In the Czech Republic, the issues of marginalisation, social inequality, and poverty are predominantly discussed in relation to the 'socially excluded population' living in 'socially excluded ...localities' (SEL). However, comprehensive information on the composition of the population in these localities is not yet available. Based on a quantitative survey (N = 2 566) carried out in socially excluded localities in the Czech Republic, this paper presents the demographics of the population while highlighting its distinguishing characteristics.
In the Czech Republic, the issues of marginalisation, social inequality, and poverty are predominantly discussed in relation to the ‘socially excluded population’ living in ‘socially excluded ...localities’ (SEL). However, comprehensive information on the composition of the population in these localities is not yet available. Based on a quantitative survey (N = 2 566) carried out in socially excluded localities in the Czech Republic, this paper presents the demographics of the population while highlighting its distinguishing characteristics.
IntroductionPrasugrel and ticagrelor have shown similar primary net-clinical endpoint (cardiovascular death, spontaneous MI, stroke, severe bleeding or revascularization at day 7) and similar ...clinical effectivity in the PRAGUE-18 study at one year.HypothesisImpact of gender on the clinical outcome up to 12 months.MethodsA total of 1,230 patients with acute MI (931 males; 75.7%) treated with primary PCI were randomized to prasugrel or ticagrelor with an intended treatment duration of 12 months. Key secondary efficacy endpoint (EP) was cardiovascular death, spontaneous MI, stroke within 30 days and at one year.ResultsFemales were older (64.9 vs 60.9 years; p<0.001), more often hypertensive (63.2% vs 47.4%; p<0.001) and diabetics (27.8% vs 17.9%; p<0.001) and there were less smokers (58.9% vs 66.8%; p=0.015). Females suffered significantly longer time interval from symptom onset to the admission to PCI center (3.3hrs vs 2.5hrs; p=0.001). In females, the primary net-clinical EP at 7 days was not different from males (4.4% vs 3.9%; p=0.645) but at 30 days, the rate of MI and combined key efficacy EP occurred significantly more often(5.4% vs 2.7%; p=0.030 HR 5.234; 95% CI, 1.902-14.401 and 3.3% vs 0.6%; p=0.001 HR 2.007 95% CI, 1.072-3.759, respectively). At 12 months, there was no significant difference between the groups, though a strong trend to higher rate of MI and bleeding was found (HR 1.968, 95% CI 0.985-3.929; p=0.055 and HR 1.399 95% CI 0.970-2.020; p=0.073, respectively). End of potent P2Y12 treatment within one year was observed more often in females than males, though not statistically significant (58.5% vs 52.0%; p=0.053). No significant difference was found in the economically driven switch to clopidogrel (43.1% vs 37.8%; p=0.103).ConclusionsIn the PRAGUE-18 study, the female patients were at higher baseline clinical risk, had significantly higher rate of MI and cardiovascular death/MI/stroke at 30 days and tended to have a higher rate of repeated MI and bleeding complications at 12 months. Longer pre-hospital ischemic time in females requires special attention.
BackgroundThe prognostic significance of periprocedural myocardial infarction (MI) remains controversial.PurposeThe study aims to evaluate the incidence of periprocedural MI in the era of high ...sensitivity diagnostic markers and intense antithrombotics, and its impact on early outcome of patients with acute MI treated with primary angioplasty (pPCI).MethodsData from the PRAGUE-18 (prasugrel versus ticagrelor in pPCI) study have been analysed. Primary net-clinical endpoint (EP) was cardiovascular death, spontaneous MI, stroke, severe bleeding or revascularization at day 7. Key secondary efficacy EP was cardiovascular death, spontaneous MI, stroke within 30 days.ResultsThe incidence of peri-pPCI MI was 2.3% (N=28) in 1230 study patients. The net-clinical EP occurred in 10.7 % of patients with and in 3.9 % of patients without peri-pPCI MI (HR 2.915; 95%CI 0.906 to 9.381; P=0.059). The key efficacy EP was 10.7 % and 3.2 %, respectively (HR 3.463; 95% CI 1.061-11.132; P=0.063). Patients with periprocedural MI were in a higher risk of spontaneous MI (HR 6.190; 95% CI 1.407-27.237; P=0.049) and stent thrombosis (HR 10.765; 95% CI 2.286-50.696; P=0.003) within 30 days. Age (OR 1.038; 95% CI 1.001-1.076; P=0.033), hyperlipidemia (OR 4.186; 95% CI 1.877-9.335; P<0.001), > 1 vessel disease (OR 2.467; 95% CI 1.078-5.644; P=0.034), post-procedural TIMI < 3 (OR 7.633; 95% CI 3.100-18.795; P<0.001), pPCI on RCX (OR 2.797; 95% CI 1.166-6.708; P=0.021), and periprocedural GP IIb/IIa inhibitor (OR 4.799; 95% CI 2.252-10.223; P<0.001) were independent predictors of peri-pPCI MI. Chronic therapy with aspirin and statin didn’t influence the risk of this event.ConclusionIn the era of intense antithrombotic therapy, the occurrence of peri-pPCI MI in AMI patients treated with primary PCI is, despite high-sensitive diagnostic markers, a rare event associated with an increased risk of early reinfarction and stent thrombosis.
Randomize çalışmalar, ST-yükselmeli miyokard infarktüsünü için reperfüzyon tedavisinde primer perkütan koroner girişimin (p-PKG) trombolize karşı üstünlüğünü göstermiş bulunuyor. Bu çalışmalardan ...ikisinin yapıldığı Çek Cumhuriyeti'nde, ülke çapındaki PKG merkezleri ve bunlara bağlı uydu hastanelerden oluşan bir ağ sayesinde, 2003 yılındaki reperfüzyon tedavilerinin %93'ü p-PKG ile yapılmış, tromboliz oranı %7'ye kadar gerilemiştir. Diğer Avrupa ülkelerinde bunun oranı büyük ölçüde değişkenlik göstermektedir (80:20 ile 1:99). Bu makalede, Çek Cumhuriyeti'ndeki başarıyı hazırlayan altyapı ve lojistik hakkında bilgi verildi.
Randomized trials have confirmed the superiority of primary percutaneous coronary intervention (p-PCI) over thrombolysis as the reperfusion therapy for ST-elevation myocardial infarction. The Czech Republic, where two of these trials were performed, developed a network of PCI centers and satellite hospitals throughout the country, enabling 93% of the reperfusion therapy to be p-PCI in 2003, with thrombolysis accounting for only 7%. In other European countries, however, the p-PCI-to-thrombolysis ratio largely varies between 80:20 and 1:99. In this article, the infrastructure and logistics of the achievement in the Czech Republic are described.
The authors of this paper dealt with the situation in agricultural enterprises in the Czech Republic, first of all from the view of main material flows and suitability and exploitation of storing ...areas. All investigated enterprises 86 were evaluated according to their acreage and divided into two groups: 1 less than 1500 and more than 1500 ha of agricultural land. As a supplement of this investigation data concerning the transport distances in km and data from the nation-wide census concerning the number and equipment of special storage houses in the Czech Republic are added.
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