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Nursing problems in patients with salivary gland tumor
No full textTumori žlijezda slinovnica su rijetki i predstavljaju oko 3% svih umora usne šupljine. Približno 85% ih nastaje u velikim slinovnicama, od toga 90% u podušnoj žlijezdi, a 10% u podčeljusnoj žlijezdi. Podjezična žlijezda je jako rijetko zahvaćena. Nešto više tumora žlijezda slinovnica nastaje u žena osim Warthinovog tumora koji je češći u muškaraca. Sestrinski problemi kod same dijagnostike i liječenja su kompleksni i uključuju različite aspekte brige i podrške. Medicinske sestre igraju važnu ulogu u brizi za bolesnike sa tumorom žlijezda slinovnica osiguravajući im fizičku udobnost te emocionalnu podršku te pomažući u održavanju kvalitete života tijekom cijelog procesa liječenja.Salivary gland tumors are rare and represent about 3% of all oral cavity tumors. Approximately 85% of them are produced in the large salivary gland, of which 90% is in the parotid gland, and 10% is in the submandibular gland. The sublingual gland is very rarely affected. Slightly more salivary gland tumors occur in women except for Warthin's tumor which is more common in men. Nursing problems in diagnosis and treatment are complex. They include different aspects of care and support. Nurses play an important role in the care of patients with tumors of the salivary glands, providing them with physical comfort and emotional support and helping them maintain their quality of life during the entire treatment process
Epidemiological characteristics of patients treated for spontaneous pneumothorax at the Split Clinical Hospital Center
No full textCilj: Cilj diplomskog rada je prikazati epidemiološka obilježja pacijenata liječenih od spontanog pneumotoraksa u Kliničkom bolničkom centru Split (KBC Split) u vremenskom periodu od tri godine.
Izvori podataka i metode: Istraživanje je obuhvatilo 115 pacijenata liječenih od spontanog pneumotoraksa u KBC Split između 2021. i 2023. godine. Podaci su prikupljeni putem bolničkog informacijskog sustava i analizirani koristeći Shapiro-Wilk test, Mann-Whitney U test, Kruskal-Wallis test, hi-kvadrat test i Spearmanov koeficijent korelacije s razinom značajnosti od 0.05.
Rezultati: Prosječna dob ispitanika bila je 53 godine, a većina su bili muškarci (78,3%). Od komorbiditeta, KOPB je prisutan kod 12,2% pacijenata, karcinom pluća kod 7%, a arterijska hipertenzija kod 14,8%. Najčešći simptomi su dispneja i bol, a prosječna duljina hospitalizacije iznosila je 6 dana. Nisu uočene značajne razlike između pacijenata u vezi s operacijom ili stranom pneumotoraksa, osim veće stopе rehospitalizacije kod pacijenata s KOPB-om. Dulja hospitalizacija povezana je s prisustvom drena ili operacijom, dok su dispneja i KOPB povezani s višim pulsom i nižom saturacijom kisika.
Rasprava: Studija potvrđuje slične spolne trendove kao prethodne studije, ali s različitim vrijednostima tjelesne građe. Stopа recidiva i postotak pušača su niži nego u drugim istraživanjima, dok je veća stopа rehospitalizacije kod pacijenata s KOPB-om. Postoje značajne razlike u vitalnim parametrima kod pušača i pacijenata s komorbiditetima.
Zaključci: Istraživanje je potvrdilo da je spontani pneumotoraks češći kod muškaraca, pacijenata srednje tjelesne građe, te da su najčešći simptomi dispneja i bol, dok je kronično opstruktivna plućna bolest (KOPB) najčešći komorbiditet povezan s ovom bolešću. Također, pronađena je značajna korelacija između duljine hospitalizacije i trajanja drenaže kod pacijenata sa spontanim pneumotoraksom.Objective: The aim of the thesis is to present the epidemiological characteristics of patients treated for spontaneous pneumothorax at the Clinical Hospital Center Split (KBC Split) over a three-year period.
Data sources and methods: The study included 115 patients treated for spontaneous pneumothorax at KBC Split between 2021 and 2023. Data were collected through the hospital information system and analyzed using the Shapiro-Wilk test, Mann-Whitney U test, Kruskal-Wallis test, chi-square test, and Spearman's rank correlation coefficient with a significance level of 0.05.
Results: The average age of the patients was 53 years, with the majority being male (78.3%). Among comorbidities, COPD was present in 12.2% of patients, lung cancer in 7%, and hypertension in 14.8%. The most common symptoms were dyspnea and pain, with an average length of hospitalization of 6 days. No significant differences were observed among patients regarding the type of surgery or side of pneumothorax, except for a higher rate of rehospitalization in patients with COPD. Longer hospitalization was associated with the presence of a drain or surgery, while dyspnea and COPD were linked to higher pulse rates and lower oxygen saturation.
Discussion: The study confirms similar gender trends as previous studies but with different body composition values. The rate of recurrence and percentage of smokers are lower compared to other studies, while there is a higher rate of rehospitalization among patients with COPD. Significant differences in vital parameters were observed in smokers and patients with comorbidities.
Conclusions: The study confirmed that spontaneous pneumothorax is more common in men and individuals of average body build, with the most frequent symptoms being dyspnea and pain. Chronic obstructive pulmonary disease (COPD) was identified as the most common comorbidity associated with this condition. Additionally, a significant correlation was found between the length of hospitalization and the duration of drainage in patients with spontaneous pneumothorax
Psyhosocial rehabilitation and quality of life in patients with mental disorders
No full textProblemi mentalnog zdravlja javljaju se u cijelom svijetu bez obzira na spol ili dob. Takvi problemi uveliko utječu na normalno funkcioniranje pojedinca, integraciju u društvo te samopercepciju. Stigmatizacija ljudi s mentalnim poremećajima narušava njihovu kvalitetu života te su izloženi pritisku društva i samostigmatizaciji. Medicinska sestra ima ključnu ulogu u oporavku osoba s mentalnim oštećenjem tijekom i nakon hospitalizacije. Uključivanjem u različite vrste grupnih, radnih i terapijskih radionica te individualnim savjetovanjima i davanju na važnosti suradnji, dolazi se do pozitivnog ishoda liječenja i uspješne resocijalizacije. Psihosocijalnom rehabilitacijom potiče se socijalizacija i inkluzija oboljelih.Mental health problems occur worldwide, regardless of gender or age. Such issues significantly affect an individual's normal functioning, social integration, and self-perception. The stigmatization of people with mental disorders undermines their quality of life, exposing them to social pressure and self-stigmatization. Nurses play a key role in the recovery of individuals with mental health issues during and after hospitalization. By involving patients in various types of group, work, and therapeutic workshops, as well as through individual counseling and emphasizing collaboration, positive treatment outcomes and successful social reintegration can be achieved. Psychosocial rehabilitation encourages the socialization and inclusion of affected individuals
Coronary diseases in professional athletes: a review
No full textKoronarne bolesti predstavljaju vodeći javnozdravstveni problem u svijetu, čineći najčešću nezaraznu bolest koja uzrokuje milijune smrtnih slučajeva godišnje. Radi se o stanju koje nastaje zbog nedostatne opskrbe srčanog mišića kisikom uslijed promjena koronarnih arterija i uključuje posljedice opstrukcije dotoka krvi u srčani mišić. Danas se ovo stanje sve više pojavljuje kod sportaša, paradigme zdravih pojedinaca, što uvelike izaziva interes javnosti. Cilj ovog rada je prema pregledanoj literaturi istražiti povezanost visoko intenzivne aktivnosti, koju provode profesionalni sportaši, sa pojavnosti koronarnih bolesti, s posebnim naglaskom na iznenadnu srčanu smrt (ISS). Za izradu ovog preglednog rada korištena je baza podataka MEDLINE putem PubMed-a gdje je nakon filtriranja dobiveno 6, odnosno 13 istraživanja među kojima je odabrano 14 istraživanja pogodnih za ovaj pregledni rad. U istraživanjima se razmatraju pitanja vezana za najčešće koronarne bolesti koje uzrokuju ISS te njenu etiologiju i učestalost. Također prema podacima iz istraživanja postavlja se pitanje utječe li spol sportaša te vrsta i intenzitet sporta kojim se bavi na pojavnost ISS-a kod istih. Istraživanja također ukazuju na mogućnost prevencije ovih iznenadnih događaja te iznose zakone o zdravstvenom pregledu kojih se sportaši moraju pridržavati kao preduvjet za bavljenje sportom. Za usporedbu su uzeti zakoni iz SAD-a, Europe te Hrvatske.Coronary diseases represent a leading public health problem worldwide, being the most common non-communicable disease that causes millions of deaths annually. It is a condition that arises due to insufficient oxygen supply to the heart muscle as a result of changes in the coronary arteries and includes the consequences of blood flow obstruction to the heart muscle. Today, this condition is increasingly appearing in athletes, who are considered paradigms of healthy individuals, which significantly attracts public interest. The aim of this paper is to explore, based on the reviewed literature, the association between high-intensity activity performed by professional athletes and the incidence of coronary diseases, with special emphasis on sudden cardiac death (SCD). The MEDLINE database via PubMed was used for the preparation of this review paper, where, after filtering, 6 or 13 studies were obtained, among which 14 studies were selected as suitable for this review. The studies examine issues related to the most common coronary diseases that cause SCD, as well as their etiology and frequency. Additionally, based on the research data, the question arises whether the athlete's gender, type, and intensity of the sport they engage in influence the incidence of SCD in them. The studies also indicate the possibility of preventing these sudden events and present the health examination regulations that athletes must adhere to as a prerequisite for engaging in sports. For comparison, laws from the USA, Europe, and Croatia were considered
Comparison of the titer of red blood cell antibodies in the tube method and method of microhemaglutination
No full textCilj rada: Cilj rada je usporediti titar antieritrocitnih protutijela u serumu imuniziranih trudnica u epruveti i mikrometodama (Ortho i Diamed). Mikrometode Ortho i Diamed su osjetljivije od metode u epruveti te će titar protutijela biti veći u mikrometodama nego klasičnom metodom u epruveti.
Materijali i metode: Odabrano je 7 pacijenata KBC-a Split s pozitivnim indirektnim antiglobulinskim testom (IAT) koje su poslane na određivanje titra protutijela. Od 7 pacijentica obrađeno je 9 uzoraka. Titar protutijela određen je klasičnom metodom u epruveti te Ortho i Diamed mikrometodom.
Rezultati: Većina pacijentica pokazuje kritični i veći titar protutijela. Mikrometode pokazuju veće titre protutijela u odnosu na mikrometode. Rezultati su pokazani kao zadnji pozitivni titar i zadnja pozitivna epruveta.
Zaključak: Mikrometode (Ortho i Diamed) pokazuju veće titre protutijela. Ova razlika je dosljedna kroz sve uzorke, potvrđujući osjetljivost mikrometoda. Metodom u epruveti mogu se razlikovati kompletna (IgM) od inkompletnih (IgG) protutijela, dok se mikrometodama određuje isključivo titar IgG protutijela. Prednosti mikrometoda, poput njihove osjetljivosti i preciznosti, mogu smanjiti broj lažno negativnih rezultata. Međutim, važno je razumjeti implikacije viših titra prikazanih mikrometodama. Ako se ne postave jasni referentni intervali i standardizirani protokoli, postoji rizik od prekomjerne dijagnoze i pretjerane terapije.Objective: The aim of this study is to compare the titer of anti-erythrocyte antibodies in the serum of immunized pregnant women using the tube method and micro methods (Ortho and Diamed). The Ortho and Diamed microhemagglutination methods are more sensitive than the tube method, and therefore, the antibody titer will be higher in the microhemagglutination methods compared to the classical tube method.
Materials and methods: 7 patients from the UHC Split with positive indirect antiglobulin test (IAT) were selected and sent for antibody titer determination. A total of 9 samples were processed from the 7 patients. The antibody titer was determined using the conventional tube method and the Ortho and Diamed micro methods.
Results: The majority of patients showed critical and higher antibody titers. Micro methods demonstrated higher antibody titers compared to the tube method. Results are presented as the last positive titer and the last positive tube.
Conclusion: The micro methods (Ortho and Diamed) show higher antibody titers. This difference is consistent across all samples, confirming the sensitivity of the micro methods. The tube method can differentiate between complete (IgM) and incomplete (IgG) antibodies, whereas micro methods exclusively determine the titer of IgG antibodies. The advantages of micro methods, such as their sensitivity and precision, can reduce the number of false-negative results. However, it is important to understand the implications of higher titers presented by the micro methods. Without clear reference intervals and standardized protocols, there is a risk of overdiagnosis and overtreatment
The importance of nursing work in the screening of chronic complications of diabetes.
No full textŠećerna bolest je kronična bolest koja se karakterizira visokom razinom šećera u krvi zbog nedostatka inzulina ili njegove neučinkovitosti. Postoje dvije glavne vrste: šećerna bolest tip 1, koja nastaje uslijed autoimunog uništavanja beta stanica gušterače koje proizvode inzulin, i šećerna bolest tip 2, koja se razvija zbog inzulinske rezistencije i postupnog smanjenja funkcije beta stanica.
Bez odgovarajuće kontrole, šećerna bolest može uzrokovati brojne kronične komplikacije, uključujući kardiovaskularne bolesti, nefropatiju, retinopatiju i neuropatiju. Također, dijabetičko stopalo je ozbiljna komplikacija koja može dovesti do infekcija i amputacija.
Prevencija i upravljanje šećernom bolešću zahtijevaju multidisciplinarni pristup, uključujući pravilno praćenje razine šećera u krvi, zdravu prehranu, tjelesnu aktivnost i medicinsku terapiju. Medicinske sestre igraju ključnu ulogu u obrazovanju pacijenata, procjeni rizika, savjetovanju o preventivnim mjerama, i koordinaciji skrbi. Njihova uloga u pružanju psihosocijalne podrške i profesionalnom usavršavanju dodatno doprinosi poboljšanju zdravstvenih ishoda i kvalitete života pacijenata s dijabetesom.Diabetes is a chronic disease characterized by a high level of sugar in the blood due to a lack of insulin or its ineffectiveness. There are two main types: type 1 diabetes, which results from the autoimmune destruction of insulin-producing beta cells in the pancreas, and type 2 diabetes, which develops due to insulin resistance and a gradual decline in beta cell function.
Without proper control, diabetes can cause numerous chronic complications, including cardiovascular disease, nephropathy, retinopathy, and neuropathy. Also, diabetic foot is a serious complication that can lead to infections and amputations.
Prevention and management of diabetes require a multidisciplinary approach, including proper monitoring of blood sugar levels, healthy diet, physical activity, and medical therapy. Nurses play a key role in patient education, risk assessment, counseling on preventive measures, and coordination of care. Their role in providing psychosocial support and professional training further contributes to improving health outcomes and quality of life of patients with diabetes
Communication in palliative care
No full textU radu se teorijski obrazlaže palijativna skrb te važnost komunikacije općenito u zdravstvu s posebnim osvrtom na palijativno zdravstvo. Cilj rada je obrazložiti ulogu medicinske sestre u palijativnoj skrbi pregledom provedenih istraživanja koji su analizirali kako medicinske sestre u palijativnoj skrbi opisuju svoju ulogu u pružanju palijativne skrbi za pacijente i način komunikacije s pacijentima i njihovim obiteljima. Zaključno se može reći na kraju rada kako su prilagođene informacije, empatija i jasan jezik osnovni elementi učinkovite komunikacije u palijativnoj skrbi. Za učinkovitu komunikaciju u palijativnoj skrbi pacijenti i obitelj osim otvorenih i iskrenih informacija, žele da zdravstveni djelatnici obrate pozornost ne samo na bolest i simptome pacijenta, već i na to tko je pacijent izvan bolesti i na ulogu obitelji. Takva pažnja može dati pacijentima i obitelji osjećaj sigurnosti unutar neizvjesnosti iskustva i putanje uznapredovale bolesti. Na kraju rada može se zaključiti kako su potrebna dodatna istraživanja o učinkovitoj komunikaciji medicinskih sestara i ostalih suradnika specijaliziranih za palijativnu skrb.The paper theoretically explains palliative care and the importance of communication in healthcare in general, with a special focus on palliative healthcare. The aim of the paper is to explain the role of the nurse in palliative care by reviewing the conducted research that analyzed how nurses in palliative care describe their role in providing palliative care for patients and the way they communicate with patients and their families. In conclusion, it can be said at the end of the paper that tailored information, empathy and clear language are the basic elements of effective communication in palliative care. For effective communication in palliative care, patients and families, in addition to open and honest information, want health professionals to pay attention not only to the patient's disease and symptoms, but also to who the patient is outside of the disease and to the role of the family. Such attention can give patients and families a sense of security amid the uncertainty of the experience and trajectory of advanced disease. At the end of the paper, it can be concluded that additional research is needed on the effective communication of nurses and other associates specialized in palliative care
Abdominal pregnancy
No full textAbdominalna trudnoća izuzetno je rijedak oblik ektopične trudnoće, kod koje se fertilizirana jajna stanica implantira i razvija unutar trbušne šupljine. Često se ne dijagnosticira na vrijeme zbog nespecifičnih simptoma, a zbog utjecaja na vitalne organe može značajno uzrokovati smrt pacijentice. Cilj rada je prikazati jedinstveni slučaj abdominalne trudnoće u posljednjih 30 godina zabilježen u Klinici za ženske bolesti i porode, KBC Split.Abdominal pregnancy is an exceptionally rare form of ectopic pregnancy, where the fertilized egg implants and develop inside the abdominal cavity. It is often not diagnosed in time due to non-specific symptoms and can cause the death of the patient because of its influence on vital organs. The aim of the thesis is to present a unique case of abdominal pregnancy recorded in the Clinic for women's diseases and childbirth, KBC Split in the last 30 years
Combined first trimester screen testing in the University Hospital Center Split
No full textNajraširenija metoda prenatalnog probira na kromosomopatije je kombinirani test.Testiranje se radi između 10. i 14. tjedna trudnoće. Kombiniraju se dva biokemijska i jedan ultrazvučni biljeg te životna dob trudnice. Kombiniranim testom moguće je iz skupine niskorizičnih trudica za trisomiju 21 (mlađe od 36 godina) uspješno detektirati visokorizične koje probirom po životnoj dobi ne bi bile otkrivene. Cilj istraživanja je prikazati rezultate kombiniranog testa probira na kromosomopatije ploda u KBC Split. Broj visokorizičnih trudnica za trisomiju 21 po životnoj dobi značajno je veći od broja visokorizičnih po rezultatima kombiniranog testa. Broj provedenih kombiniranih testova probira od 2015. godine se smanjuje.The most widespread method of prenatal screening for chromosomal abnormalities is the combined test. Testing is done between the 10th and 14th week of pregnancy. Two biochemical and one ultrasound marker and the age of the pregnant woman are combined. With the combined test, it is possible to successfully detect high-risk women from the group of low-risk trisomy 21 (younger than 36) women who would not have been detected by age screening. The aim of the research is to present the results of the combined screening test for chromosomal abnormalities of the fetus in KBC Split. The number of high-risk pregnant women for trisomy 21 by age is significantly higher than the number of high-risk by the results of the combined test. The number of conducted combined screening tests has been decreasing since 2015
Quality of life in patients with multiple sclerosis
No full textCilj: Cilj istraživanja bio je ispitati kvalitetu života bolesnika oboljelih od MS-a, zatim utvrditi činitelje koji imaju utjecaja na kvalitetu života oboljelih, te u kojoj mjeri činitelji imaju utjecaj na kvalitetu života bolenika oboljelih od multiple skleroze.
Izvori podataka i metode: U anketnom istraživanju sudjelovalo je 70 ispitanika. Ispitanici su ispunjavali aktetni uputnik te MS QoL-54 skalu kreirane posebno za potrebe diplomskog rada. Prikupljeni podaci analizirani su deskriptivnim i inferencijalnim statističkim metodama u statističkom programu. Za opis podataka korištene su mjere centralne tendencije, disperzije i Spearmanov koeficijent korelacije rangova. Za testiranje statističke značajnosti razlika korišteni su Kolmogorov-Smirnovljev test, hi-kvadrat test, Studentov t-test i analiza varijance.
Rezultati: Istraživanje o kvaliteti života oboljelih od multiple skleroze pokazalo je da postoje razlike u procjeni kvalitete života s obzirom na dob, obrazovanje i mjesto stanovanja, ali ne i s obzirom na spol. Osobe s težim oblikom bolesti i izraženijim nuspojavama terapije procjenjuju nižom vlastitu kvalitetu života. Viša razina socijalne podrške povezana je s višom procjenom kvalitete života te da je prisutnost boli/nelagode i promjena raspoloženja (depresija/anksioznost) povezana s nižom procjenom kvalitete života.
Zaključak: Temeljem dobivenih rezultata, može se zaključiti kako bi intervencije usmjerene poboljšanju kvalitete života oboljelih od multiple skleroze trebale biti usredotočene na ublažavanje simptoma bolesti poput boli, umora i promjena raspoloženja; minimiziranje nuspojava farmakoloških terapija; osiguravanje adekvatne socijalne podrške iz okoline te edukaciju o adaptivnim strategijama suočavanja s dijagnozom. S obzirom na cilj istraživanja možemo zaključiti da navedeni čimbenici značajno moderiraju zadovoljstvo životom i osjećaj blagostanja kod oboljelih od multiple skleroze.Objective: The aim of the research is to examine the quality of life of patients suffering from MS, determine the factors that influence the quality of life of patients, and to what extent these factors impact the quality of life of MS patients.
Data sources and methods: 70 respondents participated in the survey. Respondents filled out a file with instructions and the MS QoL-54 scale created specifically for the needs of the thesis. The research was conducted using a survey questionnaire and the MS QoL-54 scale to assess the quality of life of those suffering from multiple sclerosis. The MS QoL-54 scale consists of the SF-36 questionnaire and 18 additional questions specific to the symptoms of multiple sclerosis. The collected data was analyzed using descriptive and inferential statistical methods in a statistical program. Measures of central tendency, dispersion, and Spearman’s rank correlation coefficient were used to describe the data. The Kolmogorov-Smirnov test, chi-square test, Student’s t-test, and analysis of variance were used to test the statistical significance of differences.
Results: Research on the quality of life of patients with multiple sclerosis showed that there are differences in the assessment of quality of life with regard to age, education and place of residence, but not with regard to gender. People with a more severe form of the disease and more pronounced side effects of the therapy rate their own quality of life as lower. A higher level of social support is associated with a higher assessment of quality of life, and the presence of pain/discomfort and mood changes (depression/anxiety) is associated with a lower assessment of quality of life.
Conclusion: Based on the obtained results, it can be concluded that interventions aimed at improving the quality of life of patients with multiple sclerosis should be focused on alleviating the symptoms of the disease such as pain, fatigue and mood changes; minimizing the side effects of pharmacological therapies; ensuring adequate social support from the environment and education about adaptive strategies for coping with the diagnosis. Considering the aim of the research, we can conclude that the mentioned factors significantly moderate the satisfaction with life and the feeling of well-being in patients with multiple sclerosis