University Department of Health Studies Repository
Not a member yet
1537 research outputs found
Sort by
Comparison of attitudes of patients suffering from schizofrenia regarding the therapy they received during the acute phase of the illness and its stable remission
No full textCILJ: Usporediti stavove pacijenata oboljelih od shizofrenije prema terapiji s obzirom na akutnu fazu
bolesti i stabilnoj remisiji.
METODE: Istraživanje se provodilo od ožujka do srpnja 2023. godine. u Kliničkom bolničkom centru
Split (KBC Split). Ukupno je sudjelovalo 60 ispitanika, njih 30 se nalazi u fazi remisije te 30 u akutnoj fazi.
Upitnik obuhvaća sociodemografske podatke, podatke o životnim navikama te stavove o terapiji. Sastavljen
je od 13 pitanja otvorenog i zatvorenog tipa te 10 pitanja vezanih uz stavove o terapiji.
REZULTATI: Dobivenim podacima potvrđeno je pozitivniji stav prema terapiji ispitanika u fazi stabilne
remisije od onih koji se nalaze u akutnoj fazi. Potvrđena je hipoteza da pacijenti u fazi remisije imaju
pozitivnije stavove prema lijekovima. Potvrđena je hipoteza da su pacijenti u fazi remisije stariji od
pacijenata u akutnoj fazi. Razlike u dobi prikazane su srednjom vrijednošću što potvrđuje kako su pacijenti
u remisiji od ukupnih ispitanika stariji od pacijenata u akutnoj fazi.
ZAKLJUČAK: Iz dobivenih podataka možemo zaključiti da stariji pacijenti imaju pozitivnije stavove o
uzimanju lijekova i terapiji, posebno oni koji se nalaze u fazi stabilne remisije. Rezultati su sukladni
očekivanjima. Značajnije razlike u spolu ispitanika nema. Potrebna su daljnja istraživanja vezana uz
konkretne negativne stavove te s većim brojem ispitanika različite dobi.AIM: To compare the attitudes of patients suffering from schizophrenia towards therapy with regard to the
acute phase of the disease and stable remission.
METHODS: The research was conducted from March to July 2023. in the Split Clinical Hospital Center
(KBC Split). A total of 60 respondents participated, 30 of them are in the remission phase and 30 in the
acute phase. The questionnaire includes sociodemographic data, data on lifestyle habits and attitudes about
therapy. It consists of 13 open and closed questions and 10 questions related to attitudes about therapy.
RESULTS: The obtained data confirmed a more positive attitude towards the therapy of the subjects in the
phase of stable remission than those in the acute phase. The hypothesis that patients in remission have more
positive attitudes towards medication was confirmed. The hypothesis that patients in the remission phase
are older than patients in the acute phase was confirmed. Differences in age are shown by the mean value,
which confirms that the patients in remission are older than the patients in the acute phase.
CONCLUSION: From the obtained data, we can conclude that older patients have more positive attitudes
about taking medication and therapy, especially those who are in a phase of stable remission. The results
are in line with expectations. There is no significant difference in the gender of the respondents. Further
research related to specific negative attitudes and with a larger number of respondents of different ages is
needed
Nursing care of patients during surgery according to Dixon
No full textKarcinom kolona i rektuma često se grupira i naziva kao kolorektalni karcinom koji je treća najčešća
dijagnoza i druga najsmrtonosnija zloćudna bolest u svijetu. Kao heterogena bolest za nastanak sudjeluju
okolišni i genetski čimbenici rizika. Genske promjene uključuju različite nasljedne i stečene genske promjene.
Obično počinje nekanceroznom proliferacijom epitelnih stanica sluznice što se naziva polipom. Promjena
normalnog epitela u prekanceroznu leziju i konačno u karcinom zahtijeva akumulaciju genetskih mutacija u
razdoblju od 10 do 15. godina. Danas se takav proces objašnjava teorijom „adenom-karcinom slijed“. Stopa
incidencije i mortaliteta posljednjih je godina u stalnom padu, osim kod osoba mlađih od 50 godina. Rano
otkrivanje karcinoma predstavlja ključni korak u preživljavanju. U Hrvatskoj je od 2007. godine uveden
Nacionalni program ranog otkrivanja karcinoma u dobi od 50. do 74. godine života s ciljem što ranijeg
identificiranja polipa prije nego li pređu u karcinom. Procjena stadija proširenosti bitna je u određivanju
mogućnosti liječenja koje može biti kirurška resekcija, radio i /ili kemoterapija ovisno o smještaju, veličini i
stadiju tumora. Od kirurških zahvata za karcinome smještene u aboralnom dijelu sigmoidnog kolona i distalnom
rektumu radi se low anterior resection (LAR),zvana operacija po Dixonu koja može imati otvoreni ili minimalno
invazivni, laparoskopski pristup. Radi smanjenja kirurških komplikacija, boljih ishoda za bolesnike i radi
ekonomske koristi za cijeli zdravstveni sustav uvedeni su protokoli za ubrzani oporavak bolesnika nakon
operacije (Enhanced recovery after surgery protocols - ERAS) koji uključuju preporuke specifične za određenu
vrstu kirurgije. Multidisciplinarni tim svakom bolesniku pristupa individualno, tako i od strane medicinske sestre
koja čini glavnu sponu između zdravstvenih djelatnika i bolesnika. Njena uloga je postizanje najbolje fizičke i
psihičke priprema bolesnika za zahvat te intraoperacijska i poslijeoperacijska skrb za bolesnika. Svojom
stručnošću, pozitivnim stavom i motivacijom uključuje ga u aktivno planiranje i provedbu zdravstvene njege,
pomaže mu izgraditi povjerenje u stručnjake i samopouzdanje te ga usmjerava u procesu usvajanja poželjnih
znanja i načina ponašanja.Colon and rectal cancer is often grouped and referred to as colorectal cancer, which is the third most
common diagnosis and the second deadliest malignancy in the world. As a heterogeneous disease, environmental
and genetic risk factors participate in its development. Genetic changes include a variety of inherited and
acquired genetic changes. It usually begins with a non-cancerous proliferation of epithelial cells of the mucous
membrane, which is called a polyp. The change of normal epithelium into a precancerous lesion and finally into
cancer requires the accumulation of genetic mutations over a period of 10 to 15 years. Today, such a process is
explained by the "adenoma-carcinoma sequence" theory. The rate of incidence and mortality has been in
constant decline in recent years, except for people under the age of 50. Early detection of cancer is a key step in
survival. Since 2007, the National Cancer Early Detection Program has been introduced in Croatia for people
aged 50 to 74 with the aim of identifying polyps as early as possible before they turn into cancer. Assessment of
the stage of extension is important in determining the treatment options, which can be surgical resection, radio
and/or chemotherapy depending on the location, size and stage of the tumor. Of the surgical procedures for
cancers located in the aboral part of the sigmoid colon and the distal rectum, low anterior resection (LAR) is
performed, the so-called Dixon operation, which can have an open or minimally invasive, laparoscopic
approach. Enhanced recovery after surgery protocols (ERAS), which include specific recommendations for a
certain type of surgery, were introduced to reduce surgical complications, improve patient outcomes, and provide
economic benefits for the entire healthcare system. The multidisciplinary team approaches each patient
individually, as does the nurse who is the main link between health professionals and patients. Her role is to
achieve the best physical and psychological preparation of the patient for the procedure and intraoperative and
postoperative care for the patient. With his expertise, positive attitude and motivation, he involves him in the
active planning and implementation of health care, helps him build trust in experts and self-confidence, and
guides him in the process of adopting desirable knowledge and ways of behaving
TECHNOLOGICAL COMPARISON OF MAGNETIC RESONANCE 3T AND 7T IN BRAIN IMAGING
No full textUvod: MR je uvelike unaprijedila dijagnostičku medicinu u posljednjim desetljećima. Stalnim mijenjanjem i unaprjeđivanjem tehnoloških aspekata, MR postaje sve sofisticiranija i finija metoda. Stalnom težnjom da se povećava korišteno magnetno polje, zbog povećanja SNR-a povećava se prostorna rezolucija i kontrastnost. Ti faktori omogućuju detaljan i jasan prikaz ranije nevidljivih patologija, naročito patologija u mozgu.
Cilj rada: Cilj ovog rada je usporediti važnost tehnoloških značajki 3T i 7T MR-a u oslikavanju mozga te izdvojiti njihove prednosti i nedostatke.
Rasprava: MR 3T se koristi u svakodnevnoj kliničkoj primjeni diljem svijeta. Jedno od osnovnih pitanja kojim se znanstvenici bave u većini istraživanja je značajnost 7T u odnosu na 3T pri prikazu različitih patologija mozga. Utvrđeno je da poboljšane tehnološke karakteristike uređaja većeg magnetnog polja utječu na bolji prikaz epileptogenih lezija i lezija koje su specifične za multiplu sklerozu. Osim toga dobiva se i bolji prikaz unutarnje strukture tumora, bolji prikaz aneurizmi i mikrokrvarenja te promjena koje su karakteristične za neurodegenerativne bolesti kao što su Alzheimerova bolest i Parkinsonova bolest. Bilo je od velike važnosti utvrditi postoji li superiornost 7T kod ovih patologija da bi se utvrdile sve dostupne mogućnosti, prednosti i nedostaci jer su to bolesti koje imaju sve veću prevalenciju u populaciji. Na MR-u 7T susreću se i tehnološki problemi koji mogu dovesti do loše kvalitete snimke, za njih se predlažu i istražuju različita rješenja.
Zaključak: Pregledom brojnih istraživanja, utvrđeno je da je 3T MR kvalitetan uređaj za trenutnu primjenu, ali 7T ima mogućnost prikaza detalja i može pružiti kvalitetniju snimku i veću dijagnostičku preciznost te može biti od velikog značaja, posebice kod određenih pacijenata gdje 3T nije dovoljno detaljan. Treba uzeti u obzir da se 7T MR još uvijek treba istraživati, ali sigurna je za upotrebu na čovjeku i predstavlja budućnost dijagnostičke medicine.Introduction: MR has greatly improved diagnostic medicine in recent decades. By constantly changing and improving technological aspects, MR is becoming an increasingly sophisticated and refined method. By constantly tending to increase the used magnetic field, the spatial resolution and contrast increase due to the increase in SNR. These factors enable a detailed and clear presentation of previously invisible pathologies, especially pathologies in the brain
The aim of the work: The aim of this work is to compare the importance of the technological features of 3T and 7T MR in brain imaging and to distinguish their advantages and disadvantages.
Discussion: MR 3T is used in daily clinical practice worldwide. One of the basic questions that scientists deal with in most research is the importance of 7T compared to 3T in the presentation of various brain pathologies. It was found that the improved technological characteristics of the device with a higher magnetic field affect the better representation of epileptogenic lesions and lesions that are specific for multiple sclerosis. In addition, a better representation of the internal structure of the tumor, a better representation of aneurysms and microbleeds and changes that are characteristic of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease is obtained. It was of great importance to determine whether there is superiority of 7T in these pathologies to determine all the available possibilities, advantages and disadvantages because these are diseases that have an increasing prevalence in the population. On the MR 7T, there are also technological problems that can lead to poor recording quality, for which various solutions are proposed and investigated.
Conclusion: After reviewing numerous studies, it was determined that 3T MR is a quality device for current use, but 7T has the ability to display details and can provide a higher quality image and greater diagnostic precision and can be of great importance, especially in certain patients where 3T is not detailed enough. It should be noted that 7T MR still needs to be researched, but it is safe for human use and represents the future of diagnostic medicine
Rehabilitation procedures in patients with complex regional pain syndrome - case report
No full textKompleksni regionalni bolni sindrom (engl. complex regional pain syndrome – CRPS) stanje je trajne i onesposobljavajuće boli koje, zahvaća jednu regiju (najčešće ruku). Često se javlja nakon ozljede koja se težinom ne poklapa s razinom boli. Dijagnoza je poznata i pod nazivima kao što su simpatička distrofija, kauzalgija,Sudeckova atrofija, prolazna osteoporoza i akutna atrofija kostiju. Cilj ovog rada je prikazati epidemiologiju, etiologiju, patofiziološke mehanizme te načine dijagnosticiranja, liječenja, prevencije i smanjenja posljedica ove nedovoljno prepoznate bolesti. Razlikujemo dva oblika CRPS-a; tip 1 i tip 2.Oblik CRPS-a tip 1 (oblik poznat kao i refleksna simpatička distrofija) javlja se u pacijenta koji nema jasnu ozljedu perifernog živca i predstavlja približno 90% kliničkih prezentacija. Oblik CRPS-a tip 2 prije se nazivao i „kauzalgija“ i javlja se u pacijenata kod kojih je prisutna jasna ozljeda perifernih živaca. Patogeneza CRPS-a je nepoznata. Predloženi mehanizmi su promjene perifernog i središnjeg živčanog sustava i uključuju klasičnu i neurogenu upalu i maladaptivne promjene u percepciji boli. Genetski čimbenici također mogu biti uključeni u patogenezu CRPS-a.Studije temeljene na populaciji procjenjuju incidenciju između 5 i 26 na 100 000 godišnje.CRPS se u odraslih češće javlja na gornjim udovima. Zahvaćenost i gornjih i donjih udova kod istog bolesnika je neuobičajena. Međutim, simptomi CRPS-a mogu se proširiti tijekom vremena i zahvatiti susjedna područja zahvaćenog uda ili, povremeno, drugi ipsilateralni ili kontralateralni ud. Glavni klinički simptomi su bol, senzorne promjene, motorička oštećenja, autonomni simptomi i trofičke promjene u zahvaćenom ekstremitetu. Dijagnoza CRPS-a temelji se na kliničkim značajkama utvrđenim anamnezom i fizičkim pregledom. Međutim, neki istraživači tvrde da su određene pretrage korisne za dijagnozu CRPS-a, posebice troetapna scintigrafija kostiju koja pokazuje povećani unos radiofarmaka u zglobove oko mjesta ozljede. Drugi testovi s određenom mogućom korisnošću uključuju usporedne rendgenske snimke (npr. obje ruke snimljene na istom rendgenskom snimku) koje pokazuju točkastu demineralizaciju kostiju i dugotrajna ili ponavljana mjerenja temperature kože koja pokazuju razliku >1°C između zahvaćene i nezahvaćene strane. Liječenje CRPS-a je složeno kao i njegova sama patofiziologija te klinička slika stoga zahtjeva individualni rad i interdisciplinarnu suradnju. Farmakološki pristup jednako je bitan kao i sama fizikalna terapija. Uz današnju napredniju medicinu možemo postići puno veće, brže i bolje rezultate nego prije.Complex regional pain syndrome (eng. complex regional pain syndrome - CRPS) is a state of permanent and disabling pain that affects one region (most often the hand). It often occurs after injuries whose severity does not match the level of pain. The diagnosis is also known by names such as sympathetic dystrophy, causalgia, Sudeck's atrophy, transient osteoporosis and acute bone atrophy. The aim of this paper is to present the epidemiology, etiology, pathophysiological mechanisms and methods of diagnosis, treatment, prevention and reduction of the consequences of this insufficiently recognized disease. We distinguish between two forms of CRPS; type 1 and type 2. The type 1 form of CRPS (also known as reflex sympathetic dystrophy) occurs in patients with no clear peripheral nerve injury and accounts for approximately 90% of clinical presentations. The type 2 form of CRPS used to be called "causalgia" and occurs in patients with clear peripheral nerve injury. The pathogenesis of CRPS is unknown.Proposed mechanisms involve both the peripheral and central nervous systems and include classical inflammation, neurogenic inflammation, and maladaptive changes in pain perception.Genetic factors may also be involved in the pathogenesis of CRPS.Population-based studies estimate the incidence to be between 5 and 26 per 100,000 per year. In adults,CRPS occurs more often in the upper limbs. Involvement of both upper and lower limbs in the same patient is unusual. However,CRPS symptoms can spread over time to involve adjacent areas of the affected limb or, occasionally, the other ipsilateral or contralateral limb. The main clinical symptoms are pain, sensory changes, motor impairments, autonomic symptoms and trophic changes in the affected limb.The diagnosis of CRPS is based on clinical features determined by history and physical examination. However, some researchers claim that certain tests are useful for the diagnosis of CRPS, especially triphasic bone scintigraphy, which shows increased uptake of pharmacotracers in the joints around the injury site. Other tests of some possible utility include comparative radiographs (eg, both hands taken on the same radiograph) showing the point of bone decalcification and long-term or repeated skin temperature measurements showing a difference of >1°C for the affected versus the unaffected side. The treatment of CRPS is as complex as its pathophysiology and clinical picture, and therefore requires individual work and interdisciplinary cooperation. The pharmacological approach is just as important as the physical therapy itself.. With today's advanced medicine, we can achieve much bigger, faster and better results than before
Short validation of an automated method for erythrocyte sedimentation
No full textSažetak: Cilj ovog rada je usporediti dvije metode za test brzine sedimentacije eritrocita. Test brzine sedimentacije eritrocita važan je u kliničkoj praksi, a koristi se kod sumnje na upalnu reakciju. Uspoređivana je automatizirana metoda na iSED uređaju sa Westergren metodom, a prihvatljivost metode određena je statističkom analizom. Westergren metoda referentna je metoda za test brzine sedimentacije eritrocita, a metoda se izvodi tako da se na epruvetu s antikoagulansom natrijevim citratom (1:5) stavi Westergrenova cjevčica te nakon jedan sat očitaju rezultati. Uređaj iSED automatizirana je metoda za koju se koristi uzorak pune krvi u epruvetu sa K3EDTA antikoagulansom. Metoda je brza i jednostavna. U ovom radu ispitano je 119 uzoraka krvi koristeći obje metode. Kompatibilnost metoda uspoređena je statističkom analizom koristeći Bland Altman dijagram, Passing Bablok regresijska analiza te Spearmanov koeficijent korelacije. Metode su pokazale dobru koleraciju, no uočena je sistematska pogreška, nelinearnost i odstupanja, stoga je zaključeno da automazirana metoda na uređaju iSED ne može zamijeniti referentnu Westergren metodu.Summary: The aim of this research is to compare two methods for erythorcyte sedimentation rate. The erytrochyte sedimentation rate is a test important in clinical practice and is used for monitoring the inflammatory state of the patient. The automated method on iSED analyzer was compared to the referenced Westergren method and the acceptability of the method was determined by statistical analysis. The Westergren method is a refrenced method for erythrocyte sedimentation rate. This method is performed using a Westergren pippete that is inserted in the test tube with anticoagulant sodium citrate (1:5) and after one hour the results are ready to be read. Analyzator iSED is an automated method that uses a whole blood sample in the tube with K3EDTA anticoagulant. It is a fast and simple method. In this research, 119 patient's blood samples, that were non clotted and non lipemic, were analyzed by both methods. Compatibility of methods was compared by statistical analysis using Bland Altman plot, Passing Bablok regression analysis and Spearman's coefficient of colleration. The two compared methods showed a good correlation however, systematic error, nonlinearity and deviations were observed, therefore it is concluded that the automated method on iSED analyzer can not replace the reference Westergren metho
Neonatal hyperbilirubinemia as a neurorisk factor for the newborn - aspects of midwifery care
No full textRad se usredotočuje na stanje neonatalne hiperbilirubinemije i njezine implikacije kao rizičnog faktora za neurološki razvoj novorođenčadi. Prikazani su različiti aspekti njege primalja u vezi s upravljanjem i sprječavanjem potencijalnih komplikacija povezanih s ovim stanjem. Osim toga, dokument ističe važnost međustručne suradnje između primalja, neonatologa i drugih zdravstvenih radnika kako bi se optimizirala njega novorođenčadi s hiperbilirubinemijom. Učinkovita komunikacija i koordinacija među zdravstvenim stručnjacima ključne su u implementaciji odgovarajućih strategija liječenja.The paper focuses on the condition of neonatal hyperbilirubinemia and its implications as a risk factor for the neurological development of newborns. It presents various aspects of midwifery care related to the management and prevention of potential complications associated with this condition. Additionally, the document emphasizes the importance of interdisciplinary collaboration between midwives, neonatologists, and other healthcare professionals to optimize the care of newborns with hyperbilirubinemia. Effective communication and coordination among healthcare professionals are crucial in implementing appropriate treatment strategies
Laboratory diagnosis of Toxoplasma gondii infection
No full textCilj rada: Svrha rada je opisati serološku dijagnostiku toksoplazme u Nastavnom zavodu za javno zdravstvo Splitsko-dalmatinske županije.
Materijali i metode: U proces serološke dijagnostike parazita Toxoplasma gondii su u Nastavnom zavodu za javno zdravstvo Splitsko-dalmatinske županije uključeni uzorak krvi iz kojeg se za testiranje centrifugiranjem izdvaja serum, oprema s reagensima i analizator Abbot Alinity. Iz seruma se ispituju IgG i IgM antitijela pri čemu su IgM antitijela oznaka akutne infekcije, a IgG prošle. Metoda analize antitijela je CMIA, što je kratica od kemiluminiscentne metode s mikročesticama. Uzorci i reagensi imaju pripadajuće nosače te ih aparat pipetira čime ostvaruje reakciju. Signal reakcije je svjetlosni, brojčano iskazan na ekranu u dogovorenim jedinicama.
Rezultati: Serološkim testiranjem pacijentova uzorka utvrđeno je postojanje IgG antitijela uz izostanak IgM antitijela što ukazuje na preboljenu infekciju toksoplazmomObjectives: The purpose of this bachelor's thesis is to describe the method of serological diagnosis of Toxoplasma
gondii infection at the Teaching Institute for Public health of Split-Dalmatia County.
Materials and methods: In the process of serological diagnosis of the parasite Toxoplasma gondii, the Teaching Institute for Public health of Split-Dalmatia County includes a blood sample from which serum is separated for testing by centrifugation, equipment with reagents and the Abbot Alinity analyzer. IgG and IgM antibodies are tested from the serum, where IgM antibodies are a sign of acute infection, and IgG of past. The antibody analysis method is CMIA, which stands for chemiluminescent microparticle method. Samples and reagents have their own carriers and the machine pipettes them, thus realizing the reaction. The reaction signal is light, numerically displayed on the screen in agreed units.
Results: Serological examination of the patient's sample revealed the presence of IgG antibodies and the absence of
IgM antibodies, which indicates a past toxoplasma infectio
Nursing care of children with supracondylar fracture of humerus - report of a case
No full textMedicinske sestre pomažu u lakšem prihvaćanju bolesti. Njihov individualizirani pristup i adekvatna psihološka priprema djece i roditelja čine hospitalizaciju manje stresnom te samim time sprječavaju hospitalizam i utječu na brži oporavak djeteta. Takav pristup je naročito dobro došao u slučajevima prijeloma zbog osjećaja bola i neophodne hospitalizacije radi saniranja ozljede. Najčešća vrsta prijeloma u djece su suprakondilarni prijelomi. U radu je dan prikaz slučaja sestrinske skrbi jedne šestogodišnje djevojčice sa suprakondilarnim prijelomom koja je morala biti podvrgnuta operacijskom zahvatu. Rad pokazuje iznimno značajnu sestrinsku ulogu u anamnezi, procjeni, intervenciji te konačno evaluaciji zdravstvene skrbi djevojčice. Među najvažnijim prioritetima pokazale su se emocionalne potrebe djeteta. Istraživanje je pokazalo da medicinske sestre, pored same uloge kao zdravstvenog djelatnika stručnog tima, imaju zadatak zagovarati i osigurati najbolje interese djeteta smanjenjem stresa i reakcija straha koje bi se mogle pojaviti u djece i roditelja.Nurses help to make it easier to accept the disease. Their individualized approach and adequate psychological preparation of children and parents make hospitalization less stressful, thus preventing hospitalization and influencing the child's faster recovery. Such an approach is especially useful in cases of fractures due to pain and necessary hospitalization to repair the injury. The most common type of fracture in children is a supracondylar fracture. The paper presents the case of nursing care of a six-yearold girl with a supracondylar fracture who had to undergo surgery. The work shows the extremely important nursing role in the anamnesis, assessment, intervention, and finally evaluation of the girl's health care. Among the most important priorities were the emotional needs of the child. The research showed that nurses, in addition to their role as health workers of the professional team, have the task of advocating and ensuring the child's best interests by reducing stress and fear reactions that could appear in children and parents
Health care for a child with Rasmussen's encephalitis
No full textUvod: Rasmussenov encefalitis (drugog naziva Rasmussenov sindrom) označava autoimunu upalu moždanog parenhima koja za posljedicu ima niz neuroloških ispada. Jedan od najznačajnijih je parcijalna ili generalizirana epilepsija rezistentna na primjenu oralnih antiepileptika, hemipareza i afazija.
Cilj rada: Cilj ovog završnog rada je opisati sestrinsku skrb djeteta oboljelog od Rasmussenovog encefalitisa kroz prikaz slučaja.
Prikaz slučaja: U svijetu se godišnje dijagnosticira 200 -500 slučajeva Rasmussenovog encefalitisa a jedan od njih je dijagnosticiran 2020. godine u KBC-u Split 8-godišnjoj djevojčica N.N. Prvi simptomi prisutni kod djevojčice bili su motorički deficit desne ruke, odstupanje u grafomotorici, pamćenju i govoru. Dijagnostički postupci su potvrdili dijagnozu te je djevojčica provela 40 dana na bolničkom liječenju tijekom kojeg su provedeni terapijski i rehabilitacijski postupci.
Zaključak: Rasmussenov encefalitis je rijetka neurološka bolest kroničnog tijeka koja se manifestira epileptičkim napadajima, gubitkom motoričkih funkcija i promjenama u ponašanju. Sestrinska skrb za dijete oboljelo od Rasmussenovog encefalitisa zahtijeva stručnost, osjetljivost i predanost. Ona je važan faktor u tijeku liječenja te samim time utječe i na povoljnost prognoze bolesti.Introduction: Rassmussen’s encephalitis (also known as Rassmussen’s syndrome) is an autoimmune inflammation of the brain parenchyma that leads to a series of neurological manifestations. The most important of these include partial or generalized epilepsy that does not respond to oral antiepileptic drugs, hemiparesis and aphasia.
Aim: The aim of this bachelor thesis is to describe the nursing care of a child suffering from Rassmussen's encephalitis on the basis of a case report.
Case report: Of the 200 to 500 cases of Rasmussen’s encephalitis diagnosed worldwide in a year, one case was diagnosed in an 8-year-old girl at Split University hospital in 2020. Her first symptom was a motor deficit of the right hand, a graphomotor, speech and memory disorder. Diagnostics confirmed the diagnosis of Rasmussen's encephalitis and the girl was hospitalized to the Split University hospital for 40 days of therapy and rehabilitation.
Conclusion: Rassmussen’s encephalitis is a rare neurological disease with a chronic course characterized by epileptic seizures, loss of motor function and behavioural changes. The nursing care of a child suffering from Rasmussen's encephalitis requires specialist knowledge, sensitivity and commitment. It is an important factor in the course of treatment
Influence of preoperative nutritional support on length of hospitalization in colorectal cancer surgery patient
No full textCilj rada: Cilj ovog rada je usporediti duljinu hospitalizacije između dvije skupine pacijenata – pacijenti koji su uzimali nutritivnu potporu prije operacije i pacijenata koji nisu uzimali. Ispitanici i metode: U ovo je retrospektivno istraživanje u koje su uključeni pacijenti i pacijentice operirani u Klinici za kirurgiju KBC-a Split u razdoblju od 1.1. 2021. godine do 31.12.2021. godine. U istraživanju je sudjelovalo 135 pacijentica/a koji su bili dio ERAS protokola u navedenom razdoblju. Svi pacijenti su bili hospitalizirani na Zavodu za abdominalnu kirurgiju KBC Split te o njima su se brinuli isti tim liječnika i medicinskih sestara. Ispitanici su podijeljeni u dvije skupine, pacijenti koji su uzimali nutritivnu potporu prije operacijskog zahvata i oni koji nisu uzimali. Podaci su prikupljeni iz ERAS protokola Klinike za kirurgiju KBC Split i biometrijske vage Tanita 780MA. Rezultati: Pacijenti koji su bili podvrgnuti nutricionističkoj intervenciji 14 dana prije operacije pokazali su medijan boravka u bolnici od 6 dana, što je bilo isto kao i kod skupine u kojoj nije napravljena nikakva nutritivna intervencija. Aritmetička sredina sa standardnom devijacijom mišićnog indeksa bez masti unutar skupine koja nije primila nutritivnu intervenciju bila je 74,04 ± 9,26% u usporedbi sa 72,16 ± 7,66% u skupini koja je uzimala oralne dodatke prehrani prije operacije. U skupini koja je prošla edukaciju, utvrđene su značajne promjene u svim varijablama s obzirom na stanje prije edukacije, osim u varijablama ITM, VFatL i težini. Vezano uz mjerenje na dan operacije, nije utvrđena značajna razlika između skupina u niti jednom parametru uključujući NRS. Jedino je za fazni kut utvrđena granična značajnost pri čemu su vrijednosti u skupini s edukacijom bile nešto više negoli u skupini bez edukacije. Zaključak: Iako rezultat ovog istraživanja nije dao značajnu razliku između prijeoperacijske nutritivne potpore i duljine hospitalizacije, rezultati sa sličnim studijama su bolji u korist kraće hospitalizacije. Međutim teško je i donijeti samo jedan zaključak jer je jako puno stavki u ERAS protokolu koji bi trebali biti zadovoljeni. Nedostatak ERAS protokola je i needuciranost i neprihvaćanje osoblja novih smjernica. Bez obzira na to ERAS je sigurno jedan od najboljih prijeoperacijskih protokola. Danas postoji više od dvadeset smjernica u različitim granama kirurgije i sve više se razvija.Aim: The aim of the study was to compare the length of hospitalization between two groups of patients - patients who received nutritional support before surgery and patients who did not. Methods: This retrospective study included patients operated on at the KBC Split Surgery Clinic in the period from 1.1. 2021 until 31.12.2021. years. 135 patients who were part of the ERAS protocol during the specified period participated in the research. All patients were hospitalized at the Department of Abdominal Surgery of KBC Split and were cared for by the same team of doctors and nurses. The subjects were divided into two groups, patients who took nutritional support before surgery and those who did not. The data were collected from the ERAS protocol of the KBC Split Surgery Clinic and the biometric scale Tanita 780MA Results: Patients who underwent nutritional intervention 14 days before surgery showed a median hospital stay of 6 days, which was the same as the group in which no nutritional intervention was performed. The arithmetic mean with standard deviation of the fat-free muscle index within the group that received no nutritional intervention was 74.04 ± 9.26% compared with 72.16 ± 7.66% in the group that received oral nutritional supplements before surgery. In the group that underwent education, significant changes were found in all variables about the state before education, except for BMI, VFatL and weight variables. Regarding the measurement on the day of surgery, no significant difference was found between the groups in any parameter including NRS. Borderline significance was determined only for the phase angle, where the values in the group with education were slightly higher than in the group without education. Conclusion: Although the result of this study did not show a significant difference between preoperative nutritional support and length of hospitalization, results with similar studies are better in favour of shorter hospitalization. However, it is difficult to draw just one conclusion because many items in the ERAS protocol should be satisfied. The lack of ERAS protocol is a lack of training and non-acceptance of new guidelines by the staff. Regardless, ERAS is certainly one of the best preoperative protocols. Today there are more than twenty guidelines in different branches of surgery and more and more are being developed