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Physiotherapy of persons with postcovid sindrom
No full textSažetak:
UVOD: Postcovid sindrom čini skup simptoma koji su prisutni 12 tjedana nakon preboljenja COVID-19 bolesti. Javlja se u 10 do 30% osoba koje su preboljele COVID-19. Točan uzrok postcovid sindroma nije u potpunosti jasan. Najčešći simptomi postcovida su: umor, malaksalost, kašalj, kratkoća daha, nedostatak zraka, bol u prsima, nesanica, glavobolja, bolovi u mišićima i zglobovima, smetnje pamćenja i koncentracije i gubitak ravnoteže.
CILJ: Cilj ovog rada je pretražiti, opisati i prikazati rehabilitaciju bolesnika s postcovid sindromom i ulogu fizioterapeuta u rehabilitacijskom timu.
RASPRAVA: Rehabilitacija je glavni dio liječenja bolesnika s postcovid sindromom. Liječenje i praćenje bolesnika s postcovid sindromom zahtjeva multidisciplinarni timski rad, u kojeg fizijatar i fizioterapeut imaju značajnu ulogu jer se većina simptoma postcovida može ublažiti fizioterapijskim intervencijama. Unatoč malom broju podataka o dobrobiti vježbanja kod bolesnika s postcovid sindromom, najnovije preporuke naglašavaju potrebu za tjelovježbom u rehabilitaciji ovih bolesnika. Prilagođena tjelovježba smatra se učinkovitom terapijom za ublažavanje svih simptoma postcovida i poboljšanje kvalitete života.
ZAKLJUČAK: Prilagođena i nadzirana tjelovježba dokazano je učinkovita u liječenju i rehabilitaciji brojnih simptoma postcovid sindroma. Ovisno o početnoj procjeni bolesnika, njegovom kliničkom i kardiovaskularnom profilu rizika, potrebno je razviti program vježbanja koji uzima u obzir sve kliničke značajke bolesnika. Vježbanje se može modulirati u smislu intenziteta, učestalosti i brzine izvođenja kako bi se programi prilagodili ovoj novoj skupini pacijenata koja se pojavljuje kao rezultat pandemije COVID-19. Međutim, potrebna su daljnja istraživanja o učincima tjelovježbe na postcovid sindrom, o vrsti i intenzitetu vježbi.Summary:
INTRODUCTION: Post-covid syndrome is a set of symptoms that are present 12 weeks after recovering from the COVID-19 disease. It occurs in 10 to 30% of people who have recovered from COVID-19. The exact cause of post-covid syndrome is not entirely clear. The most common post-covid symptoms are: fatigue, weakness, cough, shortness of breath, shortness of breath, chest pain, insomnia, headache, muscle and joint pain, memory and concentration problems, and loss of balance.
OBJECTIVE: The aim of this work is to search, describe and present the rehabilitation of patients with post-covid syndrome and the role of physiotherapists in the rehabilitation team.
DISCUSSION: Rehabilitation is the main part of the treatment of patients with post-covid syndrome. The treatment and follow-up of patients with post-covid syndrome requires multidisciplinary teamwork, in which the physiatrist and physiotherapist play a significant role, as most symptoms of post-covid can be alleviated with physiotherapy interventions. Despite the small number of data on the benefits of exercise in patients with post-covid syndrome, the latest recommendations emphasize the need for exercise in the rehabilitation of these patients. Adapted exercise is considered an effective therapy for alleviating all post-covid symptoms and improving the quality of life.
CONCLUSION: Adapted and supervised exercise is proven to be effective in the treatment and rehabilitation of numerous symptoms of post-covid syndrome. Depending on the initial assessment of the patient, his clinical and cardiovascular risk profile, it is necessary to develop an exercise program that takes into account all the clinical features of the patient. Exercise can be modulated in terms of intensity, frequency and speed of performance to adapt programs to this new group of patients emerging as a result of the COVID-19 pandemic. However, further research is needed on the effects of exercise on post-covid syndrome, on the type and intensity of exercise
Multiplanar imaging of anterior cruciate ligament at the athlete
No full textProfesionalni sport ide u korak sa modernim svijetom, te stavlja sve veće fizičke i psihičke izazove pred profesionalnog sportaša. U takvim uvjetima, sportske ozljede su neizostavni dio svakodnevice kako za prvu skupinu, rekreativce, tako i za drugu, profesionalce. Ozljede najčešće zahvaćaju sustav za pokretanje – čak do 80% svih sportskih ozljeda. Kada u globalu pogledamo sve ozljede koje su nastale kao posljedica bavljenja sportom, gotovo polovica otpada na neku vrstu ozljede koljena. Zbog svoje složenosti i važnosti sudjelovanja u kretanju, pri čemu podnosi velika opterećenja česta je upravo ozljeda povezana sa koljenom. Kada do ozljede dođe potrebna je što točnija dijagnoza kako bi se ozljeda pravilno liječila. Ključnu ulogu ima moderna dijagnostika koja nam omogućuje multiplanarni prikaz struktura koje su ozlijeđene. Tu u prvom planu mislimo na CT i MR dijagnostiku. Upravo je MR dijagnostika metoda izbora kod ozljede koljena, zbog specifičnosti prikaza mekotkivnih struktura, a pri tom pacijenta ne izlažemo ionizirajućem zračenju. MR daje najbolji uvid i u strukturu prednjeg križnog ligamenta. Prednji križni ligament ima važnu ulogu u biomehanici zgloba koljena. Uz sudjelovanje u stabilizaciji i kontroli pokreta zgloba, njegova je glavna uloga u odupiranju prednjoj translaciji tibije. Uobičajeni mehanizam njegove ozljede vezan je na prekomjernu prednju translaciju tibije te valgus koljena uz dodatnu rotaciju tibije. U ovom radu opisuje se složenost anatomije koljena i uloga prednjeg križnog ligamenta u istom, kao jednog
od razloga čestog ozljeđivanja, tipovi i vrste ozljeda koljena te kako one nastaju, i na posljetku principi dijagnostike takvih ozljeda magnetnom rezonancijom i tehničke značajke samog pregleda.Professional sport keeps pace with the modern world, and puts increasing physical and mental challenges on the professional athlete. In such conditions, sports injuries are an indispensable part of everyday life for the first group, recreationists, as well as for the second, professionals. Injuries most commonly affect the locomotor system - up to 80% of all sports injuries. When we look at all the injuries that have occurred as a result of playing sports, almost half of them are some kind of knee injury. Due to its complexity and the importance of participating in movement, while withstanding heavy loads, it is often a knee-related injury. When an injury occurs, an accurate diagnosis is needed in order for the injury to be treated properly. A key role is played by modern diagnostics, which allows us to have a multiplanar view of the structures that have been injured. Here in the foreground we mean CT and MR diagnostics. MR is the diagnostic of choice for knee injuries, due to the specificity of the presentation of soft tissue structures, and we do not expose the patient to ionizing radiation. MR also gives the best insight into the structure of the anterior cruciate ligament. The anterior cruciate ligament plays an important role in the biomechanics of the knee joint. In addition to participating in the stabilization and control of joint movement, its major role is in resisting anterior tibial translation. The usual mechanism of that kind of injury is on excessive anterior tibial translation and knee valgus associated with additional tibial rotation. This paper
describes the complexity of the knee anatomy and the role of the anterior cruciate ligament in it, as one of the reasons for frequent injuries, types of knee injuries and how they occur, and finally the principles of diagnosis of such injuries by magnetic resonance imaging and technical features of the examination
ROLE OF THE MIDWIFE AND CHARACTERISTICS OF CHILDBIRTH GIVEN BY COVID POSITIVE EXPECTANT WOMEN AT THE WOMEN S HEALTH CLINIC OF THE CLINICAL HOSPITAL CENTRE SPLIT
No full textSažetak: Početkom pandemije pojavila su se mnoga pitanja o utjecaju COVID-19 infekcije na trudnice i
trudnoću. Najveću nepoznanicu i strah predstavljala je mogućnost da trudnoća povećava osjetljivost na
infekciju SARS-CoV-2 i da infekcija SARS-CoV-2 povećava rizik nepovoljnog ishoda trudnoće i
neonatalnog pobola i smrtnosti. Ciljevi istraživanja bili su utvrditi ukupan broj COVID-19 pozitivnih
trudnica, utvrditi osobitosti porođaja COVID-19 pozitivnih trudnica, način poroda i postojanje porodničkih
komplikacija, te zbrinjavanje trudnice i novorođenčeta u Klinici za ženske bolesti i porode u KBC Split.
Pregledom rađaonskog protokola utvrđeno je da je u periodu od kolovoza 2020. do veljače 2022. u Klinici
za ženske bolesti i porode bilo 82 trudnice koje su u trenutku rađanja imale dokazanu COVID-19 infekciju.
Porod COVID-19 pozitivnih trudnica odvijao se u prostoru i na način koji je potpuno drugačiji od
uobičajnih. Nova organizacija klinike za vrijeme pandemije COVID-19 dovela je do toga da se porod u
Klinici za ženske bolesti i porode KBC Split obavlja po Europskom standardu i principu „jedna rodiljajedna primalja“. Ishod trudnoće trudnica koje su u trenutku rađanja imale dokazanu COVID-19 infekciju
ne razlikuje se od poroda prije pandemije. U vrijeme pandemije primjećen je veći postotak poroda carskim
rezom nego vaginalnim poroda.With the beginning of the pandemic many questions about the influence of the COVID-19
infection on the expectant women and their pregnancy arose. The greatest enigma and fear represented the
possibility of the pregnancy rising the sensitivity to SARS-CoV-2 infection and that the SARS-CoV-2 infection increases the risk of a negative pregnancy outcome and neonatal disease and mortality. The goals
of the research were: to determine the total number of COVID-positive expectant women, to determine the
type of childbirth and occurrence of childbirth complications and the type of care of the expectant woman
and her newborn provided in the Women’s Health Clinic in the Clinical Hospital Centre Split. By the inspection of the birth protocol, it has been determined that in the period between August 2020 and February
2022 in the Women’s Health Centre there were 82 expectant women who were proved to be COVID-19
infected at the time of childbirth. Childbirths of the expectant women who were COVID-19 positive were
performed in the rooms and in ways completely different from the usual ones. The new organization of the
clinic during the COVID-19 pandemic led to the childbirth in the Women’s Health Clinic of the CHC Split
being carried out according to the European standard and principle “one pregnant woman – one midwife”.
The outcome of the pregnancy in the expectant women who were, at the time of the childbirth, proved to
be COVID-19 positive, does not differ from the childbirths before the pandemic. During the pandemic, a
higher percentage of caesarean delivery rather than the vaginal one was marked
Prevention of deep venous thrombosis in the intesive treatment unit
No full textSažetak: Duboka venska tromboza ili DVT se očituje zgrušavanjem krvi u dubokim venama udova, najčešće u potkoljenici, bedru ili u venama zdjelice. Nastaje u stanjima koja dovode do oštećenja i disfunkcije endotela, pogoršavaju vensku cirkulaciju ili u stanjima hiperkoagulabilnosti. Cilj ovog rada je opisati DVT i moguće komplikacije, te posljedično načine liječenja i metode koje se koriste za prevenciju DVT-a. DVT donjih ekstremiteta nastaje najčešće zbog poremećene venske cirkulacije (u imobiliziranih bolesnika), disfunkcije (nakon prijeloma noge) ili ozljede endotela, dok duboka venska tromboza gornjih ekstremiteta nastaje nakon ozljede endotela srčanim elektrostimulatorima, centralnim venskim kateterom ili uslijed intravenske narkomanije. DVT često uzrokuje plućnu emboliju koja je po život opasno stanje i zato je od iznimne važnosti prevencija DVT-a. Trombi se sastoje od fibrina, trombina i eritrocita s malo trombocita (crveni trombi). Bez liječenja trombi se mogu širiti proksimalno ili embolizirati u narednih nekoliko dana ili oboje. Uobičajene komplikacije koje ćemo detaljno opisati u radu su postflebitički sindrom, kronična venska insuficijencija, te već spomenuta plućna embolija. Važno je razlikovati bolesti koje podsjećaju na duboku vensku trombozu. Od velike važnosti je znati prepoznati znakove i simptome DVT-a od kojih imamo nespecifične i specifične simptome. DVT nastaje brzo i jako je važno naučiti postupke i metode liječenja koje se koriste u bolnicama kako bi spasili život i poboljšali kvalitetu bolesnikova života.Summary: Deep venous thrombosis or DVT is manifested by blood clotting in the deep veins of the limbs, most commonly in the lower leg, thigh, or pelvic veins. It occurs in conditions that lead to endothelial damage and dysfunction, worsen venous circulation or in conditions of hypercoagulability. The aim of this paper is to describe DVT and possible complications and consequently the treatments and methods used to prevent DVT. DVT of the lower extremities occurs most often due to impaired venous circulation (in immobilized patients), dysfunction (after a broken leg) or endothelial injury, while deep venous thrombosis of the upper extremities occurs after endothelial injury with cardiac pacemakers, central venous catheter, or intravenous drug addiction. DVT often causes pulmonary embolism, which is a life-threatening condition and therefore the prevention of DVT is of utmost importance. Thrombi consist of fibrin, thrombin and erythrocytes with few platelets (red thrombi). Without treatment, blood clots can spread proximally or embolize over the next few days or both. Common complications that we will describe in detail in the paper are postphlebitis syndrome, chronic venous insufficiency, and the already mentioned pulmonary embolism. It is important to distinguish between diseases that resemble deep vein thrombosis. It is great importance to be able to recognize the signs and symptoms of DVT from which we have non- specific and specific symptoms. DVT develops rapidly and it is very important to learn the procedures ande methods of treatment used in hospitals to save lives and improve the quality of life of patient
Specifics of nursing care in patients with Guillain Barre syndrome
No full textGuillain Barreov sindrom je akutna polineuropatija kojoj obično prethodi neki oblik infekcije, prvenstveno respiratorne ili gastrointestinalne. Početak bolesti uglavnom obilježavaju senzorni simptomi u nogama, nakon čega nastupa progresivna slabost koja se širi proksimalno. Bolest se obično javlja nakon infekcije virusom Epstein-Barr, Myocplasmom pneumoniae, ali najčešće kao posljedica infekcije Campylobacter jejuni i citamegalovirusima. Dijagnoza se temelji na nalazu cerebrospinalnog likvora i elektromiografije. Budući da ne postoji specifičan tretman za liječenje Guillain Barreovog sindroma cilj je smanjiti težinu sindroma i ubrzati oporavak. U liječenju Guillain Barreovog sindroma vrlo učinkovitom se pokazala primjena imunološke terapije (imunoglobulina) te plazmafereze. Rehabilitacija oboljelog je potrebna i tijekom akutne i rekonvalescentne faze. Istraživanja su pokazala da je gotovo 65% pacijenata postiglo potpuni oporavak sa povratom sposobnosti za rad i život. Guillain Barreov sindrom je kompleksna bolest, opširne i progresivne kliničke slike pa stoga plan se zdravstvene njege mijenja kako se mijenja i intenzitet kliničke slike. Sve intervencije osmišljene su i usmjerene da pomognu pacijentu da vrati prijašnju razinu neovisnosti. Od izrazite je važnosti da medicinske sestre budu posebno oprezne u pružanju zdravstvene skrbi osoba sa Guillain Barre sindromom jer progresija mišićne slabosti brzo nastupa i može doći do pogoršanja kliničkog stanja oboljelog.Guillain Barre syndrome is an acute semi-neuropathy that is usually preceded by some form of infection, primarily respiratory or gastrointestinal. Guillain Barre syndrome is an acute inflammatory caused by inflammation of peripheral nerves and nerve roots and is manifested by progressive weakening of muscles with loss of tendon reflexes. The onset of the disease is mainly marked by sensory symptoms in the legs, followed by progressive weakness that spreads proximally. The disease usually occurs after infection with Epstein-Barr virus, Myocplasma pneumoniae, but most often as a consequence of infection with Campylobacter jejuni and cytomegaloviruses. Diagnosis is based on cerebrospinal fluid findings and electromyography. Since there is no specific treatment for Guillain Barre syndrome, the goal is to reduce the severity of the syndrome and speed recovery. The use of immunotherapy (immunoglobulin) and plasmapheresis has been shown to be very effective in the treatment of Guillain Barre syndrome. Rehabilitation of the patient is required during both the acute and convalescent phases. Studies have shown that almost 65% of patients have achieved a complete recovery with the return of the ability to work and live. Guillain Barre syndrome is a complex disease, with extensive and progressive clinical picture and therefore the health care plan changes as the intensity of the clinical picture changes. All interventions are designed and focused to help the patient regain the previous level of independence. It is extremely important for nurses to be especially careful in providing health care to patients with Guillain Barre syndrome because the progression of muscle weakness occurs rapidly and clinical condition of the patient may worsen
OCCURRENCE OF INTRAHOSPITAL INFECTIONS IN CARDIOSURGICAL PATIENTS TREATED IN THE UNIVERSITY TREATMENT UNIT KBC SPLIT IN 2019
No full textCILJ ISTRAŽIVANJA: Glavni je cilj ovog istraživanja utvrditi pojavnost intrahospitalnih infekcija vezano za duljinu boravka u jedinici intenzivnog liječenja kardiokirurških bolesnika, prisutnost raznih invazivnih pripoja, spol bolesnika i postojanje drugih rizičnih čimbenika.
MATERIJALI I METODE: Za potrebe izrade empirijskog dijela ovog rada korišteni su podaci iz povijesti bolesti KBC Split u razdoblju od siječnja do prosinca 2019g. Analiza je rađena u statističkom softwareu STATISTICA 12 (TIBCO Software Inc4., Palo Alto, California). U istraživanje su uključeni bolesnici kod kojih su učinjene najčešče kardiokirurške operacije nakon kojih su bili liječeni i nadzirani (monitorirani) u jedinici intenzivnog liječenja (JIL-u) kardiokirurških bolesnika, a isključeni su oni bolesnici koji su se liječili od drugih medicinskih dijagnoza i nisu bili operirani, ili su liječeni u -JIL-u ponovno nakon prvotnog oporavka.
REZULTATI: Pojavnost je intrahospitalnih infekcija u kardiokirurških bolesnika bila značajno veća pri dužem boravku u - JIL-u kardiokirurških bolesnika te je utvrđena statistički značajna povezanost između duljine boravka i pojave intrahospitalnih infekcija. Intrahospitalne infekcije izolirane hemokulturom iz središnjeg venskog katetera bile su jednake zastupljenosti kao i one izolirane iz aspirata traheje. Infekcije izolirane hemokulturom iz središnjeg venskog katetera (SVK) bile su za 0,41 postotni bod učestalije od onih izoliranih iz uzoraka periferne krvi, za 0.82 postotna boda učestalije od izoliranih urinokulturom, a za 0,82 postotna boda učestalije od onih izoliranih iz nalaza sputuma, ali nije utvrđena prisutnost statistički značajne razlike među njima. Od uzročnika intrahospitalnih infekcija najučestaliji je bio Acinetobacter baumannii, a od ostalih: Escherichia coli, Klebsiella pneumoniae, Candida albicans, Staphylococcus aureus, Epidermidis hominis. U istraživanome je periodu bilo hospitalizirano više muških bolesnika nego žena i utvrđena je statistički značajna razlika. Muškarci su prevladavali za 5.75 puta više. Od ukupno 207 hospitaliziranih muških bolesnika 18 (8,7%) ih je razvilo infekciju, a od 36 ukupno hospitaliziranih žena 4 (11,11%) je razvilo infekciju. Statistički nije utvrđeno da muškarci pokazuju veću sklonost razvijanja intrahospitalnih infekcija. Od ukupno 243 bolesnika, 32 su imala dijabetes, od kojih je 5 (12,63%) razvilo intrahospitalnu infekciju. Dijabetes nije imalo 211 bolesnika, od kojih je 17 (8.06) razvilo intrahospitalnu infekciju.
ZAKLJUČAK: Ispitivanjem je utvrđena statistički značajna povezanost između dužine boravka u JIL-u kardiokirurških bolesnika i učestalosti intrahospitalnih infekcija.OBJECTIVE OF THE RESEARCH: The main objective of this study is to determine the incidence of nosocomial infections related to the length of stay in the intensive care unit of cardiac surgery patients, the presence of various invasive attachments, sex of patients and the existence of other factors.
MATERIALS AND METHODS: For the purposes of preparing the empirical part of this paper, data from the history of KBC Split in the period from January to December 2019 yr. were used. The analysis was performed in the statistical softwere STATISTICA 12 (TIBCO Softwere Inc4., Palo Alto, California). Exclusion and inclusion criteria: the study included patients who underwent the most frequent cardiac surgery after which they were treated and monitored (monitored) in the ICU of cardiac surgery patients, and excluded those patients who were treated for other medical diagnoses and were not operated on or treated in the ICU again after initial recovery.
RESULTS: The incidence of nosocomial infections was significantly higher during a longer stay in the ICU of cardiac surgery patients and a statistically significant difference between the length of stay was found. Intrahospital infections isolated by blood culture from the central venouse catheter (SVC) are as prevalent as those isolated from the tracheal aspirate. Blood culture- isolated infections from a central venous chateter were 0.41 percentage points more common than those isolated from peripheral blood samples, 0.82 percentage points more frequent than those isolated from urine culture, and 0.82 percentage points more frequent than those isolated from sputum findings, but no statistically significant difference was found between them. Acinetobacter baumannii was the most common cause of intrahospital infections, others: Escherichia coli, Klebsiella pneumoniae, Candida albicans, Staphylococcus aureus, Epidermidis. In the study period, more male patients than women were hospitalized and a statistically significant difference was found between them. Men prevailed by 5.75 times more. Out of a total of 207 hospitalized male patients, 18(8,7%) developed the infection, and out of 36 total hospitalized women, 4 (11.11%) developed the infection. It has not been statistically determined that men show a higer tendency to develop nosocomial infections. Out of a total of 243 patients, 32 had diabetes, of which 5 (12,63%) developed nosocomial infection. Patient without diabetes 211, 17 (8,06%) of them developed an nosocomial infection.
CONCLUSION: The study found a statistically significant association between the length of stay in ICU of cardiac surgery patients and the frequency of nosocomial infections
Breast Cancer Radiotherapy
No full textUloga ovog rada je obrada radioloških aspekata radioterapije karcinoma dojke. S obzirom da je karcinom dojke jedna od najučestalijih malignih bolesti današnjice, postoje razne metode i pristupi kojima se želi omogućiti što bolje izlječenje, a radioterapija je upravo jedna od njih. Radioterapija je zapravo vrlo složena metoda koja se sastoji od puno manjih zadataka koji moraju biti precizno obavljeni kako bi terapija bila uspješna. Izrada radioterapijskog plana se sastoji od CT planiranja, crtanja organa od rizika i stvaranja izodoznog plana. Radioterapiju obavlja radioterapijski tim koji se sastoji od specijalista radioterapije i onkologije, fizičara i radiološkog tehnologa pa kako bi sama radioterapija bila uspješna svi moraju kvalitetno obaviti svoj dio posla i truditi se što više doprinijeti isplaniranoj terapiji.The goal of this paper is to deal with the radiological aspects of breast cancer radiotherapy. Due to the fact that breast cancer is one of the most frequent malignant diseases in today's world, there are many methods and approaches that have the goal of tumor eradication and radiotherapy is exactly one of them. Radiotherapy is actually a very complicated method that consists of many smaller tasks that need to be precisely done in order for the therapy to be successful. The making of a radiotherapy plan includes CT planning, charting the organs that are at risk, marking the target volume that leads to creation of an isodose plan. Radiotherapy is performed by a team consisting of specialists of radiotherapy and oncology, physicists and a radiological technician, so in order for the radiotherapy itself to be successful everyone has to do their job exemplary and strive to contribute as much as they can to the planned therapy
DIFFERENCE IN AVAILABILITY OF MAGNETIC RESONANCE IMAGING DIAGNOSTIC PROCEDURE DURING THE COVID-19 PANDEMIC IN RELATION TO PATIENT DIAGNOSIS AT THE CLINIC FOR CHILDREN’S DISEASES ZAGREB
No full textU istraživanju su obrađeni arhivski podatci prikupljeni tijekom redovitoga kliničkog rada u Klinici za dječje bolesti Zagreb (izvor podataka: bolnički informacijski sustav (BIS) Klinike). Analiziran je utjecaj pandemije bolesti COVID-19 na dostupnost usluge MR-a dječjim pacijentima prema klasifikaciji MKB-10. Za tzv. pretpandemijske godine upotrijebljeni su podatci iz 2018. i 2019. godine, a za tzv. pandemijske godine podatci iz 2020. i 2021. godine.
Statistički značajnih razlika nije bilo prema dobi naručenih pacijenata najčešćih dijagnostičkih skupina snimljenih MR-om na poliklinici i u stacionaru Klinike za dječje bolesti Zagreb između pretpandemijskih (2018., 2019.) i pandemijskih (2020., 2021.) godina. Jednako tako nije bilo statistički značajnih razlika u prosječnom vremenu čekanja, koje iznosi 17 tjedana, u naručenih pacijenata snimljenih MR-om u pretpandemijskim (2018., 2019.) i pandemijskim (2020., 2021.) godinama.
U dg. skupini 1 (C00 – D48) – neoplazme i dg. skupini 6 – ostale dg. skupine MKB-10 na poliklinici je utvrđen veći broj zahvata (snimanja) u pandemijskim godinama (2020., 2021.) u odnosu na pretpandemijske godine (2018., 2019.), dok je za dg. skupinu 2 (G00 – G99) – bolesti živčanog sustava i dg. skupinu 3 (M00 – M99) – bolesti mišićno-koštanog sustava i vezivnog tkiva utvrđen manji broj zahvata (snimanja) u pandemijskim (2020., 2021.) u odnosu na pretpandemijske godine (2018., 2019.). Za dg. skupinu 2 (G00 – G99) – bolesti živčanog sustava u stacionaru je utvrđen veći broj zahvata (snimanja) u pandemijskim godinama (2020., 2021.) u odnosu na pretpandemijske godine (2018., 2019.), dok je za dg. skupinu 4 (Q00 – Q99) – prirođene malformacije, deformacije i kromosomske abnormalnosti utvrđen manji broj zahvata (snimanja) u pandemijskim (2020., 2021.) u odnosu na pretpandemijske godine (2018., 2019.). Broj pacijenata snimljenih u općoj anesteziji u pretpandemijskoj 2018. godini bio je veći od pandemijskih godina (2020., 2021.) za dg. skupinu 4 (Q00 – Q99) – prirođene malformacije, deformacije i kromosomske abnormalnosti.
Negativan trend smanjenja broja zahvata (snimanja) može se povezati s većim vremenskim razmacima između pojedinačnih snimanja, kao rezultat važećih epidemioloških smjernica te s bojazni roditelja pacijenata zbog zaraze, koji su samoinicijativno odgađali elektivne kontrole, no i zbog vlastita ili djetetova PCR testa pozitivnog na koronavirus. U slučaju povećanja broja zahvata (snimanja) možemo govoriti o upućivanju većega broja pacijenata iz drugih ustanova na MR snimanja, posebno onkoloških pacijenata.The research processed archival data collected during regular clinical work (data source Hospital Information System – BIS Clinic for Children's Diseases Zagreb). The impact of the Covid-19 pandemic on the availability of MRI services in children according to the ICD-10 classification was analyzed. For the so-called pre-pandemic years, data from 2018 and 2019 were used, and the so-called pandemic years data from 2020 and 2021.
There were no statistically significant differences according to the age of the ordered patients of the most common diagnostic groups recorded by MR at the polyclinic and in the hospital (Klaićeva) between the pre-pandemic (2018, 2019) and pandemic (2020, 2021) years. Equally, there were no statistically significant differences in the average waiting time, which is 17 weeks, in the ordered patients recorded by MR in the pre-pandemic (2018, 2019) and pandemic (2020, 2021) years.
Code dg. group 1 (C00–D48) – neoplasms and dg. group 6 (other dg. groups MKB-10) at the polyclinic, a higher number of procedures (scan) was determined in the pandemic (2020, 2021) years compared to the pre-pandemic (2018, 2019) years, while in dg. group 2 (G00–G99) – diseases of the nervous system, dg. group 3 (M00–M99) – diseases of the musculoskeletal system and connective tissue found a smaller number of interventions (scan) in pandemic (2020, 2021) compared to pre-pandemic (2018., 2019.) years. Code dg. group 2 (G00–G99) – diseases of the nervous system in the hospital, a higher number of procedures (scan) was found in the pandemic (2020, 2021) years compared to the pre-pandemic (2018, 2019) years, while in dg. group 4 (Q00–Q99) – congenital malformations, deformities and chromosomal abnormalities, a smaller number of interventions (scan) were found in pandemic (2020, 2021) compared to pre-pandemic (2018, 2019) years. The number of patients admitted under general anaesthesia in the pre-pandemic year 2018 was higher than the pandemic year (2020, 2021) in dg. group 4 (Q00–Q99) – congenital malformations, deformities and chromosomal abnormalities.
The negative trend of reducing the number of procedures (scans) can be associated with longer time intervals between individual scan, and according to current epidemiological guidelines and fears of parents of patients due to infection who delayed elective controls, but also due to their own or PCR test for coronavirus. In the case of an increase in the number of procedures (scans), we can talk about referring a larger number of patients from other institutions to MRI scan, especially of oncology patients
Methods for diagnosis of Helicobacter pylori
No full textCilj rada: Svrha rada je detaljno prikazati načine uzorkovanja i metode otkrivanja infekcije uzrokovane bakterijom Helicobacter pylori te otkriti najučinkovitiju metodu dijagnosticiranja ove bakterije.
Materijali i metode Dijagnostika infekcija uzrokovanih bakterijom Helicobacter pylori temlji se na uporabi invazivnih i neivazivnih metoda. U invazivne metode spadaju histološka analiza, kultura, brzi ureaza test i PCR metoda, dok u neinvazivne spadaju test dokaza antigena bakterije Helicobacter pylori u stolici, urea izdisajni test i serološki test. U Nastavnom zavodu za javno zdravstvo Splitsko – dalmatinske županije koristi se neivazivna metoda dokaza antigena bakterije Helicobacter pylori.
Rezultati: Pozitivan nalaz kod ispitivanja prisutnosti bakterije Helicobacter pylori očitava se na testnoj kazeti pojavom dvije crvene linije: kontrolne i linije u T regiji testa za uzorak. Od 9 uzoraka ispitanih u Nastavnom zavodu za javno zdravstvo Splitsko – dalmatinske županije jedan je test bio pozitivan na ovu bakteriju.
Zaključak: Helicobacter pylori je bakterija koja se prenosi kontaminiranom hranom i vodom, poljupcem ili fekalno – oralnim putem. Moguća je pojava asimptomatske infekcije, a ukoliko je simptomatska uzrokuje razne tegobe poput nadutosti, osjećaja žarenja u želudcu, gubitka apetita i povraćanja. Histološka metoda se i dalje smatra zlatnim standardom, međutim, radi raznih čimbenika koji ometaju proces dijagnostike, sve se više koristi neinvazivna metoda otkrivanja antigena bakterije Helicobacter pylori u uzorku stolice.Objectives: The aim of the study is to present in detail the methods of sampling and detection methods of infection caused by the bacterium Helicobacter pylori and to discover the most effective method for bacterial diagnosis.
Material and methods: Diagnostic methods of infection caused by Helicobacter pylori bacteria are based on the use of invasive and non-invasive methods. Invasive methods include histological analysis; bacterial culture; rapid urease test and PCR method, while non-invasive include a test for evidence of Helicobacter pylori antigen in stool; urea breath test and serological test. The Teaching Institute for Public Health of Split-Dalmatia County uses a non-invasive method of proving Helicobacter pylori antigen.
Results: A positive result for presence of the Helicobacter pylori antigen is interpreted on the test cassette by the appearance of 2 red lines: control line and the line in the T region for test sample. Out of 9 samples tested at the Teaching Institute for Public Health of Split-Dalmatia County, one of them was positive for bacteria.
Conclusion: Helicobacter pylori is a bacterium that is transmitted through contaminated food and water, by kissing, or fecal-oral route. Asymptomatic infection is possible. If infection is symptomatic, it causes various complaints such as bloating, burning sensation in the stomach, loss of appetite and vomiting. The histological method is still considered the gold standard. However, due to various factors that interfere with diagnosis, a non-invasive method of detecting Helicobacter pylori antigen in a stool sample is increasingly being used
Postoperative assassment of the patient after kidney surgery
No full textSvakoj kirurškoj operaciji prethodi perioperativna skrb pacijenta koju provode licencirani zdravstveni djelatnici. Postoperativna skrb je proces u kojem zdravstveni djelatnici prate i procjenjuju status pacijenta nakon operacije i nastavlja se tijekom razdoblja oporavka. Glavni cilj postoperativne njege i procjene je prevencija postoperativnih komplikacija pružajući adekvatnu medicinsku skrb. Ovisno o ozbiljnosti trenutnog stanja bubrega, postoji niz kirurških zahvata na bubrezima, a mnogi od njih se izvršavaju laparoskopskim putem koji rezultiraju lakšim i bržim oporavkom. Primarna zadaća svake medicinske sestre je dobro i temeljito isplanirana zdravstvena njega, takva zdravstvena njega treba imati multidisciplinaran pristup. Dužnost medicinske sestre je usmjeriti sestrinske intervencije na prevenciju i ublažavanje komplikacija ukoliko one nastanu.Every surgical operation is preceded by perioperative care of the patient, which is carried out by licensed health professionals. Postoperative care is the process by which health professionals monitor and assess the patient's status after surgery and continues during the recovery period. The main goal of postoperative care and assessment is the prevention of postoperative complications by providing adequate medical care. Depending on the severity of the current kidney condition, there are a numbers of renal surgeries, many of which are performed laparoscopically, resulting in an easier and faster recovery. The primary task of every nurse is well and thoroughly planned nursing care, such nursing care should have a multidisciplinary approach. The nurse's duty is to direct nursing interventions to the prevention and reduction of complications if they apear