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Therapeutic options for metastatic hormone sensitive prostate cancer
No full textMetastatski hormonski ovisan rak prostate predstavlja značajan javnozdravstveni problem i jedan je od vodećih
uzroka smrti povezanih tumorima kod muškaraca. Iako su posljednjih desetljeća razvijene brojne mogućnosti liječenja
koje omogućuju produženje života i kontrolu simptoma, sama bolest u metastatskoj fazi ostaje neizlječiva. Liječenje
se prvenstveno temelji na androgenskoj deprivacijskoj terapiji (ADT), koja se često kombinira s kemoterapijom, novim
hormonskim lijekovima i ciljanim terapijama. Međutim, uspješnost liječenja ne ovisi isključivo o izboru terapije, već
i o sveobuhvatnoj skrbi koju bolesnik prima.
U tom kontekstu, sestrinska skrb zauzima ključno mjesto u osiguravanju kontinuiteta liječenja, pravodobnog
prepoznavanja nuspojava, pružanja emocionalne i psihosocijalne podrške te edukacije bolesnika i njihovih obitelji.
Medicinska sestra ima odgovornost i zadatak djelovati kao most između bolesnika i ostatka medicinskog tima, olakšati
komunikaciju, poticati samostalnost bolesnika te unaprijediti njegovu kvalitetu života. Specifičnost sestrinske skrbi
ogleda se u potrebi za visokom razinom empatije, stručnosti i sposobnosti individualiziranog pristupa svakom
bolesniku, posebno u završnoj fazi bolesti kada su potreba za podrškom i ublažavanjem simptoma najizraženiji. Cilj
ovog rada je prikazati važnost i specifičnosti sestrinske skrbi kod bolesnika oboljelih od metastatskog hormonski
ovisnog raka prostate, u svjetlu suvremenih mogućnosti liječenja i potreba bolesnika.Metastatic hormone-dependent prostate cancer represents a significant public health problem and is one of
the leading causes of death related to malignant diseases in men. Although numerous therapeutic options have
been developed in recent decades that allow prolongation of life and control of symptoms, the disease itself in
the metastatic phase remains incurable. Treatment is primarily based on androgen deprivation therapy (ADT),
which is often combined with chemotherapy, new hormonal drugs and targeted therapies. However, the success
of treatment does not depend solely on the choice of therapy, but also on the comprehensive care that the patient
receives. In this context, nursing care plays a key role in ensuring continuity of treatment, timely recognition of
side effects, providing emotional and psychosocial support and educating patients and their families. The nurse
has the responsibility and task of acting as a bridge between the patient and the rest of the medical team,
facilitating communication, encouraging patient independence and improving their quality of life. The specificity
of nursing care is reflected in the need for a high level of empathy, expertise and the ability to individualize the
approach to each patient, especially in the palliative stages of the disease when the need for support and symptom
relief is most pronounced. The aim of this paper is to present the importance and specificity of nursing care in
patients with metastatic hormone-dependent prostate cancer, in light of modern therapeutic options and patient
needs
Possibilities of MRI in the visualization of spinal cord lesions in multiple sclerosis: yesterday, today, tomorrow - a systematic review of the literature
No full textMultipla skleroza (MS) je kronični demijelinizacijski upalni poremećaj središnjeg živčanog sustava, koja često zahvaća leđnu moždinu i time značajno doprinosi kliničkoj slici bolesti. Magnetska rezonancija (MRI) ključna je dijagnostička metoda u otkrivanju i praćenju lezija u MS-u, osobito zbog svoje osjetljivosti u prikazu bijele tvari. U ovom radu prikazan je sustavni pregled literature o mogućnostima MRI u detekciji lezija kralježnične moždine u bolesnika s multiplom sklerozom. Poseban naglasak stavljen je na usporedbu povijesnih, sadašnjih i nadolazećih tehnologija, uključujući razvoj ultravisokim poljima MRI sustava (7 T i više), koji omogućuju poboljšanu prostornu rezoluciju i kontrast slike. Analizirani su izazovi u snimanju kralježnične moždine, uključujući tehničke limitacije, artefakte i potrebu za specifičnim sekvencama. Unatoč postojećim ograničenjima, MRI se i dalje razvija kao nezamjenjiva metoda u dijagnostici i praćenju MS-a, a primjena novih tehnologija i sekvenci obećava daljnje unaprjeđenje u razumijevanju patofizioloških procesa bolesti i individualizaciji terapijskog pristupa.Multiple sclerosis (MS) is a chronic demyelinating inflammatory disorder of the central nervous system, which often affects the spinal cord and thereby significantly contributes to the clinical manifestation of the disease. Magnetic resonance imaging (MRI) is a key diagnostic tool for detecting and monitoring lesions in MS due to its high sensitivity in visualizing white matter. This paper presents a systematic review of the literature on the capabilities of MRI in the detection of spinal cord lesions in patients with multiple sclerosis. Special attention is given to the comparison of historical, current, and emerging technologies, including the development of ultra-high-field MRI systems (7 T and above), which offer improved spatial resolution and image contrast. The review also addresses the challenges of spinal cord imaging, including technical limitations, imaging artifacts, and the need for specific MRI sequences. Despite current limitations, MRI continues to evolve as an indispensable method in the diagnosis and monitoring of MS. The application of advanced technologies and imaging protocols promises further improvement in understanding the pathophysiological mechanisms of the disease and in tailoring individualized treatment approaches
Physiotherapy interventions in radial nerve damage
No full textNervus radialis je mješoviti živac koji nastaje iz stražnjeg snopa ručnog spleta. Osjetno inervira kožu stražnje strane nadlaktice i podlaktice, hrbat šake i djelomično kožu prstiju. Glavne motoričke funkcije su ekstenzija
podlaktice, ručnog zgloba i prstiju, ekstenzija i abdukcija palca, supinacija podlaktice, te pregibanje podlaktice u položaju između supinacije i pronacije. Kao posljedica oštećenja živca ovisno o mjestu ozljede mogu nastati kljenuti svih mišića koje inervira ili su pošteđene grane za pojedine mišiće. Najčešće
se manifestira visećom šakom. Oštećenje je najčešće u razini spiralnog žlijeba humerusa, a rjeđe u razini m.supinatora. Liječenje ovisi o uzroku, lokalizaciji i stupnju oštećenja, a može biti konzervativno ili kirurško. Uz prikladnu i preciznu dijagnostiku potreban je stručan plan i program rehabilitacije pacijenta koji mora biti individualno prilagođen. Fizioterapijske intervencije kao dio rehabilitacije uključuju kineziterapiju, termoterapiju, elektroterapiju, biofeedback, magnetoterapiju, hidroterapiju, laser, radnu terapiju, masažu, akupunkturu, primjenu ortoza. Fizioterapijskim intervencijama poboljšava se opseg pokreta zglobova, snaga i fleksibilnost mišića, smanjuje bol, preveniraju se ili korigiraju kontrakture te ubrzava oporavak živca. Učinkovitost fizioterapijskih procedura je dokazana u brojnim istraživanjima, ali su potrebna i daljnja istraživanja koja bi uspoređivala različite fizioterapijske intervencije.Nervus radialis is a mixed nerve that arises from the posterior bundle of the manual plexus. It sensibly innervates the skin of the back of the upper arm and forearm, the back of the hand and partially the skin of the fingers. The main motor functions are extension of the forearm, wrist and fingers, extension and abduction of the thumb, supination of the forearm, and flexion of the forearm in a position between supination and pronation. As a result of nerve damage, depending on the location of the injury, numbness of all the muscles it innervates may occur, or branches for individual muscles may be spared. Most often is manifested by a hanging fist. The damage is most often at the level of the spiral groove of the humerus, and less often at the level of the supinator m. Treatment depends on the cause, localization and degree of damage, and can be conservative or surgical. In addition to appropriate and precise diagnostics, a professional plan and program of rehabilitation of the patient is needed, which must be individually adapted to the patient. Physiotherapy interventions as part of rehabilitation include kinesitherapy, thermotherapy, electrotherapy, biofeedback, magnetotherapy, hydrotherapy, laser, occupational therapy, massage, acupuncture, application of orthoses. Physiotherapy interventions improve joint range of motion, muscle strength and flexibility, reduce pain, prevent or correct contractures, and accelerate nerve recovery. The effectiveness of physiotherapy procedures has been proven in numerous studies, but further research comparing different physiotherapy interventions is needed
A comparison of microwave ablation and cryoablation for the treatment of renal carcinoma
No full textKarcinom bubrega je oblik karcinoma koji se ubraja među najčešće maligne bolesti u svijetu. Prema statističkim podacima šesti je najčešće dijagnosticirani karcinom kod muškaraca i deseti kod žena. 4% svih malignih tumora u svijetu čini karcinom bubrega. Sve veća dostupnost radioloških metoda dovela je do porasta incidencije manjih karcinoma bubrega (KCB), što povećava potrebu za razvojem minimalno invazivnih terapija koje omogućuju očuvanje bubrežne funkcije. Kod pacijenata s izraženim komorbiditetima, osim parcijalne nefrektomije (PN) koja predstavlja zlatni standard liječenja, sve češće se primjenjuju perkutane ablativne metode. Takve metode su mikrovalna ablacija (MVA) i krioablacija bubrega, koje su se pokazale korisnima u ovim slučajevima. Naše je istraživanje pokazalo da nema statistički značajne razlike između mikrovalne i krioablacije u učestalosti komplikacija nakon zahvata, utjecaju na bubrežnu funkciju te stopi lokalnog recidiva. Mikrovalna ablacija bila je značajno vremenski kraća metoda sa kraćim trajanjem hospitalizacije. Krioablacija je bolja metoda za tumore manjeg promjera, naročito one blizu kritičnih struktura, dok je MWA pogodnija za veće tumore i brzu intervenciju. Ova studijaje potvrdila visoku učinkovitost i sigurnost ablacijskih metoda koje bi trebale zauzimati sve važnije mjesto u terapijskom algoritmu liječenja bubrežnih tumora. Odabir metode treba individualno prilagoditi svakom pacijentu.Renal cell carcinoma (RCC) is one of the most common malignant tumors worldwide, ranking sixth in prevalence among men and tenth among women. This type of cancer accounts for approximately 4% of all malignant tumors globally. Advances in and increased availability of radiological methods have led to a higher detection rate of smaller renal tumors (RCC), driving the need for minimally invasive therapies that help preserve kidney function. Although partial nephrectomy (PN) remains the gold standard for treatment, percutaneous ablative methods such as microwave ablation (MWA) and cryoablation are increasingly used in patients with significant comorbidities, as they have proven to be effective in such cases. Our study demonstrated that there is no statistically significant difference between microwave ablation (MWA) and cryoablation (CA) in terms of complication rates, impact on renal function, or local recurrence rates. Microwave ablation proved to be a significantly shorter procedure, associated with reduced hospitalization time. Cryoablation appears to be a more suitable method for smaller tumors, especially those located near critical structures, whereas MWA is more appropriate for larger tumors and when a rapid intervention is required. This study confirmed the high efficacy and safety of ablative techniques, which should play an increasingly important role in the therapeutic algorithm for treating renal tumors. The choice of ablation method should be individually tailored to each patient
Nursing care of the newborn with physiological and pathological hyperbilirubinemia
No full textPovećana koncentracija bilirubina u krvi rezultira pojavom žutice koja može biti fiziološka ili patološka. Razlikovanje i prepoznavanje ovih dvaju oblika ima ključnu ulogu u pružanju ispravne sestrinske skrbi. Fiziološka hiperbilirubinemija prolazno je stanje povećanja koncentracije bilirubina u krvi koje se javlja kod novorođenčeta zbog nezrelosti jetrenih enzima. Patološka hiperbilirubinemija može nastati uslijed hemolitičkih bolesti, infekcija, genetskih poremećaja i različitih sličnih uzroka, te može dovesti do ozbiljnih posljedica. Glavni simptom hiperbilirubinemije je žutica. Sestrinska skrb za novorođenčad s hiperbilirubinemijom zahtijeva sustavan i pažljiv pristup kako bi se osiguralo pravovremeno prepoznavanje i liječenje ovog stanja. Proces sestrinske skrbi za novorođenčad s hiperbilirubinemijom ključan je dio medicinske njege, a uključuje individualni plan skrbi za novorođenče i edukaciju roditelja, te zahtijeva visoku razinu stručnosti, pažnje i usklađenosti s kliničkim smjernicama kako bi se osigurala optimalna zaštita. Sestrinska skrb za novorođenčad s hiperbilirubinemijom igra ključnu ulogu u prevenciji komplikacija i promicanju zdravlja novorođenčadi.Increased bilirubin concentration in the blood leads to jaundice, which can be physiological or pathological. Differentiating and recognizing these two forms plays a key role in providing proper nursing care. Physiological hyperbilirubinemia is a transient condition of increased bilirubin concentration in the blood that occurs in newborns due to the immaturity of liver enzymes. Pathological hyperbilirubinemia can result from hemolytic diseases, infections, genetic disorders, and various systemic causes, potentially leading to severe consequences. The main symptom of hyperbilirubinemia is jaundice. Nursing care for newborns with hyperbilirubinemia requires a systematic and careful approach to ensure timely recognition and treatment of this condition. The nursing care process for a newborn with hyperbilirubinemia is a crucial part of medical care, involving an individualized care plan for the newborn and parent education. It demands a high level of expertise, attention, and adherence to clinical guidelines to ensure optimal protection. Nursing care for newborns with hyperbilirubinemia plays a key role in preventing complications and promoting the health of newborns
The association of self-compassion and psychological resilience with burnout of health professionals working in palliative care.
No full textCilj: Cilj rada je ispitati stupanj samosuosjećanja i psihološke otpornosti zdravstvenih djelatnika, utvrditi stupanj sagorijevanja te ispitati povezanost samosuosjećanja i psihološke otpornosti sa sagorijevanjem zdravstvenih djelatnika u palijativnoj skrbi.
Izvori podataka i metode: Ovo presječno istraživanje uključilo je 108 sudionika iz Hrvatske, koji su ispunili kriterije uključivanja, poput završenog obrazovanja iz sestrinstva i rada s palijativnim pacijentima. U istraživanju 98,15% ispitanika su bile žene, a 39,81% ispitanika imalo je završen preddiplomski studij. Analize su pokazale statistički značajne razlike u zastupljenosti medicinskih djelatnika prema spolu i stupnju obrazovanja, ali ne i prema radnom stažu. Podaci su prikupljeni anonimnim online anketiranjem koristeći metodu snježne grude, a istraživanje je obuhvaćalo sociodemografske podatke, skale otpornosti, intenziteta sagorijevanja i samosuosjećanja.
Rezultati: Medijan otpornosti na stres bio je 3,00, dok je medijan intenziteta sagorijevanja na poslu bio 26 što ukazuje na početne simptome sagorijevanja. Statističke analize su otkrile negativnu povezanost između otpornosti na stres i intenziteta sagorijevanja na poslu (rho=-0,255; P=0,008), te pozitivnu povezanost između otpornosti na stres i samosuosjećanja (rho=0,361; P<0,001). Nadalje, povećanje samosuosjećanja bilo je povezano s smanjenjem intenziteta sagorijevanja na poslu (rho=-0,430; P<0,001). Razina samosuosjećanja pokazala se prediktivnom za stupnjeve sagorijevanja medicinskih sestara na način da više razine samosuosjećanja predviđaju niže stupnjeve sagorijevanja na poslu.
Rasprava: Veća otpornost na stres i samosuosjećanje povezani su s manjim intenzitetom sagorijevanja na poslu. Razvoj otpornosti i samosuosjećanja kroz različite oblike formalnog i neformalnog učenja može pomoći u smanjenju emocionalne iscrpljenosti, depersonalizacije te povećanju osobnog postignuća medicinskjh sestara zaposlenih u palijativnoj skrbi.
Zaključci: Samosuosjećanje i otpornost na stres negativno su povezani s intenzitetom sagorijevanja na poslu dok je samo temeljem razine samosuosjećanja moguće predvidjeti razine sagorijevanja medicinskih sestara zaposlenih u palijativnoj skrbi.Objective: The aim of this study is to examine the level of self-compassion and psychological resilience among healthcare workers, to determine the degree of burnout, and to explore the relationship between self-compassion and psychological resilience with burnout in healthcare workers in palliative care.
Data sources and methods: This cross-sectional study included 108 participants from Croatia who met the inclusion criteria, such as completed nursing education and work with palliative care patients. In the study, 98.15% of the participants were women, and 39.81% had completed an undergraduate degree. The analyses showed statistically significant differences in the representation of healthcare workers by gender and level of education, but not by years of service. Data were collected through anonymous online surveys using the snowball sampling method, and the research included sociodemographic data, scales of resilience, burnout intensity, and self-compassion.
Results: The median resilience to stress was 3.00, while the median level of burnout intensity at work was 26, indicating initial symptoms of burnout. Statistical analyses revealed a negative correlation between stress resilience and burnout intensity at work (rho=-0,255; P=0.008), as well as a positive correlation between stress resilience and self-compassion (rho=0,361; P<0.001). Furthermore, an increase in self-compassion was associated with a decrease in burnout intensity at work (rho=-0,430; P<0.001). The level of self-compassion was shown to be a predictor of burnout levels among nurses, with higher levels of self-compassion predicting lower levels of burnout at work.
Discussion: Greater resilience to stress and self-compassion are associated with lower levels of burnout at work. Developing resilience and self-compassion through various forms of formal and informal learning can help reduce emotional exhaustion, depersonalization, and increase personal accomplishment among nurses working in palliative care.
Conclusions: Self-compassion and stress resilience are negatively associated with burnout intensity at work, while burnout levels among nurses working in palliative care can be predicted based solely on the level of self-compassion
Early postoperative complications during 48 hours and the importance of nursing interventions
No full textPostoperativno razdoblje obuhvaća vrijeme neposredno nakon kirurškog zahvata i traje do potpune stabilizacije
pacijenta, odnosno do povratka osnovnim životnim funkcijama. Rane postoperativne komplikacije definiraju se kao
neželjena stanja koja se javljaju unutar 48 sati nakon kirurškog zahvata. Njihova učestalost ovisi o vrsti operacije,
općem zdravstvenom stanju pacijenta, prisutnosti komorbiditeta te kvaliteti perioperativne skrbi. Upravo se tada
javljaju brojne akutne komplikacije koje mogu ozbiljno ugroziti zdravstveno stanje pacijenta, usporiti oporavak i
povećati rizik od smrtnog ishoda. Najčešće među njima su respiratorne komplikacije, infekcije kirurške rane, krvarenje
i hematomi, akutni bolni sindrom, gastrointestinalni poremećaji te tromboembolijske komplikacije. Pravodobno
prepoznavanje ovih stanja ključno je za uspješno liječenje, a medicinska sestra ima središnju ulogu u tom procesu,
osobito tijekom prvih 48 sati nakon operacije kada je pacijent najranjiviji. Upravo je sestrinska prisutnost ključna za
rano prepoznavanje znakova mogućih komplikacija, provođenje sestrinskih intervencija i osiguranje sigurnosti
pacijenta. U tom osjetljivom razdoblju medicinska sestra obavlja kontinuirano praćenje vitalnih funkcija, promatra
izgled kirurške rane, ocjenjuje razinu svijesti i boli, kao i reakcije na propisanu terapiju.
Uloga medicinske sestre obuhvaća kontinuirano kliničko promatranje, postavljanje sestrinskih dijagnoza, suradnju s
multidisciplinarnim timom te edukaciju pacijenata i članova njihovih obitelji. Istaknuta je važnost stručnosti,
pravovremene reakcije i profesionalne odgovornosti medicinskih sestara koje značajno doprinose sigurnosti pacijenata
i kvaliteti postoperativne skrbi.The postoperative period includes the time immediately after surgery and lasts until the patient is completely
stabilized, that is, until the return to basic life functions. Early postoperative complications are defined as undesirable
conditions that occur within 48 hours after surgery. Their frequency depends on the type of surgery, the patient's
general health, the presence of comorbidities, and the quality of perioperative care. It is then that numerous acute
complications occur that can seriously endanger the patient's health, slow recovery, and increase the risk of death. The
most common of these are respiratory complications, surgical wound infections, bleeding and hematomas, acute pain
syndrome, gastrointestinal disorders, and thromboembolic complications. Timely recognition of these conditions is
essential for successful treatment, and the nurse plays a central role in this process, especially during the first 48 hours
after surgery when the patient is most vulnerable. It is the nursing presence that is crucial for early recognition of signs
of possible complications, implementation of nursing interventions and ensuring patient safety. During this sensitive
period, the nurse performs continuous monitoring of vital functions, observes the appearance of the surgical wound,
assesses the level of consciousness and pain, as well as reactions to prescribed therapy.
The role of the nurse includes continuous clinical observation, establishing nursing diagnoses, cooperation with a
multidisciplinary team and education of patients and their family members. The importance of expertise, timely
reactions and professional responsibility of nurses, which significantly contribute to patient safety and the quality of
postoperative care, was highlighted
Use and differences of ultrasoud probes
No full textRad prikazuje temeljne aspekte medicinske ultrazvučne dijagnostike s posebnim naglaskom na
ultrazvučne sonde kao ključni dio sustava za slikovno prikazivanje. Ultrazvuk je neinvazivna, široko dostupna i
sigurnosno prihvatljiva metoda u različitim medicinskim disciplinama. U radu se analizira osnovna građa, način
rada i klasifikacija ultrazvučnih sondi čije tehničke karakteristike uvelike određuju kvalitetu dijagnostičkog
prikaza i kliničku primjenu. Ultrazvučne sonde su osnovni dio UZ uređaja i ključne su za kvalitetan dijagnostički
prikaz. Dijele se na konvencionalne (linearne, konveksne i sektorske) i specijalizirane. Linearne sonde prikazuju
površinske strukture visoke rezolucije, konveksne dublje organe, a sektorske se koriste za snimanje kroz uske
prostore, poput rebara. Specijalizirane sonde, poput transvaginalnih, transezofagealnih i endorektalnih,
omogućuju unutarnji pristup i detaljan prikaz ciljane anatomije. Intravaskularne sonde nude iznimnu preciznost
pri prikazu krvnih žila. Svaka sonda ima specifične tehničke karakteristike koje određuju njezinu primjenu.The paper analyzes the basic structure, mode of operation and classification of ultrasound probes
whose technical characteristics largely determine the quality of the diagnostic presentation and clinical
application. Ultrasound is a non-invasive, widely available and safety-acceptable method in various medical
disciplines. Ultrasound probes are a basic part of the US device and are crucial for a high-quality diagnostic
presentation. They are divided into conventional (linear, convex and sectoral) and specialized. Linear probes
display high-resolution surface structures, convex deeper organs, and sector probes are used to image through
narrow spaces, such as ribs. Specialized probes, such as transvaginal, transesophageal, and endorectal probes,
allow internal access and detailed visualization of the target anatomy. Intravascular probes offer exceptional
precision when imaging blood vessels. Each probe has specific technical characteristics that determine its
application
Specific injuries in futsal, their prevention and rehabilitation
No full textFutsal je jedan od najbrže rastućih sportova današnjice. Njegova dinamičnost čini ga jako zanimljivim gledateljima kao i samim igračima. Cilj ovog završnog rada bio je prikazati futsal kao sport, uključujući njegov razvoj, pravila i najčešće ozljede sa njihovom rehabilitacijom i prevencijom. U futsalu je zabilježen određen broj ozljeda, kao i u svakom kontaktom sportu. Na temelju velikog broja istraživanja zaključuje se da su najčešće ozljeđeni lokaliteti gležanj, koljeno i mišići stražnje lože. Od ozljeda izdvojeni su lateralna distorzija gležnja, ruptura prednjeg križnog ligamenta i ozljeda mišića stražnje lože. Za svaku od navedenih ozljeda opisan je mehanizam nastanka uz anatomsku strukturu i značajke lokaliteta. Rehabilitacijska načela su slična kod svih ozljeda, ukoliko se radi o konzervativnoj rehabilitaciji. Lateralna distorzija gležnja jedna je od najbrojnijih ozljeda i nastaje prilikom nagle promjene smjera ili trčanja po neravnoj podlozi. U početku se primjenjuje RICE terapija, a nakon nje kreće progresivno opterećivanje mjesta zahvaćenog ozljedom. Prije povratka na teren sportaš mora biti izložen najsloženijim motoričkim zadatcima kao i samim situacijama specifičnim za sport. Koriste se razni rekviziti poput BOSU lopte za razvoj propriocepcije i tolerancije gležnja na nestabilnu podlogu. Ozljeda prednjeg križnog ligamenta se događa pri nagloj rotaciji trupa ili koljena dok je potkoljenica fiksirana. Liječenje može biti operativno ili konzervativno te zahtjeva dugu i napornu rehabilitaciju. U ranoj fazi cilj je raditi na mobilizaciji i smanjenju otekline i bolnosti. Kasnije se prelazi na izometričke vježbe i one zatvorenog kinetičkog lanca za jačanje mišića nogu i trupa.. Završna faza je rad na eksplozivnosti, agilnosti, balansu, vježbama specifičnima za sport... Ne smije se žuriti sa povratkom na teren dok osoba nema dobar subjektivni dojam i povjerenje u ozljeđeno mjesto. Ozljeda hamstringsa je posljednje izdvojena. Najzastupljeniji je sprinterski tip ozljede kad dolazi do istegnuća m. Biceps femorisa. Nakon kratke imobilizacije prelazi se na izometričke i koncentrične kontrakcije. Obavezno moraju biti zastupljene i ekscentrične vježbe. Zadnje u planu rehabilitacije je sprinterski trening pri velikim brzinama i naglim deceleracijama. Iznimno je bitno svaku osobu gledati kao zasebnog pojedinca i rad prilagoditi njemu, odnosno primijeniti holistički pristup. Određen broj ozljeda može se spriječiti preventivnim djelovanjem. Tu je odgovornost na medicinskom i trenerskom štabu, a najviše na samom igraču. Treninzi jakosti, snage, propriocepcije i fleksibilnosti moraju biti zastupljeni. On dobrim navikama poput odgovarajućeg zagrijavanja, individualnog rada u teretani na svojim boljkama, adekvatnim životnim stilom (ponajviše dobra prehrana i san) može uvelike utjecati na svoj zdravstveni karton u budućnosti. Tek kad je rad svih osoba u klubu usklađen i koordiniran, mogu se očekivati najbolji rezultati.Futsal is one of the fastest growing sports today. Its dynamism makes it very interesting for the spectators as well as for the players themselves. The aim of this final paper was to present futsal as a sport, including its development, rules and the most common injuries with their rehabilitation and prevention. A certain number of injuries have been recorded in futsal, as in any sport. Based on a large number of studies, it is concluded that the most frequently injured sites are the ankle, knee and muscles of the back. Among the injuries, the lateral distortion of the ankle, the rupture of the anterior cruciate ligament and the injury of the muscles of the posterior lodge were singled out. For each of the mentioned injuries, the mechanism of occurrence is described along with the anatomical structure and features of the locality. Rehabilitation principles are similar for all injuries, as long as it is conservative rehabilitation. Lateral distortion of the ankle is one of the most numerous injuries and occurs during a sudden change of direction or running on an uneven surface. Initially, RICE therapy is applied, and after that, progressive loading of the injured area begins. Before returning to the field, the athlete must be exposed to the most complex motor tasks as well as the situations specific to the sport. Various props such as the BOSU ball are used to develop proprioception and ankle tolerance on unstable ground. An anterior cruciate ligament injury occurs when the trunk or knee is suddenly rotated while the lower leg is fixed. Treatment can be operative or conservative and requires long and hard rehabilitation. In the early stages, the goal is to work on mobilization and reduce swelling and pain. Later, we move on to isometric exercises and those of a closed kinetic chain to strengthen the muscles of the legs and trunk. The final phase is work on explosiveness, agility, balance, sports-specific exercises... There should be no rush to return to the field until the person has a good subjective impression and confidence in the injured place. The hamstring injury was the last to be singled out. The most common type of sprinter's injury is when the biceps femoris muscle is stretched. After a short immobilization, it is switched to isometric and concentric contractions. Eccentric exercises must also be represented. The last step in the rehabilitation plan is sprint training at high speeds and sudden decelerations. It is extremely important to see each person as a separate individual and to adapt the work to him, that is, to apply a holistic approach. A certain number of injuries can be prevented by preventive action. The responsibility lies with the medical and coaching staff, and above all with the player himself. Strength, power, proprioception and flexibility training must be represented. He can greatly influence his health record in the future with good habits such as proper warm-up, individual work in the gym on his ailments, adequate lifestyle (mainly good nutrition and sleep). Only when the work of all people in the club is harmonized and coordinated, the best results can be expected
Psychological preparation of the mother for the postpartum period
No full textPostpartalno razdoblje ili babinje vrijeme je cijeljenja žene i njene prilagodbe na novu životnu ulogu. Funkcioniranje organa i organskih sustava koji su do sad bili prilagođeni trudnoći i porodu vraća se u svoje prvobitno stanje. Rodiljino mentalno stanje pod utjecajem je velikih promjena u hormonskom sustavu stoga je razdoblje nakon poroda osjetljivo za nju, a ponekad i opasno. Porodom posteljice razine progesterona, koje su bile 10-15 puta iznad onih za vrijeme lutealne faze, i razine estrogena, koje i do 30 puta nadmašuju referentne vrijednosti prije gravidnosti, naglo opadaju. Te velike hormonalne amplitude udružene sa strukturalnim i funkcionalnim promjenama na mozgu, čine rodilju ranjivom. Iznimno je bitno pružiti podršku babinjači kroz taj period u cilju eliminiranja ili ublažavanja mogućih poremećaja. Gotovo 80% žena u puerperiju prolazi kroz „baby blues“, neki manji broj doživi težu emocionalnu nestabilnost (postporođajna depresija – PPD), dok su ekstremna patološka stanja iznimno rijetka (postporođajna psihoza). Fizička i mentalna priprema rodilje, njeno uključivanje u sustave edukacije i potpore te edukacija partnera i obitelji o važnosti njihove uloge pomaže majci u prilagodbi na novu ulogu. Razna istraživanja ukazala su da je većina rodilja nezadovoljna potporom koju prima u postpartumu. Isto tako, zabrinjavajuća činjenica je da velika većina rodilja ne traži pomoć jer se boji nerazumijevanja, ne želi pokazati svoju ranjivost i/ili smatra psihičke poremećaje „taboo“ temom. WHO opisuje postpartalno razdoblje kao najkritičniju, ali kao i najzapostavljeniju fazu tijekom života majke i novorođenčeta. Jačanjem svih karika zdravog sustava podrške i rušenjem slike “idealne majke” koju nameće društvo pomoći ćemo rodilji da se što prije vrati u svoju društvenu ulogu stabilnog mentalnog i fizičkog zdravlja.The postpartum period or midwifery is a time of healing for a woman and her adaptation to a new role in life. The functioning of the organs and organ systems that were, until now, adapted to pregnancy and childbirth returns to its original state. The mother's mental state is influenced by major changes in the hormonal system, so the period after childbirth is sensitive for her, and sometimes dangerous. With the delivery of the placenta, progesterone levels, which were 10-15 times higher than those during the luteal phase, and estrogen levels, which are up to 30 times higher than the reference values before pregnancy, drop sharply. These large hormonal amplitudes associated with structural and functional changes in the brain make the mother vulnerable. It is extremely important to provide support to the partuirent woman during this period in order to eliminate or alleviate possible disorders. Almost 80% of women in the puerperium go through the "baby blues", a smaller number experience severe emotional instability (postpartum depression - PPD), while extreme pathological conditions are extremely rare (postpartum psychosis). Physical and mental preparation of the partuirent woman, her inclusion in education and support systems, and education of partners and families about the importance of their role helps the mother in adapting to her new role. Various studies have shown that the majority of partuirent woman are dissatisfied with the support they receive in the postpartum period. Likewise, it is a worrying fact that the vast majority of women in labor do not seek help because they are afraid of misunderstanding, do not want to show their vulnerability and/or consider mental disorders a "taboo" topic. WHO describes the postpartum period as the most critical, but also the most neglected phase in the life of the mother and newborn. By strengthening all links of a healthy support system and demolishing the image of the "ideal mother" imposed by society, we will help the mother to return to her social role of stable mental and physical health as soon as possible