, Chronic Obstructive * diagnosis   nursing   therapy   MeSH
• Financing, Organized MeSH
• Intensive Care Units trends   utilization   MeSH
• Kaplan-Meier Estimate MeSH
• Clinical Studies as Topic methods   utilization   MeSH
• Humans MeSH
• Prognosis * MeSH
• Disease Progression MeSH
• Statistics as Topic MeSH
• Respiration, Artificial * methods   utilization   MeSH
• Outcome and Process Assessment, Health Care methods   trends   utilization   MeSH
• Check Tag
• Humans MeSH

• Keywords
• modlitba, Ramadán, péče o zemřelého, stravování, zákaz alkoholu, respektování intimity ženy, jazyková bariéra,
• MeSH
• Hygiene MeSH
• Islam * history   psychology   MeSH
• Clinical Studies as Topic methods   utilization   MeSH
• Humans MeSH
• Visitors to Patients MeSH
• Delivery of Health Care * ethics   ethnology   methods   standards   organization & administration   manpower   trends   MeSH
• Family ethnology   MeSH
• Taboo MeSH
• Nurses * standards   organization & administration   psychology   trends   MeSH
• Health Facilities ethics   standards   manpower   utilization   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Review MeSH

• Keywords
• sladivost stévie (steviosid) 200- 300 x,
• MeSH
• Antihypertensive Agents metabolism   therapeutic use   MeSH
• Diterpenes metabolism   therapeutic use   MeSH
• Glycosides metabolism   therapeutic use   MeSH
• Hypolipidemic Agents * administration & dosage   therapeutic use   MeSH
• Clinical Studies as Topic utilization   MeSH
• Humans MeSH
• Sweetening Agents * administration & dosage   metabolism   therapeutic use   MeSH
• Statistics as Topic MeSH
• Stevia * metabolism   growth & development   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH
• Geographicals
• Asia MeSH
• Japan MeSH

• Keywords
• výsledky studie SHARP,
• MeSH
• Azetidines administration & dosage   adverse effects   therapeutic use   MeSH
• Diabetes Mellitus * diagnosis   prevention & control   MeSH
• Renal Dialysis methods   trends   utilization   MeSH
• Edema diagnosis   etiology   prevention & control   MeSH
• Cardiovascular Diseases * diagnosis   complications   prevention & control   MeSH
• Clinical Studies as Topic methods   standards   utilization   MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Death, Sudden etiology   prevention & control   MeSH
• Renal Insufficiency * diagnosis   complications   prevention & control   MeSH
• Hydroxymethylglutaryl-CoA Reductase Inhibitors metabolism   adverse effects   therapeutic use   MeSH
• Statistics as Topic MeSH
• Kidney Transplantation methods   trends   utilization   MeSH
• Outcome and Process Assessment, Health Care MeSH
• Check Tag
• Humans MeSH

• MeSH
• Antidepressive Agents therapeutic use   MeSH
• Biomedical Research methods   MeSH
• Depressive Disorder * diagnosis   etiology   therapy   MeSH
• Electroconvulsive Therapy methods   utilization   MeSH
• Drug Therapy methods   trends   utilization   MeSH
• Clinical Studies as Topic methods   utilization   MeSH
• Congresses as Topic MeSH
• Humans MeSH
• Psychiatric Status Rating Scales * standards   MeSH
• Sleep Deprivation * MeSH
• Statistics as Topic MeSH
• Outcome and Process Assessment, Health Care MeSH
• Check Tag
• Humans MeSH

• MeSH
• Central Nervous System physiopathology   pathology   MeSH
• Surgical Procedures, Operative * MeSH
• Clinical Studies as Topic methods   utilization   MeSH
• Blood Circulation physiology   drug effects   MeSH
• Blood Transfusion methods   utilization   MeSH
• Hemorrhage diagnosis   etiology   therapy   MeSH
• Humans MeSH
• Norepinephrine administration & dosage   adverse effects   therapeutic use   MeSH
• Pulmonary Ventilation physiology   drug effects   MeSH
• Resuscitation * methods   instrumentation   utilization   MeSH
• Heart Failure * diagnosis   etiology   therapy   MeSH
• Heart Arrest etiology   therapy   MeSH
• Statistics as Topic MeSH
• Outcome and Process Assessment, Health Care MeSH
• Research organization & administration   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH

• MeSH
• Apraxias * diagnosis   etiology   MeSH
• Biomedical Research methods   MeSH
• Clinical Studies as Topic * methods   utilization   MeSH
• Disease Attributes * MeSH
• Humans MeSH
• Neurologic Manifestations MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• Keywords
• vztah expresivní a motorické afázie a apraxie,
• MeSH
• Aphasia * diagnosis   etiology   physiopathology   MeSH
• Apraxias * diagnosis   etiology   physiopathology   MeSH
• History of Medicine MeSH
• Clinical Studies as Topic * methods   utilization   MeSH
• Disease Attributes MeSH
• Humans MeSH
• Statistics as Topic MeSH
• Check Tag
• Humans MeSH

• MeSH
• Aphasia * diagnosis   etiology   physiopathology   MeSH
• Cerebrovascular Disorders diagnosis   physiopathology   MeSH
• Diagnostic Techniques, Neurological MeSH
• Integumentary System Physiological Phenomena MeSH
• Clinical Studies as Topic * methods   utilization   MeSH
• Humans MeSH
• Meningitis diagnosis   physiopathology   MeSH
• Musculoskeletal System physiopathology   MeSH
• Brain Neoplasms diagnosis   physiopathology   MeSH
• Neural Analyzers physiology   physiopathology   MeSH
• Auditory Pathways physiopathology   MeSH
• Auditory Cortex physiology   physiopathology   MeSH
• Visual Pathways physiology   physiopathology   MeSH
• Visual Cortex physiology   physiopathology   MeSH
• Check Tag
• Humans MeSH