Rizik za nastanak pneumonije u pacijenata sa astmom i hroničnim opstruktivnim bronhitisom (copd) na tretmanu inhalatornim kortikosteroidima

Conditional logistic regression was used to determine the association between the dose and type of inhaled corticosteroid and the risk of pneumonia or lower respiratory tract infection

SAŽETAK

UVOD: Smatra se da od astme boluje oko 100 miliona ljudi u svijetu dok je HOPB četvrti vodeći uzrok smrtnosti u svijetu.

MATERIJALI I METODE: Prospektivna opservaciona studija je sprovedena u Domu zdravlja Novi Travnik na odjelu porodična medicina. Istraživanjem su obuhvačeni pacijenti stariji od 18 godina koji su oboljeli od astme i HOPB na tretmanu inhalatornim kortikosteroidima, i u kontrolnoj grupi pacijenti oboljeli od astme I HOPB koji su lijećeni samo salbutamolom (ventolin).

REZULTATI: Postoji signifikantna razlika u učestalosti pneumonije kod pacijenata koji koriste inhalatorne kortikosteroide u odnosu na one koji koriste samo salbutamol (p = 0,01). Od pacijenata koji su koristili inhalatorne kortikosteroide 52 % je imalo pnemoniju ili infekciju gornjeg respiratornog trakta. Učestalost dnevnih simptoma (manje od 1 puta tijedno) i noćnih ( manje od 2 puta mjesečno ) pronađena je kod 47% pacijenata koji koriste inhalatorne kortikosteroide, do je taj broj kod pacijenata koji koriste samo salbutamol 25%. Broj pacijenata koji imaju ove simtome više od 1 puta tijedno, odnosno za noćne simtome više od 2 puta mjesečno jednak je u obje skupine i iznosi 30 % pacijenata svake pojedine skupine.

ZAKLJUČAK: Istraživanjem je utvrđeno da pacijenti sa astmom i HOPB koje koriste inhalatorne kortikosteroide imaju češće infekcije respiratornog trakta od pacijenata koji koriste samo salbutamol. Postoji statistički značajna signifikantna razlika među skupinama u odnosu na količinu simptoma, jer pacijenti koji koriste inhalatorne kortikosteroide imaju manje učestale simptome u odnosu na one koji koriste samo salbutamol.

KLJUČNE RIJEČI: astma, hronična opstruktivna bolest, inhalatorni kortikosteroidi, pneumonia

SUMMARY

INTRODUCTION: It considers that asthma affects 100 million people worldwide and HOPB is the fourth leading cause of death in the world.

MATERIALS AND METHODS: A prospective observational study was performed at the Health Center Novi Travnik in the department of family medicine. The study included patients 18 years over who were suffering from asthma and HOPB on the treatment of inhaled corticosteroids, and in the control group, patients who were suffering from asthma and HOPB who were treated only by salbutamol (Ventolin).

RESULTS: There is a significant difference between incidence rate of pneumonia for patients who used inhaled corticosteroids and incidence rate of pneumonia for patients who used only salbutamol (p = 0.01). 52% of the patients who used inhaled corticosteroids had pneumonia or upper respiratory tract infection. Daily symptoms frequency (less than once per week) and night symptoms frequency (less than twice per month) had value of 47% for patients who used inhaled corticosteroids and value of 25% for patients who used only salbutamol. Number of patients who have these symptoms more than once per week, or for night symptoms more than twice per month is equal for both groups and has value of 30% patients of each group.

CONCLUSION: In this study is shown that patients with asthma and HOPB who use the inhaled corticosteroids have more frequent respiratory tract infections than patients who use only salbutamol. There is statistically significant difference between the groups regarding the number of symptoms, because the patients who use inhaled corticosteroids have less frequent symptoms compared to those patients who use only salbutamol.

KLJUČNE RIJEČI: asthma, chronic obstructive pulmonary disease, inhaled corticosteroids, pneumonia

Nastavi čitati Rizik za nastanak pneumonije u pacijenata sa astmom i hroničnim opstruktivnim bronhitisom (copd) na tretmanu inhalatornim kortikosteroidima

The role of kinesitherapy at the rehabilitation of paralysis of n. Facialis

SUMMARY

In the case of paralysis of n. facialis, most emphasis is placed on early detection, proper diagnosis of the damage and as soon as possible starting rehabilitation.

Clinically, damages of n. facialis is manifested by rigidity on one side of the face. The patient is unable to raise his forehead while trying to close the eye, eye apple is stepping up to, and reflected the white of the eye, the eye does not close, the oral angle is lowered, and the mouth is drawn aside. Nasal groove is deleted, the eye constantly tears and corneal reflex is lost.

The success of rehabilitation depends on the causes, extent of functional damage to the facial nerve and time of starting with a treatment.

Besides drug therapy in the rehabilitation of paralysis of the facial nerve, an important place has physical therapy, but kinesitherapy is the most important part of all procedures to restore the lost function of the facial nerve.

We apply the following kinesitherapy methods: therapy with position (elongation of shortened muscles of the healthy side and the shortening of the muscles of the patient side); active movements (for affected muscles and others); breathing exercises and general exercises; exercises for the muscles of the shoulder girdle; neck muscles and for the muscles which are not affected. The treatment lasts for months, and bimonthly repeat course of treatment lasting 15 days. Main complications of neuritis n. facialis are contractures and synkinesis. The scheme for the treatment is prepared according to the results of MMT.

KEY WORDS: neuritis, n. facialis, muscles, exercise, kinesitherapy and rehabilitation

SAŽETAK

U slučaju paralize n. facialisa, najveći naglasak je stavljen na rano otkrivanje, pravilna dijagnoza oštećenja i što raniji poćetak rehabilitacije.

Klinički, oštećenje n. facialisa se manifestuje sa rigidnosti na jednoj strani lica. Pacijent nije u stanju da podigne čelo pokušavajući da zatvori oči, očna jabućica se podiže i vidi se beli deo oka, oko se ne zatvara, usmeni ugao je spušten, a usta je izvućena u stranu. Nazalni žlijeb je izbrisan, oko stalno suzi i refleks rožnice je izgubljen.

Uspjeh rehabilitacije ovisi od uzrocima, od obima funkcionalnih oštećenja nerava i vrijeme početka tretmana na licu.

Osim medikamentozne terapije, u rehabilitaciji paralize facijalisa, važno mjesto zauzima fizikalna terapija, ali kineziterapija je najvažniji dio svih procedura za vraćanje izgubljene funkcije facijalisa.

Shema za liječenje je pripremljen u skladu sa rezultatima MMT-a.

Glavne komplikacije neuritisa n. facialisa su kontrakture i sinkinezije.

KLJUČNE RIJEČI: neuritis, n. facialis, mišići, vježbe, kineziterapija i rehabilitacija

Nastavi čitati The role of kinesitherapy at the rehabilitation of paralysis of n. Facialis

Rana rehabilitacija pacijenata kod cerebralnih aneurizmi

Early rehabilitation in patients with cerebral aneurysms

SAŽETAK

UVOD: Cerebrovaskularne bolesti (CVB) uz kardiovaskularne bolesti (KVB) i maligne bolesti su najčešća oboljenja muškaraca i žena u razvijenom svijetu. Nalaze se na trećem mjestu po smrtnosti, a na prvom mjestu po invalidnosti. Pod pojmom CVB podrazumevaju se svi poremećaji u kojima je dio mozga prolazno ili trajno oštećen ishemijom ili krvarenjem i kod kojih je jedan ili više krvnih sudova mozga primarno oštećen patološkim procesom.

CILJ RADA: je ustanoviti utječe li rani početak rehabilitacije oboljelih od cerebralnih aneurizmi na: pojavu komplikacija, na dužinu akutnog liječenja i nastavak liječenja u drugim ustanovama.

METODE ISTRAŽIVANJA: Ispitivanje je retrospektivno. Studija obuhvata period od 01.12.2013.godine do 01.07.2014. godine. U istraživanje je uključeno 50 pacijenata.

U istraživanje su uključeni svi pacijenti Klinike za neurohirurgiju KCUS koji su hospitalizirani u gore navedenom periodu.

REZULTATI I ZAKLJUČCI: Analizom spolne distribucije ispitanika ustanovili smo da je statistički značajniji broj pacijenata ženskog spola 78%, u odnosu na pacijente muškog spola kojih je bilo 22%. Kada je u pitanju starosna struktura ispitanika, najveći broj ispitanika spada u dobnu skupinu od 46-55 godinu njih 44% (22), u dobnim skupinama od 36-45 godina i 56-66 godina imamo po 9 pacijenta (18%), u dobnim skupinama od 67-75 i 76-85 godina imamo po 1 pacijenta.

Prema zastupljenosti dijagnoza u našem istraživanju utvrdili smo sljedeće. Najveći broj dijagnoza je Aneurisma rupturata njih ukupno 38 (76%), zatim Aneurisma a Basilaris 9 (18%), Aneurisma Gigantea 2 (4%) i 1 Aneurisma a Ophtalmicae 2 (4%).

KLJUČNE RIJEČI: rehabilitacija, cerebralne aneurizme, cerebrovaskularne bolesti, prevencija komplikacija

SUMMARY

INTRODUCTION: Cerebrovascular diseases along (CVB) with cardiovascular diseases (KVB) and malignant diseases are the most common diseases of men and women in the developed world.There are third in mortality, and in the first place bydisability.The term CVB means all disorders in which part of the brain is transiently or permanently damaged byischemia or bleeding and in which one or more blood vessels of the brain primarily damaged by pathological process.

AIM OF THE WORK: to determine the influence of the early start of rehabilitation of patients with cerebral aneurysms on: currence of complications, the length of the acute treatment and continuation of treatment at other institutions.

METHODS OF SEARCHING: The study has a retrospective.The study included the period from 01.12.2013. to 01.07.2014.years. The study included 50 patients. The study included all hospitalized patients of the Department for Neurosurgery KCUS in the above mentioned period.

RESULTS AND CONCLUSIONS: The analysis of sex distribution of subjects showed that there is a statistically significant higher number of women (78%), compared to the number of male patients (22%).When it comes to the age structure of the respondents , most of the respondents belong to the age group of 46-55 years old- 44% (22), in the age groups of 36-45 years old and 56-66 years old there is 9 patients in each (18%), in the age groups of 67-75 years old and 76 -85 years old we have 1 patient.

We conclude that the majority of diagnoses in our study is Aneurysma rupturata with 38 (76%) cases, followed by aneurysm of the basilar artery with 9 cases (18%), Aneurisma Gigantea with 2 cases (4%) aneurysm of the ophtalmic artery with 2 cases (4%).

KEY WORDS: rehabilitation, cerebrovascular aneurysms, cerebrovascular diseases,prevention of complications

Nastavi čitati Rana rehabilitacija pacijenata kod cerebralnih aneurizmi

Rana rehabilitacija operisanih od tumora mozga

Early medical rehabilitation after neurosurgical treatment of malignant brain tumours

SAŽETAK

Aktuelni problemi neurohirurških pacijenata dovode do stvaranja funkcionalne zavisnosti različitog stepena. U procesu postoperativnog liječenja svih tumora mozga preporučuje se adekvatna fizikalna terapija i rehabilitacija u kojoj učestvuje multidisciplinarni tim.

Uvođenjem algoritma funkcionalnih-kliničkih testova možemo utvrditi stepen zavisnosti i mogućnosti uspešnijeg, bržeg i kvalitenijeg funkcionalnog osposobljavanja neurohirurških pacijenata. Prema vrsti fizikalnog faktora fizikalna terapija ima pet velikih cjelina: mehanoterapija, termoterapija, elektroterapija, fototerapija te prirodni faktori.

CILJ RADA: Cilj rada je ustanoviti utječe li rehabilitacija operisanih pacijenata sa tumorom mozga na: njihov brži oboravak, pojavu komplikacija i na dužinu akutnog liječenja

METODE RADA: Ispitivanje je retrospektivno. Studijom su obuhvaćeni neurohirurški pacijenti hospitalizirani na Klinici za neurohirurgiju Kliničkog centra Univerziteta u Sarajevu. Istraživanje je provdeno u periodu od 14.11.2013.godine do 15.04.2014. godine. U istraživanje je uključeno 50 pacijenata.

DISKUSIJA I ZAKLJUČCI: U toku našeg istraživanja imali smo 54% muških ispitanika i 46% ženskih. Najveći procenat naših ispitanika spada u starosnu skupinu od 46-55 godina, čak njih 32%. Fizikalni tretman je bio uključen kod 43 naša ispitanika (86%), dok kod njih 7 (14%) nije. Kada je u pitanju vrsta fizikalnog tretmana koja je aplicirana našim ispitanicima imamo u nejvećem broju slučajeva 67% vertikalizaciju, pasivne vježbe u 12% slučajeva, blaneofiziokineterapija u samo jednom slučaju, dok se kod 8 pacijenata (19%) fizikalni tertman odvijao na odjelu Klinike za fizijatriju.

KLJUČNE RIJEČI: neurohiruški pacijent, postoperativni tretman, fizikalna terapija, rehabilitacija

SUMMARY

INTRODUCTION: Current problems with neurosurgical patients lead to the creation of functional dependence of various degrees. In the process of post-operative treatment of brain tumors, recommendation is adequate physical therapy and rehabilitation which involves a multidisciplinary team.

By implementing the algorithm of functional-clinical tests, could be determined the degree of dependence and the possibility of more successful, faster and better functional recovery of neurosurgical patients. According to the type of physical factors, physical therapy has five large units: mechanotherapy, termote¬rapija, electrotherapy, phototherapy and natural factors.

RESEARCH OBJECTIVE: To determine does the rehabilitation of neurosurgical patients with brain tumors influence to: their faster recovery, the occurrence of complications and the length of acute treatment.

RESEARCH METHODS: The study is retrospective. The study included neurosurgical patients hospitalized in the Neurosurgical Clinic – University Clinical Center of Sarajevo. The study was conducted for the period from 14.11.2013 to 15.04.2014. The study included 50 patients.

DISCUSSION AND CONCLUSIONS: The study included 54% of male and 46% of female respondents. The largest percentage of this patients are between 46-55 years age (32%). Physical therapy treatment has been conducted on 43 respondents (86%), while on 7 respondents (14%) didn’t. Regarding to types of applied physical therapy treatments to our respondents, vertical therapy was conducted in 29 cases (67%), passive exercise therapy in 5 cases (12%), balneophysical therapy in only one case (2%), while in 8 cases (19%) physical therapy was conducted on Physical Therapy Clinic – University Clinical Center of Sarajevo.

KEY WORDS: neurosurgical patients, postoperative treatment, physical therapy, rehabilitation

Nastavi čitati Rana rehabilitacija operisanih od tumora mozga