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A rationel for an introduction of genetic screening of uveal melanoma in KBC Split (HTA Health Technology Assesment)
No full textUvealni melanom je najčešći melanom oka koji se dijagnosticira pomoću biopsije. Biopsija je dijagnostička metoda uzimanja uzoraka koja nije uobičajena u oftalmološkoj praksi. Unutar rada su objašnjene prednosti i nedostatci različitih tehnika biopsije. Klinička slika uvealnog melanoma je najčešće nedefinirana, bez jasnih simptoma i osjećaja boli te se otkrije tijekom fundoskopije. Također, se govori o važnosti uvođenja HTA metode koja može olakšati dijagnosticiranje uvealnog melanoma. Zaključno, pregledom literature ustanovljena je važnost korištenja biopsije te nedostatak podataka o preživljenju pacijenata, stoga se potencira na daljnje istraživanje.Uveal melanoma is the most common eye melanoma diagnosed using a biopsy. Biopsy is a diagnostic method of sampling that is not common in ophthalmic practice. The paper explains the advantages and disadvantages of different biopsy techniques. The clinical picture of uveal melanoma is most often undefined, without clear symptoms and feelings of pain and is detected during fundoscopy. Also, there is talk about the importance of introducing an HTA method that can facilitate the diagnosis of uveal melanoma. In conclusion, a review of the literature revealed the importance of using a biopsy and the lack of data on patient survival, so it is emphasized to further research
Assessment of quality of life and intensity of gastrointestinal symptoms in patients with irritable bowel syndrome and gastroesophageal reflux disease before and after endoscopic procedures (gastroscopy and colonoscopy)
No full textCilj ovog rada bio je procijeniti kvalitetu života i intenzitet gastrointestinalnih simptoma u pacijenata sa sindromom iritabilnog kolona (SIC) i gastroezofagealnom refluksnom bolesti (GERB) prije i poslije endoskopske procedure. U provedenu prospektivnu kliničku kohortnu studiju bilo je uklučeno 107 bolesnika s gastrointestinalnim smetnjama, od čega 52 muškarac i 55 žena. U 55 je postavljena dijagnoza GERB, a u 52 SIC. Istraživanje je provedeno u razdoblju od veljače 2023. do svibnja 2023. u poliklinici za internu medicinu, ginekologiju, opstetriciju i psihijatriju J&J MEDICI u Splitu. Učinak endoskopskih procedura i pravovremenost postavljanja dijagnoze GERB-a i SIC-a na kvalitetu života bolesnika i razinu anksioznih simptoma bolesnika s gastrointestinalnim smetnjama, procijenjena je Skalom ocjenjivanja gastrointestinalnih simptoma (engl. The Gastrointestinal Symptom Rating Scale/GSRS), Endlerovom višedimenzionalnom ljestvicom anksioznosti (engl. The Endler Multidimensional Anxiety Scales/EMAS), Endlerovom ljestvicom za procjenu anksioznosti kao crte ličnosti (engl. Endler Multidimensional Anxiety Scale-Trait/EMAS-T), kraticom EMAS-T i Skalom kliničkih ishoda u rutinskoj evaluaciji (engl. Clinical Outcomes in Routine Evaluation- Outcome Measure/CORE).
Dobiveni rezultati ukazuju da endoskopske procedure i pravovremeno postavljanje dijagnoze gastrointestinalnih bolesti (GERB i SIC) doprinose statistički značajnom smanjenju auto-emocionalne anksioznosti i kognitivne zabrinutosti u pacijenata nakon endoskopske intervencije (p<0.01). Pacijenti s GERB-om pokazuju veći intenzitet gastrointestinalnih simptoma kao što su nadutost i pojačana nadutost u usporedbi s pacijentima koji pate od SIC-a, 7 dana nakon endoskopske intervencije i postavljene dijagnoze (p<0.05). Pacijenti s GERB-om imaju statistički značajno lošiju kvalitetu života (zadovoljstvo životom i fizički simptomi). Razine anksioznosti prije endoskopske intervencije bile su značajno povezane s kvalitetom života pacijenata, posebno u aspektima zadovoljstva životom te tjelesnog i socijalnog funkcioniranja (p<0.05, p<0.001). Ovo istraživanje upućuje na to da endoskopske procedure i pravovremeno postavljanje dijagnoze doprinose pozitivnim promjenama u psihološkom stanju i smanjenju gastrointestinalnih simptoma pacijenata. Holističkim pristupom bolesniku, uvažavajući psihološko stanje bolesnika i somatske tegobe, moguće je utjecati na poboljšanje kvalitete života, trenutnog stanja tjeskobe i smanjenje simptoma gastrontestinalnih bolesti (GERB i SIC).The aim of this work was to assess the quality of life and intensity of gastrointestinal symptoms in patients with irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD) before and after endoscopic procedures. 107 patients with gastrointestinal disorders were included in the prospective clinical cohort study, of which 52 were men and 55 were women. GERD was diagnosed in 55, and SIC in 52. The research was conducted in the period from February 2023. until May 2023. in polyclinics for internal medicine, gynaecology, obstetrics and psychiatry J&J MEDICI in Split. The effect of endoscopic procedures and the timeliness of establishing the diagnosis of GERD and SIC on the quality of life of patients and the level of anxiety symptoms of patients with gastrointestinal disorders was evaluated with the Gastrointestinal Symptom Rating Scale (GSRS), the Endler Multidimensional Anxiety Scale (The Endler Multidimensional Anxiety Scales/EMAS), Endler Multidimensional Anxiety Scale-Trait/EMAS-T, abbreviated EMAS-T and Clinical Outcomes in Routine Evaluation-Outcome Measure/CORE).
The obtained results indicate that endoscopic procedures and timely diagnosis of gastrointestinal diseases (GERD and SIC) contribute to a statistically significant reduction of auto-emotional anxiety and cognitive concern in patients after endoscopic intervention (p<0.01). Patients with GERD show a higher intensity of gastrointestinal symptoms such as flatulence and increased flatulence compared to patients suffering from SIC 7 days after endoscopic intervention and diagnosis (p<0.05). Patients with GERD have a statistically significantly worse quality of life (satisfaction with life and physical symptoms). Anxiety levels before endoscopic intervention were significantly related to patients' quality of life, especially in aspects of life satisfaction, physical and social functioning (p<0.05, p<0.001). This research suggests that endoscopic procedures and timely diagnosis contribute to positive changes in the psychological state and reduction of gastrointestinal symptoms in patients. With a holistic approach to the patient, taking into account the patient's psychological state and somatic complaints, it is possible to influence the improvement of the quality of life, the current state of anxiety and the reduction of symptoms of gastrointestinal diseases (GERD and SIC)
Comparison of classic and minimally invasive aortic valve replacement
No full textKlasična zamjena aortnog zaliska i minimalno invazivna zamjena aortnog zaliska postali su alternativa kirurškoj zamjeni aortnog zaliska putem srednje sternotomije za liječenje teške aortne stenoze. Pregled postojeće literature pokazuje da je klasična zamjena aortalnog zaliska nezamjenjiv alat za inoperabilne, visokorizične i možda srednje-rizične pacijente s teškom aortalnom stenozom. Povezan je s nizom štetnih perioperativnih ishoda, kao što su valvularna regurgitacija i vaskularne komplikacije. Minimalno invazivna zamjena aortalnog zaliska je povezana sa smanjenom duljinom boravka u jedinici intenzivne njege i boravkom u zdravstvenoj ustanovi, manjom učestalošću transfuzije krvi, smanjenim vremenom ventilacije i poboljšanim kozmetičkim rezultatima. Minimalno invazivna zamjena aortalnog zaliska zadržava potencijalne prednosti u odnosu na klasičnu zamjenu, uključujući implantaciju izdržljive proteze i niske stope perioperativnog infarkta miokarda i paravalvularnog isticanja. Povezan je s dužim vremenom klemane aorte i vremena na ekstrakorporalnom krvotoku; međutim, upotreba implantata zalistaka bez šavova može to vrijeme značajno skratiti. Istraživanja koja uspoređuju klasičnu zamjenu i minimalno invazivnu zamjenu aortalnog zaliska pokazuju smanjenu postoperativnu smrtnost, valvularnu regurgitaciju i incidenciju moždanog udara kod minimalno invazivne zamjene aortalnog zaliska. Trenutačno postoji nekoliko istraživanja koje uspoređuju takva dva zahvata kod zamjene aortalnog zaliska, budući da je teško usporediti populaciju pacijenata s tipično nisko-rizičnim minimalno invazivnom zamjenom i visokorizičnom klasičnom zamjenom aortalnog zaliska.Classical aortic valve replacement and minimally invasive aortic valve replacement have become alternatives to surgical aortic valve replacement via median sternotomy for the treatment of severe aortic stenosis. A review of the existing literature shows that classic aortic valve replacement is an indispensable tool for inoperable, high-risk, and possibly intermediate-risk patients with severe aortic stenosis. It is associated with a number of adverse perioperative outcomes, such as valvular regurgitation and vascular complications. Minimally invasive aortic valve replacement is associated with reduced length of stay in the intensive care unit and hospital stay, less frequent blood transfusions, reduced ventilation time, and improved cosmetic results. Minimally invasive aortic valve replacement retains potential advantages over conventional replacement, including implantation of a durable prosthesis and low rates of perioperative myocardial infarction and paravalvular protrusion. It is associated with a longer time of cross-clamping of the aorta and cardiopulmonary bypass; however, the use of sutureless valve implants can circumvent this. Studies comparing classic versus minimally invasive aortic valve replacement show reduced postoperative mortality, valvular regurgitation, and stroke incidence with minimally invasive aortic valve replacement. Currently, there are few studies comparing such two procedures in aortic valve replacement, since it is difficult to compare patient populations with typically low-risk minimally invasive replacement and high-risk classic aortic valve replacement
Blood transfusion in puerperium during one month in Clinical Hospital Split
No full textPostporođajno krvarenje se definira kao gubitak krvi veće od 500 ml kod vaginalnog poroda ili veće od 1000 ml kod carskog reza,također znakovi i simptomi hipovolemije unutar prva 24 sata nakon poroda i do 12 tjedana nakon poroda. Uzroci krvarenja mogu biti atonija uterusa , traume od instrumenata, koagulopatije, inverzija maternica i razni drugi. Cilj ovoga rada je bio istražiti učestalost transfuzija u puerperiju kod rodilja u mjesec dana, koliki je postotak rodilja primilo transfuziju nakon poroda u odnosu na ukupan broj rodilja koje su rodile taj mjesec. Utvrditi najčešću indikaciju transfuzije, istražiti koliki je udio transfuzija nakon vaginalnih poroda i nakon carskih rezova te ih usporediti. Istražiti koju količinu krvi su rodilje primile i koje pripravke. Istraživanje je obuhvatilo 22 rodilje koje su u rujnu 2022. godine primile transfuziju nakon poroda. Rezulatati analize su pokazali da je 91% transfuzija bilo kod rodilja nakon vaginalnog poroda dok je 9% transfuzija kod rodilja nakon carskog reza. Najčešća indikacija je anemija. Najveći broj transfuzija se pojavljuje kod prvorotkinja. Najčešća količina primljene krvi je 550 ml koja se sastoji od dvije doze. Od krvnih preparata najčešća transfuzija se sastoji od koncentrata eritrocita , dok su ostali pripravci trombociti i plazma. Zaključuje se da je incidencija transfuzija nakon poroda slična kao u drugim državama, te da je najučestalija kod prvorotkinja i da je češća kod vaginalnog poroda.Postpartum hemorrhage is defined as blood loss greater than 500 ml in vaginal delivery or greater than 1000 ml in caesarean section, as well as signs and symptoms of hypovolemia within the first 24 hours after delivery and up to 12 weeks after delivery. The causes of bleeding can be atony of the uterus, trauma from instruments, coagulopathy, inversion of the uterus and various others. The aim of this work was to investigate the frequency of transfusions in puerperium in women in a month, what percentage of women received a transfusion after childbirth in relation to the total number of women who gave birth that month. To determine the most common indication for transfusion, to investigate the proportion of transfusions after vaginal deliveries and after caesarean sections, and to compare them. To investigate how much blood the women received and which preparations. The research included 22 women who received a transfusion after childbirth in September 2022. 91% were transfusions after vaginal delivery, while 9% were transfusions after caesarean sections. The most common indication is anemia. The largest number of transfusions occurs in primiparous women. The most common amount of blood received is 550 ml, which consists of two doses. Of the blood preparations, the most common transfusion consists of erythrocyte concentrate, while the other preparations are platelets and plasma. It is concluded that the incidence of transfusions after childbirth is similar to that in other countries, and that it is most common in primiparous women and that it is more common in vaginal births
Nursing care plan for patients with brain tumors
No full textMozak je kompleksni organ koji može biti zahvaćen tumorima mozga, koji se mogu podijeliti na benigni i maligni tip. Benigni tumori obično rastu polako i imaju manju tendenciju širenja, dok maligni tumori mogu biti agresivniji, širiti se i imati lošiju prognozu. Rani simptomi tumora na mozgu mogu uključivati glavobolje, neurološke simptome i promjene u ponašanju.
Planiranje zdravstvene njege pacijenta s tumorom na mozgu zahtijeva holistički pristup koji obuhvaća procjenu i intervencije. Osnovni ciljevi planiranja zdravstvene njege uključuju smanjenje ili eliminaciju simptoma, poboljšanje kvalitete života, podršku emocionalnom i psihološkom zdravlju te edukaciju pacijenta i obitelji. Planiranje zdravstvene njege također treba biti prilagođeno individualnim potrebama pacijenta, uzimajući u obzir različite faze tumora na mozgu, tip tumora, funkcionalni status pacijenta te dostupne resurse i timsko okruženje. Timski pristup, koordinacija skrbi, kontinuirano praćenje i evaluacija plana zdravstvene njege ključni su faktori u postizanju optimalnih ishoda za pacijente s tumorom na mozguThe brain is a complex organ that can be affected by brain tumors, which can be divided into benign and malignant types. Benign tumors usually grow slowly and have a lower tendency to spread, while malignant tumors can be more aggressive, spreading and having a poorer prognosis. Early symptoms of brain tumors may include headaches, neurological symptoms, and changes in behavior.
Planning healthcare for patients with brain tumors requires a holistic approach that includes assessment, diagnosis, and interventions. The key goals of care planning include symptom reduction, improvement of quality of life, support for emotional and psychological well-being, and patient and family education. Care planning should also be tailored to the individual needs of the patient, considering the different stages of brain tumors, tumor type, patient's functional status, and available resources and team environment. Team approach, care coordination, continuous monitoring, and evaluation of the care plan are crucial factors in achieving optimal outcomes for patients with brain tumors
Utjecaj vježbi ravnoteže i snage na prevenciju padova osoba starije životne dobi
No full textCilj: Glavni cilj ovog istraživanja bio je procijeniti učinak vježbi snage i ravnoteže na posturalnu ravnotežu, snagu mišića i kvalitetu života kod osoba starije životne dobi, s ciljem prevencije padova.
Metode: Istraživanje je provedeno od svibnja do rujna 2022. godine u Zdravstvenoj ustanovi Sano u Splitu. Uključeno je 50 ispitanika u dobi od 65-85 godina, od kojih je 25 ispitanika provodilo vježbe snage i ravnoteže, dok 25 ispitanika nije provodilo vježbe. Vježbe su se provodile u maloj grupi od pet osoba pod vodstvom fizioterapeuta. Tijekom 12 tjedana, vježbe su se izvodile tri puta tjedno, s trajanjem od 50 minuta po treningu. Trening je uključivao zagrijavanje i aerobne vježbe tijekom prvih 15 minuta, vježbe snage i ravnoteže tijekom sljedećih 30 minuta, te vježbe istezanja koje su trajale 5 minuta. Prije uključivanja u program vježbanja i nakon 12 tjedana provedena su testiranja mišićne snage i ravnoteže. Za testiranje mišićne snage korišteni su test uzastopnog ustajanja iz sjedećeg položaja i "time up and go" test, a za testiranje ravnoteže koristio se je Romberg test, Tandem stav test i Test ravnoteže u četiri faze. Za procjenu utjecaja vježbi na kvalitetu života ispitanika korištena je hrvatska verzija upitnika SF-36.
Rezultati: Nakon 12 tjedana provedenih vježbi, skupina koja je provodila vježbe pokazala je statistički značajno poboljšanje mišićne snage u usporedbi s kontrolnom skupinom. Također, primijećeno je značajno poboljšanje u izvedbi testova ravnoteže, uključujući Rombergov test, Tandem stav test i Test ravnoteže u četiri faze, kod vježbača u usporedbi s nevježbačima. Vježbači su doživjeli poboljšanje u fizičkom funkcioniranju te smanjenje ograničenja uzrokovanih fizičkim i emocionalnim poteškoćama, kao i smanjenje tjelesne boli.
Zaključci: Rezultati ovog istraživanja ukazuju na povoljan učinak vježbi snage i ravnoteže na poboljšanje mišićne snage, ravnoteže i kvalitete života kod osoba starije životne dobi. Preporučuje se uključivanje vježbi snage i ravnoteže u redovnu tjelovježbu starijih osoba kao dio strategije prevencije padova. Unatoč ograničenjima ovog istraživanja, dobiveni rezultati pružaju osnovu za daljnja istraživanja koja bi mogla detaljnije istražiti optimalne kombinacije vježbi, broj ponavljanja i vrste vježbi za prevenciju padova kod starijih osoba.Objective: The main objective of this research was to evaluate the effect of strength and balance exercises on postural balance, muscle strength and quality of life in elderly people, with the aim of preventing falls.
Methods: The research was conducted from May to September 2022 at the Sano Health Institution in Split. 50 subjects aged 65-85 were included, of which 25 subjects performed strength and balance exercises, while 25 subjects did not perform exercises. The exercises were performed in a small group of five people under the guidance of a physiotherapist. During 12 weeks, the exercises were performed three times a week, with a duration of 50 minutes per training session. Training included warm-up and aerobic exercises during the first 15 minutes, strength and balance exercises during the next 30 minutes, and stretching exercises lasting 5 minutes. Before joining the exercise program and after 12 weeks, tests of muscle strength and balance were performed. To test muscle strength, the test of consecutive standing up from a sitting position and the "time up and go" test were used, and to test balance, the Romberg test, the Tandem stance test and the four-phase balance test were used. The Croatian version of the SF-36 questionnaire was used to assess the impact of exercises on the quality of life of the respondents.
Results: After 12 weeks of exercises, the exercise group showed a statistically significant improvement in muscle strength compared to the control group. Also, a significant improvement in the performance of balance tests, including the Romberg Test, the Tandem Stance Test, and the Four Phase Balance Test, was observed in exercisers compared to non-exercisers. Exercisers experienced an improvement in physical functioning and a reduction in limitations caused by physical and emotional difficulties, as well as a reduction in physical pain.
Conclusions: The results of this research indicate a beneficial effect of strength and balance exercises on improving muscle strength, balance and quality of life in elderly people. It is recommended to include strength and balance exercises in the regular exercise of older adults as part of a fall prevention strategy. Despite the limitations of this study, the obtained results provide a basis for further research that could investigate in more detail the optimal combinations of exercises, the number of repetitions and the types of exercises for the prevention of falls in the elderly
The role of the nurse / technician in the postoperative care of patients after partial laryngectomy
No full textParcijalna laringektomija kirurški je zahvat kojim u karcinomima grkljana nastojimo sačuvati dio grkljana i time izbjeći trajnu traheostomu u bolesnika. Zloćudne novotvorine grkljana najčešće se javljaju kod muškaraca prosječne dobi 50 – 70 godina, te se kao najčešći uzročnici spominju konzumacija alkohola i duhanskih proizvoda, izloženost otrovnim tvarima te ionizirajuće zračenje. Zloćudna se novotvorina grkljana prvenstveno manifestira promuklošću, otežanim disanjem i gutanjem, suhim i nadražajnim kašljem kod kojeg se može kasnije pojaviti sukrvavi sadržaj. Kako bi se dijagnosticirala ova bolest potrebno je obaviti opći
klinički pregled, palpaciju i inspekciju vrata, laringoskopski pregled, napraviti biopsiju tkiva te obaviti radiološku dijagnostiku. Liječenje se vrši ovisno o stadiju bolesti, te može biti kirurškim ili onkološkim putem u ranim stadijima bolesti, odnosno u uznapredovalom stadiju kombinacija ova dva pristupa liječenja. Predoperativna priprema bolesnika za parcijalnu laringektomiju iziskuje multidisciplinarni pristup liječnika specijalista otorinolaringologije, onkologa, medicinskih sestara / tehničara, logopeda, psihologa i drugih. Uloga je medicinskih sestara / tehničara ključna radi svog rada i pristupa bolesniku gdje nastoje smanjiti
razinu prisutnog straha, tjeskobe i zabrinutosti, te pomažu bolesniku izgraditi samopouzdanje i povjerenje kao i pomoći mu u usvajanju poželjnog ponašanja. Postoperativno je iznimno važno da medicinske sestre / tehničari prate stanje bolesnika, promatraju i preveniraju eventualne komplikacije postupka, te u kasnijim fazama oporavka educiraju ga o pravilnom ponašanju, o njezi traheostome i trahealne kanile, vode brigu o pravilnoj prehrani bolesnika te ga upute gdje može potražiti adekvatnu logopedsku pomoć.Surgical procedure where we try to save a part of the larynx in laryngeal cancers and thus avoid a permaneng tracheostomy in the patient is called partial laryngectomy. Malignant neoplasms of the larynx most often occur in men with an average age of 50-70 years, and the most common causes are the consumption of alcohol and tobacco products, exposure to toxic substances and ionizing radiation. A malignant neoplasm of the larynx is primarily manifested by hoarseness, difficulty breathing and swallowing, a dry and irritating cough, which may later contain bloody contents. In order to diagnose this disease, it is necessary to perform a general clinical examination, palpation and inspection of the neck, a laryngoscopic examination, a tissue biopsy and a radiological diagnostics. Treatment is carried out depending on the stage of the cancer, and can be surgical or oncological in the early stages of the disease, or in the advanced stage, a combination of these two treatment approaches. Preoperative preparation of patients for partial laryngectomy requires a multidisciplinary approach of doctors specializing in otorhinolaryngology, oncologists, nurses/technicians, speech therapists, psychologists and others. The role of nurses/technicians is crucial for their work and approach to the patient, where they try to reduce the level of fear, anxiety and concern present, and help the patient build self-confidence and trust, as well as help him adopt desirable behavior. Postoperatively, it is extremely important that nurses/technicians monitor the patient's condition, observe and prevent possible complications of the procedure, and in the later stages of recovery educate him about proper behavior, care for the tracheostomy and tracheal cannula, take care of the patient's proper nutrition, and direct him where he can look for adequate speech therapy assistance
The nursing process in patients with pulmonary tuberculosis
No full textTuberkuloza pluća je ozbiljna bolest uzrokovana infekcijom Mycobacterium tuberculosis. Ova bolest predstavlja jedan od vodećih uzroka smrti diljem svijeta. Unatoč tome što je uzročnik bolesti poznat već dugi niz godina te postoje cjepiva i učinkoviti lijekovi za njezino liječenje, tuberkuloza i dalje ostaje značajan problem u globalnom javnom zdravstvu. Tuberkuloza se može klasificirati prema različitim parametrima, uključujući aktivnost bolesti (latentna ili manifestna), lokalizaciju bolesti (plućna ili izvanplućna), rezultate bakteriološkog ispitivanja iskašljaja (pozitivna/negativna kultura), prethodno liječenje (novootkriveni slučaj ili recidiv), režime liječenja, izvješća o ishodu liječenja i definiciju bolesti. Klinička slika pacijenta s tuberkulozom ovisi o stupnju proširenosti bolesti. U početnom stadiju bolesti, opće stanje pacijenta obično nije narušeno. Međutim, u uznapredovaloj tuberkulozi, pacijent često pokazuje znakove mršavljenja, blijedosti, iscrpljenosti (kaheksija) te suhoću (poznatu i kao "sušica"). Simptomi često uključuju vrućicu, kašalj i iskašljavanje. Ciljevi liječenja tuberkuloze uključuju potpuno uništenje infekcije uzrokovanu bakterijom M. tuberculosis, sprječavanje daljnjeg širenja infekcije, prevenciju recidiva bolesti i sprečavanje razvoja rezistencije na lijekove. Sestrinska skrb za pacijente s tuberkulozom pluća uključuje holistički pristup svakom pacijentu, prilagođenu njegu i edukaciju. Medicinska sestra treba poduzeti mjere izolacije kako bi spriječila širenje infekcije. Također je odgovorna za pružanje edukacije pacijentu o njegovoj situaciji te za prevenciju komplikacija koje mogu nastati zbog nakupljanja sekreta u dišnim putevima. Osim toga, važno je da medicinska sestra surađuje s multidisciplinarnim timom kako bi osigurala najbolju skrb za pacijenta i postizanje optimalnih rezultata liječenja tuberkuloze pluća.Pulmonary tuberculosis is a serious disease caused by infection with Mycobacterium tuberculosis. This disease is one of the leading causes of death worldwide. Despite the fact that the causative agent of the disease has been known for many years and there are vaccines and effective drugs for its treatment, tuberculosis remains a significant problem in global public health. Tuberculosis can be classified according to various parameters, including disease activity (latent or manifest), localization of disease (pulmonary or extrapulmonary), results of bacteriological examination of sputum (positive/negative culture), previous treatment (newly diagnosed case or relapse), treatment regimens, reports of treatment outcome and disease definition. The clinical picture of a patient with tuberculosis depends on the extent of the disease. In the initial stage of the disease, the general condition of the patient is usually not impaired. However, in advanced tuberculosis, the patient often shows signs of weight loss, pallor, exhaustion (cachexia) and dryness (also known as "dryness"). Symptoms often include fever, cough and expectoration. The goals of tuberculosis treatment include complete eradication of the infection caused by M. tuberculosis bacteria, prevention of further spread of the infection, prevention of relapse of the disease, and prevention of the development of drug resistance. Nursing care for patients with pulmonary tuberculosis includes a holistic approach to each patient, customized care and education. The nurse should take isolation measures to prevent the spread of infection. She is also responsible for providing education to the patient about his situation and for the prevention of complications that may arise due to the accumulation of secretions in the respiratory tract. In addition, it is important that the nurse collaborates with the multidisciplinary team to ensure the best care for the patient and the achievement of optimal results in the treatment of pulmonary tuberculosis
Nursing care in a nephrectomied patient and possible nursing complications in comparison of classical and laparoscopic surgery
No full textCILJ: Cilj ovog istraživanja je utvrditi epidemiološka obilježja bolesnika (dob, spol i radni status) i usporediti klasične i laparoskopske operacije i koje su potencijalne sestrinske dijagnoze i problemi prisutni u zdravstvenoj njezi takvih bolesnika.
METODE: u istraživanju je sudjelovalo 129 ispitanika koji su zaprimljeni na Kliniku za urologiju KBC Split pod medicinskom dijagnozom karcinoma bubrega te su kirurški liječeni u vremenskom razdoblju od godine dana od 01. siječnja 2022. do 31. prosinca 2022. godine. U ovom presječnom istraživanju korišteni su podaci prikupljeni putem bolničkog informacijskog sustava (BIS) i protokola Klinike za urologiju, a zadovoljavali su kriterij uključenja prema medicinskoj dijagnozi za tumor bubrega koji je kirurški liječen u vremenskom razdoblju od jedne godine. Oboljeli su također kategorizirani prema vrsti operacijskog zahvata.
REZULTATI: Rezultati našeg istraživanja pokazali su da je muški spol bio u većem postotku u odnosu na ženski spol (60,74%) te da je najčešća kronološka dob bila 65,21 za 129 ispitanika koji su bili uključeni u istraživanje. Najčešći bolesnici bili su u dobi od 51 do 60 godina starosti (48,07%). Dren se uklanjao 7. poslijeoperacijski dan. Vezano za uklanjanje urinarnog katetera, u našem istraživanju se urinarni kateter uklanjao dva tjedna nakon kirurškog zahvata.
ZAKLJUČAK: Usporedba komplikacija između klasične otvorene nefrektomije i laparoskopske nefrektomije pruža važan uvid u prednosti i izazove oba kirurška pristupa. Klasična nefrektomija, iako dokazano učinkovita, nosi veći rizik od komplikacija kao što su bol, produženo vrijeme oporavka, povećan gubitak krvi i veća incidencija postoperativnih infekcija. Kontinuirano praćenje bolesnika nakon operacije, pravovremeno prepoznavanje i upravljanje komplikacijama te prilagodba terapije u skladu s individualnim potrebama svakog bolesnika ključni su elementi u postizanju najboljeg mogućeg ishoda.AIM The objective of this research is to determine the epidemiological characteristics of patients (age, gender and work status) and to compare classical and laparoscopic operations and what potential nursing diagnoses and problems are present in the health care of such patients.
METHODS: 129 subjects who were admitted to the KBC Split Surgery Clinic with a medical diagnosis of kidney cancer and were surgically treated for a period of one year from January 1, 2022 to December 31, 2022 participated in the study. In this cross-sectional study, data collected through the hospital information system (BIS) and the protocol of the Clinic for Urology were used, and they met the inclusion criteria according to the medical diagnosis for a kidney tumor that was surgically treated for a period of one year. Patients are also categorized according to the type of surgery.
RESULTS: The results of our research showed that the male gender was in a higher percentage compared to the female gender (60.74%) and that the most common chronological age was 65.21 for the 129 respondents who were included in the research. The most common patients were between the ages of 51 and 60 (48.07%). The drain was removed on the 7th postoperative day. Regarding the removal of the urinary catheter, in our study the urinary catheter was removed two weeks after the surgical procedure.
CONCLUSION: Comparison of complications between classic open nephrectomy and laparoscopic nephrectomy provides important insight into the advantages and challenges of both surgical approaches. Classic nephrectomy, although proven effective, carries a higher risk of complications such as pain, prolonged recovery time, increased blood loss and a higher incidence of postoperative infections. Continuous monitoring of patients after surgery, timely recognition and management of complications and adjustment of therapy in accordance with the individual needs of each patient are key elements in achieving the best possible outcome
The educational significance of nurses/technicians in the proper nutrition of elderly people
No full textEdukacijski značaj medicinskih sestara i tehničara u pravilnoj prehrani osoba treće životne dobi je
ključan za promociju zdravog starenja. S obzirom na česte promjene koje dolaze sa starenjem, uključujući
promjene u tjelesnom sastavu, metabolizmu i apetitu, značaj pravilne prehrane raste. Medicinske sestre i
tehničari su često na prvoj liniji zdravstvene njege i, kao njihovi savjetnici, često educiraju o važnosti prevencije,
održavanja kvalitete zdravlja i dobrobiti osoba treće životne dobi. Medicinske sestre educiraju starije osobe i
njihove obitelji o važnosti prevencije bolesti i održavanju kvalitete života. To može uključivati varijacije od
pravilne prehrane, redovitog vježbanja, pa do korištenja odgovarajućih lijekova i medicinskih pomagala.
Medicinske sestre i tehničari provode edukaciju o pravilnoj prehrani kroz savjetovanje, planiranje obroka i
identificiranje potrebnih prehrambenih intervencija. Edukacija starijih osoba o zdravstvenim temama predstavlja
specifične izazove zbog fizičkih i kognitivnih ograničenja koja se često javljaju s godinama. Edukacija o
prehrani također može biti korisna u prevenciji ili upravljanju kroničnim bolestima koje su česte kod starijih
osoba, poput dijabetesa, srčanih bolesti i osteoporoze. Strategije za poboljšanje učinkovitosti edukacije i
zdravstvene pismenosti u starijoj populaciji moraju biti prilagođene specifičnim potrebama i izazovima koji se
pojavljuju s godinama i sukladno pojedincima te ne smije biti generalizirana.The educational significance of nurses in the proper nutrition of elderly people is crucial for
promoting healthy aging. Given the frequent changes that come with aging, including changes in body
composition, metabolism, and appetite, the importance of proper nutrition increases. Nurses are often on the
front line of healthcare and, as their advisors, often educate on the importance of prevention, maintaining the
quality of health, and well-being of elderly people. Nurses educate older individuals and their families about the
importance of disease prevention and maintaining quality of life. This can include variations from proper
nutrition, regular exercise, to the use of appropriate medications and medical aids. Nurses conduct education on
proper nutrition through counseling, meal planning, and identifying necessary dietary interventions. Educating
older people on health topics presents specific challenges due to physical and cognitive limitations that often
occur with age. Nutrition education can also be useful in the prevention or management of chronic diseases
common in older individuals, such as diabetes, heart diseases, and osteoporosis. Strategies for improving the
effectiveness of education and health literacy in the older population must be tailored to specific needs and
challenges that arise with age and according to individuals and should not be generalized