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Liječenje proksimalnih fraktura humerusa u dječjoj dobi
No full textCilj ovog rada je prikazati liječenje proksimalnih fraktura humerusa u djece, komplikacije i rehabilitaciju u djeteta sa prijelomima proksimalnog humerusa. U radu je prikazano dijete s prijelomom proksimalnog humerusa uzrokovano padom koje je zahtijevalo operacijski zahvat a potom i fizikalnu terapiju. U samom liječenju je neophodan timski rad, liječnik operater, medicinska sestra/tehničar, fizijatar i fizioterapeut. U radu su opisane metode, planovi i postupci koji su esencijalni za što kvalitetniju skrb bolesnog djeteta, te samim time omogućen je brži i kvalitetniji oporavak.The aim of this paper is to present the treatment of proximal humerus fractures in children, complications and rehabilitation in children with proximal humerus fractures. Paper shows a child with a fracture of the proximal humerus caused by a fall, which required surgery and then physical therapy. In the treatment itself, team work is necessary, the operating doctor, nurse/technician, physiatrist and physiotherapist. The paper describes the methods, plans and procedures that are essential for the best possible care of a sick child, and at the same time, a faster and better recovery is possible
Physiotherapeutic interventions for treatment of adhesive capsulitis
No full textCILJ: Cilj ovog rada je pregledom literature nastojati odgovoriti na pitanje koje su fizioterapijske intervencije učinkovite u liječenju adhezivnog kapsulitisa ramena.
MATERIJALI I METODE: Za izradu ovoga rada pretražena je medicinska baza podataka PubMed. Ključne riječi pri pretraživanju su bile: adhesive capsulitis, physical therapy i conservative management. Za analizu je odabrano 6 istraživanja od kojih jedno potvrđuje potrebu za medicinskom intervencijom u liječenju adhezivnog kapsulitisa, a ostalih 5 istraživanja istražuje učinkovitost fizioterapijskih intervencija u liječenju adhezivnog kapsulitisa ramena.
REZULTATI: U većini istraživanja fizioterapijske intervencije su u većoj ili manjoj mjeri pokazale učinkovitost u liječenju i rehabilitaciji pacijenata s adhezivnim kapsulitisom.
ZAKLJUČAK: Određene tehnike i modaliteti fizikalne terapije preporučuju se za ublažavanje boli, poboljšanje opsega pokreta i funkcionalnog statusa u pacijenata s adhezivnim kapsulitisom.AIM: Aim of this paper is to search a medical database for effective methods for treatment of adhesive capsulitis and find effective ones.
MATERIALS AND METHODS: PubMed database was used for research. Keywords used were: adhesive capsulitis and physical therapy. Six papers were chosen for the analysis. One of them affirmed a necessity of clinical intervention and five of them compared the efficacy of different treatment methods.
RESULTS: Most papers show that physical therapy interventions are more or less beneficial in treatment and rehabilitation of adhesive capsulitis.
CONCLUSION: Specific tehniques and modalitites of physical therapy are recomended for pain management, range of motion increase and functional status improvement for patients suffering from adhesive capsulitis
Artificial intelligence in the diagnosis of covid positive patients
No full textSvjetska zdravstvena organizacija 11. ožujka 2020. proglasila je širenje novog Sars-CoV-2 virusa globalnom pandemijom što je izvršilo značajan pritisak i ukazalo na brojne slabosti zdravstvenih sustava. Najčešći simptomi COVID-19 infekcije uključuju povišenu tjelesnu temperaturu, umor, suhi kašalj, gubitak ili promjenu osjeta mirisa ili okusa, kao i teške respiratorne i druge komplikacije koje zahtijevaju hospitalizaciju ili smještanje u jedinice intenzivnog liječenja. Rano dijagnosticiranje presudno je za otkrivanje aktivnih slučajeva, kontrolu širenja infekcije i optimalno zbrinjavanje pacijenata. Zlatni standard za postavljanje dijagnoze je lančana reakcija polimeraze reverznom transkripcijom (RT-PCR). Glavne radiološke metode dijagnosticiranja su radiografsko snimanje pluća i kompjutorizirana tomografija, svaka sa svojim prednostima i ograničenjima.
U uvjetima svjetske zdravstvene krize, zdravstvenom sustavu potrebne su nove tehnologije za praćenje i kontrolu širenja pandemije. Jedna od takvih tehnologija je i umjetna inteligencija, te se u ovom radu pregledom literature nastojalo prikazati potencijalne prednosti sustava umjetne inteligencije koji bi znatno olakšali borbu protiv pandemije i tako utjecali na smanjenje pritiska na zdravstvene sustave diljem svijeta. Početna istraživanja usredotočila su se na dijagnostiku i prognozu infekcije pomoću radiografskih slika ili CT prikaza pluća. Sustavi umjetne inteligencije u tim su istraživanjima uspoređivani s tumačenjima iskusnih radiologa te su postigli obečavajuće rezultate. Ipak, većina razvijenih sustava ograničena je malim skupovima podataka, nije dostupna za javnu upotrebu, bez otvorenog pristupa i tako nedostupna istraživačkoj zajednici za nadogradnju.On March 11, 2020, the World Health Organization declared the spread of the new SARS-CoV-2 virus a global pandemic, which put a significant pressure and pointed to a number of weaknesses in health systems. The most common symptoms of COVID-19 infection include fever, fatigue, dry cough, loss or change in sense of smell and taste, as well as sever respiratory and other complications that require hospitalization or placement in intensive care units. Early diagnosis is crucial for detecting active cases, controlling the spread of infection and optimal care for the patients. Polymerase chain reaction by reverse transcription (RT-PCR) is considered the gold standard for diagnosis. The main radiological methods of diagnosis are radiographic imaging and computed tomography of the lungs, each with its advantages and limitations.
In the context of the global health crisis, the health system needs new technologies to monitor and control the spread of the pandemic. One such technology is artificial intelligence, and this paper reviewed the potential benefits of artificial intelligence systems that would greatly facilitate the fight against the pandemic and thus reduce the pressure on health systems around the world. Initial research focused on the diagnosis and prognosis of infection using radiographic images or CT scans of the lungs. Artificial intelligence systems in these studies were compared with the interpretations of experienced radiologists and achieved promising results. However, most developed systems are limited to small data sets, not available for public use and without open access, thus inaccessible to research community for upgrades
THERAPEUTIC INTERVENTIONS IN EARLY PRESCHOOL CHILDREN WITH AUTISTIC SPECTRUM DISORDERS
No full textPoremećaj iz spektra autizma (PAS) je heterogeno neurorazvojno stanje koje pogađa jedno dijete na svakih 160 djece.Karakteriziraju ga temeljni deficiti u vještinama socijalne komunikacije i prisutnost ponavljajućeg ponašanja ili interesa koji su povezani sa značajnim individualnim, obiteljskim i društvenim troškovima. Treba napomenuti da su poremećaji govora jedni od onih koji pripadaju skupini najčešćih i najstalnijih obilježja autističnog spektra, a što se tiče poteškoća u neverbalnoj komunikaciji, događa se sljedeće: neprimjereni izrazi lica, neuobičajene upotrebe gesti, zatim neobični položaji tijela, dok se među poteškoće u socijalnoj interakciji izdvaja nedostatak empatije, slabiji kontakt očima, neprimjereno dodirivanje drugih,slijed konzistentne dnevne rutine itd. Iako uzrok ovih poremećaja još nije poznat, studije snažno sugeriraju genetsku osnovu sa složenim načinom nasljeđivanja.U novije vrijeme naglasak u terapijskom pristupu djeci s PAS-om je u što ranijoj intervenciji što se postiže kroz naturalističke razvojne bihevioralne intervencije (NDBI), primjenjenu analizu ponašanja (ABA),diskretnu probnu nastavu (DTT). Vještine se obično ne podučavaju diskretno ili izolirano, već tijekom djetetovih tipičnih svakodnevnih interakcija, iskustava i rutina.Dio ljepote bihevioralnih terapija je u tome što je vrlo fleksibilna i prilagođava se specifičnim snagama i slabostima svakog djeteta s PAS-om, usredotočujući se na to koja ponašanja treba promijeniti i koja ponašanja treba ojačati. Pojačanje putem nagrada potiče željena ponašanja, pomažući tako da se ove promjene s vremenom zadrže.Liječenje je potrebno započeti što ranije,idealno prije četvrte godine.Od poteškoća povezanih s PAS-om,posebno se ističu problemi s hranjenjem gdje u velikoj mjeri pomaže radna terapija.Jedan od oblika terapije djece s PAS-om je terapijsko jahanje gdje je uključivanje konja kao dijela terapijskog iskustva vodilja terapije,a intervencijske aktivnosti koriste kretanje konja za ciljanje funkcionalnih ishoda.Znanstvena osnova kako bi akupunktura mogla ublažiti različite kognitivne i bihevioralne dimenzije autizma nije dobro proučena,ali se smatra da bi akupunktura mogla djelovati na regulaciju neurotransmitera kao što su glutamat i gama-aminomaslačna kiselina.Glazbena terapija smatra se načinom promicanja preverbalne
komunikacije te poboljšava pažnju i pamćenje u djece s PAS-om.Uloga medicinske sestre kao člana multidisciplinarnog tima podrazumijeva holistički pristup te kvalitetnu komunikaciju s roditeljima.Potrebno je kroz edukaciju pomoći roditeljima u suočavanju sa stresom i anksioznošću kako bi djeca s PAS-om postigla odgovarajući razvoj socijalnih vještina tijekom važnog razdoblja kognitivnog rasta.Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition that affects one child for every 160 children. It is characterized by fundamental deficits in social communication skills and the presence of repetitive behavior or interests that are associated with significant individual, family and social costs. It should be noted that speech disorders are one of those belonging to the group of the most common and persistent features of the autistic spectrum, and as for difficulties in nonverbal communication, the following happens: inappropriate facial expressions, unusual uses of gestures, then unusual positions of the body, etc. , while among the difficulties in social interaction stands out the lack of empathy, weaker eye contact, inappropriate touching of others, sequence of a consistent daily routine, etc. Although the cause of these disorders is not yet known, studies strongly suggest a genetic basis with a complex way of inheritance. More recently, the emphasis in the therapeutic approach to children with ASD has been in the earlier intervention, which is achieved through naturalistic developmental behavioral interventions (NDBI), applied behavioral analysis (ABA), discrete trial classes (DTT). Skills are usually taught not discreetly or in isolation, but during the child's typical daily interactions, experiences and routines. Part of the beauty of behavioral therapies is that it is very flexible and adapts to the specific strengths and weaknesses of each child with ASD, focusing on which behaviors should be changed and which behaviors need to be strengthened. Reward reinforcement encourages desired behaviors, helping to keep these changes over time. Treatment should be started as early as possible,ideally before the fourth year. Of the difficulties associated with ASD, feeding problems are particularly notable, where occupational therapy greatly helps. One of the forms of therapy of children with ASD is therapeutic riding where the inclusion of horses as part of the therapeutic experience is the guiding principle of therapy. and intervention activities use the movement of horses to target functional outcomes. The scientific basis for how acupuncture could alleviate the different cognitive and behavioral dimensions of autism has not been studied well, but it is thought that acupuncture could act on the regulation of neurotransmitters such as glutamate and gamma-aminobutyric acid. Music therapy is considered a way to promote preverbal communication and improves attention and memory in children with ASD.The role of a nurse as a member of a multidisciplinary team implies a holistic approach and quality communication with parents. Through education, it is necessary to help parents cope with stress and anxiety in order for children with ASD to achieve adequate development of social skills during an important period of cognitive growth
Physical therapy and viscosupplementation in the treatment of knee osteoarthritis
No full textOsteoartritis je kronična degenerativna reumatska bolest karakterizirana degeneracijom zglobne hrskavice koja uzrokuje bolnost i ograničenost pokreta. Na taj način otežava pacijentu aktivnosti svakodnevnog života.
Za postavljanje ove dijagnoze najčešće se koristi RTG, na kojem se vide promjene zglobne hrskavice. Konzervativne metode u liječenju ove bolesti su fizikalna terapija i viskosuplementacija. Fizikalna terapija obuhvaća elektroterapiju, hidroterapiju, balneoterapiju, kineziterapiju, termoterapiju i samu edukaciju pacijenta. Viskosuplementacija je moderniji način borbe s posljedicama ovoga stanja. To je metoda injektiranja hijaluronske kiseline u zglobni prostor.
Fizikalna terapija se pokazala kao bolji način liječenja osteoartritisa.Osteoarthritis is a chronic degenerative rheumatic disease characterized by a degeneration of articular cartilage that causes pain and limited movement. Thus, it makes every day activities of the patient more difficult.
An X-ray, usually used to diagnose this disease, shows changes in the cartilage joint. Conservative treatment methods for this disease are physical therapy and viscosupplementation. Physical therapy includes electrotherapy, hydrotherapy, balneotherapy, kinesitherapy, thermotherapy and education of the patient. Viscosupplementation is the modern way of dealing with the consequences of this condition. It is a method of injecting hyaluronic acid into the joint space.
Physical therapy has proven to be a more successful method in treating osteoarthritis
PHYSICAL THERAPEUTIC PROCEDURES IN THE REHABILITATION OF INSERTIONAL TENDINOPATHY OF THE ACHILLES TENDON
No full textAhilova tetiva, kao najsnažnija tetiva u ljudskom tijelu, podložna je promjenama i ozljedama.
Jedna od čestih promjena su tendinopatije Ahilove tetive, koje mogu biti insercijske i neinsercijske. Insercijske
tendinopatije su degenerativne promjene na Ahilovoj tetivi koje se javljaju na mjestu do 2 cm od kalkanealne kosti.
Fizioterapijski protokoli koji se koriste nisu određeni standardima. Za liječenje koriste se ekscentrične vježbe kao
najprihvatljiviji i najučinkovitiji način rehabilitacije. Osim toga koriste se i ekstrakorporalna terapija udarnim valom
koja je, uz ekscentrične vježbe, jedan od najuspješnijih liječenja ovog problema. Osim toga koriste se i tretman
mekog tkiva (astym), injekcije PRP-a, injekcije sklerozirajućeg polidokanola te injekcije hiperosmolarnom
dekstrozom.: The Achilles tendon as the strongest tendon in the human body is subject to change and injury.
One of the common changes is Achilles tendinopathy, which can be insertional or non-insertional. Insertion
tendinopathies are degenerative changes in the Achilles tendon that occur up to 2 cm from the calcaneal bone. The
physiotherapy protocols used are not defined by any standards. Eccentric exercises are used for treatment as the most
acceptable and effective way of rehabilitation. In addition, extracorporeal shock wave therapy is used, which along
with eccentric exercises is one of the most successful treatments for this problem. In addition, soft tissue treatment
(astym), PRP injections, sclerosing polidocanol injections, and hyperosmolar dextrose injections are used
THE EXPERIENCE OF USERS OF HOMES FOR THE ELDERLY AND DISABLED DURING THE COVID-19 PANDEMIC - QUALITATIVE RESEARCH
No full textPandemija COVID 19 zasigurno je jedna od najvećih bitki s kojom se čovječanstvo suočavalo u posljednje vrijeme.
Od pojave prvog slučaja virusa u Wuhanu, Hubei provinciji Kine, slijedilo je rapidno proširenje virusa zbog čega je
SZO izdala niz protektivnih mjera među kojima je mjera izolacije. Na temu COVIDA-19 napravljeni su brojni radovi
te je adresiran utjecaj koji je virus imao na sve aspekte života. Ipak dio društva koji je uvijek predviđen i
marginaliziran, starije stanovništvo, najviše je pogođeno virusom. Cilj ovoga rada je istražiti psihološke posljedice,
samo dodatno produbljene, među ionako već jednim od našeg najranjivijeg dijela populacije. Iz toga razloga proveli
smo kvalitativno istraživanje na 9 štićenika doma za starije i nemoćne, putem polustrukturiranog intervjua. Glavni
cilj ovog istraživanja je bio utvrditi doživljaj korisnika domova za starije i nemoćne za vrijeme pandemije COVID19, dok je specifični cilj istraživanja bio utvrditi njihove strahove, nadanja i očekivanja. Kroz istraživanje protezale
su se 3 teme: straha, usamljenosti te izolacije. Na kraju istraživanja naišli smo na većinski pozitivne doživljaje i
iskustva štićenika za vrijeme pandemije. To uočavamo pretežno kod tema straha i usamljenosti, kod kojih je čak 8 od
9 ispitanika izjavilo da ih nisu osjećali. Kod teme izolacije naišli smo na pomalo drugačije rezultate, gdje njih 6
navodi da nije imala pretežan utjecaj na njih. S druge strane ostalih 3 ispitanika iskazalo je velik doživljaj tuge koju
je izolacija ostavila na njih. Zanimljivo je bilo otkriće motiva koji se pojavljivao kod svih ispitanika, a to je motiv
sudbine kao svojevrsnog načina mirenja i suočavanja sa trenutnom životnom situacijom. Na temelju rezultata
moguće je zaključiti da iako je većina štićenika zadovoljna te je imala pozitivne dojmove, opet postoje oni koje
osjećaju određenu razinu straha, usamljenosti te trpe posljedice izolacije. Smatramo da je njihov glas, kao i glas
čitave starije populacije važno čuti, stoga ovaj rad ima veliku vrijednost u nadi promicanja i unaprijeđenja sestrinske
skrbi osoba starije životne dobi te štićenika domova za starije i nemoćne.The COVID 19 pandemic is certainly one of the biggest battles humanity has faced in recent times. Since the
appearance of the first case of the virus in Wuhan, Hubei province of China, there has been a rapid spread of the
virus, which is why the WHO has issued a series of protective measures, among which is the measure of isolation.
Numerous papers have been written on the topic of COVID-19 and the impact that the virus had on all aspects of life
was addressed. However, a part of society that is always predicted and marginalized, the elderly population, is the
most affected by the virus. The aim of this paper is to investigate the psychological consequences, only further
deepened, among one of our most vulnerable population. For this reason, we conducted qualitative research on 9
residents of a home for the elderly and infirm, through a semi-structured interview. The main goal of this research
was to determine the experience of users of homes for the elderly and infirm during the COVID-19 pandemic, while
the specific goal of the research was to determine their fears, hopes and expectations. 3 themes spread throughout the
research: fear, loneliness and isolation. At the end of the research, we came across mostly positive experiences of
residents during the pandemic. We observe this mostly with the topics of fear and loneliness, where as many as 8 out
of 9 respondents stated that they did not feel them. Regarding the topic of isolation, we encountered slightly different
results, where 6 of them stated that it did not have a major impact on them. On the other hand, the other 3
respondents expressed a great experience of sadness that the isolation left on them. What was interesting was the
discovery of a motive that appeared in all respondents, which is the motive of fate as a kind of way of reconciliation
and coping with the current life situation. Based on the results, it is possible to conclude that although the majority of
residents are satisfied and had positive impressions, there are still those who feel a certain level of fear, loneliness
and suffer the consequences of isolation. We believe that their voice, as well as the voice of the entire elderly
population, is important to hear, therefore this work has great value in the hope of promoting and improving nursing
care for the elderly and residents of homes for the elderly and infirm
ANALYSIS OF IMP3 AND PODOPLANIN EXPRESSION IN GASTRIC CANCER BY DOUBLE IMMUNOFLUORESCENT METHOD
No full textCilj rada: u histološkim preparatima adenokarcinoma želuca ispitati izražaj IMP3 i podoplanina metodom indirektne dvostruke imunofluorescencije.
Materijali i metode: Parafinski blokovi tumorskog tkiva 26 ispitanika s adenokarcinomom želuca operiranih od 2014. do 2018,. u KBC Split prikupljeni su iz arhive Kliničkog zavoda za patologiju, sudsku medicinu i citologiju (dalje Zavoda). Demografski podaci prikupljeni su iz zavodske pismohrane, a podatak o smrti iz knjige mrtvozorstva. Istraživanje je provedeno u laboratoriju Katedre za patologiju MF u Splitu i imunohistokemijskom labratoriju Zavoda. U predanalitičkom postupku su iz parafinskih blokova izrezani preparati debljine 4 µm, deparafinirani, rehidrirani i obojeni I) rutinski hemalaun-eozin radi histološke analize, II) imunohistokemijski na stroju Ventana Ultrabenchmark radi kontrole istraživane metode i III) ručno metodom dvostruke indirektne imunofluorescence. Rezultati bojenje prve dvije metode analizirani su na svjetlosnom mikroskopu. U postupku imunofluorescentnog bojenja je nakon otvaranja antigena kuhanjem u citratnom puferu apliciran koktel monoklonalnog kunićjeg protutijela na IMP3 i monoklonalnog mišjeg protutijela na podoplanin, te preparati inkubirani 1h u tamnom i vlažnom prostoru. Potom su isprani u PBS-u i apliciran koktel sekundarnih protutijela specifičnih za vrstu i obilježenih različitim fluorescentnim bojama, te inkubirani 1 h. Nakon ispiranja u PBS-u aplicirana je boja DAPI 5 minuta, preparati isprani u PBS i pokriveni Immunomontom i pokrovnicom. Mikroskopska analiza urađena je na fluorescentnom mikroskopu Olympus uporabom kamere i programa Cell Sens.
Rezultati: Dokazano je prisustvo IMP3 kao granuliranog crvenog signala u citoplazmi dijela tumorskih stanica i podoplanina kao finogranuliranog zelenog signala u endotelu limfnih žila.The aim of the study: to analyze the expression of IMP3 and podoplanin in histological slides of gastric adenocarcinoma using the method of indirect double immunofluorescence.
Materials and methods: Paraffin blocks of tumor tissue of 26 patients with gastric adenocarcinoma who underwent total gastrectomy from 2014 to 2018 at University Hospital Split were collected from the archives of the Clinical Institute for Pathology, Forensic Medicine and Cytology (hereinafter the Institute). Demographic characteristics were collected from the institution's archives, and data on the deceased from the coroner's evidence. The research was conducted in the laboratory of the Department of Pathology of the Medical School and the Institute's immunohistochemistry laboratory. In the pre-analytical procedure, 4 µm slides were cut from paraffin blocks, deparaffinized, rehydrated and stained I) with hemalaun-eosin for histological analysis, II) immunohistochemically on the Ventana Ultrabenchmark machine to control the tested method and III) manually using the method of double indirect immunofluorescence. The staining results of the first two methods were analyzed under a light microscope. In the immunofluorescent staining procedure, after antigen ritrieval cooking in citrate buffer, a cocktail of monoclonal rabbit antibody to IMP3 and monoclonal mouse antibody to podoplanin was applied, and incubated for 1 hour in a dark and humid chamber. The slides were then washed in PBS and a cocktail of species-specific secondary antibodies labeled with different fluorescent dyes was applied and incubated for 1 h. After washing in PBS, DAPI stain was applied for 5 minutes, slides washed in PBS and covered with Immunomont and a coverslip. Microscopic analysis was performed on the Olympus fluorescence microscope using a camera and the Cell Sens program.
Results: The presence of IMP3 as a granular red signal in the cytoplasm of some tumor cells and podoplanin as a finely granular green signal in the endothelium of lymphatic vessels was demonstrated
EXPERIENCES OF WOMEN IN THE MATERNAL CARE SYSTEM IN THE REPUBLIC OF CROATIA
No full textCilj: Cilj istraživanja bio je ispitati iskustva žena prilikom poroda u Republici Hrvatskoj (RH). Metode: Podaci su prikupljani u razdoblju od kraja veljače do kraja svibnja 2022. godine pomoću anonimne ankete postavljene u grupe vezane uz majčinstvo na društvenoj mreži Meta. Anketa se sastojala od 36 pitanja. Na pitanja su većinom bili ponuđeni odgovori, ocijene ili navedeno u kojoj se mjeri slažu ili ne sa tvrdnjom. Rezultati: Utvrđeno je zadovoljstvo u materalnoj skrbi u podršci osoblja pri porodu, promociji dojenja i prvog kontakta, te u poštivanju privatnosti i dostojanstva i u čistoći prostora. No, uočeni su i propusti u komunikaciji, manjkavosti informacija i traženju suglasnosti. Obzirom da su porodi bili u vrijeme pandemije, utvrđeno je kako se osoblje uglavnom pridržavalo svih mjera, no maska koja je bila obavezna smatrana je otegotnom okolnošću. Zaključak: Ispitanice izražavaju zadovoljstvo s podrškom primalje za vrijeme poroda te imaju pozitivan stav vezan uz iskustvo poroda i babinja u vrijeme COVID pandemije. S druge strane, nisu zadovoljene potrebe za znanjem o vlastitoj njezi i njezi djeteta za vrijeme hospitalizacije pa u tom području i u komunikaciji postoji veliki prostor za napredak i usavršavanje.: Goal: The goal of the research was to question the experiences of woman during childbirth in the Republic of Croatia. Methods: Data were collected in the period from the end of February to the end of May 2022 using an anonymous survey posted in groups related to motherhood on the social network Meta. The survey consisted 36 questions. The questions were mostly answered, evaluated or stated to what extent they agree or disagree with the statement. Results: Satisfaction was found in maternal care in supporting staff during childbirth, promoting breastfeeding and first contact, and in respecting privacy and dignity and in the cleanliness of the space. However, gaps in communication, lack of information and seeking consent were also noted. Given that the births were at the time of the pandemic, it was determined that the staff generally complied with all measures, but the mask that was mandatory was considered an aggravating circumstance. Conclusion: Respondents express satisfaction with the support of midwives during childbirth and have a positive attitude related to the experience of childbirth and midwifery during the COVID pandemic. On the other hand, the need for knowledge about self and child care during hospitalization is not met, so there is a lot of room for improvement and improvement in this area and in communicatio
Prediction and prevention of preeclampsia; the care of a midwife
No full textCilj ovog rada bio je opisati ulogu primalje u predviđanju i prevenciji preeklampsije. Preeklampsija je najčešći oblik hipertenzivne bolesti u trudnoći. Definira se kao pojava hipertenzije nakon 20.tjedna trudnoće i to vrijednostima krvnog tlaka >140/90 mmHg (18,7/12,0 kPa) u dva mjerenja u razmaku većem od 6 sati te proteinurijom od 300mg u 24-satnom urinu ili 0,1/L urina u 2 uzorka uzeta u razmaku 4-6 sati. Obzirom na javnozdravstveno značenje preeklampsije provedena su brojna istraživanja o etiopatogenezi i prevenciji ove bolesti. Od metoda predviđanja danas postoje upoznavanje sa osobnom i opstetričkom anamnezom, mjerenje arterijskog tlaka, ultrazvučna doplerska mjerenja te biokemijski testovi i njihove kombinacije. Za prevenciju se koristi heparin, pravastatin, magnezijev sulfat, a najšire se primjenjuje aspirin u dozi 100mg od 12. tjedna trudnoće. Postoje brojne podjele preeklampsije od kojih je danas najznačajnija ona s ranim početkom (prije 24.tjedna) te ona s kasnim početkom (nakon 37.tjedna). Uloga primalje u predviđanju je da već prilikom prvog pregleda izdvoji trudnice sa osobnom i opstetričkom anamnezom koje bi mogle rezultirati nastankom preeklampsije u trudnoći. Na sljedećim pregledima primalja treba trudnicu upozoravati na znakove koji mogu dovesti do preeklampsije. Također, u dogovoru s liječnikom može trudnicu upoznati sa ostalim metodama predviđanja. U pogledu prevencije, uloga primalje je da kroz opće higijensko-dijetetske mjere uputi trudnicu kako je moguće odgovornim ponašanjem smanjiti učestalost preeklampsije.The aim of this paper was to describe the role of the midwife in predicting and preventing preeclampsia. Preeclampsia is the most common form of hypertensive disease in pregnancy. It is defined as the appearance of hypertension after the 20th week of pregnancy, with blood pressure values >140/90 mmHg (18.7/12.0 kPa) in two measurements more than 6 hours apart and proteinuria of 300 mg in 24-hour urine or 0,1/L urine in 2 samples taken 4-6 hours apart. Given the public health significance of preeclampsia, numerous studies have been conducted on the etiopathogenesis and prevention of this disease. Prediction methods today include personal and obstetric anamnesis, arterial pressure measurement, ultrasound Doppler measurements, and biochemical tests and their combinations. Heparin, pravastatin, magnesium sulfate are used for prevention, whilst the most widely used is aspirin in a dose of 100 mg from the 12th week of pregnancy. There are numerous divisions of preeclampsia, the most significant of which nowadays is early onset (before the 24th week) and late onset (after the 37th week). The midwife's role in prediction is to single out pregnant women with a personal and obstetric history that could result in the onset of preeclampsia during the first examination. At the next examinations, the midwife should warn the pregnant woman about the signs that can lead to preeclampsia. Also, in agreement with the doctor, the pregnant woman can be introduced to other prediction methods. In terms of prevention, the midwife's role is to guide the pregnant woman through general hygiene and dietary measures on how to reduce the frequency of preeclampsia through responsible behavior