Iskanje po katalogu digitalne knjižnice

Opis: Purpose: There are well-known gender differences in mortality of patients with ST-elevation myocardial infarction (STEMI). Our purpose was to assess factors of hospital mortality separately for men and women with STEMI, which are less well known. Patients and Methods: In 2018– 2019, 485 men and 214 women with STEMI underwent treatment with primary percutaneous coronary intervention (PCI). We retrospectively compared baseline characteristics, treatments and hospital complications between men and women, as well as between nonsurviving and surviving men and women with STEMI. Results: Primary PCI was performed in 94% of men and 91.1% of women with STEMI, respectively. The in-hospital mortality was significantly higher in women than in men (14% vs 8%, p=0.019). Hospital mortality in both genders was associated significantly to older age, heart failure, prior resuscitation, acute kidney injury, to less likely performed and less successful primary PCI and additionally in men to hospital infection and in women to bleeding. In men and women ≥ 65 years, mortality was similar (13.3% vs 17.8%, p = 0.293). Conclusion: Factors of hospital mortality were similar in men and women with STEMI, except bleeding was more likely observed in nonsurviving women and infection in nonsurviving men.
Ključne besede: ST-elevation myocardial infarction, female sex, male sex, sex differences, hospital mortality, 30-day survival, 6-month survival
Objavljeno v DKUM: 12.07.2024; Ogledov: 117; Prenosov: 12
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Opis: Background and Objectives: An effective strategy for cardiopulmonary resuscitation should be based on tissue perfusion. Our primary aim was to determine the association between capillary lactate values and initial rhythm as well as the probability of the return of spontaneous circulation in out-of-hospital cardiac arrest patients. Materials and Methods: This prospective observational cohort study included all patients with non-traumatic out-of-hospital cardiac arrest, older than 18 years, resuscitated by a prehospital emergency medical team between April 2020 and June 2021. Capillary lactate samples were collected at the time of arrival and every 10 min after the first measurement until the time of the return of spontaneous circulation (ROSC) or, if ROSC was not achieved, at the time of declaring death on the scene. Results: In total, 83 patients were enrolled in the study. ROSC was achieved in 28 patients (33.7%), 21 were admitted to hospital (26.3%), and 6 (7.23%) of them were discharged from hospital. At discharge, all patients had Cerebral Performance Category Scale 1 or 2. Initial capillary lactate values were significantly higher in patients with a non-shockable rhythm compared to the group with a shockable rhythm (9.19 ± 4.6 versus 6.43 ± 3.81; p = 0.037). A significant difference also persisted in a second value taken 10 min after the initial value (10.03 ± 5,19 versus 5.18 ± 3.47; p = 0.019). Capillary lactate values were higher in the ROSC group and non-ROSC group at the time of restored circulation (11.10 ± 6.59 and 6.77 ± 4.23, respectively; p = 0.047). Conclusions: Capillary lactate values are significantly higher in patients with a non-shockable first rhythm in out-of-hospital cardiac arrest (OHCA). There is also a significantly different rise in capillary lactate levels in patients with ROSC.
Ključne besede: cardiopulmonary resuscitation, out-of-hospital cardiac arrest, lactate, return of spontaneous circulation
Objavljeno v DKUM: 16.04.2024; Ogledov: 154; Prenosov: 7
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Opis: The aim of this study was to investigate the work-life quality and related workplace factors of nursing employees working in hospitals during the COVID-19 restrictions. Employees in nursing carry out nursing care at various levels of healthcare. Work-life quality refers to an individual’s feelings concerning work and outcomes and depends on different working characteristics and conditions. Quantitative research based on a cross-sectional study was used. This cross-sectional study included 486 employees in nursing from four Slovenian acute care hospitals. The results showed that most employees in nursing assessed the work-life quality on a moderate level: 76% were satisfied with their work, and 89% assessed their well-being at the workplace as positive. Considering the leaders’ support, the number of patients, adequate information, teamwork, working position, use of days off, and equipment for safe work, we can explain the 53.5% of the total variability of work-life quality. We also found that work-life quality had an essential effect on well-being at the workplace (β = 0.330, p < 0.001) and work satisfaction (β = 0.490, p < 0.001) of employees in nursing. Work-life quality refers to an employees’ feelings about their workplace, and its monitoring is important for higher employees’ well-being and health. For management and policymakers in nursing, it is important to design strategies to ensure an adequate number of competent employees and establish a supportive leadership system. Work-life quality is an important factor in the recruitment and retention of the nursing workforce. Flexible working conditions and policy changes can improve work-life quality and balance. Nursing management must understand the influencing factors of work-life quality to improve nursing employee retention strategies.
Ključne besede: hospital, work-life quality, nursing, well-being, COVID-19
Objavljeno v DKUM: 27.11.2023; Ogledov: 495; Prenosov: 19
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Opis: The theme of this master’s project is research on the significance and influence of the architecture of psychiatric facilities on the process of treatment of people with mental disorders. The capital of Montenegro, Podgorica, has been struggling with a lack of adequate facilities for its Psychiatric Clinic, which has not had the capacity to hospitalise, or provide treatment and rehabilitation services to mentally ill persons for years. With the aim of gaining an understanding of the best practices that could be transferred to the new Psychiatric Clinic, this paper delves into the historic development of psychiatry, treatment and types of hospitals, as well as the position of patients in the society. The great revolution or milestone in psychiatry, the deinstitutionalisation process, caused the closing-down of many psychiatric clinics around the world. Mental health centres that do not force long-term hospitalisation on patients, but offer a wide range of therapeutic, rehabilitation and recreational activities, started to emerge as an alternative. The main goal of this project is to create a clinic in Podgorica that would use a modern architectural language and concept to break environmental prejudices, while providing patients with all the necessary contents for a pleasant and safe stay. The project aims to create a clinic that would respect the function and dynamics of the site, while maintaining its own irreplaceability and uniqueness within that environment.
Ključne besede: psychiatry, arhitecture, psyhiatric hospital, deinstitucionalization, stigmatization, clinic centre Montenegro
Objavljeno v DKUM: 05.02.2019; Ogledov: 1589; Prenosov: 331
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Opis: Introduction: The prognosis among patients who suffer out-of-hospital cardiac arrest is poor. Higher survival rates have been observed only in patients with ventricular fibrillation who were fortunate enough to have basic and advanced life support initiated early after cardiac arrest. The ability to predict outcomes of cardiac arrest would be useful for resuscitation. Changes in expired end-tidal carbon dioxide levels during cardiopulmonary resuscitation may be a useful non-invasive predictor of successful resuscitation and survival from cardiac arrest, and help in the termination of cardiopulmonary resuscitation in the field. Methods: This is a prospective observational study of 737 cases of victims who suffered sudden out-of-hospital cardiac arrest. The patients were intubated and the measurements of end-tidal carbon dioxide were performed. Data according to the Utstein criteria, demographic information, medical data and partial pressure of end-tidal carbon dioxide (petCO2) values were collected for each patient in cardiac arrest, by the emergency physician. We presumed that an end-tidal carbon dioxide level of 1.9 kPa (14.3 mmHg) or more after 20 minutes of standard advanced cardiac life support would predict restoration of spontaneous circulation (ROSC). Results: Partial pressure of end-tidal carbon dioxide after 20 minutes of advanced life support averaged 0.92+/- 0.29 kPa (6.9mmHg +/- 2.2 mmHg) in patients who did not have ROSC and 4.36 +/-1.11 kPa (32.8 mmHg +/- 9.1 mmHg) in those who did (p<0,001). End-tidal carbon dioxide values of 1.9 kPa (14.3 mmHg) or less discriminated between the 402 patients with ROSC and 335 patients without ROSC. When a 20-minute end-tidal carbon dioxide value of 1.9 kPa (14.3 mmHg) or less was used as a screening test to predict ROSC, the sensitivity, specificity, positive predictive value, and negative predictive value were all 100 percent. Conclusions: Measurements of end-tidal carbon dioxide levels of more than 1.9 kPa (14.3 mmHg) after 20 minutes should be used to accurately predict ROSC. End-tidal carbon dioxide levels should be monitored during cardiopulmonary resuscitation and considered a useful prognostic value for determining the outcome of resuscitative efforts and termination of cardio-pulmonary resuscitation in the field.
Ključne besede: out-of-hospital cardiac arrest, cardiopulmonary resuscitation, CPR, partial pressure of end-tidal carbon dioxide, PetCO2
Objavljeno v DKUM: 29.06.2017; Ogledov: 1959; Prenosov: 163
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