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Attitudes of psychiatric employees and other health care workers towards patients with mental illnesses
No full textCILJ: Cilj ovog istraživanja je usporediti stavove psihijatrijskih djelatnika i ostalih zdravstvenih djelatnika prema pacijentima oboljelih od mentalnih bolesti.
METODE: U istraživanju je sudjelovalo 167 ispitanika od čega ih je 67 radi na psihijatrijskim odjelima dok 100 ispitanika ne radi na psihijatrijskim odjelima. Istraživanje je provedeno od travnja do srpnja 2023. godine. Korišten je upitnik Mental Illness: Clinicians’ Attitudes Scale uz 11 pitanja sociodemografskih karakteristika.
REZULTATI: Nađena je statistički značajna razlika u mišljenju ispitanika o kontinuiranom učenju o duševnim bolestima i čitanju dodatnih materijala gdje ispitanici koji ne rade na psihijatriji rijetko ističu da uče o duševnim bolestima samo kada je to nužno, te da se rijetko trude istraživati dodatne materijale. Nađena je statistički značajna razlika kod zdravstvenih djelatnika koji rade na psihijatriji koji imaju za jedan bod viši stupanj suglasnosti s tvrdnjom „Rad u području mentalnog zdravlja jednako je vrednovan kao i rad u drugim područjima zdravstva i socijalne skrbi?“ od zdravstvenih djelatnika koji ne rade na psihijatriji. Nije utvrđena statistički značajna razlika kod zdravstvenih djelatnika koji rade na psihijatriji i onih koji ne rade na njoj u upotrebi riječi kao što su „lud“, „luđak“ i slično za opisivanje osoba s duševnim bolestima koje su susreli u poslu. U našem istraživanju primijetili smo statistički značajne razlike u stavovima zdravstvenih djelatnika prema temama povezanima s duševnim bolestima. Primijetili smo da je razina slaganja s tvrdnjom „Osobe oboljele od duševnih bolesti ne mogu se nikad dovoljno oporaviti kako bi mogle voditi kvalitetniji život“ bila je za jedan bod veća kod zdravstvenih djelatnika koji rade na psihijatriji u odnosu na one koji ne rade na psihijatriji.
ZAKLJUČAK: Kroz provedeno istraživanje možemo zaključiti da zdravstveni djelatnici iz obje promatrane skupine imaju prisutnu empatiju prema oboljelima od mentalnih bolesti, ali zato zdravstveni djelatnici sa psihijatrijskih odjela u većem postotku smatraju da se mentalno oboljeli pacijenti mogu oporaviti. To ih čini skupinom koja kroz svoje iskustvo drugačije percipira pojam oporavka jer znaju šta ta riječ znači za oboljelog od mentalnih bolesti.AIM The aim of this research is to compare the attitudes of psychiatric workers and other health workers towards patients suffering from mental illnesses.
METHODS: 167 respondents participated in the research, of which 67 work in psychiatric wards, while 100 respondents do not work in psychiatric wards. The research was conducted from April to July 2023. The questionnaire Mental Illness: Clinicians' Attitudes Scale with 11 questions on sociodemographic characteristics was used.
RESULTS: A statistically significant difference was found in the respondents' opinion about continuous learning about mental illnesses and reading additional materials, where respondents who do not work in psychiatry rarely point out that they learn about mental illnesses only when necessary, and that they rarely bother to research additional materials. A statistically significant difference was found among healthcare professionals who work in psychiatry, who have a one-point higher degree of agreement with the statement "Work in the field of mental health is equally valued as work in other areas of health and social care?" than healthcare professionals who do not work in psychiatry. No statistically significant difference was found between health professionals who work in psychiatry and those who do not in the use of words such as "crazy", "lunatic" and the like to describe people with mental illnesses that they encountered at work. In our research, we noticed statistically significant differences in the attitudes of healthcare workers towards topics related to mental illness. We noticed that the level of agreement with the statement "Persons suffering from mental illnesses can never recover enough to be able to lead a better quality of life" was one point higher among health professionals who work in psychiatry compared to those who do not work in psychiatry.
CONCLUSION: Through the conducted research, we can conclude that healthcare professionals from both observed groups have a present empathy towards patients with mental illnesses, but that is why healthcare professionals from psychiatric wards in a higher percentage believe that mentally ill patients can recover. This makes them a group that, through their experience, perceives the concept of recovery differently because they know what that word means for a person suffering from mental illnes
ORGANIZATIONAL ASPECT OF INTRODUCTION SONOGRAPHERS AS AN ADDITIONAL FIELD OF WORK FOR RADIOGRAPHERS
No full textSažetak:
Sve veća potražnja za UZV pregledima dovela je do preopterećenosti radiologa kojih je sve manje na tržištu rada. Moguće rješenje problema manjka i smanjenja opterećenosti radiologa je obrazovanje radioloških tehnologa za zvanje sonografera.
Cilj: Cilj ovog diplomskog rada je istražiti mogućnost rada radioloških tehnologa kao sonografera te definirati potrebne uvjete za uvođenjem tog novog područja rada. Primarni cilj provedenog istraživanja je utvrditi postoji li interes među radiološkim tehnolozima treće godine diplomskog studija na sveučilištu u Splitu sveučilišnog odjel zdravstvenih studija i magistara radiološke tehnologije za rad na UZV dijagnostici.
Izvori podataka i metode: Pregledom dostupne literature i već provedenih istraživanja nastojalo se istražiti je li postoje značajne razlike između rezultata rada radiologa i sonografera te bi li se liste čekanja na UZV preglede smanjile uvođenjem sonografera. Mjerni instrument za ovo istraživanje bio je novo konstruiran anketni upitnik. Metoda prikupljanja podataka bila je on-line anketa koja je provedena u lipnju 2022. godine.
Rezultati: Iz rezultata provedene ankete jasno se uočava veliki interes među radiološkim tehnolozima koji pohađaju treću godinu diplomskog studija radiološke tehnologije u Splitu i već završenim magistrima na istom fakultetu, te da su voljni izdvojiti vrijeme i financijska sredstva za daljnju obuku za sonografera. Potrebna su daljnja istraživanje kako bi se imao uvid u mišljenje svih radioloških tehnologa u Republici Hrvatskoj. Literatura i rezultati istraživanja upućuju na zaključak da UZV pregledi provedeni od strane sonografera u kvaliteti i točnosti ne odstupaju značajno od UZV pregleda provedenih od strane radiologa.
Zaključak: Rastući tehnološki napredak doprinio je širokoj primjeni UZV uređaja i sve većim zahtjevima za kvalitetnom radnom snagom za provođenje UZV pregleda. Sonograferi su idealno rješenje za manjak radiologa te povećanje efektivnosti i efikasnosti UZV dijagnostike.Summary:
An increasing demand for US examinations has led to an overwork of radiologists, who are in short supply on the labour market. A possible solution to the problem of shortage and reduction of the workload of radiologists is the education of radiologic technologists for the profession of sonographer.
Aim: The objective of this thesis is to investigate the possibility of radiologic technologists working as sonographers and to define the necessary conditions for the introduction of this new field of work. The primary goal of the conducted research is to determine whether there is an interest among radiologic technologists in their third year of graduate studies at the University of Split, University Department of Health Studies and Master of Radiologic Technology to work on sonography.
Subjects and methods: By reviewing the available literature and already conducted research, an effort was made to investigate whether there are significant differences between the results of the work of radiologists and sonographers, and whether waiting lists for US examinations would be reduced by the introduction of sonographers. The measuring instrument for this research was a newly constructed questionnaire. The data collection method was an online survey that was conducted in June 2022.
Results: From the results of the conducted survey, it is evident that there is a great interest among radiologic technologists who attend the third year of radiological technology graduate studies in Split and who have already completed their master's degrees at the same university. Furthermore, they are willing to allocate time and financial resources for further sonographer training. Further research is needed in order to have an insight into the opinion of all radiological technologists in the Republic of Croatia. The literature and research results point to the conclusion that US examinations performed by sonographers do not differ significantly in quality and accuracy from US examinations performed by radiologists.
Conclusion: The growing technological progress has contributed to the wide application of US devices and the increasing demands for quality workforce to perform US examinations. Sonographers are an ideal solution for the shortage of radiologists and for increasing the effectiveness and efficiency of diagnostic US
Assessment of the effectiveness of physiotherapy interventions after caesarean section - case report.
No full textCilj ovog rada bio je na prikazanom slučaju starije prvorotkinje (primipara vetusta) procijeniti učinkovitost fizioterapijskih intervencija nakon poroda carskim rezom primjenom standardiziranih upitnika, objektivnih mjerenja i subjektivnih procjena intenziteta boli u pacijentice prije i poslije fizioterapijske intervencije. Procjenom posture rodilje u sagitalnoj, frontalnoj ravnini sprijeda i straga došlo je do poboljšanja posture, ostvarivši fiziološke krivine kralježnice te smanjenja napetosti mišića ujednačavanjem tonusa. Mjerenjem mišićne snage manualnim mišićnim testom došlo je do povećanja mišićne snage rectusa abdominisa i obliquesa abdominisa sa -4 na 5, što je postignuto opisanom kineziterapijom. Manualno mjerenje širine i dubine dijastaze pokazalo je njeno smanjenje. Opisano zatvaranje dijastaze postignuto je kombinacijom abdominalnog disanja i vježbi, miofascijalne relaksacije abdomena i zdjelice te edukacijom o aktivnostima koje treba izbjegavati pri postojanju dijastaze. Intenzitet boli procijenjen vizualno-analognom skalom pokazao je potpuni nestanak neizdržive boli intenziteta 10/10. Procjenom stanja ožiljka vancouverskom ljestvicom došlo je do smanjenja upalne pigmentacije i poboljšanja pokretljivosti ožiljka, što pokazuje i bodovanje ljestvice (s početnih 5 od 13 na 2 od 13).The aim of this work was to evaluate the effectiveness of physiotherapy interventions after cesarean section using standardized questionnaires, objective measurements and subjective assessments of pain intensity in the patient before and after the physiotherapy intervention on the presented case of an older primiparous woman (primipara vetusta). By assessing the posture of the mother in the sagittal, frontal plane from the front and back, the posture improved, achieving physiological curves of the spine and reducing muscle tension by equalizing tone. By measuring the muscle strength with a manual muscle test, there was an increase in the muscle strength of the rectus abdominis and obliques abdominis from -4 to 5, which was achieved by the described kinesitherapy. Manual measurement of the width and depth of the diastasis showed its reduction. The described closure of the diastasis was achieved by a combination of abdominal breathing and exercises, myofascial relaxation of the abdomen and pelvis, and education about activities that should be avoided when the diastasis exists. The intensity of pain assessed with a visual-analog scale showed the complete disappearance of unbearable pain with an intensity of 10/10. By assessing the condition of the scar using the Vancouver scale, there was a reduction in inflammatory pigmentation and an improvement in the mobility of the scar, which is also shown by the scoring of the scale (from the initial 5 out of 13 to 2 out of 13)
Nurse care of hospitalized patient with heart arrhythmia
No full textProblemi sa srčanim ritmom, često poznati kao aritmija, opći su izraz za srčana stanja koja utječu na provođenje ili stvaranje srčanih impulsa. Aritmije su jedan od najčešćih razloga posjeta liječnika u rutinskoj kardiološkoj praksi. Aritmije mogu pogoditi bilo koga u bilo kojoj dobi, a njihova prevalencija raste kako ljudi stare. Prilikom zbrinjavanja i pružanja zdravstvene njege bolesnika koji imaju srčane artitmije, medicinska sestra mora imati visok stupanj kvalifikacija, odnosno mora biti visoko obučena i educirana. I bolesnik i medicinska sestra imaju koristi kada se uzme sestrinska anamneza, identificiraju problemi i koriste specifične medicinsko tehničke metode. Bolesnik će se osjećati sigurnije, a medicinska sestra će znati da je izvršila sve svoje obveze. Osim što bolesniku pruža potrebnu njegu i djeluje kao veza između bolesnika i liječnika, medicinska sestra u koronarnoj jedinici također je zadužena pratiti stanje bolesnika iz minute u minutu i započeti terapiju u skladu sa svojim područjima stručnosti. Za bolesnika s aritmijom ključna je komunikacija s medicinskom sestrom ili tehničarem jer ona može odgovoriti na njegove upite i usmjeriti ga na zdrav način života. Kako bi medicinske sestre i tehničari koji rade u koronarnoj jedinici ostali motivirani potrebna je dobra suradnja, međusobno povjerenje i razumijevanje te mogućnost unošenja novih ideja koje će biti zanimljive za rad.Heart rhythm problems, often known as arrhythmia, is a general term for heart conditions that affect the conduction or generation of heart impulses. Arrhythmias are one of the most common reasons for visits to the doctor in routine cardiology practice. Arrhythmias can affect anyone at any age, and their prevalence increases as people age. When caring for and providing health care to patients with cardiac arrhythmias, the nurse must have a high level of qualifications, that is, she must be highly trained and educated. Both the patient and the nurse benefit when a nursing history is taken, problems are identified, and specific medical techniques are used. The patient will feel safer, and the nurse will know that she has fulfilled all her obligations. In addition to providing the patient with the necessary care and acting as a link between the patient and the doctor, the nurse in the coronary unit is also responsible for monitoring the patient's condition minute by minute and initiating therapy in accordance with their areas of expertise. For a patient with arrhythmia, communication with a nurse or technician is essential because she can answer his questions and direct him to a healthy lifestyle. In order for the nurses and technicians working in the coronary care unit to remain motivated, good cooperation, mutual trust and understanding, as well as the possibility of introducing new ideas that will be interesting for work, are necessary
The specifity of pregnancy and childbirth at an older age, the midwifery care
No full textCilj ovog rada bio je istražiti utjecaj veće životne dobi na učestalost perinatalnih komplikacija i komplikacija u porodu i dobivene rezultate usporediti sa učestalošću istih kod rodilja u dobi od 25 do 35 godina. Istraživanje je provedeno na 843 trudnice koje su rodile u Klinici za ženske bolesti i porode KBC-a Split u razdoblju od 1. siječnja do 1. travnja 2022. godine. Rezultati rada obuhvaćaju: dob trudnice, rodnost, termin poroda, način poroda, porodničke operacije, patologiju trudnoće (hipertenzivni poremećaji, gestacijski dijabetes mellitus, placenta previa, abrupcija placente), donošenost novorođenčeta i Apgar score. Istraživanje je dokazalo veću učestalost perinatalnih komplikacija kod rodilja veće životne dobi u usporedbi s rodiljama u dobi od 25 do 35 godina. Trudnoća i porod u većoj životnoj dobi nisu imale utjecaj na nizak Apgar score novorođenčadi ali su novorođenčad takvih rodilja češće bila hipotrofična i hipertrofična. Trudnoća rodilja u većoj životnoj dobi češće se dovršavala carskim rezom. Rezultati istraživanja djelomično se poklapaju sa rezultatima istraživanja iz svjetske literature. Razlika u rezultatima može postojati zbog različitog definiranja veće životne dobi i različitih sociodemografskih čimbenika.The aim of this work was to investigate the influence of advanced maternal age on the frequency of perinatal complications and complications in childbirth and to compare the obtained results with the frequency of the same in women who gave birth between the ages of 25 and 35. The research was conducted on 843 expectant women who gave birth in the Clinic for Women's Diseases and Childbirth of KBC Split in the period from January 1 to April 1, 2022. The results of the work include: the age of the expectant woman, fertility, pregnancy due date, mode of delivery, obstetric operations, pregnancy pathology (hypertensive disorders, gestational diabetes mellitus, placenta previa, placental abruption), newborn maturity and Apgar score. The research proved a higher frequency of perinatal complications in women of advanced age who gave birth compared to women who gave birth between the ages of 25 and 35. Pregnancy and childbirth at an older age had no influence on the low Apgar score of newborns, but newborns of such mothers were more often hypotrophic and hypertrophic. A higher percentage of the pregnancies of older mothers were terminated by caesarean section. The research results partly coincide with the research results from the world literature. The difference in results may exist due to different definitions of older age and different socio-demographic factors
Activities of nurses and health care of premature infants in neonatal intensive care units
No full textSve tek rođene bebe koje na svijet dolaze kao posljedica prijevremenog poroda nazivaju se nedonoščad
Posljedica prijevremenog dolaska na svijet je nezrelost cijelog organizma nedonoščeta, pa je ključna uloga
zdravstvenih djelatnika u skrbi. Sastavni dio medicinskog tima koji se aktivno brine za nedonošče je i
medicinska sestra. Aktivnosti medicinske sestre vezane su za nadzor nad vitalnim funkcijama, cjelokupnu
zdravstvenu njegu nedonoščeta, aktivno sudjeluju u dijagnostičkim pretragama po nalogu neonatologa te
primjeni terapije. Jedan od zadataka medicinske sestre i je briga za majku nedonoščeta, koju je potrebno
educirati i pružiti joj adekvatnu podršku.All newly born babies who come into the world as a result of premature birth are called premature babies. The
consequence of premature arrival in the world is the immaturity of the whole organism of the premature baby,
so the key role of healthcare professionals in care. A nurse is an integral part of the medical team that actively
cares for premature babies. The nurse's activities are related to the monitoring of vital functions, the overall
health care of premature infants, they actively participate in diagnostic tests ordered by neonatologists and the
application of therapy. One of the tasks of a nurse is to care for the mother of a premature baby, who needs to
be educated and provided with adequate support
Molecular diagnostics and targeted treatment of lung cancer
No full textCilj: Cilj ovog rada je detaljno prikazati molekularno testiranje kojim se utvrđuje status EGFR gena kao prediktivnog biomarkera kod pacijenata oboljelih od karcinoma pluća radi primjene ciljane terapije u njihovu liječenju.
Materijal i metode: Materijali koji se koriste za analizu mogu biti: tumorsko tkivo, citološki punktat i krv pacijenta. Opisano je uzorkovanje materija za analizu, izolacija DNA, mjerenje koncentracije DNA te detekcija EGFR mutacija uz pomoć komercijalno dostupnih kitova.
Rezultati: Rezultati koji se dobiju detekcijom mutacija EGFR gena obrađuju se softwerski i u konačnici se dobije izvještaj koji detaljno prikazuje sve detektirane mutacije u uzorku pacijenta.
Zaključak: Molekularno testiranje EGFR gena, odnosno detekcija mutacija kod pacijenta s rakom pluća važno je radi određivanja točne ciljane terapije. Da bi se utvrdila prisutnost mutacija potrebno je iz uzorka krvi ili iz tumorskog tkiva pacijenta izolirati DNA , a potom umnožiti i detektirati. Pacijenti kod kojih je utvrđena prisutnost patogenih mutacija u EGFR genu kandidati su za ciljanu terapiju.Objectives: The aim of this paper is to present detailed molecular testing which solidifies the status of the EGFR gene as a predictive biomarker in patients with lung cancer for the purpose of applying targeted therapy in their treatment.
Material and methods: The material used for analysis can be blood or tumor tissue of operated patients.Procedures for DNA isolation, measurement of DNA concentration and detection of EGFR mutations with the help of commercially available kits are described.
Results: The results obtained by detecting EGFR gene mutations are processed by software and ultimately a report is obtained that shows in detail all detected mutations in the patient's sample.
Conclusion: Molecular testing of the EGFR gene, i.e. detection of mutations in patients with lung cancer, is important in order to determine the correct targeted therapy. In order to determine the presence of mutations, it is necessary to isolate DNA from a blood sample or from the patient's tumor tissue, and then multiply and detect it. Patients with the presence of pathogenic mutations in the EGFR gene are candidates for targeted therapy
Physiotherapy evaluation of the diabetic foot
No full textŠećerna bolest globalno je rasprostranjena bolest sa stalnim porastom broja oboljelih. Napredne metode liječenja omogućile su značajno poboljšanje kontrole hiperglikemije i povezanih metaboličkih poremećaja. Međutim, šećerna bolest je i dalje povezana s brojnim komplikacijama, a jedna od njih je dijabetičko stopalo. Dijabetičko stopalo karakterizirano je prisutnošću infekcija, ulkusa i promjena mišićno- koštanog tkiva stopala, uz prisustvo neuroloških poremećaja i različitih stupnjeva periferne arterijske bolesti. Ključan čimbenik u upravljanju dijabetičkim stopalom je pravovremena i sveobuhvatna procjena čimbenika rizika i statusa stopala. To uključuje temeljit pregled muskuloskeletnog, vaskularnog i neurološkog sustava radi dobivanja cjelovite slike stanja stopala pacijenta sa šećernom bolešću. Ovaj proces uključuje evaluaciju mišićne snage, pokretljivosti zglobova, osjetljivosti na dodir i vibracije, procjenu prisutnosti otvorenih rana ili infekcija, procjenu cirkulacije i pulsa na stopalu te procjenu opće funkcionalnosti stopala. Također se provodi procjena hoda kako bi se identificirali poremećaji posture i načina hoda koji mogu utjecati na rizik od razvoja komplikacija. Nakon temeljite procjene dijabetičkog stopala, provodi se individualizirana terapija koja uključuje različite modalitete fizioterapije, pravilnu edukaciju pacijenta o njezi stopala i pravilnom ponašanju. Dodatno se primjenjuju različite elektroprocedure i alternativne terapijske metode kao dopuna konvencionalnoj fizioterapiji. Pravovremena fizioterapijska intervencija ima izuzetan utjecaj na zdravlje stopala kod osoba s dijabetesom, poboljšavajući cirkulaciju, osjet i mišićnokoštanu funkciju, smanjujući rizik od razvoja rana i ulkusa te održavajući funkcionalnost stopala. Ključni čimbenik uspješne terapije je timski pristup i sveobuhvatno djelovanje, gdje multidisciplinarni tim zdravstvenih djelatnika surađuje kako bi se postigli izvrsni rezultati u ranom otkrivanju čimbenika rizika za nastanak dijabetičkog stopala koja dovodi do rane intervencije ,a samim time prevenciji nastanka daljnjih komplikacija dijabetičkog stopala.Diabetes mellitus is a globally prevalent disease with a constant increase in the number of affected individuals. Advanced treatment methods have significantly improved the control of hyperglycemia and related metabolic disorders. However, diabetes is still associated with various complications, and one of them is diabetic foot. Diabetic foot is characterized by the presence of infections, ulcers, and changes in the musculoskeletal tissue of the foot, along with neurological disorders and varying degrees of peripheral arterial disease. A key factor in the management of diabetic foot is timely and comprehensive assessment. This includes a thorough examination of the musculoskeletal, vascular, and neurological systems to obtain a comprehensive picture of the patient's foot condition in diabetes. The assessment involves evaluating muscle strength, joint mobility, sensitivity to touch and vibrations, assessing the presence of open wounds or infections, evaluating circulation and pulses in the foot, and assessing the overall functionality of the foot. Gait analysis is also performed to identify posture abnormalities and walking patterns disorders that may affect the risk of developing complications. Following a thorough assessment of the diabetic foot, an individualized therapy is implemented, which includes various modalities of physiotherapy, proper patient education on foot care and behavior, as well as the application of different electrotherapy procedures and alternative therapeutic methods as complementary to conventional physiotherapy. Timely physiotherapy intervention has a significant impact on foot health in individuals with diabetes, improving circulation, sensation, and musculoskeletal function, reducing the risk of developing wounds and ulcers, and maintaining foot functionality. A key factor for successful therapy is a team approach and comprehensive action, where a multidisciplinary healthcare team collaborates to achieve excellent outcomes in early detection of risk factors for diabetic foot development, leading to early intervention and prevention of further diabetic foot complications
Nursing care of patient with thoracic aortic aneurysm treated with an endovascular procedure
No full textTorakalni endovaskularni popravak aorte (TEVAR) je minimalno invazivna tehnika. Sada je to preferirani tretman, koji zamjenjuje tradicionalnu metodu otvorene zamjene silazne torakalne aorte za većinu bolesti silazne torakalne aorte. Pokazalo se da ima niže stope morbiditeta i mortaliteta, osobito među visokorizičnim skupinama. U početku se koristio u liječenju aneurizme aorte, ali su se indikacije proširile na liječenje disekcija aorte, traumatskih transekcija aorte i penetrantnih ulkusa aorte. Degenerativne aneurizme torakalne aorte su u porastu; otvoreni popravak aneurizmi descendentne torakalne aorte povezan je s visokim stopama morbiditeta i mortaliteta. Popravak izoliranih aneurizmi descendentne torakalne aorte upotrebom stent graftova uveden je 1995. godine, a u anatomski prikladnoj podskupini bolesnika s aneurizmom torakalne aorte popravak endovaskularnim stent graftom daje povoljne ishode, sa smanjenim intraoperacijskom morbiditetom i mortalitetom u odnosu na otvoreni popravak. Temelji uspješnog popravka torakalne endovaskularne aneurizme su odgovarajući odabir bolesnika, temeljito planiranje prije postupka i oprezna provedba postupka. Rad sestrinskog tima je neophodan jer obavlja kontinuirano promatranje bolesnika i treba donositi brze odluke, koje zahtijeva postoperativno razdoblje zbog mogućeg razvoja neželjenih komplikacija. Medicinske sestre uz ostale zdravstvene djelatnike moraju identificirati i spriječiti komplikacije, djelujući odmah i doprinoseći smanjenju boravka u bolnici.Thoracic endovascular repair of the aorta (TEVAR) is a minimally invasive technique. It is now the preferred treatment, replacing the traditional method of open descending thoracic aortic replacement for most diseases of the descending thoracic aorta. It has been shown to have lower morbidity and mortality rates, particularly among high-risk groups. It was initially used in the treatment of aortic aneurysms, but the indications have expanded to include the treatment of aortic dissections, traumatic aortic transections, and penetrating aortic ulcers. Degenerative aneurysms of the thoracic aorta are on the rise; open repair of descending thoracic aortic aneurysms is associated with high rates of morbidity and mortality. Repair of isolated aneurysms of the descending thoracic aorta using stent grafts was introduced in 1995, and in an anatomically appropriate subgroup of patients with aneurysms of the thoracic aorta, repair with an endovascular stent graft provides favorable outcomes, with reduced intraoperative morbidity and mortality compared to open repair. The foundations of successful thoracic endovascular aneurysm repair are appropriate patient selection, thorough pre-procedure planning and careful execution of the procedure. The work of the nursing team is necessary because it performs continuous observation of the patient and needs to make quick decisions, which requires the postoperative period due to the possible development of unwanted complications. Nurses, along with other healthcare professionals, must identify and prevent complications, acting immediately and contributing to a reduction in hospital stay
Incindence of perineal rupture during 2022 year in Clinical Hospital Split
No full textRazdor međice iznimno je česta i očekivana posljedica vaginalnog poroda. Dijelimo je u četiri stupnja ovisno o težini razdora međice, od površinske ozljede kože međice pa sve do rascjepa rektuma. Većina razdora neće dovesti do dugotrajnih komplikacija, međutim teški razdori mogu utjecati na veću učestalost dugotrajne disfunkcije dna zdjelice, boli, dispareunije i neugodnosti. Cilj ovog rada bio je istražiti učestalost i stupnjeve razdora međice tijekom porođaja. Istraživanje je obuhvaćalo sve žene koje su imale razdor međice tijekom 2022. godine na Klinici za ženske bolesti i porode u Splitu. Na temelju 391 žena koje su imale neki od stupnjeva razdora međice utvrđeno je kako najzastupljeniji razdor I stupnja, te da je svaka druga rodilja s razdorom međice drugorotka, a svako četvrta trećerotka. Utvrđena je prosječna dob rodilje od 32 godine te ITM od 24,2 kg/m². Pokazalo se kako porođajna težina veća od 4000 grama novorođenčeta znatno ne utječe na učestalost razdora međice isto kao položaj i stav novorođenčeta. Zbog učestale upotrebe epiziotomije u praksi nismo je mogli usporediti kao relevantnu tehniku prevencije razdora međice.Perineal rupture is an extremely common and expected complication of vaginal delivery. We divide it into four stages, depending on the severity of the perineal tear, from the superficial injury of the skin to the rupture of the rectum. Most lacerations will not lead to long-term complications, however severe lacerations may result in a higher incidence of long-term pelvic floor dysfunction, pain, dyspareunia, and discomfort. The aim of this work was to investigate the incidence of perineal rupture during delivery. The research included all women who had a perineal rupture during 2022 at the Clinical hospital in Split. Based on 391 women who had some degree of perineal rupture, it was determined that the most common perinatal rupture was of the first degree, and that every second woman with perineal rupture was giving birth for the second time, and every fourth woman was giving birth for the third time. The average women was 32 yeas of age and the average BMI was 24.2 kg/m². It has been shown that the birth weight of a newborn over 4000 grams does not significantly affect the incidence of perineal tears, same as the position and attitude of the newborn. Due to the routine use of episiotomy in practice, we could not compare it as a relevant technique for the prevention of perineal tears