Primjena hiperbarične komore kod patoloških promjena na perifernim krvnim sudovima

Application of hyperbaric therapy to the patients with pathological changes in peripheral blood vessels

SAŽETAK

UVOD: Primjena hiperbarične terapije je efektivna komponenta kompleksnog liječenja šećerne bolesti, ne samo u liječenju kasnih komplikacija već i u ranoj fazi bolesti. Cilj je da se spriječi razvoj hipoksije i pratećih komplikacija (mikro i makroangiopatije, polineuropatije, retinopatije i nefropatije).Terapija hiperbaričnim kisikom je relativno rijetko primjenjivan metoda liječenja iako postoje brojne studije koje dokazuju pozitivne kliničke efekte kod niza bolesti. Stoga je potrebno istražiti koliko se ta metoda primjenjuje kod nas, kod kojih bolesnika kao i kakvi efekti su zabilježeni.

CILJ RADA: Utvrditi udio odnosno zastupljenost pojedinih bolesti unutar ispitivane grupe bolesnika liječenih u hiperbaričnoj komori; Utvrditi udio bolesnika kod kojih tretman u hiperbaričnoj komori nije mogao biti primijenjen ili je morao biti prekinut zbog nuspojava.

Utvrditi dužinu tretmana ispitivane grupe; Utvrditi uspješnost tretmana.

METODE ISTRAŽIVANJA: Istraživanje je provedeno na Klinici za vaskularne bolesti UKC Sarajevo u periodu od jula do marta 2015.g. Studija je retrospektivna i obuhvatila je 119 pacijenata. Za istraživanje korištene su Historije bolesti i bolnički protokol Klinike.

REZULTATI ISTRAŽIVANJA: Od ukupno 119 pacijenata 87 su bili muškaraci (73,1%) i 32 žene (26,9%). Prosječna starost ispitanika za čitavu grupu je bila 60,12 godina, (muškaraca 60,49 a žena 59,18 godina). Od ukupnog broja tretiranih, 40 pacijenata je bilo sa dijabetičnim ulkusom ekstremiteta, ishemijski arterijski ulkus je imalo 33, a radi Morbus Buerger je tretirano 12 pacijenata. Tretirana su 34 pacijenta sa venskim ulkusom.

ZAKLJUČCI: Od ukupno tretiranih pacijentata, kod 58 je registrovano poboljšavanje stanja, kod 48 pacijenata nije bilo uočljive promjene (poboljšavanja ili pogoršavanja), dok je dok je kod samo 13 pacijenata potpuno izostao učinak hiperbarične oksigenacije.

Najbolji i statistički signifikantan efekt je postignut u tretmanu venske patologije, dok su različita stanja insuficijencije arterijske cirkulacije imale slabiji efekt, koji nije bio statistički signifikantan. Tretman u hiperbaričnoj komori se pokazao kao podnošljiv jer je kod svih ispitanika tretman proveden u planiranom trajanju.

KLJUČNE RIJEČI: hiperbarična komora, dijabetes, stopalo, oksigenacija, tretman

SUMMARY

INTRODUCTION: Application of hyperbaric therapy is an effective component of a complex treatment of diabetes. In addition of treatment of late complications, therapy is also used at early stage of the disease. The main aim of therapy is to prevent the development of hypoxia and related complications (micro and macroangiopathy, neuropathy, retinopathy and nephropathy). Hyperbaric oxygen is relatively rarely applied method of treatment, although there are numerous studies that prove the positive clinical effects in a number of diseases. Therefore, it is necessary to examine how this method is applied in our medical practice, type of treated patients and what effects have been reported.

RESEARCH OBJECTIVE: To determine the precentage and distribution of certain diseases in the studied group of patients treated by hyperbaric therapy; to determine the precentage of patients that hyperbaric therapy could not be applied or had to be interrupted because of side effects; to determine the length of the treatment of the test group; and to determine treatment success.

RESEARCH METHODS: The study was conducted at the Department of Vascular Clinic – University Clinical Center of Sarajevo, in the period from July 2014 to March 2015. The study was retrospective. The study included 119 patients. Documents used for the realization of the study are History of diseases and Vascular Clinical Protocol.

RESEARCH RESULTS: The total number of treated patients was 119, from that 87 were male (73.1%) and 32 female (26.9%). The average age of the respondents was 60.12 years (male 60.49 years and female 59.18 years). Of those patients, 40 patients with Extremity ulcer diabetic, 33 with Ischemic arterial ulcer, 12 patients with Buerger’s disease, and 34 patients with Venous ulcer.

CONCLUSION: From the total number of treated patients, in 58 patients was noted improvement in their health condition, in 48 patients was noted noticeable change (improvement or deterioration), while in only 13 patients resulted totally absent effect of hyperbaric therapy.

The most statistically significant effect is accomplished in the treatment of venous pathology, while weaker effect was noted in patients with insufficiency of arterial circulation, which wasn’t statistically significant. The treatment by hyperbaric therapy proved as a tolerable method of treatment, because in all treated patients treatment carried out in a planned duration.

KEY WORDS: hyperbaric therapy, diabetes, foot, oxygenation, treatment

Nastavi čitati Primjena hiperbarične komore kod patoloških promjena na perifernim krvnim sudovima

Reduction of pain in patients with lumbar syndrome

SUMMARY

Low back pain (LBP) can interfere with an individual’s ability to work, have a meaningful and active social life, and negatively affects overall quality of life. In recent years, new approaches have been considered as alternative treatments for LBP. Spinal manipulative therapy (SMT) is one of these new approaches to acute LBP treatment. Still, recent studies have found contradicting results in terms of the effectiveness of such alternative therapies. This study aimed to compare the effect of SMT in combination with standard physical therapy (SPT) versus SPT alone to treat chronic LBP. A randomized, controlled, parallel group trial was undertaken. A total of 66 subjects were enrolled in the study. The intervention consisted of adding two consecutive SMT two days apart followed by SPT for a total period of one month. The main outcome measure was perceived level of pain intensity. Results showed that both interventions were moderately effective in managing pain and disability in patients with chronic LBP, but that the addition of a SMT seemed to add minimal supplemental benefit to standard treatment.

KEY WORDS: LBP, manipulative, physical therapy, exercise

SAŽETAK

Bol u donjem dio leda (BDDL) može ometati na sposobnost pojedinca za rad, da ima smislen i aktivan društveni život, i negativno utječe na ukupnu kvalitetu života. U posljednjih nekoliko godina, novi pristupi promatraju se kao alternativni tretmani za BDDL. Spinalna manipulativna terapija (SMT) je jedan od tih novih pristupa u akutno liječenje BDDL. Ipak, nedavna studija pokazala kontradiktorne rezultate u smislu učinkovitosti takvih alternativnih terapija. U ovoj studiji cilj je usporediti utjecaj SMT u kombinaciji sa standardne fizioterapije (SFT) u usporedbi samo sa SFT za liječenje kronične BDDL. Uradili smo randomiziranu, kontrolirana usporedba, dvije paralelnih grupa. Ukupno 66 ispitanika su bili upisani u studiju. Intervencije se sastojala od dva uzastopna SMT odvojena dva dana po koje je slijedila SFT za ukupno razdoblje od mjesec dana. Glavni metod mjerenja je bila razina intenziteta boli. Rezultati su pokazali da obje intervencije su umjereno učinkovit u upravljanju boli i invalidnosti u bolesnika s kroničnom BDDL, ali dodatkom na SMT se činilo da daje minimalnu prednost na standardno liječenje.

Nastavi čitati Reduction of pain in patients with lumbar syndrome

Uticaj muzike na nivo anksioznosti oboljelih od karcinoma pluća tokom apliciranja hemoterapije

The impact of music on the anxiety level of patients with lung cancer after administration of chemotherapy

SAŽETAK

UVOD: Jedan od najučestalijih načina liječanja karcinoma pluća je hemoterapija. Hemoterapijski tretmani su veoma često agresivni, a supstance koje koriste su neselektivne i izazivaju niz neželjenjenih efekata. Pored fizičke težine, doživljaj neudobnosti može stvoriti poteškoće, emocionalni nemir i djelovati emocionalno traumatski. Opuštajuća ili „sedativ“ muzika, koju karakteriše spor tempo, ponavljajući ritam, blage konture, često se koristi kada se pokušava smanjiti anksioznost.

CILJ: Svrha ovog istraživanja je da se ispita terapijski uticaj muzike kao dio sestrinske intervencije, na nivo anksioznosti i razinu negativne reakcije kod bolesnika sa karcinomom pluća u toku apliciranja hemoterapije.

MATERIJAL I METODE: U ispitivanje su uključene dvije grupe, po 25 ispitanika(N-50). Svi ispitanici su zbog osnovnog tumorskog procesa na plućima primali hemoterapiju. Jedna grupa je u toku apliciranja hemoterapije slušala laganu muziku (ispitivana grupa), dok je druga grupa hemoterapiju primala u tišini (kontrolna grupa). Za objektiviziranje rezultata korištena je skala subjektivne ocjene(VAS), kojom su testirani: anksioznost, strah, briga, umor, udobnost i opuštenost. Ocjenjivanje se vršilo pomoću posebno dizajniranog upitnika za pred i post testiranje za obje grupe.

REZULTATI: Anksioznost koja je u obje grupe bila niža nakon hemoterapije, znatno manja je bila u grupi koja je slušala laganu muziku. Muzika nije značajno uticala na osjećaj umora i udobnosti. Na muziku su se značajno smanjili strah i briga, a povećao osjećaj opuštenosti.

ZAKLJUČAK: S obzirom da je muzika kao terapija neinvazivna i nefarmakološka metoda, jednostavna, jeftina a učinkovita, njena upotreba kao dio sestrinske intervencije može se preporučiti kao prikladan pristup za pacijente oboljele od karcinoma pluća tokom apliciranja hemoterapije.

KLJUČNE RIJEČI: karcinom pluća, hemoterapija, sestrinske intervencije, muzikoterapija

SUMMARY

INTRODUCTION:Chemotherapy is one of the most common treatments for lung cancer. Chemotherapy treatments are often very aggressive, and substances used are non-selective and can induce side effects. In addition to the physical weight, experience discomfort may create difficulties, emotional turmoil and act emotionally traumatic. Relaxing or “sedative” music, which is characterized by a slow tempo, repetitive rhythm, gentle contours, often used when trying to reduce anxiety.

AIM: The purpose of this study was to investigate the therapeutic effect of music as part of the nursing intervention, the level of anxiety and the level of adverse reactions in patients with lung cancer during chemotherapy administration.

MATERIALS AND METHODS: The study involved two groups of 25 subjects (N-50). All of them were due to primary tumor process in the lungs receiving chemotherapy. One group is in the course of administration of chemotherapy listened to soft music (study group), while the second group received chemotherapy in silence (control group). For objectifying results is used the visual analogue scale(VAS), which have been tested: anxiety, fear, worry, fatigue, comfort and relaxation. The evaluation was carried out using a specially designed questionnaire for pre and post test for both groups.

RESULTS: Anxiety, which is in both groups were lower after chemotherapy, significantly lower in the group who listened to soft music. Music had no significant effect on the feeling of fatigue and comfort. On the music were significantly reduced fear and concern, and increased sense of relaxation.

CONCLUSION: Considering that the music therapy as a non-invasive and non-pharmacological methods, simple, cheap and effective, its use as part of nursing interventions can be recommended as a suitable approach for patients suffering from lung cancer during the administration of chemotherapy.

KEY WORDS: Lung cancer, chemotherapy, nursing intervention, music therapy

Nastavi čitati Uticaj muzike na nivo anksioznosti oboljelih od karcinoma pluća tokom apliciranja hemoterapije

Prevencija anksioznosti i njen utjecaj na nivo bola kod oralno hirurške intervecije

Prevention of anxiety and its impact on the level of pain in oral surgery intervention

SAŽETAK

CILJ: U istraživanju je procjenjivana anksioznost vezana za hirurško ekstrahiranje impaktiranih trećih molara, pomoću dobijenih vrijednosti Corahovog upitnika dentalne anksioznosti i Spilbergovih koeficijenata aksioznost. Pearsonovim koeficijentima korelacija procjenjivana je povezanost navedenih parametara i njihov utjecaj na nivo bola kod hirurške extrakcije impaktiranog trećeg molara.

DIZAJN STUDIJE: U istraživanje je bio uključen 501 pacijent, muškog i ženskog pola, od 18-45 godina starosti, Nivo anksioznosti se procjenjivao upotrebom koeficijenata: DASR, X1 i X2 Prema protokolu Nakazata i autora(tab.1.), napravljene su grupe pacijenata na osnovu gradacije skorova anksoiznosti: na pacijente sa vrlo visokom, visokom, umjerenom, niskom i vrlo niskom anksioznosti. Na osnovu protokola Gedika i autora napravljene su i grupe prema dobnoj starosti pacijenata: od 18-20 godina, od 21-29 godina, od 30-39 godina i 40-45 godina. Mjerenje parametara: 1.dan.-DAS-R, X1 i X2; 2.dan- X1 i X2; 3.dan- X1,X2 i BOL.

REZULTATI: Vrijednosti mjerenih parametara: 1. dan mjerenja DASR=14,32; X1= 47,03; X2= 50,99 ; za 2.dan mjerenja X1= 46,014; X2= 50,11; za 3. dan mjerenja X1= 39,01; X2= 41,91 (tab.3,sl.9 i 10). Prosjećna vrijednost boli je 5,7.

KLJUČNE RIJEČI: prevencija, anksioznost, bol, ekstrakcija impaktiranih zuba

SUMMARY

THE OBJECTIVE: The study evaluated the anxiety related to the surgical extraction of impacted third molars, using the obtained values ​​Corah’s questionnaire dental anxiety and Spilberg’s coefficients anxiety. Pearson’s correlation coefficient evaluated the association mentioned parameters and their impact on the level of pain in the surgical extraction of impacted third molars.

STUDY DESIGN: The study included 501 patients, male and female, from 18 to 45 years of age, level of anxiety was assessed using coefficients: DASR, X1 and X2 According to the protocol to indicate the author (table 1)., Made the group of patients on the basis of graduation scores of anxiety: patients with a very high, high, moderate, low and very low anxiety. Based on the Gedik and authors protocol have been made and the group of patients by age: from 18 to 20 years, from 21 to 29 years, 30-39 years and 40-45 years. Measurement parameters: 1.dan.-DAS-R, X1 and X2; 2.dan- X 1 and X 2; 3.dan X1, X2 and BOL.

RESULTS: The values ​​of the measured parameters: Day 1 measurements DASR = 14.32; X1 = 47.03; X2 = 50.99; for Day 2 measurements X1 = 46,014; X2 = 50.11; for the third day of measurement X1 = 39.01; X2 = 41.91 (table 3, fig.9 and 10). Average value of pain was 5.7.

KEY WORDS: prevention, anxiety, pain, extraction of impacted teeth

Nastavi čitati Prevencija anksioznosti i njen utjecaj na nivo bola kod oralno hirurške intervecije