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TEVAR in emergency situations
No full textveličine stenta i aorte i utjecaj duljine proksimalne landing zone na ishode liječenja. Ishodi su mortalitet i pojava endoleaka. Ispitati utjecaj patologije torakalne aorte na vrijeme od dijagnoze do ugradnje TEVAR-a.
Materijali i metode: Radi se o retrospektivnom istraživanju. Ispitanici su svi bolesnici koji su podvrgnuti interventnom radiološkom zahvatu ugradnje TEVAR-a u periodu od siječnja 2016 do svibnja 2022. godine. Istraživanje je provedeno na Kliničkom zavodu za dijagnostičku i intervencijsku radiologiju KBC-a Split.
Rezultati: Pacijenti su u rasponu dobi od 22 do 71 godine, a medijan dobi je 57,5 godina. Od ukupnog broja pacijenata hitnom zahvatu podvrgnuto je njih 7 (43,75%) zbog politraume, a 9 (56,25%) pacijenata imalo je druge indikacije za ugradnju TEVAR-a. Od ukupnog broja pacijenata danas je živo 12 (75%), a preminula su 4 (25%) pacijenta. Komorbiditete ( šećerna bolest ili arterijska hipertenzija) imalo je 7 (43,75%) pacijenata, dok je 9 (56,25%) pacijenata bilo bez komorbiditeta. Kod preživljenja pacijenata i pojava endoleaka u odnosu na prisutnost politraume, komorbiditeta i aneurizme nije dokazana statistički značajna povezanost. Za analizu utjecaja kronološke dobi (pe=0,32,pžp= p=0,48), omjera veličine stent grafta i aorte proksimalno (pe= p=0,43,pžp= p=0,48) i distalno (pe= p=0,91,pžp=0,48), veličine proksimalne landing zone (pe= p=0,32,pžp= p=0,48) u odnosu na pojavu endoleaka i preživljenje pacijenta identificirano je da ne postoji statistički značajna razlika. Kada smo određivali statistički značajnu razliku u vremenu čekanja na ugradnju TEVAR-a između politraumatiziranih pacijenata i onih koji to nisu dobili smo da je p=0,12 i da ne postoji statistički značajna razlika.
Zaključak: Nema razlike između dobi,komorbiditetai politraume, utjecaja omjera veličine stenta i aorte i utjecaja veličine proksimalne landing zone u odnosu na pojavu smrtnog ishoda i endoleaka.studija je pokazala da nema razlike u vremenu ugradnje TEVAR-a kod politraumatiziranih pacijenata ionih koji to nisu. Zaključke treba uzeti s rezervom s obzirom da se radi o retrospektivnoj studiji sa malim uzorkom pacijenata, ograničenim pristupom povijesti bolesti i nemogućnosti praćenja pacijenata nakon zahvata. Svakako je potrebno daljnje istraživanje na većem uzorku pacijenata.Research objective: To examine the influence of age, comorbidity and polytrauma on treatment outcomes. To determine the influence of the size ratio of the stent to the aorta and the influence of the length of the proximal landing zone on treatment outcomes. Outcomes are mortality and occurrence of endoleaks. To examine the influence of thoracic aortic pathology on the time from diagnosis to TEVAR implantation.
Materials and methods: This is a retrospective study. The respondents are all patients who underwent interventional radiological procedures for the installation of TEVAR in the period from January 2016 to May 2022. The research was conducted at the Clinical Institute for Diagnostic and Interventional Radiology of KBC Split.
Results: Patients range in age from 22 to 71 years, and the median age is 57.5 years. Of the total number of patients, 7 (43.75%) underwent emergency surgery due to polytrauma, and 9 (56.25%) patients had other indications for TEVAR implantation. Of the total number of patients, 12 (75%) are alive today, and 4 (25%) patients have died. 7 (43.75%) patients had comorbidities (diabetes or arterial hypertension), while 9 (56.25%) patients had no comorbidities. In terms of patient survival and the occurrence of endoleaks in relation to the presence of polytrauma, comorbidities and aneurysms, no statistically significant correlation has been demonstrated. To analyze the influence of chronological age (pe=0.32, pžp= p=0.48), the size ratio of the stent graft and the aorta proximally (pe= p=0.43, pžp= p=0.48) and distally (pe= p=0.91, pžp=0.48), the size of the proximal landing zone (pe= p=0.32, pžp= p=0.48) in relation to the occurrence of endoleaks and patient survival, it was identified that there is no statistically significant difference . When we determined a statistically significant difference in the waiting time for TEVAR implantation between polytraumatized patients and those who were not, we found that p=0.12 and that there is no statistically significant difference.
Conclusion: There is no difference between age, comorbidity and polytrauma, the influence of the ratio of the size of the stent to the aorta and the influence of the size of the proximal landing zone in relation to the occurrence of death and endoleak. The study showed that there is no difference in the time of TEVAR implantation in polytraumatized patients and those who are not . Conclusions should be taken with a grain of salt, given that this is a retrospective study with a small sample of patients, limited access to medical history, and the inability to follow up patients after the procedure. Further research on a larger sample of patients is certainly needed
MSCT
No full textSAŽETAK: MSCT je kao neizostavni dijagnostički uređaj u radiološkoj tehnologiji doprinio
pronalaženju, promatranju te postavljanju dijagnoza svih akutnih i kroničnihoboljenja koristeći suvremene
radiološke i tehnološke alate. Mogućnost istovremenog prikupljanja podataka iz više slojeva te građi
scintilacijskih detektora je ono što MSCT svrstava u sam vrh medicinske dijagnostike te ga razlikuje od SSCTa. Koristeći tehnologiju spiralnog CT-a možemo u svega nekoliko sekundi skenirati cijelo tijelo bez pauze
između pojedinih slojeva te na taj način reducirati vrijeme ekspozicijei poboljšati temporalnu rezoluciju. Bitno
je napomenuti da debljina sloja kod MSCT-a ovisi o beampitchu koji se definira kao prijeđena udaljenost stola u
jednoj rotaciji gentrija od 360 stupnjeva podijeljenoj s ukupnom debljinom svih istodobno stečenih slojeva.
Debljina sloja zajedno sa veličinom matriksa i polja pregleda određuje prostornu rezoluciju slike. MSCT za
razliku od SSCT-a zbog svog tehnološkog napretka također koristi nove tehnike rekonstrukcije slike koje nam
omogućavaju da s manjom dozom zračenja dobijemo dobru sliku. Nedostatak drugačije akvizicije podataka i
rekonstrukcije slike su neki artefakti slike specifični za MSCT uređaje kao što su: zebrasti artefakti, con-beam
artefakti te artefakti vjetrenjačeABSTRACT: It was show that MSCT, as an indispensable diagnostic device in radiological technology,
contributed to the finding, observation and diagnosis of all acute and chronic diseases using modern radiological
and technological tools.The possibility of simultaneous data collection from several layers and the structure of
scintillation detectors is what places MSCT at the very top of medical diagnostics and distinguishes it from
SSCT. Using spiral CT technology, we can scan the entire body in just a few seconds without pausing between
individual layers, thereby reducing the exposure time and improving temporal resolution. It is important to note
that thickness of MSCT layer depends on the beampitch, which is defined as distance traveled by the table in
one 360-degree rotation of the gantry divided by the total thickness of all simultaneously acquired layers. The
thickness of the layer together with size of the matrix and field of view determines the spatial resolution of the
image. MSCT, unlike SSCT, due to its technological progress, also uses new image reconstruction techniques
that allow us to obtain a good image with a lower dose. The disadvantage of different data aquisition and image
reconstruction are some image artifacts specific to MSCT devices such as: zebra artifacts, con-beamartifacts and
windmill artifacts
The effect of burnout on the quality of nurse care processes
No full textSindrom burnout-a ima značajan utjecaj na kvalitetu procesa zdravstvene njege. Medicinske sestre koje pate od burnout-a iskazuju iscrpljenost, depersonalizaciju i smanjeno osobno postignuće, što negativno utječe na ključne aspekte skrbi. Takvo stanje može rezultirati smanjenom komunikacijom s pacijentima, donošenjem loših odluka, nedostatkom empatije i slabim timskim angažmanom. Burnout također dovodi do smanjene motivacije, povećane pogreške i sigurnosnih rizika za pacijente. Pored toga, zadovoljstvo pacijenata i povjerenje u zdravstveni sustav također su narušeni, jer depersonalizirano osoblje pruža manje empatije i podrške. Kako bi se poboljšala kvaliteta zdravstvene njege, potrebno je prepoznati burnout i poduzeti preventivne mjere, uključujući samopomoć, podršku kolegama, poboljšanje radnih uvjeta i ravnotežu između posla i privatnog života. Također je važno pružiti edukaciju o upravljanju stresom, komunikaciji i emocionalnoj inteligenciji kako bi se medicinskim sestrama pomoglo u suočavanju s burnout-om i unaprijedilo kvalitetu skrbi.Burnout syndrome has a significant impact on the quality of the health care process. Nurses suffering from burnout report exhaustion, depersonalization and reduced personal achievement, which negatively affects key aspects of care. Such a condition can result in reduced communication with patients, poor decision-making, lack of empathy and poor team engagement. Burnout also leads to reduced motivation, increased error and safety risks for patients. In addition, patient satisfaction and trust in the healthcare system are also undermined, as depersonalized staff provide less empathy and support. In order to improve the quality of health care, it is necessary to recognize burnout and take preventive measures, including self-help, support of colleagues, improvement of working conditions and work-life balance. It is also important to provide education on stress management, communication, and emotional intelligence to help nurses cope with burnout and improve the quality of care
The relationship between sleep quality and academic achievement of health studies students
No full textCilj ovog istraživanja bio je ispitati povezanost kvalitete sna i akademskog uspjeha kod studenata zdravstvenih studija. Pored primarnog cilja, namjera je istraživanja bila i ispitati postojanje razlika u kvaliteti sna kod studenata različitih studijskih godina i studijskih smjerova te po dobi i spolu. U istraživanju je sudjelovao 261 student. Shodno rezultatima provedenog istraživanja, utvrđeno je da kvaliteta sna nema značajnog utjecaja na akademski uspjeh studenata zdravstvenih studija. Uz navedeno, ni akademske karakteristike ne utječu značajno na kvalitetu sna studenata. Također, zapaženo je da više od polovice studenata nema značajnih poteškoća s poremećenim snom. Nadalje, utvrđeno je kako je studentima fizioterapije najviše vremena potrebno da zaspu, dok je studentima radiološke tehnologije potrebno najmanje vremena za usnivanje. Specifičnosti su ustanovljene i u pogledu uzimanja lijekova za spavanje, pri čemu je opažena poveznica uzimanja lijekova za spavanje s dobnom strukturom i akademskim uspjehom studenata.This study aimed to examine the relationship between sleep quality and academic achievement in health studies students. Apart from the primary objective, the aim of the study was also to investigate the differences in the quality of sleep among students of different study years and study fields, including their age and gender. The study was carried out with the participation of 261 students. In consonance with the results of the survey, it has been confirmed that sleep quality does not have a substantial impact on the academic achievement of health studies students. In addition, neither did academic characteristics have a significant impact on the sleep quality of students. Also, it is noted that more than half of the students do not have significant difficulties with their sleep. Furthermore, it is noted that physiotherapy students take the most time to fall asleep, while radiology students take the least time to doze off. Specificities are also established in terms of the use of sleeping pills, where correspondence between the use of sleeping pills with an age structure and the academic achievement of students is observed
Knowledge of volleyball players about cardiopulmonary resuscitation
No full textU ovom radu opisan je pojam "sportskog srca" i njegova povezanost s kardiovaskularnim promjenama kod sportaša, istražujući rizik od iznenadnog srčanog zastoja. Proučeni su uzroci srčanog zastoja u mladih sportaša, uključujući prirođene kardiovaskularne bolesti, anomalije koronarnih arterija, rupturu aorte i druge faktore. Ta-kođer, analizirane su elektrokardiografske osobitosti "sportskog srca" i dijagnostičke metode za razlikovanje fizi-oloških prilagodbi od patoloških promjena. Poseban naglasak stavljen je na važnost kardiopulmonalne reanimacije kao ključnog faktora u spašavanju života osoba koje dožive srčani zastoj. Opisani su postupci kardiopulmonalne reanimacije uključujući procjenu dišnog puta, održavanje disanja, kompresije na prsni koš i upotreba automatskog vanjskog defibrilatora (AED). Ovaj rad pruža dublje razumijevanje veze između sportske aktivnosti i kardiovas-kularnog zdravlja te ističe važnost pravilnog postupanja i primjene kardiopulmonalne reanimacije u hitnim situa-cijama srčanog zastoja. Uvod: Profesionalni sportaši su oni koji se izdvajaju izvrsnošću i postignućima u svojim disciplinama, no često su izloženi rizicima iznenadnih srčanih zastoja što privlači pažnju i interes šire javnosti. Rezultati: Ispitivanje nad 110 odbojkaša i odbojkašica o kardiopulmonalnoj reanimaciji pokazalo je da većina (88,18%) zna broj hitne medicinske pomoći, dok samo 20% zna kako otvoriti dišni put. Više od polovine ispitanika (53,34%) osjećalo se spremno za izvođenje reanimacije na sportskom terenu, bez obzira na spol. Polovina ispita-nika (53,64%) nije prošla edukaciju o oživljavanju, dok su oni koji jesu, najčešće su to učinili tijekom tečaja prve pomoći na vozačkom ispitu (84,31%). Ističe se statistički značajna razlika u obrazovanju ispitanika o oživljavanju prema različitim programima edukacije (P<0,001). Zaključci: Postoji razlika u razini znanja između ispitanih odbojkaških klubova. Sociodemografska obilježja i-maju utjecaj na razinu znanja o kardiopulmonalnoj reanimaciji. Završena edukacija o kardiopulmonalnoj reanima-ciji je u pozitivnoj vezi s višom razinom znanja o kardiopulmonalnoj reanimaciji. Spremnost za obavljanje kardi-opulmonalne reanimacije u uvjetima na sportskom terenu je u pozitivnoj vezi s višom razinom znanja o kardio-pulmonalnoj reanimaciji. Postoji pozitivna razina motiviranodbojkašica i odbojkaša za sudjelovanjem u edu-kaciji o kardiopulmonalnoj reanimaciji.This paper describes the concept of the 'athlete's heart' and its association with cardiovascular changes in athletes, investigating the risk of sudden cardiac arrest. The causes of cardiac arrest in young athletes were examined, including congenital cardiovascular diseases, coronary artery anomalies, aortic rupture, and other fac-tors. Additionally, electrocardiographic features of the 'athlete's heart' and diagnostic methods to differentiate physiological adaptations from pathological changes were analyzed. Special emphasis was placed on the im-portance of cardiopulmonary resuscitation (CPR) as a key factor in saving the lives of individuals who experience cardiac arrest. The procedures of CPR were described, including airway assessment, maintaining breathing, chest compressions, and the use of automated external defibrillators (AEDs). This paper provides a deeper understanding of the relationship between sports activity and cardiovascular health, highlighting the importance of proper re-sponse and the application of CPR in emergency situations of cardiac arrest.
Introduction: Professional athletes are those who stand out for their excellence and achievements in their disci-plines but are often exposed to the risks of sudden cardiac arrest, which attracts the attention and interest of the public.
Aim: To assess the knowledge of cardiopulmonary resuscitation among volleyball players in volleyball clubs in Split and Kaštela.
Subject and methods: The research was conducted in 4 volleyball clubs: Volleyball Club Split, Volleyball Club Ribola Kaštela, Women's Volleyball Club Ribola Kaštela, Volleyball Club Marina Kaštela and included 110 re-spondents. The questionnaire was filled out anonymously, online via Google Forms from May 2023. to June 2023.
Conclusions: There is a difference in the level of knowledge between the surveyed volleyball clubs. Sociodemo-graphic characteristics have an influence on the level of knowledge about cardiopulmonary resuscitation. Com-pleted education on cardiopulmonary resuscitation is positively related to a higher level of knowledge on cardio-pulmonary resuscitation. Willingness to perform cardiopulmonary resuscitation in sports field conditions is posi-tively related to a higher level of knowledge about cardiopulmonary resuscitation. There is a positive level of motivation among volleyball players to participate in cardiopulmonary resuscitation education
The impact of nursing care on the quality of life of patients with multiple sclerosis
No full textMultipla skleroza je složena autoimuna bolest središnjeg živčanog sustava koja predstavlja izazov suvremenom zdravstvenom sustavu. Ova kronična bolest uzrokuje raznolike simptome poput poremećaja vida, motoričkih problema, umora i kognitivnih poteškoća. Simptomi se javljaju valovito, pogoršavajući se tijekom relapsa. Glavni ciljevi liječenja su poboljšanje kvalitete života, smanjenje broja relapsa te usporavanje napredovanja bolesti. Farmakoterapija i terapijske inovacije imaju ključnu ulogu u pružanju nade pacijentima za kontroliranje simptoma i očuvanje funkcionalnosti središnjeg živčanog sustava. Kvaliteta života kod osoba oboljelih od multiple skleroze prvi puta je bila istražena 1950. godine. Istraživanja su pokazala da osobe koje boluju od multiple skleroze doživljavaju nižu opću i specifičnu kvalitetu života u usporedbi s osobama koje nemaju ovu bolest, kao i s drugim skupinama koje pate od drugih kroničnih bolesti. Kvaliteta života povezana s zdravljem je složen i višedimenzionalni koncept koji obuhvaća mjere fizičkog, mentalnog, emocionalnog i socijalnog funkcioniranja. Skale za procjenu kvalitete života kod pacijenata s multiplom sklerozom mogu biti opće ili specifične za tu bolest. Upitnici koji se koriste za procjenu kvalitete života pacijenata s multiplom sklerozom uključuju subjektivne i objektivne pokazatelje, a ponekad i njihovu kombinaciju. Glavni cilj sestrinske skrbi je poboljšati kvalitetu života pacijenata i očuvati njihove funkcionalne sposobnosti. Razumijevanje procesa zdravstvene njege omogućuje medicinskim sestrama prikupljanje relevantnih podataka, postavljanje sestrinskih dijagnoza te izradu plana njege, uključujući edukaciju o bolesti, mogućnostima liječenja te prevenciji komplikacija. Medicinske sestre potiču pacijente s multiplom sklerozom da ostanu aktivni, da se pridržavaju pravilne prehrane, da koriste tehnike za smanjenje razine stresa, sve kako bi imali normalan i kvalitetan stil života.Multiple sclerosis is a complex autoimmune disease of the central nervous system that poses a challenge to modern healthcare systems. This chronic illness causes diverse symptoms such as vision disturbances, motor issues, fatigue, and cognitive difficulties. Symptoms occur in waves, worsening during relapses. The main treatment goals are to improve quality of life, reduce the number of relapses, and slow disease progression. Pharmacotherapy and therapeutic innovations play a crucial role in offering patients hope for symptom control and preservation of central nervous system functionality. Quality of life in individuals with multiple sclerosis was first investigated in 1950. Research has shown that people with multiple sclerosis experience lower overall and disease-specific quality of life compared to those without the condition, as well as compared to other groups with different chronic diseases. Health-related quality of life is a complex and multidimensional concept that encompasses measures of physical, mental, emotional, and social functioning. Scales for assessing quality of life in multiple sclerosis patients can be general or disease-specific. Questionnaires used to assess the quality of life of multiple sclerosis patients include subjective and objective indicators, sometimes in combination. The primary goal of nursing care is to improve patients' quality of life and preserve their functional abilities. Understanding the healthcare process enables nurses to gather relevant data, establish nursing diagnoses, and create a care plan that includes education about the disease, treatment options, and prevention of complications. Nurses encourage patients with multiple sclerosis to remain active, adhere to proper nutrition, and employ stress reduction techniques, all to maintain a normal and high-quality lifestyle
The role of the nurse/technician in the differential diagnosis of chest pain
No full textSve češći je uzrok smrti u općoj populaciji, a javlja se i kod mlađih osoba. Bol u predjelu prsa predstavlja jedan od
češćih razloga zbog kojih se bolesnici javljaju hitnoj službi, uz bolove u predjelu trbuha, pogađa od 20-40% populacije
tijekom života. U hitni objedinjeni bolnički prijem dolazi 10-15% bolesnika koji, kao razlog, navode bolove u prsima
koji su posljedica koronarnog akutnog zbivanja. Učestalost posjeta u hitnoj je službi veća u urbanim sredinama, u
odnosu na ruralne bolnice. Također, ispitanici su češće muškoga spola. Međutim, bolovi u prsima nisu uvijek povezani
s pojavom koronarnog akutnog zbivanja, a bolesnike se često podvrgne dijagnostičkim postupcima koji nisu potrebni,
a to povećava izdatke zdravstvene ustanove. Zbog prezentacije boli moguće je pomisliti na razna hitna/ne hitna stanja
poput infarkta miokarda, disekcije aorte, traume prsišta i plućne embolije, ali i opću slabost, bolove u trbuhu te mišićne
boli i dr. Na konačni ishod prije svega utječe kvalitetan postupak zbrinjavanja pacijenta na terenu, ali i u bolnici. Stoga
će u radu biti prikazana važnost uloge medicinske sestre/tehničara u prepoznavanju, zbrinjavanju i brizi pacijenta s
bolovima u prsimaIt is increasingly common cause of death in the general population and it also occurs in younger people. Pain in the
chest area is one of the most common reasons why patients report to the emergency service, along with abdominal
pain, it affects 20-40% of the population during their lifetime. Approximately 10-15% of patients who, as a reason,
cite chest pains as a result of coronary acute events, come to the emergency unit of the hospital. The frequency of
visits to the emergency department is higher in urban areas, compared to rural hospitals. Furthermore, respondents are
more often male. However, chest pains are not always associated with the occurrence of coronary acute events and
patients are often subjected to diagnostic procedures that are not necessary and this increases the expenses of the health
care institution. Due to the presentation of the pain, it is possible to think of various emergency/non-emergency
conditions such as myocardial infarction, aortic dissection, chest trauma and pulmonary embolism, but also general
weakness, abdominal pain and muscle pain, etc. The final outcome is primarily influenced by the quality of the patient
care process on the field, but also in the hospital. Therefore, the paper will show the importance of the role of the
nurse/technician in the recognition, treatment and care of a patient with chest pai
Approach to the patient with diabetic polyneuropathy
No full textPrema definiciji Svjetske zdravstvene organizacije, šećerna bolest je trajna metabolička patologija koja se karakterizira visokom razinom glukoze u krvi, što s vremenom dovodi do oštećenja krvnih žila u srcu, očima, bubrezima i živcima. Prema procjenama Međunarodne federacije za dijabetes (IDF) za 2015. godinu, svjetska populacija od 20 do 79 godina obuhvaća 415 milijuna ljudi sa šećernom bolešću, dok u Republici Hrvatskoj registar CroDiab bilježi 254,296 odraslih osoba koje imaju šećernu bolest. Važno je napomenuti da se procjenjuje kako i do 40 % oboljelih nije dijagnosticirano, čime ukupan broj zaraženih prelazi 400,000. U skladu sa službenom klasifikacijom, postoje različiti tipovi šećerne bolesti, pri čemu su najvažnija dva tipa DM tip1 i DM tip2. Klinička slika ove bolesti značajno varira, ovisno o tipu, dobi pacijenta te prisutnim drugim bolestima. Simptomi šećerne bolesti obuhvaćaju mnoge znakove, a dijagnoza se potvrđuje mjerenjem glukoze u krvi. Preporučuje se posebno mjerenje glukoze na prazan želudac. Dijabetička polineuropatija je jedna od kroničnih komplikacija šećerne bolesti koja se manifestira kao niz oštećenja živčanog sustava. Njeni kompleksni patofiziološki mehanizmi ukazuju na različite moguće uzroke. Detaljni simptomi i znakovi manifestirane polineuropatije, kao i neinvazivne neurofiziološke analize, ključni su za dijagnosticiranje pojedinih manifestacija polineuropatije. Medicinska sestra je neophodan član zdravstvenog tima u dijagnostici, liječenju i prevenciji dijabetičke polineuropatije. Njena uloga se posebno ističe kroz proces planiranja zdravstvene njege, gdje se uspostavlja pozitivna interakcija između nje i pacijenata. Tokom pružanja zdravstvene brige, medicinske sestre posvećuju vrijeme rješavanju problema pacijenata kroz različite intervencije, uključujući neposrednu fizičku pomoć, vođenje, usmjeravanje, motivaciju te edukaciju i savjetovanje. S obzirom na kronični tok neuropatije, konstantna briga specijaliziranog zdravstvenog tima, u kojem medicinska sestra ima ključnu ulogu, je neophodna.SUMMARY: According to the definition of the World Health Organization, diabetes is a chronic metabolic disorder characterized by elevated blood glucose levels, which over time leads to damage to blood vessels in the heart, eyes, kidneys, and nerves. According to estimates from the International Diabetes Federation (IDF) for the year 2015, the global population between the ages of 20 and 79 includes 415 million people with diabetes, while in the Republic of Croatia, the CroDiab registry records 254,296 adults with diabetes. It is important to note that it is estimated that up to 40% of those affected have not been diagnosed, resulting in a total number of over 400,000 cases. In accordance with the official classification, there are various types of diabetes, with the two most important types being DM type 1 and DM type 2. The clinical presentation of this disease varies significantly, depending on the type, patient age, and other coexisting conditions. Diabetes symptoms encompass many signs, and the diagnosis is confirmed through blood glucose measurement, with fasting glucose measurement particularly recommended. Diabetic polyneuropathy is one of the chronic complications of diabetes that manifests as a series of nerve system impairments. Its complex pathophysiological mechanisms suggest various possible causes. Detailed symptoms and signs of manifest polyneuropathy, as well as non-invasive neurophysiological analyses, are crucial for diagnosing specific manifestations of polyneuropathy. A nurse is an essential member of the healthcare team in diagnosing, treating, and preventing diabetic polyneuropathy. Their role is particularly highlighted in the healthcare planning process, establishing a positive interaction between them and patients. During the provision of healthcare, nurses dedicate time to addressing patient issues through various interventions, including direct physical assistance, guidance, direction, motivation, education, and counseling. Given the chronic course of neuropathy, continuous care by a specialized healthcare team, in which nurses play a key role, is essential
Nurse's activities in the care of patients transcatheter aortic valve implantation
No full textAorta stenoza je bolest srčanog zaliska koja ima dugu latentnu fazu, a poteškoće se pojavljuju u
uznapredovanoj fazi bolesti. Klinički simptomi se manifestiraju kao sinkopa, angina pectoris ili zatajivanje srca.
Sama bolest se dokazuje elektrokardiogramom, rendgenskim prikazom srca i pluća, ultrazvukom srca i
kateterizacijom srca. Stupanj težine aorte stenoze dijeli se s obzirom na zahvaćenosti površine srca ili s obzirom
na gradijent. Liječenje ovisi o stupnju aortne stenoze i kliničkoj slici a može biti konzervativno ili kirurško.
Kako je aortna stenoza posljedica degenerativnih bolesti povezanih sa životnom dobi tako je i rizik za ovaj
način liječenja velik. Zbog svega navedenog transkateterska implementacija aortnog zaliska našla je svoju
primjenu kao manje invazivna metoda u liječenja aortne stenoze.
Medicinska sestra sudjeluje u pripremnim radnjama vezanim za provedbu same procedure. Asistira liječniku
tijekom zahvata te se aktivno brine o bolesniku prije, tijekom i nakon samog zahvata. Ulaže sva svoja znanja,
iskustvo i vještine u sprječavanju mogućih komplikacije pazeći da se svedu na najmanju moguću mjeru, te
educira bolesnika i njegovu obitelj o zdravstveno odgovornom načinu života nakon otpusta iz bolnice.Aortic stenosis is a heart valve disease that has a long latent phase, and difficulties
appear in the advanced stage of the disease. Clinical symptoms manifest as syncope, angina pectoris or
heart failure. The disease itself is proven by electrocardiogram, X-ray of the heart and lungs, ultrasound
of the heart and characterization of the heart. The degree of severity of aortic stenosis is divided according
to the involvement of the heart surface or according to the gradient. Treatment depends on the degree of
aortic stenosis and the clinical picture and can be conservative or surgical. As aortic stenosis is a
consequence of age-related degenerative diseases, the risk for this method of treatment is also high.
Because of all the above, the transcatheter implementation of the aortic valve has found its application as
a less invasive method in the treatment of aortic stenosis. The nurse participates in the preparatory actions
related to the implementation of the procedure itself. Assists the doctor during the procedure and actively
takes care of the patient before, during and after the procedure itself. They invests all their knowledge,
experience and skills in preventing possible complications, making sure that if they appear they are
minimized. Furthermore they educate the patient and their family on how to adjust to and lead a healthier
lifestyle after discharge from the hospita
Nursing care of emergency psychiatric patients in outpatient emergency medical care
No full textCilj istraživanja: analizirati sestrinsku skrb za hitnog psihijatrijskog bolesnika, pri čemu je naglasak na
sestrinskoj skrbi za te bolesnike u izvanbolničkoj hitnoj medicinskoj pomoći.
Rasprava: Hitna psihijatrijska stanja jesu akutni poremećaji raspoloženja, mišljenja, ponašanja ili socijalnih
odnosa koja zahtijevaju hitnu intervenciju jer ugrožavaju bolesnikov život ili predstavljaju opasnost za njegovu
okolinu, kao što su suicidalnost, psihomotorni nemir i agresivnost, delirij, akutna anksiozna stanja, akutna
psihotična reakcija, akutni afektivni poremećaji, akutna intoksikacija alkoholom i/ili psihoaktivnim tvarima te
neke nuspojave određenih lijekova. Medicinska sestra/medicinski tehničar kao dio tima izvanbolničke hitne
medicinske pomoći u timu s liječnikom ili bez liječnika procjenjuje bolesnikovo zdravstveno stanje na mjestu
intervencije, postavlja sestrinske dijagnoze te intervenira u skladu sa svojim iskustvom i ovlastima. Kako bi
uspostavila efikasnu komunikaciju s bolesnikom kojeg je nužno hitno hospitalizirati medicinska
sestra/medicinski tehničar koristi razne tehnike, a prema potrebi ordinira i terapiju kako bi se bolesnik umirio,
nakon čega se bolesnik prevozi u bolničku ustanovu na liječenje.
Zaključak: Medicinska sestra/medicinski tehničar ima zahtjevnu i odgovornu ulogu kao član tima izvanbolničke
hitne medicinske pomoći u intervencijama vezanima za hitna psihijatrijska stanja te zbrinjavaju hitnih
psihijatrijskih bolesnika.Objectives: To analyze nursing care for emergency psychiatric patients, with the emphasis on nursing care for
these patients in outpatient emergency medical care.
Discussion: Emergency psychiatric conditions are acute disorders of mood, thinking, behavior or social
relations that require immediate intervention because they endanger the patient's life or pose a danger to his
environment, such as suicidality, psychomotor restlessness and aggressiveness, delirium, acute anxiety states,
acute psychotic reaction, acute affective disorders, acute intoxication with alcohol and/or psychoactive
substances and some side effects of certain drugs. The nurse/medical technician, as part of the outpatient
emergency medical care team, in a team with or without a doctor, assesses the patient's health condition at the
point of intervention, makes nursing diagnoses and intervenes in accordance with his experience and powers.
In order to establish effective communication with the patient who needs to be hospitalized urgently, the
nurse/medical technician uses various techniques and, if necessary, prescribes therapy to calm the patient down,
after which the patient is transported to a hospital for treatment.
Conclusion: The nurse/medical tehnician has a demanding and responsible role as a member of the outpatient
emergency medical care team in interventions related to urgent psychiatric conditions and care for emergency
psychiatric patient