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Health literacy of hospitalized patients suffering from diseases of the gastrointestinal tract
No full textCilj: utvrditi razinu zdravstvene pismenosti i prediktore zdravstvene pismenosti kod gastroenteroloških bolesnika.
Izvori podataka i metode: Istraživanje je provedeno u Kliničkom bolničkom centru Split, na Zavodu za gastroenterologiju i hepatologiju. Sudjelovalo je 250 ispitanika, koji su popunili papirnati upitnik koji se sastojao od dvije dijela: općih podataka o bolesniku i modificiranog Europskog upitnika za procjenu zdravstvene pismenosti (HLS-EU-16). Za obradu podataka korišteni su deskriptivna statistika i Hi kvadrat test.
Rezultati: Rezultati istraživanja su pokazali da više od 80 % ispitanika ima adekvatnu i izvrsnu zdravstvenu pismenost (47,2 % adekvatnu, a 36,5 % izvrsnu zdravstvenu pismenost). Dob (30-59 godina), duljina trajanja bolesti, liječenje u Dnevnoj bolnici, mišljenje o posjedovanju znanja o svoj bolesti i odlasci na preventivne zdravstvene preglede su prediktori koji su statistički značajno povezani s razinom zdravstvene pismenosti bolesnika oboljelih od bolesti gastrointestinalnog trakta. Rezultati su također pokazali da spol, razina obrazovanja, izvori prikupljanja informacija o svojoj bolesti i provjeravanje informacija s interneta kod zdravstvenih djelatnika nisu statistički značajno povezani s razinom zdravstvene pismenosti.
Zaključak: Razina zdravstvene pismenosti hospitaliziranih gastroenteroloških bolesnika u cjelini je zadovoljavajuća, što potvrđuje prvu istraživačku hipotezu. Provedeno istraživanje naglašava važnost
poboljšanja zdravstvene pismenosti kao ključnog čimbenika za poboljšanje zdravstvenih ishoda i smanjenje troškova zdravstvene skrbi.Objective: to determine the level of health literacy and predictors of health literacy in gastroenterological patients.
Data sources and methods: The study was conducted at the University Hospital Center Split, at the Department of Gastroenterology and Hepatology. 250 respondents participated, who filled out a paper questionnaire consisting of two parts: general patient data and the modified European Health Literacy Assessment Questionnaire (HLS-EU-16). Descriptive statistics and the Chi-square test were used to process the data.
Results: The results of the study showed that more than 80 % of the respondents had adequate and excellent health literacy (47.2 % adequate and 36.5 % excellent health literacy). Age (30-59 years), duration of illness, treatment in a Day Hospital, opinion about having knowledge about one's illness and visits to preventive health examinations are predictors that are statistically significantly associated with the level of health literacy of patients with gastrointestinal diseases. The results also showed that gender, level of education, sources of information about their illness, and checking information from the Internet among healthcare professionals were not statistically significantly associated with the level of health literacy.
Conclusion: The level of health literacy of hospitalized gastroenterology patients is generally satisfactory, which confirms the first research hypothesis. The conducted research emphasizes the importance of improving health literacy as a key factor for improving health outcomes and reducing healthcare costs
Cardiovascular Diseases of the Population of the Town of Sinj
No full textUvod: Kardiovaskularne bolesti (KVB) vodeći su uzrok smrtnosti i obolijevanja u svijetu i Hrvatskoj te predstavljaju veliki javnozdravstveni problem. Također je poznato da se kardiovaskularne bolesti u velikoj mjeri mogu i prevenirati
Cilj: Utvrditi epidemiološke osobitosti oboljelih od kardiovaskularnih bolesti na području grada Sinja.
Hipoteza: Kardiovaskularne bolesti su vodeći uzroci korištenja zdravstvene zaštite te uzroci smrtnosti stanovnika grada Sinja.
Metode: Epidemiološke osobitosti će se utvrditi na temelju podataka o korištenju bolničke zdravstvene zaštite (baze HZJZ) te mortalitetnih podataka Državnog zavoda za statistiku Republike Hrvatske za područje grada Sinja u desetogodišnjem razdoblju. Podaci će se prikazati metodama deskriptivne statistike. Za statističku analizu korišten je Hi kvadrat test za usporedbu kategorijskih podataka unutar i među skupinama te Cochran-Armitage trend test za analizu trenda kategorijskih podataka.
Rezultati: U promatranom desetogodišnjem razdoblju (2014. – 2023.) na području grada Sinja ukupno je zabilježeno 21,307 hospitalizacija, od čega se 2,541 (11,9 %) odnosila na KVB, što ih svrstava među tri vodeća uzroka korištenja bolničke zdravstvene zaštite. Najzastupljenija dijagnostička podskupina bile su ishemijske bolesti srca s udjelom od 23,5 %, dok su cerebrovaskularne bolesti činile 20,8 % svih hospitalizacija povezanih s bolestima cirkulacijskog sustava. Osim navedenih, značajan udio hospitalizacija odnosio se i na bolesti arterija, arteriola i kapilara te ostale oblike srčanih bolesti.
Analiza prema spolu pokazala je statistički značajnu razliku, pri čemu su muškarci činili 57,97 % svih hospitaliziranih zbog kardiovaskularnih bolesti, dok je udio žena iznosio 42,03 % (P < 0,001). Nadalje, razlika u učestalosti hospitalizacija između muškaraca i žena bila je značajna i u usporedbi s hospitalizacijama zbog ostalih bolesti, gdje su muškarci češće bili hospitalizirani zbog KVB u odnosu na druge dijagnoze.
Dobna struktura hospitaliziranih također ukazuje na prevagu starije populacije. Osobe starije od 65 godina činile su 62,02 % svih hospitaliziranih zbog kardiovaskularnih bolesti, dok su mlađi od 65 godina činili preostalih 37,98 % (P < 0,001). Stariji bolesnici bili su dominantno zastupljeni u gotovo svim dijagnostičkim podskupinama, osim u slučaju bolesti vena, limfnih žila i limfnih čvorova, gdje je zabilježena veća učestalost kod mlađih bolesnika.
Ukupna smrtnost u Sinju tijekom promatranog razdoblja iznosila je 2.531 osoba, od čega je 1.146 osoba (45,3 %) preminulo od posljedica kardiovaskularnih bolesti. Time su one potvrđene kao vodeći uzrok smrti u lokalnoj populaciji. Premda su udjeli umrlih od KVB-a varirali tijekom godina, analizom je utvrđen značajan trend opadanja smrtnosti od tih bolesti (P = 0,02), uz najveći udio zabilježen 2017. godine (51,79 %), a najmanji 2021. godine (37,86 %). Usporedbom s nacionalnim prosjekom (38,8 % u 2023. godini), razlika u udjelu umrlih u Sinju nije bila statistički značajna (P = 0,17).
Zaključak: Rezultati potvrđuju hipotezu da su KVB vodeći uzroci korištenja zdravstvene zaštite i mortaliteta stanovništva Sinja, što potvrđuje potrebu za pojačanim preventivnim djelovanjem, osobito među starijom muškom populacijom.Introduction: Cardiovascular disease (CVD) are the leading cause of mortality and morbidity worldwide, including in Croatia, and represent a major public health issue. It is also well known that cardiovascular disease can be largely prevented
Objective: To determine the epidemiological characteristic of individuals suffering from cardiovascular disease in Sinj
Hypothesis: Cardiovascular disease are the leading cause of healthcare utilization and the cause of mortality among residents of Sinj.
Methods: Epidemiological characteristics will be determined based on data on the use of hospital healthcare services (HZJZ database) and mortality data from the Croatian Bureau of Statistics for the area of Sinj over ten years. The data will be presented using descriptive statistical methods. For statistical analysis, the Chi square test was used to compare categorical data within and between groups, and the Cochran-Armitage trend test was used to analyse the trend of categorical data.
Results: In the observed ten-year period (2014.–2023.), a total of 21,307 hospitalizations were recorded in the city of Sinj, of which 2,541 (11,9 %) were related to CVD, placing them among the top three causes of inpatient healthcare utilization. The most represented diagnostic subgroup was ischemic heart disease, accounting for 23,5 % of all cardiovascular-related hospitalizations, followed by cerebrovascular diseases with 20,8 %. In addition to these, a significant proportion of hospitalizations were related to diseases of the arteries, arterioles, capillaries, and other forms of heart disease.
Analysis by sex showed a statistically significant difference, with men accounting for 57,97 % of all hospitalizations due to cardiovascular diseases, while the proportion of women was 42,03 % (P < 0,001). Furthermore, the difference in hospitalization rates between men and women was also significant when compared to hospitalizations for other diseases, with men being more frequently hospitalized due to cardiovascular causes.
The age structure of hospitalized patients also indicated a predominance of the older population. Individuals aged 65 and over accounted for 62,02 % of all hospitalizations due to cardiovascular diseases, while those under 65 made up the remaining 37,98 % (P < 0,001). Older patients were predominantly represented in almost all diagnostic subgroups, except for diseases of the veins, lymphatic vessels, and lymph nodes, which were more prevalent among younger patients.
During the observed period, the total mortality in Sinj was 2,531 individuals, of whom 1,146 (45,3 %) died because of cardiovascular diseases, confirming them as the leading cause of death in the local population. Although the proportion of deaths due to CVD varied over the years, the analysis showed a significant decreasing trend in mortality from these diseases (P = 0,02), with the highest proportion recorded in 2017 (51,79 %) and the lowest in 2021 (37,86 %). When compared with the national average (38,8 % in 2023), the difference in the proportion of cardiovascular deaths in Sinj was not statistically significant (P = 0,17).
Conclusion: The results confirm the hypothesis that CVD are the leading causes of healthcare utilization and mortality among the population of Sinj, highlighting the need for enhanced preventive measures, particularly among the older male population
Impact of bioelectric impedance phase angle on hospital outcomes in operable colorectal carcinoma patients: a comprehensive analysis
No full textCilj: istražiti povezanost sniženih vrijednosti faznog kuta s pogoršanjem bolničkih ishoda učinkovitosti kod operiranih od kolorektalnog karcinoma.
Izvori podataka i metode: Ova retrospektivna studija provedena na Klinici za kirurgiju KBC Split obuhvatila je 422 pacijenta operirana zbog CRC od 1. ožujka 2021. do 29. veljače 2024. Podaci su prikupljeni iz elektroničkih baza i analizirani statistički. Primarni ishodi obuhvatili su duljinu boravka, stopu rehospitalizacija, mortalitet i troškove, dok su sekundarni obuhvatili komplikacije prema Clavien-Dindo klasifikaciji.
Rezultati: Medijan dobi pacijenata bio je 69 godina, a 37,4% pacijenata činile su žene. Najčešće izvedene operacije bile su desna hemikolektomija (157), lijeva hemikolektomija (41) i resekcija sigmoida, rektuma i rektosigmoida (185), dok je laparoskopski pristup primijenjen u 132 slučaja (uz 10,6% konverzije u otvoreni pristup). Većina pacijenata imala je T3 tumore (59%), a 40% je imalo bolest proširenu na regionalne limfne čvorove. Coxovom regresijskom analizom identificirani su četiri prediktora smrtnosti: dob, fazni kut bioelektrične impedancije, masa masnog tkiva i rizik od pada prema Morseovoj ljestvici. Povećanje faznog kuta za 1° smanjuje rizik od smrti 4,45 puta. Model rizika imao je AUC 0,837, sa senzitivnošću 100% i specifičnošću 66%. Preživljavanje u prvih 30 dana nakon operacije bilo je 100% za pacijente bez rizika, dok je za rizične pacijente bilo samo 36,6% (P = 0,006). Medijan poslijeoperacijskog boravka bio je 7 dana. Laparoskopske operacije skratile su boravak za jedan dan. Dulji boravak zabilježen je kod pacijenata s višim rizikom za dekubituse i komplikacije. Povećanje faznog kuta od 1,15° skratilo je boravak za jedan dan. Stopa ponovnog prijema unutar 30 dana bila je 11,6%, s višom stopom među muškarcima (75,5%). Najveća stopa ponovnog prijema bila je nakon amputacije rektuma (20,8%) za razliku od desne hemikolektomije (8%). Medijan troškova liječenja bio je 2697 EUR, a ekstremni troškovi (>5685 EUR) zabilježeni su u 4,3% slučajeva, povezani s duljinom boravka, komplikacijama i stopom ponovnog prijema. Najniži troškovi bili su za desnu hemikolektomiju (2107 EUR), dok su laparoskopske operacije resekcije rektosigmoida bile skuplje za 443 EUR
Rasprava i zaključci: Fazni kut bioelektrične impedancije je dokazano značajan prediktivan faktor za ključne ishode liječenja kao i druga BIA mjerenja (poput mase masnog tkiva). Međutim, diferencijacija utjecaja faznog kuta na bolničke ishode učinkovitosti dominantno ovisi o tipu operacija i operativnom pristupu. Potrebna su daljnja istraživanja u uravnoteženim kohortama kako bi se jasno prikazao mogući utjecaj i predikcija na ove ishode.Objective: To investigate the association between reduced phase angle values and the deterioration of hospital outcomes in colorectal cancer (CRC) patients undergoing surgery.
Data sources and methods: This retrospective study was conducted at the Surgical Clinic of KBC Split, including 422 patients who underwent surgery for CRC between March 1, 2021, and February 29, 2024. Data were collected from electronic databases and analyzed statistically. Primary outcomes included length of stay, rehospitalization rates, mortality, and costs, while secondary outcomes involved complications according to the Clavien-Dindo classification.
Results: The median age of patients was 69 years, with 37.4% being women. The most common surgeries performed were right hemicolectomy (157), left hemicolectomy (41), and sigmoid, rectum, and rectosigmoid resections (185). Laparoscopic approach was used in 132 cases (with a 10.6% conversion rate to open surgery). Most patients had T3 tumors (59%), and 40% had disease spread to regional lymph nodes. Cox regression analysis identified four predictors of mortality: age, phase angle of bioelectrical impedance, fat mass, and fall risk according to the Morse scale. An increase in phase angle by 1° reduced the mortality risk by 4.45 times. The risk model had an AUC of 0.837, with 100% sensitivity and 66% specificity. Survival within the first 30 days after surgery was 100% for patients without risk, while it was only 36.6% for high-risk patients (P = 0.006). The median postoperative stay was 7 days. Laparoscopic surgery shortened the stay by one day. Longer stays were observed in patients with higher risk for decubitus ulcers and complications. An increase in phase angle by 1.15° reduced the length of stay by one day. The 30-day rehospitalization rate was 11.6%, with higher rates among men (75.5%). The highest rehospitalization rate was observed after rectal amputation (20.8%) compared to right hemicolectomy (8%). Laparoscopic approach reduced the need for rehospitalization, but the difference was not statistically significant (P = 0.055). Conversion from laparoscopic to open surgery was significantly more frequent in patients readmitted (21.1% vs 4.8%, P = 0.007). The median treatment cost was 2697 EUR, with extreme costs (>5685 EUR) recorded in 4.3% of cases, linked to length of stay, complications, and rehospitalization rates. The lowest costs were for right hemicolectomy (2107 EUR), while laparoscopic resections of the rectosigmoid were 443 EUR more expensive.
Discussion & Conclusions: The phase angle of bioelectrical impedance is a significant predictor of key treatment outcomes, as are other BIA measurements (e.g., fat mass). However, the differential impact of phase angle on hospital outcomes largely depends on the type of surgery and surgical approach. Further research in balanced cohorts is needed to clearly define the potential impact and predictive value on these outcomes
Association of lifestyle habits and knowledge with the prevention of microvascular and macrovascualr complications in patients with diabetes mellitus: Cross-sectional study
No full textUVOD: Šećerna bolest (diabetes mellitus) kronična je bolest koja može dovesti do ozbiljnih mikrovaskularnih i makrovaskularnih komplikacija. Ključnu ulogu u prevenciji ovih komplikacija imaju zdrave životne navike, uključujući pravilnu prehranu, tjelesnu aktivnost i higijenu, kao i adekvatna edukacija pacijenata. Medicinsko osoblje, posebice liječnici i medicinske sestre, ima važnu ulogu u pružanju točnih i pouzdanih informacija pacijentima kako bi ih motivirali na pravilnu brigu o vlastitom zdravlju. Kvalitetna edukacija pacijenata može značajno smanjiti rizik od komplikacija i poboljšati njihovu kvalitetu života.
CILJ: Glavni cilj ove studije je utvrditi povezanost između životnih navika i znanja o šećernoj bolesti s učestalosti pojave mikravosakularnih i makrovaskularnih komplikacija kod oboljelih od šećerne bolesti.
ISPITANICI I METODE: Ova presječna studija provedena je u KBC-u Split kako bi se ispitala povezanost životnih navika i znanja pacijenata sa šećernom bolešću u prevenciji vaskularnih komplikacija. Podaci su prikupljeni anonimnim anketama tijekom hospitalizacije ili pregleda, koristeći upitnike o demografiji, tjelesnoj aktivnosti, prehrani, znanju o bolesti i kvaliteti života. Studiju je odobrilo Etičko povjerenstvo KBC-a Split, a sudjelovanje ispitanika bilo je dobrovoljno i anonimno.
REZULTATI: U istraživanju je sudjelovalo 216 ispitanika, pri čemu su osobe s komplikacijama bile statistički značajno starije (p = 0,004), u mirovini (p = 0,011), živjele na otoku (p = 0,034) i imale drugu kroničnu bolest (p = 0,003). Nisu utvrđene statistički značajne razlike u pridržavanju mediteranske prehrane (p = 0,289). Nije uočena povezanost između komplikacija i pušenja (p = 0,180), konzumacije alkohola (p = 0,414) ili tjelesne aktivnosti (p = 0,213), ali je granična značajnost uočena za vrijeme provedeno sjedeći (5,0 ± 2,7 vs. 4,3 ± 2,7 sati dnevno, p = 0,051). Ispitanici bez komplikacija imali su bolje znanje o prehrani (prosječan broj točnih odgovora 4,3 ± 1,5 vs. 3,9 ± 1,6, p = 0,049), dok su ispitanici s komplikacijama bolje prepoznali oštećenja koja nisu povezana sa šećernom bolesti (94,9% vs. 85,7%, p = 0,041).
ZAKLJUČAK: Rezultati provedene studije ističu značaj kontinuirane edukacije pacijenata sa šećernom bolesti, s naglaskom na prehranu, tjelesnu aktivnost i identifikaciju rizičnih čimbenika za moguće komplikacije. Edukacijama bi se osiguralo dugotrajno održavanje i poboljšanje znanja, što bi pomoglo u smanjenju rizika od komplikacija i unapređenju kvalitete života oboljelih.INTRODUCTION: Diabetes mellitus is a chronic disease that can lead to serious microvascular and macrovascular complications. Healthy lifestyle habits, including proper nutrition, physical activity, and hygiene, as well as adequate patient education, play a key role in preventing these complications. Healthcare professionals, particularly doctors and nurses, have an important role in providing accurate and reliable information to patients to motivate them to take proper care of their health. Quality patient education can significantly reduce the risk of complications and improve their quality of life.
AIM: The main objective of this study is to determine the association between lifestyle habits and knowledge about diabetes with the frequency of microvascular and macrovascular complications in individuals with diabetes.
PARTICIPANTS AND METHODS: This cross-sectional study was conducted at the University Hospital Centre Split to examine the relationship between patients' lifestyle habits and knowledge about diabetes in the prevention of vascular complications. Data were collected through anonymous surveys during hospitalization or medical examinations, using questionnaires on demographics, physical activity, diet, knowledge about the disease, and quality of life. The study was approved by the Ethics Committee of the University Hospital Centre Split, and participants took part voluntarily and anonymously.
RESULTS: The study included 216 participants, with individuals experiencing complications being significantly older (p = 0.004), more often retired (p = 0.011), living on an island (p = 0.034), and having another chronic disease (p = 0.003). No significant differences were found in adherence to the Mediterranean diet (p = 0.289). There was no observed association between complications and smoking (p = 0.180), alcohol consumption (p = 0.414), or physical activity (p = 0.213), but a borderline significance was noted for time spent sitting (5.0 ± 2.7 vs. 4.3 ± 2.7 hours per day, p = 0.051). Participants without complications had better knowledge about nutrition (average number of correct answers 4.3 ± 1.5 vs. 3.9 ± 1.6, p = 0.049), whereas participants with complications were more likely to recognize conditions unrelated to diabetes (94.9% vs. 85.7%, p = 0.041).
CONCLUSION: The study's results highlight the importance of continuing education for patients with diabetes, emphasising nutrition and physical activity, and identifying risk factors for possible complications. Education would ensure long-term maintenance and improvement of knowledge, which would help reduce the risk of complications and improve patient's quality of life
Retrospective analysis of the causes and course of rehabilitation of patients with total hip arthroplasty at the Department of Physical Medicine and Rehabilitation with Rheumatology at the Clinical Hospital Center Split
No full textOvaj završni rad bavi se retrospektivnom analizom uzroka i tijeka rehabilitacije pacijenata s ugrađenom totalnom endoprotezom (TEP) kuka na Zavodu za fizikalnu medicinu i rehabilitaciju s reumatologijom u Kliničkom bolničkom centru Split tijekom 2023. godine. Istraživanje je obuhvatilo 109 pacijenata, od kojih je 54 imalo ugrađenu totalnu endoprotezu kuka. Glavni uzroci za ugradnju TEP-a kuka su degenerativne bolesti, posebno koksartroza, dok su traumatske ozljede rjeđe, ali zahtijevaju složeniji rehabilitacijski postupak. Analiza je pokazala da su žene češće podvrgnute ovoj operaciji, što može biti povezano s različitim životnim navikama i drugim bolestima. Rehabilitacija se pokazala ključnom za uspješan oporavak pacijenata, pri čemu su pacijenti s traumatskim ozljedama imali dulji boravak u bolnici. Prosječne vrijednosti Barthelovog indeksa i opsega pokreta značajno su se poboljšale nakon rehabilitacije, što potvrđuje uspjeh rehabilitacijskih postupaka.This thesis presents a retrospective analysis of the causes and rehabilitation process of patients with total hip arthroplasty (THA) at the Department of Physical Medicine and Rehabilitation with Rheumatology at the Clinical Hospital Center Split during 2023. The study included 109 patients, of whom 54 underwent total hip arthroplasty. The main causes for THA were degenerative diseases, particularly coxarthrosis, while traumatic injuries were less common but required more complex rehabilitation. The analysis showed that women were more frequently subjected to this surgery, which can be related to different lifestyle habits and other diseases. Rehabilitation was found to be crucial for the successful recovery of patients, with those suffering from traumatic injuries having a longer hospital stay. The average values of the Barthel Index and range of motion significantly improved after rehabilitation, confirming the effectiveness of the rehabilitation procedures
Non-attendance of patients for diagnostic examinations at the University Hospital of Split
No full textListe čekanja predstavljaju jedan od glavnih izazova u organizaciji zdravstvene skrbi, s obzirom na njihov utjecaj na pravovremeni pristup medicinskim uslugama. Cilj rada je analizirati ključne uzroke stvaranja dugih lista čekanja u KBC-u Split, posljedice koje one imaju na pacijente, te mogućnosti optimizacije i smanjenja vremena čekanja. Poseban fokus stavljen je na pregled postojećih strategija upravljanja listama čekanja u KBC-u Split, uključujući implementaciju informatičkih rješenja, promjene u raspodjeli resursa i uvođenje novih procedura. Kroz analizu podataka o prosječnom vremenu čekanja na specifične pretrage i zahvate u KBC-u Split, identificiraju se problemi poput ograničenih kapaciteta, nedovoljnog broja medicinskog osoblja te nejednake dostupnosti određenih usluga. U radu se također razmatraju mogućnosti poboljšanja, uključujući učinkovitije planiranje rada, bolju suradnju između primarne i sekundarne zdravstvene skrbi te uvođenje prioritizacije pacijenata prema medicinskoj hitnosti. Cilj je ovih mjera skratiti vrijeme čekanja, poboljšati kvalitetu zdravstvenih usluga te smanjiti pritisak na zdravstveni sustav. Rad naglašava važnost kontinuiranog praćenja i prilagodbe sustava upravljanja listama čekanja kako bi se osigurala dostupnost pravovremene i kvalitetne zdravstvene skrbi za sve pacijente.Waiting lists represent one of the main challenges in the organization of healthcare services, given their impact on timely access to medical services. The aim of this master thesis is to analyze the key causes of long waiting lists at KBC Split, the consequences they have on patients, and the possibilities for optimizing and reducing waiting times. A particular focus is placed on reviewing the existing strategies for managing waiting lists at KBC Split, including the implementation of IT solutions, changes in resource allocation, and the introduction of new procedures. Through the analysis of data on average waiting times for specific tests and procedures at KBC Split, problems such as limited capacity, insufficient medical staff, and unequal availability of certain services are identified. The master thesis also explores improvement opportunities, including more efficient work planning, better coordination between primary and secondary healthcare, and the introduction of patient prioritization based on medical urgency. The goal of these measures is to reduce waiting times, improve the quality of healthcare services, and alleviate pressure on the healthcare system.The master thesis emphasizes the importance of continuous monitoring and adaptation of the waiting list management system to ensure timely and quality healthcare access for all patients
Prevalence of the Mediterranean diet in the general adult population of the Split-Dalmatia County: a cross-sectional study
No full textCilj: Glavni je cilj ovoga istraživanja bio ispitati učestalost mediteranske prehrane u odrasloj populaciji ispitanika Splitsko-dalmatinske županije.
Metode i ispitanici: Presječno istraživanje provodilo se od travnja do srpnja 2024. godine. Korištene su metode online upitnika, papirnatih anketa (metoda snježne grude) te dijeljenja poveznice putem aplikacije Whatsapp.U istraživanju je sudjelovalo 753 ispitanika iz Splitsko-dalmatinske županije. Upitnik je obuhvaćao opće demografske podatke te MDSS (Indeks konzumiranja mediteranske prehrane). Također su analizirani i čimbenici poput dobi, spola, konzumacije doručka te broja glavnih obroka.
Rezultati: Rezultati su pokazali da se manje od 10 % ispitanika Splitsko-dalmatinske županije pridržava obrasca mediteranske prehrane. Statistički značajna povezanost vidljiva je u povezanosti starije dobi (p = 0,002), ženskog spola (p = 0,006) i redovitog doručkovanja (p = 0,029) s pridržavanjem preporuka mediteranske prehrane. Žene su se, u odnosu na muškarce, češće pridržavale preporučene količine konzumacije voća, povrća, mliječnih proizvoda te smanjene konzumacije crvenog mesa. S druge strane, muškarci su se češće pridržavali konzumacije preporučene količine vina. Multivarijantna analiza potvrđuje da su dob, spol i konzumacija doručka najvažniji prediktori u pridržavanju obrasca mediteranske prehrane.
Zaključak: Istraživanje je pokazalo nisku razinu pridržavanja mediteranske prehrane među odraslom populacijom Splitsko-dalmatinske županije. Potrebno je podignuti svijest o važnosti mediteranske prehrane u sprečavanju nastajanja kroničnih bolesti te podizanja kvalitete života ponajviše među muškarcima te mlađim dobnim skupinama.Objective: The main objective of this study was to examine the prevalence of the Mediterranean diet among the adult population of Split-Dalmatia County.
Methods and Participants: This cross-sectional study was conducted from April to July 2024. Data collection methods included online questionnaires, paper-based surveys (snowball sampling method), and link sharing via the WhatsApp application. A total of 753 participants from Split-Dalmatia County took part in the study. The questionnaire included general demographic data and the MDSS (Mediterranean Diet Serving Score). Factors such as age, gender, breakfast consumption, and the number of main meals were also analyzed.
Results: The results showed that less than 10% of participants from Split-Dalmatia County adhered to the Mediterranean dietary pattern. Statistically significant associations were found between older age (p = 0.002), female gender (p = 0.006), and regular breakfast consumption (p = 0.029) with adherence to Mediterranean diet recommendations. Compared to men, women were more likely to follow recommended intakes of fruits, vegetables, dairy products, and reduced consumption of red meat. Conversely, men were more likely to consume the recommended amount of wine. Multivariate analysis confirmed that age, gender, and breakfast consumption are the most important predictors of adherence to the Mediterranean dietary pattern.
Conclusion: The study revealed a low level of adherence to the Mediterranean diet among the adult population of Split-Dalmatia County. It is necessary to raise awareness of the importance of the Mediterranean diet in preventing chronic diseases and improving quality of life, especially among men and younger age groups
Magnetic resonance in the diagnosis of toxic and metabolic encephalopathies
No full textToksične i metaboličke encefalopatije predstavljaju skupinu poremećaja mozga koji utječu na funkciju središnjeg živčanog sustava. Mogu biti uzrokovane različitim toksičnim tvarima, metaboličkim disbalansima ili sustavnim bolestima. Zbog nespecifičnih kliničkih simptoma i često brze progresije bolesti, rana i precizna dijagnoza ključna je za pozitivan ishod liječenja. Magnetska rezonanca (MR) postala je nezamjenjiva dijagnostička metoda u prepoznavanju ovih stanja jer omogućuje detaljan prikaz struktura mozga, prepoznavanje karakterističnih promjena i razlikovanje različitih vrsta encefalopatija. MR ima značajnu ulogu u dijagnostici najčešćih toksičnih i metaboličkih encefalopatija, uključujući encefalopatije izazvane hipoglikemijom, hepatičnom disfunkcijom, trovanjem metanolom, ugljikovim monoksidom i drugim toksičnim tvarima. Prikazani su tipični MR nalazi, analizirana njihova dijagnostička vrijednost te navedena diferencijalna dijagnoza. Unatoč brojnim prednostima, ponekad je teško razlikovati pojedine entitete koristeći se isključivo MR nalazom. Prema tome, u dijagnostici toksičnih i metaboličkih encefalopatija, MR nalaz treba korelirati s kliničkim pregledom, laboratorijskim testovima te ostalim dijagnostičkim metodama. Kako bi se povećala dijagnostička vrijednost, potrebno je unaprijediti MR tehnike i raditi na integraciji s drugim kliničkim modalitetima.Toxic and metabolic encephalopathies represent a group of brain disorders that affect the function of the central nervous system. They can be caused by various toxic substances, metabolic imbalances, or systemic diseases. Due to their nonspecific clinical symptoms and often rapid disease progression, early and accurate diagnosis is crucial for a positive treatment outcome. Magnetic resonance imaging (MRI) has become an indispensable diagnostic tool in identifying these conditions, as it enables detailed visualization of brain structures, detection of characteristic changes, and differentiation between various types of encephalopathies. MRI plays a significant role in diagnosing the most common toxic and metabolic encephalopathies, including those caused by hypoglycemia, hepatic dysfunction, methanol poisoning, carbon monoxide exposure, and other toxic agents. Typical MRI findings are presented, their diagnostic value is analyzed, and differential diagnosis is discussed. Despite numerous advantages, it is sometimes difficult to distinguish certain entities based solely on MRI findings. Therefore, in the diagnosis of toxic and metabolic encephalopathies, MRI findings should be correlated with clinical examination, laboratory tests, and other diagnostic methods. In order to increase diagnostic accuracy, MRI techniques need to be improved and integrated with other clinical modalities
Nurse's activities in children's injuries
No full textOzljede djece predstavljaju veliki javnozdravstveni problem. Većina ozljeda koje nastanu kod djece su slučajna i lako sprječava. Postoje planovi prevencije za ozljede djece ali nisu još dovoljno razrađena te nisu dovoljno poznata široj javnosti. Najveći broj djece strada u prometnim nesrećama. Česte su nesreće djece pri padovima, utapanjima, opeklinama, trovanjima i pokušajima samoozljeđivanja. Padovi, prometne nesreće, opekline, trovanja i utapanja češća su u male djece dok je pokušaj samoozljeđivanja češći kod adolescenata. Kako bi se ozljede što bolje zbrinule postoji jedinstven pristup unesrećenom djetetu. Ovaj pristup se sastoji od primarnog i sekundarnog pregleda. Za pronalazak podataka korištena je baza podataka MEDLINE te internetske stranice Google Schoolar i Hrčak.Injuries to children are a major public health problem. Most injuries that occur in children are accidental and easily prevented. There are prevention plans for injuries to children, but they are not yet sufficiently elaborated and are not sufficiently known to the general public. The largest number of children are killed in traffic accidents. Accidents of children during falls, drownings, burns, poisoning and attempts at self-harm are common. Falls, traffic accidents, burns, poisoning and drowning are more common in young children, while attempts at self-harm are more common in adolescents. In order to take care of injuries as well as possible, there is a unique approach to the injured child. This approach consists of a primary and secondary examination. The MEDLINE database and the Google Scholar and Hrčak websites were used to find data
Application of magnetic resonance imaging in diagnostics of infective diseases
No full textMagnetska rezonancija (MR) predstavlja visoko osjetljivu slikovnu metodu u dijagnostici infektivnih bolesti, osobito zahvalnu zbog mogućnosti detaljnog prikaza mekih tkiva u više ravnina te izostanka štetnog ionizirajućeg zračenja. U infektivnim bolestima središnjeg živčanog sustava, MR omogućuje prepoznavanje upalnih promjena moždanih struktura i kralježnične moždine koristeći specijalne sekvence za prikaz upalnih lezija poput FLAIR-a, STIR-a, difuzije te postkontrastnog T1 i FLAIR prikaza. Kod infekcija koštano-zglobnog sustava, poput osteomijelitisa, septičkog artritisa i spondilodiscitisa, MR otkriva rane promjene u koštanoj srži, zglobovima te okolnom mekom tkivu koje druge metode često ne prikazuju na vrijeme. Za područje abdomena, MR se koristi za detekciju i diferencijaciju jetrenih cisti, upalne bolesti crijeva te intraabdominalnih apscesa. MR srca omogućuje vizualizaciju upale, edema, fibroze ili izljeva za dokazivanje miokarditisa ili akutnog perikarditisa pomoću specijalnih sekvenci i protokola za prikaz srčanog mišića. Zbog svoje visoke dijagnostičke preciznosti, MR ima ključnu ulogu u ranom otkrivanju i praćenju infektivnih procesa te doprinosi individualiziranom i pravodobnom terapijskom pristupu.Magnetic resonance imaging (MRI) is a highly sensitive imaging method used in the diagnostics of infectious diseases, particularly valuable due to its ability to provide detailed visualization of soft tissues in multiple planes without using harmful ionizing radiation. In infectious diseases of the central nervous system, MRI enables identification of inflammatory changes in brain structures and the spinal cord using special sequences for visualizing inflammatory lesions, such as FLAIR, STIR, diffusion imaging, and contrast-enhanced T1-weighted and FLAIR imaging. In infections of the musculoskeletal system, such as osteomyelitis, septic arthritis, and spondylodiscitis, MRI can detect early changes in bone marrow, joints, and surrounding soft tissue that other imaging methods often fail to reveal in a timely manner. In the abdominal region, MRI is used for detecting and differentiating liver cysts, inflammatory bowel disease, and intra-abdominal abscesses. Cardiac MRI is used for the visualization of inflammation, edema, fibrosis, or effusion to confirm myocarditis or acute pericarditis using special sequences and protocols for imaging of the heart muscle. Due to its high diagnostic accuracy, MRI plays a crucial role in the early detection and monitoring of infectious processes and contributes to an individualized and timely correct therapeutic approach