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The effect of short.term physical therapy on hand function and pain after the bone fracture of the distal radius
No full textTema ovog diplomskog rada je fizioterapeutska procjena statusa šake i ručnog zgloba nakon prijeloma distalnog dijela radiusa: prije i nakon dvotjedne rehabilitacije.
U svrhu istraživanja, prikupljeni su klinički i terapijski podaci ispitanika iz medicinske dokumentacije. Ključni ulazni podaci uključivali su: godina rođenja, spol, vrsta prijeloma, metoda liječenja (konzervativno ili operativno) te prisutnost komplikacija.
Mjerenja su obavljena prije i nakon dvotjedne fizikalne terapije koristeći goniometar za mjerenje opsega pokreta, dinamometar za mjerenje stiska šake te upitnik QUICKDASH za procjenu funkcionalnosti šake.
U istraživanju sudjelovalo je 30 ispitanika, od čega je 67% žena (N=20) i 33% muškaraca (N=10). Svi ispitanici, njih 30, pripadali su dobnoj skupini između 60 i 78 godina, s prosječnom dobi od 71,75 godina, minimalnom dobnom vrijednošću od 60 godina i maksimalnom od 78 godina.
Od 30 ispitanika, njih 17 je imalo prijelome s pomakom koji su zahtijevali operativno liječenje, dok je 13 ispitanika prošlo kroz konzervativnu terapiju bez pomaka u prijelomima.
Snaga šake povećala se s 20,7±4,5 prije terapije na 28,8±3,59 nakon terapije.
Funkcionalnost ručnog zgloba i šake mjerena QUICKDASH upitnikom povećana je s 39.8±10.74 na 19.9±6.51 (niži postotak označava bolju funkcionalnost).
Razina boli mjerena VAS skalom smanjena je s 5.6±1.38 prije terpaije na 3±1 nakon dvotjedne terapije.
Opseg pokreta fleksije u ručnom zglobu povećan je s 40.9±7.93 na 50.4±8.87 nakon dvotjedne terapije.
Opseg pokreta ekstenzije u ručnom zglobu povećan je s 35.6±10.69 na 45.13±9.46 nakon dvotjedne terapije.
Zaključak je da dvotjedna fizikalna terapija poboljšava kretnje u ručnom zglobu nakon prijeloma distalnog dijela radiusa , smanjuje bolnost te povećava funkcionalnost osobe. Poboljšanje nakon terapije ima iznimnu važnost jer ukazuje na uspješnost tretmana i rehabilitacije te poboljšava kvalitetu života pacijenata.The topic of this master's thesis is the physiotherapeutic assessment of hand and wrist status after a distal radius fracture: before and after a two-week rehabilitation period.
For the purpose of the research, clinical and therapeutic data of the participants were collected from medical records. Key input data included: date of birth, gender, type of fracture, treatment method (conservative or surgical), and the presence of complications. Measurements were taken before and after a two-week physiotherapy session using a goniometer for measuring range of motion, a dynamometer for measuring grip strength, and the QUICKDASH questionnaire to assess hand functionality.
The study included 30 participants, of which 67% were women (N=20) and 33% were men (N=10). All participants, 30 in total, belonged to the age group between 60 and 78 years, with an average age of 71.75 years, a minimum age of 60 years, and a maximum age of 78 years.
Out of the 30 participants, 17 had fractures with displacement requiring surgical treatment, while 13 participants underwent conservative therapy without fracture displacement.
Hand grip strength increased from 20.7±4.5 before therapy to 28.8±3.59 after therapy. Hand and wrist functionality measured by the QUICKDASH questionnaire improved from 39.8±10.74 to 19.9±6.51 (a lower percentage indicates better functionality).
Pain level measured using the VAS scale decreased from 5.6±1.38 before therapy to 3±1 after the two-week therapy.
The range of motion for wrist flexion increased from 40.9±7.93 to 50.4±8.87 after the two-week therapy. The range of motion for wrist extension increased from 35.6±10.69 to 45.13±9.46 after the two-week therapy.
In conclusion, a two-week physiotherapy session improves hand and wrist mobility after a distal radius fracture, reduces pain, and enhances the individual's functionality. Improvement after therapy is of utmost importance as it indicates the success of treatment and rehabilitation, ultimately improving the quality of life for patients
Differences in the analysis of reconstructions in MR angiography and MSCT brain angiography
No full textUvod: MR angiografija i MSCT angiografija predstavljaju dvije ključne metode za neinvazivnu vizualizaciju vaskulature mozga, svaka sa svojim prednostima i ograničenjima. Ove pretrage su od fundamentalnog značaja za pravovremenu dijagnozu i liječenje aneurizmi, tumora, arterio-venskih malformacija, moždanih udara i drugih patoloških stanja mozga.
Cilj rada: Ovaj rad ima za cilj usporediti njihove tehničke aspekte, dijagnostičku točnost i kliničku primjenjivost kako bi se identificirale optimalne indikacije za korištenje svake metode.
Rasprava: Uz podlogu brojnih znanstvenih studija ističe se kako MRA i MSCTA pretrage omogućuju detaljan prikaz krvnih žila i drugih anatomskih struktura mozga, koristeći različite tehnike rekonstrukcije poput multiplanarne rekonstrukcije (MPR), maksimalne projekcije intenziteta (MIP) i volumenske obrade. Posebno se naglašava važnost ovih metoda u dijagnostici i planiranju liječenja intrakranijalnih aneurizmi te karcinoma glave i vrata.
Zaključak: MRA se ističe sigurnošću (ne koristi ionizirajuće zračenje) i visokom kontrastnom rezolucijom, ali traje duže i osjetljivija je na pokret. MSCTA je brža metoda s visokom prostornom rezolucijom, korisna u hitnim situacijama, ali nosi rizik od zračenja i potrebu za kontrastnim sredstvima. Izbor između njih treba se temeljiti na kliničkim potrebama i stanju pacijenta. Oba područja nastavljaju se razvijati kako bi se poboljšale dijagnostičke mogućnosti i smanjili rizici za pacijente.Introduction: MR angiography and MSCT angiography represent two key methods for noninvasive visualization of the brain vasculature, each with its own advantages and limitations. These tests are of fundamental importance for the timely diagnosis and treatment of aneurysms, tumors, arterio-venous malformations, strokes and other pathological conditions of the brain.
Aim: This paper aims to compare their technical aspects, diagnostic accuracy and clinical applicability in order to identify the optimal indications for the use of each method.
Discussion: With the basis of numerous scientific studies, it is emphasized that MRA and MSCTA examinations enable a detailed representation of blood vessels and other anatomical structures of the brain, using different reconstruction techniques such as multiplanar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering. The importance of these methods in the diagnosis and treatment planning of intracranial aneurysms and head and neck cancers is particularly emphasized.
Conclusion: MRA stands out for its safety (because it does not use ionizing radiation) and high contrast resolution, but it is time-consuming and more sensitive to movement. MSCTA is a faster method with high spatial resolution, useful in emergency situations, but carries the risk of radiation and the need for contrast agents. The choice between them should be based on clinical needs and the patient's condition. Both fields continue to evolve to improve diagnostic capabilities and reduce patient risks.
Keywords: brain angiography, MR, MSCT, reconstruction
Assessment of knee cartilage lesions using "dGEMRIC" technique of magnetic resonance imaging
No full textKoljeni zglob je najveći i najsloženiji zglob u ljudskom tijelu i kao takav podložan je ozljeđivanju. Jedan od glavnih sastavnih dijelova koljena je i zglobna hrskavica čija je zadaća očuvanje zgloba, omogućava lakše pokrete koljenog zgloba te sudjeluje u prijenosu sile kroz zglob koljena. Kada se dogode ozljede ili se pojave određene bolesti hrskavica postaje osjetljiv aparat koji je podložan ozljeđivanju i kao takva postaje zona interesa u radiološkoj dijagnostici zbog svojih karakteristika i zadaća. Kako bi se utvrdile ozljede koljena i oštećenja zglobne hrskavice pacijent mora biti podvrgnut radiološkoj dijagnostici.
Radiologija je najmlađa, najrazvijenija i najbrže rastuća grana medicine. U otkrivanju bilo kakve promjene ili bolesti u anatomski složenom ljudskom tijelu koja je nastala prilikom rođenja, uzrokovana određenim tipom ozljede u svakodnevnom životu ili je vezana uz sportske aktivnosti važnost imaju dijagnostičke radiološke metode. Među tim metodama nalazi se i magnetska rezonancija koja se često naziva i „kraljicom dijagnostike“. Magnetska rezonancija je neinvazivna radiološka metoda koja ne koristi štetno ionizirajuće zračenje i najbolja je za prikaz mekotkivnih struktura koljena, pa tako i hrskavice. Korištenjem dodatnih
sekvenci i tehnika snimanja magnetskom rezonancijom mogu se dobiti detaljne informacije o unutrašnjoj strukturi hrskavice i metoda je izbora u usporedbi između zdrave i oštećene hrskavice, kao i između zdrave i reparirane hrskavice nakon određenog zahvata na oštećenom dijelu hrskavice. Tehnika oslikavanja magnetskom rezonancijom pod nazivom „dGEMRIC“ (odgođeno kontrastom osnaženo magnetsko snimanje hrskavice) najbolja je tehnika oslikavanja kojom se može utvrditi stupanj oštećenja hrskavice i dobiti informacija o stanju glikozaminoglikana, bjelančevine koja ključna za obranu i obnavljanje hrskavice.One of the main component parts of the knee is the articular cartilage, whose task is to preserve the joint, enable easier movements of the knee joint and participate in the transmission of force through the knee joint. When injuries occur or certain diseases appear, cartilage becomes a sensitive apparatus that is subject to injury and as such becomes an area of interest in radiological diagnostics due to its characteristics and tasks. In order to determine knee injuries and articular cartilage damage, the patient must undergo a radiological diagnosis.
Radiology is the youngest, most developed and fastest growing branch of medicine. In the detection of any change or disease in the anatomically complex human body that occurred at birth, caused by a certain type of injury in everyday life or is related to sports activities, diagnostic radiological methods are important. Among these methods is magnetic resonance, which is often called the "queen of diagnostics". Magnetic resonance is a non-invasive radiological method that does not use harmful ionizing radiation and is best for displaying the soft tissue structures of the knee, including cartilage. By using
additional sequences and magnetic resonance imaging techniques, detailed information on the internal structure of the cartilage can be obtained and is the method of choice in comparison between healthy and damaged cartilage, as well as between healthy and repaired cartilage after a specific intervention on the damage cartilage. The magnetic resonance imaging technique called "dGEMRIC" (delayed gadolinium enhanced MRI of cartilage) is the best imaging technique that can determine the degree of cartilage damage and obtain information about the state of glycosaminoglycans, a protein that is key to the defense and restoration of cartilage
Molecular diagnosis of sexually transmitted infections in women
No full textCilj ovog rada je prikazati važnost molekularne dijagnostike bakterija i virusa kod spolno prenosivih infekcija radi odabira odgovarajuće terapije u njihovom liječenju. Materijali korišteni za analizu uključuju vaginalne briseve uzete od pacijentica sumnjivih na spolno prenosive infekcije. Opisan je postupak uzorkovanja, izolacije nukleinske kiseline te umnažanja i otkirvanja patogena uz pomoć komercijalno dostupnih kitova. Rezultati istraživanja pokazali su da je real-time PCR (RT-PCR) metoda visoko osjetljiva i specifična za detekciju najčešćih uzročnika spolno prenosivih infekcija kod žena. Sve analizirane uzorke uspješno su identificirani uzročnici kao što su HPV, Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum i Trichomonas vaginalis. Molekularne metode, posebno RT-PCR, predstavljaju zlatni standard u dijagnostici spolno prenosivih infekcija zbog svoje visoke osjetljivosti, specifičnosti i brzine. Njihova primjena omogućuje rano otkrivanje i ciljano liječenje infekcija, što značajno poboljšava ishode liječenja i smanjuje rizik od komplikacija.The aim of this paper is to demonstrate the importance of molecular diagnostics of bacteria and viruses in sexually transmitted infections (STIs) for the selection of appropriate therapy in their treatment. The materials used for the analysis include vaginal swabs taken from patients suspected of having STIs. The procedures for sampling, nucleic acid isolation, and pathogen detection through commercially available kits are described. The research results showed that the real-time PCR (RT-PCR) method is highly sensitive and specific for detecting the most common causes of STIs in women. Pathogens such as HPV, Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, and Trichomonas vaginalis were successfully identified in all analyzed samples. Molecular methods, particularly RT-PCR, represent the gold standard in the diagnosis of sexually transmitted infections due to their high sensitivity, specificity, and speed. Their application enables early detection and targeted treatment of infections, which significantly improves treatment outcomes and reduces the risk of complications
Palliative care in terminal heart failure
No full textTerminalno srčano zatajenje označava konačnu fazu kroničnog srčanog zatajenja, stanje u kojem srce nije više sposobno učinkovito pumpati dovoljno krvi kako bi zadovoljilo potrebe tijela. Ova patofiziološka situacija nastaje zbog gubitka sposobnosti srca da održava adekvatan minutni volumen krvi, što rezultira smanjenom perfuzijom vitalnih organa te povećanim zagušenjem u plućima i perifernim tkivima.
Liječenje terminalnog srčanog zatajenja usmjereno je na ublažavanje simptoma i poboljšanje kvalitete života pacijenta. Farmakološke strategije obuhvaćaju upotrebu diuretika radi smanjenja viška tekućine, ACE inhibitora ili blokatora angiotenzinskih receptora (ARB) za smanjenje opterećenja srca te beta-blokatora radi poboljšanja funkcije srca. Nefarmakološke mjere podrazumijevaju prilagođavanje načina života pacijenta, uključujući dijetu s kontroliranim unosom soli i tekućine te redovito praćenje tjelesne težine.
U palijativnoj skrbi za pacijente s terminalnim srčanim zatajenjem, naglasak se stavlja na osiguravanje udobnosti, emocionalne podrške i komunikacije s obitelji. Otvorena komunikacija o prognozi, ciljevima skrbi i željama pacijenata ključna je za pružanje individualizirane njege. Planiranje skrbi temelji se na detaljnoj procjeni stanja pacijenta i uključuje postavljanje specifičnih ciljeva, odabir optimalnih intervencija te redovitu evaluaciju ishoda kako bi se prilagodila terapija prema potrebama pacijenta u terminalnoj fazi bolesti. Važan aspekt palijativne skrbi je pružanje podrške obiteljima pacijenata, uključujući savjetovanje i edukaciju o njihovim ulogama i mogućnostima sudjelovanja u skrbi. Ova multidisciplinarna pristup uključuje stručnjake različitih područja kao što su medicinske sestre, fizioterapeuti, socijalni radnici i duhovni savjetnici kako bi se osiguralo sveobuhvatno i holističko skrbničko okruženje.
U zaključku, palijativna skrb za pacijente s terminalnim srčanim zatajenjem nije samo usmjerena na medicinske aspekte bolesti, već i na njihovu kvalitetu života i dobrobit njihovih obitelji. Ova vrsta skrbi ističe važnost dostojanstva, komfora i individualiziranog pristupa kako bi se osiguralo što bolje iskustvo pacijenta u terminalnoj fazi srčanog zatajenja.Terminal heart failure denotes the final stage of chronic heart failure, where the heart is no longer able to efficiently pump enough blood to meet the body's needs. This pathophysiological condition arises due to the heart's loss of ability to maintain adequate cardiac output, resulting in reduced perfusion of vital organs and increased congestion in the lungs and peripheral tissues.The treatment of terminal heart failure aims at symptom alleviation and improvement of the patient's quality of life. Pharmacological strategies include the use of diuretics to reduce fluid overload, ACE inhibitors or angiotensin receptor blockers (ARBs) to decrease cardiac workload, and beta-blockers to enhance cardiac function. Non-pharmacological measures involve adjusting the patient's lifestyle, including a diet with controlled salt and fluid intake, and regular monitoring of body weight.
In palliative care for patients with terminal heart failure, the focus is on ensuring comfort, providing emotional support, and communicating effectively with families. Open communication about prognosis, care goals, and patient preferences is crucial for delivering personalized care. Care planning is based on a detailed assessment of the patient's condition, setting specific care goals, selecting optimal interventions, and regularly evaluating outcomes to tailor therapy to the patient's needs in the terminal phase of the illness.
An important aspect of palliative care is supporting patients' families, including counseling and education on their roles and involvement in care. This multidisciplinary approach involves professionals from various fields such as nurses, physiotherapists, social workers, and spiritual counselors to ensure comprehensive and holistic caregiving.
In conclusion, palliative care for patients with terminal heart failure is not only focused on the medical aspects of the disease but also on their quality of life and the well-being of their families. This type of care emphasizes the importance of dignity, comfort, and an individualized approach to provide the best possible experience for patients in the terminal phase of heart failure
Health literacy and awareness of the fetility of women of reproductive age
No full textUVOD: Plodnost je sposobnost muškarca i žene da ostvare kliničku trudnoću. Zdravstvena pismenost obuhvaća kognitivne, socijalne i osobne vještine koje definiraju sposobnost pojedinca da pristupi, razumije i koristi medicinske informacije za unapređenje i očuvanje zdravlja.
CILJ: Cilj istraživanja bio je utvrditi zdravstvenu pismenost i stavove prema fertilitetu s obzirom na dob, razinu obrazovanja i stupanj obrazovanja. Ispitivanjem je obuhvaćeno 52 žene, većinom u dobi između 25 i 34 godine, s različitim razinama obrazovanja.
METODE:Ovim istraživanjem smo testirali navedene hipoteze. Numeričke vrijednosti se prezentiraju upotrebom metoda deskriptivne statistike, i to aritmetičke sredine i standardne devijacije kod normalno distribuiranih podataka, dok se u slučaju odstupanja od normalne distribucije koristi medijan, te interkvartilni raspon kao pokazatelj odstupanja od medijana. Ukupan raspon vrijednosti se prezentira upotrebom minimuma i maksimuma. Normalnost razdiobe je prethodno ispitana upotrebom Kolmogorov-Smirnov testa.Razlika u zastupljenosti ispitanika prema promatranim obilježjima se ispituje upotrebom χ2 testa, dok se hipoteze ispituju upotrebom ANOVA testa, te Kruskal-Wallis testa kod varijabli čija distribucija statistički značajno odstupa od normalne.
REZULTATI: Različite dobne skupine pokazale su varijacije u razini znanja. Najveći broj ispitanica (48,08%) imao je između 25 i 34 godine, a statistički značajna razlika u znanju o fertilitetu nije pronađena među dobima, što sugerira da dob nije ključni faktor u razumijevanju fertiliteta.Stupanj obrazovanja također je pokazao utjecaj na razinu znanja. Ispitanice sa završenom srednjom školom dominirale su (40,38%), dok je najmanje ispitanica imalo završen magisterij/doktorat (11,54%). Analiza zdravstvene pismenosti pokazala je da nema značajnih razlika u znanju o fertilitetu među različitim dobnim skupinama i razinama obrazovanja. Također, nije utvrđena povezanost između zdravstvene pismenosti i stavova prema fertilitetu.Analiza NSV-HR upitnika zdravstvene pismenosti pokazala je da većina ispitanica ima visok nivo zdravstvene pismenosti, bez značajnih razlika među dobnim skupinama i razinama obrazovanja. Ovo je u skladu s nalazima koji sugeriraju da zdravstvena pismenost nije povezana s dobi ili obrazovanjem.
ZAKLJUČAK: Iako opće znanje o nekim aspektima fertiliteta postoji, značajno nedostaje razumijevanje specifičnih medicinskih informacija. Postojeći edukacijski programi o fertilitetu možda nisu dovoljno učinkoviti, pa je potrebno razviti programe koji obuhvaćaju sve aspekte fertiliteta i dostupni su svim skupinama. Programi bi trebali uključivati informacije o rizicima zdravstvenih stanja i ponašanja te općim čimbenicima koji utječu na plodnost. Različite skupine mogu imati različite potrebe za informacijama, stoga programi trebaju biti prilagođeni kako bi osigurali maksimalnu učinkovitost. Istraživanje je pokazalo visoku razinu zdravstvene pismenosti, ali to nije dovoljno; informacije moraju biti relevantne, razumljive i primjenjive.INTRODUCTION: Fertility is the ability of a man and a woman to achieve a clinical pregnancy. Health literacy encompasses cognitive, social, and personal skills that define an individual's ability to access, understand, and use medical information to promote and preserve health.
AIM: The aim of the study was to determine health literacy and attitudes towards fertility with regard to age, level of education and level of education. The study included 52 women, mostly between the ages of 25 and 34, with different levels of education.
METHODS:With this research, we tested these hypotheses. Numerical values are presented using the methods of descriptive statistics, namely arithmetic mean and standard deviation in normally distributed data, while in the case of deviations from the normal distribution, the median and interquartile range are used as an indicator of deviation from the median. The total range of values is represented using the minimum and maximum. The normality of the distribution was previously examined using the Kolmogorov-Smirnov test.The difference in the representation of subjects according to the observed characteristics is examined using the χ2 test, while hypotheses are examined using the ANOVA test, and the Kruskal-Wallis test for variables whose distribution is statistically significantly different from normal.
RESULTS: Different age groups showed variations in the level of knowledge. The largest number of respondents (48.08%) were between 25 and 34 years old, and a statistically significant difference in knowledge about fertility was not found between ages, which suggests that age is not a key factor in understanding fertility.The level of education also showed an impact on the level of knowledge. Female respondents with a high school diploma dominated (40.38%), while the fewest respondents had completed a master's/doctoral degree (11.54%).Analysis of health literacy showed that there were no significant differences in knowledge about fertility between different age groups and levels of education. Also, there is no correlation between health literacy and attitudes towards fertility.The analysis of the NSV-HR Health Literacy Questionnaire showed that the majority of respondents have a high level of health literacy, without significant differences between age groups and levels of education. This is consistent with findings suggesting that health literacy is not related to age or education.
CONCLUSION: Although general knowledge of some aspects of fertility exists, there is a significant lack of understanding of specific medical information. Existing fertility education programmes may not be effective enough, so it is necessary to develop programmes that cover all aspects of fertility and are accessible to all groups. Programmes should include information on the risks of health conditions and behaviours and general factors affecting fertility. Different groups may have different information needs, so programs should be tailored to ensure maximum effectiveness. Research has shown a high level of health literacy, but this is not enough; The information must be relevant, understandable and applicable
The comparison of the ferquency ant type of obstetric operations in KBC Split in 2022 compared to 2012
No full textUVOD: Porodničke operacije predstavljaju ključne medicinske intervencije koje se primjenjuju tijekom poroda kako bi osigurali sigurnost majke i djeteta. U porodničke operacije spadaju: epiziotomija, carski rez i vakum ekstrakcija. Cilj porodničkih operacija je smanjiti komplikacije i riješiti hitna stanja. Napretkom tehnologije, ove operacije postale su sigurnije, učinkovitije i manje invazivne, što doprinosi boljem ishodu za pacijentice i novorođenčadi. CILJ: Cilj ovog rada je usporediti vrstu i učestalost porodničkih operacija u 2022. godini u odnosu na 2012. godinu u Klinici za ženske bolesti i porode KBC-a Split. METODE: Istraživanje je provedeno u Klinici za ženske bolesti i porode KBC-a Split, za razdoblje od 1. siječnja 2012. godine do 31. ožujka 2012. godine te od 1.siječnja 2022. godine do 31. ožujka 2022. godine. Ukupan broj poroda u 2012. godini je 4270, za potrebe ovog istraživanja obrađeno je 1151 poroda iz prvog tromjesečja 2012. godine. U 2022. godini ukupan broj poroda iznosio je 3995, od toga je analizirano 965 poroda u prvom tromjesečju. REZULTATI: U 2012. godini od 1151 poroda 210 (18%) je završeno carskim rezom, a udio vaginalnih poroda bio je 941 (82%). Od 941 vaginalnog poroda napravljeno je 567 (60%) epiziotomija, dok je 374 (40%) poroda bez ureza međice. Vakum ekstrakcija primijenila se kod 17 (1,8%) poroda. U 2022. godini od 965 poroda u prvom tromjesečju vaginalnih je bilo 676 (70%) dok je udio carskih rezova 289 (30%). Od 676 vaginalnih poroda kod 426 (63%) rodilja napravljen je urez međice dok je 250 (37%) rodilo bez ureza međice. Udio poroda dovršenih vakum ekstrakcijom za 2022. godinu iznosio je 2,5%. ZAKLJUČAK: Izvođenje carskog reza se povećalo za 12% u 2022. godini, a izvođenje epiziotomije za 3%%. Upotreba vakumskih ekstrakcija nije se značajno povećala. Učestalost carskog reza i epiziotomija nije u skladu s preporukama Svjetske zdravstvene organizacije.INTRODUCTION: Obstetric surgeries are crucial medical interventions applied during childbirth to ensure the safety of both mother and child. These include episiotomy, caesarean section, and vacuum extraction. The goal of obstetric surgeries is to reduce complications and resolve emergencies. With technological advancements, these procedures have become safer, more effective, and less invasive, contributing to better outcomes for mothers and newborns. OBJECTIVE: The aim of this study is to compare the types and frequencies of obstetric surgeries in 2012 versus 2022 at the Clinic for Women's Diseases and Childbirth at KBC Split. METHODS: The research was conducted at the Clinic for Women's Diseases and Childbirth at KBC Split, covering the period from January 1, 2012, to March 31, 2012, and from January 1, 2022, to March 31, 2022. The total number of births in 2012 was 4270, and for this study, 1151 births from the first quarter of 2012 were analyzed. In 2022, the total number of births was 3995, with 965 births analyzed from the first quarter. RESULTS: In 2012, out of 1151 births, 210 (18%) were completed by cesarean section, while 941 (82%) were vaginal deliveries. Of the 941 vaginal deliveries, 567 (60%) involved episiotomy, and 374 (40%) were without episiotomy. Vacuum extraction was used in 17 (1,8%) of births. In 2022, out of 965 births in the first quarter, 676 (70%) were vaginal, while 289 (30%) were cesarean sections. Out of 676 vaginal deliveries, 426 (63%) involved episiotomy, and 250 (37%) have had no episiotomy. The rate of births completed by vacuum extraction in 2022 was 2,5%. CONCLUSION: The incidence of cesarean sections increased by 12% in 2022 and the rate of episiotomies increased by 3%. The use of vacuum extractions did not significantly increase. The frequency of caesarean section and episiotomy is not in accordance with reccomendations of the World Health Organization
Nursing perspectives on prehabilitation of colorectal cancer elective surgery patients and importance of multimodal interventions on postoperative outcomes
No full textKirurško liječenje ključan je dio terapijskog pristupa kod kolorektalnog karcinoma. Kod nekih bolesnika za liječenje kolorektalnog karcinoma bit će dovoljan samo kirurški zahvat dok će kod drugih kirurgija biti dio multimodalnog onkološkog liječenja koje uključuje kemo- i radioterapiju. Posljednjih dvadesetak godina implementacija programa ubrzanog oporavka nakon kirurškog zahvata (ERAS) u većinu kirurških specijalističkih grana dovela je do značajnog poboljšanja oporavka nakon velikih kirurških zahvata. ERAS programi podrazumijevaju multimodalni, multidisciplinarni perioperacijski pristup utemeljen na dokazima s ciljem bolje kontrole i optimizacije nepoželjnih učinaka kirurškog stresa kako bi se smanjio rizik organske disfunkcije i time ubrzao poslijeoperacijski oporavak. Upravo perioperacijska medicinska i funkcionalna optimizacija, osobito u visokorizičnih bolesnika, predstavlja izazov u kliničkom kontekstu, a neadekvatna provedba može rezultirati lošijim poslijeoperacijskim oporavkom. Medicinska sestra ključna je osoba za provođenje prehabilitacijskih programa u okviru multidisciplinarnog ERAS tima koordinirajući prijeoperacijsku procjenu, optimizaciju i intervencijske postupke kao i proces rehabilitacije s ciljem unaprijeđenja ishoda liječenja. Vještine i kompetencije ERAS medicinske sestre nužne su za optimalnu sestrinsku njegu bolesnika u programima integrirane prehabilitacije kirurških bolesnika po ERAS protokolu.Surgical treatment is a crucial component of the therapeutic approach in colorectal cancer. For some patients, surgery alone may suffice for the treatment of colorectal cancer, while for others, surgery will be part of multimodal oncological treatment involving chemotherapy and radiotherapy. Over the past two decades, the implementation of Enhanced Recovery After Surgery (ERAS) programs in most surgical specialties has led to significant improvements in recovery following major surgical procedures. ERAS programs involve a multimodal, multidisciplinary perioperative approach based on evidence with the aim of better controlling and optimizing the adverse effects of surgical stress to reduce the risk of organ dysfunction and thus accelerate postoperative recovery. Perioperative medical and functional optimization, especially in high-risk patients, poses a challenge in the clinical context, and inadequate implementation may result in poorer postoperative recovery. The nurse is a key figure in implementing prehabilitation programs within the multidisciplinary ERAS team, coordinating preoperative assessment, optimization, and intervention processes, as well as the rehabilitation process with the aim of improving treatment outcomes. The skills and competencies of ERAS nurses are essential for optimal nursing care of patients in integrated prehabilitation programs for surgical patients according to the ERAS protocol
The importance of nurses/technicians in preserving the quality of life of patients with rheumatoid arthritis
No full textUvod: Reumatoidni artritis je kronični, sistemski autoimuni poremećaj karakteriziran progresivnom upalom i oštećenjem zglobova, obilježenim izmjeničnim razdobljima egzacerbacije i remisije. Sestrinske intervencije za bolesnike s reumatoidnim artritisom obuhvaćaju različite strategije, uključujući davanje lijekova prema propisu liječnika specijalista, kontinuirano praćenje i evaluaciju upalnog procesa te procjenu pokretljivosti zglobova i mogućih deformiteta.
Cilj: Cilj rada je prikazati ulogu i značaj medicinskih sestara/tehničara u očuvanju kvalitete života bolesnika s reumatoidnim artritisom.
Rasprava: Različita istraživanja pokazala su da medicinske sestre pozitivno utječu na poboljšanje kvalitete života bolesnika s reumatoidnim artritisom. Osim pružanja općeg obrazovanja o bolestima, medicinske sestre također podučavaju pacijente o primjeni lijekova, prehrambenim smjernicama i raznim drugim bitnim vještinama potrebnim za učinkovitu samonjegu kod kuće
Zaključak: Medicinska sestra ima značajnu ulogu u poboljšanju kvalitete života bolesnika s RA. Unutar tima za zdravstvenu njegu, medicinske sestre imaju ključnu ulogu zbog njihove opsežne interakcije s pacijentima. Njihova savjetodavna sposobnost, posebno u suradnji s pacijentima i njihovim obiteljima, predstavlja temeljni aspekt sestrinske prakse.Introduction: Rheumatoid arthritis is a chronic, systemic autoimmune disorder characterized by progressive inflammation and joint damage, marked by alternating periods of exacerbation and remission. Nursing interventions for patients with rheumatoid arthritis include various strategies, including the administration of medications as prescribed by specialist physicians, continuous monitoring and evaluation of the inflammatory process, and assessment of joint mobility and possible deformities.
Objective: The aim of the paper is to show the role and importance of nurses/technicians in preserving the quality of life of patients with rheumatoid arthritis.
Discussion: Various studies have shown that nurses have a positive effect on improving the quality of life of patients with rheumatoid arthritis. In addition to providing general disease education, nurses also teach patients about medication administration, dietary guidelines, and various other essential skills needed for effective self-care at home.
Conclusion: The nurse has a significant role in improving the quality of life of patients with RA. Within the healthcare team, nurses play a key role due to their extensive interaction with patients. Their counseling ability, especially in collaboration with patients and their families, is a fundamental aspect of nursing practice
Methods of preoperative intranasal decolonization for the purpose of reducing surgical field infections
No full textPreoperativna intranazalna dekolonozicija koristi se kao metoda u svrhu smanjenja infekcija, bakterija S. aureus ima sposobnost kolonizacije u anteriornom nosnom dijelu, odnosno prednjem dijelu nosne šupljine, gdje može preživjeti dugo vremena bez izazivanja kliničkih simptoma. Glavni cilj aseptičkih postupaka je održavanje sterilnosti tijekom invazivnih medicinskih i kirurških zahvata, te uključuju sterilizaciju instrumenata, uporabu sterilnih rukavica, odjeće i barijera, te kontrolu zraka u operacijskim salama, na način da ništa što dolazi u kontakt s kirurškim poljem ili sterilnim instrumentima nije kontaminirano mikroorganizmima. Temeljni cilj antiseptika je suzbijanje mikrobiološkog opterećenja na površini tijela, čime se sprječava razvoj infekcija Trenutno se najčeće koristi mupoirocin, antiseptik te antibitoska mast. Obično se koristi u predoperativnom razdoblju, dva puta dnevno tijekom pet do sedam dana. Nekoliko je kliničkih prednosti mupirocina: učinkovitost u smanjenju rizika od postoperativnih infekcija uzrokovanih na S. aureus i druge gram-pozitivne bakterije, smanjenje rizika od sistemskih nuspojava u usporedbi s oralnim antibioticima te rijetke nuspojave. Nadalje, doprinosi smanjenju opterećenja antibiotika u bolničkom okruženju, jer smanjuje potrebu za sustavnom antibiotskom terapijom nakon operacije štu ujedno i znači da prevencija smanjuje ukupne troškove liječenja i postoperativne skrb.Preoperative intranasal decolonization is used as a method to reduce infections. The bacterium S. aureus has the ability to colonize the anterior part of the nasal cavity, where it can survive for long periods without causing clinical symptoms. The main goal of aseptic procedures is to maintain sterility during invasive medical and surgical procedures. This includes sterilization of instruments, the use of sterile gloves, clothing, and barriers, as well as air control in operating rooms to ensure that nothing coming into contact with the surgical field or sterile instruments is contaminated with microorganisms. The primary goal of antiseptics is to reduce microbial load on the body surface, thereby preventing the development of infections. Currently, mupirocin, an antiseptic and antibiotic ointment, is most commonly used. It is typically applied in the preoperative period, twice daily for five to seven days. Mupirocin offers several clinical advantages: it is effective in reducing the risk of postoperative infections caused by S. aureus and other Gram-positive bacteria, it lowers the risk of systemic side effects compared to oral antibiotics, and it rarely causes adverse effects. Furthermore, it contributes to reducing antibiotic load in the hospital setting by decreasing the need for systemic antibiotic therapy after surgery, which also helps lower overall treatment costs and postoperative car