Rauche časopis: Broj 7

Applying the isokinetic and the isokinetic diagnostics at the injures of ligamentum anterior cruciate-acl

SUMMARY

Injury to the ligaments of the knee lately is growing among athletes. In the sports literature the term sports knee is more present than before. Fresh injuries of the ligament apparatus essentially represent a serious distortion of the knee, which if improperly are treated can cause serious damage to the kinematics of the knee. According Bousget heavy distortion of the knee means: isolated ACL injury; isolated failures of the last internal angle or popliteus, isolated failures of the last internal angle with desinsertion of the meniscus and at least two or more violations of the capsule of the ligament apparatus of the knee.

The world trends show a significant quantitative increase in the sport and recreation activities dealing with people during their leisure time. Unfortunately, such attempts often result in more damage than good, because they are performed spontaneously, usually without a plan and program, and especially without adequate supervision and preparations of the bones, wrists, muscular and cardiorespiratory system.

Therefore, in such activities sometimes it comes even to severe consequences such as heart attack, stroke, but in most cases the problems usually are associated with the locomotors apparatus. So often we find stretched and ruptured muscles and tendons, wrists problem in terms of ruptured ligament, degenerative damage (mostly cartilage) and in the worst cases even stress fractures of the bones. Therefore, it would be nice firstly to strengthen muscles, to enable the wrists, tendons and bones and only then to start with activity. One extremely effective method for this is isokinetic exercise, whereby the muscles are actively strength without danger of overload of the wrists. That is important in the prevention, because it brings into balance the antagonistic groups i.e. we prepare optimally entire bone-muscle system for the planned recreation.

Isokinetic exercise is the most beneficial for people that have already led to some pathological changes, primarily damage to the joints (injuries, degenerative inflammatory diseases, etc.). After completing the isokinetic treatment it is extremely important that before to proceed with some kind of planned physical activity, as the resulting muscular force would better maintained, and cardiorespiratory system would be developed more.

KEY WORDS: ACL, BIODEX, Isokinetic, diagnostics, knee, injures

Nastavi čitati Applying the isokinetic and the isokinetic diagnostics at the injures of ligamentum anterior cruciate-acl

Kolorektalni karcinom s aspekta medicinske sestre

Nurses knowledge and perception toward colorectal cancer

SAŽETAK

UVOD: Kolorektalni karcinom nalazi se na trećem mjestu po učestalosti među svim zloćudnim novotvorevinama u svijetu, ali isto tako to je jedan od rijetkih tumora čiju pojavu možemo na vrijeme spriječiti.

CILJ ISTRAŽIVANJA: utvrditi učestalost kolorektalnog karcinoma na hirurškom odjelu Regionalnog medicinskog centra dr Safet Mujić. Ujedno cilj ovog istraživanja je ustanoviti ulogu i značaj medicinske sestre u provedbi zdravstvene njege ovih bolesnika.

ISPITANICI I POSTUPCI: Provedena je retrospektivna studija na hirurškom odjelu Regionalnog medicinskog centra Dr Safet Mujić Mostar. Ispitanici su bili bolesnici s verificiranom patohistološkim nalazom kolorektalnog karcinoma koji su hospitalizirani na odjelu u razdoblju od 1.1.2011. do 31.12.2013. Broj ispitanika bio je 131.

REZULTATI: Muškaraca je bilo 70 (53,4%) dok je žena bilo 61 (46,6%) (P=0,431). Srednja životna dob ispitanika je 69,5±5,8 godina. Najmlađi ispitanik ima 48, a najstariji 89 godina. Srednja životna dob muškaraca bila je 68,9±6,1 godina, dok je u žena iznosila 71,3±5,4 što se nije pokazalo statistički značajnim (P=0,506). Najčešće izvođena operacija je niska anteriorna resekcija koja je učinjena kod ukupno 47 (35,9%) pacijenata, dok je najmanje učestalo izvođena operacija bila resekcija kolon transversuma koja je učinjena svega kod 7 (5,3%) pacijenata (p<0,001). Najčešće zastupljen stadij kolorektalnog karcinoma bio Dukes B u 48 (36,6%) pacijentata, odnosno Dukes C u 44 (33,6%) pacijenta. (p<0,001). Prosječna dužina hospitalizacije ispitanika iznosila je 13,4 dana, od čega su prosječno 2,7 dana proveli u jedinici intenzivnog liječenja.

ZAKLJUČCI: U perioperacijskom procesu zdravstvene njege bolesnika s kolorektalnim karcinomom ključnu ulogu imaju medicinske sestre-tehničari, te o kvaliteti njihovog posla direktno ovisi i konačni uspjeh liječenja.

SUMMARY

INTRODUCTION:Colorectal cancer is the third most common malignant neoplasms among all of the world, but also it is a rare tumor whose occurrence can be prevented in time.

AIM: To determine the incidence of colorectal cancer in the surgical department of the Regional Medical Center Dr Safet Mujić. Also, the aim of this study was to determine the role and importance of nurses in implementing the health care of these patients.

PATIENTS AND METHODS: We conducted a retrospective study on the surgical ward Regional Medical Center Dr Safet Mujić Mostar. Subjects were patients with histologically verified colorectal cancer who were hospitalized in the department during the period from 1.1.2011. to 31.12.2013. The number of respondents was the 131.

RESULTS: Males were 70 (53.4%), while women were 61 (46.6%) (P=0.431). The mean age of respondents was 69.5 ± 5.8 years. The youngest participant is 48 and the oldest 89. The mean age of men was 68.9±6.1 years, whereas in women was 71.3±5.4 which did not prove to be statistically significant (P=0.506). The most commonly performed surgery is a low anterior resection, which was performed in a total of 47 (35.9%) patients, whereas the least frequently performed operation involves resection of the colon transversuma that was done only in 7 (5.3%) patients (p<0.001). The most frequent stage colorectal cancer was Dukes B in 48 (36.6%) pacijentata or Dukes C in 44 (33.6%) patients (p<0.001). The average length of hospitalization of patients was 13.4 days, of which an average of 2.7 days in the intensive care unit.

CONCLUSIONS: In the perioperative process health care of patients with colorectal cancer have a crucial role nurses-technicians, and the quality of their work depends directly on the ultimate success of treatment.

Nastavi čitati Kolorektalni karcinom s aspekta medicinske sestre

Psihičke reakcije bolesnika u perioperativnom periodu

Psychological reactions of patients in the perioperative period

SAŽETAK

UVOD: Hirurška intervencija uobičajeno dovodi do straha. Operacija je uvijek naglašeni emocionalni ulazak u sferu nepoznatog i nema čovjeka s normalnim psihološkim odbranama koji ne osjeti nelagodu pri odlasku na bilo koju operaciju. Cilj ovog istraživanja je ispitati postojanje psihičkih reakcija pacijenata koji su primljeni na operativni tretman, mogućnost iznalaženja mjera u prevladavanju mogućeg preoperativnog i postoperativnog straha, izrada plana uvođenja promena i strategija u prevladavanju preoperativnog i postoperativnog straha i praćenje njegovog ostvarivanja.

METODE: Istraživanje je sprovedeno u hiruškoj jedinici za anesteziju i reanimaciju Univerzitetske bolnice u Foči u periodu od 01.05.2013. godine do 31.05.2013. godine. U istraživanju je korišten kraći deskriptivni upitnik sa podacima o ispitaniku i upitnik samoprocjene za depresiju.

REZULTATI: Najveći broj pacijenata je par dana pred operaciju imao smanjeno interesovanje za događaje oko sebe, osjećaj praznine, neraspoloženje, probleme sa snom , umor. Najveći broj pacijenata nije imao umanjen apetit, slabost koncentracije, usporenost, suicidalne ideje. Od 20 naših ispitanika 3 pacijenta nisu pokazivala tjelesne simptome, dok njih 17 je navodilo veći broj tjelesnih simptoma iz područja svih organskih sistema. Kod 4 pacijenta pronađen je rezultat koji odgovara za uobičajenu opštu populaciju, blagi oblik depresije je pronađen kod 11 pacijenata, dok je umjereno blagi oblik depresije pronadjen je kod 5 pacijenata.

ZAKLJUČAK: Dobro osmišljena i obavljena psihološka preoperativna priprema predstavlja ne samo važan faktor pozitivnog operativnog ishoda i uspešnog postoperativnog oporavka bolesnika, već i trajniji zalog njegovog racionalnog odnosa prema zdravlju i bolesti.

KLJUČNE REČI: Strah od operacije, ličnost bolesnika, psihološka priprema

SUMMARY

INTRODUCTION: Surgical intervention usually leads to fear. The operation has always been emphasized emotional entry into the sphere of the unknown and there is no man with normal psychological defenses that do not feel any discomfort when visiting any operation.

OBJECTIVE: The aim of this study is to examine the existence of psychological reactions of patients who were admitted to the surgical treatment, the possibility of exploring measures to overcome possible preoperative and postoperative fear, development of a plan to introduce changes and strategies to overcome the preoperative and postoperative fear and monitoring its implementation.

METHODS: The research was conducted in the surgical unit for anesthesia and resuscitation at University Hospital in Foča during the period from 01.05.2013. until 31.05.2013. year. The study used a descriptive short questionnaire with information on the subject and self-assessment questionnaire for depression.

RESULTS: The majority of patients a few days before the operation had diminished interest in the events around them, a feeling of emptiness, indisposition, sleep problems, fatigue. The majority of patients had decreased appetite, weakness of concentration, slow, suicidal ideas. From all examined patients 15% of them showed no physical symptoms, while 85% were showed greater number of physical symptoms in the field of all organ systems. Twenty percent of all examined patients has no signs of depression, a mild form of depression was found in 55% of patients, while the moderately mild form of depression was found in 25% of patients.

CONCLUSION: A well-designed and conducted psychological preoperative preparation is not only an important factor for positive operational outcomes and successful post-operative recovery of patients, but also more durable pledge its rational relationship to health and disease.

KEY WORDS: Fear of surgery, patient personality, psychological preparation

Nastavi čitati Psihičke reakcije bolesnika u perioperativnom periodu

Prehospitalno zbrinjavanje djece sa urgentnim stanjima

Pre-hospital care of children in urgent states

SAŽETAK

UVOD: Hitna stanja u dječijoj dobi odnose se na stanja nastala zbog različitih bolesti ili ozljeda, što ugrožavaju život djeteta ili na stanje djeteta bez vitalnih funkcija.

U dječijoj dobi,kao i kod ostale populacije,hitno stanje nastaje kod dvije važne kategorije ugroženih: jednu čine zdrava djeca kod koje je hitno stanje nastalo kao posljedica akutne bolesti ili ozljede,a drugu kategoriju čine hronično oboljela djeca zbog izostanka povoljnog odgovora na terapiju ili pri potencijalno izlječivim bolestima u toku kojih hitno stanje nastaje zbog sekundarnih komplikacija.

CILJ RADA: Ispitati učestalost hitnih stanja u dječjoj dobi prema spolu, životnoj dobi i godišnjim dobima tokom višegodišnjeg razdoblja; Utvrditi strukturu morbiditeta i mortaliteta hitnih stanja prema životnoj dobi djece;Analizirati socioekonomske faktore koji su povezani s pojavom hitnih stanja kod djece; Analizirati primijenjene medicinske postupke u zbrinjavanju djeteta s hitnim stanjem prije upućivanja u odgovarajuću bolničku ustanovu.

METOD RADA: Zdravstveno stanje djece procijenjeno je na osnovi uvida u službeni protokol Službe hitne medicinske pomoći Doma zdravlja Sapna. Istraživanje je provedeno u periodu od 01.01. 2009.godine do 30. 11. 2014. godine. U istom razdoblju u Službu hitne medicinske pomoći u Sapni javilo se 1.761 dijete od 3.974-ero djece (44,3%).

DISKUSIJA I ZAKLJUČCI: Od ukupnog broja djece koja žive na teritoriju Općine Sapna ispitivanom periodu u Službu hitne medicinske pomoći u Sapni javilo se 68,3% djece u dobi od 0 do14 godina.

Njihova zastupljenost u ukupnom broju pregleda u Službi hitne medicinske pomoći u Sapni bila je 19%. Najveći broj djece s hitnim stanjem definitivno je zbrinut u Klinici za dječije bolesti Univerzitetskog kliničkog centra u Tuzli. Nije bilo smrtnih slučajeva, pa se može zaključiti da su primijenjeni terapijski postupci bili adekvatni.

KLJUČNE RIJEČI: urgentna stanja, djeca, zbrinjavanje

SUMMARY

INTRODUCTION: Urgent states in children age relate to states occured due to different illnesses or injuries that threaten life of children, or relate to state of children without vital functions. In children age, as well as in other populations, utgent state occurs in two important categories of threatened persons: first category are healthy children where urgent state occurs as a consequence of acute disease or injury, and second category chronically ill children due to lack of positive response to therapy or with potentially curable diseases during which urgent state occurs because of secundary implications.

AIM:To examine the frequency of urgent states in children age according to gender, age, seasons over the multi-year period; To determine the structure of morbidity and mortality of urgent states in relation with age of children;

To analyze social and economical factors related to occurence of urgent states in children; To analyze the applied medical procedures in care of children with urgent states prior to sending to the appropriate medical institution.

METHODS: Health condition of children was examined based on inspection of official protocol of Emergency Medical Service of Health Center in Sapna. The survey was conducted in the period from 01.01. 2009 to 30. 11. 2014. During this period, in Emergency Medical Service of Sapna 1761 of 3974 (44.3%) children were reported.

DISCUSSION AND CONCLUSIONS: From the total number of children who live on the Sapna municipality area, in the examined period, in the Emergency Medical Service 68.3% of children ages 0-14 were reported. Their representation in total number of examinations in the Emergency Service in Sapna was 19%. Highest number of children with urgent states was definitely taken care of on Children Disease Clinic of University Clinic Centre in Tuzla. There were no recorded death cases, and it can be concluded that applied therapeutic procedures were adequate.

KEY WORDS: emergency situations, children, medical care

Nastavi čitati Prehospitalno zbrinjavanje djece sa urgentnim stanjima