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RESULTS OF SEROLOGICAL TESTING OF BLOOD-TRANSMITTED DISEASES IN THE FIVE-YEAR PERIOD FROM 2015 UNTIL 2019 IN VOLUNTARY BLOOD DONORS AT THE INSTITUTE FOR TRANSFUSION MEDICINE KBC SPLIT
No full textCiljevi rada:
Osnovni cilj rada je utvrditi prevalenciju krvlju prenosivih bolesti u dobrovoljnih davatelja koji su testirani u razdoblju od 2015. do 2019. godine u Zavodu za transfuzijsku medicinu KBC Split kao i podudarnost serološkog i molekularnog testiranja.
Ispitanici:
Dobrovoljni davatelji krvi s područja Splitsko-dalmatinske te Šibensko-kninske županije koji su u razdoblju od 01. 01. 2015. do 31. 12. 2019. godine zadovoljili kriterije za darivanje krvi u Zavodu za transfuzijsku medicinu KBC Split.
Metode:
Serološko testiranje u Zavodu za transfuzijsku medicinu KBC Split na serumske biljege uzročnika krvlju prenosivih bolesti- HBsAg, anti-HCV, HIV Ag/At i anti-Tp.
Molekularno NAT testiranje u HZTM na virusne RNA: HBV-RNA, HCV-RNA i HIV1-RNA.
Potvrdno NAT testiranje u HZTM-u.
Rezultati:
Od ukupno 97151 testiranih donacija 273 su bile pozitivne- 259 serološki, 1 NAT inicijalno te potvrdno, 2 serološki te NAT inicijalno, 11 serološki i NAT potvrdno. Ukupno je u promatranom petogodišnjem razdoblju potvrđeno 12 donacija zaraženih uzročnicima krvlju prenosivih bolesti- 7 zaraza HBV-om, 4 zaraze HIV-om i 1 zaraza HCV-om.
Zaključak:
Prevalencija krvlju prenosivih bolesti je u dobrovoljnih davatelja krvi u Zavodu za transfuzijsku medicinu KBC Split u promatranom petogodišnjem razdoblju niska.Objectives:
The main goal of this study is to determine the prevalence of blood-transmitted diseases in voluntary donors who were tested in the period from 2015. to 2019. at the Department of Transfusion Medicine KBC Split as well as the concordance of serological and molecular testing.
Respondents:
Voluntary blood donors from the Splitsko-dalmatinska and Šibensko-kninska counties who in the period from 01. 01 .2015. to 31. 12. 2019. satisfied the criteria for blood donation in the Department of Transfusion Medicine KBC Split.
Methods:
Serological testing at the Department of Transfusion Medicine KBC Split for serum markers of blood-transmitted pathogens- HBsAg, anti- HCV, HIV Ag/At and anti-Tp.
Molecular NAT testing in HZTM for viral RNA: HBV-RNA, HCV-RNA and HIV1- RNA.
Confirmatory NAT testing in HZTM.
Results:
Out of a total of 97151 tested donations, 273 were positive - 259 serologically, 1 NAT initially and affirmatively, 2 serologically and NAT initially, 11 serologically and NAT affirmatively. In the observed five-year period, a total of 12 donations were confirmed to the causers of blood-transmitted diseases- 7 HBV infections, 4 HIV infections and 1 HCV infection.
Conclusion:
The prevalence of blood-transmitted diseases in voluntary blood donors in the Department of Transfusion Medicine KBC Split in the observed five-year period is low
SCHROTH THERAPY AS A TREATMENT FOR SCOLIOSIS IN THE ADOLESCENT AGE
No full textSkolioza predstavlja deformaciju kralježnice koju dijelimo na funkcionalnu (nestrukturalnu) i strukturalnu. Kod funkcionalne skolioze primijetit ćemo promjene u frontalnoj ravnini odnosno postranični zavoj kralježnice dok strukturalna skolioza obuhvaća promjene kralježnice u sve tri ravnine sa rotacijskom komponentom uz anatomske promjene. Ova vrsta skolioze se ne može voljno ispraviti te je primjetna bez obzira u kojem se položaju dijete nalazi. Prema etiologiji skoliozu dijelimo na primarnu (idiopatsku) i sekundarnu. Dijagnosticiranje skolioze podrazumijeva klinički pregled te radiološku obradu uz određivanje Cobbovog kuta koji se smatra zlatnim standardom u dijagnostici.
Nakon dijagnosticiranja skolioze potrebno je ustanoviti način liječenja skolioze. Operacijsko liječenje se preporuča tek kad Cobbov kut pređe 50°, dok je kod manjih razmjera krivina potrebno provesti neoperacijsko liječenje. Ono podrazumijeva nošenje ortoza, praćenje krivine ali i provođenje specifičnih vježbi za skoliozu (PSSE). Specifične vježbe za skoliozu osmišljene su upravo da bi smanjile progresiju skolioze te poboljšale sliku cijelog tijela. Znanstveno je dokazano da primjenjivanjem ovih vježbi samostalno ili u kombinaciji sa ortozom kod većine oboljelih dolazi do zaustavljanja progresije skolioze ili čak do smanjenja Cobbovog kuta. One omogućuju autokorekciju stava u sve 3 ravnine, uvježbavanje u svakodnevnim aktivnostima, stabilizaciju tog ispravljenog stava te edukaciju pacijenta i obitelji. Veliku ulogu u provođenju ovakvog tretmana ima fizioterapeut koji je licenciran za obavljanje ovakve vrste terapije. Njegov cilj je postići što bolju suradnju sa pacijentom kako bi dobili što bolje rezultate liječenja.
Školama specifičnih vježbi za skoliozu pripada i Schroth terapija koju je razvila Katarina Schroth koja je i sama patila od umjerene skolioze. Njezina metoda se temelji na principima aksijalne elongacije, defleksije, derotacije, facilitacije i stabilizacije. Nadogradnju ove terapije proveo je dr. Manuel Rigo svojom klasifikacijom skolioze koja se sastoji od 3C ili A-skolioze sa tri krivine, 4C ili B-skolioze s četiri krivine, C-skolioze sa uravnoteženom zdjelicom te E-skolioze čiji deformitet predstavlja jedna lumbalna ili torakolumbalna krivina. Cilj Schroth terapije je ostvarivanje trodimenzionalne korekcije kralježnice pomoću navedenih principa uključivanjem rotacijskog disanja uz pomoć fizioterapeuta. Konačno, bitno je zaustaviti progresiju krivine te postići održavanje korektivnog stava u svakodnevnim aktivnostima.Scoliosis is a deformity of the spine which can be functional (nonstructural) and structural. In functional scoliosis the changes in the frontal plane /lateral curvature of the spine are noticeable, whereas structural scoliosis involves changes of the spine in all three planes with a rotational component along with anatomical changes. This type of scoliosis can not be voluntarily corrected and is noticeable regardless of the position the child is in. Based on the etiology, scoliosis is divided into primary (idiopathic) and secondary. Diagnosing scoliosis involves clinical examination and radiological processing alongside the determination of the Cobb angle, which is considered to be the 'Gold Standard' in diagnostics.
After diagnosing scoliosis, it is necessary to establish a way to treat it. Surgical treatment is recommended only when Cobb angle exceeds 50°, while non-surgical treatment is required for smaller curves. It implies wearing orthoses and observation but also conducting Physiotherapy Scoliosis Specific Exercises (PSSE). Specific scoliosis exercises are designed precisely to reduce the progression of scoliosis and improve the image of the entire body. Exercises enable autocorrection of the posture in all three planes, training in daily activities, stabilization of that corrected posture and education of the patient and their family. A great role in the implementation of this treatment is played by a physiotherapist licensed to perform this type of therapy. The physiotherapist's goal is to accomplish the best possible cooperation with the patient in order to achieve the best possible treatment results.
One of the specific scoliosis exercises programs is the Schroth Method developed by Katarina Schroth who suffered from a moderate scoliosis herself. Her method is based on the principles of axial elongation, deflexion, derotation, facilitation and stabilization. Dr Manuel Rigo upgraded this therapy by his classification of scoliosis which consists of 3C or A-scoliosis with three curves, 4C or B-scoliosis with four curves, C-scoliosis with a ballanced pelvis and E-scoliosis in which deformity is presented by one lumbar or thoracolumbar curvature. The goal of the Schroth Method is to achieve a three dimensional correction of the spine with the help of stated principles by including the rotational breathing with the help of physiotherapist. Ultimately, what is important is to stop the progression of the curve and to accomplish maintaining a corrective posture in everyday activities
IMBALANCE OF SHOULDER STRENGTH AS A FACTOR OF INJURY IN THE SHOULDER JOINT
No full textRad se temelji na pregledu literature na temu disbalansa snage ramena kao faktora ozljeđivanja u ramenom zglobu.
Cilj rada je bio ukratko, ali što sveuobuhvatnije prikazati pojam ramenog zgloba, a potom detaljnije razraditi tematiku disbalansa snage ramena. Opisana su neka od provedenih istraživanja vezanih uz ovu temu.
Uslijed velikih opterećenja ramenog zgloba, dolazi i do pojave bolnog osjeta. Realizacija različitih vježbi za prevenciju ima iznimno povoljan utjecaj na snaženje mišića zgloba ramena. Iscrpnim liječničkim pregledom i učestalim realizacijama preventivnih mjera moguće je uvidjeti i odstraniti sve faktore rizika za pojavu ozljede ramenog zgloba.
Pokušavaju se utvrditi određene preventivne mjere s ciljem produženja sportske karijere te reducirali novčani troškovi procesa rehabilitacije.The paper is based on a review of the literature on shoulder power imbalance as a factor of injury in the shoulder joint.
The aim of the paper was to briefly but comprehensively present the concept of the wrist and then elaborate on the subject of shoulder imbalance. Some of the research conducted on this topic is described.
Due to heavy loads on the wrist, painful sensation may occur. Performing various preventative exercises has a positive effect on strengthening the muscles of the shoulder joint. Through a thorough medical examination and regular implementation of preventive measures, it is possible to identify and eliminate all risk factors for the occurrence of a shoulder injury.
Efforts are being made to identify specific preventative measures to extend a long-term sports career and reduce the financial cost of rehabilitation
APPLICATION OF TOMOSYNTHESIS IN MAMMOGRAPHY
No full textMamografija je dugo vremena koristila sustav filma i folije za dobivanje mamografskih slika, a prijelazom na FPD doživila je brojne prednosti. Iako je FFDM trenutno zlatni standard u dijagnostici bolesti dojke, brojna istraživanja naglašavaju prednosti DBT-a te se on uzima u obzir kao metoda koja bi mogla postati novi zlatni standard. Kod tomosinteze postoje tri vrste gibanja detektora i cijevi, a tomosinteza dojke koristi djelomično izocentrično gibanje. Ono podrazumijeva lučno gibanje rendgenske cijevi iznad nepomičnog detektora, odnosno rendgenska cijev se giba iznad detektora koji je komprimiran ispod dojke te tako stvara 3D prikaz dojke DBT pomicanjem rendgenske cijevi u luku iznad dojki slika niz projekcijskih slika pod različitim kutovima, a zatim rekonstruira puno tankih slojeva slike objekta. Zahvaljujući digitalnoj obrada slike moguće je rekonstruirati serije slojeva različitih debljina i na različitim dubinama te prikazati ono što je nevidljivo na konvencionalnoj radiografskoj snimci, brisanjem struktura koje se nalaze izvan sloja koji se prikazuje, odnosno dobiveni presjeci se mogu kombinirati za 3D (trodimenzionalnu) rekonstrukciju. Navedenim načinom tomosinteza uklanja problem 2D mamografije, odnosno uklanja preklapanje tkiva anatomskih struktura i pojačava vidljivost patoloških struktura na mamogramu. Pozicioniranje dojke provodi se kao kod konvencionalne mamografije, ali sa znatno slabijom kompresijom. Slabiji pritisak dojke tokom snimanja pacijenticama pruža veću ugodnost pretrage. Najčešće se dojka postavlja u uobičajene mamografske projekcije, odnosno MLO i CC, ali po potrebi se dojka može postavljati i u druge položaje. Kada je u pitanju rekonstrukcija, kakvoća slike i vrijeme trajanja rekonstrukcije su najvažniji kriteriji koji trebaju biti ispunjeni. Vrijeme rekonstrukcije mora biti što kraće za kliničku primjenu tomosinteze. Zbog brze rekonstrukcije slike uz očuvanje kvalitete slike dostojne sporijim metodama, Filtered Back Projection je najčešće korištena metoda rekonstrukcije u praksi. Tomosinteza povećava otkrivanje raka i korisna je za sve žene bez obzira na gustoću dojke, a posebice za žene s velikom gustoćom dojki za koje FFDM nije idealna metoda pregleda. Jedno istraživanje je pokazalo kako je dijagnostička točnost DBT-a u usporedbi s FFDM kod „ne-gustih“ dojki bila neznatno veća od DBT-a, oko 3%, dok je kod žena s gustim dojkama bila veća oko 8%. Potencijalne prednosti DBT-a su smanjenje stope ponavljanja screening mamografije, poboljšanje preoperativnog određivanja stadija raka te uklanjanje preklapajućih tkiva na 3D slikama. Sve to olakšava otkrivanje raka i poboljšava mamografsku osjetljivost što može smanjiti broj lažno pozitivnih nalaza i nepotrebnih biopsija. Unatoč kvalitetnijoj slici, smanjenoj dozi zračenja, skraćenju vremena za analizu slike te ostalim brojnim prednostima, pokazalo se da je odaziv na DBT pregled manji od odaziva na FFDM pregled. Kako bi se otkrio razlog manjeg odaziva provedena su istraživanja, a jedno od njih je pokazalo da su financijski troškovi pregleda imali najveći utjecaj na smanjeni odaziv kod DBT-a, s prosječnom ocjenom 4,68 od 5, dok su ostali ponuđeni razlozi odbijanja pregleda imali manji utjecaj na odluku pacijenta, s prosječnom ocjenom u rasponu od 1,53 do 1,72. Potencijalni trošak iz vlastitog džepa pacijenata jedan je od glavnih prepreka u uvođenju DBT-a kao standarda za probir raka dojke.Mammography has used a film and foil system to record signals for a long time, and by transitioning to FPD it has experienced numerous benefits. Although FFDM is the current gold standard in the diagnosis of breast disease, numerous studies highlight the benefits of DBT, and it is being considered as a method that could become the new gold standard. In tomosynthesis, there are three possible ways of tube and detector movement, and DBT uses partially isocentric motion where a stationary detector is located below the compressed breast and the X-ray tube moves to create a three-dimensional view. By moving the X-ray tube into the arc above the breast images, DBT takes series of projection images at different angles, and then reconstructs a lot of thin layers of the image of the object. Thanks to digital image processing, it is possible to reconstruct series of layers of different thicknesses and depths and show what is invisible on a conventional radiographic image, by deleting structures outside the displayed layer, which results with cross sections that can be combined for 3D (three-dimensional) reconstruction. Tomosynthesis eliminates the problem of 2D mammography by removing the overlapping tissues of anatomical structures and increases the visibility of pathological structures on the mammogram. Breast positioning is performed as with conventional mammography, but with significantly less pressure. The breast is most often placed in the usual mammographic positions, which are MLO and CC, but it is possible to work in other necessary positions. When it comes to reconstruction, image quality and duration of reconstruction are the most important criteria to be met. The reconstruction time must be as short as possible for the clinical application of tomosynthesis. Due to the rapid reconstruction of the image while preserving the image quality worthy of slower methods, Filtered Back Projection is the most commonly used reconstruction method in practice. As for displaying the reconstructed layers on the screen, they can be viewed individually, or as ciné loop, which is a video where the layers change one after another. Tomosynthesis has increased the detection of cancer and is beneficial for all women regardless of breast density, and special attention is given to women with high breast density for whom FFDM is not an ideal screening method. One study found that the diagnostic accuracy of DBT compared to FFDM for non-dense breasts was slightly higher than that of DBT, about 3%, while in a woman with dense breasts it was about 8% higher. The potential benefits of DBT are lower recall rate, improved preoperative cancer staging and removal of overlapping tissues in 3D images. All of these benefits improved mammographic sensitivity, resulting in a reduction of false-positive findings and unnecessary biopsies. Despite the better image quality, reduced radiation dose, shorter image analysis time, and a number of other benefits, the response of patients to the DBT has been shown to be lower than the response of patients to the FFDM. There were conducted a survey to find out the reason for the lower response of patients to DBT, and one of them showed that the financial costs had the greatest impact on the reduced response of patients to DBT, with an average score of 4.68 out of 5, while the other offered reasons for refusing the DBT had less impact on patient decision, with a mean score ranging from 1.53 to 1.72. The potential cost out of patients ’own pockets is one of the main obstacles to the introduction of DBT as a standard for breast cancer screening
NURSING CARE IN THE REPUBLIC OF CROATIA AND THE EUROPEAN UNION, STATISTICAL REVIEW AND ANALYSIS
No full textCilj ovog rada je bio definirati pojmove sestrinstva i sestrinske njege te analizirati razlike u standardu sestrinske njege u Republici Hrvatskoj i pojedinim državama Europske Unije. Definicija sestrinstva kao i sama struka su se razvijale kroz povijest počevši od 16. stoljeća do dana današnjeg. Postoje mnoge definicije, ali prije svega medicinska sestra je samostalan zdravstveni djelatnik koji pomaže i zdravom i bolesnom (2). Najistaknutije osobe sestrinstva kroz povijest su Florence Nightingale koja je rekla da je sestrinska njega: “Osiguravanje najboljih mogućih uvjeta, da bi prirodne snage ozdravljenja mogle djelovati na bolesnika“, te Virginia Henderson koja kaže da je:“ Jedinstvena uloga medicinske sestre pomagati pojedincu, bolesnom ili zdravom u obavljanju onih aktivnosti koje pridonose zdravlju ili oporavku (ili mirnoj smrti), a koje bi pojedinac obavljao samostalno kada bi imao potrebnu snagu, volju ili znanje.“
Postoje značajne razlike u sestrinstvu među članicama država Europske unije. Najboljim brojem medicinskih sestara na 1000 stanovnika može se pohvaliti Švicarska (18) kao i najboljim omjerom medicinskih sestara i liječnika (4,3). Svega 15% medicinskih sestara u Švicarskoj se žali na emocionalnu iscrpljenost. Unatoč zavidnim razlikama poprilično je visok stupanj medicinskih sestara s namjerom napuštanja posla (28%) odnosno profesije (24%). Najteže je medicinskim sestrama u Grčkoj gdje je svega 3,2 medicinskih sestara na 1000 stanovnika te je omjer s liječnicima 1,5. Od obrađenih zemalja u ovom radu može se vidjeti da su u Hrvatskoj najniža izdavanja na zdravstvo po glavi stanovnika, odnosno 1241 euro, dok je u Švicarskoj najviše s 6978,26 eura po glavi stanovnika (15).
Biti medicinska sestra nije samo struka nego i poziv. S toga je izuzetno bitno podići razine medicinskih sestara u svim državama, pružiti im mogućnosti boljeg obrazovanja i napredovanja u karijeri te im omogućiti bolje uvjete rada koji će smanjiti razine emocionalne iscrpljenosti i stresa.The aim of this work was to define the concepts of nursing and nursing care and to analyze the differences in the standard of nursing care in the Republic of Croatia and other countries of the European Union. The definition of nursing as well as the profession itself have evolved throughout history from the 16th century to the present day. There are many definitions, but above all, a nurse is an independent health professional who helps both the healthy and the sick (2).The most prominent people in nursing throughout history are Florence Nightingale who said: "Ensuring the best possible conditions, so that the natural healing forces can act on the patient", and Virginia Henderson, who says: “The unique role of the nurse is to help an individual, sick or healthy, perform those activities that contribute to health or recovery (or peaceful death), which the individual would perform independently if he or she had the necessary strength, will or knowledge."
There are significant differences in nursing among EU member states. Switzerland boasts the best number of nurses per 1000 inhabitants(18), as well as the best ratio of nurses and doctors (4.3). Only 15% of nurses in Switzerland complain of emotional exhaustion. Despite the enviable differences, there is a fairly high rate of nurses in tending to leave the job (28%) or profession (24%). It is the most difficult for nurses in Greece, where there are only 3.2 nurses per 1,000 inhabitants and the ratio to doctors is 1.5. From the countries covered in this paperwork, it can be seen that in Croatia the lowest health expenditures per capita are 1241 euros, while in Switzerland is the highest, 6978.26 euros per capita (15).
Being a nurse is not only a profession but also a vocation. Therefore, it is extremely important to raise the levels of nurses in all countries, provide them with opportunities for better education and career advancement, and provide them with better working conditions that will reduce levels of emotional exhaustion and stress
PREGNANCY PLANNING AND MIDWIFE CARE FOR PREGNANT WOMEN WITH TYPE I DIABETES
No full textDijabetes je kronični, endokrinološki poremećaj kojeg karakterizira apsolutni ili relativni manjak hormona inzulina što rezultira hiperglikemijom. Postoje dva glavna oblika dijabetesa; Dijabetes tipa I i Dijabetes tipa II te postoji poseban oblik koji se prvi put pojavljuje u trudnoći a naziva se gestacijski dijabetes. Trudnoća žene koja boluje od dijabetesa spada u skupinu rizičnih trudnoća jer predstavlja rizik od nastanka brojnih komplikacija i za majku i za fetus što povećava perinatalni mortalitet i morbiditet. S majčine strane najčešće komplikacije su hiperglikemija, hipoglikemija, hipertenzija koja vodi preeklampsiji, urogenitalne infekcije te dijabetička nefropatija, retinopatija i neuropatija. S fetalne strane postoji veći rizik za nastanak kongenitalnih malformacija, spontanih pobačaja, intrauterine infekcije ploda te fetalna hipoksija i acidoza. Kako bi se rizik od nastanka brojnih komplikacija sveo na minimum, najbitnije je održavanje razine glukoze u krvi što bliže normalnim vrijednostima. Zbog toga se preporuča da trudnoća žene koja boluje od dijabetesa tipa I bude planirana i intenzivno praćena. Preporučeno je dovršavanje trudnoće nakon navršenih 38 tjedana gestacije indukcijom porođaja ili carskim rezom. Kako bi trudnoća bila sigurna i uspješna primalja ima važnu ulogu u edukaciji trudnice. Treba je educirati o primjeni inzulinske terapije, prehrani i tjelovježbi, riziku i prevenciji od akutnih i kroničnih komplikacija dijabetesa tipa I. Ne smije se zanemariti ni važnost terapijske komunikacije s trudnicom kako bi stekla sigurnost i povjerenje u primalju.Diabetes is a chronic, endocrinologic disorder carachterized by absolute or relative insulin deficiency which results in hyperglycemia. There are two main types; Type I diabetes and type II diabetes, but there is also a special type that is diagnosed for the first time in pregnancy called gestational diabetes. Pregnancy of a woman with type I diabetes is considered a risky pregnancy because it often leads to complications for both the mother and the baby and that leads to increased perinatal mortality and morbidity rates. On the maternal side the most often complications are hyperglycemia, hypoglycemia, hypertension which leads to preeclampsia, urogenital infections and diabetic nephropathy, retinopathy and neuropathy. On fetal side there are higher risks for developing congenital malformations, miscarriage, intrauterine infections of the fetus and fetal hypoxia and acidosis. In order to minimise the risk of developing complications, the crucial thing is maintaining blood glucose levels as close to normal as possible. For all those reasons it is advised that pregnancy of a woman with type I diabetes is pre-planned and intensivley monitored. It is advised to end the pregnancy after 38 weeks of gestation by inducing labor or via Caesarian section. In order to have a safe and successful pregnancy the role of the midwife is crucial in educating the pregnant woman. She should educate her about insulin administration, diet regime and implementing exercise, risk and prevention of acute and chronic diabetic complications. The importance of therapeutic communication must not be neglected in order for the pregnant woman to achieve the feeling of safeness and trust in her midwife
COMPARISON OF POSTOPERATIVE BLEEDING OF PATIENTS OPERATED WITH OFF-PUMP AND ON PUMP CORONARY BYPASS TECHIQUE
No full textCilj istraživanja: Cilj ovog istraživanja je usporediti poslijeoperacijsko krvarenje nakon primjene dvije različite kardiokirurške metode revaskularizacije miokarda sa ili bez upotrebe stroja za vantjelesni krvotok.
Ispitanici i metode: U istraživanje su bili uključeni bolesnici operirani u razdoblju od 1. lipnja 2013. godine do 1. lipnja 2017. godine. Istraživanje je obuhvatilo 102 bolesnika koji su zahtijevali žurno trostruko aorto-koronarnopremoštenje. Od tog broja 75 ih je operirano OPCAB, a 27 CABG tehnikom. Skupine su uspoređene s obzirom na ishode liječenja.
Rezultati: Bolesnici u OPCAB skupini su imali prosječno krvarenje unutar 24 sata u iznosu od 386±176.48 mililitara, dok su bolesnici u CABG skupini imali prosječno krvarenje unutar 24 sata nakon operacijskog zahvata u iznosu od 577.22±247.90 mililitara. Zabilježena je statistički značajna razlika između eksperimentalnih skupina (t test, P<0.0001).
Zaključci: OPCAB metoda je optimalan način liječenja žurnih kardiokirurških bolesnika. Zabilježeno je manje poslijeoperacijsko krvarenje u odnosu na bolesnike operirane CABG metodom.Objectives: The aim of this study is to compare postoperative bleeding between two surgical tehniques: off-pump coronary surgery and on-pump coronary surgery.
Patients and methods: The study involved 102 patients who underwent urgent coronary procedures at the Department of cardiac surgery, University hospital Split. Patients underwent triple coronary bypass surgery. They were divided into two groups. OPCAB group had 75 and CABG group had 27 examinees.
Results: Examinees in OPCAB group had mean first day postoperative bleeding of 386±176.48 ml and examinees in CABG group had mean first day bleeding of 577.22±247.90 mililitara. There was significance between those outcomes (t test, P<0.0001).
Conclusions: OPCAB method is optimal way of urgical revascularization of urgent patients. There was less postoperative bleeding in comparison to patients operated by CABG method
HOW CLEAN IS TOO CLEAN - DOES CLEANLINESS CAUSE ALLERGIES AND AUTO-IMMUNE DISEASES?
No full textCilj ove studije bio je istražiti postojeće dokaze o povezanosti osobne higijene s rizikom za pojavu alergijskih i autoimunih bolesti. Rad je osmišljen i proveden kao pregledni članak, proveden kao sekundarno istraživanje. Rezultati dosadašnjih radova vezanih uz ovu temu prikazuju široki opseg metodoloških pristupa, koji ne daju dovoljnu količinu uvjerljivih dokaza o povezanosti čistoće i rizika. Stoga je sumarni zaključak da ne postoji jasna veza između osobne higijene i povećanog rizika. Čini se da je povećanje učestalosti ove dvije skupine bolesti multifaktorijalno te da je za njihovu kontrolu potrebno provesti cjelovite javnozdravstvene intervencije, u skladu s postavkama medicine životnog stila.The aim of this study was to investigate existing evidence on the association of personal hygiene with the risk of developing allergic and autoimmune diseases. The paper was designed and conducted as a review article, conducted as a secondary research. The results of previous work related to this topic show a wide range of methodological approaches, which do not provide a sufficient amount of convincing evidence of the relationship between purity and risk. It is therefore a summary conclusion that there is no clear link between personal hygiene and increased risk. It seems that the increase in the frequency of these two groups of diseases is multifactorial and that for their control it is necessary to carry out comprehensive public health interventions, in accordance with the principles of lifestyle medicine
VACCINE AGAINST INFLUENZA IN REPUBLIC OF CROATIA
No full textCilj: Glavni cilj ovog rada bio je retrospektivno analizirati ukupan pobol od gripe te kategorizirati po dobi, prikazati mortalitet, procijepljenost protiv gripe kao i analizu procijepljenosti po rizičnim skupinama tijekom petogodišnjeg razdoblja.
Metode: U ovom retrospektivnom istraživanju analizirali su se javno dostupni podatci objavljeni u Hrvatskom zdravstvenom statističkom ljetopisu i Izvješću o provedbi cijepljenja Hrvatskog zavoda za javno zdravstvo u periodu od 2014. do 2019. godine. Za analizu podataka koristila se opisna statistika.
Rezultati: U promatranom razdoblju od 2014. do 2019. godine najveći oboljelih od gripe evidentiran je u sezoni gripe 2014./2015. te iznosi 78 234 oboljelih. Najmanje ih je oboljelo u sezoni gripe 2015./2016., s iznosom od 21 138. Incidencija gripe najviša je kod djece školske i predškolske dobi (od 5- 14 godina) te je najveća bila 2014./2015. kad je rezultirala pobolom od 3528,1 na 100 000 djece. Najniža incidencija gripe bila je kod osoba u dobi od 65 godina i više te je u promatranom periodu najniža zabilježena u sezoni gripe 2015./2016. kad je na 100 000 starijih osoba oboljelo svega 139,2 osobe. Godine 2015. zabilježen je i najmanji broj prijavljenih osoba umrlih od gripe, 5 osoba; dok je najviše zabilježeno 2016. godine i to 27 umrlih. U sezoni gripe 2018./2019. postignuta je najveću procijepljenost, s 323 085 cijepljenih osoba. Najniža procijepljenost je zabilježena 2015./2016. godine s 250 826 cijepljenih. U rizične skupine kojima se cijepljenje preporučuje svrstani su umirovljenici, kronični bolesnici i zdravstveni djelatnici, te su od njih najviše cijepljeni umirovljenici; 67% cijepljenih u sezoni gripe 2018./2019. Procijepljenost kroničnih bolesnika bila je najveća u sezoni 2017./2018. te pada 2018. godine i iznosi 25%. Zdravstveni djelatnici održavaju konstantu s malih 3%. U sezoni gripe 2018./2019. distribuiran je najveći broj doza cjepiva u promatranom razdoblju te je od toga iskorišteno 98% doza.
Zaključak: U Republici Hrvatskoj je došlo do porasta procijepljenosti protiv gripe u promatranom razdoblju. Najveći udio procijepljenih zabilježen je kod osoba starijih od 65 godina i osoba oboljelih od kroničnih bolesti. Unatoč dobroj procijepljenosti osoba starijih od 65 godina, nije postignut cilj cjepnih obuhvata od 75%. Djeca su najmanje procijepljena.
Za učinkovitu prevenciju gripe, potrebno je postići visoke cjepne obuhvate. Tako bi se smanjio pobol i komplikacije, kao i „višak smrti“ kod starijih osoba. Medicinska sestra ima važnu ulogu u svim mjerama prevencije, dijagnosticiranja i liječenja gripe. Treba osigurati kontinuirano informiranje i edukaciju te osvijestiti populaciju o prevenciji i cijepljenju protiv gripe.Objective: The main objective of this study was to analyze total influenza morbidity, categorize it by age, to show mortality and vaccination against influenza as well as the analysis of the vaccination by risk groups.
Methods: In this retrospective study, publicly available data published in Croatian health statistics yearbook and the Report of vaccination implementation of Croatian institute of public health was analyzed, in the time period from 2014. to 2019. Descriptive statistics was used for data analysis.
Results: In the time period from 2014. to 2019. largest number of inhabitants infected from the influenza in Republic of Croatia was recorded in the influenza season 2014./2015., with 78 234 infected. In the season 2015./2016. there was least infected inhabitants, 21 138. Influenza incidence is highest in school and preschool age children (5- 14 years old) and highest incidence was recorded in 2014./2015. season when 3528,1 of 100 000 children was affected with influenza. Lowest influenza incidence was in persons in age of 65 years old or more and in season 2015./2016. only 139,2 of 100 000 elderly got infected. In 2015., the lowest number of reported deaths from influenza was recorded, 5 deaths; while the highest number was recorded in 2016., with 27 deaths. Season 2018./2019. achieved highest vaccination coverage, with a population of 323 085. Lowest vaccination coverage was recorded in 2015./2016. season with 250 826 inhabitants. There are risk groups that vaccination is recommended and those are elderly/retirees, chronic patients and health workers. From these, the most vaccinated are retired people, 67% vaccinated in the influenza season 2018./2019. Highest vaccination coverage of chronic patients was recorded in 2017./2018., but falls in 2018./2019. with total of 25%. Health workers maintain a constant of 3%. Largest number of distributed vaccines was in the season 2018./2019. and 98% of those doses were used.
Conclusion: In the Republic of Croatia there has been a trend of increasing vaccination coverage against influenza. The highest vaccination rate is in persons over 65 years old. Despite the good vaccination coverage of older persons, the targeted coverage of 75% was not achieved. Children are least vaccinated and therefore risk group. It is necessary to achieve high vaccination coverage against influenza. That would reduce morbidity and complications, as well as reduce „excess deaths“ in elderly people. The nurse plays an important role in prevention, diagnosis and treatment of influenza. Also, it is necessary to ensure continous informing and education and raise awareness about influenza prevention and vaccination
THE ROLE OF DONATION IN TISSUE AND ORGAN TRANSPLANTATION
No full textUvod: Transplantacija tkiva i organa sve je češća metoda liječenja, ali potrebe nadilaze dostupna tkiva i organe. Krvotvorne matične stanice su samoobnovljive, a služe kao ishodište svim krvnim stanicama organizma. Darivateljstvo je potpuno besplatno i bezopasno i na taj se uzvišeni čin možemo odlučiti u bilo kom trenutku. Prije same transplantacije potrebno je odrediti alele sustava HLA primatelja i darivatelja.
Cilj: Cilj ovog rada bio je upoznavanje i osvještavanje ljudi o važnosti i ljepoti darivateljstva u transplantaciji tkiva i organa.
Materijali i metode: Metode koje se koriste za određivanje alela sustava HLA primatelja i darivatelja su serološke (test mikrolimfocitotoksičnosti) i molekularne (PCR-SSO i PCR-SSP) metode.
Rasprava: Hematološke su bolesti, nažalost, sve učestalije, ali i potrebe za organima uvelike premašuju broj prikupljenih, stoga je nužno osvijestiti i educirati stanovništvo o darivateljstvu i transplantaciji.Introduction: Tissue and organ transplantation is an increasingly common method of treatment. However, the needs go beyond available tissues and organs. Hematopoietic stem cells are self-renewing and serve as the origin of all blood cells in the body. The donation is completely free and safe and we can decide for that generous act at any time. It is necessary to determine the alleles of HLA system of recipients and donors before the transplantation.
Goal: The aim of this thesis was to introduce and aware people about importance and beauty of the donation of tissue and organ transplantation.
Materials and methods: The methods which are used to determine alleles of HLA system of recipient and donor are serological method (microlymphocitotoxicity test) and the molecular biology methods (PCR-SSO i PCR-SSP).
Disscusion: Hematological diseases are becoming more common and also the need for organs is growing. Therefore, it is necessary to raise awareness and educate the population about donation and transplantation