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Nursing care in the treatment of patients with respiratory diseases
No full textRespiratorne bolesti široko su zastupljene u današnjici. Akutne respiratorne infekcije nose dvije trećine svih infekcija suvremenog čovjeka, dok su kronične respiratorne bolesti treći najčešći ubojica današnjice. I prije stotinu godina, za vrijeme španjolske gripe, a i danas skrb medicinske sestre kod respiratornih bolesti, možda je najzahtjevnija i najzastupljenija grana sestrinske skrbi o bolesnima. Postoje mnogi simptomi koji mogu ukazivati na neku respiratornu bolest, a neki od njih su kašalj, zapuha dispneja, bol u prsima, iskašljavanje sekreta, grlobolja itd.
Medicinska sestra u svome radu s respiratornim bolestima, mora koristiti brojne vještine i očuvati empatiju. Bolesti dišnog sustava su brojne i jedinstvene, a medicinska sestra mora sa svima njima biti dobro upoznata. Kod astme, koja je jedna od najčešćih kroničnih bolesti, važno je da medicinska sestra bolesnika educira o pravilnoj primjeni inhalatora, o rizičnim čimbenicima koji pogoršavaju kliničku sliku (okidači) i o pravovremenom prepoznavanju simptoma statusa astmaticusa. Ukoliko njezin bolesnik ima pneumoniju, medicinska sestra mora osigurati prohodnost dišnog puta, snižavati tjelesnu temperature, pravilno uzimati mikrobiološke i laboratorijske uzorke. Osim toga, podučava bolesnika vježbama disanja te aktivno sudjeluje u prevenciji same bolesti edukacijom stanovništva o važnosti higijene ruku, izbjegavanja zatvorenih prostora s mnogo ljudi te kašljanja u maramicu. Boluje li osoba od raka pluća, medicinska sestra ima osjetljivu i vitalnu ulogu za bolesnika i obitelj. Ona mora bolesnika smiriti, pomoći mu da se nosi s dijagnozom i problemima koje ona nosi. Kod svih komplikacija kemoterapije, medicinska sestra mora pomoći u otklanjanju ili olakšavanju simptoma koje ona nosi. I kada nikakva terapija ne pomaže, medicinska sestra mora očuvati kvalitetu života i osigurati mirnu i dostojanstvenu smrt.Respiratory diseases are widespread in today world. Acute respiratory infections carry two-thirds of all infections in modern man, while chronic respiratory diseases are the third most common cause of death today. A hundred years ago, during the Spanish flu, and even today, nursing care for respiratory diseases is perhaps the most demanding and prevalent branch of nursing care for the sick. There are many symptoms that can indicate a respiratory disease, and some of them are cough, dyspnea, chest pain, coughing up secretions, sore throat, etc.
The nurse in her work with respiratory diseases, must use a number of skills and maintain empathy. Respiratory diseases are numerous and unique, and the nurse must be well acquainted with all of them. In asthma, which is one of the most common chronic diseases, it is important that the nurse educates the patient about the proper use of inhalers, about the risk factors that worsen the clinical picture (triggers) and about the timely recognition of status asthmaticus symptoms. If her patient has pneumonia, the nurse must ensure airway patency, lower body temperature, and take microbiological and laboratory samples properly. In addition, she teaches patients breathing exercises and actively participates in the prevention of the disease itself by educating the population about the importance of hand hygiene, avoiding closed spaces with many people and coughing into a tissue. If a person has lung cancer, the nurse has a sensitive and vital role for the patient and the family. It can calm the patient, help him cope with the diagnosis and the problems it brings. With all the complications of chemotherapy, the nurse must help eliminate or alleviate the symptoms chemotherapy is carrying. And when no therapy helps, the nurse must preserve the quality of life and ensure a peaceful and dignified death
NURSING CARE OF TERMINAL ONCOLOGICAL PATIENTS AND QUALITY OF LIFE
No full textZloćudni tumor je drugi najčešći uzrok smrtnosti odmah poslije kardiovaskularnih bolesti. U Republici Hrvatskoj kod muškaraca je najveća stopa oboljelih od zloćudnih tumora prostate dok žene najviše obolijevaju od zloćudnog tumora dojke. Najčešći maligni uzrok smrtnosti u Republici Hrvatskoj kod muškaraca je zloćudni tumor pluća, a kod žena zloćudni tumor debelog i tankog crijeva. U svijetu je zloćudni tumor vodeći uzrok smrtnost, a najčešći zloćudni tumor je tumor pluća. Kako bi se smanjio eksponencijalan rast pojavnosti zloćudnih tumora diljem svijeta važno je raditi na prevenciji zloćudnih tumora odnosno redovito odlaziti na preglede kod liječnika i ukloniti ili smanjiti moguće čimbenike rizika za nastanak zloćudnog tumora(pušenje, pretjerana konzumacija alkohola, tjelesna neaktivnost, pravilna prehrana, korištenje zaštite prilikom seksualnih odnosa). Redoviti odlasci na preglede izuzetno su važni kod ranog dijagnosticiranja zloćudnih tumora. U situacijama kasnog otkrivanja zloćudnog tumora najčešće se pruža palijativna skrb kojoj je cilj olakšati simptome prouzrokovane bolešću i poboljšati kvalitetu života bolesnika. Važnu ulogu u skrbi za terminalne onkološke bolesnike ima onkološka medicinska sestra koja kroz proces sestrinske skrbi osigurava bolesnicima najkvalitetniju skrb. Onkološka medicinska sestra provodi jako puno vremena uz bolesnike i prva uočava novonastale promjene. Neki od najčešćih problema kod terminalnih onkoloških bolesnika s kojima se onkološka medicinska sestra suočava su: bol, anoreksija i kaheksija, konstipacija, mučnina i povraćanje, dispneja, proljev, umor i depresija. Za onkološku medicinsku sestru je bitno da poznaje hitna stanja u onkologiji kako bi pri nastanku nekog od njih mogla pravovremeno intervenirati. Onkološke medicinske sestre moraju imati fokus na njezi i zbrinjavanju akutnih bolesnika, edukaciji bolesnika i njihovih obitelji, uspješnom oporavku bolesnika i pružanju potporne skrbi. Na kraju provedene sestrinske skrbi potrebno je evaluirati ciljeve i planove sestrinske skrbi i utvrditi da li je potrebno ponovno provesti određene intervencije kako bi se poboljšala kvaliteta života bolesnika. Prema istraživanjima na kvalitetu života terminalnih onkoloških bolesnika bitno utječu simptomi uznapredovalog zloćudnog tumora, pa je stoga potrebno učinkovitom skrbi utjecati na nastanak simptoma kako bi se terminalnim onkološkim bolesnicima povećala kvaliteta života.Cancer is the second most common cause of death immediately after cardiovascular disease. In the Republic of Croatia, men have the highest rate of prostate cancer, while women have the highest rate of breast cancer. The most common malignant cause of death in the Republic of Croatia in men is lung cancer, and in women cancer of the colon and small intestine. Cancer is the leading cause of death in the world, and the most common cancer is lung cancer. In order to reduce the exponential growth of cancer worldwide, it is important to work on cancer prevention, ie to see a doctor regularly and to eliminate or reduce possible risk factors for cancer (smoking, excessive alcohol consumption, physical inactivity, proper diet). Regular check-ups are extremely important in the early diagnosis of cancer. In situations of late cancer detection, palliative care is most often provided, which aims to alleviate symptoms and improve the quality of life of patients instead of treating the disease. An important role in the care of terminal oncology patients is played by the oncology nurse who, through the process of nursing care, provides patients with the highest quality care. The oncology nurse spends a lot of time with patients and is the first to notice the new changes. Some of the most common problems in terminal oncology patients faced by an oncology nurse are: pain, anorexia and cachexia, constipation, nausea and vomiting, dyspnea, diarrhea, fatigue, and depression. It is important for an oncology nurse to know the emergencies in oncology so that she can intervene in a timely manner in the event of any of them. Oncology nurses must have a focus on caring for and caring for acute patients, educating patients and their families, successfully recovering patients, and providing supportive care. At the end of the nursing care, it is necessary to evaluate the goals and plans of nursing care and determine whether it is necessary to re-implement certain interventions in order to improve the quality of life of patients. According to research, the quality of life of terminal cancer patients is significantly affected by the symptoms of advanced cancer, so it is necessary to effectively influence the onset of symptoms in order to make life easier for patients
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
Influence of Age and Diabetes Mellitus Type 1 on MSH2 (MutS homolog 2) Expression in a Rat Kidney Tissue
No full textUvod: Homeostaza proliferirajućih tkiva ovisi o cjelovitoj DNA molekuli. MSH2 (MutS homolog 2) pripada sustavu gena popravljača pogrešno sparenih baza i aktivan je u više faza staničnoga ciklusa. Neki tumori i neneoplastične bolesti povezane su s ugašenom ili smanjenom aktivnošću MSH2. Na animalnome modelu štakora analiziran je utjecaj starenja i šećerne bolesti tipa 1 na imunohistokemijski izražaj MSH2 u bubregu, a iz humane transkriptomske javno dostupne baze izražaj mRNA MSH2 u karcinomu bubrega. Tvoriva i postupci: U kohorti je 25 štakora podijeljenih u kontrolnu skupinu i u dijabetičnu skupinu kojoj je u drugom mjesecu života strepotozocinom inducirana šećerna bolest tipa 1. Životinje su žrtvovane u dobi od dva, osam, odnosno 14 mjeseci i oformljeno je pet skupina: zdravi štakori stari 2 mj., stari 8 mj. i stari 14. mj., te štakori sa šećernom bolesti tipa 1 stari 8 mj. i stari 14. mj. Preparati bubrežnoga tkiva obojeni su protutijelom na MSH2 indirektnom imunofluorescentnom metodom, mikroskopski analizirani, fotografirani i izražaj MSH2 kvantificiran u ImageJ računalnome programu. Transkriptomska analiza izražaja mRNA MSH2 u humanome karcinomu bubrega učinjena je iz javno dostupnih baza podataka s mrežne usluge Xena. Rezultati: Dob je glavni čimbenik koji utječe na izražaj MSH2 u tkivu bubrega štakora. Učinak dobi na MSH2 prati paraboličnu dinamiku s vrhuncem izražaja u dobi od 8 mjeseci, dok su razine u dobi od 2 i 14 mjeseci slične (p < 0,001). U štakora sa šećernom bolesti tipa 1 starih 14 mjesec značajno je veći izražaj MSH2 nego u zdravih kontrola iste dobi (p = 0,026). Kad se izražaj MSH2 na mRNA razini u uzorcima humanoga karcinoma normalizira na stopu proliferacije izraženu s mRNA Ki-67, niži je u karcinomu nego u zdravome tkivu (p = 0,011). Zaključak: Starija životna dob smanjuje izražaj MSH2 u bubregu, a šećerna bolest povećava. Utvrđen je relativni manjak mRNA MSH2 u karcinomu bubrega u odnosu na zdravo tkivo što upućuje na relativnu MSH2 deficijenciju.Background: Introduction: Homeostasis of proliferating tissues depends on the complete DNA molecule. MSH2 (MutS homolog 2) belongs to the base mismatch repair gene system and is active in several phases of the cell cycle. Some tumors and non-neoplastic diseases are associated with suppressed or reduced MSH2 activity. The influence of aging and type I diabetes on the immunohistochemical expression of MSH2 in the kidney was analyzed using a rat animal model, and MSH2 mRNA expression in kidney cancer from the publicly available human transcriptome database. Methods: To study the influence of age, three groups of healthy rats were formed: 2 months, 8 months and 14 months old. Two groups of diabetic rats were formed: 8 months old and 14 months old. 8-month-old diabetic rats were diabetic for 6 months, similarly 14-month-old diabetic rats were diabetic for 12 months. The expression of MSH2 in the kidney was studied by quantification of immunofluorescence staining. Transcriptomic analysis of MSH2 expression in human renal carcinoma was performed on a publicly available dataset from the Xena platform. Results: Age was identified as a major factor affecting MSH2 expression in the kidney. The effect of age followed a parabolic dynamic, with peak expression at 8 months of age and similar levels at 2 and 14 months of age (p < 0.001). Diabetes had an age-dependent effect, as evidenced by an increase in MSH2 expression in 14-month-old diabetic rats compared to healthy animals (p = 0.026). In an analysis of MSH2 in human kidney cancer from publicly available datasets, MSH2 mRNA normalized to Ki-67 mRNA proliferation rate appears to be lower in cancer than in healthy tissue (p = 0.011). Conclusions: Age affects MSH2 expression in kidneys more than diabetes mellitus. Since aging is a risk factor for renal neoplasia, the reduction of MSH2 in aged rats could represent one of the pro-oncogenic mechanisms of aging
Influence of Age and Diabetes Mellitus Type 1 on MSH2 (MutS homolog 2) Expression in a Rat Kidney Tissue
No full textUvod: Homeostaza proliferirajućih tkiva ovisi o cjelovitoj DNA molekuli. MSH2 (MutS homolog 2) pripada sustavu gena popravljača pogrešno sparenih baza i aktivan je u više faza staničnoga ciklusa. Neki tumori i neneoplastične bolesti povezane su s ugašenom ili smanjenom aktivnošću MSH2. Na animalnome modelu štakora analiziran je utjecaj starenja i šećerne bolesti tipa 1 na imunohistokemijski izražaj MSH2 u bubregu, a iz humane transkriptomske javno dostupne baze izražaj mRNA MSH2 u karcinomu bubrega. Tvoriva i postupci: U kohorti je 25 štakora podijeljenih u kontrolnu skupinu i u dijabetičnu skupinu kojoj je u drugom mjesecu života strepotozocinom inducirana šećerna bolest tipa 1. Životinje su žrtvovane u dobi od dva, osam, odnosno 14 mjeseci i oformljeno je pet skupina: zdravi štakori stari 2 mj., stari 8 mj. i stari 14. mj., te štakori sa šećernom bolesti tipa 1 stari 8 mj. i stari 14. mj. Preparati bubrežnoga tkiva obojeni su protutijelom na MSH2 indirektnom imunofluorescentnom metodom, mikroskopski analizirani, fotografirani i izražaj MSH2 kvantificiran u ImageJ računalnome programu. Transkriptomska analiza izražaja mRNA MSH2 u humanome karcinomu bubrega učinjena je iz javno dostupnih baza podataka s mrežne usluge Xena. Rezultati: Dob je glavni čimbenik koji utječe na izražaj MSH2 u tkivu bubrega štakora. Učinak dobi na MSH2 prati paraboličnu dinamiku s vrhuncem izražaja u dobi od 8 mjeseci, dok su razine u dobi od 2 i 14 mjeseci slične (p < 0,001). U štakora sa šećernom bolesti tipa 1 starih 14 mjesec značajno je veći izražaj MSH2 nego u zdravih kontrola iste dobi (p = 0,026). Kad se izražaj MSH2 na mRNA razini u uzorcima humanoga karcinoma normalizira na stopu proliferacije izraženu s mRNA Ki-67, niži je u karcinomu nego u zdravome tkivu (p = 0,011). Zaključak: Starija životna dob smanjuje izražaj MSH2 u bubregu, a šećerna bolest povećava. Utvrđen je relativni manjak mRNA MSH2 u karcinomu bubrega u odnosu na zdravo tkivo što upućuje na relativnu MSH2 deficijenciju.Background: Introduction: Homeostasis of proliferating tissues depends on the complete DNA molecule. MSH2 (MutS homolog 2) belongs to the base mismatch repair gene system and is active in several phases of the cell cycle. Some tumors and non-neoplastic diseases are associated with suppressed or reduced MSH2 activity. The influence of aging and type I diabetes on the immunohistochemical expression of MSH2 in the kidney was analyzed using a rat animal model, and MSH2 mRNA expression in kidney cancer from the publicly available human transcriptome database. Methods: To study the influence of age, three groups of healthy rats were formed: 2 months, 8 months and 14 months old. Two groups of diabetic rats were formed: 8 months old and 14 months old. 8-month-old diabetic rats were diabetic for 6 months, similarly 14-month-old diabetic rats were diabetic for 12 months. The expression of MSH2 in the kidney was studied by quantification of immunofluorescence staining. Transcriptomic analysis of MSH2 expression in human renal carcinoma was performed on a publicly available dataset from the Xena platform. Results: Age was identified as a major factor affecting MSH2 expression in the kidney. The effect of age followed a parabolic dynamic, with peak expression at 8 months of age and similar levels at 2 and 14 months of age (p < 0.001). Diabetes had an age-dependent effect, as evidenced by an increase in MSH2 expression in 14-month-old diabetic rats compared to healthy animals (p = 0.026). In an analysis of MSH2 in human kidney cancer from publicly available datasets, MSH2 mRNA normalized to Ki-67 mRNA proliferation rate appears to be lower in cancer than in healthy tissue (p = 0.011). Conclusions: Age affects MSH2 expression in kidneys more than diabetes mellitus. Since aging is a risk factor for renal neoplasia, the reduction of MSH2 in aged rats could represent one of the pro-oncogenic mechanisms of aging
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
NURSE EDUCATOR IN THE CARE OF A PATIENT WITH METABOLIC SYNDROME, IMPACT ON QUALITY OF LIFE
No full textSuvremeni način života obilježen prekomjernim sjedenjem i nedostatnom tjelesnom aktivnošću te nepravilnom, neredovitom i neuravnoteženom prehranom u uvjetima užurbanosti i stresa doprinosi razvoju brojnih kroničnih stanja, a jedan od njih je metabolički sindrom. Navedeni sindrom nema jednostavnu patogenezu, već je rezultat skupa rizičnih čimbenika kao što su visceralna pretilost koja uzrokuje upalne procese u organizmu te doprinosi otpuštanju viška slobodnih masnih kiselina u organizam, zatim hipertenzija, dislipidemija te inzulinska rezistencija. Dugoročna izloženost stanju povišenih vrijednosti šećera u krvi unatoč povećanom izlučivanju inzulina u gušterači koja se događa uslijed inzulinske rezistencije vodi do dijabetesa, srčanih i moždanih udara te smanjenja funkcije bubrega.
Medicinske sestre imaju ključnu ulogu edukatora kod bolesnika oboljelih od metaboličkog sindroma. Individualni pristup edukaciji i motivaciji bolesnika za provedbu programa modifikacije životnog stila (prehrana, kretanje, prestanak pušenja i konzumacije alkohola) ključan je i učinkovit u primarnoj i sekundarnoj prevenciji komplikacija koje mogu nastati kao posljedica metaboličkog sindroma, a to su prvenstveno kardio-vaskularne bolesti. Preuzimanjem odgovornosti za vlastito zdravstveno stanje unaprjeđuje se nesmetano funkcioniranje oboljelih te se podiže kvaliteta njihova života.
CILJ: Cilj istraživanja je razumjeti patogenezu nastanka metaboličkog sindroma i njegovu korelaciju sa kritičnim čimbenicima te cjelovito obrazložiti ulogu medicinske sestre kao edukatora u skrbi za bolesnika oboljelog od istoga. Edukativna uloga medicinske sestre/tehničara je ključna obzirom da je esencijalni čimbenik o kojem ovisi ishod liječenja metaboličkog sindroma upravo promjena životnog stila i navika kao što su povećana tjelesna aktivnost, uvođenje kvalitetnije prehrane te prestanak pušenja i konzumacije alkohola.
METODE: Narativni pregled literature je prikazan na osnovu pretrage znanstvenih i stručnih članaka i publikacija dostupnih u bazama podataka Medline, scholar.google.hr i hrcak.srce.hr. Pretraživanje baza podataka je provedeno na osnovu ključnih riječi „metabolic syndrome“, „nursing management“, „nurse specialist“ i „educational role“ na engleskom i hrvatskom jeziku u bazama podataka PubMed i hrcak.srce.hr. Pretraga je rezultirala sa 137.000 rezultata. Potom je pretraga sužena prema kriteriju recentnosti rezultata, a kao granična godina je uzeta 2012. U užu pretragu su uključeni članci u kojima se obrađuje utjecaj uloge medicinske sestre edukatora na kvalitetu života i ishod liječenja oboljelih od metaboličkog sindroma, te je u radu prikazano ukupno šest istraživanja na tu temu.
REZULTATI: Prema rezultatima istraživanja Pincere i suradnika, individualan i dugotrajan pristup edukaciji i motivaciji pacijenta za usvajanje zdravih navika ključan je u uspješnom razvoju odgovornog pristupa samog pacijenta u pogledu brige za vlastito zdravlje [31]. Chang, Fritschi i Kim su pak radili istraživanje o utjecaju edukacije i promjene načina života na hipertenziju. Rezultati istraživanja pokazali su da je program utemeljen na sestrinskim intervencijama rezultirao uspješnijim ishodima u smislu promjena u sistoličkom i dijastoličkom tlaku te obujmu struka nego kod kontrolne skupine. Chia-Huei i suradnici su kroz analizu ukupno pet različitih programa za promjenu životnog stila također potvrdili kako edukacija i promocija zdrave prehrane i tjelovježbe te savjetovanje i poticanje motivacije imaju pozitivne ishode na sistolički i dijastolički krvni tlak te obujam struka i razinu triglicerida u krvi. Rezultati istraživanja Iquiza i suradnika ukazuju kako je primjena edukacijskih programa od strane medicinskih sestara/tehničara rezultirala brojnim dobrobitima u fizičkom zdravlju za ciljne skupine pacijenata, i to u pogledu brige o vlastitom zdravlju, unaprjeđenja funkcionalnosti i kvalitete života [34]. Rezultati istraživanja Lawler i suradnika pokazali su pozitivan učinak sestrinskih intervencija na stanje pacijenta na način da se kroz edukaciju bolesnika s dijabetesom smanjuje vrijeme i frekventnosti hospitalizacija i povećava razina zadovoljstva pacijenta [34]. Poljičanin i suradnici su proveli CroHort studiju o utjecaju edukacijskih i motivacijskih mjera koje provode medicinske sestre na razini zajednice koja je rezultirala spoznajom velikog utjecaja motivacije oboljlih na poboljšanje parametara i vrijednosti hiperlipidemije, hipertenzije te tjelesne mase. Istraživanje Felixa i suradnika temelji se na procjeni standarda za postavljanje sestrinskih dijagnoza i intervencija te je rezultiralo visokim stupnjem sukladnosti procesa sestrinske dijagnostike utemeljene na teorijskom okviru ljudskih potreba sa standardom ICNP® 2015 [36].
ZAKLJUČAK: Metabolički sindrom se smatra stanjem rezultiranim kumulacijom genetskih čimbenika, suvremenog načina života bez dovoljno tjelesne aktivnosti i neadekvatne prehrane te štetnih životnih navika. Kriteriji za dijagnostiku metaboličkog sindroma se razlikuju, no u rizične čimbenike se ubrajaju visceralna pretilost, hipelipidemija, hipertenzija, inzulinska rezistencija i hipeglikemija. Ukoliko bolesnik ima tri od pet navedenih rizičnih čimbenika, dijagnosticira mu se metabolički sindrom. Utjecaj intervencija medicinskih sestara/ tehničara na poboljšanje stanja i liječenje uzroka metaboličkog sindroma nije zanemariv. Motivacija, edukacija i savjetovanje pacijenata uvelike dopridonose smanjenju vrijednosti hiperlipidemije, hipertenzije te tjelesne mase pacijenata, a to se postiže pravodobnim dijagnosticiranjem uzroka i individualnim holističkim pristupom oboljelima.The modern way of life characterized by excessive sitting and insufficient physical activity, as well as unbalanced and irregular diet combined with stressful and busy life, contributes to the development of numerous chronic conditions, one of which is metabolic syndrome. This syndrome does not have a simple pathogenesis, but is the result of a set of risk factors such as visceral obesity, which causes inflammatory processes in the body and contributes to the release of excess free fatty acids into the body, hypertension, dyslipidemia and insulin resistance. Long-term exposure to a state of elevated blood sugar levels despite increased insulin secretion in the pancreas that occurs due to insulin resistance leads to diabetes, heart attacks and strokes, and decreased kidney function..
Nurses play a key role as educators in patients with metabolic syndrome. An individual approach to educating and motivating patients to implement a lifestyle modification program (diet, exercise, smoking cessation, and alcohol consumption) is crucial and effective in primary and secondary prevention of complications that may result from metabolic syndrome, primarily cardiovascular disease. By taking responsibility for one's own health, the everyday functioning of patients is improved and the quality of their lives is raised.
AIM: The aim of the research is to understand the pathogenesis of the metabolic syndrome and its correlation with critical factors and to fully explain the role of the nurse as an educator in the care of patients with the metabolic syndrome. The educational role of the nurse / technician is crucial given that the essential factor on which the outcome of metabolic syndrome treatment depends is a change in lifestyle and habits such as increased physical activity, introduction of a better diet and smoking cessation and alcohol consumption cessation.
METODHS: Narrative literature review is presented based on a search of scientific and professional articles and publications available in the databases of Medline, scholar.google.hr and hrcak.srce.hr. The database search was performed on the basis of the keywords "metabolic syndrome", "nursing management", "nurse specialist" and "educational role" in English and Croatian in the PubMed and hrcak.srce.hr databases. Search returned 137,000 results. Then the search was narrowed according to the criterion of recent results, and the limit year was 2012. research on the subject. The shortlist includes articles that deal with the impact of the role of the educator nurse on the quality of life and the outcome of treatment of patients with metabolic syndrome, and the paper presents a total of six studies on this topic.
RESULTS: According to research by Pincera and associates., An individual and long-term approach to educating and motivating the patient to adopt healthy habits is crucial in the successful development of a responsible approach of the patient to care for their own health [31]. Chang, Fritschi, and Kim, on the other hand, did research on the impact of education and lifestyle changes on hypertension. The results of the study showed that the program based on nursing interventions resulted in more successful outcomes in terms of changes in systolic and diastolic pressure and waist circumference than in the control group. Through an analysis of a total of five different lifestyle change programs, Chia-Huei and colleagues also confirmed that education and promotion of healthy eating and exercise and counseling and motivation have positive outcomes on systolic and diastolic blood pressure and waist circumference and blood triglyceride levels. The results of research by Iquiz and associates indicate that the implementation of educational programs by nurses / technicians has resulted in numerous physical health benefits for target groups of patients, in terms of caring for their own health, improving functionality and quality of life [34]. The results of a study by Lawler et al showed a positive effect of nursing interventions on the patient's condition by reducing the time and frequency of hospitalizations and increasing patient satisfaction through education of patients with diabetes [34]. Poljičanin and colleagues conducted a CroHort study on the impact of educational and motivational measures implemented by nurses at the community level, which resulted in the realization of the great impact of motivation of patients on improving the parameters and values of hyperlipidemia, hypertension and body weight. The research of Felix and co-workers is based on the assessment of standards for setting nursing diagnoses and interventions and has resulted in a high degree of compliance of the nursing diagnosis process based on the theoretical framework of human needs with the ICNP® 2015 standard. [36].
CONCLUSION: Metabolic syndrome is considered a condition resulted because of the accumulation of genetic factors, a modern lifestyle without sufficient physical activity and inadequate nutrition, and harmful lifestyle habits. Criteria for the diagnosis of metabolic syndrome vary, but risk factors include visceral obesity, hypelipidemia, hypertension, insulin resistance, and hypoglycemia. If a patient has three of the five listed risk factors, he is diagnosed with metabolic syndrome. The impact of the interventions of nurses / technicians on the improvement of the condition and the treatment of the causes of the metabolic syndrome is not negligible. Motivation, education and counseling of patients greatly contribute to the reduction of the values of hyperlipidemia, hypertension and body weight of patients, and this is achieved by timely diagnosis of the causes and individual holistic approach to patients
Influence of Age and Diabetes Mellitus Type 1 on MSH2 (MutS homolog 2) Expression in a Rat Kidney Tissue
No full textUvod: Homeostaza proliferirajućih tkiva ovisi o cjelovitoj DNA molekuli. MSH2 (MutS homolog 2) pripada sustavu gena popravljača pogrešno sparenih baza i aktivan je u više faza staničnoga ciklusa. Neki tumori i neneoplastične bolesti povezane su s ugašenom ili smanjenom aktivnošću MSH2. Na animalnome modelu štakora analiziran je utjecaj starenja i šećerne bolesti tipa 1 na imunohistokemijski izražaj MSH2 u bubregu, a iz humane transkriptomske javno dostupne baze izražaj mRNA MSH2 u karcinomu bubrega. Tvoriva i postupci: U kohorti je 25 štakora podijeljenih u kontrolnu skupinu i u dijabetičnu skupinu kojoj je u drugom mjesecu života strepotozocinom inducirana šećerna bolest tipa 1. Životinje su žrtvovane u dobi od dva, osam, odnosno 14 mjeseci i oformljeno je pet skupina: zdravi štakori stari 2 mj., stari 8 mj. i stari 14. mj., te štakori sa šećernom bolesti tipa 1 stari 8 mj. i stari 14. mj. Preparati bubrežnoga tkiva obojeni su protutijelom na MSH2 indirektnom imunofluorescentnom metodom, mikroskopski analizirani, fotografirani i izražaj MSH2 kvantificiran u ImageJ računalnome programu. Transkriptomska analiza izražaja mRNA MSH2 u humanome karcinomu bubrega učinjena je iz javno dostupnih baza podataka s mrežne usluge Xena. Rezultati: Dob je glavni čimbenik koji utječe na izražaj MSH2 u tkivu bubrega štakora. Učinak dobi na MSH2 prati paraboličnu dinamiku s vrhuncem izražaja u dobi od 8 mjeseci, dok su razine u dobi od 2 i 14 mjeseci slične (p < 0,001). U štakora sa šećernom bolesti tipa 1 starih 14 mjesec značajno je veći izražaj MSH2 nego u zdravih kontrola iste dobi (p = 0,026). Kad se izražaj MSH2 na mRNA razini u uzorcima humanoga karcinoma normalizira na stopu proliferacije izraženu s mRNA Ki-67, niži je u karcinomu nego u zdravome tkivu (p = 0,011). Zaključak: Starija životna dob smanjuje izražaj MSH2 u bubregu, a šećerna bolest povećava. Utvrđen je relativni manjak mRNA MSH2 u karcinomu bubrega u odnosu na zdravo tkivo što upućuje na relativnu MSH2 deficijenciju.Background: Introduction: Homeostasis of proliferating tissues depends on the complete DNA molecule. MSH2 (MutS homolog 2) belongs to the base mismatch repair gene system and is active in several phases of the cell cycle. Some tumors and non-neoplastic diseases are associated with suppressed or reduced MSH2 activity. The influence of aging and type I diabetes on the immunohistochemical expression of MSH2 in the kidney was analyzed using a rat animal model, and MSH2 mRNA expression in kidney cancer from the publicly available human transcriptome database. Methods: To study the influence of age, three groups of healthy rats were formed: 2 months, 8 months and 14 months old. Two groups of diabetic rats were formed: 8 months old and 14 months old. 8-month-old diabetic rats were diabetic for 6 months, similarly 14-month-old diabetic rats were diabetic for 12 months. The expression of MSH2 in the kidney was studied by quantification of immunofluorescence staining. Transcriptomic analysis of MSH2 expression in human renal carcinoma was performed on a publicly available dataset from the Xena platform. Results: Age was identified as a major factor affecting MSH2 expression in the kidney. The effect of age followed a parabolic dynamic, with peak expression at 8 months of age and similar levels at 2 and 14 months of age (p < 0.001). Diabetes had an age-dependent effect, as evidenced by an increase in MSH2 expression in 14-month-old diabetic rats compared to healthy animals (p = 0.026). In an analysis of MSH2 in human kidney cancer from publicly available datasets, MSH2 mRNA normalized to Ki-67 mRNA proliferation rate appears to be lower in cancer than in healthy tissue (p = 0.011). Conclusions: Age affects MSH2 expression in kidneys more than diabetes mellitus. Since aging is a risk factor for renal neoplasia, the reduction of MSH2 in aged rats could represent one of the pro-oncogenic mechanisms of aging
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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