University Department of Health Studies Repository
Not a member yet
1537 research outputs found
Sort by
Incidence of dialysis patients in Croatia and in the world and nurses activities in dialysis
No full textDijaliza je postupak pročišćavanja krvi i izlučivanja otpadnih tvari i viška vode iz tijela uz pomoć dijalizatora. Dijaliza je potrebna bolesnicima sa kroničnim bubrežnim bolestima onda kada bubrezi prestanu obavljati svoju funkciju filtriranja krvi. Medicinska sestra provodi najviše vremena uz bolesnika, pa je tako njena uloga u zbrinjavanju bubrežnih bolesnika jako velika. Medicinska sestra ima veliku ulogu u samom postupku dijalize, a prije postupka je jako važno educirati bolesnika o dijalizi i načinu života s dijalizom. Cilj rada je prikazati učestalost dijaliziranih bolesnika u Hrvatskoj i svijetu te aktivnosti medicinske sestre kod samog postupka dijalize, ali i edukacije pacijenta te prevencije kronične bubrežne bolesti. Izvori statističkih podataka za ovaj rad su razna istraživanja provedena u Hrvatskoj i svijetu koja daju podatke o prevalenciji bubrežnih bolesnika koji su na dijalizi, glavnim osnovnim bolestima bubrežnih bolesnika koje su dovele do oštećenja funkcije bubrega, prosječnoj dobi bolesnika, broju transplantacija bubrega koje su obavljene u Hrvatskoj i svijetu te o predviđanjima za budućnost. Pretraživanjem literature opaženo je kako je broj bubrežnih bolesnika kojima je potrebna dijaliza svakodnevno u porastu kod oba spola i u svakoj životnoj dobi, iako je i dalje najučestalija kod bolesnika prosječne dobi od 65 godina. Kronična bubrežna bolest postala je globalni problem javnog zdravstva, a potrebe za dijalizom dovode do preopterećenosti zdravstvenog sustava što rezultira povećanim mortalitetom bubrežnih bolesnika u manje razvijenim i nerazvijenim zemljama.Dialysis is the process of purifying the blood and removing waste products and excess water from the body with the help of a dialyzer. Dialysis is needed in patients with chronic kidney disease when the kidneys stop performing their blood filtration function. The nurse spends most of her time with the patient, so her role in caring for kidney patients is very great. The nurse has a big role in the dialysis process itself, and before the procedure it is very important to educate the patient about dialysis and lifestyle with dialysis. The aim of this paper is to show the frequency of dialysis patients in Croatia and the world and the activities of nurses in the dialysis procedure, but also patient education and prevention of chronic kidney disease. Sources of statistical data for this paper are various studies conducted in Croatia and the world that provide data on the prevalence of renal patients on dialysis, the main underlying diseases of renal patients that led to impaired renal function, average age, number of kidney transplants performed in Croatia and the world and predictions for the future. A search of the literature showed that the number of renal patients requiring dialysis is increasing daily in both sexes and at each age, although it is still most common in patients with an average age of 65 years. Chronic kidney disease has become a global public health problem, and the need for dialysis leads to overloading the health system resulting in increased mortality of kidney patients in less developed and underdeveloped countries
FREQUENCY OF THE PERINATAL COMPLICATIONS OF PREGNANT WOMEN WITH COVID INFECTION IN THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY SPLIT
No full textCilj rada bio je istražiti perinatalne komplikacije kod trudnica koje su tijekom trudnoće i poroda imale
Covid 19 infekciju a rodile su u Klinici za ženske bolesti i porode KBC-a Split i usporediti dobivene
podatke s rezultatima objavljenim u literaturi. Retrospektivno istraživanje provedeno je kod 422 trudnice
u periodu između kolovoza 2020. godine i veljače 2022. godine. Rezultati rada obuhvaćali su: godine
trudnica, rodnost, dob trudnoće kada su imale infekciju, termin poroda, težina novorođenčadi, učestalost
perinatalnih komplikacija (preeklampsije, gestacijskog i/ili dijabetes melitusa, prijevremenog poroda,
intrauterinog zastoja rasta ploda (IUZR), abrupcije posteljice, intrautrine smrti ploda, tromboembolijskog
ncidenta u trudnoći i smrti trudnice), Apgar score novorođenčeta, način poroda, ozljede u porodu, boravak
na neonatološkoj jedinici intenzivnog liječenja. Istraživanjem je dokazana manja učestalost perinatalnih
komplikacija u Klinici za ženske bolesti i porode KBC-a Split u usporedbi s podacima iz literature što se
se može objasniti malim brojem trudnica sa teškim simptomima Covid-19 infekcije i dobrom
perinatološkom zaštitom trudnica. Komplikacije Covid-19 infekcije kod novorođenčadi također su manje
u odnosu na podatke dostupne u literaturi. Novorođenčad Covid pozitivnih trudnica ili trudnica koje su u
trenutku rađanja bile pozitivne na Covid su na jedinicu intenzivnog neonatološkog liječenja bila smještena
zbog zbrinjavanja i nadzora zbog prijevremenog rođenja.The purpose of this research work was to investigate perinatal complications in expectant
women who suffered Covid-19 infection during childbirth or pregnancy and who gave birth at the Women’s
Health Clinic of Clinical Hospital Centre in Split and to compare the acquired data with the results published
in the literature. Retrospective research was conducted on 422 expectant women in the period between
August 2020 and February 2022. The research results included: the age of the expectant women, fertility,
stage of pregnancy when they had the infection, pregnancy due date, the weight of the new-borns, frequency
of the perinatal complications (preeclampsia, gestational and/or diabetes mellitus, premature childbirth,
intrauterine fetal growth retardation (IUGR), abruption of placenta, intrauterine fetal demise,
thromboembolic disease incidence in pregnancy or death of the expectant woman), Apgar score of the newborns, type of childbirth, injuries during childbirth and sojourn at the neonatal intensive care unit. With the
research conducted it has been proven that there is a fewer frequency of perinatal complications in the
Women’s Health Clinic of CHC Split in comparison with the literature data, which is to be explained by
the small number of expectant women with severe symptoms of the Covid-19 infection and by appropriate
perinatal protection. The complications caused by Covid-19 infection in new-borns are also rarer in analogy
to the data available in the literature. New-borns of the Covid-positive expectant women or the expectant
women who were positive for Covid-19 at the time of the childbirth were situated at the neonatal intensive
care unit because of the care and supervision due to premature childbirth
SPECIFITIES IN PHYSIOTHERAPY OF CARDIOLOGICAL PATIENTS
No full textIshemijska bolest srca jedna je od vodećih uzroka smrti u svijetu. Na nastanak ishemijske bolesti srca utječu mnogi čimbenici rizika kao što su pušenje, nezdrava prehrana, visoka razina stresa te nedostatak tjelesne aktivnosti. Iako se liječenje značajno poboljšalo organizacijom mreže primarne perkutane intervencije za zbrinjavanje akutnog infarkta miokarda, značajan broj bolesnika i dalje umire. Komplikacije infarkta miokarda i reinfarkcije su česte, a pravilnom kardiološkom rehabilitacijom i prevencijom njihova učestalost se može smanjiti.
Fizioterapija kardioloških bolesnika zahtijeva interdisciplinarni timski pristup bolesnicima s funkcionalnim oštećenjima kao posljedice bolesti srca.
Kardiološka rehabilitacija se provodi u tri faze. Prva faza uključuje razdoblje bolesnikovog boravka u bolnici za vrijeme akutne faze bolesti. Druga faza se provodi u poliklinici ili u specijalnoj bolnici za kardiološku rehabilitaciju, a treća faza je doživotna i uključuje vrijeme kada se pacijent vraća aktivnostima svakodnevnog života i nije vezana uz zdravstvenu ustanovu.
Prije započinjanja rehabilitacije potrebno je postaviti ciljeve rehabilitacije te prema njima definirati terapijski plan. Kod sastavljanja terapijskog plana fizioterapeuti nailaze na problem određivanja intenziteta vježbanja. Međutim, kroz fizioterapijsku procjenu fizioterapeut uzima anamnezu, procjenjuje razinu aerobnog kapaciteta i mišićnu snagu bolesnika primjerenim i specifičnim testovima te prema tome određuje vježbe koje će pacijent koristiti. Osim rehabilitacije, fizioterapeut treba educirati bolesnika o čimbenicima rizika, te motivirati i poticati da nakon završetka rehabilitacije nastavi primjenjivati naučeno kroz cijeli život.Ischemic heart disease is one of the leading causes of death in the world. The occurrence of ischemic heart disease is influenced by many risk factors, such as smoking, unhealthy diet, high levels of stress and lack of physical activity. Although treatment has significantly improved with the organization of a network of primary percutaneous intervention for management of acute myocardial infarction, a significant number of patients still die. Complications of myocardial infarction and reinfarction are common, but with proper cardiac rehabilitation and prevention, their frequency can be reduced.
Physiotherapy of cardiac patients requires an interdisciplinary team approach to patients with functional impairments as a result of heart disease.
Cardiac rehabilitation is carried out in three phases. The first phase includes the period of the patient's stay in the hospital during the acute phase of the disease. The second phase is carried out in a polyclinic or in a special hospital for cardiac rehabilitation. The third phase is lifelong and includes time when the patient returns to the activities of daily living and is not connected to a health facility.
Before starting rehabilitation, it is necessary to set rehabilitation goals and define a therapeutic plan. While creating a therapeutic plan, physiotherapists encounter the problem of determining the intensity of exercise. However, through the physiotherapy assessment, the physiotherapist takes medical history, assesses the level of aerobic capacity and muscle strength of the patient with appropriate and specific tests, and according to them determines the exercises that the patient will use. In addition to rehabilitation, the physiotherapist should educate patients about risk factors, motivate and encourage them to continue with what they have learned throughout rehabilitation in their lives after rehabilitation
Specifics in the health care of a patient with Myasthenia gravis
No full textMijastenija gravis je neuromuskularna autoimuna bolest koja se javlja u odrasloj dobi češće kod žena. Najizraženiji simptom bolesti je slabost mišića koja se smanjuje nakon odmora. Iako je u najvećem dijelu bolest izazvana stvaranjem protutijela na aceltilkolinske receptore, u 10-15% izazvana je timomom. Najčešći simptomi bolesti su ptoza, dvoslike, umor, disfagija, dizartrija, slabost mišića ruku i nogu. U dijagnostici bolesti služimo se elektromioneurografijom, laboratorijskim pretragama, radiološkom dijagnostikom i provođenjem tenzilonskog testa. Bolest se liječi konzervativno imunosupresivima, kortikosteroidima, inhibitorima acetilkolinesteraze, plazmaferezom i intravenski imunoglobilinima, i kirurški ako postoji tumor timalne žlijezde. Karakteristična pojava za ovu bolest je pojava mijastenične i kolinergične krize koje zahtijevaju hitno liječenje. Redovito bi se trebala provoditi rehabilitacija ali u umjerenom trajanju i pružiti psihološka pomoć. Cilj sestrinske skrbi je povećati stupanj samostalnosti u obavljanju aktivnosti koje pacijent ne može sam obavljatiMyasthenia gravis is a neuromuscular autoimmune disease that occurs more often in women in adulthood. The most pronounced symptom of the disease is muscle weakness that decreases after rest. Although the disease is mostly caused by the production of antibodies to acetylcholine receptors, in 10-15% it is caused by thymoma. The most common symptoms of the disease are ptosis, double vision, fatigue, dysphagia, dysarthria, weakness of the muscles of the arms and legs. In the diagnosis of the disease, we use electromyoneurography, laboratory tests, radiological diagnostics and conducting the Tenzilon test. The disease is treated conservatively with immunosuppressants, corticosteroids, acetylcholinesterase inhibitors, plasmapheresis and intravenous immunoglobulins, and surgically if there is a tumor of the thymus gland. A characteristic feature of this disease is the occurrence of myasthenic and cholinergic crises that require emergency treatment. Rehabilitation should be carried out regularly, but in a moderate manner, and psychological help should be provided. The aim of nursing care is to increase the degree of independence in performing activities that the patient cannot perform alone
Frequency and specificity of positive indirect antiglobulin test in patients in the Department for Transfusion Medicine of the University hospital of Split 2019-2020.
No full textUvod: Antigeni su strukture koje tijelo prepoznaje kao strane te izazivaju imunološku reakciju. Eritrocitni antigeni su podijeljeni u 35 sustava krvnih grupa.Hemoliza je raspadanje eritrocita. U sklopu imunološke transfuzijske reakcije može biti izazvana antitijelima i/ili komplementom. Može biti akutna ili odgođena, intravaskularna ili ekstravaskularna.
Cilj: Ispitati učestalost pronalaska antieritrocitnih antitijela i odrediti njihovu specifičnost u pacijenata u Zavodu za transfuzijsku medicinu KBC-a Split u razdoblju 2019. - 2020.
Metode: Identifikacija antieritrocitnih antitijela provodi se indirektnim antiglobulinskim testom (IAT) kod svih potencijalnih primatelja krvnih pripravaka. Detektiramo prisutnost iregularnih antitijela u serumu pacijenta koristeći testne eritrocite poznatog antigenskog fenotipa.
Rezultati: Broj detektiranih antitijela u 2019. godini naspram 2020. godine se mijenjao za najčešća antitijela: anti-D (35 naspram 33), anti-M (46 naspram 18), anti –K (27 naspram 20), anti-E (29 naspram 15) i anti-Lea (15 naspram 10).
Zaključak: Pad broja detektiranih antitijela vremenski korelira s padom broja ukupno provedenih testova zbog proglašenja pandemije SARS-CoV2.Introduction: Antigens are structures that the body recognizes as foreign and cause an immune reaction. Erythrocyte antigens are divided into 35 blood group systems. Hemolysis is the breakdown of erythrocytes. As part of the immune transfusion reaction, it can be caused by antibodies and/or complement. It can be acute or delayed, intravascular or extravascular.
Objective: To examine the detection frequency of anti-erythrocyte antibodies and determine their specificity in patients at the Department of Transfusion Medicine in University hospital of Split in the period 2019 - 2020.
Methods: The identification of antierythrocyte antibodies is carried out by the indirect antiglobulin test (IAT) in all potential recipients of blood products. We detect the presence of irregular antibodies in the patient's serum using test erythrocytes of a known antigenic phenotype.
Results: The number of detected antibodies in 2019 versus 2020 changed for the most common antibodies: anti-D (35 versus 33), anti-M (46 versus 18), anti-K (27 versus 20), anti-E (29 versus 15) and anti-Lea (15 versus 10).
Conclusion: The drop in the number of detected antibodies correlates in time with the drop in the total number of tests performed due to the declaration of the SARS-CoV2 pandemic
HEALTH CARE OF PATIENTS AFTER ACUTE HEARING LOSS
No full textCilj: Prioritet ovog istraživanja bio je ispitati učinkovitost RHHI (engl. Revised Hearing Handicap Inventory) upitnika u sestrinskoj procjeni bolesnikova sluha i planiranju zdravstvene njege za bolesnike s akutnim gubitkom sluha.
Izvori podataka i metode: Istraživanje je provedeno na Klinici za bolesti uha, nosa i grla s kirurgijom glave i vrata, KBC-a Split. U istraživanju je sudjelovalo 32 ispitanika koji su zadovoljili kriterije uključivanja: akutni gubitak sluha u zadnja 72 sata, gubitak sluha potvrđen tonskim audiogramom i medicinska dijagnoza idiopatskog gubitka sluha. Korišten je RHHI upitnik za samoprocjenu socijalnih i emocionalnih posljedica oštećenja sluha na svakodnevni život bolesnika, sastavljen od 18 pitanja. Istraživanje je vršeno u vremenskom razdoblju od 28.10.2021. do 26.04.2022. godine.
Rezultati: Nije postojala statistički značajna razlika između višeg rezultata bodovanja na konstruiranom RHHI upitniku i višeg rezultata gubitka sluha na testiranju audiogramom. Istraživanje je pokazalo da je iznenadni idiopatski gubitak sluha izraženiji unilateralno. Ukoliko je oštećenje sluha mjereno audiogramom za desno uho veće, na lijevom uhu će biti manje i obrnuto (p=0,030). Kliničku pomoć zatražili su uglavnom ispitanici koji u RHHI upitniku imaju ≥ 6 sumu bodova. Nije postojala značajna razlika u rezultatima ispitivanja između ispitanika mlađe dobi oboljelih od iznenadnog idiopatskog gubitka sluha koji su imali blaže oštećenje sluha od starijih sa istom kliničkom slikom. Rezultati su pokazali da starija dob bolesnika uvjetuje težem oštećenju sluha na lijevom uhu. Utvrđena je povezanost postojanja osjećaja frustracije pri komunikaciji osoba s idiopatskim gubitkom sluha i poteškoća prilikom prisustvovanja zabavi (p=0,028). Dokazano je da muškarci i žene podjednako obolijevaju od idiopatskog gubitka sluha.
Zaključak: RHHI upitnik može imati praktičnu svrhu u sestrinskoj procjeni bolesnika, omogućuje brzo prepoznavanje patoloških obrazaca pojedinca i rješavanje sestrinsko medicinskih problema. Skrbeći za bolesnika s akutnim gubitkom sluha medicinska sestra/tehničar će pridonijeti poboljšanju sluha i kvaliteti života.Aim: The priority of this study was to examine the effectiveness of the RHHI (“Revised Hearing Handicap Inventory”) questionnaire in nursing assessment of patient hearing and health care planning for patients with acute hearing loss.
Subjects and methods: The research was conducted at the Clinic for ear, nose and throat diseases with head and neck surgery, University hospital center Split. The study involved 32 subjects who met the inclusion criteria: acute hearing loss in the last 72 hours, hearing loss confirmed by tonal audiogram, and medical diagnosis of idiopathic hearing loss. The RHHI questionnaire was used to self-assess the social and emotional consequences of hearing impairment on patients' daily lives, consisting of 18 questions. The research was conducted in the time period from 28.10.2021. to 26.04.2022..
Results: There was no statistically significant difference between the higher scoring score on the constructed RHHI questionnaire and the higher hearing loss score on the audiogram test. Research has shown that sudden idiopathic hearing loss is more pronounced unilaterally. If the hearing impairment measured by the audiogram for the right ear is greater, it will be less in the left ear and vice versa (p=0.030). Clinical assistance was requested mainly by respondents who have ≥ 6 points in the RHHI questionnaire. There was no significant difference in the results of the study between younger subjects with sudden idiopathic hearing loss who had milder hearing impairment than the elderly with the same clinical picture. The results showed that the older age of the patient causes more severe hearing damage in the left ear. An association between the existence of feelings of frustration when communicating with people with idiopathic hearing loss and difficulty attending a party was found (p= 0.028). It has been proven that men and women suffer from idiopathic hearing loss equally.
Conclusion: The RHHI questionnaire can have a practical purpose in nursing assessment of patients, allows rapid recognition of individual pathological patterns and solving nursing medical problems. By caring for a patient with acute hearing loss, a nurse will contribute to improving hearing and quality of life
Assessment of physical activity using the IPAQ questionnaire within the physiotherapeutic assessment
No full textTjelesna aktivnost je najvažnija komponenta ljudskog života u održavanju zdravlja. Njezina procjena u fizioterapijskoj procjeni je malo zastupljena te se ne daje na važnosti. Cilj ovog rada je pokazati jednostavnost i korisnost korištenja procjene tjelesne aktivnosti kod mladih ljudi.Ovaj rad objašnjava tjelesnu aktivnost, sadrži preporuke tjelesne aktivnosti za mlade, daje pregledava mogućnosti kod mjerenja tjelesne aktivnosti te opisuje prednosti tjelesne aktivnosti i rizike manjka tjelesne aktivnosti. Istraživanje se provelo u svrhu dokazivanja jednostavnosti primjene IPAQ upitnika kratka verzija u mjerenju tjelesne aktivnosti na 4 prvostupnika zdravstvenih usmjerenja. U radu je korišten IPAQ upitnik kratka verzija te pedometar kao direktno mjerenje tjelesne aktivnosti. Kao rezultat rada je ustanovljeno da se IPAQ upitnik kratka verzija i pedometar mogu koristiti u široj primjeni kod fizioterapijske procjene tjelesne aktivnosti te je njihova pristupačnost i jednostavnost pokazala kako su odličan alat u mjerenju tjelesne aktivnosti koji mogu dovesti do promjene ponašanja u kratkom vremenuPhysical activity is the most important component of human life in maintaining health. Its assessment in physiotherapy assessment is little represented and is not given enough importance. The aim of this thesis is to show the simplicity and usefulness of using physical activity assessment in young people. This thesis explains physical activity, contains recommendations for physical activity for young people, reviews methods for measuring physical activity, and describes the benefits of physical activity and the risks of lack of physical activity. The research was conducted with the purpose of proving the simplicity of the application of the IPAQ questionnaire short version in measuring physical activity on 4 students with bachelor's degrees in health studies. This thesis used the short version of the IPAQ questionnaire and a pedometer as a direct measurement of physical activity. As a result of the thesis, it was established that the short version of the IPAQ questionnaire and the pedometer can be used in a wider application in the physiotherapy assessment of physical activity, and their accessibility and simplicity have shown that they are an excellent tool in measuring physical activity that can lead to a change in behavior in a short tim
Ethical issues in healthcare
No full textSestrinstvo se percipira kao etička struka od samih početaka. Tijekom vremena je neminovno došlo do
promjene percepcije etike i etičnosti. Danas se sestra smatra zagovornicom pacijenta (engl. patient advocate) koja
pomaže pacijentima kod donošenja kompleksnih odluka. Medicinska sestra i sama nastoji etički postupati u
svakodnevnim kliničkim situacijama. Napredak dijagnostike i terapije u medicini je omogućio bolji i kvalitetniji
oporavak pacijenata i produljenje životnoga vijeka. Posljedično svekolikom napretku medicine dolazi i do sve
učestalijih moralnih i etičkih dvojbi vezanih za pacijentov integritet, boljitak, kvalitetu i cijenu zdravstvene skrbi. Iako
se uglavnom općenito zna ili nagađa o postojanju etičke problematike ista nije sistematski istražena i to prvenstveno u
smislu vrste i učestalosti. Glavni cilj ovog rada je utvrditi vrstu i pojavnost etičkih problema medicinskih
sestara/tehničara te korelirati povezanost etičkih problema s godinama staža u struci, vrstom struke i spolom. U KBCu Split je provedeno presječno istraživanje (engl. cross-sectional study) koje je uključivalo medicinske sestre i
tehničare zaposlene u KBC-u a koji su bili voljni sudjelovati u istraživanju i ispuniti upitnik etičkih dvojbi. U
istraživanju je korišten obrazac za upis demografskih podataka i upitnik Skala etičkih problema(dvojbi) (engl. Ethical
Issues Scale). U ovom istraživanju je potvrđeno postojanje etičkih problema ispitanika. Najčešći etički problemi su iz
domene ljudskih prava. Rezultati ovog istraživanja su u suglasju sa rezultatima etičkih istraživanja iz razvijenih država.
Nije potvrđena korelacija rezultata s trajanjem radnog staža, dobi i spolom ispitanika. Iako se općenito zna o postojanju
etičkih problema sestara isti nisu sistematski istraženi kako u našoj državi tako i u svijetu. Identifikacija etičkih
problema je put ka efikasnom rješavanju istih jer neriješeni etički problemi negativno utječu na produktivnost. Etički
problemi ovise o individualnom, ali i o organizacijskom aspektu zdravstvenog radnika i zdravstvene ustanove. Najčešći
etički problemi medicinskih sestara i tehničara koji su sudjelovali u ovom istraživanju su iz domene problematike u
svezi s ljudskim pravima. Takvi rezultati su u suglasju s publiciranim istraživanjima razvijenih država. Temeljem ovih
rezultata postoji konkretna osnova za rješavanje tj. ublažavanje etičke problematike.Nursing has been perceived as an ethical profession since its inception. Over time, the perception of
ethics inevitably changed. Today, a nurse is considered a patient advocate who helps patients make complex decisions.
Nurse tries to act ethically in everyday clinical situations. Advances in diagnostics and therapy in medicine have
enabled better recovery of patients and prolongation of life expectancy. As a result, with the progress of medicine,
there are much more moral and ethical doubts related to the patient's integrity, well-being, quality and cost of health
care, etc. Although it is generally known about the existence of ethical problems it has not been systematically
investigated, primarily in terms of type and frequency. The main goal of this work is to determine the type and
occurrence of ethical problems of nurses/technicians. Also we wanted to correlate the relationship between ethical
problems and years of experience in the profession, type of profession and gender. A cross-sectional study was
conducted at University hospital Split, which included nurses and technicians employed at KBC who were willing to
participate in the research and fill the Ethical Issues Scale questionnaire. The research used a form for entering
demographic data and the Ethical Issues Scale questionnaire. In this research, the existence of ethical problems of the
nurses was confirmed. The most common ethical problems are from the domain of human rights. The results of this
research are in agreement with the results of ethical research from developed countries. The correlation of the results
with the length of service, age and gender of the respondents was not confirmed. Although it is generally known about
the existence of ethical problems of nurses, they have not been systematically investigated both in our country and in
the world. Identification of ethical problems is the way to their efficient solution. Ethical problems depend on the
individual but also on the organizational aspect of the health worker and the health institution. The most common
ethical problems of nurses and technicians who participated in this research are from the domain of issues related to
human rights. Such results are in agreement with published studies of developed countries. Based on these results,
there is a concrete basis for solving, i.e. mitigating, ethical issues
Nurses's activities with laryngectomized patients
No full textKarcinom grkljana predstavlja jedan od velikih javnozdravstvenih problema, a liječenje istog uključuje kiruršku intervenciju zvanu laringektomija. U većini slučajeva indicirana je totalna laringektomija koja uvjetuje doživotnu traheostomu. Istraživanja su dokazala da bolest uglavnom zahvaća muškarce nakon 40. godine života. Priprema bolesnika zahtijeva multidisciplinaran pristup liječnika specijalista, onkologa, kirurga, medicinskog tehničara, psihologa, logopeda i dr. Čimbenici rizika za nastanak karcinoma larinksa su najčešće: konzumacija duhanskih proizvoda i alkohola, gastroezofagealni refluks, infekcija humanim papilloma virusom, izloženost radioaktivnom zračenju i raznim kemikalijama, genetika i okoliš. Ova bolest se očituje simptomima kao što su promuklost, palpacija tvrdih bezbolnih tvorbi na vratu, stridor, kašalj, disfagija, bol u uhu, gubitak tjelesne težine hemoptoza i dr. Uloga medicinske sestre kao edukatora značajno utječe i na podizanje svijesti i zdravstvenog odgoja stanovništva te prevenciji nastanka bolesti. Logopedska terapija se svodi učenje novih metoda govora poput ezofagealnog, elektrolaringealnog i trahoezofagealnog govora. Do najčešćih komplikacija nakon operacije dolazi u prvih 30 dana po izlasku iz bolnice. U Hrvatskoj postoji veliki broj klubova laringektomiranih pacijenata gdje pacijenti mogu međusobno dijeliti iskustva i savjete.Laryngeal cancer is one of the major public health problems. Treatment for it involves a surgical intervention called laryngectomy wich conditions lifelong tracheotomy. Studies have proven that the disease mainly affects men after the age of 40. Patient preparation requires a multidisciplinary approach of specialist doctors, oncologists, surgeons, nurses, psychologists, speechtherapists, and others. Risk factors for laringeal cancer are the most common consumption of tobacco products and alcohol, gastroesophaegal reflux, human papilloma virus infection, exposure to radioactive radiation and various chemicals, genetics and others. This disease is manifested by symptoms such as hoarseness, palpation of hard,painless formations on the neck, stridor,cough, dysphaiga, painintheear, weightloss, hemoptysis and others. The role of the nurse as an educator significantly affects the raising of awarness and health education of the population and the prevntion of disease. Speech therapy is reduced to learning new methods of speech such as esophageal, electrolaryngeal and trachoesophageal speech. The most common complications after surgery occur in the first 30 days of the hospitalizaton. There are many clubs of laringectomized patients in Croatia, where patients can share experiances and advices with each others
Diagnostic of Clostridioides difficile infections
No full textCilj istraživanja: Cilj istraživanja je opisati metode mikrobiološke dijagnostike C. difficile te istražiti mikrobiološke osobitosti toksigenih sojeva i demografske karakteristike pacijenata oboljelih od CDI u KBC-u Split od 1. siječnja do 31. prosinca 2020. godine.
Materijali i metode istraživanja: U ovom istraživanju korišteni su podatci Kliničkog zavoda za mikrobiologiju i parazitologiju KBC-a Split. Uključeni su svi pacijenti kojima je u navedenom razdoblju dokazan toksigeni soj C. difficile iz uzorka stolice. Mikrobiološka dijagnostika CDI provodi se prema smjernicama ESCMID-a prema tkz. dvostupanjskom i trostupanjskom dijagnostičkom postupniku. U ovom istraživanju je korišten kombinirani membranski imunoenzimski/ imunokromatografski test (Savyon Diagnostics Ltd.) koji istovremeno testira glutamat dehidrogenazu (GDH antigen) i proizvodnju toksina A i B C. difficile. Na taj način se istovremeno provode prvi i drugi korak preporučenog ESCMID-ovog postupnika za dijagnostiku CDI. . Kao potvrdni test, korišten je HG C. difficile molekularni test proizvođača HiberGene. Test koristi izotermalnu LAMP (engl. loop-mediated isothermal amplification) tehnologiju kojom se dokazuje prisustvo toksigene regije u genomu C. difficile.
Rezultati: U Kliničkom zavodu za mikrobiologiju i parazitologiju Kliničkog bolničkog centra Split u 2020. godini pod sumnjom na C. difficile infekciju zaprimljeno je 1675 uzorka stolice. Od toga je 1265 bilo negativno, a u 397 (24 %) uzoraka dokazan je toksigeni soj C. difficile. Od ukupno 397 toksigenih sojeva C. difficile, 3 % je bilo pozitivno samo na proizvodnju toksina A, 5 % uzoraka je bilo pozitivno na proizvodnju toksina B, 65 % uzoraka je bilo pozitivno na proizvodnju toksina A i B, a 27 % toksigenih sojeva C. difficile nije stvaralo toksine u trenutku testiranja. Muškaraca je bilo 176 (44 %), dok je žena bilo 221 (56 %). Najveći broj pacijenata (66 %) je imao 65 ili više godina. Bolničkih pacijenata je bilo 72 %, a najveći broj njih je liječen u Klinici za unutarnje bolesti (34 %), Klinici za infektivne bolesti (16 %) te u Klinici za plućne bolesti (14 %). Najčešće uputne dijagnoze su crijevne infekcije (20 %), ostale bolesti probavnog sustava (23 %) te respiratorne bolesti (16 %).Aim of the study: The aim of this study is to describe the methods of microbiological diagnostic of C. difficile and to investigate the microbiological characteristics of toxigenic strains and demographic characteristics of patients with CDI in the University Hospital of Split from 1 January to 31 December 2020.
Materials and methods of the study: Data base of the Department of Clinical Microbiology and Parasitology in the University Hospital of Split was used in this study. All patients for whom a toxigenic strain of C. difficile from a stool sample was detected during this period were included. Microbiological diagnostic of CDI is carried out according to the guidelines of the ESCMID according to the so-called two-stage and three-stage diagnostic procedure. A combined membrane enzyme-linked immunosorbent assay/ immunochromatography test (Savyon Diagnostics Ltd.) was used in this study, which simultaneously tests glutamate dehydrogenase (GDH antigen) and the production of C. difficile toxins A and B. This way, the first and second step of the recommended ESCMID procedure for diagnosing CDI are performed simultaneously. As a confirmatory test, the HG C. difficile molecular test manufactured by HiberGene was used. The test uses loop-mediated isothermal amplification technology to prove the presence of a toxigenic region in the C. difficile genome.
Results: In 2020, 1675 stool samples were received at the Department of Clinical Microbiology and Parasitology in the Univeristy Hospital of Split under suspicion of C. difficile infection. Of these, 1265 were negative, and a toxigenic strain of C. difficile was detected in 397 (24 %) samples. Of a total of 397 toxic strains of C. difficile, 3 % were only positive for toxin A production, 5 % of samples were positive for toxin B production, 65 % of samples were positive for toxin A and B production, and 27 % of toxigenic C. difficile strains did not produce toxins at the time of testing. There were 176 men (44 %) and 221 women (56 %). The largest number of patients (66 %) were 65 or older. There were 72 % of hospital patients, and the largest number of them were treated in the Clinic for Internal Medicine (34 %), the Clinic for Infectious Diseases (16 %) and the Clinic for Lung Diseases (14 %). The most common diagnoses are intestinal infections (20 %), other diseases of the digestive system (23 %) and respiratory diseases (16 %)