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Activities of nurses in patients with polytrauma: case report
No full textCILJ: Cilj završnog rada je prikazati složenost zbrinjavanja politraumatiziranog bolesnika, kao i aktivnosti
medicinske sestre pri prijemu životno ugroženog bolesnika. U radu će biti prikazan slučaj
politraumatiziranog bolesnika od dolaska na Objedinjeni hitni bolnički prijem, zbrinjavanje u sobi za
reanimaciju, pratnja na radiološke dijagnostičke pretrage te aktivnosti medicinske sestre u operacijskoj
dvorani.
RASPRAVA: Bolesnik K.Š. dovezen na OHBP kao sudionik prometne nesreće, u ulozi vozača. Po prijemu
spojen na kontinuirani monitoring: RR niži, 100/60 mmHg, puls ubrzan 105 o/min, disanje plitko i ubrzano
23 u/min, SpO2 92%, uzeti uzorci krvi, urina te uzorak krvi za KG. Po dolasku somnolentan, na poziv
otvara oči, reagira na bolni podražaj, GCS 11. Pri dolasku politraumatiziranog bolesnika na OHBP u
reanimacijsku salu započinje primarni pregled bolesnika s ciljem identifikacije stanja koja neposredno
ugrožavaju bolesnikov život. Aktivnosti medicinske sestre uključuju: monitoring vitalnih funkcija,
neinvazivno mjerenje krvnog tlaka, mjerenje pulsne oksimetrije, EKG monitoring, postavljanje venskog
puta, uzorkovanje krvi i urina, pratnja na dijagnostičju obradu uz kontinuirani monitoring. Po završetku
radiološke obrade bolesnika se odvozi u operacijsku dvoranu te se pristupa operacijskom zahvatu.
Aktivnosti medicinske sestre u operacijskoj dvorani uključuju brzinu i spretnost jer je u kratko vrijeme
potrebno izvršiti niz popstupaka kako bi se operacijski zahvat nesmetano odvijao. Te aktivosti uključuju:
postavljanje dodatnih venskih puteva, priprema anesteziloškog uređaja, pribora, opreme i lijekova za
endotrahealnu intubaciju, asistenciju pri postavljanje invazivnog monitoringa (arterijska kanila i CVK),
uzimanje uzoraka krvi za analizu tijekom operacijskog zahvata.
ZAKLJUČAK: Multidisciplinarni pristup politraumatiziranom bolesniku uključuje brojne specijalnosti, a
uloga medicinske sestre u ovom je timu neizostavna. Kontinuirana edukacija, dobra komunikacija i izražene
vještine važne su karakteristike za kvalitetno zbrinjavanje vitano ugroženog bolesnika.AIM OF THE PAPER: The aim of the final paper is to show the complexity of caring for a
polytraumatized patient, as well as the nurse's activities when receiving a life-threatening patient. The paper
will present the case of a polytraumatized patient from the time he arrived at the Emergency service,
treatment in the resuscitation room, accompanying him to diagnostic tests and the activities of the nurse in
the operating room.
DISCUSSION: Patient K.Š. brought to Emergency service as a participant in a traffic accident, driver.
Upon admission connected to continuous monitoring: RR lower, 100/60 mmHg, pulse accelerated 105
r/min, breathing shallow and accelerated 23 r/min, SpO2 92%, laboratory tests taken, urine sample, as well
as sample for blood type. Upon arrival, he is somnolent, opens his eyes when called, reacts to a painful
stimulus, GCS 11. When a polytraumatized patient arrives at the OHBP in the resuscitation room, the
primary examination of the patient begins with the aim of identifying conditions that directly threaten the
patient's life. The nurse's activities include: monitoring of vital functions, non-invasive blood pressure
measurement, pulse oximetry measurement, EKG monitoring, venous line placement, blood and urine
sampling, accompaniment to diagnostic processing with continuous monitoring. At the end of the
radiological treatment, the patient is taken to the operating room and the surgical procedure is started. The
activities of the nurse in the operating room include promptness and dexterity, as a series of procedures
must be performed in a short time in order for the operation to proceed smoothly. These activities include:
setting up additional venous lines, preparation of anesthesiology device, accessories, equipment and drugs
for endotracheal intubation, assistance in setting up invasive monitoring (arterial cannula and CVC), taking
blood samples for analysis during surgery.
CONCLUSION: A multidisciplinary approach to a polytraumatized patient includes numerous specialties,
and the role of the nurse in this team is indispensable. Continuous education, good communication and
expressed skills are important characteristics for quality care of a critically endangered patient
Epidemiological features and nursing care concerns in patients treated in the KBC Split coronary care unit
No full textCILJ ISTRAŽIVANJA: Cilj ovog rada jest prikazati epidemiološka obilježja i probleme u zdravstvenoj njezi
bolesnika liječenih na Jedinici koronarne skrbi KBC Split unutar jedne godine.
MATERIJALI I METODE: U ovom istraživanju korišteni su podaci prikupljeni putem programa BIS KBC
Split, a zadovoljavali su kriterij uključenja prema medicinskoj dijagnozi tj. hospitalizaciji u KBC Split na Klinici
za bolesti srca i krvnih žila, Jedinici koronarne skrbi – lokalitet Križine za obuhvaćeno vremensko razdoblje
01.siječnja 2022. – 31.prosinca 2022. godine.
REZULTATI: Temeljem analize prikupljenih podataka u promatranom razdoblju ukupan broj hospitaliziranih u
koronarnoj jedinici je 1237 od čega 67,66% čine muška, a 32,34% ženska populacija. Najviše bolesnika je u dobi
od 62 do 81 godine, a boravak u koronarnoj jedinici je najčešće u trajanju od jednog dana (39,69%). Vodeća
dijagnoza je STEMI sa 33,31%. Više od polovice bolesnika uradilo je koronarografiju 50,20 %. Većina pacijenata,
njih 736 boravilo je bez urinarnog katetera u koronarnoj jedinici. 837 bolesnika je primljeno iz stacionara zavoda
kardiologije dok je učestalost prijema tijekom mjeseci, kroz godinu podjednaka 7,28-10,67 %.
ZAKLJUČCI: U Jedinici koronarne skrbi KBC Split češće su liječeni muškarci. Najčešća kronološka dob
liječenih bolesnika rođena je u razdoblju 1941-1960 godine. Najzastupljenija prijemna dijagnoza je STEMI.
Prosječni boravak bolesnika u Jedinici koronarne skrbi KBC Split iznosio je 1 dan dok je najčešći način prijema u
Jedinicu koronarne skrbi bio s jednog od Zavoda klinike za bolesti srca i krvnih žila. .Najučestalija hospitalizacija
(prijem) u Jedinicu koronarne skrbi KBC Split bio je u mjesecu ožujkuAIM: The aim of this paper is to present the epidemiological characteristics and problems in the health care of
patients treated at the Coronary Care Unit of KBC Split within one year.
MATERIALS AND METHODS: In this research, data collected through the BIS KBC Split program were used,
and they met the inclusion criteria according to medical diagnosis, i.e. hospitalization in KBC Split at the Heart
and Blood Vessel Clinic, Coronary Care Unit - Križine locality for the covered time period January 1, 2022 -
December 31, 2022.
RESULTS: Based on the analysis of the collected data in the observed period, the total number of hospitalized in
the coronary unit is 1237, of which 67.66% are male and 32.34% are female population. The majority of patients
are between the ages of 62 and 81, and the stay in the coronary care unit usually lasts one day (39.69%). The
leading diagnosis is STEMI with 33.31%. More than half of the patients underwent coronary angiography
(50.20%). Most of the patients, 736 of them, stayed without a urinary catheter in the coronary unit. 837 patients
were admitted from the inpatient department of the Cardiology Institute, while the frequency of admissions during
the months and throughout the year is equal to 7.28-10.67%.
CONCLUSIONS: Men were treated more often in the Coronary Care Unit of KBC Split. The most common
chronological age of treated patients was born in the period 1941-1960. The most common admission diagnosis is
STEMI. The average stay of a patient in the Coronary Care Unit of KBC Split was 1 day, while the most common
method of admission to the Coronary Care Unit was from one of the Departments of the Clinic for Cardiovascular
Diseases. .The most frequent hospitalization (admission) to the Coronary Care Unit of KBC Split was in the month
of March
Percutaneous CT-guided cryoablation of renal carcinoma
No full textPerkutana krioablacija, inovativna terapeutska opcija za liječenje prvog stadija karcinoma bubrega, postaje sveprisutniji izbor zbog svoje dokazane učinkovitosti. Brojne znanstvene studije sugeriraju da pacijenti podvrgnuti ovoj metodi doživljavaju bolje rezultate u preživljavanju u usporedbi s tradicionalnim kirurškim zahvatima. Ova tendencija povećava popularnost perkutane krioablacije, posebice zbog njezinih minimalnih nuspojava i znatno ubrzanog procesa oporavka. Cilj ovog istraživanja je prikazati učinkovitost metode krioablacije kao jedne od opcija pri liječenju karcinoma bubrega te usporediti znanstvene studije koje su do sada objavljene s posebnim naglaskom na rezultate provedenih istraživanja u jednom od naših medicinskih centara. Ova analiza ima za svrhu potvrditi da perkutana krioablacija predstavlja visoko učinkovitu metodu liječenja, pridonoseći visokim stopama preživljavanja kod pacijenata s karcinomom bubrega prvog stadija, uz istodobno minimalne nuspojave. Dosadašnje studije ukazuju na obećavajuće rezultate, naglašavajući prednosti perkutane krioablacije u smislu smanjenja rizika i ubrzanja procesa ozdravljenja. Očekujemo da će naše istraživanje pridonijeti daljnjoj potvrdi ove metode kao preferirane opcije za liječenje karcinoma bubrega u I stadiju, pružajući tako važan doprinos medicinskoj praksi i poboljšavajući kvalitetu života pacijenata.Percutaneous cryoablation, an innovative therapeutic option for the treatment of stage 1 kidney cancer, is becoming a more ubiquitous choice due to its proven efficacy. Numerous scientific studies suggest that patients undergoing this method experience better survival results compared to traditional surgical procedures. This tendency increases the popularity of percutaneous cryoablation, especially due to its minimal side effects and significantly accelerated recovery process. The aim of this research is to demonstrate the effectiveness of cryoablation as one of the treatment options for kidney cancer and to compare scientific studies published so far, with a particular emphasis on the results of conducted research in one of our medical centers.. This analysis aims to confirm that percutaneous cryoablation represents a highly effective treatment method, contributing to high survival rates in patients with stage 1 kidney cancer, while at the same time having minimal side effects. Studies so far indicate promising results, highlighting the advantages of percutaneous cryoablation in terms of reducing risks and speeding up the healing process. We expect that our research will contribute to the further confirmation of this method as a preferred option for the treatment of stage I kidney cancer, thus providing an important contribution to medical practice and improving the quality of life of patients
Health care of patients with glioblastoma
No full textGlioblastom je najteži tip tumora na mozgu čovjeka koji ima jako nisku stopu preživljavanja i vrlo lošu
prognozu. Stopa preživljavanja pacijenata nije se poboljšala unatoč napretku kirurgije i medicine. Dvije su vrste
glioblastoma: primarni glioblastom koji je češći i uglavnom pogađa osobe starije životne dobi, te sekundarni
glioblastom koji je rjeđi, a učestaliji je kod osoba mlađe životne dobi.
Znakovi i simptomi koji se javljaju kod pacijenata oboljelih od glioblastoma se razlikuju ovisno o tome gdje
se tumor primarno nalazi, kao i o njegovoj veličini. Gotovo kod svih pacijenata se javljaju glavobolje, mučnine,
dvoslike, vrtoglavice, problem sa govorom i motorikom, epileptički napadaji te mnogi drugi simptomi.
Postavljanje dijagnoze obično započinje detaljnim medicinskim pregledom (neurološka obrada), radiološkim
pretragama (CT i/ili MR mozga), te uzimanjem biopsije tkiva (stereotaksija). Liječenje je obično jako kompleksno
i uključuje kombinaciju kirurškog liječenja, radioterapije, kemoterapije i ciljane terapije lijekovima. Kod
planiranja zdravstvene njege pacijenta s glioblastomom najbitniji je holistički pristup koji obuhvaća procjenu i
intervencije medicinske sestre. U zdravstvenoj njezi medicinska sestra/ tehničar ima izrazito veliku ulogu kao dio
multidisciplinarnog tima jer sudjeluje u svim pripremama za dijagnostičke pretrage, fizičkoj i psihičkoj pripremi
bolesnika za operaciju i nakon nje, primjeni ordinirane terapije, održavanju vitalnih funkcija i praćenju promjena
ponašanja pacijenta. Osim velike količine znanja, medicinska sestra mora posjedovati iskustvo, vještine i empatiju
jer je odgovorna za planiranje zdravstvene njege pacijenta od trenutka prijema pacijenta u bolnicu te do njegovog
povratka u obitelj.Glioblastoma is the most severe type of human brain tumor that has a very low survival rate and a very poor
prognosis. Patient survival rates have not improved despite advances in surgery and medicine. There are two types
of glioblastoma: primary glioblastoma, which is more common and mostly affects older people, and secondary
glioblastoma, which is rarer and more common in younger people.
The signs and symptoms experienced by patients with glioblastoma vary depending on where the tumor is
primarily located, as well as its size. Almost all patients have headache, nausea, double vision, dizziness, speech
and motor problems, epileptic seizures and many other symptoms.
Diagnosis usually begins with a detailed medical examination (neurological examination), radiological
examinations (CT and/or MRI of the brain) and taking a tissue biopsy (stereotaxy). Treatment is usually very
complex and includes a combination of surgical treatment, radiotherapy, chemotherapy and targeted drug therapy.
In planning the health care of patients with glioblastoma, the most important is a holistic approach that includes
the assessment and interventions of the nurse. In health care, the nurse/technician has an extremely important role
as part of a multidisciplinary team, because she participates in all preparations for diagnostic tests, physical and
psychological preparation of the patient for surgery and after it, application of prescribed therapy, maintenance of
vital functions and monitoring of changes in the patient's behavior. In addition to great knowledge, a nurse must
possess experience, skills and empathy because she is responsible for planning the patient's health care from the
moment the patient is admitted to the hospital, until his return to the family
Frequency of circulatory (vascular) system treated at Split-Dalmatia County's emergemcy department
No full textCilj: Cilj ovog rada je utvrditi učestalost cirkulacijskih (krvožilnih) bolesti liječenih u Zavodu za hitnu medicinu Splitsko-dalmatinske županije (ZHM SDŽ), gledano kroz vremena prije pojave pandemije COVID-19, godine COVID-19 pandemije i vremena nakon završetka pandemije COVID-19.
Materijali i metode: Ovo retrospektivno istraživanje obuhvaća sve pacijente koji su primali medicinsku skrb u razdoblju od ožujka 2019. do ožujka 2022. godine u Zavodu za hitnu medicinu. Informacije o njihovoj dobi, spolu i dijagnozi prema MKB-10 klasifikaciji prikupljene su u Zavodu za hitnu medicinu Splitsko-dalmatinske županije. Analize su provedene putem medicinskog programa zavoda „e-Hitna“.
Rezultati: Najveći broj oboljelih prisutan je u godini prije COVID-19 pandemije. U odnosu na dob i spol, veća je incidencija prisutna kod ženske populacije životne dobi od 65 do 100 godina. Zabilježen je veći broj bolesnika koji su pomoć zatražili u ambulantama tijekom tri promatrane godine, usprkos većem broju zahtjeva za intervencijom tima hitne medicine u dobi od 65 do 100 godina. Incidencija gledana u odnosu na mjesece kroz godinu pokazuje porast oboljenja u ljetnim mjesecima, gdje ujedno u kolovozu imamo najveći broj oboljelih, a blagi porast bilježi se i u zimskim mjesecima (prosinac, siječanj), što je ujedno posljedica utjecaja turizma.
Zaključci: Za vrijeme COVID-19 pandemije dolazi do naglog pada broja oboljelih. Napretkom pandemije ženska populacija te starija životna dob i dalje imaju veću incidenciju oboljenja. U odnosu na prvu promatranu godinu, koja prethodi COVID-19 pandemiji, u drugoj i trećoj promatranoj godini veći postotak otpada na intervencije tima ZHM SDŽ, u odnosu na broj bolesnika u ambulantama. Usporedba ukupnog broja bolesnika, s brojem bolesnika M i H kategorije, kroz pojedine mjesece ukazuje na utjecaj turizma na sami raspored incidencije oboljenja.Objective: The aim of this thesis is to determine the frequency of diseases of the circulatory (blood vessel) system treated at ZHM SDŽ, viewed through the time before the onset of the COVID-19 pandemic, the year of the COVID-19 pandemic, and the time after the end of the COVID-19 pandemic.
Materials and methods: This retrospective study includes all patients who received medical care in the period from March 2019 to March 2022 in the Department of Emergency Medicine. Information about their age, gender and diagnosis according to the ICD-10 classification was collected at the Department of Emergency Medicine of the Split-Dalmatia County. The analyzes were carried out through the medical program „e-Hitna“.
Results: The largest number of patients was present in the year before the COVID-19 pandemic. In relation to age and gender, the incidence is higher in the female population between the ages of 65 and 100. A greater number of patients who sought help in outpatient clinics during the three observed years was recorded, despite the greater number of requests for intervention by the emergency medicine team between the ages of 65 and 100. The incidence seen in relation to the months throughout the year shows an increase in diseases in the summer months, where we have the highest number of patients in August, and a slight increase is also recorded in the winter months (December, January), which is also a consequence of the influence of tourism.
Conclusions: During the COVID-19 pandemic, there is a sharp drop in the number of patients. Along with the progress of the pandemic, the female population and the older age group continue to have prestige in the incidence of the disease. In contrast to the first observed year, which preceded the COVID-19 pandemic, in the second and third observed years, a higher percentage was spent on the interventions of the ZHM SDŽ team, compared to the number of patients in outpatient clinics. A comparison of the total number of patients with the number of M and H category patients in individual months indicates the influence of tourism on the very distribution of the incidence of diseases
Imaging approacch to immunocompromised patient
No full textImunokompromitiranost se definira kao stanje narušenog ili disfunkcionalnog imunološkog sustava, koji nije u stanju obraniti organizam od vanjskih patogena. Imunodeficijencija se u pacijenta može razviti na razne načine, te u ovisnosti o etiologiji ima različitu kliničku sliku. Najogledniji primjer imunodeficijencije u svijetu jest onaj uzrokovan virusom humane imunodeficijencije (eng. human immunodeficiency virus, HIV), koji je postao globalni problem, te sa sobom nosi široku lepezu raznih stanja i oportunističkih infekcija. Imunokompromitirani bolesnik ima povećanu sklonost nastanka infekcije uzrokovane nekim patogenom u odnosu na bolesnika s funkcionalnim imunološkim sustavom.
Različiti oportunistički uzročnici iz skupine gljivica, parazita, bakterija i virusa napadaju imunosuprimirane domaćine. Unutar njih se, s obzirom na nepostojanje obrambenog sustava, brzo množe, te lakše razvijaju upalna i druga stanja gdje zahvaćaju neurološki, respiracijski, ali i druge organske sustave. Tijekom pandemije Covid-19 virusa, imunokompromitirani pacijenti su zbog svoje vulnerabilnosti predstavljali značajan medicinsko-sociološki problem. Primjena odgovarajućih radioloških metoda ima važnu ulogu u ranom otkrivanju i dijagnosticiranju različitih infektivnih i drugih bolesti koje su svojstvene imunokompromitiranim bolesnicima.To be immunocompromised is defined as state of impaired or dysfunctional immune system, precisely a system that is unable to defend the organism against external pathogens. Immunodeficiency in a patient can develop in various ways, and depending on the etiology, it has a different clinical presentation. The most concrete example of immunodeficiency in the world is the one caused by the human immunodeficiency virus (HIV), which has become a global problem and brings with itself a wide variety of conditions and opportunistic infections. An immunocompromised patient has an increased tendency to develop an infection caused by a pathogen compared to a patient with a functional immune system.
Various opportunistic agents from the group of fungi, parasites, bacteria and viruses attack immunosuppressive hosts. Because of the absence of a defense system, pathogens multiply faster and can more easily develop inflammatory and other conditions, with involvement of the neurological, respiratory and other organ systems. During the Covid-19 virus pandemic, immunocompromised patients represented a significant medico-sociological problem due to their vulnerability. The use of appropriate radiological methods plays an important role in the early detection and diagnosis of various infectious and other diseases that are characteristic for immunocompromised patients
Activities of nurses in the prevention of intrahospital infections in the ICU
No full textIntrahospitalne ili nozokomijalne infekcije su infekcije koje se javljaju za vrijeme boravka bolesnika u zdravstvenoj ustanovi u razdoblju od 48 do 72 sata nakon hospitalizacije, ovisno o inkubaciji određene infekcije. Predstavljaju ozbiljan problem u svijetu, kako zdravstveno tako i financijski. Unatoč napretku medicine, a i silnim naporima u prevenciji, ove infekcije uzrokuju značajan morbiditet, mortalitet i produženje boravka bolesnika, što rezultira opterećenjem zdravstvenog sustava. Pojavljuju se neovisno o primarnoj bolesti, a problematika otpornosti antibiotika dodatno komplicira situaciju. Bolničke infekcije nastaju kao posljedica nekvalitetnog održavanja higijene u zdravstvenim ustanovama, te izazivaju zabrinutost zdravstvenog osoblja i samog stanovništva zbog sve veće učestalosti, osobito u jedinicama intenzivnog liječenja. Stope bolničkih infekcija odražavaju kvalitetu zdravstvene skrbi. U jedinicama intenzivnog liječenja, bolesnici su više podložni infekcijama posebno zbog imunokompromitiranosti, što može dovesti do komplikacija pa tako i zahtjevnijeg oporavka. Najčešća intrahospitalna infekcija u JIL-u jesu infekcije mokraćnog sustava. Između ostalog, izazov u radu za medicinske sestre/tehničare predstavlja i ventilatorom povezana pneumonija (VAP), te infekcije sepsa i infekcije kirurških rana. Važno je imati kvalitetan sustav kontrole infekcija zbog prevencije i suzbijanja intrahospitalnih infekcija te osiguranja sigurnosti bolesnika i pružanja kvalitetne zdravstvene skrbi. Strogo pridržavanje higijenskih protokola, pravilna upotreba antibiotika, redovito čišćenje i dezinfekcija prostora i opreme, te edukacija medicinskog osoblja i bolesnika o mjerama prevencije ključni su za smanjenje incidencije bolničkih infekcija.Intrahospital or nosocomial infections are infections that occur during the patient's stay in a health institution in the period from 48 to 72 hours after hospitalization, depending on the incubation of a certain infection. They represent a serious problem in the world, both health and financial. Despite medical progress, and great efforts in prevention, these infections cause significant morbidity, mortality and prolongation of the patient's stay, which results in a burden on the health system. They appear independently of the primary disease, and the problem of antibiotic resistance further complicates the situation. Hospital infections arise as a result of poor quality maintenance of hygiene in health-care facilities, and raise concerns among health personnel and the population itself about the increasing incidence, particularly in intensive care units. Hospital infection rates reflect the quality of health care. In intensive care units, patients are more susceptible to infections, especially due to immunocompromise, which can lead to complications and thus a more demanding recovery. The most common intrahospital infection in the ICU is urinary tract infections. Among other things, the challenge in the work for nurses/technicians is represented by ventilator-associated pneumonia (VAP), as well as sepsis infections and surgical wound infections. It is important to have a quality infection control system to prevent and control intrahospital infections and to ensure patient safety and provide quality health care. Strict adherence to hygiene protocols, proper use of antibiotics, regular cleaning and disinfection of spaces and equipment, and education of medical staff and patients on prevention measures are key to reducing the incidence of hospital-acquired infections
The role of radiology in the COVID-19 pandemic
No full textPandemija COVID-19, uzrokovana SARS-CoV-2 virusom, predstavljala je globalni zdravstveni izazov koji je zahtijevao brzu reorganizaciju zdravstvenih sustava i uvođenje strogih zaštitnih mjera. Zlatni standard kod postavljanja dijagnoze COVID infekcije svakako je RT-PCR test, te uz test, radiološke metode koje svojim specifičnim prikazima ukazuju na oboljenja. Radiološki prikaz manifestacija COVID-19 infekcije uključuje radiograme torakalnih organa koji se koriste za evaluaciju plućnih promjena, kompjutoriziranu tomografiju (CT) koja pruža detaljan prikaz abnormalnosti uzrokovanim infekcijom, PET/CT i ultrazvuk pluća (LUS) koji dodatno pomažu u dijagnostici i praćenju, te magnetsku rezonanciju (MR) koja se koristi za detaljnu procjenu komplikacija i post covid sindroma. Komplikacije COVID-19 infekcije s najvećom incidencijom su plućne, neurološke, hematološke, bubrežne i srčane. Tijekom pandemije pokazala se njihova ozbiljnost i nepredvidljivost s obzirom da su ishod bolesti dodatno činile neizvjesnim i otežavale oporavak. Posebnu inspiraciju i motivaciju za nova znanstvena istraživanja daju sindrom post covid-a i multisistemski inflamatorni sindrom u djece s obzirom da imaju karakteristične značajke kliničke slike. Algoritmi umjetne inteligencije pokazali su se kao značajan pomoćni alat u radiološkoj obradi covid pacijenata, pomažući u bržoj i preciznijoj dijagnostici, te olakšavajući procjenu stanja pacijenata i praćenje razvoja bolesti.The COVID-19 pandemic, caused by the SARS-CoV-2 virus, posed a global health challenge that required rapid reorganization of healthcare systems and the implementation of strict protective measures. The gold standard for diagnosing COVID infection is certainly the RT-PCR test, along with radiological methods that provide specific visual indications of the disease. The radiological presentation of COVID-19 infection includes thoracic organ radiographs used to evaluate lung changes, computed tomography (CT) which offers a detailed view of abnormalities caused by the infection, PET/CT and lung ultrasound (LUS) which further assist in diagnosis and monitoring, and magnetic resonance imaging (MRI) used for a detailed assessment of complications and post-COVID syndrome. The complications of COVID-19 infection with the highest incidence are pulmonary, neurological, hematological, renal, and cardiac. During the pandemic, their severity and unpredictability became evident, as they further complicated the disease outcome and recovery. Post-COVID syndrome and multisystem inflammatory syndrome in children provide particular inspiration and motivation for new scientific research due to their characteristic clinical features. Artificial intelligence algorithms have proven to be a significant auxiliary tool in the radiological processing of COVID patients, aiding in faster and more accurate diagnosis, and facilitating patient condition assessment and monitoring disease progression
Nursing care of a child with meningitis andv sepsis
No full textSAŽETAK
Meningitis označava upalu moždanih ovojnica, koja može biti uzrokovana bakterijama, virusima, gljivicama ili parazitima. Danas su u općoj populaciji djece najčešći bakterijski uzročnici N. meningitidis i S. pneumoniae, a kod djece mlađe od tri mjeseca to su Streptococcus agalactiae i Escherichia coli. Klinička slika meningitisa varira ovisno o dobi djeteta, a obuhvaća vrućicu, glavobolju, fotofobiju, osip i meningealne znakove koji su posljedica nadražaja moždanih ovojnica. Rana dijagnostika je ključna i temelji se na kliničkoj slici i analizi cerebrospinalnog likvora. Ukoliko postoji sumnja na bakterijski meningitis, antibiotska terapija se ne smije odgađati. U liječenju je ceftriakson antibiotik koji se najviše koristi. Kod pojedinih slučajeva dolazi do dugoročnih posljedica od kojih je najčešći gubitak sluha. Virusni meningitis najčešće uzrokuju enterovirusi, klinička slika se uvelike ne razlikuje od bakterijskog, a liječenje je većinom simptomatsko. Meningokokna sepsa je hitno stanje koje obuhvaća sistemnu reakciju organizma, a najteži oblik je fulminantna sepsa koja brzo napreduje i može dovesti do septičkog šoka i organskog zatajenja. Kod oboljelih su prisutni simptomi poput vrućice, osipa, boli u nogama, promjene u stanju svijesti i ponekad je potrebno zbrinuti bolesnike u jedinicama intenzivnog liječenja. Liječenje meningokokne sepse je uvelike slično kao i kod bakterijskog meningitisa, samo su sada u nekim slučajevima potrebne dodatne mjere za napredno održavanje života. Uloga medicinske sestre u zbrinjavanju djeteta oboljelog od meningitisa i meningokokne sepse je važna. Medicinska sestra sudjeluje u prvoj procjeni djeteta i prepoznavanju simptoma i znakova, sudjeluje u provedbi dijagnostičkih postupaka i primjeni antibiotske terapije. Tijekom djetetove hospitalizacije aktivno educira pacijenta i njegovu obitelj.Meningitis refers to the inflammation of the meninges, which can be caused by bacteria, viruses, fungi, or parasites. Today, the most common bacterial causes in the general pediatric population are N. meningitidis and S. pneumoniae, while in children under three months, the most frequent causes are Streptococcus agalactiae and Escherichia coli. The clinical picture of meningitis varies depending on the child’s age and includes fever, headache, photophobia, rash, and meningeal signs resulting from irritation of the meninges. Early diagnosis is crucial and is based on the clinical picture and cerebrospinal fluid analysis. If bacterial meningitis is suspected, antibiotic therapy should not be delayed. In treatment, ceftriaxone is the most commonly used antibiotic. In some cases, there are long-term consequences, the most common being hearing loss. Viral meningitis is most commonly caused by enteroviruses, and the clinical picture does not differ significantly from bacterial meningitis, with treatment being mostly symptomatic. Meningococcal sepsis is an emergency condition involving a systemic reaction of the body, with the most severe form being fulminant sepsis, which progresses rapidly and can lead to septic shock and organ failure. Symptoms in affected individuals include fever, rash, leg pain, changes in consciousness, and sometimes intensive care is required. Treatment of meningococcal sepsis is very similar to that of bacterial meningitis, but in some cases, additional measures for advanced life support are needed. The role of the nurse in caring for a child with meningitis and meningococcal sepsis is important. The nurse participates in the initial assessment of the child and recognition of symptoms and signs, participates in diagnostic procedures, and administration of antibiotic therapy. During the child’s hospitalization, the nurse actively educates the patient and their family
Epidemiological characteristics of women who underwentmastectomy withreconstruction due to breast cancer in KBC Split
No full textUvod: Karcinom dojke u modernom svijetu predstavlja veliki izazov i javnozdravstveni problem jer je to jedan od najčešće dijagnosticiranih karcinoma kod žena, ali sve češće i kod muškaraca . Svake godine od karcinoma dojke oboli više od dva milijuna žena u svijetu, a u Hrvatskoj više od dvije tisuće. Ovaj karcinom jednako pogađa žene u svim dijelovima svijeta samo je smrtnost manja u razvijenim zemljama jer je dijagnostika razvijena i dostupna te važnu ulogu imaju preventivni postupci i edukacija žena koje razvijene zemlje standardizirano provode. Rekonstrukcija dojki kod žena koje su podvrgnute mastektomiji zbog karcinoma može se napraviti u istom aktu kada i mastektomija ili pak postupak rekonstrukcije može biti odgođen za drugi akt ukoliko je potrebna priprema kože ekspanderom ili postoji neka druga problematika koja zahtjeva odgođenu rekonstrukciju.
Cilj: Cilj ovog diplomskog rada je prikazati epidemiološke i socioekonomske parametre kod pacijentica oboljelih od karcinoma dojke koji utječu na odluku istih o rekonstrukciji odstranjene dojke
Rezultati: Prosječna dob ispitanica bila je 54 (47 - 62) godine, veći je udio udanih (u bračnom statusu) ispitanica (72.6%). Većina ispitanica ima srednju stručnu spremu (54.8%), živi u gradu (urbanom području) (69.6%) te je zaposlen (63.9%). Prosječna duljina hospitalizacije iznosila je 5 (4 - 6) dana. Većini bolesnica dojka je rekonstruirana u jednom aktu (primarna rekonstrukcija) implantatom (81,4 %) dok je kod 18,6 % bolesnica rađena sekundarna rekonstrukcija najčešće ekspadnerom. Ponovljena hospitalizacija i operacija bili su potrebni u 16.6% pacijentica. Odluka o primarnoj rekonstrukciji nije bila statistički značajno povezana s dobi (P=0.803), bračnim statusom (P=0.767), obrazovanjem (P=0.366), prebivalištem (P=0.901) niti radnim statusom (P=0.934) ispitanica.
Zaključak: Znatno veću učestalost ženskih ispitanica koje su pristale na rekonstrukciju dojki nakon operacije karcinoma dojke u životnoj dobi starijoj od 50 godina, u bračnom statusu to jest udane, žive u gradu(urbanom području) i koje su pristale na rekonstrukcija u jednom aktu (primarna rekonstrukcija).Objective:In the modern world, breast cancer represents a great challenge and a public health problem, as it is one of the most frequently diagnosed cancers in women, but increasingly also in men. Every year, more than two million women in the world get breast cancer, and more than two thousand in Croatia. This cancer affects women equally in all parts of the world, only the mortality rate is lower in developed countries because diagnostics are developed and available, and preventive procedures and education of women, which are standardized in developed countries, have an important role. Breast reconstruction in women who have undergone a mastectomy due to cancer can be done in the same act as the mastectomy, or the reconstruction procedure can be postponed for another act if it is necessary to prepare the skin with an expander or there is some other problem that requires delayed reconstruction.
Objective: The objective of this thesis is to present the epidemiological and socioeconomic parameters in patients with breast cancer that influence their decision to reconstruct a removed breast.
Results: The average age of the respondents was 54 (47 - 62) years, the proportion of married (in marital status) respondents was higher (72.6%). Most of the respondents have a secondary education (54.8%), live in a city (urban area) (69.6%) and are employed (63.9%). The average length of hospitalization was 5 (4 - 6) days. Most of the patients had their breast reconstructed in one act (primary reconstruction) with an implant (81.4%), while in 18.6% of the patients, secondary reconstruction was performed, most often with an expander. Repeated hospitalization and surgery were required in 16.6% of patients. The decision on primary reconstruction was not statistically significantly related to the age (P=0.803), marital status (P=0.767), education (P=0.366), place of residence (P=0.901) or work status (P=0.934) of the respondents.
Conclusion: Significantly higher frequency of female respondents who agreed to breast reconstruction after breast cancer surgery at an age older than 50, in marital status, i.e. married, living in a city (urban area) and who agreed to reconstruction in one act (primary reconstruction)