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PREDICTIVE ROLE OF SOCIODEMOGRAPHIC CHARACTERISTICS AND MORNING-EVENING DEGREE OF INTERNET ADDICTION ON HEALTH STUDY STUDENTS
No full textCiljevi. U ovom istraživanju ispitane su razine ovisnosti o internetu, preferirane vrste internetskih aktivnosti i prevladavajući kronotip kod studenata zdravstvenih studija. Također su ispitane razlike u stupnjevima ovisnosti o internetu temeljem sociodemografskih obilježja (spol), karakteristika internetskih aktivnosti (vrijeme provedeno na internetu i vrsta internetskih aktivnosti) i kronotipa ispitanika.
Metode. U istraživanju je sudjelovalo 87 studenata druge godine preddiplomskih studija Sveučilišnog odjela zdravstvenih studija. Za odgovor na postavljene istraživačke ciljeve korištena je Kompozitna skala jutarnjosti, Test ovisnosti o internetu i Upitnik općih podataka.
Rezultati. Rezultati su pokazali da gotovo polovica studenata na internetu dnevno provodi 1-3 sata, dok više od trećine na internetu provodi 3-6 sati. Instant poruke (WhatsApp, Viber i sl.) i društvene mreže koristi najveći broj studenata. Vezano uz kronotip, najveći broj studenata, njih 38%, najradije bi ustalo između 7:45 i 9:45 sati ako bi potpuno slobodno mogli planirati svoj dnevni raspored. Oko 50% studenata bi najradije išlo spavati između 22:15 i 00:30 ako bi potpuno slobodno mogli planirati svoju večer i ako bi se mogli ravnati prema svom osobnom ritmu. Gotovo jednak broj studenata u normalnim uvjetima jutarnje ustajanje podnosi prilično teško (36,05%) , a 37,5% podnosi lako. Ukupno 47,67% studenata je više večernji tip, a 3,49% isključivo jutarnji tip, što je za 13,67 puta više studenata koji su više večernji tip u odnosu na studente koji su isključivo jutarnji tip. Nakon provedenog istraživanja dokazano je da više razine ovisnosti o internetu imaju ispitanici koji više vremena provode na internetu, dok nisu utvrđene razlike u stupnju ovisnosti o internetu s obzirom na vrste korištenih internetskih aktivnosti. Najveća ovisnost o internetu utvrđena je među ispitanicima koji su isključivo „večernji“ tipovi, te je vrijednost za 14,45 bodova veća u odnosu na ispitanike koji su više „jutarnji“ nego „večernji“ tip.
Zaključak: Ovisnost o internetu veliki je društveni problem, a posebno su ugrožene mlađe dobne skupine. Čimbenik rizika je trenutna pandemija koja povećava rizik povećanja incidencije internetske ovisnosti. Vrijeme provedeno na internetu i „večernji“ tip kronotipa utvrđeni su kao značajni prediktori internetske ovisnosti.AIM: This study examined levels of Internet addiction, preferred types of Internet activities, and the predominant chronotype in health studies students. Differences in the degrees of Internet dependence were also examined based on sociodemographic characteristics (gender), characteristics of Internet activities (time spent on the Internet and type of Internet activities) and chronotype of respondents.
Material and methods: The study involved 87 second-year undergraduate students of the University Department of Health Studies. The Composite Morning Scale, Internet Addiction Test and General Data Questionnaire were used to answer the set research goals.
Results: The results showed that almost half of students spend 1-3 hours a day online, while more than a third spend 3-6 hours online. Instant messaging (WhatsApp, Viber, etc.) and social networks are used by the largest number of students. Regarding the chronotype, the largest number of students, 38% of them, would prefer to get up between 7:45 and 9:45 if they could plan their daily schedule completely freely. About 50% of students would prefer to go to bed between 22:15 and 00:30 if they could plan their evenings completely freely and if they could follow their own personal rhythm. Almost the same number of students in normal conditions tolerate getting up in the morning quite difficult (36.05%), and 37.5% tolerate it easily. A total of 47.67% of students are more of the evening type, and 3.49% of the exclusively morning type, which is 13.67 times more students who are more of the evening type compared to students who are exclusively of the morning type. After the research, it was proven that respondents who spend more time on the Internet have higher levels of Internet addiction, while no differences were found in the degree of Internet addiction with regard to the types of Internet activities used. The highest dependence on the Internet was found among respondents who are exclusively "evening" types, and the value is 14.45 points higher than respondents who are more "morning" than "evening" type.
Conclusion: Internet addiction is a major social problem, and younger age groups are particularly at risk. A risk factor is the current pandemic that increases the risk of an increased incidence of Internet addiction. Time spent on the Internet and the "evening" type of chronotype have been identified as significant predictors of Internet addiction
THE INFLUENCE OF FAITH IN IMPROVING THE QUALITY OF LIFE OF THE DISEASED
No full textCILJ: Glavni cilj ovog istraživanja je utvrditi utjecaj vjere (i drugih dimenzija i elemenata religioznosti) na subjektivnu procjenu opće kvalitete života i generalnog zadovoljstva kvalitetom života kod neuroloških pacijenata, koji su po svojoj vjeroispovijesti kršćani.
METODE: Šezdeset neuroloških pacijenata tijekom rehabilitacije u specijalnoj bolnici za medicinsku rehabilitaciju sudjelovalo je u ovom istraživanju u vidu ankete. Korištena su 3 upitnika: upitnik religioznosti koji ima 3 dimenzije, upitnik zadovoljstva kvalitetom života na 7 domena za odrasle (PWI) te upitnik koji sadrži jedno pitanje o zadovoljstvu kvalitetom života u cjelini.
REZULTATI: Duhovna dimenzija religioznosti ispitana je upotrebom 8 čestica. Najveća razina utvrđena je kod čestice „Osjećam se vjernikom“ a najmanja kod „Zbog svoje vjere spreman sam na odricanja i žrtvu“. Najveća razina religioznosti utvrđena je kod obredne dimenzije, zatim kod duhovne i najmanja kod dimenzije utjecaja vjere na ponašanje. Na temelju 3 promatrane dimenzije religioznosti zaključak je da kod ispitanih neuroloških pacijenata prevladava vrlo visoka razina religioznosti. Što se tiče zadovoljstva kvalitetom života na 7 domena, najzadovoljniji su odnosima s bližnjima a najmanje zadovoljni sa zdravljem. Zadovoljstvo kvalitetom života pokazalo se vrlo visoko kod oba mjerena upitnika. Testiranjem povezanosti religioznosti I (duhovne dimenzije) i zadovoljstva kvalitetom života na 7 domena te testiranjem povezanosti religioznosti I sa zadovoljstvom kvalitete života u cjelini nije utvrđena povezanost. Testiranjem povezanosti između zadovoljstva životom na 7 domena i zadovoljstva kvalitetom života u cjelini utvrđena je pozitivna, umjerena i statistički značajna povezanost.
ZAKLJUČAK: Nakon provedenog istraživanja utvrđene su visoke vrijednosti kod sve 3 razine promatranja. Zbog nedostatka kontrolne skupine (manje religiozni) u postojećoj skupini hipoteza nije mogla biti utvrđena. Na osnovu svega navedenog zaključujemo da duhovnost može imati jedinstvenu ulogu u promicanju kvalitete života oboljelih te bi trebala postati standardni dio skrbi u liječenju pojedinca.OBJECTIVE: The aim of this research is to determine the impact of faith (and other dimensions and elements of religiosity) on a subjective assessment of overall quality of life and satisfaction with the quality of life in general with neurological patients, who are Christians by belief.
METHODS: Sixty neurological patients during their rehabilitation in a special medical rehabilitation hospital participated in this study in the form of survey. Three different questionnaires were used: a three-dimension questionnaire about religiosity, a questionnaire about satisfaction with the quality of life in 7 adult domains (PWI) and a questionnaire containing one question about satisfaction with the quality of life in general.
RESULTS: The spiritual dimension of religiosity was tested using 8 particles. The highest level was found in the particle "I feel like a believer" and the lowest in "For my faith I am ready for renunciation and sacrifice". The highest level of religiosity was found in the ritual dimension, followed by the spiritual dimension and the lowest is the influence of faith on believers' behavior. A very high level of religiosity prevails in neurological patients that were surveyed (based on the 3 observed dimensions of religiosity). In terms of satisfaction with the quality of life in 7 domains, the respondents are most satisfied with their relationships with their loved ones and least satisfied with their health. Satisfaction with the quality of life turned out to be very high in both questionnaires. By testing the connection between religiosity (and other spiritual dimension) and satisfaction with the quality of life in 7 domains, and by testing religiosity and satisfaction with the quality of life as a whole, no connection has been established. By testing the connection between the satisfaction with life in 7 domains and the satisfaction with the quality of life as a whole, a positive, moderate and statistically significant relationship was found.
CONCLUSION: After the research conducted, high values were determined at all three levels of observation. Due to the lack of a control group (less religious) in the existing group, the hypothesis could not be confirmed. Based on all the above, we conclude that spirituality can play a unique role in promoting the quality of life with the diseased and should become a standard part of care in the curing treatment of an individual
DIAGNOSTIC REFERENCE LEVELS IN PET/CT DIAGNOSTICS
No full textCILJ: Evaluirati utjecaj konstitucijskih faktora pacijenata na DRL uspoređujući dobivene rezultate sa preporučenim razinama međunarodnih i nacionalnih stručnih udruženja.
METODE: U uzorku od 34 pacijenta statistički smo obradili faktore dob, spol, visina, težina prema kojima se određuje vrijednost CTDI-a, injicirane aktivnosti u MBq i aktivnosti po kilogramu tjelesne mase. Također smo usporedili vrijednost CTDI-a i aktivnosti u ovisnosti o BMI faktoru.
REZULTATI: U pacijenata jače tjelesne konstitucije dobivene srednje vrijednosti i raspon koji se koriste u svrhu određivanja DRL-a bile su više. Za uspostavu dobre kvalitete slike kod težih pacijenata preporuča se regulacija ekstrinzičnih parametara kod CT protokola, povećanje doze injiciranog radiofarmaka ili produženje vremena skeniranja. Rezultati ovog istraživanja su vrlo slični rezultatima već objavljenih istraživanja.
ZAKLJUČAK: Konstitucijski parametri bolesnika utječu na evaluaciju doze, a samim time i na uspostavu DRL-a.OBJECTIVE: To evaluate an influence of constitution factors of patients on the DRL, comparing to final results with recommendes levels of international and national expert organizations.
METHODS: In the sample of 34 patients, we staticstically procceded factors: age, gender, height and weight according to which the value of CTDI is being determined, injected activity in Mbq and activities according to kilogram of body mass. We also compared values of CTDI and activities with dependance on BMI factor.
RESULTS: Patients with stronger body constitution had heigher obtained middle values and span wich are being used to determinate DRL. To achieve a nice quallity pictures from heavier patients, it is recommended to regulate extrinsic parameters of CT protocol, to increase a dose of injected radiopharmaceutical, or to extend aquisition time. Results of this research are very similar to those who have been published already.
CONCLUSION: The constitution parameters of a pacient are affecting on the evaluation dose, and along with that, on the DRL establishment itself
ADVANTAGES OF CT UROGRAPHY RELATING TO EXCRETION UROGRAPHY
No full textMokraćni sustav sastoji se od organa zaduženih za stvaranje i eliminaciju mokraće iz tijela; bubrega, mokraćovoda, mokraćnog mjehura i mokraćne cijevi. Za prikaz patologije i anomalija nužno je koristiti niz radioloških pretraga, počevši od konvencionalnih pa sve do najsuvremenijih metoda. Za najkvalitetniji prikaz aplicira se ionsko kontrastno sredstvo, osim kod nativne snimke, kojom započinje konvencionalna radiološka obrada. Nakon aplikacije kontrasta, za prikaz gornjeg mokraćnog sustava izvode se ekskrecijska ili intravenska urografija te antegradna i retrogradna urografija. Cistografije se koriste za prikaz donjeg dijela mokraćnog sustava, i to mikcijska cistouretrografija i uretrocistografija. Suvremene metode obuhvaćaju CT, MR i UZ, a za prikaz bubrežnih žila izvodi se DSA kao invazivna metoda, MRA i CTA kao neinvazivne metode. IVU je metoda visoke dijagnostičke točnosti za detekciju konkremenata, tumora i uzroka hematurije kao najčešćih indikacija za izvođenje urografije. To je 2D metoda kojom se utvrđuje izgled i djelomično funkcija mokraćnog sustava. Nakon aplikacije kontrasta, rade se snimke u vremenskim intervalima za što bolji prikaz djelova mokraćnog sustava. Pretraga nije skupa i što je najvažnije doza zračenja za pacijenta je niska. CTU je metoda suvremene tehnologije koja potiskuje klasičnu ekskrecijsku urografiju. CTU se temelji na kompjutorskim dostignućima, a omogućava 3D prikaz. Kao takva, preuzela je niz indikacija za IVU i time polako potiskuje IVU iz upotrebe. Za CTU značajno je da je pretraga izvediva u kratkom vremenu, rezultira boljom kvalitetom snimke i omogućena je naknadna obrada. Ipak, visoka doza zračenja i skupocjena izvedba ograničavaju bezbrižno izvođenje. Uvođenjem različitih algoritama i korištenjem „low dose“ protokola značajno je smanjena doza tako da se CTU sve više izvodi. Tehnike postprocessinga prikazuju organe u svim ravninama, uz ravninu snimanja, pa je time omogućena detekcija i najsitnijih tvorbi. Radiološke snimke moguće je digitalno pohraniti i dijeliti s drugim liječnicima za lakše i bolje postavljanje dijagnoze. U odnosu na IVU, CTU ima bolju dijagnostičku točnost u detekciji najčešćih patoloških stanja mokraćnog sustava i kongenitalnih anomalija kod djece, a u nekim ustanovama potpuno je zamijenila IVU. Financijske mogućnosti svake ustanove su različite i najčešće je to presudni faktor za izvedbu CTU, ali uspješnim rješavanjem svih ostalih nedostataka, IVU postaje prošlost.The urinary system consists of the organ responsible for making and removing urine from the body; kidney, ureter, bladder and urethra. To show pathology and anomalies, it is necessary to use a series of radiological examinations, starting from conventional to the most modern methods. For the highest quality display, an ionic contrast agent is applied, except for unenhanced image, which begins conventional radiological processing. After contrast application, excretory or intravenous urography and antegrade and retrograde urography are performed to show the upper urinary tract. Cystography are used to show the lower part of the urinary system and for urinary cystourethrography and urethrocystography. Modern methods include CT, MR and ultrasound, and DSA as an invasive method, MRA and CTA as noninvasive methods to show renal vessels. IVU is a method of high diagnostic points for the detection of kidney stones, tumors and cause of hematuria as the most common indications for performing urography. It is a 2D method that determines the appearance and partially function of the urinary system. After applying the contrast, the function is recorded at time intervals for a better display of parts of the urinary system. It’s not expensive and the highest radiation dose for the patient is low. CTU is a method of modern technology that suppresses classical excretory urography. CTU is based on computer achievements and allows 3D display. As such, it has taken over the indications for IVU and time is slowly pushing IVU out of use. CTU is required to report in a short time, result in better recording quality and it is very possible to reward processing. However, the high radiation dose and expensive performance limit worry-free performance. By introducing different algorithms and using a "low dose" protocol, the dose has been reduced so that CTU is increasingly performed. Post processing techniques show organs in all planes, along with the imaging plane, so it is possible to detect the tiniest creations. Radiological images can be digitally stored and shared with other physicians for easier and better diagnosis. Compared to IVU, CTU has better diagnostic accuracy in detecting the most common pathological conditions of the urinary system and congenital anomalies in children so some institution has completely replaced IVU. The financial capabilities of each institution are different and it is a crucial factor for the performance of CTU but, by successfully addressing all other shortcomings, IVU remains a thing of the past
ECTOPIC PREGNANCY AND MIDWIFE ACTIVITY IN DIAGNOSIS AND CURING OF ECTOPIC PREGNANCY
No full textEktopična trudnoća je trudnoća implantirana izvan šupljine maternice. Još se naziva i izvanmaternična, no s obzirom da abnormalno sijelo može biti i unutar maternice, precizniji i sveobuhvatniji naziv je ektopična. Potrebno ju je rano dijagnosticirati i adekvatno liječiti jer je rupturirana ektopična trudnoća po život opasno stanje, stoga je stopa mortaliteta visoka. Javlja se kod 1-2% svih trudnoća. Poseban oblik ektopične trudnoće je heterotopična trudnoća, prisutnost unutarmatarnične i izvanmaternične trudnoće javlja se u 1/ 30 000 poroda. Ektopična trudnoća se može podijeliti na tubarne i izvantubarne trudnoće. Tubarne trudnoće, odnosno trudnoće lokalizirane u jajovodu, najčešće u ampularnom dijelu čine oko 95% svih ektopičnih trudnoća. Većina podataka upućuje da ektopična trudnoća u jajovodu proizlazi iz abnormalnog transporta embrija i zbog patoloških promjena u jajovodu. Klasični trijas simptoma koji se javlja u 50% žena čine amenoreja, krvarenje i bol u trbuhu ili zdjelici, najčešće na strani ektopične trudnoće. U akutnom obliku tubarne ektopične trudnoće dolazi do prsnuća jajovoda i krvarenja u trbuh pa dolazi do akutnog abdomena i kardiovaskularnog kolapsa. U subakutnom obliku trudnoća i dalje raste, prisutna je bol u abdomenu i amenoreja te dolazi do krvarenja. U tihom, asimptomatskom obliku nema znakova krvarenja ni boli, već je samo prisutna amenoreja. Najčešće se dijagnosticira uzetom anamnezom, serijskim mjerenjem biokemijskih biljega i transvaginalnim ultrazvukom, a ponekad je potrebno kiretažom, kuldocentezom ili dijagnostičkom laparoskopijom. Humani korionski gonadotropin hCG nastaje iz sinciciotrofoblasta 7. dan nakon ovulacije Za ektopičnu trudnoću je karakterističan nepravilan rast zato je potrebno serijsko mjerenje razine hCG. Znak koji prilikom transvaginalnog ultrazvučnog pregleda ukazuju na veliku vjerojatnost tubarne trudnoće je adneksalna masa, krećući se odvojeno od jajnika, zvan ''blob'' znak, s praznom gestacijskom vrećicom koja se ponekad opisuje kao hiperehogeni prsten, nazvan ''bagel''. Kiretaža se koristi u slučajevima kada je dvojba između intrauterine i ektopične trudnoće i kada su niske vrijednosti hCG- a. Kuldocentezom se nekoć koristilo kao glavnom dijagnostičkom metodom, no danas je zamijenjena laparoskopijom, zlatnim standardom u dijagnosticiranju i liječenju ektopične trudnoće. Liječenje ovisi o obliku tubarne ektopične trudnoće, stanju pacijentice i njezinoj želji za budućom reprodukcijom. Može se liječiti ekspektativno, medikamentozno i operativno. Zaključno, potrebna je rana dijagnoza i adekvatno liječenje ovog opasnog patološkog stanja da bi žena preživjela i kako bi u budućnosti moglo doći do naknadne reprodukcije. Kako bi se to postiglo, ključan je timski rad između liječnika i primalje, njihovo znanje i vještine te potpora pacijentici.An ectopic pregnancy is a pregnancy implanted outside the uterine cavity. It is also called ectopic, but since the abnormal gland may also be inside the uterus, the more precise and comprehensive name is ectopic. It needs to be diagnosed early and adequately treated because a ruptured ectopic pregnancy is a life-threatening condition and therefore the mortality rate is high. Ectopic pregnancy occurs in 1-2% of all pregnancies. A particular form of ectopic pregnancy is heterotopic pregnancy, a condition when both intra-maternal and ectopic pregnancies are present and occurs in 1/30,000 births. An ectopic pregnancy can be divided into tubal and extracorporeal pregnancies. Although non-tubal pregnancies represent only 5% of all ectopic pregnancies, they have a higher mortality rate than tubal pregnancies. The classic triage of symptoms, which occurs in the half of women, is amenorrhea, bleeding, and abdominal or pelvic pain, most commonly on the side of ectopic pregnancy. Acute form of tubal ectopic pregnancy is specific by ruptured of the fallopian tube, abdominal bleeding into and cardiovascular collaps. In the subacute form, pregnancy continues to develop, abdominal pain and amenorrhea are present and bleeding is involved. In quiet asymptomatic amenorrhea is present, but there is no sign of bleeding or pain. It is most commonly diagnosed with a anamnesis, serial measurement of biochemical markers and transvaginal ultrasound, and sometimes requires curettage, culdocentesis, or diagnostic laparoscopy. Ectopic pregnancy is characterized by irregular growth, so serial measurement of hCG levels is needed. A sign suggesting a high probability of tubal pregnancy during transvaginal ultrasound examination is an adnexal mass, moving separately from the ovary, called a 'blob' sign, with an empty gestational sac sometimes described as a hyperchoic ring, called a 'bagel'. Curettage is used in cases where there is a doubt between intrauterine and ectopic pregnancy and when hCG values are low. Culdocentesis was once used as the main diagnostic method, but today it has been replaced by laparoscopy, the gold standard in the diagnosis and treatment of ectopic pregnancy. Treatment depends on the shape of the ectopic pregnancy, the patient's condition and her desire for future reproduction. It can be treated expectively, medicamentally and surgically. Early diagnosis and adequate treatment of this pathological condition is necessary for the woman to survive and in the future to be possible to reproduce later. Teamwork between doctors and midwives, their knowledge and skills, and patient support are crucial to achieve this
MOTOR ABILITY ASSESSMENT IN CHILDREN WITH DUCHENNE MUSCLE DYSTROPHY
No full textDuchenneova mišićna distrofija teška je i progresivna bolest koja uništava mišiće kod djece. Bolest zahvaća jednog od tri tisuće – pet tisuća dječaka. Smatra se jednom od najčešćih smrtonosnih genskih bolesti u djece. Nastaje zbog promjene gena za protein distrofin na X kromosomu. Takve mutacije za posljedicu imaju postupnu zamjenu mišića masnim i vlaknastim vezivnim tkivom. Približno u jednom od tri slučaja bolest nastane zbog spontane mutacije. Kod djece s dijagnosticiranom Duchenneovom mišićnom distrofijom obično se očekuje da trebaju invalidska kolica prije puberteta.
Cilj ovoga istraživanje bio je usporediti progresiju bolesti i promjene koje se događaju razvojem same bolesti kod djece. Najupečatljivija promjena koja je uočena je slabljenje motoričkih funkcija koje su posljedica propadanja mišića i zamjene mišićnog tkiva masnim i vlaknastim vezivnim tkivom. Osim promjena na mišićima uočene su i promjene na zglobovima i kralježnici. Također kao dodatne nuspojave progresije bolesti javljaju nam se i problemi s plućima i srcem kod kojih djeca često zahtijevaju i respiratornu potporu mehaničkom ventilacijom.
Najučinkovitijim tretmanom liječenje djece oboljele od Duchenneove mišićne distrofije uz liječenje lijekovima smatraju se tretmani fizikalne terapije. Djeca oboljela od ove bolesti koriste glukokortikoide u svojem liječenju te zbog njihove konzumacije često obolijevaju od osteoporoze. Zlatni standard u liječenju ove bolesti predstavlja pravovremena prevencija i liječenje ranih indikacija. Također i rana prevencija kontraktura i fraktura kod oboljele djece. Istraživanjem je uočena iznimna korist fizikalne terapije u liječenju i rehabilitaciji djece ali i poboljšanju njihove afirmacije u društvo.Duchenne muscle distrophy is a severe and progressive disease which destroys children muscles. Incidence of disease is one in three to five tousand children . It is considered as one of the most common deadly genetic diseases in children. The disease is caused by altering the dystrophin gene on the X chromosome. Such mutations result in the gradual replacement of muscle by adipose and fibrous connective tissue. Approximately one in three cases the disease is caused by a spontaneous mutation. Children diagnosed with Duchenne muscular dystrophy are usually expected to have a wheelchair before puberty.
The aim of this study was to compare disease progression and changes that occur with the development of the disease itself in children. The most striking change observed is the weakening of motor functions resulting from muscle deterioration and the replacement of muscle tissue by adipose and fibrous connective tissue. In addition to changes in the muscles, changes in the joints and spine were also observed. Also, as additional side effects of disease progression, we have lung and heart problems in which children often require respiratory support by mechanical ventilation.
The most effective treatment for curing children with Duchenne muscular dystrophy is considered to be physical therapy treatment. Children suffering from this disease use glucocorticoids in their treatment and because of their consumption they often suffer from osteoporosis. The gold standard in the treatment of this disease is the timely prevention and treatment of early indications. Also early prevention of contractures and fractures in sick children. The research revealed the exceptional benefit of physical therapy in the treatment and rehabilitation of children, but also in improving their affirmation in society
METHODS OF DETERMINING ANTIGENS AND ALLELES OF THE HLA SYSTEM LOCI
No full textHLA sustav je glavni sustav tkivne snošljivosti kod čovjeka, nalazi se na 6. kromosomu, na njegovom kraćem kraku, a čine ga antigeni I, II i III razreda. Njegova uloga je razlikovanje vlastitih stanica od tuđih te kada organizam dođe u kontakt sa stranim antigenima aktiviranje imunološkog odgovora. Neke od najvažnijih značajki ovoga sustava su izraziti polimorfizam te povezanost s bolestima. Značajan je kod transplantacije krvotvornih matičnih stanica i solidnih organa te kod dijagnostike i terapije autoimunih bolesti.
Cilj ovoga rada je bio ukazati na osobitosti sustava HLA vezane uz bolesti posebice uz psorijazu, dermatitis i psorijatični artritis te opisati prednosti i nedostatke serološke naspram molekularne metode tipizacije tkiva.
Kod određivanja antigena i gena sustava HLA u ovome radu koristile su se dvije metode serološka i molekularna PCR-SSO. Serološkom metodom sam odredila alele lokusa razreda I (HLA-A i HLA-B), a molekularnom metodom prisustvo HLA-Cw6 antigena kojeg nije moguće odrediti primjenom isključivo serološke metode.
Na primjeru 70 ispitanika s uputnim dijagnozama psorijaze, dermatitisa i psorijatičnog artritisa te drugih reumatskih bolesti iz Laboratorija za tipizaciju tkiva dokazana je važnost primjene dvije različite metode za određivanje antigena i alela lokusa sustava HLA.
Zaključno, bez tipizacije tkiva dijagnostika autoimunih bolesti i njihovo liječenje bilo bi znatno otežano. Njenim provođenjem kliničarima se olakšava rad kod odabira ispravne terapije.The HLA system is the major tissue tolerance system in humans, located on chromosome 6, on its shorter arm, and is made up of class I, II, and III antigens. Its role is to distinguish its own cells from other people's and when the organism comes into contact with foreign antigens to activate the immune response. Some of the most important features of this system are pronounced polymorphism and association with diseases. It is important in the transplantation of hematopoietic stem cells and solid organs, as well as in the diagnosis and treatment of autoimmune diseases.
The aim of this study was to point out the peculiarities of the HLA system related to diseases, especially psoriasis, dermatitis and psoriatic arthritis, and to describe the advantages and disadvantages of serological versus molecular method of tissue typing.
Two methods, serological and molecular PCR-SSO, were used in the determination of HLA antigens and genes in this study. I determined the alleles of class I loci (HLA-A and HLA-B) by the serological method, and the presence of HLA-Cw6 antigen by the molecular method, which cannot be determined using exclusively the serological method.
The importance of using two different methods for determining antigens and alleles of the HLA system loci was demonstrated on the example of 70 subjects with reference diagnoses of psoriasis, dermatitis, psoriatic arthritis and other rheumatic diseases from the Tissue Typing Laboratory.
In conclusion, without tissue typing, the process of diagnosing the autoimmune diseases and their treatment would be significantly more difficult. Its implementation makes it easier for clinicians to choose the right therapy
GESTATIONAL DIABETES: THE ROLE OF MIDWIFERY IN PUBLIC HEALTH
No full textTrudnički (gestacijski) dijabetes je oblik dijabetesa koji se prvi put dijagnosticira tijekom trudnoće. Dijagnoza se postavlja kod trudnica na temelju testa opterećenja glukozom. Primalje imaju aktivnu ulogu u liječenju i prevenciji gestacijskog dijabetesa. One imaju važnu savjetodavnu i edukacijsku podršku. Javnozdravstvena važnost primaljske skrbi za trudnice vrlo je značajna jer primalja provodi kliničke preglede, pruža zdravstvenu i roditeljsku edukaciju i predstavlja oslonac majci i njenoj obitelji u razdoblju iščekivanja i tijekom samog poroda, čime olakšava roditeljima da se što bolje snađu u novoj ulozi. Primalja je dužna surađivati i s ostalim zdravstvenim i socijalnim službama kako bi zadovoljila potrebe majke. Pruža informacije o trudničkom dijabetesu i informira trudnicu o testu opterećenja glukozom. Primalja je dužna educirati trudnicu i skrenuti joj pažnju na važnost pridržavanja savjeta i uputa o trudničkom dijabetesu kako liječničkih tako i primaljskih.Gestational diabetes is a form of diabetes that is first diagnosed during pregnancy. The diagnosis is made in pregnant women based on a glucose load test. Midwives play an active role in the treatment and prevention of gestational diabetes. They have important advisory and educational support. The public health importance of midwifery care for pregnant women is very important as the midwife conducts clinical examinations, provides parental and health education, and is a support for the mother and her family in the period of expectation and birth of the child in order for parents to get better at their parental role. The nurse also works with other health and social services to meet the needs of the mother. Provides information on pregnant diabetes and informs the pregnant woman about the glucose load test. The nurse practitioner should educate the pregnant woman and point out to her the importance of adhering to the advice and guidance on pregnant diabetes not only of medical doctors but also of midwives
HEALTH CARE OF PATIENTS WITH INFLAMMATORY BOWEL DISEASE
No full textCilj: Cilj ovog rada je definirati i objasniti upalne bolesti crijeva te njihovu epidemiološku pojavnost u svijetu, prikazati najčešće simptome te načela dijagnostike i terapije, osnovna načela prehrane te proces zdravstvene njege bolesnika s upalnim bolestima crijeva.
Rasprava: Upalne bolesti crijeva zajednički je naziv za Crohnovu bolest i ulcerozni kolitis. Ulcerozni kolitis je bolest čiji je upalni proces ograničen na debelo crijevo, a Crohnova bolest može zahvatiti bilo koji dio probavne cijevi, od usta do anusa. Smatra se da nastaju kao posljedica djelovanja više različitih čimbenika na pojedinca s genetskom predispozicijom. Incidencija i prevalencija povezane su s globalnim promjenama u načinu življenja te su u porastu zadnjih desetljeća. Pojava simptoma ima bimodalni raspon. U mlađoj životnoj dobi javljaju se prije 30 godine, a u starijoj između 50-70. Specifična je i različita zahvaćenost stijenke probavne cijevi: kod Crohnove bolesti karakteristična je transmuralnost (zahvaćenost pune debljine stijenke) dok je kod ulceroznog kolitisa upala ograničena na sluznicu. Osnovu dijagnostike čine anamnestički podatci kojima bolesnik ukazuje na najčešće tegobe, endoskopske i radiološke metode laboratorijske pretrage te patohistološka analiza bioptičkog materijala. Liječenje obuhvaća kombinaciju farmakoterapije i promjene stila života odnosno pridržavanja adekvatne prehrane. Važanu ulogu u skrbi bolesnika ima i medicinska sestra koja svojim znanjima i vještinama doprinosi postizanju najbolje moguće skrbi za bolesnika.
Zaključak: Na globalnoj razini upalne bolesti crijeva su u kontinuiranom porastu. S obzirom na kompleksnost problematike ovih dvaju bolesti suvremena medicina još uvijek istražuje potencijalne uzroke i nove terapijske opcije. Pristup riješavanju problema oboljelih zahtjeva multidisciplinarnost. Suvremeno sestrinstvo temelji se na individualizaciji pristupa bolesnicima i pružanju najbolje moguće skrbi.Aim: The aim of this bachelor thesis is to define and explain inflammatory bowel diseases and their epidemiological occurrence in the world, to present the most common symptoms and principles of diagnosis and therapy, basic principles of nutrition and the process of health care of patients with inflammatory bowel diseases.
Discussion: Inflammatory bowel disease is the common name for Crohn's disease and ulcerative colitis. Ulcerative colitis is a disease whose inflammatory process is limited to the colon, and Crohn’s disease can affect any part of the digestive tract, from the mouth to the anus. They are thought to arise as a result of the action of several different factors on an individual with a genetic predisposition. Incidence and prevalence are associated with global lifestyle changes and have been on the rise in recent decades. The onset of symptoms has a bimodal range. They appear in younger age 30 years ago, and in older between 50-70. Different involvement of the gastrointestinal wall is also specific: in Crohn's disease, transmurality (full wall thickness involvement) is characteristic, while in ulcerative colitis the inflammation is limited to the mucosa. The basis of diagnosis is anamnestic data by which the patient indicates the most common problems, endoscopic and radiological methods of laboratory examination and pathohistological analysis of biopsy material. Treatment includes a combination of pharmacotherapy and lifestyle changes or adherence to an adequate diet. An important role in patient care is also played by the nurse, who with her knowledge and skills contributes to achieving the best possible care for the patient.
Conclusion: On a global scale, inflammatory bowel diseases are on the rise. Given the complexity of the problems of these two diseases, modern medicine is still exploring potential causes and new therapeutic options. Approach to solving the problem of patients requires multidisciplinarity. Modern nursing is based on individualizing the approach to patients and providing the best possible care
COMPARISON OF MOTIVATION TO MASTER OF NURSING STUDY AND EMPLOYMENT STATUS SATISFACTIONS AFTER MASTER OF NURSING STUDY GRADUATION
No full textCilj istraživanja: Utvrditi strukturu ispitanika prema sociodemografskim obilježjima i motivacijske čimbenike za upis na diplomski studij sestrinstva; ispitati stupnjeve zadovoljstva radnim statusom nakon završenog diplomskog studija sestrinstva; usporediti motivaciju za upis na diplomski studij sestrinstva sa zadovoljstvom radnim statusom nakon završetka studija; ispitati povezanost općih obilježja ispitanika sa zadovoljstvom radnim statusom nakon završetka diplomskog studija sestrinstva.
Metode: Istraživanje je ustrojeno kao presječna studija. Anketni upitnik je primijenjen na 74 medicinske sestre/tehničara koji su u stalnom radnom odnosu s važećom licencom Hrvatske komore medicinskih sestara za samostalan rad kao magistre/-i sestrinstva. Sudjelovali su ispitanici oba spola koji su zaposlenici različitih Klinika/Zavoda/Odjela i Služba sa završenim diplomskim studijem sestrinstva iz KBC-a Split, OB Dubrovnik i OB Šibenik, Zavoda za hitnu medicinsku Splitsko-dalmatinske županije, Doma zdravlja Splitsko-dalmatinske županije i Šibensko-kninske županije s patronažnom službom, Zdravstvene škole Split, a istraživanje je provedeno u lipnju i srpnju 2019. godine.
Rezultati istraživanja: Osobni rast i razvoj su za 0,65 bodova veći nakon završetka diplomskog studija sestrinstva (Z=4,89; p<0,001). Percepcija Zadovoljstva je bilježila porast nakon završetka studija za 0,60 bodova (Z=3,16; p=0,002). Zaposlenici s većim brojem djece imaju veću razinu zadovoljstva Odnosima na radnom mjestu (rho=0,24; p=0,040).
Zaključci: Potvrdili smo da diplomski studij sestrinstva upisuju većinom žene iz bolničkog segmenta djelatnosti, uglavnom na pozicijama glavnih sestara koje ne prakticiraju rad u dežurstvima, prosječne starosne dobi 42,69 godina i 22,28 godina radnog staža, u bračnoj zajednici s prosjekom od 2 djeteta i prosječnom plaćom od 7000-9000 kn. Motivacijski čimbenici koji su na visokoj razini za upisom na diplomski studij sestrinstva su: Status i napredovanje, Osobni rast i razvoj, Stručnost, Odnosi i Zadovoljstvo, dok je motivacijski čimbenik Uvjeta rada na niskoj razini za upisom na sestrinstvo. Potvrdili smo negativnu povezanost između Statusa i napredovanja i Uvjeta rada sa zadovoljstvom radnim statusom, dok Osobni rast i razvoj, Stručnost i Odnosi dokazano daju pozitivne rezultate u zadovoljstvu ispitanika; nakon završenog diplomskog studija sestrinstva. Dokazali smo umjereni stupanj povezanosti motivacije za diplomski studij sa zadovoljstvom radnim statusom nakon završetka studiranja kod magistrica/-ara sestrinstva. Kod ispitanika prakticiranje smjenskog rada nema ulogu u zadovoljstvu radnim statusom nakon završetka diplomskog studija sestrinstva. Zaposlenici s većim brojem djece imaju veću razinu zadovoljstva, u kategoriji Odnosi na radnom mjestu nakon završetka diplomskog studija sestrinstva. Dokazali smo da u segmentu Statusa i napredovanja nakon završetka diplomskog studija sestrinstva sestre iz bolničke djelatnosti su na niskoj razini motiviranosti dok su iz ostalog segmenta visoko motivirane.Aim: The aim of the current study was to determine the structure of respondents according to socio-demographic characteristics and motivational factors for admission to graduate Study of Nursing. Additional aims were to examine the levels of job satisfaction after graduating master program from Nursing, to compare the motivation for enrollment in graduate nursing with job satisfaction after graduating master program from Nursing, and to examine the relationship between general characteristics of respondents with job satisfaction after graduating from master program of Nursing.
Methods: The research is organized as a cross-sectional study. The questionnaire was applied on 74 nurses/technicians who were in permanent employment with a valid license of the Croatian Chamber of Nurses for independent work as masters of nurses. Participants of both sexes who were employees of different Clinics/ Departments and Services with completed graduate master program from Nursing from Clinical Hospital Center Split, Dubrovnik General Hospital and Šibenik General Hospital, the Institute of Emergency Medicine of Split-Dalmatia County, Health Center of Split-Dalmatia County and Šibenik -Knin County with the patronage service, Health School Split, and the research was conducted in June and July 2019.
Research results: Personal growth and development are 0.65 points higher after completing the graduate study of Nursing (Z = 4.89; p <0.001). The perception of Satisfaction increased after the completion of the study by 0.60 points (Z = 3.16; p = 0.002). Employees with more children have a higher level of satisfaction with Workplace Relationships (rho = 0.24; p = 0.040).
Conclusions: We confirmed that the Graduate Study of Nursing is enrolled mostly by women from the hospital segment, mainly in the positions of head nurses who do not practice shift work, average age 42.69 years and 22.28 years of service, in a marital community with an average of 2 child and an average salary of 7000-9000 kn. The motivating factors that are at a high level for enrollment in the Graduate Study of Nursing are: Status and Advancement, Personal Growth and Development, Expertise, Relationships and Satisfaction, while the motivating factor of the Working Conditions at a low level for admission to the Study of Nursing. We confirmed the negative correlation between Status and Promotion and Working Conditions with job status satisfaction, while Personal Growth and Development, Expertise and Relationships have been proven to give positive results in respondent satisfaction; after completing the graduate Study of Nursing. We have demonstrated a moderate degree of correlation between motivation for graduate study and job status satisfaction after graduation from the Master of Nursing. In the case of respondents, the practice of shift work has no role in job satisfaction after the completion of the graduate Study of Nursing. Employees with a larger number of children have a higher level of satisfaction, in the Workplace Relations category after completing the graduate Nursing Study. We proved that in the segment of Status and promotion after the completion of the Graduate Study of Nursing, nurses from the hospital activities are at a low level of motivation, while from the rest of the segment they are highly motivated