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REHABILITATION AFTER LUMBAR INTERVERTEBRAL DISC PROTRUSION SURGERY
No full textCilj: Cilj ovog rada je pretragom medicinskih baza podataka napraviti narativni pregled literature o
trenutno dostupnim rehabilitacijskim postupcima nakon operacije protruzije lumbalnog intervertebralnog
diska i na temelju dobivenih rezultata opisati najoptimalniji pristup u rehabilitaciji.
Metode: Za izradu ovog rada pregledana je literatura u bazama relevantnim za područje fizikalne i
rehabilitacijske medicine: PubMed i Cochrane Central. Ključne riječi koje su se koristile: intervertebral
disc displacement, lumbar vertebrae, surgery, discectomy, rehabilitation, exercise therapy. Za detaljnu
analizu pregledom dobivenih članaka izabrana su četiri istraživanja, od kojih su tri uspoređivala
učinkovitost vježbanja u odnosu na neprovođenje vježbi, a jedan je uspoređivao učinkovitost vježbi u vodi
i vježbi s progresivnim otporom na snagu lumbalne ekstenzije.
Rezultati: Kako bi objektivizirali rezultate, sva istraživanja su koristila određene testove i mjerne skale.
Njihova kontrolna mjerenja su pokazala bolji učinak u pokusnim skupinama koje su za intervenciju imale
dinamičke stabilizacijske vježbe jačeg intenziteta kao i vježbe s progresivnim otporom. Dobre rezultate je
postigla i skupina koja je radila vježbe u vodi. Zanimljiv je i rezultat kako nema razlike u učinku ako su
vježbe provođene pod nadzorom fizioterapeuta ili samostalno.
Zaključak: Jednoznačno je dokazano da terapijske vježbe uz edukaciju daju najučinkovitije poboljšanje
kliničkih i funkcionalnih parametara u pacijenata nakon operacije diska lumbalne kralježnice. Ostaje
nedefinirano kakav bi točno trebao biti program vježbi, koji oblik i vrste vježbi bi se trebale izvoditi,
intenzitet i učestalost i što donosi najveći i najdugotrajniji učinak.Objective: The aim of this thesis is to search medical databases to make a narrative review of the literature
on currently available rehabilitation procedures after lumbar intervertebral disc protrusion operations and,
based on the obtained results, describe the most optimal approach in rehabilitation.
Methods: To prepare this paper, the literature was reviewed in databases relevant to the field of physical
and rehabilitation medicine: PubMed and Cochrane Central. Key words used: intervertebral disc
displacement, lumbar vertebrae, surgery, discectomy, rehabilitation, exercise therapy. For the analysis of
this work, a review of the obtained articles selected four studies, three of which compared the effectiveness
of exercise in relation to the control group, and one compared the effectiveness of water exercises and
exercises with progressive resistance to lumbar extension.
Results: To objectify the results, all studies used certain tests and measurement scales. Their control
measurements showed a better effect in the experimental groups, which had dynamic stabilization exercises
of higher intensity as well as progressive resistance exercises for the intervention. Good results were also
achieved by the group that did the exercises in the water. Another interesting result is that there is no
difference in performance if the exercises are performed under the supervision of a physiotherapist or done
independently.
Conclusion: It has been unequivocally proven that therapeutic exercises with education provide the most
effective improvement of clinical and functional parameters in patients after lumbar spine disc surgery. It
remains undefined what exactly the exercise program should be, what form and types of exercises should
be performed, the intensity and frequency and what brings the greatest and longest lasting effect
The role of midwifes in patients with premature ovarian insufficiency
No full textPrijevremena insuficijencija jajnika (POI) klinički je sindrom definiran amenorejom zbog
gubitka funkcije jajnika prije 40. godine života koji pogađa 1% ženske populacije. Definicija prijevremene
insuficijencije jajnika važna je u kliničkoj praksi kako bi omogućila razlikovanje POI-a od fiziološke
menopauze. Žene oboljele od POI-a, osim što pate od nedostatka estrogena sklonije su i razvitku osteoporoze i
kardiovaskularnih bolesti. Zbog prestanka ovulacije i gubitka fertilnosti, žene se susreću i s psihosocijalnim
problemima koji znatno utječu na kvalitetu njihova života. Simptomi POI-a slični su onima koje žene pogađaju u
menopauzi. POI može biti uzrokovan kromosomskim i genetskim anomalijama, metaboličkim bolestima,
autoimunim poremećajima, infekcijama, jatrogenim uzrocima, ali u većini slučajeva uzrok je nepoznat. Kasno
otkrivanje ili ne liječenje POI-a usko je povezano sa sve većim brojem žena koje ne mogu ostvariti trudnoću.
Kriteriji za dijagnozu POI-a kod žena mlađih od 40 godina s 4 do 6 mjeseci amenoreje, oligomenoreje ili drugih
disfunkcijskih krvarenja, uključuje laboratorijske pretrage: humani karionski gonadotropin, folikul stimulirajući
hormon (FSH), TSH, estradiol i prolaktin. POI nosi povećan rizik za neplodnost, osteoporozu, bolesti
kardiovaskularnog sustava te prijevremenu smrt. Simptome kao i smanjenje rizika može poboljšati primjena
hormonskog nadomjesnog liječenja (HNL). HNL nadomješta nedostatak estrogena i progesterona te se danas
smatra zlatnim standardom u liječenju POI-a.Premature ovarian insufficiency (POI), is a clinical syndrome defined by amenorrhea due to
loss of ovarian functioning before the age of 40, that affects 1% of the female population. The definition of
premature ovarian insufficiency is important in clinical practice to enable distinguishing between POI and
physiological menopause. Females with POI, other than suffering from lack of oestrogen, are more likely to
develop osteoporosis and cardiovascular diseases. Due to cessation of ovulation and loss of fertility, women also
face psycho – social issues that considerably affect their quality of life. Symptoms of POI are similar to those
that affect women in menopause. POI can be caused by chromosomal and genetic anomalies, metabolic diseases,
autoimmune disorders, infections, iatrogenic causes, but in most cases the cause is unknow. Late diagnosis or
nontreatment of POI is closely related with the increasing number of females that cannot achieve pregnancy.
Criteria for diagnosing POI in females younger than 40 years old with 4 to 6 months of amenorrhea,
oligomenorrhea or other dysfunctional bleedings, involves laboratory tests: human karyonic gonadotropin, FSH,
TSH, oestradiol and prolactin. POI carries a high risk of infertility, osteoporosis, cardiovascular diseases and
premature death. Symptoms, as well as risk reduction, could be improved by applying hormonal replacement
therapy (HRT). HRT replaces the lack of estrogen and progesterone and is considered to be the golden standard
in the treatment of PO
RADIOLOGICAL APPROACH TO BONE TRAUMA IN CHILDREN
No full textKoštana trauma u djece karakterizira kompleksnost koju nemaju prijelomi u odrasloj dobi, jer je djetetov kostur fleksibilniji od odraslog i aktivno raste. Dječji prijelomi se mogu klasificirati u pet osnovnih vrsta: plastična deformacija, „torusna fraktura“, fraktura zelene grančice, cjeloviti prijelomi i prijelomi epifizne ploče rasta. Pedijatrijska radiologija se bavi dijagnosticiranjem koštane traume u dječjoj dobi. Međutim, dijagnoza traume u djece može biti teška jer se dječja kost strukturno i patološki razlikuje od kostiju odraslih. Radiološke metode izbora uključuju klasičnu radiografiju, kompjuteriziranu tomografiju (CT), magnetsku rezonanciju (MR) kao i ultrazvuk te nuklearnu medicinu.Paediatric skeletal trauma is characterized by a complexity that fractures do not have in adulthood because the child's skeleton is more flexible and actively growing. Paediatric fractures can be classified into five elementary types: plastic deformation, buckle fractures, greenstick fractures, complete fractures and physeal fractures. Paediatric radiology oversees the diagnosis of bone trauma in childhood. However, the diagnosis can be somewhat challenging because a child’s bone is structurally and pathologically different from an adult’s bone. Radiological methods of choice include classical radiography, computed tomography (CT), magnetic resonance imaging (MRI) as well as ultrasound (US) and nuclear medicin
Oncofertility and fertility preservation in patients with malignant diseases - midwifery care
No full textOnkofertilitet je posebna grana medicine koja omogućuje očuvanje fertiliteta pacijentima
oboljelim od neke maligne bolesti. S obzirom na to da liječenje malignih bolesti, odnosno kemoterapija i
radioterapija uvelike utječu na kvalitetu reproduktivnog sustava, razvoj metoda i postupaka onkofertiliteta
ključna je stavka u očuvanju plodnosti pacijenata oboljelih od zloćudnih bolesti. Metode očuvanja plodnosti
su krioprezervacija oocita, embrija, tkiva jajnika kod žena i krioprezervacija sjemena kod muškaraca.
Također se primjenjuje i upotreba gonadotropin – oslobađajućeg hormona, in vitro maturacija i
transpozicija jajnika. Prilikom odabira prikladne metode, veliku važnost treba predavati individualnom
pristupu svakoj pacijentici u cilju što uspješnijeg provođenja postupaka onkofertiliteta. Izbor metode
očuvanja fertiliteta ovisi o dobi pacijentice, tijeku liječenja, protokolu terapije i vremenu koje je preostalo
do početka terapije, te stavka postojanja partnera za vrijeme provođenja postupaka očuvanja plodnosti.
Tijekom cijelog procesa onkofertiliteta, osim liječnika, primalja ima jednu od najvećih uloga. Osim svoje
stručnosti i profesionalnosti, svakoj pacijentici treba pružiti najveću dozu empatije, razumijevanja i podrške.Oncofertility is a special branch of medicine that enables the preservation of fertility in
patients suffering from a malignant disease. Given that the treatment of malignant diseases, chemotherapy
and radiotherapy greatly affect the quality of the reproductive system, the development of methods and
procedures for oncofertility is a key item in preserving the fertility of patients with malignant diseases.
Methods of preserving fertility are cryopreservation of oocytes, embryos, tissues of ovaries in women and
cryopreservation of semen in men. The use of gonadotropin-releasing hormone, in vitro maturation and
ovarian transposition is also used. When choosing the appropriate method, great importance should be
given to the individual approach of each patient in order to more successfully conduct oncofertility
procedures. The choice of fertility preservation method depends on the patient's age, the course of treatment,
the treatment protocol and the time remaining until the start of therapy, and the item of existence of the
partner during the implementation of fertility preservation procedures. Throughout the oncofertility process,
apart from the doctor, the midwife has one of the biggest roles. In addition to their professionalism , each
patient should be given the highest dose of empathy, understanding and support
Ectopic pregnancy and the role of a midwife in diagnosis and treatment
No full textEktopična trudnoća je stanje u kojem se trudnoća implantira izvan šupljine maternice. Najčešća pojavnost je u jajovodu. Ostale lokacije na kojima se može pronaći su na jajniku, u rodnici, peritoneumu abdominalne šupljine ili rudimentarnom rogu maternice. Ektopična trudnoća ima specifične znakove i simptome ovisno pojavljuje li se u akutnom ili subakutnom obliku. U akutnom obliku dolazi do izrazite boli u napetom trbuhu, znakova hemoragičnog šoka i boli u ramenima radi nakupljanja krvi ispod ošita. Kod subakutnog oblika prisutno je točkasto krvarenje i amenoreja. Asimptomatski ili ‘’tihi’’ oblik ektopične trudnoće je specifičan jer se takva trudnoća vodi kao uredna, s jedinim simptomom amenoreje. Trijasom simptoma ektopične trudnoće se smatra amenoreja, bol i vaginalno krvarenje. Rana dijagnostika je važna za pravilno liječenje takvih trudnoća. Dijagnoza ektopične trudnoće postavlja se na temelju kliničkog, anamnestičkog, ultrazvučnog i biokemijskog nalaza. U nejasnim situacijama kiretaža i kuldocenteza dolaze u obzir. Punkcije Douglasovog prostora se danas u potpunosti zamijenila s laparoskopijom. Liječenje se provodi ekspektativnim, medikamentoznim i kirurškim putem. Ekspektativnim načinom liječenja nadzire se vitalno stanje pacijentice i uočavaju se promjene. U medikamentoznom načinu liječenja u najvećem broju slučajeva koristi se metotreksat. Najbolji izbor kod kirurškog liječenja ektopične trudnoće je laparoskopija. Izvantubarne ektopične trudnoće su iznimno rijetke i čine samo 5% svih ektopičnih trudnoća. I na samome kraju, da bi se dijagnoza ektopične trudnoće uspješno provela bitna je suradnja primalje i liječnika. Iako primalja samostalno ne može odlučivati o postupcima koji će se vršiti kod pacijentice ona upućuje liječnika na to. U daljnjem dogovoru s liječnikom zajednički dolaze do zaključka što bi bilo najbolje za pacijenticu da bi osigurali najbolji mogući ishod.Condition in which a pregnancy is implanted outside the uterine cavity is called ectopic pregnancy. The most common occurrence is in the Fallopian tube. Other locations where it can be found are on the ovary, in the vagina, the peritoneum of the abdominal cavity or the rudimentary horn of the uterus. Ectopic pregnancy has specific signs and symptoms depending on whether it occurs in acute or subacute form. In the acute form, there is marked pain in the tense abdomen, signs of hemorrhagic shock and pain in the shoulders due to the accumulation of blood under the shield. In the subacute form, spotting and amenorrhoea are present. The asymptomatic or \"silent\" type of ectopic pregnancy is explicit on the grounds that such a pregnancy is treated as should be expected, with the solitary side effect of amenorrhoea. The ternion of manifestations of ectopic pregnancy is viewed as amenorrhoea, torment and vaginal dying. Early conclusion is significant for the appropriate treatment of such pregnancies. The conclusion of ectopic pregnancy is made based on clinical, anamnestic, ultrasound and biochemical discoveries. In unclear situations, curettage and culdocentesis are considered. Douglas space punctures have today been completely replaced by laparoscopy. Treatment is carried out by expectoration, medication and surgery. The patient's vital condition is monitored by an exhaustive method of treatment and changes are noticed. In most cases, methotrexate is used in medical treatment. The best choice in the surgical treatment of an ectopic pregnancy is laparoscopy. Extrauterine ectopic pregnancies are very uncommon and record for just 5% of every ectopic pregnancy. And finally, in order to successfully diagnose an ectopic pregnancy, the cooperation of a midwife and a doctor is essential. Although the midwife cannot independently decide on the procedures to be performed on the patient, she refers the doctor to do so. In further agreement with the doctor, they come to a joint conclusion on what would be best for the patient to ensure the best possible outcome
Physiotherapeutic assessment of posture using functional- postural tests according to a dynamic neuromuscular stabilization approach
No full textPrimarni cilj ovog rada je prikaz procjene posture funkcionalno- posturalnim testovima prema pristupu dinamičke neuromuskularne stabilizacije. Prikaz provedbe fizioterapijske procjene posture kod ispitanika muškog spola, rekreativnog sportaša J.B. r. 1992. s kroničnim lumbalnim bolnim sindromom. U fizioterapijskoj procjeni korišten je standardni fizioterapijski upitnik i fotodokumentacija. U procjeni posture korištene su dvije metode opservacija: klasična fizioterapijska procjena posture u uspravnom stavu i procjena upotrebom funckionalno- posturalnih testova prema pristupu dinamičke neuromuskularne stabilizacije. Rezultati su potvrdili tezu istraživanja u kojoj se spominje važnost procjene prema statičkom i dinamičkom konceptu. Klasičnom procjenom dobivamo uvid iz statično zauzetih položaja dok dinamičkom neuromuskularnom stabilizacijom funkcionalnu procjenu upotrebom stabilizacijskih testova ispitujući stabilnost jezgre trupa i centralizaciju ključnih zglobova. Sjedinjenjem ove dvije metode procjene, usavršavanjem razlikovanja fiziološkom od patološkog te prepoznavanja ispravnih obrazaca kao i korekcije neispravnih, pojedincu omogućujemo kvalitetniju fizioterapijsku procjenu te brži oporavak prilikom rehabilitacije.The primary goal of this Bachelor’s thesis is to present an assessment of body position by functional-postural tests according to the approach to dynamic neuromuscular stabilizations. Review of the implementation of physiotherapeutic assessment of posture in male subjects, recreational athlete J.B. born 1992. with chronic lumbar pain syndrome. A standard physiotherapy questionnaire and photo documentation were used in the physiotherapy assessment. Two methods of observation were used in posture assessment: classical physiotherapeutic assessment of posture in an upright position and assessment using functional-postural tests according to the approach to dynamic neuromuscular stabilization. The results confirmed a research study mentioning the importance of estimates according to the static and dynamic concept. Classical assessment provides insight from statically occupied positions while dynamic neuromuscular stabilization provides functional assessment using stabilization tests examining the stability of the trunk nucleus and the centralization of key joints. By combining these two methods of assessment, perfecting the distinction between physiological and pathological and recognizing the correct patterns as well as correcting the incorrect ones, we enable the individual a better physiotherapeutic assessment faster recovery during rehabilitation
CAROL GILLIGAN AND ETHICS OF CARE
No full textEtika je filozofska disciplina koja proučava moral te istražuje ljudsko ponašanje kroz prizmu moralnog dobra i zla. Postoji više etičkih teorija, a najzastupljenije su deontološka i konzekvencijalistička. Teorija etike vrline je svojevrsni most između te dvije teorije, odnosno ona na drugačiji način određuje vrednovanje ljudskih postupaka. Kao poddisciplina primjenjene etike medicinska etika se suočava s moralnim dilemama u medicini uslijed znanstvenih dostignuća, a ona je nezamisliva bez skrbi. Mit o skrbi pokazuje da je skrb važna odrednica čovjeka kroz koju on postiže puninu svog djelovanja. Briga i skrb su predmeti i filozofskih promišljanja. U filozofiji M. Heidegera i S. Kierkegaarda briga je imala važno mjesto jer su čovjekov život smatrali bremenitim skrbi. Međutim, medicinska etika je uglavnom izgrađena na principima. Kako bi se na uspješan način riješili etički sukobi Thomas Beauchamp i James Childress dopunili su Hipokratova načela neškodljivosti i dobročinstva s načelima autonomnosti te pravednosti. Za ispravno moralno vrednovanje važne su i određene karakteristike čiji razvoj potpomažu teološke kreposti vjere, nade i ljubavi, te kardinalne kreposti mudrosti, hrabrosti, umjerenosti i pravednosti. Ideju skrbi u promišljanju morala zastupala je američka psihologinja Carol Gilligan. Za razliku od tradicionalnog pogleda na moralnost, gdje se autonomnost i pravednost shvaćaju kao najviši stupanj moralne vrijednosti (Kohlberg), C. Gilligan pruža drukčiji pogled na moralnost, gdje naglašava važnost pojmova kao što su briga i skrb za svakog čovjeka, neovisno o spolu, te nedjeljivost razuma i osjećaja pri donošenju moralnog suda.Ethics is a branch of philosophy that studies morals and explores human behaviour through the prism of moral good and evil. There are multiple ethical theories with the deontological ethics and consequentialism being the most represented. Virtue ethics bridges, in a way, the two aforementioned theories, i.e. it evaluates human actions using a different approach. As a branch of applied ethics, medical ethics faces moral dilemmas within the medicine and its scientific achievements while it is also inconceivable without care. The Myth of Cura (care) shows how care is an important human aspect through which a person achieves fulfilment. Care is also a subject of philosophical thought. Care had an important place in the philosophies of M. Heidegger and S. Kierkegaard because they considered human life to be full of care. However, medical ethics is mostly built on principles. In order to successfully resolve ethical conflicts, Thomas Beauchamp and James Childress complemented the Hippocratic principles of nonmaleficence and beneficence with the principles of autonomy and justice. Certain characteristics, whose development is aided by theological virtues of faith, hope and charity as well as cardinal virtues of prudence, fortitude, temperance and justice, are also important for accurate moral evaluation. American psychologist Carol Gilligan advocates the idea of care in moral deliberation. Unlike the traditional view on morality where autonomy and justice are seen as the highest level of moral value (Kohlberg), C. Gilligan provides a different viewpoint on morality where she emphasizes the importance of the notions such as care for every person, regardless of gender, as well as indivisibility of reason and emotion in making moral judgement
MAGNETIC RESONANCE IMAGING TECHNIQUES-SYSTEMATIC REVIEW OF THE LITERATURE
No full textMRI je jedno od glavnih postignuća moderne znanosti i tehnologije. Različite znanstvene discipline sudjelovale su u razvoju MR-a od kojeg se u daljnjoj budućnosti očekuje napredak koristeči matematička i informatička dostignuća. Od svog izuma prije tri desetljeća, MRI razvila se u način snimanja koji se rutinski koristi za dijagnostičko snimanje i postao je nezaobilazan alat za biomedicinska istraživanja in vivo. Napredak u MRI obećava proširenje korisnosti na mnoga ranije nezamisliva područja.
U ovom radu analizirani su neki od brojnih publikacija autora koji su iznijeli tehnike brzog oslikavanja, spiralne i paralelne tehnike snimanja i njihovu kliničku primjenu.MRI is one of the major achievements of modern science and technology. Various scientific disciplines have participated in the development of MR, which is expected to progress in the future with the help of mathematical and IT achievements. Since its invention three decades ago, MRI has evolved into an imaging modality hat is routinely used for diagnostic imaging and has become in vivo biomedical research. Advances in MRI promise to extend utility to many previously unimaginable areas.
This work analyzes some of the numerous publications of the authors who presented fast imaging techniques, spiral and parallel imaging techniques and their clinical application
CLINICAL NUTRITION OF PATIENTS IN THE INTENSIVE CARE UNIT
No full textJedinica intenzivnog liječenja posebna je radna jedinica unutar bolnice U kojoj se liječe, njeguju i nadziru životno ugroženi bolesnici. Jedan od važnih aspekata liječenja ovih bolesnika je primjena kliničke prehrane koja će osigurati opskrbu organizma svim potrebnim nutrientima važnim za osiguranje homeostaze energetskih i drugih metaboličkih procesa. U većini slučajeva kod bolesnika na odjelu intenzivne njege postoji potreba za djelomičnom ili potpunom parenteralnom i enteralnom prehranom. Prije primjene bilo kakvog načina hranjenja potrebna je procjena bolesnikovog nutritivnog statusa te njegovog stanja s posebnim naglaskom na stanje gastrointestinalnog trakta. Ovisno u kakvom je stanju probavni sustav bolesnika ćemo odrediti enteralni ili parenteralni način prehrane. Enteralna prehrana se primjenjuje kod bolesnika koji imaju očuvan probavni trakt, ali prirodnim putem ne mogu unijeti dovoljnu količinu hrane. Enteralni pripravci se unose putem sonde ili stome direktno u želudac ili u početne dijelove tankog crijeva (dvanaesnik ili jejunum). Različite vrste nazalnih sondi (nazogastrična, nazojejunalna, nazoduodenalna) koriste se kod bolesnika kojima je kraće vrijeme indicirana enteralna prehrana, kod bolesnika kod kojih je ona indicirana duže vrijem postavljaju se, kirurški ili endoskopski, stome (gastrostoma,jejunostoma). Parenteralna prehrana opskrbljuje tijelo vodom, energetskim nutrijentima, aminokiselinama i drugim hranjivim tvarima putem krvožilnog sustava. Ako bolesnikovo stanje zahtjeva potpunu parenteralnu prehranu, bolesniku je potrebno ugraditi centralni venski kateter u jednu od većih središnjih vena, a ako mu je potrebna samo djelomična parenteralne prehrana pojedinih tvari, bolesnik potrebne nutrijente može primati perifernim venskim putem. Infekcija je česta komplikacija intravenozne primjene putem katetera, koja može dovesti i do fatalnih rezultata, te je zbog toga važno poduzeti pravodobne mjere te spriječiti infekciju na vrijeme i ne ugroziti život bolesnika. Važan aspekt primjene enteralne prehrane je održavanje tzv. crijevne barijere. Naime, i najmanje količine hrane u lumenu crijeva mogu spriječiti stanjivanje crijevne stijenke i atrofiju crijevnih resica i tako utjecati na smanjenje prijelaza bakterija iz crijevnog lumena u sustavni krvotok. Na taj način sprječavamo nastanak infekcije, sepse i drugih težih stanja u organizmu.The intensive care unit is a special work unit within the hospital that includes supervision, care, treatment and maintenance of the lives of critically ill or severely injured patients. Intensive care units (ICUs) require proper and properly applied nutrition of patients because quality nutrition and absorption of nutrients from the intestinal cavity are a prerequisite for maintaining the integrity of the organism and keeping homeostasis of all energy and metabolic processes. In most cases, patients in the intensive care unit need partial or complete enteral and/or parenteral nutrition. Before using any method of feeding, it is necessary to assess the patient's nutritional status and condition, with special emphasis on the condition of the gastrointestinal tract. Depending on the condition of the patient's digestive system, we will determine the enteral or parenteral diet. Enteral nutrition is used in patients who have a preserved digestive tract, but cannot naturally ingest a sufficient amount of food. Enteral preparations are administered by feeding tube or stoma directly into the stomach or into the initial parts of the small intestine (duodenum or jejunum). Different types of nasal probes (nasogastric, nasojejunal, nasoduodenal) are used in patients for whom enteral nutrition is indicated for a short period of time. In patients for whom it is indicated for a longer period of time surgical or endoscopic stomas are placed. Parenteral nutrition supplies the body with water, energy nutrients, amino acids and other nutrients through the circulatory system. If the patient's condition requires complete parenteral nutrition, the patient needs to have a central venous catheter inserted into one of the larger central veins and if he needs only partial parenteral nutrition of certain substances, the patient can receive the necessary nutrients peripherally. Infection is a common complication of intravenous catheters, which can lead to fatal results, so it is important to take timely measures and prevent infections in order not to endanger the patient's life. Due to the growing problem of malnutrition of patients in hospitals, today's priority goal of clinical nutrition is to maintain the integrity of the mucosa of the small and large intestine, with emphasis on feeding patients normal food with modifications or enteral preparations, if there are no absolute contraindications. Even small amounts of food in the intestinal lumen can prevent thinning of the intestinal wall and atrophy of the intestinal villi, and thus affect the reduction of the transition of bacteria from the intestine into the systemic bloodstream. In this way, we prevent the occurrence of infection, sepsis and other serious conditions in the body
THE COMPARISON OF SEROLOGICAL TESTS AND PCR ANALYSIS IN THE ASSESSMENT OF CORONA VIRUS INFECTION
No full textCilj: Cilj ovog rada je prikazati serološke i molekularne testove za dijagnostiku SARS-CoV-2 infekcije te usporediti njihovu osnovnu zadaću, prednosti i nedostatke u procjeni zaraženosti korona virusom.
Materijal i metode: Identifikacija SARS-CoV-2 provodi se dvjema metodama: molekularnom - RT-qPCR koja otkriva prisutnost samog virusa i serološkim - testovima koji dokazuju kontakt s virusom otkrivanjem antitijela koja su nastala nakon preboljenja bolesti ili nakon cijepljenja.
Za RT-qPCR metodu materijal za analizu je bris uzet iz nosa ili grla , a za serološko testiranje uzima se uzorak krvi.
Rezultati: Pozitivan PCR test znači da osoba koja se testira ima virus koji uzrokuje COVID-19.
Pozitivan test na antitijela znači da je osoba koja se testirala u prošlosti vjerojatno zaražena COVID-19 i da su u njezinom imunološkom sustavu nastala antitijela.
Zaključak: PCR testovima se identificira prisustvo samog virusa organizmu kako bi se utvrdilo postoji li aktivna infekcija SARSCoV-2.Serološkim testiranjem se utvrđuje postojanje antitijela protiv SARS-CoV-2 u krvi kako bi utvrdila je li netko bio zaražen.
S obzirom da PCR i serološko testiranje imaju različite prednosti i ograničenja kada se međusobno uspoređuju , najbolje je korištenje obiju metoda u pružanju najboljih rezultata.Objectives: The aim of this paper is to present serological and molecular tests for the diagnosis of SARS-CoV-2 infection and to compare their basic task, advantages and disadvantages in the assessment of coronavirus infection.
Material and methods: Identification of SARS-CoV-2 is performed by two methods: molecular - RT-qPCR which detects the presence of the virus itself and serological - tests that prove contact with the virus by detecting antibodies formed after overcoming the disease or after vaccination.
For the RT-qPCR method, the material for analysis is a swab taken from the nose or throat, and for serological testing, a blood sample is taken.
Results: A positive PCR test means that the person being tested has the virus that causes COVID-19. A positive antibody test means that the person being tested was likely infected with COVID-19 in the past and that their immune system developed antibodies to try to fight it off
Conclusion: PCR tests identify the presence of the virus itself in the body to determine if there is an active SARSCoV-2 infection. Serological testing determines the presence of antibodies against SARS-CoV-2 in the blood to determine if someone is infected.
Since PCR and serological testing have different advantages and limitations when compared with each other, it is best to use both methods in providing the best results