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92. Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units : a comparison of two large cohortsYasser Sakr, Bruno François, Jordi Solé-Violan, Katarzyna Kotfis, Ulrich Jaschinski, Angel Estella, Marc Leone, Stephan M. Jakob, Xavier Wittebole, Luis E. Fontes, Viktorija Tomič, 2021, izvirni znanstveni članek Povzetek: Background. Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. Methods. This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1–15, 2002 (SOAP study, n = 3147), and May 8–18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO2 corresponding to the most abnormal value of arterial PO2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. Results. The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1–7) days after admission in SOAP and 2 (1–6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH2O) and driving pressure (> 14 cmH2O) on the first day of mechanical ventilation but not tidal volume (> 8 ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. Conclusion. The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH2O and driving pressure > 14 cmH2O on the first day of mechanical ventilation but not tidal volume > 8 ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies.
Ključne besede: respiratory insufficiency, artificial respiration, tidal volume, airway pressures, driving pressure
Objavljeno v DiRROS: 16.06.2021; Ogledov: 1201; Prenosov: 556
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96. Navodila za izvajanje programa Zora : državni program Zgodnjega Odkrivanja predRAkavih sprememb materničnega vratu (Zora)Marjetka Uršič-Vrščaj, Maja Primic-Žakelj, Irena Kirar-Fazarinc, Ana Pogačnik, Dunja Obersnel Kveder, 2003, slovar, enciklopedija, leksikon, priročnik, atlas, zemljevid Objavljeno v DiRROS: 24.03.2021; Ogledov: 1021; Prenosov: 376
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97. Rak debelega črevesa in danke : kaj morate vedeti o bolezniJanja Ocvirk, Vaneja Velenik, Franc Anderluh, Maja Ebert Moltara, Ibrahim Edhemović, Zvezdana Hlebanja, Irena Oblak, Martina Reberšek, 2013, slovar, enciklopedija, leksikon, priročnik, atlas, zemljevid Ključne besede: rak debelega črevesa, rak danke, zdravljenje, bolniki, priročniki
Objavljeno v DiRROS: 19.03.2021; Ogledov: 1117; Prenosov: 388
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98. Pogledi bolnikov in onkologov na uvajanje telemedicine v času epidemije covid-19Miha Oražem, Irena Oblak, Tanja Španić, Ivica Ratoša, 2020, izvirni znanstveni članek Povzetek: Izhodišča: Pandemija koronavirusne bolezni 2019 (covid-19) je zaradi epidemioloških ukrepov, zlasti spodbujanja fizične distance, marsikje po svetu pospešila uvajanje telemedicine v klinično prakso. Zato smo želeli pridobiti stališča onkoloških bolnikov in zdravnikov do tovrstne obravnave v onkologiji. Metode: K izpolnjevanju dveh ločenih kvantitativnih vprašal-nikov smo med 27. majem in 11. junijem 2020 prek elektronske pošte ter s pomočjo Slovenskega združenja organizacij bolnikov z rakom (ONKO NET) povabili bolnike z rakom, ki so bili bodisi na aktivnem zdravljenju bodisi na sledenju po zaključenem zdravljenju, in zdravnike onkologe. Dodatno je bil v Sektorju radioterapije Onkološkega inštituta Ljubljana izveden presečni dan za bolnike med obsevanjem. Rezultati: Na spletni ali natisnjen vprašalnik za bolnike je odgovorilo 475 bolnikov, od tega 310 (65,3 %) na aktivnem onko-loškem zdravljenju in 132 (27,8 %) v fazi sledenja. Skoraj polovica bolnikov (48,4 %) je kot primarno diagnozo navedla rak dojk. Več kot desetina vseh (11,3 %) je zaradi pandemije želela opustiti zdravniški pregled. V zasebnem življenju jih pametni telefon ali tablico uporablja 72,4 % in vsaj 30 % bolnikov bi bilo pripravlje-nih v bodoče pogosteje uporabljati telemedicinske storitve. Od 168 povabljenih zdravnikov jih je na vprašalnik odgovoril 101 (60 %) in ocenil, da bi s pomočjo telemedicine lahko opravil 21 % (0%80 %) vseh svojih storitev. Če bi se sami znašli v vlogi bolnika, bi bila prip-ravljena po telemedicini poseči dobra polovica sodelujočih (54,5 %). Zaključki: Uporaba telemedicine v onkologiji bi bila ob upošteva-nju nekaterih omejitev sprejemljiva za pomemben del bolnikov in zdravnikov
Ključne besede: telemedicina, covid-19, onkologija
Objavljeno v DiRROS: 18.03.2021; Ogledov: 1584; Prenosov: 431
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