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Causes and results of infertility treatment by artificial reproductive tehniques ( ART) at Department of Obstetrics and Gynecology, University Hospital of Split, 2022
No full textCilj ovog istraživanja je analizirati neplodnost parova, kao i najčešće uzroke ovog medicinskog problema koji posljednjih godina bilježi značajan porast. Istraživanje je provedeno za period od siječnja 2021. godine do prosinca 2021. godine. Analizirali smo dob pacijentica, odabrani postupak liječenja te same ishode liječenja. Postoji mnogo uzroka neplodnosti, koji mogu uključivati hormonske poremećaje, problema sa testisima ili jajnicima, problemima s jajovodima ili endometrijem i mnoge druge. Jedna od metoda liječenja neplodnosti je medicinski potpomognuta oplodnja (MPO), koja uključuje različite tehnike za pomoć u začeću. Vrste MPO-a uključuju intrauterinu inseminaciju (IUI), in vitro oplodnju (IVF) i intracitoplazmatsku injekciju spermija (ICSI). Cilj rada je bio istražiti koje metode medicinski pomognute oplodnje se najviše koriste i imaju najveću uspješnost začeća i poroda živorođenog djeteta u Klinici za ženske bolesti i porode. Metode koje se koriste su IUI, IVF/ET (embriotransfer), ICSI/ET, FET (frozen embryo transfer). Stopa uspješnosti svih metoda pomognute oplodnje varira ovisno o različitim faktorima, kao što su dob žene, kvaliteta jajnih stanica i spermija, vrsti metode oplodnje. U Klinici za ženske bolesti i porode u Splitu, najveći broj pacijentica je u dobnoj skupini mlađih od 34 godine, a najmanje ih je starijih od 40 godina. Kod pacijentica starijih od 40 godina najveći uspjeh je pokazalo liječenje postupkom ICSI. Izbor tehnike ovisi o uzroku neplodnosti i drugim čimbenicima. Važno je razgovarati s liječnikom o opcijama liječenja i očekivanjima prije nego što se odlučite za bilo koju metodu liječenja neplodnosti. Istraživanjem je također potvrđeno kako su rezultati Zavoda za humanu reprodukciju i endokrinologiju Klinike za ženske bolesti i porode Split usporedivi s rezultatima drugih razvijenih zemalja.The aim of this study was to investigate infertility occurring in couples, as the most common cause of this growing medical problem involving both partners. The research was conducted for the period from January 2021 to December 2021. The results included the age of the patients, the chosen treatment procedure and the outcome of the treatment itself. There are many causes of infertility, which can include hormonal disorders, problems with the testicles or ovaries, problems with the fallopian tubes or endometrium, and many others. One of the methods of treating infertility is artificial reproductive techniques (ART), which includes various techniques to assist in conception. Types of ART include intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI). The aim of the work was to investigate which medical methods that help fertilization are used the most and have the highest success rate of conception and delivery of a live-born children in the Clinic for Women's Diseases and Childbirth. The methods used were IUI, IVF/ET (embriotransfer), ICSI/ET, FET (frozen embryo transfer). The success rate of all fertilization methods varies depending on various factors, such as women’s age, quality of eggs and sperm, type of fertilization method. In the Clinic for Women's Diseases and Childbirth in Split, the largest number of patients were in the age group under 34 years old, and the smallest number were over 40 years old. In patients over 40 years of age, ICSI treatment has shown the greatest success. The choice of technique depends on the cause of infertility and other factors. It's important to talk to your doctor about your treatment options and expectations before deciding on a fertility treatment method. The research also confirmed that the results of the Institute for Human Reproduction and Endocrinology of the Clinic for Women's Diseases and Childbirth in Split were compared with the results of other developed countries
ANALYSIS OF MORTALITY OF PATIENTS WITH SARS-CoV2 INFECTION IN THE "FOURTH WAVE" TREATED IN THE INTENSIVE CARE UNIT OF THE CLINICAL HOSPITAL CENTER SPLIT
No full textCILJ: Cilj ovog istraživanja je analizirati mortalitet bolesnika od infekcije virusom SARS-COV-2 u
„Četvrtom valu“ koji su liječeni u jedinici intenzivnog liječenja Kliničkog bolničkog centra Split.
METODE: Podaci su prikupljani u vremenskom razdoblju od početka srpnja do kraja prosinca 2021.
godine u Jedinici intenzivnog liječenja Kliničkog bolničkog centra Split. Na temelju prikupljenih podataka
obrađivani su povezanost broja komorbiditeta, dobi i statusa cijepljenja s mortalitetom oboljelih od
infekcije COVID-19 liječenih u Jedinici intezivnog liječenja.
REZULTATI: Prikupljeni su podaci o 425 bolesnika koji su liječeni u Jedinici intezivnog liječenja u
razdoblju od početka srpnja do kraja prosinca 2021. godine. Rezultati istraživanja su pokazali raznolikost
među bolesnicima liječenima u COVID-19 u promatranom vremenskom razdoblju.
ZAKLJUČAK: Delta varijanta virusa je pogubnije djelovala na muškarce, poglavito starije životne dobi,
necijepljene, kao i bolesnike s komorbiditetima. Isto se može reći i za ostale varijante virusa, što dovodi
do zaključka da COVID-19, zarazna bolest uzrokovana virusom SARS-CoV-2, nije bezazlena bolest
kako je u jednom trenutku izgledalo, naprotiv, vrlo je opasna i nepredvidljiva zarazna bolest za koju se
ni danas ne može reći da je stavljena pod kontroluAIM: The aim of this research is to analyze the mortality of patients from SARS-COV-2 infection in the
"Fourth wave" who were treated at the Intensive Care Unit of Clinical Hospital Centre Split.
METHODS: Data were collected in the period from July to the end of the December of 2021 at the
Intensive Care Unit of Clinical Hospital Centre Split. On the basis of the collected data, the association
of the number of comorbidities, age and vaccination status with the mortality of COVID-19 patients
treated at the Intensive Care Unit of Clinical Hospital Centre Split were analyzed.
RESULTS: The results of the research showed diversity among patients treated at the Intensive Care
Unit of Clinical Hospital Centre Split in the observed period. Data were collected on 425 patients who
were hospitalized at the department in the period from the beginning of the July to the end of the
December 2021.
CONCLUSION: The delta variant of the virus had a more devastating effect on man, especially the
older ones, unvaccinated, and patients with comorbidities. The same can be said for the other variants,
which leads to the conclusion that COVID-19, infection caused by SARS-CoV-2, is not a harmless
disease as it once seemed, but on the contrary, a very dangerous and unpredictable infectious disease
that even today cannot be said to have been put under contro
DIFFERENCES IN ATTITUDES ABOUT VACCINATION AGAINST COVID 19 DISEASE BETWEEN DOCTORS AND NURSES/TEHNICIANS IN THE AREA SPLIT-DALMATIA COUNTY
No full textCILJ: Glavni cilj ovog istraživanja bio je istražiti razliku u stavovima između liječnika i medicinskih sestara/tehničara o cijepljenju protiv COVID – 19 bolesti na području Splitsko-dalmatinske županije.
METODE: Provedeno je presječno istraživanje u svrhu ispitivanja stavova o cijepljenju protiv COVID - 19 bolesti među liječnicima i medicinskim sestrama/tehničarima na području Splitsko – dalmatinske županije. Za potrebe izrade empirijskog dijela ovog rada proveden je anketni upitnik na koji je odgovorilo 396 zdravstvenih djelatnika. Prikupljeni su podatci o sociodemografskim karakteristikama, kao i podatci o stavu ispitanika o COVID - 19 bolesti i cjepivu protiv COVID - 19 bolesti.
REZULTATI: U istraživanju je sudjelovalo 396 zdravstvenih djelatnika. Ispitanici su kategorizirani u dvije skupine – liječnike (77 ispitanika ili 19,44 %) i medicinske sestre/tehničare (319 ispitanika ili 80,56%) te je za 4,14 puta više medicinskih sestara/tehničara u odnosu na liječnike. U obje promatrane skupine veći je broj ispitanica u odnosu na ispitanike. Najveći broj medicinskih sestara/tehničara se cijepio s dvije doze cjepiva protiv COVID – 19 bolesti (n=123; 38,56%), dok je najveći broj liječnika s tri doze (n=35; 45%). Najveći broj zdravstvenih djelatnika u obje skupine je cijepljeno Pfizerom te je za 24,94% više liječnika cijepljeno Pfizerom u odnosu na medicinske sestre/tehničare. Najviša medijan srednja vrijednost slaganja je utvrđena na tvrdnje Smatram da su cjepiva općenito korisna. (Medijan=5; IQR=3-5) i Cijepio sam/cijepio bih svoju djecu redovitim cjepivima po nacionalnom kalendaru. (Medijan=5; IQR=4-5). Najniža medijan srednja vrijednost slaganja je utvrđena na tvrdnje Smatram da bi cijepljenje protiv COVID - 19 infekcije trebalo biti obvezno za sve. (Medijan=2; IQR=1-3) i Smatram da su nuspojave cjepiva gore od simptoma COVID - 19 infekcije. (Medijan=2; IQR=1-4).
ZAKLJUČAK: Analizom dobivenih podataka potvrđeno je da medicinske sestre/tehničari imaju negativnije stavove prema cijepljenju protiv COVID - 19 bolesti od liječnika, te da viši stupanj obrazovanja utječe na pozitivnije mišljenje o cijepljenju.AIM: The main aim of this study was to investigate a difference in attitudes between nurses/technicians and doctors regarding vaccination against the COVID - 19 disease.
METHODS: A cross-sectional study was conducted in order to examine attitudes towards vaccination against the COVID - 19 disease among doctors and nurses/technicians in the area of Split-Dalmatia County. For the purpose of creating the empirical part of this study, a survey questionnaire was conducted among 396 healthcare workers. Data were collected on sociodemographic characteristics were collected, as well as data on the attitude towards the COVID - 19 disease and the vaccine against the COVID - 19 disease.
RESULTS: In the study 396 healthcare workers participated. Respondents were categorized into two groups – doctors (77 respondents, 19,444%) and nurses/technicians (319 respondents, 80,556%). There were 4.14 times more nurses/technicians than doctors. The number of female respondents was higher in both observed groups. The largest number of nurses/technicians received two doses of the vaccine against the COVID - 19 disease (n=123; 38.56%), while the largest number of doctors received three doses (n=35, 45%). The largest number of health workers in both groups were vaccinated with Pfizer, and 24.94% more doctors were vaccinated with Pfizer compared to nurses/technicians. The highest median value of agreement was found on the statement I think vaccines are generally useful (Median=5; IQR=3-5) and I have vaccinated/would vaccinate my children with regular vaccines according to the National Immunization Program Schedule (Median=5; IQR=4-5). The lowest median value of agreement was determined on the statement I believe that vaccination against the COVID - 19 infection should be mandatory for everyone (Median=2; IQR=1-3) and I think the side effects of the vaccine are worse than the symptoms of the COVID - 19 infection (Median=2; IQR=1-4).
CONCLUSION: The analysis of the obtained data confirmed that nurses/technicians have more negative attitudes towards vaccination against the COVID - 19 disease than doctors, and that a higher level of education influences a more positive opinion about vaccination
Limiting factors in hematopoietic stem cell transplantation
No full textCilj: Cilj rada je bio ispitati i analizirati rezultate tipizacije HLA pacijentice i njene obitelji. Pacijentici koja je bolovala od teškog oblika akutne mijeloične leukemije (AML) utvrdili smo je li postoji HLA identičan srodnik kako bi mogla krenuti u postupak transplantacije.
Materijal i metode: Metode korištene u ovom završnom radu su: serološka metoda tj. test mikrolimfocitotoksičnosti i metode molekularne biologije PCR - SSP i PCR– SSO metode.
Rezultati: Razvojem metoda u medicini i biologiji, povećava se osjetljivost i točnost rezultata. Samim time pacijentu je moguće pružiti više opcija liječenja. TKMS postale su rutinske operacije i čest izbor u liječenju mnogih bolesti.
Zaključak: Najvažnija stavka prije provedbe transplantacije krvotvornih matičnih stanica je pronalazak odgovarajućeg donora, kako bi liječenje oboljelih od malignih i nemalignih bolesti završilo što uspješnije.Objectives: The objective of the paper was to analyze the results of the HLA typing of the patient and her family. For a patient who suffered from a severe form of acute myeloid leukemia (AML), treated at the Department of Hematology of the Split Clinical Hospital Center, we determined whether there was an HLA-identical relative so that she could start the transplantation procedure.
Material and methods: The methods used in this final work are: serological method and molecular biology method PCR-SSO.
Results: By developing all the methods used in this system of treatment and typing, by determining the genes and antigens of the system, the sucess rate of hematopoetic stem cell transplatation has increased. With the discovery oh the HLA system, hematopoetic stem cell transpatation is a choice in the teratment of many hematological diseases.
Conclusion: The most important step before carrying out the transplantation of hematopoietic stem cells is finding a suitable donor, so that the treatment of patients with malignant and non-malignant diseases ends as successfully as possible
The role of the midwife in the antenatal care and delivery of twin pregnancies in KBC Split during 2022
No full textUloga primalje u blizanačkim trudnoćama važna je zbog fizičke i emocionalne
pripreme trudnice. Blizanačke trudnoće, zbog postojanja dva ploda, vode većim i češćim
komplikacijama za trudnicu i dijete koje se očituju tijekom same trudnoće, tijekom i nakon
poroda. S obzirom na navedene čimbenike, uloga primalje je, uz pripomoć liječniku,
uspostaviti emocionalnu povezanost s budućom majkom, te objasniti način na koji bi
proces trebao ići. Blizanačke trudnoće mogu biti jednojajčane i dvojajčane, traju 35 do 37
tjedana, te njihovo utvrđivanje treba biti pravovremeno. Cilj antenatalne skrbi je spriječiti
prijevremeni porod, prepoznati intrauterine poremećaje rasta, poduzeti mjere za
pravovremeni porod i smanjiti rizik od oštećenja djeteta. Četiri su porođajna doba, te kod
svakog postoji opasnost od komplikacija u bilo kojem trenutku.The role of the midwife in twin pregnancies is important because of the physical
and emotional preparation of the pregnant woman. Twin pregnancies, due to the existence
of two fetuses, lead to greater and more frequent complications for the pregnant woman and
the child, which manifest themselves during the pregnancy itself, during and after
childbirth. Considering the above factors, the role of the midwife, with the help of the
doctor, is to establish an emotional connection with the expectant mother, and to explain
the way in which the birth should proceed. Twin pregnancies can be monozygotic or
fraternal, they last about 35 weeks, and their determination should be timely. The goal of
antenatal care is to prevent premature birth, recognize intrauterine growth disorders, take
measures for timely delivery and reduce the risk of damage to the child. There are four
stages of childbirth, and with each there is a risk of complications at any time
Nursing care of a newborn with hypertrophic pyloric stenosis - report of a case
No full textSestrinska skrb u novorođenčeta s hipertrofičnom stenozom pilorusa predstavlja kompleksno područje zdravstvene zaštite koje zahtijeva pažljivo, brzo praćenje, intervencije, podršku novorođenčetu i njegovoj obitelji. Hipertrofična stenoza pilorusa je patološko stanje karakterizirano suženjem izlaza želuca, zahtijevajući ranu dijagnozu i promptno liječenje kako bi se izbjegle ozbiljne komplikacije. U pripremi novorođenčeta za operaciju, medicinske sestre imaju ključnu ulogu u prikupljanju relevantnih podataka, edukaciji roditelja i osiguravanju optimalnih uvjeta za kirurški zahvat. Tijekom istih operacija, sestre pažljivo prate vitalne znakove, podržavaju anesteziju i surađuju s kirurškim timom kako bi se osigurala sigurnost i uspješnost zahvata. Poslijeoperacijska skrb obuhvaća praćenje vitalnih znakova, kontrolu boli, hranjenje, prevenciju infekcija i emocionalnu podršku obitelji. Medicinske sestre prate oporavak operativnog područja, potiču mobilizaciju i educiraju roditelje o postoperativnoj njezi kod kuće. Ova cjelovita sestrinska skrb usmjerena je na osiguranje brzog oporavka novorođenčeta, minimiziranje rizika komplikacija te pružanje emocionalne i stručne podrške obitelji tijekom čitavog procesa. Timski pristup, multidisciplinarna suradnja i visoka razina senzibiliteta prema potrebama novorođenčeta čine temelj uspješne sestrinske skrbi u slučaju hipertrofične stenoze pilorusa.The nursing care of neonates with hypertrophic pyloric stenosis is a complex area of health care that requires careful, rapid intervention monitoring and support of the patient and family. Hypertrophic pyloric stenosis is a pathologic condition characterized by narrowing of the gastric outlet that requires early diagnosis and prompt treatment to avoid serious complications. When preparing a newborn for surgery, nurses play a key role by collecting relevant data, educating parents and ensuring optimal conditions for surgery. During surgeries, nurses carefully monitor vital signs, assist with anesthesia and collaborate with the surgical team to ensure the safety and success of the procedure. Postoperative care includes monitoring vital signs, pain control, nutrition, infection prevention, and emotional support for the family. Nurses monitor recovery of the surgical area, encourage mobilization and educate parents about postoperative care at home. This comprehensive nursing care aims to ensure the rapid recovery of the newborn, minimize the risk of complications and provide emotional and professional support to the family through the entire process. A team approach, multidisciplinary collaboration and a high degree of sensitivity to the needs of the newborn form the basis of successful nursing care for hypertrophic pyloric stenosis
The need and effectiveness of mechanical stool cleaning in children with Hirschsprung's disease at CHC Split
No full textHirschsprungova bolest (HB) je prirođena anomalija inervacije crijeva. Uglavnom je ograničena na kolon te dovodi do potpune ili djelomične opstrukcije u prolasku crijevnog sadržaja. U većine bolesnika, radi se o bolesti kratkog segmenta u kojih je zahvaćen uglavnom rektum i rektosigmoidno područje. Bolest dugog segmenta odnosi se na aganglionozu proksimalno od sigmoidnog kolona dok je potpuna aganglionoza kolona prisutna u rijetkim slučajevima bolesnika te može zahvatiti i tanko crijevo. Mehaničko čišćenje stolice potpomaže smanjivanju distendiranog dijela crijeva što je velika prednost za izvedbu operacije jednog akta. Smanjuje i mogućnost nastanka ozbiljne komplikacije razvoja toksičnog enterokolitisa koje nastaju zbog zadržavanja stolice i umnažanja patogenih bakterija u dilatiranom dijelu crijeva. Cilj istraživanja je utvrditi potrebe i uspješnost mehaničkog čišćenja stolice u djece s dijagnozom HB. Hipoteze istraživanja su da mehaničko čišćenje stolice u djece oboljele od Hirschsprungove bolesti smanjuje duljinu hospitalizacije, primjenu antibiotika te umanjuje broj komplikacija. Istraživanje je provedeno na Klinici za dječju kirurgiju Kliničkog bolničkog centra Split. Podaci su prikupljani putem sekundarnih izvora odnosno putem baze podataka Kliničkog bolničkog centra Split. U istraživanje je uključeno 21 dijete od kojih je ispitivana skupina (n=5) bila podvrgnuta mehaničkom čišćenju stolice. Prikupljeni podaci su statistički obrađeni koristeći Hi kvadrat test, Fisherov egzaktni test, te Mann-Whitney U test. Analiza je napravljena u statističkom softwareu STATISTICA 14, proizvođača TIBCO. Većina djece je bila muškog spola te mlađa od jedne godine. Statistički značajni rezultati uočeni su u broju dana primjene antibiotika (p=0,002), dok u duljini boravka provedenog u bolnici kao i u podacima vezanim za komplikacije nismo pronašli statistički značajne rezultate. HB je rijetka bolest stoga je i ova studija provedena na malom uzorku pacijenata. Potrebno je prikupiti više podataka i u daljnja istraživanja uključiti veći broj bolničkih centara.Hirschsprung`s disease is a congenital anomaly of intestinal inervation. It is mostly limited to colon and leads to complete or partial obstruction and couses problems of passing stool. Majority of patients have a short-segment disease in which the rectum and sigmoid colon are affected. The long segment disease refers to aganglionosis proximal to the sigmoid colon, while complete aganglionosis is present extremly rarely it can it can affect small intestine as well. Mechanical stool cleaning helps to reduce the distended part of the intestine, which is a great advantage for the preformance of a single-stage pulltrough operation. It also reduces the possibility of developing serious complications such as toxic enterocolitis coused by stool retention and multiplication of pathogenic bacteria in the dilated parto f the intestine. Thea im of the research is to determine the needs and effectivenes of mechanical stool cleaning in children with Hirschsprung disease. The reasearch was conducted at the Pediatric Surgery Clinic of University hospital Split Hypotetheses of the research are that mechanical stool cleaning in children with Hirschsprung disease reduces the lenght of hospitalization, use of antibiotics and reduces complications. Dana were collected trought database of the CHC Split. Of 21 children that participated in the research five of them underwent mechanical stool cleaning. Collected dana were statisticaly processed with Chi-square test, Fisher`s exact test and Mann-Whitney U test. Analysis was done in ststatistical software STATISTICA 14, produced by TIBACO. Most of them were male and under one year old. Statisticly sigbificant results were observed in the lenght of antibiotic administration and in the lenght of hospitalisation but there were no significant difference in number of complications between two groups. Hirschsprung disease is rare therefore this study was conducted on a small sample of patients. It is necessary to collect more data and include a larger number of hospital centers in further research
Frequency of injuries and poisonings treated at Split-Dalmatia County's emergemcy department
No full textCilj: Cilj ovog rada je utvrditi učestalost ozljeda i trovanja liječenih u ZHM SDŽ, gledano kroz vremena prije pojave pandemije COVID-19, godine pandemije COVID-19 i vremena nakon okončanja 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: U vrijeme pandemije Covid-19 najmanji je broj prijavljeni intervencija u ZHM SDŽ, za razliku od vremena prije i poslije pandemije. Više od 60% u svim navedenim razdobljima su muškarci. Bolesnici su najčešće zatražili liječenje od ozljeda i trovanja u mjesecima lipanj, srpanj, kolovoz, rujan. Najveći broj zatraženih intervencija hitne medicinske pomoći je kod dobne skupine 0-19, zatim dobne skupine 65 i više godina. Veći broj pacijenata traži liječenje putem ambulante, dok kod starije populacije, odnosno umirovljenika u dobi od 65 i više godina, češće se obraćaju timovima za intervencije (TIM 1 ili TIM 2) u usporedbi s ambulantom.
Zaključci: Veći broj intervencija odvijao se u razdoblju prije nego u razdoblju s pandemijom COVID-19. Primijećena je značajna razlika u učestalosti dolazaka pacijenata tijekom ljetne sezone u svim razdobljima pandemije. Najčešće na liječenje dolazila je muška populacija ,a dobna skupina najzastupljenija su najmlađi od 0-19 godina.Objective: The aim of this work is to determine the frequency of injuries and poisonings 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: During the Covid-19 pandemic, the lowest number of reported interventions in ZHM SDŽ, in contrast to the time before and after the pandemic. More than 60% in all mentioned periods are men. Patients most often requested treatment for injuries and poisoning in the months of June, July, August, and September. The largest number of requested emergency medical interventions is for the age group 0-19, followed by the age group 65 and older. A greater number of patients seek treatment through an outpatient clinic, while the elderly population, that is, pensioners aged 65 and over, more often turn to intervention teams (TIM 1 or TIM 2) compared to the ambulance.
Conclusions: A greater number of interventions took place in the period before, than in the period with the COVID-19 pandemic. A significant difference was observed in the frequency of patient arrivals during the summer season in all periods of the pandemic. Most often, the male population came for treatment, and the age group most represented were the youngest 0-19 years old
Significance of laboratory diagnostics in patients with Hashimoto's disease
No full textCilj ovog rada je prikazati ulogu i važnost laboratorijske dijagnostike u pacijenata koji boluju od autoimune bolesti Hashimotovog tireoiditisa. Ova dijagnostika je temelj kako za postavljanje dijagnoze, tako i za praćenje i prognozu ove bolesti, a uz neke druge metode poput ultrazvuka omogućuje također sigurne i pouzdane rezultate. Rad se prvo bavi opisivanjem organa štitne žlijezde i objašnjava kakva je to bolest Hashimotov tireoiditis te time uvodi u važnost same tematike rada. Za dijagnostiku su napravljeni biokemijski testovi na koncentracije najvažnijih hormona štitne žlijezde, hormona TSH, T4, fT4, T3 i fT3. Mjerene su na uređaju Roche cobas e 800 metodom elektrokemiluminiscentnim imunoesejem „ECLIA”. Količina antitijela protiv tireoglobulina (anti-Tg) i antitijela protiv tireoidne peroksidaze (TPO) mjerene su na uređaju Abbott-Alinity kemiluminiscentnom imunokemijskom metodom „CMIA”. Također je provedeno određivanje alela lokusa HLA-B i HLA-DRB1 molekularnom metodom PCR-SSO (Polymerase chain reaction sequence-specific oligonucleotide) na Luminex® aparatu. U svrhu tipizacije pacijenta kako bi se odredila potencijalna genetska podloga bolesti. Rezultati su pokazali izrazito visoke koncentracije antitijela protiv tireoglobulina (anti-Tg) i antitijela protiv tireoidne peroksidaze (TPO), ali rezultati tipizacije nisu ukazali na genetsku predispoziciju bolesti kod ovog pacijenta.The aim of this paper is to show the role and importance of laboratory diagnostics in patients suffering from the autoimmune disease Hashimoto's thyroiditis. This diagnostic is the basis for establishing a diagnosis, as well as for monitoring and prognosis of this disease, and along with some other methods such as ultrasound, it also provides safe and reliable results. The paper first deals with describing the organs of the thyroid gland and explains what kind of disease Hashimoto's thyroiditis is, thereby introducing the importance of the topic of the paper itself. For diagnosis, biochemical tests were performed on the concentrations of the most important thyroid hormones, TSH, T4, fT4, T3 and fT3. They were measured on a Roche cobas e 800 device using the "ECLIA" electrochemiluminescent immunoassay method. The amount of antibodies against thyroglobulin (anti-Tg) and antibodies against thyroid peroxidase (TPO) were measured on an Abbott-Alinity device using the chemiluminescent immunochemical method "CMIA". The alleles of the HLA-B and HLA-DRB1 loci were also determined by the molecular method PCR-SSO (Polymerase chain reaction sequence-specific oligonucleotide) on a Luminex® device. For the purpose of typing the patient in order to determine the potential genetic basis of the disease. The results showed extremely high concentrations of antibodies against thyroglobulin (anti-Tg) and antibodies against thyroid peroxidase (TPO), but the typing results did not indicate a genetic predisposition to the disease in this patient
Importance of cardiac surgery scrub nurses education on prostetic heart valves
No full text: Bolesti srčanih zalistaka važan je izvor kardiovaskularnog morbiditeta i mortaliteta.
Trenutačne mogućnosti zamjene protetskih zalistaka, kao što su bioprostetski i mehanički srčani zalisci,
ograničene su strukturnom degeneracijom zaliska koja zahtijeva ponovnu operaciju ili potrebu za
doživotnom antikoagulacijom. Nekoliko novih polimernih tehnologija razvijeno je posljednjih godina u
nadi da će se stvoriti idealna polimerna zamjena za srčani zalistak koja nadilazi ta ograničenja.Kirurška
zamjena bolesnog srčanog zaliska protetskim zaliskom ili transkateterska implantacija protetskog zaliska
može pružiti značajnu kliničku korist. Takvi postupci zamjenjuju štetne učinke prirodne bolesti za
komplikacije povezane s protezom. Učestalost različitih komplikacija ovisi o vrsti i položaju zaliska te
drugim kliničkim čimbenicima rizika. Komplikacije uključuju emboličke događaje, krvarenje, opstrukciju
zaliska, infektivni endokarditis, strukturno propadanje, paravalvularnu regurgitaciju, hemolitičku anemiju
i nekompatibilnost proteze i bolesnika. Važnost edukacije kardiokirurških instrumentarki je važna u
pogledu provedbe asepse za vrijeme zahvata, poznavanja mogućih komplikacija te promptno reagiranje
na sve promjene koje se događaju za vrijeme operativnog zahvata.Heart valve disease is an important source of cardiovascular morbidity and mortality.
Current prosthetic valve replacement options, such as bioprosthetic and mechanical heart valves, are
limited by structural valve degeneration requiring reoperation or the need for lifelong anticoagulation.
Several new polymer technologies have been developed in recent years in the hope of creating an ideal
polymer replacement heart valve that overcomes these limitations. Surgical replacement of a diseased
heart valve with a prosthetic valve or transcatheter implantation of a prosthetic valve can provide
significant clinical benefit. Such procedures substitute the adverse effects of the natural disease for the
complications associated with the prosthesis. The frequency of various complications depends on the type
and position of the valve and other clinical risk factors. Complications include embolic events, bleeding,
valve obstruction, infective endocarditis, structural deterioration, paravalvular regurgitation, hemolytic
anemia, and prosthesis-patient incompatibility. The importance of the education of cardiac surgical
instruments is important in terms of implementing asepsis during the procedure, knowing possible
complications and promptly reacting to all changes that occur during the surgical procedure