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Precautions for magnetic resonance imaging
No full textIako magnetska rezonancija ne koristi ionizirajuće zračenje te ne predstavlja rizik od razvoja karcinoma uzrokovanih njenom primjenom, zbog svog specifičnog načina akvizicije slike nosi sa sobom jedinstven niz sigurnosnih problema prvenstveno povezanih s korištenjem jakog magnetskog polja. Svi dijelovi MR uređaja su povezani s određenim sigurnosnim rizcima, kao što su: opasnost od ozljeda uzrokovanih projektilima koji mogu nastati unutar jakog magnetskog polja; akustična oštećenja nastala zbog buke uzrokovane pomicanjem gradijentnih zavojnica; te mogućnost porasta tjelesne temperature zbog taloženja energije otpuštene od strane radiofrekventnih zavojnica. Kako bi se što više smanjila mogućnost nastankapotencijalnih nesreća nužno je da osoblje koje rukuje MR uređajem bude adekvatno educirano o svim mehanizmima nastanka tih nesreća, njihovim uzrocima i posljedicama. Nužno je i da pacijenti ne budu bez nadzora i u prostor MR uređaja ulaze tek nakon temeljite sigurnosne provjere.Although magnetic resonance imaging does not use ionizing radiation and does not pose the risk of developing cancer caused by its use, a unique set of safety problems occurs due to its specific image acquisition primarily related to the use of the strong magnetic field. All parts of the MR device carry with them certain safety risks, such as the risk of injuries caused by projectiles caused by the power of the main magnet field, acoustic damage caused by the noise produced by the movements of gradient coils and the possibility of increasing body temperature due to energy depositions released by radiofrequency coils. To reduce the number of potential accidents it is necessary that the staff that handles the device itself is well-educated on all the mechanisms on which these accidents happen, their causes and consequences. It is also necessary that the patients are not unattended and only enter the MR space after a thorough safety check
Activities of a nursein prevention of acute complications of type 1 diabetes
No full textŠećerna bolest (lat. diabetes mellitus) je kronična i progresivna bolest od koje boluje nekoliko stotina milijuna ljudi na svijetu. Šećerna bolest posljedica je poremećaja metabolizma ugljikohidrata, masti i bjelančevina koja rezultira hiperglikemijom, temeljem koje se postavlja dijagnoza. Najčešće akutne komplikacije šećerne bolesti tipa su dijabetička ketoacidoza, hiperosmolarno stanje, acidoza mliječnom kiselinom, hipoglikemijska kriza. U terapiji šećerne bolesti edukacija je ključni element. Kvaliteta postignute skrbi za oboljele ovisi o pravilnoj prehrani i terapiji, pomagalima za terapiju i samokontrolu, znanju, vještinama i edukativnim sposobnostima zdravstvenih djelatnika, ali i oboljelih. Važna uloga medicinske sestre, edukatora, je provođenje edukacije pacijenta uz procjenu izvođenja praktično usvojenih znanja, o čemu ćemo govoriti u ovom završnom radu.Diabetes mellitus is a chronic and progressive disease that affects several hundred million people worldwide. Diabetes is the result of a disorder in the metabolism of carbohydrates, fats and proteins that results in hyperglycemia, on the basis of which the diagnosis is made. The most common acute complications of type 1 and 2 diabetes are diabetic ketoacidosis, hyperosmolar condition, lactic acid acidosis, hypoglycemic crisis. In the treatment of diabetes the key element is education. The quality of achieved care for the ill patients depends on proper nutrition and therapy, aids for therapy and self-control, knowledge, skills and educational abilities of health professionals, but also the ill patients. An important role of the nurse, educator, conducting patient education with the assessment of the implementation of practically acquired knowledge, which we will talk about in this thesis
Mediterranean diet assessment challenges: Validation of the Croatian Version of the 14-item Mediterranean Diet Serving Score (MDSS) Questionnaire
No full textMediterranean diet (MD) is among the most commonly investigated diets and recognized as one of the healthiest dietary patterns. Due to its complexity, geographical and cultural variations, it also represents a challenge for quantification. The aim of this cross-sectional study was to assess reliability and validity of the Croatian version of the 14-item Mediterranean Diet Serving Score (MDSS), using the Mediterranean Diet Adherence Screener (MEDAS) as the referent test. We included the exploratory sample of 360 medical students, and a confirmatory sample of 299 health studies students from the University of Split, Croatia. Test-retest reliability and validity of the MDSS were tested using intra-class correlation coefficients (ICC), while Cohen's kappa statistic was used to test correct classification of subjects into MD adherent/non-adherent category. A very good reliability was shown for the overall MDSS score (ICC = 0.881 [95% CI 0.843-0.909]), and a moderate reliability for the binary adherence (κ = 0.584). Concurrent validity of the MDSS was also better when expressed as a total score (ICC = 0.544 [0.439-0.629]) as opposed to the adherence (κ = 0.223), with similar result in the confirmatory sample (ICC = 0.510 [0.384-0.610]; κ = 0.216). Disappointingly, only 13.6% of medical students were adherent to the MD according to MDSS, and 19.7% according to the MEDAS questionnaire. Nevertheless, MDSS score was positively correlated with age (ρ = 0.179: P = 0.003), self-assessed health perception (ρ = 0.123; P = 0.047), and mental well-being (ρ = 0.139: P = 0.022). MDSS questionnaire is a short, reliable and reasonably valid instrument, and thus useful for assessing the MD adherence, with better results when used as a numeric score, even in the population with low MD adherence
SUICIDAL BEHAVIOUR IN ADOLESENCE
No full textSuicidalno ponašanje je smrtonosni čin samoozljeđivanja sa svrhom smrtnog ishoda te koje
podrazumijeva niz autodestruktivnih ponašanja. Svakih 40 sekundi u svijetu netko počini suicid što bi značilo
da godišnje 700 000 ljudi umire jer izvrše samoubojstvo na svjetskoj razini. Zbog toga se suicid naziva
„tihom epidemijom“ i predstavlja ozbiljan javnozdravstveni problem na globalnoj razini. U Republici
Hrvatskoj također je zabilježen porast suicida među adolescentima između 15-19 godine. Razni društveni,
psihološki i socijalni čimbenici utječu na pojavu suicidalnog ponašanja adolescenata. Velik dio adolescenata
sa suicidalnim ponašanjem, njih 80%, ima u pozadini neke od psihijatrijskih poremećaja kao što je poremećaj
raspoloženja, konzumiranje psihoaktivnih tvari te eksternalizirajući poremećaji. Ponekad suicidalno ponašanje
adolescenta nema u cilju smrtni ishod nego samo želju za osjećajem olakšanja. Prevencija suicidalnog
ponašanja dijeli se na primarnu, sekundarnu i tercijarnu. Medicinska sestra djeluje kroz sve tri razine
prevencije, prateći pacijenta te edukacijom obitelji i zajednice.Suicidal behavior is a deadly act of self-harm with the purpose of death and which involves a
series of self-destructive behaviors. Every 40 seconds someone in the world commits suicide which results in 700
000 deaths yearly on a global level. For that reason, suicide is being called a „silent epidemic“ and represents a
major public health problem all around the world. Croatia also registred increase in suicide rates commited by
adolesence between 15-19 years. On adolesence suicidal behaviour affects a lot of social, pshychological and
biological risk factors. An 80% of adolescents with suicidal behaviour have a background of some kind of
psychiatric disorders such as mood disorder, using psyhoactiv substances or externalizing disorders. Sometimes
the aim of adolescent suicidal behaviour is not death, but the sense of a relief. Prevention of suicidal behaviour is
based on primary, secondary and tertiary prevention. The nurse is active in all three levels of prevention by
monitoring the patient and educating patients familly and whole communit
Influence of the lenght of service, the type of clinical department and the level of education on hand compliance among hospital nurses
No full textCilj
Cilj ovog istraživačkog rada je utvrditi suradljivost u higijeni ruku među medicinskim sestrama u Općoj bolnici Šibensko-kninske županije te utvrditi na koji način duljina radnog staža, vrsta odjela na kojima rade i razina obrazovanja utječu na suradljivost.
Metode
Istraživanje je provedeno prema metodologiji za praćenje suradljivosti u higijeni ruku Svjetske zdravstvene organizacije. Tijekom jutarnje njege direktnim promatranjem se pratio rad medicinskih sestara i uočavale prilike u kojima su trebale izvršiti higijenu ruku i njihove akcije (higijensko utrljavanje, higijensko pranje, izostanak higijene) u uočenoj prilici. Uočene prilike i akcije bilježile su se na za to predviđenom obrascu.
Rezultati
Ukupna suradljivost medicinskih sestara internističkog, kirurškog i pedijatrijskog odjela Opće bolnice Šibensko-kninske županije je 72,9%. Najmanja pojedinačna suradljivost je 40%, a najveća 100%). Ne postoji značajna razlika u suradljivosti s obzirom na odjel (interni - 66,36%; kirurški - 81%; pedijatrijski - 72%), (p=0,0567). Suradljivost u higijeni ruku značajno se razlikuje kod prvostupnica sestrinstva (80%) i medicinskih sestara srednje stručne spreme (68,42%), (p=0,0255). Suradljivost s obzirom na radni staž značajno se razlikuje (1-2 godine staža - 65%; 3-5 godina staža - 85%; 6-15 godina staža - 75,45%; 16-30 godina staža - 80%; 31 i više godina staža - 53,33%), (p=0,028%). Postoje značajne razlike u ukupnoj suradljivosti u odnosu na indikacije (prije kontakta s bolesnikom - 36,67%; prije čistih/aseptičnih postupaka - 64,71%; nakon rizika izlaganja tjelesnim tekućinama - 95,70%; nakon kontakta s bolesnikom - 93,75%; nakon kontakta s bolesnikovom okolinom - 24,50%), (p<0,001). Higijena ruku u 54% situacija se provodi higijenskim utrljavanjem, a higijenskim pranjem u 46% slučajeva.
Zaključci
Postoji značajna razlika suradljivosti u higijeni ruku medicinskih sestara srednje stručne spreme i prvostupnica, pri čemu prvostupnice imaju bolju suradljivost. Ne postoji statistički značajna razlika u suradljivosti između internističkih, kirurških i pedijatrijskih medicinskih sestara. Postoji značajna razlika u suradljivosti medicinskih sestara s obzirom na duljinu staža, pri čemu najmanju suradljivost imaju one sa 31 i više godina staža. Medicinske sestre prilikom higijene ruku podjednako koriste higijensko pranje i higijensko utrljavanje.Goal
The aim of this research is to determine hand hygiene compliance among nurses at the General Hospital of Šibenik-Knin County and to determine how the lenght of service, the type of clinical departments they work and the level of education affect hand hygiene compliance.
Methods
The research was conducted according to the methodology for monitoring hand hygiene compliance of the Word Health Organisation. During the morning care, nurses was monitored by direct obversation and circumstances in which they had to perform hand hygiene and their actions were observed on the observed occasion and recorded on the provided form.
Results
The total compliance of nurses of the internal deparment, surgical department and pediatric department of General Hospital of Šinenik-Knin County is 72;9%. The lowest individual comlpiance was 40%, the higest 100%. There is no significant difference in compliance acccording to the type of department (Internal - 66,36%; Surgical - 81%; Pediatric - 7 2%), (p=0,0567). There is significant difference in compliance between bachelors of nursing (80%) and nurses with secondary school education (68,42%), (p=0,0255). Compliance according to the lenght of work significantly differs (1-2 years of working - 65%; 3-5 years of working - 80%; 6-15 years of working - 75,45%; 16-30 years of working - 80%; 31 and more years of working - 53,33%), (p=0,028). There are significant differences in the total compliance according to the indications (before touching a patient - 36,67%; before clean/aseptic procedures - 64,71%; after body fluids exposure risk - 95,70%; after touching a patient - 93,75%; after touching patient surroundings - 24,50 %), (p<0,001).
Hand hygiene is perform by hygienic rubbing in 54% of cases and by hygienic washing in 46% of cases.
Conclusions
There is significant difference of hand hygiene compliance between nurses with secondary school education and bachelors, with bachelors have better compliance. There is not significant difference in compliance between internal, surgical and pediatric nurses. There is significant difference in compliance according to the nurses lenght of service, with those with 31and more yeras of service have the lowest compliance. When perform hand hygiene, nurses use hygienic rubbing and hygienic washing equally
Physiotherapeutic assessment and the most common modalities of physical therapy in gerontological population - literature review
No full textU radu je obrađena tema najčešćih modaliteta fizikalne terapije u gerontološkoj populaciji kojoj je prethodila procjena fizioterapeuta. Starenje je biološki proces koji započinje rođenjem i kroz koji prolazi svaki čovjek, dok je starost posljednje razvojno razdoblje u ljudskome životu. Karakteristike starijih ljudi se očituju u pogledu njihovih funkcionalnih sposobnosti. S odmakom životne dobi odvijaju se brojne promjene u organizmu, što izaziva progresivno slabljenje i oštećenje funkcije organa pa je u toj dobi čest multimorbiditet, a to dodatno pogoršava kvalitetu života. Fizioterapijska procjena proces je prikupljanja i interpretiranja podataka potrebnih za razumijevanje osobe, situacije ili sustava, uključujući planiranje terapijskog procesa, i dokumentaciju, uz korištenje specifičnih oruđa i instrumenata koji su sastavni dio fizioterapije. Procjena uključuje pregled pojedinca s vidljivim ili potencijalnim oštećenjima, kao i funkcionalnim ograničenjima. Glavni ciljevi fizioterapije u intervenciji starijih bolesnika su smanjenje boli, povećanje snage, povećanje ili održavanje opsega pokreta u zglobovima, održavanje ili uspostavljanje ravnoteže i koordinacije, učenje hoda uz pomagala i korištenje invalidskih kolica, poboljšanje funkcionalnih sposobnosti u svakodnevnim životnim aktivnostima, te naposljetku i edukacija pacijenta i obitelji o novonastalim problemima i navikama. Cilj ovog preglednog rada je pretragom medicinskih baza podataka napraviti pregled literature o najzastupljenijim modalitetima fizikalne terapije u gerontološkoj populaciji, fokusirajući se na one najčešće, te na temelju rezultata opisati najoptimalniji pristup rehabilitaciji koje će pomoći budućim istraživačima u izradi još preciznijih smjernica za rehabilitaciju iste. U obzir su uzete sve studije zaključno sa 2019. godinom, a pretražene su baze podataka koje su relevantne za područje fizikalne i rehabilitacijske medicine: PubMed, PEDro (Physiotherapy Evidence Database) i Cochrane Central. Dosadašnji dokazi u istraženim radovima ukazali su za sada kod gerontološke populacije, samo učinkovitost aerobnog vježbanja i krio terapije kod reumatoloških bolesti, dok ultrazvuk, magnet i elektroterapija ukazuju na benefit, ali vrlo su niske razine dokaza.The paper deals with the topic of the most common modalities of physical therapy in the gerontological population preceded by the assessment of physiotherapists. Aging is a biological process that begins at birth and that every human being goes through, while old age is the last developmental period in human life. The characteristics of older people are manifested in terms of their functional abilities. As age progresses, numerous changes take place in the organism, which causes progressive weakening and impairment of organ function, so multimorbidity is common at that age, which further worsens the quality of life. Physiotherapy assessment is the process of collecting and interpreting the data needed to understand a person, situation, or system, including planning the therapeutic process, and documentation, using specific tools and instruments that are an integral part of physiotherapy. The assessment includes an examination of the individual with visible or potential impairment as well as functional limitations. The main goals of physiotherapy in the intervention of elderly patients are to reduce pain, increase strength, increase or maintain range of motion in the joints, maintain or establish balance and coordination, learning to walk with aids and using a wheelchair, improving functional abilities in daily activities, and finally education patient and family about emerging problems and habits. The aim of this review is to search medical databases to review the literature on the most common modalities of physical therapy in the gerontological population, focusing on the most common, and based on the results to describe the most optimal approach to rehabilitation that will help future researchers develop even more precise guidelines for rehabilitation. All studies up to 2019 were taken into account, and databases relevant to the field of physical and rehabilitation medicine were searched: PubMed, PEDro (Physiotherapy Evidence Database) and Cochrane Central. To date, evidence in the studies has indicated for now in the gerontological population, only the effectiveness of aerobic exercise and cryotherapy in rheumatoid arthritis, while ultrasound, magnet and electrotherapy indicate a benefit, but very low levels of evidence
BRACHIAL PLEXUS PARESIS AND VOJTA THERAPY
No full textOštećenje pleksusa brahijalisa je stanje koje najčešće nastaje uslijed mehaničkog
oštećenja nastalog tijekom poroda. Brahijalni pleksus tvore korijenovi živaca C5-Th1,
a oštećenje pleksusa brahijalisa spada u oštećenje perifernih živaca.
Postoji više vrsta zahvaćenih živaca, pa tako možemo navesti četiri.
Erb-Duchenneova pareza koja zahvaća C5-C6, srednja ili proširena pareza koja
zahvaća C7, Klumpkeova pareza koja zahvaća C8-Th1 i miješani tip lezije koja
zahvaća C5, C6, C7, C8, Th1.
Nakon procjene postavlja se plan terapije koji je individualan za svakog pacijenta.
Važna je i edukacija roditelja u handlingu jer ipak oni provode najviše vremena s
djetetom.
Vojta terapiju teško je objasniti bez shvaćanja pojma neuroplastičnosti mozga. Mozak
nadoknađuje štetu tako da reorganizira i uspostavlja nove veze između zdravih,
nedirnutih neurona te se na toj spoznaji temelji Vojta terapija. Temelji Vojta terapije
su neuroplastičnost mozga, refleksna lokomocija i fenomen neuronskog prelijevanja.
Preko 9 zona i 2 strane tijela Vojta terapeut ciljanim pritiskom na određene točke
izaziva pokret.
Prilikom provođenja terapije, terapeut treba bilježiti napredak ili zaostatak s obzirom
na djetetov razvoj, prilagoditi vježbe obzirom na sam ishod te educirati roditelje.Plexus brachialis is a condition most commonly caused by mechanical damage caused
during childbirth. The brachial plexus is formed by nerve roots C5-Th1, and damage
of brachial plexus is damage of peripheral nerves. There are several types of involved
nervs, so we can list four. Erb-Duchenne paresis involving C5-C6, middle or extended
paresis involving C7, Klumpkes paresis involving C8-Th1 and mixed type of lesion
involving C5,C6,C7,C8,Th1.
After the assessments we set a treatment plan that is individual to each patient.
Education of parents in handling is also important because they spend the most time
with child.
Vojta therapy is difficult to explain without understanding the notion of brain
neuroplasticity. The brain compensates damage by reorganizing and establising new
connections between healthy, intact neurons and Vojta therapy is based on this
knowledge. The foundations of Vojta therapy are neuroplasticity of brain, reflex
locomotion and phenomen of neural overflow. Over 9 zones and 2 sides of body,
Vojta therapist causes movement by targeting certain points.
During therapy, the therapist should measure progress or lag considering the child`s
development, adjust the exercises according to the outcome and educate parents
EFFECTIVENESS OF SIMULATION – BASED LEARNING IN NURSE EDUCATION
No full textCiljevi: Spoznajni cilj istraživanja: utvrditi učinkovitost treninga temeljnih hitnih medicinskih postupaka u izvanbolničkoj hitnoj medicini kao dijela projekta kontinuiranoga stručnog osposobljavanja radnika u djelatnosti hitne medicine. Pragmatični cilj istraživanja: ponuditi smjernice za unaprjeđenje procesa osposobljavanja medicinskih sestara izvanbolničke hitne medicine.
Metode: Istraživanje je provedeno postupcima anketiranja, samoprocjenjivanja i procjenjivanja prije i poslije treninga temeljnih hitnih medicinskih postupaka u izvanbolničkoj hitnoj medicini pri Zavodu za hitnu medicinu Splitsko-dalmatinske županije (u daljnjem tekstu ZHM SDŽ).
Rezultati: Rezultati provedenoga inicijalnog ispitivanja pokazali su da su se ispitanici u samoprocjeni sigurnosti u obavljanju većine temeljnih hitnih medicinskih postupaka (87,50 % postupaka) osjećali prilično sigurnima dok su se donekle sigurnima osjećali u izvođenju manjeg broja temeljnih hitnih postupaka (u 12,50 % postupaka). Rezultati provedenoga finalnog ispitivanja pokazali su da su se ispitanici u samoprocjeni sigurnosti u obavljanju temeljnih hitnih medicinskih postupaka osjećali gotovo potpuno sigurnima za razliku od inicijalnog ispitivanja gdje su se osjećali od donekle do prilično sigurnima.
Zaključci: Zaključeno je da je učenje kroz simulaciju bilo učinkovito i da su polaznici treninga zadovoljni i programom i sudionicima treninga.Objectives:The cognitive objective of the research is to determine the effectiveness of the training courses in essential emergency medicine procedures in outpatient emergency department as a part of continuous professional training of emergency medical technicians.The pragmatic goal of the research is to offer guidelines for improving the training process of outpatient emergency medicine nurses.
Methods: The research was conducted by means of surveying, self-assessment and evaluation before and after the training course in essential emergency medicine procedures in outpatient emergency department at the Institute of Emergency Medicine of the Split-Dalmatia County (hereinafter ZHM SDŽ).
Results: The results of the initial survey showed that the subjects in the self-assessment of confidence in performing the majority of essential emergency medicine procedures (87,50% of procedures) felt quite confident, while they felt somewhat confident in performing a smaller number of essential emergency procedures (12,50% of procedures). The results of the final survey showed that the subjects in the self-assessment of confidence in performing essential emergency medicine procedures felt almost completely confident, in contrast to the initial survey when they felt somewhat to quite confident.
Conclusions: It was concluded that learning through simulation was effective and that the trainees were satisfied with both the program and the trainees
COMPARISON 1.5T AND 3T MAGNETIC RESONANCE IN THE DIAGNOSIS OF KNEE
No full textZahvaljujući multiplanarnim mogućnostima i izvrsnim kontrastom mekih tkiva, magnetska rezonancija postala je vodeći modalitet za neinvazivnu procjenu muskuloskeletnog sustava. Većina pacijenata se snima uređajima za magnetsku rezonanciju jačine magnetskog polja 1.5T obzirom da su uređaji jakosti 3T manje dostupni u kliničkoj praksi.
Iako se isprva primarno koristio za neurološko snimanje, sve je veći broj studija koje pokazuju mogućnosti i prednosti 3T u muskuloskeletnom oslikavanju. Najistaknutija prednost uključuje povećani omjer signala i šuma (SNR) koji može dovesti do kraćeg vremena snimanja čime se smanjuje šansa za artefakte gibanja ili poboljšati kvalitetu slike povećanjem rezolucije.
Mnogo je istraživanja kako optimizirati protokol za 3T MR kako bi se postigla što bolja procjena muskuloskeletnog sustava. Kombinacijom brzih morfoloških metoda visoke rezolucije s novim tehnikama snimanja kao što su T2 mapiranje, T1rho oslikavanje i oslikavanje natrijem moguće je poboljšati detekciju ranih degenerativnih promjena hrskavice.
Ubrzani razvoj tehnologije omogućio je razvoj umjetne inteligencije u radiologiji. Zasad, softverski algoritmi za procjenu muskuloskeletnog sustava su rijetki te je dostupan mali broj provedenih studija, stoga su potrebna daljnja istraživanja.With its multiplanar capabilities and excellent soft-tissue contrast, magnetic resonance imaging has established itself as the leading modality for noninvasive evaluation of the musculoskeletal system. Most clinical evaluation are performed at the field strenght 1.5T due to a less availability of 3T MRI machines.
Although at first used primarily for neurological imaging, an increasing number of studies have demonstrated the abilities and advantages of 3T MR systems in musculoskeletal imaging. The most notable advantage includes an increased signal-to-noise ratio (SNR) which can lead to a shorter imaging time and reduces the chance of motion artifacts or improved image resolution.
Much promising research is being done in how to optimize the 3T MRI protocol to achieve the best possible evaluation of the musculoskeletal system. A combination of fast high-resolution morphologic imaging methods with new imaging techiques as T2 mapping, T1rho imaging and sodium imaging could improve the sensitivity of early cartilage degeneration changes.
Due to rapid techonological development, artificial intelligence has developed in radiology. So far, software algorithms for musculoskeletal system evaluation are rare and a small number of studies are available, therefore further research has to be done
CYTOLOGICAL DIAGNOSTICS OF LYMPH NODES
No full textCilj istraživanja: Utvrditi udio abnormalnih limfnih čvorova u odnosu na dob, spol i lokalizaciju promjene kao i utvrditi vrijednost punkcije tankom iglom i citološke analize u diferencijalnoj dijagnostici patološkog limfnog čvora.
Materijali i metode: Analizirano je 510 uzoraka punktata limfnih čvorova dobivenih punkcijom tankom iglom, analiziranih na Odjelu za kliničku citologiju KBC Split od 1. siječnja 2019. do 31. prosinca 2019. godine Klinički podatci kao i podacti o rezultatima citološke analize punktata limfnih čvorova dobiveni su uvidom u medicinsku dokumentaciju.
Rezultati: Od 510 punktata limfnih čvorova analiziranih u istraživanju, patološki limfni čvor dijagnosticiran je u 52% uzoraka i to u 51% muškaraca. Medijan životne dobi bio je 66,5 godina, a samo 3,4% ispitanika bilo je mlađe od 30 godina. Dijagnoza patološkog limfnog čvora je u 94,6% slučajeva postavljena iz punktata perifernog limfnog čvora. Najčešća lokalizacija patološkog limfnog čvora bili su vrat te aksilarna regija. Metastatski limfni čvor dijagnosticiran je u 64% ispitanika, s nepoznatim primarnim sijelom malignog tumora u 37,2% ispitanika. Metastatski karcinom dojke dijagnosticiran je u 12,2% žena. Među metastatskim karcinomima štitnjače papilarni karcinom dijagnosticiran je u 80% ispitanika. U 36% ispitanika nađena je primarna bolest limfnog čvora uz predominaciju non Hodgkin limfoma (90,7%).
Zaključak: Punkcija tankom iglom i citološka analiza limfnog čvora je jednostavna, ali korisna, a ponekad i jedina metoda u dijagnostici patoloških limfnih čvorova, a zlatni je standard u dijagnostici metastatske bolesti.Objectives: The aim of the study was to determine the proportion of abnormal lymph nodes in relation to age, gender and localization of the abnormal lymph nodes as well as to analyze the utility of FNAC in the diferential diagnosis of lymph nodes malignancy.
Patients and methods: The study included 510 samples of lymph node FNA analyzed at the Department of Clinical Cytology University Hospital Split, from January 1st 2019 till December 31st 2019. Clinical data and cytologic diagnosis were colected from the medical records of the Department.
Results: Of the 510 samples analyzed in this study, abnormal lymph nodes were diagnosed in 52% cases. Among these patients, 49% were men. The median age of the patient was 66,5 years and only 3,4% patients were younger then 30. Cytomorphologic diagnosis were made form peripheral lymph node FNA in 94,6% of patients. The most common localization of abnormal lymph nodes was the neck and axillary region. Metastatic lymph nodes were diagnosed in 64% of patients, with unknown primary site of malignancy in 37,2%. Metastatic breast carcinoma was diagnosed in 12,2 % women. Among the metastatic thyroid carcinomas, 80% were papilary carcinoma Primary lymph node disease was found in 36% of cases and non Hodgkin lymphoma was the most common type (90,7%).
Conclusion: Lymph node FNAC is a simple but very useful and somethimes the only tool in the diagnosis of lymph node abnormality and gold standard for metastatic disease